Toothy Tigers - ESSENTIAL KNOWLEDGE FOR DENTAL PROFESSIONALS IN SCOTLAND JUNE 2021 - Scottish Dental magazine
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E S S E N T I A L K N OW L E D G E F O R D E N TA L P R O F E S S I O N A L S I N S CO T L A N D
JUNE 2021 RRP £5.50
Toothy
Tigers
D e ntal s tude nt s’ initiative to p rom ote
goo d oral he alth am ong childre n
2 | Scottish Dental Magazine
JUNE 2021
E N S U R E YO U CO N T I N U E TO R E C E I V E S COT T I S H D E N TA L M AG A Z I N E
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V i s i t W W W. S D M A G .C O. U K / E M A I L - S U B S C R I B E
04 Editorial
07 Insider
09 News
FEATURES
24 The growth in private care
41
plans
28 Celebrating Vermilion’s
10th anniversary
34 Practice recovery and
remobilisation
36 CDO quizzed on where
next for dentistry?
40 Report from the annual
Scottish LDC Conference
42 Launch of CGDent - bringing
the dental team together
44 The Glasgow graduate
rebuilding dentistry in Mosul
46 Making mental health
a priority
47 Running Scotland update
48 Dundee’s Toothy Tigers
MANAGEMENT
44
50
Never let a good crisis
go to waste
52
Dental managers take
the floor
PROFESSIONAL FOCUS
54
Advisers and suppliers
72 Meet the Professionals
78 Product News
MANAGING EDITOR ADVERTISING EDITORIAL BOARD © Connect Publications
David Cameron Ann Craib Tony Anderson Peter Ommer (Scotland) Ltd
david@connectmedia.cc Tel: 0141 560 3021 Roger Currie Andrew Paterson The copyright in all articles
ann@connectmedia.cc Ulpee Darbar Professor J Mark Thomason published in Scottish Dental
EDITOR
Dr Michael Davidson Dr Donald J Thomson magazine is reserved, and
Will Peakin DESIGN
Toby Gillgrass Professor Angus Walls may not be reproduced
Tel: 0141 560 3019 Scott Anderson
Professor Mark Hector without permission. Neither
editor@sdmag.co.uk
SUBSCRIPTIONS Professor Richard Ibbetson the publishers nor the editor
Will Peakin Gordon Morson necessarily agree with views
Tel: 0141 560 3019 expressed in the magazine.
editor@sdmag.co.uk ISSN 2042-9762
June 2021 | 3
Editor
Will Peakin editor@sdmag.co.uk
Follow Scottish dental on Twitter at: @ScottishDental
As a patient,
I just don’t get it
H
ere’s my Nye Bevan anecdote; the second – free care for all NHS patients – is to be delivered over
founder of the NHS once bought my the lifetime of the parliament; that is, five years. He said they
mum a fish supper. I remember, as a were “mindful” of the potential for increased demand, even
child, her telling me and her specific use initially with care experienced patients. “In terms of the free
of the phrase “fish supper”. Which is odd, dental care,” he said, “in my mind that’s tied up with the new
given she was born in Murton, County model of care that we were hoping to do. There’s probably no
Durham, where her father was a miner point in having two major policy changes over the course of the
and a local councillor. Or perhaps not. Possibly fish supper is Parliament – ‘let’s make dentistry free and then let’s completely
a phrase commonly used in the North East of England. I don’t change the system of how we deliver dentistry’. Our view is
recall. Sweet and sour chicken and fried rice was more my part of that system reform will bring in a new, preventatively
thing as a teenager growing up in Durham City; more effective, focused, patient centred dental system that is free at the point
come the end of an evening, at absorbing previously consumed of care, and we’ll do both things together.”
pints of beer. Or possibly it was because of a family affinity with And we could be talking five years.
Scotland (see ‘Cross-contamination laddie’1). Anyway, I digress. As Scottish Dental went to print, there was a warning
On the occasion of the fish supper, Bevan was in Murton of “flaws” in the Government’s plans for interim tiered
campaigning on behalf of my grandfather. support arrangements (see page 18). It is understood that the
What I had not known, shamefully until quite recently, was Government currently plans to use Item of Service (IoS) as the
that Bevan – and Harold Wilson – resigned from the Labour sole measure of activity in the forthcoming arrangements. It
Government in 1951 because their colleagues forced through is said that using IoS as the sole measure of activity will force
a proposal to introduce prescription charges and fees for young patients to the back of the queue, widening the gap
dental and optical care. Now, here we are today, with the SNP’s in dental health inequalities and increasing the likelihood of
manifesto commitment – and the new Scottish Government’s life-threatening and avoidable general anaesthetic procedures.
policy – to scrap the patient charge for NHS dental care. What Using IoS, as the sole measure of activity also does not take
can possibly go wrong? Plenty, according to the profession. into account the administrative demands of the new Standard
As we report in this edition (see page 9), scrapping the charge Operating Procedures. In all, it is claimed that NHS dentists
– which currently subsidises the provision of dental care by effectively face a pay cut of up to 45 per cent.
around £75m - coupled with the increased demand from In my naïve moments, of which there are many, I wonder
patients, caused by lifting this barrier to access, would require why – and this is speaking from the perspective of a patient,
between £90m and £100m in funding. This is according to an rather than the editor of a dental journal – NHS dentistry
analysis presented at the annual conference of Scottish Local is provided by what are effectively small businesses (and,
Dental Committees (LDCs) and an estimation by the British increasingly, corporates). I get that an entrepreneurial
Dental Association (BDA). approach can help meet demand where the state might be
Is the Government going to faithfully replace that £75m too bureaucratic and slow to respond. A community needs a
funding of NHS dentistry and top it up with another £25m practice, or an additional practice? Go for it. Young, aspiring
to meet the increased demand (and that’s without even practitioners fulfil their ambition and communities are well
taking into consideration the increase in demand caused by served with a mix of NHS and – if they can afford it – private
deteriorating oral health experienced during the pandemic)? “A care. But then other times, I just don’t get it. Why is NHS
hae ma doots,” as my mum might have said (ok, possibly that’s dentistry not provided across Scotland by well-funded – and
stretching it a bit). Scepticism aside, if only it was that simple. leading edge in their expertise – practices, that are purely NHS?
Before we were so rudely interrupted by the pandemic, the If there remains a demand for purely private care – as there is in
Government had been working on its – increasingly general health provision – that’s fine.
infamous – ‘new model of care’ which was intended Of course, that’s probably a step too far for those currently
to replace the then existing Item of Service funding tasked with formulating the long-term model for NHS
model with one that rewarded prevention of dentistry. There are currently around 1,100 mixed practices
disease, not treatment. As I have written previously, in Scotland. What would it cost for all but say, 100, to be fully
it’s difficult to discern what work – if any – has funded by the NHS? Considerably more than the ‘missing’
been done on this during the 12 months-plus of £100m that the profession is currently concerned about,
lockdown. obviously. As I write this, Friday evening is approaching.
As we also report in this issue (see page 36), Tom I may have a beer, or two. And a fish supper; perhaps its
Ferris, the Chief Dental Officer, and his team are alcohol absorption properties are equal to sweet and sour
currently working on the first part of SNP commitment chicken after all.
on dentistry, to remove dental charges, within 100 Editorial, Scottish Dental, June 2020
1
days, for care leavers and young adults. The
4 | Scottish Dental Magazine
June 2021 | 5
Insider
Arthur Dent is a practising NHS dentist in Scotland
Got a comment or question for Arthur? Email arthurdent@sdmag.co.uk
New model of care?
Let’s stop talking about change and start talking about patient care,
and what dentistry can do to treat everyone as soon as possible
I
want to get over COVID-19. Not that I’ve had the stuff that’s coming out and I see no assessment
it. I want us all to get over it. I want to stop of the issues, no understanding of the massive unmet
writing about it. I’m getting frustrated with the need which is growing and will overwhelm us. No
delay to my life and everyone else’s. Midway understanding of the workforce nightmare we face with
through last month, Glasgow was told it had a year group delayed and a large chunk of senior dentists
to remain in Tier 3. The hospitality sector was waiting for the end of financial support measures to
dismayed once again, and the Delta variant retire. Not to mention the DCPs who are on furlough or
was driving a fresh increase in cases. However, the the self-employed equivalent who, if there is no change
early information suggested that this variant, although to provide an incentive or ability to work more, could
potentially more transmissible, does not seem to lead drop from the profession.
to more serious illness and the vaccine appears to be All the time we are talking about a ‘New Model of
useful in limiting its effect. So, are we going to see more Care’, Core Service and financial models including
stringent restrictions again? If cases are rising, then salaries. The SNP and new Government have committed
surely that will be the case? to free dental care for all over the course of the next
Or perhaps not: rather than confirmed cases, should Parliament – without any ability to enhance our capacity
we not be asking about hospital admissions, ICU to see people. I just don’t get it. We are storing up a huge
admissions or deaths? In the first flush of the pandemic, amount of treatment and unmet need, we are facing a
we were told we had to stay home, stay safe and protect serious drop in personnel power and have no clue about
the NHS. Now, the Nightingale hospitals are being stood when we will be allowed to carry out more treatment
down. The vaccine programme has passed 20 million for social distancing and probably PPE supply reasons,
double doses. The only ones left to get the first dose despite the fact we can queue cheek-by-jowl in Tesco
are those aged under 40 and healthy. So, should we (other supermarkets are available), day in day out.
not be starting to think about accepting new cases and I use the same argument that the hospitality sector
concentrating on the more serious numbers? Does it has been using. Shops with little or no control are fine,
matter if we have cases, although controlled, if but a controlled and regularly cleaned environment, like
hospital admissions are controlled and serious illness a dental surgery, can’t be allowed to open up to more
is suppressed? care? Not even mentioning AGPs and ventilation; the
At some point the pandemic stops and endemic starts. PPE donning and doffing, waiting room restrictions, pre-
I’m sure there’s a technical line for this, but the real test screening and one-way systems killing the throughput
must be when the collateral damage is worse than the we need to see enough people to do our regular tasks.
disease. And here we are with dentistry. We are still in Let alone 14 months of backlog.
the mire of this pandemic and there has been no change The ‘New Model of Care’ is supposed to change the
since November. We have been told a ‘New Model of way we work, to enhance prevention. Now, I’m all for
Care’ will be prepared for and that the current financial prevention, but that will not address the current need. Is
support is not fit for purpose and will be replaced with a this really the time to be talking about change? Is it really
new transitional arrangement. This will allow practices the time to focus our attention on ‘New Models’, clinical
to plan, we are told. or financial? Regardless of how good bad or indifferent
Well, we are now more than six months on. We have they will be, the profession will take time to adjust to
no information about patient care, about transitional them and throughput will reduce. We can’t afford that.
financial arrangements, about a new Health Minister, We need everyone’s attention focused on treating
about how we are going to care for our patients and the the patients. When we are still in the midst of a global
backlog, and about what’s going to happen to practices pandemic, when the finances of the Government will
when furlough ends in September. If we can’t deal with be at their lowest and we have a huge backlog across
the communication of some of this information, let alone healthcare, could we concentrate on the real problem?
the detail, then what hope do we have? How do we treat the patients we have and how do we
We are a profession which is becoming factionalised. deal with the backlog of care that we know will be
The BDA, SDPC, SDA, SDPO, CDO and SG are all required? Let’s stop talking about change and start
acronyms for a lack of communication and consistent talking about patient care and what dentistry can do to
thought. I like to think I have a decent handle about treat everyone as soon as possible. We might just save
what’s going on in the profession: I don’t. I’m reading our profession in the process.
June 2021 | 7
8 | Scottish Dental Magazine
NEWS
Scrapping
charge ‘could
cost £100m’
THE SNP’s manifesto pledge to
scrap the patient change, and
consequent increased demand
from patients, would require
between £90m and £100m in
funding, according to an analysis
presented at the annual
conference of Scottish Local
Dental Committees (LDCs) and
an estimation by the British
Dental Association (BDA).
Kenny MacDonald, of Glasgow
& Greater Clyde LDC, told the
Tom Ferris, Chief Dental Officer,
LDC conference last month: “The
speaking at a Scottish LDC
webinar last month reality is that not only will the
Scottish Government have to
meet the cost of lost patient
charge revenue, approximately
CDO’s time in job
£75m, but they will also have to
fund the anticipated fresh
demand for services.”
In 2019, the British Dental
‘should be limited’
Association (BDA) had
undertaken modelling work to
look at the demand suppression
effects that patient charges had
in England. When using a
Appointment must also be subject to consultation, says the profession multiplier on GDS budgets, said
MacDonald, this indicated a
potential cost in Scotland of
£90m. In a letter this month to
THE post of Chief Dental Officer in Scotland have an input into who guides the profession Maree Todd, the new Minister for
should be for a fixed-term and the profession in Scotland. As a profession we should be Public Health, Women’s Health
should be consulted on the appointment, confident the CDO can understand us and and Sport, the BDA put the figure
according to motions passed at the annual represent the profession to the Government.” at £100m.
conference of Scottish Local Dental The calls for the CDO’s appointment to The pledge was also raised at
Committees (LDCs). be subject to consultation and for a fixed the LDCs’ annual conference,
“A set term of office would … show a term came in the run-up to the conference’s with a delegate asking Tom
conscious effort to avoid stagnation of ideas webinar, Scottish Dentistry – where next?, at Ferris, the CDO, how it will be
and concepts,” said Donald Morrison, of which the current CDO, Tom Ferris, spoke. implemented. He said that the
Ayrshire & Arran LDC. In proposing the He faced questions from delegates over the short-term focus was on free
motion, he said: “Dentistry done well should level and quality of communication with dental care for care leavers and
be a dynamic, evolving, forward looking the profession during the pandemic. Ferris young adults, part of the SNP’s
discipline and rotation of this role could be responded by saying: “Before the pandemic, ‘100 days’ package of
a better reflection of this. Better succession CDO letters were relatively rare. We almost commitments, as well as funding
planning would help moderate direction only communicated with GDPs through PCAs, for practices to upgrade
of policy, reintroducing some checks and which are quite technical and may not always ventilation, and on an interim
balances that will help the profession gain and have been widely read. model for funding for NHS
retain confidence in the office, avoiding the “So going forward, the CDO letter can be dentistry as a whole.
compounding and proliferation of entrenched used more frequently to help signal changes But he added: “In terms of the
views.” that are coming, for example the manifesto free dental care [for all NHS
The conference also heard from Arabella commitment [by the SNP to scrap the patient patients], that’s tied up with the
Yelland, also of Ayrshire & Arran, whose charge].” Ferris said that the webinar itself, new model of care that we were
motion said the profession should have and others he had spoken at this year, was a hoping to do. There’s no point in
input into the selection of any future chief format that could be used more extensively. having two major policy changes
dental officer. “In the last year, it has become “Harnessing the power of digital, the over the course of the Parliament
increasingly apparent that the CDO does not simplicity of a CDO letter, and the detail of a – ie., ‘let’s make dentistry free and
understand how general dental practices PCA.” then let’s completely change the
operate,” she said. “Past and current CDOs Ferris also acknowledged the way in system of how we deliver
have come from the realm of public health. which the profession learned of important dentistry’. Our view that system
“While an overall understanding of public developments, for example via a TV news reform will bring in a new,
health is clearly important to the role, the report, was not always as it should have been. preventatively focused, patient
vast majority of dental treatment carried “We learned from that, too,” he said. centred dental system that is free
out in Scotland is in general dental practices at the point of care, and we’ll do
by general dental practitioners. We should Scottish Dentistry – where next?: see page 36 both things together.”
June 2021 | 9
NEWS
More than half dentists
‘emotionally exhausted’
Study also raised concern at unprompted disclosure of suicidal thoughts
A SURVEY of dental trainees and primary dental care staff in this disclosure in the free-response comments of our survey gives
Scotland has found that more than a quarter of respondents cause for concern.”
displayed symptoms of depression, and more than half rated Publication of the study was cited at the launch last month of a
themselves as “emotionally exhausted”. new initiative to encourage all dental workplaces to make mental
The study1 by St Andrews University’s School of Medicine, health wellness a priority. The Mental Health Wellness strategic
Dundee University’s Dental Health Services Research Unit, and NHS steering group was formed through the Dental Professional Alliance,
Education for Scotland, said: “Primary care staff felt less prepared to co-design, develop and maintain a framework that “encourages
for managing their health, coping with uncertainty and financial and enables all dental professionals to act in a timely, appropriate,
insecurity compared with their trainee counterparts. Depressive and safe manner when identifying mental health wellness issues in
symptomology was rated higher than reported community samples. the workplace.”
Burnout was indirectly implicated and a major path from trauma to The framework calls for a ‘mental health wellness lead’ to be
burnout was found to be significant in primary care staff.” appointed in every dental setting “with an underlying ethos that early
One respondent, a GDS dentist, wrote: “This survey has intervention and safe signposting is paramount”.
highlighted the despair, hopelessness and uncertainty I feel for my Roz McMullan, Chair of Probing Stress in Dentistry in Northern
future and ability to cope with such a shocking and uncontrollable Ireland, said: “No one should feel alone or unable to talk to
change to my financial and working situation. I have suicidal someone at work and for this very reason, this call to action asks
thoughts on a daily basis, but the only reason I am able to function decision makers and line managers to adopt this cultural change to
is the business bounce back loan I have [which] my new accountant mental health wellness in the dental workplace and commit to the
told me was available.” recognised training pathway.”
Researchers had not included a question on so-called ‘suicidal
ideation’ in their survey, carried out between June and October last A call to action: page 46
year, so were unable provide a quantitative comparison with other 1
Exploring the Effect of the COVID-19 Pandemic on the Dental Team:
similar studies, but they noted: “The non-solicited volunteering of Preparedness, Psychological Impacts and Emotional Reactions
The dental camera for your practice or laboratory
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Like no other camera, the EyeSpecial the integrated flash system provides the
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10 | Scottish Dental MagazineJune 2021 | 11
NEWS
Oral health ‘may prevent’
severe COVID-19 disease
Hypothetical model may provide a rationale for understanding why some develop
COVID-19 lung disease and others do not
THE potential for healthy gums to reduce or damaged gums could weaken the mucosal
the severity of Covid-19 disease is outlined barrier in the mouth and allow the virus to
in a paper published in the Journal of Oral more easily enter the bloodstream.
Medicine and Dental Research. “If confirmed, this hypothetical model
The paper follows evidence published may provide a rationale for understanding
earlier this year in the Journal of Clinical why some individuals develop Covid-19
Periodontology, the official publication of lung disease and others do not,” states the
the European Federation of Periodontology paper. “It would also fundamentally change
(EFP), that patients with Covid-19 were the way Covid-19 is managed, providing
three times more likely to experience a new line of exploration into treatments
complications if they also had gum disease. body through the upper airways (nose and targeted at the source of the viral reservoir,
Gum disease, also called periodontitis, is a mouth), collects in the saliva in the mouth the mouth.”
common condition affecting up to half of and enters dental plaque under the gums. It The authors add that, if correct, “simple
all adults worldwide3. then crosses the gums into the blood vessels, antimicrobial oral healthcare measures
The authors compiled existing evidence where it travels to the arteries in the lungs – could be implemented not only with the
to propose a pathway by which the severe rather than travelling to the lungs via aim of reducing the risk of transmission
acute respiratory syndrome coronavirus the airways. between individuals” but also as “a means
(SARS-CoV-2) is transmitted to the lungs, The biological basis for this route of of mitigating the risk of developing lung
where it causes Covid-19 lung disease. infection is outlined. In addition, the disease, and therefore the most severe form
They suggest that the virus enters the authors put forward the idea that diseased of the disease.”
Sustainability in
dentistry bid
THE FDI World Dental involves numerous
Federation has launched a new stakeholders. CO2 emissions,
initiative, with commitments plastics use, waste
from four founding industry generation and other
partners – Colgate, Dentsply- environmental impacts are
Sirona, GSK Consumer major challenges at all levels
Healthcare, and TePe – to lead of the dental resource supply
the charge on sustainability chain as well as in care delivery.
in dentistry. Reducing the impact of the
Over the next two years FDI dental profession on the
will work collaboratively with its environment will require action
partners and other key and collaboration from many
stakeholders to map out different actors. The four
strategies and implement founding partners are part of
solutions to help reduce the a pro-active approach to
environmental impact of tackling these environmental
dentistry and the dental threats and developing
industry. concerted and far-reaching
The work will lead to the solutions.
publication of an FDI The project will also equip
Sustainability Code of Practice dentists and their teams with a
that provides guidelines and suite of tools and resources to
objectives for achieving a help them improve
sustainable procurement and sustainability in their dental
supply procedure, which will be practices, while informing the
signed by co-signatories across general public of their role in
the supply chain. sustainability in dentistry
Environmental sustainability through improved oral health
in dentistry is multifaceted and and making informed decisions.
12 | Scottish Dental MagazineJune 2021 | 13
NEWS
Regenerative
dentistry ‘a step
close’ with 3D printing
Exoskeleton of crustaceans, such as crabs and shrimps, used in
pioneering process
A TEAM of interdisciplinary researchers seen less focus. However, tissue engineering used as an additional polymer, while genipin
at KU Leuven University in Belgium has and regenerative medicine have recently and 3-glycidyloxypropyl trimethoxysilane
taken a step closer to being able to regrow been explored for the replacement of (GPTMS) were used as cross-linking agents.
teeth from the root using 3D printing. injured and missing dental tissues with After printing, the scaffolds were
Dental conditions resulting from promising results, such as for regenerative investigated for their direct clinical
trauma and developmental anomalies can endodontic procedures. These procedures application in cell-free regenerative
often affect developing permanent teeth, aim to repair or replace the inflamed or endodontics of immature teeth to control
particularly in children, leading to tissue damaged dental pulp in order to restore infections, induce dentine formation and
or even whole tooth loss. To combat this, vascularisation, immune response, nerve root formation. The researchers also believe
dental tissue engineering has arisen as a supply and dentin disposition. their tailored scaffolds could be modified
potential means of repair, regeneration, According to the researchers, chitosan through adding inorganic components such
and even tooth replacement through the has attracted attention for dental tissue as bioactive glass to promote alveolar bone
fabrication of bioengineered “tooth-root”. engineering applications due to its regeneration.
In their latest study1, the team antimicrobial and immunomodulatory The team now intends to focus on
investigated the 3D printing of chitosan properties, in addition to its obtaining a deeper understanding of stem
scaffolds derived from animal and fungal biocompatibility, biodegradability, and gel- cell and immune cell behaviour in response
sources which could potentially be used in forming ability. Chitosan is derived in part to the scaffolds, in order to optimise
such regenerative dentistry applications in from the exoskeleton of crustaceans such as their application in dento-alveolar
the future. crabs and shrimps, fungi, or insects. tissue engineering.
Despite sizeable strides taken in 3D Two types of chitosan were selected for
printing for dental applications such as the study; chitosan of animal origin and 1
3D printing assisted fabrication of chitosan
customised aligners, permanent crowns, fungal chitosan derived from aspergillus scaffolds from different sources and cross-linkers
and dental implants, regenerative medicine niger, a common species of fungus that for dental tissue engineering: www.ecmjournal.
developments for dental applications have causes black mould. Gelatine powder was org/papers/vol041/vol041a31.php
Mydentist deal done
IDH group – which runs clinical directors, who support NHS, this transaction will give us opportunities this new
Mydentist – announced that practices and clinicians in their the fresh investment that we ownership structure will provide
Palamon Capital Partners will provision of patient care. need to pursue our exciting plans to continue improving care for
buy the remaining shares in the Mydentist has a network of for the future. And to focus more patients. As well as supporting
business from The Carlyle Group. almost 600 practices, including than ever on helping patients clinicians across Mydentist to
Mydentist says the buy-out will 40 in Scotland, making it the access the affordable care they grow their careers.
provide fresh investment to largest provider of NHS dentistry need and supporting our “The management team –
support the company’s future in the UK. clinicians to build the careers including our leading clinical
plans, as well as provide the Tom Riall, chief executive of they want.” directors – are more in the
management team with greater IDH Group, said: “This is a great Nyree Whitley, group clinical driving seat than ever. They can
control of strategy. outcome for Mydentist, our director of IDH, added: “Having continue to listen to clinicians,
The existing team will remain clinicians, our practice teams, led our clinical leadership team act on their feedback, and build
to guide IDH through the next and our patients. Building on our for the last four years, I am on the success we have seen
stage. This includes Mydentist’s long-term partnership with the hugely excited about the over the last few years.”
14 | Scottish Dental MagazineJune 2021 | 15
NEWS
Zoom boom
The new patient guidelines from the GDC
acknowledge vital principles long advocated
by the BDA that orthodontic patients
need to be fully assessed by a dentist, that
amid DIY warning direct dentist-to-patient interaction – the
basis for informed consent – is essential,
and that patients must know the name
and registration number of the dentist
Heightened interest in ortho tempered by warning over responsible for their care. However, the
direct-to-consumer fad BDA said guidance does not offer any clarity
on what sanctions the GDC might utilise and
how the regulator backs up its assumption
FIGURES from The British Orthodontic smile they’ve always dreamed about.” that such models of care are “safe for many
Society (BOS) have revealed a surge in The developing trend comes at the people”.
adults seeking orthodontic treatment since same time as concerns mounts over Dentists have stressed the risk of
the start of the pandemic. With close-up direct-to-consumer orthodontics; an issue misdiagnosis and lack of informed consent
video conferencing the new work norm, first highlighted by the BOS. The British in the absence of face-to-face consultations
people have become more conscious of their Dental Association has warned that newly throughout the course of treatment.
teeth. More than three quarters (84 per published guidance for patients on the The BDA has seen cases of patients with
cent) of orthodontists reported an increase risks of direct-to-patient orthodontics is no advanced gum disease that have been
in adult patients. substitute for meaningful regulation. provided with these retainers, potentially
“It is interesting to see the rise in demand Remote provision – offering patients leading to tooth loss. Dentists have stressed
for orthodontic treatment over the last 12 plastic aligners based on a 3D scan of their the risk of misdiagnosis and lack of
months,” said Anjli Patel, BOS Director of mouths or via an impression taken from informed consent in the absence of face-to-
External Relations. “I know from patients at-home moulding kits – are growing in face consultations throughout the course
I see at my practice that many have become popularity but can lead to fundamental of treatment.
increasingly more aware of their teeth changes to a patient’s mouth that may Last year an investigation into
through the ‘Zoom effect’. We want to be irreversible. The BDA has raised a leading provider by U.S. network
ensure patients are given the very best concerns with regulators – the Care Quality NBC revealed a wide range of complaints
advice about orthodontic treatment. Tooth Commission and General Dental Council following treatment, including migraines
straightening can give people the confident – about this practice since 2019. and nerve damage.
16 | Scottish Dental MagazineJune 2021 | 17
NEWS A new
series,
with fresh
narrative
EURUS is the new range from
Belmont.
Named after the god of the
East Wind, it embodies
Belmont’s passion to bring
powerful, innovative products to
the dental industry. Eurus is
designed with the end-user in
mind.
Firstly, you have the option of
Government
either a continental or holder
type delivery.
If you prefer the former, you
warned over
will immediately note the
improved flexibility of the
console; you can pick up and
start treating patients without
‘flawed’ funding plan
having to reposition, and the
roller guide gently supports the
weight of the hose, and enables
it to retract with ease, both of
Use of Item of Service will result in an up to 45 per cent cut in pay, which prevent wrist strain.
The hose length and swivel
claims LDC, even as Government announces funding for ventilation action of the roller facilitates
treatment from whichever angle
you chose to position yourself.
THE Scottish Government has been recognition that this activity now accounts The holder type option offers
“repeatedly” warned of flaws in its plans for a far greater proportion of clinical time,” similar benefits. The large table
for new tiered support arrangements. It is added the spokesperson. “We have proposed has a wide vertical range of
understood that the Government currently that an SDR fee is attached to the existing motion and glides effortlessly.
plans to use Item of Service (IoS) as the 8,000 codes to represent - in IoS terms - the Sitting discreetly underneath is
sole measure of activity in the forthcoming clinical time spent ensuring the safety of our an adjustable holder, which is
arrangements, which were due to be patients and colleagues. completely separate from the
announced as Scottish Dental went to print. “To our knowledge, in no other branch table and can be moved to one
A spokesperson for Greater Glasgow of the NHS are individual workers being of three different positions, to
& Clyde Local Dental Committee (LDC), threatened with an up to a 45 per cent pay suit the preference of the user.
said: “We have repeatedly highlighted the reduction should their service or practice as a Once you’ve selected a
flaws in this approach, at all levels, but our whole fail to meet imposed targets. handpiece, the interface
concerns do not appear to be registering at “In fact, in all other NHS contractor automatically shows only
the top level.” services – GMP, optometry and pharmacy relevant information.
The LDC believes that using IoS as the sole – funding has been maintained at 100 per Torque will no longer need to
measure of activity will force young patients cent, with no mention of tiered reductions, be calculated; instead, the
to the back of the queue, widening the gap despite similarly devastated levels of service micromotor, turbine and scaler
in dental health inequalities and increasing provision.” each have a bespoke screen,
the likelihood of life-threatening and Meanwhile, the Government confirmed it with operating levels clearly
avoidable general anaesthetic procedures. will continue funding the delivery of free PPE visible. Never before has so
“By only including the financial value of to dental practices until the end of March much been achievable from a
IoS as a measure of activity, dentists will be 2022 and earlier this month announced £5m single touch.
forced to favour adult patients over children in funding to help NHS dental practices Some things are best
or face severe cuts to their funding,” said the purchase, renew or upgrade ventilation experienced, rather than
spokesperson. equipment. explained, so why not visit their
“GDPs are being put in the impossible Humza Yousaf, the Health Secretary, showroom and see for yourself
position of choosing between child dental said: “The Scottish Government remains All necessary protocols are in
health and keeping practices afloat. This is committed to ensuring that NHS dental place to ensure a safe
wholly unacceptable. services emerge from this pandemic well- face-to-face visit.
“By way of a short-term solution, we have placed to care for the oral health of the belmontdental.co.uk
proposed a temporary SDR fee be attached population.
to all capitation treatment items so that dental David McColl, chair of the British Dental
activity for young patients carries the same Association’s Scottish Dental Practice
weight as for adults.” Committee, said: “Investment in ventilation Eurus S1
In addition, said the LDC, using IoS as the can future proof Scotland’s dental services, New series.
sole measure of activity does not take into boost patient numbers, and pay for itself.” Fresh narrative.
Next level.
account the administrative demands of the But he added: “We must avoid half
new Standard Operating Procedures. measures. Many dentists have had no option
“We cannot be expected to be able but to buy portable systems to get patients
to practice safely – screening and triaging back through their doors. Ministers must
patients in line with guidance – without ensure they do not lose out.”
18 | Scottish Dental MagazineProsthodontics
We are delighted to accept
your patient referrals and
offer advice, support,
Dental Implants
education, second opinions
& dental laboratory services
Endodontics
Prosthodontics: Oral and maxillofacial surgery:
Dr K A Lochhead | Specialist in Mr M Paley | Consultant Oral and
Prosthodontics Maxillofacial Surgeon
Oral & Maxillofacial Dr P Coli | Specialist in Periodontics Prof L Sennerby | Professor in Oral
and Prosthodontics Implantology
Surgery
Dr M J Brennand Roper | Consultant
Dr G Ainsworth | Specialist in Oral
and Specialist in Restorative Dentistry.
Surgery
Specialist in Prosthodontics
Dr C Millen | Consultant and Specialist Dr S Lello | Specialist in Oral Surgery
in Restorative Dentistry. Specialist in
Periodontics Periodontics:
Prosthodontics and Periodontics
Dr Maria Brincat | Special Interest
Dr S Campbell | Specialist in in Periodontics
Prosthodontics
Radiology:
Endodontics:
Dr C Tait | Specialist in Endodontics Dr D Thomson | Specialist in Dental
Orthodontics and Maxillofacial Radiology
Dr R J Philpott | Specialist in
Endodontics Orthodontics:
Dr G Ragazzini | Specialist in
Orthodontics
Dental Radiology
Join our virtual study clubs
To book a place on one of our virtual courses or study
clubs please email Gemma on:
gemmagrant@edinburghdentist.com
If you would like to discuss referring a patient please contact our friendly reception team on 0131 225 2666 or visit us
online at edinburghdentist.com It is our pleasure to be able to offer second opinions, advice and support from all our
clinicians using our tele-dentist service tele-dentist@edinburghdentist.com
Edinburgh Dental Specialists, 178 Rose Street Edinburgh EH2 4BA • tele-dentist.com • allonfourscotland.com
June 2021 | 1920 | Scottish Dental Magazine
NEWS
Updated guidelines for lower
3rd molar management
Providing a fresh approach to comprehensive management
AN expert working group has updated the includes management of ‘high risk’ third
20-year-old National Institute for Health molars, the current status of patients’ social
and Care Excellence (NICE) guidelines for wellbeing and their involvement in the
lower third molar surgery to give them a decision-making.”
fresh approach to patient care, explaining Since 1999 there have been developments,
that retaining third molars can often have a advancements and research in: technology
detrimental impact on patients. (Cone beam CT scans); pharmacology
The group, led by Geoff Chiu, Consultant (steroids and local anaesthetics); and
Oral and Maxillofacial Surgeon (OMFS), outcomes in supreme court judgements
Retaining third molars in some
at East Lancashire and Bolton NHS Trust, patients has had a detrimental impact
(Lanarkshire vs Montgomery) all of which
Professor Paul Coulthard, Consultant in Oral have changed the management of third
Surgery at Barts Health NHS Trust, and molars. Retaining third molars in some
Professor Tara Renton, Specialist in Oral Committee (Royal College of Surgeons of patients has had a detrimental impact,
Surgery, at King’s College London, updated England). said Mr Chiu. “This has led to patients
the guidelines for lower third molar surgery “Over these 20 years we have been able developing latent caries or periodontal
that were originally published in 1999. to see the effects that NICE guidelines have disease, which can often result in the loss of
Parameters of care for patients had on the oral health of patients in the both the third and second molars.”
undergoing mandibular third molar surgery1 UK,” said Mr Chiu. “The new guidelines
has recently been published by the Faculty take into account all the developments since 1
Br Dent J 230, 563 (2021). https://doi.
of Dental Surgery Clinical Standards the NICE guidelines were published. This org/10.1038/s41415-021-3045-5
Sales Representative Dental
Implants Scotland (m/f)
– Full time
Job Summary: Education/Experience Requirements
Sell Zimmer Biomet Surgical, Restorative, Regenerative and - 3 years experience in sales of dental products
Digital Solutions range through effective sales presentations - Customer-, sales- and success-oriented thinking
to dental clinicians and technicians in accordance with and acting
company sales, compliance, pricing and profitability - Good presentation, training and influencing skills
requirements in order to maximize sales and distribution - Team player mindset with ability to work successfully
of Zimmer Biomet products and services in the designated in a matrix organization
territory so that the company can perform its functions and - High level written and spoken English
achieve its objectives. - High level MS Office knowledge
At Zimmer Biomet, we believe in The Power of Us, which - Driving license mandatory
means that we are stronger together. We are committed
to creating an environment where every team member Travel Requirements:
feels included, respected, empowered, and celebrated.
This position covers the following regions - Durham,
Cumbria, Northumberland, Scotland, Isle of Man
Principal Duties and Responsibilities
- Sell Zimmer Biomet surgical, restorative, regenerative Our company:
and Digital Solutions product range
As an affiliate of one of the largest musculoskeletal
- Schedule meetings and visits to dental clinician practices,
companies in the world, Zimmer Biomet Dental offers
hospitals, corporate groups and dental laboratories
dental professionals the kind of premium service and
- Perform Product training on the safe and effective use
quality rarely found in today’s world of dentistry.
of our products to dental clinicians, nurses, practice staff
Please follow the link for more information about
and dental laboratory staff
the company:
- Identify future projects and develop business proposals
https://www.zimmerbiometdental.com/en-GB/
to increase sales Attend exhibitions, local evening
meetings and company events
You can apply for the role at the following link:
- Complete all required reports in timely and accurate
https://bit.ly/34SYmZ3
manner
June 2021 | 2110 SEPTEMBER events.iti.org/congressuk-ireland National Dental
Nursing Conference
D AT E S Dental Care for
People with Cancer 18-19 OCTOBER www.badn.org.uk/Public/Events/
FOR Royal College of Surgeons 8th Global Conference on Smart National-Dental-Nursing-
YOUR of Edinburgh Materials and Nanotechnology Conference.aspx
DIARY Online Including dental implants
Edinburgh, venue TBC
(Normally co-located with
BDC&DS, see below)
www.tinyurl.com/yyav7myx
https://smart.
14 SEPTEMBER materialsconferences.com POSTPONED FROM
Molar Incisor 2021 TO 2022
Hypomineralisation and Hall 12-14 NOVEMBER
Crowns: Current understanding BSP Conference 13-14 MAY 2022
Note: Where possible this list
and treatment options The Royal College British Dental Conference
includes rescheduled events,
BDA – Aberdeen Section of Physicians, London & Dentistry Show
but some dates are still subject
Online www.tinyurl.com/yyh2bcq3 NEC, Birmingham
to change.
https://tinyurl.com/kvseha7d www.thedentistryshow.co.uk
22 NOVEMBER
12 JUNE
26-29 SEPTEMBER Core Recommended 15-18 JUNE 2022
Annual Conference of LDCs CPD Update
FDI World Dental Congress EuroPerio10
Online Hilton Glasgow, William Street
Sydney Copenhagen
www.ldcuk.org https://tinyurl.com/chsnevmv www.efp.org/europerio/
www.world-dental-congress.org
18 JUNE 3 DECEMBER 24-25 JUNE 2022
1 OCTOBER
Dental Care Professionals Vermilion Biennial Symposium FGDP(UK) Scotland Study Day Scottish Dental Show
Study Day, RCSE Royal College of Physicians Updates on treatments for perio Glasgow
Online of Edinburgh and endodontics. www.sdshow.co.uk
www.tinyurl.com/y26s8u7n Email events@vermilion.co.uk Glasgow Science Centre
for more details. www fgdpscotland.org.uk/ 11-13 AUGUST 2022
26-27 JULY book-glasgow-study-day International Symposium
Dental Health Forum 1-2 OCTOBER on Dental Hygiene
CTF, Manchester University ITI Congress UK & Ireland POSTPONED UNTIL Dublin
www.10times.com/e11s-rx6x-gs52 EICC, Edinburgh FURTHER NOTICE www.isdh2022.com
22 | Scottish Dental MagazineJune 2021 | 23
PRIVATE PRACTICE GROWTH
Taking back
control
WORDS
The pandemic and
ISABEL
JOHNSTON
uncertainty about
future funding of
NHS dentistry is
making payment
plans more
F
attractive
or Greenlaw Dental probably the most stressful time we will ever go
Care, last year’s first through. There were so many things that were
COVID-19 lockdown highlighted by the lockdown. When things run
was an accelerator to well and it is profitable you go about your daily
change tack after six routine, but the pandemic has really made us
decades as an NHS reassess what we wanted for our practice and our
practice. Richard patients. We thought about the level of and access
Alexander, Eilidh to care we wanted to provide and the preventive
Craig and their treatment we wanted to make available to
team recently joined
Denplan to “take
back control” of their
business, with both staff and patients embracing
the transition and benefits of using a
payment plan.
“Coming out of the first lockdown last year,
we really asked ourselves what we wanted as a
TO BE IN A POSITION WHERE WE
practice team and Denplan was a natural part of
that,” said Richard. Their NHS practice has been CAN AFFECT CHANGES, INSTEAD
OF BEING DICTATED TO BY SOMEONE
in the family for more than 60 years, with he and
his wife taking over 12 years ago, when Eilidh’s
father retired. With a generational shift, Richard,
Eilidh and their three associates knew they
wanted to push the practice forward and do new
and different things. “Dentistry as a profession
ELSE, HAS BEEN SO IMPORTANT FOR US”
has been hammered by COVID and for us it was RICHARD ALEXANDER
24 | Scottish Dental MagazineJune 2021 | 25
PRIVATE PRACTICE GROWTH
our patients. Suddenly, joining Denplan was training Denplan’s Training Academy has given
something that was quite an easy decision to them in recent months. They are already part of
make. For us to now be with Denplan and be in a growth programme and will have members of
control and in a position where we can affect the team trained as Denplan Champions in the
those changes instead of being dictated to by coming months. The practice has also joined
someone else, has been so important for us,” Denplan’s latest membership scheme, Denplan
said Richard. The family-run dental practice Plus (www.denplan.co.uk/plus-SDMC),
in Paisley offers routine dental care, as well which gives them access to even more benefits
as specialist treatment including implants, including compliance expertise, reduced admin
IV sedation, adult braces, facial aesthetic and fees and the removal of patient joining fees.
dental cosmetic treatments. Greenlaw joined “For us as a practice it is all about pushing
Denplan, part of Simplyhealth, in October 2020 on to the next level, so Denplan Plus felt like
after initial conversations with their Business a natural next step. The extra staff training
Development Consultant, Heather MacMillan. and the ability to access more information
It was vital for Richard and Eilidh to make about compliance and up-to-date training is so
their long-standing practice team part of the important. Not having the patient joining fee
journey and they maximised all aspects of probably made one of the biggest differences in
Denplan’s support when joining the payment allowing patients to access Denplan. We found it
plan provider. made it much easier to offer Denplan to patients
“Denplan’s support has been invaluable. Their and we noticed it gave us the ability to ramp up
investment in our practice to ‘learn the ropes’ the growth even more,” said Richard.
as we transitioned has been essential to me and While the practice is still catching up on
the whole team. When change has to happen, it where they were before the pandemic, Richard
is so vital to have all our staff on board. Joining explained how they are already enjoying the
Denplan includes training, support and access change of pace since joining Denplan. “The
to their vast resources, which has made the ability to have that longer length of appointment
transition much more straightforward for all to discuss clinical care with patients is great.
of us,” he said “To be able to do our training Time is such a commodity which you just don’t
virtually when some companies have not even have enough of, so it is so important to be able
set that provision up yet, is so important. All to get that. As a clinician, to be able to have an
the training we have done has been great and open discussion with patients about what their
it has really brought us together and made us clinical options are that is not regulated by any
feel part of the wider Denplan community. Also NHS restrictions has been quite liberating.
knowing there is a consultant to go to, customer “As a business owner, one of the most
service teams at the head office and an online important things you can do is to be able to have
portal with resources has been so reassuring for a plan for where you want to go. The pandemic
us in a period of transition. Honestly, it has been took that away but joining Denplan has given
such an easy change, we keep thinking why we this back to us. Our stress levels are down,
haven’t done it before.” our levels of anxiety are down, and it has also
More than 100 patients signed up to Denplan allowed us as a team to have something positive
in the first three months, with numbers growing to focus on. We can look forward instead of
every day. “We have had such positive feedback. worrying about how the practice may or may
Patients have understood there has been a not survive,” he said. And his final words of
change in service and system. Now being on advice to others in the profession? “If there is
Denplan they have enjoyed the extra time they uncertainty and you are not happy where your
have with us and the treatment a payment plan own practice and patient care is going, then be
allows them. Some patients have been coming proactive. Take back control. Don’t just sit there
to us for decades. They know us and trust our and wait and hope for the best. For us, Denplan
clinical judgement. By being open and honest, provided us with that option.”
and explaining why Denplan is so important for Find out more at www.greenlawdentalcare.co.uk
them as patients and our practice has really been & www.denplan.co.uk
understood. Some patients had been asking for
payment plans and now have been given ‘There is a risk that NHS dentistry becomes less
the option and they really appreciate that,” advantageous to practitioners’– see page 34
said Richard.
Business Development Consultant Heather,
who supports practices all over Scotland,
has also been delighted with the practice’s
IF THERE IS UNCERTAINTY AND YOU ARE NOT
growth in such a short period of time. “I am so
impressed with all that Greenlaw Dental Care
has achieved,” she said. “The whole team has
been on board, and it has been great supporting
a practice which has come out of the pandemic
with a positive attitude and mindset to take back
HAPPY WHERE YOUR OWN PRACTICE AND
control of their business.” Greenlaw Dental
Care’s staff have particularly enjoyed all the PATIENT CARE IS GOING, BE PROACTIVE ”
26 | Scottish Dental MagazineJune 2021 | 27
VERMILION
Vermilion’s 10th anniversary
The best:
The future for Vermilion is to double-down
on its unswerving commitment to referring
dentists and their patients
day-in, day-out
I
WORDS t wasn’t the best of times to launch a new interiors beautiful. Also, Southern Implants, a leading
WILL venture. Ten years ago, the world was provider of unique and innovative dental implant products
PEAKIN
recovering from the 2008 financial crisis. Banks with a focus on top-end professional users who want more
were unwilling to lend, and landlords were choices, and Planmeca, whose 3D ProMax classic CBCT
only interested in businesses with a robust has been one of the driving forces for the practice with
trading covenant. “Directors’ guarantees were its ability to provide 3D diagnostics in-house, helping to
even required for the hire purchase of dental deliver the very best in patient care all under one roof. Plus
equipment,” recalls David Offord, founder of Edinburgh- Systems for Dentists, who offer the best in dental practice
based Vermilion – The Smile Experts. “My property management software, focusing not only on clinical
lawyer at the time was working two days a week, there practice but involving the entire practice team in the
were so few transactions taking place.” David remembers planning, running and management of the dental business.
the mix of emotions he experienced: “The first few years David graduated from the University of Edinburgh in
were exciting and scary in equal measure. But Grant 1994, spent four years in NHS general dental practice,
Mathieson, Madeleine Murray, Colette Ballantyne and I then two years GDS in Australia and Singapore. In 2000,
were a great wee team and we backed each other to make a he moved to hospital-based oral and maxillofacial surgery
success of this new venture. That we set out our stall to be positions, over a six-year period, in North Wales, London,
referral-only seemed commercially crazy to the bankers, Forth Valley and Fife. In 2001, he attained MFDS from the
but that fundamental principal has been key to our success Royal College of Physicians and Surgeons of Glasgow, and
in attracting referrals from the dental community.” in 2007 was recognised by the General Dental Council as
A decade on, and David is energised about what he and a specialist in oral surgery. He spent five years working
the team have achieved — and their plans for the future. between Edinburgh Dental Specialists and the Edinburgh
“I am excited about Vermilion being an independent Dental Institute before founding Vermilion aged 39 in
referral clinic surrounded by corporates. We will see 2011. “I am not one of those people who claim to have been
what direction private equity-owned dental chains take driven from a young age to be an entrepreneur,” he said.
over the next few years,” he said. “I am lucky to work “But through my thirties I realised that I wanted to run my
with eight clinicians — prostho, perio, endo, ortho, own business, and hopefully make a difference.”
implant maintenance, and now also paediatric — and two Highlights from the past 10 years? “I am really proud
hygienists, across Vermilion’s three sites in Edinburgh that we have trained more than 20 referring colleagues
and Kelso. We are a tight group. Referral dentistry is very to regularly restore their own patients’ dental implants,
demanding, and we do work hard, but we know that we’re bringing variety to their day and new income to their
making a difference, and derive a lot of personal and practice,” he said. “Also, building our Kelso practice out
collective satisfaction from the patient outcomes we see.” of the ground in 2018 — a stunning clinic in a beautiful
A supporting cast of 12 dental nurses and 12 staff takes location, and a £1m investment in the Borders’ dentistry.
a lot of managing: “I am very grateful to general manager The delivery of our popular biennial symposiums, which
Kay MacMillan for her calm leadership,” he added. He we started in 2017, have also been a great achievement.
also paid tribute to the companies who have supported Each brings together our referral community, and we are
Vermilion, including IWT Dental Services, who provide very much looking forward to welcoming them to our
the perfect blend of ergonomic design, functional next symposium, this autumn, at the Royal College of
equipment, and adaptable IT infrastructure, and NV Physicians of Edinburgh.”1 What has it been like for him,
Design, specialists in making dental clinics easy to work personally and professionally? “I enjoy it. The blend of
within, patient areas comfortable and safe, and practice clinical and business development really works for me.
28 | Scottish Dental MagazineYou can also read
