The third Up To Date Oral-B Scientific Seminar took place at the grand setting of the National Motorcycle Museum in Solihull, Birmingham, in March. Although P&G have for many years organised this event, the current series was set to be different as the evening was to include a live demonstration.
The CPD event was introduced and chaired light heartedly by Stephen Hancock OBE, Editor of the BDJ and Editor-in-Chief of the International Dental Journal. The main speakers for the evening were both home grown talent, with the first, Prof Iain Chapple, giving an informative talk titled Periodontal medicine: a window on the internal medicine of the body. Having been taught by him as an undergraduate, I knew how captivating his talks are and this was echoed by the other delegates.
There have been numerous classifications for periodontal disease and the talk began by highlighting some of the confusion over these. Although classifications can be important and help with treatment protocols, it was clear that a working knowledge of the discipline is necessary and more important.
The talk was delivered well covering the diagnostic algorithm and how this brings to light special investigations needed with the aim of arriving at a differential and then definitive diagnosis. Case reports with numerous photographs were used to effectively highlight the scope of periodontal medicine and to demonstrate that an oral diagnosis can have an impact and contribute to a general medical diagnosis. This close relationship of periodontal and general health is increasingly apparent with scientific breakthroughs such as the relationship with cardiovascular disease.
Historically dental care has focused on a surgical model of care therefore treatment has consisted of physical intervention. The talk highlighted that a paradigm shift for periodontal disease management leads us towards a medical model over a surgical approach for these conditions and an understanding that for medical conditions, surgical management is inappropriate. It was stressed that underlying systemic disease which can manifest as understated changes in the periodontium are often overlooked. This reiterated the importance of a thorough history and appropriate investigations as well as having an awareness of when to refer within the scope of periodontal medicine.
The live demonstration took place before a refreshments break. This was overseen by guest speaker, Philip Bellamy, who is a principal scientist for Oral-B, and has been working in oral health research for a large part of his 15 year career. Most recently he has pioneered new methods for research into plaque control.
He outlined Oral-B's groundbreaking research on image analysis as a tool for understanding plaque control. It was interesting to put faces to the research that is carried out, to see the work that is done behind the scenes and how Oral-B conducts research.
The volunteer for the demonstration had spent the day eating bananas and chocolate in the name of scientific research!
An analysis was then completed involving disclosing the plaque and using a blue light, which then produced an image using intelligent computer software and allowed the interested areas to be masked and an analysis to be made which was shown live on screen to demonstrate the information that it was possible to be obtained. This is an innovative method of reliably, accurately and efficiently, making such analyses.
There was also mention of ProExpert, the awaited toothpaste from Oral-B which has undergone 10 years of research and work and is due to hit the market later this year.
The evening reconvened for an entertaining final talk by renowned Prof Trevor Burke. The talk was titled A pragmatic approach to the treatment of tooth wear.
Although it was getting late, Prof Burke kept all the delegates' attention and concentration with his humour and topic. The golden proportion was first assessed and it became clear that there is no consensus among dentists with regard to smile design! Although the Recurrent Esthetic Dental (RED) Proportion was highlighted from surveys as the most popular among dentists, this was only by a small majority. It could therefore be surmised that, other than symmetry of the central incisor teeth, there is no real consensus with regard to tooth dimensions. The main message from the earlier part of the talk was 'other than symmetry of the central incisor teeth, there is no real consensus with regard to tooth dimensions'.
Aetiology and epidemiology of tooth surface loss was revisited and the Bartlett BEWE scoring system (basic erosion wear examination) was identified as a useful method of measuring tooth wear. In particular, the contribution that erosion makes to tooth surface loss can often be overlooked and this contributory factor was further looked at and useful advice was given for patients.
The second part of the talk looked at dentine bonding and highlighted that although successful bonding to dentine is difficult, systems are now effective and reliable. Interestingly, it was also shown that current self etch adhesives are not yet producing bond strengths as high as separate etch and rinse systems and therefore the traditional method is favoured where there is little retention.
Photographs of successful cases clearly demonstrated great results that can be achieved from the use of composite in the treatment of tooth wear, with consideration to the Dahl principle for some cases.
The idea that destructive treatments such as crowns are ideal treatment options for tooth surface loss was shown to be outdated. The point was well demonstrated that in teeth with limited tooth substance, 'Resin composite restorations may provide a minimal intervention and predictable treatment for tooth wear.'
Clinical photographs made clear that treatment of affected teeth should not be with further destruction and with the advances in bonding techniques and resin composites, a great result is possible. It was also noted that the aesthetics may not always be as good as may be possible with a crown for example; however this is compensated for by preservation of tooth tissue and cost effectiveness for the patient.
The informative evening was drawn to a close with Oral-B further extending their generosity in giving all delegates a top of the range electric toothbrush and sample of the previously mentioned ProExpert toothpaste. The evening was well received by all and I would highly recommend attending if you get the opportunity.
Places are still available for the seminars in Glasgow on June 23 and Milton Keynes on June 30. Contact Julia Fish by email julia@ab-communications.com or call 07585 508550.