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RESTORATIVE INSTRUMENTS Available individually orDental asSupplies customised, We are now working on the April issue of the Magazine. multi-instrument kits. Artwork and editorial will be due for the 23rd March 2015. Front cover size TRIM: 245mm wide x 256mm high BLEED: Add an extra 3mm to each edge so 251mm wide x 262mm high. Please ensure no crucial logos/text falls any closer than 10mm to any TRIM edge. The full page article if you supply 800- 850 words with a picture or you can supply as a full page article 240 x 340 (mm) Can you let me know if you need any further information.

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Contents WELCOME TO DSM

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Dentistry Show 14

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Enjoy.

Business in Practice

Disinfection & Decontamination

Education & Training

Practice Design & Refurbishment

Tooth Whitening 44

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Editorial Amy-Louise Thompson t. +44 (0)7731 802 262 e. amy@dsmag.co.uk

We also have feature articles on how to make your practice a successful business from Dental Elite and The Dentistry Business, disinfection and decontamination advice from Eschmann, W&H, and many more, practice design ideas from Paradigm and Hague Dental, and much more. Don’t forget to log your CPD time when reading our articles; keep an eye out for the QR codes. Plus, dig into the latest news and interviews with dental experts on rebranding their practices. We will see you at our stand (B51) at The Dentistry Show! See you there!

Publishing Director Scott Colman t. +44 (0)7595 023 460 e. scott@futurepublishingsolutions.com

Welcome back to another issue of Dental Supplies Magazine. The dentistry industry has been a very busy place in the last few weeks, with the IDS in Cologne, preparations for The Dentistry Show and the BDA conference, changes in the NHS pension schemes, and the results of dental surveys around the country being published. Just check out our news pages to find out everything you’ve missed, and don’t forget to visit our website for the latest news. While you are there don’t forget to subscribe to our e-newsletters to keep your finger on the pulse each week. Whilst the dental industry is preparing for The Dentistry Show, the team here at DSM has been working on finding out everything you need to know about what’s going on behind the scenes. Our Dentistry Show review gives you a great overview of everything that’s going on at this year’s show in Birmingham, including seminars, talks, and product launches.

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Dental Supplies Magazine (DSM) is the magazine and web/digital resource for the UK community of dentists with purchasing authority for equipment, technology, pharmaceuticals and services.

General News LORD HOWE LAUNCHES ORAL HEALTH FOR OLDER PERSONS INITIATIVE On the 3rd of March the Churchill Room at the House of Commons played host to the official launch of the Improving Oral Health of Older Persons Initiative (IOHOPI). The hugely successful event was supported by leading members of the dental profession and dental organisations. Launched by Parliamentary Undersecretary of State for Quality The Right Honourable Earl Howe, the IOHOPI programme has been developed to address the growing need to prioritise the oral health of older people in a care environment. The initiative includes an e-learning platform Domiciliary Dental Care that has been developed by Healthcare Learning: Smile-on. This innovative programme is made up of four educational storylines, available on the website – www.IOHOPI.

co.uk. The stories demonstrate how carers can work within the community and care environments to carry out oral care assessments, making referrals where necessary and providing informative resources and practical tips for both dental and non-dental professionals. With the growing number of older persons as the recipients of care or living in care homes across the UK, it is vital to ensure that their oral health needs are adequately met. This initiative seeks to establish this as a priority in the community, in hospitals and places of care, by informing and educating those responsible. www.healthcare-learning.com

DDRB REPORT – ANOTHER BLOW FOR SCOTTISH GDPS BDA Scotland has criticised the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) and its recommendation for a 1.6 per cent pay award for general dental practitioners in Scotland for 2015/16. Dr Robert Donald, Chair of the BDA’s Scottish Dental Practice Committee (SDPC) said: “The 1.6 per cent award is extremely disappointing and will do nothing to address the low morale among Scotland’s GDPs.

“From 2009 to 2013 there has been a massive drop in taxable income for Scottish GDPs - according to the government’s own figures. This equates to a pay cut of over £16,000. It would take a pay rise of 23.5 per cent just to bring GDP earnings back to 2009 levels. “This isn’t pay restraint. This is a pay cut.” www.bda.org

BDIA Dental Showcase will take place at the NEC, Birmingham on 22 – 24 October 2015. For more information visit www.dentalshowcase.com or call the team on 01494 782873. *2014 visitor research, carried out by Serendipity Sales Solutions

suitable for the whole dental team. Birmingham is a great location and will offer the same quality and variety of exhibitors that visitors of BDIA Dental Showcase have come to expect.” We are delighted to confirm that Oral-B continue to support the show, and are this years’ headline sponsors. Jane Kidson, Country Leader at Oral-B comments:“Oral-B is once again proud to be collaborating with the BDIA as head line sponsor of BDIA Dental Showcase, the UK’s premier dental event. The exhibition provides the most incredible opportunity for the entire dental team to keep up to date with the very latest developments in dentistry, meet and exchange ideas on a one-to-one basis, and most importantly, to experience first-hand the widest selection of dental products and services. Our sponsorship is part of Oral-B’s commitment to collaborating with dental professionals to drive dentistry forward. BDIA Dental Showcase is an essential date in the dental calendar.”

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The world of dentistry is evolving and it’s vital for companies to stay innovative and up to date with modern practices.With the expansion of digital methods and competition in the marketplace, putting innovation into practice is more important than ever. BDIA Dental Showcase is the UK’s premier B2B dental show where manufacturers and distributors choose to unveil the very latest developments in their field. With over 9,500 unique visitors, and 350+ exhibitors, BDIA Dental Showcase is the best opportunity to and meet with suppliers, see what’s new and broaden your knowledge. BDIA Dental Showcase is primarily a trade show and not a conference. It provides a platform for manufacturers and suppliers to present their latest products and services, with many offering delegates fantastic show deals. The majority of delegates take advantage of the opportunity with more than two thirds actually making a purchase at the show*. In addition, there are some 50 mini lectures put on by our industry leading exhibitors, many of which qualify as valuable verified cpd. Tony Reed, Executive Director at the BDIA, comments, “Every year BDIA Dental Showcase continues to be a highly enjoyable and efficient opportunity for the dental team to find out about the latest innovative products, services and trends that are constantly evolving to address the practical needs of modern dentistry.The vast array of dental products, equipment, materials, techniques and solutions on display is unparalleled. “This year the show builds on previous year’s successes in providing a show

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BDIA DENTAL SHOWCASE

MDDI Launches a new Sterile, Single-Use Restorative Instrument Range Find out how they could save you time and money... The product development team at Medi Dent Disposable International (MDDI) has announced the release of their range of sterile, single use restorative dental instruments. This new restorative range features diﬀering end combinations and MDDI Managing Director, Perry Johnson, explains: “These disposable instruments save on labour costs by reducing long cleaning times, reprocessing and sterilisation procedures and assist in helping eliminate crosscontamination by their single-use design and functionality.” The sterile single-use dental instrument kits feature high quality, precision made instruments with stainless steel tipped probes and ergonomic plastic handles. Individually packaged in a convenient dispenser box, the restorative range allows you to customize a kit specific to your operating requirements.

The range currently includes: • Flat Plastic (Code 54) • Amalgam Carver (Code 55) • Ball Burnisher (Code 56) • Small Amalgam Plugger (Code 57) • Spoon Excavator (Code 58) • Flat Plastic/Ball Burnisher (Code 59) • Flat Plastic/Amalgam Carver (Code 60) • Extra Large Amalgam Plugger (Code 61) • Wards Carver No. 2 (Code 62)

ALSO AVAILABLE FROM MDDI: Dental Examination Instrument Kits

Periodontal Treatment Kit

Additional options to be announced.

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General News 5

A GREAT PLATFORM TO CREATE INTEREST Amanda Oakey, Director of Educational Resources for the British Dental Health Foundation eagerly spoke about The Dentistry Show 2015: “The British Dental Health Foundation has exhibited at The Dentistry Show since its inception and has always found this event well attended with very enthusiastic delegates. “The conversations we have with the dental professionals that visit are always passionate and it is a great platform to create an interest in both our campaigns and our charitable work and activities.” Amanda also spoke of the successes of this year’s campaigns designed to improve the oral health of the public:

“The National Smile Month campaign continues to grow, building on previous successes. The campaign provides a stage from which dental professionals can deliver important oral health education messages. “Mouth Cancer Action Month is also performing better than ever this year, partly due to the popularity of the #bluelipselfie and the social media campaign that this has fuelled.” Get involved by visiting The British Dental Health Foundation stand at The Dentistry Show. Register for your FREE passes today! www.thedentistryshow.co.uk

BRIDGE2AID TO HOST VILLAGE FETE AT THE DENTISTRY SHOW 2015 Bridge2Aid will host a ‘Village Fete’ at this year’s Dentistry Show, with traditional games such as ‘test your strength’ strongman and ‘hook a duck’, as well as a Willy Wonka ice-cream stand. This will present the perfect opportunity to find out more about what Bridge2Aid does and how you can get involved while having fun. Shaenna Loughnane, UK Manager at Bridge2Aid, says: “We are really looking forward to our Village Fete at The Dentistry Show, as they’ve very kindly donated the space to us.We’ve always found the event to be a great time to meet existing supporters as well as new potential supporters, in a fun and relaxed environment.” Bringing the fun back into dentistry while also offering two days of free education with world-class speakers, hands-on workshops and hours of CPD, The Dentistry Show 2015 is one dental event not to be missed.

If you haven’t yet, make sure you and your whole team register for your free delegate passes today at www.thedentistryshow.co.uk, and don’t miss out! www.thedentistryshow.co.uk

•The prevalence of the hyper-inflammatory type patient and the concept of epigenetics •Discuss the role of nutrition in relation to chronic inflammation and the impact on periodontal tissues •Examine new research surrounding dietary factors implicated in the resolution of chronic inflammation •And ask the question: Can we draw together nutritional protocols to support the periodontal patient?

www.thedentistryshow.co.uk

The presentation will consider:

Delegates will get the chance to enhance their knowledge of this important area and learn to identify the fundamental dietary factors that exacerbate the inflammatory process. Following the presentation attendees will know how to assess and review nutrition implicated in the resolution of chronic inflammation. Juliette believes The Dentistry Show is a must for every member of the dental team: “The Dentistry Show is a really lively and interactive event. The great combination of exhibitors, on stand lectures, workshops and presentations makes it the most comprehensive event for the whole dental team.” Come and learn from the very best at The Dentistry Show 2015 – book your free pass today.

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Juliette Reeves, experienced dental hygienist and trained nutritionist, will be speaking at The Dentistry Show 2015, presenting on: Nutritional Influences in Chronic Inflammation.

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ENHANCE YOUR KNOWLEDGE AT THE DENTISTRY SHOW

General News 6

FINALISTS ANNOUNCED FOR THE DENTAL AWARDS 2015 Alfonso Rao, Queen Square Dental Clinic, Bristol

Nicola Jaram, Abbey House Dental, Stone

Shivana Anand, Stratford House Dental Practice, Milton Keynes Barry Holmes, Kee Dental Care, Swansea

Ivory Dental Care, Blackpool Cahill Dental Care Centre Ltd, Bolton Vita Dental Spa, Monifieth, Dundee Flagg Court Dental Practice, South Shields Ramsbottom DentaL Surgery, Bury Andrea Ubhi,York Sharoe Green Dental Practice, Preston Genix Healthcare, Blackpool Waterside Dental Care, Manchester The Old Surgery Dental Practice, Crewe Clay Cross Family Dental Centre, Chesterfield Hoyland Family Dental Centre, Barnsley Dunmurry Dental Practice, Belfast Thompson & Thomas, Sheffield The Berkeley Clinic, Glasgow

Dental/Orthodontic Therapist of the Year

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The Dental Awards 2015 is excited to announce the finalists for this year’s awards ceremony. For the first time, the Dental Awards have teamed up with The Dentistry Show to host the final, which will take place on the first evening of the event at a glittering gala ceremony. The list of finalists was compiled by a judging panel, consisting of practitioners and members of various leading dental professional associations. This year’s Awards have seen entries from across the UK. All those shortlisted have been notified and are now gearing up to celebrate at the glittering, black-tie ceremony, taking place on Friday, 17 April 2015 at the Birmingham NEC Metropole Hilton Hotel. Commenting on the finalists, Anna Lambert, chair of the judging panel and editor of The Probe, said, “We’re delighted to announce the dental practices, dental professionals and dental teams that have been shortlisted as finalists by judges for this year’s Dental Awards. “Each year brings more entries than the last, so to be selected as a finalist is a real achievement. I know the judges found their job particularly tough this year, simply because there are so many dental professionals out there doing a great job. Congratulations to all our finalists - and we hope to see as many as possible of you on the night.” Now in its 17th year, the Awards showcase the best in the dental profession, and recognise the achievements of both teams and individuals from across the country. Guests on the night will enjoy a gala dinner, with a champagne reception, three-course meal and the awards ceremony hosted by comedian, Simon Evans, best known for his radio and TV appearances. The Dental Awards 2015 is organised by Purple Media Solutions Ltd (publisher of The Probe,Smile, BDNJ and dentalrepublic.co.uk). The event is sponsored by B.A. International, Denplan, Milkshake, Premier, Voco, Waterpik and Zesty.

The finalists for The Dental Awards 2015 are: Dental Laboratory of the Year Mitchells Orthodontics Ltd, Addlestone Costech Elite Dental Laboratory, Gravesend Nash Smile Centre, Gravesend Aesthetic World Laboratory Ltd, Bolton Sparkle Dental Labs Ltd, Leeds United Smile Centres Ltd, LondonAshford Orthodontics, Sunderland

Best National Smile Month Event Ivory Dental Care, Blackpool Arnold Dental Centre, Nottingham Ghyllmount Dental, Penrith Liverpool University Dental Hospital Gemma Allen, Dursley Perfect 32, Beverley Dental Health Spa, Brighton

Dentist of the Year North

Michael Cahill, Cahill Dental Care Centre Ltd, Bolton Duncan Ralston, The Dental & Cosmetic Clinic, Leicester Dannick Jethwa, Spondon Dental, Derby Greig McLean, The Berkeley Clinic, Glasgow Jamie Newlands, The Berkeley Clinic, Glasgow Mike Gow, The Berkeley Clinic, Glasgow Pamela Coates, Waterside Dental Care, Rochdale Graeme Rowden, Genix Healthcare Monik Vasant, Fresh Denta,l Wigan Philip McLorinan, Dunmurry Dental Practice, Belfast

Dentist of the Year South

Mitesh Badiani, Plymouth Dental Centre of Excellence Esmail Harunani, Dentistry for you, Hockley Glenn Steffin, East Preston & Ferring Dental Clinic Ian Hallams, Meon Dental, Petersfield Nissit Patel, Progressive Dentistry, Fulham, London Nicholas Tomes, St Paul’s Dental Practice, Newton Abbot Reginald O’Neill, Reginald O’Neill Dental Care, Billericay Richard Budworth, River Dental, Stockbridge Yee Lee Community Dental Service CIC, Houghton Regis

Young Dentist of the Year North Adam Calvert, Thompson & Thomas, Sheffield Adam E. Patel, Leicester Adam Nulty, Ramsbottom Dental Surgery, Ramsbottom Alif Moosajee, Oakdale Dental, Leicester Alison Livingston, Stevenson Cross Dental Practice, Stevenson, Ayrshire Edward Young, Amblecote Dental Care, Brierley Hill, West Midlands Ektaa ‘Icky’ Abrol, Ivory Dental Care, Blackpool Jonathan Kennair, Holly Dental Practice, Preston Morven Gordon-Duff, Deveron Dental Centre, Huntly Neil Patel, University Dental Hospital, Manchester

Young Dentist of the Year South Dev Patel, Parrock Street Dental, Bexley Callum Limer, Community Dental Services, Bury St Edmunds Kamil Ahmed, 53 Dental, London Jonathan Warton, Gidea Park Dental Practice, Romford Olumide Ojo, Ten Dental Health, London Sachin Sedani, North Hill Dental, Colchester

Clare Brown Cahill Dental Care Centre Ltd, Bolton Kathryn Carey Cahill Dental Care Centre Ltd, Bolton Linda Holmes, Ghyllmount Dental Penrith Suzanne Morton, Sharoe Green Dental Practice, Preston Nicola Hubbard, Fresh Dental, Wigan Lesley Oldfield, River Practice Specialist Centre, Truro

Dental Hygienist of the Year

Debbie Gee, Cahill Dental Care Centre Ltd, Bolton Eva Tkacova, Senova Dental Studios, Watford Jemma Clarke, Brixworth Dental Practice, Northampton Sofia Mendes, Ten Dental Health, London Jurinda Ramanauskiene, Ten Dental Health, London Chloe Brotherhood, Norfolk Dental Specialists, Norwich Joanne Alibone, The Dental & Cosmetic Clinic, Leicester Jo Dickinson, The Old Surgery Dental Practice, Crewe Alison Brown, River Practice Specialist Centre, Truro Sally Melrose, Carling Dental Practice, Bucks

Oral Health Promoter of the Year The Tooth Fairies of Nottingham Oral Health Promotion Team The Clean Team, Cahill Dental Care Centre Ltd, Bolton Suzanne Morton, Sharoe Green Dental Practice ,Preston Gemma Allen, Archway Dental Practice, Dursley Adam Nulty, Ramsbottom Dental Surgery, Bury

Dental Nurse of the Year

Paula Dynes Community Dental Service (CIC), Bedford Jennifer Phillips, Cahill Dental Care Centre Ltd, Bolton Gemma Holden, Sharoe Green Dental Practice, Preston Louisa Dallinger, Reginald O’Neill Dental Care, Billericay Lynsey Anselin, Norfolk Dental Specialists, Norwich Bakula H Srikanta, Dental Solutions, Ilford Stacey Cooke, Genix Healthcare, Gloucester Bethany Stacey, Genix Healthcare, Conisborough Karen Mangham, The Dental & Cosmetic Clinic, Leicester Helen Mackenzie, River Practice Specialist Centre, Truro Emmeline Stewart, Abbey House Dental, Stone Julie Fawkes, Abbey House Dental, Stone Danica Williams, East Quay Dental Practice, Bridgewater

Dental Receptionist of the Year Amanda Wallis Community Dental Service (CIC), Newmarket Samantha Mileham,Youngs Dental Practice, Snaith Lisa Price, Quest Dental Care, Maldon Mary Mayhew, Dillwyn & Carolline Griffiths, Radlett, Herts Tamara Franklin, West Street Dental Practice, Leighton Buzzard Jess Morse, River Practice Specialist Centre, Truro Maureen Smith, Chingford Smile & Orthodontic Studio, Chingford

Team of the Year North

Team of the Year Midlands / Central

The Dental & Cosmetic Clinic Team, Leicester Oral Health Promotion Team, Nottingham Norfolk Dentsl Specialists Ltd, Norwich Station House Dental Practice, Telford 76 Dental, Birmingham Brixworth, Dental Practice, Northampton Arnold Dental Centre, Nottingham Synergy Dental Care, Biddulph, Stoke-on-Trent Goodsmiles Dental Team, Beeston, Notts Campbell Huber Orthodontics, Peterborough Sneinton Family Dental Centre, Sneinton Notts Seven Dental, Nottingham Market Place Family Dental Centre, Mansfield, Notts Portland Road Family Dental Centre, Hucknall, Nottingham Somercotes Family Dental Centre, Alfreton, Derbyshire The Dentist, Walsall

Team of the Year South

West Street Dental Practice, Leighton Buzzard North Hill Dental, Colchester Meon Dental, Petersfield Crown House Dental Practice, Egham East Preston & Ferring Dental Clinic, Ferring Gentle Dental, Newquay NSH Dentist, London Chantry Dental Clinic IV Sedation Team, Ipswich Oral Health Promotion (Bedfordshire) Pont Steffan Dental Practice, Lampeter

Practice Manager of the Year

Debbie McLorinan Dunmurry Dental Practice Belfast Lesley Holden Sharoe Green Dental Practice Preston Jo Locke WS4 Dental Care Walsall Louisa Dallinger Reginald O’Neill Dental Care Billericay Joanna Koussertari Meon Dental Petersfield Shanicea France Genix Healthcare Leeds Barbara Kirk Genix Healthcare Gloucester Cheryl Bissaker The Dental & Cosmetic Clinic Leicester Gayna Horridge Cahill Dental Care Centre Ltd Bolton Lisa Holmes River Practice Specialist Centre Truro Mahkameh Mafi Bury Knowle Dental Practice Headington Jane Torrance Docklands Smile Studio London Kelly Murray Weston Lane Dental Practice Southampton Kelly Ward South Ham Dental Practice Basingstoke Holly Meyer Havant Dental Practice Havant Jane Armitage Thompson & Thomas Sheffield River Practice Specialist Centre, Truro United Smile Centres Ltd, London Bridge Street Dental, Banbury

General News 8

SLEEP AND METABOLISM Dr Aditi Desai BDS, MSc is a dentist with a special interest in sleep medicine. She is a clinical teacher at Guy’s, King’s and St Thomas’ teaching hospitals. She is also an Honorary Research Fellow at the SleepDisorders Unit, King’s College London.

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General CPD: 45 minutes Modern society is becoming more aware of the importance of sleep and its disorders. Sleep is linked to the metabolic cycle in the body and any deviation from healthy sleep leads to a chain of events that precipitates metabolic dysregulation due to hormonal imbalance, sympathetic overstimulation and subclinical inflammation with cardiovascular implications. As a society we now sleep less than we did a century ago averaging 6.8 hours 1,2. Although obesity and diabetes have now reached pandemic levels, due to lifestyle choices, lack of exercise and diet being some of them, the impact of sleep on obesity is becoming apparent. The impact of suboptimal sleep on metabolic function in the body is an important part of sleep medicine that should be understood so that we as medical professionals can do our utmost to minimise the consequences of sleep disorders in its various forms2. In order to understand the impact of sleep deprivation or fragmentation on a person’s well being, the nature of sleep in its various stages together with how the body’s metabolic cycle functions during the day and night should be understood. This understanding establishes the impact of sleep not only on the brain but also the whole body. Human sleep comprises two sleep stages, REM and N-REM sleep, the latter further subdivided into three stages, N1, N2 and N3. N3 is the slow wave sleep which is deep restorative sleep and when the metabolic processes are least active and REM sleep signifies, an active brain with vivid dreams and rapid eye movement with in effect a paralysed body. The four stages make up a 90 minute recurring pattern in a person with a sound sleep pattern, called Sleep Architecture. The sleep architecture demonstrates longer periods of N-REM sleep in the first half of the sleep period with the latter half demonstrating an increased number and length of REM sleep. (Principles and Practice of Sleep Medicine, 5th Edition. M Kryger, T Roth and W Dement. Metabolism comprises two processes called anabolism and catabolism. This the build up and breakdown of energy. In effect N-REM sleep when metabolism at its lowest depicts a time when the body can recover from cell injury due to the release of free radicals while awake1. Metabolism is the sum total of the amount of energy that is required to maintain a homeostatic balance in the body. Metabolic rate and utilisation of glucose with ensuing energy expenditure is lowest during N-REM sleep and can reduce during the sleep cycle by as much as 15%.

This may seem a small drop during the period of inertia while asleep but at least 80% of the body’s energy is required for basal cellular activity during sleep. Cortisol and growth hormone are two hormones that regulate the utilisation of glucose hence regulating its levels in the body. The highest level of cortisol is found during the latter half of sleep and growth hormone highest during the first half of sleep3,4,9. There are two ways in which sleep affects the metabolic processes in the body. One is the effect on the pituitary and the other is the autonomic nervous system. The release of hormones from the pituitary which is the central endocrine organ that controls the hormone release from the body’s other endocrine organs is influenced by the quality and quantity of sleep. Hence, activity of the hypothalamic releasing or hypothalamic inhibiting factors that influence pituitary function determine and modulate the release of the peripheral hormones. As an example, sleep promotes the release of growth hormone and inhibition of cortisol release5. During sleep, sympathetic nervous system activity decreases and parasympathetic activity increases. Sleep loss increases sympathetic activity and decreases parasympathetic activity. This change in balance affects the endocrine organs which are sensitive to these changes such as the release of pancreatic insulin and release of leptin, the appetite suppressing hormone by fat cells. It has been documented that the effects of short term acute sleep loss are reversible with no lasting damage to the systems. Chronic partial sleep loss on the other hand can lead to more profound effect. More recent studies have shown the effect of chronic partial sleep loss on hormones, metabolism and immune system. In a study carried out by Spiegel K et al6, Levels of cortisol decrease rapidly as evening approaches in well rested individuals whereas the levels decrease at a much lower pace in those subjects who had been sleep deprived for six days.6 Higher levels of cortisol, the stress hormone, are likely to promote insulin resistance which is a risk factor for diabetes and obesity. Thyroid stimulating hormone release has also been shown to be affected by sleep deprivation. This affects thyroid function.13 Growth hormone secretion is affected by sleep deprivation. The GH which is normally released once, is released in two smaller pulses if sleep deprived, with one occurring just before sleep onset and the other after. The peripheral tissues are exposed to GH for a longer period of time. The adverse effect on the tissues is that of glucose intolerance since GH has an antiinsulin like effect on the body.8 Levels of Leptin, the appetite suppressing hormone and Ghrelin, the hunger hormone, are affected by sleep loss. 6 Calorie requirement is increased during wakefulness and lowered during sleep. Sleep loss promotes the release of Ghrelin associated with an increase in appetite that is excessive in relation to the caloric demands of extended wakefulness. During a study when subjects were deprived of more than 4 hours sleep over 6

days showed the levels of Leptin dropping significantly.14 In another study, the levels of Leptin decreased and levels of Ghrelin increased in sleep restricted individuals. The ability of Leptin and Ghrelin to accurately signal calorific need is affected by sleep loss and can lead to increased calorie intake. Sleep loss can affect those individuals who engage in calorie controlled diets due to this imbalance in Leptin and Ghrelin levels in the body. With modern sleep deprived lifestyles, and decreased hours of sleep that has been shown over the decades, it is no wonder that obesity is now a major health concern in the developed world.7,10,11,12 Sleep deprivation may adversely affect glucose tolerance and involve an increased risk of type 2 diabetes as shown by recent studies. In a study, where glucose was injected into human subjects, the rate of disappearance of glucose in sleep deprived subjects was significantly (40%) slower than in those with adequate sleep. The insulin response was also 30% slower in those who were in sleep debt.5 There may be multiple mechanisms which may have a play in the adverse effect of sleep deprivation on glucose intolerance and beyond the scope of this article but one of these parameters may be the irregularity with which Ghrelin and Cortisol hormones are released in the body. It is apparent that the need for sleep is not just for the brain but for the rest of the body in order that the various metabolic functions remain sound in order to maintain the metabolic chain from being interrupted or broken. In my next article I will discuss sleep architecture and the impact of sleep deprivation on cardiovascular disease.

Figure 1: Impact of sleep deprivation on Leptin, Ghrelin and Cortisol levels in the body https://dental.cpdpro.org.uk dental@cpdpro.org.uk

1. National Sleep Foundation. Sleep in America Poll, 2001-2002. Washington, DC: National Sleep Foundation. 2. G. R. Goldberg, A. M. Prentice, H. L. Davies, and P. R. Murgatroyd, “Overnight and basal metabolic rates in men and women,” European Journal of Clinical Nutrition, vol. 42, no. 2, pp. 137–144, 1988 3. E. Van Cauter, M. Kerkhofs, A. Caufriez, A. Van Onderbergen, M. O. Thorner, and G. Copinschi, “A quantitative estimation of growth hormone secretion in normal man: reproducibility and relation to sleep and time of day,” Journal of Clinical Endocrinology and Metabolism, vol. 74, no. 6, pp. 1441–1450, 1992. 4. E.Van Cauter and F.W.Turck, “Endocrine and other biological rhythms,” in Endocrinology, L. J. DeGoot, Ed., pp. 2487–2548, Saunders, Philadelphia, USA 5. Spiegel K, Leproult R,Van Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999;354:1435-1439. 6. Spiegel K, Tasali E, Penev P, et al. Sleep curtailment in healthy young men is associated with decreased leptin levels: elevated ghrelin levels and increased hunger and appetite. Ann Intern Med. 2004;141:846-850. 7. Taheri S, Lin L, Austin D, et al. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index (BMI). Sleep. 2004;27:A146-A147. 8. Spiegel K, Leproult R, L’Hermite-Baleriaux M, et al. Leptin levels are dependent on sleep duration: relationships with sympatho-vagal balance, carbohydrate regulation, cortisol and TSH. J Clin Endocrinol Metab. 2004;89:5762-5771. 9. Rachel Leproult and Eve Van Cauter. “Role of Sleep and Sleep Loss in Hormonal Release and Metabolism” Endocrine Development. 2010; 17: 11-21. 10. Causes of obesity “ UK National Health Service, Gov UK. 11. ‘Sleep May Be Factor In Weight Control” American Thoracic Society, 2009, 12. S Taheri. “The link between short sleep duration and obesity: we should recommend more sleep to prevent obesity” Arch Dis Child. 2006 November 13. Spiegel K, Leproult R, L’Hermite-Baleriaux M, et al. Leptin levels are dependent on sleep duration: relationships with sympatho-vagal balance, carbohydrate regulation, cortisol and TSH. J Clin Endocrinol Metab. 2004;89:5762-5771. 14. Leproult R, Copinschi G, Buxton O, et al. Sleep loss results in an elevation of cortisol levels the next evening, Sleep. 1997;20:865-870

General News 10

‘WRONG APPROACH, WRONG CONCLUSIONS’ – BDA RESPONSE TO DDRB

The British Dental Association (BDA) has criticised both the approach and conclusions of the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) in its recommendations for pay awards for General Dental Practitioners in England for 2015/16. The DDRB has opted to leave the question of dental expenses for GDPs to negotiation. Rather than negotiating, however, the Department of Health, has simply applied a Retail Price Index (RPIx) uplift to the review board’s formula, producing a 1.34 per cent uplift for GDPs in England. The BDA has said that today’s report has yet again failed to grasp the 25 per cent decline in real incomes since 2006, and has called for action on establishing

a new basis for calculating dental expenses. John Milne, Chair of the BDA’s General Dental Practice Committee (GDPC), said: “We aren’t surprised by the DDRB’s conclusions, but we are unhappy about their approach. “The DDRB has backed a low uplift and placed dental expenses on the too difficult list. So now we have the unedifying sight of the government stepping in to provide a quick fix as a substitute for meaningful negotiation. “What we need is a fit and proper mechanism for establishing uplift for expenses, not last minute improvisation. The disproportionate rise in expenses facing practitioners cannot continue to go unrecognised. It needs proper consideration. “The current approach does nothing to arrest or even recognise the long term fall in practitioner incomes, and simply adds ambiguity to an already unsustainable position on pay. Dentists are realists. We are living in an era of pay restraint, but restraint should not mean pay cuts.” www.bda.org

GUM DISEASE BACTERIA ‘A CATALYST’ FOR CANCER CELL GROWTH

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A bacteria that causes gum disease may aid the growth of cancer cells, according to new research. Published in the journal Immunity, it was discovered the bacteria fusobacterium nucleatum – which has heavy links with gum disease – could hamper the body’s ability to fight off cancer.1 When combined with human tissue cells, researchers found the bacteria attached itself to the parts of the immune system responsible for attacking cancer cells, preventing them from performing this function. Ken Lavery, Consultant in Oral and Maxillofacial Surgery, believes the research could prove to be invaluable in the fight against cancer. Ken said: “This is further evidence for establishing and maintaining good oral hygiene. Oral cancer is on the increase, and anything that people can do themselves to reduce their risk – coupled with a reduction in smoking, drinking alcohol to excess and immunisation against HPV – are all good public health measures. Prevention is infinitely better than having to treat established disease, especially with oral cancer.” Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, added that the research should provide further evidence as to why

maintaining good oral hygiene is so important. He said: “Given the bacteria is found in the mouth, it should prompt everyone into improving their oral health. The number of links between low levels of oral health and killer diseases are growing by the minute and should not be dismissed as irrelevant. Brushing your teeth for four minutes during the day doesn’t sound like a life-saving practice, but more and more research suggests it could go a long way to reducing the risk of some of these diseases. “If further research supports this theory, it places even greater importance on maintaining your oral health. The good news is there is a very simple way to prevent and treat gum disease. “Gum disease is a very common disease. In fact it’s one of the largest noncommunicable diseases worldwide. You need to make sure you remove all the plaque from your teeth every day.This is done by brushing for two minutes twice a day, last thing at night and at least one other time during the day with fluoride toothpaste, as well as using interdental brushes or floss to clean in between teeth where gum disease starts. “Regular visits to the dentist for a thorough check-up will help your dentist identify any problems that are developing. If your gums do start to bleed this is a sign that you may have not been cleaning well enough so increase your tooth brushing. If things do not settle within a few days get along to the dentist before problems begin to mount up.” www.dentalhealth.org

HAVE YOUR PICTURE TAKEN AND SHOW YOUR SUPPORT FOR THE BENEVOLENT FUND – C45

Come and have your photo taken on Friday 8th May on Stand C45. Get into the spirit with your team! We need fun “I support” photos for the Benevolent Fund’s Charity Gallery, everyone welcomed. Create a memorable moment with friends and colleagues; photos are available to keep for a small donation. The BDA Benevolent Fund has been helping dentists in need for over 125 years and needs your help now more than ever. Any support you can give will be much appreciated. www.bdabenevolentfund.org.uk

General News NHS PENSION CHANGES Changes to the NHS pension scheme have finally come into effect on the 1st April 2015, after ten years of revising and tuning the fine print. Most NHS dentists will know by now that this means a rise in the cost to be a member. The main cause of this change is that a 40 year career are no longer standard practice, in modern life there are much higher demands on early retirement, part time work and flexible hours.With increasing life expectancy the pension scheme needed to change to fit into today’s working society. If you are already an existing member the good news is that you will be able to keep the vast majority of your existing NHS pension rights.You’re retirement age will continue to be 60 and the accrual rate will also remain the same. The bad news is that is going to cost you more. The average NHS dentist

will earn £80,000 a year which means they’ll be paying an extra 1.5% or £1,200 a year. With deductible tax the net extra cost would average at around £720 a year, which over the course of 35 years will be an extra £25,200. Those with NHS earining more than £100,000 the new pension rate will be 8.5% rather than the old 6%. There is a limited time for you to switch to the new scheme and some may want to opt to move, however for most it may be beneficial to stay in their existing scheme. Those who wish to opt out should look at private pension options. For more information about your options visit http://www.nhsbsa.nhs.uk/pensions

BDA RESEARCH ON WELL-BEING REVEALS DENTISTS ARE DOWN IN THE MOUTH Dentists are almost twice as likely as the general population to feel dissatisfied with life, a survey on their personal well-being suggests. The research, carried out by the British Dental Association (BDA), found that dentists rated their levels of satisfaction with life, happiness, and whether the activities they engage in seem worthwhile, at much lower levels than the wider population. They also reported higher levels of anxiety. The survey, based on 481 responses from community dentists and 903 from general dental practitioners (GDPs), sought to measure dentists’ perceptions of their own well-being using four indicators developed by the Office of National Statistics. Analysis of the responses showed little difference between the two groups. In addition, it was irrelevant whether GDPs were associates or practice owners. However, GDPs who do mainly NHS work reported lower levels of well-being than those doing mainly private work. Among community dentists, almost half (47 per cent) of those surveyed last summer reported low levels of life satisfaction.A similar proportion (45 per cent) reported low levels of happiness and 55 per cent said they experienced high levels of anxiety during the day before they took part in the study. Similarly, almost half of GDPs surveyed (47 per cent) reported low levels of life satisfaction. As many as 44 per cent reported low levels of happiness and around six out of ten said they experienced high levels of anxiety on the day prior to responding to the survey. Among GDPs, the BDA researchers also observed a significant reduction in levels of personal well-being across all four indicators between 2013, when the BDA first started monitoring this, and 2014.

The Chair of the BDA’s Principal Executive Committee, Mick Armstrong, said: “It’s hardly surprising that dentists are stressed – just providing good dental care for our patients and managing their increasing expectations within a shrinking budget is challenging. Inevitably job satisfaction will suffer when you also factor in the multiple layers of unnecessary bureaucracy and targets that dentists have to face. “If that wasn’t enough, dentists now practise under the shadow of litigation and arcane, over-zealous regulation. In the past, GDPs could reasonably expect to follow a well-trodden career path from being an associate to practice owner, but for most young dentists that certainty has been blown away. It’s not that rosy either for those who are established as more dentists contemplate leaving the profession early due to unfulfilling careers, or ill health. “Commissioners, managers and regulators would do well to heed these warning signs and we urge them to design contracts and systems that assist dentists in delivering high quality care to their patients and to provide understanding and support where difficulties arise.” The BDA will soon be publishing a second report in this series, focusing on the links between dentists’ working conditions and work-related stress. www.bda.org

www.dentalhealth.org

over the decision, but after lobbying the government to review the evidence available common sense has prevailed. “Smoking can cause a variety of oral health problems including tooth staining, dental plaque, bad breath, tooth loss and gum disease. Of more concern is the significant risk of developing life-threatening diseases such as lung disease and mouth cancer. “Tobacco remains the largest risk factor for mouth cancer, a disease that has increased dramatically in the last decade. Last numbers show there are more than 6,500 cases and 2,000 deaths each year from the disease. This announcement is a significant and large step in the right direction to start reducing those figures.”

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The British Dental Health Foundation is delighted that MPs have voted to introduce standardised packaging of tobacco in England. In a free vote in Commons 367 MPs voted yes to only 113 no’s, a huge majority and a significant step towards vast health improvements in England. The move will also hopefully bring about improvements in oral health and a reduction in the number of mouth cancer cases, and Ken Lavery, Consultant in Oral and Maxillofacial Surgery and Trustee of the British Dental Health Foundation, praised the decision. He said: “I am delighted that standardised packaging will now become law in May next year. We have often criticised the government on its lack of movement on the issue, but this is a real win and one we can be very proud of. “There was a concern that the government would continue to drag its feet

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STUBBED OUT! MPS FINALLY EXTINGUISH TOBACCO PACKAGING

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UNDERSTANDING OCCLUSAL FORCES

Restorative dentistry relies on an in-depth and comprehensive understanding of occlusion, and the way in which the dentition meet and interact with each other plays a fundamental role in the success of any restoration. From simple fillings to more complex crowns and bridges, all restorations placed in the oral cavity can fundamentally affect a patient’s bite and so must be carefully calculated to conform to their existing occlusal pattern. When the upper and lower jaws work together harmoniously, this allows for smooth uninterrupted movement. Adversely, excessive occlusal forces exerted between teeth can exacerbate the risk of fractured cusps or restorations, increased tooth mobility, muscle fatigue and tooth wear.i Following restorative dentistry, articulation paper is routinely used to reveal the ‘high spots’ where the teeth contact during biting or grinding. This is customarily made of a thin paper strip that is covered in fluorescent ink or dye-containing wax. When placed between the teeth, the desired mandibular movements are performed and the strip leaves behind a series of markings on the tooth surface. Traditionally, these markings are then used to highlight and analyse the occlusal forces, revealing the areas where the clinician needs to focus.The dentist may then address those high spots, to ensure that a restoration is not receiving too much force to prevent it from breaking, or worse still, damaging the tooth that it is biting against. The size and colour of the markings have generally been used to identify the areas that need the most attention, with the size and shade of the markings indicating the range of the applied occlusal loads. However, recent research has shown that there is little evidence to suggest that the size of an articulation paper mark alone is a reliable indicator of applied occlusal force.ii With some studies concluding that no linear relationship between the force of the applied load and the articulation paper mark could be found.iii What’s more 94% of dentists in one particular study struggled to pinpoint occlusion using articulating paper alone.iv This research, and many more studies besides, reveal that clinicians who use articulation paper alone to determine the adjustments that need to be made to the occlusion based on the size of the marks, risk doing so under potentially limited information. As, in a given pattern of marks spread over the neighbouring teeth, any size mark could indicate any load.v This subjective method of ascertaining occlusal information does not seem to be in keeping with the state-of-the-art technological innovations of recent years, such as 3D imaging and digital radiography. More significantly, it fails to reveal any data on the temporal aspects of occlusion, which can have serious repercussions for the patient. What this means is that using just the markings created through articulation paper alone, a practitioner cannot tell which areas of the dentition

come into contact first or which release last. Of course, the more information a clinician has at their disposal regarding the details of the occlusion, the more accurately and reliably they are able to treat, diagnose and analyse problems. Using articulation paper marks alone to adjust restorations and occlusion, is a subjective and potentially unreliable method and can therefore lead to clinicians missing significant details. Thankfully, the modern practitioner now has the opportunity to expand on the traditional method. By using the T-Scan, available exclusively from Clark Dental, a practitioner can visualise and treat destructive forces before they become a problem. This unique digital device records a short video clip that reveals the relative occlusal forces over time. By doing this, the T-scan allows a practitioner to see the entire bite sequence of the oral cavity and to ascertain exactly what percentage of the whole force is being placed on a specific restoration or tooth at any time during the biting process. By understanding where, as well as when, occlusal force is exerted on the dentition, practitioners are able to achieve enhanced clinical outcomes, ensuring the occlusal forces are even across the whole mouth. This can also prove to be a useful asset in diagnosing and addressing symptoms of pain, such as with patients that suffer from TMJ problems, poor occlusion, or high spots on restorations. For more information contact Clark Dental on 01270 613750, email info@clarkdentalsales.co.uk or visit www.clarkdentalsurgerydesign.co.uk A.J. McCullock. Making occlusion work: 1. Terminology, occlusal assessment and recording. Available at http://visiondentalab.com/pdf/ MakingOcclusionWork%281%29.pdf [accessed 7/1/15] Relationship between articulation paper mark size and percentage of force measured with computerized occlusal analysis. Available at http:// www.ncbi.nlm.nih.gov/pmc/articles/PMC3303923/ [accessed 17/3/15] Determining a relationship b e t we e n ap p l i e d o c c l u s a l load and articulating paper mark area. Available at http:// www.ncbi.nlm.nih.gov/pmc/ articles/PMC2581523/ accessed 17/3/15] Kerstein, R.B., and Radke, J. Clinician Accuracy When S u b j e c t i ve l y I n t e r p re t i n g Articulating Paper Markings,The Journal of Craniomandibular & Sleep Practice, 2013, VOL. 32 NO. 1 Robert B. Kerstein, DMD. Articulating paper mark misconceptions and computerized occlusal analysis technology: a clinical brief. Available at http:// w w w. b i o re s e a rc h i n c . c o m / images/kerstein.pdf [accessed 17/3/15]

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NOT JUST ALL MOUTH THE DENTISTRY SHOW 2015

Not only a dental event that the whole team will enjoy but also the perfect opportunity to gain valuable education and experience, The Dentistry Show, taking place on Friday 17th and Saturday 18th April, is the place for all dental professionals to be. Having consistently grown since its inception in 2009, The Dentistry Show expects a record high of 7,500 delegates this year. Held alongside the Dental Technology Showcase (DTS), this will ensure hugely varied networking opportunities for all, enabling you to meet old friends and new from all corners of the profession. So don’t miss out!

Renowned for its electrifying atmosphere, exceptional speaker line-up and diverse learning opportunities,The Dentistry Show is one of the few completely FREE events on the dental calendar. You will have access to a 400-strong trade exhibition hosting the top dental manufacturers and suppliers from around the world. The outstanding educational programmes will be bursting with insight and fresh ideas, with sessions presented by world-class speakers such as John Kanca, Luca Dalloca, Walter Davoto, Chris Orr, Martin Trope, Sheila Scott, and many, many more. New to 2015…

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•New dates – last year, a huge 69% of 756 dentists who had not attended the Show in 2014 or 2013 said they were likely or very likely to visit if the event moved to April. So to enable even more professionals to attend, we are holding the 2015 event on Friday 17th and Saturday 18th April, at the central location of the NEC in Birmingham. •Launchpad UK – following the global launches at IDS, the very latest products, materials and technologies to reach the UK will be unveiled from leading dental suppliers. You’ll be able to get to grips with an array of cutting-edge innovations, with experts available to provide first-chance hands-on opportunities, as well as all the information you could need.

•Dental Awards 2015 – having fun with friends has always been an important aspect of The Dentistry Show, and we are delighted to host the prestigious Dental Awards with Purple Media Solutions on the Friday evening. Let your hair down at this glittering black-tie gala dinner and enjoy a four-course meal and great entertainment while celebrating outstanding individuals and teams whose commitment continues to raise the bar in UK dentistry. •Dental Update Study Day – having sold out fast, the day will offer lucky delegates who booked the chance to listen to and learn from some of the finest experts on the Dental Update editorial board including Professor Trevor Burke, Professor Avijit Banerjee, Professor Crispian Scully and Professor Jonathan Sandler. •EndoLounge – designed in association with the British Endodontic Society, this Lounge will provide an update on the latest clinical techniques, materials and research in the field of endodontics.

•Facial Aesthetics Theatre – in 2014, 18% of attendees were looking to source research, products and services in the field of facial aesthetics. Delivered in association with CCR, this new programme will explore the latest clinical techniques and products in the area to help you deliver safe and effective treatment for all your patients.

•Association of Dental Administrators and Mangers – attending the event for the first time, the team from the association will be available on the Professional Hub and within the new Practice Management Today panel in the Dental Business Theatre, helping practice managers streamline their daily process. •Compliance Clinic – hosted by the experts at Apolline, this theatre will offer a vast array of practical hints and tips to ensure regulation compliance for all practice. •Village Green with Bridge2Aid – the charity will this year host a ‘Village Fete’ with traditional games such as ‘test your strength’ strongman and ‘hook a duck’, as well as a Willy Wonka ice-cream stand. Find out more about what Bridge2Aid does and how you can get involved while having great fun at stand E60. Aside from all this, the old favourites are also back this April including: •The ever popular PerioLounge, delivered in association with the British Society of Periodontology •The Short-Term-Orthodontics Lounge •The ADI Implant Theatre •The GDP Theatre •The CORE CPD Theatre •Business Skills Workshops, provided in conjunction with Practice Plan •Hands-on workshops with leading dental suppliers and educators including 3M ESPE, Implant Centres of Excellence, Software of Excellence, DENTSPLY and Schottlander •The Aesthetic Dentist Theatre, National Dental Nursing Conference, Hygienists & Therapists Symposium and Dental Business Theatre, tailored specifically to each area of the profession. Comments from previous shows included: “This conference has a real buzz and the speakers are all excellent” “The lectures have inspired me” “A great exhibition” “This conference is excellent and we will go back to our practice with renewed enthusiasm” With all of this plus much more to look forward to, all free of charge, what are you waiting for? Register for yourself and your whole team online at www.thedentistryshow.co.uk/preview. If you only attend one dental event in 2015, make sure it’s The Dentistry Show 2015! www.thedentistryshow.co.uk

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DISCOVER TANDEX AT THE DENTISTRY SHOW Delegates at The Dentistry Show 2015 will get the chance to explore the innovative product range on offer from Tandex. Tandex provide a large variety of products suited for all ages and dentitions. A comprehensive array of toothbrushes and interdental brushes are available in many colours and designs, each specifically targeted toward a certain age range, dental treatment or patient requirement. With over 80 years’ experience producing and supplying the highest quality products for optimal oral hygiene, the team from Tandex are keen to

share their knowledge and passion for all aspects of oral health care. All Tandex brushes and adjuncts are free from PVC and latex, and developed and tested with the help of leading clinicians and hygienists. If you’re planning on attending The Dentistry Show 2015, make sure you visit the team from Tandex on stand D90. www.tandex.dk

WATERPIK INTERNATIONAL, INC. RETURNS TO THE DENTISTRY SHOW TO LAUNCH THE NEW WATERPIK® ULTRA PROFESSIONAL WATER FLOSSER Always a popular stop for delegates at The Dentistry Show, Waterpik International will showcase its range of water flossers and sonic toothbrushes on stand C70, as well as presenting the NEW Ultra Professional Water Flosser line! The Ultra Professional features water on/off control on the handle and 7 water flosser tips. And this latest in Water Flossing technology comes in four great designer colours! The Waterpik® Water Flosser is a clinically proven alternative to traditional floss for removing plaque biofilm and reducing bleeding and

inflammation and in the latest study was up to 145% more effective at reducing bleeding around implants. You will also get a chance to see the Waterpik® Complete Care, which combines water flosser technology with a Sensonic® Professional Plus toothbrush for healthy teeth between appointments. Easy to use and effective, so both you and your patients will reap the benefits. Come and meet the team from Waterpik International at The Dentistry Show 2015 to find out more, and be among the first to discover the fantastic NEW Designer Series! www.waterpik.co.uk

Nobel Biocare T: +44 (0)208 756 3300 W: www.nobelbiocare.com

for use in all bone qualities.The NobelParallel® CC facilitates a straightforward surgical protocol, which enables shorter treatment times and immediate function in most cases. For the final restoration, delegates can explore the cutting-edge Full-Contour Zirconia (FCZ) Implant Crown – its impressive strength ensures maximum predictability even under high occlusal forces and eliminates any concerns of chipping. For all this and much more, meet the Nobel Biocare team on stand F50 at The Dentistry Show to help your business flourish in 2015.

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Discover the array of Nobel Biocare innovations designed to enhance your clinical offerings and grow your business, at The Dentistry Show 2015. Brand new innovations will be unveiled, delivering a phenomenal level of stability, accuracy and efficiency when placing implants in various different clinical situations. You’ll have the opportunity to find out more about the NobelActive® Wide Platform. Building on the award-winning design of the NobelActive® implant system, it provides a shorter body to avoid nerves plus a wider diameter for optimal emergence profile. Alternatively, practitioners can choose the NobelParallel® Conical Connection (CC), also designed with a wide platform option and suitable

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HELPING YOUR BUSINESS FLOURISH

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MAKING A CHANGE “I have now switched over to The Dental Directory for most of our ordering, from consumables to tools and equipment. They are consistently cheaper than other companies, and the price match guarantee means we never pay more. If you are thinking of switching over, contacting your rep and providing a list of the items and current prices you are paying is a great idea. I gave Dave a copy of several invoices, and he was able to come back to me with a list of alternative products at lower costs in no time. “What’s more, I really like the added discount you receive if you order via the website, which is generally what I do. Dave was the one who advised me about this, which is a facility we didn’t have set up before. Each week the nurses put a list together and I do the ordering. It couldn’t be simpler. “If any product doesn’t quite live up to our expectations, the Dental Directory also offer a credit note on products and are always able to provide an alternative. Further to this, Dave also helped introduce me to reps from manufacturing companies, which has again really helped us to reduce our costs. “The only obstacle we thought we would encounter during the transition was in replacing the own brand products we were previously using. Amazingly, what we found was that The Dental Directory products were considerably cheaper, and they also stocked branded products that were much better quality, as well as being less expensive, than the own brand we were getting before. “The Dental Directory has saved us money on many products across the whole practice. If there is anything you require, I recommend giving them a call. They are always happy to help, have an experienced equipment department and offer handpiece repair at very competitive prices from the Handpiece Express service. “I’ve already recommended The Dental Directory to other practices and I would definitely recommend to anyone looking for: good customer service, friendly, helpful advice, knowledge on a vast range of products and improving the quality of products you use. The main benefit for us is that we are now getting better quality items at far better prices. We would definitely not consider going elsewhere for a very long time!”

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For more information, contact The Dental Directory on 0800 585 586 or visit www.dental-directory.co.uk http://www.dentaldirectory.co.uk

Melissa Saunders, Practice Coordinator at Westcombe Park Dental Practice in London uses The Dental Directory for her practice supply needs, she says: “When I took over as practice coordinator in April last year I decided we needed to switch to The Dental Directory. I was reviewing all the invoices from our previous supplier and realised they were charging us different prices all the time without any clear communication, so I thought I would give The Dental Directory a call as I had worked with them before. “I contacted my old rep, Zara Vickers, and found that she was not working in my area any more, but she gave me Dave Hoskin’s contact details. I gave him a call and we arranged a meeting for a few days later to discuss the needs of my practice. As a new rep in the area, Dave was really helpful, very informative and had plenty of good suggestions for alternative products. “I gave him a list of all the products we were currently using and he offered us substitute materials and gave me clear prices. A lot of the prices were cheaper – in fact, most of them were. Once we had been using The Dental Directory for a couple of months, Dave produced a spreadsheet to show me the savings we were making and it really was quite a lot.

Dentistry Show

17th-18th April 2015 NEC Birmingham

See us at stand

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The pathto finding the rightequipment foryou starts here

Trustâ&#x20AC;Ś

0800 585 585 www.dental-directory.co.uk The Dental Directory, 6 Perry Way, Witham Essex, CM8 3SX Liverpool Office: Aintree Industrial Estate, Wareing Road, Liverpool L9 7AU Telephone: 0151 523 5499. Fax: 0151 525 0411 Perth Office: Unit C11, Inveralmond Grove, Inveralmond Industrial Estate, Perth PH1 3UG Telephone : 01376 532700. Fax: 01738 451553

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COURSES AND MENTORING Would someone in your team benefit from training? Whether you are a Dentist, Nurse or Hygienist, courses by Devonshire House Dental Education are tailored to meet the individual needs of all of the members of your team. Practical training for your entire team · Long and short courses · Beginners and Advanced courses · Implant Training Covering many areas of dentistry, our courses are led by Specialist Prosthodontists who are also lecturers and examiners at the Eastman Dental Institute. With a focus on practical skills and hands on learning, many of the courses also feature live surgery. In addition, interest free payment terms mean you can pay as you learn on year courses and none of the courses have any hidden costs or VAT. All courses consist of small teaching groups and enable you to maximise your learning experience by participation and observing fellow delegates. “The best CPD I’ve been on in ages” “The course has been extremely beneficial, excellent mentoring and practical skills which are easing me into implantology. Really good course, I would recommend it without reservation” Mentoring - Expert advice at a time and place to suit you If you prefer a more personal approach to learning, we also offer one-toone case advice and mentoring. Whether it be some specific advice on how to proceed with a difficult case, a visit to your practice or even a bespoke training pathway, Devonshire House mentoring offers support in all aspects of general and

specialist dentistry. · Independent and confidential advice · Support for all dentists, from students to experienced Practitioners · Pay as you go mentoring · No contract Come along to our Implant Lecture When Implants Go Wrong - Rescues and Remedies by Wail Girgis, Devonshire House Course Clinical Lead and Lecturer and Examiner at The Eastman Dental Institute. Saturday 18th April 2.30pm in the ADI Implant Theatre An insight into the 5Ps of implant problems - poor placement, poor planning, peri-implantitis, post-operative complications, and patient aftercare. A look at cases where implants have gone wrong and the options available for rescues, remedies or removal. Visit us on stand P50 to find out more about Devonshire House Dental Education and enter our business card draw for a chance to win an iPad mini. www.devonshirehousedental.co.uk/courses

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BA INTERNATIONAL For almost 25 years, BA International has been at the forefront of the handpiece repair business. We have provided repair and sales services to dental clinicians and we have worked with you in providing what you need; the highest quality at the lowest prices and being able to repair any make of dental handpiece.To this day, we continue to work with dentists up and down the country to surpass expectations in what a repair company can offer. So how are BA international more than just a yellow repair bag? • We offer steel & ceramic bearing replacements & cartridge replacements for all makes and models of handpieces. In addition to this, we can offer world leading high quality BA parts as well as OEM spares. With every single one of our repairs, we include a full strip clean and service to ensure that your handpiece returns to you as new. During the service process, we carry out very specific tests in our world leading repair facility. We carry out a chuck retention test, speed test, concentricity test, water system check, chip air check and air exhaust check to ensure that every handpieces is in full working order. • “The Yellow Bag”. You can use our Free industry recognised pre-paid repair bag to send us your handpieces and we will return them in protective reusable & autoclavable BA Steriboxes to ensure your handpieces arrive safe and sound. If you have small equipment that you need repairing, we can create custom made insured boxes using our foam moulding technology to protect your equipment during transit and to ensure your small equipment arrives safely. Once you receive your items back safely, you can keep the custom box for the future thus saving you further possible costs. • When your items arrive to us, after a concise initial examination of your handpieces and equipment, we will offer you Free quotations on all of your repairs. This will allow you to make any informed decisions on whether it would be beneficial to repair your existing handpieces or to invest in new state of the art BA handpieces. • We can offer Free preventative maintenance advice upon request to help reduce your handpiece repair overheads and maximise your chair time utilisation.We have found that advising dental staff over the phone on preventative maintenance has dramatically reduced our customer’s overheads and repair expenses. • We have an extensive range of handpiece spare parts and thus we can offer a same day turn around on your handpiece repairs (when applicable). We are proud to say that we stock the largest amount of spare parts in the UK more than any other provider and are therefore more likely to offer you a same day turn around. • BA can offer advice on servicing, maintenance, regulations and recommended uses for handpieces and dental equipment. Working with leading

manufacturers, we also offer guidance on reprocessing and adhering to the HTM01-05 guidelines in the most cost effective and time efficient ways. • We offer after sales services on repairs and purchases as well as consumables. If you have any requirements from a handpiece or piece of small equipment, our experienced staff can advise the best product for your clinical needs. • We offer validation and servicing for the DAC Universal as we are an approved DAC service centre. Our loan service ensures that whilst your DAC is with us, you are not left without one therefore not disrupting your daily operational requirements. • We offer loan services on many items to help you when you need it the most (when possible). We work with dentists to ensure that you experience as little interruption as possible to your clinical work, thus ensuring the best patient care. • We can repair a huge array of small equipment devices such as amalgamators, ultrasonic baths, DAC and Sci Can Statim autoclaves, Curing lights, Endo units and so much more. Why not call our technical service department to find out if we can repair your faulty device. Technical problem? NO PROBLEM. No other company can provide you with the full service peace of mind that we offer. As manufacturer and repair centre, we are ISO 9001 and ISO 13485 accredited. Our ISO 9001 certificate ensures that we have quality management systems in place, to ensure exacting industry standards and to continually develop and improve our services. In addition to this, we are also ISO 13485 certified as a manufacturer of dental handpieces. We are also pleased to say that BA International has the longest serving expertise and experience in the dental repair field. With over 150 combined years in the handpiece repair industry, our fully OEM accredited engineers ensure you will get the best possible service in the industry. As a testimony to their excellence, all of our engineers are certified and approved by the following companies; Kavo, W&H, NSK, Sirona, Bien Air, 3M ESPE, Elma, Sci Can, Nitram, Henry Schein, Micro Mega and EMS. As you can see, we are far more than just a yellow bag. We can offer all this at the best price with the best service in the industry. If you can find a better price with this level of service, we’ll beat it, guaranteed. www.bainternational.co.uk 01604 777700

INTERNATIONAL SPEAKERS

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NEW: FACIAL AESTHETICS THEATRE

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Dentistry Show TURNING A SIMPLE BUT EFFECTIVE IDEA INTO REALITY

Lisa Riley has extensive business experience having previously enjoyed a very successful career in the retail industry. After gaining an MBA, she rose quickly to become the Marketing Director of BHS at the age of 31 and subsequently went on to become the Managing Director at Somerfield 24-7 and Chief Executive of Women.com. Lisa is now the Chief Executive of Centre for Dentistry, and she looks back on how the business came to be… We started Centre for Dentistry in 2011, with the aim of creating easy access to dental services in a convenient and costefficient way, located in supermarket. The many benefits of such a service are c l e a r – m a x i mu m convenience and accessibility for shoppers at affordable prices. Further advantages are available for people who suffer from dental fear or anxiety, as there are fewer of the usual sights and smells of a practice, and the environment is somewhat more familiar and perhaps less daunting. The process works on the basis of us being allocated areas within the store and then working with The Dental Directory to get the best possible design and layout we can within that space. The Dental Directory team then help us to select the best kit and equipment for the surgeries and they are absolutely brilliant throughout the process – they install all the equipment quickly and efficiently, help us overcome any issues and provide support every inch of the way.

The success of Centre for Dentistr y has been such that we now have 15 practices located across the UK within Sainsbury’s stores. Aside from slight adjustments to the original business strategy, there have been few changes from the initial concept in terms of design, materials and approach. With each new practice we install, the twomonth time frame has even progressively shortened slightly with more efficient processes and familiarity with the procedures on our part. Looking to the future, we have an exclusive deal with Sainsbury’s to open a further 60 practices.We currently have 11 more in the process of design and installation for 2014, and we are excited to be extending our service provision by so much more in the next few years. Our goal is simply to continue providing easy access to the highest standard of dental treatment and care to the public, and we look forward to continue our great working relationship with The Dental Directory. The UK’s largest purchaser of dental products For more information, contact The Dental Directory Equipment Department on 0800 585 585, or visit www.dental-directory. co.uk.

GET THE RIGHT ADVICE The Dentistry Show 2015 is proud to bring you two days of Compliance Clinics in association with Apolline, designed to help you to better understand the rapidly changing regulatory environment facing the dental profession. From 1 April 2015, the CQC will have new inspection procedures in place, causing concern and anxiety for many.The timing and popularity of The Dentistry Show make it the perfect arena for dentists and their teams to learn about these changes, with plenty of help and support on offer. The Compliance Clinics will examine some of the obstacles the dental

profession must overcome, while helping you to discover ways to survive and prosper in what can feel like an increasingly stormy future. Experts in the field of compliance and regulation from the team at Apolline will provide first-class advice and guidance to the whole dental team. Register for your free delegate passes today and receive updates on the full programme. www.thedentistryshow.co.uk

www.thedentistryshow.co.uk

Krishan’s lecture, entitled “Top 5 Critical Points to Improve Your Website and Attract Enquiries from Your Ideal Patient”, will explore how to optimise your practice website in order to attract your ideal patients and grow your business. To make the most of the Dental Business Theatre, as well as the many other outstanding learning and networking opportunities on offer at The Dentistry Show 2015, register for your free pass today!

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The Dentistry Show is an anchored memory of consistent success for Dental Focus.” Krishan Joshi, CEO of Dental Focus® Web Design, will be attending The Dentistry Show once again in 2015, to speak from within the popular Dental Business Theatre. “I remember giving my very first lecture at the event about five years ago to an overflowing standing theatre of hundreds of delegates,” he says. “I have always been a raving fan of The Dentistry Show and love its energy, quality speakers and the people. The value for delegates and the profession is off the charts.”

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VALUE IS OFF THE CHARTS

Hot Topic 22

DRILLING DOWN YOUR DENTAL COMPETITION WITH SEO By Andrew Thomas – Breathe Online Marketing

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In private dentistry having a great looking website is crucial; it gives confidence to the potential patient and projects professionalism. But nice looks are never as important as function. Whether a website is a vanity project for the principal dentist (as is often the case) or not, it must facilitate sales by bringing in new patients consistently. That means never squandering traffic because of common gaffes like slow page loading speeds, longwinded explanations of your services and incoherent calls to action. Getting traffic in the first place is another matter, which all comes under the banner of search engine optimisation (SEO). On a good dental practice website the rate at which traffic becomes leads – that’s someone who goes to the site and either makes an online inquiry or picks up the phone – is around six per cent. So as you can imagine it’s a numbers game. You really need your practice to be hitting the top of the first page of Google rankings to generate a decent number of leads. However, with so many dentists moving online it’s becoming harder to get to the top, never mind stay there. So why does the dentist down the road always rank above you? Well, it could be a number of factors, from the age of their domain (URL), to the size of their website. Look at Wikipedia or Amazon; they continually rank high partly due to the fact they have a continuous supply of content being added minute by minute. Fresh, relevant and unique content is very important these days, and feeding the search engines with great content is a really good starting point. But you can’t stop there! The website needs to be technically optimised and a flow of natural links coming in from other trusted websites is the key factor for increasing the rankings for target key phrases. Then using your social profiles to push this content further is a must. Competitor analysis is also a really useful strategy; it’s not bad to admit your competitor has better rankings than yourself, and it should be set as a goal to seek out why, improve and overtake them.

So, step back and look at the online marketing efforts currently undertaken by your practice – are there any? Is it working? Are you aware of what’s going on? Despite the pressures of running multi-million pound practices, the most successful principals in the UK are spending at least an hour a month in meetings or Skypes with their online marketing teams who talk them through the monthly reports on traffic gains, improved conversion and ranking positions to prove what they are undertaking is working. Online marketing should always provide a solution to ensure you see a return on investment from your marketing spend, by driving traffic on highly profitable phrases such as ‘implants’ and ‘orthodontics’. Your most important measure of success is always going to be new patient numbers. This is the lifeblood of any dental practice and all new patients generated online can be tracked with tags that will tell your online marketing team where they’re going right. When this happens they should be asking you for sign off on budget reallocation to put the boosters on growth.

Hot Topic PUT YOUR PRACTICE BESIDE HOUSEHOLD BRANDS FOR FREE WITH AD RETARGETING

By Stewart Roode, Breathe Online Marketing Stewart is director of Breathe Online Marketing, part of Breathe Business, a specialist dental consultancy (www. breathebusiness.co.uk). He has worked in theonline marketing industry since 2004 and started out managing paid search campaigns upon early search advertising adaptors from the likes of Espotting(the first European pay per click search engine), Overture, Yahoo!, MSN andGoogle. He has a wealth of insight into the growth and movement of the industry and search clients outside dentistry include: Mammas and Pappas, Nestle, Playboy, Lovefilm, Mars Drinks, Jaguar, Kaplan.

Rules and segregation This is where list rules and segregation come into play.With an efficiently run pay per click campaign, your marketing agency should be tracking which monthly Google ads and search terms generate phone calls (via digital call tracking) and

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User lists The big message from Google is that agencies should create ‘user lists’ on behalf of their clients. For example, if we take this into the dental world; a list would be created of all users who have visited your dental practice website in say the last 180 days (anything longer than 180 days can result in diminishing ROI due to the time passed from the initial visit). It is then possible to display banner image ads and text ads to those users elsewhere on the web. You might say, “What’s the point of targeting everyone who’s been to my website? Surely some will be loyal, active patients who will just get annoyed at being harassed?”

enquiry form submissions. With the 180 day user list, a rule can be applied to single out all those users who have been on the website but have yet to make an enquiry. Or at another level, those who have been to the website twice but have yet to make an enquiry. These users have displayed a higher level of interest and are most likely in their ‘research’ stage - at this point you can jump in and encourage them to enquire with a retargeted ad. Lists can also be made of users at a treatment level, for example those users who have been looking at your implants page, and lists can then be combined. For example, let’s display an implant banner ad only to users who have been looking at our implants page but have yet to make an enquiry. In essence retargeting allows you to: - display highly relevant, treatment-specific ads - place time-sensitive offers within the ads - employ brand recall for your practice (the ability of consumers to generate and retrieve your brand in their memory) - encourage browsers to make enquiries One of the benefits of retargeting I like most is that, like pay per click, the ad only costs you money if users click on it. Users will see your brand on other mainstream websites alongside household brand adverts, giving you the brand recall and kudos - but this will only cost if the ad is clicked. And remember, these are users who have already been to your website, so they have already shown interest - very different to traditional blanket banner advertising. If you’d like to start using retargeting to boost new patient numbers at your practice, use a dental coach like me to make sure you’re getting the best results possible. Dental consultancy should always be measured on Key Performance Indicators so if you don’t see a return on investment, particularly in online dental marketing, you shouldn’t have to pay.

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Google’s London HQ may not be quite as epic as its global HQ in San Francisco which is home to 19,000 workers, but it is nevertheless a very exciting day out for a techie. The offices in Victoria include a room stocked with musical instruments, and data on staff movements around the building is used to tweak the feng shui so people work harder and never want to leave. I visited this bastion of the world’s tech elite for a day on behalf of the dental consultancy Breathe Business to hear about the latest in retargeting – the practice of making tailored adverts pop up on the screen in response to consumers’ online browsing habits. At the moment Google is pushing retargeting hard and it wants everyone to know about the return on investment this marketing channel can generate. The day in London was designed to discuss the detailed strategies you can use to get the best return possible. Retargeting happens when you visit a website, leave that website, and then adverts follow you and appear elsewhere on the web from that site. The ad targeting can be quite sophisticated so that the exact product/colour/ size/service you were initially looking for on the original website appears again. I am director of the online dental marketing division of Breathe Business and part of my job is being an online dental coach to dentists who are too busy to research their online dental marketing techniques themselves, so this day out was all about soaking up the latest tips from the big boys on their behalf.

Hot Topic 24

Q& A WITH... Mike Hesketh BchD MJDF (Eng) is the owner and principal dentist of the award-winning Exeter Dental Centre. Mike started his career as a Royal Navy dentist providing dental care to sailors and soldiers all over the world for eight years. He completed the Royal Marines Commando Green Beret course and saw action in Afghanistan leading a team bringing medical aid to local populations. He bought The Exeter Dental Centre, located in the heart of Exeter, two years ago and completely overhauled the practice, before becoming the first dental practice in the South West to offer appointments seven days a week. The practice has also become a centre of excellence, taking referrals from all over Devon for specialist periodontal care, advanced restorative implant dentistry and orthodontics.

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For more information, see www.exeterdentalcentre.co.uk or call 01392 248 927. Q: How old are you? 33 years old. Q: Why did you get into dentistry? I had an interest in science at school and I did my high school fourth year work experience placement in my parent’s friend’s dental practice. The owner was so passionate and I loved the interaction he had with his patients. Q: What made you decide to run your own practice? I had leadership experience within the Royal Navy and also wanted to be in control of the pennies… I had a bad experience upon leaving the steady income of the RN working for an unscrupulous dental chain owner around London. It was a shock to not be paid properly. Also the standards of care were poor and not what I was used to in the RN so I couldn’t continue like that. Q: How does private dentistry compare to the Forces? Very similar timelines for treatment, but different patient bases. In the Forces patients are always fit and well and compliant, in private practice more tact is required! We run our private practice with flexible choice on all materials and the Forces was the same.The standard of treatment is similar and the high calibre of clinicians I work with are the same. To be honest I’ve modelled my clinic on a military format as the ethos and standards in both are high. Q: How is The Exeter Dental Centre performing? Our third year of trading has been our best to date.We gain consistently over a hundred new private patients a month and the team are winning more awards. I’m really happy with how our team’s approach to large reconstructive cases is coming on and our patient satisfaction surveys are positive. Q: Do you have any growth plans for The Exeter Dental Centre? I’m pleased to say that we are expanding from our current four chair format to seven surgeries this year. We are full to the brim, with clinicians’ chair time rationed, so we really need to get going with the expansion. We have our draft architect plans including a new patient lounge on our ground floor, which is currently occupied by a jewellers who are vacating in June. This will give us a high street presence and on the floors above will be new surgeries, a business/ telephony hub and teaching/skin treatment centre. Q: How have you achieved growth in the past? Did you get help from anyone? We changed everything on takeover. I agreed with the three retiring principals that it was best for them to retire on takeover so didn’t tie them in, which turned out to be the most inspired decision we made. It gave us a clear run at changing the way the business operated and how patients were cared for.We redecorated, invested in IT, changed opening hours to seven days a week, recruited charming front of house staff and sent all new clinicians on training courses; it was all guided by the team at Breathe Business. Joining Breathe was the best investment we made as I had no commercial experience.They liked me as I didn’t come with bad habits from the industry, basically I was a blank canvas who was good at implementing the suggestions they made. I thought that with their amount of clients they must know what they are doing, so trusted them and it’s worked out great. Q: Where do you want to be in five years? With a hub and spoke model bringing other local practices under our umbrella using our current site as the referral hub. I would do the same process again and not tie vendors in. When a dentist retires, most patients try their old practice at least once, so I’d back any team I put in place to wow them and convince them to stay.

Q: What’s your favourite thing about your job? Solving staff concerns. To be honest, the most compliments we get from patients are about our self-employed and employed staff so I genuinely enjoy talking to all of them all the time – but this probably annoys them... Q: The worst thing about your job? The creative side of branding etc. I am a more logical scientific type as I suspect most dentists are. I can get processes but I can’t get the more ethereal creative side of the business. Luckily my wife and business partner excels at this. Q: Your biggest challenge as a principal? Was turning a steady ship that was slowly sinking 180 degrees to gain momentum going the other way, trying to take staff with us on the journey. Q: How much do you work? I see patients two days a week to give room for my associates to build a book and I work on the business the rest of the week. Our team is building experience now so there will come a point where I will focus more on external opportunities than I do on the internal running of the business. Q: How do your earnings compare to your expectations as an undergrad? I had a contract with the forces when I was an undergrad so had a good idea of my earnings for the eight years in the RN before joining. I’d say it’s comparable but better in the way we are paying off practice purchase loans/leases and hopefully building equity in our business. Q: Do you have an exit plan? No, I should do I know, but we are riding the crest of a wave of momentum and we’re still innovating with this year’s new facilities and services so we’ve got the excitement lined up for the next few years, then there are other local opportunities, so not for a long time yet. Our children are one and three years old so it’s all about providing a stable life and income to raise them. Q: What’s the biggest change you’ve seen in dentistry since you qualified? I think the loss of the old long standing family NHS dentist locally. We don’t do NHS dentistry but a lot of our new patients come from practices where their dentist has retired and it’s been bought by some corporate and they seem to not have the same trust as they did have, which is a shame. Q: Do you think the way people consume dental services will be different in 10 years? I think it will be different in one year.There have been a lot of external reports looking at the industry of dentistry. With a lot of recommendations such as clearer pricing. I think dentistry will follow what happened to opticians. Q: Any advice for teens thinking about getting into dentistry? When you qualify, keep going with courses and work in Maxfax for a year. Maxfax gives you confidence that whatever problem comes in, you can deal with it. All our dentists are encouraged to enrol on Msc degree courses or similar to really have a great clinical ability. After that a communication course is good as there is no use being brilliant at fixing teeth if no one believes you. Q: What’s your stance on fluoride in drinking water? (The latest in the news is 98 per cent of GP practices in England found high rates of underactive thyroid were 30 per cent more likely in areas of the greatest fluoridation.) Fluoride is already in water, it’s just optimised in some areas to help prevent tooth decay. Numerous studies show that it can decrease child dental decay in populations. So long as the process is rigorous and is safe then I am an advocate. Q: And amalgam fillings? I believe that advances in material studies has resulted in better tooth coloured substitutes being available.

Business in Practice A DENTAL PRACTICE IS A BUSINESS!

By Sim Goldblum Sim has a deep understanding of how businesses, large and small, function effectively. This is gained as a result of many years working for Ford of Europe, ultimately as Director of Product Planning, and as Director of Business Development. Sim put much of that experience into play as a board member of several companies, and as a Non-executive Director of a large NHS Hospital Trust, helping the Trust to achieve Foundation Trust status. Sim brings those same skills to the dental sector, and finds it deeply satisfying to see the personal and business transformations that take place as a result of our educational and training programmes, as well as through his support of individual practices. Sim is a registered and approved Growth Coach for GrowthAccelerator, providing coaching and training to growth-oriented practices.

www.thedentistrybusiness. com

That you are running a business is undoubted. If you do not know where to start, seek out one of the professional business coaches to give you a helping hand, or take one of the accredited, parttime Dental Practice Management courses that are being offered. If you need further assistance, do not hesitate to contact me!

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appearance (expensive looking can deter as many people as it can attract, so be careful that you understand your local demographics); Are you planning to be a “we take anybody” or “by invitation only” practice, to quote Paddi Lund? • Goals: What do you want to achieve in years 1 to 5? Whether they be number of patients, total fees earned, a plan is required – it maybe the one you used to persuade your financier to support your purchase, or it may be a more realistic one….. How many clinical, nursing and reception staff do you plan to employ? What skills do you want them to have and what behaviours do you want them to demonstrate? • Budgets: Given the Chancellor’s latest Budget, you may have scant regard for the phrase, but let us examine how important your Budget is. I will assume that, as the practice owner, you wish to earn/take home a certain amount of money to meet your lifestyle. So, working from that amount, what fees will you have to generate (with or without the assistance of any associates and assuming feasible operating patterns), to meet all your expenses (fixed and variable) and still meet the desired income you want - and don’t forget to allow yourself some profit as a return on your investment! • Key Performance Indicators (KPIs): these measures allow you to know whether you are on track to achieve your annual, monthly and even weekly budgets and will be different for every practice. Some are essential, such as fee output per dentist (UDAs per dentist in NHS practice), staff, material and laboratory costs as a percentage of gross fees, profitability per surgery, number of new patients per week (critical for squat practices or those determined to expand to fill open surgeries), complaints resolved/unresolved each week, patient satisfaction ratings and staff turnover.

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Well, of course it is, some of you will say, while others will stare open-mouthed and be horrified! I’m a clinician, respected for my ability to solve patients’ oral health problems and I know nothing about business! In fact the Head of a UK Dental School was once heard to pronounce “there is no need for dentists to learn about business during their course, as we teach NHS dentistry, which has nothing to do with money or profits”. Shock, horror you may say, but little has changed in the last 10 years; dentists emerge from Dental School and FD with no taught understanding that being an Associate requires business awareness – your “chair rental agreement” with a principal, your responsibility for outstanding communications with patients to ensure your expert diagnosis and recommended treatment plan is understood well enough for informed consent, your working relationships with practice staff meets employment law and best practice teambuilding requirements; oh and your accountant will want to be able to assure you on a regular basis that you are earning enough to repay that fancy car you just leased! Cynical, you may say, but when you decide to open your first practice, you change immediately from Michael Gerber’s “Technician” (The E-Myth Revisited” is essential reading for all aspiring dental principals) to the “Entrepreneur” and have some understanding of what his “Manager” does as well! Technicians (read Associates) do not want to be managed but want to practice their highly developed skills unfettered by systems, authorities and people (which, of course, is why the GDC and CQC are “required”). The typical business, whether a corner-shop or a multi-national enterprise, has a vision, goals, budgets and KPIs, recruits effectively, develops people to achieve their potential, builds teams, understands, meets or even exceeds customer expectations and has communication techniques and complaints processes in case anything goes slightly wrong. Are any of those NOT required by a dental practice? I think not, and I am sure you would all agree. I suppose that part of the problem is that we do not know where to start. Having obtained expert help from our solicitor and accountant to acquire our dream practice, will they continue to support you? In general, no, unless you ask/pay, because their roles are primarily transactional – helping you buy and then calculating and ensuring you pay the correct amount of tax. Let’s look briefly at the key first steps: • Vision: what type of practice do I want (hopefully you asked and answered this question when you bought), but circumstances change – are you a passionate NHS sector dentist or have you wider ambitions to expand your skillset beyond even the NHS’ significant skill requirements? What does that mean for the type of practice, its location, its interior and exterior

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Couple this with a massive product range, great everyday prices and our PriceMatch Guarantee and you can understand why so many UK dentists are happy to say that they are a customer of The Dental Directory.

Trust… 0800 585 586 www.dental-directory.co.uk The Dental Directory, 6 Perry Way, Witham Essex, CM8 3SX

*PriceMatch guarantee applies to any nationally advertised published price, from any dental dealer on all identical consumables, sundries and materials products. **Order fulfillment rate based on average figures for the 12 month period January-December 2014.

Business in Practice CONSULT, LEARN AND GROW New for 2015, Business IQ is a new initiative that has been developed to positively impact the profitability of dental practices by offering a range of products and services to either help increase revenue or reduce costs. Bringing together the core service offerings from Software of Excellence and Henry Schein Dental, along with expertise from a range of third party partners, Business IQ aims to improve your business performance through a range of practical solutions, under the headings: Consult, Learn, Grow. Consult: Finding a trusted advisor for your business can be difficult. Whether you want to benefit from the business tools within EXact from Software of

Excellence, want to explore the latest digital restorative solutions or are thinking about refurbishing your practice, Business IQ has a solution to help. Learn: Ensure your team are up to date with training and Core CPD.Through Business IQ you’ll be able to choose from a wide range of clinical and non-clinical courses that will help to improve both practice and personal development. Grow: From reduced rates on recruitment and financial advice, through to all aspects of practice marketing, including patient literature and developing patient engagement through social media, Business IQ has a range of solutions to help your practice grow. www.hsbusinessiq.co.uk

INCREASE YOUR ONLINE PRESENCE WITH ZESTY Increase the flow of new patients into your practice when you join Zesty, the UK’s leading online healthcare marketplace. Patients can search for appointments in their area and book straightaway, giving them convenience and you the chance to fill vacant slots. Since 2012, Zesty has been on a mission to make access to healthcare easier. Patients can book outside of office hours and, because Zesty is optimised for smart phones and tablets, your patients can book anywhere, too. A dedicated practice page will allow people to read ratings and reviews, and find out about pricing and treatment specialities.

Joining Zesty will increase your online presence without the need to pay for any additional advertising.You can spend less time managing your schedule and worrying about a marketing strategy and more time providing quality treatment. With the online diary, you can upload your available appointments in seconds and they are displayed immediately. Zesty is the choice for practices looking to raise their profile and increase patient flow. Contact Zesty today to find out more… www.zesty.co.uk

TO SELL OR TO MERGE?

For more information and to find out how Dental Elite can help to sell your practice visit www.dentalelite.co.uk

and streamline expenses. Principals looking to merge with a new practice should, however, pay close attention to ensure that the cultures of the two businesses align. For example, a practice that offers mostly general dentistry at mainstream prices would find it very difficult to merge with a dental provider that offers specialist services for which it charges more. If two disparate practices from different ends of the spectrum were to merge together, then there is likely to be some element of clash in the type of dentistry they’re delivering. It is also important to ensure that the current principal is fully on board with the project. Ideally you would want to make sure that the principal moves with the goodwill, at least at first, as this will help to encourage the patient base to move across too and make the transition more seamless. And of course, any NHS merger must be completed in line with the NHS England policy on the merging or relocation of NHS contracts.As these contracts are location-dependent, you will need to agree an intended merger or relocation with the Local Area Team (LAT) and NHS England before you can go ahead. Whatever your current situation, at Dental Elite we understand the complexities you face and can provide you with the right advice to make the most suitable arrangement.Why not make the most of what a merger could offer you and your business? Our highly experienced team are on hand to help you explore all the possibilities and to ensure you get the very best deal.

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If you are considering the acquisition of a second practice, it’s important to remember that this is not the only viable option available to you. This is great time in the dental industry to consider a merger, and what’s more, it might provide a cheaper solution to grow your business. There are several different benefits to a practice merger as opposed to an outright purchase, and one of the most influential advantages is that it’s less expensive to effectively buy-in goodwill. The example being that if you were to acquire a practice, it might be valued at up to seven times the EBITDA (earnings before interest, tax, depreciation and amortisation). However, if you were to merge with this practice instead, the EBITDA growth could potentially be bought at less than half that price, providing a much cheaper way of gaining the goodwill value. What’s more, combining two practices under the same roof means they are far easier to manage as a single business. Amongst other benefits, this ensures staff are within close enough proximity to each other to complete collaborative cases with ease and the practice manager can oversee the business from one single location. All these aspects increase the likelihood of success for the merger, and consequently the long-term success of the business. While an ideal option for independent practices wishing to grow, it is just as common for micro- or macro-corporates to merge practices to increase their efficiency. If a practice has spare surgery rooms that are not being fully utilised by the existing business, then merging the practice with another will fill the space

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Luke Moore is one of the Founders and Directors of Dental Elite and has overseen well in excess of 750 practice sales and valuations. With over 11 years working in the dental industry, Luke has extensive knowledge in both dental practice transfers and recruitment and understands the complexities of NHS and Private practices.

Disinfection & Decontamination Section Sponsored by

REUSABLE INSTRUMENTS AND INFECTION CONTROL A report from the Health Protection Agency estimates that the number of people in the UK living with HIV rose to 96,000 in 2011, increasing by 6,280 new diagnoses. As was the case in 2010, almost a quarter of those infected (24%) remained unaware of their status. It is a sobering thought. However, for dental professionals, this news shouldn’t impact on infection control in the practice, as strict, consistent standards are required regardless of the health issues of individual patients. Whether or not the person in your chair has HIV, suitable precautions must be adopted. Practitioners have a responsibility to ensure a clean environment and use safe systems of working to minimise the risk of cross infection. As the GDC states in its Maintaining Standardsii publication: “Failure to employ adequate methods of cross-infection control would almost certainly render a dentist liable to charges of serious professional misconduct.” The oral cavity is teeming with bacteria and many of these microorganisms are capable of causing infection, which can be transmitted through the blood or saliva. Clearly, reusable instruments that have been used on a patient will be contaminated with such vectors and must be thoroughly cleaned and sterilised after usage. This crucial aspect of decontamination and sterilisation procedure in the practice can’t be left to chance. In fact, dental practices are increasingly turning to automated systems to eliminate error and maintain standards. Computerised instrument tray tracking software brings a number of benefits both to single practices and those with centralised sterilisation. As when any series of tasks is automated, administrative time is significantly reduced, while efficiency and accuracy are enhanced. The software automatically tracks

the progress of reusable instrument trays, including cycle parameters and cycle success or failure, as they move through the cleaning and sterilisation process. Users are alerted when a tray is approaching the end of its sterile period, or when a cycle has failed, and can respond accordingly in a timely fashion. These user-friendly systems link the instrument tray to the patient, generating a full decontamination history and creating an auditable trail. One leading solution is Steritrak Instrument Tracking from Carestream Dental, which can be installed on any computer with internet access, and connects an authorised user to a web-based service. Steritrak promotes process standardisation and produces a solid data path; its powerful reporting capacity generating documentation and reports at the touch of a button, which help practices demonstrate CQC and HTM 01-05 compliance. Healthcare providers are under intense scrutiny from the media and the public, and their expectations are high, demanding and unforgiving. Dental practices cannot afford to suffer the stigma of negative publicity if their infection control is found wanting. Prevention, as ever, is the key. Protect your patients, members of staff, and practice reputation from irrevocable harm with the latest advances in instrument tracking software; the foolproof way to meet essential standards of care. www.carestreamdental.co.uk Health Protection Agency (2012) HIV in the United Kingdom: 2012 Report. Available through: www.hpa.org.uk [accessed 16th January 2013] GDC. Maintaining standards. November 1997, as amended November 2001.Available through: http://gdc-arf.com/Newsandpublications/Publications/ Publications/MaintainingStandards%5B1%5D.pdf [Accessed 17th January 2013]

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ZEPF CARE SYSTEM – INSTRUMENTS LAST LONGER AND LOOK BETTER! As UK Distributors of the complete Zepf instrument range, manufactured entirely in Germany from the highest quality German materials and arguably the finest instruments available in the world, General Medical now offer the complete Zepf Care System, designed to enable Practices to take optimum care of their instruments, ensuring they last longer and look better! The range includes AdCon Cleansing Foam, NCDC-Cleanser and ProActive-Cleanser plus all the relevant auxiliary products. AdCon is Zepf’s surface active and micro-organism cleaning foam which facilitates effective pre-cleaning of all instruments. Applied immediately after use to prevent debris adhering to instruments, it facilitates easier and less damaging cleansing. Helping to extend the life of instruments it is ideal for use when there will be a delay before cleaning. NCDC-Cleanser is Zepf’s highly effective liquid concentrate for cleaning and disinfecting rotary and manual instruments in an ultrasonic bath.This Aldehyde- and Phenol-free solution is gentle and has a low electrical conductivity, further helping reduce the risk of corrosion and thereby extending the life of instruments. ProActive-Cleanser is Zepf’s high performance cleanser, ideal for use with new instruments and to revitalise older and tired looking instruments. www.generalmedical.co.uk

Disinfection & Decontamination Section Sponsored by

DENTIST CLEANSING WIPES

Refreshening dentist cleansing wipes are perfect for patients to use before and after every dental treatments. Patience visiting dental practises are becoming more concerned about hygiene & cleanliness within dental practises. These high quality cleansing wipes have been specifically developed to help reduce the risk of healthcare associated infections (HCAI) by simply cleansing and preventing cross contamination. Individually wrapped and balanced to skins natural pH these soft and strong dental cleansing wipes can be personalised upon the outer wrappings with your own logo design from only 6p each or simply purchased from stock. Show your patients you care about hygiene and cleanliness within your dental practise by giving your patients a cleansing wipe for that personal touch.

Of all the all instruments within the Dental cliniciansâ&#x20AC;&#x2122; armoury, hand-pieces offer a particular challenge when performing the sterilisation process. Unlike many solid instruments such as probes, scalers, forceps etc. dental Hand-pieces contain a range of parts and it is this complexity of design such as gearings, turbines and fine lumens encased within the outer shell that creates challenges for the decontamination team. If not flushed internally dental handpieces can suffer from a build-up of debris which will be baked on to surfaces, not only does this pose a problem when sterilising, it can also lead to parts failing. Conventional hand-piece maintenance and sterilisation protocols will usually involve an initial manual clean followed by lubrication using a hand held can of oil prior to sterilisation. Although a relatively simple process it is important that the operator is aware of the various adaptors that might be needed and is confident in lubricating via the drive air tube as this is the only line that leads directly to the turbine or vital moving parts, the other holes act as exhaust, water, or chip air.

It can also be a challenge to ensure a hand-piece is not over oiled, under oiled or not oiled at all! The conventional sterilisation process will often include a cycle in a washer disinfector followed by a cycle in a B type vacuum autoclave however, there is a growing preference for automated processes which combine the processes and removes the maintenance responsibility from clinicians all together. The preference for an automated protocol has led to various products emerging which lubricate and or flush hand-pieces and in some cases both. Autoclaves which will lubricate and sterilise can have a beneficial effect on the life span of hand-pieces and in certain cases return investment through reducing hand-piece repair costs and even reducing the number of handpieces needed due to their quick cycle time. The DAC Universal will fully process six hand-pieces in 16 minutes. As with any piece of decontamination equipment it is important that the equipment can be supported by trained technicians who can carry out this work on site and validate to the appropriate standard.Validation of all decontamination equipment is vital to ensure that equipment is meeting all the required parameters and standards for cleaning, disinfecting and sterilising. It is also important to ensure that the technicians carrying out the validation are suitably qualified and trained. Without correct validation there is no evidence that the equipment is meeting the required European standards. The hygiene formula for the DAC Universal is: Safe. Clean. Rapid. DAC Universal cleans, lubricates and sterilises 6 instruments â&#x20AC;&#x201C; fully automatic at the touch of a button.Wrapped and solid instruments can also be sterilised in just 16 minutes. Save yourself time consuming manual preparation and protect yourself and your patients reliably. www.js-davis.co.uk.

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THE HYGIENE FORMULA FOR CLEAN INSTRUMENTS

Disinfection & Decontamination Section Sponsored by

GOING VIRAL The Ebola outbreak, originating in West Africa in February this year, has frequented the news headlines and will not have escaped your notice. Incidences like this heighten public concerns over infection and controlling the risk of contamination. Due to the low profile of Ebola until its recent outbreak, there is now a widespread fear surrounding its effects. Given the heightened news coverage, lack of treatment and poor prognosis for those who contract it, the disease has given rise to anxiety and fear among the public. Due to its severity and the fatal threat Ebola poses, patients and professionals alike may question whether hygiene practices within the dental setting are adequate and rigorous enough to protect us. Although currently there has only been one reported case of the deadly disease in the UK, and the risk in this country remains low, the constant reports on the news are enough to increase concern and make many question cleanliness in healthcare settings. As there have been reported cases in the USA and more potential contact with infected people, the American Dental Association (ADA) released advice to its dental professionals on 24 October 2014. These suggest adding questions to medical history checks about whether patients have travelled to west Africa and if they feel feverish. With the low risk in the UK it might be an overreaction to do this too, but perhaps caution, vigilance and common sense should be on your agenda instead.

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On your radar Headline hitting diseases like this can also increase public concern over contamination in general. Of greater risk to us – especially at this time of year – is influenza, or the flu, a common viral illness that is usually spread by coughs and sneezes. The virus can also be caught by touching a surface that has been contaminated making public places a breeding ground for the spread of infection. Certain groups of people are at higher risk, such as the elderly, pregnant women, and those with certain existing medical conditions or weakened immune systems. Another virus that should be on our radar is Norovirus, or the winter vomiting bug, although it can affect people at any time of year. This is the most common stomach bug in the UK1 as it can affect people of all ages and is highly contagious. Norovirus can survive for days, and in some cases weeks, on surfaces touched by an infected person2, so healthcare settings are a common place for it to be spread. With this in mind, using effective surface sprays and wipes between patients is a quick and simple method of ensuring surfaces are clean, disinfected and free from pathogens at all times. Be compliant When diseases hit the press in the way Ebola has, it can be a topical way of discussing your practice protocols with the team. Ensure everyone is aware of the signs and symptoms of particular infectious illnesses and that they know how to deal with a potential risk without causing alarm to others. The Department of Health’s HTM 01-05: Decontamination in primary care dental practices sets out best practice standards, highlighting how important it is that the ‘transmission of infections be minimised as much as possible’, so it is part of your duty of care to prevent the spread of disease. In order to comply with this, your practice’s sterilisation and decontamination procedures must be a top priority for the whole team. There are a variety of single-use instruments and items that can be employed, which also provide peace of mind to patients who can see that specific items are used only for that individual. Having hand gel in reception and waiting areas and requesting that patients use it – and letting them see you do the same – is not only good hygiene practice but it can help to ease concerns and anxieties that some may have over the spread of infection. Giving your patients these insights instils trust within you as

a professional and ensures their comfort and satisfaction with the dental practice. HSE also introduced a new directive in 2013 on sharps regulations to prevent incidences of needlestick injuries. Serious blood-borne infections, such as Hepatitis B and C and HIV, can be transmitted via contaminated needles accidently and this directive has been put in place to protect healthcare workers from such a risk. Employers and employees must understand their legal obligations under these regulations in order to ensure the health and safety of all involved. A complete solution Ensuring your infection control procedures are of the highest standards will mean that the risk of spreading infections is eliminated. Instrument decontamination processes should be second to none and must be applied across all areas of your dental practice. Eschmann can provide you with a complete decontamination solution including washer disinfectors, autoclaves, accessories and a full range of consumables to meet your daily requirements. Offering unbeatable prices, unrivalled service and outstanding protection, you need look no further for all your decontamination needs. When an outbreak of an infectious disease, like Ebola, hits the news it can cause a pique in the focus on cross-contamination in healthcare settings. While our risk remains low in the UK, it is worthwhile understanding the anxiety that heightened media coverage can stir up, while also giving ourselves a moment to consider the risks that are posed to us.These incidences can also provide us with the chance to review our hygiene and infection-control standards, ensuring that they are at an optimum level and that all staff are confident with the protocols in place. For more information please visit www.eschmann.co.uk

NHS Choices, Norovirus. http://www.nhs.uk/conditions/Norovirus/Pages/Introduction.aspx (accessed 4 November 2014) NHS Choices, How long do bacteria and viruses survive outside the body? http://www.nhs.uk/chq/Pages/how-long-do-bacteria-and-viruses-liveoutside-the-body.aspx (accessed 4 November 2014)

Weekly Water System Cleaning Scientifically developed for dental water systems Developed specifically for routine cleansing / disinfection of dental unit water supply equipment. Clean Water Solution • A routine weekly application using Alkazyme-W diluted with ordinary tap water is sufficient to ensure chair side water delivery equipment remains clean and contamination free Powerful Action • Detergent/Disinfectant system combined with protease enzymes rapidly removes harmful bio-film rendering the internal surfaces thoroughly clean and disinfected Highly Economical • A recommended weekly system clean using just 5 grams of Alkazyme-W diluted with ordinary tap water negates the need for daily additive dosing Alkazyme-W is available direct from all dental sundry suppliers.

Product information / Safety data sheet available from the website.

Disinfection & Decontamination Section Sponsored by

FAST,VALIDATED HANDPIECE CLEANING AND MAINTENANCE W&H is working to develop products and services that make compliance with current decontamination guidelines easy, quick and cost-effective. In order to ensure total efficacy of the decontamination process,W&H offers a suite of products which complement each other. A particularly important aim is to help dental professionals improve handpiece decontamination and maintenance routines; correct handpiece care and maintenance will improve the lifespan of your handpieces and reduce risk of cross infection to both dental team and patients.

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Handpiece Cleaning and Lubrication The Assistina 3X3 is the most thorough handpiece maintenance system currently available, cleaning and lubricating 3 handpieces in a 3-stage process. Assistina 3X3 provides an extensive cleaning process, combining a thorough cleaning of internal spray channels and transmission parts with external handpiece cleaning and precise, consistent automatic lubrication of all internal components to improve the reliability of handpieces and extend their working life. The Assistina 3X3 forms an ideal part of your decontamination routine as it is validated to remove commonly encountered microbes in the dental surgery, with a cleaning efficacy of 99%. Using the Assistina 3X3 offers a real alternative to putting handpieces in a thermo washer disinfector, with gentle yet effective cleaning at ambient temperatures, using water-based active fluid designed especially for handpiece care. It prepares your handpieces quickly and easily prior to sterilization. With the Assistina 3X3 three step process, the internal cleaning stage cleans the spray channels and gearing components of the handpiece with W&H Active Fluid, a specially formulated handpiece cleaning solution. The spray channels and gearing components are then blow-dried to remove any fluid residues. The thorough cleaning removes debris and ensures that the handpieces operate correctly, extending their working lives. The automatic external cleaning removes organic deposits by spraying the exterior of the handpiece and then blow-drying it, prior to sterilization, ensuring improved patient and user safety by eliminating a potential source of contamination. To maintain your handpiece performance and protect internal components, the Assistina 3X3 then lubricates your handpieces, with precise and consistent automatic lubrication of all gearing components. Because the lubricant is measured precisely, this prevents wastage of oil from over-oiling and minimises oil leakage upon use of the handpieces. The W&H Service Oil F1 lubricant is formulated to withstand high temperatures, thus protecting your handpieces through the sterilization phase, extending the working life of the handpieces and reducing service costs. Up to three handpieces can be cleaned and lubricated per cycle and the short cycle time of 6 minutes, which includes the contact time for the active fluid to ensure effective breakdown of organic deposits, reduces the time normally required for the preparation of handpieces prior to sterilization. The Assistina 3X3 operates intuitively, starting preparation at the press of a button. There is no need for special training and this process is fully validated. The Assistina 3X3 enhances the Assistina range which includes the ever popular Assistina 301plus. Handpiece Sterilization W&H covers the next stage of the decontamination process, sterilization, with a range of sterilizers to meet your practice needs, including the renowned Lisa autoclave which now comes with a highly effective “Fast Cycle“. This improves efficiency as you do not have to wait for your instruments to go through a full load cycle. In addition to the proven Class B cycles and the gentle ECO B function, which minimises duration of instrument exposure to high temperatures, the new ‘Fast Cycle’ offers the option of an even faster more economical sterilization cycle at no extra cost. This enhancement to the Lisa allows you to sterilize unwrapped handpieces as well as solid instruments in just 14 minutes, improving efficiency as the Lisa requires no cooling down period between cycles. In addition, with the Lisa “fully automatic” sterilizer, even the standard B cycle is quick; cycle duration is automatically optimised dependent upon size of load using the patented ECO-Dry system, to ensure you can re-use your equipment as quickly as possible: a typical B cycle for wrapped instruments takes around 33 minutes, resulting in equipment that is dry and ready for use or storage. To optimise your decontamination process still further, you can save time filling and draining your sterilizer by using Lisa in combination with the LisaOsmo reverse osmosis water demineralizer, which connects to the mains water supply.

Blows through spray channels and transmission parts with compressed air.

Internal cleaning of spray channels and transmission parts and external cleaning

Lubrication of transmission parts with W&H Service Oil F1

Packaging With its patented double roller system, the W&H Seal2 hermetically seals the sterilizer bags protecting your sterile handpieces. The Seal2 is convenient, easy to use and seals in just 2 seconds. Traceability To record sterilization data with your Lisa “fully automatic” sterilizer, details of user and sterilization cycle can be logged and recorded using the LisaSafe traceability kit. In order to better support our customers,W&H Premium Care and Premium Careplus Service Plans for W&H decontamination products have been developed to enhance your decontamination facility in line with current guidelines, ensuring peace of mind and the confidence that your sterilizers are working at peak performance. A logbook to record test results and maintenance is also available. W&H also offers a top class in house handpiece repair facility for all W&H handpieces. W&H provide the ECOnomical Solution for your decontamination needs, working to comply with all local guidelines. For more information regarding W&H’s full range of products go to www. wh.com or visit the W&H youtube channel at http://www.youtube.com/user/ whdentalwerk where there are a number of educational and fun videos to watch. W&H. People Have Priority. www.wh.com Marketing.uk@wh.com +44 (0) 1727 874990

Handpieces and Decontamination Designed by experts for maximum performance, quality and reliability Instruments Straight and contra-angle handpieces Turbines Assistina 3x3 Internal cleaning External cleaning Lubrication

LisaWare Traceability

Assistina 301 Internal cleaning Lubrication

LisaSafe Labelling

SealÂ˛ Packaging

Lisa / Lina Sterilization

From start to finish, W&H offers the most efficient and effective way to clean, lubricate and decontaminate W&H (UK) Ltd,6 Stroudyour Woodhandpieces Business Centre, Park Street, St Albans, AL2 2NJ

W&H (UK) 6 Stroud Business Centre, Park Street, St Albans, AL2 2NJ Tel: +44 (0)Ltd, 1727 874990Wood Fax: +44 (0) 1727 874628 Email: marketing.uk@wh.com Tel: +44 (0) 1727 874990 Fax: +44 (0) 1727 874628 Email: marketing.uk@wh.com 6 Stroud Wood Business Centre, Park Street, St Albans, AL2 2NJ W&HW&H (UK)(UK) Ltd,Ltd, 6 Stroud Wood Business Centre, Park Street, St Albans, AL2 2NJ Tel: +44 (0) 1727 874990 Fax: +44 (0) 1727 874628 Email: marketing.uk@wh.com

Multidem Water treatment

Scan the QR code for more information on the complete range of W&H products

Tel: +44 (0) 1727 874990 Fax: +44 (0) 1727 874628 Email: marketing.uk@wh.com

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Disinfection & Decontamination Section Sponsored by

CROSS INFECTION AND DECONTAMINATION Cross Infection or the transfer of micro-organisms from one person to another via surfaces and instruments either directly or indirectly are a huge concern for dental practises and if proper disinfection is not carried out it can be devastating for your patients too. Micro-organisms are passed through the blood or saliva of a patient and these can be easily passed via the use of hand pieces and instruments. The dental team as a whole is responsible for making sure that all hand pieces and instruments, surfaces and equipment are all maintained to a high standard, thus ensuring the health and well-being of their patients. Infection control is not something which is optional; it is an important and required element to ensure good quality care. Hand pieces and instruments that have not been cleaned in the proper way can carry viral and bacterial infectious diseases, the most serious of which being Hepatitis B. Other diseases such as Hepatitis C and D, Herpes, HIV, Tuberculosis and Legionella can also be contracted from unclean hand pieces and instruments. These diseases are most commonly passed from patient to patient however; it isnâ&#x20AC;&#x2122;t just patients who are at risk from infection. Dentists themselves and dental nurses are also at risk if they are handling dirty or infected items, especially if they are not wearing the correct protection on their hands and face, of which should be changed with every patient. There are various products of the market today which dentists can use to clean and sterilise their instruments, one of which is Cattaniâ&#x20AC;&#x2122;s Magnolia range

comprising of various different solutions for different applications. Puli-Jet is an aspirator cleaner and disinfectant solution that is dispensed via the pulse cleaner, the bucket that creates the necessary turbulence to remove dirt. Continuous use of a disinfectant with anti-scale such as Puli-Jet dissolves blood and mucus and removes scaling from the internal components of the suction system and both internal and external suction tubings on the dental unit, therefore preventing bacterial biofilm adhering to it, without damaging the aspirator and tubes.This process should always be carried out at the end of each working day to ensure cleanliness and hygiene is at its best. Cattaniâ&#x20AC;&#x2122;s Eco-Jet spray and Tissues are available for disinfection of all surfaces including dental chairs and trollies. Our Fast and Steril, Quick Steril and Eco-Jet 2 products can be used to disinfect surgical instruments after each use, so that infection cannot be passed from patient to patient. Cattani also have a range of products for lubricating surgical instruments which are non-flammable and ozone friendly. Lubri-Jet Spray can be used on plastic and metal surfaces exposed to rubbing such as O-rings. Lubri-Jet Drop can be used on surgical instruments with parts subject to friction such as scissors, forceps etc. www.cattaniesam.co.uk

ULTRA CLEANLINESS

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David Williams explores the challenge of dental unit water lines. Water from dental unit water delivery systems may pose a risk particularly to immune compromised patients. Contaminated water caused through biofilm within the dental water system is a risk that can be avoided Dental unit water lines are an ideal environment for bactericidal bio-film formation due to the high surface to volume ratio utalised within the dental water delivery system, this regardless of water continuously moving through the working dental unit a now all too common concern regarding the quality of water at the point of delivery Microorganisms proliferate on surfaces exposed to moisture they form bio-films that are resistant to most disinfectants and not always detected. This is a microbial community contained in a matrix of polymers and water forming a layer anything from micrometers to several millimeters thick that adheres to the internal surfaces of water lines. Although the first scientific study devoted to biofilms dates from the 1940s but it was not until the 1970s that their abundance in natural environments was known. Biofilms form on all submerged surfaces be it in soft water or sea water or any surface frequently moistened from floors to teeth and of course water pipes. In certain environments the presence of biofilms is not harmful as the polymers of the matrix can trap organic molecules or minerals as well as particles in suspension present in a flow of water, these substances, pollutants for example can be broken down by the bacteria thus contributing to the purification of natural water environments or to that of used water in treatment sites. In the medical environment however biofilms can contribute to a real danger through sheltering harmful bacteria including respiratory pathogens Legionella, Pneumophila and Mycobacterium Rinsing of the dental water lines and/or adding disinfectant additives to the reservoir is not necessarily the answer as one of the prime factors which explains the

resistance of biofilms to disinfection is there powerful adhesion to surfaces, this results from a complex process, physical forces determine the attachment of the molecules of the bacteria to the surface. This contact stimulates the secretion of glucidic organic molecules, which adhere to the surface while remaining connected to the bacterial walls. The biofilm forms, multiplication then causes the film to thicken, consequently the matrix anchors biofilms to the surface. The cells of the superficial layer are aerated and fed on each contact with water, the products of their metabolism result in a continual shredding into the water supply. Disinfection is made extremely difficult as the matrix anchoring the biofilms limit the penetration of disinfectants. What can the dental practice do to reduce the risks? Contamination of the system is reversible particularly in the early stages as the adhesion to the surface is not strong however if untreated the inner surface of the water system will become over colonized and adding a disinfectant and/or flushing alone may only have limited effect on reducing the bactericidal count within water supplied at the point of delivery. There are several products targeted specifically targeted for the disinfection of dental water delivery systems however careful consideration should be given to using a product with specific stated ability to thoroughly clean and remove biofilms. Cleaning of the system must be carried out routinely and in accordance with the specific product manufactures recommendations, routine weekly or even daily cleaning may be the requirement together with regular purging of the water lines following each patient treated. www.alkapharm.co.uk

Education & Training THE BRITISH DENTAL CONFERENCE AND EXHIBITION 2015 – A LOOK AHEAD…

School; Richard Cure, Head of Dentistry Studies and Clinical Director of Orthodontics at the University of Warwick; and Ian Dunn, Specialist Periodontist and Undergraduate Teaching Lead in Periodontics at Liverpool University. Back this year… Alongside all of our clinical headliners the event will offer a wide variety of career development and business-focused presentations, Core CPD, a large exhibition with over 150 top suppliers and organisations, and an evening programme of social events – including a Cuban night! Popular features such as the Training Essentials and Demonstration theatres in the Exhibition Hall will make a return, and BDA advisers will once again be offering free 15-minute one-to-one advice sessions in the Advice Zone. Finally, don’t forget the Speakers’ corner for quick, accessible sessions in a more informal environment. This year also sees the return of the FGDP mini-series which will include presentations on complaint management, record keeping, special care dentistry and ‘life after FD’. The British Academy of Cosmetic Dentistry (BACD) mini-series will also be returning with a variety of sessions of interest to GDPs looking to expand their knowledge of cosmetic dentistry. Booking and more

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Daniel Wismeijer, Professor and Head of Department of Oral Implantology and Aesthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACDA) is undoubtedly one of the headline speakers for 2015. His not to be missed presentation on Thursday will look at the continued growth of digital dentistry and the impact this is having on everyday practice. He will describe the various digital tools that are available in the dental practice, from Computer Aided Design and oral scanning to Computer Aided Manufacturing and crown insertion. He will also discuss the latest research on the precision and application of these tools and technologies. The event’s opening speaker, Basil Mizrahi, is another of the names to look out for. A specialist in Prosthodontics and Restorative Dentistry Dr Mizrahi runs a full time private practice, is an Honorary Clinical Lecturer at the UCL Eastman Dental Institute, and Diplomate of the American Board of Prosthodontics. Dr Mizrahi will be delivering two lectures on the first day of the event. In his opening presentation he will look at contemporary treatment of worn dentition and how to combine longevity with aesthetics whilst his second lecture will cover the pros and cons of different types of anterior all-ceramic crowns and how to achieve long-term success with the right systems. Jason Smithson, Private Practitioner, Cornwall and well known expert in restorative dentistry is a further draw. On Saturday he will be leading delegates keen to emulate nature’s morphology through an anterior composite resin masterclass. Additional speakers to look out for across the three days include Francesco Mannocci, Professor of Endontology at King’s College London Dental Institute; Chris Tredwin, Professor of Restorative Dentistry and Head of Peninsula Dental

The Government has announced that a UK general election will take place on Thursday 7 May 2015. If you are planning to attend the event on this day and wish to vote in the election you will need to apply for a postal vote if you cannot attend your local polling stations.

Don’t miss our headliners

Please note!

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Dentists attending this year’s British Dental Conference and Exhibition can look forward to presentations from some of dentistry’s top speakers, live demonstrations, career and business-focused sessions and large Exhibition complete with Innovation zone. Returning to the Manchester Central Convention Complex from 7-9 May 2015 the three-day event will offer delegates a chance to hear from experts in a broad range of dental specialisms as well as the opportunity to gain up to 15 hours free CPD.

Booking for the event is now open. A range of price options are available for BDA members and non-members with 3-day Conference Passes free for BDA Extra and Expert members, and significantly reduced for Essential members. BDA Expert members are also entitled to two free 3-day DCP Passes or six free 1-day DCP Passes. Prices are significantly reduced for Foundation Dentists and BDA student members can attend for free. Prospective delegates can find out more and register online at www.bda.org/ conference or by calling 0870 166 6625. Dentists and students considering joining the BDA or upgrading their membership can find details at www.bda.org/join.

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INVESTMENT IN PRIVATE DENTISTRY TRAINING PAYS DIVIDENDS, SAYS LEADING ACADEMY

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One of the UK’s leading dental training academies has conducted a survey which shows that dentists who invest in training are likely to earn £2,500 more per month on average. Tipton Training, which has teaching locations in Manchester and London, offer a wide variety of courses for dentists. Delegates can study the fields of restorative, implant and cosmetic dentistry through a mixture of practical training seminars and theoretical lectures under the direct supervision of qualified ‘specialists’. Courses come in a variety of formats, including post-graduate, corporate, one-to-one, one day and international syllabuses. Created 25 years ago by Professor Paul Tipton, Tipton Training has helped its dentists improve their careers by enrolling on one of its four dentistry courses. By taking these courses, many dentists have seen a large rise in their income, as well as better job prospects. “We want people to get the most out of their dental career, that’s why we offer a variety of courses to help dentists improve their knowledge and bolster practice income,” explains Professor Paul Tipton, founder of Tipton Training. “For example, 60% of our delegates who took The Phantom Head Course at Tipton Training have reported that their private work has increased by £2,500 per month on average as a result. “These improved profit averages are all based on cumulative total earnings, divided by the number of delegates. Many delegates also claim that Tipton Training courses increase their rate of job satisfaction. So investing into quality training holds significant potential for dentists who want an exciting future in dentistry.” Professor Tipton also believes that improved education holds the key to halting a five year slump in average income for NHS dentists. Recently published statistics by NHS England show that median earnings for dentists has fallen by £22,000 in a period of five years. Tipton Training has however seen its network of NHS delegates buck the recent falling income trend by expanding their private treatments through educational training.

“The statistics really do demonstrate how difficult it is for NHS dentists to increase profitability,” explains Professor Paul Tipton, founder of Tipton Training. “It’s trend we’ve witnessed first-hand, as many of our past and current delegates are NHS practitioners who are looking to widen their portfolio of private treatments in areas of dentistry such as restorative, implantology and cosmetic. By focusing on these areas, these dentists have been able to withstand the constraints that have been placed on NHS dentists, and ultimately run successful practices.” Not only do Tipton Training courses improve a dentist’s ability to take on more complex cases, they also help build confidence and enjoyment in what can be considered a challenging career. “Working privately within the dental industry has huge benefits, as it gives many professionals the opportunity to strike a healthy work to life balance. As private dentists tend to earn more than their NHS counterparts, they have more flexibility with their time and finances.,” adds Professor Paul Tipton. “The reason for this is simple. By taking courses like The Restorative Course and The Cosmetic & Aesthetic Course, these dentists have been able to increase their skills and knowledge so that they are better equipped to take on a broader range of complex cases, and ultimately run more profitable practices.” Tipton Training courses aims to provide with the latest dental scientific knowledge and clinical techniques. Lecturers teach the best practices across a range of disciplines in a way that makes them understandable and easy to implement, through a mixture of practical and theoretical modules. Successful completion of Tipton Training’s dentistry courses can also lead to delegates being fast tracked into the third year of either the MClinDent Restorative and Cosmetic degree, or the MClinDent Dental Implantology degree, from the City of London Dental School. “It’s our affiliation with the British Academy of Restorative Dentistry (BARD), and the British Academy of Dental Implantology (BADI), that allows our delegates to fast-track onto the MClinDent degrees,” explains Professor Paul Tipton, founder of Tipton Training. Those interested in The Restorative Course can enquire about the up and coming London and Manchester (April 2015) sessions by contacting a member of the Tipton Training team; while those interested in The Cosmetic & Aesthetic Course (April 2015) can also get in touch. For further information about Tipton Training and comprehensive range of dentistry training courses, please visit www.tiptontraining.co.uk or call +44 (0)161 348 7848.

Want to double your private income?*

The Cosmetic and Aesthetic Course “Thank you Mr Paul Tipton, along with the entire team! Thank you for your dedication and delightful humour which made this challenging material an absolute treat! This course has made such a positive impact in my life, it has opened my eyes to new perspectives in my career. I would recommend this course to anyone who is serious about a career in the dental field”- R Drug-Ionescu, 2015

12 days approx 1 day per month 6hrs CPD per day Offer more complex cosmetic treatment options Keep more, high fee generating, work in-house Improve treatment results & earn more for your work

Enrol Now Starts May 2015 Manchester & London From £499+VAT per day*** ***Payment by direct debit

Fast track your MclinDent in association with

Discover more at

www.tiptontraining.co.uk

T: 0161 348 7848 E: enquiries@tiptontraining.co.uk

*15% of delegates questioned suggested their private income has at least doubled as a result of the aesthetic course. Source: questioned delegates from 2014 Cosmetic & Aesthetic Course

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PREPARING FOR MEDICAL EMERGENCIES IN THE DENTAL PRACTICE

David Howarth is Chief Executive of defibshop.co.uk, an online defibrillator distributor and AED / CPR and Medical Emergencies training provider, and has been involved with First Aid for over 25 years. General CPD: 15 minutes Learning how to deal with Medical Emergencies in the dental practice is a key part of any dental professionals training and is one of the four core CPD modules. It is highly recommended by many key professional bodies including the Resuscitation Council (UK) who state that “There is a public expectation that dental practitioners and dental care professionals should be competent in managing common medical emergencies”. More recently, the Care Quality Commission (CQC) have stated that: “Equipment for resuscitation or other medical emergencies is available and accessible for use as quickly as possible”. More importantly, the General Dental Council (GDC) has outlined the level of staff training they expect: “All members of staff, not just registered team members, [should] know their role if a patient collapses or there is another kind of medical emergency...all members of staff who might be involved in dealing with a medical emergency are [should be] trained and prepared to deal with such an emergency at any time” Medical Emergencies Response Training covers a number of vital topics to prepare your staff against the worst case scenario, including the use of an Automated External Defibrillator (AED). Having an AED on site at your surgery as well as having the right staff training are absolutely crucial to saving the life of a patient should they suffer a sudden cardiac arrest (SCA). Although there are currently no legal requirements to have an AED in dental practices, it is highly recommended by all the appropriate organisations and, if any kind of medical emergency did occur in your practice, it could lead to a member of your team being challenged if it is believed that having one could give a positive outcome, particularly if your practice differs from the guidelines set out by the GDC and Resuscitation Council.

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Background • SCA kills four times as many women as breast cancer • An estimated 60,000 people each year in the UK suffer an out-of-hospital cardiac arrest and, sadly, less than 10% of these people survive. • After suffering an SCA; survival chances drop by 7-10% for every passing minute. • Early and effective CPR can almost double a patient’s chance of survival whilst early defibrillation can triple it. • Many people who suffer an SCA show no prior symptoms of illness. Medical Emergencies Training The primary goals of Medical Emergencies Response Training are to increase the chance of a patient’s survival and give them the highest chance of making a full recovery. As a core subject, a minimum of 10 hours of each CPD cycle must be dedicated to medical emergencies training. A Medical Emergencies Response Training course typically lasts 6 hours and includes modules on: • The importance of early recognition of the critically ill patient •The cause of cardio-respiratory arrest • The ABCDE Approach • Chain of survival • Basic Life Support • Airway Management including the use of adjuncts, OP / Naso Laryngeal masks/ ET tubes • Ventilation of a patient using a face shield / pocket mask / bag valve mask • Emergency oxygen administration • Automated External Defibrillation & AED safety Having the right AED and CPR training is absolutely vital to saving the life of a patient who has suffered a cardiac arrest or cardiorespiratory arrest.The chance of surviving a cardiac arrest falls 10% every minute after the event and immediate treatment and resuscitation is vital.

Using an AED The AED algorithm as set out by the Resuscitation Council (UK) in their 2010 guidelines is as follows: • If the patient is unresponsive then call for help and check if they are breathing normally. • Call 999 immediately then send for or go and get an AED. • Until the AED is properly attached perform CPR on the patient in the ratio of 30 compressions to 2 breaths. • Allow the AED to assess the patient’s rhythm, if they do not have a shockable rhythm then immediately resume CPR then reassess the patient’s rhythm. • If there is a shockable rhythm (Ventricular Tachycardia or Ventricular Fibrillation), make sure no-one is touching the patient and deliver the shock. • Immediately resume CPR and reassess the patient’s rhythm. Continue this cycle until the patient starts to wake up, i.e. moves, opens eyes and breathes normally. Without proper CPR training this algorithm becomes completely useless. However, CPR is only a way of prolonging life after a cardiac arrest and cannot effectively treat it. Access to an AED is therefore also vital to providing any immediate treatment to a patient. Conclusion • The Resuscitation Council (UK) and GDC highly recommend that dental practices should be equipped with AEDs and that staff members should have gone through the appropriate Medical Emergencies Training • Whilst CPR is vital for maintaining a shockable rhythm, defibrillation is the only effective treatment for SCA • Having an on-site defibrillator can increase the chance of surviving a sudden cardiac arrest from 6% to 74% https://dental.cpdpro.org.uk dental@cpdpro.org.uk

Practice Design & Refurbishment

5 YEAR WARRANTY NOW AVAILABLE! UNIC Treatment Centres from Heka Dental are now available with up to 5 Years Warranty and with their exciting bespoke design options the only limit is your imagination! Take this recent installation in an Orthodontic Practice in Holland for example. With its dynamic colour scheme and layout it doesn’t look or feel like a Dental Practice it all. Just imagine how exciting it looks to its young patients and how relaxed they must feel as a result! What is more, because of the novel way the UNIC Treatment Centres have been installed it enables the Clinicians to operate in the most relaxed and ergonomic way possible, whilst simultaneously allowing the easiest access possible to the patients. It features traditional delivery systems, but with the cuspidors sited on the left rather than the more conventional right, 12 o’clock suction and ceiling mounted operating lights. Why not create something similar in your Practice? Available in a wide range of inspirational colours, Heka Dental’s bespoke UNIC Treatment Centres combine aesthetic beauty with state-of-the-art ergonomic efficiency. With their unique bespoke design capability, UNIC treatment centres can be built to individual specifications and are supplied with a fully comprehensive 12 month Warranty as standard plus an option for an extended 5 Year Spare Parts Warranty.

Anglian Dental on 01763 849990, DB Dental on 01484 401015, Eclipse Dental on 01322 293333; alternatively email either info@angliandental.co.uk, Info@eclipse-dental.com or sales@dbdental.co.uk or www.heka-dental.com. Why wait!

For further information on the complete range of Heka Dental equipment contact:

CASTELLINI – OUTSTANDING PRODUCTS AND SERVICE Castellini is dedicated to providing an exemplary customer service that complements the high-quality innovative dental units available. The renowned company strives for perfection in everything it does, from the unique craftsmanship and attention to detail achieved on every product to the dedicated training and support given to employees. Choosing and purchasing a dental unit is a huge investment for any dentist, and it must fit perfectly and suit both the individual and practice.

At Castellini you can rely on the experienced team to guide you through the whole process. With extensive product knowledge they can offer you the best advice and after-sales care. Furthermore, with sales and service centres throughout the UK, experts are always on hand to provide regular maintenance and support services. Castellini also offers free training to any service engineer to become accredited to work safely on their equipment. For products and services you can rely on turn to Castellini. If you want more information on how to receive Castellini Technical Accreditation, please call 08000 933975 and speak to Castellini UK Ltd directly for assistance

Clark Dental T: +44 (0)1268 733 146 W: www.clarkdental.co.uk E: info@clarkdental.co.uk

surgery, it comes in a variety of colours and finishes. What’s more, using Clark Dental’s unique 3D surgery design solution you can take a ‘virtual tour’ of your surgery prior to construction to ensure it’s the right design for you. When looking to update or renovate your practice, contact the experts at Clark Dental and ensure your cabinetry doesn’t let you down.

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A modern surgery needs functional cabinetry that doesn’t compromise on quality, and Clark Dental can make this a reality in your practice. Providing a selection of interior design options from the traditional Apex range to the contemporary Edarredo collection, Clark Dental ensures all your needs, both practical and aesthetic, are met. The Apex range offers an array of individual wall and base units, hand crafted to your specifications to make the most of your workspace whilst reflecting your practice brand and identity. Or choose the Edarredo collection for sleek, contemporary cabinetry designed for maximum efficiency and safety. Perfect for a space conscious

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CONVENIENT, CLINICAL CABINETRY

Look Sharper Dental Design Services with Create Consulting

Web Design brochure content and design exhibition design and planning advert design via print / digital / electronic html design â&#x20AC;&#x201C; email / digital brochures print handling & branding

e:emma@createconsulting.eu w:www.createconsulting.eu t:+44 (0) 1270 522132

Practice Design & Refurbishment

PLANNING A DENTAL SURGERY REFURBISHMENT

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2 - Choosing Equipment and ensuring good Ergonomics, more than just choosing colours When choosing your surgery layout and equipment, take time to make a prioritised wish list – speak to all of the associated staff - what you all expect from this room – draw on your experience of what has worked about the current room, and what has caused issue. This is usually subjective; don’t assume the Dental supply companies automatically know your list. There are many ways to design a room, but with your list can get the right solution without it costing any more. Do organise for the relevant staff members to try out the equipment, to discuss their ailments and issues with the designer so that the right format of equipment can be demonstrated, selected and put into practice. Options can be integrated in to the equipment and cabinetry layout to reduce clutter, improve the working environment, increase productivity and look sharp! To put it simply you may well use this equipment/ sit in this room layout on this chair for forty hours a week, so try it all out first before you buy it, make sure it’s right – it’s your chance to get it right.

20 stage Itinerary for a single surgery project: 1. Initial site meeting – to introduce those involved 2. Pull out the old equipment 3. Pull out the old cabinetry and flooring 4. Remove any unwanted layers off the wall 5. Plaster walls/ ceiling if necessary 6. Raise floorboards or channel flooring for services run 7. Run new services – electrics, plumbing and pneumatics 8. Services inspection meeting – to ensure all present and correct 9. Floorboards back down or back fill the channel 10. Decoration 11. Room lighting 12. Sub layer flooring 13. Final flooring 14. Cabinetry installation 15. 2nd fix of sinks and sockets etc 16. Equipment installation 17. Hand over meeting/ initial training 18. Final decoration 19. Meeting with builder for final snagging 20. 1-2 weeks after handover for further product and maintenance training

1 - Project Management - yourself or a specialist company? Whether you are planning just a refurbishment to a single surgery or to the whole practice, there are different ways of going about it – but always include a company capable of full Surgery Design. A poorly designed room will cause inefficiency and reflect badly on your practice. It is not impossible to achieve a great result whilst project managing the build yourself, but it can be hard work! There are many issues including choosing the right trades people, legislation with commercial buildings and with the Dental industry, logistics for the project and the duration. There will be a lot of learning involved to ensure the target is reached, ask your Surgery Design and Equipment Company to assist you where they can. It is possible to save good money by managing yourself, and using local tradespeople, but don’t be tempted by cutting necessary corners, though often the initial estimates of costs and duration go well over as many “unknowns” surface. To this extent, ensure you spend good time with your trades people discussing the exact service requirement early on – so that these unknowns are minimised. Delays with one of your trades may cause extra costs in last minute delays to you, or your other trades. By opting to use a reputable Turn-key company all will be taken care of for you but you can still be involved/ feel a part of your new surgery/ practice. The project management will be done for you ensuring the right surgery layout, equipment, service plans, experienced tradespeople, quality cabinetry, long lasting/ easy maintenance flooring etc. The initial cost for the full turn-key solution can appear more, but you will be assured that there are contingencies built in so that there will be no unknown costs passed on to you and that all will be completed on time with the minimum disruption to your business. By working with the same well-coordinated team, time and time again, the efficiency improves and this is the way to get the job done well and quickly, on time and on budget.

3 - Timing – Planning ahead to do it when it suits you Allow yourself plenty of time to work out the best solution for you/ your practice, as before, but within this time, if you are opting to project manage the refurbishment, work out the proposed itinerary with your dealer to establish a realistic duration for the works - you may be able to tie in this refurbishment with your staff holidays to avoid unnecessary surgery down-time. If one company manages the whole refurbishment then all the work can be done in less time, sometimes just a few days (it depends on the job in hand). As the whole team know each other well, coordination and timing are made simpler. It varies, but with self-management allow a few more days down-time in order to complete the works. 4 - Looking at legislation – Getting the right materials for the job. Discuss your project with your chosen equipment supplier; they will be able to advise you on the current legislation and how to include this within your chosen design. If you are project managing the refurbishment then ensure the chosen materials are suitable for the job and compliant – floors, cabinetry and even walls and ceilings – no grout, unsealed joins. Remember - bespoke cabinetry is usually more suitable than off-the-shelf type as it will create the right housing for your needs, create space by avoiding wasteful empty areas, and be of a Medical grade (easily cleaned and a higher level of moisture resistant properties). Medical grade flooring will have superior cleaning and slip resistant properties, can also lessen the risk of marking from your stools and can require less maintenance. The sub floor is equally important, using ply rather than hard wood on top of floor boards, and levelling screed on top of concrete floors. Do allow additional drying time for back-filled channels to dry, as well as the applied screed, this can be a good time for decoration.

Hague Dental offer one to one appointment and group classes in surgery design and refurbishment at their NEW Dental Practice Design Centre, near Gatwick. www.haguedental.com

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Pooling together his engineering, design and ergonomics experience, Jim Hague founded Hague Dental Supplies in 1996. The intention was to provide a top quality service, looking after customers with service support, well thoughtout achievable designs, full turnkey build projects and comprehensive aftercare. Here are Jim’s ‘Top Tips’ on how to ensure your surgery refurbishment runs smoothly and is designed with ergonomics in mind for the whole team.

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PUTTING YOUR BEST FOOT FORWARD.... HOW BEST TO UPGRADE YOUR PRACTICE It’s a fair question.Why invest in your practice and risk capital that you may not get a return on? Generally it will be because you want to safeguard your future or even take the practice more up market. If you are standing still then actually you are slowly and surely going backwards. Gavin Willis, Managing Director of Paradigm Design Solutions, explains the options available to you. Once you move out of ‘Needs Driven’ into ‘Desire Driven’ dentistry you are firmly in the retail sector. Other businesses in the High Street will be targeting your patients’ disposable income, strengthening their brand identity and energetically aiming their marketing efforts at them. Of course you can always justify your situation by saying ‘If it ain’t broke, don’t fix it’ but time is ticking and your best years are rolling slowly by whilst your earning capacity may well be at its peak. On the other hand, if you are confident that your practice is punching its weight in the market and you are happy that your earnings are as good as they can be for your circumstances then this article is not for you. If however, you feel there is more potential in the area you are in, or that you would like to increase your percentage of private patients, then read on. The importance of positioning and targeting Clearly positioning your practice and focusing on the demographic sector that is reachable by your practice are critical to attracting the appropriate patients. But if your ‘Shop Front’ and/or ‘Patient Journey’ through the practice do not accurately say what you want them to, how do you set about upgrading the image your practice presents and how do you best use your building and the position it is in? If you do decide you would like to lift your practice above where it is at the moment, essentially you have three alternatives that need to be considered carefully: 1. Redecorate, purchase a new reception desk and move the furniture about. 2.Take a fresh look at the whole practice and get professional help to use the space available to maximum effect. 3. Move premises. Let’s take a look at the pros and cons of each one of these.

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1. Redecorate, purchase a new reception desk and move the furniture about. This may buy you time and give the practice a lift; but whilst this is the least costly and the least risky, it can also be the least productive in actually repositioning the practice. So, concentrate on what the patient will notice. One practice we chatted to recently had undergone a massive revamp of equipment and put in the latest digital technology, chairs etc. Because they spent their budget on technology for the use of the practitioners and didn’t spend enough on revamping the image of the practice, they sort of missed the boat. Great to work in, but one comment from a patient put it all into perspective. When sitting in the new dental chair, bristling with technology and asked if they noticed anything different, they said, ‘yes, you’ve changed the colour of the mouth rinse!’ Primarily the equipment is there to treat the patients effectively; the public areas are there to reassure the patient they have come to the right place to invest in their smile. 2.Take a fresh look at the whole practice and get professional help to use the space available to maximum effect. Many dental practices are like un-pruned rose bushes. Potentially beautiful but needing some careful rationalisation. Most of the time, it will need an outsider to overcome the traditional ‘Oh that has always been there!’ or ‘We can’t do that - can we?’ But a word of warning…..whoever you choose, make sure they know what they are doing. There are lots of very talented interior designers and architects who can set the scene for you. They may confidently produce a mouth- watering ‘artist’s impression’, but how will it all look and work on a busy Wednesday afternoon during half term when the practice is flat out? Make sure the professional designer you choose understands the minutiae of the day-today function of the practice so the image doesn’t slip at peak times.

One of the key ways to smarten up the ‘Front of House’ is to change the function of the reception desk from a desk/office area/telephone call centre to just a ‘Meet and Greet’ position. You may have to be a bit creative with staff resources, but there are simple solutions to this. If you can achieve this, then it will significantly upgrade the patient experience at first point of contact. And, of course, you only get one chance to create a first impression. 3. Move premises. High street commercial property is very god value at the moment. Many dental practices are in converted housing stock which would actually be more valuable as a domestic residence. Put those issues together and it can be entirely possible and cost effective to create a new practice in shop premises nearby. The big advantage of doing this is that the new practice can be created and finished to avoid the mess and inordinately expensive downtime of refurbishing your existing practice. When the messy building works are done and it is time to occupy the new practice, just move across and put the old ‘house’ on the market. It is a good idea to get financial advice on this as your pension could play a big part of the structural funding for this expansion. As the economy improves, some practices are expanding by creating satellite squat practices in adjacent towns/villages to increase traffic to the hub that has specialist dental services available. Either way, the opportunities available in the commercial property sector are plentiful at the moment, so if the idea appeals, investigate the options as a priority. This situation will not last indefinitely. The ‘Holy Grail’ of course is to find a plot of land or a dilapidated commercial building that can be demolished and built on. If the chance presents itself, treat it seriously; take advice and if it ticks the boxes, grab it with both hands! Creating a bespoke landmark practice can set you up for life. Whichever way you choose, it is a fact that many dental practices in the UK are not making the best of the opportunities available to them.Take a fresh look at what can be achieved and you might just surprise yourself. www.paradigm-group.co.uk

“Since joining we’ve rebranded the practice and I can see the benefits of being associated with such a strong healthcare brand. Personally, it’s great to be able to concentrate on my clinical work and not to have to worry about day to day running of the practice, and of course it also means I’ve more time to spend with my family and pursuing other interests.” Dr. Lance Knight, Bupa Dental Centre Manchester

More and more dentists are choosing to become part of our growing national network of quality dental centres. Isn’t it time you left behind the pressures of running a business to focus on what you do best – being a great dentist.

If you’re thinking of selling your practice and would like to find out more about joining Bupa, please email practiceenquiry@bupa.com or call

07836 765054

bupa.co.uk/sellingyourdentalpractice All enquiries are treated in the strictest of confidence. *Lines are open Monday to Friday, 6am - 10pm. Call charges to mobile numbers may vary.

Tooth Whitening 44

WHITE SITE

Around one million people enter the words ‘teeth whitening’ as keywords into search engines every month and the whitening is considered to be the gateway treatment to entice potential new patients into dental practices. In fact research shows that 77 percent of people visiting a practice are concerned about yellowing teeth1and are interested in tooth whitening.

To capitalise on this burgeoning demand for information Philips Oral Healthcare - with its ‘most often requested’ Zoom! tooth whitening portfolio of chairside and take home products - has embarked on an extensive campaign of search engine optimisation to channel this interest and help searchers find an expert Zoom! provider near to their home or work . Philip Zoom! tooth whitening products offer the fastest way for dental practitioners to achieve results, with the best sensitivity and enamel protection of any professional whitening brand. This is thanks to the inclusion of its unique propriety Amorphous Calcium Phosphate (ACP) in its whitening gels. The Zoom! treatment protocol makes it possible to achieve a six shade elevation in one hour using the WhiteSpeed lamp to offer chairside whitening to those who want immediate results. This can then be augmented by convenient award-winning night and day time take home solutions which can be tailored to patients’ lifestyles. Enticingly Philips is offering the providers with whom they work the chance to sign up their practice to appear on its newly revamped tooth whitening website with its online Zoom! locator facility prominently featured on the home page: www.zoomwhitening.com/en_uk. With a massive number of untapped patients using the words ‘teeth whitening’ in their computer searches every month this service provides practices with an excellent opportunity to capitalise on a high level of consumer demand and drive new patients to their practice at no cost to themselves. www.philips.co.uk

A SENSITIVE SUBJECT For patients with hypersensitivity try Clinpro White Varnish from 3M ESPE. The optimised formula contains the fluoride and Tri-Calcium Phosphate (TCP) components naturally found in saliva that help to maintain strong teeth. Each dose contains the same amount of fluoride so you can always be sure of precision, unlike with tube dispensing systems. Not only does Clinpro white varnish relieve hypersensitivity, it is easy to paint on and turns white on application making it virtually invisible. Its enhanced flow characteristics also allow the product to reach interproximal areas with ease. Contact 3M ESPE today to try Clinpro white varnish for yourself. www.3Mespe.co.uk

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EVEN MORE TO SMILE ABOUT Offering tooth whitening to patients to enhance their smile and make it look even healthier can be a great incentive to encourage a good oral care regime. After professional tooth cleaning, including air polishing to remove calculus, Zaris White & Brite Tooth Whitening System from 3M ESPE is an excellent method of offering patients a whiter smile. Using a simplified tray technique and available in two concentrations of Carbamide Peroxide, Zaris White & Brite provides a safe method of enhancing patient smiles. Give your patients even more to smile about with Zaris White & Brite Tooth Whitening System from 3M ESPE. www.3Mespe.co.uk

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ANOTHER WAY Matthew Lloyd qualified from Leeds University where he won the Restorative Dentistry Prize in his final year. He has since worked in mixed practices around West Yorkshire and has recently completed 6 months working in an Australian hospital. Always keen to enhance his learning in dentistry, Matthew is currently undertaking an advanced restorative course with Tipton training. Elective cosmetic dental treatments are great profit boosters for any practice and more and more we are finding that patients are keen to go down a less drastic route. This is music to many dental practitioners’ ears, as we all want our patients to keep their natural dentition healthy. Profit booster Tooth whitening is also a huge hit with patients wanting a cosmetic fix. It works well as an add-on to other treatments and is a fantastic tool for outlining the benefits of a healthy smile. As a dental professional, you will only provide whitening to those who are at a certain level of dental health, so it can provide the incentive required to get your patients to work with you by taking more care over their oral hygiene in between appointments. The result is the smile of the patient’s dreams, while still reaching those important oral health goals; and that’s what we’re all working towards. The great thing about tooth whitening is that you can boost your profits by offering take-home kits so that patients can keep their smile topped up to maximum whiteness. Once you’ve carried out in-practice whitening, patients love having a product to maintain that beautiful bright smile, making these really easy sells. You could even build the kit into your whitening package price as an initial

bonus, but subsequently offer it as an extra once their first kit has been used. There are plenty of systems you can offer for home tooth whitening and most involve whitening trays, but there is now another way. Tooth whitening strips remove the need for trays, meaning you can now offer your patients a comfortable, tray-free method of gaining that whitening top up. Having a professional product like this available to buy directly from your practice is a great profit booster, as patients will come back time and time again to buy it. Winners Dissolving Teeth Whitening Strips from WhiteWash Laboratories are 6% hydrogen peroxide, meaning that patients can only buy these from their dentist. Having a professional strength product available for your patients will give them better results than whitening strips available to buy online, a real selling point for your practice.The fact that these strips dissolve mean it is infinitely easier for the patient to use, and they only need to wear them for 20 minutes – that’s shorter than their favourite television soap! Giving your patients the aesthetic smile that they crave while boosting your profits by selling professional products means everyone is a winner. Contact WhiteWash Laboratories today to find out more about Dissolving Teeth Whitening Strips. www.whitewashlaboratories.com

QUICKWHITE WHITENING SPECIALISTS SINCE 1992

Our revolutionary teeth whitening products are supplied by our professional and experienced staff, using the most up to date and advanced technology available. The procedure is entirely safe, non-invasive and the Diamond Whites LED system we use will give you the results you have always wanted. Following self-application of our cleansing paste, you will receive a self-administered pre-filled mouth tray

which is placed comfortably over your teeth. You will then have the use of our revolutionary LED Diamond Whites Light.The LED Light system soothes heals and de-sensitises at the same time as activating the product to achieve exceptional results. www.diamondwhites.co.uk

DIAMOND WHITES

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www.quicklase.com

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Quickwhite offer a variety of whitening kits such as, in-surgery, home and intenz kits, which are a combination of in-surgery and home. The home kits are available with either hydrogen peroxide 6% or carbamide peroxide 10% or 16%. The whitening syringes are large 3cc and very competitively priced, which means you get more for your money. In addition Quickwhite also provide different packaging options for their home kits, the professional whitening kit comes in a black sleek presentation box with a velvet insert to hold 5 syringes, and costs only £29! Making it the luxury patient kit at the most attractive price. Alternatively Quickwhite offer branded kits, these feature your surgery logo and details printed on the box free of charge, so you can promote your surgery not the whitening brand.These boxes are available with 5 or 10 syringes starting from £29 and additional empty branded boxes can be bought. Quickwhite provide offers on all their whitening kits, so the more you buy

the better the price! Quickwhite have been manufacturing teeth whitening for over 20 years, they have the knowledge and experience to provide reliable, effective whitening products, which are used in the UK and worldwide. The Quickwhite brand has become well known in the industry and is always in the forefront with new ideas to help dentists provide the best treatment for their patients.

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ICON: SEE THE LINDA GREENWALL VIDEO ON DMG’S UK WEBSITE Icon is DMG UK’s revolutionary treatment for incipient caries and carious white spot lesions …. without drilling! To find out how Icon can enhance your Practice and introduce a new revenue stream watch the Linda Greenwall video on DMG UK’s website uk.dmg-dental.com. Follow the link uk.dmg-dental.com/products/caries-infiltration/icon/ product/caries-infiltrant-smooth-surface/ Icon is an innovative caries infiltration therapy. It represents a breakthrough in micro-invasive technology that reinforces and stabilizes demineralised enamel without the need for drilling or sacrificing healthy tooth structure. The first product to bridge the gap between prevention (fluoride therapy) and caries restoration, Icon’s micro-invasive infiltration technology can be used to treat smooth surface and proximal carious lesions up to the first third of dentine. In just one visit Icon can arrest the progression of early enamel lesions and remove carious white spot lesions. Icon offers a simple alternative to the “wait and see” approach, enabling Dentists to offer an immediate treatment without unnecessary loss of healthy tooth structure. It prevents lesion progression and increases life expectancy for the tooth. Providing a highly aesthetic solution, carious white spot lesions treated with Icon take on the appearance of the surrounding healthy enamel. Total treatment time is about 15 minutes. For further information contact Rachel Moreland, DMG UK’s Icon and Flairesse Product Specialist, on 07854 725544 or rachelm@dmg-dental.co.uk

BRITE SMILE Teeth whitening is a world wide subject. Everyone understands the importance of having beautiful bright white teeth. BriteWhite Teeth Whitening System® is the newest, most exciting, and innovative, fastest and safest system in today’s teeth whitening market. The developer and manufacturer of BriteWhite Medical, specifically for the dentist, is Joyce Osborn Wilson, CEO, who theorized that LEDs would be effective in teeth whitening. She consulted with a scientist’s friend who provided LEDs for NASA. He confirmed her theories. This system is the first chair-side “inside-themouth” for the ultimate for Professional teeth whitening. BriteWhite Teeth Whitening System® treats the entire front and back teeth. A disposable barrier sleeve is applied over the high intensity Blue LED mouthpiece, whitening gel is applied to the teeth. The mouth plate is inserted directly inside the teeth without the aid of cheek retractors, rubber dams, or goggles.The machine is auto timed for a comfortable 20 minute treatment, without sensitivity to the teeth or gingival. BriteWhite is FDA cleared and US manufactured and their dedicated design, production and support team are committed to the manufacturing and marketing of quality and clinically effective systems.

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BriteWhite is easy to use, maintenance-free and portable; the BriteWhite Teeth Whitening System® makes a solid and profitable investment, with low overhead and high investment return. BriteWhite is the leader in teeth whitening. This is what everyone is looking for as teeth whitening continues to grow beyond the 15 billion dollar industry. BriteWhite Teeth Whitening ® is definitely the next generation for teeth whitening. It is safe, effective and affordable. info@britewhitesystems.co.uk www.britewhitesystems.co.uk +44 (0) 1633 415 325

Alternatively contact your local dental dealer or DMG Dental Products (UK) Ltd on 01656 789401, fax 01656 360100, email paulw@dmg-dental.co.uk or visit www.dmg-dental.com

The latest innovation…Blue LED kills the black bacteria that cause periodontal disease! Red LED boosts healing! No cheek retractors, rubber dams or goggles! www.britewhitesystems.co.uk

Made in the USA

BriteWhite whitens teeth whiter leaving the teeth beautiful, glossy white. Average 4—6 shades in just 20 minutes. No goggles or uncomfortable check retractors. Safe, affordable and effective. Just 20 minutes per application. BriteWhite’s unique global patent pending mouth piece is inserted directly against the front arches of the teeth preventing oxidizing of the bleaching gels, giving quicker results. NO need to purchase additional mouth pieces with the Disposable Barrier Sleeves for sanitation. Statistics show that 85% of people say the smile is the first thing noticed.

- Conforms to EU Legislation - FDA Approved - Zero Sensitivity - Instant Results

Revuline Limited Merlin House, Langstone Business Park Tel: +44 (0) 1633 415 325 | Fax: +44 (0) 1633 415 324 Newport, NP18 2HJ. Gwent, UK Email: info@britewhitesystems.co.uk | Web: http://www.britewhitesystems.co.uk

My Working Week 48 By Victoria Jones practice her spellings for the week. She’s ready for bed by 8pm and I then have two hours to myself before I head to bed at 10pm. Tuesday: We’re out of the house again by 7am and I start work at 9am. Today we have a new dental nurse starting with us, so after a morning of seeing patients I take her for lunch at our local meeting place. After lunch I go through her contract with her and various other paperwork before we head back to the practice. Once the afternoon finishes I am able to head straight home as Bethany is with her Dad this evening. I am waiting to exchange contracts on my house in anticipation of moving to Southwell to reduce my commute to Bethany’s school. So the evening is mostly spent sorting out issues in relation to that and planning my move. I stay up later than I should and am finally in bed by 11pm. Wednesday: The practice opens at 10am on Wednesdays so I don’t have to leave the house until 9am. I normally park slightly out of town so that I can walk in, which helps me get a bit more exercise than I would do otherwise. The working day is fairly uneventful with some hygiene treatments, an orthodontic retainer fit, a bridge fit and new patients and some recall appointments. At the end of the day I head over to see a friend who lives near town for a catch up. I leave about 9pm and am in bed for 10.30pm. Thursday: On Thursdays we start at 8am, so I leave the house at 7am. Again, a fairly standard day clinically; root treatments, denture impressions, recall appointments. After lunch I have a monthly review meeting with one of my new nurses who has now been with us for a month and we catch up with some issues that have cropped up since she started. In the afternoon we see some more patients before finishing at 4pm, as I need to travel to Southwell to pick my daughter up from afterschool club, before travelling home to Ruddington. We arrive home at about 6.30pm, complete the bedtime routine and I get an update on the stickers she received that day. Bethany is in bed by 8pm and I follow suit shortly after.

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Victoria Jones Dental Studio is a small boutique practice in the centre of Nottingham. Victoria also works as a local dental adviser for Dental Protection and was clinical manager in Nottingham Emergency Dental Service, Boots Dentalcare and The Dental Clinic before establishing her practice in 2008. Monday: Wake up at 6am, leave the house at 7am and arrive at my daughter Bethany’s school breakfast club in Southwell at 8am. It’s then a one-hour commute into town to meet engineers at my practice. We aren’t normally open on Mondays but my air conditioning broke down a couple of weeks ago and needs to be completely replaced. I’m based in a hairdressing salon and as that business is closed I have arranged to come and let the engineers in. I have some paperwork and treatment plans I need to work on anyway, so it’s not a problem. To break up the day I call a colleague and old friend and ask him if he wants to meet for lunch. As it turns out he’s meeting another mutual friend, so I join them and we enjoy a very pleasant extended lunch at the local Brown’s restaurant in Nottingham. After lunch I head back to the practice. The engineers have finished, so I lock up and head back to Southwell to collect my daughter from school. On the way home I bump into a good friend whose son started school with Bethany and we pop round to theirs for a cup of tea before heading back to Ruddington where I live. Once home I listen whilst my daughter reads her reading book to me and we

Friday: It’s World Book Day at my daughter’s school and Bethany wants to wear her ‘Anna’ Disney costume for the event. We hadn’t thought about her hair until this point, but a quick internet search reveals the style required and after a quick raid of the various hair accessories I manage to put something together that looks pretty good and Bethany is happy. We leave at 7am and I start work at 9am. I see patients in the morning and then I have yet another meeting booked over lunchtime. This time it’s with my accountant and we catch up on various issues. Once our meeting is finished I have a few more patients to see before leaving at 4pm to collect Bethany. Saturday: This is the first Saturday in seven weeks that I haven’t been working so I take a well-deserved rest by having a whole day with nothing booked to do and Bethany and I enjoy each other’s company. Sunday: We’re joined by a friend of Bethany’s from school and her mum. We have tea and cake in the conservatory while we watch the girls empty the shed in order to make it a pretend school. They write stories and then come and read them to us, before our guests head home for dinner at 5pm. Bethany and I then get ourselves ready for Monday morning and the week begins again! www.victoriajonesdentalstudio.co.uk

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