InDent 2015 by King's College London

InDent

A NEWSLETTER FOR DENTAL ALUMNI OF GUY’S, KING’S COLLEGE AND THE ROYAL DENTAL HOSPITALS | ISSUE 14 | JANUARY 2015

HELPING STUDENTS IN NEED

LINKS BETWEEN MOUTH AND MIND EDWINA KIDD: CARIOLOGY PIONEER

Dianne Rekow’s greeting

COVER PHOTOGRAPH BY ARNHEL DE SERRA

n behalf of everyone at the Dental Institute, I am pleased to present you with the 2015 issue of InDent. It is a pleasure to report that the Dental Institute notched up several achievements in the last year that are benefiting our students, staff and patients. As you’ll read on pages 14–15, we have refurbished multiple spaces at the Institute, which have improved the learning environment for our students and made their lives just a little less hectic. We also celebrated the completion of an off-campus construction project in 2014: the West Norwood Health and Leisure Centre.Years in the making, this new facility is providing our students with a fantastic opportunity to practise their clinical skills in a primary care facility, and it will strengthen their relationship with medics, which will further their understanding of the oral-system linkages in our patients. Members of our staff have logged countless hours working with King’s Health Partners, Lambeth Clinical Commissioning Group and Lambeth Council to make the centre possible, and I am immensely proud that the Institute is actively involved in this partnership. We’re constantly learning more about the linkages between oral health and our overall wellbeing, and our researchers are expanding our understanding into the importance of these connections. On pages 10 – 11, you can read about Dr Wael Sabbah’s research into whether poor dental care can accelerate cognitive decline. He is working with staff at King’s Institute of Psychology, Psychiatry & Neuroscience to determine if public health programmes can be harnessed to stave off mental health issues through improved dental care.

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hile the Dental Institute is a forwardlooking faculty, we believe it is important to honour those who paved the way for today’s achievements, and this year we are featuring Professor Edwina Kidd. Her pioneering work helped set the stage for much of the work we are doing today, such as Professor Nigel Pitts’s exploration of enhanced remineralisation, the work of our Tissue Engineering & Biophotonics Division, which is investigating ways to differentiate between active and inactive caries with implications into tooth preservation, and Professor Avijit Banerjee’s minimally invasive dentistry programme. I want to close by asking you to consider becoming a member of the Dental Circle, if you’re not already. Funds raised through the Circle support educational and research innovations and assist our students in many ways, including through our Hardship Fund, featured on page 7. The Circle is essential for the Institute to remain a world-leading academic and research centre.

NO MORE DRILLING?

It’s an idea that has captured the world’s attention

in January 2013 by Professor Nigel Pitts and Dr Chris Longbottom. Formed specifically to enable interdisciplinary collaborations involving innovative research and technologies to achieve maximum impact, this work on EAER is the perfect model. Research from St Andrews has been carried out in its School of Chemistry, whilst Abertay’s contribution is from work in 3D modelling within soil science – two disciplines ostensibly quite removed from dentistry. Reminova Ltd, co-founded by Professor Pitts and Dr Longbottom, is the Dental ITC’s first spin-out company. News of the device garnered worldwide media attention, with Professor Pitts interviewed by journalists from across Europe, the US and Australia. Four months on from the initial press release, it was still in the news. ‘We’ve been absolutely thrilled with the scale of the response, which is bigger than I’ve ever seen before,’ he says. ‘It’s been slightly crazy but it’s great that there is that interest. This has spread around the world, beyond the media. What’s reassuring is it’s not just dentists that are interested, it’s patients; and it’s not just dentists and patients, it’s also potential companies and investors. ‘This is not just a UK issue; the fundamentals are the same wherever you’re having that discussion. People, not surprisingly, don’t like having

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This has spread around the world, beyond the media

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A new pain-free remineralisation process enabling decayed teeth to repair themselves could soon be in use globally, thanks to work at the Dental Institute. The new technology, known as electrically accelerated and enhanced remineralisation (EAER), has evolved from several decades of research within King’s alongside three other institutions: the University of Dundee, the University of St Andrews and Abertay University – and it has already captured worldwide attention. The two-step method is delivered at the early to moderate stage of decay using a handheld device around the size of a highlighter pen. The device first prepares the damaged part of the enamel outer layer of the tooth through cleaning, then uses a tiny electric current to ‘push’ minerals into the tooth to repair the defect. The process has been described as providing a ‘time warp’, as the lesion is taken back in its time course and encouraged to self-repair. It will provide an alternative treatment to drills, injections and fillings, reducing the need for these invasive techniques, with the aim of eventually phasing them out entirely. Before dentists can put away their drills, however, there is the challenge of translating the science to practice, policy and product. The Dental Innovation and Translation Centre (Dental ITC) was launched at King’s

injections, they don’t like having drills and vibration. So if someone says there’s a possibility of having care that doesn’t involve that for you and for your children, it’s inherently exciting. That very simple core message seems to have struck a chord.’ Reminova is in talks to establish investment and development partnerships. As well as providing a kinder and more cost-effective way to treat dental caries – Professor Pitts says it should be cheaper than comparable methods – the same technique can also be used to whiten teeth in a way which is pain-free and doesn’t lead to sensitivity. With the possibility of similar technology and remineralising agents also being delivered in protective, over-thecounter products such as toothpaste and mouthwash, there are many avenues to explore. Thanks to the media attention and ongoing communication with interested parties, Reminova has been given ‘a range of choices’, says Professor Pitts, and its success could lead to more advancements at King’s. ‘We hope that this can be the first of a series of successes,’ says Professor Pitts. ‘We’re playing our part in a global dental world and rather than just be passive, we can be leaders in taking the bright ideas and the science from King’s and translating it into products, into policies, and really improving health and healthcare. That’s part of our mission.’ January 2015 | InDent | 3

SARAH LEE/THE GUARDIAN

Interviewed by reporters from across the globe, Professor Nigel Pitts says the idea of dental care without drilling ‘seems to have struck a chord’

Institute news

Two staff members garner major grants

wo Dental Institute staff members, Dr Abigail Tucker and Professor Jeremy Green, received prestigious research grants in 2014. Dr Tucker, a reader in craniofacial development, won a Wellcome Trust Senior Investigator Award to support her research to understand how the middle ear develops and how defects can impact the ear’s function. The award is expected to be worth £800,000 over five years. ‘The mammalian middle ear is an air-filled space lined by an epithelium and housing three small bones that conduct

sound from the ear drum to the inner ear,’ says Dr Tucker. ‘The project uses the mouse as a model and is an extension of our recent novel finding that part of the middle ear is lined by neural crest cells that undergo a mesenchymalepithelial transformation. Our aim is to identify the signals involved in this transformation and to understand the consequence of the dual origin of the epithelium for susceptibility to ear infection and the development of middle ear cysts, both major problems in the middle ear.’ Professor Jeremy Green

Professor Green received a £436,000 BBSRC Research Grant for his research into the bending of ‘a sheet of cells’, which is critcally important during the development of teeth and glands, including salivary glands. Genes control the embryonic development of tissues and organs of the body in the way that software drives a computer, says Professor Green. Researchers are beginning to understand ‘gene programmes’ written in the genome. However, much less is known about how genes drive the body’s physical shapes. To advance research into this field, the elaborate process of the body’s physical construction must be broken down into more easily analysed sub-processes.

ConsEuro coming to London

ing’s Dental Institute will host the ConsEuro 2015 conference, 14–16 May, in the Queen Elizabeth II Centre, close to the Houses of Parliament. This is the first time that the biannual meeting will take place in the United Kingdom. The theme of the conference will be the technologyenhanced dental care journey for patients and professionals and it will provide opportunities to explore the impact of technology on the practice and teaching of dentistry. The conference

is a collaboration between the Dental Institute, the European Federation of Conservative Dentistry, the British Society for Restorative Dentistry and the British Association of Teachers of Conservative Dentistry. Clinical presentations and scientific demonstrations will prove of great interest to general practitioners, specialists, dental teachers and researchers, dental students and all members of the dental team. There will also be several opportunities for hands-on training over the two days.

Some of the programme’s highlights include sessions on clinical advances in imaging, radiology and ‘smart’ bioactive restorative materials, e-dentistry and the impact and opportunities of technology on clinical dentistry. There will also be sessions on technologyenhanced learning and social media, looking specifically at the strengths and pitfalls in the dental profession. Please visit www.conseuro2015.com to view the conference programme and to register.

Pain management prize

rofessor Tara Renton and a team from Orofacial Pain Services at King’s College Hospital have won £10,000 for the top prize at the 2014 Grünenthal Awards, which recognise excellence in the field of pain management. Professor Renton and the pain management team received the award for their research into the development of artificial intelligence diagnostics for 4 | InDent | January 2015

orofacial pain. The prize money will help support their novel project on the development and assessment of artificial intelligence methods into diagnosing and managing patients with orofacial pain conditions. ‘Patients will complete specific questionnaires online via our website, which is under development for patients with orofacial pain,’ says Professor

Renton. ‘This will help streamline treatment methods for patients with chronic orofacial pain by highlighting those requiring urgent care and the type of treatment required by the patients, while also facilitating research into these conditions. The Grünenthal Awards recognise innovation and major advancements in pain management for patients.

Dr Abigail Tucker

One of these processes is the bending of a sheet of cells to make a groove or pit, which is how teeth and glands form. This is called ‘invagination’; it occurs in making the brain and spinal cord and its failure is a major cause of birth defects, such as spina bifida.

Getting creative at the Institute

rtist and designer Paddy Hartley has taken up residence at the Dental Institute as part of Creativeworks London’s Creative Entrepreneur-inResidence programme, which aims to develop partnerships between universities, creative businesses and cultural organisations. The Institute’s successful bid was led by Dr Ian Thompson, whose research focuses on dental biomaterials, and is supported by the university’s Cultural Institute. Hartley’s work interprets the experiences of First World War veterans who underwent pioneering facial surgery at the hands of surgical innovator Sir Harold Gillies. During the war’s centenary, he will work in partnership with King’s to build a network of institutions and individuals – from museums and galleries to writers and app developers – to develop and deliver a series of highprofile projects interpreting the stories of those whose faces were injured in the war, possibly including a digital graphic novel.

MSc in Minimal Intervention offered

he Dental Institute has launched the UK’s first postgraduate master’s programme in advanced minimum intervention dentistry. The concept of minimum intervention dentistry is a patient-centred approach to maintain lifelong oral health based on early detection and risk assessment of disease as well as minimally invasive treatment strategies, all designed to empower patients to take responsibility for their dental health. The Dental Institute is leading the way in this approach and provides this unique and comprehensive distance learning programme with a view to maximising the clinical and financial future of the

practitioner’s dental practice. ‘We’re proud to offer the first MSc in this exciting field, which has been developed in response to the dental profession’s push towards a minimum-intervention, preventive approach to caring for patients’ oral health,’ says Professor Dianne Rekow, Dean of the Dental Institute. ‘This innovative, three-year master’s programme is the first truly holistic, practice-based master’s degree to market,’ says Programme Director Professor Avijit Banerjee. ‘Practitioners will develop and enhance their knowledge and clinical skills in the practice of contemporary, profitable and entrepreneurial minimum interventional dentistry.’

Professor Avijit Banerjee, left, with Dean Rekow and Deputy Director Michael Thomas

Distance learning programmes continue to grow

tudents from 54 nations around the world, from Australia to Zimbabwe, are now participating in the Dental Institute’s broad range of distance learning programmes. In these popular programmes, online webinars are used as a method of conducting tutorials, seminars and lectures. Students

are also given the opportunity to listen, contribute and record the session from the comfort of their own home or work environment. Students can use online fora and social media networks to interact with each other as well as with their tutors and academics. The programmes are designed to meet a range of professional

development needs of dental practitioners, while preventing disruption to any family or work commitments. These distance learning programmes are extremely popular with mature female students. Most students still manage to complete their programmes with distinction because of the

flexibility offered by a virtual learning environment. International students also benefit hugely from the flexibility of distance learning programmes as they are given the choice to take examinations in their home country, with assessment centres in 150 countries.

Student news Society honours postgraduate

King’s student captures gold medal

ostgraduate student Fahd Saleh (below) has won the Royal Society of Medicine’s Odontology Section President’s Prize for best clinical paper. The prize, awarded annually, is open to clinicians at various stages of training who have qualified less than 12 years prior to the meeting.

It is awarded for either the best research paper or best clinical paper. Saleh, who studies periodontology at the Dental Institute, gave a presentation of his work, ‘The relationship between neutrophil numbers and Human Neutrophil Peptides 1-3 in Periodontal Disease’.

rishti Datta, who completed her BDS in 2014, captured the University of London Gold Medal for Dentistry. Each year, King’s and Queen Mary University of London (QMUL) nominate their top-performing students in finals examinations for this prize, which is awarded to the student who most distinguishes himself or herself in a series of oral exams. ‘Being chosen to represent the Dental Institute in the prestigious University of

London Gold Medal was an immense honour and pleasure,’ says Datta. ‘My achievement would not have been possible without the excellent teaching and state-of-the-art facilities at the Dental Institute. I will forever be grateful for the hard-working and dedicated staff who inspired me.’ Professor Mark Woolford, Associate Dean for Education, praised Datta as ‘a truly remarkable student’, adding, ‘It is especially heartening to win it for King’s after we let QMUL borrow it for a couple of years.’ January 2015 | InDent | 5

Alumni news

Dr Hitman: the first pro boxer-dentist

r Arthif Daniel (Dentistry, 2008), former honorary clinical teacher at the Dental Institute, has obtained his professional boxing licence with the British Boxing Board of Control, making him the first professional boxer-dentist. Dr Daniel is a general dental practitioner four days a week in Manchester and London. As a boxer he is known as Dr Hitman and trains at Amir Khan’s gym in Bolton and in Manchester. He has trained with Oliver Harrison, the former trainer of Amir Khan, but has now teamed up with Kevin Maree to launch his professional

Dr Arthif Daniel, aka Dr Hitman

Wilson elected

Remembering Alex Inglis

rofessor Nairn Wilson, former Dean of the Institute, has been elected President of the British Dental Association (BDA), and will take the helm of the organisation in May. The BDA is the largest professional organisation in dentistry in the UK, with an active membership of more than 20,000. Professor Wilson, who has served as President of the Metropolitan Branch of the BDA and is a long-standing member of the Association’s Health and Science Committee, will be the organisation’s 139th President, serving for one year. His responsibilities will include acting as a facilitator between the BDA’s members, elected officers and staff, and overseeing ceremonial activities. ‘I am delighted to have been elected President-elect of the BDA,’ says Professor Wilson. ‘ I hope, amongst other activities, to do more to enhance the image of dentistry, promote further improvements in oral health and increase awareness of the importance of oral health to general health and wellbeing.’

r Alex Inglis, a distinguished staff member for many years, died in September 2014, aged 77. He was the last in a line of outstanding King’s dental deans prior to the merger of the then-King’s College School of Medicine and Dentistry and the United Medical and Dental Schools of Guy’s and St Thomas’ (UMDS). Dr Inglis was appointed Head of the Department of Restorative Dentistry in 1983 on the retirement of Ivan Curzon. He served as Dean

DAVID TETT

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career. He has also trained alongside Floyd Mayweather at the world champion’s gym in Las Vegas, under the eyes of former world champion Eddie Mustafa Muhammad. ‘At the moment, I balance work with training. At a later stage I may have to reassess my current timetable according to my boxing,’ says Dr Daniel. ‘However, I love dentistry and would never like to leave it; I am as passionate about my dentistry as I am about my boxing.’ He first laced on a pair of boxing gloves at the age of eight. While focusing on his deep desire to work in dentistry, he continued training and

of Dental Studies at King’s from 1987 to 1998, when the merger with UMDS took place. At that stage, Professor Frank Ashley was the Senior Dean of the merged schools and became the first Dean of the new Guy’s, King’s and St Thomas’ Dental Institute (GKT). On Professor Ashley’s death, Dr Inglis became Dean of the merged schools and remained so until his retirement, at which time he was the longest serving dental dean ever in the United Kingdom. Dr Inglis’s management

taught boxing to his colleagues at the Dental Institute. He went on to teach undergraduate students in primary dental care one day a week under Professor Stephen Dunne, but stopped when boxing opportunities arose in Manchester. Dr Daniel says boxing is one of the best sports for getting in shape, and it instils both physical and mental discipline. ‘I would recommend that other dentists take up boxing to keep fit, rather than to compete,’ he says. ‘With the dentist’s lifestyle of prolonged sitting and so much emphasis on posture, boxing is a great help in burning calories and preventing back problems.’

style was based on charm, persuasion and loyalty. His achievements were immense. With staff working harmoniously on three sites, he helped establish the successful integrated five-year GKT undergraduate programme, introduced team training for undergraduates and championed distance learning, making King’s a leader in that field. He achieved all of this while balancing the books during a difficult phase in the evolution of the Dental Institute.

Staff, Class of 1974 honoured

Apologies

rofessor Moya Meredith Smith, Professor Peter Morgan and the Guy’s Class of 1974 were honoured at the Annual Dental Dinner in February. Professor Meredith Smith was named Alumnus of the Year. Currently Professor of Evolutionary Dento-skeletal Biology at the Dental Institute, she has been a leading researcher in two distinct fields of study – developmental biology and paleontology – and has become the international authority in the

In the autumn 2014 issue of In Touch, we erroneously listed Jennifer Harris (Guy’s, Dentistry, 1987) as deceased. We sincerely apologise to Mrs Harris, her family and her friends for the distress caused by this mistake.

evolution and diversification of skeletal tissues, proposing developmental models to explain the evolution of the teeth and jaws. Professor Morgan received the Alumnus Distinguished Service Award. Recognised internationally for his work in oral pathology, he has led the largest oral pathology department in the UK and has held a variety of posts over the years. The Guy’s Class of 1974 was honoured for having the largest turnout for Dental Alumni Weekend.

CALLING ALL ALUMNI

If you have news to share with your fellow alumni, please let us know. You can email alumoff@kcl.ac.uk or call +44 (0)20 7848 3053. January 2014| InDent | 6

HELPING STUDENTS IN NEED Professor Mark Woolford says the Dental Institute is seeing ‘more and more students in financial need’

problems in the family, such as illness or financial difficulties, or something as simple as the car they rely on to get to college breaking down.’ The sums of money granted range from a few hundred pounds to something rather more substantial. Last year, the fund paid a full year’s tuition fees for a student who could not receive money from his parents, who live in a war-torn country. More typically, the fund might cover travel or accommodation costs for a set period of time, so that students can get back on their feet. ‘We found out one student was sleeping in his car,’ says Professor Woolford. ‘His final examinations were coming up. As well as being cold and uncomfortable, it was very stressful for him. We found him

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This is a situation where a small gift can change someone’s whole life

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In times of trouble, even a relatively small amount of money can mean the difference between promising students having to give up their studies or completing their training and becoming successful dental professionals. For students who have exhausted all other options, and are in desperate need of funds to tide them over, the Dental Institute’s Hardship Fund can be little short of a lifesaver. ‘We’re definitely seeing more and more students in financial need,’ says the Institute’s Professor Mark Woolford, who helped establish the fund. ‘It’s not just tuition fees; the cost of living in London, and in particular transport, can be prohibitive. And, inevitably, students are sometimes faced with circumstances beyond their control – there might be

a place in a hall of residence and paid his first three months’ rent. He then found work and funded the rest of his time at the university himself.’ Cases may involve a family trauma of some kind. Professor Woolford cites a recent application from a student whose father – the family breadwinner – had died. ‘She was trying to survive on the £230 per month she earned from her Saturday job,’ he says. ‘Because she already had a degree, she was having to use her maintenance loan to pay her fees. She was desperate. In her letter she wrote, “I woke up this morning and there was no electricity in the house and a huge crack in the bath. I can’t live like this any more.” She was also contemplating skipping lectures to try to earn more money – that’s obviously a threat to her long-term prospects.’ A four-member panel reviews each case on its own merits, says Professor Woolford. ‘Funds are very limited, so we have to make a lot of tough decisions. Our guiding principle is always to do what we can to avoid losing that student.’ The Hardship Fund relies heavily on donations, something Professor Woolford is at pains to point out to those receiving help. ‘I always say to them, remember us when you’re a rich and famous dentist!’ he says. ‘The best way for people wanting to help is by joining the Dental Circle – there’s no restriction on spending capital that comes into the university via that route, so it’s a very direct way of helping our students. For anyone considering supporting us, I would say that our students are facing more pressures than ever before, and any help we are able to give them is appreciated beyond words. This is a situation where a small gift can change someone’s whole life.’ The Hardship Fund provides essential support to students with serious financial needs. Please make a gift to the fund to ensure that these young men and women can continue their studies. Call +44 (0)20 7848 3406 to learn more. January 2015 | InDent | 7

MICHAEL DONALD

The Dental Institute Hardship Fund is helping students in dire financial need and keeping them focused on their studies

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It’s essential that training in the later years occur in a primary care setting

dental service free of charge to all patients, students visit local schools to offer preventative advice. In particular, the initiative is helping the unemployed, vulnerable and less-privileged residents of the community gain access to dental care, which they might not otherwise receive. Dental students in their final year train at the academy fortnightly on a rotation basis and are supervised by experienced practitioners. Trainee dental nurses, therapists and hygienists also work and train there, benefitting from the integrated primary care setting. Students are gaining invaluable experience by treating members

ARNHEL DE SERRA

location. This partnership has recently been recognised for its innovative approach by being shortlisted for an HSJ Award (Health Service Journal) in the ‘Improved Partnerships between Health and Local Government’ category. The Dental Institute moved its renamed Maurice Wohl Dental Academy to the centre to expand its training facilities, which now consists of 12 dental surgeries, where final-year students offer free dental care to members of the public. There is also a community special care service, comprising two dental surgeries, offering dental care to local residents with special needs. As well as providing this outreach

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The West Norwood Health and Leisure Centre has been three years in the making, but on 8 September the doors of this exciting new fitness and health centre finally opened. Spacious, bright and airy, the building is situated in the heart of a culturally diverse south London suburb, with a local park, tube station and bustling high street on its doorstep. The centre is the product of a highly successful collaboration between King’s Health Partners, Lambeth Clinical Commissioning Group and Lambeth Council, and provides local residents with a facility to meet their health and fitness needs in one accessible

PART OF THE

COM King’s students are providing care

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The new centre in West Norwood, opposite, brings together healthcare services and fitness facilities; left, students at West Norwood provide care for local residents; below, Dr Igor Blum

of the local community in an environment that mirrors conventional dental surgeries. The academy also has the individual treatment rooms found in most conventional surgeries, which is unique compared to other training facilities. ‘The set-up makes the transition process from dental school to dental foundation training as smooth as possible for students and improves their confidence once they have qualified,’ says Dr Igor Blum, Consultant/Honorary Senior Lecturer in Restorative Dentistry and Director of the academy. Professor Stephen Dunne, Maurice Wohl Chair in Primary Dental Care and Advanced Dental Practice, says, ‘The vast majority of dental students will qualify and leave to work in primary care. ‘However, much of the early training occurs in a dental school or hospital secondary care facility,’ he adds. ‘It is therefore essential that training in the later years occur in a primary care setting. In addition, the opportunities for working with the medical practitioners in the provision of whole patient care are unprecedented.’

of whole-patient health,’ says Professor Dunne. ‘The dentists will screen their patients for common health problems such as diabetes, smoking, alcohol use and obesity and direct patients to the medical facility, as appropriate, while the doctors will direct patients with oral or dental problems to the dentists and promote oral health measures.’ Most importantly, patients are receiving vital advice and treatment to prevent dental disease in the future. In the long term, the new training facility allows students to develop and expand their skills and experience in a real-life environment.

Fergus Daunall, a final-year dentistry student, says he is enjoying his current rotation at the academy and has been ‘impressed with the training facilities’ and those offered in the leisure centre. As well as the dental services, members of the public and staff have access to a 25-metre pool, a fitness suite with 100 work stations and a dance studio, local GP medical practices and other Guy’s and St Thomas’ Trust medical services, a Lambeth Council customer service point and community room. Many students choose to go for a swim during their lunch break. ‘The community now has the opportunity to coordinate their medical, dental and leisure activities,’ says Professor Dunne. ‘Customers in the leisure centre will be exposed to general medical and dental health promotions, while dental and medical attenders will be encouraged to use the leisure facilities,’ he says. Though it has only been open for a few months, feedback from students, staff and the community has been very encouraging. ‘The medical and dental facilities are collaborating on the promotion

MMUNITY through an innovative partnership

January 2015 | InDent | 9

LINKS BETWEEN MOUTH AND

MIND

For some older people, visits to the dentist may not be a priority as they struggle to cope with the problems that accompany ageing. Illness, increasing frailty, anxiety about mobility and financial worries can deter them from seeking regular dental care. Unfortunately, the effects of not visiting their dentist regularly are not limited to oral pain and discomfort. Observational studies carried out at King’s and other research centres show a clear link between poor oral health and a decline in cognitive function. Now the Dental Institute is launching the first study in the UK to show that interventions as simple as repairing dentures or replacing lost teeth could have a positive impact on mental wellbeing. ‘The pain resulting from cavities, loose teeth or periodontal disease can affect an older person’s ability to eat healthy food, like fresh fruit and vegetables, and benefit from the essential nutrients that maintain cognitive wellbeing,’ says Dr Wael Sabbah, Senior Lecturer in Dental Public Health, who is leading the study. ‘We are proposing to restore their dental function by performing routine procedures such as filling cavities, removing loose teeth and repairing dentures.’ Initially, Dr Sabbah’s team will carry out a pilot study using a sample group of people aged 65 and older drawn from south east London. As a baseline, the patients will complete 10 | InDent | January 2015

a short questionnaire that assesses memory, recall and problem-solving and can detect changes in cognitive function over a short period of time. They will then complete two more questionnaires at regular intervals during the 18-month treatment period. For this part of the project, Dr Sabbah is collaborating with the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), another faculty of King’s, based at Denmark Hill. ‘Colleagues at the IoPPN will be helping us to put together an appropriate questionnaire and interpret the findings,’ says Dr Sabbah. ‘The pilot will cover a wide variety of people and collect data on socio-economic factors as well as other health-related behaviours, including physical activity, alcohol intake and smoking.’ With an ageing population, this type of research is vital, he says. Ironically, the problem of maintaining oral health in old age has resulted partly from the huge improvements in

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Investing in this area could bring about significant improvements in people’s wellbeing

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SUKI DHANDA

Dr Wael Sabbah is exploring whether regular dental care can improve the mental wellbeing of older people

dental care over the last 50 years or so. ‘Older people now have more teeth than they used to have,’ says Dr Sabbah. ‘The common practice used to involve removing many or all of the teeth and using dentures. So these days there is actually a greater incidence of decay, tooth mobility and periodontal disease.’ He hopes that tackling these problems with practical interventions will provide evidence for the wider benefits of better dental care for older people. ‘Currently, the issue of oral health and old age is a priority for research and policy. Investing in this area could bring about significant improvements in people’s wellbeing.’ After practising as a dentist in Egypt, his home country, and then Canada, Dr Sabbah moved into epidemiology research, working at UCL, the University of Toronto and finally Oregon Health and Science University before joining the Dental Institute in 2013. His research feeds into public health programmes that aim to change behaviour, and he is fascinated by the complex interplay between social factors – such as poverty, ageing and mental health – and the choices an individual makes that affect their health. ‘Taking the right action to maintain good health, including regular trips to the dentist, is not always a simple choice as there are so many other factors that affect our behaviour.’

Children’s oral health suffers when mothers are under stress Young children can’t visit the dentist or even brush their teeth alone. With parental support playing such a large role, observational studies under way at the Dental Institute show a link between poor oral health in children younger than five and chronic stress in mothers. ‘If a mother is stressed at work or at home over long periods of time, there is usually an impact on how she raises her children,’ says Dr Wael Sabbah, who is carrying out the research. ‘It can affect how she feeds them – for example, they may have more sweets or sugary drinks to pacify them – and dental hygiene may be neglected.’ Working with other clinicians, Dr Sabbah can gauge a mother’s allostatic load, which is the wear and tear on the body caused by repeated and chronic exposure

Many factors combine to make this happen

to stressors, by measuring secondary markers such as high blood pressure, central obesity, low HDL cholesterol and high plasma glucose. ‘Under stress, the body repeatedly releases chemicals such as cortisol and adrenaline, which wear down the immune system over time,’ he explains. Dr Sabbah believes that this type of research shows the need for dentists to take the social determinants of health into account. ‘We don’t see all the factors influencing the mother,’ he says. ‘The stress she suffers could mean that she simply doesn’t have the mental energy to make sure her children brush their teeth. ‘It is important that dentists work together with other clinicians to show the links between dental health and growing problems like stress, diabetes and obesity.’

January 2015| InDent | 11

LONDON METROPOLITAN ARCHIVES, CITY OF LONDON

Trailblazer

EDWINA KIDD: CARIOLOGY PIONEER She helped change how an entire profession cares for teeth

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Wanting to work with her hands, Professor Edwina Kidd chose a career in dentistry, qualifying at the Royal Dental Hospital in 1967. Her school friends suggested she might prefer teaching to dentistry, and that’s exactly what she eventually did, becoming a professor of cariology. Those decisions, however, may have been the only times during her career that Professor Kidd followed a traditional route. She not only became a professor, she was England’s first professor in clinical dentistry and she emerged as an international leader in the field of conservative dentistry. Her contributions to the study of cariology are numerous: she has published extensively in research journals, with more than 100 papers to her name, and is the author of three well-known and respected undergraduate textbooks. ‘I was just one of several people worldwide who pushed for conservative dentistry to be seen as part of the science of cariology,’ she says. ‘In Scandinavia at that

Professor Edwina Kidd, below, sitting by the hotel that now inhabits the former Royal Dental Hospital in Leicester Square; far left, Royal Dental as it looked half a century ago

a rewarding career. In addition to lecturing internationally, she co-edited, with Professor Ole Fejerskov, the textbook Dental Caries, which is now used worldwide. In recognition of her achievements, the American Academy of Operative Dentistry last year presented her with the Hollenback Memorial Prize at its annual meeting in Chicago. ‘This is my Oscar!’ says Professor Kidd. Like most Royal Dental alumni, she has fond memories from her time at Leicester Square. She remembers free tickets to the theatre, the common room with a sprung dance floor (the former Ciro’s, frequented by the Prince of Wales and Wallis Simpson) and the Golden Egg, which was one of the first restaurants in London to offer hamburgers topped with a fried egg. ‘Leicester Square was an amazing site for a dental school,’ she says. ‘The world walked through that square and into the hospital with toothaches – duchesses to call girls, city slickers to market traders!’

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There is no other way to teach conservative dentistry but to base it on the science of cariology

JULIAN ANDERSON

on extracted carious and filled natural teeth’. Her teaching involved removing an appropriate amount of caries and then restoring. But she mainly wanted her students to stop the caries by preventative treatment. Professor Kidd had to work against the traditional treatment of dental decay, which was to fill a tooth. ‘Tooth-filling mends holes,’ she says. ‘But more important than that is the nonoperative approaches of encouraging twice-a-day cleaning with fluoride toothpaste and a low-sugar diet. It is this, not the fillings, that is the treatment of caries.’ One of the challenges she faced when teaching at Guy’s was the points-system, which only awarded students points for fillings, but not for preventive treatments. So she came up with a different system and also began awarding students points for every tooth not filled – the intellectual decision to treat preventively. Professor Kidd says she has enjoyed

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time [the 1970s], there were no departments of conservative dentistry or restorative dentistry as there were in the UK, but rather departments of cariology. These were the trailblazers and I was meeting them at research conferences in Europe. Once this becomes your attitude, there is no other way to teach conservative dentistry but to base it on the science of cariology.’ ‘I took this attitude from the London Hospital in Whitechapel to the Royal Dental Hospital in 1976, when I was appointed senior lecturer, and then to Guy’s in 1982.’ Championing such a novel approach required her to convince colleagues and students of its advantages. Professor Kidd was given her own group of junior students at Guy’s and was allowed to take an innovative approach in teaching them. The main difference in her approach was ‘to teach about the disease, dental caries, and teach cavity preparation and restoration – where holes required mending –

January 2015 | InDent | 13

WORLDCLASS FACILITIES Students, staff and patients are all benefiting from a series of renovation projects at the Dental Institute

A new Academic Centre, vastly upgraded clinical facilities and a colourful, friendly dental centre for children – opening one of these in a year would have been a major achievement, but the Dental Institute managed to complete all three projects in 2014. Guy’s and St Thomas’ NHS Foundation Trust made these renovation projects possible with a £6.2 million investment that clearly demonstrates its support of dentistry and the importance of re-investment in its stakeholders. As a result of these refurbishments, students, staff and patients are enjoying world-class facilities that reflect the Institute’s internationally renowned reputation. Thanks to refurbishments to the 18th floor, the Academic Centre now has a home within the Tower Wing at Guy’s Hospital. It is a welcome change of location that means students no longer have to navigate down lifts, across the quadrangle and into another building to complete basic administrative tasks. The centre has a light, welcoming reception that also serves as the place for 14 | InDent | January 2015

Student Deepak Singh-Aulak reviews a patient’s dental history, left, and provides care in the renovated 26th floor clinical facilities

students to hand in coursework, or meet with staff in the adjoining meeting room. Staff members are able to work more cohesively now that the Academic Centre team are in the main hub of the Institute, making for a more efficient and unified work environment. Hirra Kirmani is in her fourth year studying dentistry at the Institute and is a frequent visitor to the 18th floor.

‘It is very bright and welcoming coming onto the floor now; it’s like it has had a facelift,’ she says. ‘It was sometimes difficult to get to Henriette Raphael House in time to use the Academic Centre services. It is better now having the entire Dental Institute in one place and makes the experience as a student more joined up.’ Undergraduates are now practising

MICHAEL DONALD

Orthodontic services are also based in the new unit and are available to adults as well as children. The Dental Centre (Children’s Dentistry and Orthodontics) opened in October, sporting bright colours and cheerful artwork in the theme of ‘Visiting London’ throughout. Scenes include the London Eye and deer from Richmond Park on the walls and, perhaps more importantly, on the ceilings. With these services moving from the Tower Wing, space was freed for yet another refurbishment project, which has seen the 22nd floor transformed into a dedicated postgraduate centre. For the first time ever, the Dental Institute has a unit solely for postgraduate study, allowing students to work and learn from their restorative specialties and orthodontics together. One further addition to the Tower Wing is the Oral Clinical Research Unit on the 25th floor. A team with extensive research experience is based there, available to provide advice to researchers and support for the whole life

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We aspire to be worldclass. Now we’ve got the facilities

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their skills in state-of-the-art clinical facilities on the 26th floor, thanks to an £800,000 project that included the installation of 21 dental chairs in an open-plan suite, and the addition of new dental surgery equipment, allowing for students to learn in the optimum environment. Patient response has been positive, with the facilities being ‘overwhelmingly praised’, according to Professor Avijit Banerjee, Head of Conservative and Minimum Intervention Dentistry. ‘Having been part of Guy’s and now King’s for 27 years, man and boy, it is energising to be a part of the system that is responsible for instigating change and evolution in the delivery of education to our undergraduates and the quality of patient care to those who seek the best clinical management the NHS has to offer,’ says Professor Banerjee. Following the undergraduates’ move from St Thomas’ to study in the Tower Wing’s new facilities, space was available for children’s dentistry to consolidate in a new unit at St Thomas’ near to Evelina London Children’s Hospital.

of each clinical trial, from funding applications to maintaining data. The Student Care Clinic on the 25th floor was also refurbished with 30 new chairs and associated facilities. Associate Dean for Education Professor Mark Woolford believes the new learning environment rivals the facilities of any dental school in the world. ‘We aspire to be world-class. Now we’ve got the facilities, which really are as good as it gets,’ says Professor Woolford. ‘We’ve always had the staff, we’ve always had good students, we’ve had a nice location and now we’ve got the facility. It was never bad, but it’s just fantastic now. It’s as healthcare should be.’ Reflecting back on when she chose to study at King’s, Kirmani says she made her decision based on the high calibre of staff, friendly students and the facilities. ‘Now many years later, I am still so inspired by King’s,’ she says. ‘I think the Dental Institute continues to better itself and be at the forefront of dental education in the UK and I am so proud to be a student here.’ January 2015 | InDent | 15

Calendar

Events

Reunions

Postgraduate Open Evening

Reunite at the Dental Dinner

Date: Tuesday 27 January 2015 Venue: Guy’s Campus Details: Alumni who are considering a

The Annual Dental Dinner during Dental Alumni Weekend provides the perfect occasion to reunite with classmates and friends, whether you graduated last year or 50 years ago. If you graduated in a year ending with a 0 or a 5, then this is a special anniversary year for you. Renew old friendships, embrace new ones and reminisce about your uni days whilst enjoying a champagne reception and a three-course meal. The Alumni Office can prepare special tables, provide commemorative gifts and will also present an award to the largest reunion group. If you would like to get your classmates together for a reunion at the dinner, or even if you have already started making plans, we would be delighted to hear from you. Simply email reunions@ kcl.ac.uk or call +44 (0)20 7848 3053. Date: Friday 6 March 2015 Venue: Grange Tower Bridge Hotel Details: Tickets for the dinner are £65 per person (£50 for classes 2009-14).

return to university for a postgraduate degree or PhD are invited to this open evening, to be held from 17.30 to 20.00, to meet with academics who can provide advice and insight into the Dental Institute’s postgraduate offerings. For more information, please email openday@kcl.ac.uk

Dental Alumni Weekend 2015 Date: 6-7 March 2015 Venue: Hygienists and therapists’

specialist section meeting at Guy’s Campus; Annual Dental Dinner at the Grange Tower Bridge Hotel; Clinical Day and Dental Alumni Association AGM at New Hunt’s House, Guy’s Campus Details: Dental Alumni Weekend brings together professional development and social opportunities for alumni and friends of the Dental Institute. This year, we are delighted to offer four core CPD workshops at Clinical Day, along with the chance to reunite with classmates and network with leading names in dentistry – all in one weekend!. The full programme can be found in the Dental Alumni Weekend brochure or online at www.alumni. kcl.ac.uk/dental2015 The weekend’s organising body is the Committee of the Dental Alumni Association. All alumni are invited to attend the association’s AGM on Saturday. To learn more, contact Suzie Moore, c/o Alumni Office, First Floor, Virginia Woolf Building, 22 Kingsway, London, WC2B 6NR, or email suzie. moore@kcl.ac.uk

Dental Alumni Weekend: reunite, reminisce and take advantage of the professional development opportunities

KCLA Address Date: Thursday 12 March 2015 Venue: The Royal Society Details: All alumni are invited

to the fifth annual KCLA address. Diana Garnham (War Studies, 1979), Chief Executive of the Science Council, will give a talk entitled ‘Is Science winning the argument?’ Email alumoff@kcl.ac.uk to register.

Alumni Weekend 2015 Date: 12-14 June 2015 Venue: Multiple locations Details: King’s 12th annual Alumni

Weekend will feature lectures, tours and entertainment for alumni from all years, faculties and merged institutions. This year’s theme is Happiness is… For more information, please visit alumni.kcl.ac.uk/events or email alumoff@kcl.ac.uk

The Guy’s Class of 1999/2000 will meet on Friday 6 March, during Dental Alumni Weekend. To learn more, email us at reunions@kcl.ac.uk or call +44 (0)20 7848 3053. When booking, please let us know you want to be seated with a reunion group. Calling all 2016 reunion leaders!

Royal Dental Hospital Alumni Association

We are missing email addresses for many RDH alumni. To stay in touch, please contact the Alumni Office with your current email address; email us at alumoff@kcl.ac.uk or call +44 (0)20 7848 3053. The next RDH alumni luncheon is set for 10 October 2015.

InDent Editorial team: Louise King, Publications & Information Officer, Dental Institute, louise.king@kcl.ac.uk James Bressor, Deputy Head, Print & Editorial, james.bressor@kcl.ac.uk Designed by Esterson Associates Tel +44 (0)20 7684 6500

16 | InDent | January 2015

Guy’s Class of 1999/2000

If you graduated in a year ending in a 6 or a 1, now is the perfect time to start planning your reunion celebration during Dental Alumni Weekend 2016, scheduled for 4-6 March. The Alumni Office can support your reunion by providing your classmates’ contact details, sending out a ‘save the date’ message on your behalf in October and advertising your reunion via our website and social media. To start planning for your reunion in 2016, email reunions@kcl.ac.uk or call +44 (0)20 7848 3053.