Principal and Founder of AURA Centre of Dental Excellence and Facial Aesthetics in Kingston upon Thames, Dr Nadine Skipp asks, ‘Where to begin?’ when taking up the provision of facial aesthetics.

It’s exciting times for dentistry. We have all seen the growing interest and popularity in non-surgical cosmetic anti-ageing treatments in recent years. But how do we make the most of this in our dental practices?

There is no doubt that the provision of facial aesthetics is perfect for dental practitioners looking to expand their practice and develop their businesses. It stands to reason that dentists are particularly suited to offering this, especially when you consider the years of training and experience in facial anatomy and familiarity with various injection techniques.

Of course, many dentists recognise the enhanced opportunities available through expanding into this growing lucrative market, but do not know how to bring this into their practice. It all begins with training and building up confidence. The first thing would be to explore the entire range of treatments available, considering all the areas and fields that initially appeal to you. From Botulinum Toxin and Dermal Fillers to Dermaroller (microneedling) and Chemical Peels, there are a wealth of options available and the more disciplines you can learn, the more likely you will be able to accommodate all your patients’ potential needs and requirements.

In any dental clinic, unless you’re performing a specific procedure all the time, it will take a while to build up your competence. Following my own initial training, a dental colleague told me that a great way to gain practical experience, increase my confidence and build upon the foundations of my education was to work for a larger provider of facial cosmetic treatments. So that’s exactly what I did. I worked part-time as a sessional non-surgical practitioner at a leading facial aesthetic clinic. It was perfect for building up my skill levels and completing a diversity of facial aesthetic treatments throughout each day.

Of course, it’s not always possible or practical to move into such an environment, especially if you already work in a demanding dental practice, but it is crucial to get as much experience early on as possible. This really helps to cement what you have learnt and build up your confidence.

Regardless of where you apply your newfound talents, the ideal starting point is to undergo the procedures yourself. After all, you can’t expect to be able to adequately explain, understand or empathise with your patients, unless you have experienced the procedures first hand. In fact, I still have my ‘before’ and ‘after’ pictures prior to embarking on my very first treatments, and I regularly use these for educating patients and marketing. This has a real wow factor for my patients and builds valuable confidence in my skills.

Also essential is to ensure that every member of staff is well educated in the treatments being offered. To help with this, it is worth encouraging staff members to undergo various treatments, where appropriate, and to use the products themselves. Your practice team can be the ultimate advert for your services and this will help to increase their knowledge and familiarity with the processes. It will also allow them to provide reliable, honest advice and assurance to patients, while also promoting the excellent results on offer.

Encouraging interest in your facial aesthetics offering is all down to your marketing and the way you spread the word about the fantastic treatments you provide. Using e-shots and leaflets that detail the procedures and outcomes patients could expect, as well as offering promotions on certain treatments will help to do this. As will talking about it during routine dental appointments. It is important not to be afraid to mention these or to hesitate when suggesting a facial aesthetic treatment to your patients. There’s nothing wrong with saying, “Have you ever thought about having this done?”

Ultimately, the best way to advertise is by ensuring the provision of high quality services. Patients that are happy at your clinic will always promote you to other people, so it’s crucial to show each patient consistently high standards of care and support to encourage this right from the start. As important as any marketing technique is, a lot of the early interest comes from word of mouth. So, by nurturing existing patient relationships and with the support from your whole practice team, you can be sure to get your facial aesthetics practice off to a great start. 

To find out more visit www.auradental.co.uk, call 020 8549 5710, or contact This email address is being protected from spambots. You need JavaScript enabled to view it.

The concept of digital dentistry is a three-legged stool. In no particular order, those legs are digital equipment, the tools used to make teeth; digital smile design, the way you treatment plan; and digital marketing, the way you get people in through the door.

I frequently speak about what is known as the ‘adoption cycle’. This is a bell-shape curved graph, and working from left to right you have ‘innovators’, ‘early adopters’, ‘late adopters’ and ‘laggards’. At the far left hand-side of the curve, you have the few people who are keen to try something new without any concrete evidence. The ‘early adopters’ are those who will try new things once some evidence of their success is made available, and the ‘late adopters’ will only jump on the bandwagon once solutions are tried, tested and refined. The ‘laggards’ tend to be those who are open to very little change, if any at all.

As a group, dentists are not brilliant at moving through the adoption cycle. The majority of dentists operate at the ‘late adoption’ stage of the curve, with the next largest group ‘early adopters’ and an ever-diminishing number of ‘laggards’. There aren’t, unfortunately, many dentists working in the ‘innovation’ phase either, although this is somewhat understandable – as trained medical professionals, they want to see clinical evidence of new products or technologies working effectively before they employ them in their own businesses. This does, however, make the process of innovation and development quite difficult in dentistry, as suppliers and manufacturers have limited options regarding who will trial their latest products.

Digital equipment

There is a growing range of dental technologies available on the dental market designed to facilitate the reproduction of natural-looking and functional dentition. Equipment has been advanced and refined over time to now produce clinical results of previously unparalleled accuracy and quality, enhancing the standard of dental treatment provided to patients, increasing their satisfaction and therefore helping businesses to grow. Technologies have also been developed to streamline the clinical and management workflows within practices, allowing more efficient daily processes for happier and more relaxed staff.

The umbrella term of ‘digital equipment’ now includes everything from milling machines to CAD/CAM software and 3D printers, but its place on the adoption cycle varies between countries. In the USA, for example, digital equipment is in the ‘early adoption’ phase, but the UK is slightly behind in the ‘innovation’ stage. This is an opportunity for the manufacturers of digital technologies in the UK and Europe to expand their market reach, and we will continue to see the arrival of more new equipment on British shores in the near future for this reason.

Digital Smile Design (DSD)

Here we start to get into the territory of Christian Coachman – a kind of ‘Photoshop on steroids’ for enhanced treatment planning. Once again, much of the developed world is currently moving into the ‘early adopters’ stage with regards to DSD, while the UK remains in the ‘innovation’ step of the curve. Deployment of the DSD concept may be somewhat slow here at the moment, but it offers huge potential for those who invest.

Digital Marketing

This embraces the lifecycle marketing concept that is now working its way through the dental arena. Following seven proven principles, digital marketing involves attracting new patients, encouraging them to return and encouraging referrals for new business from them. When considering Google, pay-per-click, adwords, search engine optimisation and effective website design, most dentists in the UK are probably towards the top of the curve, moving from ‘early’ to ‘late adopters’. Even the most cantankerous principals now widely accept that a practice website is necessary for the growth of a modern business. When you look at elements such as Facebook advertising, however, most practices will slide back down to the ‘innovation’ stage very quickly. This is a similar story when you consider CRM software, such as that available from InfusionSoft, and automated email marketing.

Don’t break a leg

It is essential for dental practices to look at all three legs of the digital stool in order to successfully adopt the concept and technologies and use them to enhance the patient service provided. This is particularly important for independent practices – corporates and large groups of practices will take more time to innovate and implement the changes needed as they have more management levels to work through. Independent, single practices have the opportunity, therefore, to get ahead of the game and distinguish themselves from the competition.

We at 7connections can provide any bespoke advice or information you might need to make sure you remain at the cutting-edge of dentistry, while also helping you optimise your business for maximum long-term success.

For more information about 7connections and the business coaching opportunities available, please call 01647 478145,

email This email address is being protected from spambots. You need JavaScript enabled to view it.. or visit www.7connections.com

November this year sees the 12th BACD Conference play host to some of the world’s foremost dentists. Delegates will have the chance to learn from leading national and international experts across a range of specialities, as well as the opportunity to network with peers and like-minded professionals over the course of the three-day event. 

Speaking at the conference will be a number of renowned practitioners who will focus on helping clinicians achieve the optimum balance to help them become the best dentists they can. Among the presenters will be Dr Andy Toy, who will be delivering his lecture, Posterior-guided occlusion.

Andy qualified from Bristol University in 1980 and in 1982 he attended Roy Higson’s first ever occlusion course and visited the Pankey Institute for Advanced Dental Education, USA.  He has since made a life-long study of occlusion and its application to practice. In recent years he has been working with the innovative posterior-guided occlusion model. This model references an extensive anthropological evidence base, along with more recent published studies from the Faculty of Health and Sport Science in Loughborough University. Andy is also the co-author with Dr Presswood of ‘Is there such a thing as a healthy occlusion?  Lessons from history’ Primary Dental Care 2008;15(2):65-69. 

Andy says, “The whole field of occlusion is very often misunderstood and there are significant elements of the profession that ignore occlusion altogether, including many academics. This is because the evidence for the models up to this point has been so poor. But clinicians working in day-to-day practice appreciate that understanding occlusion is vitally important. What is more, as dental techniques change and evolve, and we employ less invasive dentistry, understanding occlusion becomes ever more significant. More minimally invasive dentistry is less able to resist some of the forces of occlusion, so we urgently need to understand it better.

“In my lecture I will be challenging the accepted thinking on occlusion, reviewing the evidence on some of the traditional models and presenting evidence for an updated model. Examining the various models of occlusion currently in use and critically exploring their historical evidence base, the lecture will introduce an alternative model of occlusion based on anthropological studies, along with a quick summary of the evidence to support it. Finally, the application of this new model to aspects of clinical care will be discussed, including orthodontics, prosthodontics and TMD treatment.

“The session will be aimed at all practitioners who are involved in altering people’s occlusion, especially those who work in orthodontics, restorative dentistry, or those who treat patients with jaw-joint and TMD problems. If professionals have a better understanding of the evidence surrounding occlusion, they will be able to apply their professional judgement much more successfully. This will not only immediately benefit their patients, but they will also find they have less problems further down the line with less patients returning with deteriorated dentitions or jaw-joint problems.

“Whilst I will be challenging old thinking and offering some new thoughts on the subject, I will welcome any discussions around the new approach. The development of the new methodology is always on-going and we are hoping to build a positive dialogue around this subject.”

Whatever stage of your dental career, the BACD Annual Conference will have something for you. Book your place today and enjoy three days that will help you raise standards, refine your clinical technique and achieve your aesthetic equilibrium.

The BACD’s 12^th Annual Conference runs from 12^th - 14^th November 2015 at The Hilton London Metropole Hotel. Go to www.bacd.com, email Suzy Rowlands at This email address is being protected from spambots. You need JavaScript enabled to view it. or call 0207 612 4166.

Tim Bradstock-Smith from The London Smile Clinic shares his thoughts on the increasingly popular field of implant surgery and how dental referrals can help you and your practice...

Although traditional dentures still have a place, implant surgery is fast becoming an indispensible part of mainstream dentistry. Global forecasts suggest that Europe will continue to drive and dominate the area of dental implants and prosthetics until at least 2018.[1] What’s more, the current economic recovery is likely to see a further push and market expansion.

Successful restoration for an edentulous patient takes both functional and psychosocial adaptation, but their self-confidence is significantly enhanced[2]  by their resulting satisfaction with comfort, function, appearance and health. When compared to conventional complete dentures, data has provided scientific evidence of an improved quality of life after dental implant therapy.[3] Implants are much more convenient for patients and offer improved appearance, looking and feeling like natural teeth. Additionally, patients with positive self-esteem have been shown to experience significantly fewer physical health symptoms[4] and some researchers have gone so far as to suggest that the larger your smile, the longer you may live.[5] Whichever way you look at it, successful smile restoration has both physical and psychological benefits for patients.

The medical advantages of implants are that they help to prevent bone loss and actually stimulate growth to maintain the structure of the face. Also, well-maintained implants placed into adequate bone can be expected to last for many years.

Replacing or restoring missing or damaged teeth with virtually undetectable implants can be a complex procedure. However, it can be extremely rewarding for dentists who are able to not only produce a beautiful smile, but also raise patient self-esteem and confidence.

Successful implant surgery requires considerable attention to detail, outstanding accuracy and a comprehensive set of surgical skills acquired through on-going training and experience. Specialist technology and imaging is also needed to plan and execute implant treatment meticulously, ensuring optimal placement.

One clinician or indeed one practice may not have all the technology, space or the surgical skills required to provide the scope of treatment necessary for all implant surgery, particularly if a practice already provides specialist treatment in an alternative field of dentistry. Equally the patient demographics of the area may not make it financially worthwhile to support this provision. In addition, the training and education clinicians require to place implants successfully takes a significant amount of time as well as expense and often, if this knowledge is not used regularly, it is difficult for practitioners to maintain the skills required to achieve high quality work.

Even when a clinician is qualified to undertake implant surgery, there are still cases that require more specialist surgical skills with treatment sites that require advanced preparation or enhancement before implant surgery can take place. Some cases will require socket augmentation procedures, for example, or advanced regenerative procedures such as guided bone regeneration, bone condensation, ridge splitting, particulate grafting, autogenous block grafting, sinus augmentation, connective tissue grafting and further special methods such as inferior dental nerve lateralisation and distraction osteogenesis.

However, successful implant surgery can be still be delivered by suitably experienced clinicians or specialists in a team approach.

A centre of excellence such as London Smile Clinic provides a referral service to practitioners to undertake implant procedures on their behalf. Dr Zaki Kanaan is a highly trained implantologist, who will work closely with you to form a team, ensuring the best possible results for your patients. Whether you wish to refer more complex cases to Zaki or just refer out part of the overall treatment, the team at London Smile Clinic will keep you informed throughout the procedure. The patient will then return to you for continued treatment or on-going maintenance and care. London Smile Clinic prides itself on delivering a 5 star service and first class dentistry, and referring dentists can be confident that their patients will be in safe hands.

Keeping up in an ever-advancing industry can be both expensive and problematic. Equally, patient expectations are now much more forward thinking with an increase in people wishing to undertake corrective or cosmetic procedures.[6] It is not always possible to provide all services individually but by making use of the technology, facilities and skills offered by referral practices, it is possible to extend your areas of expertise and professionalism to enhance your treatment provision. In doing so, patient satisfaction and confidence is improved and as a result, these patients will return to your practice time and time again.

For more information, please contact 020 7255 2559 or
visit www.londonsmile.co.uk/refer

There is no doubt that the dental practice landscape has evolved dramatically over the last 20 years, and we are seeing this shift continue as changes to contracts, authorities and organisations affect the way we perceive and run practices. Parallel to the developments in the way dentistry is governed and managed there has been a dramatic increase in competition between surgeries, both locally and nationally. This has caused the emphasis to move more towards viewing a practice as a business, with attention given to its profitability and commerciality.

As such, the business model for a dental practice is wholly unrecognisable from that which we would have been accustomed 3 years ago, let alone to 20. Not only that, but the dentistry on offer is entirely different too. Technology has moved forward at such a pace that complex procedures that would have been either prohibitively expensive or logistically impossible are now a part of the everyday provision. As well as this the demands on a practitioner, from maintaining levels of CPD to managing staff, and the increased amount of paperwork, have snowballed, leaving very little time to consider the well-being and direction of a business.

Dentists are therefore finding themselves pushed and pulled in many directions, with their focus spread increasingly thinly over an array of equally significant issues. In such circumstances it is all too easy for one issue to take a backseat or be neglected altogether and unfortunately, more often than not, it is the marketing of a practice that suffers. This will of course have disastrous repercussions, as the reality is that marketing is just as relevant to dentistry as it is to any other business. Every practice needs to promote itself and the services it provides to ensure a steady stream of new patients. But knowing you need to make a change with your marketing and actually understanding how to do so can be two entirely different problems.

The knee-jerk reaction can be to adopt a scattergun approach, aiming everything at everyone. However, this can be an expensive and potentially pointless exercise. Closely considered and targeted tactics are much more effective in ensuring the right messages are sent to the right people. To create a successful marketing strategy for your practice, it helps to follow a tried and tested formula. The much discussed seven-step principle known as ‘lifecycle marketing’, effectively encapsulates the process of attracting new patients and retaining them by building and developing long-term relationships.

A customer centric strategy, founded on the idea of sending the right message at exactly the right time, lifecycle marketing combines CRM, e-commerce, social media and email marketing into an online system for converting leads into customers and growing sales. It utilises sophisticated email campaigns that treat each recipient individually, taking into account their level of interest in a product or service on offer. For instance, a simple exercise of splitting email recipients into three categories such as interested prospects, current patients and lapsed patients, will allow you to approach your interactions in three distinct ways, tailoring your communication to suit.

Four Main Practice Types

Across the profession, in line with the developments discussed earlier, we now see four distinct practice types emerge, each with its own identifiable set of challenges and opportunities. But whatever your practice type, adopting lifecycle marketing will help you to develop and grow your business and there are specific benefits for each category.

NHS - The primary benefit for an NHS dentist will be in the automation of the patient system and the improved efficiency of the business model – this will lead to fewer missed appointments, less time spent chasing customers and more repeat appointments.

Private - For a private practice it will revolutionise the way the dental team works, enhancing practice turnover and profitability by growing the amount of time spent performing the right treatments and increasing the uptake of elective procedures.

Mixed NHS and Private – A mixed practice will see all the benefits the purely private dentist will see, but most importantly, adopting lifecycle marketing will help to accelerate the acquisition of more private clients.

Dentist Entrepreneur (multiple practices) – The benefits for a dentist running multiple practices is the ability to automatically scale their lead generation, conversion and upsell, whilst also generating a greater consistency of service between practices AND much more efficient use of the team’s time.

No matter your practice type, the aim of your marketing will always be to increase sales and profitability. By adopting the techniques of lifecycle marketing this mission will be made far more achievable thanks to the provision of clear structures and methods for meeting new patients and expanding your clinical reach. By embracing solutions designed, customised and put together for you by the experts, you can save precious time and money without compromising the results. Working with 7connections and software giant Infusionsoft, for example, you can implement effective strategies and fresh ideas with ease.

Dentistry has certainly changed over the last two decades, but that doesn't mean your practice has to be left behind. Make sure you are able to remain competitive by ensuring your marketing is up to scratch. If your practice is feeling its age and in need of greater profitability, client retention, and lead conversions, then you need lifecycle marketing in your business.

For more information about 7connections and the Ultimate Marketing Academy, please call 01647 478145, email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit www.7connections.com

Friday 28^th March was an exciting day for the team behind the IAS Academy, as it brought with it the launch of the very first hands-on training course for the ClearSmile Brace.

A select group of forward-thinking GDPs attended the two-day course, which was led by professionals at the forefront of anterior alignment orthodontics. ClearSmile Brace trainers Professor Ross Hobson, Anoop Maini, Nick Simon and Andrew Wallace were all in attendance of the inaugural course, as were Inman Aligner trainers from IAS Academy Tif Qureshi and James Russell.

About the innovative training course, delegate Geoff Stone from Bannockburn Dental Practice said:

“Having been an Inman Aligner provider for several years, I was looking to advance to a fixed system that involved labs within the UK. With the introduction of the IAS Academy, ClearSmile Brace and UK labs, this was a perfect opportunity for me to develop my orthodontic training with a team I trust.

“I really enjoyed the course – it was comprehensive, the format was excellent and the quality of instruction was first-class. Training provided the relevant skill set and knowledge with which to approach simple cases of adult anterior orthodontics, while also covering the limitations involved. I left confident to commence treating patients, knowing that there is a network of orthodontists and experienced dentists at the IAS Academy available to support me.”

Reiterating the calibre of the instruction and support provided, Dr. Greg Marshall from Bramcote Dental Practice commented:

“The two day course was of a very high standard. It was boosted by the presence of Professor Ross Hobson, a Consultant Orthodontist, who added to the content wherever necessary. The course improved and increased my knowledge of case selection and when referral elsewhere would be appropriate. The safeguard of mentoring prior to any treatment taking place is reassuring.”

Dr. Gareth Hargreaves from Victoria Street Dental Practice added:

“I like the IAS Academy’s approach as it's firmly based upon correct diagnosis, treatment planning and informed consent, and the good support available offers peace of mind in an area of dentistry that's not without its detractors and increasing litigation. I thought the content, format and quality of the training course were all good. I would certainly recommend the ClearSmile Brace and training course from IAS Academy to other GDPs.”

During the reception drinks in the evening of the first day, Tif thanked everyone for their time and efforts in organising the course, also thanking delegates for being a part of such an exciting new endeavour. Anoop went on to mark this as an occasion he was personally very proud of saying:

“This first ClearSmile Brace course is a very important moment for me in my career, and it is a milestone I am delighted to have reached. The process of designing the course and working with Ross Hobson has been enlightening and has completely changed the way I approach orthodontics.

“I have spent several years of my career fighting for GDPs performing orthodontics – some specialists still unfortunately believe that GDPs should not be offering any orthodontic treatments. To have someone like Ross, an orthodontic specialist, embrace our goals and help us achieve them is fantastic – he provided me with the vision, direction and the passion to change my philosophy. We are all looking forward to the future and we aim to build a network of mentors around the world, who can provide any support clinicians might need with cases. We want to raise the bar for modern GDP orthodontic training.”

As a further thank you to delegates, a raffle was organised and the lucky winner was awarded a Venus® Pearl PLT Masters Kit donated from Hereaus Kulzer.

Professor Ross Hobson, Specialist Orthodontist, later addressed delegates, highlighting the importance of adequate skill and experience in order to ensure ideal case selection and delivery of appropriate treatment:

“I love what I do and I am very passionate about dentistry. I feel that anyone can perform orthodontics, but it’s important that the right person does the right thing on the right patient at the right time. This guided learning programmed designed provides a comprehensive process. More importantly, it also enables you to explain to the patient what they need, whether you can deliver the treatment yourself or not. I look forward to working with this pathway for years to come.”

The guided learning pathway offered by IAS Academy has been created to prove an appropriate solution for general dentists looking to carry out orthodontics, from simple removables to comprehensive orthodontics. The ClearSmile Brace is an innovative aesthetic fixed appliance, now available in addition to the popular Inman Aligner and ClearSmile Aligners to resolve anterior alignment issues.

Each ClearSmile Brace course is a continuum and following completion of the initial hands-on training, delegates must submit five cases for evaluation in order to gain full certification. On-going advice and guidance is also available both from GDPs and specialist mentors via the online support, ensuring clinicians have all the tools they need to treat patients safely and effectively from their very first case, with emphasis on quality assurance. At the top of the pathway, IAS Academy also offers a ClearSmile Advanced course which spans over 13 months for those GDPs seeking more advanced, comprehensive orthodontic training to resolve complete malocclusions in children and adults.
 

For more information, go to www.iasortho.com, email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 0845 366 5477.

There are many costs when owning a vehicle such as fuel, repairs and maintenance, insurance, car tax, roadside assistance, depreciation, parking and lease payments. This leaves many dentists questioning the best possible way to purchase a car in order to minimise their tax bill. Lansdell & Rose have outlined and outlined factors to consider when purchasing a vehicle to maximise your tax relief.

The methods of tax treatment differentiate between different types of businesses and there are clear distinctions between how the tax of a vehicle works when trading as a sole trader or partnership, as opposed to a limited company. For most newly qualified doctors and dentists who are sole traders or in partnerships, the purchase of a vehicle can be represented as an asset to the business. Purchasing the vehicle through the business account would mean the company would gain full tax relief for all business use of the vehicle. An adjustment can then be made in the tax return to represent any proportion of private use.

For limited companies, a different approach applies and there are two main options. The first is that the company owns the vehicle and claims full tax relief, excluding fuel, as claiming tax relief on fuel may have further implications. The employee/director pays tax for their personal use for the vehicle. The second option sees the director purchasing the vehicle and claiming mileage at 45p per mile for the first 10,000 miles and 25p thereafter. The company consequently claims tax relief and the director incurs the cost of the vehicle through the mileage claim. It is important to note that traveling to and from work is considered private and not business use of the vehicle.

Deciding the most tax beneficial ownership of a vehicle is largely dependent on the type of vehicle and most notably its fuel emissions. If the vehicle’s fuel emissions are less than 95g/kg then it might be more tax efficient for the company to own the car. However, if the emissions are higher than 95g/kg you could receive better tax relief if you own the vehicle personally.

Lansdell & Rose are specialist medical and dental accountants and tax advisers who answer questions like these for dentists and medical consultants every day. If you have a question please contact us to ensure you maximise your tax relief before making key decisions for you and your business.

T: 020 7376 9333

E: This email address is being protected from spambots. You need JavaScript enabled to view it.

There’s a NEW place to be online as Straumann UK & Ireland announces the launch of its NEW digital dental hub - THE REVU. 

GDPUK took the time to interview Simon Reynolds – Commercial Director of Patient Plan Direct, one of the UK’s fastest growing and most cost effective plan providers, as well as a GDPUK partner.

In the past six months more practices than ever before have opted to work with Patient Plan Direct, either launching a new plan for the first time or transferring an existing base of plan patients from another plan provider. Jonny Jacobs of GDPUK took the time to find out more about Patient Plan Direct’s success:

Jonny GDPUK: Please give us a brief background to how you ended up working in the dental industry?

Simon: “Following my studies in the North West I stuck around the Manchester area and joined Patient Plan Direct’s parent company, First Capital Cashflow, as a business development associate working with both the sales and marketing teams.

“I eventually focused on the marketing side of things and after undertaking a diploma in digital marketing, took up the role of marketing manager at Patient Plan Direct, going on to progress through to my current role as commercial director – managing the business development and marketing teams. I have been involved with Patient Plan Direct for almost five years now, in which time the company has significantly evolved and grown year on year.”

Jonny GDPUK: For those that don’t know of Patient Plan Direct, can you give us a brief potted history?

Simon: “Patient Plan Direct is a dental plan provider similar to the likes of Denplan, Practice Plan and DPAS. The company was formed in 2008 as a subsidiary of our parent company First Capital Cashflow – a long established payments bureau providing payments related services and technology.

“We have embraced technology, cut out a lot of unnecessary paper based administration and benefited from the economies of scale and efficiencies nurtured from our parent company, thus cutting a lot of our own cost bases – resulting in lower fees for our clients!

“Since our inception we’ve sustained our low cost, flat and transparent fee structure of £1 per patient per month (inclusive of VAT and patient Worldwide A&E cover underwritten by Hiscox) whilst other plan providers have marginally increased their administration fees each year.

“Since the company formed, our team has grown and our service delivery and support has evolved in line with market demands. We now work with over 300 practices across the breadth of the UK, helping them to develop, grow and retain a solid base of plan patients.”

Jonny GDPUK: How does Patient Plan Direct differ to other plan providers?

Simon: “Our core proposition is our low cost fee structure, enabling a dental practice to maximise the income and profitability a dental plan generates. It is our ethos to maintain this position in the market, at the same time ensuring we provide first-class training alongside business and marketing support to ensure we can help a practice reach its objectives.

“Our fee structure can easily prove to be 2-3 times more cost effective than other plan providers, enabling a practice with even a modest base of plan patients to easily make significant cost savings year on year in comparison to working with other plan providers. Moreover, we’re very focused on flexibility and branding, offering a fully practice branded solution with the freedom for a practice to determine their own plan offering, structure and price point.

There may be some misconceptions that our service is a no frills / vanilla option when it comes to dental plan administration. However, on the contrary, whilst we don’t offer support in other areas such as CQC guidance, hold annual golf days, invite ‘key’ clients to trips abroad, or hand out ice creams at dental shows, we do invest in our team, processes, technology and support whilst keeping our costs to a minimum and passing these savings on to the many happy practices that work with us."

Jonny GDPUK: What trends are you seeing in the payment plans market?

Simon: “The biggest trend I have noticed for some time now is the lack of appetite from practitioners to either introduce or continue to grow an existing capitation based plan such as Denplan Care. There are so many reasons this is the case, which I could talk about separately for hours on end.  We have worked with many practices that have transferred from another plan provider and opted to put a cap on their capitation plans (only keeping existing capitation patients on this type of plan), opting to only promote and grow a maintenance based plan moving forward.

“The other noticeable trend is the increase in principal dentists making the switch to private dentistry and using a dental plan as a vehicle to make the transition, enabling their patients to budget with a monthly payment to see their preferred dentist. Of course this is all in line with not keeping all their eggs in one basket in light of the uncertainty around the future of the NHS. My team and I relish the opportunity to get involved in this type of plan launch, delving into the viability analysis and financial modelling to identify and recommend the best strategy for the principal, practice and patients.

“Finally, we’ve worked with a number of practices recently that have decided not to take on a plan provider transfer for a number of reasons, but instead have opted to run a new plan administered by Patient Plan Direct alongside their existing plan, taking advantage of cost savings in admin fees  for new patients joining the practice’s plan.”

Jonny GDPUK: How long have you been aware of GDPUK? Why do you think it works so well?

Simon: “I have been aware of GDPUK for as long as I’ve been involved in dentistry. It’s the place I usually hear about the latest news and opinion. As such, I visit the site daily to keep up to speed on what’s new in the world of dentistry.  With all the challenges that the dental profession faces these days (many of which are well documented and discussed within GDPUK), it’s so important there is a place where dental professionals can freely express opinion, discuss ideas and offer each other advice, feedback and moral support.

“Every credit to yourself and Tony for keeping the forum running for what is now coming up to 20 years! Long may it continue.”

Jonny GDPUK: As an advertiser on the site, have you found the site a good place to gain business?

Simon: “Without doubt the site has helped raise our brand awareness and helped us extend our message to market, educating the industry on our service proposition. We have had plenty of new enquiries and new clients that initially explained “we saw you on GDPUK”.

“I see the forum as very well respected and trusted amongst the industry; as such it’s a fantastic site to attach our brand to.”

As a private plan provider, how do you see the future of NHS dentistry panning out?

Simon: “Now we have the general election out of the way and details of the prototype dental contracts are becoming a hot topic of discussion, I think it’s safe to say that irrespective of what the new contract eventually looks like, employment under the NHS is not likely to provide greater income for less graft and a stress free life. As such, I’m pretty certain the NHS won't be for everyone and as there was in 2006 there will be a noticeable shift in the number making the move to practicing privately – a process which has already begun.

“Clearly if a dentist or practice is considering the switch from NHS to private, the introduction of a dental plan is a very obvious and proven strategy to achieve the move successfully and retain happy patients.”

Contact Details for Simon:

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Tel: 08448486888

Mob: 075407063232

Web: www.patientplandirect.co.uk

Web: www.firstcapitalcashflow.com

Twitter: @PatientPlan

If you are combining your role as a clinician and practice owner you will be well aware of the responsibilities you shoulder. Carrying the business risk of the surgery as well as the obligation of managing the premises, staff and equipment involves many hours of hard work, but it is imperative to keep the demands of the job under control.

Often it is necessary to work extra hours to manage the heavy workload or even just to keep the head above water. There are also outside commitments and responsibilities to manage, but it can be exhausting and even counterproductive to try to juggle too many obligations at once. It can be easy to lose perspective on what is important in our lives and feel dissatisfied; therefore, it is vital to maintain a good work-life balance to enjoy a healthy and happy life.

Top tips to gain a balance

• Take a look at your working hours; try to find a balance that suits your home life with planned holidays and regular days off to relax and enjoy a social life.
• Participate in an outdoor activity everyday; enjoy the fresh air.
• Look after your body: eat a regular balanced diet and incorporate some exercise with particular emphasis on stretches or massages to take care of your back.
• Be realistic about what you can achieve; schedule your appointments generously to prevent stress and unwelcome time pressures.
• Listen to your colleagues; utilise their wisdom and experience. Even the most practiced clinician can learn from others and it is interesting to explore how another practitioner would approach a scenario.
• Set aside specific time periods to complete management or administration tasks rather than trying to just grab time between clinical commitments.
• Take full advantage of systems that make life easier; make the most of helpful technology.

Technology

The correct technology can help enormously to manage time and minimise daily stress. For example, scheduling management functions, calendar alerts and reminder applications can help you to remain organised and in control. An internal email or messaging service can also help to keep the practice running smoothly and avoid lengthy meetings that reduce productivity.

Technology that streamlines the workflow is an asset to you and the entire dental team. A reliable practice management system helps the business to run efficiently by quickly and seamlessly delivering up-to-date relevant information for both administration and clinical staff. Carestream Dental offers cutting-edge CS R4+ practice management software that is easy to use, and enables accuracy and efficiency for diagnostics and treatment planning to simplify your working day.

CS R4+ also evaluates your practice performance expediently by providing live data through the innovative Springboard feature, which allows you to monitor the core areas of your business in ‘real time’. This gives you clear, uncomplicated results at any period during the month and, more importantly, at a time that is most convenient for you.

Keeping it real

Efficient planning and organisation can really help to free up time and enable you to participate in the activities you love the most, but make sure you implement a sustainable strategy. After all, there is little point in creating a plan that is unrealistic or increases pressure. As all dental providers know, looking after your patients is imperative but it is also essential to look after your own wellbeing too.

For more information on from Carestream Dental,

please call 0800 169 9692 or visit www.carestreamdental.co.uk

On Wednesday 27^th May the dental industry came together to launch The Implant Hub, a unique and exciting new online resource for dentists looking to grow their dental implant business. 

This brand new digital hub, at www.theimplanthub.com, provides information on topics that will directly impact profitability for both GDPs and specialists, supporting the business of implant dentistry.

A venue where you can gain valuable insight into growing your dental business, The Implant Hub delivers exclusive support and advice in implant dentistry through articles and blogs to Google Hangouts, as well as LIVE Q&As from our three top coaches: Chris Barrow (Business Coach), Mark Oborn (Marketing Coach) and Dr Nav Ropra (Inspirational Coach).

Speaking about The Implant Hub, Ken O’Brien, General Manager of BioHorizons UK, the team behind this new offering, said:

‘Always mindful that we provide unparalleled support for our clients in the business of implant dentistry – and beyond the sale of implants – The Implant Hub was the natural development in our offering to this industry. We are delighted to launch The Implant Hub and, together with our three coaches, our aim is to provide a resource that helps our clients develop their practices from a business perspective.’

Recently added content includes:

- White Paper Marketing in Implant Dentistry

- How to differentiate yourself from the practice down the road

- Why online marketing is more powerful than conventional marketing techniques.

To see for yourself what The Implant Hub has to offer your implant dentistry business, please visit www.theimplanthub.com. 

The Implant Hub is currently available free of charge to all BioHorizons customers. For  those who are not BioHorizons customers, please register your details on the website to find out how you can gain full access.

 

Dear Colonel Hurley,

The profession would like to congratulate you on your appointment to the post of Chief Dental Officer. As someone with a reputation for professional change management, then your appointment is seen as a welcome one by many.

The profession has not recently been blessed with a CDO who it can feel it truly relates to, and many may feel that the last few years have been detrimental to the quality of dental care available in the United Kingdom. Whilst the position of CDO will always be to do the will of its paymaster, Her Majesty’s Government, I am sure you will continually keep your professional responsibility to the profession at the forefront of your mind.

At a time of unprecedented change and pressure within the profession, you will have the opportunity to rebuild the bridges that have been lost over the years. One of the ways of doing this would be to listen very closely to the concerns of the profession, and most importantly do not be afraid to tell the truth of the problems we are experiencing. After all, you are a member of our profession first and foremost, and what is bad for the profession is bad for patient care.

A New NHS contract will no doubt be a priority; but in whatever incarnation this takes, it needs complete and total clarity as to what treatment is available for patients under the rules. There should be no room for abuse by those who use a lack of definition to perpetuate the problems of the current system. Contract negotiations based on honesty are a must; and if the government cannot afford what it wants, then it should be told in no uncertain terms that this is impossible to achieve. Not only do our representatives the BDA have this responsibility, but so do you. Only by listening to and working with the profession in a fully engaged and mutually respectful manner can this be secured. If this means a core service for the NHS, or a new way of thinking that benefits both patients and teams alike then it should be piloted properly and not forced on the profession in the manner it has before; please don’t forget that the success of dental care depends on those delivering it. You have a track record in delivering high quality change within a budget; but do not underestimate the suspicion of the profession as to how government will treat them.

The inequities of dental care must be addressed; and the continued lack of a joined up policy on dental health in the nation is still something that makes dentistry a poor cousin to other health issues. When dental problems are the number one cause of admission to hospital for children, can nobody actually see it would be cheaper to fight the problem at source rather than wait until the problem occurs? There would be no better long term legacy for a CDO than to have truly changed the face of dental health in the UK for the better. A public face of the profession that is prepared to stand up for the patient and not hide behind government spin and empty promises is what the profession requires if faith in the position of CDO is to be renewed. A clear message is what the public need.

The situation with our young practitioners having to play some kind of bizarre lottery to gain a job on graduation is another aspect of the profession that you must turn your attention to. At the very beginning of their careers, we have an increasing number of them considering whether or not they have made the right choice for their futures; and by association this is the future of the profession too. Whilst part of this lack of morale lies at the door of our failing regulator, to then heap on the uncertainty of a tiering system will eventually result in the profession being devoid of is youngest talent, without which it will wither.

So, as you approach the start of your tenure as CDO, the profession can only really ask one thing of you.

After years of obfuscation, spin, and confusion;

We need clarity.

Yours Sincerely,

The Profession.

Image credit - Jason Dean  under CC licence - not modified.

I have been reading coverage and watching interviews about the latest book by Steve Hilton. Apparently, he is the favourite political guru of David Cameron and therefore his ideas are ones we might expect to be implemented in the next five years. You might find a perusal of @stevehiltonguru on Twitter to be interesting, his TV appearances suggest he has been coach to “Call me Dave” in the way Chris Barrow has been a polarising national coach to the UK dental profession.

Our profession has massive frustrations with our daily lives and the restrictions which are all around us, reaching out to almost affect our pattern of breathing. Steve Hilton argues that what has happened, as our information society has developed, is that it has become easier and easier for systems which we must follow to be written and then codified. I believe our dental profession has been trapped by this codifying of systems, almost trying to make every dentist work and behave in the same way, with the same paperwork, the same records. The words I am using here could be used for every field in the UK, ask your spouse, your friends, professional colleagues, business people, all are being stifled by the weight of the state's hefty duvet of regulation.

In the 20th century, Hilton argues, due to the way communications worked, only the people in the centre were able to make decisions, and these rippled out, in some cases enforced. Before the Industrial Revolution, decisions were taken locally as the communications of the times meant a distant ruler in the capital city may impose large scale decisions such as war and taxation. The King in the castle could not micro-manage the daily actions of subjects hundreds of miles away, the local lord, or sherrif imposed their version for their area.

Can the philosophy of applying those systems allow us to be trusted again with making our own decisions, our own leadership, rather than being force fed by the nanny state?

Nationally, this broad idea encompasses powerful, executive, city mayors. This concept is being taken forward, we will see this as more and more city mayors take office across the UK. The benefits will be a translation of what may be a well meaning law or regulation emanating from a Whitehall Minister's desk, into what this means in a locality, where a well argued, seemingly sensible, national edict may be counter intuitive to the situation on the ground.

If there are to be more and more local mayors, or decision makers, could this idea be applied to dentistry? Many agree that the whole profession is frustrated daily by the national edicts which do not fit in with how we run things on the ground, in our own practices, or in our own areas?

In oral health provision, the needs of differing areas do vary widely. Truly local decisions will help people on the ground, the providers of healthcare working together with the recipients of this care. How can we move the profession away from political control, away from the politicos who are able to speak publicly and utter soothing platitudes, but when devising and enacting changes, they seem to be regularly and plainly wrong? But our decision makers must be of the people, possibly elected, and definitely not from the present Dental Public Health elite who continue to drive change in their narrow eyed image.

Decision making for the future of our profession needs to be more human, more involving, and not just showered onto dentistry from the top down. This itself will mean different things to different people, but will allow concepts from grass roots to flourish, we have many mechanisms for communication, to set the agenda, and make the changes. The age of imposing change must now be over.

My call now is for our largest trade union, the BDA, to take this forward to this new Government on terms that fit in with their style, their politics, their understanding,  in order to make a change to the top down mindset. This is about freedom, modern politics, and a move away from the paternal style of the last century, using modern coimmunications but not only in a single direction.

Things are changing in the website world, mobile websites are becoming increasingly important with Google placing an emphasis on websites having a mobile version. Users of mobile phones now expect a mobile version or an app for the business that makes their lives easier.

Over the last few years, there has been a huge growth in mobile apps, with large businesses having their own mobile app but things are now changing and evolving with smaller businesses now getting in on the act. It is now possible to have one for your dental practice. This seems a strange concept to some but there are a number of benefits that could really help your dental practice.

As we all know, everyone seems to be using their mobiles for the majority of tasks, with the average person in Britain, using their mobile for over 2 hours a day. Your patients will be no different.

The GDPUK Services team can now offer you the ability to have your own app custom built for your dental practice. Once it is built (usually takes approx 4 weeks) it will be made available on the Apple and Google Play Stores for download by your patients.

Below are five reasons an app could benefit your practice.

1. Loyalty Scheme

With the loyalty scheme built into the app, all you have to do with an app is scan a code in the practice and the patient's loyalty card is automatically marked, they can then redeem a voucher when they reach a certain number. All this is done automatically. This will be a reason your patient will keep the app on their phone, they will feel like they are getting extra value / service from visiting their dentist.

2. Presence

Having your own app is a great way of doing something different and innovative in your local area and will impress your patients. Having an app gives your patients a constant reminder of your presence in the community and that your practice can be seen as innovators.

3. Engage with patients

Patients can message your practice directly from the app, they can request an appointment for specific items of treatment. They can also gain direct access from the app to your Facebook and Twitter accounts as well as your blog or any other social media etc.

4. Push Messaging

You can push messages directly to everyone who has it. Push messaging is free and has close to a 95% read rate which when you compare to an average open rate of just 20% for an email that practices send to patients.

5. Referrals

With a mobile app your patients can refer you directly to their friends and family via Facebook, Twitter, email or text. As we are all aware there is nothing more powerful than a personal referral for any business, for dentists personal recommendations / referrals often work brilliantly because they provide confidence to the potential new patient and also prove to your team and yourself that you are doing the right things. A number of referrals a month from the app will make the small investment in the app totally worth it.

For further information on the app and the costs involved please have a look at our new services website and specific page on the app. Links below. If you have any further questions please email us - This email address is being protected from spambots. You need JavaScript enabled to view it.

www.gdpuk.com/services

www.gdpuk.com/app

The second NHS Confidence Monitor - a survey designed to capture how confident the profession are in the future of NHS dentistry - is now open for dentists to take part and share their views.

The first survey was conducted at the end of 2014 and is being repeated to monitor how confidence levels ebb and flow as new information about the contract reforms emerges and the selected prototype practices reveal their thoughts and findings on the potential new systems. The results will then help to provide a snapshot of how the profession perceives the future of NHS dentistry.

The survey explores the profession’s thoughts on the future of:

• Career prospects

• Remuneration levels

• Getting the balance of treatment versus prevention within the NHS right

• The ability of the team to work effectively within the NHS.

Among other findings, the first survey revealed that 39% of the respondents asked were less confident about their career prospects within NHS dentistry over the next 12 months than they were a year ago.

Commenting on the opportunities the survey presents, Eddie Crouch, Vice Chair of the British Dental Association Principal Executive Committee, said:

‘It will be very interesting to see how confidence levels in NHS dentistry have changed, particularly in light of the General Election, and I look forward to the results. I hope to see even more NHS dentists taking part in this survey so the profession has a greater insight into the possible future effect of NHS dentistry.’

As an NHS dentist, how do you feel about the future of dentistry? To have your say and help to inform your colleagues, please visit https://www.surveymonkey.com/s/NHSConfidenceMonitor

It will take just two minutes of your time to take part in this unique opportunity, while the results may inform the long-term future of many.

If you would like to see the results from the first survey, please visit www.practiceplan.co.uk/NHSDentistryInsights

The NHS Confidence Monitor is an independent survey commissioned by Practice Plan.

Is it safe to come out from my cave now? Can we talk politics?  It is tempting to be cynical and use that worn phrase, Plus ça change … [1]  

To those of you with connections in Nepal, my sympathy and best wishes - coping with such a series of natural disasters is never easy. The Nepalese Governments rejection of the UK's Heavy Lift helicopter offer suggest that politics can rear its ugly head in any circumstance.

In a small way, I suspect UK dentistry will prove no different.

Unfinished Business

The election has been and gone. [You have noticed, haven’t you?] As revolutions go it was typical – the outcome was unexpected, although change was assured.  Everything is up in the air, and yet already the dust is settling and the view of the future challenges is clearing. There is a sense of unfinished business in many respects, allied to concern that reform, be it to Regulatory Bodies or or Contract Reform, is going to suffer Mission Creep

In the space of a month for all its abject lack of mention during the election campaign, there has been a series of small seismic shifts in dentistry.

 

Tremors of Change

The new CDO was appointed [2] and Colonel Dr Sarah Hurley's name was confirmed; although announced on the NHS England web site, it is strangely absent from the DH Portal.  NHS England stated:

Sara will ….. champion the role of dentists and dentistry within the health system.

I look forward to that because it was for sure absent under the previous incumbent who even now is espousing the increased use of Dental Therapists.  Her military experience should stand her well in trying to wrench the proud profession of dentistry away from the red braced bean counters.

The BDA Conference, following on the heels of the UK wide Vote, was a successful venture, multiple stages and speakers offering a cracking breadth of topics to hear about. Big Dr Mick issued his rallying call, [3] and if anyone can lift an Agincourt like salute to the DH, he and his PEC  are your ‘archers’.

The election threw an unpredicted outcome of a moderately strong Government, albeit with a large degree of SNP oversight.

The former CDO has already hit the lecture circuit and interview network, the glossy big magazine from Practice Plan being the one to catch the early eye, but with what agenda in mind it remains to be seen, except perhaps to self-aggrandise the achievement of the 2006 UDA contract. A strange retirement project I would suggest.

Jimmy Steele, the ubiquitous Toon Professor of all that is good, has spoken about the new Prototypes in guarded terms [4]  – suggesting that we are heading toward a sensible format for NHS funded dental delivery. The nature of his caution suggest that money will be the driver or the deal breaker.  Model Two appears to win his tentative vote at this time

Perhaps most interestingly, the FGDP, in a move to assist beleaguered dentists, has made their standards Open Source, [5] as well as criticising the GDC and its appointed ‘experts’ for constantly placing the bar too high in FtP cases.  The GDC it must be said have publicly challenged this respected professional body. [6]

So what now?

We now face the prospect of proper austerity, with a new budget in July. Further real cuts are forecast  and I for one would not bet on dental funding under the NHS increasing to ensure proper delivery of any new contract.  Suddenly massive promises are on the horizon for 24/7 operation allied to an increase of 5000 WTE GMPs – and you can see dentistry as funded by the Government being parked up a narrowing alley.

 

So the rallying call is very simple –

We must expose the lack of clarity of the NHS offering which looks to be similarly present under the new contract proposals.

We must drive increase dental funding to be directed at child dental health

If ever the case for fluoridation should now be put to bed, it surely must be now – the cost effectiveness alone must appeal to a newly empowered Chancellor.

And the GDC are still awaiting the HSC Report, but our regulator is hardly a reformed body despite their strongly worded rebuff to the FGDP

Dental revolutions are often subtle, like slow burning fuses.  I think there are a number of fuses smouldering here.  The summer should be interesting because at some stage there will be a loud bang.

Enjoy your long weekend

[1] http://en.wiktionary.org/wiki/plus_%C3%A7a_change

[2] http://www.england.nhs.uk/2015/04/27/new-chief-dental-officer/

[3] https://www.bda.org/news-centre/press-releases/Pages/Dentists-leader-issues-rallying-cry-to-the-profession.aspx

[4] https://www.bda.org/news-centre/press-releases/steele-on-contract-reform-type-b-prototypes-closest-to-my-original-vision

[5] http://www.fgdp.org.uk/content/news/fgdpuk-launches-the-open-standards-initiative.ashx

[6] http://www.gdc-uk.org/Newsandpublications/Pressreleases/Pages/General-Dental-Council-challenges-FGDP(UK)-stance.aspx

As the digital workflow continues to evolve, the vast benefits of real-time data management are becoming ever more apparent.

Leading the way for innovation in the field is Carestream Dental, who’s CS R4+ practice management software now features Springboard.

The cutting-edge technology delivers live data in easy-to-read reports, whenever they are needed. By monitoring key areas within the practice in real-time, the software provides an accurate and up-to-the-minute representation of how the business is performing.

Delegates at the BDA Conference the year were able to witness first-hand how the intuitive software can also integrate seamlessly with additional technologies, for a smooth and highly efficient daily workflow.

Visitors to the stand were particularly interested in the innovative CS 8100 3D imaging system, bringing the power of 3D imaging within the reach of every general practice. Other popular solutions included the CS 3500 intraoral scanner and the new CS 7200 phosphor plate system.

To advance your practice management and imaging processes, discover the innovations available from Carestream Dental today.

For more information, contact Carestream Dental on 0800 169 9692 or visit www.carestreamdental.co.uk

With more than a century of experience between the team of practice valuers and finance experts at Dental Elite, they can provide all the advice and support you need when buying or selling a dental practice.

The team were on hand at the BDA Conference this year, with delegates flocking to the stand to find out more about the services available to them. Whether they sought information on practice valuations, the CQC application process or the different types of acquisition agreements, Dental Elite were able to help.

Delegates also had the opportunity to attend Dental Elite’s Exit Seminar on the evening of Thursday 7^th May. Throughout the five engaging presentations, delegates received a wealth of fresh ideas and support to help ensure they implemented the most suitable exit strategy for them.

If you missed the team at the BDA Conference, or want to find out more about how you can ensure a smooth and successful practice sale or acquisition, contact Dental Elite today.

For more information and to find out how working with Dental Elite can help fulfil your practice aspirations visit www.dentalelite.co.uk, email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 01788 545 900

Plan provider Patient Plan Direct and Goodman Grant Solicitors have teamed up alongside a range of expert speakers to put together and host a series of unique and not-to-be-missed seminars focusing on how to develop a profitable practice in today’s challenging market.

The seminar series kicks off in Manchester on the 19th June at the Lowry, with further events later in the year to be held in Birmingham and London.  

The Manchester event sees speakers share their expertise in six of the most important areas influencing a practices growth potential, sustainability and profits; legal considerations, business finances, personal finances, patient membership and capitation schemes, business and marketing planning and of course CQC compliance.

Simon Reynolds of Patient Plan Direct and John Grant of Goodman Grant Solicitors will be joined in Manchester by Brendan Coburn of dental specific financial advisers – Essential Money, John Minford of leading UK dental accountants – Minfords, CQC compliance specialist Keith Hayes and Andy McDougall of Spot on Business Planning.

The full day events provide a holistic view of what it takes to succeed in developing a profitable practice, explained by experts that have proven to help practices achieve this exact objective whilst offering the best in patient care. Delegates will be treated to a top quality lunch hand-prepared by chef’s on-location and gain 4.5 hours CPD.

Simon Reynolds, Commercial Director of Patient Plan Direct commented; “There is plenty to consider when it comes to developing a profitable practice and lots of pieces of the jigsaw to put together to keep up to pace with the many changes experienced within the industry in recent times, as well as potential changes on the horizon. In attending any of the seminars across the UK, dentists can expect to take away plenty of food for thought and expert advice to help them maintain competitive edge and nurture profitability.”

For more information about the seminar series and to book on to any of the events, visit: www.patientplandirect.co.uk/events  

About Patient Plan Direct

Patient Plan Direct provides an easy to use, highly efficient and very cost effective method of enabling practices to offer patients a dental plan. Patient Plan Direct’s unique approach embraces 21st century technology, gives a practice control and is proven to improve plan income and profitability.

Since 1987, the Edison Awards™ have recognized and honored some of the most innovative new products, services and business leaders in the world. The Awards are named after Thomas Alva Edison (1847-1931) whose extraordinary new product and market development methods garnered him 1,093 U.S. patents and made him a household name across the world. The Edison Awards symbolize the persistence and excellence personified by Thomas Edison, while also strengthening the human drive for innovation, creativity and ingenuity.

The Edison Awards™ are among the most prestigious accolades honoring excellence in new product and service development, marketing, human-centered design and innovation. Unique to the world of award programs, the Edison Awards™ are focused on the innovators as much as the innovations. Award winners represent "game changing" products, services and excellence and leadership in innovation around four criteria: Concept, Value, Delivery and Impact. An Edison Award represents significant value to the award winner and to the cause of innovation.

In the Dental Tools catergory, NSK won gold for the Ti-Max Z45L. The handpiece is the worlds first 45 degree electric attachment handpiece. It features a unique, two-way water spray mode. A jet spray option helps prevent subcutaneous emphysema in surgical procedures and a mist spray option effectively cools the bur making it suitable for both surgical and traditional procedures with difficult access.

Link to the award winners here. If you have a look at the page, there are some very interesting and innovative products that have won awards. Worth a read. 

Below is a video about the handpiece that won the prestigious award.

Further information on the handpieces can be found on the NSK website

http://www.uk.nsk-dental.com/products/contra-angles/ti-max_z/

tel: 0800 634 1909

• http://www.nsk-uk.com

Tony Jacobs writes: Massive thanks to Pramod for writing this series of blogs against a backdrop of political change both in Scotland and of a backlash against the Coalition's minority partner party. All at GDPUK wish him well in finding a job and settling back down again, I will make sure he keeps us informed!

Johnson & Johnson, the makers of LISTERINE®, are delighted to bring you new content following the successful introduction of our CPD programme in 2014, with the aim of supporting the ongoing CPD needs of dental healthcare professionals in improving and maintaining the oral health of their patients.

Through our programme, we aim to deliver recent clinical findings, useful information for in-practice management of oral diseases and patient communication strategies for improved preventive home care, as well considering the effects of lifestyle and other external influences on your patients’ oral health.

Please visit http://www.listerineprofessional.co.uk/cpd-educational-programme to earn verifiable hours from our expanding library, including our newest pieces on:

• The challenge of dental anxiety 

• Gum health: a systematic review update

• Meeting the oral health need of an ageing population.

In addition, soon to be made available are CPD articles on:

• Successfully delegating care

• Health-related technology in the dental care setting.

Upon completing each module successfully, we will send you a CPD certificate via email within 14 days.

For further information, please email This email address is being protected from spambots. You need JavaScript enabled to view it..

In response to the demands of their customers and business colleagues the team at Lily Head Practice Sales took to the floor at the recent Dentistry Show 2015 at the NEC.

‘We spend a good deal of time talking to clients on the phone and visiting them in their places of business’ explained Lily Head.  ‘The next progression was to plant ourselves in the hub of the Dental profession who we serve, by creating a unique LHPS space at the Dentistry Show.  This meant my whole team & I were able to engage with our clients, prospective clients, our subject matter experts invited to our stand and the wider dental industry.  It is not just dentists and health professionals who benefit from keeping up to date with innovation & better ways of doing business.

We were very impressed with all the stands we saw and the energy at the event.  From our perspective we were thrilled with the response we got from delegates on our business offerings and environment we created on our stand.

The LHPS Team:- From left - Lily Head, Kate Ball & Helen Cheskin

My team & I pride ourselves on being able to close sales in good time, often converting sales which have languished elsewhere but also in providing a first rate team of associated experts in the Healthcare Arena for the benefit of all our clients.  I am particularly pleased that Paul Shinwell (Abrahams Dresden), Alex Hall (Meade King) and Ranjit Virk (Essential Money) were on hand on our stand to add value to the visits delegates made to our stand.

The next event in the LHPS 2015 road show is the BDA Conference in Manchester on May 7^th – 9^th in Manchester at stand C43.  Lily Head Practice Sales will be joined by Alex Hall (Meade King), John Grant (Goodman Grant), Paul Shinwell (Abrahams Dresden) & Michael White (Capital Wealth).

Needless to say, Lily & her team will be hosting any delegates who would like to join them at the end of each day at the BDA Conference for a relaxing drink(s) on their stand.

The British Dental Association (BDA) and the British Dental Industry Association (BDIA) are delighted to announce that they have agreed a new ‘Strategic Partnership’ allowing both organisations to work more closely over the coming months and years. 

BDA Chief Executive, Peter Ward, commented, “This exciting new Strategic Partnership will benefit the whole Dental Community and will provide a higher level of engagement, from manufacturers and trade companies, right through to the Dentists and their teams.”

The aim of this Partnership will be to;

• Bring both Associations closer together in the eyes of the whole dental sector,
• Deliver better value to the sector through a change of culture and a closer working relationship between the BDA and BDIA,
• Provide value for members and the wider industry wherever it is possible to do so.

The Partnership recognises the strong identities and individual nature of each Association, whilst effectively looking to deliver a comprehensive business solution for the profession and the industry through activities such as both the BDA’s British Dental Conference and Exhibition in the spring and BDIA Dental Showcase in the autumn of each year. 

Tony Reed, BDIA Executive Director, added, “By working in partnership we believe than we can create better value for the members of both Associations. Our two major dental events can together provide all that practices need to maintain an up to date understanding of developments in materials, equipment and techniques and a solution to their educational requirements in terms of clinical and business needs”. 

By working in partnership both Associations believe that better value for their members can be achieved.

John Grant Director from Goodman Grant Solicitors discusses the importance of bespoke written associate agreements.

If you were to study the legal test into whether someone is an employee or self-employed, you might quickly conclude that most dental associates are employees. The dental profession has quite frankly always enjoyed what can only be called a special dispensation from the Inland Revenue. In other words, the Revenue have not, as yet, challenged dental associates’ self-employed status. Although there is little sign of this changing at present, that is not to say it never will and it is certainly better to do what one can to protect oneself – not only against the Revenue, but also against claims of unfair dismissal by former associates

If there is no written associate agreement and a practice principle decided to terminate an associate’s contract, that associate could seek legal advice and if it was deemed that they were an employee, they could pursue a claim for unfair dismissal. This could then culminate into a sizeable compensation sum.

In addition, not only are there the risks of compensation claims, there are also tax implications. If the Inland Revenue were to pursue the case, it would be entitled to ask the principle to pay all tax that the associate should have paid as an employee over their entire period of employment. This is regardless of any tax the associate may have already paid.

Consider the criteria of the legal multiple test that is used to determine if someone is an employee or self-employed:

Personal service – does the servant have to perform the service personally or can someone else carry it out

In most associate’s agreements, the right to appoint a locum is provided – however in the vast majority of cases, it is limited and may only apply if the associate were away ill and even then, the appointment of a locum is usually subject to the practice owner’s approval.

Mutuality of Obligation- An obligation to do the work and an obligation to be paid for it.

The overall reality of a dental practice is that the principle or owner does introduce patients. Whilst many associate agreements state there is no obligation, the reality is that such an obligation does exist – otherwise principals would quickly find associates giving notice to leave the practice. When the work is complete, there is the obligation to pay the associate.

Control – how much control does the employer exercise over how the servant carries out their job?

Not only are there controls imposed by CQC, the NHS and the GDC, but in addition many written agreements stipulate that associates must comply with the practice policies and procedures – even to the extent of requiring associates to participate in practice appraisals.

Similarly, most large dental corporates go into great detail within associate contracts to explain exactly how the individual should perform the work, which I would submit is entirely contrary to the notion of associates being self employed. If they are required to attend team meetings and have to attend out of hours emergencies, this too suggests a degree of control that is most commonly found in an employee/employer relationship.

John Grant of Goodman Grant Lawyers for Dentists - a Past Chairman of ASPD

For more information call John Grant on 0113 834 3705 or email This email address is being protected from spambots. You need JavaScript enabled to view it.

www.goodmangrant.co.uk
 

ASPD MEMBER

It is well documented and often discussed that the professional climate we work in at the moment is an unhappy one, and there is a lot of uncertainty and disharmony with the regulators and governing bodies.

Indeed a recent news report that suggested doctors and dentists should ‘snoop’ on colleagues to ensure they are not prescribing too many antibiotics made me question the amount of negative press the healthcare professions receive.[i] We have all heard about the dangers and concerns around the over-prescription of antibiotics and the inevitable antibiotic resistance crisis, and certainly action is required to counteract the rise in the unnecessary prescription of these medicines.

However, this report appeared to be yet another negative piece designed to make doctors and dentists worry about every move they make. Rather than galvanising the profession into action, the effect that this will have will be to encourage the opposite. Doctors and dentists soon won’t feel able to do anything at all because they’ll all be too frightened to do something wrong.

It’s interesting to note that there is so much negative press in the news towards doctors and dentists, and yet at the same time, a recent report from the NHS, a Summary of the Dental Results from the GP Patient Survey: July to September 2014, showed that the majority of NHS dental patients rate their care as positive.[ii] Indeed we hear more about the failures and mistakes and horror stories form the profession than the good news stories – of which I am sure there are many. To a certain extent this is to be expected, it’s how the national media works, but who is there standing up for us? Shouting about the amazing things UK doctors and dentist do on a daily basis? Yes there can be issues in dentistry around pricing and communication, as highlighted by the Which? report, but anything positive seems to get swept under the carpet.

Of course the GDC’s job is to regulate us, not to promote the profession. So who is out there actively advocating the good things about dentistry? Who is supporting better oral health and the excellent, tireless, often thankless work doctors and dentists do?

The national media is all too quick to vilify and denigrate the healthcare professions, when what we really need is a series of good new stories. Perhaps we should all stop and consider something amazing a colleague has accomplished lately; or an instance where someone has gone above and beyond the call of duty. Share this story with your peers and friends and maybe we can all start to spread a little good news.

For further information please call EndoCare on 020 7224 0999

Or visit www.endocare.co.uk

Dr Michael Sultan BDS MSc DFO FICD is a Specialist in Endodontics and the Clinical Director of EndoCare. Michael qualified at Bristol University in 1986. He worked as a general dental practitioner for 5 years before commencing specialist studies at Guy’s hospital, London. He completed his MSc in Endodontics in 1993 and worked as an in-house Endodontist in various practices before setting up in Harley St, London in 2000. He was admitted onto the specialist register in Endodontics in 1999 and has lectured extensively to postgraduate dental groups as well as lecturing on Endodontic courses at Eastman CPD, University of London. He has been involved with numerous dental groups and has been chairman of the Alpha Omega dental fraternity. In 2008 he became clinical director of EndoCare, a group of specialist practices.

If you want to stand out from the crowd, think about joining a professional academy. This shows your patients your ongoing commitment to education, an outstanding quality of service provision and dedication.

The academy that you choose will depend on the education avenues available, so ensure that you select one that suits your learning needs.

A worthwhile academy should offer the latest in education, career support, assistance to find more patients and value for money. The larger academies will hold an annual conference, featuring internationally recognised experts in the field so you can find out about techniques and developments from all around the world, but close to home.

It’s not what you know, but who you know

Another important aspect of attending annual conferences is networking – you can meet with old and current acquaintances and catch-up on their news. But, you also get to the chance to connect with new contacts and opinion leaders that have similar professional interests, too.

It is at some of the better conferences that you can get access to the speakers on a one-to-one basis. This allows you to seek valuable career advice, clinical case counsel, get suggestions on specialist courses to attend and hear their experiences with particular products and materials.

The most talked about conference of the year!

The most influential conference in the aesthetic dentistry calendar is no doubt the British Academy of Cosmetic Dentistry’s (BACD) Annual Conference in November. As always, the 2015 event it is expected to be one of the most talked about conferences of the year! For the last 12 years, the BACD has staged professional educational conferences that have attracted the most eminent of dental professionals offering their insights into their specialist topics.

This year the conference is titled, ‘The Aesthetic Equilibrium’ and it seeks to achieve harmony between biology, science, technical aspects, aesthetics and mechanics, as well as balancing the patient’s emotional, financial and clinical needs. By using the finest national and international speakers, the BACD hopes the topics will inspire you and offer an insight on how to achieve this balance.

There is something for everyone at the BACD Annual Conference – technicians as well as clinicians will find something to interest them on the programme, which has also been carefully designed to be relevant to all levels of experience.  

As a dental professional, you will never stop learning, or training to be the very best that you can be. As well as honing your skills, keeping up-to-date with the latest research, equipment and materials is essential. When you join an academy, its programme of events can offer you all this and more. Contact the BACD to find out more about Annual Conference, and the other education opportunities it offers its members. 

The BACD’s 12^th Annual Conference runs from 12^th - 14^th November 2015 at The Hilton London Metropole Hotel. Go to www.bacd.com, email Suzy Rowlands at This email address is being protected from spambots. You need JavaScript enabled to view it. or call 0207 612 4166.

Dr Adyl Asani, principal dentist at TwentyOne Dental Clinic in Hove, has been using Impregum Impression Materials from 3M ESPE for over 15 years. “As far as I am concerned, it is the most superior impression material on the market,” he says. “I use it for all my indirect restorations and implant work.

“Currently, I am using Impregum Penta because I feel it reproduces the detail I need in my indirect preparations most accurately. Of course, I have used a variety of other impression materials over the course of my career, though none have provided me with the stability, accuracy and level of detail that Impregum has.

“It has ideal flow properties which means I can ensure the first impression I take is the only one I need. The flowability reproduces even the most minor details and the hydrophilic properties exhibited by Impregum guarantee excellent accuracy every time. In addition, I don’t experience drags or airblows in my impressions.”

Dr Asani uses the Pentamix Automatic Mixing Unit from 3M ESPE to ensure an efficient process. “It allows ease of mixing and handling,” he says. “Messy hand-mixing is now something from a bygone age.

“While the setting time of the Impregum is slightly longer than others, my patients readily accept that if I am to give them extremely accurate and stable restorations, a couple of extra minutes in their mouth is insignificant.

“I would have no hesitation in recommending Impregum to other practitioners if they are looking to provide their patients with the best possible accuracy and marginal fit of their indirect restorations.”

Discover the qualities of Impregum Penta Impression Material and the Pentamix Automatic Mixing Unit from 3M ESPE for yourself today.

For more information, call 0845 602 5094 or visit www.3Mespe.co.uk

The one thing that has been a constant in my entire career so far, and has been the fundamental guiding force to everything I do, has been my ethical compass.

Where it came from originally I suppose was my upbringing, but then further refined by exposure to teaching (particularly clinical) of such a style it helped me to understand what an important position we as professionals hold, and the huge responsibilities we have to other people, primarily our patients.

Whilst clinical experience and techniques have doubtless changed through my practicing career as it does for all of us, the ethics of how and what I do have remained a fundamental baseline that cannot be compromised in my opinion.

I’m sure for the majority of the profession this rings happily true. So much so I have wrestled with even submitting this blog for publication. After all, none of us know anyone in the profession who could do with taking a good look at themselves and thinking about what I’ve written here…..

There are times when I have had to wrestle with what the right course of action is clinically, but these dilemmas have always been fairly straightforward when put in the perspective of how other medical professionals might have to act, and I’m actually quite grateful that for the vast majority of us our day to day decisions are rarely likely to have life changing impacts on our patients, especially when compared to the huge responsibilities of cardiac surgeons or oncologists for example.

But….

If our ethical compasses have become somehow magnetized by a malign influence that we fail to see, ignore, or indeed we positively allow to affect us in some way, then our actions will have potentially life changing impacts on our patients. Ok, so maybe not as severe as for the medical professionals mentioned above; but certainly at odds with the ‘First do No Harm’ principle we swear an oath to.

I am purposely NOT going to go into the potential malign influences of the NHS contract and how it might be abused or gamed; I leave readers to draw their own conclusions about this after reading this piece. What I will say is that my examples below probably only scratch the surface of what might be happening in our profession.

There is huge increase in the cost of indemnity, and whilst we have a GDC that is not fit for purpose causing at least part of this increase, it surely cannot be solely due to that alone. We can blame no win-no fee solicitors to a degree, but don’t forget that cases have to have some merit to be paid out, even if only on the balance of probabilities. Otherwise, they are defensible.

So, consider the parallel increase in availability of orthodontics and implants in recent years. This blog incidentally is NOT aimed solely at the orthodontic aspect although it may seem so; it is purely written from my personal experience of one aspect of our profession that I have experience in so feel able to comment on a bit more.

These treatments are by their very nature high value items, and potentially have a higher profit margin that some of the more routine treatments offered. The courses maybe expensive, as is the equipment needed to carry out the treatment. Being the principal of a practice that offers both these treatments, I am pretty well placed to know the financial aspects of them. What is worrying is that there seems to be a section of the profession that immediately has a new direction on their ethical compass when they start to offer these services, sometimes after only a weekend course. Admittedly this might apply more to the orthodontic side of things as I think it is now more recognized that implants are not quite as simple as Meccano to install.

But with the increase in availability (or is it an increase in higher pressure marketing and selling??) we see the parallel, and often steeper rise in litigation and Fitness to Practice associated with these treatments. Personally, I think a good chunk of this is due to the magnetism that potentially affects the compass of some of the profession after being exposed to these treatment modalities.

It’s one thing coming away from a weekend composite course having learnt what is likely to be a refinement of an existing technique, to actually introducing a whole new treatment modality to your patient base that wasn’t taught at all at undergraduate level. The ethics of such a situation are different in my eyes. When at least some of the course is given over to how to sell the new treatment to your patients on some courses (rather than spending it further exploring the ethics, assessment, case selection etc) it is not surprising that magnetism is already starting to alter the direction of the needle on your compass…

There is nothing wrong with a return on investment, but it’s how you go about getting that return that might be the problem.

Let me give you some background with regard to my orthodontic experience to put into perspective where I am coming from.

I was fortunate to work as a clinical assistant in the mid 90’s in orthodontics. One morning per week I treated patients under the supervision of a consultant in a regional hospital, and this continued for about 4 or 5 years. By that time I had seen and indeed treated some pretty advanced cases under very close supervision. I was also treating simpler cases in practice as an associate. Along with another general practitioner, we estimated this experience prepared us to treat perhaps 30% more of our orthodontic patients in practice, but more importantly it had taught us how to identify what we definitely couldn’t or shouldn’t treat. The ethics of what we could now do was drilled home all the time since we often got to see the slightly more ‘random’ orthodontic treatments that had failed in the hands of practitioners with experience only of removable appliances at undergraduate level.

We had begun to Know what we Didn’t Know.

Since then I have also been on the courses for commercially available appliances of different types, and had the advantage of my previous experience in looking at the systems and the teaching a little more objectively than perhaps some of the other delegates.

The problem comes when some of our profession don’t have these limiting factors in their internal ethical system. Some are possibly not enough motivated by the desire to always only do the right thing by their patient, but by their own financial and even egotistical drives. There have always been those in our profession who seem to have a sliding scale of principles, and are more driven for their own gains (and the patients may or may not gain as a result). I actually don’t feel that there are any more truly ‘bad guys’ in dentistry now as a percentage than in the past despite what the GDC think; but I think the potential for damage to our patients has increased because perhaps the fundamental ethics we should all have in place, in some are allowed to erode.

Combine this with the further issue now that with a lack of experience at undergraduate level for some aspects of dentistry, the starting point for not knowing what you don’t know is now much lower than perhaps it was in the past. This is where the ethics should come in to play, and whilst I applaud the efforts to fill a gap in the treatment needs by offering training in fields not covered by the undergraduate training, there doesn’t seem to be an ethical ‘lock’ in place with some practitioners to prevent them seeking their financial gain over that of the patient.

More controversially with regards to their ethical direction, perhaps they Don’t (want to) know what they Don’t Know about ethics?

So when the treatment goes awry because of not knowing enough about what wasn’t known, and the ethical direction was slightly (or massively) off, the profession has a HUGE potential for life changing impacts on both patients and its members.

This brings me on to the thorny subject of ‘selling’ in dentistry. Now, I have absolutely NO issues with dentistry as a retail environment, offering services to patients. Indeed, in order to keep a viable business in this ever competitive age, you have to consider how best to let your patients know the services you can offer them. I certainly do, and I feel it is another method of protecting ourselves from criticism that we are not offering a full range of options to our patients.

But ‘selling’ has to be fundamentally and overwhelmingly in the patient’s benefit, and not ours. I worry about some of the techniques I know can be used by some industries that if (or should that be when?) used in ours would exert an influence on the patient designed to get them to agree to treatment whether that is the right thing for them or not, or even more worryingly, whether the practitioner is truly capable of providing the treatment correctly or not. The pound signs appear, the ethics can get completely switched off, and it becomes a one sided benefit.

But what if you actually CAN’T solve those issues? (and are either aware you can’t, or just bite off more than you can chew?). The classical ‘Over Promising and Under Delivering’ is a guaranteed route to problems for patients and the reputation of the profession.

This is where the huge problem occurs. The practitioner that doesn’t know ENOUGH about what he/she doesn’t know, having been blinded by clinical and other courses that seem to offer all the answers to patients problems and get them to agree to treatment, with an underlying anaesthesia of the ethical values (if they ever had one in some cases) for what ever reason is not doing the best for their patient.

At all.

Without the ethical compass pointing in the correct direction, then there are those in the profession who cannot with their hands on the hearts say that they are truly driven by doing the right thing for patients. Take the ego and the financial aspect out, and their direction is quite possibly completely lost.

Until we make sure all our ethical compasses are calibrated properly, I’m afraid the GDC (in whatever guise it takes) will continue to be on our backs, and our Indemnity will continue to rise. The press will see us in the wrong light, and so will patients.

We need a return to the fundamental values of what we do and what that means to us and the patients.

And to do that, The Only Way is Ethics.

Image credit - Paul Downey  under CC licence - not modified.

These are politically exciting times in which we live. The earth shaking events in Nepal are unrelated of course and to those of you connected in any way, I hope that our thoughts and prayers provide comfort.

The French have had their revolutions. So have the Russians. The North American history is littered with conflict. Closer to home the Scots were victim of some brutal clearances.  The Irish found themselves on a similar receiving end of some English-driven realpolitik. The English have had their civil wars be they flower based or parliamentary in origin.

The definition of the word revolution includes this:

• a dramatic and wide-reaching change in conditions, attitudes, or operation.
  • synonyms:  dramatic change, radical change, drastic/radical alteration, complete shift, sea change, metamorphosis, transformation, conversion,innovation, breakaway;

The 8th May - the day things changed

And now we are about to witness a UK wide political revolution.  A conflict of ideas and ideals as dramatic as any more military revolution.

On Friday the 8^th May, the manifestos of the various parties will be torn into small bargaining chips. All political discussion will become secret and behind many sets of closed doors as the hidden powerhouses of advisers thrash out a deal which allows either Mr Miliband or Mr Cameron to pay a visit to Her Majesty and request that they be allowed to form a Government.

Your conversation with your patients on Friday 8th will at least be a bit different from the usual weather and holidays. But what will you think?  If we have no clear large party, by definition we have a coalition at best and minority Government at worst.  First past the post only work if you have a winner. Imagine you are overseeing a race and because you forgot your stopwatch and glasses, the result looks like a sort of fuzzy dead heat where does that leave the voting system?  In dentistry of course we used to have transferrable votes for electing the GDC - heady days, eh? We were ahead of the game I suggest.

Where does this leave dentistry in the minds of our politicians?

I for one find it quite extraordinary that less than a year ago we as a profession were making headlines with child dental health and child hospital admissions being the headline concern, but allied to issues of obesity, diet and refined carbohydrate.  You all know what it takes to be dentally healthy.

The drive for caries-free children is not a mystery. You all know that.

Dentistry... why, is there a problem?

So has dentistry been, if not a headline element, perhaps a second string part of any debate?

Nah.  Non.  Nyet.  Not a dicky bird.  It’s as though the 45% of the population who never visit a dentist are happy to take their own teeth out, [and for those of you so inclined to listen again, our colleague Dr Tony Kilcoyne had to endure a strange slot on Jezza Vine on BBC R2 recently].^[1]

Meanwhile the 55% of the population who do visit a dentist are commendably happy with their service and experience, and are no doubt filling out the FFT as we speak.

Well they will be, until told by dentist A that their crown and root canal must be privately funded, and yet dentist B can provide the same treatment for a friend under the NHS and everyone is correct!

Clarity of NHS provision in dentistry is a ticking political time bomb with a shortening fuse. The lawyers are the ones who keep relighting the fuse and at some point it will be a major problem.

And yet sadly, dentistry has as a profession and an NHS Primary Care service been parked in the sidings of political irrelevance. We have in political terms, been marked with a large tick.

Have the politicians taken their eyes off the dental ball? You might think so. If you read the NHS Confidence Survey by Practice Plan, ^[2]  the mood of dentists is darkening from so many angles it is hard to find true optimism anywhere for Government funded activity. ^[3]

Well come the 8^th May we are going to witness the start of a Revolution whoever polls the most votes.  Indeed those who poll the least may feature the most.

Perhaps dentistry will feature during the post-election negotiations?

And of course for those of you in Manchester for the BDA Conference…  ^[4]   Well maybe that will be the long-needed start of a dental revolution.

It’s not too late to check in and go have an excellent three days of networking and updating across a huge range of dentistry

A chance perhaps for at the very least a bit of private revolution.

Enjoy the long weekends coming up.  That grass is still growing...

[1]  Dr Tony Kilcoyne on BBC R2  http://www.bbc.co.uk/programmes/b05qsjpl

[2]  Practice Plan NHS Confidence Monitor  http://www.NHSDentistryInsights.co.uk

[3]  Dr Claire Roberts at Dentistry portal http://www.dentistry.co.uk/2015/04/22/reflecting-future-nhs/

[4]  BDA Conference agenda 
https://bdaconnect.bda.org/wp-content/uploads/2015/04/Conference-Preview-Brochure-2015-WEB.pdf

GDPUK were proud to have exhibited last week at the Dentistry Show 2015. We really enjoyed being there and taking part in the wide-ranging exhibition.

Below are a few short observations from my two days at the show…...

• The stands and displays seemed larger than ever, a sign that the show is growing and continues to evolve.

• There was a huge range of exhibitors and lectures, this meant there was something for everyone

• The inclusion of DTS alongside the Dentistry Show made the exhibition even bigger and inclusive.

• Closer Still Media (the owners of Dentistry Show) are very commercially minded which reflects on the show, is this good for dentistry? I would say yes because it means the other exhibitions improve what they are offering and they have managed to gain support from the majority of the larger dental trade companies. What do you think?

• Great to meet loads of people from the GDPUK community. Feedback on the site is always important and it is great to receive compliments about the website. It remains extremely popular with dentists and an amazing resource for advice, information and opinion. Join for free today. We have had nearly 400 new members in the last 6 weeks alone.

• From a personal perspective, loads of interest and commitment to advertising on the site, GDPUK is seen as a great marketing tool and community to be involved in! It was great to catch up with old friends and new. Over the next year we hope to improve the service and range of options available to our clients.

• The one negative from our experience was that in our exhibitor agreement with the Dentistry Show we were to be associated with the GDP Theatre but on arrival at the show, there was no GDPUK logos anywhere to be seen, either at the theatre or in the programme. This was very disappointing, as it was something we had heavily publicised before the show.

• A positive thread was posted on the forum in the aftermath of the Dentistry Show, created by an enthusiastic dentist on the site, Jeremy Cooper. Why the Dentistry Show is the BEST. It has thoughts on the show from a number of prominent people in dentistry including members of the trade. Worth a read!

Members of the forum meeting - putting names to the faces!

Our feeling about exhibiting was summed brilliantly by our website designer, resident techie and dentist, Steve Van Russelt who posted on another thread “Its great to meet up with the real people behind the posts that make the forum so vital. Most people think or suspect that we are there as a commercial concern so have to be reassured that yes it is free to members and no we're not going to sell their contact details. So we encouraged new members to join, but the majority of the voluntary traffic and the most heart-warming aspect was all of those current members that went out of their way to visit, say how important the site is to them to keep them informed, entertained and in the loop - reducing any sense of isolation and just saying thanks for that.”

So overall it was a very enjoyable few days in Birmingham. We hope we will be able to exhibit again next year. In the meantime we will continue to improve the site and all it offers. It was great to meet people in the flesh and not just from their online persona or email address, we look forward to meeting you all again.

**Thanks to Erica Kilburn and her team at EK Communications for the pictures - http://ekcommunications.co.uk/

With over 8,000* dental professionals in attendance, The Dentistry Show 2015 proved an even bigger success than previous years. First-class education was provided by some of the most renowned speakers in the industry, including John Kanca, Walter Devoto, Sanjay Sethi, Martin trope, Sheila Scott, Christina Chatfield, Morag Powell, Julian Webber, Ian Dunn and Sanjeev Bhanderi, to name but a few. With two-day lecture programmes dedicated to each area of dentistry, as well as more than 400 leading exhibitors, there was definitely something for everyone.

A Year of Firsts

Brand new features introduced to the 2015 event all proved hugely popular:

• The EndoLounge, provided in conjunction with the British Endodontic Society, allowed those delegates who wanted more in-depth knowledge on the subject, the time and space for exploration.
• The Facial Aesthetics Theatre was another greatly received new feature, designed in association with CCR. Topics covered everything from maximising indemnity insurance to skin rejuvenation and the world-class presenters had their audience engrossed.
• The Compliance Clinic, hosted by Apolline, offered a popular two-day programme dedicated to helping professionals face the challenges of regulatory compliance head-on.
• Launchpad UK was one of the top highlights for owners and managers of both dental practices and laboratories, with more than 100 innovations unveiled by globally leading manufacturers and suppliers.
• The National Dental Nursing Conference, designed by the British Association of Dental Nursing (BADN), was held at the show for the first time, ensuring a relevant and inspirational educational programme for all nurses in attendance.
• The Dental Update Study Day was held at The Dentistry Show for the first time this year, providing an inspirational day of lectures led by Professor Trevor Burke, Professor Avjitit Banerjee, Professor Crispian Scully and Professor Jonathan Sandler. Thought-provoking topics were discussed including minimal intervention dentistry, the impact of emerging oral diseases and the future of amalgam replacements.

Further Highlights

The Association of Dental Administrators and Managers (ADAM) attended The Dentistry Show for the first time in history, leading a popular discussion session in the Dental Business Theatre on Practice Management Today. Chaired by Sheila Scott and led by a panel of leading lawyers and business experts, the session highlighted the importance of effective patient communication, as well as exploring delegates’ concerning regarding employment law and contractual issues.

As well as many ‘firsts’ that set it apart from other annual meetings, The Dentistry Show 2015 also presented key features enjoyed by delegates in previous years. These included the BSP PerioLounge, Short-Term-Ortho Lounge, ADI Implant Theatre and Core CPD Theatre, each bringing something different to the table and ensuring all delegates’ needs were met.

Of her overall experience, Darshna Haria, Associate Dentist at Clocktower Dental Practice commented:

“I have really enjoyed the speaker sessions, from oral cancer and compliance to the hands-on meetings. I will definitely be attending next year; it’s great to be able to hear all the educational elements and be encouraged to learn and develop.”

Matthew Brooks, Dentist, added:

“The Dentistry Show is a regular event for me. I like to see the latest clinically and combine that with some CPD. It’s a great show for researching new products – I’d recommend it to any dentist.”

Aside from the abundant free learning and networking opportunities, the prestigious Dental Awards were also presented at The Dentistry Show 2015. Held by Purple Media Solutions, a fantastic night was had by all in celebration of individuals’ and teams’ achievement across the country. Congratulations to all the winners!

For those who missed out this year, make sure you put the dates in the diary for 2016 and we look forward to seeing you at The Dentistry Show next year!

The Dentistry Show and DTS 2016 will be held on Friday 22^nd and Saturday 23^rd April, NEC in Birmingham. For further details visit www.thedentistryshow.co.uk call 020 7348 5269 or email This email address is being protected from spambots. You need JavaScript enabled to view it.

*Pending BPA audit

Kerr is excited to announce that Arshad Ali and Gill Callaghan will be offering a SonicFill™ lecture, demonstration and participation opportunity at this year’s Scottish Dental Show on Friday 29 May.

SonicFill enables clinicians to perform posterior restorations with an easy-to-use, single-step technology that combines the advantages of a flowable composite with a universal composite. SonicFill reduces the time needed for placing, packing and sculpting restorations by an incredible 30%. 

Also on show will be the Elements™ Free obturation system, which has all the great benefits of the original Elements system, plus it’s cordless! Designed for accuracy, it also offers a 360° activation ring to improve your experience and clinical outcome, and digital temperature control for procedural accuracy.

For further details on these products and so much more, please visit Kerr’s team at stand F09, where you can be sure of a warm welcome and expert advice.

Come and meet the Dental Elite team at the BDA Conference and Exhibition 2015 on stand B36 or join us after the show at our Exit Seminar. We will hold five short presentations exploring retirement, selling a dental practice and exit planning on Thursday 7^th May.

The event will carry 2 hours of verifiable CPD and will be held at the Midland Hotel directly opposite the GMEX. The speakers will include:

• Sim Goldblum – The Dentistry Business www.thedentistrybusiness.com
• Rizwan Akhtar – RA Accountants www.raaccountants.com/ra-dentists
• Luke Moore – Dental Elite, ‘Dental Practice Sales Agents & Valuations’ dentalelite.co.uk//selling-your-practice
• Alex Hall – Partner – Meade King Solicitors, Specialist Dental Solicitor ww.meadeking.co.uk/alexanderhallcv.html
• Ray Prince – Rutherford Wilkinson, Financial Planner www.rwpfg.co.uk/who-we-are/staff/ray-prince

The drinks reception with canapés will begin at 6pm, followed by the seminar, so come and meet us there.

For more information and to find out how working with Dental Elite can you plan your exit visit www.dentalelite.co.uk, email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 01788 545 900

Delegates at The Dentistry Show enjoyed the opportunity to meet specialist property experts Christie + Co and shared in the wealth of experience and expertise on offer.

Utilising years of experience across many business sectors, the friendly team at Christie + Co deliver an unrivalled service that puts commitment to its clients first. Visitors to the stand were able to benefit from their specialist knowledge of business property transactions and heard all about Christie + Co’s passion towards accuracy, confidentiality and clarity of communication.

Simon Hughes, Director and Head of Medical at Christie + Co said, “We were delighted to welcome so many interested visitors to our stand. Christie + Co launched its dental brokerage service in 2013 and has since seen significant momentum as awareness of its expertise in this market has increased.” He added, “The dental sales market has recently been buoyed by the recovering UK economy and this positivity looks set to continue in the year ahead.”

If you missed them at The Dentistry Show, contact the team friendly today to see how Christie + Co can help you achieve your goals.

To discuss how Christie + Co might help you achieve your future plans please contact Simon Hughes on 020 7227 0749

Nobel Biocare impresses at The Dentistry Show 2015

Demonstrating how it remains at the forefront of innovation in implant dentistry, Nobel Biocare unveiled exciting new solutions at this year’s Dentistry Show.

Leading the way for successful implant placement and restoration in the posterior zone, Nobel Biocare launched the impressive Complete Posterior Solution to the UK.

Designed specifically to deliver the increased stability required for implants in the posterior region, the solution consists of:

• NobelActiveÒ Wide Platform (WP) implant
• NobelParallelÒ Conical Connection implant system
• Angulated Screw Channel (ASC) abutment and Omnigrip tooling
• PEEK healing and temporary abutment
• NobelProceraÒ Full Contour Zirconia (FCZ) Implant Crown.

Effective as stand alone products, these solutions integrate seamlessly for even better results when used together.

Another highlight for visitors to Nobel Biocare’s stand was the creos^TM xenoprotect collagen membrane, which offers exceptional handling properties and high mechanical strength[1] for successful soft tissue and bone regeneration procedures.

With such innovative products at your disposal, you and your patients can have confidence in the procedures you perform. Find out more about the solutions from Nobel Biocare and contact the team today.

For more information, contact Nobel Biocare on 0208 756 3300 or visit www.nobelbiocare.com

This Spring look out for never seen before savings on an array of top quality UnoDent products when sourced from The Dental Directory.

Save up to 45% on UnoDent Gloves – Excellent quality with improved grip in Nitrile and Latex Powder Free, available in different sizes.

Save up to half price on Masks – High filtration efficiency and low breathing resistance, available in tie on or elasticated ear loops.

Save over 30% on UnoDent Latit Flow – A superb light-curing glass filled resin material, with excellent flow characteristics and adaption to cavity walls and preparation margins.

Save up to 33% on the Classic Impression range – From Classic Impression Putty to Classic Impression Wash, the new range of high quality vinyl polysiloxane materials feature all the qualities you would expect from a modern impression material.

The Dental Directory is the place to source all of your UnoDent products and so much more. Pick up a copy of the UnoDent flyer today to explore the full range of offers and promotions available.

For more information, contact The Dental Directory on

0800 585 585, or visit www.dental-directory.co.uk.

At The Dentistry Show this year, Clark Dental celebrated 40 years’ providing the very best surgery design and equipment solutions for the UK and Irish Dental markets, with a drinks reception for its partners and clients. Renowned facial aesthetics expert, Dr Bob Khanna marked the auspicious occasion with a fine endorsement of Clark Dental as he introduced the Managing Director, Stuart Clark, who noted the history of the company that his father John had started 40 years ago in Hullbridge Essex. 

Stuart also took the opportunity to thank the partners on the exhibition stand; Medifinance, Taylor Roberts Accountants and the Dr BK Training Institute, along with the dental press and over 150 customers for joining in on the celebration. Attendees and exhibitors alike congratulated Stuart and the team at Clark Dental for this outstanding achievement, offering their best wishes for continued success in the future.

With a commitment and passion for high quality, efficiency, style and reliability, the whole team at Clark Dental genuinely care about their clients’ success, putting a strong focus on delivering exceptional personal service. This truly came across as they welcomed delegates to the stand and shared their experience and expertise.

Clark Dental provides the finest equipment from leading manufactures across dentistry; including A-dec dental units, radiography and digital imaging solutions from Nomad, Schick and Sirona, and unique innovative products such as the Florida Probe periodontal and probing system and T-scan Digital Occlusal Analysis Device. Visitors to the stand were able to see first hand how these ground-breaking solutions can help their practice to stand out from the competition.

Over the course of the two-day exhibition, delegates were also treated to innovative and exciting lectures at the stand, delivered by renowned speakers from across the associated companies. These included, Advances in Periodontal Dentistry; Patient Finance – Benefits to You and Your Patients; Facial Aesthetics – Why and How this should be part of Your Clinical Practice; and In Partnership with the Dental Profession – an introduction. Well–received by all who attended, these lectures gave delegates useful insights into all aspects of dental practice and exemplified the knowledge and commitment on offer.

Clark Dental would like to thank everyone who was able to attend the reception at The Dentistry Show, as well as its partner companies at the event, and looks forward to another 40 years of success in dentistry.

For more information call Clark Dental on 01268 733 146, email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit www.clarkdental.co.uk  

The NHS contract reform is a hot topic in dentistry today, with many professionals differing in opinion as to the success of the pilot process so far. While progress has been made and the prototypes are of course set to be rolled out in the next few months, it remains clear that several areas still need to be addressed in order to encourage success of the reformed contract in the future.

Affecting all members of the dental team, profession and industry, the contract reform was a key topic explored in the GDP Theatre at The Dentistry Show 2015. An open debate session was held by the British Dental Health Foundation (BDHF), led by a panel of professionals who represented various different areas of dentistry. The panel consisted of Ben Atkins, BDHF Trustee and Principal of a pilot practice; Rebecca Harris, Professor / Honorary Consultant, Oral Health Services Research, University of Liverpool; Steve Williams, Clinical Services Director of the IDH Group; Dr Tony Kilcoyne, Dentist and Principal of a private practice in Yorkshire; and John Milne, National Dental Advisor for CQC.

Once Ben had welcomed delegates in attendance and noted the absence of representation from the Department of Health (in light of the forth-coming General Election), each of the panel members took to the podium to share their views of the contract reform. Rebecca offered the perspective of a public oral health dentist, raising concerns over whether patient access to NHS dentistry can be increased while meeting the financial restrictions imposed on Government spending.

Steve then spoke on behalf of a dental corporate, commenting that it was the responsibility of the profession to continue driving the pilots, and that they should share their experiences throughout the process so as to help create the best possible system.

Next, Tony very passionately shared his views, making the point that dentists providing NHS dentistry lacked sufficient time to deliver quality services to the quantity of patients they were expected to see. He emphasised the need for clarity both amongst the profession and public regarding which services are available on the NHS, and highlighted the importance of increased communications between the two.

Finally, John questioned the Government’s ambition to change the system, suggesting that those patients with the greatest needs are the least welcome in a practice under the current contract.

Following all this, delegates then had the opportunity to raise their own worries and ask the panel for their thoughts. Key areas brought to the floor included the dangers of reduced teamwork and the need to utilise the skill mix within a practice efficiently. Delegates also voiced concerns about whether expected standards would continue to rise in the future, how to protect patients from neglect under the proposed reformed contract and how Government cuts would affect NHS Dentistry.

All in all, the very interactive session highlighted two main points – there are still a lot of questions and uncertainties that need to be addressed before the NHS dental contract is perfected, and perhaps we as a profession should making more noise about it.

The Dentistry Show and DTS 2016 – Friday 22^nd and Saturday 23^rd April – NEC in Birmingham. For more information please visit www.thedentistryshow.co.uk, call 020 7348 5269 or email This email address is being protected from spambots. You need JavaScript enabled to view it.

Attention all DBG members!

- Look out for exclusive promotions with The Dental Directory

As a valued DBG member, if you open an account with The Dental Directory before the 31^st May you could receive up to £100 in UnoDent vouchers!

If you haven’t ordered from The Dental Directory in the last 6 months, reactivate your account and you will qualify too!

All you have to do is quote your DBG membership number when you call The Dental Directory and you will receive a £50 UnoDent voucher with your first order of £500 or more (excluding VAT), OR a £100 voucher on any order of £1000 or more!*

Additionally, as a DBG member, The Dental Directory offers discounts of up to 15% off catalogue prices, an extra 1.5% for all electronic orders, plus a wide range of promotional prices across the vast range of products.

Call The Dental Directory today and see how you can benefit from all these fantastic offers!

For more information, contact The Dental Directory on

0800 585 586, or visit www.dental-directory.co.uk

*Offer ends 31^st May 2015, order total value excludes VAT 

The Chartered Insurance Institute (CII) has awarded PFM Dental (Financial Advice) Chartered Financial Planner status, the financial planning industry’s gold standard of excellence and integrity. PFM Dental, which offers independent financial advice, a professional dental sales agency, practice valuations, and chartered accountancy services, is the first organisation dedicated to advising dentists to be awarded Chartered Financial Planner status.

To be awarded Chartered Financial Planner status, an organisation has to have CII approved financial qualifications well beyond the minimum requirements, be able to demonstrate relevant experience, adherence to the CII's Code of Ethics and Conduct and a commitment to continuing professional development.

PFM Dental director, Jon Drysdale, commented: "Because such high standards of professionalism, capability and ethics are required, Chartered Financial Planner status is conferred on fewer than 10 per cent of UK financial advisory firms. We are delighted to be the only financial advisers dedicated to the dentistry profession to meet the criteria."

PFM Dental offers independent financial advice exclusively to dentists. For more information visit www.pfmdental.co.uk

You may well have seen the adverts for a new medical drama on Sky 1 HD called Critical. This is a 13-part series set in a major trauma centre and each show covers one story, in one place, in one hour. It's a gripping medical and emotional rollercoaster but it's also incredibly realistic – if you've seen it, you're probably already hooked.

You might be wondering why this is news on a dental website. If you look a little closer, you'll notice that during all surgical procedures the characters are wearing face visors. Of course, this is essential costume attire for an authentic medical programme that portrays life or death medical treatment. What you may not know is that these are Pegasus Face Visors, created by the UK dental manufacturer, Astek Innovations.

Critical's producer, Christopher Hall explained why these face visors were chosen for the characters to wear: 'The design concept of Critical was driven by two factors, we wanted at all times to depict a real medical environment but also one at the very cutting edge of medical practice. Pegasus Face Visors achieved just that; they protected both patient and doctor while looking very sexy and ultra modern. For film-making purposes there was the added bonus that the whole face of the actor was revealed to the camera rather than hidden behind an opaque mask. This meant that the audience had no visual barriers between them and the character, useful also in the real world of medicine and dentistry where a sympathetic and open relationship between practitioner and patient is so important.'

The cast of Critical would also have benefited from the anti-glare properties of the visors as the camera lighting would not have caused any reflective dazzle on the material. Not only that, the material also resists fog, keeping them perfectly clear throughout filming. Astek Innovations designed Pegasus Face Visors using high quality materials to avoid glare and fogging in order that vision is always clear for the wearer and to help maintain a trusting relationship with the patient. They are suitable for all dental staff including dentists, dental hygienists and therapists, and dental nurses.

To discover more about the fully autoclavable Pegasus Face Visors, that are available in a wide range of colours to complement your dental practice scheme, contact Astek Innovations today on 0161 942 3900 or their website - www.astekinnovations.co.uk or email - This email address is being protected from spambots. You need JavaScript enabled to view it.

John Rogers was the photographer and the picture is copyright of Sky and Hat Trick Productions

Thursday 16th April 2015 is the day I will never forget.  I was in surgery with Amy.  Bea was at reception.  It was a life changing moment for me and I am sure, for all of us, by Dr Chris Tavares BDS

THE CARDIAC ARREST

We were ready to get the patient in.  At around 3:45 pm,  Amy went out to get him in.  As the surgery door opened I could hear him having a laugh with Bea.  He came in, we exchanged the usual superficial pleasantries, had a laugh.  Asked him how he was. He said “Fine, very well thank you”.   Soon, was this to change.

He told me he had fractured a tooth in the upper right area this morning. There was no pain but it was sharp.  I turned round to type this into the clinical notes.  I could see that his ASA rating was 1.  Nothing medically to worry about.  As I was typing, I heard heavy breathing behind me.  I turned round and saw his eyes had closed, his right leg was hanging off the side of the dental chair and as I faced him, calling his name and shaking him and lightly slapping his face, the breathing became more laboured.   I lowered the chair back right down and called him again.  Suddenly he came round and said: “Yes, yes I’m ok”…and then….he was ‘gone’ again. The breathing became more laboured to an alarming level. 

I asked for the emergency kit and Amy came back with it.  He was still breathing heavily.  As I attached the pulse oximeter to his finger, his head suddenly came forward, tongue protruded and his breathing become a desperate stridor.   His face then went completely purple / ashen. 

Immediately I instructed Amy to let reception know “Medical Emergency.  Cardiac Arrest. Call an Ambulance.”  She went straight outside.  I noted the time and started CPR immediately.  30 compressions to 2 breaths.   At one stage, I vaguely remember thinking part consciously, that If I don’t do this, he will die. It was a battle between death and I and death was not going to take him, not on my watch.  I pumped like mad.

I heard Bea, shout, if he was breathing. I shouted back: “No. Cardiac arrest. Not breathing.”  

Amy came back in and brought the AED in. We connected it up and followed the instructions.  Bea stayed on the phone in, in case 999 needed to speak to her.

The AED spoke in an incredibly loud ‘voice’:

“Stand back. Do not touch the patient.  Assessing rhythm…..Shock advised…….Press the red button and shock.”  I did this and the whole chest arched and lifted off the chair with part of his body.  The AED assessed the rhythm again and instructed us to continue to carry out CPR. 

Meanwhile as Bea had more training in Med Emergency, she came in and Amy went outside to wait for the ambulance.  As I carried out compressions, the pulse oximeter showed a pulse of 110  and oxygen content of 70%.   This little bit of information was reassuring as our AED did not have a screen with the ECG tracing. 

The AED instructed again:  “Stand back. Do not touch the patient.  Assessing rhythm…..Shock advised…….Press the red button and shock.”  I followed the instructions.

The first paramedic arrived. This was about 11 minutes from the time the patient went into cardiac arrest.   I continued CPR.  He took over immediately to check the back of the chair was firm enough and immediately said ‘yes’, good.  I then took over again as he got his gear out.

The AED instructed again:

“Stand back. Do not touch the patient.  Assessing rhythm…..Shock advised…….Press the red button and shock.”  I did this and the chest arched and lifted off the chair.  The AED assessed the rhythm again and instructed us to continue to carry out CPR. 

Suddenly the patient responded and pushed my hands off his chest!  Then went still again.

The paramedic was in no hurry to attach his AED.  He asked if our AED showed what was happening on a screen.  I said no.  He seemed happy to continue with our AED at the moment.

The AED instructed again:  “Stand back. Do not touch the patient.  Assessing rhythm…..Shock advised…….Press the red button and shock.”  I did this and the chest arched and lifted off the chair.  The AED assessed the rhythm again and instructed us to continue to carry out CPR. 

By now two more paramedic vehicles and the ambulance had arrived.  Literally minutes if not seconds, 4 more paramedics came into the surgery.   The lead paramedic, the first one who arrived, switched over to his AED which had an ECG tracing.   The second lead asked about the medical history of the patient and I informed him it wall all clear. 

The third paramedic took over external cardiac massage as the second put an IV line in.  Sugar level was tested. Negative.

It is difficult to recall exactly what happened when and what was done when and in what order.  An airway was put in.   A drip was set up.  At some time I think they also injected something.  They did other things I am not sure what.  They also attached a contraption that carried out external cardiac massage.

As they looked at the ECG I heard the second paramedic say to the lead, “That’s VT” (I think that’s what he said. There was definitely a ‘V’ in his sentence) and this was confirmed by the first.  Everyone was instructed to stand away from the patient, they pressed a button, you could hear a ‘whine’ as the defibrillator charged and they shocked the heart again. 

The ECG tracing went flat and suddenly started up again and I could see what appeared as a more ‘normal’ tracing.  Then it took on another pattern again. 

They were in the surgery for about 1 hr to 1 hr 30 mins.  The tracing on the ECG was erratic and inconsistent in that time.  Every time they shocked him, the line went flat and then started again.

I had to help to deliver the oxygen for a few minutes.   In total the patient’s heart was shocked 6 - 7 times.

I am sure he had ‘come’ round a few times in that 90 minutes.

After the last shock, I cannot say exactly when but I suddenly realised they had stopped the compressions and delivery of oxygen.   They were moving around more relaxed. The lead paramedic asked one of the ambulance drivers to bring something in.  Then he asked her to bring the stretcher in.  I thought: “What, is he…dead?”. 

I had forgotten about the ECG.  I suddenly remembered it and looked over at it…..even though the patient was unconscious and no obvious signs of life, to me, ……… there was a ‘normal’ heart tracing on the ECG.   Very regular and steady.  I looked at his chest…he was breathing on his own!  I thought: “My God, there’s a normal rhythm!”  

They lifted him onto the stretcher with the airway and ‘automatic cardiac massage’ contraption still in place, I think. The airway was definitely in.   I suppose in case he needed it again.

3 of the paramedics went with the patient to the hospital, having taken the patient’s personal details.  2 stayed behind to pack up and clear up.  I asked the second paramedic if the patient was OK.  He looked at me, looked at our AED the oxygen cylinder and said pensively:

“He’s OK. Will have to see if he pulls through.  Hopefully there is no brain damage.  You got the oxygen,…. (he looked at the AED again, which was lying on the surgery floor) …….you had the defib…….you saved his life.” He said nodding.   It had not dawned on me at the time the significance of what he was saying.

The two remaining paramedics left, saying that they’ll be back to pick up the last remaining paramedic vehicle when they’ve finished at the hospital.

THE IMMEDIATE AFTERMATH

The three of us sat down, numb and started talking about the incident.  Bea made cups of tea and we sat in the staff room.  We agreed we could not have done anymore.  When he had been put into the ambulance, Amy said she heard one paramedics say to another that the patient had pulled the airway out.  This was put back in then the doors were closed. So it was good, it was reassuring to know that he was alive when he left the surgery to be taken to the hospital. 

There were no elation and shouts of joy. Just numbness.  The shock and disbelief that we had just be part of and witnesses to a full blown cardiac arrest in our dental chair.

As Amy and Bea were talking, I remember I had asked one of the paramedics if there was something we should do or someone we should report to. He said there was nothing.  If the patient dies, the police will be round to make their enquires and investigate.  If he pulls through, we probably won’t hear from anyone.

When I look back now, I cannot help but feel what a sad and unacceptable and ridiculous situation the profession has been put into by those who have the authority to ‘rule’ over us but really have been given or taken more authority that they deserve.  I have been told by a paramedic that we did the right things and possibly saved someone’s life, at the moment, but instead of elation at a professional stance of doing the right thing, unfortunately I started worrying about whether I had all the right ‘paperwork’, dotted all the ‘i’s and crossed all the ’t’s if there was an investigation!

When we finished our tea and I could see we were alright, we went down stairs to tidy up.  Bea put a note to order a new set of adult pads for the defibrillator.  I checked the oxygen content whilst Amy put the Medical Emergency things away.

It would have been about an hour to 90 mins when the door bell rang. Paramedics 1 and 2 were there.  We looked at them holding our breaths.  I asked how the patient was.  The lead said, looking at the ground:

“We have some news for you.  Looked up and smiled. We have him up and talking.  He’s actually up and talking.  He must have had a massive blood clot in the artery. They are thinking of discharging him in a few days. Well done” as he looked at each of us.

The relief from the three of us was palpable in the air.  He’s OK!

The 2nd paramedic looked at the three of us, then at me in the eyes and said something about CPR, getting the oxygen in then…..

“You had the defib…….YOU SAVED HIS LIFE””, nodding and repeated as he looked round at the three of us: “you saved his life, well done” and smiled.

I thanked them for delivering the good news, thanked them for getting here so quickly and for all they had done.

The two then left.

We shut the door and elation!  The total release of suppressed, involuntary tension.  Earlier on once the paramedics had arrived, Bea had cancelled the rest of the patients for the day and evening. I felt they deserved to have the rest of the day off!  Fortunately we weren’t seeing patients the next day.  They went home.

I stayed behind for a bit.

PERSONAL REFELECTION

Bea and Amy were just great.  I could not have asked for better support.  This was the first, and last I hope (!), medical emergency we had to deal with and, for all that, in at the deep end.    Amy just carried out unquestioning what she was asked to do.  Bea, calmly called the ambulance and handled the reception area.  In fact, as Bea was cancelling one of the patients’ appointment, he commended her on how calm she was when talking to him, given what she was in the midst of.

We were lucky there were no other patients in then.  No one ‘collapsed’ , broke down in tears or freaked out.  They both held it together.  Just amazing.

I will forever be grateful for the regulation that insisted we had Continual Professional Development (CPD) on “Medical Emergency” every year.  Every year we had a hands on 3 hours training session and I would also attend an additional lecture session.  I was never sure how much of this I actually retained in my head.

I made sure we held a medical emergency drill once a month. Only I knew when I would call one. I would always choose a time so we had a different number of staff around. We may miss a month at most but we held the drill regularly.

I am in no doubt this was one of five things that affected the outcome.

INSTINCT

When something like this happens, there is no time to think, no time to work your way through some mental venn diagrams or following the boxes of a mental flowchart.  It had to be instinct and what was already in your subconscious. 

Everyone just went into action. Everything just went so smoothly.  The call for the ambulance. Staying online with the 999 operator. Waiting outside for the ambulance.  Amy saw him and made a beeline for him.  CPR: 30 compressions to 2 breaths.

I have no doubts the regular drills helped us all.

STRIDOR & SUBSEQUENT LOSS OF COLOUR

I did not have to work out if he was breathing or his heart was beating. This just told me …negative.  I was lucky to have had these signs.

I just started immediate CPR and the ambulance was called. 

The rapid response I am sure contributed to the outcome.

CARDIAC COMPRESSIONS

One can never know if one is compressing chest deep enough.  You can’t measure the depth of compressions in such situations.In this case the colour of his face instructed me.  I could actually see the colour come back to his face.   This helped a lot when one is not consciously in a thinking mode and operating on instinct.

AUTOMATIC EXTERNAL DEFIBRILLATOR

The enemy to anything we do …….is ‘doubt’.  If you start asking yourself, doubting your actions, for anything, it is a recipe for disaster or failure.

He was, as I came to know, in VT/VF. I have no doubts the AED contributed to the positive outcome, directly and INDIRECTLY. 

Before the AED was connected, I was just pumping away but no idea if it was helping. 

The question always in the back of my mind is if I’m doing the right thing at the right time. 

When I connected the AED up, the minute I heard its “voice”, I was immediately aware of a sudden mental, physical and emotional relaxation. It was like having the consultant cardiologist in the surgery.

“Stand back…do not touch the patient…assessing rhythm….shock advised….press the red button and shock.”  I just thought: My God, his heart is being monitored now.  “Somebody” knew what was going on.  There is nothing more to do but follow the instructions.  It had an immediate calming effect on the whole process.

I had wondered if I should buy the AED.  I did. We’ve had it for 5 - 6 years now, every day checking the “green ready” light is on, never once thinking we will need it.  I have absolutely no regrets in buying it. 

I am well aware that there is still going on a major disagreement amongst professionals whether the AED is necessary in the dental surgery.  I will have no hesitation now to say YES.  I cannot be more appreciative of the AED.  It made the whole incident so much more easy to handle and I will forever be grateful we had one.  It actually helped to calm the room.   Was it ‘the thing’ that saved his life?  I don’t know.

I remember hearing at a lecture on Medical Emergencies.  I cannot remember who it was.  What he said was that we can never fully know exactly what is happening to the heart muscle and how it will respond to anything we do.  The patient, to all intents and purposes, is dying or nearly dead. If there is anything we can do that will remotely contribute to a positive outcome….DO IT.

Of course there is never absolute certainty in life.  The consequences of our actions can never be fully predictable.  If one will only act if one is always absolutely certain of the consequences of one’s actions, then one would just sit and do nothing.

The AED contributed in two major ways:

1    It really calmed the room whilst we waiting for the paramedics to arrive.

2    As I saw on the ECG screen later, it gave the heart a chance to re-establish a normal rhythm.

I HAVE ABSOLUTELY NO DOUBTS THE AED CONTRIBUTED TO THE POSITIVE OUTCOME in this case.

LUCK

Pure luck had a lot to do with it.  We were lucky the paramedics were able to arrive so quickly and there were so many.   They were just amazing.  They went about what they had to do in a calm, confident and controlled manner. 

We were lucky, before the paramedics arrived, none of us freaked out.  I have no doubts the regular drills we had played a large part.

One can never say for sure what exactly it is that brought about the positive outcome but I am sure luck played a part in it.

WHERE AM I NOW?

There is the disbelief that I was actually  deep in the middle of it all.  I actually looked at the face of someone who was clinically dead and he pulled through?   I came back from the Dentistry Show the day after ‘the event’ and went straight to the surgery, to call the hospital to see how he was. There was a slight eerie feeling going into that empty building, into the surgery. It was all clean, tidy and quiet. I could not help but wonder if 24 hours earlier, did all that really happen?

The suddenness of it all is what is so frightening. There were no medical history concerns.  One minute he was there, two minutes later he was gone. If he had been in his car, 5 minutes late for his appointment, he would have had it in the car and could have ploughed into a bus stop with men, women and children.

I value my life much more now.  An appreciation of what I have, life, wife and children,friends and who I am.  So much we take for granted. 

I was surprised how well we all were when we attended to patients two days later.  It will take some time for the slight apprehension to dissipate.  Is this person going to suddenly have a heart attack on me?

The recent developments, all the nonsense, in the dental profession had really got me down.   All the effort in having to keep a surgery running with all the nonsense regulatory compliance and then having more piled on, unnecessarily.  I had been tired of putting so much effort into working as a dentist and getting so little back in return as the pressure of legislature piled on.  I was tired of legislature getting in the way of patient care. 

This ‘event’ has helped me to see things in perspective. This has been a good boost in morale as at least, all this effort came to fruition.  I am very proud of my staff and I hope they are of themselves too.

There is a mixture of emotions or feelings in myself.  Of course there is an immense feeling of gratefulness that we had a positive outcome.  Then, there is the feeling that one has been in a ‘privileged’ place, if that’s the word to use.  To have been involved in the thick of things and have a positive outcome.  Then there is something else I am aware of.   I am not sure how to describe it but it is a good feeling……….there is a deep seated feeling of stillness.

Every so often, the words that still ring in my ears:  “You had the defib……you saved his life.”

That inner stillness…..is….good.

Chris.

Dr Chris Tavares,

Dental Practitioner, Derby

April 2015

This blog was first published in April 2015, a few days after the event. In May 2016, after seeing more data, Dr Chris Tavares added the following:

I wanted to correct a few inaccuracies so as to be fair to the East Midlands Ambulance Service who did such a fantastic job on the day and to give credit when and where credit is due.

In the heat of things, a second can seem like a minute. A minute can seem like three minutes. I was able to download the data from the AED which records an ECG tracing every second. The AED analyses the rhythm every 2 minutes and advises to shock or not.  I was able to work out the exact timeline from this.

The heart was in VF.  CPR was started within 10 seconds of cardiac arrest.  The first shock to the heart was within two minutes of cardiac arrest.  The first paramedic arrived 5 minutes from the time we dialled 999. The five paramedics were in the surgery for about half an hour when a normal heart rhythm and spontaneous respiration were re-established and the gentleman was taken to the hospital. 

I have no doubts the rapid sequence of responses added to the positive outcome.

 The whole situation can best be summed up:

 “We did what we had to do ... the paramedics did their magic ... and the hospital staff performed the miracle.”

The gentleman is alive and leading a full life, no brain damage, no external scars.

Buy an Automated External Defibrillator and save a life.

On Monday 30^th March the Church Street Dental Practice in Caernarfon re-opened  under the expert guidance and leadership of Simon Gallier, a dentist with 32 years of experience.

Two recognisable members of staff are working alongside Simon; Sian Roberts and Jenny Ellis. The team worked  hard to get the practice back up to speed to welcome as many patients as possible.

Speaking about the reopening, Simon said, ‘We are excited to welcome our patients – new and old – to the practice. We’ve been busy behind the scenes getting the practice up and running again, and we look forward to delivering exceptional dental care to the local community.

‘Why not visit the practice to see some new and some familiar faces for yourself, working in a newly super-efficient and, as always, caring environment. We’d be delighted to see you.’

Church Street Dental Practice offers a unique model for running a dental practice. Maintained by Future Health Partnership as a community interest company, Simon, Sian, Jenny and their colleagues each own a share of the business, much like John Lewis partners do.

If you would like to book an appointment for a visit or to talk to someone about your dental care, please call (01286) 672601 or email This email address is being protected from spambots. You need JavaScript enabled to view it..

Leanne Ridley, Dental Nurse at Ghyllmount Dental in Penrith says:

“With The Dental Directory, online ordering makes it really easy and we are moving over to a big, monthly order schedule very soon. We use The Dental Directory for all our consumables.

“We have done price comparisons recently and The Dental Directory was shown to be very competitive. Our rep, Rebecca keeps in touch, which is great and will go through new deals with us, although we obviously get the flyers through the post and can see offers online. Rebecca is very efficient at dealing with our practice needs.

Our experience with The Dental Directory is that they are easy and positive to work with and I would recommend them.”

For more information, contact The Dental Directory on 0800 585 586 or visit www.dental-directory.co.uk

Practice Plan presents an overview of the current situation with NHS dentistry, to help dentists make an informed decision as to what may be best for their patients in the future.         

Dental contract reform – prototypes

On 15 January, the Department of Health announced that a new stage of reform will start in 2015/2016. In this new prototype stage dental practices will test whole versions of a possible new system, rather than, as in the pilots, key elements needed to design a new system.

The prototypes will consist of:

• A clinical pathway

• A set of clinical measures (DQOF – Dental Quality and Outcomes Framework)

• Remuneration better aligned with access and clinical outcomes (a blend of quality, capitation and activity).

The prototype stage is intended to be a forerunner of a reformed system, but is not the final version. Wider adoption of the approach depends first on the prototypes demonstrating this is a viable approach.

Prototype practices have not yet been selected, with the process potentially continuing until 2019, the earliest date at which a reformed contract could become the prevalent approach.

In 2014, John Milne, Chair of the BDA’s General Dental Practice Committee (GDPC), spoke at a series of Local Dental Committees-organised roadshows offering valuable insight into the NHS contract, both now and in terms of what the future might hold.

A significant issue for the dental professional as a whole, is that the potential reform of the dental contract has been the subject of considerable discussion for many months now, with pilots continuing in 2015.

As Dr Milne noted at the 2014 Local Dental Committees (LDC) Conference and was subsequently reported to say on the LDC website: ‘…on-going pilots were not the finished article but were intended to contribute to a workable reform. He [Dr Milne] reminded delegates of his demands of the minister at the BDA Conference: some clear commitment from Government to make progress; expansion of the pilots and modifying them to make them into a real test to be some sort of prototype and a clear timetable and a roadmap to implementation. He had also said that practitioners would need preparation as part of training time for practices, and maybe a release from the UDA targets during the transitional phase. The Minister wasn’t able to confirm this last demand, but was able to confirm the first three.’

Dr Milne ‘…also reflected on some of the big questions GDPC had discussed around capitation contracts at their recent meeting and urged delegates to consider these and discuss them with speakers; e.g., what are the risks and benefits of arguing for the highest possible percentage of capitation? How do we avoid neglect? How do we monitor the capitation contract? Should there be a limit on who gets care? How should activity measures be paid for? How do we avoid the disadvantages of the UDA with its perverse incentives? Should payment for activity be limited to just advanced or complex care? And can we actually define what those things are?’

Practical application

So, what does this mean in reality for NHS dentists? For most of those working at grass roots level, thus far nothing has changed, but for the piloting practices, it has been an interesting journey. 

For example, in July 2014 at the Westminster Health Forum seminar on oral health inequalities, dentistry commissioning, regulation, and the dental contract reform, dentist Sabrena Kara shared with the audience that the new system had led her to overcome a backlog in care by improving time management and using dental therapists to provide treatment, allowing her time to deal with more complex dentistry.

Other comments from pilot providers, published in last year’s report from the dental contract pilots evidence and learning reference group, include:

• ‘I think I could make it work better if I had a hygienist or therapist, that would make a massive difference because I could then you know, offload…I’m a very expensive hygienist at times really’

• ‘The patients are very positive… actually love it because they get such a lot of personal attention and they think it’s great, marvellous’

• ‘…to do the pilot properly takes longer… you’re talking to the patient more… I’m not saying that’s a bad thing but I just think it should be taken on board if we’re spending less time treating people… there’s either going to be a shortfall somewhere, there’s going to be complaints or there’s an element of people who might consider going somewhere else’

• ‘The throughput of patients has reduced and so there’s a pleasanter atmosphere. They’re [the dental team] not rushed off their feet like they were and it’s a more steady pace…they’ve had a little bit more work to do explaining to the patients about ICs and charges...I think they’re happier’.

These comments suggest that there may be a need to balance the time required to deliver the preventive aspect of the clinical pathway with treatment, but actually that isn’t anything new for NHS dentists. There is always a learning curve with anything new, and one hopes that results gathered from the ongoing pilots will help to make any transitions as easy as possible for the dental team.

Looking to the future

There is a general sense among the dental profession that we are most likely looking at the introduction of a reformed contract that will not drastically change, let alone improve NHS dentistry. 

With patient care the focus of the current contract, and, presumably any reforms, for dentists happy with the NHS status quo of restoring the function of dental health in the most cost-effective way possible, the big question is whether the remuneration will be sufficient to run a viable business. Sadly, as has been the case for many years, the NHS is squeezed for funds and, much as we would all like to consider only the level of clinical care, no-one can hope to continue to run a non-viable business.

Nonetheless, NHS dentists have worked hard to ensure patients get the best possible care under the existing contract and, no doubt, will strive to do the same under a reformed model, if the parameters of what is on offer allows them to meets their clinical goals and the needs of their patients, while maintaining a viable business.

Practice Plan is the UK’s number one provider of practice-branded dental plans. They have been supporting dentists with NHS conversions for more than 20 years, helping them to evaluate their options and, for those who decide to make the change, guide them through a safe and successful transition to private practice. So, if you’re thinking about your future and would like some expert advice you can trust, then call 01691 684120 or visit www.practiceplan.co.uk/nhs.

Dentist David Griffiths shares his experience of those first few, all-important years in practice with Young Dentist readers.

I knew from the start that I would begin working primarily under an NHS contract. Upon completing my training, it felt a ‘safer’ environment in which to initially advance the techniques, skills and practical abilities I’d learnt during my undergraduate studies.

I believe it would be almost impossible to be employed by a private dental practice as a new graduate (in the UK) without any prior experience, as usually employers would request a minimum of two years’ clinical experience post-graduation. Also, new graduates usually have zero business experience and are in no financial position to set up their own practice. Therefore, initially working under an NHS contract is the natural progression after graduation.

The ups and downs of the NHS

The benefit of working under an NHS contract is that it provides professional stability. I did soon realise, however, that there were some less favourable aspects. Despite the current NHS contract being able to benefit patients in the majority of clinical scenarios, there are some circumstances in which private options become more feasible. When treatment does not fall within NHS’ criteria, it can lead to patient dissatisfaction with the dentist, rather than the system.

Also, if a dental practice is to survive within any community, it must engage with it in a positive way, and so dentists must be able to spend time providing treatments that patients are happy with. The NHS contract may be seen as only allowing the time fundamental to completing treatment. Additional time would be appreciated to enable, for example, building rapport with patients so that they are more likely to return for follow-up care, or to expand on long-term treatment options.

Sharing knowledge

There is limited impartial guidance regarding the benefits and downfalls of a career either under an NHS contract or providing only private treatments within the undergraduate curriculum. This division is rarely discussed, as it is not a simple case of NHS versus private.

For those a few years behind me I would recommend they gain experience in both these areas either before or in the years following graduation, to experience the diversity of the spectrum of treatment for themselves.

Training should focus on the ability to carry out good quality treatment and be expanded upon during a dentist’s career within their level of competency. It is up to the individual to decide what form this should take

 Biog

After graduating from Liverpool University in 2011, David Griffiths moved to Newcastle to complete a two-year General Professional Training programme (VT1 and 2), which included working within a large NHS practice in the centre of Sunderland and within several specialist departments in Newcastle Dental Hospital. Following this, he worked as an Oral and Maxillofacial SHO in the Royal Victoria Infirmary Hospital in Newcastle. Currently, David is working back in Merseyside, beginning his first year within a General Dental Practice as a full-time associate dentist; he focusses primarily on NHS treatments and the practice offers private care through a patient membership plan administered by Practice Plan.

If you’re thinking about your future and would like some obligation-free expert advice you can trust, please call 01691 684120 or visit www.practiceplan.co.uk/nhs.

GDPUK are proud to be sponsoring the GDP Theatre alongside Colgate at next weeks Dentistry Show. 

This theatre will provide further insight into both new and everyday clinical techniques and procedures. Experts in their respective fields will run sessions covering a variety of subjects from endodontics to pain management to a new approach to electric toothbrushing!

Another focus of the theatre will also be the recent changes to the rule and regulations governing the profession, how they affect you and what you have to do to demonstrate your compliance to them.

Below you will find the latest timetable for the Theatre. (subject to change)

Please come and visit GDPUK at the Dentistry Show - Stand E01

The GDPUK stand will be situated next to the GDP Theatre.

Look forward to seeing you all at the Show.

Isn’t it funny, as a child you can’t wait to leave school and get away from all that ‘edumacation’ and then something weird happens.  

It probably starts to emerge in your late 20’s and really kicks in through the next couple of decades. We morph into stay at home information junkies and search the internet for books, DVD’s and training modules to expand our minds!  All done from the comfort of your home.  

Devoting other precious minutes of your time to ‘staying in-touch’ via Social Media which in many ways could be better named Social Pariah as the last thing it is ….. is particular social as you hammer out your latest Post from the bathtub!

So our internet based information driven society means we are becoming increasingly neglectful about personal contact and building those all-important relationships with colleagues as we would have done in the past.  

Dentistry IS all about people – from the Team in your Practice to your clients coming through the door.  So our ability to communicate the right way is fast becoming challenged.  Leaving many a Team’ lost for words’ which won’t build a motivated Team or a loyal client base.  

So for me the Dentistry Show is all about making new connections and reconnecting with others.  Putting the face of NBS Training at the forefront of everything I do and stand for.  But above all it’s about sharing valuable information with people.  People who truly want to build an inspirational Team who excel in the eyes of every client for their award winning Patient Care.

Tracy Stuart will be speaking at the Dentistry Show

Further information about her business and ideas can be found here - www.nbstraining.co.uk

Chris Barrow will be among leading business experts from across the dental profession speaking at Practice Plan’s Practice Management Conferences in June.

Delivering an unmissable session on how to develop and grow your practice, Chris will introduce delegates to the latest innovations and thought in practice marketing in his session ‘Boosting your profits and how to do it”.

In Reading on 5th June and Manchester on 19th June, Chris will take attendees on a guided tour on how to market and manage your practice and provide a clear understanding of ‘what you should do next’ and how to avoid missing the boat.

If you’re looking for solutions to your practice marketing and want to learn from the experts, make sure you attend the Practice Plan Management Conferences in June.

For more details please contact Sarah Whittall, Practice Plan at This email address is being protected from spambots. You need JavaScript enabled to view it.

For more information about the business services available from 7connections please call 01647 478145,

email This email address is being protected from spambots. You need JavaScript enabled to view it. or

visit www.7connections.com.

Spinalis UK is launching the unique concept of dental stools and lab chairs designed to allow free movements in all directions. Spinalis stools and chairs are designed to counter the ill-effects of sitting. The seat is mounted on a spiral providing flexibility without bouncing allowing your spine to stay in the correct position without 'breaking' in the lower back and relieving disc pressure. 

Spinalis stools and chairs are the perfect health solution wherever it is necessary to lean over a patient or a work surface while maintaining maximum mobility. The seat and the backrest rotate and move independently, allowing for comfort in unusual positions.

Spinalis flexible seat mimics sitting on a gym ball, improves core stability and postural mechanisms.

We supply three models of Spinalis dental and lab stools and seven models of Spinalis chairs in a wide range of colours and materials.

Spinalis chairs and stools are high quality EU products a recognized medical device across the EU. All backed up with our three year warranty.

http://spinalischairs.co.uk/

Visit us at this year's Dentistry Show at the National Exhibition Centre in Birmingham at D91 stand.

As the Chairman of the Lawyers section of the National Association of Specialist Dental Accountants and Lawyers (NASDAL), Andrew Lockhart-Mirams, Senior Partner from Lockharts Solicitors, will be in attendance and exhibiting as a member of NASDAL at this year’s The Dentistry Show. The Show is held at the NEC in Birmingham on Friday 17 and Saturday 18 April, 2015.

Lockharts will be supporting NASDAL in attracting various Dental professionals, practice managers and owners at the event, to share their knowledge and skills about a range of issues relating to the accounts, legal, and tax and business affairs for dentists.

Formed in April 1988, NASDAL’s objective is to ensure that it provides a means of establishing a high quality of service to members of the dental profession at all times. The Chairman of NASDAL, Nick Ledingham, along with various other respected members of NASDAL will also be attending.

Andrew Lockhart-Mirams, Lockharts Senior Partner, said “Lockharts Solicitors are delighted to be part of such a fantastic event for Dentists, and to also be supporting NASDAL as a member and exhibiting at this year’s event. It is a great opportunity to for each NASDAL member to bring their specialist knowledge and business to the table and showcase how their individual business are able to support Dentists and more importantly, also collectively under the NASDAL umbrella, to further benefit Dentists and to improve further in all areas of the overall business. NASDAL is the one-stop shop for Dentists for everything legal and accounting.”

Visit Stand G32 at The Dentistry Show to find out more, or visit www.nasdal.org.uk.

We hope to see you there!

Disclaimer: The content of this article is only intended as information and should not be considered to be legal advice. Lockharts cannot be held liable for any loss caused by any act or omission as a result of the information in this article.

The Clock is Ticking

As of writing, there are about 30 odd days to go to the UK General Election [1] and politics may have changed for ever. The 2-party system may well be broken. It seems likely that the smaller parties will have a relatively huge amount of influence over the eventual policies of the Government that emerges. If Proportional Representation had no role to play in “First Past The Post”, it perhaps does under a mixed multi-party system of coalition where FPTP does not produce a clear Government.  A clear outcome is … well, far from clear. I sense a theme I might return to.

Who remembers the HSC?

Until then of course, we are in the frenetic work up to Election Day across the UK, allied to significant numbers of local elections are due to take place on 7^th May.[2] Parliament dissolved of course at the end of March. The Health Select Committee report of the GDC Accountability Hearing will now have to be signed off under the new Government.  Wouldn’t you just love to know what’s in the draft that no doubt sits in a pending tray somewhere?  You can never get a decent leak when you want one! For those of you with short memories in Wimpole Street, it was clear the HSC were collectively unimpressed with the performance of certain executives.

Dentist in Politics

Many Dentists and Dental Professionals play their part in local communities and will have local or national agendas of their own. To all of you, the very best of luck. It’s a busy time.  Stay focussed and may the votes go your way.

Indeed in the GDPUK forum we have our very own blogger Dr Pramod Subbaraman [3] who is a parliamentary candidate for the Liberal Democrat party in Edinburgh South. Scotland of course are still vibrant in their political engagement after the 2014 independence referendum. Sir, we wish you well.  Ironically, if present polls are to be believed, the Independence agenda re-emerge after the election because of the influence of an enlarged Scottish National Party in the House of Commons.

More wet fingered dentists in top level politics is a positive process – it can only help the cause of the nation’s Oral health and ensure that the dental and oral health inequalities rise up the political agenda.  There is a sense of “Rome burning” about the facts on the ground of GA Admissions for children for surgical dentistry [4] while the Department of Health and its mouthpieces at NHS England assure one and all that the system of UDA related access  has clearly been a big success, broadly speaking. I really must get a new pair of hindsight-o-scopes.

You ARE political influence

But imagine you are standing around one day in your local market place and the candidates for your local seat are canvassing your support.  You were planning to “do you bit for the profession” and therefore plan to ask one question. 

What should it be?

What would swing it for you if a candidate were to ask you for their vote?

Let me take you back to a previous blog in which I raised a “Trumpet Call for Clarity of the Deal”.[5]  In it I suggested the GDC might take this role on and demand clear rules on what dental care is available under the NHS.  For those who are interested, I did write to the Chairman of the GDC and he delegated his reply that “It was not their job”. Too busy counting the FtP hearings, I suspect!

The consumer organisation Which? [6] and the Office of Fair Trading [7] tear their hair out over the constant complaint that patients never know what’s available under the NHS and what’s not . Report after report is critical – and yet – this strange fudge is NOT of the dentists’ making.

We did not choose this system or the lack of clarity. 

The DH chose this. It is the Department of Health who seem content to see dentists accused of misleading patients.  What could their motive possibly be?  Surely not to deflect eyes and attention away from the other concerns over Government funding and management of oral health?

It is patently wrong that every individual dentist should decide what constitutes ‘need’ on a one by one process with every single patient.  How can anyone with half a political brain even remotely justify it?

Unclear Prototypes & Mixed Practice

The new Prototype Contracts are being rolled out at “Pilot” level and still there is no clarity.  The now retired CDO was on record as saying it was not required as part of the new contracts. We can but hope that the new incumbent will see sense and change this unsustainable approach.

The future of dental practice in this country will depend on the success of mixed practice.

The ability to fund privately some dental care alongside an NHS funded element is critical to the small business that is dentistry. Multiple strings of income may well be the ONLY reason that many practices will continue to subsidise the State offering for the benefit of their patients.

But there have to be clear rules. At the moment there are NO rules.  In fact it is so ridiculous at the moment that the rules appear to be written only when the patient complains. At that point the GDC seem to think that investing in your London Day Care might be a jolly good use of funds.

If McEnroe had been a dentist ...

Our old ranting tennis star John McEnroe would have had something to say.  “You cannot be serious” [8]

The patient has a right to know where the boundaries lie. All patients should be able to share an experience of the same rules being applied. The dentists need to know where the boundaries lie. 

Otherwise there is a great risk that the GDC call you to order at an FtP hearing should the patient complain that you applied too harsh a judgement of NHS “need”.

So the one question, I put to you, that you should raise with your candidate who asks for your vote is

“Will you ensure Clarity of NHS Dental Treatment?”

Our politicians need to look at dentistry through the patients eye’s, not through the upturned bottle lens that the Department of Health use.

Patients deserve better and it is the Parliamentary candidates you will meet in the next 4 weeks who will influence future policy

At present 22000 dentists apply different rules across 20 patients per day – because that is what the DH require.

That’s half a million confused patients per day

Ask them:  Will you put a stop to the confusion?  Will you provide absolute clarity on what the patient can expect under NHS dental care?  

If not, why not?

Meanwhile – control that excitement out there.   I am off to watch some paint dry …

“Now, will you be voting Mrs Goggins, open wide, there’s lovely, bring the next one up Nurse …!

Makes a change from talking about the weather and holiday plans. May your Easter break be relaxing and Spring like. The onslaught has yet to come!!

[1]          http://may2015.com/

[2]          http://www.parliament.uk/about/how/elections-and-voting/general/general-election-timetable-2015/

[3]          https://www.gdpuk.com/news/bloggers/pramod-subbaraman

[4]          http://www.telegraph.co.uk/news/health/news/10964323/Tooth-decay-is-the-biggest-cause-of-primary-school-children-being-hospitalised.html

[5]          https://www.gdpuk.com/news/bloggers/enamel-prism/entry/907-the-gdc-clarity-of-purpose

[6]          http://www.which.co.uk/campaigns/dental-treatment-costs/

[7]          http://webarchive.nationalarchives.gov.uk/20140402142426/http:/www.oft.gov.uk/shared_oft/market-studies/Dentistry/OFT1414.pdf
 

[8]          https://www.youtube.com/watch?v=ekQ_Ja02gTY

This week marks the beginning of the election period. Parliament has been dissolved, there are no longer any sitting MPs and the most unpredictable and arguably the most interesting election begins! I have had a busy month leading up to this.

There were two Liberal Democrat conferences ( one Federal and one Scottish ). I had the pleasure of meeting with Norman Lamb, the Liberal Democrat health spokesperson at the federal conference and I informed him of the various concerns of the profession, especially those to do with the GDC.

Obviously, it was too late for anything specific from our discussions to get into a manifesto for the election, but I remain hopeful that Liberal Democrat MPs in the next parliament will be more amenable to our concerns especially to do with proposals for a new NHS contract for dentistry in England. In addition, I also met with Jim Hume the Scottish Liberal Democrat health spokesperson and informed him of the issues faced here in Scotland. Unsurprisingly, the GDC figured prominently in that chat too! One thing is for sure and that is " The era of single party government has come to an end ". Whatever the combination of parties in the next government and whatever their arrangement ( coalition or confidence and supply ) it surely will not be a government with the agenda of just one party.

There will have to be discussions about policies and no single person or single group of persons can have undue influence on any policy decision. I also spoke at the Scottish Conference where I gave the EMLD (Ethnic Minority Liberal Democrats) address. In this speech, I stressed the importance of diversity. We see it in the dental workforce and industry where there are more women and minorities than ever before, why is parliament lagging behind so badly? And diversity isn't just about ethnic minorities, it is also about the representation of women, sexual minorities, the disabled, in fact anyone who isn't a pale male! Parliament does need people from non political backgrounds in it and we all lose when there is insufficient diversity. The most successful businesses are those that can represent the diversity of their target populations in their work forces and on their boards. Parliament should be ahead on that count! Not far behind as it is now!

I had a hustings on the 26th of March which I attended on behalf of the Edinburgh North Lib Dem candidate. The hustings was conducted by the left leaning Common Weal. It was a very interesting first experience and I will report on the various hustings' that I attend over the coming weeks. This week, my nomination papers will be filed and I will be working on producing a second campaign leaflet as well as an election address. Interesting times ahead! I now hope to be able to contribute to this blog weekly and then maybe daily in the last few days leading to polling day and afterwards until the formation of a new government with an analysis of what I see on the ground.

Next week, my plan is to discuss the various manifestos.

Friends and Family Test [FFT]

The FFT will be introduced to dentistry in England on 1^st April 2015, which some might consider an appropriate date to introduce such a tool. David Cameron is an enthusiastic supporter and believes this simple test will provide “a single measure that looks at the quality of care across the country."

Others, including the Picker Institute, the Kings Fund and the British Medical Association are somewhat less impressed with the value of implementing such a tool. Chris Graham of the Picker Institute has stated that “the ‘simple, headline metric’ used for the test does not provide a reliable basis for comparing services or identifying those performing best.” Dr Kailash Chand, deputy Chair of the BMA, is slightly more direct in his criticism. He has described the FFT as a “political gimmick” and asserts that the last thing we need is to collect “more meaningless or misleading data”, a comment which I’m sure will resonant with many dentists.

Sadly this point is obviously lost on the Prime Minister, who continues to believe that the FFT will allow everyone to “have a really clear idea of where to get the best care”. It is hard to believe that such a simplistic tool could actually improve the quality of patient care in dentistry. (I refer to the FFT, and not the Prime Minister!) 

The only value would appear to be in the free text question, which we have naively been given freedom to design ourselves.

The simplest approach would be to ask …. “Why?”

As in, “why did you answer the previous question in the way which you did?” Rather than “WHY?” in the context of a dentist screaming at the moon, as another pile of ill-conceived bureaucracy is dumped on them from a great height courtesy of some narcissistic NHS manager.

Other suggestions for free text questions have included:

“How much of a waste of time do you think this is?”

“What three words best describe the people who developed this questionnaire?”

In the spirit of Patient and Public Involvement, it might also be worth considering the following as a suitable second question…..

“What question do you think we should include as our second question?!!!!”

It is tempting to treat the FFT with the respect which it deserves. NHS England appears to be resigned to this approach, judging by the fact that there is currently no target set for the number of responses required! The introduction of FFT is a contractual obligation and I can’t imagine that this laissez-faire attitude will persist. Perhaps they will include it within a future iteration of the DQOF as another measure of how well we complete our paperwork. The term “biro dentistry” is about to take on a whole new meaning!

So what should you do?

In our practice, we are fortunate to have a highly motivated, efficient practice manager, who seems to revel in the imposition of NHS bureaucracy. She obviously looks at the FFT as yet another challenge to be overcome, and failure to do so would be seen as a sign of weakness. She has organised strategy meetings, staff training, team discussions and already delegated duties. None of which involve me filling in a pile of FFT forms…… as yet!

There is unanimous agreement within our practice that the FFT question is a complete waste of time. It is not a reliable indicator of quality and provides inadequate information compared to our existing patient questionnaires. We see this as an additional burden on our staff, our patients and our practice, but will reluctantly comply and attempt to use the free text question properly to gather some feedback.

So what should the profession do?

As a profession, we need the BDA to take a strong stance and challenge NHS England on the introduction of additional bureaucracy, which quite clearly has limited patient benefit. It is correct that the BDA support the introduction of measures of quality, but such tools need to be valid, appropriate and worth the paper they are written on. 

Patient experience data is of considerable value in terms of improving the quality of patient care and there is obviously an increasing amount of data that is going to be collected, analysed and interpreted. This takes time and resources, but can only be justified if the data collected is robust, reliable and can ultimately be translated into improvements in patient care. If the data is not robust and reliable, the exercise will be a waste of time and simply add to the level of unnecessary bureaucracy and administration, which we have to deal with. It is not acceptable to measure what is easy to measure, rather than what is actually meaningful. This is ineffectual, burdensome and demoralising for staff.  

Jocelyn Cornwell of the Kings Fund states that “patient experience measures will only work if clinicians as well as managers take them seriously, and in general they don’t. Clinicians will reject measures they see as inappropriate or unreliable, and will not act on the results.”

We have an opportunity to put quality at the heart of the dental contract reforms, and Patient Reported Experience Measures are going to play an important role in the evaluation of quality. The current approach of NHS England does not instill confidence and it is therefore vital that the BDA, the FGDP and others influence how quality is measured within general dental practice.

1.    Department of Health. NHS dental services in England - An independent review led by Professor Jimmy Steele. In: Health Do, editor. London: The Stationery Office; 2009.

2.    Professor the Lord Darzi of Denham K. High Quality Care For All. NHS Next Stage Review Final Report. London2008.

3.    Kings College London and The Kings Fund. What matters to patients'? Coventry2011.

4.    Department of Health. Dental contract reform: Prototypes, Overview document. In: Legislation and Policy Unit DaES, editor. London: HMSO; 2015.

 Image credit - Glyn Lowe  under CC licence

Get more from GDPUK. Save money and improve your services with our exclusive partner offers.

GDPUK is partnering with carefully chosen providers to offer you services and products that will be of value to you and your practice.

We’ve chosen trusted providers whose products or services have already achieved positive feedback from members, and who have promised to provide a high level of service and support, along with competitive pricing.

Commissions or referral fees earned by GDPUK as a result of introducing members to service partners will be ring-fenced by us for future use in advancing appropriate causes relevant to the profession.

Further information on what we are offering can be found here - www.gdpuk.com/services

Insurance is one of the services we are pleased to be offering to our members.

Save money and receive better service with our bespoke, brokered insurance for dentists. We have reached an advantageous arrangement with reputable insurance brokers who have extensive experience in arranging both professional and personal cover for dentists.

Through our partner brokers, you will receive all the claims handling and underwriting flexibility available from a good broker, along with highly competitive quotes.

What cover can you arrange?

Our brokers will be pleased to discuss your precise requirements with you, and then to prepare personal quotes providing you with the most suitable cover at the best available prices. Should you need to extend or adjust your cover, or need to claim against your insurance at any time, you’ll be assured of their attentive and knowledgeable assistance.

Insurance can be arranged in the following principal areas:

• Practice and Surgery Insurance
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Click on the link below for further information and fill out the form at the bottom of the page. We will then forward your details automatically to our broking partner who will contact you to discuss your requirements.

They will then prepare some quotes for you and progress your application directly and in a timely manner.

www.gdpuk.com/insurance