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Making decisions to make progress - Tim Bradstock-Smith

Making decisions to make progress - Tim Bradstock-Smith

The most responsible elements of a dental professional’s remit is making effectual clinical decisions and planning appropriate dental care. Most often patients seek treatment to address comfort function and aesthetics but this can be compromised by fear, cost, time and access.

Practitioners are able to base clinical decisions on their professional knowledge, scientific evidence and experience. However, in order to preserve the trust and to serve patients well, dental professionals must take time to understand their expectations and limitations before any treatment begins.

Patients favour a personally active approach to dental treatment. A collaborative decision, with patient and dentist equally sharing responsibility for decision-making, is increasingly popular.[1]  As well as examination, diagnosis, determining aetiology and formulating appropriate treatment options, individual preferences and requirements should be tailored into the treatment plan. Additionally, well-informed, engaged patients are placed in a stronger position when deciding between treatment options and are more likely to take ownership of the final treatment decision and outcome.

Patient expectations should be considered carefully and practitioners need to recognise that the focus of the general population has shifted from ensuring teeth are healthy and pain free to an ever-stronger desire that they should also be aesthetically pleasing.[2] As a result, the demand for higher standards of treatment and cosmetic procedures are on the increase, but when both the practitioner and patient bring value and information to the treatment plan they can build an agreement together, which is more likely to result in patient satisfaction.

There will, of course, always be occasions when things happen that are beyond our control but by covering every eventuality, both patients and professionals can be aware of any factors or risks that could compromise the treatment outcome. When shared decision-making takes place, patient acceptance of any less desirable consequences increases and the likelihood of complaints and claims arising from clinical decision-making are also reduced.

Planning well is an attribute that all professionals aspire to achieve. It is particularly important in the dental practice because a detailed treatment plan is beneficial not only for the patient and practitioner but the dental team and laboratory. With forward thinking, realistic scheduling and organisation, the skills, services, materials and time can be communicated and allocated efficiently to ensure the most effective results.

At times, cases present that are beyond the technological parameters or skill set of the practice. This could be due to the complexity of the treatment or due to the patient needs and enhanced imaging, sedation or specialist clinical skills may be required. Whatever the circumstances, dental professionals need to recognise any limitations and make a decision to refer.

Calling upon the additional assistance will ensure the success and accuracy of treatment. Furthermore, it extends the professionalism of the referring dentist and practice. However, these professionals must be able to trust the people and services they chose to work with and have confidence in their expertise.

London Smile Clinic is able to provide a referral service that can be integrated into any treatment plan. Referring dentists can rest assured that they will remain informed throughout the treatment and feel confident that their patients will receive first class treatment to achieve the most successful results possible.


For more information, please contact 020 7255 2559 or



[1] H Chapple, S Shah, A-L Caress & E J Kay. Exploring dental patients' preferred roles in treatment decision-making – a novel approach. British Dental Journal 194, 321 – 327.  Published online: 22 March 2003 | doi:10.1038/sj.bdj.4809946.

[2] House of Commons Health Committee Dental Services Fifth report of Session 2007-08 HC 289-I 2 July 2008.


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You’re never too old to wear a brace - Tim Bradstock-Smith

You’re never too old to wear a brace

With near-invisible options available, plus faster treatment times, it is no surprise that more adults than ever before are embarking on orthodontic treatment.

With the means to afford it, they know that improving their teeth will benefit them professionally as well as personally, particularly if they add an adjunctive treatment like whitening. Orthodontics are now much more stable than they were in the past; correcting work they had done as a child is also highly appealing.

It is far easier to practice a successful oral care routine and keep the mouth clean if teeth are aligned properly and gaps closed up. Correct a patient’s bite and you can reduce toothwear too. A course of orthodontics may also prevent problems with the gingiva getting worse.

However, it might be the case that not only do you not currently offer orthodontic treatment, but that you have no plans to do so either. The cutting-edge OPG machines and 3D scanners on the market are exciting, yet out of the reach for many, particularly if you are only seeing a couple of potential cases a month. The technology is moving fast and staff need to be trained and retrained.

Referrals are not something to be feared - you will not ‘lose’ your patient. Instead, referring out can enhance and expand your treatment provision. It can also be a conduit to building and consolidating loyalty. By referring people out to a trusted partner, you are saying that, although you do not have the resources to provide the required orthodontics yourself, you want to give your patient a successful route through the (expensive) minefield. Especially if their previous experience of this kind of treatment was not a positive one, you will be supporting patients to improve their smile and oral health with the help of a clinician that you trust.

Adult orthodontic patients have high expectations of aesthetically pleasing and stable results.  They are aware of the choice out there and will use the internet to look at practitioner reviews and compare pricing. They will know what they want to achieve, including a reassurance that they are in safe hands. Choose your referral partner wisely – you want to feel confident about a successful outcome every time. For example, The London Smile Clinic has world-class specialists, plus has the latest technology already in place to guarantee fantastic results for even the most complex problems.

Investing time and money in developing new services can be daunting and, for many practices, an impossible notion. Referrals can be an easy solution to the rise in demand for adult orthodontics. The right referring clinic will work with you to allay your patients’ fears and promote the benefits of the latest ethical and minimally invasive techniques. It is therefore crucial to find the best referring partner for you, to make life easier for your patients as well as guaranteeing excellent results.  


For more information, please contact The London Smile Clinic on 020 7255 2559 or visit


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Scanning solutions for elderly patients - London Smile Clinic

Scanning solutions for elderly patients - London Smile Clinic

Orthopantograms, or OPGs, have many benefits and a huge number of uses. They are especially useful in the treatment and care of elderly patients, who will be a huge proportion of your caseload if not now, but in the future.

OPGs are a powerful tool to have at your disposal. They can give you information on periodontal bone loss, help find the source of pain, assist with the correct placement of implants and much more. Digital OPGs mean fewer repeat scans are needed, so less time and cost required, and also less exposure to radiation. Patients can usually understand a panoramic image more easily and they can be emailed to colleagues effortlessly.

These images are also invaluable when dealing with challenging cases, such as elderly patients. The number of older patients you will be treating in the future is growing – and fast. In 2012, the BDA published a review of its 2003 Oral Healthcare for Older People report[1] which concluded that the ageing population was growing faster than had been originally predicted.

OPG scans are quick and comfortable. The detail means that you will be able to anticipate future complications.  Caries, periodontal disease and recession of the gingiva can have devastating consequences as a patient gets older and can lead to life-threatening complications, such as cardiovascular problems and diabetes. Type-2 diabetes generally affects people over the age of 40, and oral health is a key component of diabetes management, so it’s a two-way relationship. If a patient has type-2 diabetes, they are also more likely to develop gingivitis, caries and xerostomia, too.[2]

Setting up an OPG scan is quick, and OPGs can be used comfortably for elderly people who cannot open their mouths wide. Patients are usually asked to bite down on a spatula for about a minute while the machine moves around the head. A detailed, informative scan that won’t have to repeated and is easily explained will help you move forward with implementing an effective treatment plan with confidence.

If you do not have OPG technology, look carefully for the right referral partner. Work with a practice that not only has the latest OPG equipment in place, but that employs clinicians who can be trusted to work sensitively with older people and other vulnerable groups. The London Smile Clinic takes referrals, for example, and will meet all of these needs with ease and professionalism.

OPGs will help you deal with the enormous challenges ahead as you treat more elderly and vulnerable people. With a saturated market, and expensive technology that is developing fast, you don’t have to invest in new equipment. Referring out can be the perfect solution to provide the highest-quality care for these patient groups now, and in the future.

For more information, please contact The London Smile Clinic on 020 7255 2559 or visit


[1] BDA. Oral healthcare for older people 2020 vision. Check-up January 2012. Found at (accessed 7 July 2015)


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The Power of Personalities - Tim Bradstock-Smith

The Power of Personalities - Tim Bradstock-Smith

Our personalities show individual differences in behaviour, feeling and thinking. We are all unique and some of us are extrovert and some introvert, but a mix of personalities can be very useful in the dental practice.


A blend of both social and analytical skills is required for a successful dental team. For example some dental professionals may feel shy around patients but excel in clinical tasks or organisation. Others may have a warm chair-side manner and are able to put patients at ease instantly, but may struggle with elements such as keeping records or ordering supplies. There are many elements that go into team chemistry and performance, which frequently fluctuate and coexist at varying levels.


The diversity of patients that visit the practice is also an eclectic mix of personalities that may act very differently at the dental surgery. Some enjoy meeting people, having a chat and telling the dental team about many facets of their lives. Others prefer to remain quiet and simply want to get in and out. Some patients are able to cope with all types of treatments without worry while others can become very anxious. Indeed, national surveys reveal that around 36% of patients experience moderate dental anxiety and 12% of adults are classified as having extreme dental anxiety.[1] It is the role of the dental professional to evaluate how patients feel and behave and to conduct their service accordingly.


Of course it is impossible to understand all personalities but it is important to remember that everyone is different. Even the most shy or fearful patients attend dental check ups while battling with a whole host of anxieties. In all cases empathy is needed with a non-judgemental, kind and gentle approach, the dental team need to be able to assess the reactions of their patients and adapt in order to provide the most appropriate care.


Sometimes in order to achieve the best results and to keep the interests of a patient at the forefront, it may be necessary to refer them to a specialist practice. However, the referral practice needs to work well alongside your practice to ensure good communication and successful results. With patient care a priority, when you choose a referral practice you need to feel confident that their team have the ability and skills to treat your patients whilst also fitting in well with the personalities and characteristics of you and your dental team.


London Smile Clinic is a referral practice with a team of specialist dental practitioners that are experienced in liaising successfully with dental professionals on all levels. They understand the variances of personality and provide open communication, trust and confidence to both practitioners and their patients. As a centre of excellence with exceptionally high standards of clinical dentistry, London Smile Clinic can offer a range of specialist orthodontics, implants and periodontal treatments and can consistently extend a professional and considerate approach to all patients.


You may not always be able to work with perfect people but recognising their strengths is a valuable step to building a well-rounded team of people that will not only streamline operations but also help you to achieve the most favourable results for your patients.


For more information, please contact the London Smile Clinic on 020 7255 2559 or visit

[1] Adult Dental Health Survey 2009.
pdf [Accessed 25th February 2015]


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