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Take a look at the KPIs for this chain of dental practices.

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Take a look at this private healthcare provider's financial statements to help you get a better understanding of Crowncare's account.

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The usefulness of 3D technology in dental service

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The usefulness of 3D technology in dental service

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Take a look at this article on 3D printed toothbrushes.

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They say using their 3D printed brush could save up to 50 hours per year.

However, just one of the brushes costs £250 - although they do say they can last up to a year.

A traditional manual toothbrush costs around £1.50 by comparison, although some high end electric toothbrushes can cost more than £100.

Describing how the brush works, Blizzident said: "You simply bite and release quickly 10 to 15 times.

"This creates little vibrating, jiggling and slightly circling movements. Grinding left-right and backward-forwards, while your teeth are closed... additionally cleans the top surfaces of your molars.

"Opening your mouth causes the gum line-bristles to additionally wipe dirt out

"Because you are brushing all your teeth at the same time, you are brushing extremely quickly.

"You brush all the difficult-to-reach and interdental regions without even having to think about it."

Blizzident says the brushes are created using scans and 3D models of the patient's mouth.

These are then used to create a brush that is then printed out of soft plastic using a 3D printer with the inner surfaces covered in thousands of hair-like bristles.

The brush exploits two techniques for teeth brushing at once - known as the "bass" technique, where the brush is placed on the teeth at a 45 degree angle, and the "fone" technique, where a circular motion is used while brushing.

It also contains slots where floss can be fixed to clean in between teeth, the company claims. Blizzident has now submitted patents for the technology.

However, the company has still to publish any clinical trials to show how its new brush compares to other tooth brushes.

Some dentists have warned that brushing for just six seconds may be insufficient time to allow fluoride in toothpaste enough time to be absorbed.

Professor Damien Walmsley, scientific adviser to the British Dental Association, said tests proving the safety of the new brush were important.

Speaking to the BBC, he said: "It's not what you use, it's how you brush, it's your technique. It needs to be checked that it's completely safe."

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3D printed toothbrush that claims to clean teeth in six seconds

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They say using their 3D printed brush could save up to 50 hours per year. However, just one of the brushes costs £250 - although they do say they can last up to a year. A traditional manual toothbrush costs around £1.50 by comparison, although some high end electric toothbrushes can cost more than £100.

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This article highlights the benefits of lasers.

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Lasers have been used to regenerate parts of damaged teeth and could one day be used to prevent root canal treatments, claim US researchers.

The laser beam triggered a series of changes that led to the formation of new dentin, the layer below the enamel, in animal tests.

The results, in Science Translational Medicine, showed stem cells in the dental pulp were activated.

Experts said it was intriguing, but a long way from the dentist's chair.

The team at Harvard University used a drill to remove part of a tooth in mice and rats.

One dose of laser therapy on the damaged tooth led to the production of a partial layer of dentin 12 weeks later.

New tissue

It was not a perfect match for natural dentin, but the researchers argue it would be easier to achieve with human teeth, which would be larger, and by refining the laser.

The scientists could not produce a new layer of the hard enamel that protects the tooth from wear and tear.

However, Dr Praveen Arany said his research could have a role in preventing root canal treatment - the dreaded and painful procedure involving the removal of a tooth's nerve and blood vessels.

Dental cement is currently used to trigger new dentin formation, but it is not always successful.

Dr Arany told the BBC that lasers may be a better option: "The laser tool and the mechanism we have outlined would ideally be used in pulp capping that would prevent root canal treatment and hopefully preserve the tooth without the need for it to be eventually extracted.

"But once you reach the pulp and the pulp is necrotic, the cells you have to work with are no longer there so this would not work in those cases."

Prof Ian Needleman, the director of the International Centre for Evidence-Based Oral Health at University College London, said full tooth repair was still a distant prospect.

"What wouldn't come out of this is that a whole tooth could be regenerated. One tooth tissue could show some signs of regeneration or repair, but that's a million miles from regenerating a tooth.

"It is interesting as a model of whether laser light can play a part in regenerative medicine, but in terms of dentistry it's not offering an innovation at the moment."

Stem cells

The source of the new dentin was traced back to stem cells in the dental pulp.

Experiments showed energy from the laser light was creating highly reactive oxygen inside the dental tissues.

It in turn activated growth chemicals that stimulated the stem cells to produce a new layer of dentin.

Chris Mason, a professor of regenerative medicine at UCL, said: "I was intrigued that shining a little bit of light triggered stem cells to differentiate.

"It's incredibly low-cost and would be patient-friendly so it seems to have a lot going for it, but they can't grow the enamel.

"The tooth is like a house, the dentin is the inner walls, but it still needs a roof and outside walls."

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Lasers have been used to regenerate parts of damaged teeth and could one day be used to prevent root canal treatments, claim US researchers. The laser beam triggered a series of changes that led to the formation of new dentin, the layer below the enamel, in animal tests.

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Similar to article on p.25 of the preseen.

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Fluoride For Teeth, Effects | Colgate® Oral Care

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Fluoride helps teeth in two ways. When consumed in small doses it becomes a part of their permanent teeth. When applied to teeth it helps with remineralization.

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This article demonstrates what could go wrong.

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"Metal fillings 'leak mercury after scan'," reports BBC News. Experiments found teeth with fillings put through new higher powered MRI scanners released more mercury into a test tube of artificial saliva than teeth exposed to conventional lower powered scanners.

Silver-coloured amalgam, which contains mercury, is widely used for fillings in the UK. Although amalgam fillings can release low levels of mercury vapour, particularly when they're put in or removed, there's no evidence that exposure to mercury from amalgam fillings has any harmful effects on health.

MRI scans may heat up the dental amalgam, which might increase leakage of mercury vapour. Previous studies using standard power MRI scanners haven't found any evidence of an increase in mercury vapour.

But the researchers looked at what are known as 7.0-Tesla MRI scanners. These produce much more powerful magnetic waves than conventional MRI scanners, so they're currently mainly used for research and during clinical trials. At the time of writing, they're rarely used for standard diagnostic procedures.

This experimental study used test tubes with extracted teeth and artificial saliva. We don't know if the results would be the same when people with fillings have MRI scans, or whether mercury vapour released in this way is absorbed by the body in a harmful way.

The study is useful, as it's likely the cost of 7.0-Tesla MRI scanners will drop in the years to come and they may become more widely used.

Where did the story come from?

The study was carried out by researchers from Akdeniz University and Kirikkale University in Turkey.

It was funded by Kirikkale University Scientific Research Projects Coordination Unit.

The study was published in the peer-reviewed journal Radiology on an open access basis, so it's free to read online.

The Mail Online played up the potential dangers of mercury, stating: "High levels of mercury in the blood can cause brain damage such as paralysis or slow reflexes, may increase the risk of heart attack or heart disease, and can reduce men's sperm counts or increase the risk of a woman having a deformed baby."

While this is correct, the study doesn't tell us whether the mercury released from the fillings could make its way into the blood at a high enough level to cause these problems.

BBC News and The Independent carried more balanced stories.

What kind of research was this?

This experimental laboratory research, carried out in test tubes (ex-vivo) rather than in the human body. It is early-stage research to look for potential problems which might need further investigation.

The next-generation of 7 Telsa MRI scanners have the advantage of providing a much more detailed image. As BBC News put it in a 2016 report: "going from an ordinary TV picture to HD".

A potential concern is that these new types of scanner generate a much greater magnetic field than the kind of MRI scanner you would find in your local hospital.

What did the research involve?

Researchers used 60 teeth which had been extracted for clinical reasons. All were given standard dental amalgam fillings. The teeth were then randomly divided into 3 groups of 20. Nine days after the fillings were done, teeth in each group were put into test tubes with artificial saliva.

1 group was stored for 24 hours

1 group was exposed to standard 1.5 T (Tesla) MRI for 20 minutes, then stored for 24 hours

1 group was exposed to high powered 7T MRI for 20 minutes, then stored for 24 hours

After 24 hours, all the teeth were taken out of the tubes and the artificial saliva was analysed for mercury concentration. The researchers compared the concentration between the 3 groups.

What were the basic results?

Mean mercury levels in the artificial saliva were:

141 micrograms per litre (plus or minus 152) for teeth not exposed to MRI

172 micrograms per litre (plus or minus 60) for teeth exposed to standard MRI

673 micrograms per litre (plus or minus 179) for teeth exposed to high powered MRI

The differences between the control group and the group exposed to standard MRI were so small they could have come about by chance.

How did the researchers interpret the results?

The researchers said: "We concluded that, 9 days after dental restoration, exposure to 7.0T MRI was associated with mercury release from dental amalgam in an ex-vivo [out of the body, ie test tube] setting."

Conclusion

Sensationalist headlines such as the Mail Online's: "High-strength MRI scanners may release toxic mercury from dental fillings putting people at risk of brain damage, heart attack or infertility" can cause panic, but in this case, there is little to worry about for most people. This is an experimental study, carried out in test tubes not in people, using a technology that only a handful of hospitals in the UK have access to. 7T MRI has only recently been approved for use, and only a few research hospitals have the new scanners.

There have been panics about mercury in fillings for many years now, with no evidence to show that they actually cause harm. The low levels of vapour release usually happen when they are first put in (until the amalgam has hardened and sealed the mercury inside) or if they are taken out. Taking out mercury fillings to replace with alternative fillings (except when the fillings are worn out or broken and need replacing) is likely to do more harm than good.

The standard MRI scans that most people have do not seem to increase the release of mercury vapour. The study suggests this may be more of a problem with the new high-powered scans, and this should be further investigated.

However, the study has limitations:

it cannot tell us whether the mercury found in artificial saliva would be absorbed into human tissue, as the study was carried out in test tubes not in people

the fillings were not polished after being made, as is usually done in practice, which might have caused an increase in release of mercury

the saliva samples were tested just once so we don't know whether levels of mercury would have reduced over time

we don't know the effect of repeated MRI scans

In the unlikely event that you need a high-powered MRI scan (for example you are invited to take part in a clinical trial) and have amalgam fillings, it may be worth discussing the pros and cons with doctors and your dentist. They should be able to provide advice about whether the benefits of the high-power scan outweigh any possible risks.

Analysis by Bazian
Edited by NHS Website

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New, more powerful MRI scanners may cause fillings to leak mercury

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"Metal fillings 'leak mercury after scan'," reports BBC News. Experiments found teeth with fillings put through new higher powered MRI scanners released more mercury into a test tube of artificial saliva than teeth exposed to conventional lower powered scanners. Silver-coloured amalgam, which contains mercury, is widely used for fillings in the UK.

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Ideas for new technology in the dental industry

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Ideas for new technology in the dental industry

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A look at the latest gadgets.

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Lara Lewington looks at the latest home dental tech from electric toothbrushes to mouth flossers.

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The importance of good hygiene standards

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The importance of good hygiene standards

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This article illustrates the risks that Crowncare is exposed to.

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Rogue dentist whose appalling hygiene standards led to 22,000 patients being recalled is struck off

All but one of over 50 allegations against Desmond D'Mello were proven

He was secretly filmed by a whistle-blower breaching standards in 2014

Failed to change gloves between patients and wiped his hands on his clothes instead of washing them

General Dental Council ordered him to be erased from the dental register

A dentist whose poor surgery hygiene standards sparked a major health scare has been kicked out of the profession.

More than 50 malpractice allegations were found proven against Desmond D'Mello after a whistle-blower exposed poor levels of cleanliness at his practice.

The disciplinary hearing came after he was caught on camera failing to change gloves between treating patients.

The footage led to more than 22,000 patients being offered free blood screening for blood-borne viruses including HIV, hepatitis B and hepatitis C.

He was secretly filmed breaching clinical standards at the Daybrook Dental Practice in Gedling, Nottinghamshire, over the course of three days in 2014.

A conduct hearing at the General Dental Council (GDC) in London found all but one of the 56 allegations against him to be proven.

The Professional Conduct Committee ruled there was 'no doubt' his behaviour would be considered 'serious and deplorable' by fellow dental professionals.

They concluded the facts amounted to misconduct and ordered him to be erased from the dental register.

The panel said in its determination: 'The committee considered that Mr D'Mello's acts and omissions as particularised in the heads of charge constituted a grave and reckless disregard for the standards set out above.'

His failure to wear or change gloves and a surgical mask - and wiping his hands on his tunic and trousers instead of washing them - were 'gravely hazardous' and put his patients at 'serious risk of infection,' they concluded.

Dental nurse Caroline Surgey admitted to more than 20 allegations which happened when she was working alongside Mr D'Mello.

The 43-year-old told the hearing she failed to re-educate herself following a break from the profession and was scared to challenge Mr D'Mello in case she lost her job.

The mother-of-two said: 'I have let myself down, I have let my family down, I have let the profession down, I have let the patients down and I have the public down, and it will never, never happen again.'

The panel found her behaviour also amounted to misconduct and ordered she be subject to conditions of practice for 12 months.

When the whistleblower's footage was shown to health bosses, 22,000 patients listed on the practice database were written to and offered screenings, with about 6,000 coming forward.

D'MELLO'S DIRTY DOSSIER

It is believed to be the largest recall in NHS England's history and screenings were offered for blood-borne viruses including HIV, hepatitis B and hepatitis C.

Of the patients who came forward, 4,526 patients of Mr D'Mello were tested, five of whom were found to have hepatitis C. None were found with HIV or hepatitis B.

Due to the multiple ways in which these infections can be transmitted, however, it is not possible to identify how those with hepatitis C caught it.

Ms Surgey spoke of how Mr D'Mello insisted on seeing 'massive amounts of patients' and the panel heard this could mean more than 60 in one day.

One witness had previously described to the panel the 'filthy' state of his surgery and how she had been rebuked by him for cleaning too much.

Mr D'Mello did not attend the hearing, instead opting to write to the committee last week to express his 'total shock' at the allegations, the handling of which he said was 'humiliating'.

He informed the committee prior to the hearing he had applied to the GDC for voluntary removal from the register.

The panel was informed that his application was refused by the GDC.

On Monday he wrote to the committee, saying: 'I cannot see how this long, expensive GDC hearing determining my fitness to practice is impaired has any relevance except to cause me and my family serious distress and hardship.'

The former dentist had a contract for the NHS for the financial year 2014-15 worth nearly £675,000, but was suspended when the allegations were made in June 2014.

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Dentist whose hygiene standards sparked a health scare is struck off

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All but one of over 50 allegations against Desmond D'Mello were proven He was secretly filmed by a whistle-blower breaching standards in 2014 Failed to change gloves between patients and wiped his hands on his clothes instead of washing them General Dental Council ordered him to be erased from the dental register A dentist whose poor surgery hygiene standards sparked a major health scare has been kicked out of the profession.

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What could go wrong at Crowncare....

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Rogue dentist jailed for bungling operations

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'Dishonest and incompetent' Ronnie Barogiannis caused serious damage to eight of his patients at East Yorkshire practice

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This is the UK's regulatory body for the dental profession. Take a look at their website to see how the Varentian Dental Council might work.

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We are the voice of dentists and dental students in the UK. We support our members through education, advice, the BDJ publications and campaigning.

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Take a look at this website of this company which specialises in provision of private healthcare (including dental services).

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Bupa Dental Care (formerly Oasis Dental Care)

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Dental Services | Bupa Dental Care (formerly Oasis Dental Care)

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Your dental health is important to us. We want to make sure that as many people as possible benefit from our clinical care and customer service

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Ideas for court cases that could be brought against Crowncare

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Ideas for court cases that could be brought against Crowncare

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This article highlights the type of legal risks that a dental practice is exposed to.

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(Image: Liverpool Echo)

A man who says he was repeatedly given "joke shop teeth" from a dental firm has won a full refund.

Sean Porter, 24, took Instasmile to court earlier this month and walked away with the £299 price of the clip-in teeth plus £50 in costs.

Sean now wants to show people that when you buy a faulty product - the law is on your side.

His nine-month journey to getting his money back began in July 2016, when he got a 3D scan at the Leigh-based firm so a specially made veneer mould could be manufactured.

Sean had a baby tooth he wanted to cover up, but when he received his veneers said they "didn't even fit my mouth".

He told the Liverpool Echo : "They did not fit my mouth how they were supposed to, curling away from my gum line, exposing my natural teeth underneath.

"The clip-in veneers had a thick excess around the edges, which looked awful and really made it obvious that these were not natural teeth.

"You can't eat in them or talk in them, and they do not look natural at all.

"It was like they had just taken the plastic veneers out of a mould and hadn't even bothered to file it down or clean up the edges to a professional standard."

He said that some people online had "compared them to joke shop teeth, and I can see what they mean".

When Sean asked for a replacement, he was given a pair that felt very different to the original mould. After five wears, it appeared the heat of the mouth had remoulded the plastic.

A third pair was offered, but he was told by a customer service manager that the warranty was up and he was only receiving another pair as a goodwill gesture.

Sean said the package was wrapped tightly in foil and looked suspicious. When he opened it, he believed it was the first pair he originally received.

He said: "I thought it was disgusting how they thought they could do that,"

After numerous letters to Instasmile got him nowhere Sean took the matter to court where he was awarded a full refund.

Instasmile, part of the Denlab portfolio, has now refunded Sean the full amount.

Sean said that while the process might be a long one, the law is on the consumer's side.

He said: "People should stand up for their rights and not be fobbed off by companies. if you believe them to be in the wrong, do a bit of research, call the Citizens Advice, gather evidence to support you just in case you have to pursue it via the legal system.

"Don't let the formal process scare you off, especially the civil court proceedings. That system is there to protect us as consumers so don't be afraid of using it to challenge a company that you believe has denied you of your legal rights."

An Instasmile spokesperson said: "The item was out of warranty and was therefore not refundable."

It has refunded Sean the full amount ahead of the court-imposed deadline of May 2.

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Dental firm 'that gave man "JOKE SHOP" teeth' forced to cough up full refund

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A man who says he was repeatedly given "joke shop teeth" from a dental firm has won a full refund. Sean Porter, 24, took Instasmile to court earlier this month and walked away with the £299 price of the clip-in teeth plus £50 in costs.

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Useful article on what might go wrong with one of Crowncare's suppliers

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Useful article on what might go wrong with one of Crowncare's suppliers

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Crowncare relies on dental laboratories for fittings such as dentures, bridges and crowns. The exam could test the scenario of the failure of a key supplier.

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THE largest dental laboratory in the UK has gone into administration with the loss of 120 jobs.

Workers at Acodent in Little Lever say they were called in on Wednesday and told they were being made redundant before being asked to leave the premises.

Leeds-based accountant Mazars has been appointed administrator.

One technician who has worked for the company, in Stopes Road, for more than 10 years said he "fuming" at the situation.

The worker, who asked not to be named, said: "At around 3pm were called into a meeting and asked to bring our personal belongings.

"We were all being made redundant and that was pretty much it. The meeting didn't last longer than 10 minutes.

"We were then herded out like cattle and the gates were locked.

"There has been something going on for the last three months.

"We also haven't been paid this month's wage.

"We've not got any redundancy pay yet and we're all jobless."

Another employee told The Bolton News: "One minute we were working away, and the next they say we have 10 minutes to get our stuff and get out."

The Acodent website boasts a distribution service which covers the UK and Ireland and the European Union. The firm also has an address in St Helier, Jersey.

The company is run by Peter Smith and his wife Aileen who is also a director.

Mrs Smith said: "We are in a situation where we are trying to recover what we can. We are in a very delicate negotiating situation.

"I was a director of the company up until yesterday. We've lost everything. We have been running this business for 25 years and it has taken everything we've got.

"Hopefully, we will know what's happening by Monday. If the negotiations are successful it is going to be helpful to everyone, including the people who have lost their jobs."

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120 jobs lost as UK's largest dental laboratory in Little Lever goes into administration

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THE largest dental laboratory in the UK has gone into administration with the loss of 120 jobs. Workers at Acodent in Little Lever say they were called in on Wednesday and told they were being made redundant before being asked to leave the premises. Leeds-based accountant Mazars has been appointed administrator.

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Useful article on what might go wrong for a dental practice 

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Useful article on what might go wrong for a dental practice 

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This could give you ideas for risks that Crowncare may be exposed to.

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Hundreds of customers who wanted the perfect smile have been left out of pocket after a dental company closed.

The closure of Pure Clinic, based on Albion Street in Manchester, has left customers angry and frustrated at work that hasn't been done at all or was only partially completed.

Many had shelled out £1,095 for its 'six month smile' deal, using braces to straighten crooked teeth. Others paid for whitening and other cosmetic dental work.

One customer is said to have paid £15,000 but no work has been done.

The firm's director Haroon Ahmed, who has also closed the firm's London office, admitted the company could go bankrupt but he is now in dispute with another dental firm over who is liable to refund customers.

Tatum Flynn, 26, from Widnes, who paid £795, waited three months for her first consultation and a brace was eventually fitted in November. Appointments to have the brace tightened in December and January were cancelled, she said.

Tatum added: "The company has just disappeared and I'm left with this brace on my mouth. I've been quoted £450 to remove it at another clinic. It's been the most stressful experience of my life. I've emailed them but they said there have been 'administration issues' with my refund."

Another customer Kimberley Lo, 30, from Leigh, said she paid £1,095 for work to correct her crooked teeth which she says has left her so self-conscious she hasn't yet posed for a picture with her baby daughter Holly. The work was never completed.

"I have a brace on my mouth and I was already quite self-conscious. I was looking forward to getting the thing off. I wanted to have straight teeth to get my confidence to have a photo with my daughter," she said.

'I can't do anything about it'

"It's been a nightmare," said Kelly Williamson, 36, a mother-of-two from Audenshaw, who paid £1.095 for the 'six smonth smile deal' but her braces have not been removed. "I was supposed to have an appoinment on January 7 but they texted me to say the dentist was off sick. I'm going to have to pay for someone else to take them off. They said they would be back in touch but it never happened. I tried phoning and nobody answered." said Kelly.

Security superviser Usman Subani, 25, from Oldham, paid £1,095 for the 'six month smile' deal but cancelled when he read terrible reviews online. He is still waiting for his refund. "I'm very angry," he said.

Another customer, 32, from Warrington, who declined to be named, said he paid £1,100 for braces which were fitted in March last year but at least five appointments to have them removed have been cancelled.

He said: "The metal is all rusting off and I can't do anything about it. It was five months after I paid for it that they fitted the braces. There have been so many delays. I have been quoted £600 and £900 to get the work finished elsewhere."

After setting up an email account for customers to get in touch, he said he has 130 messages from people who are thousands of pounds out of pocket.

"One has told me has been saving up for years for implants. He's paid £15,000 up front and he's not even seen a dentist. All told people are owed hundreds of thousands of pounds quite easily," he said.

Another customer, aged 39, from north Wales, told how he paid £800 for implants which she suspected at the time was 'too good to be true'. The work was completed in November although it was delayed for 15 months. She said she paid another £800 for a second in-plant but has not been able to get through to the clinic.

Dental firms brace themselves for legal row over who should compensate customers

Pure Clinic is locked in a legal dispute with another dental firm about who should refund customers left out of pocket.

Haroon Ahmed, director of Pure Clinic's parent company Skin Store Ltd, admitted the company was 'struggling to survive' and could go bankrupt.

He insisted another firm, Manchester Smiles, which is based in the same Albion Street building, provided the dentists to carry out the work brought in by Pure Clinic, which he claimed was merely a 'marketing company' which brought in the customers and took 'nine or ten per cent commission'.

Mr Ahmed admitted he had been 'lumbered' with the firm when he took over in October.

When Pure Clinic ceased trading, its name was taken from over the door and replaced with a Manchester Smiles sign.

Manchester Smiles owner, dentist Syed Maududi, 45, said Pure Clinic had rented three rooms from him and had their own dentists doing the work.

"We are victims in this too," he said, claiming Pure Clinic staff had 'just vanished without paying their staff'. He said the firm owed him three months' rent.

He told the M.E.N: "They have just vanished without paying their staff. People have been blaming us but we are victims in this too. People have been ripped off but so have we. The dentists who worked there are all young, in their 20s and 30s. They are all competent dentists. They are upset too."

He said he had tried to help out Pure customers but some had been abusive to his staff.
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Angry dental customers left out of pocket after cosmetic firm's collapse

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Hundreds of customers who wanted the perfect smile have been left out of pocket after a dental company closed. The closure of Pure Clinic, based on Albion Street in Manchester, has left customers angry and frustrated at work that hasn't been done at all or was only partially completed.

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Take a look at this website of a national chain of UK dentists to see the typical services and products offered.

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Dentists & Orthodontists Across The UK | mydentist

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mydentist is Europe's largest dental care provider - find your local dentist & book your appointment online at one of over 650 UK practices.