Modern Dentist Magazine Issue 7

Issue

07 ISSN 2515-6128

MASTERING DIGITAL MARKETING Shaz Memon, Digimax Dental

Dentistry is on the move, literally!

Jessica Emery, The Mobile Dentist Company

RECEPTION SERVICES

Glenys Bridges, Glenys Bridges Practice Pathways

Treating dental anxiety at Dental Excellence Harewood

Key contributors to this issue

Donald Sloss, Dental Excellence Harewood

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Welcome You’ve probably heard the phrase, “you never get a second chance to make a good first impression”. Well, when it comes to your dental practice, a potential patient’s first impression is crucial and will often determine whether they become a permanent patient or not.

Everything about their initial contact with your practice should be perfect in order to encourage them to keep coming back. This edition is all about making that first impression a good one and making sure that your patients have a comfortable and positive experience at your practice. Glenys Bridges CMIPD, Glenys Bridges Practice Pathways Ltd, discusses the important of reception services and how the reception area is the ‘shop window’ of your practice and the driver of business service. Patient focus is the most visible at the front of house and this needs to be more readily recognised as an important place to build patient trust and loyalty.

Part of making a great impression is mastering your digital marketing because websites are becoming the first point of call for the public when sourcing practices. Shaz Memon, Owner and Creative Director of Digimax, and its arm Digimax Dental, helps practices to stand out and grow using their online presence. His interview discusses why online is the way forward in order to attract and retain patients. We also have interviews with Fiona Ellwood from the Society of British Dental Nurses and Michael Clarke, Chairman of the Federation of London LDCs.

team? David Wright BDS, Wright’s Dental, discusses his experience of using Isopharm’s Enhanced CPD training and why an e-learning platform is the perfect fit for his practice. Dr Kev Patel, Bond Dental, explains why he chose Digimax Dental to help create and establish his brand online, and Mark Woodger, a former practice owner, gives some advice for selling your dental practice and why he decided to use PFM Dental. We also have Dr Anh Ky To, Principal and Dental Surgeon at Blueberry Dental, discussing his latest challenge: the Marathon Des Sables, and why he is taking his Sleepwell device from S4S with him.

And as always, we have our panel of experts featuring their columns on the editorial board. I hope you enjoy this issue, and if you have any comments or feedback, then please do get in touch via the details below.

Poppy

Poppy Green Co-Editor, Modern Dentist Magazine 01765 600909 | @Modern_Poppy poppy@charltongrant.co.uk | www.moderndentist.co.uk

In this edition we also have our special product review section, dedicated to providing you advice on everything from selling your practice to your CPD requirements. Wanting to enhance your

Editorial Contributors Bill Carr

Kat Michaels

Dr Richard Brown

Chris Webb AMCIPR

Kelly Saxby

Rob Griffin

Heidi Marshall

Mark Barry

Sophie Kwiatkowski

Issac Qureshi

Mike Hughes

Jim Lister

Nathalie Smets Marketing and Sales Country Manager Ancar

Associate Director Medifinance Director Precision PR Partner Dodd & Co

Director Ogilvy & Haart Partner BLM Law

Deputy Head of Teaching Tempdent Recruitment & Training Managing Director Green Apple Dental Recruitment Limited

Parrys Lane Dental Practice and Bupa Dental Care Geo Orthodontics Business Owner Aspired Finance Accountant PFM Townends LLP

Director ESM Digital Solutions Principal Dental Practice Consultancy Service

Co-Editor - Poppy Green, poppy@charltongrant.co.uk Project Manager - Amanda King, amanda@charltongrant.co.uk

Modern Dentist Magazine is published by Charlton Grant Ltd ©2019

All material is copyrighted both written and illustrated. Reproduction in part or whole is strictly forbidden without the written permission of the publisher. All images and information is collated from extensive research and along with advertisements is published in good faith. Although the author and publisher have made every effort to ensure that the information in this publication was correct at press time, the author and publisher do not assume and hereby disclaim any liability to any party for any loss, damage, or disruption caused by errors or omissions, whether such errors or omissions result from negligence, accident, or any other cause.

Cover Shot

Courtesy of Shutterstock

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Modern Dentist Magazine

ModernDentistMagazine

Contents

07 14

Mastering digital marketing

31

Reception services the shop window of your practice and the driver of business success News

Reception services - the shop 07 window of your practice and the

driver of business success

Patient focus and procedural competencies are most visible at the front of house, which is why our reception services need to be at the top of their game. Glenys Bridges, Managing Director, discusses customer service approaches and why we need to recognise the reception area as an important place to build patient trust and loyalty.

Interviews

10

Recognising the dental nurse

Established with the dental nurse in mind, the Society of British Dental Nurses (SBDN) are a not-for-profit organisation who are acknowledging the challenges facing dental nurses and encouraging them to collectively come together and share their voice. Modern Dentist spoke to Fiona Ellwood, Patron of the Society, about how the SBDN will be driving the profession forward and acting as a space specifically for the dental nurse.

14 Mastering digital marketing

In this issue of Modern Dentist, we hear from Shaz Memon, Owner and Creative Director of Digimax. Digimax Dental, an arm of Digimax, helps practices to stand out and grow in an increasingly competitive market. We spoke to Shaz about why he set up Digimax Dental but also why it is important for practices to have an outstanding online presence in order to attract and retain patients.

4|Modern Dentist Magazine

18 Regional Focus: London

Modern Dentist’s Regional Focus examines London, and we spoke to Michael Clarke, Chairman of the Federation of London LDCs, about the challenges currently facing dental professionals in London, how the region’s LDC is attempting to address these and what the future holds for Greater London’s dental sector.

Editorial Board

23 Making Tax Digital is coming…

Sophie Kwiatkowski, PFM Dental Accountancy

is the impact of a 23 What beautiful smile?

Kat Michaels, Tempdent Recruitment & Training

25

What is on the horizon for employment law?

Jim Lister, BLM Law

25 Shareholder protection

Mike Hughes, Dental Practice Consultancy Service

27 Building and retaining a team

Dr Richard Brown, Parrys Lane Dental Practice and Bupa Dental Care

can a specialist dental 27 What accountant do for your practice?

Heidi Marshall, Dodd & Co

First impressions count

29 Kid’s Club – dental care for children Tax Digital: 29 Making what you need to know Nathalie Smets, Ancar

Issac Qureshi, Ogilvy & Haart

31 First impressions count good are your human 31 How resources?

Bill Carr, Medifinance

Kelly Saxby, Green Apple Dental Recruitment Limited

33 File away the filing

Chris Webb AMCIPR, Precision PR

Features

– 34 Toothbeary working with children

Toothbeary is a unique, London-based dental practice designed specifically for children aged 0 – 18; the atmosphere is relaxed, positive and child-friendly, yet incorporates the highest standard of individualised paediatric dental care.

Over the past 10 years, Toothbeary has successfully treated over 15,000 children and in doing so has laid the foundation of what is now a large community of the next generation of health-conscious children and young adults who will benefit from a happy smile, and good, long-term oral health.

Issue 7 | ISSN 2515-6128

42

Treating dental anxiety at Dental Excellence Harewood

38

Dentistry is on the move, literally!

38 Dentistry is on the move, literally! 55 Enhancing your team Jessica Emery, Director, introduces The Mobile Dentist Company and how they are bringing quality private dental care to those people who need or choose to have dental services at home.

All dental professionals are required to take part in continual professional development (CPD) in order to maintain their registration and meet the current GDC standards. David Wright BDS, Wright’s Dental, discusses his experience using Isopharm’s Enhanced CPD training for his staff and why using the e-learning platform is the perfect fit for his practices.

practice set for 40 Dental investment after changing hands

A family-owned dental practice is set to receive significant investment after being sold by its long-standing former owners, in a deal completed by a number of North East dealmakers.

Treating dental anxiety at Dental 42 Excellence Harewood

A multi-disciplined dental centre, located within the grounds of Harewood House in Leeds, West Yorkshire, Dental Excellence Harewood has been developed to put patients at ease. Donald Sloss, Founding Partner and Dentist, talks about the challenges we face when treating anxious patients and how the atmosphere and layout of a dental practice can make that particular challenge easier for both the patient and dental team.

46 A new era, a new Chairman

As the ADG enters a new era in its history, it is delighted to introduce Mr Neil Carmichael as its new Chairman.

Product Review

57

Embarking on an adventure!

Subscribe for

FREE

www.moderndentist.co.uk

Supported By

Dr Anh Ky To, Principal and Dental Surgeon at Blueberry Dental, discusses his latest challenge: the Marathon Des Sables, and why he will be sacrificing the space and taking his Sleepwell device with him.

Case Study

Minimal Intervention 58 Aesthetics in a Molar Incisor

Hypomineralisation (MIH) case ANCAR presents its new dental 61 units at the rhythm of violin and

laser lights

10 Minutes with...

62 Dr Dev Patel

CEO and Co-Founder of Brushlink

to sell your dental 51 Planning practice?

When selling your practice, it is important to get the best price as well as an efficient and streamlined process.

Mark Woodger, former practice owner, discusses his experience when he sold his practice through PFM Dental.

53 Stand out from the crowd

Speaking to Dr Kev Patel, Bond Dental, we found out why he decided to use Digimax Dental to help create his brand and establish an online presence different from other dentists in the market.

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Modern Dentist Magazine

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NEWS

Reception services -

the shop window of your practice and the driver of business success Patient focus and procedural competencies are most visible at the front of house, which is why our reception services need to be at the top of their game. Glenys Bridges, Managing Director, discusses customer service approaches and why we need to recognise the reception area as an important place to build patient trust and loyalty.

Prescribed levels of Verifiable Enhanced CPD Never before has the whole team is now a requirement for all dental registrants. approach been more crucial to the The categories to be covered are not wholly clinical, instead they are designed to cover success of a dental business than the entire field of practice for each registrant, right now. Over recent years, the therefore including legal, regulatory and expectation of patients has been procedural requirements as outlined in Standards for the Dental Team, these are shaped by publicity concerning applicable to both registrants and nonshortfalls in Health and Social Care registrants because they provide the basis for provisions highlighted in the press, a culture in which the patients’ interests are our highest priority; and patient focus and along with the current focus on administrative systems are designed to deliver the security and privacy of patients patient-centred care. personal data means that patients view front of house aspects of care The public face of practice services Alongside the GDC Standards, the Health under the microscope and interpret and Social Care Act Regulations and Friends and Family Tests give the public access to the standards of care through the independently assessed information about the prism of their observations. standards of care provided by practice teams, in England these are interpreted into Fundamental Standards and inspected by the Care Quality Commission (CQC), with their findings being published on their website. CQC are equally interested in well-led and administrative

Never before has the whole team approach been more crucial to the success of a dental business than right now standards, as they are in clinical outcomes. These are all indicators patients will take note of; but possibly the most influential elements that keeps patients coming back is how cared for feel during each visit. With a combination of thoughtful, well designed and effectively implemented processes, to make patients feel cared for and cared about.

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Modern Dentist Magazine

News

The front of house services are so important in building the practice’s reputation, it is essential that the reception team moves on from the old ‘I’m only the receptionist attitude‘ and begin to recognise the many positive ways that excellent reception services enhance the working day Good dental experiences are the result of the practice’s patient focus and procedural competencies. Both of these measures are the most visible at the front of house. Here patients feel better equipped to recognise the standards of excellent being delivered.

Any worthwhile customer service approach will begin by recognising that there is a need create reliable and consistent standards of service to build patient trust. These should be standards which, when achieved create bring together the correct balance of: processes and procedures and patient focus.

The following four types of customer care can be used to measure your current levels of customer care and identify where improvements can be made to ensure systems are continually improving.

Customer care Type 1 The Freezer This describes service that is: • Deficient in customer focus.

• Deficient in processes and procedures.

The freezer approach communicates to customers: ‘We don’t care’. It is procedurally slow and inconsistent, with an insensitive and impersonal client focus. This is so often the face of poorly managed corporations with disaffected employees who do not enjoy their work and will do only the least amount possible to get by. This does not inspire customer loyalty or trust.

Good dental experiences are the result of the practice’s patient focus and procedural competencies.

Both of these measures are the most visible at the front of house 8|Modern Dentist Magazine

Customer care Type 2 The Factory: This describes service that is: • Deficient in customer focus.

• Strong in processes and procedures.

The factory approach to service communicates to customers: ‘You’re our number one; we are here to process you.’ It is procedurally timely, efficient and uniform, but the customer focus is insensitive, apathetic, and aloof. This often makes customers feel that all the business wants is their money, nothing else matters.

Customer care Type 3 The Friendly Zoo: This describes service that is: • Strong in customer focus.

• Deficient in processes and procedures.

It is very person-centred personal but lacks procedural consistency. This type of service communicates to customers: ‘We are trying hard, but don’t really know what we are doing’.

It is procedurally slow, inconsistent, disorganised and chaotic. Its customer focus is friendly, personable, interested and tactful.

Customer care Type 4 - Professional and Caring customer service: Patients want the standard of customer care that is defined as, ‘we care and we deliver’.

• Strong in customer focus.

• Strong in processes and procedures.

Dental teams should work together to define how they can create this blend. How could you create this standard of customer care?

• What do you want to communicate to patients?

• What procedural qualities does this require?

Once you have defined your customer care blend and put the procedures in place it is essential to ask the patients how they experience your customer service processes.

The retail sector has long recognised the importance of understanding their customers’ ‘gut responses’ to their products, image and customer service. Dental businesses can draw information from a range of relevant sources to gain the insight necessary to build a suitable customer care strategy, which will to drive continuously improving customer service.

In any sector, excellent customer service is a fundamental requirement. In dentistry, a steady flow of new patients is desirable, but it is those patients who return to you over and over again who are a testament to the quality of care and service they receive.

This level of satisfaction means they are likely to give recommendations leading to new patients. With each satisfied customer your business is likely to win many more customers through recommendations. Dentistry is all about building relationship and trust to meet patient satisfaction. It’s about how you give outstanding customer service; greet patients by their name, staying on time and all-round look at the patient group that the practice wants to attract. Having these strategies can help you identify your goals, set company targets and budget to help achieve that goal.

Since the front of house services are so important in building the practice’s reputation, it is essential that the reception team moves on from the old ‘I’m only the receptionist attitude‘ and begin to recognise the many positive ways that excellent reception services enhance the working day of clinical colleagues and enables patients to build long term relationships with the practice, based on mutual respect and trust.

Glenys Bridges CMIPD

is the Managing Director of Glenys Bridges Practice Pathways Ltd. Training and development opportunities for both new and experienced receptionists to create these dynamic and professional reception services are available on our website www.glenys-bridges.co.uk.

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Interview

Recognising the dental nurse

Established with the dental nurse in mind, the Society of British Dental Nurses (SBDN) are a not-for-profit organisation who are acknowledging the challenges facing dental nurses and encouraging them to collectively come together and share their voice. Modern Dentist spoke to Fiona Ellwood, Patron of the Society, about how the SBDN will be driving the profession forward and acting as a space specifically for the dental nurse.

Q A

Why was it important to you to set up the Society of British Dental Nurses?

The word ‘dentistry’, since registration and the introduction of digitisation, has changed dramatically and had a knock on effect on the career structure and focus of the dental nurse. This has been compounded by the widening of the scope of practice and the pushing of boundaries in order to address the needs, demands and expectations of the patients. Whilst there is an existing organisation, it is very different in its make-up and purpose. The Society prides itself on connecting with the current workforce given that the ambassador group and the core committee are all registered dental nurses.

The Society has been established specifically with the dental nurse in mind.

We recognise that dental nurses face many challenges in their day-to-day work

10|Modern Dentist Magazine

A good dental nurse anticipates what is needed, is intuitive, perceptive and is team and patient-centric and to all intents and purposes, a mind reader and jargon buster and we want to encourage them to come together collectively and share a voice.

Through learning, application, experience and reflection, we believe that the dental nurses of today will be instrumental in driving the profession forwards.

Q A

What does the Society offer its members?

The Society provides a number of benefits to its members, some of the

most important being: an out of hours helpline, mentorship, 1-1 careers advice and planning, contact with experts in each field of dentistry and our regional groups mean that this is possible on a wider scale and across the nations.

The education and research group helps with academic studies and revision, and contributes to the writing and development of educational courses, which in turn informs the development and extension

Interview

The word ‘dentistry’, since registration and the introduction of digitisation, has changed dramatically and had a knock on effect on the career structure and focus of the dental nurse

of current levels of education. We are also affiliated with the National Oral Health Promotion Group and contribute to oral health improvement work. We also support a number of charities and encourage our members to also get involved.

We keep our members up to date with regulatory information and link them to consultations to have a voice and produce frameworks for policies and guidelines. We also produce newsletters and yearly roundups. We provide meeting events, ‘the dental learning hub’, on a wide variety of topics, which are free for members to attend, plus discounted study days and priority tickets for events. We also provide speakers and, of course, our Fellow’s panel keeps us aligned to the evidence-based literature.

Of course, we provide all of the other things that a society would be expected

to: links to indemnity, legal help lines and news briefings and statements.

We also introduced the National Dental Nurses Day on the 22nd November.

Q A

How are you looking to get more dental nurses and the wider dental community involved in the Society?

We are always thinking about our ‘reach’ and nobody more than us appreciates the challenges in the current climate of having a membership group, and we also know that doing the same thing over and over again isn’t going to help anyone. We have links to educational settings and with local and national groups, plus close links with the other dental care professional groups which is really beneficial.

We have been invited to speak in secondary schools at careers events and

work in specialist environments outside of dentistry to try and get more people involved in dentistry because it is a fantastic industry to work within.

Q

What would you identify as the biggest challenges and opportunities currently present to dental nurses in the UK?

A

It is an exciting place right now, with changes to treatments and techniques and the widening of the scope of the practice, and the different things going on in the other nations. More and more dental nurses are moving to specialist fields such as implantology and are becoming involved in cosmetic dentistry too. There are so many different opportunities now; even out in sales, recruitment and treatment coordination too.

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Modern Dentist Magazine

Interview

There are a number of things that present challenges and the biggest one being professional protectionism and a lack of willingness to adopt skill-mix or role substitution. Some of the primary qualifications can bring challenges if dental nurses wish to move to other areas of dentistry, i.e. hygiene and therapy. Of course this question would be answered differently by others and would perhaps look at the scope of practice as a barrier plus the lack of trust and respect that there seems to be for the dental nurse. Some would perceive the long working hours and the level of responsibility and accountability and the low level of remuneration as the biggest challenge, others may consider the lack of flexible working for a large proportion of dental nurses.

Q A

How important is the dental nurse to a practice’s team?

A dental nurse is a key component of any team – they have so many skills to ensure the smooth running of any clinical setting and that the patient is cared for in the best way. Many are shocked at the wide range of skills a dental nurse is expected to own and the duties that they are expected to undertake. Those who really embrace the role see it as a craft to be learned.

A good dental nurse anticipates what

12|Modern Dentist Magazine

The years to come are looking, on the one hand, very exciting, and on the other, uncertain, and as long as dental nurses continue to be employed, regulated and confined in the way that they are, we are always going to have a very divided landscape to contend with is needed, is intuitive, perceptive and is team and patient-centric and to all intents and purposes, a mind reader and jargon buster.

Q A

How is the SBDN working with other organisations and associations to promote the role of the dental nurse?

SBDN work very closely with other organisations for the greater good. We share perspectives and viewpoints, we discuss the impact situations have on us in collaborative meetings and communicate across other organisations. There are a number of meetings today that invite members to attend for their expertise, so it is not always about being a separate group. Of course, like any profession, this brings

with it challenges and some groups are not always willing to embrace the dental nurse.

Q A

How will the SBDN be looking to influence and inform change in 2019 and the years to come?

SBDN work very hard to contribute toward future proofing the dental nursing profession. We would like to see more joined up thinking, collaborative working and an open door to the wider stakeholders. We don’t want to see change for the sake of change, but change in order that a difference can be made, whether it is through further developing and expanding the roles and scope of practice or whether this means

Interview

With the educational and clinical excellence amongst us, we are keen to help others get on in life and support anyone who may need a leg up Fiona Ellwood M.Ed L.M, MSc PG Cert Public Health, PG Cert Mentoring in Dentistry, BA (Hons) Education studies, Cert Ed, OHE, DN (Hon) FFGDP UK, FIAM, FDTF (RCS Ed), Patron of S.B.D.N, Chair NOHPG. Fiona is the Patron of the Society of British Dental Nurses. She is also the Chair of The National Oral Health Group. She acts as a key opinion leader and is an advisor for oral health education and preventative programs across the dental arena, as well as infection control and professional practice. She is a former President of BADN and examiner for NEBDN. Fiona is a trained mentor and has fostered and developed a mentoring culture in a number of areas both within and outside of dentistry. Her Mentoring work has been far reaching and more recently has included supporting a scheme to help dental colleagues when working with underperforming dentists. Her final dissertation for her M.Ed looked very closely at the concept of leadership as a potential mechanism of change, which has given her greater insight to the ever changing world of health, education and dentistry.

This has also helped her in her role as an External Examiner for the University College of Cork; Fiona is also the External Examiner for the Uni West of Scotland and a GDC QA Education Associate. She has recently studied an MSc PG Cert in Public Health and has been accepted onto a PhD programme looking closer at education. Fiona is the QA & enhancement Lead at Leamington Spa Orthodontics Centre and an honorary nonclinical lecturer at Uni Warwick and a subject expert at the Uni Bangor.

Fiona is the founder of ‘Dental Mentoring Network’ and a member of Dental Mentors UK. She has received an honorary Fellowship from the Faculty of General Dental Practitioners (UK) (the first DCP to do so), a Fellow of the Faculty of Dental Trainers at the Royal College of Surgeons Edinburgh and Fellow of Institute of Administrators and Managers. More recently she became a member of the Interim Education Advisors Board RCS Edinburgh and a trustee of Dentaid, as well as becoming the vice President of BSDHT. Fiona’s underlying ethos is to open doors for others and help others find their way through their journey whether clinical or academic.

growing new professional groups. We are passionate about the dental nurse not being looked at in the subordinate role of old but rather someone who can be more involved in patient care and outcomes.

The years to come are looking, on the one hand, very exciting, and on the other, uncertain, and as long as dental nurses continue to be employed, regulated and confined in the way that they are, we are always going to have a very divided landscape to contend with. My golden nugget is not one to share just yet.

Q

How important is it to continue to encourage learning and development while in the dental profession, and how do you encourage your members?

A

This is our whole purpose. With the educational and clinical excellence amongst us, we are keen to help others get on in life and support anyone who may need a leg up. We believe that not everyone is fortunate enough to establish how they learn best or even find their niche and often when they come to learning for the second time, although it can feel daunting, they attack it in a different way. We give

We are passionate about the dental nurse not being looked at in the subordinate role of old but rather someone who can be more involved in patient care and outcomes

time to members, we offer support and mentorship, academic guidance and create links with others to help as much as we can. The student liaison team are truly wonderful.

Q A

What support mechanisms are in place for dental nurses?

There are very few, if I am honest, away from the chain of professional reporting and that had to be our consideration.

With trained mentors, coaches and counsellors to hand and our free legal helpline and emergency helpline, we do a lot. We also have a triage of services for problems that need to escalate and a good relationship with those in this situation. We offer this independently to their place of work and their place of study. We have also had a hand in informing indemnity provision and a links framework.

Q A

What will 2019 bring for the SBDN?

Already 2019 is setting off at a rate of knots, there are some exciting things in the pipeline, but if we can continue to grow our membership and keep supporting dental nurses on the ground, we won’t go far wrong.

We have a couple of more ‘nuts to crack’, metaphorically speaking, but I am truly very proud of the dental nurses and the Fellows who are involved, who believed in us and who have driven the Society to where it is today. I would encourage any dental nurse to get involved; we are not a Trade Union, we exist to be close to those dental nurses on the ground and their futures.

Fiona Ellwood

is the Patron of the Society of British Dental Nurses.

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Modern Dentist Magazine

Interview

In this issue of Modern Dentist, we hear from Shaz Memon, Owner and Creative Director of Digimax Dental. The world’s highest rated marketing agency that specialises in helping practices to stand out and grow in an increasing competitive market. We spoke to Shaz about why he set up Digimax Dental but also why it is important for practices to have an outstanding online presence in order to attract and retain patients.

MASTERING DIGITAL MARKETING 14|Modern Dentist Magazine

Q A

How was the concept of Digimax Dental brought about?

Going back to high school, Digimax was a name I came up with in Maths class.

This was merged from ‘Digital Design’ and ‘Maximum Effect’. Digimax Dental, an arm of Digimax, came about in 2004, when I first started working with dental practices. The brand was started after I quickly realised that marketing for dental practices was unlike marketing for any other non-dental business. Practices needed help promoting ‘outcomes’ instead of services.

Interview

Every practice already has a brand, a personality; a way patients are made to feel when they visit. At Digimax, we encapsulate this into a brand identity which resonates with what the practice stands for today, and intends to stand for in the future

Digimax Dental is situated in Marylebone, London and has a team of dental web designers, SEO experts, branding specialists and graphic designers. At Digimax Dental, we have a vast amount of marketing experience in order to help create solutions for dental businesses – we want practices to be able to stand out to their target audiences and grow using digital marketing. I work as a designer in my own company – every design that leaves Digimax has either been seen by me, or I have personally worked on it.

Q A

What challenges and opportunities did you face when you first created Digimax Dental?

The biggest challenge was the amount of knowledge about dentistry that was required from both a dentist’s perspective and a patient’s perspective. Short of studying for a BDS, I spent a lot of time with Principals who were happy to transfer their knowledge to me. I was able to sit in the practice, see consultations and witness the patient journey to understand how dental treatments needed to be marketed.

Failing a few times was a challenge for me, as I wasn’t used to negative feedback --- but this is what has made us so strong today. It was incredible, how something that was traditionally seen as a ‘needs based’ service, was now changing lives and the confidence of patients throughout the country with the emergence of cosmetic dentistry. I remember seeing a patient after they had their teeth aligned, and cosmetically enhanced with whitening.

She was beaming with confidence and excitement and almost in tears of joy with the outcome!

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Modern Dentist Magazine

Interview Poor design has unfortunately become a trend in Dentistry. We are changing this, one site and brand at a time

Q A

What are the first steps to creating a brand and website for a new dental client?

Every practice already has a brand, a personality; a way patients are made to feel when they visit. At Digimax, we encapsulate this into a brand identity which resonates with what the practice stands for today, and intends to stand for in the future. There are a lot of questions involved, which ultimately help us produce a beautiful and powerful outcome. Once the brand identity and visuals are in place - we study the treatments the practice offers, the current target audience, the future target audience, business goals, what the practice is currently doing well and what goals it may have - we pull to the surface all the ‘purchase beacons’ onto the homepage that the practice’s ideal audience wants to see.

At Digimax we are proud to have the lowest bounce rates on our designs – this has come about by taking a visionary approach to design, instead of a short sighted approach, which solely relies on the principal’s colour and image preferences!

Q

Why is it becoming increasingly important for dental practices and businesses to have an online presence?

A

It’s not unusual for many of the practices we work for to only have online marketing as a way of attracting new patients (that have not been referred by other patients). I don’t want to state the obvious, but patients of today look for practices on Google!

Future proofing a practice’s patient flow can only be done from having an excellent in-house patient experience

and journey, backed by consistent online exposure from an incredibly powerful, high converting dental website.

Some dental practice location searches total over 2000 a month in Google alone. I believe everyone already understands an online presence is needed, it’s how you go about this that is so important. An online presence alone is not enough, a presence that converts visitors into patients is what makes our ‘Success Formula’ at Digimax so popular.

Q A

and brand at a time. By poor design I don’t mean a design that doesn’t look good. This is part of the problem, there are a lot of good looking websites. The problem of poor design comes down to a design that doesn’t convert the maximum number of visitors into ones that wish to enquire at your practice.

Each person is wired differently, this is why the biggest brands are constantly evolving their sites and messages, online and offline to ensure that if 1000 people visit a site, the largest % of that number want to make contact or transact with that business.

Why are online first impressions so important for a practice?

Patients decide within five seconds whether they want to stay on your website – or not. After all the studying, training and investment that a practice makes in its business, if a patient has made it to your site – it would be a huge shame to lose them as a result of poorly executed design. Poor design has unfortunately become a trend in Dentistry. We are changing this, one site

A single treatment plan is not one size fits all, so your branding and site design certainly can’t be 16|Modern Dentist Magazine

The most successful practices I have ever worked with do one thing really well, make people feel special

Q A

Why is it important for dental practices to stand out from the crowd in this competitive market, and how can dental website design help to do that?

There are so many dental websites that just look the same, don’t you think? What makes us unique is that we also serve

Interview

Future proofing a practice’s patient flow can only be done from having an excellent in-house patient experience and journey, backed by consistent online exposure from an incredibly powerful, high converting dental website some of the UK’s leading non-dental brands, which helps us infuse a fresh approach to dentistry. Taking a custom approach to branding and website design is the only way to stand out from the crowd. Say no to stock templates and stock designs. A single treatment plan is not one size fits all, so your branding and site design certainly can’t be. If it is, you will ultimately lose patients that you didn’t even know you were losing.

Q A

What advice would you give to dental practices looking to attract new patients?

Start of by looking at the design of your website. At Digimax, it’s undisputed that we build the world’s most powerful website. If we cannot work with you due to exclusivity agreements, we will give you free advice where we can. Before you even look at marketing to new patients, you must ensure your site is going to convert the maximum number of those patients when they arrive.

There is no point pouring more water into a leaking bath tub!

Q A

Why is it important to engage with patients both in the real world but also online?

The most successful practices I have ever worked with do one thing really well, make people feel special. They offer a concierge approach and communicate phenomenally well. Referrals are the biggest free source of new patients for any practice. We will not work with poorly organised practices, as no amount of online marketing can help them.

Referrals will also reference a website, and at that point they are still deciding if they should visit – or not.

Q A

improvement in our product offering, and helping practices grow through further enhancing websites. We intend to enter more awards, following the win of Customer Service Provider of The Year 2018 at the dental industry awards.

Shaz Memon

is the Owner and Creative Director of Digimax Dental.

What does 2019 hold for Digimax Dental?

Digimax has been growing at a phenomenal rate. We receive over 120 enquiries a month at present, of which we only agree to work with five clients a month. This has produced a three month waiting list at any one time. This year is about continuous

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Modern Dentist Magazine

Interview

Regional Focus:

London

Modern Dentist’s Regional Focus examines London, and we spoke to Michael Clarke, Chairman of the Federation of London LDCs, about the challenges currently facing dental professionals in London, how the region’s LDC is attempting to address these and what the future holds for Greater London’s dental sector.

Q

What are the main challenges that dental professionals in London are facing at the moment and how are they tackling these?

issues inherent in the dental contract.

At the local level and in the short term, we have to work with what we’ve got.

This means engaging with NHS England (London region) to maximise the use of UDAs for the sake of NHS patients, improve access to prevention-based interventions and create a single way of working for London to reduce confusion and variation.

A

Where to start! As with many parts of the country, practices in London are finding it harder and harder to recruit associates to work under NHS contracts, practice costs are increasing, and contractual uplifts are not keeping pace. London’s population continues to grow, yet services are not able to keep up with demand. We all know that there is under-delivery of UDAs and annual clawback of undelivered UDAs. But we equally know that this is not because there is no demand for our services but that the current contract is not sufficiently flexible to allow us to deliver the care our patients need.

Contract reform is in the hands of the GDPC and BDA and is a long term approach to addressing the systemic

18|Modern Dentist Magazine

Q A

What has been the key positive or negative area of change in the London region in the past decade, and how have professionals in the area responded to this?

One issue that has been coming up with increasing regularity, and indeed was raised by the Brent and Harrow LDC at LDC Conference 2018, is the state of older adults’ oral health. The 2006 contract removed GDPs’ ability to provide ad hoc domiciliary care and, as a result, placed an enormous strain on our

CDS colleagues to pick up the burden.

The population continues to age, and as that ageing population has different healthcare needs than those who aged before them, as a profession we need to be mindful of this and prepare ourselves to address these different needs. Brent and Harrow LDC is leading a pilot piece of work on behalf of the LDCs in the LDC Confederation, in conjunction with Brent Council, Public Health England and Health Education England to upskill care staff and to look at the feasibility of partnering care homes to dental practices.

Something which we still lack in London, and which would lead to huge improvements in patient safety and satisfaction is a Dental Electronic Referral Service. I really hope that in the near future this part of the service can be brought into the 21st century.

Interview The local voice is so important in informing the national debate and to meet challenges on the ground

It has become more important than ever before that we have a loud enough voice to confidently speak up to the various authorities to try to ensure that fairness prevails in the regulation and funding of the dental service

Q A

What are your core aims as a regional representative to the London LDCs?

The LDCs in London are very active, engaging with NHS England (London region), Public Health England (London region), as well as local stakeholders including borough councils and the Mayor of London.

I am proud of the proactive work we are doing in London to improve the image of dentistry and I see my role as the London representative to the London Regional Group at the BDA as championing the work we do, taking it to colleagues and sharing our experiences. The local voice is so important in informing the national debate and to meet challenges on the ground.

Q A

How have the needs of dental professionals in the London region changed in the last five years?

The dental profession has been subject to ever increasing regulation and bureaucracy, during a period in which

NHS dental funding has been relentlessly squeezed. At the same time, there has been an expectation from patients that the dentistry provided should be of the highest quality, using the latest materials and techniques. It has become more important than ever before that we have a loud enough voice to confidently speak up to the various authorities to try to ensure that fairness prevails in the regulation and funding of the dental service. Our collective support for colleagues has been a key feature over the last five years.

Q A

Have patient expectations changed in London and to what do you attribute any such changes?

Patient expectations are always changing; some changes are caused by social developments and the rise of the internet and celebrity culture. Aside from shifts in clinical expectation and questions over more cosmetic treatments and their availability, we’ve seen a shift to questions

over integration and environmental sustainability. In an ever more connected world, it is a travesty that primary care dentists have not been provided with access to NHS digital resources that would help us care for our patients. Hopefully this will be addressed sooner rather than later. There is a huge shift in the public’s awareness around sustainability and the environment and that will affect our profession in other ways than just the phase down and eventual phase out of dental amalgam.

The LDCs have also been engaged with the Dental Sustainability Advisory Group to help the profession play its part in reducing damage to the environment.

Q

How do you and the LDCs in the region ensure LDCs maintain their relevance to the profession?

A

The structure of the NHS has shifted as a result of the health reforms of 2012 and LDCs have had to reassess their focus. In London, most of the

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Modern Dentist Magazine

Interview One of our key aims for 2019/2020 is to increase our engagement at the STP level, to embed the importance of oral health and dental services through the life course and whole of the health system LDCs have joined together in the LDC Confederation and this has helped us pool our efforts where required and has given us a new focus. The move away from local commissioning at PCT level to the pan-London implementation of a national commissioning agenda means that we have to use our collective voice where once we could influence more individually. This has had some positives as it means we have to think in a more united and strategic way to address the concerns of dentists across London. But it has also helped individual LDCs refocus on their local work. Every LDC in the LDC Confederation is actively engaged with their local council, and community dental service colleagues, looking at innovative ways to address children’s oral health, the health of older adults and those experiencing homelessness.

By being constructive and collaborative, bringing solutions to the table we ensure that the profession is relevant to local stakeholders. As well as working hard at the local level to ensure that local dentists are up to date with what is happening locally we work at the national level and representatives on sit on working groups at the General Dental Council to make sure the voice of frontline GDPs is heard.

We also provide more hands-on support to dentists in London via a centralised support function that is able to draw on our considerable network of contacts across London and beyond.

Q

How do you feel the pace of innovation differs in London compared to other regions? Where is the region ahead of curve in this area and here might it be behind?

A

We try to ensure that we are at the front of the curve. LDCs in London are driving projects on older adult oral health, access for those experiencing homelessness, piloted the roll out of NHS Mail for

I think that there is always much to learn from our colleagues elsewhere.

For instance, the experience of colleagues in Manchester has provided them with insights into how a devolved healthcare system might seek to deliver dental services. The opportunities they have had to be involved in discussions and framing the debate with other clinical colleagues is something that we aim to follow in London. One of our key aims for 2019/2020 is to increase our engagement at the STP level, to embed the importance of oral health and dental services through the life course and whole of the health system.

Q

Q

We hope so. We try hard to ensure that the voice of dentists in London is heard at every level. Representatives from the London LDCs continue to be involved in working groups at the GDC for instance, and we have contact with national bodies such as NHS Digital and the NHS Business Services Authority. Like other LDCs, we speak at the Annual Conference of LDCs and work closely with the BDA to ensure that the London voice and perspective is heard at the national level.

A

Dentistry suffers from some image problems, not least because of the transactional nature of the relationship we have with patients and the tension between private and NHS care. Issues around what is and is not clinically necessary cause confusion for patients and this will be exacerbated by the introduction of so-called “level 2” providers. As the voice of the profession locally, LDCs play a vital function in improving the perception of the profession among the local community. Many of the LDCs in the LDC Confederation have actively engaged with their local Healthwatch to ensure that their reports about dentistry are fair and balanced, and we have seen them

Do you feel that the London dental market has a voice in wider conversations outside of the region?

A

How do you think the dental profession is perceived by the public?

Do LDCs have a part to play in building relationships on this level?

We all want things to get better today not tomorrow but change in the NHS takes time and change in NHS dentistry, it seems, takes the most time of all!

20|Modern Dentist Magazine

respond positively to our comments.

There has been a culture of defensiveness in recent years brought about by the development of a more litigious culture more widely. To address this, we need to be more proud of the excellent care which we provide our patients with and of the contribution we make to their lives. The way for the dental profession to achieve the change it needs is with the support of the public. LDCs should be acting on behalf of the profession engaging with stakeholders to find solutions to problems at the local level. Through constructive, solution-focused engagement, we will be able to show the profession as the fantastic force for good it is.

dental practices, shisha awareness, and are involved in national working groups and projects such as dementia friendly dentistry and TMJ and Orthognathic referrals, so there is a lot going on.

Educationally, London dental schools are among the best in the world and that is something we don’t hear enough about.

Q

What does the future look like to the dental professionals in the London region?

A

I think we have to be cautiously optimistic. There is a lot of negativity about the future but we are adaptable and we provide an important service.

If we are to have a sustainable dental service that we want to work in, that provides effective care for our patients, we have to make the argument for it. We need to frame the debate and we need to bring the solutions. By taking ownership, as we are doing in London, we are building credibility as a profession which has the answers, not just the problems.

We all want things to get better today not tomorrow but change in the NHS takes time and change in NHS dentistry, it seems, takes the most time of all!

Dr Michael Clarke

is the Chairman of the Federation of London LDCs.

Discover the future with us at IDS 2019 March 12 - 12 / Cologne (Germany) Hall 11.3 - Stand G-20 / J-29

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Dr Mark Lawrence “We have used several other specialist dental accountants in the past but none have been as pro-active as PFM Dental Accountancy.

Their level of professionalism and approachability has been excellent and an added bonus is the “in-house” financial management we have enjoyed for many years with PFM Dental The addition of a legal team now can only add to a great team”.

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Editorial Board

Making Tax Digital is coming…

What is the impact of a beautiful smile?

Kat Michaels,

Deputy Head of Teaching, Tempdent Recruitment & Training.

You may have heard on the news about Making Tax Digital (MTD) from April 2019 for VAT registered businesses, but don’t think as a dentist MTD doesn’t apply to you.

Cloud based accounting can transform your business’s efficiency, and allow you to maximise profitability. It can help you save time on day-today book-keeping as well as allowing you to plan for the future.

1. Automatic and direct bank feeds mean that no data inputting is needed. This not only saves time, but reduces the margin of error.

You can set up bank rules which allow you to reconcile your bank statements at the click of a button.

2. You can have access to your accounting information 24 days a week, 365 days a year, wherever you may be in the world. Software updates are done automatically, meaning every time you log onto the software, you are accessing the most up-to-date version.

3. Real-time information means that accounts can be prepared as soon as the year end has passed. It also means that if you require regular management information to meet loan covenants, then this can be prepared in a timely manner.

4. Tax planning becomes easier. As accountants, cloud accounting enables us to be pro-active with our advice due to the real time data being available. This means a couple of months before your year end, we can look at your profits and see if any tax savings can be made.

5. You can also process your payroll through cloud accounting packages which allows you to streamline your business functions.

Originally it was HMRC’s plan to roll out quarterly reporting for all businesses from 2020, so it makes sense to get into the routine of the cloud before it becomes a legal requirement. HMRC may not bring in MTD and quarterly reporting for all businesses, but the benefits from cloud-based accounting are still worth the switch-over. If all this sounds too good to be true, you must think there is a catch – which is usually the cost.

PFM champion Xero software, and their standard package is £22/ month. There are always deals available, so just ask us! They also offer a 30-day free trial, so you can try before you buy! We can also offer training to clients to help get the cloud software set-up.

They say that smiling instantly makes you feel better... In a world where life sometimes doesn’t allow you catch your breath, it’s beautiful to know that a smile can be the solution to some of life’s trivialities.

Many psychologists who have researched the benefits of a smile have found that smiling can actually lengthen your lifespan, and since smiling is often found to be contagious, isn’t it a wonderful notion that smiling at someone will make them smile back in return and inadvertently increase their lifespan? What a selfless benefit to the receiver of the smile!

So when you smile, serotonins, endorphins and dopamine will be released naturally into your blood stream, these will relax you, boosting your immunity and controlling your circulatory system. You may have also heard the phrase: ‘grin and bear it’, well there maybe some truth in that phrase because when you smile these hormones become natural painkillers.

Even more bizarre is the current study that says a smile can make an individual look more attractive and more successful in comparison to someone who never smiles. So smile more if you want to have stronger and more meaningful relationships with others, not to mention a wealth of success.

So in conclusion, if you are in pain, just smile and the pain will instantly lesson; if you are sad, just smile for your mood to lift, and if you want to be attractive and successful. JUST SMILE! Here at Tempdent, we smile all the time because we teach our learners, clients and our recruitment candidates the future of their smiles. If you want to learn about the true benefits of your smile, we recommend you have a look at the various courses we offer, whether it’s Practice Manager or Dental Nurse Qualifications or our excellent face to face or online CPD. However, why don’t you shine even brighter by letting us find you that inspiring position where you can use that beautiful smile of yours right to the top of the ladder of success.

Sophie Kwiatkowski,

is an Accountant at PFM Dental Accountancy.

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Modern Dentist Magazine

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Editorial Board

What is on the horizon for employment law?

Shareholder protection

Mike Hughes,

Principal, Dental Practice Consultancy Service.

For directors and managers, little in business is more closely regulated than your relationship with your staff. When employment regulations change, so must your existing arrangements. A number of upcoming developments in employment law and enforcement could have particular impact on owner managed businesses.

From 6th April 2020, legislation requires that a written contract must be provided to all workers, not just employees, on, or prior to the first day of employment. The current legislation gives employers two months to supply this. Failure to comply remains in line with current legislation, meaning that there will be no stand-alone right to bring a claim for a failure to provide a written contract. Employers who want to follow best practice must provide contracts on day one.

An employee who leaves his or her role and returns after a gap of one week will usually have broken the continuity of their employment.

However, amendments are proposed which allow employees to leave their employment for up to four weeks, whilst retaining their existing employment rights. Short contractual “breaks” of this sort are quite common and employers need to be aware of this.

Recent case law on statutory holidays makes it clear that employees who receive overtime, or other benefits such as premium weekend rates, must receive these benefits as part of their holiday pay. From 6th April 2020, employers must calculate holiday pay based upon the employee’s 52 week average pay prior to annual leave, and not 12 weeks as is currently the case. For employees with less than 52 weeks service the number of fully completed weeks should be used.

Employers paying at, or close to minimum wage, should be aware of HMRC’s increasingly aggressive approach to enforcement. Working a few minutes beyond contracted hours on minimum wage, forces the pay below the legal minimum. The onus is on the employer to keep accurate records showing the hours worked. This year it is expected that HMRC will be closely monitoring small employers to ensure compliance.

If you’re grappling with the proposed changes, BLM’s specialist employment lawyers are able to help and ensure your business is compliant.

For those who are in partnership arrangements, whether true partnerships or expense sharers, or those who operate through limited companies in multiple ownership, have you considered what would happen in the event that one of you became critically ill or indeed, died? If you are the one who is unfortunate enough to be the person who has become ill then in the event of a critical illness you continue to have the worries of owning and running a business and will possibly will have suffered a reduction in income and in the event of your death your beneficiaries will find themselves owning a share of a dental practice that they probably do not want or may not be legally entitled to own. If it is your business partner that has suffered one of the events you are in the difficult position of trying to control the business whilst at the same time dealing with the emotional fallout that the event causes.

Sadly, it is still the fact that many dental practices operate without a formal Partnership Agreement in place but even if one exists it may well need to be amended to cater for these eventualities. What do you need to do?

The first step that you need to have in place are clauses within your Partnership Agreement or in the event of a limited company your Memorandum and Articles of association that give the parties the agreement options to buy or sell as appropriate, in the event that the circumstances should arise.

The second step is to arrange life and/or life and critical illness insurance policies so that the surviving party/parties are the beneficiary of the policy proceeds. The level of benefit needs to be broadly commensurate with the value of the business share owned by each individual.

In the event that the need arises, the insurance policy would pay out thus giving the survivor the financial resources to complete a purchase transaction meaning that the ill or deceased parties interests are purchased and they or their estate are left with liquid assets to invest how they choose. The surviving party then has full ownership and can proceed to run the business as they wish.

Jim Lister,

Partner, BLM Law.

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Modern Dentist Magazine

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Editorial Board

Building and retaining a team

Heidi Marshall,

Partner, Dodd & Co. How important is the investment in people within a dental practice, and what forms should this take?

In today’s ever changing and increasingly competitive dental market, it is clear that investing in the best materials and furnishings for your practice can help attract patients. This is all well and good, however, once the patients have been engaged to make contact with the practice, it is the team that either encourages them to inquire further, or fails to engage them and so they try elsewhere.

I will cover investing in people within the practice, e.g. reception, treatment coordinators and nursing staff, and the investment in people, e.g. lab technicians who are outside of the practice but play a massive part in your success.

For me, investing in people within your practice should be second nature. It is absolutely crucial that the message throughout the patient journey is the same. One simple way to improve this continuity is to have a team that remains the same. Look at what keeps your team members happy and discuss what drives them, and you can have the chance of building and retaining a team that is on message.

By investing in your dental assistants, be that through further training or simply engaging them in treatment and patient discussion, you can create a happier environment within the surgery. Patients will pick up on subtle signals and the interaction between yourself and your assistant.

If a patient feels the work environment is a happy place as well as a professional place, it will usually make them feel more comfortable.

Lately, for me, I have seen the benefit of investment in external professionals to help advance my practice. By spending time talking to the best technicians, you get to know how each other work and how to get the best results from your combined efforts. This can improve results for your patients and make your daily practice so much more satisfying and rewarding. Personally, I value a face to face meeting with anyone I am intending to work with.

In summary, I feel it is vital to view yourself as part of a wider team, if you can all work towards the same goal, you will have a better chance of achieving or exceeding that goal.

Dr Richard Brown,

Parrys Lane Dental Practice and Bupa Dental Care, is a Nuvola Speaker for Nuvola courses.

What can a specialist dental accountant do for your practice?

It’s a good question and one I’m very happy to answer.

Dodd & Co have been dental advisers for over 30 years now and we can offer dentists far more than a set of accounts and a tax return.

I know what’s happening in your world and I know what’s important to you at any one time. I regularly attend (and present) seminars, I’m regularly researching legislation and I keep up to date with the dental press making sure my knowledge is fresh and current.

There’s a whole list of “special stuff” that sets us apart from other non specialist advisers (calculating your net pensionable earnings, understanding how NHS pensions work and checking your record is correct for example!), but more recently I’ve had a run on assisting clients in buying and selling practices. Getting the right price in either circumstance is of course very important and goodwill valuations, due diligence work and obtaining finance are areas I have a lot of experience in. So it’s true I can’t fit you with a crown but I’m qualified to give you great advice when you need it.

Many of our clients stay with us for a lifetime. From starting out as a foundation dentist to thinking about retirement, we are there, every step of the way, making sure you get the best advice through the highs (and sometimes lows) of your financial life.

Most importantly I’m good at what I do because I love it. I have some fantastic clients that make coming into the office each day a pleasure (hey, don’t get me wrong there are challenging days!). I also have to credit my team at Dodd & Co – we’re so lucky to have such talented and hardworking staff all as equally committed to doing a great job for our clients.

I’ll leave you with a quote from one of our clients: “Dodd & Co have been instrumental in the development and growth of our practice, most impressive of all is their unparalleled knowledge and understanding of the dynamic industry of dentistry. They consistently deliver expert advice which has helped keep me and my business one step ahead of the rest”.

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Moden Dentist Mag1_Layout 1 17/01/2019 16:41 Page 1

Specialist Dental Accountants Business Well Planned www.doddaccountants.co.uk ow Kn w ho for ts tis n e d

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For a confidential, no obligation discussion about how we can help your dental business, accounting and advisory needs contact Heidi Marshall on 01768 864466 or email heidi@doddaccountants.co.uk.

Editorial Board

Kid’s Club - dental care for children

Nathalie Smets,

Marketing and Sales Country Manager, Ancar.

It is not fun to go the dentist. Period. My six year old used to hate it.

Like almost all children, he was afraid of the dentist. However, after a while he got over it. How, you ask? Well, a part from the dental office being kid-friendly and decorated (bright colours, pictures and posters of cartoons on the wall), the dentist used the following techniques to gain his trust.

Say - show - do Children, especially ones with anxiety, tend to do better when they’ve got a sense of predictability. They are much more likely to tolerate a procedure when they have been told in advance what to expect.

When the dentist explains to the child what he is going to do, showing him the instruments and imitating some of the necessary actions, he will feel more at ease. It is important that you use words that the child can understand so that the technique really alleviates the fears and does not end up generating new fears and anxieties. In fact, it is essential that the explanation be brief but very clear.

Know your audience Distraction is a very useful technique to divert the attention of the child from the discomforts that may be felt during the procedure. By attracting his attention and stimulating his imagination, the little one is abstracted from the dental procedure. Therefore, a good paediatric dentist should know all Disney movies, pop stars, important football players, latest hits and video games… It is amazing how my six year old likes his dentist just because they talk about the Marvel Super Heroes and all of their powers… During the whole procedure.

Relax!

Other proven techniques are voice control and relaxation techniques.

By modulation of the tone, rhythm and volume of your voice, the child will calm down more easily and be more cooperative. Breathing exercises for very anxious children are also useful. A deep-breathing exercise with deep inhalations and slow exhalations in a pace manner.

Reinforce the positive In terms of praise and small, tangible rewards, (e.g. stickers, temporary tattoos, etc.) positive reinforcement can be a useful incentive for cooperation and for “brave behaviour.” Kids don’t forget the “fun” dentist who gave them a sticker at the end.

Making Tax Digital: what you need to know Making Tax Digital for VAT will start from 1st April 2019. Eventually HMRC will introduce Making Tax Digital for income tax and corporation tax.

Making Tax Digital for VAT VAT-registered businesses with taxable turnover above the VAT registration threshold will need to keep digital records and send digital VAT returns from April 2019. For lots of businesses, this means from accounting periods starting on or after 1st April 2019.

Making Tax Digital for individuals (income tax) It’s not compulsory (yet), but self-employed people and landlords can sign up for a digital tax returns pilot scheme. The pilot lets you keep records digitally and send income tax updates to HMRC instead of filing a Self-Assessment tax return. Both sole traders with income from one business and landlords who rent out UK property (excluding furnished holiday lettings) can sign up. At the end of the accounting year, you’ll send a final report and your tax for the year will be calculated. This is the point at which you’ll claim any allowances and reliefs.

Making Tax Digital for corporation tax There’s not much information out there on when Making Tax Digital will come into play for Corporation Tax. HMRC are waiting to see how the VAT rollout goes first before making any decisions. The only news at the moment is that the earliest it’ll be introduced is April 2020.

Making Tax Digital software Businesses will need to use compatible software to send digital tax returns. HMRC wants data to flow and be exchanged digitally by 31 March 2020. Until then you can use copy and paste to transfer information. The product you use to submit digital tax returns needs to be compatible with HMRC. They have a full list of compatible software.

Businesses that don’t already use accounting software are likely to face one-off and ongoing costs. While the government has estimated costs of £70 a year over four years, the Institute of Chartered Accountants puts it at £1,250.

Issac Qureshi,

Director, Ogilvy & Haart.

Are you ready for Making Tax Digital? If you would like to discuss your tax and how this can be reduced, then please contact the team on 0333 444 0820 or at admin@ogilvy-haart.co.uk

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Modern Dentist Magazine

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Editorial Board

FIRST IMPRESSIONS COUNT

Bill Carr,

Associate Director, Medifinance.

First impressions count and you should treat your practice reception very much like a hotel entrance, by creating a relaxed and welcoming feel. Many practices create unnecessary “barriers” by cluttering their reception area with posters, notices, out of date magazines and patient information, which is better displayed neatly on clean notice boards or in folders, rather than being stuck to walls with pins or sticky tape or dotted along the top of the reception desk in a disorganised mess.

If you often have a busy waiting area, ensure that the layout allows patients to easily move around and that there is room for wheelchairs or buggies. Magazines and papers should be regularly tidied and in date. Waiting area furniture should be clean and in good condition and in keeping with the profile of patients that you treat. If you don’t already have a uniform policy, this is something else that you could consider. Not only will staff look professional and cohesive but they will also feel like part of a team.

Consideration should be made to the outside of your practice. Is the car park litter free? Is the access to the entrance in good repair? Is it obvious how new patients enter the building? Is the building in good repair and looking smart? These are all things that a new patient will consider before stepping foot into your surgery.

Generally, you only have one chance to impress a new patient, so you need to ensure that this opportunity is not missed, and you gain, not lose a potential patient. It is also important that you don’t lose existing patients either by allowing standards to slip, so you must continually review your practice and keep it as clean, up to date and uncluttered as possible.

Over the years I have seen some interesting concepts, and all have worked with patients commenting on the friendly openness or asking if this really is a dental practice! If you are thinking of refurbishing your practice in the near future, don’t be afraid to ask your architects or designers for something unusual and, if you can, try to think outside the box and be different.

How good are your human resources?

How important is the investment in people within a dental practice, and what forms should this take?

How good are your human resources? This is a complicated question, as human resources not only refers to the staff in your practice but also to your ability to recruit, train, motivate, evaluate and retain your employees and look after their wellbeing within your organisation.

Often with small businesses, the human resource’s manager is the owner of the company who wears multiple hats. Finding the time to invest in every element of the employee’s journey within your practice can be hard, but in a service and care industry such as dentistry, it is fundamental to your success.

Recruitment of the right staff is crucial. The goal is to create a team of hard-working individuals who not only care about patients and providing a high quality level of treatment, but who also care about their working environment and being part of the overall customer experience. Using an experienced recruitment agency can help you to save time finding suitable candidates.

Dentists, nurses, therapists and hygienists will have most of the training required to fulfil their role when you hire them.

An induction will give them the awareness of how the practice functions as a whole, and is essential to operating at a high level of safety. Reception and management staff may require more training and it’s important to invest the time in this as they will help you to keep the business running smoothly and the rest of the team working efficiently and happily.

Motivation and evaluation can often be worked on simultaneously.

Addressing issues and concerns that arise is important, as is sitting down with an employee and discussing their contributions and ideas. Principals are often working closely with just one nurse and don’t always know the daily ins and outs outside of their surgery.

Block out some patient free time and sit down with employees to talk to them. Taking time to say thank you and offer a compliment on a job well done also goes a long way.

Retaining good staff is about more than a financial investment: it’s also making sure they have a clear understanding of their role and the chain of command, that they have the equipment to complete their job, and that they have someone who cares about them having a pleasant working environment.

More often than not, happy staff means happy patients, and these two together are a winning combination.

Kelly Saxby,

Managing Director, Green Apple Dental Recruitment Limited.

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Editorial Board mandatory checks to ensure they have answered accurately. The updated details are automatically attached to the patient’s record, meaning that the clinicians can check them without the need of fussy paperwork.

In some implementations, such as the ‘PearlPad’ extension to Pearl Dental Software, changes to medical history raise a flag so the dentist is aware of the need to discuss the change with the patient. This obviously makes life easier for the patient and more efficient for the dentist. It also means that nurses and receptionists don’t have to fiddle around with filing and can instead focus on patient care.

“So much less filing”

File away the filing Like most people, I hate filing almost as much as I hate filling in forms. For me, a truly great piece of technology would make both easier – or even disappear altogether.

And that’s exactly what’s happening in the waiting rooms of hundreds of dentists.

The reason? They’ve implemented ‘tablet computers’ as data capture devices for personal details and medical history.

The device works by showing the patient a copy of their most recent personal information and allowing them to update it – with a few

Chloe, who is part of the reception team at one dental practice that has already adopted this idea, says; “It’s made my life a lot easier on reception, so much less filing!”

Using PearlPad means she doesn’t need to print off a medical history form, treatment plan, consent forms, FP17DCs or a PR Form for the patient to sign. And the tablet also means she doesn’t need to collect, scan, or stack them for filing afterwards.

The pad is handed to the patient for them to fill-out in the waiting area and handed back once completed. The completed forms are automatically stored or updated on the patient record depending on what the patient has filled in. It simply makes life easier for both the patient and the practice team.

Because people are used to computers, patients aren’t over-burdened by paperwork and see the practice as efficient and organised. As a professional communicator, I see this is an excellent example of how a practice can use technology to make a great first impression with patients.

Chris Webb,

Director, Precision PR.

For more Modern Dentist Magazine insights, news, trends, blogs, events news and stories FOLLOW US ON @ModDentistMag Modern Dentist Magazine

Send us over your news for our website www.moderndentist.co.uk To get in touch and find out how you can be featured in the magazine call Amanda on 01765 600909

Features Toothbeary’s fundamental principle revolves around positive reinforcement, a key component of a successful treatment. This however needs to be combined with truthfulness and authenticity

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Features

TOOTHBEARY

WORKING WITH CHILDREN Toothbeary is a unique, London-based dental practice designed specifically for children aged 0 – 18; the atmosphere is relaxed, positive and child-friendly, yet incorporates the highest standard of individualised paediatric dental care. Over the past 10 years, Toothbeary has successfully treated over 15,000 children and in doing so has laid the foundation of what is now a large community of the next generation of health-conscious children and young adults who will benefit from a happy smile, and good, long-term oral health.

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Features Parents are encouraged to use positive words such as ‘fun’, ‘exciting’, ‘playing’ and ‘counting teeth’ rather than saying ‘there is nothing to be worry about’ or ‘it won’t hurt’ The Toothbeary experience Founder and principal dentist, Nicole Sturzenbaum, designed Toothbeary with children in mind, a place where children feel at home. The journey starts before the child even arrives. During the initial contact, usually by phone, the receptionist collects detailed information about the child (medical history, previous experiences, pain, anxiety etc.). This ensures that the team is aware of preferences as well as potential challenges when approaching the child. Parents also receive a list of do’s and don’ts to support them in preparing their child for the initial visit.

Parents are encouraged to use positive words such as ‘fun’, ‘exciting’, ‘playing’ and ‘counting teeth’ rather than saying ‘there is nothing to be worry about’ or ‘it won’t hurt’. Despite a child not having a prior association of what a visit to the dentist is like, the latter implies that something unpleasant might lie ahead!

When it comes to the actual visit, the first impression dictates the way the child will feel and behave. The child-friendly experience starts from check in. The reception desk is low to ensure that the patient can see the receptionist, who greets the child personally and make them feel welcome. The Toothbeary branding is reflected consistently throughout the practice using colours chosen to create a calming effect on the child. The waiting room is a play area, with carpeted floors for children to lie on, holes to climb through and places to hide, as well as plenty of toys and books.

The Toothbeary team always keep the child at the centre of attention. They use open questions in a child-appropriate language.

Basic postulates of psychology state that if the child answers five questions in a row with ‘yes’, she/he will not say ‘no’ when asked if they want to lay down to have their teeth counted. Active listening has a reassuring effect and implies that everything is normal.

Nonetheless, as any parent can testify, giving children directives does not always work, especially when they are in an unfamiliar environment. At Toothbeary, children are given choices - choice over what DVD they wish to watch while they are lying on the treatment bench, choice over what flavour they can smell during the treatment, a choice of polishing paste, fluoride varnish and a host of other things.

Toothbeary’s fundamental principle revolves around positive reinforcement, a key component of a successful treatment.

This however needs to be combined with truthfulness and authenticity. Parents are encouraged to explain why they are visiting Toothbeary and it is important to uphold the positive but true representation of the dentist.

When it comes to the actual treatment, one has to remember that the attention span of a child is usually limited to around 20 minutes.

It is therefore of paramount importance to keep treatment times to a minimum while maximising the amount of treatment performed. This is achieved by means of 4 handed dentistry and meticulous planning.

Equipment is prepared in advance and kept out of sight when the child enters the treatment room. The child is guided through the treatment using behaviour management, voice control or visual imagery. Parents are invited to sit quietly in the corner of the room to ensure the child feels safe, however they are asked to refrain from interrupting the treatment.

The friendly hygienist accompanies the child and parent(s) to a purpose built and calming dental spa with individual stations designed to resemble a real bathroom. Here it is all about learning how to brush and floss your teeth effectively.

Thereafter, the child and parents will meet the dental nurse who will spend time to chat about oral hygiene, diet, hobbies etc., to build rapport/trust and make everyone feel comfortable and relaxed. Only then does the dentist join, who is dressed in the same colours as the nurse. During this first encounter, the dentist will assess the child in a holistic manner, namely evaluate overall health and not limited to teeth. Barring an emergency, Toothbeary avoids invasive treatment during this first visit. The ultimate goal is the complete assessment plus a comprehensive approach and treatment planning. This ensures that the child goes home with the positive feeling of success and emotionally prepared for their next visit, which may include treatment.

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Patient testimonials: “My 12 year old son has high functioning autism, sensory processing disorder and as a result of this was extremely anxious about his treatment. The staff were incredibly patient and managed to coax what must have been an extremely difficult patient into accepting the sedative. Everyone was amazing – thank you very much!”

“Outstanding! The nurses are incredible and they really know how to take care of children!”

Features

There are different treatment options at Toothbeary, all optimised for the needs of each individual child. The set-up at Toothbeary caters for all age groups and advanced treatment options include inhalation sedation, nasal or intravenous sedation. Toothbeary has built up a very successful sedation clinic with an experienced and dedicated sedation team.

The focus of any treatment is safety, and to be as gentle, effective and stress-free as possible. The equipment used is state-ofthe-art, and the child’s experience is always of primary importance, for example, the benches are equipped with TV screens, the instruments are colourful and the drills used are smaller than and not as noisy as the standard model.

The Toothbeary team always keep the child at the centre of attention

Toothbeary believes that every child has the right for a happy and beautiful smile in a healthy and strong body. Their concept is based on a holistic approach and combines a range of disciplines: • Caries risk assessment and individualised treatment and preventative approaches; • Specialist orthodontics and speech therapy to access dental and myofunctional development, breathing and swallowing patterns and related sleeping and concentration habits; • Hypnotherapy to combat anxieties and mental inhibition (including special needs children); • Dedicated dental trauma and Endodontic clinic for young and immature teeth; • Specialist Oral and Maxillofacial surgery for advanced treatment needs; • Specialist sedation as an alternative to general anaesthesia; • Working with Future Health Biobank for stem cell storage.

Dr Nicole Sturzenbaum holds a dentistry degree (University of Würzburg, Germany), a postgraduate certificate in paediatric dentistry (APW Germany) and a doctorate (Dr med dent) in paediatric dentistry (University of Jena, Germany). In 2008 she relocated to London to establish Toothbeary.

Nicole is on the Reader Panel of the BDJ Team, has published in national and international journals and regularly features as an expert regarding children’s dental health matters on BBC, ITV and Sky and in the Sunday Times.

Dr Nicole Sturzenbaum

is the Clinical Director of Toothbeary Children’s Dental Practice, Richmond.

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Features

DENTISTRY IS ON THE MOVE, LITERALLY! Jessica Emery, Director, introduces The Mobile Dentist Company and how they are bringing quality private dental care to those people who need or choose to have dental services done at home.

“We are a team dedicated to providing quality private dental care to people who need or choose to have a home dental service…”

The Mobile Dentist Company is a trading name of Advance Healthcare Logistics Ltd, which began, with a specialist registration, supplying on-site dental services in 2011, starting with a regular clinic at a medium secure hospital where taking service users out to local practices was problematic and expensive. Today we offer similar clinics at a range of NHS and private mental healthcare facilities as well as visiting care home residents and individuals in their own homes. We use portable equipment, including digital x-ray and carry out a wide variety of treatment including examination, hygiene, fillings, certain extractions and a full denture fabrication and repair service.

Our dental teams (dentist and dental nurse) travel in company vans and wear uniforms.

We have dental software that allows remote access and we are steadily working towards paperless clinical operation.

When we first started, people were surprised to hear about a mobile dental service and now, eight years later, people

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are still surprised to find that we exist. For patients unable to get out to a surgery, dentistry often becomes the missing piece of the healthcare puzzle as changes to the NHS contract and stricter regulatory and indemnity requirements mean very few practices now offer domiciliary visits.

Demonstrating that we can carry out “real” dentistry in different locations while adhering to the regulatory requirements is extremely important to us. Given that almost all of our patients fall into the category of vulnerable adults (occasionally children), proving that we are here to help resolve and prevent dental issues rather than to sell products or promote particular treatments is a high priority. We aim to focus on preventive care and while many of our patients initially come to us with a problem, a high proportion stay for regular follow-ups. We also offer a domiciliary Denplan scheme, which helps to spread the cost of care.

Sometimes the patients themselves make contact but often it will be a family member, friend or solicitor with power of attorney, a care home manager or domiciliary care agency. We are also asked for help by patients suffering with conditions like agoraphobia or

severe anxiety who do not meet the referral criteria for an NHS CDS visit. Our office staff need to be skilled at dealing patiently and professionally with a wide range of enquiries and expectations and able to explain the administrative hoops which must be gone through before an appointment can be arranged. These include ensuring that consent has been obtained and recorded, costs have been discussed and accepted and any necessary medical information is available.

Although this sometimes takes longer than we would wish, it is crucially important that all the paperwork is in place before a patient is seen by one of our clinicians.

When the dental team arrives for an appointment, everything will be doublechecked and the dentist will make their own assessment of the patient’s capacity. Our clinical staff are chosen for their experience, temperament and genuine interest in working with our patient groups - not all dentists and DCPs are suited to or enjoy it. Treating the elderly, people with limited mobility or those with physical, mental or emotional frailties takes a lot of time and patience - we allow much longer for each appointment than would be the case in a conventional practice because

Features Given that almost all of our patients fall into the category of vulnerable adults (occasionally children), proving that we are here to help resolve and prevent dental issues rather than to sell products or promote particular treatments is a high priority

For patients unable to get out to a surgery, dentistry often becomes the missing piece of the healthcare puzzle as changes to the NHS contract and stricter regulatory and indemnity requirements mean very few practices now offer domiciliary visits

building up a rapport with the patient and carers is key to a successful outcome. If a patient is unwilling or unable to co-operate we do not sedate, restrain or otherwise try to enforce treatment – although we have sometimes been asked to! Instead, we try to reschedule for a different time of day in the hope that the patient’s mood will be different.

If we cannot help, we will refer the patient and monitor the referral for them or their power of attorney.

Clearly, there is a limit to which treatments can safely be offered outside a surgery and our dentists must have the confidence to make their own decisions in this regard.

They are never under any pressure from the company to carry out any treatment. If, as occasionally happens, a patient or family member persists in requesting treatment

which is unnecessary or unsuitable in the home environment, our admin staff take over dealing with the matter, which can usually be resolved by calmly explaining the parameters in which we are allowed to operate.

After appointments we provide the patient or power of attorney with a report which details the results of the examination, any treatment given and any planned. If the patient is in residential care, they or their representative will often ask us to share this information with care staff so they can better help them manage their oral health. We try to be part of the healthcare team for our patients but always conscious of patient confidentiality and our obligations under the GDPR, which again highlights the importance of the administrative role in our business.

When we first started, people were surprised to hear about a mobile dental service and now, eight years later, people are still surprised to find that we exist

In secure hospitals, we are also dealing with a range of people, from the hospital director, through the clinical staff to the patients themselves. Effective communication and strict adherence to our policies and protocols, especially around consent, is essential to protect all parties. As well as providing effective dental care for the patients, we help hospitals by ensuring that they meet their CQC and NHS England requirements for dental access by monitoring appointments, FTAs and recalls. Where we provide this service, our admin staff and our clinicians have worked to become part of the hospital team, rather than providing a service in isolation.

We are a team – and we believe that our mix of clinical and non-clinical personnel is key to our being a successful one.

Jessica Emery

is a Director of Advance Healthcare Logistics Ltd and The Mobile Dentist Company. www.themobiledentistcompany.com www.advancehealthcarelogistics.com

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Features

Dental practice set for investment after changing hands

A family-owned dental practice is set to receive significant investment after being sold by its long-standing former owners, in a deal completed by a number of North East dealmakers.

Ridgway Dental Practice, in Chester le Street, has been owned by Paul and Marjorie Ridgway since 1996, and has grown significantly during that time.

The practice has expanded from its original home on the town’s High Street into much larger premises on South Burns, increasing from one to six surgeries and raising patient numbers five-fold to 25,000. Ridgway Dental Practice now has seven dentists working there and employs 13 other people.

Now, the practice has been sold to Dr Anjali Malhotra and her husband Rajan, who are now planning to invest in their new fast-growing business, which is adding 100 new patients a month to its books, to introduce a number of changes, including an expanded range of services, extended opening hours, updating equipment and modernising the interior.

Paul and Marjorie, whose two sons are following in their father’s footsteps by becoming dentists, admitted it was a

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“wrench” to sell their flagship practice after so many years but will retain ownership of another dental surgery in Wallsend.

The sale of Ridgway Dental Practice was brokered and completed by dealmakers at law firm Sintons, accountants UNW and specialist business property advisor Christie & Co, all of which are prominent advisors in the healthcare sector and have collectively overseen a number of major deals in this sphere.

Marjorie, who has worked with her husband at Ridgway Dental Practice for the last few years, said: “When we first started off in Chester le Street, it was in a little premises

based above a butcher’s shop – now we have a really nice dedicated premises and have seen strong growth in terms of patient numbers, numbers of surgeries and how many people we employ. We have become well known to so many people in the town, and really feel part of the community.

“It was a difficult decision to sell, and is one that Paul made for personal health reasons, but we are happy to have found a buyer who we believe will bring the business on. It was important to us not to sell to a big corporate, but instead someone who would have the same approach as us and run it as a family business.”

The opportunity to purchase Ridgway Dental Practice was the next step for me in my career and I was delighted when my offer was accepted Dr Anjali Malhotra

Features

The future of the practice has never been stronger. It truly is an exciting time to be a part of Ridgway Dental Practice and I am grateful to have an experienced team working alongside me to support the future vision of the practice, building on the strong foundations that Paul started 20 years ago Dr Anjali Malhotra

Anjali, who graduated with her Masters in dentistry earlier this year, said: “The opportunity to purchase Ridgway Dental Practice was the next step for me in my career and I was delighted when my offer was accepted.

the deal on behalf of the Ridgways, who are long-standing clients of the firm. Amanda Maskery, head of NHS healthcare at Sintons, alongside head of corporate and commercial Karen Simms and real estate partner Victoria Armstrong acted for the couple.

“I worked in the practice as an associate while my sale agreement was being prepared, which gave me the time to get to know and understand the practice, patients and the staff. I think this really helped with the announcement of the sale so the transition was easy, as I was already part of the family.

Amanda Maskery said: “We have known Paul and Marjorie for many years and they have done a fantastic job in building up their practice in Chester le Street into the sizeable, thriving operation it is today, and is at the heart of its community. We are pleased they have found a purchaser in Anjali who shares their vision and values, and can rest assured the business they have worked so hard to build is in safe hands.”

“The future of the practice has never been stronger. It truly is an exciting time to be a part of Ridgway Dental Practice and I am grateful to have an experienced team working alongside me to support the future vision of the practice, building on the strong foundations that Paul started 20 years ago.”

The specialist nationally-renowned dental team at Sintons, based in Newcastle, completed

Alan Suggett, head of the dental business unit at UNW, said: “We are delighted to have helped Paul and Marjorie sell their practice and thrilled that the buyer Anjali was another UNW client – although sadly, due to a conflict of interest, we couldn’t act for both parties in the transaction. Paul and Marjorie leave an excellent dental legacy for Anjali to develop

further. We wish all parties the very best for their respective futures.”

Paul Graham, director at Christie & Co, handled the sale. He said: “It was great to be part of this significant sale and work alongside Amanda and Alan, who helped ensure a smooth transaction.

Paul and Marjorie were keen to find a buyer who would continue the legacy and reputation of their excellent practice.

“Following a successful marketing campaign and multiple bids being received, we found the perfect buyer. The business sold in excess of the original asking price, highlighting the continued demand for dental practices across the region with demand outstripping supply.”

The Malhotras were represented by Betsan Powell from JCP Solicitors in Swansea and John Minford from Minford Chartered Accountants, York.

Sintons Law is a full service law firms based in Newcastle upon Tyne, providing first class legal advuce across a wide range of legal services.

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Features

First impressions are so important

Treating dental anxiety at Dental Excellence Harewood First impressions are so important and when patients drive through the imposing archway and arrive in the beautiful Harewood country estate, they are immediately more at ease. Parking in front of a caringly restored Georgian building and walking into a relaxing reception and waiting area confirms that this is not like any previous experience they have had of dentistry. All of this is vitally important as most reasons for dental anxiety stem from previous bad experiences, so the more we can distance ourselves from these previous experiences the better.

I have spent the last thirty-six years tackling the challenge of treating anxious patients.

I have many, many examples of anxious patients that I have treated over the years, ranging from mildly anxious to extreme phobia. Although every single patient needs a specific approach, there are many common factors to most patients.

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A fresh start A lot of the techniques that I have developed over the years have been based on doing the opposite to what most anxious patients have experienced: “What didn’t I like about the dentistry I experienced growing up?”

• Being kept waiting • Being rushed • Being treated as a walking set of teeth • Being hurt • Lack of explanation • Not being listened to • Counting the cobwebs/cracks on the ceiling • The smell When we set up Dental Excellence Harewood it was purposely designed to not look like any dental practice a patient had previously attended.

This was to be a new start, a clean sheet to allow us to regain the confidence of patients.

As already mentioned, the building and location are very different. No stress driving into a city centre, no worry about finding a parking space and walking to the practice or even how much to put in the parking meter. Just drive up to the front door, park and walk in.

Keep on time We all accept that occasional unforeseen events cause us to run late. These must be very occasional. If you routinely run late, change your appointment timings or build in buffer zones. The only complaints I used to get was when I took a patient in early. They were enjoying a quiet coffee in the relaxing waiting room. I now make sure to check which patients want to be seen early and which ones want their full coffee time.

Features

A multi-disciplined dental centre, located within the grounds of Harewood House in Leeds, West Yorkshire, Dental Excellence Harewood has been developed to put patients at ease. Donald Sloss, Founding Partner and Dentist, talks about the challenges we face when treating anxious patients and how the atmosphere and layout of a dental practice can make that particular challenge easier for the both the patient and dental team.

Listen to your patients When patients enter the surgery they are the centre of everything. They must get our complete and undivided attention. With new patients I like to sit down with them in comfy chairs away from the dental equipment and listen to them. Again, not something patients normally expect. Their previous experiences are usually to come straight into the surgery, sit down in the dental chair with the dentist leaning over them asking them questions.

Taking time to listen to patients is vital. It makes them feel important and cared for. It lets them tell you what has happened in the past and how to avoid repeating previous bad experiences. It lets you know how to treat them going forward. It only needs to take a few minutes but it transforms the patient’s attitude to you and their future treatment.

Eye contact and lack of background noise and distractions is vital. The dental nurse is a vital part of the team. They may be helping by taking notes of the conversation, this should not be by ‘banging’ on the keyboard. What they must not do is to be clattering about tidying up the surgery. Even when they try to do this quietly, it is a major distraction for the dentist and more importantly, the patient.

Once you have let the patient talk to you, show them that you actually listened. There are so many factors to good listening including body language and the phrases you use, but essentially, make sure you reference what they tell you, summarise it and offer reassurance and possible solutions.

When the patient is ready they can progress to sit in the dental chair, and yes, it is a very comfy one. Many of the procedures we carry out at Harewood can last several hours. It’s

really important patients are comfortable not just initially but for a lengthy period of time.

Distractions Rather than looking for cobwebs, our patients watch the flat screen television above the chair. Just be careful what channel it’s on; although some patients actually enjoy Jeremy Kyle but most don’t and it’s certainly not the most relaxing program. Although you can ask patients what they want to watch, most new, anxious patients don’t want the trouble of making a decision like that at this point.

Different for more routine patients where it is more appropriate to take the time and courtesy to ask them. I tend to leave it on a ‘safe’ channel initially.

After the clinical examination digital radiographs and photographs are taken. We can then retire back to the comfy chairs.

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Features

It’s a privilege to be part of such an inspiring team There we can look at the radiographs and photographs on a large screen to let the patient understand and own their problems and jointly plan solutions to their problems.

It’s amazing to see the difference in patients from being so anxious on arrival to being so much more relaxed when leaving.

Having a great team makes the difference Although I have the main responsibility at Harewood for treating anxious patients, the same ethos runs through the whole team, from reception, through to the nursing and hygiene teams to the specialists. It’s great to have complete confidence that whoever is involved in the care of your patients will add to the increased sense of confidence.

Apart from their skills in patient management, the spread of expertise at Dental Excellence allows us to plan and

provide all treatment necessary for our patients. From complex endodontics, through to periodontal therapy, whether treating chronic disease and boneloss or aesthetic gingival grafting through to immediate full arch implant placement. It’s a privilege to be part of such an inspiring team. Especially to now be able to take someone from having failing teeth straight through to having full arches of fixed implant bridges in one day is truly revolutionary. I still shudder to think of the clearances I used to perform placing immediate dentures for six months healing before making definitive dentures. What would I want for my nearest and dearest in that situation? A mouth full of bleeding sockets and two lumps of acrylic or the immediate placement of fixed implant retained bridges?

Dr Donald Sloss was voted Dentist of the Year for his work with anxious dental patients and is the immediate past President of the British Academy of Cosmetic Dentistry.

Donald and Howard will be running an evening on then management of dental anxiety at Dental Excellence Harewood, for further details on this and all other courses on our educational calendar visit www.dentalexcellenceharewood.com

Fears and phobias Getting back to specific fears, fear of being hurt is top of the list so it really helps to

When patients enter the surgery they are the centre of everything.

They must get our complete and undivided attention 44|Modern Dentist Magazine

Features

When we set up Dental Excellence Harewood it was purposely designed to not look like any dental practice a patient had previously attended. This was to be a new start, a clean sheet to allow us to regain the confidence of patients be able to look the patient in the eye and promise ‘pain free’ treatment. There should be no excuse for painful injections and even less excuse for painful treatment. With a bit of time and care, nothing should hurt in dentistry. When talking to patients, we also need to be very conscious of our words, so although I can talk about ‘hurt’ and ‘pain’ to dentists, I use words like ‘comfort’ and ‘uncomfortable’ when talking to the patient.

Taking the use of words much further, we have the great benefit of having a colleague who has a much better understanding of the use of words then I do.

Howard Samuels and I completed our diploma in conscious sedation together and we then lectured together on dental anxiety and sedation. Whereas I concentrated on sedation, Howard went down the psychotherapy route. He has now retired from clinical dentistry and spends his time dealing with all sorts of phobias and anxieties both dental and non-dental. This allows us to offer the full spectrum of options to patients who come to see us. From simple comfortable dentistry through to sedation, NLP/conditioning or hypnosis. In terms of

dentistry as a whole, it is much better to have all the tools to treat patients rather than be a master of one tool and have to use it on every patient regardless of whether it is the most appropriate.

I am conscious that at Dental Excellence Harewood we have the benefit of beautiful facilities and the back-up of a great team.

None of the dentists at Harewood were born with the skills that they have now developed.

We are all appreciative of the work done in general practice because we have all been there. We appreciate when dentists place their trust in us and refer their patients to us and we appreciate that past treatment has been done in more difficult circumstances than we are able to operate in so no referring dentist should worry about being judged in the treatment they have managed to provide.

We look on ourselves as an extension of the referring practice’s team and look to return the patients happy and appreciative for having been referred.

Dr Donald Sloss

is a Founding Partner and Dentist at Dental Excellence Harewood.

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Modern Dentist Magazine

Features

A new era, a new Chairman As the ADG enters a new era in its history, it is delighted to introduce Mr Neil Carmichael as its new Chairman.

Neil served as a Member of Parliament for Stroud Valleys and Vale from 2010 to 2017, and was Chair of the Education Selection Committee from 2015 to 2017. He previously established two Parliamentary Party Groups – Governance and Leadership in Education, and Vascular Diseases.

“I have always been interested in public policy and in making sure that public services – in as wide a sense as possible – are properly promoted and navigated through the world of politics, decision making and government,” he comments. “I was in the House of Commons for seven years so I appreciate the importance of getting complex arguments across as necessary when decisions were being made in Whitehall.”

Having kept abreast of healthcare policies over the years, Neil understands what dentistry means for the wider sector and for the well-being of the general public. He says: “I think that dentistry needs to be recognised as a really important part of public health.

46|Modern Dentist Magazine

Having access to a good dental practice is critical for both people’s oral health and general well-being. It seems to me that we need to put dentistry right at the top of the political and policy agenda.

“I have four main objectives that I hope to see achieved while fulfilling my role as Chairman of the ADG. The first is to make sure that the ADG is one of the first ports of call when decision makers are thinking about the future of dentistry. The ADG should be even more widely acknowledged as a critical contact for constructive engagement with policy makers in this area.

“The second objective would be to tackle some of the issues affecting the sector as a whole right now, such as workforce planning. We need to consider where dental professionals will come from in the future and how we might encourage them to continue working as dentists in the UK. That leads on nicely to the third area I hope to focus on – a lot of work needs to be done regarding the relationship between dentists,

dental professionals and the NHS. The contract, in particular, still requires attention, and with a breadth of combined knowledge and experiences, ADG members are well placed to remain involved in the reform process as it unfolds.

“Finally, I believe it is critical that we think very carefully about how the general public is served by the dental profession. Dental groups have a very strong role to play in this, as they have the opportunity and the passion to become active promoters and guardians of high standards across the profession.”

These are, of course, difficult political times and so the challenge is certainly to help the right people understand the importance of dentistry and the potential consequences good dental care can have on other areas of the NHS and general health of the nation.

For example, effective preventive dental care could help to reduce the number of children requiring extractions in hospitals.

This would not only improve child oral health in the UK, but also lessen the burden on an

Features

Dentistry needs to be recognised as a really important part of public health.

Having access to a good dental practice is critical for both people’s oral health and general well-being

already strained workforce and reduce the overall cost to the NHS. Neil is passionate and practical about how the ADG could help to affect change.

“We need to produce solutions that are both appropriate and deliverable for the issues currently being faced. Working through our policy ideas and converting them into wellresearched policy papers is the first step. We may be approaching this from the perspective of dental providers, but our ultimate aim is always to improve the dental environment for the benefit of patients.

“To the same end, it’s also very important that we engage thoroughly with all stakeholders – of which there are many in this sector. We all need to understand each other’s roles and work together in order to achieve outcomes that serve the best interests of both the profession and patients. The ADG will be reaching out to more dental groups in the coming months to seek their input and invite them to join our crusade, giving us an even stronger voice.

The Association of Dental Groups (ADG) is a professional trade organisation whose members are dental providers and employers that operate corporate or group models to serve private and/or NHS patients in the UK. It is committed, above all else, to improving access and quality of dentistry for patients across the nation.

It is critical that we think very carefully about how the general public is served by the dental profession. Dental groups have a very strong role to play in this, as they have the opportunity and the passion to become active promoters and guardians of high standards across the profession “Having attended my first ADG Board and Members’ meeting, I have discovered a vibrant, well-informed, professional and highly motivated group of people. I am absolutely convinced we can use all of these strengths to make sure that dentistry is at the top of the political agenda, so we can advance the best ideas for dentistry as a whole. I believe my long-time interests and involvement in health and public services will help me continue driving the ADG towards its goals and I look forward to seeing what we achieve together.”

Neil Carmichael

is the Chairman of the Association of Dental Groups.

For more details about the ADG visit www.dentalgroups.co.uk

|47

Modern Dentist Magazine

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PRODUCT REVIEW

51

Planning to sell your dental practice?

When selling your practice, it is important to get the best price as well as an efficient and streamlined process. Mark Woodger, former practice owner, discusses his experience when he sold his practice through PFM Dental.

53

Stand out from the crowd

Speaking to Dr Kev Patel, Bond Dental, we found out why he decided to use Digimax Dental to help create his brand and establish an online presence different from other dentists in the market.

DENTAL

TM

55

Enhancing your team

All dental professionals are required to take part in continual professional development (CPD) in order to maintain their registration and meet the current GDC standards. David Wright BDS, Wright’s Dental, discusses his experience using Isopharm’s Enhanced CPD training for his staff and why using the e-learning platform is the perfect fit for his practices.

57

Embarking on an adventure!

Dr Anh Ky To, Principal and Dental Surgeon at Blueberry Dental, discusses his latest challenge: the Marathon Des Sables, and why he will be sacrificing the space and taking his Sleepwell device with him.

CASE STUDY

58

Minimal Intervention Aesthetics in a Molar Incisor Hypomineralisation (MIH) case

61

ANCAR presents its new dental units at the rhythm of violin and laser lights

|49

Modern Dentist Magazine

Planning to sell your dental practice?

Planning Planning to to sell sell your your dental dental practice? practice?

Planning Planningto tosell sellyour yourdental dentalpractice? practice?

Selling your practice is a big deal. That’s why we pride ourselves Selling Sellingyour yourpractice practiceisisa abig bigdeal. deal.That’s That’swhy whywe wepride prideourselves ourselves on integrity and professionalism -That’s with why a why unique blend of services Selling Selling your yourpractice practice isisa abig bigdeal. deal.That’s we wepride prideourselves ourselves ononintegrity integrityand andprofessionalism professionalism- with - witha aunique uniqueblend blendofofservices services that make the whole process as -streamlined as possible. onon integrity integrity and and professionalism professionalism with - witha aunique unique blend blendofofservices services that thatmake makethe thewhole wholeprocess processasasstreamlined streamlinedasaspossible. possible. that thatmake makethe thewhole wholeprocess processasasstreamlined streamlinedasaspossible. possible.

An ethical approach An Anethical ethicalapproach approach An Anethical ethicalapproach approach Our valuations are based on solid data, reliable

Our Our valuations valuations areare based based onon solid solid data, data, reliable reliable calculations and an unrivalled knowledge of the Our Our valuations valuations are are based based onon solid solid data, data, reliable reliable calculations calculations and and an an unrivalled unrivalled knowledge knowledge ofof thethe market. Every practice is different and that’s why calculations calculations and and anan unrivalled unrivalled knowledge knowledge ofof thethe market. market.

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Experienced specialists Experienced Experiencedspecialists specialists Experienced Experienced specialists We’re a specialistspecialists dental practice agency, so

We’re We’re a specialist a specialist dental dental practice practice agency, agency, so whether you’re selling to a corporate, ansoassociate We’re We’re a specialist ayou’re specialist dental dental practice practice agency, agency, soassociate so whether whether you’re selling selling to to a corporate, a corporate, an an associate or on the open market, we’ve helped hundreds of whether whether you’re you’re selling selling to to a corporate, a corporate, an an associate associate oror onon thethe open open market, market, we’ve helped helped hundreds hundreds ofof other people just like we’ve you. or or onon the the open open market, market, we’ve we’ve helped helped hundreds hundreds ofof other other people people just just like like you. you. other other people people just just like like you. you.

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These These buyers buyers really really are are engaged: engaged: 95% 95% ofbusiness. of NHS NHS practice practice sales sales are are to to priority priority buyers buyers and they’ll cover the agency fee on your behalf. and of of NHS NHS practice practice sales sales areare to to priority priority buyers buyers and and they’ll they’ll cover cover thethe agency agency fee fee on on your your behalf. behalf. they’ll they’ll cover cover thethe agency agency feefee onon your your behalf. behalf.

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Over to legal Over Overtotolegal legal Over Overto tolegal legal Once we’ve unearthed the perfect buyer, our

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Our legal team takes care of the transaction and Our Our legal legal team team takes takes care care of of the the transaction transaction and and accountancy colleagues can prepare your figures, Our Our legal legal team team takes takes care care of of the the transaction transaction and and accountancy accountancy colleagues colleagues can can prepare prepare your figures, figures, ready for sale.

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Considering selling?

Considering Considering selling? selling?

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We’re here to selling? help We’re We’rehere heretotohelp help We’re We’rehere heretotohelp help

01904 670820 sales@pfmdental.co.uk pfmdental.co.uk 01904 01904670820 670820 sales@pfmdental.co.uk sales@pfmdental.co.uk pfmdental.co.uk pfmdental.co.uk 01904 01904670820 670820 sales@pfmdental.co.uk sales@pfmdental.co.uk pfmdental.co.uk pfmdental.co.uk

Planning to sell your dental practice?

When selling your practice, it is important to get the best price as well as an efficient and streamlined process. Mark Woodger, former practice owner, discusses his experience when he sold his practice through PFM Dental.

Q A

When looking at selling, what were your main priorities?

Finding the right buyers who would look after our staff and patients well; getting a fair price for the practice we’d worked so hard to build and ensuring a smooth transition as quickly as possible.

Q A

What features did you look for when choosing a sales agent?

We wanted someone who understood dentistry well, who was able to advise us on how to market discreetly, and ensure we got the right return on our investment. We also wanted a supportive agent who would guide us through the process and make sure it all went smoothly.

Q A

What made you choose PFM?

PFM has provided our practice with advice for many years. Their attention to detail and customer service has always been at a high level, which made approaching them an obvious choice for us.

Q A

How do you feel they enhanced your requirements?

Using PFM’s in-house legal team greatly enhanced the experience and took the pressure off. Having the sales agent and legal team working together meant that we were able to get from sale agreed to completion in six months. They helped us to do all the right preparation, supported us with the diligence work, and kept us on schedule all the way through. We had personal contact with the team any time we needed it so were able to get advice and support in a timely way.

Q A

Would you recommend a specialist agent to other people looking to sell?

Having someone who understood the complex business of dentistry, the market, and our requirements for sale made an enormous difference. We had confidence throughout the whole process, which got very complicated at times. Without the support and advice of PFM we’d have had much higher stress levels, and a far less efficient transition.

Why PFM Dental?

We’re proud to be able to offer an unrivalled blend of in-house expertise. We only work for dentists, so we know the business inside out.

And we know our clients too.

From preparing the first set of accounts for a newly-qualified associate to wealth management for the retired, we’re the trusted advisers for dentists throughout their careers - and beyond.

PFM Dental was established in 1990 and over the years we’ve worked hard to put together a unique all-round service exclusively for the dental profession. We work together as one team but with four specialisms: practice sales and valuations, wealth management, legal and accountancy.

Mark Woodger

is a former practice owner and the current Technical Director at Digitally Transform Me.

Having someone who understood the complex business of dentistry, the market, and our requirements for sale made an enormous difference

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Modern Dentist Magazine

Stand out from the crowd Speaking to Dr Kev Patel, Bond Dental, we found out why he decided to use Digimax Dental to help create his brand and establish an online presence different from other dentists in the market.

Q A

How has Digimax Dental enabled you to grow as a practice?

Our brand is strong and that is the key if you want to be remembered

Digimax Dental has been fundamental in the growth of my business. As I am based in Central London it is a very competitive market. They know how to attract attention in a positive way.

Q A

How did Digimax Dental help you to establish your brand identity?

After deciding on our practice name, Bond Dental, the Digimax team helped create a brand and style that fitted well with both the name, location and the type of patients that would be attracted to our clinic.

They really involved us in the decision making with back and forth emails on the designs, layout and content.

Q A

Why is it important to have a large presence online in this day and age?

Online presence was a ‘no brainer’ for me as a growing business. Online presence is key, with a lot of the public being time poor, they quickly turn to the internet for reviews and images. A website and a social media presence are important to attract and inform potential patients of all ages.

Q A

Has there been an improvement in retention and gathering new patients?

We have had big increase in new patients. Our brand is strong and that is the key if you want to be remembered.

Q A

What is it like working with Digimax Dental?

The Digimax team are awesome. They are an extension of my Bond Dental team. It is particularly great as they are a one minute walk away in Marylebone, London. Very approachable and extremely friendly. I would not go anywhere else!

Dr Kev Patel

is the Principal of Bond Dental.

Online presence was a ‘no brainer’ for me as a growing business. Online presence is key, with a lot of the public being time poor, they quickly turn to the internet for reviews and images

Digimax Dental We are an award-winning Dental Marketing Agency based in Marylebone, London. We have been helping practices Stand Outand Grow since 2003. Our team consists of dental web designers, SEO experts, branding specialists and graphic designers. From website design, social media, through to digital advertising and printing – at Digimax Dental, every marketing need for your practice is catered for – requiring minimal input from you.

We have a deep understanding of dentistry from a patient and dentist’s perspective and know what is required to make your practice marketing a success. We apply the very best design talent to produce work proven to convert patients.

Our clients tell us our work is unique, and they have seen nothing like it in dentistry.

Our solutions are never one-size-fits-all – we strive to be better every day and produce unique work that makes you stand out from the competition.

DENTAL

TM

Watch their film at:

www.digimax.dental

|53

Modern Dentist Magazine

33,000

Clinical Courses

Enhancing your team All dental professionals are required to take part in continual professional development (CPD) in order to maintain their registration and meet the current GDC standards. David Wright BDS, Wright’s Dental, discusses his experience using Isopharm’s Enhanced CPD training for his staff and why using the e-learning platform is the perfect fit for his practices.

Q

How has the introduction of the product not only facilitated the practice and dental professionals but also enhanced the patient experience?

A

It’s fantastic that we can direct all our staff to one place to fulfil their training requirements, especially as our staff cover more than one practice. This has provided confidence, while offering us comfort in the staff competency’s in ensuring excellent patient care.

Q A

What features did you look for when choosing such a product?

We wanted to ensure that all the training we invested in was compliant and regularly kept up to date, which Isopharm provide in an affordable way. The PDP feature has really been an added benefit with the step by step guide helping my team along the way.

Q A

Q A

How has it improved the way you and your team work?

With all staff utilising the same training site, we can now set training courses to be completed by our team at their own pace.

Having this facility in any practice is a must for all practice owners wanting the best for their teams.

Q A

How can you see the need for products like this evolving in the future?

I’m looking forward to the group reporting functionality being released in the near future as I feel this is the next step to aid Practice Managers and Practice Owners.

David Wright BDS

is the Principle Dentist at Wright’s Dental.

How easy was it to implement the product into your practice?

We signed up using the group sign up service, which was a very easy process.

With the site being very intuitive, our team found it very easy to navigate and access the training they needed.

ISOPHARM Isopharm provide a professional, interesting and easy way of completing your learning requirements whatever role you play in the dental team.

Our dental training is offered via our E-Learning platform, as we understand that you have busy professional lives.

This means you can access CPD and learning when you have time.

Isopharm comply with GDC Enhanced CPD stipulations, including reflective learning, linking all courses to relevant development outcomes and quality assurance on course content. Annual subscribers benefit from automated PDP functionality, enabling the achievement of compliance goals and enhancing a user’s current knowledge base. Isopharm utilise SWOT analysis to identify areas that may affect progress and allow successful planning throughout your CPD cycle. Subscribe and save, with instant access to all our online verifiable CPD courses for only £36 per annum. Alternatively pay as you go, buying the online verifiable CPD courses that you need, when you need them. Prices range from £2.99 - £6.99.

It’s fantastic that we can direct all our staff to one place to fulfil their training requirements, especially as our staff cover more than one practice

|55

Modern Dentist Magazine

Around 1 in 3 men and 1 in 4 women snore.

Snoring and Sleep Apnoea - A Role for the GDP Presented by Professor Ama Johal

For dates and to book your place, visit s4sdental.com/ecpd.

Embarking on an adventure!

Dr Anh Ky To, Principal and Dental Surgeon at Blueberry Dental, discusses his latest challenge: the Marathon Des Sables, and why he will be sacrificing the space and taking his Sleepwell device with him.

On the 5th April 2019, I will be taking part in the Marathon Des Sables race. It has been described as The Toughest Footrace on Earth. I have never been much of a runner; a sports physiotherapist once told me that I wasn’t designed for running so I am looking forward to seeing what my body can achieve. In just six days I will attempt to run/ walk/crawl over 250km (156 miles) through the Sahara Desert. I will be self-sufficient, carrying all food and equipment required for the week in my rucksack.

Over the 14 years at Blueberry Dental Surgery I have managed to detect 14 patients with cancer. Early detection has helped these patients to make an amazing recovery and go on to enjoy their future wellbeing. For this reason, I would like to raise money for the Mouth Cancer Foundation, for the great work that they have done, so that everyone can benefit from early detection and receive the best treatment available. With 12,000 cases of head and neck cancer a year being detected, I hope my contribution to help those patients to have the best outcome possible.

Marathon des Sables: MDS is a six-day, 251 km ultramarathon, which is approximately the distance of six regular marathons. The longest single stage is 91 km long. This multi-race is held every year in southern Morocco and attracts 1000 runners from all over the world. The first event of the Marathon started in 1986. The youngest competitor ever was only 16 years old!

Whilst in the Sahara desert we will be sleeping in close proximity with eight other people under a bouvier. Being a snorer, I am going to invest in getting a Sleepwell device from S4S so I can have a good night’s sleep and keep things quiet for my fellow tent mates!

I have been training consistently for 12 months now, yet this will still be the most demanding and gruelling thing I will have done in my life.

I have done Spartan races and half marathons in the past. Most recently I have completed the Pilgrim Challenge – a two day, 66-mile ultra-marathon across legendary North Downs Way. My everyday training consists of some weight training and as you can guess - plenty of running! I also wear a weighted vest of 8 kilograms at work; this will help me to prepare to carry a rucksack filled with all the essentials and food in the desert. To be ready for the hot temperatures of Sahara desert I also train on a static bike with electric heaters on in my bathroom. I am also planning to do some hot yoga in the near future!

As they say, the best things in life are just outside your comfort zone. I am looking forward to embarking on this life-changing epic adventure!

Wish me lots of luck!

Dr Anh Ky To (Bob)

is the Principal and a Dental Surgeon at Blueberry Dental.

Find out how Bob gets on in one of our future issues.

Being a snorer, I am going to invest in getting a sleepwell device from S4S so I can have a good night’s sleep and keep things quiet for my fellow tent mates!

The best things in life are just outside your comfort zone. I am looking forward to embarking on this life-changing epic adventure!

S4S At S4S, we are passionate about supporting good causes where we can, and, as such, host a Dental Charity Ball each year. This year will be our 5th event, where we are fundraising for Sheffield Children’s Hospital Charity. In previous years, we have supported charities including DentAid, CLAPA, Mouth Cancer Foundation and Bridge2aid. We are proud to support Dr Bob, a valued customer of ours, on his amazing journey!

I’m sure his fellow runners will also be grateful of his weight sacrificed by taking along his Sleepwell. A good night’s sleep will be vital on this physically demanding challenge. You too can support Bob – visit www.justgiving.com/bob-to or Text MDSB51 £2/£5/£10 to 70070.

From all at S4S, we wish Dr Bob To the best of luck!

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Modern Dentist Magazine

Case Studies

Minimal Intervention Aesthetics in a Molar Incisor Hypomineralisation (MIH) case Case presentation and diagnosis This patient attended the practice and was referred in by a friend who had undertaken treatment in the practice for white spots. This patient complained of white speckling on her central incisors. She had previously had composite placed on the incisal edge of her UL1 as it had been chipped for many years.

Medically the patient was fit and well and had been a regular dental attender, and clinical and radiographic examination had shown good oral hygiene, although some areas of bleeding on probing, no caries present and no signs of pathologically worn or fractured teeth. The patient did have similar white spot defects noted on her molars. The patient was diagnosed with mild gingivitis and Molar Incisor Hypomineralisation (MIH). The patient had signs of hypomineralisation on her first molars, however these teeth were healthy without any clinical caries (fig.1).

this case are outlined below in ascending order of level of invasion: 1. Do nothing 2. Whitening Only 3. ICON resin infiltration (+/- whitening and or composite) 4. Microabrasion 5. Restorative direct: composite (+/- whitening) 6. Restorative indirect: veneer/crown restoration (+/- whitening)

experience or management armamentarium (Kelleher 2010) The patient was keen to improve the colour of her teeth whilst masking the white spot lesions in the most minimal manner, which follow the principles of ultraconservative dentistry (Banerjee 2013).

Treatment plan The case posed the perfect situation for resin infiltration. The white spots were relatively superficial, and a minimalist approach was something the patient was looking for.

1. Full mouth supra and subgingival scaling and prophylaxis 2. A two-week period of home whitening with 10% and 16% Carbamide Peroxide.

3. ICON resin infiltration with achromatic composite bonding.

4. 1-week post-operative review.

The patient had been advised by her previous dentist to not undergo any treatment for her white spots, as treatment would entail drilling out the white spots, or even preparation of the teeth for veneers. To the credit of the previous dentist, the option of no treatment was advised. The options for

Do nothing was still an option, but not one the patient was considering. Many years ago, the patient had completed whitening and this did not seem to improve the appearance of the white spot, conversely, the appearance of the white spots had worsened. This is a very important consent and communicative point to have with patients. Microabrasion is an option, which is not too dissimilar to resin infiltration, however may be considered more invasive, as this requires the removal of the white spots completely. Restorative options in this scenario are somewhat excessive in terms of level of invasion of tooth structure.

Although the UR1 will need new composite bonding incisally, removal of the white spot using traditional methods would be considered too invasive. Indirect restoration seems far too excessive under these circumstances and would never be considered as an active treatment option in the authors

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Discussion regarding treatment options

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Treatment sequence The treatment sequence was a hygienist appointment to optimise her gingival health.

Upper and lower alginate impressions were then taken to fabricate whitening trays to whiten the teeth. By increasing the value of the teeth (‘degree of whiteness’) maximises the ability of masking white spots. In addition, Greenwall (2009) outlines that there is a

Case Studies

The most significant stage in the ICON process is the ICON dry as it is the opportunity to test drive what the tooth will look like once infiltrated

significant chance for the white spot to be reduced in size and appearance. However, an important communicative point is that the white spots may almost appear more apparent during the initial whitening phase.

In this case the patient used Enlighten Home Whitening with 1x10% CP and 1x16% CP. Once the whitening has been completed, it is important to wait 14 days before committing to any composite bonding. Firstly, this is related to colour stabilisation, the value will stabilise over this 2-week period, rather than the slightly exaggerated white on the day of finishing whitening. More importantly, it has been shown by many colleagues (Comlekoglu et al 2010; Neto et al 2018, Moosavi et al 2015) that the bond strength of resin composite can be reduced by as much as 20%.

The patient then attended for resin infiltration.

As has been shown by many colleagues, rubber dam is an effective and important

method for isolation when undertaking adhesive restorative dentistry (REF Cajaziera et al 2013; Heintze et al 2012; Gilbert et al 2010). With reference to ICON, I would say this is absolutely mandatory, as the etchant used is 15% Hydrochloric acid, and adequate barrier selection is of paramount importance.

The teeth were isolated (fig.2), and existing composite was removed on the upper right central’s incisal edge (fig.3).

The tooth pellicle was removed using a slow hand piece and a prophylaxis brush, without any prophylaxis paste.

The first cycle of ICON-etch was carried out (fig.4). This is applied topically to the white spot region, with a light scrubbing motion for 2 minutes (fig.5). This is then washed copiously.

Each application has been shown to remove 50 microns of Enamel (Paris et al 2010)

This case demonstrates how modernday techniques can be used to maximise the ability to improve the appearance of white spots whilst minimising their intervention

The most significant stage in the ICON process is the ICON dry as it is the opportunity to test drive what the tooth will look like once infiltrated. The tooth is washed and air dried (fig.6) Apply this solution (99% Ethanol) over the tooth and monitor over 30 seconds (fig.7).

If the white spot is still visible, then a re-etching process is undertaken and repeat the ICON dry (fig.8, 9). This case after 3 cycles of etching had shown complete masking of the white spots on both central incisors. Then the white spots are infiltrated with the resin (TEGDMA based).

This is applied using a scrubbing motion for 2 minutes over the tooth (fig.10), followed by a 1 minute of letting the resin sit on the teeth. The excess is removed by flossing interproximally and cotton wool pledget to remove excess infiltration. This is cured for 40 seconds per tooth. As this is a low viscosity resin with no-filler particles, there is a high degree of contraction, therefore the resin is re-applied for 1 minute, left to sit for one minute and excess is removed in the same way. The infiltrant is again cured for 40 seconds per tooth (fig.11).

Having completed the ICON process in this case meant that we had invaded the tooth structure by 150 microns. Although this is minimal by comparison of more conventional restorative procedures, this is sufficient to leave a depression on the labial surface of the enamel.

Fig.7

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Case Studies Overall the patient was delighted with the result, and whilst perhaps more enamel tertiary anatomy could have been created, the overall result was a huge step forward for this patient, giving her the confidence to smile openly again References Bannerjee, A. Minimal intervention dentistry: part 7. Minimally invasive operative caries management: rationale and techniques. British Dental Journal. 2013 (214): 107–111 Cajazeira, M.R.R., De Saboia, T.M., Maia, L.C. Influence of the operatory field isolation technique on tooth-coloured direct dental restorations. American Dental Journal (2014); 27: 155-159 Comlekoglu ME1, Gokce B, Kaya AD, Turkun M, Ozpinar B. Reversal of reduced bond strength after bleaching. General Dentistry (2010) 58(3):258-63 Gilbert, G.H., Litaker, M.S., Pihlstrom, D.J., Amundson, C.W., Gordan, V.V. Rubber dam use during routine operative dentistry procedures: findings from the Dental PBRN. Operative Dentistry (2010); 35(5): 491-499 Greenwall L.H. ( 2009) White lesions and bleaching treatments. Aesthetic Dentistry Today Volume 3:2 page 15-18 Heintze, S.D., Rousson, V. Clinical Effectiveness of direct class II restorations – a meta-analysis. Journal of Adhesive Dentistry (2012) 14(5): 407-431 Kelleher, MGD. The “Daughter Test’ in Aesthetic (‘Esthetic’) or Cosmetic Dentistry. Dental Update 2010: 37(1):5-11 Lima Neto, Cantídio Francisco de, Silva, Carolina Batista da, Silva, Marcos Aurélio Bomfim da, Vitti, Rafael Pino, Zanta, Carmem Lúcia de Paiva e Silva, & Tonholo, Josealdo. (2018). Tooth whitening affects bond strength of adhesive systems in enamel. Matéria (Rio de Janeiro), 23(4), e12227. Epub December 06, 2018.https://dx.doi.org/10.1590/s1517-707620180004.0561 Horieh Moosavi, Hamideh Sadat Mohammadipour, Marjaneh Ghavamnasiri, and Sanaz Alizadeh, “Effect of Bleaching and Thermocycling on Resin-Enamel Bond Strength,” International Journal of Biomaterials, vol. 2015, Article ID 921425, 6 pages, 2015. https://doi.org/10.1155/2015/921425.

Meyer-Lueckel H, Paris S, Kielbassa AM. Surface layer erosion of natural caries lesions with phosphoric and hydrochloric acid gels in preparation for resin infiltration. Caries Res 2007, 41(3):223-30 Paris S, Dörfer CE, Meyer-Lueckel H. Surface conditioning of natural enamel carious lesions in deciduous teeth in preparation for resin infiltration. J Dent 2010; 38: 65 – 71

Therefore, labial composite bonding can be undertaken. There was a necessity for the patient on the UL1 to restore incisal edge form and shape, however the UR1 was also restored labially with composite. As the figures show, the white spots had disappeared with the ICON, prior to composite. Therefore, the reason is not to further mask the white spot, but rather to restore the labial form. In this case, a very thin layer of bottle 2 of the adhesive system for Optibond FL (Kerr) was used to aid adhesive strength. An achromatic enamel Shade (NE, Asteria Estillite, Tokuyama Dental) was used buccally with a palatal shell of A1E from Filtek XTE (3M ESPE) for the UL1 (fig.12,13).

Teeth are then grossly polished on the first visit and final polish is undertaken at the review stage. During the polishing procedure the Astrapol system (Ivoclar Vivadent) was used as this achieves a high lustre (fig.14).

Reflective Commentary This case demonstrates how modern-day techniques can be used to maximise the ability to improve the appearance of white spots whilst minimising their intervention.

This patient was not keen on having veneers, but also did not like the idea of drilling out the white spots. Whilst we discuss minimal invasive dentistry, this does not mean non-invasive.

Subsequently, an ultimate invasion into the tooth structure is required to mask the white spot. In this case the white spot is not removed, but the refractive index is made more similar to that of the surrounding enamel.

Overall the patient was delighted with the result, and whilst perhaps more enamel tertiary anatomy could have been created, the overall result was a huge step forward for this patient, giving her the confidence to smile openly again (fig.15, 16, 17).

Dr Shiraz Khan

is a Dental Surgeon, Lecturer and International Fellow.

Fig.13

Fig.14

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Fig.15

Case Studies

ANCAR presents its new dental units at the rhythm of violin and laser lights ANCAR, the designer of dental treatment units has presented its new series of products in a private event. The meeting took place in the Esferic building located in Barcelona and has had as guests the main national and international distributors of ANCAR, as well as its own members of the team.

The guests enjoyed a spectacular show of music and lights thanks to a violinist from the Berlin Philharmonic Orchestra who flew over from Germany especially for this presentation. A mix of electric violin music and laser beams that were projected throughout the room gave the event a unique touch.

ANCAR is a family business with over 30 years of history within the dental professional world, and currently has focused on six new pillars on which they always rely: value, design, ergonomics, flexibility, technology and human factor. As the CEO, Antoni Carles, said: “This is our future, this is our goal, and this is our philosophy”.

competitive ones on the market. A big, modern touch screen, ambidextrous (you can put it on both sides of the instrument tray), orientable (vertical or horizontal) a lot more regulations of the unit and instruments, and so much more.

You can see and try them at IDS in Cologne or BDIA Dental Showcase in Birmingham.

Apart from these changes, Ancar has also opted for new electronics, new low-tension motors and finally… to incorporate their current series 7 knee-break chair in the new S3 and S5 range. Which basically means you can have a fully reclining (90º) knee-break chair in combination with vertical elevation.

Hereby reducing the visual impact of the chair and allowing a much better working position for both dentist and assistant.

The new treatment units are the fruit of the effort and years of investigation of the entire ANCAR team. They will officially present their creations during the International trade show IDS in Cologne, Germany. From then on, the new ANCAR dental series will go on sale in all countries.

For more information, contact: Nathalie Smets, Marketing & Sales Country Manager of ANCAR at nathalie.smets@ ancar-online.com

Under the slogan “Creating our future” the new range of units, S3 and S5, were presented and they promise to be spectacular. The units combine a new design, better ergonomics, new motors, new touch screen, vertical elevation, and much more.

New instrument arm and delivery tray A big change in the delivery tray is the 3D movement of the instrument hoses of the continental delivery system. As well as the removable, autoclavable and adjustable instrument holders for the hanging hoses delivery tray. The handles on both delivery systems are removable and adjustable and due to changes in the arm the tray moves very smooth and is very light to handle. They have also changed the design of the tray in order to make it sleeker and more modern. By minimising the delivery tray, you minimalize the visual impact for the patient.

Assistant keyboard and small instrument tray The assistant side gets renewed with a complete new capacitive keyboard, which you can adjust in height as you wish. The small instrument tray can be put in various positions or you can opt for the new Ancar Tray: a very light to handle tray that can support up to 4 kg or 8.8 pounds.

New touch screen: Touch Expert Pro Ancar has invested years in designing a new touch screen and it seems to be one of the most

The new treatment units are the fruit of the effort and years of investigation of the entire ANCAR team

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10 Minutes with...

Dr Dev Patel

Another change is the amount of jobs available in dentistry. When I came out of university it was definitely an employer’s market – getting a job was difficult and there was an over-supply of dentists. Now it is the opposite - it is difficult to get good dentists in certain positions because there is a shortage of dental professionals.

Q

What have been the key positive or negative changes in your area of the profession?

A

One of the key areas that stills needs addressing is the NHS contract, which still hasn’t been sorted out; leaving dentists uncertain about what’s next. It needs to be finalised as soon as possible.

Dr Dev Patel

The positives are that dentistry is definitely getting better in terms of technology and innovation. We are seeing some really cool things appearing on the market which are making patient’s lives easier and the quality of the treatments better too. A plus point for me is that technology is making dentistry fun on a day to day basis.

is the Founder and CEO of Brushlink.

Q A

Has the dental profession changed since you started working in it?

I graduated in 2012 and lots has changed since then. I wouldn’t say that the clinical side of things has changed that much but what we are seeing is digital dentistry.

We are seeing much more integration and the use of technology in practices – people are finally starting to realise the benefits and the manufacturers have started to bring the prices down in order to become more viable financially in order to implement these technologies into practice.

When I graduated, the level of fear towards getting through the profession and landing a job was extremely high.

Therefore, your FD year becomes a really important year in terms of acquiring the clinical experience you need in order to move forward.

However, I am now seeing a lot of dentists not wanting to work full time anymore and do flexible working instead. People have the opportunity now to move outside of dentistry and pursue other interests as well as working part-time within the industry.

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There a wide range of courses available now too which is great and it is becoming much easier to access, so people can do courses online and at home.

There is also a lot people engaging and enjoying working in dentistry and using social media to share their recent work. We are really progressing in terms of showcasing our work more and marketing ourselves really well.

Q A

We are really progressing in terms of showcasing our work more and marketing ourselves really well

Who inspires you and why?

One of my biggest inspirations, clinically, was Chris Orr. When I came out of university and after my FD year, I went on his course and it was a big game changer for me because I felt like I learnt dentistry properly – it really opened up my eyes to the future of dentistry.

It really changed the way I teach and practice dentistry today.

Q

Have you got a mentor? If so, what was the most valuable piece of advice they gave you?

A

Someone once told me ‘train and retain your staff and your business will grow”.

That saying has really helped me to focus when training staff and dentists in order to help them progress their own careers and maximise their potential growth.

My father-in-law, Kirti Patel, has also been a great mentor for me – he has really helped me to focus on my career and ambitions over the years.

Q A

If you were not in your current position, what would you be doing?

I was going to move to Australia when I was in my FD year as my brother is a dentist out there and he was always trying to convince me to move out there with him. If I was not doing what I do now, I would probably be out in Australia doing a couple of days a week of dentistry and the rest relaxing on the beach!

Green Apple Dental Recruitment is the UK’s leading Dentist Recruitment Agency As experts in Dentist Recruitment, we help hundreds of GDC registered Associates find Locum and Permanent roles in NHS, Mixed, Private and Specialist practices across the UK every day Why do Dentists choose Green Apple Dental Recruitment to help with their job search?

Top Locum and Permanent jobs throughout the UK Extensive knowledge of the marketplace A professional and personal service Discreet and considerate at all times The UK’s most experienced Dentist Recruitment Team Handle the entire process from interview to contract stages

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Don’t just take our word for it, visit our website to read the testimonials we have received and view the hundreds of vacancies we have:

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Contact us today for a confidential discussion about how we can help you find the perfect new role

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