#dental care

Aesthetics doctor reports the first case of a patient’s hypersensitivity reaction to hyaluronic acid filler following COVID-19.

Dr MJ Rowland-Warmann, a facial aesthetics practitioner and trainer, has warned that there is an increased risk of hypersensitivity to hyaluronic acid dermal fillers in people who subsequently contract COVID-19.

Her report is in the Journal of Clinical Dermatology. It explains that both COVID-19 and flu‐like illnesses can trigger an immune reaction at the site of filler placement. It poses a possible risk of inducing delayed hypersensitivity.

Hyaluronic acid filler

Her case report describes a fit and healthy 22-year-old woman. She experienced a delayed reaction after hyaluronic acid dermal filler treatment to disguise a dorsal hump (a bone/cartilage irregularity) on her the nose.

The young woman subsequently contracted a moderate case of COVID-19. For which she received a positive test saying it was like a bad cold. She needed no medical treatment for this.

Three weeks after her successful and problem-free hyaluronic acid filler treatment, the young woman awoke to find her nose was red, swollen, hardened, tender, and the skin felt tight.

There was no other reason why her nose should become inflamed. She had no injury, hadn’t taken any medication or damaged her nose, which may lead to a skin infection. The swelling was only on her nose. She had no other symptoms.

After determining that the young woman had COVID-19, but that there were no other reasons for the belated complication, Dr Rowland-Warmann offered the young woman oral steroids to treat the inflammation.

She declined this and over the next week, the swelling and other symptoms subsided without the need for medical intervention.

COVID-19 impacts

Interestingly, the hump on her nose, completely masked by the hyaluronic acid filler immediately after treatment, appeared prominently once again when the swelling went down.

Typically delayed hypersensitivity after hyaluronic acid dermal filler treatment occurs in up to 4% of people. Previous reports have shown this in patients who subsequently develop flu-like illnesses. However, this is the first documented case of a patient who had a delayed reaction after contracting COVID-19.

Viral infections activate the T-Lymphocytes in the body. Their roles include directly killing infected cells, activating other immune cells and regulating our immune response. Dr MJ Rowland-Warmann considers this is the reason for the reaction to the filler. Something that the body regards as a foreign body and needs attacking.

We also think that flu-like illnesses can trigger an acceleration in the degradation of the dermal filler. Hence the reappearance of the patient’s dorsal hump.

Dermal filler procedures using hyaluronic acid have become extremely popular for people seeking temporary, non-invasive aesthetic improvements.

Complications

In 2019 a 15.7% increase in the number of hyaluronic acid dermal filler procedures to over 4.3 million worldwide was recorded from the preceding year.

The treatment is relatively low risk. However, given the significant number of people contracting COVID-19, this will not be the only reported case of complications.

Although this case resolved without the need for intervention, Dr MJ Rowland-Warmann advises that clinicians should be aware of the risk of a hypersensitivity reaction to hyaluronic acid dermal filler in light of the pandemic.

She also advises that patients should wait for a few weeks after contracting COVID-19 to have an hyaluronic acid filler treatment.

Dr Rowland-Warmann suggests that this should make people having hyaluronic acid treatments consider the need to have treatment with a medical professional who can identify and address any complications.

You can read a full copy of Dr Rowland-Warmann’s paper in the Journal of Cosmetic Dermatology:https://doi.org/10.1111/jocd.14074.

Dr MJ Rowland Warman founder and clinical director of Smileworks, Liverpool and runs the Aesthetics Hub training academy  smileworks-hub.co.uk.

The post Does COVID make your hyaluronic acid filler swell? appeared first on Dentistry.co.uk.

Join Christian Mehl as he discusses the benefits of guided implant surgery on Tuesday 30 March at 19:00.

The aim of this session will give delegates an insight into some of the incredible digital treatment and planning options available for implant surgery today.

This session will focus on cases that showcase the new world of digital dentistry in combination with immediate implant placements.

Learning outcomes

• An overview of the dental anatomy
• The aesthetic golden rules
• The scientific data and the rules on immediate implant placement
• Case selection and ethical questions
• Implant planning – how many and where?
• The digital world
• Guided versus non-guided implants.

Christian Mehl

Professor Christian Mehl is a specialist prosthodontist certified by the German Society of Prosthodontics (DGPro) and the General Dental Council (GDC).

Professor Mehl qualified in dental implants in 2007 and is certified by the German Society of Implantologie (DGI). His PhD and most of his research has been in the field of dental implants, bone augmentation surgery, immediate implant placement, complete oral rehabilitations and reconstructive periodontal surgery.

He has been working in dentistry for over 20 years. And he continues to find the developments exciting, both, as a scientist and clinician.

Christian is a professor at the University of Kiel and is actively involved in the clinical research and development of dental implant systems.

He regularly publishes articles in national and international specialist magazines and lectures internationally.

To sign up and watch this webinar for free, visit dentistry.co.uk/webinars.

Catch up with previous On Demand webinars

• How to hold a successful Invisalign promotion day
• Secrets to grafting techniques
• Full arch reconstruction with pterygoid implants.

The post Man versus machine – guided versus non-guided implant surgery appeared first on Dentistry.co.uk.

In an exclusive interview, Amish Raichura shares how he built his implant business, offering valuable insight to dental colleagues looking to follow in his footsteps.

What was it like for you when you got started in implant dentistry?

The early stages were challenging. The courses that I attended were helpful, but I found it difficult to visualise the entire treatment pathway. Because of that, I initially lacked confidence. I was very aware I did not want to be in a position where I was working beyond my capabilities or performing sub-optimally.    

How did you overcome those challenges?

To build my knowledge and skills, I found mentors whom I could observe placing and restoring dental implants.

Once I could see the entire treatment pathway, it helped me to bring the whole process together and I was able to put the various stages into context.

In addition, my mentors enabled me to have case-based discussions and reflect upon the elements that had been challenging.

I was also able to ask a lot of questions. That gave me the confidence to enter a more extended programme of study. I used what I had learnt to acquire the Diploma in Implant Dentistry from the Royal College of Surgeons (Edinburgh).   

For general dentists considering expanding their treatment offering, how does implant dentistry fit in with existing treatment options?

For a missing tooth, there are invariably four options. To leave the space, to have a denture, to have a bridge, or to have a dental implant.

Of course, there are factors that may preclude one or more of these options. However, provided that they are all possible, a dental implant becomes an integral part of any discussion with a patient. As they are often the least destructive, the most predictable, the most cosmetic and the longest lasting, they are commonly the best choice.

To be able to offer such an option is therefore important. It can help to build an already thriving dental practice.

How can dentists gauge whether their practice’s catchment area would allow implants to be a financially viable option?

I found that the best indicator was patient feedback. You can acquire this directly during consultations or more proactively through methods such as questionnaires.

You can only derive this feedback from a sample of your patients. Although, it can often be a very accurate indicator of the needs and wants of your entire patient base.   

What do you think the long-term prospects for dentists incorporating implants into their practice might be? 

The long-term prospects can vary, as they depend largely on the aims and objectives of the individual practitioner or practice.

I know dentists who have limited their practice to dental implants. I also have colleagues who, like myself, spend a large proportion of their time placing and restoring dental implants but have continued to enjoy a flourishing general dentistry career alongside.

For the practice itself, it adds variety to the lives of the clinicians and the staff. It enables one more treatment modality performance in-house rather than referring it out. It can also be be a great way to grow the business.

How can dentists and their teams get the practice ‘implant-ready’?

The most important step in getting the practice ‘implant-ready’. This ensures that all team members are involved in the management pathway.

This includes ensuring the receptionist who greets the patient, the treatment co-ordinator who answers any queries, the nurses who assists the dentist, the operator who performs the treatment, or the technician who builds the restoration, are all appropriately trained and confident in their role.

You must suitably equip the practice to perform surgical implant placements in a safe environment that is free from cross-contamination.

How and why have you chosen your implant partners?

I have used various dental implant systems in the past, as I wanted to assess their differences first hand.

But I soon started to use Biohorizons in the treatment of all my implant patients. I have found that their protocols are straightforward, their equipment is simple to use, their technology is cutting edge and their customer support is always exemplary. 

What advice would you offer general dentists looking to kickstart their career in implant dentistry?

It is always worth attending day courses to get an initial idea of what is involved in implant dentistry. What you learn can then be put into context by observing mentors place and restore dental implants. Afterwards, there is often an opportunity to ask questions on a one-to-one basis, learn protocols and even debate treatment plans in a relaxed and non-judgmental environment. After observing between five and 10 cases, I believe most dentists would hold a firm idea of whether an extended programme of study is suited to them. This will lay the foundations for a career in implant dentistry.

Biohorizons offers a wide range of courses for all members of the dental team. For more information visit www.theimplanthub.com.

This article first appeared in Implant Dentistry Todaymagazine.You can read the latest issue here.

The post Dental implants – a business booster appeared first on Dentistry.co.uk.

An expert in restorative dentistry has hammered home the importance of routine check-ups after a woman discovered a lump on her jaw was oral cancer.

A report on the BBC describes the case of a 29-year-old from Paisley, Scotland, who got in touch with a dental hospital after experiencing pain in her jaw.

A CT and biopsy revealed she had developed a cancerous tumour called osteosarcoma.

Dr Beth Burns, a consultant in restorative dentistry at Glasgow’s dental school, emphasised the importance of dental teams in identifying signs of oral cancer.

She pointed out that dentists are constantly examining soft tissue in the mouth and, as a result, often spot early signs of disease.

Additionally, she urged the public to check their mouths and visit a dentist if they notice anything unusual.

Fall in referrals

This comes as the Oral Health Foundation revealed last year that mouth cancer referrals had dropped by one third since the beginning of the pandemic.

Data showed that referral appointments fell by 33% overall following the onset of COVID-19.

In Scotland, this figure stood at 30%, sparking calls for quick action surrounding diagnosis.

‘Regular dental check-ups and GP appointments are the main routes for identifying the early stages of mouth cancer,’ said Dr Nigel Carter, chief executive of the Oral Health Foundation.

‘We fear that without access to dental and wider health professionals, many mouth cancer cases will go undiagnosed.

‘A person’s quality of life after being treated for mouth cancer, as well as their chances of beating the disease, is highly dependent on the time of diagnosis. By not treating so many potential mouth cancers, there is a real danger of more people losing their life to the disease.

‘While dental and GP visits remain disrupted it is important that everybody knows how to check themselves for mouth cancer.’

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Revolutionising dentistry is an advanced form of communication. Digital signage for dental practices is rapidly growing in popularity, and there are many reasons why. Sophie Olver explains how digital signage can help to deliver information in dental practice waiting rooms.

Since reopening after lockdown, dental practices have to adapt to new technologies and processes to ensure the safety of staff, visitors, and patients.

As a result, digital signage has taken dentistry by storm. It provides a smart solution for hands-free, easily manageable communication.

Yet, the benefits of digital signage go beyond coronavirus and hygiene. Digital signage’s growing popularity in dentistry is rooted in its affordability, effectiveness, versatility and attention-grabbing potential.

It can reduce patient anxiety, promote additional service and offer reminders, and increase patient numbers by retaining existing customers and attracting new ones.

As more and more dental practices turn to waiting room TVs, digital display windows, digital hand sanitisers, and more, this article explores the reasons why digital signage has become dentistry’s rising trend.

What is digital signage?

Digital signage in dentistry is fast growing in popularity. But what is it?

Digital signage consists of an electronic screen conveying information to an audience at a particular location.

Content is created, scheduled and managed through digital signage software. Then a media player is used to display this content onto a screen.

Unlike conventional static or print signage, it can display multimedia content from images and videos to social media and animated text.

The possibilities are near limitless, making digital signage an unparalleled tool of communication.

What makes digital signs so popular?

It reduces patient anxiety

For many, booking a dentist appointment and then sitting nervously in the dreaded waiting room takes courage.

According to the Oral Health Foundation, around 10 million adults in the UK suffer from dental anxiety. With only uninspiring posters and out-of-date magazines to keep waiting patients occupied, this anxiety can escalate.

Digital signage for dental practices provides a solution to this, however.

Waiting room TVs have risen in popularity due to their ability to reduce patient anxiety. These TVs can display interesting and reassuring content to keep patients both distracted and entertained while they wait.

Content can include staff profiles to humanise the dentist behind the face shield, customer testimonials to show treatment successes, and live TV to distract people from their upcoming appointment.

Otherwise, video content on dental products and services or ‘how to’ videos can occupy patients’ attention. This can ease them before they go in for treatment.

What was once wasted time in the dental practice waiting room is now time to entertain patients and reduce anxiety. This can in turn lead to higher customer retention.

Moreover, engaging content decreases the perceived wait time for patients.

It promotes relevant offers and treatments

The popularity of digital signage stems from its flexibility and manageability.

Whilst you must take print signage down, before reprinting and replacing every time a promotion ends, you can update digital signage content and immediately project it onto the screen. This ease means advertised promotions, offers, and treatments remain up to date and relevant.

Screens can be positioned in dentist window displays to reach passers-by or in the reception and waiting rooms to reach visitors and patients.

The bright screens and multimedia capabilities of digital signage effectively attract potential customer attention. Significantly, patients who regularly visit the dentist are keen to improve their oral hygiene, making waiting room clientele the perfect audience for promotional content.

The scheduling potential also allows preparation of promotional content in advance to present on the screen promptly when necessary.

This scheduling functionality has catalysed the popularity of digital signage for dental practices.

It streamlines communication

Information is constantly changing, especially during the pandemic.

As a result, print posters and static signage have proved inefficient in keeping people updated.

Digital signage has, therefore, soared in popularity. It provides an effective way for dentists and dental practices to deliver necessary and valuable information.

A dental practice is a busy place. Consequently, staff often fail to read notice boards or handouts on the staff room table. Digital signage improves internal communication by succinctly displaying important messages on bright screens that capture immediate attention and stick in people’s minds.

These screens can also project a playlist of information on safe working environments, work timesheets, or changes at the practice.

Rather than having information displayed on multiple sources, digital signage streamlines communication for both staff and patients. Content playlists allow rotation of valuable information in one place, improving time and cost-efficiency.

It encourages hygiene effectively

Dentists want to educate people. They want to prevent people from needing dental surgery or avoidable treatments.

Displaying static and conventional information, digital signs provide an effective way to encourage dental hygiene.

Digital screens provide an innovative way to reinforce this message and the importance of oral hygiene. Waiting room TV screens can display before and after photos, ‘how to’ videos, or animated content on dentist food and oral hygiene advice.

Patients are likely to remember bright screens, video content, and high-quality images, encouraging hygiene effectively.

In addition, digital hand sanitisers are rising in popularity in dentistry. Each time someone uses the pump, targeted information from hygiene advice to promotional content plays on a connected screen. When not in use, the screen acts as traditional digital signage. These stations make hygiene useful and fun.

By taking advantage of its multitude of benefits, dental practices have retained existing customers and attracted new customers.

This innovative communication solution has revamped dentistry and will continue to rise in popularity.

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The post Digital signage – is it dentistry’s rising trend? appeared first on Dentistry.co.uk.

Mini (minimally invasive) Smile Makeovers aims to produce the longest-lasting aesthetic result with the minimum biological and financial cost. 

Ride the composite wave with the Mini Smile Makeover two-day anterior direct composite course with Dipesh Parmar.

About Dipesh Parmar

One of the most in demand speakers on minimally invasive aesthetics on the global lecture circuit, Dipesh’s teaching style is direct and highly approachable.

Are you getting an increase in demand for composite bonding? Are you unsure as to which cases you can do directly and indirectly? Do you have the confidence to produce long lasting minimally invasive results on a consistent basis?

Do you have trouble with any of the following:

• Anatomy
• Line angles
• Finishing and polishing
• Treatment planning
• Contact points
• Diastema closure
• Peg laterals
• Full veneers
• Marketing and fee setting
• Instrumentation
• Matrix selection and wedging
• Occlusal considerations
• Repair of composites
• Opaquers and tints
• Incisal halos and effects
• Picking the right composite
• Layering.

Mini Smile Makeover has been attended by over 1,000 UK dentists with amazing feedback.

The immersive two-day anterior composite course is designed to take dentists and therapists of all levels to the next level. Three full hands-on exercises guide delegates from the basics to more advanced layering.

Single and multi-shaded makeover

Master step by step protocols for common clinical situations like composite veneers, diastema closures, class fours and edge bonding.

Discover the instruments and protocols to get you perfect, shade, form, function and long-lasting polish.

Market a Mini Smile Makeover centre

Join our consumer website as a provider and benefit from marketing materials and content.

‘I’ve learnt more than I ever thought I was going to in a two-day course. I’ve done a few similar courses to this but I find this one head and shoulders above the rest. […] very very very helpful’. – Dr Susan Mcbride

Remarkable lectures

Highlighting both clinical successes and failures, a ‘how to’ on marketing to increase case numbers and clinical photography.

The course is suitable for all levels. It provides a step-by-step processes that anyone can follow and repeat.

For more information visit www.minismilemakeover.com.

The post Mini Smile Makeovers – long-lasting aesthetic results appeared first on Dentistry.co.uk.