The Dental Technician Magazine August 2017 Issue Online by The Dental Technician Magazine

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AUGUST 2017 Technical

Technical

Business

Insight

Germain. O Gallucci London ITI Study Clubs Page 16 -18

Orthodontic Study Models Andrea Johnson Page 29 & 30

Marketing Simplified Jan Clarke Page 8

Data Security Warning Page 14

INSIDE THIS ISSUE Vol 70 No 07

SUMMER AND TIME TO REFLECT I tâ&#x20AC;&#x2122;s August and the summer holidays are in full flow. Teachers can start to think of getting their senses back for a few weeks and those of us in technical dentistry must learn the ebb and flow of our particular practices. Will we be busy or will we be twiddling out thumbs? Itâ&#x20AC;&#x2122;s that crazy time of year and all that, comes along with the Brexit negotiations. Will they affect us? Of course they will, a recent post on Facebook quoted a French Canadian source, which suggested that changes due to be enforced within all EU countries in May 2020 would significantly change the legal status of chair side CAD/ CAM restorations. Making them illegal because they are available via an established manufacturing base, namely Dental Laboratories. The DLA and possibly the DTS and any other group organisation with interests in the world of Dental Technology should now be gearing up to confirm the report and its detail and begin to ensure the legislation is not abandoned, along with other considerations during the Brexit law changes. The stated position at this time within the UK is a commitment to maintain the EU legislation on medical devices even after the Brexit process is concluded. It would be good to find a way of ensuring the particular area covering the manufacture of dental restoration is more tightly controlled and that wholesale sub-standard chair

side restorations are not to become the order of the day.

In a recent survey conducted via Eastman Dental Institute (published in the DT Magazine April Issue) in which more than 300 Dentists responded it was clear there was a concern about the knowledge and ability of the processes for design and manufacture by the untrained clinical staff. The dentists felt strongly that the training (via companies selling the equipment) was not sufficient to provide a safe basis for treating patients. Together with the changes over the past two decades within the undergraduate teaching establishments, there is a clear suggestion the clinicians are not equipped to deal with the restorative techniques demanded. It would be interesting to know if the NHS has recorded the remake rate of chair side restorations and how they compare with the traditional laboratory supplied devices. Figures from America suggest that more technicians are being involved working within practices, with a year on year increase in their numbers. Perhaps the penny has dropped and the work of the technician is ready for a new renaissance. I really cannot see how such a suggestion is not right on the money.

Continued on page 4

The Dental Technician August 2017/Vol 70 Issue 07

CONTENTS

THE DENTAL TECHNICIAN AUGUST 2017 4

STATEMENT FROM GDC

DENTISTRY SHOW

GC UK LIMITED

MARKETING SIMPLIFIED

RENISHAW CONTRIBUTES TO PIONEERING CANADIAN MEDICAL DESIGN CENTRE

DENTAL OPINION FROM SIR PAUL BERESFORD, BDS. MP

WHAT IS THE IDEAL MODELLING WAX FOR TODAYâ&#x20AC;&#x2122;S PRIVATE MARKET?

STORING A CLINICAL PHOTO ON A MOBILE DEVICE COULD BE A BREACH OF THE DATA PROTECTION ACT

DIGITAL DENTISTRY COMES OF AGE PART 2

5 10

16 - 18 GERMAN O. GALLUCCI SPEAKS AT THE ITI STUDY CLUB LONDON 20 - 21 STRAUMANN SETS OUT ON THEIR DIGITAL PERFORMANCE ROADSHOW 22 - 26 DENTAL NEWS 27 & 28 VERIFIABLE CPD 29 & 30 THE IMPORTANCE OF ORTHODONTIC STUDY MODELS AND HOW TO CAST THEM 31

CLASSIFIED ADVERTS

29 PUBLISHERS: THE DENTAL TECHNICIAN LIMITED, PO BOX 430, LEATHERHEAD KT22 2HT TELEPHONE: 01372 897463 Subscriptions The Dental Technician, Select Publisher Services Ltd, PO Box 6337, Bournemouth BH1 9EH Editor: Larry Browne FBIDST. FDTA, ITI Fellow, LCGI, RDT. Tel: 01372 897461 Email: editor@dentaltechnician.org.uk Subeditor: Sharon (Bazzie) Larder Email: inthedoghousedesign@gmail.com Advertising: Chris Trowbridge Tel: 07399 403602 Email: sales@dentaltechnician.org.uk Editorial advisory board K. Young, RDT (Chairman) // L. Barnett, RDT // P. Broughton, LBIDST, RDT // L. Grice-Roberts, MBE // V. S. J. Jones, LCGI, LOTA, MIMPT // P. Wilks, RDT, LCGI, LBIDST // Sally Wood, LBIDST

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The Dental Technician August 2017/Vol 70 Issue 07

STATEMENT FROM GDC T

he regulator of dental professionals, the General Dental Council (GDC) today (Tuesday 11 July) publishes its Annual Report and Accounts for 2016. The annual report gives details of achievements and activities in 2016 and the GDC’s ambitions for the coming years as it continues with the second year of a three-year roadmap and presses ahead with improvements to dental regulation set out in Shifting the balance: a better, fairer system of dental regulation. The report is published at a time of increasing challenges and uncertainty in the wider environment in which the GDC and other health professional regulators operate in is increasingly challenging and uncertain. The implications of the UK’s decision to exit the EU are still unfolding, while the health sector is working hard to deliver the best care to patients. Demand is greater than ever and patients’ needs are becoming more complex. Questions regarding structural change are being asked across the UK, and dental professionals in England at least are also wrestling with imminent changes to the NHS contract. It is in this context that the GDC is taking forward reform of dental regulation, rethinking its processes

and moving resources “upstream” with the aim of preventing harm. This work continues apace in 2017, with an end-to-end review of our entire fitness to practice process to drive further improvements, and an online tool for the “self-filtering” of complaints to ensure the most appropriate body is dealing with concerns about dental care. William Moyes, Chair of the GDC Council, said: “In this period of political uncertainty, the GDC is planning for an improved model of dental regulation that is better for patients and fairer for dental professionals. “The UK’s withdrawal from the European Union and the effect on a range of issues from workforce planning to language testing and how to deliver care to patients with complex, long-term conditions, – presents still unknown challenges for the delivery of dental care.

transparent and engaged with all our key stakeholders, who have generally welcomed the scale and pace of change and the direction in which the GDC has been taken. I look forward to working with these stakeholders to deliver our vision of improved dental regulation.” Ian Brack, Chief Executive of the GDC, said: “Looking back, 2016 saw the GDC continue to improve its performance. “These improvements have been reflected in the Professional Standards Authority’s review against the standards that they apply to the health professional regulators’ statutory functions, as we achieved 21 out of the 24 standards. This is a significant improvement on the review in 2015, although we recognise that there is still more work to be done.

“This is at a time when all health professionals are trying to deliver care that is in patients’ best interests, to populations that are increasingly elderly with multiple, complex conditions.

“The vision we have set out in Shifting the balance: a better, fairer system of dental regulation involves focusing a greater proportion of resources ‘upstream’ to prevent harm, working in collaboration with patients, dental professionals and our partners and re-focusing fitness to practice.

“And the GDC has faced its own challenges. We improved significantly over the past few years -new people, new processes, tighter controls and much more

“We will continue to work with the profession and our partners to improve patient and public safety and increase the public’s confidence in dental services.”

a report on a recent review of the case the charges were repeated and interestingly one of the major findings was that the particular gentleman and his, company, along with two counts of not telling patients he was not legally allowed to construct dentures directly without a dentist’s prescription was the offence quoted as follows:

by a particular patient, the name of the authorised person who drew up the prescription, the particular features of the medical device as specified in the prescription and a statement of conformity.

In 2016, the GDC introduced Case Examiners, who have the power to issue undertakings, meaning the GDC will be able to agree the steps that need to be taken to bring the dental professional’s practice up to the required standard without going to a full hearing, improving our ability to regulate in a proportionate way. This also achieves more efficient outcomes for patients. By working with the NHS in England, the GDC also established an improved mechanism for dealing with patient concerns that cannot be appropriately dealt with using the GDC’s fitness to practice powers. NHS Concerns encourages more local resolution between the dental professional and the patient. Each year, the GDC receives hundreds of concerns that could be resolved locally, which we now seek to reroute to the local NHS, enabling them to be dealt with more appropriately. In 2016, the GDC has also been working with the Chief Dental Officer in Scotland, and other key stakeholders, to create one process for handling complaints about dental professionals in Scotland. l To read the Annual Report and Accounts for 2016 visit: www.gdc-uk.org/about/what-wedo/publications.

Continued from page 1 So Technicians, gear up to learn a bit more about the clinical environments and the language and be prepared to be a Technical Consultant within restorative practices. Digital technology can of course be an advantage but it must be learned and mastered together with the traditional knowledge and techniques for restorative technical skills of the working, trained, technically qualified and registered Dental Technician. There have been several examples where clinicians have become masters of some of the restorative techniques but all of them have spent many years learning to be that able. A recent discipline case before the GDC., which involved the MHRA was for a “Denturist” working illegally directly to patients. He was found guilty of the charges and was handed a 15month suspension. In

Between 20th March 2014 and 12 March 2015 failed without reasonable excuse to comply with the requirements of regulation 15 of the Medical Devices Regulations 2002, in that he did manufacture custom made medical devices, namely dentures, and on each occasion did fail to provide a statement to the consumer (Patient) containing the required statutory information , in particular that the device is intended for exclusive use

A clear example of the failure to supply a SOM, was included as an equal offence to constructing dentures illegally. Now you are all thinking we had better take this seriously and indeed remind our clients that they may be committing a similar offence if they are not offering the SOM with their restorations. You of course are of course providing the paperwork for each case. Yes I know they probably come back in the delivery box the majority of times but the offence is quite clearly quoted as above. I really do think that the dental practitioners are leaving themselves

open to a real risk of a complaint. It only takes a complaint to activate the investigation and what is to stop another registrant using this as an excuse to cause mischief. I do really believe it is time the Clinical professionals woke up to the need for local and national education about their responsibilities to the patients and to the professional bodies who enforce the regulations, the GDC and the MHRA. The fact that so few are providing this vital piece of written record for the patients benefit is appalling, but it is good to see the authorities acting in the patients interest, as we are all supposed to do. Perhaps we should accept the responsibility of trying to ensure the patients is offered the SOM, to ensure we are complying with the spirit of the legislation. Regular reminders to the practices might be a worthwhile idea.

The Dentistry Show has excelled once again this year with thousands of dental professionals gathering at The Dentistry Show on Friday 12th and Saturday 13th May (NEC), making it the UK’s largest free to attend, education and trade event for the dental profession.

Visitors gave the free-toattend, two-day CPD training and education conference and exhibition a resounding thumbs up – as did the 400+ exhibitors, including the trade’s biggest brand names, Dentsply Sirona, The Dental Directory, Oral-B, Colgate, Planmeca, Philips, GSK amongst others, who showcased hundreds of the latest products

and services on the exhibition floor which has increased yearon-year for the last ten years! The aisle and theatres were packed with delegates on both days enjoying plenty of lectures available for every member of the dental practice, plus hands-on education at exhibitor stands. l More than 100% of the 2017 show’s exhibit space is already booked for 2018! If you want to be part of the most exciting show in the profession, which returns to the NEC (hall 5) on May 18th and 19th, 2018 then visit: www.thedentistryshow. co.uk/exhibiting/why-exhibit/ exhibiting-enquiry-form

The Dental Technician August 2017/Vol 70 Issue 07

GC UK LIMITED

LISA JOHNSON HOSTS GC GRADIA PLUS COURSE IN LEUVEN

isa Johnson DTG, from Nexus Dental Laboratory in Harrogate, is one of the UK’s top aesthetic Technicians with over 20 years’ experience using composite systems and specialising in large implant frameworks. From early trials onwards, both Lisa and her colleagues at Nexus Dental Laboratory were involved in the development of GC’s new Gradia Plus composite resin crown and bridge system and have layered many frameworks using injectable techniques with the Gradia Plus One Body System.

Delegates hard at work

For Lisa’s Gradia Plus Course, day one began with a presentation of the Gradia Plus Concept and the One Body Flasking Technique. This was followed by a practical session on flasking and opaquing frameworks, followed by dentine injections.

Pouring clear silicone

Lisa, Delegates and Neill Clark GC. U.K.

Lisa Johnson

Consequently Lisa was a natural choice to host GC’s most recent Gradia Plus Advanced Two-day Hands-on Course at the GC Europe Campus on the 27th and 28th April. Located on their site in Leuven, Belgium, this state-of-theart environment enables GC and their worldwide network of dental professionals to deliver handson courses, presentations and demonstrations of all their major technologies and products.

Lisa waxes the Sprues

Delegates finished work

The day finished with a delightful evening in Leuven where the Delegates enjoyed dinner at the Mykene restaurant, which specialises in regional dishes, followed by drinks in Leuven’s 15th Century Old Market Square admiring the amazing architecture in this buzzing city. Day two commenced with a practical session on the dentine cut back technique, followed by another practical session on dentine modification, light body application and lustre paint, and enamel injection. Then, following a splendid lunch at the GC Campus, the last practical session concentrated on gingiva cut back and application, and glaze application.

There were nine Delegates on the course, who were a mixture of Prosthetic and C&B Technicians because Gradia Plus crosses both specialities.

has also been invited to run a similar course in Norway for a large Laboratory in Oslo. Unfortunately this course is only going to be open to Norwegian Technicians.

This was Lisa’s first course for GC, but she will be running more following very positive comments from Delegates with the next one scheduled for 14th & 15th September 2017. Meanwhile Lisa

l For further information about Gradia Plus and September 14th & 15th Hands-on Course please contact GC UK Ltd on 01908 218999, email info@gcukltd.co.uk or visit www.gceurope.com

Gradia Plus

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The Dental Technician August 2017/Vol 70 Issue 07

MARKETING SIMPLIFIED JAN CLARKE BDS FDSRCPS

Jan qualified as a dentist in 1988 and worked in the hospital service and then general practice. She was a practice owner for 17 years and worked as an Advisor with Denplan. Jan now works helping dental businesses with their marketing and business strategy. Web: www.roseand.co Email: Jan@roseand.co

elcome to my regular column about marketing. I hope to lead you through the maze and confusion that is marketing in the world of the dental technician. You will learn to understand what marketing is and how to create your own marketing strategy and plan without spending a fortune. Lots of business owners do get overwhelmed with marketing and you’ve probably been contacted by marketing organisations offering you all sorts of deals from an advert in the local press to inclusion in a telead in the post office. What ends up happening is, for most, it becomes a spray and pray marketing technique with no real plan and knowledge where the spend is and what return on the spend you are getting or your return on investment ROI. I aim to simplify this so you can be confident you know what the plan is! So first things first, what is marketing? Ask and you will no doubt receive many different answers. Advertising, website, leaflets, logo, these are all part of marketing but one definition I think encompasses it really well is. “Marketing is everything a company does, from how they answer the phone, how quickly and effectively they respond to email, to how they handle accounts payable, to how they treat their employees and customers. Done right, marketing integrates a great product or service with PR, sales, advertising, new media, personal contact. In other words, marketing is not a discipline or an activity – it is everything a company is – at least if the company wants to be successful.”

B.L. Ochman, President, What’s Next. This definition pre-supposes you know what your business is about, your “Why?”. Have you given this much thought? Perhaps you think you are a dental technology service and that’s as far as it goes. It is a good idea to spend some time considering this. • What differentiates you from the competition? • Why would a dentist choose to use your business? In the absence of any differentiator people will choose on price. It may be that is your differentiator, being the cheapest, for most I don’t think that is the case. What could make you different from your competition? • Quick turnaround – efficient service • Best technology • Personal service with pick ups and deliveries • Education seminars to increase knowledge • Quality of product • Welcoming, friendly • Discounts on multiple accounts • Aesthetic artistry As you can see there are lots of areas to be considered and it is probably worth spending some time thinking about your business, about how you want it to look, feel, and be, especially before we start to put a marketing strategy together. Once you have started to consider your “Why” or “Value proposition” the next stage is to consider who are your customers? • What kind of customers do I want? • What kind of customers don’t I want? • Who is my ideal customer or “Super” customer? • Where do they “hang out”

It really is worth spending as much time thinking about the customers you don’t want as much as the ones you do want. If you connect with the right customer your business life will be so much more happy and you will be fulfilled which in turn will have a positive effect throughout your business. How many times have you agreed to do a job cheaper or quicker for someone you wouldn’t normally work with and it’s backfired? Whilst you don’t want all your “eggs in one basket” as a dental technician, a few “super” clients who totally work well with you, will be more profitable and easier to work with than lots of clients who aren’t ideal for you. Take time to understand who you really want to work with. Once you’ve decided who you want to work with you need to decide where they are. That may seem a strange sentence as they will be in dental surgeries won’t they? What I mean is how do we reach them? • Direct contact at your office • Website • Social Media • Study groups/ dental meetings • Conferences • Trade shows • Open evenings • Demonstrations • Flyers • Articles in journals • Case studies Once you know whom your Ideal Customer is you can talk directly to them in their language. The old fashioned approach of “spray and pray” marketing can be replaced with marketing that is a little more clever and targeted. Marketing plans can be very complicated but I would encourage you to use this Marketing Wheel (pictured below right) and keep it simple. The wheel will have 6 or 8 main areas where you should consider allocating time to. You may also have to allocate a budget to them but some of these areas of activity can be carried out with minimal cost. It is up to you to decide where to spend time

and resources. I am a big fan of social media with it’s capacity to really reach targeted audiences, however, if you really don’t like it or “get” it then there is no use having activity there until you do understand why and how it works. Once the areas of activity are decided upon I would recommend planning a whole year of activity in each field using a spread sheet format. This is not set in stone but having a framework ensures the activity is more likely to happen. The problem with running a small business is often that the ”boss” is doing everything and so things slip. If you have a framework you can then share it with your team and delegate activity so everyone is involved and it is much more likely to happen. Your marketing can then become consistent and incremental as it grows month on month. It is probably worth mentioning that a potential customer will take between 5 and 27 “marketing touches” before they purchase from you. This means that activity in all these sectors need to be maintained and not to be disheartened if you feel there is little return initially. Ensure your team tracks where the new enquiries come from but you will more likely find they have seen you and know of you from several areas. By breaking down your marketing activities into the Marketing Wheel you can simplify your strategy and take the mystery out of marketing. Each month I will talk in more detail about each aspect of your potential “marketing touches’ as we work through a marketing strategy together and I hope you will start to foster a “marketing mindset”.

The Dental Technician August 2017/Vol 70 Issue 07

RENISHAW CONTRIBUTES TO PIONEERING CANADIAN MEDICAL DESIGN CENTRE

lobal engineering and scientific technologies company Renishaw is contributing to a new medical centre in London, Canada. The centre, Additive DEsign In Surgical Solutions (ADEISS) is the result of a partnership between Western University, the London Medical Network and Renishaw. The centre will focus on the research, development and commercialisation of additively manufactured medical devices and surgical instruments. It will also aid in the development of additively manufactured medical technology to resolve healthcare issues across the globe.

Renishaw will take the lead on the additive manufacturing processes used in the production of the 3D printed medical devices and surgical tools, which will include replacement joints, jigs and guides. The devices can be manufactured out of titanium or cobalt chrome. Once developed, the devices will be available to the medical, dental and orthopaedic sectors to push the boundaries of healthcare practices in North America and beyond. The newly launched facility is located on the Discovery Park on the Western University campus. ADEISS is the first business to come out of

the London Medical Innovation and Commercialisation Network, a fund to develop healthcare businesses in the city. The business received $CAD1.5 million in support from this fund as well as $CAD1 million from Western University and a further $CAD1.5 million, of in-kind support. Renishaw has invested an additional $CAD3 million of in-kind support. The collaborative project draws on knowledge and expertise of several organisations; Renishaw, Western University, Western’s Schulich School of Medicine & Dentistry, Robarts Research Institute, and

St. Joseph’s Health Care London. ADEISS is currently pursuing ISO 13485 accreditation in the US, Canada and Europe. “Renishaw is very excited to be a fundamental part of the ADEISS programme,” explained Dafydd Williams, President of Renishaw Canada. “Following on from the great success of our Healthcare Centre of Excellence located in Miskin, South Wales, ADEISS will be crucial in Renishaw’s ability to impact the North American market. “We anticipate this uniquely placed facility will yield many new innovations in both medical device design and the use of additive manufacturing technology, to push the boundaries of current thinking and design in this technically very demanding field.” Renishaw has recently launched its inaugural North American Solutions Centre in Kitchener, Canada which provides companies with access to its additive manufacturing systems to develop and test new products and advance their confidence with the technology. Renishaw is using its global network of Solutions Centres to aid the development of additive manufacturing as an industrial technology. Renishaw is a world leader in additive manufacturing technology. In the UK, it makes class III custom medical devices at its Healthcare Centre of Excellence in South Wales. l For further information on Renishaw visit www.renishaw.com Enquiries: Ed Littlewood. Tel: +44 1453 524530.

and brain surgery. It has over 4,000 employees located in the 35 countries where it has wholly owned subsidiary operations. UK-based Renishaw is a world leading engineering technologies company, supplying products used for applications as diverse as jet engine and wind turbine manufacture, through to dentistry

For the year ended June 2016 Renishaw recorded sales of £436.6 million of which 95% was due to exports. The company’s largest markets are China, the USA, Japan and Germany.

Throughout it’s history, Renishaw has made a significant commitment to research and development, with historically between 14 and 18% of annual sales invested in R&D and engineering. The majority of this R&D and manufacturing of the company’s products is carried out in the UK.

The Company’s success has

been recognised with numerous international awards, including eighteen Queen’s Awards recognising achievements in technology, export and innovation. Renishaw is listed on the London Stock Exchange (LSE:RSW) where it is a constituent of the FTSE 250, with a current valuation of around £1.8 billion.

The Dental Technician August 2017/Vol 70 Issue 07

DENTAL OPINION FROM SIR PAUL BERESFORD, BDS. MP

APPG AND BDA SHOWCASE D

entistryâ&#x20AC;&#x2122;s profile in the minds of politicians is not top of the list. This is hardly surprising considering all of the events at the moment.

Dual UK/NZ nationality. New Zealand born, bred and educated, with post graduate education in UK. Worked as an NHS and private dentist in East and South West London. Private dentist in the West End of London thenand currently in a very part time capacity in South West London. Councillor including Leader of Wandsworth Council moving to the House of Commons. A Minister in the John Major Government, MP for the then Croydon Central, then elected as MP for Mole Valley as a result of the boundary changes for the 1997 election.

Last year as a trial I worked with the British Endodontic Society in a small showcase to try to explain to politicians the difficulties and intricacies of root canal treatment. Videos, demonstration tabletops, a dental chair (for MP photos) plus a microscope were all set up in a House of Commons room off Westminster Hall. MP and Peer attendance was not huge but proved to be significant. Most of those MPs who turned up were quite absorbed especially when asked to look down a microscope and try their hand at clearing and cleaning a root canal. All attendees got sufficiently fascinated as to stay and to learn. Last month with huge help from Anna Wojnilko, of the BDA, the APPG ran a broader showcase inducing more MPs to come and learn. Attendance was higher and again those we induced through the door were fascinated. The BDA and the dental industry came up trumps. We were helped by the energetic presence of Sara Hurley, the Chief Dental Officer who is fighting hard to get politicians and especially ministers at the Department of Health to recognise the importance in health terms of the dental profession. Sadly the Minister

responsible was called away on other business at a key moment. MPs were able to try their feet on the dental pedal drill from early last century through to the virtual reality of trying to prepare a cavity. Needless to say almost every virtual reality tooth was destroyed by these amateur MP dentists. Tabletops

were as diverse as re- mineralisation methods, laser surgery and CAD/ CAM crown production. Moderate although the success was the All-Party Group intend to produce an enlarged showcase at a key time next year and hopefully with representation from dental technicians.

Photos: www.michaelkyle.co.uk

Sir Paul Beresford. BDS. MP.

The All Party Parliamentary Group (APPG) for Dentistry was set up a number of years ago with the British Dental Association providing the major personnel driving force and with me as Chairman. Membership is open to dental groups on request as well as any MP or member of the House of Lords who wishes to join any of the meetings. Attendance of politicians is generally low but the meetings do pull together considerable interest from dental professional groups, led by the BDA along with many from the dental products manufacturers. Disappointingly attendance from dental technicians has, to the best of my knowledge, been zero.

The Dental Technician August 2017/Vol 70 Issue 07

What is the ideal modelling wax for today’s private market?

ab technicians across Britain can all agree there are certain elements that are essential for the ideal modelling wax.

1. High strength and rigidity at mouth temperature. 2. Wide softening range above mouth temperature. 3. Easily mouldable in the softened state, without flaking, cracking or tearing. 4. Low thermal contraction. 5. Easily carved at room temperature without flaking or chipping. 6. No residue on boiling out and finally 7. Good value for money

Kemdent’s Anutex HS - High Stability Modelling Wax and Anutex Eco Modelling Wax tick all those boxes.

Anutex HS will not irritate oral tissues plus it does not distort unduly in the mouth.

ANUTEX HS High Stability Modelling Wax is a high temperature stability wax which is easy to work and fabricate. This is due to the unique rolling process used at the Kemdent factory where Anutex HS is made; this process imparts excellent handling characteristics to the wax.

ANUTEX ECO Toughened Modelling Wax is a modelling wax that has been, manufactured environmentally with a 30% reduction in C02 emissions. It has a primary softening temperature typically of 35°C – 41°C.

Anutex HS trims easily and cleanly with a primary softening temperature typically of 41°C – 45°C.

It is an ideal wax for creating the high quality wax-ups needed in today’s private market and with the added benefit of being environmentally friendly.

During August, when you buy 2 x 2.5kg Anutex HS - High Stability Modelling Wax you will get 1 x 2.5kg free for only £58.00 + VAT. Or Buy 2 x 2.5kg Anutex Eco Modelling Wax and get 1 x 2.5kg free for only £47.90 VAT. Kemdent has the ideal Modelling Wax for you at the ideal price. l For further information on Kemdent’s Modelling Wax range contact Kemdent on 01793 770256. Email sales@ kemdent.co.uk or visit our website www.kemdent.co.uk

BSC Centre of Dental SCienCeS In September Barnet and Southgate College will open the BSC Centre of Dental Sciences within the newly refurbished Southgate Campus, a dedicated state-of-the-art dental science training school. Cour SeS o n offer: • Foundation Degree in Dental Technology – Level 5 • Higher Apprenticeship Dental Technician – Level 5 • Higher Apprenticeship in Dental Practice Management – Level 4 • BTEC Extended Diploma in Dental Technology – Level 3 020 8266 4000 info@barnetsouthgate.ac.uk www.barnetsouthgate.ac.uk/dentistry @BSCDentistry BarnetSouthgateDentalTechnology

• Apprenticeship in Dental Laboratory Assistant – Level 3 • Diploma in Dental Nursing – Level 3 • Apprenticeship in Dental Nursing – Level 3 • Technical Certificate in Working in Dental Settings – Level 2

The Dental Technician August 2017/Vol 70 Issue 07

Storing a clinical photo on a mobile device could be a breach of the Data Protection Act, says the DDU A word of caution for the Dental professionals regarding storing patient information on mobile devices

t has been reported that the Dental Defence Union has cautioned Dentists and presumably Dental Professionals of the potential risk if confidential information is stored on smart phones or other mobile devices. In an age when Clinical photographs are being used to improve the communication between the clinician and other involved professionals it needs to be remembered the information is highly confidential and may be equally sensitive. It is so easy within a busy schedule when you may be visiting one or more surgery taking helpful clinical photos (i.e for shade taking or shaping) and without realising are carrying this information to and fro and hopefully safely back to the Laboratory.

The process may not be permitted under the Data Protection Act. Even if that data is later transferred to the patients records system and subsequently deleted from the mobile device! So quotes David Lauder, dento-legal adviser, in the latest editorial within the DDU Journal.

in the dental surgery,” Lauder wrote. “But because of the legal considerations associated with the protection of personal data, and the potential for mobile devices to be lost or stolen, it would be wise to avoid taking clinical photographs on a mobile phone.”

Under the Data Protection Act 1998, clinical photographs of patients, even when unidentifiable, are considered personal confidential data. A breach can lead to fines and potentially breach of the terms of the GDC Regulations.

Instead, he said practices are advised to use a dedicated clinical camera that can be stored away securely in the practice and to always seek written consent to the use of the photographs from their patients in order to avoid possible legal consequences. “The impact that mobile devices have had on society is undeniable. As they become an increasingly common part of our daily lives, it is understandable that many practitioners use them

THE FOLLOWING IS TAKEN FROM THE INTERNATIONAL DENTAL TRIBUNAL Naz Haque Dental Focus, Suite 6 Metropolitan House 38/40 High Street, Croydon CR0 1YB, UK Tel: +44 2071838388 E-Mail: naz@dentalfocus.com Web: www.dental-focus.com n Naz Haque, aka the Scientist, is Operations Manager at Dental Focus. He has a background in mobile and network computing, and has experience supporting a wide range of blue-chip brands, from Apple to Xerox. As an expert in search engine optimisation, Naz is passionate about helping clients develop strategies to enhance their brand and increase the return on investment from their dental practice

WEBSITES Data security and governance is a very tricky area. I must make it clear I am not a lawyer, and technician professionals should make their own decisions about specific aspects of Care Quality Commission (CQC) compliance and GDC Regulations.. Even if your dental laboratory has not embraced the digital age and all records and correspondence are ink and paper based, you still

have a number of responsibilities regarding data security. As dental practices collect patient details, they must register with the Information Commissioner’s Office (ICO). All dental records must be stored safely and securely for a number of years (up to six years for the National Health Service; NHS) and kept for a maximum of 30 years (Department of Health). Aside from the General Dental Council, NHS and CQC governing bodies in the UK, there are a number of legislative acts, the DPA being the most well known, that require dental record storage, such as the Consumer Protection Act 1987, under which an action could arise for a defective product (such as implants), the Medical Devices Directive (Council Directive 93/42/ EEC), which relates to custom-made devices (such as retainers or aligners), as well as the Medicines Act 1968 and the Misuse of Drugs Regulations 2001. Records must also be disposed of in a policed manner to avoid fines. What about those who have who have embraced digital? Data is accessed in two situations, storage and movement, the same as physical records are. This also means that there are the two situations in which data can be compromised in the

digital world. You have an obligation to ensure patient data is backed up, recoverable (in case of disasters), secure and protected. This applies during both storage and movement. If you are using one of the popular industry patient management systems, such as EXACT (Software of Excellence), it should have features to support this in place; liaise with your systems supplier to verify this. The next area of concern then is movement of data. This can be via e-mail, online referral tools or portals, feedback platforms or devices, and your website. E-mail is not a secure medium, and communication with patients about their medical history or medical circumstances using this platform raises potential issues. The service provider you use for your e-mail could also be inadvertently making you breach data security rules. For example, if you are using one of the popular US-based organisations for e-mail, such as AOL, Hotmail and Gmail, and liaise with your patients via this e-mail platform, you have to consider where the e-mails are being stored; most likely on servers outside the UK. The DPA states that “personal data shall not be transferred to a country

or territory outside the EEA [European Economic Area] unless that country or territory ensures an adequate level of protection for the rights and freedoms of data subjects in relation to the processing of personal data”. As a dental professional you should reconsider if you are using a commercial e-mail provider to liaise with your dentist and the patients, and determine whether your website communication tools and feedback portals are compliant and if not ensure your designated data policy controller addresses this as a priority. The ICO can issue monetary penalty notices, requiring organisations to pay up to £500,000 for serious breaches of the DPA occurring on or after 6 April 2010. If you have reservations, there are a number of solutions to protect practices from these risks. Clients at Dental Focus expect us to take care of online compliance and provide guidance on keeping up to date and resolving these issues. Make sure your data is secured and protected before it is too late. All patient information in our possession will be governed by the above quoted Authorities, check and be sure you are not breaching one of their guidelines.

The Dental Technician August 2017/Vol 70 Issue 07

DIGITAL DENTISTRY COMES OF AGE WRITTEN BY MARK WELCH (QUALIFICATION DENTAL TECHNOLOGIST) PART TWO - CONTINUED FROM JULY ISSUE

To change print materials takes n less than 30 seconds, which Asiga claim is the fastest change over time on the market today. These printers are very user friendly once set up and are solid production units. Currently Asiga have printers in their range capable of outputting X, Y resolutions of 75µm up to 27µm. The control of the Z-axis however, is even programmable in 1 µm increments. This means that Laboratories benefit from a wide range of options that can match their existing and future requirements in terms of production. For example, the Pico 2 HD (available in 27 µm & 37 µm) has the highest resolution of the Asiga range. The Pico 2 HD 37 µm can produce multiple quadrant models or 2 full arch models and restorations such as pressable or cast to metal, crowns, copings, bridges making them suitable for laboratories with a small output. The Pico 2 is available in 39 µm & 50 µm and the 50 µm in particular is suitable mainly for the production of quadrant C&B models, ortho models, partial frameworks, custom trays, surgical guides, splints, pressables & castables, making them also attractive for small production laboratories. The Asiga MAX (available July 2017) has been optimised for a wide range of dental applications and with an X, Y resolution of 62 µm, Asiga claim this is the sweet spot for dental laboratory applications. It has an output for medium to large size laboratories and with a build plate size of 119 x 67 x 76mm it is suitable for the production of multiple full arch C&B models, Ortho models, partial frameworks, custom trays, surgical guides, splints, inlays, onlays & crown and bridge casting patterns. As an example, the Asiga MAX can produce 7 full arch dental models in less than 1.5 hours.

For laboratories looking for a high output, the Pro2 75 (75 µm) is the biggest unit and has the biggest build plate making it possible to build 8-10 full arch models (in 100µm layers) with a build time of approximately 2- 3 hours. Using the multi-stacking feature in the Asiga composer software, 16-20 full arch models (in 100µm layers) can be achieved in a build Time of approx. 6.5- 7.5 hours. This unit is also capable of multiple splints, surgical guides, full arch models, partial frameworks and crown and bridge casting patterns. Curing is an important part of the dental laboratories process from cold or heat cure acrylics to composites and special trays but it is especially important when considering equipment that is specialised for 3D printing. Every Asiga printer comes with a care package that includes a calibration kit, goggles, resin tray, bottle of resin and an Asiga flash cure unit, meaning it is ready for labs to get printing out of the box. Curing bio compatible printer resins can be a grey area that’s why Detax amongst others recommend the G 171 Otoflash Flash-curing Unit. This is an incredibly high powered & fast curing unit for the necessary secondary curing process of certain resins and is capable of 10 flashes per second. This unit ships as a standard flash cure unit, although another model including a nitrogen flush adapter, which is available for flushing the unit with nitrogen whilst flash curing for the manufacturers recommended amount of time. This high spec unit is something that is not normally supplied with 3D printers but is essential in the curing process (removal of inhibition layer) of biocompatible materials, such as Detax Freeprint splint or Detax temp (temporary crown resin) before they can be placed in the mouth as it completely removes the sticky inhibition layer that is left after the printing process has been completed and cannot be solely removed with an alcohol bath. Another benefit of Asiga machines is that they are very simple to maintain should the need arise to replace

parts etc. The machines ship with a lifetime support guarantee meaning technical issues are resolved quickly using Asiga’s support ticket system. In addition, we at Bracon have trained registered Dental Professionals and inhouse engineers, that are trained and qualified to install, repair and service all the Asiga units should this ever become necessary. The LED has a 5-year warranty and should the projector ever need replacing Bracon are able to quickly and easily swap it out. The projector calibration is performed in house by engineers before the machines leave Bracon and are shipped to the customer. The print plate calibration is straightforward and the build quality of these units is excellent. All of the units Asiga manufacture can be supplied in either 385nmUV or 405nm Light waves. This not only means slightly faster printing times with the 385nmUV version but also clear resins (such as Detax Freeprint splint) cure to a “glass clear” finish making splints or surgical guides aesthetically pleasing to the eye. Supplied with every new system is the Composer software. This is a crossplatform nesting programme that is compatible with Windows, Mac and Linux. The Composer software automatically corrects common minor defects in STL files and helps you create support for the print parts on the build platform. A great benefit is that this programme is free, there are no onward licence charges and the software offers unlimited users throughout your Laboratory, meaning it can be installed and operated from multiple PC’s offering maximum accessibility. Again, this is of huge benefit to Dental Professionals who will expand their services to new clients. When connecting to the printer locally (either wirelessly or by Ethernet cable) you can select multiple printers in your lab and begin the print process specifying which printer or material you are using or by tweaking parameters such as layer thickness, burn in times or heater operation.

Incredibly, providing the resin tray is loaded with the appropriate material, the print cycle can be started through a VPN so you can add the desired objects to be printed to the plate (e.g. models) and start the print process in the comfort of your own home. Being an open system printer you will encounter many different types of resins for all build requirements that are compatible with an Asiga 3D printer. The beauty of Asiga is that they are committed to bringing you the best resins available to use with their machines. As well as several big resin manufacturers being officially compatible with Asiga printers, Asiga are determined to make many more materials available to the dental laboratory for compatibility with their machines. Asiga does this by regularly testing resins new to the market and creating files that are downloadable for seamless compatibility with their units. These files contain the specific parameters relevant to each machine they have available and contain the material name, printer heater temperature, time of exposure/height of z axis, number of burn in layers to encourage initial adhesion to the print plate and support generation parameters. I am aware that for those people interested in the Digital Revolution, one of the biggest headaches is knowing the right questions to ask. That is why I thought it would be good to give you an outline overview of these printers. At least with this information you will be able to compare units and begin to see the advantages that those Laboratories embracing this technology will have and benefit from. This trip exceeded my expectations of the Asiga range and was invaluable in extending our knowledge, allowing us to give a specialist back up and installation package to new and existing customers. I hope that my fellow Dental Technologists find this of interest; the Digital Revolution has come of age.

The Dental Technician August 2017/Vol 70 Issue 07

German O. Gallucci

SPEAKS AT THE ITI STUDY CLUB LONDON At a combined meeting of the London ITI Study Clubs held at the BDA Headquarters in Wimpole Street on June 21st, delegates gathered to hear from one of the truly knowledgeable masters in the field of Implant Dentistry. Prof. Gallucci is Associate Professor and Chair of the Department of Restorative Dentistry and Biomaterial Sciences at Harvard.

he Presentation, entitled: Esthetic Outcomes and Digital Technology in Implant Dentistry could not have come at a better time for many of us happily attending. In an expected scientific and clear delivery professor Gallucci outlined the step-by-step process of planning, confirming plan and process and taking the cases through to the inevitable. He showed examples at each stage of the case, the virtual image on the computer screen and the completed stage procedures. In an expected manner each of the procedures had been subject to on-going research as to the accuracy or indeed the effectiveness of each process. The accuracy of digital planning and digitally controlled construction were analysed and verified with a very positive outcome for the new technologies. He showed the comparison between conventional and digital process and compared results and patient satisfaction. Undoubtedly there is a necessary learning curve for the newer technology but Professor Gallucci demonstrated the great advances already made and the remarkable predictability of outcomes with the integrated new technology. He showed the considerations, which should not be overlooked, within the planning and the Virtual imaging and stressed the constants of emergence profile, and soft tissue support. He demonstrated the changes in appearance and health will play a great part in the

Note: Emergence Profiles of Healing Caps

Note: the bone form changes at 3 years

eventual outcomes and long-term survival of the aesthetics. Using some straightforward imaging and photos of crowns constructed he showed how a small variation of the emergence profile of the healing cap could create a problem for the final shape and integrity of the implant borne crown. A case with Central Crowns, side by side, but with a different soft tissue outcome due to

healing cap shape variation. The team at Harvard have spent a lot of their time and energy in working towards a classification of potential Implant patients and a logical sequence in order to plan for successful outcomes for the restorative design. The Volume of bone and its related position will determine the category.

Category 1

Category 3 Categories of Edentulous jaws by Age for prosthetic Implant planning. Based on Study of 168 patients in 2005.

Category 4

Continued on page 18

Category 2

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The Dental Technician August 2017/Vol 70 Issue 07

Continued from page 17 As a useful guide and as an aid to better understanding and communication the above guides will undoubtedly prove useful. Particularly, when considering whether to use, fixed or removable. The age of a patient may well indicate the need to consider dexterity for cleaning and maintenance as an added concern and guide to the eventual design. Professor Gallucci took us on a walk through a full maxilla arch case with provisional bridgework, maintained through the healing phase, screw retained on transitional implants, which were also used to fix down the surgical template prior to placing the final implants. While the full Digital workflow will not suit all cases for logistic and cost reasons there is no doubt the ability to adopt to the computer driven techniques and the facility to use digital in line with conventional really does add appeal to the processes. As is shown by the final graphic outline below. The operators can weave in and out of the potential mix to suit the patient and the case and their own level of empathy with the Digital systems. As expected a full and interesting evening with a great deal of impressive research and knowledge for consumption. Professor Gallucciâ&#x20AC;&#x2122;s relaxed and quietly confident manner underlined that the work had been done and the results were there for all to see. A full house waited right on to the end of the scheduled evening. Thank you ITI for another very interesting, scientific and stimulating evening in the home of British Dentistry.

The Dental Technician August 2017/Vol 70 Issue 07

Big and beefy - the Straumann road show covers the country

STRAUMANN SETS OUT ON THEIR DIGITAL PERFORMANCE ROADSHOW

his July Straumann UK invited all technicians, CDTs and clinicians looking to enhance their digital offering in 2017 and beyond to join them on the Straumann Digital Performance Roadshow. Featuring a highly impressive customised juggernaut with the Straumann digital performance logo emblazoned all over, this was a truly remarkable sight. Not only was the juggernaut visually impressive, its clever design revealed that the inside doubled as a wonderful mobile demonstration and teaching area of all the very latest in Straumann® CARES® Digital Solutions. It contained a treasure trove of the world of digital dentistry for both the practice and the lab, including scanners as well as a full range of

3D printers and CADCAM milling machines, all showing what is now possible to achieve in the modern world of hi-tech restorative dentistry.

FIRST STOP SANDOWN PARK

The first stop on the nationwide tour was just south of London at Sandown Park Racecourse, one of the Jockey Club’s finest venues and a wonderful background for a mixture of insightful presentations, hands-on demonstrations and digital education, not to mention great food and live music.

Welcome to the digital World of Straumann

In the working area, which expanded out from the centre of the juggernaut, the Straumann team provided demonstrations of the latest clinical scanners from 3Shape

The Dental Technician August 2017/Vol 70 Issue 07

Simon Wright tells the story of Ice Hospital Centre

The surgeries are equipped with Dental Wings and 3Shape TRIOS® scanners together with all, the necessary laboratory support equipment to complete any operation. A fully equipped and sparkling clean dental laboratory with all things digital gives a fine example of the very latest in dental laboratory design.

Top: Last few steps to digital wonderland. Above left: Straumann Cares M digital scanner. Above right: Demonstrating the 3Shape Intra-Oral Scanner

and Dental Wings, showing how easy they are to use and the remarkable images it is possible to achieve, as well as the latest manufacturing processes for CADCAM milling and 3D printing. With an afternoon of interactive and practical involvement under our belts it was time to enjoy a great evening of food and exceptional live entertainment from band Rollercoaster!

STRAUMANN ROLLS INTO MANCHESTER

Having completed visits to Exeter and Coventry, on 10th July the Straumann Digital Roadshow rolled into Manchester to set up base at the world-famous home of Manchester United Football Club - Old Trafford. For those attending the Manchester event it included a visit to the remarkable Implant Centre of Excellence (ICE) Hospital

& Postgraduate Dental Institute at Salford Quays. Greatly supported by Straumann, the centre offers a very popular referral and learning resource, including a range of courses in implant and digital dentistry. Conceived and set up by Prof. Cemal Ucer, this multi-surgery facility provides a state-of-theart referral service for implant placement and restoration and incorporates several continuing educational programmes up to degree level for those wishing to become fully verified in implants within restorative and digital dentistry. The facilities are housed in a wonderfully laid out modern building over two floors containing everything from CBCT scanning and digital radiography to fully equipped surgeries and teaching facilities, covering every area of dental implant and digital treatment applications.

Thanks are very much due to Howard who committed himself to ICE some years ago by taking his own laboratory and re-siting within the ICE Hospital. All of the visitors, including clinicians and technicians, were very impressed with this well-executed concept and the on-going commitment to continued training for all aspects of implant and restorative dentistry.

A DIGITAL SUCCESS

The Straumann Digital Roadshow has proved to be an outstanding and educational experience for everyone concerned. A rolling presentation of Case Planning, Digital Impressions, Lab Scanners, In-lab Milling, External Milling and Scan & Shape. Despite having visited London, Exeter, Coventry, Manchester, Leeds, Newcastle and Edinburgh in the space of just two weeks, the Straumann team are still full of enthusiasm for digital dentistry. By including an all-encompassing digital dimension to their portfolio Straumann have added a completely new vibe to their offering- they’re more than a dental implant company, they’re your digital solutions partner! l To find out more about digital dentistry, contact Straumann on 01293 651230 or visit straumann-cares-digital-solutions.com www.straumann.co.uk therevu.co.uk Facebook: Straumann UK Twitter: @StraumannUK

Air Guitars just played In Rhythm. Were the band phased by the competition?

Justin and the Straumann Team ready for the road to Leeds, Newcastle and Edinburgh.

Justin Annett greets Prof. Cemal Ucer and colleagues David Speechley and Simon Wright at the ICE Hospital

The Dental Technician August 2017/Vol 70 Issue 07

DENTAL NEWS uuu

STRINGENT COURT REACTION TO REPEATING TECHNICIAN CRIMINAL BEHAVIOUR

The Dental Technician August 2017/Vol 70 Issue 07

former dental technician has been ordered to pay more than £10,000 after being convicted of offering tooth whitening illegally. Jeffrey Lehmann has also been given a Criminal Behaviour Order, which - if breached - could result in imprisonment, a fine, or both, following a prosecution by the General Dental Council (GDC). This is the first time that the GDC has sought – and had granted – a Criminal Behaviour Order. The order imposed prevents Mr. Lehmann from advertising and offering dentistry. Mr. Lehmann, a former Dental Technician, was removed from the GDC’s dental register by the Professional Conduct Committee in May 2012 for acting outside the scope of his profession, causing harm to patients, failing to accept professional accountability for his actions and for acting without integrity. However, the General Dental Council received a complaint claiming that Mr. Lehmann was still practicing dentistry, by offering tooth whitening services at Whitening Smile, in Pinner, London. Following an investigation, he was charged with offering dental services whilst not being on the register of dental care professionals. He was subsequently found guilty of the offence following a trial at Uxbridge Magistrates’ Court. The judge presiding over the case, requested Mr. Lehmann’s business accounts for the past three years, prior to making a decision on sentencing. These documents were provided at the sentencing hearing at Ealing Magistrates’ Court. The judge, at Ealing Magistrates’ Court, said: “The accounts produced are not complete and they don’t seem to relate to your business, I believe this selective submission of accounts is subterfuge in order to disguise the true extent of your earnings.

THE TERMS OF THE CRIMINAL BEHAVIOUR ORDER ARE AS FOLLOWS: THE DEFENDANT MUST: 1) Not offer advice in connection with tooth whitening or denture fitting to any person in England and Wales; 2) Not be in possession of a tooth whitening kit other than for personal use and have no more than one at any time; 3) Not be in possession of a tooth whitening kit in any premises or part of any premise used by you (the defendant) for business purposes; 4) Not advertise services of tooth whitening or denture fitting anywhere including websites (after a period of 2 weeks to allow the defendant time to remove content from his website); 5) Not advertise any premises owned, managed or occupied by yourself as a “dental clinic”; 6) Not advertise yourself as a “denture specialist” 7) Not make dentures save for copy dentures already moulded by any dentist or dental technician. • Scope of Practise describes what a dental professional once registered, is trained and competent to do using the knowledge, skills and

experience to practice safely and effectively in the best interests of patients. • An individual must be registered with the General Dental Council to practice dentistry in the United Kingdom – this includes dentists and dental care professionals. If someone is practicing dentistry without being on the GDC’s register, this is illegal. • Date he was found guilty and sentenced • Jeffrey Lehman was found guilty of holding himself out to practice dentistry, contrary to Section 38 (1) and (2) of the Dentists Act 1984. Section 38 of The Dentists Act 1984 makes it a criminal offence for a person who is not a registered dentist or a registered dental care professional to practice dentistry, or hold themselves out whether directly or by implication as practicing or as being prepared to practice dentistry. • The GDC’s role is to protect patients and work to maintain public confidence in the dental profession. Part of the way we achieve this is by regulating dental professionals and investigating and, where appropriate prosecuting, cases of illegal practice.

Shaun Round, Interim Head of the Illegal Practice team, said: “This outcome shows how seriously both the GDC and the magistrates’ courts take the illegal practice of dentistry. To ensure patient safety, tooth whitening can only be carried out by dentists and dental care professionals who are registered with the GDC. The GDC investigates and, where appropriate, prosecutes those who carry out illegal dentistry, to ensure that members of the public are protected and not put at risk. “This is the first time that the GDC has sought – and been granted – a Criminal Behaviour Order (CBO), which aims to stop people reoffending and further endangerment of the public. “We hope this outcome will encourage patients to ensure that when they seek dental treatment – such as teeth whitening – they check whether the practitioner is registered with the GDC.”

“You do not have the qualifications or registration with the GDC [to carry out tooth whitening] and I’m quite certain that places members of the public are at risk.” Mr. Lehmann was then fined £4,500 and ordered to pay a £120 victim surcharge and full costs to the GDC totaling £5,703.39.

The Dental Technician August 2017/Vol 70 Issue 07

DENTAL NEWS FROM IRELANDuuu ALL NEWS REPORTS ON THIS PAGE ARE TAKEN FROM THE INTERNATIONAL DENTAL TRIBUNAL

EIB fund Irish health care facilities n

Work began on over a dozen new primary care health centres across Ireland this month after confirmation of the grant of 70 million Euro from the European Investment Bank (EIB). The project funding comes from the European Fund for Strategic Investments. The 14 new facilities will provide general health care as well as Dentistry, Community nursing and a number of other services. The centres, which will be built in the capital and other

provincial cities, such as Limerick and Waterford are expected to open within the next two years. According to the department of Health in Dublin, they will provide services to the public at least five days a week, with extra hours at weekends and evenings where required. A consortium of Prime, Balfour Beatty and its investors Prime UK Holdings and HICL Infrastructure, is handling the project. It was announced as the preferred

NEW FIGURES FROM EUROSTAT SHOW THE NUMBER OF DENTISTS PRACTICING IN IRELAND IS FALLING n

Despite the rise in the number of new graduates Ireland shows the greatest drop in the number of practicing dentists per 100,000 inhabitants anywhere in the European Union. With only 2,649 dentists licenced to practice in Ireland the country occupies the sixth lowest position within the EU. According to the Irish Independent, the reports do not come as a great surprise. Fintan Hourihan, CEO of the Irish Dental Association, blames the recent cuts to patient support funding. Which, he maintains, has led to a significant drop in patient attendance numbers. This of course has reduced Dentists incomes by an equal amount making the maintenance of a dental practice very challenging. “The number of dentists per 100,000 is certainly lower than plenty of other countries and that’s probably because it’s not as attractive an option for people to live and work here because it’s so expensive to run practices as much as anything else,”

Consequently, an increasing number of dentists are leaving the country to pursue their careers elsewhere in the world. “They’re no longer going across to the UK, people are going to Canada where there is a reciprocation of recognising qualifications. They’re also going to New Zealand and Australia and that is not a pattern in dentistry that was there before,” Dr. Hourihan stressed. At the end of the five-year evaluation period in 2013, there were 183 fewer dentists (a decrease of 6.5 per cent) practising in Ireland. This development is especially alarming when considering that the number of graduates between 2008 and 2013 from the two dentistry schools based in the country, Trinity College Dublin and University College Cork, actually grew by 18.67 per cent, up to a total of 89. l More information can be found at www.ec.europa.eu

tenderer in May last year. It is the first time that the EIB has approved an investment in Irish health care facilities. According to reports, the balance of the significant finance required will be provided by the Bank of Tokyo-Mitsubishi, UFJ and German insurance company Talanx. Minister for Health, Simon Harris said “We look forward, with their support and assistance, to the delivery of state-of-the-art 21st

century health care facilities. Enhancing and expanding capacity in the primary care sector is crucial to ensuring delivery of a preventive, joined-up approach to the management of the nation’s health and the modernisation of primary care delivery.” My ultimate goal is to ensure that people get the care they need as close to home as possible, and have access to a greater range of health and social care services in their community,” he concluded.

Health Care Funding Abuse In N. Ireland cost £44 Million n

Health and Dental care worth £44 million were lost to cross-country fraud last year. Health and Social Care in Northern Ireland has reported this rather disturbing figure. A spokesman said that, of the over 30,000 dental and ophthalmic treatments claimed for exemption in the region in 2013, over 8,000 have been under investigation owing to charges of abuse. More than 400 people have been removed from general practitioner lists in the last 18 months owing to fraudulent activities and more than 200 are facing legal action. In most of these cases, exemption from health care charges was claimed under false pretences. Fraud was committed by practice staff submitting false time or travel sheets. In one case, for example, £25,000. was claimed by a nurse who forged her manager’s signature. The total loss is estimated at 3–5% of the region’s health care budget, which is £4 billion.

“Fraud affects us all. All organisations suffer as a result and the health service is no exception. Every penny lost to fraud means less to spend on front line services, meaning that the range of treatment and care we may receive is severely reduced,” commented Northern Ireland’s Health Minister Jim Wells on the figures. He said that the government is doing everything possible to investigate fraud and recover money lost, but support is also needed from the public to tackle the problem. “No one is above the law. I would encourage everyone within the Health and Social Care system to familiarise themselves with how to report it and ask the public to ensure that they are aware of to what they are entitled,” Wells said. Since 2013, the service has been working with Counter Fraud Services to detect and prevent cases of fraud. This collaboration has resulted in a conviction rate of 96 per cent, according to Health and Social Care.

The Dental Technician August 2017/Vol 70 Issue 07

DENTAL NEWS uuu

DENTIST REMOVED FROM REGISTER FOR FAILINGS SPANNING 12 YEARS

dentist has been removed from the General Dental Council’s (GDC) register of dental professionals after a series of failings which span 12 years. Alan William Henry faced 21 charges at a Professional Conduct Committee (PCC) hearing relating to the treatment of two patients – and all of them were found to be proven. It was found that between 2006 and 2014, Mr Henry failed to adequately assess, treat and refer Patient A for her periodontal condition; did not take suitable radiographs from patient A; failed to obtain Patient A’s consent; both patients’ records were not kept up to date; Mr Henry prescribed antibiotics without justification

on numerous occasions, he didn’t prepare adequate treatment plans; and used Periochips rather than other suitable treatments. A spokesperson from the PCC said: “The Committee received expert evidence that Mr Henry’s failures resulted in poor outcomes for patients A and B. In the case of Patient A, there was poor prognosis for her entire dentition and in the case of Patient B, the loss of six teeth over a relatively short period of time. “Both patients suffered harm as a result of Mr Henry’s acts and omissions.” In June 2016, a PCC found that Mr Henry’s fitness to practise was impaired due to the treatment and record keeping involving

three other patients. Conditions were placed on his registration, however a review found that he had not engaged with the GDC, nor had he shown any insight or remediation. He was then suspended in December 2016 by the PCC for a period of 12 months. A spokesperson from the PCC said: “He has chosen not to engage with the GDC on these proceedings or indeed at his previous hearings before the PCC. He was given an opportunity to demonstrate that he had remediated the shortcomings identified in 2016 but he did not do so.” Jonathan Green, Executive Director, Fitness to Practise, said: “The findings by the PCC in Mr Henry’s case, outlined that he failed to provide an adequate

level of care spanning more than a decade and caused two patients harm. The Practice Committee found that the care shown amounted to a substantial deviation from the standards expected from dental health professionals and as such Mr Henry’s conduct was incompatible with him continuing to remain on the register of dental professionals.” The PCC therefore decided to remove Mr Henry from the GDC’s register of dental professionals. Mr Henry – who has been immediately suspended - has 28 days to appeal the decision. If he does not appeal, he will be removed from the register of dental professionals after this time which means he will not be able to practise as a dentist in the UK.

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The Dental Technician August 2017/Vol 70 Issue 07

DENTAL NEWS FROM IRELANDuuu REPORT TAKEN FROM THE INTERNATIONAL DENTAL TRIBUNAL NEWS

IRISH DENTISTS TURN ON GOVERNMENT AS PRIVATE SPENDING REACHES NEW LOW HOUSEHOLDS IN IRELAND ARE CURRENTLY SPENDING JUST €84.53 PER YEAR ON THEIR DENTAL CARE, A 57 PER CENT FALL FROM 2010.

In a letter to Ireland’s new prime minister, Leo Varadkar, the Irish Dental Association (IDA) has called for better funding of public dental services. The demand comes after a recent survey published by the Central Statistics Office in Dublin found that average annual household spending on dental care has almost halved over the last five years. Consequently, households in Ireland are currently spending just €84.53 on their dental care, a 57 per cent fall from 2010, according to the Office. The last time people in Ireland spent that little on dental care was in the early 2000s. Alarmed by the figures, IDA CEO Fintan Hourihan said there is need to form a crossdepartmental group to devise a response plan that includes measures like expanding the Med 2 system and prioritising a new dental plan. He also suggested increasing investment in existing dental schemes, like Pay Related Social Insurance, and the Health Service Executive appointing extra dentists to cater for vulnerable populations, such as children and special care patients. “We are seriously concerned about the impact of cuts in household spending on citizen’s dental health,” Dr. Hourihan said. While he admitted the low spending could be due to the recession, among other reasons, he said the government also needed to

introduce measures to encourage people to visit the dentist.

explained. “The state will simply have to take a lead.”

“This is not an optional expense. Prevention is cheaper than cure and if we don’t address the issue now we are simply storing up problems for the future,” he

It makes great sense to invest in prevention, which will inevitably lead to lower repair and replacement bills not too far down the road.

According to the IDA, cuts on treatment like those offered under the medical card accounted for almost €500 million less in dental care spending, resulting in 80 per cent of dentistry services in Ireland now being paid out of patient’s pockets or through insurance payments.

The Dental Technician August 2017/Vol 70 Issue 07

FREE VERIFIABLE CPD As before if you wish to submit your CPD online it will be free of charge. Once our web designers give it the all clear there will be a small charge. This will be less than the CPD submitted by post. This offer is open to our subscribers only. To go directly to the CPD page please go to https://dentaltechnician.org.uk/dental-technician-cpd. You will normally have one month from the date you receive your magazine before being able to submit your CPD either online or by post. If you have any issues with the CPD please email us cpd@dentaltechnician.org.uk

4 Hours Verifiable CPD in this issue LEARNING AIM The questions are designed to help dental professionals keep up to date with best practice by reading articles in the present journal covering Clinical, Technical, Business, Personal development and related topics, and checking that this information has been retained and understood. LEARNING OBJECTIVES REVIEW: n Strength of Zirconia. n Implant planning n Customised Special trays n Business of Management LEARNING OUTCOME By completing the Quiz successfully you will have confirmed your ability to understand, retain and reinforce your knowledge related in the chosen articles.

Correct answers from July DT Edition:

Verifiable CPD - AUGUST 2017 1. Your details First Name: . ................................................Last Name: ............................. Title:.................. Address:................................................................................................................................. ............................................................................................................................................... ........................................................................................Postcode:....................................... Telephone: ..................................... Email: . ..........................................GDC No:.................. 2. Your answers. Tick the boxes you consider correct. It may be more than one. Question 1

Question 2

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Question 10 Question 11 Question 12 Question 13 Question 14 Question 15 Question 16

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Q10. C. Q11. C. Q12. A. Q13. C. Q14. B. Q15. C. Q16

3. Evaluation: Tell us how were doing with your CPD Service. All Comments welcome.

As of April 2016 issue CPD will carry a charge of £10.00. per month. Or an annual fee of £99.00 if paid in advance. You can submit your answers in the following ways: 1. Via email: cpd@dentaltechnician.org.uk 2. By post to: THE DENTAL TECHNICIAN, PO BOX 430, LEATHERHEAD KT22 2HT Payment by cheque to: The Dental Technician Magazine Limited. Natwest Sort Code 516135 A/C No 79790852

You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers. Answers will be published in the next issue of The Dental Technician. Certificates will be issued within 60 days of receipt of correct submission.

The Dental Technician August 2017/Vol 70 Issue 07

VERIFIABLE CPD AS YOU NEED IT VIA THE DENTAL TECHNICIAN RENISHAW CONTRIBUTE TO PIONEERING WORK IN CANADA. Q1. What area is covered by this project?

GALLUCCI SPEAKS AT THE BDA IN LONDON. Q9. What was Professor Gallucci speaking about?

Q2. In what will Renishaw be taking the lead?

Q10. Will digital technology reduce the need for a full patient assessment?

ORTHODONTIC STUDY MODELS Q3. How long should you keep children’s Study Models in general practice?

Q11. How many patients took part in the prosthetic Implant planning study?

A. B. C. D. A. B. C. D.

A. B. C. D.

Making Dental Implant Abutments. Making prosthetics for implant supported restorations. Developing new solutions to Medical and Dental restorative problems. Increasing production of their Abutment selection Cad/Cam Milling. Additive Techniques such as 3DPrinting. Heat treatment techniques. Metal Surface treatments.

To the age of 25 years. Until 8 years after their death. 11 years. 8 years.

A. B. C. D. A. B. C. D. A. B. C D

The accuracy of digital procedures. The simplicity of digital procedures. The aesthetic potential of digital procedures. The simplicity of digital procedures Yes because it’s all on computer. No because the information has to be gleaned from the patient. Yes because the computer can be programmed to assess. Yes because it can be done on camera. 49. 130. 168. 87.

Q4. What angle is required for the labial segment?

THE STRAUMANN ROADSHOW Q12. What do Straumann call their in house system?

Q5. To what angle should the heels of the upper be trimmed?

Q13. Which of their chair side scanners produces colour images?

Q6. How should the bases be trimmed?

Q14. How many cities did they visit in 11 days?

DATA STORAGE CAUTION. Q7. Where should you not store patient Data?

STRINGENT COURT REACTION. Q15. What is unique about this case?

Q8. Where should you store patients Data?

Q16. What could happen if he ignores the order?

A. B. C. D A. B. C. D. A. B. C. D.

A. B. C. D. A. B. C. D.

65o. 45o. 30o. 25o.

115o. 85o. 160o. 45o.

Parallel to the occlusal plane. In line with the base of the lower model. In line with the base of the upper model. So it looks good.

On your home computer. On a mobile device. On your laptop. On your associates computer.

On the i Cloud. On a computer used only for that purpose. On a secure and software protected computer. On the main office computer.

A. B. C. D. A. B. C. D. A. B. C. D.

A. B. C. E.

A. B. C. D.

Truck digital system. Lab digital system. Cares digital system. Swiss digital system.

Dental Wings. 3Shape Trios. Cares digital scanner. Armann Girbach scanner. 5. 9. 7. 6.

The GDC being involved. The Criminal Behaviour Order. The size of the fine. The Bleaching process.

Imprisonment. Could be struck off. Could be warned not to do it again. Could be forbidden to work as Technician.

Payment by cheque to: The Dental Technician Magazine Limited. NatWest Sort Code 516135 A/C No 79790852

You can submit your answers in the following ways: 1. Via email:cpd@dentaltechnician.org.uk 2. By post to: THE DENTAL TECHNICIAN LIMITED, PO BOX 430, LEATHERHEAD KT22 2HT You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers. Answers will be published in the next issue of The Dental Technician. Certificates will be issued within 60 days of receipt of correct submission.

The Dental Technician August 2017/Vol 70 Issue 07

THE IMPORTANCE OF ORTHODONTIC STUDY MODELS AND HOW TO CAST THEM

BY ANDREA JOHNSON WHAT ARE ORTHODONTIC STUDY MODELS AND WHAT ARE THEY USED FOR?

Well simply put they are diagnostic records, which allow the clinician to study the occlusion, dentition and surrounding soft tissues in 3 planes of space. They are kept for medico legal reasons and are a good way to show the patient progression through their treatment. They are used to Peer Assessment Rate (PAR) the treated case which is a method of measuring how much improvement there has been over the course of the patient’s treatment to give a percentage change. As they form part of the patient medical records they must be treated as such, therefore you cannot just dispose of them as soon as the patients treatment is complete. So how long do you have to keep them? Well this decision is not as simple as it seems as the Data Protection Act says that someone holding sensitive personal data (which includes, dental records) should retain that information no longer than necessary (GOV.UK, n.d.), but there is no definition of ‘necessary’; and so this will depend on each individuals circumstances. The Department of Health has offered assistance by setting out some guidance in the Code of Practice on Retention/Disposal of Records under the NHS. By their guidance we are encouraged to put a maximum period of 30 years on retention. If you cannot keep records for 30 years then the NHS code suggests the following: Community care l 11 years (adults) l To the age of 25 years (children) Hospital care 8 years (adults) To 25 years or 8 years post death (children)

l l

The most sensible advice would be to adopt the same period of time set out under the NHS Code for Community care as an absolute

minimum, however; records that relate to complex treatment cases or particularly difficult patients should be kept for longer if possible, up to the 30 years after the active treatment phase. Digital imaging impressions can also be used to make extremely accurate versions of the stone casts, which reproduce the jaws, teeth, gingival tissues, and palatal area. This is can be done though the intraoral digital scanners which are moving rapidly into the profession or the use of conventional materials which remain the most common source for making impressions. These records are also subject to same rules regarding retention. The digital system must also be designed so that no matter how much you manipulate the image of the records on screen there will always be an original untouched version of the scan saved.

Once the plaster is set enough (you will be able to feel a slight resistance when touching the built up plaster) carefully invert the impressions onto the plaster bases.

Using a plaster knife carefully remove any excess plaster in the lingual region of the lower and around the periphery of the trays so that they do not become trapped once the plaster has set.

HOW TO CAST ORTHODONTIC STUDY MODELS

First of all check to make sure your impressions are suitable for use. They need to be relatively free from voids and firmly attached to tray, clean and then rinse your impressions well prior to casting, this is to ensure any residual disinfectant and debris is removed. Once the impression is clean shake off the excess water. You now need to mix your plaster, when mixing your plaster you should have a water to plaster ratio of 35:100. I use Crystal R and mix at room temperature taking care not to add too much air and bubbles into the mix. Tap the plaster mix carefully into the impression avoiding trapping any air between the impression and the plaster then carefully build up plaster bases in layers allowing each layer a little time to partially set/firm up before adding next layer on top.

Carefully remove the impression trays from the models and check for any breakages of the teeth before discarding the impressions.

Trim away the excess plaster around the periphery of the models.

Check the fit of the wax bite.

Once the plaster is set firm enough for you to pick up, trim away excess plaster leaving enough for the base to be suitably trimmed.

Trim the lower model so that the incisal edges of the incisor teeth and occlusal surfaces of the last molars are parallel to create a level occlusal plane.

Check that the plaster has set and that the exothermic reaction is complete. – the models will heat up as the plaster sets and cools when the process is complete.

Continued on page 30

The Dental Technician August 2017/Vol 70 Issue 07

Continued from page 29 Check the bite to determine which classification it falls into as this will affect the way in which they are trimmed, for example a class III bites usually require a wider lower base and the upper needs to be trimmed to allow for this.

Taking care to ensure that the dental midline is facing directly forwards, trim the back edge of the upper model level 90 degrees to the base.

Using a slide attachment if available trim the buccal sides of the upper model to a 65 degree angle, checking that enough space is left for the lower to be trimmed to match especially if this is a class III case.

If you have a smoothing wheel on your grinder smooth the sides of the models at this stage.

Place in a model dryer to dry or leave at room temperature for a minimum of 48 hours to dry completely before boxing away. This will ensure that all the excess water has dried off and that the models will not be susceptible to mould during storage.

Trim the labial segments of the upper model to a 25 degree angle, do this to either side of the model making sure that the central point which is subsequently formed meets at the midline point.

Place the upper and lower models into occlusion with the wax bite and trim the backs level using the upper as the guide.

FINISHED PRODUCT Neaten off the edges of your models once more at this stage to flatten them off.

Trim the heels of the upper to 115 degrees

Place the upper and lower into occlusion and trim the lower base to match the upper, however; instead of making the lower front a point round it off instead. Using a slide attachment if available or by eye, trim the top surface of the upper model so that the bases are parallel. This is dictated by the lower and the occlusal plane trimming done previously.

Mark the models with the patientâ&#x20AC;&#x2122;s details.

REFERENCES: 1) GOV.UK, n.d. Data Protection. [Online] Available at: https://www.gov.uk/dataprotection/the-data-protection-act [Accessed 16 July 2017]. 2) GOV.UK, n.d. Records management code of practice for health and social care. [Online] Available at: https://www. gov.uk/government/publications/recordsmanagement-code-of-practice-for-healthand-social-care [Accessed 16 July 2017]

The Dental Technician August 2017/Vol 70 Issue 07

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