The Dental Technician Magazine May 2019 by The Dental Technician Magazine

VO L 7 2 N O. 5 I M A Y 2 0 1 9 I B Y S U B S C R I P T I O N

GDC DILEMMA!

VERIFIABLE ECPD FOR THE WHOLE DENTAL TEAM

TO PROTECT ILLEGAL MANUFACTURERS OR TO PROTECT THE PATIENT? SEE PAGES 4 & 8

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

THE DTS SHOW 2019 VISIT THE DENTAL TECHNICIAN STAND NO.A10 PAGE 32-33

INSIGHT SNORING & OBSTRUCTIVE SLEEP APNOEA - A ROLE FOR THE DENTAL TEAM PAGE 28-29

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

FOCUS MAXILLO FACIAL SURGERY AT BIRMINGHAMâ&#x20AC;&#x2122;S QE11 HOSPITAL PAGE 24-25

Inside this month

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P.15

CONTENTS MAY 2019 Welcome Editor - Larry Browne FBIDST. FDTA, ITI Fellow, LCGI, RDT. E: editor@dentaltechnician.org.uk T: 01372 897461

Thoughts from the Editor

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

Dental opinion from Sir Paul Beresford, BDS. MP

Advertising Manager - Chris Trowbridge E: sales@dentaltechnician.org.uk T: 07399 403602 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. Subscriptions The Dental Technician, Select Publisher Services Ltd, PO Box 6337, Bournemouth BH1 9EH

Extend your subscription by recommending a colleague There is a major change in CPD coming soon. The Dental Technician Magazine is a must read. Tell your colleagues to subscribe and if they do so we will extend your subscription for 3 months. The only condition is that they have not subscribed to the magazine for more than 12 months. Just ask them to call the Subscriptions Hotline. With four colleagues registered that means your subscription would be extended for a year free of charge. At only £39.95 per year, for UK residents, this must be the cheapest way of keeping up to date. Help your colleagues to keep up to date as well. Ask them to call the subscriptions Hotline on 01202 586 848 now.

Insight 6

Insight GDC considering ‘Illegal?’ registrant manufacturers By Baxter Wall Snoring and Obstructive Sleep Apnoea - A role for the dental team by Matt Everatt Welcome to Dental Doris: What gets you out of bed in the morning?!

8-9 28-29 30-31

Marketing Marketing Simplified by Jan Clarke

Company News Shofu/Zirkonzahn/3Shape

Digital Dentistry Taking a look at Digital Dentures - Perhaps the future now? By Lola Welch Mastering the implant digital workflow by Ross Cutts

15 18-19

Education T-Levels in Healthcare Science by David Smith

Dental News Do dentists treat people with extreme dental fear (phobia) differently? 19 Oral hygiene contributes to a healthy heart 31 Good news for EU Qualified Registrants for the future 33 GC International AG 34 EXACLEAR: Your Transparent Partner 34 Alerting patients to disease risk improves dental hygiene and oral inflammation 34

Recruitment The importance of passive candidates by Andy Foster

Focus Dental Technicians Great Britain and The Dental Technician Magazine Maxillo Facial Surgery at Birmingham’s QE11 Hospital

22-23 24-25

ECPD Free Verifiable ECPD & ECPD questions

26-27

DTS 2019 DTS 2019

Classifieds

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32-33 35

THOUGHTS FROM THE EDITOR

WELCOME to your magazine THE GDC DILEMMA

TO PROTECT ILLEGAL MANUFACTURERS OR TO PROTECT THE PATIENT?

This may seem to us, who are registered and following the perceived rules, to be a no brainer but the lack of communication or the avoidance of communication, with the GDC (see Page 6 article by Baxter Wall) is a bit more than worrying. There has been less than open access to answers for technician registrants when the process of protecting the patient against nonregistrants is raised. There is a broad measure of agreement amongst the technician organisations that as many as 40% may not be registered with the GDC. A potentially higher number may not be registered with the MHRA. It is illegal to manufacture a custom made medical (Dental) device if you are not MHRA registered. Many clinicians and a good number of their staff are certainly

not registered to manufacture. All those assistants who make the odd! Bleaching tray or Occlusal splint or indeed a stabilising post-ortho device and in some instances snore devices. Registration with the MHRA allows the qualification and suitability of the operative to be judged, taking into account the training and qualification claims.

seem unwilling to share the relevant information. The article by Baxter Wall points to the difficulty this magazine has had in obtaining answers about the reported illegal operators. If the number one publication in the UK and Ireland representing technicians cannot get a reply what does that say about the system and its operational integrity?

Following the highly publicised scandal of the Breast Implant abuses the government decided that nonqualified practitioners should not be allowed to operate. The act applies across the medical fields in order to protect the patients. It is very difficult to discover whether the MHRA and the GDC are co-operating to eradicate such practices within UK dentistry, as they

Registration should be a safeguard for the patient but if it is being ineffectively monitored, it is little more than a press flag waving exercise for the GDC and the MHRA. Come on, those in charge of these organisations, make a bigger effort to include all registrants with equal respect. The patient must be protected, it is not clear that dentistry is doing much to demonstrate how.

THE DTS 2019

Itâ&#x20AC;&#x2122;s getting closer! The BDA Conference and the DTS show is just around the corner. May 17th and 18th will be the biggest and most diverse offering of everything dental for Clinicians, Hygienists, Therapists chair side nursing assistants and Technicians and Clinical Technicians. Demonstrations and lectures, for a full two days at the NEC in Birmingham. This is now the established show to see whatever you need whether it is for clinic or laboratory and together with the BDA Conference there will be a broad and varied programme of lectures and demonstrations for all those working in dentistry. Bringing the clinical and technical together just makes perfect sense, which has long been ignored by others who have, for too long, assumed ownership of all things commercial across the dental field. Following on from IDS in Cologne last month all the worlds new innovations and improvements will be on show and the

VISIT THE DENTAL TECHNICIAN STAND NO. A10

digital revelations will be there for all to see and touch. New materials and new processes will be revealed and will allow you to decide on your future direction for investment in time and money. You will see that many of the Implant companies are offering their in-house milling services. Some may have gone even further and are balancing on the brink of dealing directly with clinicians and trying to circumvent laboratories. Good luck to them I say, let them learn the difficulty of dealing effectively with clinicians and restorative dentistry.

Technical dentistry is becoming a more predictable and manageable process with the new techniques and materials now available. It is sometimes difficult to contemplate a change of direction for your laboratory but you must at least go along and view what is on offer. Your

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future pathway may be influenced by what you see. I will see you there on Stand No. A10. Come along and have a chat and tell me what you may like changed within your own Journal, The Dental Technician Magazine. You may have a really good idea for other technicians to share or perhaps a project you would like the magazine to get involved with. Case presentations you may have some ideas on altering the format or perhaps a profession wide suggestion for improving the techniciansâ&#x20AC;&#x2122; lot. I am very much here to listen to and act on good ideas, so don't be shy, express your self and you may be able to help all of us to take a few steps forwards or upwards.

Larry Browne Editor

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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

IT HAD TO HAPPEN - ECO FRIENDLY BRUSHING

ust let’s forget Brexit for a moment and focus on health (and the environment)Everyone knows the importance of brushing teeth twice daily (at least), for healthy teeth and gums. We dentists have, with a mixture of success, being pushing this for generations.

actually the stiff, coarse hairs taken from the back of a hog's neck and attached to handles made of bone or bamboo. Boar bristles were used until 1938 when nylon bristles were introduced by Dupont de Nemours. The first nylon toothbrush was called Doctor West's Miracle Toothbrush.

Such activity helps stop decay, helps in keeping happy gums, makes you breath good or at least better. In times gone by folks didn’t have brushes but used their fingers to clean the teeth sometimes using charcoal.

Of course the early toothpastes were fairly basic. The first genuine helpful additive was fluoride. The positive effect of fluoride in toothpaste regularly and properly used is dramatic. That is the key - regularly and properly applied. Of course as any dental professional knows we are bombarded with different toothpastes with other additives that claim to ease tooth sensitive and repair enamel. They IONhave come a long way over the last decade or two. According to the Dental Health Foundation we each buy 4 toothbrushes a year. These brushes predominately have plastic handles and nylon type bristles. They come in many shapes and sizes with varied claims to the benefits of the various shapes.

As kids the parental patter first thing in the morning before school and last thing at night before bed was “Wash Face, Hands, Teeth”. It rings in my ears even today. It appears the first toothbrushes were rather basic and it sounds revolting. The bristles were

That doesn’t mean we all have toothbrushes or that we all use them. The campaigns to teach children to brush their teeth are steadily improving the state of children’s teeth is starting to have effect. Even some parents are learning as well. The next biggest change in toothbrushes has been the invention of the electric toothbrush. It is increasingly catching on as it is estimated probably 23 million people in the UK use electric brushes. Amazingly the first electric toothbrush was produced by the Electro Massage Tooth Brush Company in the U.S. in 1927. In Switzerland in 1954 Dr. Philippe Guy Woog introduced the Broxodent. Woog's electric toothbrushes were

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originally manufactured in Switzerland (later in France) for Broxo S.A. It used line voltage hence had to be connected to a power outlet whenever one needed to use it. Somewhat dangerous to use leaning over the hand basin ½ full with water! As far as I can gather the first battery operated electric toothbrush was invented in 1961 and the first “sonic” brush in 1992. All of this has been helped by the dramatic improvement in batteries especially the Lithium battery. Most toothbrushes are rechargeable but some have replaceable batteries. These machines have got dramatically more sophisticated with sensors and cameras and Bluetooth connectivity to guide you to brushing properly. I am not going to get into the argument about which electric brush is best but numerous studies have shown that people using electric brushes clean their teeth markedly better. I am sure there are a very few folks who use a manual brush to the same effect as if they had used an electric brush but you have to be a special tooth brusher and probably rare. Now the problem! We live in an ecofriendly day and age. Those eco-friendly folks are pushing manual brushes that are eco-friendly. These are fully biodegradable toothbrushes with a handle made from sustainably harvested wood and bristles made from pig hair. That could be difficult for many of these folks if they are vegetarian or worse still vegan. The pig hair is a by-product of the Chinese meat industry. From the little I know of Chinese farming standards there may be a problem. All very exciting and it even featured on a BBC 4 programme . I am all for saving the planet but as a dentist with an interest in the UK dental health I will continue to promote the use of electric toothbrushes to try to ensure better brushing with better toothpaste to get better oral hygiene.

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INSIGHT

GDC CONSIDERING ‘ILLEGAL’ REGISTRANT MANUFACTURERS By Baxter Wall

he Dental Technician (DT) continues looking at the way technicians are regulated, with this article focusing on the way medical device regulation is implemented in dentistry. The MHRA and the Professional Standards Authority (PSA, the GDC’s regulator) have provided information but the Dental Technician has waited unsuccessfully for certain information from the GDC. By the end of this article readers will be able to consider, if after the Francis report the GDC is correct in saying it is “committed to transparency” and “Improving the use of data and information sharing between regulators”. Or whether some manufacturers are taking advantage of uncertainty or a hidden data sharing policy between the GDC and the MHRA. An area of concern similarly raised in the DLA’s Dental Lab Journal. is upstream regulation the solution? THE LAW AND THE WAY IT’S ENFORCED Any custom-made dental devices fitted in the UK should have come from a registered and regulated manufacturer or importer who will have followed the relevant regulation. Registering is a legal requirement. The MHRA have told the DT “With regard to exemptions from the medical device directive, all custom-made dental devices which fall into the definition of a medical device and are placed on the market, and need to meet the requirements of the medical device directive.” So, no one is exempt. This will include making a statement of manufacture. Not making this available to the patient is still a criminal offence, the way dentists can avoid problems is explained in the GDC’s guidance document for patients saying “The person who prescribes your treatment (usually your dentist) must offer you a statement of manufacture with full details of the appliance. The statement is like a certificate or warranty, and proves that your device has been made to legal standards especially for you. You don’t have to take a copy of the statement. It will be kept on file and you can ask for a copy at any time during the lifetime of the appliance.”

Where does the GDC fit in? It’s the MHRA, not the GDC, who will enforce the directive, but as the regulator we require all professionals to keep up to date with legal requirements.

the Medical Devices Directive 93/42/EC and who is not registered with the MHRA should be referred to assessment and a referral made to the MHRA.”

The Website also says “We take action where our standards and legal requirements are not met.”

The PSA have told the DT that “During our recent performance review the GDC advised us that in July 2017 it revised its guidance to replace its former Casework Manual, producing separate guidance with regard to concerns about medical devices and potential breaches of the MHRA. We have no evidence to suggest that the guidance is anything other than genuine and active.”

The GDC has developed guidance for its caseworkers and it has been released for publication by Jonathan Green GDC, (the then) executive director of fitness to practice. Extracts have been published in the DT. “This project has now been completed and all of the below changes implemented. The project reviewed several key areas: Any complaint received about a registrant who is manufacturing medical devices as defined in

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DATA SHARING BETWEEN THE GDC AND MHRA Mr Green also said the GDC has been “in contact with the MHRA and are in the

process of developing a formal Information Sharing agreement”. To see how this project is developing the DT asked the MHRA the following questions:

Q. When will it be complete? The MHRA chose not to answer. Q. If the process of developing a formal information sharing agreement has stopped, who stopped it? The MHRA chose not to answer. HYPOTHETICAL ILLEGAL MANUFACTURER A story has been circulating in dental technology. It does not matter if it is true or not but it does serve as a good example of a simple case that the GDC might have to deal with if it became aware of it. The MHRA was asked to give an account of what ‘it’ believes should happen. Example - A young child has an orthodontic retainer fitted. The hard plastic is sharp and when it is removed, it cuts the child’s mouth and the gums bleed (the retainer was finished only with a pair of scissors!). The manufacturer has not had training to make the device. They trained in a dental hospital in another role where statements of manufacture were not made and offered to patients as per GDC guidance, so the manufacturer was not registered with the MHRA and had not produced a statement of manufacture. If the GDC was given this case and asked for the statement of manufacture that should go with the case, what is the agreed process, given what happened in the example? The MHRA answered “If the MHRA became aware of the scenario you put forward, we would investigate in conjunction with the relevant regulator(s).” After receiving this reply the DT asked the BADN if it would share the advice it gives dental nurses to make sure they understand the regulations and don’t break the law. The BADN chose not to reply. ACTUAL ILLEGAL MANUFACTURERS (?) REPORTED TO THE GDC Dental technicians who are also manufacturers will be aware that the MHRA has recently required manufacturers to reconfirm their registration and declare what kinds of medical devices they manufacture. This information then appears for anyone to see on the MHRA public database. If you search for key words in the database and the name and address of a manufacturer you are taken to the entry. The Dental Technician has been made aware that there seem to be large numbers

INSIGHT

Q. Is the process still under way? The MHRA chose not to answer.

of manufacturers advertising on the internet that do not appear to be on the MHRA database. As these manufacturers will also be GDC registrants the Editor of the Dental Technician has given a small sample of these manufacturers to the GDC illegal practice team so that in becoming the complainant the Dental Technician and its readers can understand what would happen if a patient raised such concerns. As illegal activity over MHRA registration may have other implications, these were raised as well.

Why pay more? Equivalent To

The information was sent in October 2018 and an acknowledgment was received.

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After approximately 12 weeks (at the end of January 2019) the illegal practice team was asked for an update. No response was received. In February a letter was sent to the GDC executive asking if the cases were closed and if the registration status had been found. They said that a response would be given in 14 days. No other response has been received since. A third request has been sent and still no contact or answers. COMMENT The manufacturers in the cases are either registered or not, the cases are either open or closed. This article is only being published at this time because the GDC will not tell the complainant if the cases are open or closed. It should very much be seen as a fourth more public call for the GDC to answer the questions in the complaint. The GDC has shown that it is willing to enforce the statement of manufacture when it attempted to prosecute David Smith in the mistaken belief that rules around the statement of manufacture had been breached. Readers may think it strange that the GDC gives assurance to patients and registrants around this legislation and the MHRA says it works with other regulators when it becomes aware of illegal activity but there is no written account of how this should happen (barring the caseworker guidance). Who stopped the process of agreeing with the MHRA how it should happen? Where does illegal practice fit in with patient complaints about dental devices and the GDC’s policy of ‘shifting the balance’?

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If a patient complained to the GDC or DCS about a dental device would the fact that it had been manufactured or imported illegally not factor in the complaint? This situation has massive implications for Patients, Legal manufacturers, Dentistry as a market and particularly for GDC standards. What does the GDC Council think is happening? The Dental Technician will keep its readers informed as this situation unfolds.

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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

HOW CAN I BUILD MY BUSINESS USING SOCIAL MEDIA

always enjoy introducing a new client to the word of social media and watching their disbelief as to how social media can help their business turns into an “Aha” moment of understanding and excitement. I was fortunate enough this week to experience just that as I started working with a new client. Most of my clients are dental practices looking to gain more of the high cost treatments, dental implants, Invisalign and the like. They have often played around with social media themselves and usually, once I audit the accounts, I find the same problems….they broadcast, post about offers and generally bomb at social media! Dental technicians have a different audience to dental practices so you would be correct in thinking a different thought pattern is required when marketing on social media, but, the basic principles remain the same! 1. Know your audience 2. Engage with your audience 3. Gain trust and social proof GETTING STARTED IN SOCIAL MEDIA I would encourage you all to consider activity on Facebook and Instagram, do set up business pages for them and start from there. If you are active on social media yourself you will, no doubt, have been bombarded by posts, about Facebook ads. These do have their place and when targeted correctly can be an amazing source of referrals but I truly believe you need an active page first. If a potential client sees your ad, they will visit and check out your page first. If it has no posts or activity or repeats of the same couple of posts then your potential client will lose interest. Much better, they arrive at a vibrant colourful page with lots of activity. This is my mantra with all my clients, we need to breathe life into your page before we pay for any Facebook advertising. 1. Know your audience Who is your ideal client? What makes them tick and what are they looking for? This is an important step and remember, you don’t have

to be everything to everybody, you can have a niche business that may not appeal universally. Once you are clear of your vision and audience then you work to.. 2. Engage your audience How do you engage with your audience on social media? The same way you engage with any person and gain rapport and trust – be yourself, be authentic, be honest. There is no need to pretend to be a big business if you are a small team, many dentists turn away from the larger labs to ensure a more personalised, consistent service. Then as you post you will want your followers to trust you and see you as the go to place for information. By offering help and information rather than broadcasting or selling you will gain trust. Add in some reviews and recommendations from clients and your social proof starts to build. 3. Gain trust and social proof You will then start to see your page followers increase and the page take on a life of it’s own. It’s important to note that this does not happen overnight. Building a good, loyal following will take time and commitment. There will be times that you will wonder if it is worth the work but I would encourage you to persevere as all the accounts I have worked with have had two things in common, consistent posting and persistent posting. That doesn’t mean posting every hour or even every day, although every day is my preferred timing. It does mean sticking to some sort of timetable, maybe 3-5 posts a week. There is nothing worse than a page with large gaps in the timeline, it sends out the wrong message to potential new clients. WHAT TO POST? This is the big question that everyone seems to get caught up with and those new to managing a business account can sometimes get writers/post block. I think it’s best not to overthink this and start to post. Consider a combination of posts to achieve a good variety on your timeline, posts:1. About your team, business, premises. People love to find out about your team and you will

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no doubt be surprised as to the engagement with this type of post. No one can be that interested surely? Well yes they are, celebrate birthdays of your team, post from a night out, or just a typical day in the office. These allow your new followers to really get to know you and understand what your business is all about in a very friendly approachable manner. This is how they will start to trust you. 2. About your services, treatments that you have been involved with. Perhaps share some case studies, befores and afters. This allows your followers to comment and discuss the cases creating quite a bit of engagement. 3. That are shared from other trustworthy sites that are also relevant to your business. As you progress you will feel more comfortable posting and find your own personality and voice. You may be formal and reserved or quite loud and outgoing, anything goes really, just find your voice. Of course, you will still need to work within the GDC guidelines for social media behavior. REPUTATION MANAGEMENT It is important once you set up your page and start to post that you are able to respond quickly to any comments, messages or requests. Take time to set up the messaging service properly and one great tip to avoid any adverse or rude comments is to set the profanity filter to high! This is in <Settings> <General> It may seem unnecessary but I have seen many accounts that would have avoided an embarrassing pots or review had this been set up correctly. A page that is vibrant, colourful with a variety of posts and where the owners of the page respond quickly will soon start to build a following and gain numbers quickly. Next time I will talk about strategies to increase your following without paying for nonrelevant followers. 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!

Focus on Teeth

So light, so simple, so precise!

17th & 18th May 2019 / NEC Birmingham

Stand A51

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COMPANY NEWS

THE DENTAL TECHNICIAN MARKETPLACE THE IDEAL CAMERA FOR THE ENTIRE SPECTRUM OF DIGITAL DENTAL PHOTOGRAPHY: EYESPECIAL C-III BY SHOFU w SHOFU’s new EyeSpecial C-III is very pleasant to use in daily practice, thanks to its easy handling and excellent image quality. And it can be used for lots of purposes, e.g. taking mockup images of planned anterior restorations, which patients can take home on USB sticks right away; after all, an-ticipation is the greatest pleasure. By visualising the functional and aesthetic quality of a planned treatment result in the decision phase, the EyeSpecial C-III can greatly enhance dentist-patient communication. The EyeSpecial C-III creates excellent high-resolution images for all indications and applications of dental photography. This compact camera for one-handed use with intuitive LCD touchscreen con-trol features a 12-megapixel CMOS sensor for fast imaging

at high frame rates, outperforming even its predecessor, the EyeSpecial C-II. SHOFU’s next-generation camera, which weighs only 590 grams and can be easily disinfected with wipes, sets new standards for photography in dental practices by combining exceptional user-friendliness with outstanding versatility. Delegating routine photography to dental assistants? No problem. Eight shooting modes with preset parameters for exposure time, aperture and flash allow users to easily take the desired image. In-traoperatively documenting treatment steps as an image sequence: That is exactly what the “Sur-gery” mode is designed for. Taking perfect pictures of distal tooth aspects: With the integrated mir-ror, the “Mirror” mode correctly photographs distal areas and automatically reverses the image taken. Further improving the reliability of shade communication with the dental laboratory:

ZIRKONZAHN: DIGITAL IMMEDIATE LOADING IS HERE! w Free conference in Milton Keynes, Winchester and Bristol from June 17-19. We all have to admit it: for high-quality, modern dental restorations, digital has become the norm. Protocols and workflows have evolved, hinged on new technologies that consider full digital patient analysis and predictability as core concepts. The fast advancements in the digital sector impose changes also within dental practices and laboratories. Zirkonzahn (South Tyrol, Italy), manufacturer and innovation driver for the dental sector, will come to Milton Keynes, Winchester and Bristol from June 17th to June

Right from the implant planning, the digital workflow based on the 3D scan of the patient allows for predictable, safe and 100% individual restorations.

19th 2019 with a lecture tour for dentists and dental technicians. The lectures aim to help participants evaluate the digital approach to everyday work by exploring the benefits of a flawless digital workflow with practical insights. The lectures, held by DT Sean Wilkinson, CAD/CAM expert, worldwide instructor at

“Isolate Shade” combines a true-colour image with a copy displaying soft tissues in grey. In addition, “Low Glare” makes incisal transparencies of reference teeth much easier to read for technicians. And the EyeSpecial C-III features even more special modes for intra- and extraoral images. Besides, the shooting modes may be modified by additional, easy-to-configure settings to meet indi-vidual preferences. This smart concept, into which even radiographs can be integrated, helps to make day-to-day data exchange with the lab clear and easy. For further information please contact Shofu UK on 01732 783580 or sales@ shofu.co.uk or visit www.shofu.co.uk

Zirkonzahn and officially registered ITI-lecturer, will cover the most emerging topics in dentistry, such as the advantages of incorporating the digital patient analysis, the digital axiograph and 3D facial scans as diagnostic tools for obtaining more accurate results for the final solution. A comparison between modern immediate loading protocols and conventional implant placement techniques will also be provided. Step into digital dentistry with Zirkonzahn, we know the way! Participation is free, but registration is obligatory. Enrol now, places are limited! For more information and registration: carmen.ausserhofer@zirkonzahn.com Tel: +39 0474 066 662 or visit www.zirkonzahn.com

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The 3Shape E4 * scans a full arch in 11 seconds which is 2 times faster than the E3â&#x20AC;&#x2122;s 22 seconds.

The E4 delivers accuracy of 4 microns compared to the E3â&#x20AC;&#x2122;s 7 microns accuracy.

4x5MP cameras enable scanning of dies in the model omitting extra steps for scanning dies individually.

Contact ukenquiries@3shape.com for more details Learn more at go.3shape.com/e4 * The E4 will be available Summer 2019

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By Lola Welch, Senior Prosthetics Technician, Ceramic Designs Laboratory, Hove, UK l Lola

graduated in 2004 (BSc Medical University of Warsaw). Soon afterwards she joined a general practice in London as an in-house Dental Technician, and then Lola joined Ceramic Designs in 2016. Her main areas of interest are Implantology – involving all aspects from same day restorations to full arch, implant-supported composite bridges, in this multi-disciplinary laboratory. Lola has already made a name for herself in this field, due to her technical skills combined with her artistry. Lola was very interested to see what could be achieved by taking an approach where the entire prosthesis was printed as a single component (teeth and gum combined), which was then coloured with composite. The photographs, and the work in the photographs, were all fabricated by Lola and speak for themselves in regards to aesthetics.

INTRODUCTION: This case was carried out as a way of investigating the feasibility of different digital workflows for fabricating dentures. Various workflows are being introduced as 3D printers, milling systems and 3D printable resins develop. Most people will be aware that amongst the alternatives to traditional workflows, the digital revolution brings possibilities for milling and printing. For the fabrication of Dentures these are largely based around having two components, the arch of teeth in one material, bonded to another material, which forms the Denture Base. Prior to that manufacturing stage there are various software packages that can be used to design those components. Currently amongst other considerations, production costs vary widely depending on milling or 3D printing. On the 3D printing side for prosthetics, it’s possible to print models, custom trays, baseplates, bite registration items, try-in etc., all of which can be easily modified or reproduced once the files are created. Outline of the process involved and the materials used by Lola Welch: “After printing was completed on our Asiga MAX UV 3D Printer in Detax FreePRINT Temp resin (images 1, 2, 3), I firstly removed the printing supports (images 4, 5). As these supports were very thin, they easily snapped off, leaving only small rough points. After tidying them up with a fine acrylic burr, I started my anterior teeth cutback for enamel (image 6) and gum customisation of the labial and buccal flanges. The dentures were then cleaned and the adjusted surfaces were sandblasted and primed for the application of composite (image 7). I then proceeded with painting on the internal teeth staining (image 7_b) and after that applied the enamel layer of composite. On the posterior sections (which were not reduced for enamel) I used stains externally (image 8). Once I was happy with the finished appearance of the teeth, I proceeded with applying pink composite. I’ve been working on “pink aesthetics” for many years and I’m always trying to improve my techniques, this is one, which I’ve recently learned on a course. Like with the teeth, the intense colours (of flowable composites) were applied directly onto the denture and then covered with a layer of a natural pink shade

7_b

paste (images 9-13). All the festooning and texture were applied prior to light curing and the final gum work did not require any trimming. After the full curing process I sealed the composite build-up with a varnish (images 14-15). To customise this denture I’ve used various materials, composites from Shottlander, Vita and AnaxDent. The glaze that I used was Optiglaze from GC. I did spend about 2.5 hours to customise this denture however, this time could be significantly reduced if I had not cutback for enamel and used only external teeth characterisation, which I believe would still provide very successful aesthetics result”. CONCLUSION: This was an interesting exercise and leads to many future possibilities as materials develop, with this approach it could potentially be possible to 3D print dentures all in just one

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resin material and then colour just the gum work, which could meet the challenges of the economic end of the market. Conversely the same 3D printed resin denture could be further characterised to individual shade prescriptions, to meet the requirements of more cosmetically demanding patients. It will be interesting to see how things progress, as resin manufacturers are working closely to develop their systems. With new printable denture base resins and tooth shaded resins becoming available, as well as conventional denture teeth, there will be many possibilities and material options available, depending on the technique one wants to use. Asiga 3D printers and Detax Freeprint premium 3D printer resins are available in the UK through Bracon Ltd, who also supply most of the composite materials used in this case study. Coincidentally Lola’s partner Mark Welch (RDT) also works at Bracon Ltd as their Digital Specialist. CONTACTS: Lola Welch: www.ceramicdesigns.com Mark Welch: www.bracon.co.uk

DIGITAL DENTISTRY

TAKING A LOOK AT DIGITAL DENTURES - PERHAPS THE FUTURE NOW?

EDUCATION

T-LEVELS IN HEALTHCARE SCIENCE: A NEW ENTRY LEVEL QUALIFICATION TOWARDS DENTAL TECHNOLOGY By David Smith

ast year the education Minister, Damien Hinds announced reforms to technical education and the development of Technical Levels including the health and science sector. Next year the Government will introduce the first phase of T-Levels followed by the next phase including Dental Technology in 2021. The education department formed panels to advise them of the content in each sector with a mixture of shared learning and specific skills and training. I was invited to join the Healthcare Science panel with other members from different healthcare sciences. As we know the routes into technical training are very much the poor cousin of academic pathways and we find ourselves struggling to find students with any knowledge of careers in healthcare science. For students with more applied interests they find themselves on a conveyor belt towards academic subjects when these may not be their first choice. Career choices for school leavers have been very much centred on academic subjects with those that choose not to attend University deemed as ‘dropping out’ or underachieving. For many this type of education is not their preferred choice but it doesn’t mean they don’t want to learn. Education through work is successfully used throughout the world and is especially good for technical based subjects. Dental Technology is invisible to most students, hidden behind the front end of dentistry, predominantly dentists and dental nurses. The pool we recruit from is small, often from family recommendation, so many potential students pass this career by, because they were never exposed to it. I am sure this is similar in many other fields of work.

T-levels are aimed at students from 1618 years old and will be a recognised entry qualification given parity to A-levels. T Level programmes are likely to be equivalent to 3 A Levels and will have more teaching time built in to enable students to acquire more and better knowledge, skills and behaviours than can be achieved through other vocational qualifications currently offered. Employer panels are designing the outline content of courses based on the Apprenticeship Standards. Each student’s programme will be around 900 hours a year for 2 years, including a substantial work placement of at least 45 days. T Levels are not intended to lead to full occupational competence, as an apprenticeship would. T Levels will make students ready for the job, whereas apprenticeships at same level will make students competent in the job. T level students will have a wider breath of knowledge as the Pathway core extends occupational specialism knowledge found in many Apprenticeship Standards. T Levels will provide numeracy, literacy, digital skills and wider transferable skills, attitudes and behaviours needed to succeed in occupations relevant to a student‘s chosen route and the wider 21st Century workplace. The first three T Levels in Digital, Construction and Education & Childcare routes will begin

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teaching in the 2020 21 academic year and the first 52 colleges and other providers all around England have been announced. More T Levels comprising occupations within (routes): Construction; Digital; Engineering and Manufacture; Health and Science; Legal, Financial and Accounting; Agriculture, Environmental and Animal Care; Business and Administration; Hair and Beauty; Creative and Design; Catering and Hospitality will begin phasing in from 2021 onwards. The T Level for Healthcare Science will include dental technology and for Health will include dental nursing.

Of course for this to have its maximum impact and effectiveness it must be supported by the profession and industry it is designed to support. That will be our job. I do hope we can come together with the department of Education, colleges and schools, examination boards and create effective courses that fully prepare these students for the workplace and life long careers.

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DIGITAL DENTISTRY

MASTERING THE IMPLANT DIGITAL WORKFLOW By Ross Cutts, UK I January 30, 2018

Dental Wings I/O Scanner

hether we like it or not, we are embracing the digital era in our brave new world. Many dental practices are now becoming paper-free - a digital innovation - and even using tablet computers to record patient details and medical histories. We are continually surprised by the rising age of the technologically savvy patient, particularly those of a certain generation, who perhaps we assume would be less so than the perceived iPhone generation. This change in the patient demographic and attitude towards technology is filtering through to us in the dental profession. The nuts and bolts of implant dentistry tends to lend itself more readily to the digital revolution of dentistry in the UK and now globally. Many practitioners opposed to or reluctant to embrace it are actually being influenced by it through shifting workflows in dental laboratories, even where more traditional clinical practices are followed Chair-side. Quite often, wet impressions are poured and stone models are scanned to produce STL files for laboratories to process during crown and bridge unit manufacturing. As an implant clinician, one does not have to invest in a CT scanner or chair-side intra-oral scanner - there are ways that other centres and laboratories can provide these services. However, having these tools at your disposal greatly increases efficiency and means you are not reliant on external services for your own patients.

“If you fail to plan, then you plan to fail” Benjamin Franklin So how do we begin the implant digital workflow? Successful implant treatment begins with thorough case assessment and planning of the proposed restoration. This is important for all cases, not just what we deem the complex ones. Even the most experienced implant clinician can miss a potential, treatment-planning hazard, especially during a busy day. Accurate study model casts are an essential part of this; however, we can now use intra-oral scans preoperatively to begin the digital workflow. We take a scan rather than impressions to form digital models. Our laboratory can then use these to create digital wax-ups of proposed treatment outcomes. We are routinely used to 2-D radiographic imaging techniques in dentistry, but with the availability and access to CBCT scanning devices now, we are able to assess bone quantity and quality of proposed implant surgical sites.

CLOCKWISE FROM TOP LEFT: Digital Printed Models; 2D I/O X-Ray Image; Codiagnostix digital images; 3D Digital image; Digital Guide with Sleeves; Codiagnostix tooth borne guide

With ever-reducing doses of 3-D imaging and improving accuracy, we are able to use CBCT scans, combined with clever software packages such as codiagnostix (Dental Wings), to plan safe and accurate implant placement and restoration. We are able to preoperatively plan precise implant placement with safe surgical margins away from important anatomical structures, such as the inferior alveolar nerve or maxillary sinus. From this, we are then able to design and either mill or print a surgical guide to use for precise implant placement. Even with assisted surgery or guided surgery, there are sometimes certain restrictions that prevent us from achieving the most ideal implant placement, such as this case shown where posterior access in the second molar region was reduced, so achieving the perfect parallel was extremely difficult. There are fully guided systems available that allow for absolutely precise implant placement, but these are fraught with complexities and should be reserved for experienced clinicians. The accuracy of surgical guides should not be used to make up for a lack of surgical competency however. There are many factors to be considered when using surgical guides, including whether the guide is tooth, soft tissue or bone-supported. Tooth-supported allows the greatest degree of accuracy. If tooth-supported, are there windows in the guide that direct full seating of the guide? Are the teeth that support exact positioning of the guide mobile? Any mobility adds a degree of inaccuracy. • Is the guide made from a direct intra-oral scan or a scan of a study model? If scanning a study model, is this an accurate stone model representation? Otherwise, there is the risk of poor seating and inaccuracy of the guide. If soft tissue-supported, mobility completely

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negates any accuracy of the guide, so it should only be used for a pilot drill and then a more conventional surgical protocol adopted. If bone-supported: • raising a very large surgical flap is likely. • it is very difficult to ensure accurate full seating of a bone-supported guide in the precise planned position and this relies upon external fixation. Once the implants are placed in situ and fully integrated, we then have a choice of conventional “wet impression” techniques versus digital intra-oral scanning. For the majority of cases, intra-oral scanning is extremely predictable and reliable-more so than conventional techniqueswith milled (and lately printed) models having excellent properties and less accumulation of processing errors. However, deeply placed implants relative to adjacent teeth with deep contact points are very difficult to scan and pick up. Straumann tissue level implants offer a very straightforward restorative platform to scan from. With greater numbers of implants and fewer teeth to act as reference points, intra-oral scanning becomes less reliable - particularly across the arch - so we need to exercise caution and be aware of its limitations. We have used composite flow stuck to the soft tissue to increase reference points for our scanners, increasing their ability to stitch images more accurately together. With this in mind, we cannot assume the scan is accurate and any framework fabricated would be non-passive; therefore, we must use other methods to verify the scan’s accuracy. We have found locking temporary abutments within a composite framework intra-orally, the easiest and most reproducible way to do this. It then allows us to design and mill a truly passive framework by Createch and a temporary acrylic bridge.

DIGITAL DENTISTRY

CONCLUSION There are many opportunities to opt in and out of using technology regarding the digital implant workflow. For anyone considering capital investment, the most important question to ask is, how will or can this improve the outcomes I provide to my patients, and then determine whether that warrants the expenditure. Too many times we are subjected, to sales promise for the next biggest thing, by company sales representatives, and gadgets and gizmos end up by the wayside.

TOP ROW (L TO R): Implants in-situ; Surgical placement of Implants; Straumann Tissue level implants in-situ; Scan Bodies In-situ; Screw Removable Crowns on Printed Model 2ND ROW (L TO R): Crowns In-situ; Scan Bodies in Situ; Verification Jig locked in place; Createch Bridgework 3RD ROW PHOTO: Screw retined bridgework In-situ

Acknowledgements Andy Morton and Ian Murch, the fantastic laboratory technicians at Borough Crown and Bridge that I work closely with.

BDS (LOND) DIP IMP DENT RCS (ENG) GDC NO.: 78162

l Ross graduated from Guy’s Hospital, London in 2000. He is a dentist with Special Interests in Implant Dentistry and Advanced Restorative Procedures. He has placed over 2,000 implants in the last 10 years. He is a Fellow of the International Team for Implantology (ITI) – and is the Study Club Co-Ordinator for the UK and Ireland, which is an extremely prestigious appointment. Ross is also a clinical mentor and registered speaker for this Worldwide Organisation. Ross has attended

extensive Higher Education across the UK, Europe and North America from the world leaders in Implant Dentistry. Ross has also been awarded the highly-regarded Diploma in Implant Dentistry from the Royal College of Surgeons, London – one of few to have gained this qualification. He works closely with Straumann implant system – however he has extensive experience with many other implant systems – ensuring that he provides care scientifically proven to be long lasting for his patient’s best interests. He regularly holds implant courses and lectures nationwide and globally on a variety of topics at different levels, however he has a particular interest in Aesthetic Implant Dentistry, Digital Dentistry

and Complex Bone Grafting procedures. Ross accepts referrals from colleagues for all levels of complicated treatments at both his Cirencester and Stow-on-the-Wold practices. As well as being a Fellow of the ITI, he is also a member of the Association of Dental Implantology (ADI) and the Royal College of Surgeons (RCS). His commitment to Cosmetic Dentistry maintains his Full Membership of the British Academy of Cosmetic Dentistry (BACD). To ensure his standards are of the highest possible, he regularly submits his work to scrutiny by his peers - often at national awards. Ross is the Practice’s CQC Registered Manager and his CQC Manager ID No. is 1-153017339.

l Over 50% of the British public claim they are anxious about a visit to the dentist, but almost 12% have such high levels of anxiety, it is classed as a phobia. Those with dental phobia will often avoid a visit to the dentist, unless in an emergency situation. Avoiding a visit to the dentist can exasperate the situation; those with dental phobia commonly have poorer oral health and higher rates of tooth decay. The oral health of those who do manage to eventually visit the dentist can be so extreme that the only course of action might be to extract the tooth, leaving them with fewer healthy teeth. Dental phobic patients may prefer this treatment option as it requires one dental visit with no post procedure check up’s that may worsen their phobia, in comparison to, for example, a root canal. In a study recently published in the British Dental Journal, researchers from King’s College London set out to test whether the presence of dental phobia modifies the proposed care plan for a patient, compared to a similar non-phobic patient. As patients with dental phobia commonly have poorer oral health, the team from the Faculty of

Dentistry, Oral & Craniofacial Sciences wanted to know if dentists take the patients’ phobia into consideration when preparing a care plan. To answer these questions the research team devised a study inviting 79 UK based dental practitioners to create a care (treatment) plan for an ‘imaginary’ patient that had simple, or complex treatment needs. Each case had the option of a dental phobic patient and a nondental phobic patient. Dependent variables included frequency of care planning elements, including periodontal treatment, prevention, restorations, root canal treatment, extractions and provision of crowns, bridges and prostheses. The results found that dentists offered a more complex treatment plan for the complex conditions. The treatment plans were influenced by patients’ dental needs and not the presence or absence of dental phobia. This shows that while practicing dentists’ attitudes towards patients with dental phobia are not a barrier for receiving the best possible dental care, it is still important to consider patients’ anxiety and its management in the treatment plan to ensure the best possible care options are available.

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Lead of the study Dr Ellie Heidari from King’s College London said: “In order to deliver dental care for people with dental phobia, it is important to adapt an approach, where prevention of oral diseases and preservation of teeth (when possible) is provided as part of dental care plans.” “Another important component in their care would be to address dental phobia by providing them with an opportunity to access Cognitive Behavioural Therapy. This is a therapy that has been proven to be very successful,” she adds. Professor Tim Newton, Professor of Psychology as Applied to Dentistry at King’s College London commented: “Those with dental phobia are experiencing both the enormous challenges of living with their fear, and of having poorer oral health. It is gratifying to see that for the dental team the presence of a phobia is not perceived to be a barrier to complex restorative or preventive approaches. We hope to be able to ensure that not only do people with dental phobia derive the benefits of good oral health but also overcome their fear through the most effective treatment - Cognitive Behaviour Therapy.”

DENTAL NEWS

DO DENTISTS TREAT PEOPLE WITH EXTREME DENTAL FEAR (PHOBIA) DIFFERENTLY?

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

THE IMPORTANCE OF PASSIVE CANDIDATES

hen looking to engage your next technician, for whichever position in the lab that might be, your first port of call might be to post an ad and engage all of those candidates who are actively looking for a new role. That way you’ll get the most eager and enthusiastic candidates, right? You want candidates fighting over your role, throwing CVs your way and begging for an interview! But is this really the best group of candidates to be interviewing?

spectrum of issues including work-life balance, remuneration, commute and benefits.

In fact, by limiting yourself only to technicians who are actively seeking a new role, not only are you cutting your candidate pool in half, but you are also potentially missing out on candidates who are looking to move jobs for the same reason you want to hire them! Perhaps you DON’T want someone who is desperate to move jobs because they’re not getting on with their team members. Perhaps the best candidate for your role is not one who is desperate for a better job title.

The number one reason (according to LinkedIn) why an active candidate chooses a new role is because of greater opportunities for advancement. For a passive candidate, the number one reason is better compensation and benefits. So what does this mean to you as an employer? Well, if you’re looking for a candidate who wants to progress and is eager to climb the ladder, then an active candidate might be what you need. However, more often than not, a passive candidate is someone who is successful in their current role. They’re not actively seeking as they’re currently employed and what they have would need to be bettered in order to warrant a move. What this means to an employer is that, whilst your candidate might not be looking to climb to the top of your business, they have a proven and steady loyalty to their role and their reasons for changing jobs are more rooted in their ‘needs’ rather than a desperation to move.

WHAT’S THE DIFFERENCE BETWEEN AN ACTIVE AND PASSIVE CANDIDATE? An active candidate is one who is actively seeking a new role. They will have signed up to job boards, registered with agencies and will be interviewing regularly until they find their new role. Their reasons for wanting to change roles could be anything from being unhappy in their current position, being unsuccessful in their current position to simply wanting a change. Of course, they could also be unemployed. A passive candidate, on the other hand, is one who is currently in a role and is not actively looking for their next career move. They may be quite happy in their current role; however they’re open to moving if a ‘better’ role came along. For passive candidates, what constitutes a ‘better’ role is very different to that of an active candidate. As previously mentioned, for an active candidate, a better role might simply be one where they can get on with their team! However, for a passive candidate, their decision to change jobs will be based on a much wider

But are passive candidates really out there? And if so, how do you find them? A recent report from Indeed ‘Talent Attraction Study: What Matters to the Modern Candidate‘ states that 71% of workers would be open to a new opportunity if it was the right move for them. To an employer, this means that your pool of candidates is far larger than you might have first thought!

Further to this, from interviewing passive candidates, you will be seeing quality employees who are not currently being interviewed by

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several other dental labs. This means that you are not up against your own competitors to win the talent that comes everyone’s way. Honesty plays a key part in the interviewing process for an employer; if a candidate is desperate to get a job, they might be more willing to stretch the truth on their CV or inflate their achievements to make themselves seem more desirable. If you reach out to a passive candidate to come and interview for your role, they are much less likely to behave in this way as you have already submitted your interest due to their current position in their establishment. In summary, when looking to engage your next employee, don’t underestimate the importance of seeking out passive candidates; more people than you think are open to changing their jobs if the right role comes along! With approximately 75% of dental technicians being passive candidates (eg; not actively seeking jobs), advertising with sites such as Indeed.com often doesn’t produce the best quality candidates. At www.dentaltechnicianjobs.net we dedicate our time to getting your jobs seen by the 75% of superstar technicians that ordinarily would not see your job vacancy. We do this via social media, email marketing and online advertising. For more information on advertising for technicians, contact us today at admin@marshallhunt.co.uk

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DENTAL

TECHNICIANS GREAT BRITAIN AND THE DENTAL TECHNICIAN MAGAZINE

These are your pages for comment, questions, case pictures, and anything you want to share with your fellow technicians

A BIG THANK YOU!

Alan Wright

By Alan Wright

Well the DTGB merger with the l Dental technician magazine is going from strength to strength and I would like to personally thank you all. Last months article from Andrea on Den-tech Charity gaining from this merger, Veterans Bite Back which myself and a close ex-military friend of mine set up via the Veterans walk-in Centre in Southampton. And I thank you all.

As soon as the Dental Centre and lab that my guys at Blueprint Dental and the generous donations of materials from so many, is up and running we will be bringing in those people from the streets to help restore their confidence, by giving them their smile back. Technicians from all over the UK have already kindly contacted myself and Andrea to say they are happy to already carry out work in there labs making units or appliances and I salute you for that.

The advertising side of the group is now looked after by Chris Trowbridge from the team at the Dental Technician Magazine, and he and his team are working very hard, speaking to the companyâ&#x20AC;&#x2122;s within the group about placing interesting articles and subjects, but are mindful of not overloading the group.

Once we have the Centre up and running with the on site lab we will be able to have technicians interacting with the Dentist and the individual requiring your skills. This is gathering a lot of media interest and they have already had Chris Evans from, now Virgin radio, down to the Centre and various Majors from other regions looking at how this can be rolled out around the Country so those of you that have already helped with Den-tech thank you without you we couldnâ&#x20AC;&#x2122;t do it. HOW ARE YOU HELPING? Well in many ways by your individual interaction within the group, by speaking

We have the forthcoming DTS 2019 show coming in May and hopefully many of you will attend and come along to the Dental Technicians StandA10 and have a chat with the team regarding your thoughts on what you would like to see. to other technicians who are daily joining the group and taking advantage of the information and articles being posted by the Dental Technician team and Larry Browne. Lots more to come with the awards scheme, that will be voted on by you the technicians and allow you to voice your opinion and thoughts on how you see the industry developing.

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With the growth of the group, many new members will not know me other than through my postings on DTGB. They may well ask who is he? Well I set up the DTGB when I was coming to the end of my military career in the Army where I served with the Royal Army Medical Corp, and then transferred into the Royal Army Dental Corp. I worked predominantly in

For the growing number of Study clubs around the Country, we hope to provide a place that they can all come together to profile and inform others on when and where they are taking place. Lets get behind those study clubs and you may well be surprised at the

number of fellow techs and manufacturers that will come along and support your events. You asked for CPD points, well we are listening to your request so keep checking in to see how the future of this merger benefits us all. Please be aware of the following guidelines to the group. Another opportunity for the individuals here in our group, if you want to post articles, show your skills, bang the drum for your laboratory contact Larry Browne and his team who would be only too happy to come and have a chat

over-tea and biscuits at your lab and show the members your skills or tips and tricks.

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the Maxillofacial/Hospital lab side of things. With the onset of media and Facebook I saw this as an opportunity to keep in touch with fellow technicians, military and ex-military I had worked with, and met during my time at various civilian establishments. It has grown from that time to where we are now.

Any suggestion or requests on how you Looking good for would like to see the Birmingham! group development please message me, or one of the admin team. Have a great April and see you at the DTS in Birmingham. Contact: Alan@blueprintdental.co.uk

SOME RECENT POSTS

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MAXILLO FACIAL SURGERY AT BIRMINGHAM’S QE11 HOSPITAL

ow many of you watched the programme on BBC regarding the Maxillofacial surgeon dealing with a tumorous growth which was destroying the jaw bones and soft tissues, and reducing the patients muscle ability to open and close her mouth. Even after radiotherapy and steroid medicine she was in constant pain and could hardly open her mouth. The disease, at first thought to be a cancer, was in fact a very rare condition about which not too much was known. So rare that there was no guidance as to how it would react to surgery and whether it could be removed and the jaw reconstructed. Here was however no other choice as the growth continued to destroy the patient’s oral structure. When you see the pressure these surgeons are under it makes you feel very humble indeed. I have taken some shots of the screen during the operation but I cannot convey the pressure, over a 12 hour operation, the surgical team must have been under.

Maxillofacial Consutant Tim Martin

It was clear on the radiographs the growth had progressed through some of the jawbone and had infected some others. This despite the patient undergoing radiotherapy and a regime of steroid treatment over a nine month period. It was very fibrous and needed extreme care to remove. Using CBCT for 3D planning it was possible to outline the target area, as shown in the image below. It could not be ignored as it would have gone on destroying the oral tissues. Accompanied by his close colleague Sat Palmer, Consultant Maxillo Facial Surgeon, who would be responsible for removing the donor bone from the hip, it was decided to remove the growth.

Adjacent tissue nerves and arteries were difficult to isolate from the fibrous mass and during the operation the artery was severed. Remarkably the surgeon managed to stop the bleeding and suture the 4 mm diameter artery together and re-establish the blood supply. Continuing to work on, still not knowing what he was facing but trusting in his teams ability and support.

Working towards the back of the maxilla the nerves and arteries of the jaw needed to be carefully avoided if possible. However the tumour proved to be very fibrous which increased the complications of it’s removal.

Designed to slip over the patient’s hip to the exact size as needed to replace the anticipated removed diseased tissues. The template fitted and outlined an area of hip needed, to be removed. By cutting around it, the exact bone form

We saw Heather, the 3D Biotech use the CBCT and associated digital techniques to establish a model and a template for removing the bone from the donor site at the hip. Heather is the only NHS employed 3D Biotech in the UK.

TOP ROW: Radiograph shows areas of bony destruction; highlighted area of tumour activity; fibrous growth 2ND ROW: Severed artery; careful suturing required; repaired artery 3D ROW: Further tumour ingress confirmed; hip donor site; CT 3D image and design of graft template

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FOCUS

TOP ROW: Donor site in virtual image; digital designing of the template; template designed and digitally created; the bone replacement with blood and nerve fibres 2ND ROW: It’s been a long day!; patient and spouse with something to look forward too.

required was removed and transferred to the Jawbone after the removal of the diseased tissue. The very experienced surgeon and his colleague were clearly relieved when it all went as well as it did. The blood and nerve connections were re-established with the greatest of care. Many of us would be familiar with the digital process used to provide the matrix template for the bone graft from the hip. But none of us would be facing the uncertainty the surgeon faced, over ten hours into the operation, of not knowing what had being removed and whether that which was left was

as expected at the beginning. Gladly that was the case and the planning and measuring carried out proved to be correct. Seeing the difficulty faced by the surgeons and the unexpected amount of diseased tissue removed it was fortunate that everything was allowed for and the grafting was successful. The patient was shown some few weeks later and was very positive of the eventual outcome. She would need to face some more tissue additions but not requiring such complex surgical procedures. She could move her jaw and just needed some filling out to replace the facial profile. So little is known about the condition she will need

to be monitored to ensue no return of the problem. But she was certainly looking much more optimistic as the case was reviewed. Clearly the surgeon and his team were delighted that their decision-making and judgement, in a very difficult situation, had proven right. That is why Tim Martin and others of similar ability and experience take on those cases that are complex, and not just because of the anatomy. A genuine treat to watch the operation and appreciate the amazing pressure under which these dedicated professionals work.

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Payment by cheque to: The Dental Technician Magazine Limited. Natwest Sort Code 516135 A/C No 79790852 You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers. Answers will be published in the next issue of The Dental Technician. Certificates will be issued within 60 days of receipt of correct submission.

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VERIFIABLE ECPD AS YOU NEED IT VIA THE DENTAL TECHNICIAN DENTAL OPINION FROM SIR PAUL BERESFORD Q1. When and where was the first plastic bristle toothbrush invented? A. 1927. USA. B. 1938. USA. C. 1935. JAPAN. D. 1929. GB. Q2. A. B. C. D. Q3. A. B. C. D.

When and where was the first electric toothbrush invented? 1954. SWITZERLAND. 1928. ITALY. 1927. USA. 1951. FRANCE. How many people in the UK. are estimated to use an electric toothbrush? 10 million. 23 million. 18.7 million. 16 million.

DENTAL DORIS Q4. What is the Japanese word for the primary meaning in their life? A. Tokai. B. Oranogi C. Asanghi. D. Ikigai. Q5. A. B. C. D.

Who said “Follow your Bliss”? Waldo Emerson. Joseph Campbell. Howard W Thurman. David Gates.

MASTERING THE IMPLANT DIGITAL WORKFLOW Q6. How are models produced in the digital workflow? A. Milled. B. Laser sintered. C. 3D Printed. D. Centrifugal casting. Q7. A. B. C. D.

What do the CBCT letters indicate? Chromic Beam Computerised Topography. Classic Binding Collected Tissues. Cone Beam Computerised Tomography. Clinically Based Computer Template

Q8. A. B. C. D.

What does the author think is the most stable surgical guide? Tooth borne. Implant borne. Tissue borne. Bone supported guide.

Q9. A. B. C. D.

What implants does the author think are difficult to scan? Buried two stage implants. Deeply placed implants. Tissue level implants. Bone grafted implants.

Q10. A. B. C. D.

How is the accuracy of the scanned image confirmed? Using computerised photography. Using a locked verification jig. Using a second impression. Making a measuring guide.

DTS CONFERENCE BIRMINGHAM Q11. Who are the two named speakers? A. Loren Patel and Sigfried Lundquist B. Michael Davos and Peter Stuters. C. Jameel Gardee and Rowland Gardner D. Thomas Othello and Justin Timmings. NEWS Q12. What has been found to improve patient oral hygiene and inflammation rates? A. The right toothpaste. B. The correct design of toothbrush. C. Interdental cleaning. D. Telling the patient about the risk they face. GOOD NEWS FROM THE EU Q13. How many NHS Staff qualified in the European Union? A. 5,000. B. 15,000. C. 63,000. D. 120,000. Q14. How many care workers qualified in the European Union? A. 63,000. B. 120,000. C. 104.000. D. 96,000. ORAL HEALTH CONTRIBUTES TO A HEALTHY HEART Q15. What Organisations supported and published the study? A. The WHO World Health Oganisation. And IAP. the International Association of Periodontics. B. WFDC World Federation of Dental Committees and WACS, World Association of Cardiac Surgery. C. EFP European Federation of Periodontology and WHF World Heart Federation. D. UNHF United Nations Health Foundation and ICPH The International College for Periodontal Health. A STUDY ON DIGITAL DENTURES Q16. How were the dentures produced? A. CAD/CAM Milled. B. Laser Sintering. C. Traditional Investment and finishing. D. 3D Printing.

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INSIGHT

SNORING AND OBSTRUCTIVE SLEEP APNOEA A ROLE FOR THE DENTAL TEAM By Matt Everatt

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WHAT IS OBSTRUCTIVE SLEEP APNOEA (OSA)? OSA is caused by the repeated collapsing of the airway during sleep, resulting in complete (apnoea) or partial (hypopnoea) obstruction of airflow for 10 seconds or more. Left untreated, these regular disruptions can lead to serious consequences for the sufferer, including: increased blood pressure, heightened risk of cardiovascular disease, strokes, diabetes and excessive daytime sleepiness. Obstructive sleep apnoea, often recognised by the sleeping partner as the â&#x20AC;&#x2DC;silence before a huge snort or gasp, is most prevalent in middle-age, affecting 4% of males and 2% of females, until hormonal changes in menopause appear to balance the gender difference.

What is a Mandibular Advancement Splint (MAS)? A MAS is an oral appliance that repositions the mandible in a protrusive position, creating more space for the tongue to come forward, in turn opening the airway around the oropharynx, nasopharynx and hypopharynx. There are many types of MAS available. Most laboratories or technicians making them will use devices such as the Silensor, Negus and Herbst, all of which have been proven effective in treating snoring and OSA. Research has shown that appliances that can be advanced incrementally, known as titration, have been proven to be better tolerated by patients. In addition devices such as the Sleepwell device with its 9mm of available titration, are the most clinically effective in reducing the effects of snoring and OSA (Barnes et al, 2004). WHAT MAS DEVICES ARE AVAILABLE? Research has shown that almost all MAS devices are clinically effective in treating snoring and OSA to a degree. Devices such as the Negus devices, which is simply two soft EVA sheets that are formed and welded together were used in a clinical study by Johnston et al (2002). Even this device improved OSA in 35% of wearers. The Negus device was one of the first devices used in the UK, the life expectancy is poor as the devices delaminate over time and cannot be titrated.

Whilst most OSA sufferers are aware that they do not wake feeling refreshed following sleep, most - just like the simple snorer - are unaware that they can seek help from their dentist, often consulting their GP instead. Patients suffering from snoring often consult their GP for a solution, where certain lifestyle changes may be suggested including: weight loss, different sleeping positions, staying well hydrated and avoiding alcohol. Whilst these changes will likely have a positive impact on snoring from a holistic perspective, and should be encouraged, many dentists have been trained to provide oral appliances to reduce snoring. The use of a mandibular advancement splint (MAS) has been clinically proven to have a significant impact. It is important to understand the risk of OSA when a patient presents with snoring, this can be done with the use of a pre-screening questionnaire. Dentists can undertake training to screen for signs and symptoms that may indicate the patient suffers with OSA. As well as asking the patient and the sleeping partner subjective questions about their sleep quality, the patient will be asked medical questions relating to their current health and a neck circumference measurement will be taken and used as a scoring system known as The Flemons Adjusted Neck Circumference.

advance blocks or buccal shields. A patented device with buccal fins came to market in the early 2000s. The design and components have now become commercially available for dental labs to purchase and use. The device such as the Dorsal appliance has the benefits of self titration and can be beneficial in cases with limited dentition for retention.

Dorsal

In 2004, a new MAS came to the Sleep market in Australia; The MDSA, now known in the UK as the SleepwellTM. It was popularised by UK Orthodontists, Professor Ama Johal. In 2005, he began presenting a series of lectures to GDPs on the subject of Snoring and Sleep Apnoea. The Sleepwell device was used in one of the largest clinical studies on Snoring and Sleep Apnoea to date. Maree Barnes et al (2004), used the device alongside CPAP (Continuous Positive Airaway Pressure) and a Placebo tablet in the study. The Sleepwell device had a success rate of over 80% in treating Snoring and Mild - Moderate OSA and 98% of patients reported that comfort was acceptable. The components for the Sleepwell device have now become commercially available from WHW Plastics.

Negus

The Silensor device became popular in the late 1990â&#x20AC;&#x2122;s. It was a great step forward in terms of titration. Erkodent had introduced a design that could be advanced by the dentist. The titration amount is limited to 3-4mm by changing the buccal arms to shorter ones in order to advance the mandible.

SleepwellTM

Silensor

MAS devices started to become more sophisticated and many designs came to market, including orthodontic screws to

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It is without doubt, that MAS devices have a role to play in the treatment of Snoring and OSA. Dental Laboratories and Dental Technicians are well placed to offer their clients some of the most clinically proven devices available. ALL IMAGES: S4S (UK) Limited www.s4sdental.com

INSIGHT

WHAT IS SNORING? Simple snoring is the noise resulting from a partial closure of the airway during sleep. It is estimated that over 45% of the population snores, leading to disrupted sleep for the sufferer - and their bed partner [Young et al, 1993]. Ranging from 50-100 decibels, the equivalent of a pneumatic drill, snoring can lead to relationship issues, daytime sleepiness, increased stress & depression. Less often, snoring can also take place as part of a more serious condition, obstructive sleep apnoea (OSA), which is potentially life-threatening.

INSIGHT

WELCOME TO... DENTAL DORIS DENTAL DORIS HAS WORKED IN DENTISTRY FOR MANY YEARS AND LIKES TO MUSE ABOUT ALL KINDS OF DENTAL AND NON-DENTAL TOPICS

WHAT GETS YOU OUT OF BED IN THE MORNING?

hen asked what is the single most powerful contributing factor to one’s health and vitality many doctors would say ‘having a sense of purpose’. While some people develop great regimes including nutrition, lifestyle activities and movement to support their wellbeing; those without a clear sense of purpose struggle with physical health issues.

in order to help reveal the essential role that each member was born to play in the greater tribe and story of life; though the space and reverence for this question does not always seem to exist today. For many, our decisions around life-focus unfold in a more reactionary way, propelling us into educational, professional and life-directional paths based less on deep inner calling or soul-inspired vision, and more on societal expectations, so-called ‘practical reality’ and what is required to survive in the systems we’ve created to live in.

The distinguishing quality of many very healthy people is their ability to transcend common health challenges by being aligned towards a primary meaning in their life. Japanese culture actually has a word which addresses this focus. The word is ‘ikigai ‘and translates simply as, ‘reason for being’. WHAT IS YOUR ‘REASON FOR BEING’? According to the Japanese, everyone has an ikigai. To find it often requires deep enquiry and lengthy ‘search of self ’ – a search which is highly regarded. The term ikigai is composed of two Japanese words: iki referring to life, and kai, which roughly means “the realisation of what one expects and hopes for”. Unpacking the word and its associated symbol a bit further, ikigai is seen as the convergence of four primary elements: • What you Love (your passion) • What the World Needs (your mission) • What you are Good at (your vocation) • What you can get Paid for (your profession)

the behaviours that make us feel ikigai are not the ones we are forced to take based on the expectations of the world around us, but rather they are the natural actions and spontaneous responses that emerge from a deep and direct connection to life. THE QUESTION OF PURPOSE Many ancient indigenous cultures took time to honour the question of purpose through ceremony, vision quest and rites of passage

The word ikigai, that space in the middle of these four elements, is seen as the source of value or what makes one's life truly worthwhile. In Okinawa, Japan, ikigai is thought of as "a reason to get up in the morning". Interestingly, while certainly incorporating the financial aspects of life, the word is more often used to refer to the mental and spiritual state behind our circumstance as opposed to our current economic status alone. Even if we are moving through a dark or challenging time, if we are moving with purpose, if we are feeling called toward something or have a clear goal in mind, we may still experience ikigai. Often

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The truth is, if there was ever a time on our planet where a sense of true purpose was needed, required, or desperately called for, now would be that time. But amidst the multi-layered pressures of our modern world, how do we peel back the layers and discover why we are here and what we are really supposed to be doing? American mythologist and author Joseph Campbell shared his view on fulfilling our purpose when he said, My general formula for my students is, ‘Follow your bliss.’ Find where it is, and don’t be afraid to follow it. Meanwhile, philosopher and civil rights leader

While each of these viewpoints are powerfully compelling in their own right, whether we are following our bliss, following our heartbreak, or that which makes us come alive (or a combination of all three!), for many of us there is also an apparent need to follow that which pays the bills each month and allows us to cover the basic necessities of life. So how do we balance all of these factors in the creation of a life which is meaningful, purposeful and aligned with our true calling? Is it possible to have it all? The essence of ikigai gives us a framework to balance these elements into a cohesive whole. PASSION AS A VEHICLE FOR CHANGE AND CONTRIBUTION As the world moves through massive change on many levels, more and more people are feeling called to align their skills and gifts with a higher cause or sense of contribution. Beautiful examples are emerging in many arenas of social change and activism where people are not abandoning their passion for the cause but rather channelling the thing they most love doing in the direction of positive change – and discovering inspired ways to support themselves along the way. WHAT IS YOUR IKIGAI? Take a moment to draw your own version of the overlapping circles of the ikigai symbol and consider the following: • What do you Love? • What are you Great at? • What aspects of your life bring you into your heart and make you come alive? • What unique skills do you have that come most naturally to you? • What talents have you cultivated and what do you excel at? • What Cause do you believe in? • What breaks your heart or pulls at your gut? • What change would you most love to create in the world? • What would you give your life for? • What do people Value and pay you for? • What service, value or offering do you bring to others? • Something people need and are happy to pay for or share some value in exchange? Take a few minutes to write whatever keywords, phrases, and ideas come up for you in each circle, then look for areas of natural overlap. Reflect on the sum total of these elements and how they may relate to each other. Bring yourself quietly to the centre of the circles and leave space in your mind for whatever impulse or calling may emerge naturally in the coming days… What is one simple thing you could do or be today that would be an expression of your ikigai?

ORAL HYGIENE CONTRIBUTES TO A HEALTHY HEART

DENTAL NEWS

Howard W Thurman said: Don’t ask what the world needs. Ask what makes you come alive and do that… Because what the world really needs is people who have come alive.

27 FEBRUARY 2019 l Proper oral hygiene and regular visits to the dentist can support cardiovascular health. This, in a nutshell, is what dental and heart experts agreed today at a joint workshop in Madrid. Representatives from the European Federation of Periodontology (EFP) and the World Heart Federation (WHF) reviewed the evidence linking cardiovascular diseases and gum disease (periodontitis) to prepare joint recommendations for health professionals and patients. “Both periodontitis and cardiovascular disease affect many people worldwide. Determining the importance of periodontal disease prevention and therapy as a means to reduce cardiovascular risk can have significant public health and economic implications,” said Prof Mariano Sanz, EFP Chair of the event. Prof Pablo Perel, WHF senior science adviser, said: “More awareness is needed of the link between oral health and cardiovascular disease. The Perio & Cardio workshop has provided evidence-based recommendations in relation to cardiovascular health and periodontology. Since cardiovascular disease is the first cause of death in the world, reducing risk factors that contribute to heart disease is of utmost importance.” Cardiovascular diseases (CVDs) are the number one cause of death globally, while severe periodontitis is the sixth most common chronic condition. Evidence suggests that patients with severe gum disease are at greater risk of heart attack and stroke, particularly if they have had a previous cardiovascular event. Bacteria in the mouth can move into the circulatory system and promote inflammation and hardening of the arteries (atherosclerosis). Periodontitis and heart disease also share common risk factors including smoking, alcohol consumption, age and diabetes. Workshop participants discussed four key areas: • Epidemiological evidence linking periodontitis and CVDs; •Biological mechanisms for the increased risk of atherosclerosis in patients with periodontitis;

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•The effect of periodontal treatment on the risk of atherosclerosis; •The potential cardiovascular risks of oral interventions. “Cardiologists should be aware of the connection between gum disease and heart disease and encourage their patients to be screened for periodontitis and pursue good oral hygiene because it will improve cardiovascular outcomes,” explained Dr Alvaro Marco Del Castillo, WHF Co Chair of Working Group 1. Prof José Ramón González Juanatey, WHF Co Chair of Working Group 2, which looked at the effect of periodontal treatment on the risk of atherosclerosis, said: “More research is needed about the effect of dental treatment in patients with CVD, but current evidence suggests that the progression of CVD may be influenced by good oral hygiene and successful periodontal treatment.” “Patients with periodontitis should be advised that they have a higher risk of heart disease and should manage their CVD risk factors. Regarding potential cardiovascular risks of periodontal treatment, available research indicates that periodontal treatment is safe for cardiac patients,” said Prof Søren Jepsen, EFP Co Chair of Working Group 2. Prof Sanz concluded: “The Perio & Cardio workshop achieved its objectives by arriving at a consensus. It also pinpointed areas where more research is needed such as clinical trials using hard cardiovascular outcomes and further studies to understand the mechanisms by which oral bacteria may cause damage to cardiovascular tissues.” Regarding the next steps, Prof Sanz explained: “The EFP and WHF recommendations will be published in the Journal of Clinical Periodontology and a project will be developed to create awareness about the essential role of oral health in reducing the risk of heart disease.” Source: www.alphagalileo.org

DTS 2019

DTS 2019 THE BENEFITS OF IOS

r Jameel Gardee will be sharing valuable insights into the world of digital impression taking at the Dental Technology Showcase (DTS) 2019. He will be speaking in the Digital & Innovation Theatre sponsored by Henry Schein, presenting a session entitled “Intraoral scanning, its benefits and results in simple and complex cases”. “Intraoral scanning (IOS) is changing the way that dentistry is practised,” he says. “Traditional ways of providing dentistry and performing clinical work have been turned on their head with IOS. The latest technology in the field makes procedures quicker, more accurate and more effective. These are all relevant when the dental team is trying to put the needs of the patient first.

Dr Jameel Gardee

“Of equal importance is that patients actually prefer the digital impression taking over conventional methods. Regarding traditional techniques that can put patients off attending regular check-ups, most people dislike 1) the injection 2) the sound of the drill and 3) have a fear of choking on the gloopy material used for conventional

impressions. IOS takes the last issue away, notably improving the patient experience and encouraging individuals to attend the practice more frequently. Digital intraoral scanners are therefore great practice builders.” Jameel will explore the benefits of IOS for patients, dentists and technicians in more detail during his lecture. He acknowledges that there can be barriers that prevent dental professionals from utilising all the advantages available. He continues: “A major barrier to IOS in practices is cost. A fairly high initial investment is required, which some professionals feel is prohibitive. However, if you ask anyone with IOS whether they would return to traditional methods and get their initial investment back, none would – so it’s definitely worth it. There are always ways to manage the initial cost and make it more manageable. The scanners themselves are also coming down in price, with entry level models being made available on the market that offer basic services at much lower prices. Soon, IOS will be easily accessible to every practice and so every dental laboratory needs to be ready for that. “There has never been a better time to take on digital dentistry. Everything in our lives and our patients’ lives is now based around digital from our iPhones to our Apple watches, movies downloaded online, Uber called through the app or shopping ordered on Amazon. As such, patients expect digital when it comes to dentistry as well. To be successful

in the future, dentists and technicians alike need to stay ahead of the curve.” Henry Schein will be showcasing the full range of digital equipment including the newly launched CEREC Primescan from Sirona, as well as the Trios 4 and E4 scanner from 3Shape, on stand J20. Demonstrations will be available, allowing you to immerse yourself in a hands-on experience and work out the next step on your digital journey. DTS 2019 will offer 40+ hours of CPD throughout its two days of lectures and workshops tailored to every member of the dental profession. There will also be an extensive trade floor where leading dental product suppliers will be on hand to offer demonstrations, bespoke advice and amazing show-only deals. Why not take the opportunity to mingle with friends and colleagues and have fun outside the lab? Jameel adds: “This event provides a great platform and meeting place for dental professionals. There is good CPD and a good range of speakers presented. The trade is also very well represented, offering great deals. The two-day event is very good value for the time you take off work to attend – plus, the whole team benefits.”

GETTING THINGS STRAIGHT

s part of the dynamic two-day lecture programme at the Dental Technology Showcase (DTS) 2019, the OTA Seminars – sponsored by the Orthodontic Technicians Association (OTA) – will provide technicians with an update on materials, techniques and ideas in the field. Leading lights will share their experiences and offer a wealth of advice to help delegates improve their processes and take their skills to the next level.

Rowland Gardner

His session will cover three main areas: 1. Getting things straight: Communication and terminology 2. Getting things straight: Contemporary laboratory techniques in straightening teeth and arches 3. Getting things straight: using conventional and digital techniques for the planning and fabrication of devices used to straighten faces.

On Saturday 18th May, Rowland Gardner – Head of Dental/MPT Technology at King’s

College Hospital NHS Trust – will present “Let’s Get Things Straight”.

He explains: “Through the national network

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”There have been many theories, treatment protocols and device innovations throughout the past decades. Products are either named after the innovator, the centre where they were developed or in a way that is descriptive of the action or process they belong to. This can cause confusion when prescribing, so during my session, I’ll consider if a universal catalogue of devices could ever be agreed for improved communication among professionals.

“I’ll look at the role of the hospital-based dental/orthodontic technician. It is especially important to be clear about what is prescribed in this environment. Hospital dentistry tends to focus on patients who are referred due to scoring high on the Index of Treatment Need. The treatment planning for these patients will often involve restorative enhancement of dentoalveolar anomalies, devices to enhance facial growth or surgical correction of skeletal anomalies. “As is true for any patients we deliver care to, changing their faces can change their lives. In order to ensure more predictable and higher quality treatment, many surgical cases are now being planned using specialist software and occlusal surgical matrices printed direct. I will explore both digital and conventional treatment planning concepts, covering who takes responsibility for the digital planning and whether there’s a need for ‘Clinical Scientists’.

“Finally, I will consider the rapid development of printed devices and how the digital revolution has and will continue to change the daily routines of orthodontic technicians.” Aside from the OTA Seminars, DTS 2019 will feature a CDT Conference, DTS Lecture Theatre and Digital & Innovation Theatre to meet the educational needs of all members of the dental lab community. The dedicated trade floor will offer further opportunity to discover the latest innovations in the profession, with product experts on hand to provide demonstrations and bespoke guidance to delegates.

DTS 2019

of the Orthodontic Technicians Association, technical innovations are shared and developed, and treatment trends are discussed. I will provide a brief historic journey from the agenda of the inaugural meeting of the OTA and the evolution of treatment trends over the past five decades to where orthodontic technicians are today. I will be looking at digital diagnostics and planning technologies, as well as the increasing demands of wire free printable devices.

Rowland concludes: “DTS has evolved into the ‘go-to’ event for education, networking and updates in our profession.”

DTS 2019 WILL BE HELD ON FRIDAY 17TH AND SATURDAY 18TH MAY AT THE NEC IN BIRMINGHAM, CO-LOCATED WITH THE BRITISH DENTAL CONFERENCE AND DENTISTRY SHOW For further details, visit www.the-dts.co.uk, call 020 7348 5270 or email dts@closerstillmedia.com

BY DENTAL TRIBUNE UK I APRIL 17, 2019 l It comes as welcome news, that Matt Hancock, Secretary of State for Health and Social Care, has reassured all EU-qualified healthcare professionals that they will be able to continue working in the UK even in the case of a no-deal Brexit. Legislation introduced by the Department of Health and Social Care last month means that the 63,000 NHS staff members and 104,000 social care workers who qualified in the EU will have their training accepted by regulatory bodies such as the General Dental Council (GDC) in the UK.

Danny Mortimer, Chief Executive of NHS Employers and Chair of the Cavendish Coalition, said: “We have been clear that we must continue to embrace the vital contribution of our talented colleagues from overseas in caring for our patients and communities. We very much welcome the news, as will employers and staff, that the UK will recognise the qualifications of EU professionals in a no-deal situation. We would hope for similar

confirmation of recognition for those with UK qualifications working in the EU.” This development comes after a survey commissioned by the GDC earlier this year found that 32 per cent of EEA-qualified dentists who currently work in the UK intend to leave in the next few years. Half of these respondents indicated that Brexit was the reason behind this intention.

In addition, those who have qualified in the European Economic Area (EEA) and in Switzerland can register after Brexit even if the UK leaves the EU without a deal. Employment contracts will not need to be changed, regardless of whether a deal is reached. Hancock said. “My message to EU staff is clear - we all want you to feel valued and stay in the UK. My priority is to make sure high standards are maintained across the healthcare system and that patients continue to receive the high-quality care they deserve. This legislation helps ensure that will continue to be the case,” he added.

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DENTAL NEWS

GOOD NEWS FOR EU QUALIFIED REGISTRANTS FOR THE FUTURE

DENTAL NEWS

GC INTERNATIONAL AG APPOINTS DR KIYOTAKA NAKAO AS PRESIDENT AND CEO Top leadership succession announcement for GC The success of this family-owned business is based on solid principles: Its corporate philosophy, drawing from the Japanese wisdom of “Semui” and “GC No Kokoro”, calls for selfless and objective actions, always putting the common good before short-term growth objectives.

lGC International AG, based in Lucerne, Switzerland, has officially appointed Dr Kiyotaka Nakao as President and Chief Executive Officer. Dr Nakao’s new role follows from the recent retirement of Mr Makoto Nakao, who served in GC’s top leadership for 42 years. Going forward, Mr Makoto Nakao will remain in his position as Chairman of the board of GC International AG. In addition, he will dedicate the majority of his time to the newly-established Foundation Nakao for World-wide Oral Health, which was funded by his generous donation of privatelyowned GC shares. The Foundation promotes academic research and clinical studies on topics that affect oral health on a global scale.

About Dr Kiyotaka Nakao Dr Kiyotaka Nakao joined GC Corporation in Japan in 2006 and advanced his career in various functions such as R&D and international business. He assumed the position of Director in 2008, followed by Vice President in 2012. Since 2013, he has served as President of GC Corporation. GC Corporation, headquartered in Tokyo, Japan, is one of the world’s leading suppliers of dental products, with more than 3200 employees and numerous manufacturing sites in Japan, the United States, China, India and Europe. Established in 1921, GC has been devoted a century to the development and provision of dental materials, contributing to the worldwide oral health.

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ALERTING PATIENTS TO DISEASE RISK IMPROVES DENTAL HYGIENE AND ORAL INFLAMMATION, STUDY FINDS BY DENTAL TRIBUNE UK I APRIL 18, 2019 lLONDON, UK: As dentistry becomes more technologically advanced, the importance of having an informed patient continues to grow. With this in mind, a new study has found that using psychological techniques to communicate the risk of developing periodontal disease to patients improved their dental hygiene and was associated with reduced scores for gingivitis over a three-month period. The study, which was led by a team from the Faculty of Dentistry, Oral and Craniofacial Sciences at King’s College London, tested a group of 97 adults with moderate periodontal disease who were registered patients at a London general dental practice. The participants received treatment as usual, an individualised report on their periodontal disease risk, or an individualised report plus a

programme of goal setting, planning and selfmonitoring based on psychological theory. The results of the study showed that, over 12 weeks, dental plaque was reduced significantly in the two groups to whom risk of disease was

Communicating the risk of disease to dental patients has been shown to improve dental hygiene and oral health, according to the results of a recent study. (Photograph: George Rudy/Shutterstock)

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communicated, but there was no change in the group who received treatment as usual. In addition, the frequency of interdental cleaning improved only in the intervention groups. Lead author of the study Dr Koula Asimakopoulou, Reader in Health Psychology at King’s College London, said: “Our study shows that by adopting a simple psychological intervention, aided by the use of an online risk assessment tool, we can significantly improve measurable clinical outcomes and reduce initial signs of gum disease in patients seen routinely in general dental practice.” The study, titled “The effect of risk communication on periodontal treatment outcomes; A randomized controlled trial”, was published online in the Journal of Periodontology.

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