This year the Oral B seminar was held at the St Johns Hotel, not the usual venue for the Birmingham seminar but nevertheless a good choice to host the third of nine of the events.
The first talk was the third in a series of lectures on minimum intervention dentistry by Professor Avijit Banerjee (King’s College London Dental Institute at Guy’s Hospital) with his focus being on modern restorative dental materials and their use in MI dentistry. With the concept of “less is more”, Professor Banerjee briefly recapped his previous talks and explained how, caries being a lifestyle/behavioural disease, an integrated oral healthcare team approach is needed for care to be successful long term.
From the materials perspective, minimally invasive dentistry incorporates much of what is new in adhesive dentistry. It is therefore important for practising clinicians to understand the chemistry behind the materials they use on a daily basis.
Professor Banerjee’s enthusiasm and passion were evident throughout and this made the information understandable and useful. There was a detailed recap on a selection of contemporary dental materials and an interesting and clear explanation on the classification of dental adhesives and the clinical handling techniques needed to optimise their properties.
The key take home message was that as a clinician you must take responsibility for knowing your materials and how to use them!
Professor Iain Chapple, the events second speaker, discussed early diagnosis of periodontal disease as a factor in saving teeth and lives. Clinical images were used to illustrate the information which helped to cement the points being made.
A build-up of pathogens in the biofilm can lead to an inflammatory response. It was explained that it is not the bugs that cause the periodontal tissue damage but the inflammatory response they initiate. The latter is exaggerated in susceptible people and therefore the biofilm threshold that triggers such destructive immune responses is very low, creating an oral hygiene challenge to such patients.
With chronic periodontal disease affecting teenagers and younger adults, early diagnosis is imperative if there is hope for a successful outcome. As such BPE for children/adolescents is advised for the central incisors and first molars only. For ages seven to 11 years this is only to assess Code 0, Code 1 and Code 2 and from ages 12-17 years this would involve a full BPE for the central incisor teeth and first molars.
Professor Chapple also raised further awareness of the ticking time bomb of peri-implantitis and the difficulty in its management. This is partly due to the increase in cases but also the rise of dental tourism and the multiple different implant systems available.
To understand from a clinical, practice angle delegates were given the distinction between peri-implant mucositis and peri-implantitis and signs to look out for such as bleeding/pus discharge, increased probing depths and radiographic bone loss with bleeding on probing in particular being a useful indicator. The importance of early diagnosis also applies to periimplantitis.
Professor Mike Lewis delivered the closing talk on the topic of mouth cancer.
There is a general increase in mouth cancer occurring in younger age groups with recent examples of 16 year old patients being diagnosed.
The five year survival expectancy is reduced considerably the larger the tumour, particularly if it has spread to neck lymph nodes.
Delegates were taken through the physical examination of a patient from visual inspection to palpation. Various products that are available to aid in the detection of mouth cancer were introduced, however, it was emphasised that these are only adjuncts to diagnosis; the gold standard investigation is still a mucosal biopsy.
Mike's key message was that it is the size of the tumour (less than 2cm) that is important since the velocity of
tumour growth varies considerably between patients.
The new format worked really well with three informative and useful talks that despite being delivered after a working day were a pleasure to listen to. Although differing in topic, all were on point in helping diagnose, treat and manage patients in the best way possible.
The Up to Date talks will be continued in Exeter, May 21, and in Leeds, June 7. For more information or to reserve a place visit www.dentalcare.com