Tracey Bell Dental Press 2012

volume 3 issue 12 www.apexezine.com

Rising trend of bespoke ezines A closer look at Gradia Core

by GC Europe The products changed the way I practice in 2011 – Marty Jablow

Reflecting on 2011:

women in dentistry

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Contents Thought leader

4 Reflecting on 2011: Women in dentistry Apex interviews three prominent women dentists about their experiences in the profession this year 14 Rising trend of bespoke ezines Communication channel reinforces brand engagment

Product Spotlight 16 Step by step introduction to Gradia Core by GC Europe 20 Innovation Station: Glass ionomer cement as an occlusive barrier in Class III furcation defect

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Women in dentistry

Apex interviewed two women in dentistry about their experiences in the profession in 2011 and what they expect and look forward to in the New Year

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Judith Husband

Prison dentist, BDA council member, Northampton

Looking back at 2011, what are three highlights that stand out to you in regard to your own work?

Judith Husband: Without doubt this year has been a very challenging one, both on a personal and professional level. My real achievement this year was actually managing to fulfil my contract and fulfil the additional legislative responsibilities imposed upon the profession.

The year began, as it did for most practice owners, with many long hours after surgery compiling all the relevant material together to enable CQC compliance and registration.

In addition we were required to complete the Information Governance tool kit, all whilst doing the day job.

In the arena of dental politics, this

year has been one of constant change with countless documents having to be read, understood and often responded to. My role in the British Dental Association gave me first-hand knowledge and direct input into NHS reforms, GDC consultations and most recently the OFT investigation.

The huge workload could have been daunting, however the professionalism and diligence of the BDA staff demonstrated that teams can achieve infinitely more than the individuals that compose them.

On a lighter note 2011 heralded my discovery of Twitter. Initially an odd pastime but it soon became an integral part of most days. A vibrant Twitter dental community shares “dental top tips�, political links and Apex volume 3 issue 12

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comments. For any sports fans we also have a dental Formula1 get-togethers on race weekends!

List some of the dental events you attended this year (and enjoyed) and why?

Judith Husband: The first major event of 2011 was BDA/Eastman Careers Day. For me this was a very busy day as it involved two conferences (not to be recommended, especially in snowy February!)

BDA /Eastman Careers day is one of the events I have the pleasure of helping our Events team organise and this year my role was to Chair the is the BDA Annual Conference and panel debate.

Exhibition. This year Manchester Immediately after the morning became my home for almost a week as session it was straight to Euston for it will again next April. The exhibition is wonderful for meeting friends whilst exploring developments in dentistry and, of course, take advantage of money-saving conference deals. The lectures are varied with a good mix of clinical, business and motivational speakers from around the world.

“Being a dentist is more than just treating patients - improving healthcare provision and the future of our profession should be an integral aspect of every dentist’s work.”

What is your opinion on the amount of young women choosing dentistry as a career nowadays?

Judith Husband: Dentistry is an intellectually challenging and rewarding profession. Traditionally, the the train to Birmingham presenting flexibility it offered provided women to the National Association of Prison a career that could be moulded to fit Dentists Annual Conference. This with their family as well as professional event is a fantastic opportunity to learn and share knowledge with teams aspirations. The greater proportion of women dentists does present some from across the UK working in prison challenges as historically practice dentistry. ownership has been greater amongst The highlight of my year (dentally)

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men and women have tended to be more likely to work part-time with career breaks. Certainly ownership of practices is declining amongst young dentists but this could be influenced by new contracting within the NHS acting as a barrier or the impact of student debt on career choices.

The need for “back to practice” support schemes will have to be addressed as it is likely that a larger proportion of the profession will take career breaks. In a profession acknowledged to be stressful and physically demanding, practitioner support groups and occupational health services accessible to all dentists are already desperately required. These services will need to be developed and funded, accessible to all and not reliant on locality or employment status.

Do you have any advice for newly qualified women dentists who www.apexezine.com

are unsure of what career path to choose within dentistry?

Judith Husband: A wide variety of experience at the beginning of a dentist’s career is very valuable both in gaining new skills but also deciding on a future path. Specialisation is a very popular aspiration amongst young dentists.

This is commendable however careful planning is required to ensure the correct specialty is chosen to result in a successful and happy long-term career.

I would urge all young dentists to be fully informed of developments in dentistry both clinically and also in the wider practising environment.

Get involved and active within the profession as early as possible. Local networks such as study groups, LDCs and of course professional organisation including the BDA provide individual support and valuable information. Being a dentist is more than just treating patients 7

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improving healthcare provision and the future of our profession should be an integral aspect of every dentist’s work.

Who have been your mentors in your career?

Judith Husband: Every dentist I have had the pleasure of working with has acted to some degree as a mentor, actually not just the dentists but also dental nurses and practice managers.

One dentist in particular provided me with support, knowledge and opportunities. Alison Lockyer was my principal after completing GPT. This was my first associate position with full business freedom and Alison also introduced me to prison dentistry.

Perhaps not a mentor in the dictionary sense of the word but a person I owe everything to is my mother who sadly died in April following a very short illness. Her enthusiasm and “have a go” attitude ensured my career aspirations would never be limited by lack of self-belief.

What do you enjoy about working in the dental profession?

Judith Husband: Helping patients and educating them to improve their health is a significant factor but without doubt it is the fellow dental professionals within my teams that have made working in dentistry enjoyable. Contributing to wider developments in the profession through my work with the BDA is also both rewarding and a challenge.

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If you could change three things about the dental profession in the UK what would they be?

Judith Husband: The dental profession must be more united and act together for the benefits of patients and its members. Huge challenges lie ahead with changes to the delivery of care against a backdrop of continued economic downturn.

Accurate workforce planning is essential. Training the right number of dentists and DCPs to provide a stable, contented workforce for the future. The significant burden of debt incurred completing the undergraduate dental course needs to be recognised; whilst there is no guarantee of employment for any graduate, the dental profession and government must be honest about future prospects.

What do you most look forward to next year?

Judith Husband: Next year will be another difficult year for many in the profession with “efficiency savings”, even cuts to NHS budgets and private practices will continue to face the impact of the recession upon their patients.

My hope is that 2012 will finally see the removal of the ban on HIV positive dentists from practising clinical dentistry. This may not seem that relevant to many dentists but we all quite rightly treat any patient in need, no dentist should ever be discouraged to seek diagnosis and treatment for fear of losing a career.

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Tracey Bell

Dentist, entrepreneur, Isle of Man

Looking back at 2011, what are three highlights that stand out to you in regard to your own work/ career situation?

Tracey Bell: I would love to give you three highlights, however, one thing over shadows the lot: Divorce.

Yes, those who aren’t in the know- I went through my divorce and after a three year rollercoaster ride, I am more than glad to say: ‘I survived’ and so did my businesses. For 2011, that is one big highlight. Divorce was the onset of a learning curve; it taught me about individuals, work colleagues, friendships, friends and the ability to survive. It also gave the businesses an opportunity to experience all of this as well.

From Forensic Accountants to stellar contributions and the value of a brand, my company and I have had a complete overhaul and scrutinised right down to the last paperclip. I am glad to say that through adversity, I now have a first class, well serviced business that from 29th September 2011 –when my papers came throughit turned a corner, switched on the engines and declared: ‘I’m back’. So, let’s start motoring.

List some of the dental events you attended this year (and enjoyed) and why?

Tracey Bell: I personally think events are the perfect way to meet and greet dentists, reps and individuals outside www.apexezine.com

of the clinical environment. I always attend the BDTA Birmingham. Why? To catch up on technology, see the development of equipment and plan for next year. One of my passions is public speaking, I have presented at a number of independent seminars, as I love to teach and showcase what I know, which mistakes I have made and, if possible, help where I can. In terms of practices, I have had the opportunities through my non-surgical businesses to visit a number of other practices in the UK. Basically, down to business, pleasure, building and collaborating business and long-term measures to help each other in the coming years, something I hold a lot of belief in.

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What is your opinion on the amount of young women choosing dentistry as a career nowadays?

Tracey Bell: Dentistry as a career choice, for a woman or man, is an excellent choice. From a woman’s point of view, it brings independence, security, flexibility and great career opportunities. As a woman, businesswoman and a mother, I have been lucky enough to enjoy all of the above because I am a Woman in Dentistry. I also hold in high esteem that women in dentistry have a great many advantages - but there are also the disadvantages that come with this. Historically, the field was male dominated, today; this has certainly been turned on its head.

For young women in dentistry I think that huge opportunities exist - the same for young men. Dentistry, although a medical necessity and need, is a lifestyle choice as well. Dentistry has changed and, as in any profession, it is up to the individual to stamp their mark, interpret it as they think in an ethical and professional manner.

Do you have any advice for newly qualified women dentists who are unsure of what career path to choose within dentistry?

Tracey Bell: Choices are dependent on experiences and I would urge any dentist to think: ‘Nothing Is Impossible’.

A career pathway in dentistry can be diverse or as uniform as the individual wants. I would advise any young dentist to, primarily, never hold back and always explore, ask and pick up the phone to enquire and experience 10

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what the industry can offer you. There are plenty of established dentists out there who have lived, and learned, and had fantastic careers and experiences.

They would certainly help advise and impart great knowledge and a wealth of experience of ‘how they did it’ and how they are still doing it- like me, even at 41.

“Dentistry has changed and, as in any profession, it is up to the individual to stamp their mark, interpret it as they think in an ethical and professional manner.”

Who have been your mentors in your career?

Tracey Bell: I am a great believer that mentors are important and in my case my family, especially my mum and dad, are great mentors. Their work ethic, their ability to survive adversity and their positivity - I have all of their traits and believe it is an inherent attribute I am fortunate to have.

Clinically, I have to thank Trevor Burke, Nairn Wilson, Nick Grey and Tony Cleehugh from Manchester University, for ‘believing’ and probably understanding how fortunate I was to be there. Mentoring is useful, however I believe that the individual is the important factor to drive any business, life and to aid development, socially and professionally.

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Create æ-motion with flowables from GC. G-ænial Flo & Universal Flo Handless like a flowable – Perfor Performs rms lillike k a restorative. ke

What do you enjoy about working in the dental profession?

Tracey Bell: I love diversification, art, and the ability to be able to help and make a difference. Yes, with a drill but also on an individual basis. I love to communicate with patients, friends and colleagues. I love to spend and I value even five minutes with another person. I believe dentistry allows me to do this.

If you could change three things about the dental profession in the UK what would they be?

Tracey Bell: NHS. I consider that huge changes are needed in the NHS. I see more and more patients arriving at the age of 23 requiring countless extractions, dentures, emergency treatments- the list goes on. This is something that I have never experienced- even when I qualified in 1993.

I left the NHS in 2000, but still see many patients who refer to me that have been a ‘NHS patient’- always with many problems. Yes, it is the system.

As a Healthcare Professional I would 12

love the day to come where we all as a profession witness great change and a great improvement in oral health and care across the country.

Communication & Collaboration.

Simply I would like to see unity collaboration on an individual basis amongst dentists. Dentistry is about friendship, trust and I believe: working together.

Regulation. Not mentoring organisations individually, but more governing body and regulatory powers should be established for a complete revamp. I believe that the system of complaints and control need to be revised and ‘real’ individuals appointed to give a true representation and council on the profession.

What do you most look forward to next year?

Tracey Bell: I look forward to growing my business, personal life for me as an individual but also for my team. People who know me, know that I love life, people and simply being here. I cherish my health, time and happiness and in 2012 I hope all the boxes are ticked.

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GC EUROPE N.V. Head Office Tel.+32.16.74.10.00 info@gceurope.com com http://www.gceurope.com

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Rising trend of bespoke ezines ApexEzines a division of ApexHub has seen a marked rise in the demand for bespoke ezines this year due the level of branded content they provide and the technology that encourages readers to engage and interact.

“The ezine format is an excellent way to get your message and branding across to your audience,” says Marita MacDonald, chief content officer at ApexHub and manager of all the ezines. “A key aspect of the ezine concept is that you engage your readers with relevant content 14

and allow them to see your brand in a new light – one in which you’re not necessarily trying to sell them something,” she continues. Businesses and individuals who have had ezines created for them have found them to complement their other online channels such as social media, email marketing and websites. Another benefit is the ability to measure and track reader habits online, which helps with planning future issues once you know what attracts your audience the most in terms of content.

Apex volume 3 issue 12

Ezine projects undertaken have included a biannual Dental Practice Guide for dental manufacturer W&H which focused on topics around socially aware dentistry. Another popular title is MID, a minimum intervention dentistry ezine for GC Europe that published content around MI research and products. The Eastman Dental Institute, top postgraduate training facility in the UK, has also opted for an ezine as a way to connect graduates from around the world and update them on news and courses.

Individual business people have also chosen this format of communication as a way to update their audiences on their speaking engagements, offers and latest articles. These have included clinical photographry and treatment coordinator trainer, Laura Horton, social media healthcare www.apexezine.com

expert, Rita Zamora and dental business coach, Chris Barrow.

Online engagement will continue to be a priority for businesses and brands in

“The ezine format is an excellent way to get your message and branding across to your audience” 2012 and the more innovative and user friendly your format, the better the chances of building a highly interactive audience across all marketing channels.

For more information visit apexhub.com 15

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At a Glance Ps Product Spotlight

GC Gradia Core & Fiber Post ●●

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All-around system with limited steps allowing easy realisation of complete core build-up in 1 appointment Optimal handling: ideal thixotropic consistency for luting and core buildwith only one material. Once cured, the cutting feeling is similar to dentin for an easier preparation Secured and simple adhesion: no etching needed with the self-etching dual cure adhesive. Optimal cure is achieved through contact cure and unique light transmission from top till bottom of the posts The highly filled (75%) composite core and the post made of densely arranged glass fibers are both contributing to form a strong support for the prosthetic element

GC Gradia Core & Fiber Post Are you looking to combine simple clinical solutions and time saving with the best performances and aesthetics for your core build-up restorations?

With Gradia Core and Fiber Post, you can simplify your daily work with an intelligent system.

From now on, offer your patients

enduring restorations which are more conservative and gentle on the remaining tooth structure. Providing an aesthetic and fully adhesive solution, the composite core build-up requires minimum tooth preparation and combines with small diameters of posts for minimum root space enlargement.

And with a modulus of elasticity much closer to natural tooth than metal core restorations, the stress on the remaining tooth structure is minimised. The final core build-up is therefore preserving the tooth and avoiding risks of root fracture while also ensuring a strong support for the prosthetic.

Gradia Core is using a dual cure self-etching bonding agent which cures securely and thoroughly, in both curing modes in order to achieve high bond strength. In addition, it contains a polymerization accelerator that helps the curing of the core paste when it comes into contact at the interface.

With excellent light guidance, the GC Fiber Posts further ensures the polymerization of the paste, even in deep post spaces.

Gradia Core contains 75% dense

+ visual

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vakmentor accomodates all learning styles

Tracked personal development Intuitive, self-paced learning Entertaining education Virtual mentoring Earn CPD

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fillers, giving the material a high compressive strength and enhancing its resistance to occlusal pressure. On the other side, GC Fiber Post offers a high density of glass fibers (77% in weight) with no structural defects, ensuring a high resistance to load.

Finally, there is a system that makes life easier by combining luting and core

build-up into one product with ideal handling properties. The comfortable dispenser and cartridge system with elongation tips makes it possible to precisely apply the composite both in the canal and on the coronal tooth preparation. The Radiopacity superior to enamel allows for easy control of the restoration in time.

Application of Gradia Core & Fiber Post Pictures courtesy Docteur D’Incau, France

1. PREPARE a. Prepare the canal, leaving 4 mm Gutta Percha. b. Try in the post and check its adaptation with an X-Ray. Adapt to the desired length (1 to 2mm of occlusal surface of restoration) with a diamond disk. c.

Clean the post in alcohol, dry and apply Silane coupling agent like Ceramic Primer A&B; wait 1 min and dry.

2. BOND a. Clean the root canal, rinse and dry with paper point. Mix Gradia Core Self-etching Bond A & B; apply the mixed self-etching bond to the prepared root canal and coronal tooth

structure and leave it for 30 seconds. b. Blow dry (medium air pressure) and light cure all faces for 10 seconds.

3. LUTE a. Dispense Gradia Core into the root canal, seat the post and light cure for several seconds.

4. BUILD a. Continue dispensing Gradia Core around the post to form the core. Light cure the surfaces for 10 seconds each. b. Once set, prepare the core in the standard technique. If chemo-polymerization is used, final finishing can start after only 5 minutes.

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Reading material Further reading links Video clips Animated examples

visual

These learners need to see the teacher's body language and facial expression to fully understand the content of a lesson. They tend to prefer sitting at the front of the classroom to avoid visual obstructions (e.g. people's heads). They may think in pictures and learn best from visual displays including: diagrams, illustrated text books, overhead transparencies, videos, flipcharts and hand-outs. During a lecture or classroom discussion, visual learners often prefer to take detailed notes to absorb the information.

Visual Learners:

learn through seeing...

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Innovation Station Martin Jablow DMD, practices general dentistry in a group setting in Woodbridge, NJ. He enjoys promoting the use of technology in the dental office to improve efficiency and patient care. As a partner in Dental Technology Solutions, he lectures and writes articles on the use of technology to enhance the practice of dentistry.

Read his blog at dentechblog.blogspot.com

Q: What changed the way you practiced in 2011?

A: As usual nothing remained constant in my practice in 2011. I really enjoy writing this column as I get to do a retrospective of the past year and see the changes technology makes in my practice. There were some new technologies that have supplemented and replaced my previous way of doing things. The big thing about 2011 is that I can now say there is nothing that I do on a regular basis that I was taught in dental school. This is not to say I don’t

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fall back to the tenents of my dental school education at times but those teachings are not the first way I do things in 2012.

So what was the last procedure to change in my office? It was extractions. I acquired the Golden Physics Forceps. Physics Forceps are useful for achieving atraumatic extractions of all teeth. The unique design delivers a powerful mechanical advantage by employing an efficient first-class lever. Think of it the same way you take the top off a beer bottle with an opener.

When the periodontal ligament is traumatized with the Physics Forceps or elevators, hyaluronidase (hyaluronate glycanohydrolase) is released. These forceps in many cases make extractions easier for me and less traumatic for the patients. In this age of regularly placing dental implants the need to preserve bone is paramount. These forceps help preserve the buccal plate and have Apex volume 3 issue 12

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Expert panel discussions Voice prompted tests

auditory

They learn best through verbal lectures, discussions, talking things through and listening to what others have to say.

Auditory learners interpret the underlying meanings of speech through listening to tone of voice, pitch, speed and other nuances. Written information may have little meaning until it is heard. These learners often benefit from reading text aloud and using a tape recorder.

Auditory Learners:

learn through listening...

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made extractions less stressful for me.

I am a big fan of the use of magnification and illumination in the practice of dentistry for use in every procedure. I have been wearing surgical loupes for years and have gone on a progression from tethered halogen lamps to battery powered LEDs along with increasing my magnification.

The tethered halogens would give me whiplash when I would forget to remove the light from my head as I exited the operatory and were expensive to repair the broken fiber. I was very happy to switch to the smaller and lighter LEDs. Initially the battery packs were large but they have since come down in size and weight. The only problem with these portable LED lights and batteries for me was the cord was like a magnet for any doorknob or object jutting out in my office. I would occasionally watch the battery back fly down the hallway as it snagged on something. This year I acquired the Orascoptic Freedoms surgical loupes.

They are surgical loupes with a cordless LED light attached. I chose the 4.8 magnifications. They are available in magnifications from 2.5x to 4.8.

The battery packs are attached to the back of the eyeglass frame. I love the fact I can now wander around the office with them on or dangling from my neck and I no longer have any 22

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errant battery packs being launched around the office.

The face of oral cancer is changing and I decided to step up my ability to find pathology in my patients so I acquired both a Velscope and an Identifi.

These devices assist me through the use of fluorescent technologies to help identify any areas of potential dysplasia in the mouth. So why did I need both? Because one is an extra oral device and the other is an intraoral device. Many HPV related oral pharyngeal cancers are located far back at the base of the tongue. This can make visualisation difficult. Each device has its benefits and weakness and I chose both to offer my patients all the possible tools to assist in identifying pathology. I can say that both of these devices have assisted me in detecting potential pathologic areas that required further follow up and that I may have previously missed with a standard white light examination. In retrospect it is not that the areas were not visible under white light exam but both the Velscope and Identifi helped to highlight these potential pathologic areas and assisted me in their visualization.

The use of cone beam 3-D imagining technology is assisting me in the treatment planning of Apex volume 3 issue 12

Interactive quizzes Activity-based outcomes Emotive engagement Humour-triggered learning

kinaesthetic

Tactile/Kinaesthetic Learners:

Tactile/Kinaesthetic persons learn best through a hands-on approach, actively exploring the physical world around them.

They may find it hard to sit still for long periods and may become distracted by their need for activity and exploration.

learn through , moving, doing and touching...

vakmentor.com

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implants and retreatment of failing endodontics. I have not yet purchased a cone beam machine but I hope to do so in the future. I am lucky that there is a mobile cone beam scanning service available in my area that will either come to my office or the patient’s home or office to take the scan. This makes it easy to use the latest imaging technology without the capital outlay at this time.

I had never done orthodontics in my office but I started doing short term orthodontic treatment using the 6 Month Smile program in 2011.

The excellent 2-Day course gave me the confidence to try orthodontics.

This easy to use system has allowed me to enhance the smiles of many of my patients in a way I had never been able to do before. Treating cases has been easy and assistance from the 6 Month Smile website has been excellent. The orthodontist that I refer to is also happy because I have a better understanding of orthodontics

and have referred additional cases to him that are outside the 6 Month Smile protocols and beyond my capabilities.

The last thing that changed the way I practice in 2011 has been Kerr’s Sonicfill. Sonicfill is a specially formulated bulk fill composite and handpiece combination. Through the use of sonic forces the composite changes from a very high viscous state to a lower one.

The composite comes out of the handpiece and is fluffy. It reminds me of a soft ice cream machine dispensing my favorite flavour. As the sonic energy dissipates the composite starts to harden making for very easy carving of the composite. You can place up to 5mm increments into your preparations and light cure. This bulk filling greatly reduces the time and effort to place posterior composites.

Watch the Sonicfill video for how easy it is to place the composite restoration.

So these are the new technologies and procedures that I have incorporated into my practice in 2011. What new technologies will be incorporated into my practice in 2012? I have some ideas of what is coming down the road in my practice and I am sure I will be in for a few surprises. I have a whole year to see what new technologies enhance my practice of dentistry and make the 2012 list of things that changed the way I practice.

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