A wake up for dental prevention, COVID is worse for patients with periodontal disease.

We are all (well most of us!) now actively involved in prevention and risk assessment. 

We stay at home, keep our distance, wash our hands and wear masks.  We know some people are at higher risk of serious complications and death from COVID than others, so we shield the elderly and those who are clinically vulnerable, and we require our medics, dentists and care workers to wear PPE and engage in comprehensive disinfection routines to protect them and their patients from the close contact they have to have in their essential work.  Our vaccination programmes have initially been targeted at those who, by nature of their inherent risks or lifestyle risk factors, are in most danger. 

It is the coming of age of risk assessment and prevention, a time when the public accept that the inconveniences of doing the right thing are essential to ensure a better future.

I strongly believe that NHS dentistry post-COVID will take on this challenge: the one that says prevention comes first, and to prevent you must first to know your susceptibility and what you personally can do to protect your health.  Treatment is a fix, not a cure and whilst essential to get patients out of pain, should not be the focus of a modern health service.  Advanced restorative treatment on an unhealthy periodontium should not be paid for out of the public purse. 

A study has just been published from Qatar on the impact of perio disease on COVID outcomes.  Qatar has electronic health records containing medical and dental data (definitely something for the NHS to aspire to!) which facilitated the analysis of confounding factors.  To quote the press release here:

 The case control study of more than 500 patients with COVID-19 found that those with gum disease were 3.5 times more likely to be admitted to intensive care, 4.5 times more likely to need a ventilator, and almost nine times more likely to die compared to those without gum disease.

Blood markers indicating inflammation in the body were significantly higher in COVID-19 patients who had gum disease compared to those who did not, suggesting that inflammation may explain the raised complication rates.

Professor Mariano Sanz, one of the study’s authors, noted that oral bacteria in patients with periodontitis can be inhaled and infect the lungs, particularly in those using a ventilator.

“The results of the study suggest that the inflammation in the oral cavity may open the door to the coronavirus becoming more violent,” said Professor Lior Shapira, EFP president-elect. “Oral care should be part of the health recommendations to reduce the risk for severe COVID-19 outcomes.”

Causality, which is very difficult to prove, is not claimed here, and as always, whilst confounding factors have been adjusted for, those with perio disease often also have other health issues. Maybe the periodontitis is just a manifestation of a tendency to inflammation, and the COVID response simply results from that.   However, the evidence for periodontal disease raising your risk for other systemic diseases is indisputable and growing.

The crunch is this:  gum disease is the easy part to deal with: it is not invasive, expensive or harmful.  When you can stop the disease in its tracks, why risk COVID complications?  Why accept the heightened discomfort and dissatisfaction with your teeth, and the tooth loss that results from periodontitis?  Knowing that gum disease is associated with diabetes, CVD, kidney disease, dementia etc, why would the susceptible patient not choose health over bleeding?

Now is the time to talk prevention: to explain to the susceptible periodontal patient how they are more vulnerable than others in the population; to identify and share the lifestyle factors which put them personally at risk of the disease; to explain the potential impacts on their systemic health, and persuade the patient that it is up to them to take the decision to work with you to take charge of their future. 

Liz Chapple

OHI Ltd, UK provider of PreViser and DEPPA technology

www.previser.co.uk

In April 2015, a group of key opinion leaders met with a team from Johnson & Johnson at a National Advisory Panel event in Dublin to advise on the topic of ‘Improving the periodontal health of Irish population – prevention and treatment’.

At the meeting, the key opinion leaders agreed on the following periodontal health consensus statement:

• ‘Effective plaque and calculus removal is key to oral health;

• Dental healthcare professionals have a responsibility to educate patients on their disease status and to direct patients appropriately;

• Patients should receive tailored oral hygiene instruction and demonstration;

• Patients have a responsibility to act upon the advice given by dental healthcare professionals;

• For effective management optimal patient home care and professional debridement are both essential;

• Long-term periodontal maintenance with continuity of care is critical for successful treatment outcome;

•Clinically proven mouthwashes, gels and pastes should be considered for recommendation to those individuals who are not achieving optimal levels of plaque control in their home care routine.’

The key opinion leaders were:

Dr Amit Patel is a registered specialist in periodontics; graduating in 1997 from the University of Liverpool, he is now the principal of the Birmingham Dental Specialists as well as working as the Associate Specialist in Periodontics and Honorary Clinical Lecturer at the University of Birmingham dental school. He is a prolific lecturer both nationally and internationally and is enthusiastic about practising better dentistry. To this end, Amit always ensures to use the best equipment possible to achieve excellent results.
 

“Everything I use is A-dec,” says Amit. “I have an A-dec 500 dental chair, an A-dec LED light and, after trialling one recently, I’m using the A-dec 500 stool as well. Together, these pieces of equipment allow me to practise better dentistry – not just for my patients, but for myself as well.
 

“Many dentists will suffer from back pain and musculoskeletal disorders throughout their careers. The positions we must assume to perform even the simplest of dental treatments can have a real effect on our wellbeing – indeed, the majority of dentists who are forced to retire early, do so because of these debilitating conditions.
 

“But modern, ergonomic equipment, like that supplied by A-dec, can have a huge impact on the ease with which we can practise dentistry and the quality of life we can enjoy as a result. For example, the 500 stool allows me to assume a comfortable posture in which I can remain for long periods of time; even during implant surgery I do not get fatigued. What’s more, because the stool is so lightweight and easily manoeuvred, I can move around my patient without having to stretch.
 

“Similarly, a good light will help eliminate eye strain. Repeatedly focussing in and out of the oral cavity and having to adjust to the different ambient lights can cause unnecessary strain. The A-dec LED light I use is bright enough to negate this: it illuminates everything. I find it particularly useful since I perform a significant amount of surgery and I need a light bright enough to fulfil my needs. Rather than investing in an incredibly expensive theatre light, the A-dec LED is more than satisfactory. It’s also incredibly light and easily manoeuvred, making it applicable for many indications. Some of my patients comment on just how bright is – but they appreciate that the better I can see, the better the result of their treatment will be.
 

“I also work with the University of Birmingham Dental School and use A-dec equipment there as well. As a way of promoting good posture and ergonomic practice, A-dec products are the best.
 

“I wouldn’t hesitate to recommend A-dec and its products to any dentist.”
 

With an eclectic range of dental equipment that has been specifically made with dental professionals in mind, A-dec will provide you with everything you need to practise better, healthier dentistry.
 

To find out the benefits yourself, contact the friendly team today.

For more information about A-dec Dental UK Ltd, call 02476 350 901 or visit: www.a-dec.co.uk

It has been known for centuries that dental health and systemic health are linked. However within the challenging environment of a hospital, oral care is still, quite often a low priority. Recent studies reveal that total bacterial count of dental plaque increases during hospitalisation[1] and the oral cavity of hospitalised patients can harbour high frequencies of bacterial respiratory pathogens.[2] As a result, this can lead to infections and hospital acquired pneumonia (HAP)².
 

As well as inadequate oral hygiene, the potential risks to oral disease and discomfort in hospitalised patients include a significant number of medications as well as artificial feeding and high-calorie food supplements used to maintain nutrition. In addition, the effects of nasal oxygen, mouth breathing, intermittent suction of the airway and the restriction of oral food and fluid all contribute to a decrease in saliva production and symptoms such as xerostomia.[3]
 

Another common problem for sick patients is the dry mouth and discomfort caused by constant open mouth posture that is required for intubation. For those undergoing surgery, there can also be further complications. A study involving 404 surgical patients under general anaesthesia facilitated by endotracheal intubation, revealed that 6.9% sustained various degrees of oral trauma including soft tissue laceration, tooth fracture, prosthesis damage, tooth avulsion, ecchymosis and numbness of tongue.[4] In addition, a recently published study on the oral health of 162 patients found an increase in plaque levels and deterioration of gingival health during just a short stay in hospital.[5]
 

If a patient that has recently been hospitalised attends the dental practice, practitioners may observe oral tissue and tooth trauma, high plaque levels, gingivitis and periodontal disease. As always, it is fundamentally important to reinforce oral health instructions and to treat any dental problems efficiently. If, for example, periodontal disease has developed, it is first necessary to remove and disrupt the plaque using root surface debridement (RSD). In cases with deep periodontal pockets it is usually necessary to implement an adjunctive therapy to inhibit further periodontopathic bacterial growth and allow the periodontium time to heal and stabilise. Some practitioners use antibiotics for this purpose, but, if the patient has recently been unwell and had antibiotics prescribed previously, the risks of resistance are greater and it is preferable to use an antimicrobial alternative.
 

Practitioners should therefore consider PerioChip^® – a wafer thin dental insert that is an effective, non-antibiotic alternative for treating periodontal pockets over 5mm. PerioChip^® is applied directly into the periodontal pocket and slowly releases chlorhexidine digluconate to eliminate 99% of bacteria over 7-10 days.^[6] Furthermore, the insert employs a controlled-release system and continues to provide an antibacterial effect to suppress bacterial growth for up to 11 weeks after placement.^[7]

As it seems that care for medical and dental problems are still less coordinated than we might expect, it is imperative to emphasise to patients that successful recovery after a period of ill health or hospitalisation is not just about the body but also their oral health.

PerioChip^® is available exclusively from Dexcel Dental, to order or for further information call 0800 013 2333 or email This email address is being protected from spambots. You need JavaScript enabled to view it.

For a complete electronic probing and charting system that allows a single operator to complete a comprehensive periodontal exam in under ten minutes, turn to the Florida Probe from Clark Dental.

The Florida Probe handpiece exerts a constant force regardless of the strength or pressure of the operator, which guarantees accuracy and reproducibility between users.

Alternatively, the new VoiceWorks microphone and headset system can be used to capture the same data into the same software.

Using either system means there is no need to have another member of staff present to record the results. 

The Florida Probe aids patient communication by providing a detailed periodontal chart that can be used to create a “treatment map” for scaling and root planing, subgingival antimicrobials or laser treatment. When combined with the patient diagnosis sheet, this becomes an invaluable clinical and legal record of informed consent to protect your practice.

To explore the benefits of utilising the Florida Probe, contact Clark Dental’s team of experts who will be pleased to demonstrate and offer advice about the Florida Probe System and the new Voice Works system.

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

In May 2015, the World Health Assembly endorsed a global action plan to tackle antimicrobial resistance, including antibiotic resistance, the most urgent drug resistant trend.

The World Health Organisation (WHO) defines antibiotic resistance as “resistance of a microorganism to an antimicrobial drug that was originally effective for treatment of infections caused by it.¹” They go on further to say it is a “natural phenomenon” and that the misuse and overuse of the medication accelerates this worldwide problem. The effect of this “ticking time bomb” is felt across the health of the global population and worldwide healthcare budgets.

The meeting in May created five strategic objectives to tackle the issue including increasing awareness and understanding, reducing the incidence of infection and developing the economic case for sustainable investment². A survey carried out by the WHO a month earlier found that of 133 participating countries, only 34 had a comprehensive national plan to fight resistance to antibiotics. It discussed how management of the situation was paramount but due to inadequate laboratory capacity, infrastructure and data management practice, trends and outbreaks were poorly detected and monitored. Importantly, many countries had no stringent guidelines on the prescription of antibiotics, which could result in overuse and misuse by prescribers.

Excess Expenditure

There is not only the effect this issue has on the health of the global population, but also the impact it has on a country’s economy. Drug-resistant infections could kill an extra 10 million people across the world every year by 2050 if they are not treated successfully. By this date they could also cost the world around $100 trillion in lost output². Health expenditure in most countries is rising steeply already and resistance to antibiotics is going to contribute significantly in the near future. Excess costs associated with the resistance are due to longer hospitalisation, delayed therapy, higher morbidity rates, the necessity for surgery and the need to use more expensive antibiotics³.

Jim O’Neill, an economist leading a review into antimicrobial resistance for the UK government, estimated that $37 billion is needed over the next 10 years to spur the pharmaceutical industry into developing innovations in this troublesome segment. He went on further to say that this was a “modest sum” compared to the cost of not doing anything. During the 1990’s, pharmaceutical companies withdrew from investing in this kind of research due to a high uncertainty around what the final market potential would be, and still the pipeline does not look particularly robust. Also, antibiotics work so fast and so well that they provide relatively weak returns for high investment. Companies prefer to channel their funds towards the treatment of chronic illnesses, such as diabetes, as drug treatment for this type of disease will be taken for longer periods of time; usually for the rest of the patient’s life.

Prevention Strategies

This naturally occurring threat is not going to be eradicated without preventative measures being implemented globally. In one research paper on the subject, Sipahi suggests that the following strategies should be followed:

-       Optimal use of existing antimicrobial agents

-       Where possible, use alternative therapies

-       Increase immunity

-       Educate healthcare professionals

-       Regulations and policies

-       Stringent infection control protocols³.

There are scientists working to develop new drugs able to combat bacteria that are resistant to antibiotics. One of the more recent discoveries reported in The Guardian earlier this year has been hailed as a “game changer” and is called teixobactin. It can kill a wide range of bacteria, including Methicillin-resistant Staphylococcus aureus (MRSA). Teixobactin works by blocking the capacity of resistant bacteria to build cell walls, therefore making it almost impossible for bacteria to develop resistance⁴. It is, of course, still early days.

Alternatives to Antibiotics

The alternative is to use drugs and therapies that do not contain antibiotics, yet are as effective in the results that they deliver. PerioChip® is a non-antibiotic solution and can therefore be used in the longer term. It is designed for use in conjunction with traditional treatment to suppress bacterial flora in periodontal pockets of 5mm or more. It contains 2.5 mg of Chlorhexidine Digluconate and is recommended for first line treatment of periodontal pocketing. Results from clinical studies show a pocket reduction of more than 2mm in almost three quarters of patients when placed every three months⁵.

Antibiotic resistance is a looming problem that all governments and healthcare professionals around the world need to take responsibility for. With alternatives to antibiotics available that can be used in dental treatment plans, dental practitioners need to carefully consider what they prescribe and ensure they are doing what they can.

To order PerioChip® or for further information Freephone 0800 013 2333 or email This email address is being protected from spambots. You need JavaScript enabled to view it.

Summary of product link;

http://www.old.health.gov.il/units/pharmacy/trufot/alonim/PerioChip_dr_1337488974840.pdf

Abbreviated Prescribing Information

PerioChip® 2.5mg Dental Insert (Chlorhexidine digluconate)

For full prescribing information, including side effects, precautions and contraindications, see Summary of Product Characteristics (SmPC).

Presentation: Dental insert: bullet shaped orange brown containing Chlorhexidine digluconate 2.5mg.

Indications: PerioChip® is an adjunctive antimicrobial treatment for moderate to severe chronic periodontal disease in adults with pocketing, combined with Root Surface Debridement (RSD). Not indicated in children and adolescents.

Dosage and Administration: One PerioChip® is inserted into a periodontal pocket with a probing pocket depth of ?5mm. Retreatment with PerioChip® following mechanical plaque removal at 3 month intervals may provide additional benefit if pocket depth remains ?5mm. For details see SmPC. Removal is unnecessary as PerioChip® biodegrades.

Contraindications: Hypersensitivity to Chlorhexidine digluconate or excipients.

Precautions: Allergic reactions have occurred but are rare.

Interactions: Avoid nystatin: antagonistic of Chlorhexidine. Chlorhexidine is incompatible with anionic agents present in some toothpastes and with dietary sucrose, but there is no significant impact on the efficacy of PerioChip®.

Undesirable effects: During the first few days after insertion, transient pain or discomfort of gums or teeth; redness and/or swelling of the gums.

Overdose: Not reported

Pregnancy/ Lactation: Controlled studies in pregnant women have not been conducted, so weigh expected benefits against possible foetal risks: caution in nursing mothers (see SmPC).

NHS list price: £207.20

Legal category: P, Product Licence Number: PL 14017/0035

MA holder: Full prescribing information is available on request from Dexcel Pharma Ltd, 7 Sopwith Way, Drayton Fields Industrial Estate, Daventry, Northants, NN11 8PB.

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard.

Adverse events should also be reported to:

Dexcel Pharma Ltd on 01748 828784

1. Fact Sheet No194, WHO

2. http://amr-review.org

3. Sipahi OR. Economics of antibiotic resistance. Expert Rev Anti Infect Ther. 2008 Aug;6(4):523-39. doi: 10.1586/14787210.6.4.523.

4. The Guardian, 7^th January 2015

5. Soslkolne W.A et al. Probing depth changes following 2 years of periodontal maintenance therapy including adjunctive controlled-release of chlorhexidine. JOP 2003;74:420-427

The John Zamet Memorial Prize has been established to recognise and commemorate the significant contribution made to clinical periodontology by the late Dr John Zamet.
 

Dr Zamet was an Honorary Consultant and Senior Research Fellow at the UCL Eastman Dental Institute, a Past President and Honorary Member of the British Society of Periodontology and the founder Chairman and a Trustee of the Alpha Omega London Chapter and Charitable Trust.

Applications are open to all UK-based postgraduate dental students studying for a Masters degree or PhD who are undertaking or who have recently completed original research associated with clinical periodontology.

The prize will be awarded every other year with a value of £2,000.

Applicants should submit a covering letter and an abstract not exceeding 1000 words which should, at least, cover the following areas:

1. Background to project?
2. Aims
?3. Methods?
4. Relevance to clinical periodontology
?5. Start and completion dates (estimated completion date will suffice if ongoing)

Three paper copies of the application should be submitted by 31st December 2015 to:

Professor Andrew Eder?Chairman, The Alpha Omega London Charitable Trust 2nd floor, 57a Wimpole Street, London W1G 8YP

And also sent electronically via email to: This email address is being protected from spambots. You need JavaScript enabled to view it.?. The applicant must also submit a letter of support from their research supervisor confirming their supervision of the project. The submission will be considered by a panel of at least two Specialists in Periodontology of Professorial/Consultant status whose decision is final.

The successful applicant would normally be invited to present the results and/or clinical implications of the research at a meeting of the Alpha Omega London Chapter.

Described as a global burden, severe periodontitis has been reported to be the sixth most prevalent medical condition in the world.[1]

In the UK, periodontitis affects about half of all adults with up to 15% estimated to have the condition severely.[2] These shocking statistics echo the findings of the 2009 Adult Dental Health Survey, which reported that, although this generation has a better outlook than their predecessors, there are still many people whose oral health and function does not meet the best possible standards.[3]

Periodontal disease is a particular area of concern because it can cause serious oral health problems and when left untreated, and can result in tooth loss as well as deterioration of both gingiva and bone. Ominously the potential effects and implications of periodontal disease may also extend beyond oral health and recent research has established that periodontal infection is a probable risk factor for various systemic diseases, including pulmonary disease.[4]

Furthermore, periodontal disease has the capability of changing the chemical composition of the blood and glucose levels as well as interfering with the body's inflammatory system and thereby increasing the risk of diabetes, rheumatoid arthritis,[5] respiratory[6] and cardiovascular diseases.[7]^,[8]

As we know, tobacco use, stress and obesity may be significant risk factors in the development and progression of periodontal disease. However people with other general health conditions also have an increased risk of developing the condition. Evidence has consistently revealed that diabetes is a risk factor for the prevalence of gingivitis and periodontitis^[9] and a five-year follow-up, population-based study in Taiwan[10] has also indicated that patients with osteoporosis might have an increased chance of developing periodontitis.

EuroPerio8, the triennial world leading conference in periodontology, made its visit to London this year.

With lectures held throughout the duration of the conference, EuroPerio Platinum Sponsor, Acteon, presented lectures on Thursday and Saturday.

On Thursday, Dr Amit Patel and Donna Schembri explored the concept of ‘Seeing the Unseen’ - Utilising Fluorescent Technology for Optimal Periodontal Care.

The theme from Acteon and the two speakers was clear: improve patient understanding to empower self-care and utilise technology to see better and treat faster.

Cutting-edge products mentioned as examples for the effective removal of plaque included the Newtron P5xs ultrasonic generator, the Air n Go easy airpolisher and Soprocare - which utilises state of the art photonics technologies.

It was a similar story from the Ziv Mazor lecture on Minimal Invasive Surgery Utilizing Piezo Surgical Device - Optimizing Biological and Functional Outcome in the Posterior Maxilla.

Using products such as Piezotome® and Sinus Lift Kit as examples, he articulated that innovative technology minimises complications, reduces treatment and healing time, and ultimately enhances function.

Improve patient understanding and encourage them to look after themselves by giving them the tools and the knowledge: together we can improve patient care.

Find out more about innovations available from Acteon by calling the team today.

For more information on Acteon and how to educate your patients, email This email address is being protected from spambots. You need JavaScript enabled to view it., call 01603 227019 or visit www.acteongroup.com

When it comes to unveiling your new and exciting products, timing is key! As one of the first major dental shows of the year, The Dentistry Show 2016 will enable you to reveal your latest and greatest in style, while networking with the 8,000 plus delegates expected.

The Dentistry Show 2016 will be working alongside leading societies and associations to deliver you a high quality and high value experience, including names such as the British Academy of Cosmetic Dentistry (BACD), British Society of Periodontology (BSP), British Endodontic Society (BES), British Association of Dental Nurses (BADN) and many more.

With the support of The Product & Services and Launchpad UK Guides exhibitors receive extensive coverage leading up to the event through print and online media platforms, show guides and direct mail to delegates promoting your products and company logo.

80% of exhibitors from 2015 have already booked in for 2016 with a confirmed total of 196 stands. With a first come first serve choice on location avoid disappointment and book your place now!

Sign up now and guarantee your place at one of the biggest dental events of the 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 5270

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

The on-stand experts will be at this year’s BDIA Dental Showcase 2015, showing delegates why PerioChip^® is a first line treatment for periodontal disease.

PerioChip^® provides unique adjunctive treatment for periodontitis. After root surface debridement (RSD), PerioChip^® is a reliable product to supplement your hard work by controlling bacteria and preventing infection without using antibiotics.

Designed for treating periodontal pockets >5mm, PerioChip® takes only 30 seconds to apply. Once placed, the chip immediately releases a high local concentration of chlorhexidine diglucontate, killing 99% of subgingival pathogenic bacteria over a seven to ten day period.^[i] For further peace of mind the antimicrobial effects of PerioChip^® continue to suppress bacterial flora for up to 11 weeks enabling the periodontium to stabilise and heal.[ii]

The BDIA Showcase is ideal opportunity to have a practical hands-on demonstration from the PerioChip^® team and grab some valuable information to help your patients. Come and see us on stand D115.

To order PerioChip^® or for further information Freephone 0800 013 2333 or email This email address is being protected from spambots. You need JavaScript enabled to view it.

Nobel Biocare sponsored two sessions at this year’s EuroPerio8, presenting outstanding speaker line-ups and updates on the very latest advancements in the field.

On Thursday, Christer Dahlin, Iñaki Gamborena and Eric Rompen presented to a capacity crowd on ‘Hard and soft tissue parameters to support optimal aesthetics – innovative approach to materials and techniques’.

They discussed everything from the challenges of biological mechanisms to the benefits of healing abutments and the evidence supporting biocompatible materials currently on the market. Key innovations mentioned included the Angulated Screw Channel (ASC) abutment, PEEK healing abutments and the new NobelActive® Wide Platform and NobelParellel® Conical Connection implant systems.

On Friday, leading international clinicians Chadur Wadhwani and Stefan Holst joined Eric Rompen to consider ‘Multi-causality of peri-implanitis – Give the bone the chance to survive’. This session explored aetiology of complex chronic infections like peri-implantitis and demonstrated factors that can facilitate bone healing.

The crowded lecture theatre was packed full of enthusiastic delegates keen to learn from some of the best in the business and advance their own skills. Inspiration and innovation were clearly abundant and a great event was enjoyed by all.

To discover more about the cutting-edge products available from Nobel Biocare and the benefits they offer your implant patients, contact the team today.

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

Mr Matthew Garnett is a specialist Periodontist and Prosthodontist and works as a Consultant in Restorative Dentistry at Newcastle Dental Hospital; he uses Carl Zeiss EyeMag Pro F loupes with a Feather Light LED and is delighted with the enhanced visualisation they provide.

“Having routinely utilised loupes for in excess of 10 years, I have been well aware of the visual and postural benefits that can be achieved; however that being said, I have recently invested in the EyeMag Pro F loupes, and the optical clarity of the prismatic lenses and greater magnification is outstanding and has far surpassed my expectations. I have greater vision with a clear and wide field of view and excellent illumination is offered by way of the Feather light LED. All of these features facilitate the way I undertake all of my periodontal plastic surgery in addition to my general operative dentistry.

“There is no reason not to use the loupes, the weight is compatible with comfort and you can use them all day and not feel any added pressure. As well as this, the charge on the battery for the Feather Light is more than sufficient for a full days clinical work.”

Carl Zeiss magnification systems are exclusively available in the UK from Nuview, contact the team today to see how your daily practice could benefit from the enhanced visualisation on offer.

For more information please call Nuview on 01453 872266,

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

Innovation, inspiration and knowledge are key elements for the advancement and maintenance of a practitioner’s skills in dental implantology. At EuroPerio8, practitioners had the chance to hear from those at the very forefront of the profession in sessions sponsored by Nobel Biocare.

On Thursday, an outstanding line-up of leading speakers including Christer Dahlin, Iñaki Gamborena and Eric Rompen presented to a capacity crowd on ‘Hard and soft tissue parameters to support optimal aesthetics – innovative approach to materials and techniques’.

Dr Christer Dahil, Professor in Oral Surgery and Guided Tissue regeneration at the Department of Biomaerials Science, Institute for Clinical Sciences in Sweden, was the first to take to the podium. He explored the biological mechanisms that present challenges for the implant clinician, highlighting the importance of guided bone regeneration and discussing the various bone defect classifications.

Dr Iñaki Gamborena, Associate Professor at the University of Washington Dental School, was keen to highlight the importance of the soft tissue, encouraging minimally invasive techniques by exposing as little bone as possible during procedures. Favouring a graftless approach, he considered the benefits of healing abutments to improve the condition of the soft tissue before conventional abutments are placed.

Finally, Professor and Head of the Department of Periodontology / Dental Surgery at the University of Liège in Belgium, Dr Eric Rompen looked further at the interface between the soft tissue and implant. Discussing the properties and clinical evidence supporting biocompatible materials, he used case studies to demonstrate the adhesion process and warn how easily detachable the soft tissue is even when using these materials.

Throughout the inspirational session, cutting-edge products from Nobel Biocare were described which are designed specifically to enhance the clinical outcome of implant treatment. These included the Angulated Screw Channel (ASC) abutment, increasing workflow flexibility and access; PEEK healing abutments, optimising the emergence profile; and the new NobelActive® Wide Platform and NobelParellel® Conical Connection implant systems, ideal for the posterior region.

Nobel Biocare also sponsored a session on the Friday, with leading international clinicians Chadur Wadhwani, Stefan Holst and Eric Rompen once again. Entitled ‘Multi-causality of peri-implanitis – Give the bone the chance to survive’, this session explored aetiology of complex chronic infections like peri-implantitis and demonstrated factors that can facilitate bone healing.

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

Tel:     01788 575050  |  Email: This email address is being protected from spambots. You need JavaScript enabled to view it.  |  Web:   www.bsdht.org.uk

Address:  Smile House, 2 East Union Street, Rugby, Warwickshire, CV22 6AJ

Speaking at EuroPerio8 on Thursday June 4^th, Dr Amit Patel and Donna Schembri explored the concept of ‘Seeing the Unseen’ - Utilising Fluorescent Technology for Optimal Periodontal Care.

With the two speakers covering the subjects of diagnosis, communication and the treatment of periodontal disease and peri-implantitis, the message was clear: innovation changes products and progress changes behaviours.

Studies have shown that 40 - 80% of information is forgotten immediately by patients[i]. Donna therefore noted that if you want your patients to be better informed about periodontal disease, you need to find better ways to enhance their understanding. By replacing dental jargon with emotive wording and replacing negative and daunting connotations of treatment with positivity, this has the potential to empower and motivate your patients - increasing your chance of success and improving overall patient care.

With comfort and increased effectiveness at the forefront of innovation, Donna and Amit firmly believe that by using the right technology and products you can minimise the presence of plaque on teeth and dental implants: achieving the ultimate goal of tooth loss prevention.

Using photos and videos for examples, the fluorescence protocol was put to the test with demonstrations of how pioneering products can be utilised to treat and maintain periodontal disease effectively. Both speakers also highlighted the need for

continued focus on educating patients about the differences between supragingival cleaning, subgingival cleaning, root planning, use of medication and x-ray and follow up treatment. They need to be informed of the benefits of prophylaxis as well; those being tartar removal, aesthetics and fresher breath.

Examples of cutting-edge products mentioned included Acteon’s Newtron P5xs ultrasonic generator, the Air n Go easy airpolisher and the Soprocare - which utilises state of the art photonics technologies. With products like these, patients can reap the benefits of accurate detection, quick visual follow up, comfort, oral hygiene education and complete removal of plaque and stains with minimally invasive treatment.

As the question and answering session post lecture depicted, the main concerns highlighted among professionals included patient’s lack of understanding. “It is a relationship,” Dr Amit Patel explained, “Give them the tools to do it themselves and lead them in the right direction.”

It would seem then that the answer to better patient care is twofold: improve patient understanding and rapport to empower patients to look after themselves and utilise technology to see better and treat faster.

On Saturday June 6^th, Ziv Mazor examined the concept of Minimal Invasive Surgery Utilizing Piezo Surgical Device - Optimizing Biological and Functional Outcome in the Posterior Maxilla, once again sponsored by Acteon.

In order to explore invasive surgery, Mazor first identified potential obstacles that can occur during treatment.

He noted that implant placement in the atrophic posterior maxilla often causes complications due to the quality and volume of the bone that is available. With the height and width of the residual ridge being affected by post-extraction resorption patterns, physical trauma, periodontal disease and pneumatisation of the sinus, he highlighted that longer and wider implants are needed to enhance long-term survival.

Research points towards infected sockets being the most common cause of post-extraction complications, with a study showing a percentage of 48.7. Bleeding sockets came second with 41% and retained roots caused 10.3% of problems[ii].

Recent innovation in this area highlights that trauma to the tissues and the underling bone can be eliminated, minimising both the procedure time and post-operative complications.

With sinus lifts and osteotome techniques often being associated with higher morbidity rates and complication risks, technological advances are a revelation in achieving a reduced risk and high standard of patient care.

Mazor went on to suggest that with the use of reliable, powerful and simple products such as Piezotome® ultrasonic surgery unit from Acteon, there are fewer complications and emphasis can be instead placed on the application of autologous growth factors. By utilising the sinus lift balloon technique, patients can also benefit from the reduction of risk to damage of the Schneiderian membrane. An example of this product is the Sinus Lift Kit by Acteon, which offers the practitioner a straightforward and safe answer to the sinus lift operation.

The point of this lecture was clear: in reducing complications with the aid of innovative technology, ultimate function of patient dentition can be reached in a shorter time period and risk-free way.

Thus there is a noticeable change in the direction of periodontology. The products that are being developed are innovative and effective not just because of what they can do for professionals, but also for how they engage and empower the patient.

For more information on products available email This email address is being protected from spambots. You need JavaScript enabled to view it., call 01603 227019 or visit www.acteongroup.com

Proud partner of the British Society of Periodontology (BSP), PerioChip® was among the Gold Sponsors of EuroPerio 8 and delighted delegates with an array of first class speakers and educational content.

Prior to the exhibition, the professional team looked forward to extolling the advantages of PerioChip®. EuroPerio 8 was a fantastic place for PerioChip® to raise awareness amongst the dental community about gum disease and its potential links to systemic illnesses such as diabetes and cardiovascular disease.

The speakers taking to the stage at the show included: Professor Eli Machtei, Professor Arie J Van Winkelhoff and Dr Rajan Nansi.

Professor Machtei of the Rambam School of Dentistry in Israel is Clinical Associate Professor at the Faculty of Medicine at the Technion (Israel Institute of Technology in Haifa, Israel). His session, Guided Tissue Regeneration: When to use it, focused on periodontal regeneration and looked at how far the profession has progressed and what future research is needed in order to improve our clinical outcomes. He asked what the limitations are, and where should dentists complete or refrain from completing guided tissue regeneration.

Professor Arie J Van Winklehoff of the University of Groningen in the Netherlands is Co-owner of Laboral Diagnostics en Laboral International, a service in the field of clinical microbiology for dental professionals. His session, When should we use systemic antimicrobials? discussed the rationale behind using these drugs in treating periodontitis. It considered the recent World Health Organisation recommendations surrounding the over-prescription of antimicrobial medicines and encouraged a more evidence-based approach to the prescription of antibiotics for periodontitis.

Dr Rajan Nansi, Chair of Early Careers Group, BSP UK also spoke at the event and his session, Management of periodontitis in practice: Practical concepts, aimed to discuss the effectiveness of non-surgical periodontal therapy and explore the use of adjunctive locally applied antimicrobials in periodontal treatment.

Delegates at EuroPerio 8 could see that PerioChip® is passionate about supporting, educating and communicating with the dental community to highlight the importance of keeping gums healthy, and treating gum disease effectively without the risk associated with using antibiotics.

This is where the advantages of this wafer thin biodegradable insert really come into their own. By using PerioChip® you can ensure that harmful bacteria are eliminated for up to 10 days^[i] and, for on-going therapy, PerioChip® suppresses the growth of bacterial flora in the treated site for up to 11 weeks, giving the all-important time needed for gum reattachment and stabilisation of the periodontium[ii].

If you missed out on attending EuroPerio 8 and want to learn more about PerioChip® email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 0800 013 2333 today!

Summary of product link;

http://www.old.health.gov.il/units/pharmacy/trufot/alonim/PerioChip_dr_1337488974840.pdf

Abbreviated Prescribing Information

PerioChip^® 2.5mg Dental Insert (Chlorhexidine digluconate)

For full prescribing information, including side effects, precautions and contraindications, see Summary of Product Characteristics (SmPC).

Presentation: Dental insert: bullet shaped orange brown containing Chlorhexidine digluconate 2.5mg.

Indications: PerioChip^® is an adjunctive antimicrobial treatment for moderate to severe chronic periodontal disease in adults with pocketing, combined with Root Surface Debridement (RSD). Not indicated in children and adolescents.

Dosage and Administration: One PerioChip^® is inserted into a periodontal pocket with a probing pocket depth of ?5mm. Retreatment with PerioChip^® following mechanical plaque removal at 3 month intervals may provide additional benefit if pocket depth remains ?5mm. For details see SmPC. Removal is unnecessary as PerioChip^® biodegrades.

Contraindications: Hypersensitivity to Chlorhexidine digluconate or excipients.

Precautions: Allergic reactions have occurred but are rare.

Interactions: Avoid nystatin: antagonistic of Chlorhexidine. Chlorhexidine is incompatible with anionic agents present in some toothpastes and with dietary sucrose, but there is no significant impact on the efficacy of PerioChip^®.

Undesirable effects: During the first few days after insertion, transient pain or discomfort of gums or teeth; redness and/or swelling of the gums.

Overdose: Not reported

Pregnancy/ Lactation: Controlled studies in pregnant women have not been conducted, so weigh expected benefits against possible foetal risks: caution in nursing mothers (see SmPC).

NHS list price: £207.20

Legal category: P, Product Licence Number: PL 14017/0035

MA holder: Full prescribing information is available on request from Dexcel Pharma Ltd, 7 Sopwith Way, Drayton Fields Industrial Estate, Daventry, Northants, NN11 8PB.

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard.

Adverse events should also be reported to:

Dexcel Pharma Ltd on 01748 828784

Delegates at EuroPerio 8 could see first hand that PerioChip® is passionate about supporting, educating and communicating with the dental community to highlight the importance of keeping gums healthy, and treating periodontitis effectively without the risk associated with using antibiotics.
 

By using PerioChip® you can ensure that harmful bacteria in and around the gingiva are eliminated for up to 10 daysⁱ and, for on-going therapy, PerioChip® suppresses the growth of bacterial flora in the treated site for up to 11 weeks, giving the all-important time needed for gum reattachment and stabilisation of the periodontiumⁱⁱ.
 

EuroPerio 8 was a fantastic venue for PerioChip® to raise awareness amongst the dental community about gum disease the links to systemic illnesses such as diabetes and cardiovascular disease. The speakers taking to the stage at the show to share their knowledge included: Professor Eli Machtei, Professor Arie J Van Winkelhoff and Dr Rajan Nansi, and attendees were wowed by their passion and expertise for the subject.
 

If you missed out on attending EuroPerio 8 and want to learn more about PerioChip® email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 0800 013 2333 today!