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E S S E N T I A L K N OW L E D G E F O R D E N TA L P R O F E S S I O N A L S I N S CO T L A N D
D E C /J A N 2 0 2 2 RRP £5.50
Net Zero Dentistry
A new initiative
that will save you
money …and help
save the planet
see p40
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DECEMBER 2021 / JANUARY 2022
E N S U R E YO U CO N T I N U E TO R E C E I V E S COT T I S H D E N TA L M AG A Z I N E
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V i s i t W W W. S D M A G .C O. U K / E M A I L - S U B S C R I B E
04 Editorial
07 Insider
09 News
FEATURES
24 Linking paediatric dentistry
and orthodontic treatment
9
26 Orthodontics; an opportunity
for health improvement
30 Cracking the molar mystery;
timing is everything
36 Transform your approach
to practice safety
44
38 Remembering Professor
Ruth Freeman
40 Introducing Net
Zero Dentistry
42 Clyde Munro - leading the
charge on sustainability
44 The story of Running
Scotland 2021
CLINICAL
50
Medical emergencies
in practice
PROFESSIONAL FOCUS
72 Meet the Representatives
84 Product News
MANAGING EDITOR ADVERTISING © Connect Publications
David Cameron Ann Craib (Scotland) Ltd
david@connectmedia.cc Tel: 0141 560 3021 The copyright in all articles
ann@connectmedia.cc published in Scottish Dental
EDITOR
Will Peakin DESIGN magazine is reserved, and
Tel: 0141 560 3019 Felipe Perez and Stuart Mathie may not be reproduced
editor@sdmag.co.uk without permission. Neither
SUBSCRIPTIONS the publishers nor the editor
Stephanie Koetsier necessarily agree with views
Tel: 0141 560 3019 expressed in the magazine.
steph@connectmedia.cc ISSN 2042-9762
Dec/Jan 2022 | 3
Editor
Will Peakin editor@sdmag.co.uk
Follow Scottish dental on Twitter at: @ScottishDental
‘What about if we
make it £300?’ It pays to help someone do their research, apparently,
but I’d welcome readers’ thoughts
I I COULD HAVE GONE ALL WOODWARD
nvitations for me to connect with people on LinkedIn
are not a regular occurrence, I must admit; more what
you would describe as occasional. In most instances
there is a valid reason; a PR who’s been in touch
separately about a client, perhaps, or a source I have
spoken to for a story. Every now and then, though,
& BERNSTEIN AND HEADED OUT TO
it seems to be completely random, with no obvious
reason why we should be connected.
Recently, however, in the space of a fortnight, I have been
A MEETING WITH DEEP THROAT
asked to connect by two people – apparently unconnected researcher – to connect on LinkedIn. Then, on the same
themselves, but in eerily similar lines of work. One describes day that £300 was being waved in my face, an email from
himself as a ‘Healthcare Marketing Consultant & Business the second researcher arrived: “Hello,” he wrote. “Hello,” I
Analyst’ and the other as a ‘Healthcare Researcher’. thought to myself. “I have a client,” he said, “who would like
The former is based in Europe, the latter in the UK. I didn’t to interview (for 1 hour) someone who could be described as a
accept either invitation and, in hindsight, perhaps should have ‘Dental Journalist’.”
clicked the ‘Ignore’ button at the time. “Ok,” I said out loud to myself, brow furrowing slightly. “I
Because, there then followed emails from both. think I can accept that description. I’ve been called worse.” He
The Europe-based researcher said he was conducting a study continued: “They would be happy to pay £300 to someone who
on “filling materials”. Would I be willing to take part in a “web- could do it this week.”
assisted telephone interview” that would take about an hour? Hm, was this a separate offer or were the two connected?
He added: “We would like to offer you a 200 GBP compensation The second brief was certainly different; it didn’t mention
for your time (PayPal or bank transfer), paid immediately after anything about “filling materials” and would range across
completing the interview.” a different set of topics, such as – and these are his words –
I wrote back: “Thanks for the invitation, but it’s not “Biggest innovations in dentistry in recent years and on the
something I am able to do.” Twenty minutes later, he horizon today … Biggest changes observed in last two years in
responded: “Thank you and absolutely understand your answer. the areas of interest at conferences, seminars … COVID related
Nevertheless, allow me to insist because this discussion is rather … Non COVID - within Dentistry and adjacent areas connecting
‘open’ on the subject of dental medicine, and to talk about…”, with dentistry, eg sustainability … What see coming in the future
and he went on to list a series of topics for discussion. as new focus areas … At home oral care – where does it feature in
“We are not looking for any info about you or your news this world”.
organisation and you are always free to decline any given I’ve never been good at maths, but if it was the former then,
question,” he said. “I would be extremely grateful if you could by my calculation, I now had the opportunity to earn £600 for
consider participating, your background and expertise will be two hours ‘work’. Don’t snigger; I am a ‘Dental Journalist’,
very useful to us and participation is absolutely anonymous after all.
(first name use only). Would you be kind to consider I thought long and hard about the offer(s). Well, that’s not
participating? I would be extremely grateful!” true. I just thought, this is weird. Or is this ‘a thing’ in the
I thought silence would be the best option. Three healthcare sector; paying journalists for their insights?
days later the same email arrived in my inbox, except You tell me. I could have gone all Woodward & Bernstein and
for one change: “We have increased compensation hit the ’phones, or thrown on the jacket of my corduroy suit as
to 300 GBP as to reflect the high value of your I headed out to a meeting with whoever is the Deep Throat of
involvement.” the healthcare market research world.
He gave me some time to think; a full 11 days, to be But I wrote this instead; thought I’d crowdsource it.
precise. Then another email: “Allow me getting back
to me whether you could still consider participation.” Correction: In a feature (‘Looking forward’) in the October edition of
Despite the fractured English, I understood he was Scottish Dental, we wrongly described Graham Smith, Chair of the Scottish
keen that we should have that discussion. Public Dental Services Committee, as a consultant oral and maxillofacial
In the meantime, however, I had received the surgeon. We apologise for this error, which resulted from information
provided to us by a third party.
second invitation – from the UK-based
4 | Scottish Dental Magazine
June 2021 | 5
Insider
Arthur Dent is a practising NHS dentist in Scotland
Got a comment or question for Arthur? Email arthurdent@sdmag.co.uk
A turning point
Let’s get the next wave of professionals trained
and ready to upgrade our profession
W
e are near at critical mass. People now know this will end in April. Time to twist. Anyone
I talk to have concerns about what waiting to retire will do so. This will have been delayed
is coming and a certainty there will (if they have any sense) and I suspect anyone who has
be change. I’m not going to continue been swithering will see the workload and difficulties
harping on about COVID and its coming and jump ship. Anyone who has enjoyed a more
effect, but it plays a role here. relaxed pace and fewer hours and who can afford not to
Dental professionals’ working patterns have changed. go back, will work part-time.
For some a little, for many, very dramatically. In the last The privatisation of dentistry is rearing its head
20 months, many of us have worked in a more flexible again, too. Some practitioners will not wish to return to
and, perhaps, less time pressured way. Albeit, without NHS care, particularly with the SDR and its inevitable
financial incentives to work faster or longer and without ‘hamster’s wheel’. They may even change their whole
performing our usual level of activity. While there are practice business model to private care. Thereby, not
many reasons for this and reasons that may not change, only a ‘person power’ reduction but a loss of NHS dental
I want to explore what’s likely to happen and the impact infrastructure. This will be a huge challenge to the
on the profession in the next five to 10 years. I see huge workforce. We will need to adapt to overcome it. Supply
challenges to our ability to cater for the demand. and demand economics dictate that, if the Scottish
Firstly, we have a backlog. This will lead to increased Government wants NHS dentistry, they’re going to have
volumes of work, increased complexity and increased to fund it. If we suffer, what I fear could be a 20 per cent
time required to treat people. This is not a new concept. plus reduction in the workforce available to perform
We won’t know the magnitude until we start really NHS care, we are going to need to change the way we
addressing it and we don’t know how long it’ll take to get work. We will need more people: most likely in the form
through. What we do know is that it’s coming, and it will of therapists. They’re quicker to train. Quicker to fill the
be very challenging to our workforce. void: should I say cavity? If this is the way forward,
Secondly, free dentistry on the NHS will increase we’re going to need to adapt our style. More consultant-
demand. Again, it’s not certain how this will affect things. led care with other providers involved on prescription.
However, I suspect the effect will only really be felt The funding model will need to shift too. Therapists
after the first wave of the backlog is dealt with and the can’t perform enough care using the SDR to make
second phase of more advanced treatment (rather than them viable. If we need many more of them, we’ll need
stabilisation) begins. I think this will be two to three years bigger infrastructure. Investment in infrastructure is
down the line, when we’ve done the basics and the Scottish expensive and risky without a well-established system
Government has let more age groups access free care. and funding model.
The final and most complex point is workforce. We’ve How do we get that? We have to adapt what we’ve got
already lost a lot of DCPs. Registration with the GDC is at to suit. In my opinion, a whole new model will create too
an all-time low. Many will be concerned about the risk of many risks. Practices (whether independent or corporate)
further disruption to normal dental work and feel their won’t invest until they get a handle on the system and
jobs may be at risk. The inflationary pressures on wages banks will make lending more difficult without a track
and a continued agenda to lift the Living Wage bring record of profits. There could be a decade of delayed care
enormous pressure to bear on practices to pay top rates, in dealing with the backlog; loss of staff and dentists; and
reducing the workforce further. Simpler, less stressful a new system to get used to before there’s any reasonable
jobs paying similar money will attract people from the benefit to the patients and the profession.
profession. It was not my intention in this article to create a
A younger cohort of dentists, keen to strike a more doomsday scenario. I’m simply expressing what I think
reasonable work/life balance, will not fill the shoes of is about to happen to our profession. I don’t even have
older workaholics. The pressures, in terms of increased much of an answer. What I would urge is that we think
volume and complexity, and inflation-squeezed margins seriously about what will need to happen and invest in
are likely to promote the ‘life’ and decrease the ‘work’ people and our infrastructure. Many of these changes
quotient of their week. Furthermore, there’s a huge drive were happening in the wider society, not just dentistry.
towards speciality in younger dentists. While benefitting However, Covid has pushed it to the fore and accelerated
the skills of the profession, the time taken to learn our change. We must be proactive to ensure the best care
and perfect them, and the inherent decrease in overall for our patients and that we don’t burn out trying to wade
productivity, adds to the tension. through the next decade. Turn on the training tap now.
Then there’s the rest of us. As long as the financial Get the next wave of professionals trained and ready to
support measures are in place, people will stick. We upgrade our profession.
Dec/Jan 2022 | 7
NEWS
Government plans risk
‘catastrophic impact’
Emergency support will be withdrawn from 1 April 2022
NEW STANDARD operating procedures for on one of two pathways, given the likelihood questions in identifying symptoms of the
dentists, published at the end of November1, of them carrying a respiratory illness. It Omicron variant.
will not restore access to dentistry for the replaces what amounted to a ‘one size fits David McColl, Chair of the British Dental
public to pre-COVID levels, the British all’ approach that has been in place since Association’s Scottish Dental Practice
Dental Association has warned. the outset of the pandemic, which reduced Committee, said: “We are still facing massive
With high levels of COVID-19 and other capacity across the service. backlogs, saddled with a system that is unfit
seasonal infections, and the emergence The new model was unveiled on the for purpose. New protocols will not soften
of the Omicron variant, the BDA said the same day last month (29 November) that the blow of plans to pull away emergency
procedures will also “do nothing to avert the the Omicron variant was confirmed to be support at this challenging time for
potentially catastrophic impact of Scottish present in Scotland. Even setting aside any infections and try and return to a ‘business
Government plans to withdraw pandemic potential spike in COVID infection, large as usual’ model during a pandemic.”
support from NHS practices”. numbers of patients are likely to end up More than 3.5 million NHS dental
Humza Yousaf, the Cabinet Secretary for on the respiratory pathway given typical appointments have been lost in Scotland
Health, wrote to all NHS dental teams in patterns with seasonal flu and the common since the first lockdown.
October stating that all emergency support cold, said the BDA.
will be withdrawn by 1 April 2022, as part It is anticipated dentists may opt
of a new policy to return to what the BDA for a ‘safety first’ approach and use flexibility 1
www.nipcm.scot.nhs.uk/winter-2122-
described as the “low margin and high- within new protocols to maintain existing respiratory-infections-in-health-and-care-
volume” service operating pre-pandemic. protective measures, particularly given settings-infection-prevention-and-control-ipc-
Patients in Scotland will now be placed the uncertain effectiveness of triage addendum
8 | Scottish Dental Magazine
Oral health team’s
walk to raise
mouth cancer
awareness
In Lerwick, the town hall was lit up
in blue as part of the campaign
THE NHS ORAL health improvement team found that more than one-in-four (27%) do As part of Mouth Cancer Action Month,
in Shetland embarked on a walk around not know any of the potential early warning Denplan and the Oral Health Foundation
Lerwick last month to raise awareness of signs for the disease. urged people to learn more about mouth
mouth cancer for Mouth Cancer Action More than 2,700 people in the UK lost cancer. You can find more information
Month’s Blue Wednesday. their life to mouth cancer last year – a 48% on mouth cancer by going to www.
Their initiative came as new research rise compared to a decade ago. dentalhealth.org/mouthcancer and by
by the charity and Denplan, part of With almost half (45%) of all mouth following the campaign on social media via
Simplyhealth, showed that almost two-in- cancers diagnosed in stage IV, the most #MouthCancerAction.
three (64%) have never checked themselves advanced phase of the disease, the Oral In Lerwick, the town hall was lit-up
for signs of cancer in or around the mouth. Health Foundation is appealing for more in blue as part of the Shetland oral
Carried out as part of November’s Mouth people to routinely look for signs of health improvement team’s efforts to
Cancer Action Month, the investigation also mouth cancer. raise awareness.
Dec/Jan 2022 | 9
NEWS
Edinbrugh dentist wins Profession’s
opinion of
international award GDC hits
new low
Awards recognise visionary treatment concepts and The results of research
outstanding achievements of women in dentistry worldwide undertaken in 2020, designed
to better understand
professionals’, students’ and
DR EIMEAR O’CONNELL, Clinical Workflow; Digital other stakeholders’ perceptions
principal dentist at Bite Dentistry Patient Communication; of the General Dental Council
in Edinburgh, was among the Innovative Infection Control (GDC), and test understanding
winners at this year’s Dentsply and Prevention; Management of of the regulator’s role, were
Sirona Smart Integration Awards. Dental Equipment; and Smart published last month.
Dentsply Sirona presented the Lab-Dentist Cooperation. The results indicate that
second iteration of its awards to Dr O’Connell was a winner overall perceptions of the GDC
women in dentistry last month. in the Smart Lab-Dentist were more negative (58 per
With the award, which was Cooperation category. cent) than positive (21 per cent)
launched in 2019, the company Dr Terri Dolan, Vice President in 2020, and that views
recognises visionary treatment and Chief Clinical Officer at amongst the dental team have
concepts and the outstanding Dentsply Sirona, said: “The worsened from when the same
achievements of women in significant interest from women questions were posed in 2018.
dentistry worldwide, while worldwide shows us how Conversely, views of the GDC
creating a network of women in important awards like this are. improved slightly amongst
dentistry. The 2021 applicants They recognise achievement and dental students and other
came from nearly 40 countries. boost professional confidence, stakeholders.
Dentists and dental helping us promote gender parity The report also highlights a
technicians from around the in dentistry to support the next lack of universal understanding
world submitted their ideas for generation of female leaders.” of the regulator’s role, with
integrating digital technologies by 90 nominees, who had been almost half of all professionals
into the practices and dental selected by an international jury surveyed believing the GDC was
laboratories of the future of Dentsply Sirona executives All winners of the Smart responsible for setting clinical
and improving the treatment and renowned external experts. Integration Award 2021 can be standards, which the GDC
experience for patients. The Winners were awarded found at: www.dentsplysirona. pointed out – is not the case.
award ceremony was attended in five categories: Digital com/smart-integration-award “The findings don’t make
comfortable reading,” said
Stefan Czerniawski, the GDC’s
Executive Director.
GC symposium addresses
Ian Brack, the GDC’s Chief
Executive and Registrar, added:
“The findings in this report
challenges of ageing population illustrate some of the
frustrations felt in the sector
and where we can direct our
IN SEPTEMBER, the Continental College London, UK), was opened increases with age. The first focus efforts.
European division of the by Prof. Jo Frencken (Radboud should always be on prevention “The pandemic has thrown
International Association for University, Netherlands) with and non-restorative treatment. up new challenges for us all and
Dental Research (CED-IADR), consensus recommendations for However, when the treatment fails exposed some historic ones,
together with the association’s the primary and secondary or symptoms arise, restorative not least the need for those we
Scandinavian division (NOF), prevention of root caries lesions treatment is unavoidable. regulate to understand our role
welcomed more than 500 and their operative management. The series of lectures was and our shared responsibilities
participants from 47 countries Being a founding father of closed by Dr Gerry McKenna in ensuring patients are
all over the world to the 2021 atraumatic restorative treatment (Queen’s University Belfast, UK), protected, and public
hybrid CED-IADR/NOF Oral (ART), he emphasised its ease of who provided a broad overview on confidence is maintained.”
Health Research Congress in application and effectiveness of its ways to optimise treatment for Reflecting on the findings
Brussels, Belgium. use in modern caries management. older adults. In addition to that dissatisfaction with fitness
The event, held over two and a According to Prof. Frencken, ART preventive care and preservation of to practise performance was a
half days, offered a broad scientific with high-viscosity glass ionomer natural teeth, he recommended significant contributor to
programme consisting of cement has been proved to be a that tooth replacement follows a negative perceptions, Brack
state-of-the-art symposia, keynote successful approach to managing functionally oriented approach. At continued: “I am accountable
lectures and presentations by root surface caries. the end of the day, Prof. Banerjee for performance of the GDC
researchers from Europe and The next speaker was Prof. Falk moderated a Q&A session. and very clear about what has
beyond. On the first day, GC Europe Schwendicke (Charité— not gone well and what we’re
hosted a symposium focusing on Universitätsmedizin Berlin, doing about it.
the challenges of an ageing Germany), who pointed out the For further information contact “I am determined that we
population with respect to cervical importance of cost assessment of GC UK on 01908 218999, email will make the improvements
lesions. The symposium, chaired treatment. The prevalence of info.uk@gc.dental or visit we can.”
by Prof. Avijit Banerjee (King’s non-carious cervical lesions www.gceurope.com
10 | Scottish Dental MagazineNASDAL DCby1 Practice of the
Year Award 2022 launches
Providing access to dentistry for young people is now top of the agenda
THE launch of the 2022 NASDAL Dental
Check by One Practice of the Year award
has been announced by the Chairman of
NASDAL, Nick Ledingham. The award
recognises a practice that has successfully
introduced the British Society of Paediatric
Dentistry (BSPD) Dental Check by One.
The aim of the campaign is to increase the
number of children who access dental care
aged 0-2 years.
It seeks to highlight excellence in the
provision of oral care and prevention in
children and showcase the opportunity to
achieve a real business improvement. Credit
is given to applications from dental practices
with evidence supporting their contribution
to the overall health of their community. The Claire Stevens, spokesperson for BSPD, Practices interested in entering should
award will be presented at the BDIA Dental added: “The last 18 months have been tough visit www.nasdal.org.uk/award. Entries must
Showcase on 25 March 2022. for dental practices but as dentistry builds be submitted before 5pm, 31 January 2022.
Nick said: “We look forward to hearing back following the enforced pause, providing The winner will receive £1,000, a trophy, and
how the entrants have reached out to their access for children and young people will be the right to use the NASDAL Dental Check
communities and engaged with families.” top of the agenda.” by One Practice of the Year 2022 title.
Dec/Jan 2022 | 11NEWS
Scots dentist to be Rotary
International President
Dundee University graduate calls for people to serve and help others
GORDON McINALLY, Congregational Board, and member for 37 years and plans
a graduate of dental surgery at commissioner to the church’s to boost member engagement to You can read more about his
the University of Dundee, has general assembly. help grow the organisation. appointment here: www.bit.
been selected to serve as A Rotary member since He complimented the Rotary’s ly/31lYzp6. He is the second Rotary
2023 Rotary International 1984, he has been president ability to adapt technologically president from Scotland.
President. and vice president of Rotary during the COVID-19 pandemic, Rotary brings together a global
Mr McInally, who owned International in Great Britain saying the approach should network of volunteer leaders
and operated a dental practice and Ireland. He has also served continue and be combined with dedicated to tackling the world’s
in Edinburgh, was the Rotary International as a the best of traditional practices humanitarian challenges. Rotary
chair of the East of director and as as Rotary seeks to grow and connects 1.4 million members of
Scotland branch of the member or chair increase engagement. more than 46,000 Rotary clubs in
British Paedodontic of several committees. “We have learned there more than 200 countries and
Society and has held He is currently an is a willingness within geographical areas. Their work
various academic adviser to the 2022 communities to care for one improves lives at both the local
positions. Houston Convention another,” he said, “and we and international levels, from
He has also served Committee and chair must ensure that we encourage helping those in need in their own
as a Presbytery of the Operations people who have recently communities to working toward a
elder, chair of Review Committee. embraced the concept of polio-free world.
Queensferry Gordon
Mr McInally volunteering to join us to allow
Parish McInally has been a Rotary them to continue giving service.”
FOR
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All offers will be considered.
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12 | Scottish Dental MagazineNEWS
‘Exodus’ from public
dentistry feared
80 per cent of practices will reduce their NHS commitment, survey reveals
THE BRITISH DENTAL Association has pre-COVID capacity. While the Scottish NHS dental care, free at the point of use,
warned the Scottish Government plans to Government has offered a support package remains a centrepiece SNP policy. BDA
revert to pre-COVID models of care risks to boost capacity, many practices are Scotland has said the Scottish Government
sparking a flight of dentists from the NHS, unwilling to commit to a broken NHS must change course to achieve that goal,
with potentially devastating consequences model. More than 30 per cent say they have develop an interim funding package to
for patient access across Scotland. not applied, and among those, half (50 per support dentists and their teams as they
In October, Cabinet Secretary Humza cent) say they are now unable to commit to work through the backlog, and begin work on
Yousaf wrote to all NHS dental teams that the NHS long-term. Support for ventilation a new, sustainable model for delivering care.
all emergency support will be withdrawn by costs requires a minimum three-year David McColl, Chair of the British Dental
1 April 2022. Since the first lockdown, NHS commitment to the NHS. Association’s Scottish Dental Practice
practices have operated under a COVID • 9 in 10 dentists (89 per cent) estimate the Committee, said: “Free NHS dentistry
support package, reflecting pandemic removal of emergency funding will have for all is a worthy ambition. Rather than
pressures and tight infection control a high impact on the short-medium term exploring ways to actually achieve that goal,
restrictions that continue to limit capacity sustainability of their practices. the Scottish Government has blindly headed
across the service. down a road that could destroy this service.
According to a survey of dentists in Scotland: BDA Scotland has warned from the “COVID has slashed our capacity, yet
• 80 per cent of dentists estimate their outset that a return to a ‘business as usual emergency support will end. Yes, Ministers
practices will reduce their NHS model’ – low margin and high volume – will have offered some support, but with small
commitment should the Scottish put practices under unsustainable financial print many practices simply could not sign
Government withdraw emergency support pressure and will likely lead to closures or up to in good conscience.
and return to pre-COVID models of care. movement to the private sector. “Dentists are unwilling to be shackled to
Over a third (38 per cent) of dentists indicate Practices are facing an unprecedented a corpse. When aid hinges on committing
they are now likely to change career or backlog, with recent data from Public Health to an NHS model that is now frankly
seek early retirement in the next 12 months Scotland indicating that the number of unsustainable, it is unsurprising take up
should the policy be taken forward. 15 per treatments delivered in the year to March appears so modest.
cent say they are likely to practice dentistry 2021 was less than 25 per cent of those “We doubt Humza Yousaf wants to be
outside of Scotland, and 1 in 10 estimate delivered in the previous 12-month remembered as the man who killed NHS
their practice is likely to cease operations. period, corresponding to more than dentistry in Scotland. Without a willingness
• Half of dentists report that they are 3.5 million appointments lost as a result to reflect on choices made in recent weeks
operating at less than 50 per cent of of the pandemic. that risks being his legacy.”
Study proves benefits of AI technology for dentistry
DEVELOPMENTS in artificial the control group, who found
intelligence (AI) are of growing 44.3%. The results reflect the
interest to the dental profession difficulty of spotting early-stage
and now a peer-reviewed study1 proximal caries when examining
has proven that a new AI tool bitewing radiographs, as the subtle
significantly enhances dentists’ patterns that represent
ability to detect enamel-only demineralisation are often missed
proximal caries. by the human eye.
University of Manchester Dental The AI tool was proven to aid
School’s ADEPT (AssistDent clinical judgement and, if identified
Enamel-only Proximal caries early enough, the disease can be
assessmenT) study, published in reversed by non-invasive means,
the British Dental Journal, involved a critical aspect of preventive
23 dentists, randomly divided into dentistry. The AssistDent®
a control arm (without AI software is developed by
assistance) and an experimental Manchester Imaging, a company
arm in which AI assistance established to commercialise
provided on-screen prompts research into preventive dentistry
indicating enamel-only proximal been inspected previously by an The participants in the ADEPT from the University of Manchester.
caries. expert panel who identified 65 study who used AssistDent® AI
Participants in the study enamel-only carious lesions and software identified 75.8% of the
analysed 24 bitewings which had 241 healthy proximal surfaces. caries - considerably more than www.bit.ly/ADEPT-study
1
14 | Scottish Dental MagazineNEWS
Improving response for
people at risk of suicide
Group established to drive forward approach
A NEW GROUP will be set up to for Mental Wellbeing and Social “We know there are some found that more than a quarter of
make sure that everyone at risk Care, said: “I welcome the excellent examples of suicidal respondents displayed symptoms
of suicide can access the right report from the NSPLG and the crisis support services across of depression, and more than half
support when then they need it, recommendations it makes on Scotland already, and we have an rated themselves as “emotionally
the Scottish Government said, improving responses to people in opportunity to learn from those exhausted”. Earlier this year,
following recommendations suicidal crisis. We will consider to make sure this type of support an initiative was launched to
made by the National Suicide the recommendations in full. is available right across Scotland. encourage all dental workplaces
Prevention Leadership Group “To deliver the scale of change “Every day, people in our to make mental health wellness
(NSPLG)1. set out in their recommendations, communities, and those a priority2.
The Suicidal Crisis Support a dedicated Suicidal Crisis working in statutory and third
Action Group will drive Support Action Group will be sector services, are responding 1
www.gov.scot/publications/
implementation of the Time, established to take forward and compassionately to people in third-annual-report-national-
Space and Compassion approach, oversee the implementation of crisis. However, there is more we suicide-prevention-leadership-
a new way to improve help this work. The appointment can do. This report offers a real group-nsplg/
for people who are suicidal. of Nigel recognises his career opportunity to transform how
Nigel Henderson, former Chief in developing compassionate we engage and support our most 2
https://mhwd.org
Executive of Penumbra, has been support for vulnerable people, vulnerable people at times of
appointed as National Lead for including those at risk of suicide. suicidal crisis.” See also ‘Dentists run length of
Suicidal Crisis Support to lead The group will be accountable to A survey of dental trainees Scotland in aid of aid of mental
this work. ministers and continue to work and primary dental care staff health support and services’ –
Kevin Stewart, the Minister in close partnership with NSPLG. carried out in Scotland last year page 44
16 | Scottish Dental MagazineNEWS
Dental firm introduces
paperless patient journey
Group has appointed six of its practices across Scotland as ‘eco-champions’
CLYDE MUNRO has introduced a
‘sustainability protocol’ which it says
has enabled the group to save the paper
equivalent of four trees per month. Around
164,000 forms were completed electronically
across Clyde Munro Dental Group’s
practices between April and July this year,
with each form averaging one sheet of paper.
It comes after the Scottish dental firm
launched its ‘Paperless Patient Journey’,
encouraging patients to communicate
electronically. Clyde Munro has been
working with software partners to reduce its
paper usage by introducing a user-friendly
online patient platform that will replace the
traditional paper-based forms.
The pursuit of going paperless comes as
part of the group’s wider environmental
initiative to reduce, reuse and recycle where Torwood Dental Practice in Inverness
is one of six ‘eco-champions’
possible and encourage an eco-friendly
dental practice and a greener future for the
dental industry as a whole. number of sustainable ideas that can help to
Amy Reilly, Head of Commercial Finance reduce the firm’s environmental footprint.
and Lead on the project, said: “By using less These ideas include ink cartridge recycling,
paper, we can reduce our impact on forests, eco-friendly dental care products, and
cut energy use and climate emissions, limit reducing plastic cup usage.
air, water and other pollution and produce Amy added: “We are working together as
less waste. a business and a community to consciously
“We are very keen to encourage all look at the ways in which we can better
Amy Reilly, Head of Commercial
patients who have not already done so Finance, Clyde Munro manage our environmental impact and to
to provide an email address or a mobile drive change in those areas in which we
number as part of their patient record, are able.
which allows us to arrange for all offers a key method by which to reduce “We are passionate about supporting the
communication to be sent to them paper generated in practice but also supports dental industry to make a difference for the
electronically, including appointment necessary COVID-19 protection procedures.” better, not only for our patients but also for
reminders and appointment forms. After appointing six of its practices across our wider society.”
“When patients complete their forms Scotland as ‘eco-champions’, the Glasgow-
using the online patient portal, this not only based dental group has begun to trial a Leading the charge - see page 42
Dental labs market set to increase
THE GLOBAL DENTAL laboratories advancements are also expected to nearly 137 million in 2017. Geriatric equity firms. These mergers and
market size is anticipated to reach fuel growth. For instance, the population is highly susceptible to acquisitions are anticipated to lead
$43.5bn by 2028 and is expected to digitalisation of dental labs and the dental conditions such as to market consolidation and enable
expand at a CAGR of 5.5 per cent. introduction of Computer Aided xerostomia coronal and root caries, leverage advantages of white space
According to a report, Global Manufacturing (CAM) and and periodontitis. As a result, the acquisition.
Dental Laboratories Market Size, Computer Aided Design (CAD) market is projected to witness For example, Smile Brands, a
published by researchandmarkets. technology has improved the significant growth in the near future. Gryphon Investors backed
com, this can be attributed to accuracy of dental appliances. The market for dental company, acquired Johnson Family
increasing cosmetic dental According to an article published laboratories is highly fragmented Dental as an add-on acquisition in
procedures, the geriatric population, by United Nations, the number of and is anticipated to witness a 2017. This acquisition is anticipated
and awareness regarding oral adults in the age group of 80 years significant merger and acquisition to contribute to the company’s
hygiene. and above is anticipated to reach activity from both large dental growth through the addition of new
In addition, technological around 425 million in 2050, from service organisations and private practice locations.
18 | Scottish Dental MagazineNEWS Pictured (L-R): Yi Xuan Lim, Cara Marcuccilli, Aisha Asif, Libby MacLean, Emma Copley. Also featured in the exhibition were Siya Sharma and Rou Voon Teo. Dental students ‘get their A.C.T. together’ Dundee Dental School has launched an initiative, Art in Clinical Training, where healthcare trainees can express themselves ART in Clinical Training (A.C.T.) is an project. Each student interpreted the word local coffee shop, EH9 Espresso. The opening initiative developed at Dundee Dental School and produced a piece in their own medium. night was a success, after which the pieces during lockdown, giving dental students a The results were incredibly impressive and were displayed in the shop for a week. For community and outlet to express themselves, personal, ranging from renaissance inspired those unable to appreciate the art in person, write Cara Marcuccilli and Clement pieces to tarot cards. It was very interesting to the pieces were uploaded to Instagram Seeballuck. see the different directions each student went for everyone to enjoy. Going forward the After a particularly difficult time for dental with their art. goal is to host pop-up galleries at different students due to the ongoing COVID-19 Cara Marcuccilli led the project and institutions, as well as involving students of pandemic, we thought this presented the created her own piece for the first exhibition. other clinical courses to further grow the perfect project for the talented students The objective was to highlight decay of group and future projects. of Dundee. A.C.T. was also created to traditional art techniques through a study allow dental students from different years of marble sculptures completed in oil to collaborate and to build a supportive paint. This piece was intended to create Any trainee/student from any university is community. For this reason, the group was appreciation from the viewer of the skill welcome to get involved and join the group. If open to any dental student with an interest required of older art techniques. The you would like to follow the progress or create in art, regardless of ability. A theme of collection featured eight pieces which were your own pop-up galleries as part of A.C.T., you ‘Decay’ was, collectively, chosen for the first displayed at a pop-up gallery hosted by our can contact and follow us on @a.c.t.dundee. BOS joins European consensus: ‘DIY ortho’ is hazardous for patients THE BRITISH Orthodontic Society over Europe are witnessing the and regular clinical monitoring or her treatment so that their has joined a Europe-wide increasing activities of start-up can cause severe risks to treatment is practised safely.” consensus that sees 31 professional companies promoting and selling patients’ health.” Anjli Patel, Director of External dental and orthodontic societies, orthodontic treatment using Professor Christian Scherer, who Relations for the British Orthodontic associations, and institutions from aligners by post with great concern, coordinated the project for EFOSA, Society added: “Orthodontic 25 countries come together to said the BOS. This type of remote said: “The unanimity shown by treatment without thorough clinical endorse and fully support a joint treatment is provided without either European orthodontists on this face-to-face examination of the declaration regarding the proper initial diagnosis or any subject makes it clear that patient, x-ray imaging and regular unacceptable and potentially form of regular clinical monitoring, orthodontics is more than just clinical monitoring, is potentially unsafe remote treatment of it added. aligning the front teeth. hazardous to the patient’s health. malocclusions. “These companies often present “It is about a holistic approach to “Any self-administered and The Declaration by EFOSA [the their services as affordable, fast, and care where the patient’s best remote treatment cannot be European Federation of Orthodontic safe, although they clearly do not interests are at the heart of our justified from a professional Specialists Associations) states the meet required professional dental treatments. Every patient should medical perspective and basic requirements that must be standards,” said the BOS in a make sure that the basic thus represents a serious met for any orthodontic treatment. statement. “Orthodontic treatment requirements formulated in the Joint violation of ethical, medical Dentists and orthodontists all without proper initial diagnosis Declaration are also observed in his and dental standards.” 20 | Scottish Dental Magazine
25-26 MARCH 15-18 JUNE
D AT E S
EVDA Congress 2022 EuroPerio10 Copenhagen
Edinburgh Surgeons Quarter www.efp.org/europerio
https://evda-online.com/product/
FOR YOUR evda-congress-edinburgh-2022/ 24-25 JUNE
Scottish Dental Show
DIARY 1-2 APRIL
European Carriere Symposium,
Braehead Arena, Glasgow
www.sdshow.co.uk
Portugal
https://web.cvent.com/ 11-13 AUGUST
event/70ccbece-04c1-4ccb-93f2- International Symposium on
2022 10-11 MARCH 5183ed39da80/summary Dental Hygiene
28 JANUARY Challenging the Dogma in Dublin
Scottish Orthodontic Prosthodontics 7-8 APRIL www.isdh2022.com
Conference P&J Live venue Aberdeen Euro Implanto 2022, Nice,
Royal College of Physicians and https://www.bsspd.org/Conferences/ France 7-8 OCTOBER
Surgeons of Glasgow & Online Annual+Conference+2022.aspx www.dental-tribune.com/event/ BADT Conference 2022
https://community.rcpsg.ac.uk/event/ euro-implanto-2021/ Crewe
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22 | Scottish Dental MagazineORTHODONTICS
One in a...
Vermilion management with conscious sedation,
which is not readily available outside
of the PDS or hospital dentistry.
This gives parents and referrers
access to sedation services without
long waits to undergo treatment.
In addition, the team give advice/
manage cases with dental trauma or
those that require surgical removal or
exposure of impacted teeth.
Multi-disciplinary treatment
For dentists referring patients,
Vermilion also provides accessible
and expeditious paediatric dentistry
and orthodontics under one roof, with
treatments that are consultant-led
and overseen by their specialists.
Aman said: “Being closely linked
with clinicians from Vermilion – The
Smile Experts and our very skilled
referring practitioners, we are able to
provide complex multi-disciplinary
treatment (MDT) with close
communication between clinicians.
Focusing on the link between the Lead Clinician for Orthodontics
at the Edinburgh Dental Institute,
“For MDT cases, we are in
an excellent position to provide
paediatric dentistry and providing complex multi-disciplinary
orthodontic treatment.
treatments which require restorative
dentistry, for example hypodontia, or
orthodontic treatment At Vermilion Orthodontics, Aman surgical input such as implants.
V
will provide orthodontic service that “Our focus is on aesthetic
will cover the full range of treatments, appliances for both children and
ermilion Orthodontics, WORDS from interceptive treatment for young adults, with an emphasis on treating
a new private WILL PEAKIN children to comprehensive adolescent complex cases with clear aligners and
orthodontic and and adult orthodontics. ceramic labial brackets.”
paediatric dentistry He is joined by his colleague of
clinic, was launched seven years, Dr Graeme Wright, a Launch of study club
earlier this year by Dr Consultant/Specialist in Paediatric As well as accessibility and a swift
David Offord, founder of Vermilion Dentistry. response for referring dentists’
– The Smile Experts, and his clinical Graeme is Lead Clinician for patients, the Vermilion Orthodontics
colleague and business partner, Dr Paediatric Dentistry at the Edinburgh team is also augmenting the support
Aman Ulhaq. Dental Institute and The Royal it provides to dentists through the
With the patient at the centre Hospital for Children and Young launch of a monthly two-hour study
of every treatment, Vermilion People in Edinburgh. club (both face-to-face and live
Orthodontics offers a bespoke service streaming).
undertaken by its experienced team A range of services “We will look to assist our referring
of specialist clinicians. At Vermilion Orthodontics, Graeme practitioners by giving advice for
“The aim is to provide a high offers a wide range of paediatric orthodontic treatment planning and
quality orthodontic and paediatric dental services, often facilitated by mentoring for cases they may wish to
dentistry service with short waiting conscious sedation for nervous or treat within their own clinics.
times for consultation and treatment,” anxious children. “These study groups will be held
said Aman. He has a specialist interest in the in the evening throughout the year -
“We want to work closely with our dental management of medically more information will follow soon.”
referring practitioners and the team compromised children, cleft lip and
at Vermilion – The Smile Experts, to palate, dental anxiety, and paediatric
provide tailored treatment plans for dental trauma.
patients.” The paediatric service, offered at For more on Vermilion Orthodontics
Aman is a Consultant/Honorary Pictured, above: Edinburgh’s St John’s Road clinic, and its services, visit:
Dr Aman Ulhaq vermilionorthodontics.co.uk
Senior Lecturer in Orthodontics, and provides the option of anxiety
24 | Scottish Dental MagazineORTHODONTICS
Demand is
‘higher than ever’
Increased demand for orthodontic treatment is an opportunity to
embrace the many health improvements, both functionally and
psychologically, the profession can provide
T
he 2021 annual WORDS orthodontic treatment has placed followed by small, group case-
British Orthodontic WILL PEAKIN many of us under increased pressure. based discussions. This primarily
Conference (BOC) took “We should look on this as a focused on establishing an enhanced
place in September positive and embrace the many health appreciation of joint restorative and
at the Midland Hotel, improvements both functionally orthodontic approaches in diagnosing
Manchester. and psychologically we can provide. and managing complex patient
It combined in-person presentations Additionally, the need to continue cases. The interface between both
and a trade exhibition with online professional development and approaches demonstrated methods to
virtual access. learning is always paramount and tackle cases such as hypodontia.
David Waring, the British the British Orthodontic Conference Day one of the main scientific
Orthodontic Society’s Director, aims to go some way to fulfil this programme included the Chapman
Professional Development, and aspiration. Prize 2020 presentation, delivered
conference chair, commented: “The “However, a conference is not jointly by Professor Padhraig Fleming
last 18 months have been the most only about learning – it is also the and Dr Pratik Sharma, in which they
challenging time, both professionally wellbeing that comes from meeting presented their mixed-methods
and personally, that many of us have colleagues and friends. I am sure research study. It incorporated a
ever encountered. We are all hopeful I speak on behalf of us all as I relish randomised control trial (RCT)
however that with the incredible the time when we can meet, chat, investigating the effectiveness of
advances of science we are developing and socialise with friends at the full versus part-time Twin Blocks
ways of living with and managing the Orthodontic Conference. The British appliance wear, while a qualitative
virus and pandemic that has torn our Orthodontic Conference team have evaluation was utilised to explore
world apart. had a busy 18 months organising, the factors affecting compliance with
“The need for quality orthodontics cancelling, and re-organising a prescribed wear protocols.
has not gone away, and the demand is conference and it is with absolute This was followed by Dr Simon
higher than ever. delight that we welcome you to the Littlewood’s presentation on
“Whether that is the impacted 2021 BOC.” enhancing the clinical application
canine, or a desire to improve the The pre-conference course of evidence-based tooth retention
appearance, the aspiration to seek offered a hands-on seminar, regimes. It was supported by
26 | Scottish Dental MagazineORTHODONTICS
LOOKING
AHEAD TO 2022
Returning for its seventh year,
the annual Scottish Orthodontic
Conference will welcome
both face-to-face and virtual
delegates and will provide
updates on current practice
and contemporary topics
including temporary anchorage
devices, 3D printing and
orthodontic management
of traumatised teeth.
With a mix of engaging
speakers, clinical pearls and panel
sessions, the conference will be
of interest to those based in both
primary and secondary care and
is intended to engage the whole
orthodontic team and those with
an interest in orthodontics.
SPEAKERS INCLUDE:
contemporary research into Advances in the Dr Mandall continued by discussing • Dr Niall McGuinness, Consultant
orthodontic-bonded retainers, dental profession how the specific research has since and Honorary Senior Lecturer,
will bring benefits
ultimately helping mitigate the risk to patients
changed her clinical practice, as well Edinburgh Dental Institute
of relapse. as future proposals for a further RCT. (Orthodontic management of
Dr Sarah Good’s presentation The BOC’s 2019 dual parallel track traumatised teeth)
underlined the significance of sessions, Driving Private Practice • Dr Finn Geoghegan, Principal
providing closely aligned, joint and So, You Want To Know About Orthodontist, Specialist
paediatric-orthodontic services and Orthodontics, were repeated in the Orthodontist Practice,
incorporated the presiding evidence 2021 programme schedule. The latter Glenageary
that guides the management of was beneficial for those interested in • (3D models and printing)
complex cases including molar gaining an increased appreciation of • Richard Cousley, Consultant
incisor hypomineralisation. the orthodontic speciality training Orthodontist and Clinic Director,
pathway. It was key in highlighting The Priestgate Clinic
Range of subjects the associative clinical and research Peterborough (TADs and
On the second day, the Northcroft commitments required. Dr Guy anterior open bite management)
Memorial Lecture 2020 was Deeming’s presentation discussed • Dr Aubrey Craig, Senior
delivered by Professor Jonathan a range of key factors necessary in Dentolegal Adviser, MDDUS
Sandler. He covered a range of contributing towards a more cohesive (Update on medico-legal trends
subjects, from the importance dental team and its unified benefit in within orthodontics)
of serial clinical photography, to enhancing practice performance. • Dr Mohammed Almuzian,
osseointegrated palatal implants With the aim of increasing Specialist Orthodontist, Sunrise
as substitutes for headgear, and awareness around Orthodontic Dental Clinic, Edinburgh
the effective incorporation of Technology, Education and Design, • (My favourite 20 orthodontic tips
temporary anchorage devices (TADs) the 2021 OrthoTED lecture series and pearls)
into orthodontic practice. RCTs offered a dynamic and informative • Dr Catherine McCanny, Specialist
were provided as supplementary, insight into various thought-provoking Orthodontist, St Michael’s
supportive material throughout and concepts. Topics ranged from the Orthodontics (Aligners)
provided a comprehensive, evidence- provision of oral health advice through
based overview of the techniques social media, digital marketing LEARNING OUTCOMES
discussed. and alternative team leadership INCLUDE:
Dr Aliki Tsichlaki presented approaches. This was supported by • Have updated knowledge in the
the Chapman Prize 2021 lecture. clinical pearls, providing more specific management of anterior open
Her PhD research looked into the clinical advice around the utilisation bite treatment with TADs
development of a standardised, core of floss ligatures, video consultations, • Have an understanding of the
orthodontic outcome set for future efficacious pontic-archwire adhesion management of traumatised
implementation across clinical trials. and much more. teeth undergoing orthodontic
The standardised measures installed treatment
would look to enable improved • Demonstrate understanding of
outcome consistency between future 3D printing within specialist
orthodontic studies and enhanced practice
research yield, while guaranteeing an
improved measurement of outcomes THE 2021 ORTHOTED LECTURE SERIES • Be aware of updates to clinical
skills for aligner treatments and
OFFERED A DYNAMIC AND
significant to all stakeholders the patient journey
including clinicians and patients. • To have participated in academic
Dr Nicky Mandall followed, discussion relating to current
reflecting upon her multi-centre
RCT. It assessed both the clinical
and psychosocial influence of Twin
INFORMATIVE INSIGHT INTO VARIOUS projects/QIPS within
orthodontics
Block treatment delay, as well as
the associated dentofacial changes. THOUGHT-PROVOKING CONCEPTS www.bit.ly/3rfKRPq
28 | Scottish Dental MagazineYou can also read
