The Dental Technician Magazine March 2019 by The Dental Technician Magazine

VO L 7 2 N O. 3 I M A R C H 2 0 1 9 I B Y S U B S C R I P T I O N

VERIFIABLE ECPD FOR THE WHOLE DENTAL TEAM

IDS 2019 WILL YOU BE THERE?

www.dentaltechnician.org.uk w w w.d e n t a l t e c h n i c i a n .o r g .u k

INSIGHT DENTAL TECHNICIANS: WW2 THE FINAL CHAPTER BY TONY LANDON PAGE 26-27

FOCUS THE CHANGING FACE OF UK DENTISTRY BY SUE KARRAN PAGE 17

YO BY UR R S A EC UB C O S SE OL MM CR E LE EN IPT PA A D IO G GU IN N E E G 3

DIGITAL TECHNOLOGY ZIRKONZAHN, MDT ENRICO STEGER - CASES STUDIES PAGE 6 & 9

Inside this month

DenTeamCPD

in association with

The South-West Dental Congress 2019

21st and 22nd June 2019. Sandy Park, Exeter Join us for two days of great continuing professional development delivered by some of the leading lights in dental technology. Gain up to 14 hours of verifiable CPD and go hands-on with the latest equipment

Saturday 22nd June

The Dental Technology Stream A full-day programme for dental technicians, in association with the DTA and chaired by Barry Tivey and Delroy Reeves. ► How to avoid expensive remakes in fixed prosthodontics

► EU Medical Device Regulations: they are changing...

► The case for metal-free dentistry: myths debunked

► Orthognathic model surgery and

Andrew Taylor

Sean Wilkinson

James Green

TJ Nicolas

David Smith

Barry Tivey

Delroy Reeves

Matthew Hill

PLUS: Hot Topics Forum – grill the day’s speakers on the issues that matter to you

Hands-on sessions include... Zirkonzahn.Implant-Planner and Zirkonzahn.Software – join Sean Wilkinson as he guides you through the digital workflow, showing how to transfer and combine the patient’s data properly in the virtual world.

intermaxillary wafers

► Enhanced CPD: are you ready? ► Tired of being told implants are the only way to save bone...

► Moving upstream: toward a better, fairer system of dental regulation

Don’t miss out on the Friday’s packed programme – medical emergencies, sepsis, careers, orthodontics, indemnity, the holistic approach to dentistry, mouth cancer, facing the future, and much more!

Full details and online booking: 2

www.denteamcpd.com

www.dentaltechnician.org.uk

£190 fo r two d ays £105 fo r one d ay (plus V A T ) 25% dis co DTA me unt for mbers! Fee includes: hot lunch, event guide, proceedings and refreshments, etc.

Delegate/exhibitor enquiries: telephone 07801 657608 or email chris@teamworkprofessionals.co.uk

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CONTENTS MARCH 2019

Editor - Larry Browne FBIDST. FDTA, ITI Fellow, LCGI, RDT. E: editor@dentaltechnician.org.uk T: 01372 897461

Welcome Thoughts from the Editor

Designer - Sharon (Bazzie) Larder E: inthedoghousedesign@gmail.com

Digital Technology

Advertising Manager - Chris Trowbridge E: sales@dentaltechnician.org.uk T: 07399 403602

Zirkonzahn Case studies Digital Technology â&#x20AC;&#x201C; The end for dental labs or a new beginning? By Sue Karran

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 Published by The Dental Technician Limited, PO Box 430, Leatherhead , KT22 2HT. T: 01372 897463 The Dental Technician Magazine is an independent publication and is not associated with any professional body or commercial establishment other than the publishers. Views expressed in this journal are not necessarily those of the editor, publisher or the editorial advisory board. Unsolicited manuscripts and photographs are welcome, though no liability can be accepted for any loss or damage, howsoever caused. No part of this publication may be reproduced in any form without the express permission of the editor or the publisher.

6&9 25

Marketing Marketing Simplified by Jan Clarke

Focus Kate Clemson : My digital journey The changing face of UK dentistry by Sue Karran

12 17 & 19

Insight Dental opinion from Sir Paul Beresford, BDS. MP Dental Technicians: Dangerous role of WW2 -the final chapter by Tony Landon

14 26-27

Dental News Food industry bodies ask for delay in junk food advertising reform The remarkable story of Jan Clarke Taplin Mouth cancer foundation announce new president Dentsply Sirona is "Top Employer 2019" Researchers examine regenerative potential of mice teeth Study questions health benefits of artificial sweeteners

15 18 20 22 30 30

Company News Zirkonzahn/ Shofu/ Kemdent

Subscriptions The Dental Technician, Select Publisher Services Ltd, PO Box 6337, Bournemouth BH1 9EH

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How to beat the big dental labs in the race to find top talent by Andy Foster

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THOUGHTS FROM THE EDITOR

WELCOME to your magazine IDS IN COLOGNE IS APPROACHING FAST WILL YOU BE THERE? Every 2nd year the IDS dominates l the international world of dental exhibitions. Everybody who is anybody

with products to introduce or continue to promote will be in Germany for some time in the Week of 12th March 2019. All the American and European big hitters make Cologne their major launch and promotion pad for the world of Dental Trade. There will be a big push on Digital innovations with all the major players presenting their “complete” answer to your Digital questions. But there will be a huge selection to look at and consider. There will be nearly 1200 laboratory stands alone. Luckily there are always others who come on to the scene with really interesting additions of Materials and Equipment. There will be numerous lectures and demonstrators of the very latest techniques and those chosen to demonstrate or lecture are usually the very best and well worth taking the time to watch and listen. Digital dentistry will probably be the major promotion but it is worth taking the time look at the new materials that now have become part of the future trends in aesthetic and restorative techniques. With the huge increase in Implant supported dentistry there is an equally large interest in the techniques and materials best suited to the needs of the clinician and patient. While Ceramic has dominated as the aesthetic material of choice for some 50 years there may be changes coming. Large scale bridgework finished in Ceramic, can undoubtedly still impress but if you are restoring large scale in opposing arches the brittleness of ceramic and the noise potential is sometimes unacceptable. Patients who invest in such expensive restorations expect not to have to be too aware of it. The answer is either not using ceramics or using a mixture of ceramic and plastic. The new toughened polymers now

coming fully on to the market from Japan, Germany, Scandinavia, the USA, Australia and of course the UK will occupy your minds for some time. These materials are tough and wearable with a real ability to copy the appearance of natural teeth. There will be lectures on these new innovations and there appeal with most of them in English or with instant translation. The rise of Carbon as a strengthening additive has been leading to a new generation of strong but aesthetic materials as a spin off from the Aircraft industry. Most of the larger of the modern planes are indeed made from “plastics” and more of you are discovering the amazingly wide choice now available from various manufacturers. The Laboratory materials and technique booths at all the major shows will undoubtedly feature a demonstration of building and colouring of these innovative choices. As materials developed for the space and Aeroscience their pedigree is unquestionably first class and adds a really new dimension in aesthetic restorations without some of the negatives of Ceramic. I have been to several laboratories and various demonstrations across the country and those who have chosen to work with the material are as enthusiastic as the early advocates of ceramic. The work I have seen is very impressive and matches the aesthetic effects of the high quality ceramic options. Hopefully I can persuade some of these talented technicians to let me have some case

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studies so we can share these new materials and techniques. With the number of suppliers and manufacturers at IDS it would be difficult not to pick up some useful information and techniques. Cologne is an interesting and friendly city with walks along the Rheine and lots and lots of beer bars and eateries. You can meet with some international colleagues and compare notes as well as enjoy the excellent choice of menus available. Be sure to book your accommodation. This year for the first time, if you have a ticket for the IDS the rail and public transport come free. So you can stay at a greater choice of areas in and around the city. Make sure you visit the Cathedral (the DOM) and note the twin spires. Set on high ground near the Rheine. I have been told by some former pilots that the cathedral was not bombed because the spires made a perfect aiming device for their raids. They could fly through the line of the towers and knew it was left for the docks and right for other areas. Perhaps it explains why Cologne was so damaged in the conflict but the cathedral survived. If you have not been before you will be delighted and amazed at what is on show and the array of materials and sundries form all parts of the world will be brought together. Housed in 6 halls it would be wise to pick those you are wanting to see early, and then wander around and browse. If it is available it will be at IDS.

Larry Browne, Editor

Celtra ® Press

Developed to make a difference The benefits of the Celtra® Press system for your dental laboratory: • A unique combination of excellent esthetics and high strength > 500 MPa (natural opalescence and translucency, stable margins) • Excellent shade fidelity according to the VITA shade system and a surprising chameleon effect (easy shade adaptation to the surrounding teeth) • Simple and fast processing (minimal reaction layer, easy to polish, a simplified shade system reduces inventory costs) celtra-dentsplysirona.com

Just try it! Celtra® Zirconia-reinforced lithium silicate, ZLS The new generation of high strength glass ceramic. Celtra ® Press is now available for the traditional pressableceramics technology. The system includes ingots, investment, and veneering ceramics.

DIGITAL TECHNOLOGY

ZIRKONZAHN, MDT ENRICO STEGER and his cases as he presented them at the HTSC Meeting on Wednesday 23rd January

n last months issue we featured a look at the HTSC and particularly the very interesting speaker Enrico Steger, MDT. Enrico was introducing his company Zirkonzahn and the wonderful digital possibilities for creating some extensive and advanced restorative work. During the presentation, I was crammed into the full meeting room and was using my camera to capture some of the images Enrico was presenting. I hope you read the article and found it interesting. I sent a copy of the article to Enrico and, while he was pleased with the feature, he was more than a little upset with my amateur images of his excellent work. To make amends and to present the work in its rightful quality I have asked and received the correct images directly from Enrico and his staff and I am more than happy to let you see the originals. The whole concept of the Zirkonzahn company grew from Enricoâ&#x20AC;&#x2122;s early fascination with zirconia as a potentially strong aesthetic material for the reproduction of natural teeth as crowns and bridges. As a laboratory owner, he always tried to use the best materials and methods for the patients he was involved with restoring. After some false starts, he eventually dedicated himself to producing the best available material and the techniques needed to produce a consistent high standard of restoration. Eventually, he became a manufacturer of the digital system with which to produce the desired quality of product. The photo of his laboratory will give you some idea of his commitment to excellence. The following three cases are an example of what is potentially available with a digital system and illustrate the flexibility and adaptive choices that can be made to produce the ultimate restoration. There is quite a lot to consider in these examples of what is possible when digital techniques are used by good technicians working with good equipment and scans. You will set your own standards, but at least you can see the system will not prevent you expressing your technical knowledge and skill and cannot be blamed for not producing the ultimate result. Enrico Steger is undoubtedly a highly skilled and knowledgeable Master Dental Technician with a particular advanced ability with digital techniques, and these cases demonstrate what is possible to do using these modern advanced techniques, equipment and materials.

Enrico Steger's Laboratory in Brunico (South Tyrol, Italy)

THE FIRST CASE Fig.2: Illustrates the virtual articulation scanned from records of the patients mouth. The articulator values on the left-hand side of the screen allow you to change the articulator or adjust the patient individual parameters on the articulator Fig.3: Shows the milled denture base for the intended full denture with preparations for the individual teeth Fig.4: Is the final set-up with the finished dentures, with natural looking composite layered gingiva and the individual teeth bonded to the denture base. Fig.5: A happy patientâ&#x20AC;&#x2122;s smile Fig.6: Shows Hochtek, in Valle Aurina, where components and technological equipment for dental technology are produced according to high precision standards

Fig. 2 Fig. 3

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u p9

Fig.6

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30/03/2019 CONFERENCE “3D FACIAL SCANNING & THE DESIGNING OF UNIQUE VENEERS”

THE VALLEY OF KNOWLEDGE 12 – 16 MARCH HALL 4.2 G-010/J-019

NEW ZIRKONZAHN.IMPLANT-PLANNER RELIABLE DENTIST-TECHNICIAN COOPERATION FROM IMPLANT PLANNING TO SURGICAL GUIDES, CUSTOM IMPRESSION TRAYS, MODELS AND RESIN PROVISIONALS www.dentaltechnician.org.uk

Zirkonzahn Worldwide – South Tyrol (Italy) – T +39 0474 066 680 – info@zirkonzahn.com – www.zirkonzahn.com

MARKETING SIMPLIFIED JAN CLARKE BDS FDSRCPS MARKETING

l 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 and heads up the Social Media Academy at Rose & Co.

Web: www.roseand.co Email: jan@roseand.co Facebook: Jan ClarkeTaplin Twitter: @JanetLClarke Instagram: janlclarkeacademy LinkedIn: Jan Clarke BDS FDSRCPS

STOP MARKETING!

ell this seems a strange way to start a marketing column! STOP marketing! What on earth do you mean, I hear you say! I know I’ve been encouraging you all to start marketing and looking at your businesses from different angles so what am I trying to say? Sometimes I become so dismayed with marketing messages from businesses. • Use us we’re the best • We have the best product • We have the best customer service awards • Quality is of upmost importance to us • Your satisfaction matters to us The reality can be far from these messages, we certainly see this in some of the dental businesses we are asked to help with. If you’re using any of the above messages in your marketing can you be certain that the statement is absolutely correct? Running before you can walk or fake it till you make it! Many advocate this ethos, to make your business look better than it actually is or be able to offer services that you haven’t before. Is this sensible and what about sustainable? There’s a lot to be said to this approach, offer it and then become good at it. The problem is though when something goes awry and you can completely lose face, which in turn can severely damage your reputation. How about a different way? Instead of drumming your marketing message out for a business that hasn’t got a perfect reputation for customer service and perhaps you’ve made some mistakes with incorrect deliveries, could there be a different way? How about just getting good at everything you do? • Great customer service • Precise technical work • Quality control no one can deny

• The best team who deliver consistent quality in a timely manner with great service. Imagine if you looked at every element of your business and lifted it up to be the best you could possibly achieve? What might be the repercussions of such a business? • Customers who are raving fans and tell all their friends about this amazing business • Incredible reputation • Lots of new enquiries and new customers There would be no need for marketing, or would there? Is this what I mean by STOP marketing? If you concentrate on being the best you can then marketing isn’t required because your reputation will speak for you? To some extent yes although I would advise a slightly different approach. If you remember from earlier columns, I talk about marketing being everything you do, not just your web site, adverts, social media and so on. Everything you do, how you answer the phone, how you deal with complaints, how your team are outside the business, how you treat your suppliers as well as customers. If your business is lacking in these areas then I would advise you spend time getting it right, this is as much as working on your marketing as it would be to fix your website.

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WHERE TO START? When trying to lift your business it can often feel overwhelming. You can write down a long list of where improvements are needed but I think the best place is to start with you, the leader, and being absolutely certain that you know and understand everything you want your business to be, your “Why?” Remember there is no wrong or right way here, your business can be exactly what you want it to be but if you don’t know, how are you going to be able to guide others to achieve your dream and goals? Invest some time and money in your self to explore your “Why?” as from this everything will flourish. You can then spend time to enthuse your team and get them on board and together build a business of your dreams. There will always be naysayers out there who will try and stifle your enthusiasm and indeed some of these may be in your team, but once you have your vision, stay committed and the right people will be attracted to you. Once you are committed to building the best version of your business as you can you will see the benefits almost immediately. By focusing on all areas your reputation will improve which will start to see new enquiries coming in. After your business is settled in its new direction them by all means start your more obvious marketing but remember everything you have been doing to build its reputation is also marketing. So yes! STOP marketing and work on your business, getting all aspects as good as they can be. Invest in yourself, your team and your systems to be the best you can. Then you can go back to the table and talk about your traditional marketing to attract new customers but chances are you will not feel under the same sort of pressure to attract numbers. As ever I am here to help with any of these issues so do email or connect online with me, I look forward to meeting some of you in cyberspace!

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DIGITAL TECHNOLOGY

ucontinued from page 6 THE SECOND CASE illustrates the step-by-step processing of two full arch removable PrettauÂŽ zirconia restorations with titanium bars to secure and retain the patient restorations Fig.7: Shows the master models with laboratory analogues in-situ ready for the scan and design process to begin Fig.8: Demonstrates the milled zirconia reproduction of the design for the patientâ&#x20AC;&#x2122;s restoration prior to colouring and sintering Fig.9: Is a wonderful example of the zirconia surface coloured and ready for sintering (1600 Â°C) Fig.10: The completed restorations showing the milled bars for both jaws and the friction sleeves Fig.11: The final mandibular and maxillary zirconia removable restorations, with layered ceramic gingiva

Fig.11

THE THIRD CASE demonstrates the step-by-step production of a patient removable telescopic restoration on 4 zero degree telescopes. The case is scanned and designed to produce a full metal restoration with composite gingiva work and individually milled crowns. A partial was added to provide strength and stability to the restoration Fig.13: The master model with the milled zero degree telescopes in-situ Fig.14: Demonstrates the working screen from the scan to which the design will be made Fig.15: Is a wonderfully clear illustration of the design process on the working screen. It shows the design for the upper partial with 14 abutments ready for fitting milled crowns and the partial bracing resting on the palate. Clearly shown in green Fig.16: Clearly shows the milled reproduction of the design in the previous picture, ready for cutting out and finishing Fig.17: The individually milled and finished teeth to be fitted to the metal framework Fig.18: The natural and polished resin gingiva clearly showing the preps to which the teeth will be cemented The following is an illustration of the process of producing milled zirconia crowns to fit the substructure and the gingiva work with each tooth being individually milled from zirconia. Fig.19: The framework completed with the natural looking gingiva build-up ready for teeth to be fitted. Fig.20: A screen shot of the design for the milled zirconia crown for the upper right central incisor Fig.21: The design screen showing the upper anterior teeth which will be important for the aesthetic outcome Fig.22: Clearly demonstrates the upper right incisors prior to sintering and polishing with the upper left teeth already finished Fig.23: The upper left central finished and polished as a clear example of what is possible with this strong and durable material Fig.24: The individually finished and polished anterior teeth demonstrating the potential for characterisation of the shape by using this method Fig.25: The remarkable result which clearly illustrates lively and natural looking gingiva work with individual looking zirconia teeth.

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CPD / ECPD

BOOKINGS NOW OPEN FOR DENTEAM, THE NEW SOUTHWEST DENTAL CONGRESS

new dental CPD event – DenTeam 2019 – which is taking place on 21st and 22nd June at Sandy Park Conference Centre in Exeter, is offering dental technicians a full day’s programme on the Saturday. Up to 14 hours of CPD are available over the two days.

We expect a good mix of all members of the dental team, but felt it was essential to put together a compelling programme that really appeals to dental technicians.” For delegates who prefer the ‘handson’ approach, there will be various workshops and product demonstrations held throughout both days, including Zirkonzahn’s workshop during which Sean Wilkinson will guide technicians through the digital workflow. By demonstrating patient cases, Sean will perform an in-depth analysis of the latest state-of-the-art devices for a smooth, individual workflow that relies on the 1:1 transfer of the patient’s specific situation into the firm’s software, for the creation of predictable, reproducible and 100% individual restorations.

Aimed at the entire dental team, the event’s programme is geared towards ‘team learning’ – rather than separating the various dental team members, the programme is mostly of cross-appeal. Highlights of the dedicated all-day Dental Technology Stream on Saturday 22nd, in association with the DTA, include David Smith looking at the changing EU medical device regulations, Andrew Taylor explaining ‘How to avoid expensive remakes in fixed prosthodontics’, James Green presenting on ‘Orthognathic model surgery and intermaxillary wafers’ and TJ Nicolas introducing a new alternative to implants. Sean Wilkinson and Andrew Taylor will examine ‘The case for metal-free dentistry: myths debunked’; the General Dental Sean Wilkinson will guide dental technicians through the digital workflow

David Smith will talk about eCPD, the new T-levels, and the upcoming changes to the EU medical devices regulations

Council’s Matthew Hill will talk about how the GDC is moving towards a ‘better, fairer system of dental regulation’; and David Smith will also cover ‘Enhanced CPD: are you ready?’ Friday 21st’s programme also features much of interest to dental technicians, according to event director, Chris Ritchie. “We have former Denplan chief dental officer and now life president, Roger Matthews, delivering each day’s keynote on ‘Dentistry UK – Black Hole or Big Bang?’ and ‘Dentistry UK – Revolution or Evolution?’, plus Dr Chet Trivedy presenting sessions on mouth cancer, medical emergencies and safeguarding. Professor Simon Wright will lecture on ‘human factors in dentistry’, asking ‘why do we make errors?’, and TJ Nicolas will tackle ‘The holistic approach to dentistry’. Implants, orthodontics, impression-taking, indemnity, career paths – apprenticeships and the new ‘T’ levels – will all feature, and we’re encouraging delegates to attend any sessions they like.

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Participants will assess the importance of digital technology in everyday workflow, focusing on the advantages of 3D virtual patient-based treatment planning (matching intra-oral, model, facial and DICOM data) to enhance patient satisfaction, analyse new solutions for implant planning that simplify the communication between dentists and dental technicians, and witness the use of the digital axiograph for capturing the patient’s jaw relation. Each day concludes with an informal ‘Hot Topics’ forum in the trade exhibition area, allowing delegates to quiz many of the speakers on the burning issues of the day. Delegates can help themselves to free tea and coffee throughout both days and all attendees will also receive lunch, an event guide and proceedings. For full details of fees (DTA members can claim a 25% discount), to book online or to download a form, visit www.denteamcpd.com For further information, contact Chris Ritchie on 07801 657608 or email chris@teamworkprofessionals.co.uk

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BODY

FOCUS

MY DIGITAL JOURNEY - AN EXPERIENCE TO LEARN FROM

y name is Kate and I have worked within the dental industry for over 30 years, although not always as a dental technician. Dental technology fascinated me whilst working as a dental nurse and when things changed at the surgery and I needed a new challenge it was the technical side I went into. That was some years ago and having had great success with prosthetic work and getting to grips with the new systems such as Eclipse, Flex press and the new pourable material Weropress I wanted something more. I was offered the chance to try a digital scanner and printer by Blueprint Dental and thought this was my next major step into a new era of Dental Technology. So I purchased a Medit Hybrid scanner and an Envisiontec Vida printer and then have to learn to use them! It took some time to understand how each machine was going work and more importantly how much time, effort and what sort of quality I could expect to achieve. The scanner was possibly the easiest step, the software easy to use and provided you remembered that it needs to be calibrated on a regular basis there were very few issues. A miss scan was usually caused by something not be clamped down tight enough or that the impression material was a little too shiny and needed spraying to make the surface a little duller. . Models could be scanned in seconds and then adapted to whatever the use you required, whether for creating a crown or a model. So yes I could say to anyone start you journey digital journey with a scanner take your time and learn all its little quirks. The next step was Exocad, my interest in computers was always reasonable when it came to using software for typing and editing but this is a slightly different ball game. Exocad

isn't exactly cheap but it does have several advantages, you buy it without having an annual licence fee and you can buy each section you require separately, in other words, if you just want model creator you can buy it, if on the other hand you want to be able to design chromes, or crowns then you can add these items on, when they are upgraded you just buy that bit. What could be more sensible being able to purchase software as and when you want to. The disadvantage is that Exocad are not necessarily though a leader in producing all their software on time or being able to keep up with the fast moving requests we as technicians require. So there are pros and cons in which software package you choose. Next was the printer, a separate challenge, and one which has probably taken more understanding and time than the other two put together. I wanted to be able to achieve accuracy at a reasonable price. Each printer has its own little quirks, mine was that it required some careful looking after as the membrane inside the tank can be damaged and therefore

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meaning that care on looking after it this since has been replaced by a silicone disposable tray which can be purchased and you can keep a spare. I though have stuck with my replaceable membrane. So within the first week I had managed to puncture the membrane use probably at least a complete bottle of material playing round with supports on models and how to stop perforating a membrane which was going to cost â&#x201A;Ź300 to replace. Somewhat frustrated by all this and terrified of whether I had done the right thing. The printer had posed probably the biggest challenge but after time I can say that I now have probably mastered the art of high quality digital printing. So where to now? I will this year look forward to creating courses run over the weekends with accommodation provided for those of you who would like to understand more and have the opportunity to see digital printing can help them expand their business. I will also look forward to learning how to produce dentures, bleaching trays and various other items. Contact: Kate Clemson Tel: 01737 832710 email: 3ddigitaldentaldesigns@gmail.com

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DENTAL OPINION FROM SIR PAUL BERESFORD, BDS. MP 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 then and currently in a very part time capacity in South West London. l Councillor including Leader of Wandsworth Council moving to the House of Commons. l 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. l

INSIGHT

BREXIT AND TOOTH PROTECTION

as there life before Brexit and will there be life after? Generally the public have had enough. But not all. The letters and emails are still coming in on every aspect. Most want us to accept the referendum and want to get out. Some of those are urging us to get out come hell or high water with no deal but with absolutely no idea of what we lose from the deal and the consequences of the WTA desert we would face. A very few, often with shaking hand writing may be fighting WWII still. On the other side are those who wish us to about face on the referendum and the Tory and Labour manifesto promises and bin Brexit. Many of these dress that up as a “Peoples vote” or similar. If we had another vote and it was for out again would they wait a short while and try yet again or if it was for Remain would UKIP revive supported by those who voted out 2 years ago and demand another referendum. The third group is those who realise the referendum said out and that at the last election about 80% of those voting supported a party that promised to implement the referendum. There are many business people and farmers in this group who cannot understand why we can’t accept whatever improvements Theresa May and Geoffrey Cox can get out of the EU and get on with the job. I am in that camp. EVERY SO OFTEN AN OBSCURE ISSUE REMINDS ME OF THE MACHINATIONS OF THE EU I am a founding member of the British Dental Bleaching Society. We are 10 years old and have worked to spread the education on safe dental bleaching in the hands of the

profession. We have worked hard with the Government and local authorities to stop bleaching in nonprofessional hands. The main targets have been the socalled beauty profession. The horror stories abound such as the individual who was a Kent building plasterer by day and in the evening did bleaching “in your home”. He used 38% peroxide with no gingival protection. I mentioned this to a Daily Mail reporter who said what happens if the bleach strays on the gums. My reply was a little dramatic when I said it takes the soft tissue off the bone. Even Daily Mail reporters can be shocked. For seven years the Society worked with UK and EU Dental organisations to regulate the concentrations of bleaching gels, and that only professionals should undertake this task on patients. The Secretary of Health at Richmond House called some of us in, took soundings and backed us. The EU took a magnificent seven years to agree and to implement the legislation. Unfortunately a number of enterprising firms jumped on the white smile bandwagon. They produced non hydrogen peroxide over the counter bleaching products. These were

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sold by reputable high street names in the correct belief there is a desire by many to have beautiful white teeth but not go to the dentist. Big mistake. Linda Greenwall and her son Joseph Greenwall-Cohen got busy on this and have just published a research document on five non peroxide over the counter tooth bleaching products. These were bought on the internet and from the high street firms such as Boots and Superdrug. If you want the details look at the Bleaching Society web site or the British Dental Journal. In essence extracted teeth were cleaned and sectioned to give one half as a control and the other half to test. The results showed these products had the potential to damage teeth. The enamel surface was substantially damaged and the hardness of the teeth significantly reduced. There is now a call to get non peroxide tooth bleaching products to be banned. Another campaign. If we want an EU wide ban we are in for another seven years campaign. After Brexit, choosing our opportunity, perhaps by a Private Members Bill or a Ten Minute Rule Bill, of even under Government legislation means a speedy result.

DENTAL NEWS

FOOD INDUSTRY BODIES ASK FOR DELAY IN JUNK FOOD ADVERTISING REFORM

(PERHAPS A CASE OF PROFITS BEFORE PEOPLE) BY DENTAL TRIBUNE UK

FEBRUARY 20, 2019

l LONDON, UK: More than 30 food

industry trade bodies have a sent a letter to Michael Gove, the Secretary of State for Environment, Food and Rural Affairs, asking for any non-Brexit-related reforms to be paused until the drama surrounding the Brexit negotiations ceases. Among these policies is an attempt to curb the advertising of high-sugar products, leading the British Dental Association (BDA) to accuse the British food industry of using Brexit to block action on this issue. The letter outlined how the British food industry is focused on mitigating the consequences of the potential catastrophe

of a no-deal Brexit and resultantly has little time or resources to address other policy issues. “At this moment of potential crisis, it cannot be ‘business as usual’ within government,” the letter says. “Neither we nor our members have the physical resources nor organisational bandwidth to engage with and properly respond to non-Brexit-related policy consultations or initiatives at this time. Government has recruited many extra staff; we cannot,” it continues. However, the BDA questioned whether the letter was merely a delaying tactic by the food industry regarding

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the publication of proposals on such topics as the advertising of high-sugar foods and drinks. “Junk food barons can’t get away with using Brexit as a get-out clause for action on sugar,” said Chair of the BDA’s Principal Executive Committee Dr Mick Armstrong. “Sugar is fuelling epidemics of tooth decay and obesity, that are stretching our health services to breaking point. Concrete action on advertising and reformulation, is long overdue. Ministers must not let shameless lobbyists kick the can any further down the road,” he added. PS. “Perhaps sweeties before teethies”!

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FOCUS

THE CHANGING FACE OF UK DENTISTRY SUE KARRAN. DIRECTOR AT MANAN LTD.

t is now more than 12 years since the ‘new’ NHS contract was introduced for general dental practice in England, and since day one, there has been dissent and demand for change. In what must have been the longest trial run in NHS history, contract pilots, then prototypes, have persisted for over half of that dirty dozen years. The profession can be forgiven its cynicism that we will ever see the end of the dreaded UDA contract. But in 2019, it feels as if a shift may be coming. One way or the other, April 2020 is going to be decisive – we will either see the start of a wider roll-out of contractual change or the plug will be pulled on the prototypes. Taking the glass half full approach, there are grounds for optimism. Evaluation indicates prototype practices are doing okay from a business perspective, or at least better than colleagues back in UDA land, and the clinical approach remains popular for practices and patients. Up to 50 new prototypes are being taken on board over the autumn and winter of 2018, and there seems renewed urgency from the Department of Health in nailing down the shape of the new contractual terms. There is still plenty to be done. Even amongst this enthusiastic and engaged bunch of practices, 25% are facing the clawback of monies because they cannot, for whatever reason, meet their NHS targets. The business model needs tweaking at least if we are to see successful wider implementation. And change is needed in NHS general practice. In England, ever greater numbers are facing clawback outside of the prototypes – more than a third of NHS contract holders are in such difficulties. We are also seeing NHS practices closing and handing back NHS contracts because they can’t make them work. It is not just in England where change is in the offing in the NHS. In Wales, work is being undertaken to develop a more flexible variation on the existing contract, and in Scotland, the Oral Health Improvement Plan introduces the prospect of a more fundamental overhaul of the NHS framework. Spare a thought also for Northern Ireland,

where attention is desperately needed but the lack of functioning government is either an excuse or a reason for inertia, depending on your perspective. So why are practices struggling to serve NHS patients? BDA and other research show that across the UK a large number of practices are facing associate recruitment difficulties. Our survey of practice owners last year found that two-thirds of those trying to recruit associates experienced problems, up from half in the previous year. Practices with the highest NHS commitments are struggling the most. No discussion about recruitment problems would be complete without at least a word about Brexit. It is potentially a big issue for dentistry, with around 16% of dentists qualified in the EU. We are yet to see any significant change in registration levels from Europe, but the NHS and corporates, in particular, rely on European dentists, and General Dental Council research suggests there may yet be a Brexit effect. The more technical issue of how to go about recognising overseas qualifications may also introduce an added barrier to importing the future workforce. Whilst the NHS contract hasn’t changed since 2006, plenty of other things have at that time. The BDA has highlighted its concern about long-term sustainability, with NHS Digital data showing that NHS dentists in England and Wales have experienced a 35% earnings squeeze over the last decade. Real incomes for practiceowning dentists have fallen by as much as £47,000, and for associates by over £23,000. Costs facing the profession have not gone the same way. One of the most significant changes across the UK is in the structure of dental practice, with practice owners in England and Wales falling to 12% of the GDPs in NHS general practice, reducing 28% over the life of this contract. That reflects a shift to purely private practice and the increasing importance of corporates, as well as the structural barriers in England and Wales to obtaining new NHS contracts.

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The shift towards private work is reinforced by reducing the proportion of dental spend represented by NHS work. NHS spend as a proportion peaked at 52% in 2012/13 and is now down to under 44%. As we potentially head into choppy economic waters, the profession and industry will no doubt be aware that there is a close relationship between spending on dental care and wider economic performance. The NHS may yet again represent a safe harbour. Let’s just hope we can make it attractive enough.

MARTIN WOODROW Acting Chief Executive, British Dental Association

THE FACTS AND FIGURES

As we head towards 2020 it could be beneficial to look at the changing face of dentistry within the UK and which aspects are on the increase or decrease. The Spotlight Survey 2018 conducted by the BDIA stated that the number of NHS high street dentists increased to 28,730, with the highest increase coming from Northern Ireland at 2.3% compared to 0.2% for the UK as a whole and that the number of private dentists had increased by 44% since 2008. UK gross spend on NHS high street dentistry decreased by 0.8% to £3,428m, however, spend on private dentistry increased by 6.3% to £4,416m and this trend is set to continue. When it came to buying products, services, and equipment the internet is king with over two-thirds stating that they conducted detail research on the internet before making a purchase decision and nearly 70% going on to complete the purchase online. Price is a very influential factor in the dental market place and for nearly 40% purchasers it is the deciding factor, however more positively of 80% of clinicians stated that clinical need influenced their decision making.

A total of 27,827,400 adult NHS Courses of Treatment were carried out in 2017/18 and p19

DENTAL NEWS

THE REMARKABLE STORY OF JAN CLARKE TAPLIN

YES THE LADY WHO WRITES OUR MARKETING COLUMN! This is Jan’s story which is a lesson to all of us that the unexpected and unwanted can happen without warning. Her attitude and response is a great example for us all to learn from. Good Luck Jan.

n January 2016 I had a very frightening experience when my eyesight in one eye deteriorated quite quickly to the extent that I wasn't able to continue my work as a dentist. Over the next year and numerous tests I was no further forward and my eye made some recovery. Following a second episode with my other eye in 2017 I had further scans and a lumbar puncture, which finally led to the diagnosis of RRMS or relapsing remitting multiple sclerosis. I started to learn about treatments, being a medic, I was sure I would follow the disease modifying therapies DMTs or daily injections of immune-suppressants, but I was encouraged to try another approach. There is no cure for MS, treatments centre on suppressing the immune system and attempting to lessen attacks as MS is an autoimmune condition. So I embarked on the Best Bet Diet http://www.msIn January 2017 in the middle of feeling a bit lost regarding my health and still unable to return to clinical work I decided to start running. I joined our local Five Star Active group based in Auchterarder and puffed and panted my way through 2 minute runs!! I remember the elation I felt when eventually running one dark Friday night we realised we had run for 12 minutes non-stop!! From there I ran a 5k then a 10k. With news in December 2017 that I may be facing MS I decided to sign up for a Half Marathon as I was terrified if I didn't do it then it may never happen. So in May 2018 a month after my confirmed diagnosis I proudly completed Loch Leven Half in 2 hrs 17. During the rest of 2018 I tried to keep my miles up and my fitness level, as I started to come to terms with having this chronic disease. I was learning (and still am) when to push my body, and when to rest, how to fuel and which foods keep me healthy. It is thought that 70% of people with RRMS will eventually in time progress to secondary progressive MS but no one knows what the future holds. Coming to terms with this uncertain future and living with a chronic disease has its ups and downs. I

am extremely grateful to MS UK for the help I have received, and continue to receive counselling from them. MS-UK was established in 1993, and is a national charity dedicated to empowering people with multiple sclerosis to make the most of today, and live life to the full. MSUK put people affected by MS at the heart of the work that they do. They provide high quality, professional services to support MSUK, unlike other MS charities, receive no funding from the pharmaceutical industry and the donations they receive from London Marathon sponsorship make up 25% of their annual funding.

I am therefore delighted to be able to raise funds for MS-UK to be able to help them do all the wonderful things they do to help people live independent lives and have the best life possible. I don't know what the future holds, none of us do, but I run and keep as healthy as possible and stay in the moment as much as possible. Thank you so much for reading my story and I hope you enjoy watching my progress, this is a journey I am so pleased to be on. London, here we come!

Raised so far:

£2,000 target

£1576.20

78%

YES YOU CAN DONATE: https://www.justgiving.com/fundraising/jan-clarketaplin

JAN CLARKE TAPLIN Fundraising for #TeamPurple, Virgin Money London Marathon 2019 run by MS-UK

the most increased NHS Course of Treatment was fissure sealants, up 3% with the biggest decrease being inlays, down 12.9%. 2016/17 was the 11th year of the current dental contract for NHS high street dentists in England and Wales, the introduction of which on 1 April 2006 was, as with the contract introduced in October 1990, marked by a period of disequilibrium as dentists adjusted to the new system. With such a radically different payment mechanism, this lasted several years but clear trends have now emerged. Perhaps the most significant trend in England and Wales also experienced in other countries of the UK (albeit to a lesser extent although gathering pace), is in the structure of dental practice. Practice owners in England and Wales continued to fall, down 1.6 percentage points, to represent 12.4% of NHS high street dentists – a decrease of 27.9 percentage points over the life of the current contract. Alongside this is the continuing and significant fall in the number of NHS high street practices in England, down 0.1% to 7,172, and 20.7% lower than on the eve of the introduction of the current contract – the full reduction is disguised by the inclusion of trust dental services (TDS) access centres post 1 April 2006.

The rate of increase in the number of NHS high street dentists continues to fall, up just 0.2%, 3.8 percentage points below its peaks in 2009/10 and 2010/11, to 28,730, while in England the number fell for the first time since the introduction of the current contract. A continuing characteristic of dental practice throughout the UK is its low level of profitability, with this up by just 0.01% to £115,800 for NHS practice owners in England and Wales. In real terms, this represents a decrease of 2.2% on 2015/16, 28.4% on 2008/09 and 35.2% on 2006/07. In Scotland, this fell 1.6% to £109,000 – representing a real-terms fall of 3.7% on 2015/16 and 25/6% on 2008/09. In Northern Ireland, the decrease was 15.7% to £99,100 – real terms fall of 17.5% on 2015/16 and 38% on 2008/09. NASDAL’s UK data shows that, for purely private practice owners, profitability increased 6.7% to £138,479 compared to an increase of 4.4% to £136,315 for NHS practice owners. The fall in the proportion of the total spend accounted for by NHS high street dentistry from its peak of 51.5% in 2012/13 to an all-time low the following year returned, down 1.7 percentage points to 43.7% in 2016/17.

The UK gross spend on NHS high street dentistry fell for the second time, the first time being in 2013/14, down 0.8% to £3,428m. In real terms, this represents a fall of 2.8% on 2015/16 and 3.9% on 2005/06. Patient charge revenue accounted for £908m or 26.5% of this – up 4.4%. The fall in gross spend was the result (as it was in 2013/14) of a fall in England, down 1.3% to £2,768m. In real terms, this was down 3.4% on 2015/16 and 8.4% on 2005/06. The significant increase in the proportion of expenditure contributed by Patient Charge Revenue (PCR) continued in England, up 1.6 percentage points to 28.1% and up 9.5 percentage points on 2005/06. The private spend increased by 6.3% to £4,416m, representing a real-terms increase of 4.1% on 2015/16 and 15.3% on 2005/06. Therefore, the UK spend on high street dentistry increased by 3.1% to £7,844m (or £7.844 billion) marking a real-terms increase of 1% on 2015/16 and 6% on 2005/06. The nominal value of the laboratory sector was up 6.3% to a new peak of £526m, marking a real terms increase of 3.8% on 2015/16 but a decrease of 5.2% on 2005/06. Data from Spotlight Survey 2018 BDIA

Locum Dental Technician St Helena Island, South Atlantic

6 months FTC commencing ASAP – £25k pa pro rata, taxable in St Helena; a tax free International Supplement will also apply A sub-tropical island of spectacular and beautiful landscapes in the South Atlantic with a warm and friendly population of 4,500, St Helena is a self-governing overseas territory of the UK. With the opening of a new international airport last year there is now a weekly scheduled flight from Johannesburg. The 28-bed General Hospital in the capital, Jamestown, covers all areas of acute medical and surgical care.

You will be responsible for fabrication of a small number of removable orthodontic appliances, of bite raising appliances and splints and of acrylic and cobalt chrome dentures and required prior stages. These include casting of models, fabrication of special trays and bite blocks, articulation of models, wax up and setting up of teeth, flasking, packing and finishing of dentures. You will also perform repairs, relines and additions to dentures.

The population of St Helena suffers with high levels of periodontal disease so the construction of new dentures and addition of missing teeth to existing dentures are priorities. The denture waiting list is long and the focus is on significantly reducing this, which you will collaborate to achieve. You will also help to prioritise cases and assist with the supervision and training of the trainee dental technician.

Holding a dental technology qualification that is recognised by the GDC or equivalent authority, you will be up to date with all CPD requirements of your registering authority. Having experience in a busy dental laboratory and in constructing dentures you must demonstrate a very good command of English.

We offer an extensive benefits package with 10 days leave, fare paid travel, freight, pension contribution and relocation allowance (see overseas vacancy information). An application form can be found at www.sthelenacareers.co.uk where further information can also be found, or you may contact Kedell Worboys on 0203 818 7610 or email: shgukrep@sthelenagov.com. This is where applications must be sent and received by 25 March 2019. Interviews will be held in London.

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FOCUS

ucontinued from page 17

DENTAL NEWS

SAVING LIVES AND IMPROVING LIVES MOUTH CANCER FOUNDATION ANNOUNCE NEW PRESIDENT

n 19th January, Krishan Joshi (pictured left) was elected President of The Mouth Cancer Foundation Board of Trustees. Krishan takes over the unpaid day-to-day running of the charity from his father, Charity Founder, Dr Vinod Joshi, who remains as Chairman.

Krishan is the Founder & CEO of Dental Focus Marketing, which he established in 2001 at the London School of Economics (LSE) whilst gaining a BSc in Accounting & Finance. The very first website design that Krishan worked on was for his father Dr Vinod Joshi’s hospital-based ‘Restorative Dentistry Oncology Clinic’ (RDOC), which would soon become hugely successful and be registered as the charity now known as the Mouth Cancer Foundation. Together as father and son they were passionate about spending days and all-nighters over the many years creating the best website community for mouth, head and neck cancer patients. Krishan says “I am honoured to be taking on this role as President for the next three years because I believe in growing the core values that were instilled by my father from the very beginning. The Mouth Cancer Foundation is a pioneering organisation helping people through their mouth, head and neck cancer journey - ‘at point of need’. We have put in place a fantastic, hands-on team of Trustees and Ambassadors to support my vision and goals. Together, I am looking forward to this next chapter in growing the charity’s value and impact!”. Vinod has been an outstanding asset to the Mouth Cancer Foundation for the past 15 years. From humble beginnings in 2004 when the charity was registered, Vinod has grown the Mouth Cancer Foundation into a significant charity player in the field of head and neck cancer and this year marks the 14th Annual 10 KM Mouth Cancer Awareness Walk, which has always been a consistent event in the diary to inspire everyone. He has done an amazing job of raising awareness about the signs, symptoms and risk factors of all head and neck cancers, saving and improving the quality of thousands

of lives in the process while also advising both patients, professionals and the general public in the vital areas of screening and early detection. During the recent annual general meeting the charity also voted in more Trustees as follows: • Dr Geeta Perks - Co-Founder, Trustee • Dr Mahendra Bulabbhai Patel - Trustee • Natalie Kolf - Trustee • Mr Mahesh Kumar - Trustee & Clinical Ambassador • Dr Philip Lewis - Trustee & Clinical Ambassador “I have made it my life’s work to improve the lives of mouth, head and neck cancer patients, survivors and carers while also saving lives through early detection by raising awareness within the dental profession and general public. The charity was born out of the success of sharing patient and survivor stories, and then creating the world’s first Online Support Group for mouth, head and neck cancer patients, which was an Internet forum community created for patients and carers to connect and help one another. The small team I have worked with at the Mouth Cancer Foundation has done remarkable groundwork getting the charity to where it is today. Now it is time to hand over the reins to our Co-Founder Trustee Krishan to grow the charity together with new Ambassadors and Trustees, to raise more awareness and help even more patients, survivors and carers”. Founder, Mouth Cancer Foundation, Dr Vinod Joshi

The charity would also like to thank the retiring Trustees for their dedication and hard work during the past 15 years. The Mouth Cancer Foundation also relies on the never-ending support from its Ambassadors as follows: Clinical Ambassadors • Mr Mahesh Kumar FDS RCS (Eng), • FRCS (Eng) • Dr Philip Lewis • Dr Hisham Mehanna PhD, BMedSc (hons), MBChB (hons), FRCS, FRCS (ORL-HNS) • Mr Bhavin Visavadia BDS (Lond), MBBS(Lond) • Toheed Nasir • Jocelyn Harding CEB DipDH 1992, GDC 4276 • Chloe Lewis Patient Ambassadors and Survivors • Rachel Parsons • Stuart Caplan • Paul Roebuck • Eva Grayzel • Steve Harris Aka Hagg People’s Ambassadors • Pat Jones • Tim Parsons • Colin Jones • Joy Lewis For full details of ‘Who is Who’ at what they do at the Mouth Cancer Foundation visit https://www.mouthcancerfoundation. org/about/board-trustees and https:// www.mouthcancerfoundation.org/about/ ambassadors

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DENTAL NEWS

DENTSPLY SIRONA IS "TOP EMPLOYER 2019"

THE TOP EMPLOYERS INSTITUTE RECOGNIZED DENTSPLY SIRONA FOR ITS EXCELLENCE IN PERSONNEL MANAGEMENT AND STRATEGY AND HONORED THE COMPANY AS “TOP EMPLOYER GERMANY ENGINEERS" AND "TOP EMPLOYER SWITZERLAND". THIS IS THE 7TH YEAR IN A ROW DENTSPLY SIRONA HAS RECEIVED THIS DISTINCTION BENSHEIM/ SALZBURG

I FEBRUARY 06, 2019

he Top Employers Institute has once again recognized Dentsply Sirona as "Top Employer" in Germany and Switzerland. This award honors the world's largest manufacturer of dental products for its exemplary personnel management and strategy and its exceptional personnel programs. Since 1991, the Top Employer Institute, which is based in the Netherlands, has been examining participating companies from all over the world for this award according to standard criteria. In order to achieve certification, companies must meet the Institute's requirements of an above-average standard.

ABOVE LEFT: Fig. 2: In 2019, the Top Employer Award for excellent personnel management and strategy once again goes to Dentsply Sirona. ABOVE RIGHT: Fig. 3: In 2019, Dentsply Sirona Switzerland receives the Top Employer Award for the second time for excellent personnel management and strategy.

The awards will be presented during the traditional Certification Dinner at the Areal Böhler, Düsseldorf, on February 12, 2019. Double audit process reaffirms Dentsply Sirona as a Top Employer In addition to the thorough assessment by the Top Employers Institute, all of the results are also subjected to an external examination and audit. The external audit noted Dentsply Sirona’s extraordinary performance with regard to employee orientation – which is why the company was certified as Top Employer. EMPLOYEES AS THE COMPANY'S GREATEST ASSET "We are very pleased to have received the Top Employer Award once again this year. This reaffirms

our personnel strategy, because at Dentsply Sirona our employees are our greatest asset," says Maureen MacInnis, Senior Vice President, Chief Human Resources Officer and Communications. Through its Dentsply Sirona University, the Company offers a variety of courses in which employees can participate to strengthen their skills and develop their careers. Dentsply Sirona also fosters diversity and inclusion throughout the organization. For example, one program, known as the Women Inspired Network (WIN), provides a platform for women leaders at Dentsply Sirona to support the acceleration of their career development by building key leadership competencies and developing stronger networks. Now in its fourth year, the current cohort includes 27 participants, who join the more than 75 who are already part of the Network.

FIG. 1: Maureen MacInnis, Senior Vice President and Chief Human Resources Officer at Dentsply Sirona: "We are very pleased to have received the Top Employer Award once again this year. This reaffirms our personnel strategy, because at Dentsply Sirona our employees are our greatest asset."

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COMPANY NEWS

THE DENTAL TECHNICIAN MARKETPLACE ZIRKONZAHN.IMPLANT-PLANNER: RELIABLE COOPERATION FOR IMPLANT INSERTIONS w With the Zirkonzahn.Implant-Planner implant planning software, the cooperation between the dentist and the dental laboratory can be taken to new levels, reconciling the planned aesthetic design of a prosthetic restoration with the planned implant situation (backward planning). Based on digitally merged patient data (such as DICOM data or data from model or face scans), the dentist can determine the optimal implant position in terms of function, anatomy and aesthetics, taking bone structure and set-up into account. The user is guided through the planning process one step at a time, making implant planning an easy task right from the outset and requiring only a minimum of user familiarity with software procedures. With the data transfer feature the data can easily be sent to the dental lab. Here, the surgical guides, the restorations, the custom impression trays and/or the models with laboratory analogues

CERAMAGE UP BY SHOFU: THE STATE OF THE ART IN COMPOSITE LAYERING! w The best of both restorative worlds: technologically sophisticated and aesthetically optimised. Ceramage UP, the flowable C&B composite system combines all the benefits of composites and ceramics in an innovative high-performance material. Its high ceramic filler load and homogeneously compacted nanostructure guarantee excellent abrasion resistance, flexural strength and colour stability. At the same time, its perfectly structured layering concept with opalescent enamel and hightranslucency colours allows dental technicians

The surgical guide and the immediate prototype matched with the 3D patient and the Dicom data

are made. This allows the dentist to receive all components required for an implant case simultaneously (immediate loading). All structures - from surgical guide to the prosthetic restoration itself - can be manufactured using the Zirkonzahn CAD/ CAM system. Every step fits perfectly with the

existing Zirkonzahn workflow. The open dataexchange feature allows the use of CAD/CAM systems by other manufacturers or 3D printers for the production of surgical guides or models. For more information: Tel: +39 0474 066 662 Website: www.zirkonzahn.com

to achieve amazingly natural aesthetic results, comparable to layered porcelain restorations. Ceramage UP is indicated for almost all anterior and posterior restorations and comes in a modular system featuring great ease of use. The individual shades are ready for use and thixotropic, so that tooth shapes can be freely sculpted using a probe or brush directly after dispensing. To further customise the appearances of anterior and posterior restorations, the flowable materials can easily be mixed with each other or characterised with the light-cured stains of the Lite Art system. Thanks to the additive layering technique, only minor shape adjustments will be necessary. So the Ceramage UP C&B

KEMDENT: PLASTERSAFE – THE READY TO USE PLASTER SOLVENT

composite system, which is suitable for all types of crowns, bridges, inlays, veneers and long-term temporaries, uniquely combines cost-effectiveness, efficiency and aesthetics. For further information, please contact the Shofu office on 01732 783 580 or email: sales@shofu.co.uk

just remove any excess plaster or alginate, then immerse your trays and dentures in PlasterSafe. This can either be done rapidly in an Ultrasonic bath or soaked. The plaster dissolves and the dentures are ready to polish.

w During March take advantage of Kemdent’s offer on buy 1 get 1 free on PlasterSafe – Plaster Solvent 5L. Only £27.50 + VAT.

Designed with the technician in mind, this product saves valuable time.

PlasterSafe is a plaster solvent that is a ready to use, alcohol free solution that aids the safe removal of dental plaster and stone from the fitted surface of dentures and the hard to reach areas. This water based solution has no harmful chemicals. It is easy to use,

To find out more about PlasterSafe call Jodie on 01793 770256. Email sales@kemdent.co.uk or visit our website www.kemdent.co.uk

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RECRUITMENT ANDY FOSTER, RECRUITMENT SPECIALIST RECRUITMENT

Andy Foster is a recruitment specialist for dental technicians. Andy manages www.DentalTechnicianJobs.net the online job-board for dental technicians. Andy spent 20+ years running his crown & bridge lab, before moving into dental recruitment and online networking. When he’s not working, Andy is a dedicated father, with an unhealthy weakness for coffee! You can contact Andy at andy@marshallhunt.co.uk

HOW TO BEAT THE BIG DENTAL LABS IN THE RACE TO FIND TOP TALENT

e all know that to build a successful dental laboratory, you need to bring in top talent, talent that is highly skilled and experienced. You need to find the right people who have the energy, drive, and commitment to take your company to the next level. But how can you compete with bigger dental labs to get the perfect candidate? It’s true that often bigger labs can offer better salaries and benefits, but don’t ever underestimate smaller company values. Bigger companies can’t always offer that, so you should use this to your advantage to attract candidates who really want to make a difference in their careers.

talent will stay away. Start by building a strong employer brand by creating stories of all the good work your lab does, as well as what you have accomplished, and don’t forget to mention your plans for the future. This will help potential candidates understand more about your company and what it’s like to work there.

Here are our top 5 TOP TIPS to help attract top talent to your dental lab.

EMPLOYEE AMBASSADORS A great way to build up your employer brand is to have Employee Ambassadors. There’s a couple of ways to do this. You can get existing top talent involved with the hiring process, so potential candidates can have a chat with them to find out what it is like to work for your lab. The other way is by getting employees to write reviews about your company on websites such as www.dentaltechnicianjobs.net as 4 in 5 job seekers research company reviews and ratings before deciding if they want to apply for the job.

STRONG EMPLOYER BRAND You already have a strong reputation with your clients but what about your reputation with your employees? If you have a high turnover rate, or there are rumors that your dental lab isn’t a great place to work, top

LET CANDIDATES KNOW THEY CAN MAKE A DIFFERENCE Employees working at small dental labs wear a lot of hats. It’s one of the major things that can help you attract top talent from bigger labs. As employees have the opportunity to

As well as having smaller company values, there are other ways to attract and retain top talent for your company.

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have more variety in their day to day tasks, as well as making active changes, and actually seeing the results that benefit them and others. Let potential candidates know you actively encourage employees to have a say in company strategy and decision making. FASTER CAREER DEVELOPMENT Another way to attract top talent is to offer faster career development than bigger dental labs. Smaller companies can give employees more opportunities and responsibilities, quicker than larger ones. Let potential candidates know that this is your employee strategy for your business and give them examples of how other employees have progressed their careers within your company. FLEXIBLE WORKING Offering flexible working to employees, can not only attract top talent from bigger labs but can also help you retain the top talent you already have. Candidates are looking for a better work-life balance and many candidates will forgo working at a bigger, well-known company, for flexible working. Visit www.DentalTechnicianJobs.net to find live vacancies, job-seeking candidates, courses and more...

– THE END FOR DENTAL LABS OR A NEW BEGINNING? SUE KARRAN DISCUSSES THE CHANGING MARKET

’ve been in dentistry for over 40 years and when I started vacuum fired porcelain was the latest thing! Now the buzz words CADCAM, intraoral scanning, 3-D milling, and 3-D printing are reverberating throughout the dental industry. It seems whenever dental professionals get together it’s not long before at least one of these topics is discussed and this year's IDS in Cologne will be no different www.english.ids-cologne.de. While everyone seems to agree that “the future is now,” there was also some ambivalence and trepidation toward the future that is knocking on the doors of dental labs and surgeries. The question worrying some, especially the older and more established labs and technicians, is whether its arrival is sounding the death knell of the traditional, craftsmen-based prosthetics and restoration business, or heralding a boom that will see more demand? The doomsday scenario in many technicians’ minds is that the advances in scanning technologies, coupled with more powerful and capable software, feeding virtual 3-D models to ever cheaper and more accurate 3-D printers, will mean dentists will be able to handle their own manufacturing needs. According to the manufacturers and purveyors of the various digital dental technologies, that day has already arrived. The technology is available to allow dentists to scan patients’ teeth and create crowns for patients while they wait. A process that traditionally took weeks can now be done in an hour or two. Instead of taking an impression and sending it to a lab for scanning, a wellequipped dentist can use a variety of technologies, from intraoral cameras to CBT, to scan teeth directly. The digitised scan can then be sent to an on-site milling or 3-D printing machine to carve the crown from a block of porcelain or print it from resin while the patient relaxes in the waiting room. After a little finishing and preparation work, the

learning curve too steep or are put off by mishaps or clinical issues. The majority of those that do use the equipment do so only for single posterior crowns, and still, send the more complex posterior and all anterior jobs to external labs. Either that or they have hired their own in-house technicians to utilise the equipment to its full potential. • It’s unlikely that the majority of dentists with 10 to 20 years before retirement will be willing to change to these new technologies. While they might be at the stage of their careers where they can afford it, they are usually put off by the daunting learning curve. crown is ready for fitting, and the satisfied patient is heading back to work. This is a scenario that definitely appeals to patients - a single visit with no need to wander around with a temporary crown that offers them savings in both time and money. In theory, it appeals to quite a few dentists too, as they see an opportunity to cut out the impression stage and the middleman - the poor technician. But is this yet reality? The short answer is no. Any lab owners or technicians who have been losing sleep over the imminent loss of their livelihoods can relax. It’s not that CADCAM won’t revolutionise the industry, it is certainly already doing that and will continue to do so, but it is unlikely that it will do so in the hands of dentists. A FEW FACTS AND FIGURES • While 3-D printing is still new, CADCAM is not. In Europe, the United Kingdom, United States, and Japan, dentists have had access to the scanning technology, computer power, and even desktop milling machines for 20 years or more, but they have not adopted it en masse. Even in the U.S., the world’s largest and most technically advanced dental market, only something like 8% to 10% of dental surgeries have in-house CADCAM facilities. • Roughly one in 10 of those don't use the equipment despite significant financial investments, usually, because they find the

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• The latest generation of dentists and current dental students are more comfortable with digital technology and prefer the latest methods, and the ability it gives them to work closely with technicians. However, while fresh graduates are comfortable with the latest scanning technology at the start of their careers, they are unlikely to have the capital to invest in in-house production facilities. • Technicians and lab owners do need to be agile in adopting new technology, however, a world without a highly skilled, artist technician who creates elaborate and complex restorations will probably become increasingly important in delivering the best possible outcome for patients. • The machines and technologies, technicians use may change, but the need for experts to operate them will remain. So as long as technicians keep their skills and knowledge up to date, they will always be a vital part of the dental team.

SUE KARRAN l Sue is a qualified

technician and has worked in the UK dental industry for many years in sales, marketing, and management.

DIGITAL TECHNOLOGY

DENTAL TECHNICIANS INSIGHT

DANGEROUS ROLE IN WW2 THE FINAL CHAPTER

BY TONY LANDON

THE CANADIAN DENTAL CORPS Male dental assistants were freed up from working in Canadian base camps when female dental assistants were enrolled into the Canadian Women's Army Corps, in 1941. The male dental assistances were then transferred overseas to Canadian Dental Corps units where ever they were engaged in close support of their armed services. The Canadian Dental Corps used their wellmaintained dental records for forensic purposes. These records proved useful in identifying war casualties during WW2. Fatalities might be identified orally where there lacked any other means of a soldier’s identification. Canadian dental forensic techniques were also used to identify their deserters and determine cases of fraudulent enrolment. A Canadian paratrooper, a lieutenant, brought to a field hospital so badly wounded that a surgeon was about to perform an instantaneous amputation to his right arm. He was saved from amputation for that time by a nurse who offered herself immediately for an arm to arm blood transfusion. AUSTRALIAN ARMY DENTAL CORPS Following the outbreak of WW2 the small number of full-time dental personnel were augmented by Militia officers and civilian volunteers. Although early enlistment was low, the October 1939 mobilisation process allowed for the establishment of dental units consisting of one dental officer, two dental laboratory technicians and one clerk orderly. They were placed in a variety of distribution centres such as three field ambulances, one casualty clearing station, two general hospitals and one convalescent depot. Initially, dental equipment and supplies were insufficient for the tasks required. One single division of their armed forces required an estimated 40,000 extractions, 50,000 fillings and 10,000 dentures. However it was reported that the Australian dental military personnel managed to overcome their shortages by acquihiring suitable stores of necessary equipment and materials from local areas they were serving in. During April 1943, authorisation was approved for the Australian military dental

Battle of Anzio, January-June 1944 . A giant Red Cross insignia over a front-line hospital dominates this scene at an Anzio beachhead. In the foreground, US Army men inspect the ruins of a recently shelled building to look for the injured or dead, February 1944. Photograph received 25 April 1944. Official U.S. Navy Photograph, now in he collections of the National Archives. (2014/03/12).

service to split from the Medical Corps and for the formation of a separate corps known as the Australian Army Dental Corps In tribute to those dental technicians whom died whilst working for their country’s soldiers during WW2 At the end of the Second World War the Canadian Dental Corps had a total strength of over 5000 serving staff members. It had been noted that fourteen Dental Officers and nineteen Dental Technicians died on active service during the WW2 years. During the dreadful Italian prolonged campaign on the Anzio beachhead, 1 dental officer was killed, 5 wounded, and 1 captured. A temporary dental laboratory was set up in a marquee tent protected by an encirclement of sand bags as they endured constant shelling and bombing during March 1944. Medical dental causality centres were unfortunately positioned close to command centres thus the enemy targeted such operational sites. The dental personnel however managed to complete 373 denture cases. Personal testament U.S. Army Serviceman Lawrence Schaub stated that, while excruciating and somewhat barbaric it appeared at times in the dentist chair, the restorative dental appliances made by the dental technicians during the WW2 were well done. Our fellow soldiers did not have to suffer from prolonged severity of oral injuries, tooth decay, and loss of teeth that might have been too much to bear when trying to fully focus on

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engaging the enemy. Dental technicians during WW2 completed their appliances remarkably considering the technical equipment they had available to them at the time in their makeshift laboratories. Ref **** REFERENCES George F. Jeffcott Colonel, DC, USA Office of the Surgeon General Department of the Army Washington D.C. Medical Department, United States Army Dental Service in WWII Chapter VIII Administration of the dental service in a theatre of operations Published 1955 *Reference to the French Civilians dead caught out on Normandy D-Day Antony Beevor, Pg. 112, Published 2009, ISBN 978 0670 887033 ** Reference to Private Louis Kalil, The Longest Winter, Alex Kershaw, Published 2005 ISBN 978 0141 018492 *** WW2 Jewish POW’s at Colditz Castle. Martin Sugarman interviewed Dennis in New York and Ontario Canada May 2003. These interviews came about by meeting Dr Andrew Caplan of Royal Holloway College, University of London, England. **** Reference to Lawrence Schaub, Interviewed by Sean Zimny, Milbank, South Dakota, October 23, 2015. Harry Blumenfeld, Interview by John K. Discoll, Wisconsin Veterans Museum Research Center, 2004, accessed November 2, 2005 Freddy Hulm, Dentistry in the field – a mobile dental laboratory during world war II, British Dental Journal 202 (January 2007): 107. Charles B. MacDonald, D-Day casualties The Mighty Endeavor: American Armed Forces in the European Theater in World War II, New York: Oxford University Press, 1969, p. 279. V Corps casualties are broken down into dead, wounded, and missing in Rpt, V

Areas, in Medical Division, COSSAC/SHAEF, War Diary, July 1944. For 4th Medical Battalion statistics, see 4th Medical Battalion Report of Operations, 6-30 Jun 44, box 6727, RG 407, NARA. On the 83d Division, see VII Corps Medical Plan, pp. 33 and 35, encl. 1 to Surg, VII Corps, Annual Report, 1944, and 134th Medical Group Annual Report, 1944, p. 8. For other examples of collecting and clearing station activities, see Medical Bulletin, 2d Infantry Division, June 1944, box 388, RG 112, NARA; Report, Surg, 9th Infantry Division, 1944, sub: Medical Activities-Marigny Sector, box 388, RG 112, NARA; 1st Medical Battalion After-Action Reports, May, June, and July 1944, box 5966, RG 407, NARA; Richardson Interview, tape 2, side 1, CMH. Fairbank, L. C.: Prosthetic dental service for the Army in peace and war. J. Am. Dent. A. 28: 801, May 1941. Quotation from Memo, Kenner to CofS, SHAEF, 20 Jun 44, sub: Report of Inspection ETO, in Medical Division, COSSAC/SHAEF, War Diary, July 1944. In same file, see Memo, Kenner to CAdminOf, 26 Jul 1944, sub: Evacuation of Casualties by Air. See also Professional Services Division, OofCSurg, HQ ETOUSA, Annual Report, 1944, Chief Consultant in Surgery sec., pp. 12-13; First U.S. Army Report of Operations, 20 Oct 43-1 Aug 44, bk. VII, pp. 69-70; John W. Pace, "Air Evacuation in the European Theatre of Operations," Air Surgeon's Bulletin 2 (October 1945): 324; Dowling, Normandy Report, I1 Jan 1945, p. 17; Report, ProvESBGp, 30 Sep 1944, sub: Operation NEPTUNE, pp. 115, 335, 339; VII Corps Medical Plan, pp. 21-22, encl. 1 to Surg, VII Corps, Annual Report, 1944; 134th Medical Group Annual Report, 1944, p. 8.

Data compiled by author from reports in the files of the Dental Division, SGO, 1947. ETMD Report, SWPA, 6 Jul 1944. HD: 350.05. Quarterly Report of Dental Activities, Hq. Base Section No 3, SWPA, 20 Apr 1944. HD. Thank you to Tony Landon and John Windibank FOA. for letting us share their collections of memories over the past many issues. John has been very instrumental in negotiating, on behalf of his fellow technicians, improvements in conditions and salary scales and has managed to work diligently, over many years, to help keep Dental Technology a respected and an essential part of the medical and dental services to patients and other professionals He has contributed hugely to his chosen field of Orthodontics. Tony Landon has a huge enthusiasm for all his years of working as a technician and has shared with us many of his memories and those of interest from other areas of his experience. I have had many compliments about the articles, which seemed to be enjoyed by readers from across the age spectrum. Contributions such as theirs are always welcomed. All of us like to reflect on our experiences but when viewed through the eye and memory of another it always seems more interesting. Thank you Gentlemen. Larry Browne Editor

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INSIGHT

Corps, Sub: Operations in the ETO, 6 January 1942 to 9 May 1945, p. 64. For airborne losses, see Harrison, Cross-Channel, pp. 28 n and 300. Col. Hayes was replaced as VII Corps surgeon on 4 July 1944 by Lt. Col. Robert H. Barr. Surg, 82d Airborne Division, Annual Report, 1944, an. I, p. 1; Surg, 101st Airborne Division, Annual Report, 1944, pp. 1-2; Interview, OSG with Capt. Ernest Gruenberg (hereafter cited as Gruenberg Interv), 13 Jun 1945, box 222, RG 112, NARA. This account of a unit medical support is based on Surg, 82d Airborne Division, Annual Report, 1944, an. I, pp. 1-2; Surg, 101st Airborne Division, Annual Report, 1944, pp. 2-6; Gruenberg Interview, 13 Jun 1945, box 222, RG 112, NARA, and in RG 407, NARA, 82d Airborne Division Combat Interviews, box 24057, and 101st Airborne Division Combat Interviews (source of quotation), box 24072. Surg, 101st Airborne Division, Annual Report, 1944, pp. 2-3; 3d Auxiliary Surgical Group Annual Report, 1944, pp. 17-19; Capt. W. P. McKee Recorded Report, pp. 2-4. Quotation from Interview, OSG with Maj A. J. Crandall (hereafter cited as Crandall Interview), 8 Jun 1945, box 222, RG 112, NARA. Report, ProvESBGp, 30 Sep 1944, sub: Operation NEPTUNE, p. 334; 3d Auxiliary Surgical Group Annual Report, 1944, pp. 13-14 and 22-29; Tegtmeyer "Diary," pt. 1, ch. 20, p. 11. Quotation from Bradley, Aid Man, p. 51. See also ibid, pp. 48-70; Tegtmeyer "Dairy," bk. II, pp. 15-16. Quotation from Memo, Kenner, 13 Jul 1944, sub: Report of Inspection of Medical Service in Liberated

FREE VERIFIABLE ECPD As before if you wish to submit your ECPD 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 ECPD 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 ECPD either online or by post. If you have any issues with the ECPD please email us cpd@dentaltechnician.org.uk

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LEARNING OBJECTIVES REVIEW: n Strength of Zirconia n Implant planning n Customised Special trays n Business of Management

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VERIFIABLE ECPD AS YOU NEED IT VIA THE DENTAL TECHNICIAN IDS. DENTAL EXIBITION Q1. How often is IDS Held? A. Every year. B. Evert four years. C. Every two years. D. Every three years.

Q9. A. B. C. D.

Q2. Approximately how many Lab stands will there be? A. 1200. B. 600. C. 780. D. 1340. JAN CLARKE TAPLIN STORY Q3. What condition was Jan diagnosed with? A. Mustiple Sclerosis. MS. B. Relapsing remitting multiple sclerosis. RRMS. C. Persistent Cramp Syndrome. PCS. D. Rheumatoid Arthritis. RA. Q4. A. B. C. D.

What symptoms made Jan seek help? She could not run as much. She felt dizzy when she ran. She began to have eye trouble. She could not sleep.

Q5. What per cent of their income do MS-UK earn from the London Marathon? A. 16%. B. 90%. C. 23%. D. 25%. ZIRKONZAHN PRESENTATION AT THE HTSC Q6. What is the second case featuring? A. Telescopic framework with individual crowns. B. Milled partial metal denture. C. A Full over Full removable restorations on Milled Titanium Bars. D. Individual milled Telescopic Crowns Q7. A. B. C. D. Q8. A. B. C. D.

What does fig.7 indicate? The milled Zirkonia Crowns. Zirkonia Surface staining. Milled Zirconia reproduction. The master models with Implant analogues in-situ ready for scan.

What was the milled angle of the Conus crowns shown? 6 degree. 4 degree. 0 degree 5 degree.

THE CHANGES FACING UK DENTISTRY Q10. What percentage of practices report difficulty in recruiting? A. 50%. B. 47%. C. 66%. D. 29%. Q11. What is the percentage fall in the number of high street practices in England since the introduction of the new contract? A. 0.1%. B. 2.2%. C. 16%. D. 27%. Q12. A. B. C. D.

What was the nominal value of the Laboratory Market sector in 2015/16? £456 m. £526 m. £567 m. £578 m.

Q13. A. B. C. D.

What was the private market worth in? £4.416 m. £916 m. £3.893 m. £4,217 m.

Q14. What according to GDC research may be the Brexit effect on High street Dentistry? A. None whatever. B. An increase in private work. C. A lack of Dentists available. D. An increase in Orthodontics. Q15. What is the percentage increase in private dentists in England since 2008? A. -5%. B. 14%. C. 21%. D. 44%.

What is the name given to the milled telescopic restorations? Milled sub-castings. Conus Crowns. Angled Telescopes. Primary telescopes.

TOP AWARD TO DENTSPLY SIRONA Q16. What was the award? A. Best International retailer for the year. B. Best Overseas sales organisation. C. Best marketing organisation. D. Top Employers Institute, Top employer of the year.

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DENTAL NEWS

RESEARCHERS EXAMINE REGENERATIVE POTENTIAL OF MICE TEETH BY DENTAL TRIBUNE UK I FEBRUARY 21, 2019 l LONDON, UK: The concept of regrowing teeth is considered somewhat of a holy grail in dentistry. Though most reptiles and fish have multiple sets of teeth throughout their lifetimes, most mammals only have one set of replacement teeth—and sometimes not even that. A new analysis of mouse tooth development has shed new light on why this tooth regeneration happens, and the findings may be relevant to the future of human tooth replacement. Prof. Abigail Tucker, Dean for Research at the Faculty of Dentistry, Oral and Craniofacial Sciences at King’s College London, and Elena Popa, a doctoral candidate at the Centre for Craniofacial and Regenerative Biology in the Division of Craniofacial Development and Stem Cell Biology at King’s, conducted a molecular analysis of mouse tooth development to better understand why they only have a single set of teeth with no replacement. The researchers were able to pinpoint why mice do not generate replacement

teeth by comparing the gene expression in the dental laminae of mice with those of minipigs, animals which are able to generate a replacement set of teeth. By studying Wnt signalling, which is known to be required for tooth replacement in other vertebrates, the researchers were able to show that Wnt activity is absent in the rudimental successional dental laminae (RSDL) of mice. Though this structure initially forms in mice, it subsequently disappears, halting the generation of another set of teeth. Using sophisticated genetic techniques, Tucker and Popa were able to activate Wnt signalling in the mice’s RSDL at certain stages of development. This revitalised the structure and consequently led to the formation of additional teeth. These results demonstrate the potential of RSDL as a source for replacement teeth in mice and provide an experimental system suitable for studying the mechanisms behind tooth regeneration.

“Why the potential for tooth replacement varies so much across vertebrates is an intriguing question,” said Popa. “Our results show that, although the mouse normally does not form a second replacement set of teeth, it still has the potential to do so given the right signals.” In addition, the researchers found that culturing the RSDL in isolation stimulated its tooth-forming potential, suggesting that the first generation of teeth might prevent replacement teeth from developing. “This is relevant to human tooth replacement, as structures similar to the RSDL have been identified next to the permanent teeth during development,” Tucker explained. “In normal development of our teeth, therefore, the second set or permanent tooth may inhibit the generation of a third set of teeth.” The study, titled “Revitalising the rudimentary replacement dentition in the mouse”, was published in the February 2019 issue of Development (it can be viewed online).

STUDY QUESTIONS HEALTH BENEFITS OF ARTIFICIAL SWEETENERS BY DENTAL TRIBUNE UK I FEBRUARY 18, 2019 l LONDON, UK: By providing a sweet taste without the calories and other deleterious side effects of sugar, artificial sweeteners have often been lauded for their supposed health benefits and benefits to oral health. A new systematic review, however, suggests that these sweeteners and other sugar alternatives may not actually be as healthy as they are generally thought to be. Often marketed as a healthier alternative, products such as sugar-free soft drinks have become increasingly popular in recent years. The demand for these options is often driven by health and quality of life concerns, as obesity and oral diseases have been repeatedly linked to an excessive intake of added sugar. A number of sugar alternatives have been approved for widespread commercial use in innumerable foods and drinks. Though they are generally perceived to be a healthier option than sugar, their actual benefits and drawbacks are not exactly clear owing to a limited and conflicting body of evidence. A team of European researchers, led by the University of Freiburg in Germany,

aimed to develop their understanding of these benefits and drawbacks by conducting a systematic review of 56 studies that compared a high intake of sugar substitutes with either a lower intake or complete avoidance. The results of their study showed that, overall, there were no statistically or clinically relevant differences between study participants who had a high intake of artificial sweeteners and those who abstained. Additionally, a number of the reviewed studies indicated that there was an association between a higher intake of sweeteners and slightly more weight gain, and slightly less weight gain for those with a lower intake. However, the certainty of this evidence was low. Overall, there was no definitive evidence that sugar alternatives aided overweight or obese adults or children who were actively attempting to lose weight. A spokesperson for the British Dental Association told the British Dental Journal: “We don’t recommend any ‘sugar-free’

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alternatives to fizzy drinks other than milk and water. We remain concerned that many soft drinks either encourage a sweet tooth, or come with high levels of acidity that harm oral health.” “Every Christmas, Coca-Cola spin doctors try their best to claim there’s a ‘healthy option’ for teeth while marketing low- or no-sugar products more acidic than vinegar or lemon juice. When nearly half of teenagers are showing signs of dental erosion, dentists know many of these brands have as little place as a festive tradition as their sugar-laden stablemates,” the spokesperson continued. The study, titled “Association between intake of non-sugar sweeteners and health outcomes: Systematic review and metaanalyses of randomised and non-randomised controlled trials and observational studies”, was published online on 2 January 2019 in the British Medical Journal.

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