Sunday, 25 October 2015

Could YOU walk a Marathon a Day for 5 Months?

Following last year’s tremendous success, the Sterling Dental Foundation is delighted to invite you to the Annual Sterling Dental Charity Ball 2015.

Bobby setting off on his way to India


Once again supporting Bobby, the Chairman of the India Association, as he undertakes his monumental five-month, 2,600 mile charity walk across India, the Sterling Dental Foundation is hoping to raise money for underprivileged children across the globe.


Bobby’s Walk Full Circle is an exceptional event, that showcases one man’s passion for bringing smiles to the faces of those less fortunate. Starting in Kanyakumari in the south of country, Bobby will be walking along the vast east coast, through seven Indian states, to New Delhi – raising awareness of oral hygiene and dental health every step of the way.


The Sterling Dental Foundation is proud to be able to support Bobby in this spectacular feat and, this year, is inviting UK and Indian dental practitioners to join Bobby on various legs of the journey – helping to spread happiness and good oral health to some of India’s poorest areas.


In line with their own initiatives to raise awareness of oral health and dental education across all 29 states of the country, the Indian Government is also fully supporting the event. With their help, special pop-up clinics will be opening along the way – which will be perfect for sharing crucial information and treatments throughout the five-month journey.


The Charity Ball is a fantastic event, where you can learn more about Bobby’s amazing undertaking and show your support for a worthy cause. Promising to be a sensational evening of top-quality entertainment and award-winning cuisine, the Charity Ball will undoubtedly show how generous and supportive the UK dental profession truly is.


And it is hoped that, through this unparalleled generosity, over £1.5 million will be raised. Donated to the Great Ormond Street Hospital Charity, HRH the Prince of Wales charity, the British Asian Trust and many other admirable causes that seek to provide high quality care and innovative new treatments for children all across the world, this money will help ensure all children can receive the dental care they need.


The Sterling Dental Foundation humbly asks for your support in this astounding endeavour. The Charity Ball is sure to be a wonderful evening of dancing and dining as well as a fantastic opportunity to see old colleagues, meet new friends and relax – all while helping those who need it the most.


With special guests and renowned entertainment, plus the chance to learn more about Bobby’s good works and help make a real difference yourself, this is one event that simply cannot be missed.


The Annual Sterling Dental Charity Ball 2015, in support of Bobby’s Walk Full Circle:

Saturday 28th November 2015 at the Hilton London Metropole, 225 Edgware Road, London W2 1JU.



For information about the Sterling Dental Group and to book your tickets, visit www.sterlingdentalgroup.co.uk

#GoBobbyGo

Thursday, 22 October 2015

Peri-implantitis with Dr Ope Sodeinde

Last week, I attended the first ever Perio-Implant Study Club hosted by Ope Sodeinde



Ope is a specialist periodontitist working in Wimpole Street in a specialist periodontal referral practice. Ope offers some fantastic support for GDPs who refer patients to him including being able to attend study clubs. 

Last week, the topic Ope discussed was peri-implantitis - a growing concern in modern dentistry. 
Here's a brief summary of his talk. 

What diseases can affect implants?


1. Peri-mucositis - appears as redness/swelling of gingivae, bleeding on probing, sometimes suppuration but no bone loss

2. Peri-implantitis - this will have the same clinical appearance as above BUT with bone loss


Commonly, peri-implant disease presents with no complaints from the patient until the situation becomes very advanced. Inflammatory lesions appear deeper and much quicker around implants than teeth as there is no connective tissue present, so if a patient presents with a mobile implant, the implant itself is probably about to fall out.

There could be the added issue in a patient with a thick gingival biotype, the inflammed tissues are masked and are less likely to recede so detection can be delayed. Pockets around implants are also physiologically deeper than around teeth, so a 4mm pocket may indicate disease around a tooth but not around an implant. The pockets themselves may be difficult to measure around an implant due to subgingival threads or bulbous crowns making access parallel to the long axis impossible. 

So how can we detect Peri-Implant disease?


Regular maintenance and imaging is paramount to the early detection of disease. 
CBCTs are not useful as the implants create scatter, but bitewings are very good to show bone levels around implants. 


Risk factors for Peri-Implant disease


Patient factors:
  • History of periodontal disease 
  • Smoking
  • Poor oral hygiene
  • Lack of maintenance
Implant factors:
  • Implant surface roughness 
  • Soft tissue cuff height
  • Presence of keratinised tissue
  • Implant-abutment junction - if there is biofilm at this junction, there is increased risk of failure

How do I treat Peri-Implant disease?


Non-surgical management:
  1. Scaling (hand instruments/ultrasonic). - whatever you may use for the treatment of periodontal disease
  2. Local/systemic antibiotics
  3. Lasers
You can also manage this disease surgically, but some things you need to consider are:
  • Is there enough keratinised tissue present?
  • Is the thread pitch of the implant (the distance between the threads) enough for Guided Bone Regeneration (GBR)?
  • Can the implant be adequately decontaminated?
  • How much recession is acceptable? (especially in anterior teeth)

Thanks so much to Ope, Jo and the team for organising a really informative evening. Can't wait for the next one!

To see more information see Ope's practice website here


Do you feel confident diagnosed peri-implant disease? Let me know in the comments below!



Sunday, 18 October 2015

It's Good to Talk: BDJ Student Magazine Article

Following my previous post with an article on communication in the Young Dentist FMC, I've been writing my top tips when communicating with patients; this time in the BDJ Student Magazine. 



Learning how to communicate well with patients can be difficult and is a skill you will get better at the more you see and treat patients. 

Communication isn't always something we are directly taught at dental school, so learning some structured ways to approach things can be useful.

In this article, I share with you some tips I think are pretty useful when seeing patients. Let me know what you think! 

To read the full article click here

Monday, 12 October 2015

London Museum Guide: The National History Museum

It's been a while since I've posted something about London, so here goes: another museum review. See my other museum reviews here.

The famous escalator up through the earth to the Earth Lab

So another adventure to South Kensington to visit the National History Museum, one of the most famous museums in London. 

The museum is most famous for it's dinosaurs exhibit which I remember going round when I was a kid, but there is still lots to explore in other parts of the museum!

Going on a busy, sunny Saturday was a bit of mistake though - the best parts of the museum were pretty packed and to get through to see the dinosaurs was an ordeal. We had to queue to get into the room and walking along the walkway was like a slow moving queue at a theme park. 

The museum opened in the late 19th century when the dinosaur collection outgrew the walls of the British Museumand the building is pretty impressive. The museum, similar to the Science Museum next door, is FREE so you can re-visit as many times as you wish. 


The impressive main hall of the museum with Dippy, the resident diplodocus skeleton

Exhibits we visited as well as the famous dinosaurs included: The Earth Lab, Volcanoes and Earthquakes, Creepy Crawlies and Minerals. 

The museum also holds night events and soon there will be an ice rink for the Christmas period. Unless you are taking children, I think that if you are planning to visit a late night event would be great (no kids!!) or a week day would be best. The crowds at weekends and bank holidays really spoil what could be a really fun and educational trip! 

To see more, take a look at the museum's website here

Have you been to the museum? What was your favourite exhibit? Let me know in the comments below!


Monday, 5 October 2015

Product Review: Memosil 2, The Magic Matrix

If you've read about some my recent posts with Aspire Dental Academy, you'll have read about some tips when placing composites. From that day I learnt a nifty trick with a product called Memosil




Memosil is a transparent addition silicone - therefore it can be light-cured through which lends it to some pretty cool uses in dentistry, such as:
  • Occlusal stamp technique for posterior composites
  • Anterior stamp for provisional restorations and demonstrating wax ups
  • Anterior stamp for the placement of composite build ups or veneers
  • Fixation material for x-ray measuring spheres when planning for implants 
  • Transfer matrix for bracket constructions on plaster models

After our study day with the Aspire team, I tried out this material on a couple of wear cases I was treating in practice. 

I had a patient who had generalised anterior tooth wear which looks to be attritive in origin. He was interested in building his teeth back up, so after I stabilised the patient's oral health, we decided to use composite to increase his OVD

I asked for a wax up from my lab and used the automix system to squirt out the Memosil onto the models to make matrices as below:

My memosil matrices in place on the model


The matrices removed from the models

After showing the wax ups to the patient and agreeing the shade I carried out the build-ups in the following way:
  1. Rubber dam and clamp isolation 5-5
  2. Cleaning teeth with US scaler and roughening of dentine surface with a rosehead bur. Ideally I would have done this with a sand-blaster if it were available
  3. Isolate individual teeth with floss/Teflon/Mylar strips
  4. Etch, prime and bond EVERY OTHER tooth (this is really important as you don't bond the teeth together)
  5. Place composite into the Memosil matrix, full seat in the mouth and cure according to your curing light's guidelines. This will take a while unless you have a ValoLight!
  6. Remove index and cure again
  7. Finish/polish interproximally with whatever system you wish. I used fine diamond burs, interproximal strips and hand scalers to remove excess composite
  8. Repeat with all the remaining teeth
  9. Use KY Jelly to cover all composite and cure once again to prevent staining
  10. Polish using your preferred protocol
  11. Check occlusion, make sure contacts are even and the patient feels comfortable with new OVD
I also provided my patient with a mouthguard to wear at night time to slow down the wear of the composites. 

Here are the before and after pictures of the patient I treated:

Patient on initial presentation after I provided a gross scale

Immediately post treatment

These are my favourite before and after pictures of a patient I've treated! Cases like this give you real satisfaction and are very fulfilling. 

You can see how I've opening him up and his posteriors are not occluding, but the patient felt comfortable and using this Dahl principle they will begin to move back together. This will of course need lots of maintenance and monitoring, but is much less destructive than other restorative options such as full coverage crowns. 

If you have any cases like this, consider getting some of this product to help get a great result which is a really easy and quick way to treat wear cases. It's also a much cheaper way of making a matrix than asking your lab for a suck down splint. A cartridge costs around £45 and that will probably make 10-15 matrices.

To see more about the product, click here


Let me know what you think of the product!



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