the magazine from independent care plans - ident.co.uk · design by blue horizons marketing...

Exploring KPI’s and goodwill

with Johnston Carmichael

Fountain Dental Group share their fundraising efforts

Update on Dental Materials

Care Dental Implant Clinic

Courtesy of Wrights, our preferred supplier, find attached your complimentary TePe Easypick samples

Winter 2016

The Magazine from IndepenDent Care Plans

nSIGHT

2 ICP Insight Magazine

TRIGGER POINTS FOR DISCUSSING DENTAL PLANS WITH PATIENTS

Some great opportunities to discuss your plan with patients

FOUNTAIN DENTAL BEAST RACE

A challenge for the team at Fountain Dental Group, but all for a good cause...

Roddy Anderson talks about preparing and understanding your accounts

ACCOUNTS, KEy PERFORmANCE INDICATORS & GOODWILL

18

10

23

Editor Eilidh Morgan Sub editor Bert Hay

Design by Blue Horizons Marketing

Published by IndepenDent Care Plans, River House,

Young Street, Inverness IV3 5BL Telephone 01463 223399

Email [email protected]

3ICP Insight Magazine

20

6

4 A NOTE FROm THE EDITOR

5 NEW WEBSITE RESOURCES

6 ANDERSON DENTISTRy

ExPANSION PLANS 2017

8 ARE yOU READy FOR AUTO

ENROLmENT?

10 ACCOUNTS, KEy PERFORmANCE

INDICATORS & GOODWILL

14 INCREASE THE UPTAKE OF yOUR

COSmETIC AND DENTAL

TREATmENTS

16 mOTIvATION, ENGAGEmENT

& yOUR ROLE IN CUSTOmER

CARE

18 FOUNTAIN DENTAL BEAST RACE

20 UPDATE ON DENTAL mATERIALS

23 TRIGGER POINTS

FOR DISCUSSING DENTAL

PLANS WITH PATIENTS

24 BDm NEWSLETTER

ANDERSON DENTISTRy ExPANSION PLANS

Learn about the plans for growth at the practice in 2017

The latest experiences and clinical findings

UPDATE ON DENTAL mATERIALS

Content


A note from the editor

We are always

pleased to get

feedback and have

people contribute

to the magazine; I

would encourage all

our members to feel

free to contact me

Welcome to the Winter edition of ICP

iNSIGHT. As the year draws to a close

we naturally reflect on the events that

have taken place. Thankfully, 2016

hasn’t been as turbulent for ICP as in

other factions!

In this edition of the magazine we are

going to hear from Care Dental about

their latest findings when it comes to

dental materials, Roddy Anderson from

Johnston Carmichael talks us through

KPI’s and understanding our businesses

and we get an insight into Anderson

Dentistry in Aberfeldy as they expand

their practice.

On the front of the magazine you should

have some samples of Tepe’s Easypicks

courtesy of Wrights, our preferred

supplier! Get in touch with your local

representative from Wrights to get the

best deal for your oral hygiene stock

items reminding them you’re a member

of ICP.

We are always pleased to get feedback

and have people contribute to the

magazine; I would encourage all our

members to feel free to contact me on

[email protected] with any

suggestions.

On behalf of myself and the rest of

the ICP management committee I’d

like to wish you all a Happy Christmas

and a prosperous New Year. See

you all in 2017.

Eilidh MorganInspire Dental, KingussieMagazine Editor


Non-discretionary dental indemnity cover

Our cover includes • £10m malpractice & legal expenses

• General dentistry, sedation, botox/filler & implant placement cover at no extra cost

Scotland’s fastest growing indemnity company

t: 07577486909 w: [email protected]

The ICP blog has been redesigned to make things easier for you. All of our useful articles, news and information are now organised into four separate sections.

· Recruitment of plan patients – contains articles about encouraging patients to join your plan

· Marketing your dental practice – includes great tips to promote your treatments and services.

· Practice management – provides useful information on running your practice

· News & events – features our email newsletter back catalogue, plus dates for your diary

New website resources

See for yourself at www.ident.co.uk/categories

Recruitment of plan patients

Marketing your dental practice

News & events

Practice management


Anderson Dentistry expansion plans 2017Hello, we are Ross and Morag Anderson, principal dentists and owners of Anderson Dentistry, Aberfeldy. We met in an anatomy lecture theatre on our first day at Glasgow University in 1989 and have been stuck with each other ever since! Following graduation we moved to Oxford and, after many happy years in one of the city’s most prestigious dental practices, we relocated back to Scotland with our growing family.

With the whole of Scotland in our sights,

we settled upon beautiful Highland

Perthshire and, in 2008, established

Anderson Dentistry in an old Victorian villa

in Aberfeldy. As a private practice, we have

a strong and very loyal patient base that is

constantly growing. Alongside our fantastic

dental colleague, Deborah Hannigan, our

aim is to provide the best dentistry we can,

not the most. We are also very proud to be

registered as a Living Wage Employer - one

of only two dental practices in Scotland

- and are thankful for the wonderful and

loyal staff we have.

We are continuing to thrive in our rural

town with Ross’ implant clinic going from

strength to strength but we now need more

space, and being in such an old building

comes with limitations. 2017 brings exciting

changes as our practice expands into the

building that previously housed The Crown

Hotel (aptly named!) We are very excited

to be bringing new life to a wonderful, and

very prominent building in the town.

Local architect, Colin Smith (casarchitect.

co.uk), and local artist, Lindsay Turk

(lindsayturk.com) will be collaborating with

us to create a unique and very beautiful

space from which we will continue to

deliver an exemplary service to dental and

implant patients from near and far. Both

Colin and Lindsay have a remarkable ability

to use natural shape and light to create

captivating work.

The success of Ross’ implant clinic means

that our expansion into new, bigger

premises will allow an easier pathway for

the external referral of patients for implant

and rehabilitation therapy.

Anderson Dentistry Implant Services

Ross first became involved in implant

dentistry in 2001 in London, and has been

restoring implants ever since. However,

with so many patients expressing a desire

to have the surgical placement of their

implants locally, rather than travelling out

of town, Ross began his implant placement

career in 2013.

2017 brings exciting

changes as our

practice expands...

We are very excited

to be bringing

new life to a

wonderful and very

prominent building

in the town


Under the tutelage of world class surgeons

and tutors, through the International Team

For Implantology (ITI), Ross’ surgical skills

progressed rapidly. Extensive training at

The Campbell Academy in Nottingham, a

centre for implant excellence, allowed Ross

to further advance his surgical techniques:

live skills courses; advanced aesthetic live

skills courses; sinus lift cadaver courses.

Now, in his role as Director of the

Edinburgh Study Club for the ITI, Ross is

committed to furthering not only his own

continuing professional development,

but also that of his Scottish colleagues.

Lecturing recently to an international

audience at The Royal College of

Physicians and Surgeons in London, Ross

has helped to put Scotland firmly at the

forefront of dental implant development.

In early November, he was invited to tutor

budding implant surgeons in the art of

custom impression technique at the

Young ITI Conference in Glasgow. The ITI is

a worldwide Association of professionals

in implant dentistry whose objectives

are the promotion and dissemination

of knowledge about implant dentistry.

ITI Study Clubs in Edinburgh, Perth and

Aberdeen all extend an open invite to

dental practitioners wishing to further

their understanding of implantology.

Implant & Rehabilitation Referral Service

From single tooth to full arch dental

implants, or full mouth rehabilitation of a

failing dentition, we are very happy to help

your patients achieve a healthy, functional

and confident smile with as much, or as

little, involvement as you desire. Please

feel free to call the practice to organise a

telephone conversation or meeting with

Ross to discuss how we can help you deliver

implant services to your patients.

It will undoubtedly be a very busy, but

exciting, 12 months ahead for Ross, Morag,

Deborah and their team but one which

will bring a very positive outcome. The

practice is also embarking upon the year

long Campbell Academy Business Course

in order to ensure that we are consistently

striving to provide our patients and referring

dentists a First Class service.

Implant Case Study 2

A severe trauma to the upper anterior teeth resulted in the loss of

an upper central incisor in this 22 year old female. A bone level

Straumann implant was placed and restored temporarily using the

customised impression technique to counteract biological recession.

This improves the aesthetics of the soft tissue which was especially

important in this case as the patient had a very high lip line.

Implant Case Study 1

60 year old female with failing maxillary dentition. Four Straumann

implants with a Createch Bar to hold an implant retained denture.

She wanted teeth as white as possible, despite my protestations.


Are you ready for Auto Enrolment?

All dental practices, in common with all

other businesses will have already or

will soon have to contribute to a pension

scheme for their eligible employees.

The date from which this must be done

(known as the staging date) has already

arrived for some dental practices, but

for others it will be as late as 2017.

From that date employers have a duty

to automatically enrol certain workers

(depending on their age and salary

level) into a qualifying workplace

pension scheme. You can find out

your staging date by going to www.

thepensionregulator.gov.uk and enter

your PAYE reference.

Fines for noncompliance are high

and employers need to ensure that

they take action on this prior to their

staging date.

If you are concerned about meeting all

of the regulatory obligations or if you

require further information please get

in touch.

The level of contributions required for eligible employees is:-

1st October 2012 - 30th September 2017:2% of which 1% must come

from the employer

1st October 2017 - 30 September 2018:5% of which 2% must come

from the employer

From 1 October 2018 on an ongoing basis:8% of which 3% must come

from the employer

Roddy Anderson, Johnston Carmichael t 01307 465 565 e [email protected] w jcca.co.uk


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Accounts, Key Performance Indicators & Goodwill

Keeping records of the business transactions in order for your accountant to prepare these accounts can be a chore and the resultant accounts, for many of you, are a total mystery.

You may receive very little explanation of

their meaning and how the figure represent

the reward of your work, how much the

business is worth, and how the earning

capacity of your business compares to other

practices. With a little more understanding

and the assistance of a specialist dental

accountant, the accounts can become a tool

to understand the financial performance

and recognise where improvements in your

practice could be made.

There are a number of measures where Key

Performance Indicators (KPI’s) can quickly

and easily highlight where the practice

can become more efficient and identify

development areas which, once addressed,

can lead to improved profits.

The initial KPI’s will be based on the

accounts and through having benchmarking

information on materials, laboratory fees,

wages and most other expenses. These can

assist in understanding how your practice

is performing in comparison with other

practices and identify areas which, once

addressed, can lead to improved profits.

Some of the typical KPI’s to look for are:-

1. SuRgERY oCCuPANCY RATE – CHAIR uTILISATIoN

This KPI indicates the percentage of total

time available in the surgery that each

dentist has spent treating patients. It also

takes into account the FTA’s, and these

should be monitored for therapists and

hygienists as well.

Your practice software will suggest you

should be aiming for 95% chair utilisation


time per month. If upon analysing the data it

becomes evident that this target is not being

reached, further scrutiny maybe required to

ascertain the reason, for example, are you

over staffed, is recall systems not working

effectively, encouraging the reception staff

to book the diary more efficiently may

reduce FTAs by confirming appointments.

Keeping up with technology is key. You may

consider investing in online booking which

means that patients can book their recalls

online 24/7 and new patients can book a

RODDy ANDERSON

Johnston Carmichael

registration appointment. It has a real time

view of spaces which can be filled without

speaking to a receptionist. This together

with text messages and email reminders,

can be sent to patients to fill remaining

appointment slots and maximise the dental

chair time. The average chair utilisation

is 82%, whereas the top 5% practices

is 95%. The gap of around 13% can be

around £25k per chair per year.

2. INCoME PER HouR

You will have a gut feel for who earns what

at your practice, however this indicator

provides you with a clearer picture.

Measure the total income that each dentist

has earned during the month. You may also

wish to calculate it for the whole practice,

including plan fees, private fees, NHS

income in line with the Items of Service

performed during the calendar month.

Subtract the laboratory bills and divide by

the total number of clinical hours available

to calculate the income earned per hour.

The practice software report will show

how much each principal and associates

are earning for the practice per hour. You

may want to give associates targets and

ask them to earn a minimum amount

per hour, it will help if you sit down and

analyse the figures with the associate. This

usually is the catalyst to inspire associates

to continue to work ethically and more

productively. Having analysed the figures

with the Associates, you may have asked

them to earn a minimum of £100 per hour,

£157k after a period of time their earnings

will have increased from around £85 per

hour, £134k per year to over £100 per hour,

£120-£190k.

3. LABoRAToRY FEES RATIo

This ratio measures the percentage of

income spent on laboratory costs and can be

useful to scrutinise individual performance

as well as the practice as a whole. If it is

high, question if your treatment prices take

these higher rates into accounts. These

typically range between 7-10% of turnover,

however it may be higher depending on the

type of practice.

4. MATERIAL CoSTS RATIo

This measures the percentage of income

spent on material costs. If it is high, is the

practice overstocking? Is there unnecessary

waste? Do you need to implement a more

robust stock management system? As with

laboratory fees, material costs in the region

of 7-10% of turnover would be considered

typical.

5. STAFF CoSTS RATIo

By measuring your monthly staffing cost

against the practice, a high ratio can

highlight when staff costs are higher than

they could be and help you to flag potential

excess staffing.

However, each practice will have its own

level of staffing and the variation on

practice manager salaries can impact on this

ratio quite dramatically. Consequently, this

can vary significantly between practices,

however, staffing costs often represent 20

to 28% of income.

It is equally essential to have positive and

professional support staff. A welcoming

receptionist creates an excellent first

impression for patients and can only

enhance the reputation of the practice. It is

very easy to underestimate how important

these staff members are in developing a

practice and strengthening your relationship

with patients.

6. ASSoCIATE CoNTRIBuTIoN

This is a very useful indicator to help

practice principals fully understand what

financial contribution each associate is

making towards general practice overheads

and profitability.

Key Performance

Indicators can

quickly and easily

highlight where

the practice can

become more

efficient.


This KPI measures the total income less lab

fees and associate fee, less a proportion (in

accordance with hours worked) of some

of the higher costs. Such as staff costs,

materials and premises. Dependent on size

of practice, type of practice and number of

associates, this percentage can be similar to

the staff percentage level.

It is important to sit down with associates

and give them proper guidance about how to

be efficient, whilst still doing good dentistry,

and they should see their production and

contribution to the practice increase.

Keeping a close eye on these KPI’s will help

you make informed decisions to improve

your practice and most importantly your

net profit.

Also, KPI’s that would be useful to have are

conversion rates, fail to attend hours, take

up rate of treatment plans, waiting time and

marketing costs per new patients.

The accounts, KPI’s and detailed knowledge

of your dental business is not only

paramount to running a successful business,

it allows you to be in control of where you

want the business to be when you decide

to either allow an associate to buy into the

practice or for your eventual exit strategy.

There are many factors that can influence

the sale price of a practice.

The most valuable asset (not including

heritable property), when selling a practice

is goodwill. This is the value attributed

to the income and profit stream that the

practice generates. The main question

raised by a potential investor is how safe

and reliable is this goodwill value. Dental

goodwill is normally valued in relation

to other similar dental practices and the

sustainable profits. The profit is the main

determining factor as it is this that will be

needed to fund and repay any borrowing

to purchase the practice over a 10 year

period or more. The valuation and price

paid are not necessarily the same, as it will

depend on demand from investors wanting

to purchase the practice.

The profits for a dental practice is closely

linked to its patient list. Although cost

efficiencies and sales per patient have

an impact, patient numbers are critical.

Sustainability of profits has to be considered

as are the retention and prospect of growing

the patient base. This leads to the question

about your patients and how loyal they are.

Typically, every practice is different, every

dentist is different as are the patients.

There is a suggestion that NHS patients are

as loyal to the NHS brand as they are to the

contractors. These patients are likely to

continue to go to the same practice after a

change in ownership because it is still NHS

and few patients tend to be lost.

Goodwill in private practices is arguably

less strong as some patients may leave

the practice once their dentist has gone.

However, there is another factor which

can influence private patients and that

is inertia, where people are less likely to

change if positive action is required. For

this reason, practices with a patient plan

are likely to have a stronger goodwill than

those without. The strength of goodwill will

be greater as the percentage of patients on

a plan increases.

Sustainability

of profits has to

be considered as

are the retention

and prospect

of growing the

patient base

KPI’S – based on real cases (illustrations)

Practice Typical Practice

Practice High Performing

£ £

Turnover - Fees 800,000 100% 800,000 100%

Cost of Sales

Laboratory Fees 72,000 9% 64,000 8%

Materials 88,000 11% 64,000 8%

Associate & Hygienist Fees 208,000 26% 176,000 22%

gRoSS PRoFIT 432,000 54% 496,000 62%

Overheads

Employee Costs 192,000 24% 160,000 20%

Premises Costs 32,000 4% 24,000 3%

Postage & Stationary 8,000 1% 8,000 1%

Advertising 4,000 0.50% 4,000 0.50%

Other Costs 84,000 10.50% 84,000 10.50%

NET PRoFIT 112,000 14% 216,000 27%


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In Dental Innovation

Fund your tax bill by contacting us today.


The purpose of our tax loan facility is simply to allow you to take control of your cash flow and spread the cost of your tax bill into more manageable monthly payments.Finance approval is subject to status and terms and conditions apply.We fund business, corporate and personal tax demands.

Braemar Finance is a trading style of Close Brothers Limited. Close Brothers Limited is registered in England and Wales (Company Number 00195626) and its registered office is 10 Crown Place, London, EC2A 4FT.

Would monthly payments help you manage this expense?

We can help pay your tax bill


Would you like to increase the uptake of your cosmetic and dental treatments?

Braemar Finance offer finance solutions for dental businesses and recently launched its online funding solution, ‘Fast Track’. This enables dental sector patients to apply for a credit facility to finance necessary treatment or cosmetic procedures.

Fast Track is designed both for sole

practitioners / small partnerships and

larger corporate groups who want to be

able to offer a no-frills funding option to

their clientele. It is available online and

consumers can either request funds whilst

on the business premises of their dentist,

or at home at a time that suits them. End-

users will then be provided with an instant

decision to their application. Please note

that finance is subject to status and terms

and conditions apply.

Dental professionals can register for

Fast Track by providing Braemar Finance

with the relevant information about their

business. They will then be offered choices

from the interest free and interest bearing

options with terms that best suits their

business and their customers.

Braemar Finance has a nationwide network

of area managers, and in conjunction with

the dedicated Fast Track team can provide

introduction and training sessions to

identify ways the Fast Track solution can

best enhance your business objectives.

With on site training your team receives

one hour of verifiable CPD and you will

have continuous support and guidance.

Incorporated within the package is live

management information and sales

reporting which allows you to monitor the

uptake of finance within your practice.

David Foster, managing director at Braemar

Finance said: “We take time to listen to

and understand our clients. That’s why

we created Fast Track. We fully believe

this product will give dental businesses

the much needed support they require,

in order for them to realise their business

potential.”

A client recently said: ”Since the

introduction of Fast Track we have doubled

the number of patients using finance and

this is helping to further develop our

business.”

Our specialist team are available to explain

how we can incorporate Fast Track into your

practice and assist with the development

of your business and can be contacted by

one of the methods below.

t 01563 852113

e [email protected]

w www.braemarfinance.co.uk


Working in Partnership with

Call for more information: Wrights - 0800 66 88 99 | www.wrightdental.co.uk


Motivation, engagement and your role in customer careFriday 26th August 2016,Mercure Ardoe House Hotel, Aberdeen

When I was asked by Gary Moore to provide

a talk on Customer Service for some dental

practices in the Aberdeen area my first

thought was “ to provide top class customer

service your team has got to be motivated

and engaged to want to provide it.”

There’s no point putting staff through the

training if they don’t want to be there, aren’t

interested and basically “turn up for work

because they get paid.”

As a high performance team coach I

am very interested in the Government

initiative “Engage for Success”

www.engageforsuccess.org

A number of very high profile businesses

are running engagement programmes

as they realise that in order for the UK to

survive in a global economy then they need

to motivate their workforce to increase

efficiency, productivity, innovation and

turnover.

Research shows that organisations with

high levels of employee engagement are

more efficient and effective, and that highly

engaged employees:

are more customer focused, find they •

are more creative at work, and take

less time off sick;

care about the future of their •

organisation and put in greater effort

to help it meet its objectives;

feel proud of the organisation they •

work for and are inspired to do their

best and motivated to deliver the

organisation’s objectives.

Surely this is what the UK needs at a time

when UK productivity has stagnated since

2008/9 and remains about 15% below

historical trends, and where UK GDP per

hour is around 17% below the G7 average.

There are some interesting figures for

“engagement and motivation “of people in

business today.

I believe we have

to have total

clarity when

talking to patients

about their

treatment

ILLONA mCLAy ENGAGING WITH THE DELEGATES


Disturbing facts about Employee

Engagement

70% are not fully engaged or •

totally disengaged

20 million workers are not •

delivering their full potential

64% of employees have more •

knowledge and skills to offer

Only 20% of Managers are passionate •

about their jobs

30% of employees do not have good •

relationship with managers

49% feel valued at work, 51% •

don’t feel valued

Poorly engaged companies make •

less profit

Disengaged leaders cause •

disengaged employees

Poor engagement will cause •

customers to leave

I decided to start the day in Aberdeen with

some ball throwing just to break the ice and

get the 3 teams talking to each other and

we eventually managed to work together

to throw 3 balls at the same time, to each

other! It was a bit chaotic at times but it’s

about communicating with each other and

having a bit of fun too.

Everyone took part in the morning session

where we discussed the 4 enablers of

engagement and we came up with some

really good ideas for motivating the teams

in the dental practice.

Ardoe House is a lovely hotel and the

service and food was exceptional. Lunch

was served and we all welcomed a

short break with time to pop outside

into the sunshine.

Afternoon session: Customer Service

I was in London recently to listen to David

Moffet for 2 days (author of the Ultimate

Patient Experience). Yes, even I have to

expand my knowledge and skill set!

I decided to bring some of his ideas to

the course as I agree with his way of

thinking when looking after our patients

/customers.

operational Standards:

Service Defects

Experiential Standards:

Wow or above and beyond

After I had gone through the perfect Patient

Journey the teams looked at where a dental

practice could improve especially in our

patient systems.

For example at every stage when we deal

with a patient we should have a list of

everything which provides top service.

Operationally, experientially and how to go

above and beyond that service. Yes Wowing

our patients!!

We should also be able to look at our

service defects when things go wrong.

This helps us to improve and “risk assess”

certain procedures in our business.

I believe that we have to have total clarity

when talking to patients about any of

their treatment. They know exactly what

treatment they are getting, why they need

it, how much it is going to cost and when

and why they have to come back. Very often

patients arrive at the front desk and haven’t

a clue about what’s going on.

The Handover

Handing over patients from one team

member to another throughout the day is

so important and this is where a patient can

feel especially vulnerable.

I set up a little ball game to get the teams

to think about it too. Great fun and a super

way to finish off a good days training. The

feedback was excellent overall.

Thanks to all the delegates who came

along with open hearts and minds and Gary

Moore for the invite.

Illona McLay

High Performance Team Coach

Web: www.illonamclay.co.uk

Email: [email protected]

Phone: 07510307716

ROLE PLAy TO ALLOW DISCUSSION ABOUT THE PATIENT jOURNEy


Fountain Dental Beast Race

If getting down and dirty in the mud is your idea of a good day out, then the Prime Four Beast Race Banchory may be the very thing you should consider.

The nurses and dentists of Fountain Dental

Group have entered a team on each of the

three previous years, and managed to put

together a team of six for this years fourth

running of the event in September. Each

year we try to choose a dental themed

name for the team. This year it was ‘We

Know The Drill’.

The event is organised by Firetrail Events

and involves a 10km course through rough

country whilst tackling 25 obstacles on

the way. From the start there is a hay bale

barrier to climb over, then the long slog

up the hill for around 3km climbing over

fences, ducking under cargo netting, wading

through waist deep bog and crawling under

barbed wire netting, before the long run

back down towards the loch.

Once back at the loch, the fun really starts

with the remaining obstacles. There’s

a tangle of ropes to negotiate, a steep

muddy bank to climb, followed by a long

slide down a polythene track into cold

water. By this point the team are mostly

beyond caring and launch themselves

into the loch through narrow piping, haul

themselves over the loch on ropes and out

the other side. A 3 metre wall then has to

be negotiated, and definitely requires a bit

of teamwork to get everyone over safely

and round the next set of obstacles. After

a brief respite, it’s back in the loch again,

over some obstacles to the island, then

a zip-wire escape off the island and over

the finish line for a well-deserved medal

and a cup of soup.

The event is a fundraiser for Chest, Heart,

Stroke Scotland, with a proportion of the

entry fee going towards the charity. We

also fundraise for the charity with personal

sponsorship. We were delighted this year

when Highland Dental Plan agreed to

help our total with a contribution of £200,

bringing our total raised for CHSS to just

over £2000.

It’s a great event, well organised, and

certainly gets the adrenaline going as the

race is about to start. If you don’t mind a bit

of discomfort and cold, it’s an event that

leaves the competitors with a real sense

of achievement afterwards. If you fancy

it, but don’t want to travel too far, Firetrail

also organise the same event based

around Loch Ness. And Monday morning

back in the surgery brings the inevitable

comparing of bruises!

From left to right, Alan Bennett, Michelle Webster, Hayley Massie, Jonathan Nichol, Katie Boyle, Ben Nichol.

ICP Insight Magazine 19


Update on Dental MaterialsIn the ever evolving world of dental materials, it’s sometime difficult to keep up with the latest developments. Luckily, we have dentists like Bruce Strickland of Care Dental Implant Clinic, Crieff who are willing to share experiences and clinical findings.

Dr Eilidh Morgan kindly invited me to write an article on the current or recent developments within my area of expertise; implant and

reconstructive dentistry. Interestingly though, looking back on the last 22 years of career in Implantology you could compare the progression

of this science to the life of a Pygmy Three-Toed sloth, very deliberate.

The Three Toed Sloth, slow & deliberate.

At the EAO (European Association of

Implantology) congress in Paris last

month, one of the key-note presentations

was given by two European professors

presenting their research data for the

last 12 years of their work. They summed

it all up giving the audience their solid

recommendations, as if all their advice

was new and revolutionary. In reality it all

sounded just like a repeat of a presentation I

heard from Professor Danny Buser, given 15

years ago when the EAO congress was last

in Paris. Not much has been really new for

many years, the challenge has always been

to master and use the existing knowledge

and science. I think that this will remain

the same for a while on the surgical side of

treatment, but I do believe that large and

fundamental changes are in front of us all

with regards restorative implant dentistry.

These changes will filter through to much

of general practice.

So what is new? It is the ability of laboratory

technicians to impregnate colour into

pre-sintered, translucent zirconia, allowing

digital dentistry to finally deliver beautiful

restorations for all areas of the mouth.

Full-thickness zirconia crowns have been

around for a while, but they have not

looked great; they have been opaque

and mono-coloured or surface stained.

Layering porcelain onto a zirconia has

been an option, but anyone using large

layered zirconia bridges will be aware of

a high chance of porcelain fracture. This is

because the zirconia is so ridged. Emax has

been an answer for small restorations but

not large ones.

The significant changes have been in part

developed by an Italian laboratory product

manufacturer called Zirkonzahn. Not

only have they developed a translucent

zirconia, but they have also developed

a way of impregnating it with colours in

its raw state. This means that we can get

really beautiful restorations, from single

teeth to full arch restorations, without any

porcelain layering. This therefore allows

for a fully digital work flow.

So how strong are they? I could talk about

Mega Pascal strength and show you some

graphs, but how boring is that? Why not just

show you how they stand up to a hammer.

A Bruxist with a hammer!

The hammer & crown.


An unbroken crown embedded into the

wood without even a chip.

So they are really strong. Zirconia does

reduce in strength over time, so it is

important to build in extra strength with

large structures. But the main development

is in the appearance that can be achieved

without the need for veneering porcelain.

The restorations are computer designed

and milled out of a pre-sintered zirconia.

After the design stage the zirconia is milled

in the raw state. The restorations come out

double sized and it is at this stage that the

colours are impregnated into the zirconia

before the restoration is sintered at 2000

degrees. After this the crowns are finished

and glazed.

Because the process requires no layering of

the zirconia with porcelain, the process can

be fully digital. This changes everything.

Take as an example full arch bridge work.

The restorative options are:

• An acrylic denture carried by the

implants. These are un-cleanable and

are thick to give strength. Or they can

be made as a chrome based denture

veneered with acrylic teeth.

These are less bulky but acrylic teeth in

implant dentistry all wear down quickly

because of the much higher forces

within implant occlusions.

• Porcelain Fused to Metal structures

• Porcelain Fused to Zirconia.

Full arch implant bridge work, using

conventional veneering techniques is very

complex for the dentist and technician.

This includes the metal try-in, followed by

the pre-glazed ceramic try-in. Much can go

wrong and there can be distortion within

the structures due to the veneered porcelain

contracting leading to non-passive bridges.

(This can/ will cause the implants to fail).

On top of this the technician is creating the

restoration by hand, the challenge here

being the controlling and checking of the

occlusion, plus the cosmetics, particularly

the occlusal characteristics.

With the new full contour restorations, the

process following the initial impressions

and bite registration is a PMMA try in. This

is a digitally designed copy of the intended

final result.

Here the design can be tried in and modified.

The best aspect though is the checking and

developing of the occlusion. It is virtually

impossible for a dentist to record accurately

enough a patients jaw movements.

Even with a Face-bow, a fully anatomical

articulator and Lateral Check-bites we

cannot be fully accurate, so our laboratory

models and articulation will not completely

represent the patient. So our restorations

have to be adjusted or tolerated. With

these new production techniques the

adjustments can all be confirmed in these

cheap PMMA prototypes. The finished

products are therefore normally exact

without adjustment required. The cosmetics

are superb and not just facially but also

occlusally.


We care to know.Accounting for the dental profession is a specialist area that requires expertise and a thorough understanding of the industry.

Talk to our multi-disciplinary dental team who have the local knowledge and technical expertise to support your business.

Contact Roddy Anderson,Registered member of NASDAL,

T: 01307 465 565E: [email protected]: jcca.co.uk

Dental advert 5th May.indd 1 16/11/2016 13:56:42

The bridge is fully monolithic zirconia,

without porcelain veneering.

Within my implant clinic in Crieff, I have a

crown and bridge laboratory with 2 very

skilled technicians, servicing my own clinic

and also other dentists, usually those that

I work with on an implant referral basis.

I invested in the Zirkonzahn equipment,

materials (Prettau Zirconia) and process

2 years ago. It has been truly difficult to

get our head around this new technology,

both in the zirconia and with the abutment

designs. It has caused much stress and for

a while the service that we were able to

offer was way short of the mark. But we

have now made about 30 full arch bridges

from full contour Prettau Zirconia and the

results are really amazing. In addition

to the finished results, the restorative

process is much simpler and this is one

of the most satisfying aspects for me as

a referral practitioner; I want my referring

dentists to restore as much as they can,

with the appropriate training.

As to our confidence in the restoration, we

passed an interesting milestone last week.

One of my technicians, Craig Holmes,

was recruited by me to the laboratory as

a master of Emax technician. He needed

some new crowns and he chose Zirkonzahn

Prettau Zirconia rather than Emax.

Bruce Strickland BDS DipImpDent RCS( Eng)

My career journey has come through general

dental practice and I have been working in Implant

dentistry for 23 years. I have been a full time

implant clinician for over 12 years working from

my referral implant practice in Crieff, Care Dental

Implant Clinic. I also provide an access clinic in

Inverness with Dr Neal Drummond. I work with

general practitioners from all across Scotland

and a large focus of my work is in their training,

encompassing implant and restorative dentistry.

An underlying aim of my clinic is that as much

restorative treatment as possible is provided by

the referring dentist when they want to. To this

end we provide, for our referring colleagues, a

large post graduate teaching program, ranging

from simple implants to a Diploma in Restorative

dentistry, partnered with Professor Paul Tipton.

Our laboratory is an integral part of this service

to our referring colleagues. For any information

please feel free to contact me at either bruce@

care-dental.co.uk or [email protected]


Trigger points for discussing dental plans with patientsAs well as ensuring that your general marketing materials mention your dental plan, don’t miss out on the following opportunities to discuss dental plans with patients:

New patient consultationsAs part of your new patient process,

informing them about your dental plan

should form a key part of the process (and

not be an after-thought). Remember a ‘no’

now isn’t a ‘no’ forever. Check out our blog

http://www.ident.co.uk/blog/effective-

follow-ups-for-the-think-about-it-patients.

Recall appointmentsAgain, as part of your systems and

processes those patients who are not

already on your plan should be asked at

recall appointments whether they would

like to join. Make use of your practice

management system to make notes on the

patient’s file regarding your discussions

with them about the dental plan and

follow up accordingly.

Patients who require additional treatmentIt may be that previously, those patients

who haven’t required any additional

treatments didn’t see the need to join the

dental plan. However, if their dental health

changes and they find themselves needing

to visit you more often and undertake

more treatments, they may now be prime

candidates to join.

Patients who the hygienist feels would benefit from more frequent visitsEmpower your hygienists to suggest

joining the plan to those patients who

perhaps need more frequent visits. You

may even want to consider setting in

place targets and incentives to those staff

who get new patients signed up to the

dental plan.

Contact with inactive/ dormant patientsPeriodically send out a mailing to inactive

and dormant patients on your database.

As well as a good exercise to clear up

your database it can also act as a prompt

to those patients who’ve been meaning

to make an appointment but haven’t got

round to it.

Promoting the benefits of joining the

dental plan within this mailing is an

excellent idea. It acts as a trigger for

patients who’ve been meaning to get

in touch and the concept of the plan -

spreading the cost in return for regular

check-ups – is an excellent incentive.

Make use of

your practice

management

system to make

notes on the

patient’s file

regarding your

discussion with

them about

the dental plan

and follow up

accordingly

We are here to help you make the most of your dental plan. Please give us a call on

01463 223399 so we can discuss your requirements in detail.


BDM NewsletterSo here we are with the first magazine ‘post Brexit’ and without getting embroiled in a ‘heated debate’ on the topic following the UK populations decision on 23rd June; it will without doubt create further comment and opinion as the terms to leave the EU become demonstrably more apparent and we begin to understand what the potential impact on the dental industry and marketplace might be.

Politics aside (thankfully) there has been

plenty of news to bring members since the

summer edition of ‘iNSIGHT’, and where

better to start than the two seminars ICP

exhibited at during the autumn hosted by

Professional Dentistry which combined

educational topics in conjunction with

CORE CPD for delegates.

It is becoming increasingly difficult to select

appropriate events to attend/exhibit at quite

simply because of the plethora of seminars,

lectures and exhibitions available, however

Professional Dentistry appeals in that the

event is only two days, the subject matter is

relevant (especially the CORE CPD element)

and therefore the ‘audience’ is primarily

dentists; which offers ICP the opportunity

to raise brand awareness to potential new

clients whilst catching up with existing

members, and both seminars in Glasgow

and Manchester proved to be thoroughly

enjoyable and productive events.

As ever, it was great to see some familiar

faces at both events whilst also chatting

to prospective new customers who were

considering a dental plan for the first time

or interested in ‘switching’ provider (more

of this later in my newsletter), but also

reviewing the various products and services

available from fellow exhibitors.

Talking of great events, I attended the full

day presentation from renowned business

coach Illona McLay in August (sponsored

by ICP), which focused on the topics of

“motivation, patient engagement and

developing excellent customer service”,

and it certainly created lots of discussion on

If you wish to

discuss how we can

help and support

any associated plan

activity, just get

in touch.

By Gary Moore


the day, and provided all 17 delegates with

plenty of ‘food for thought’ on what could

be changed, improved, developed, upon

return to the surgery.

Illona works primarily in the dental industry

and is just as happy working with large or

small groups, individual practices, principal

partners, etc. so if you think you could

benefit from Illona’s services, check out

page 16 for greater insight into the days’

proceedings or to obtain Illona’s details.

On the subject of ICP sponsored events, we

unfortunately had to cancel both Ivoclar

‘hands on’ presentations planned for the

summer due to lack of demand, and this

is always disappointing especially when

speakers and venues have been organised.

However, it got me thinking about future

training events, and as we head into 2017,

I would be keen to establish the thoughts

of members with regards the type of events

you would be interested in attending, so

that we are more ‘in tune’ when organising

and promoting presentations, lectures,

hands on courses, etc., and therefore likely

to improve delegate numbers.

For example, would you be interested in

events that focus on particular clinical

issues/topics, or perhaps subjects that

concentrate more on the business side

such as marketing, sales skills, customer

service and so on.

I welcome your comments, preferences

and suggestions, and simply drop me an

email to [email protected] with

your thoughts.

If you are a regular visitor to the ICP

website www.ident.co.uk and more

specifically the ‘blog’ section, you will

be aware of the substantial ‘library’ of

valuable information available.

I am pleased to advise that we have

further improved and updated the blog

content to in effect create a ‘best practice

guide’, providing a more accessible and

structured overview of useful ideas, tips

and suggestions to support practices in

recruiting and retaining plan patients,

marketing your practice, and providing

excellent standards of customer care.

There are four new categories to select

from, namely:

• Recruitment of plan patients

• Marketing your dental practice

• Practice management

• News & Events

I sincerely hope members find this new

development beneficial and the ‘library’ will

continue to be regularly updated with fresh

and relevant new content going forward.

In an increasingly competitive marketplace,

it’s always pleasing to welcome new

members to the Group, and 2016 has been

particularly overwhelming with regards the

number of new practices who have chosen

ICP as their plan provider.

A popular feature with both existing and

new to group members this year has been

the “£10 per plan” incentive, and I’m

delighted to announce that as a result of its

continued success, this initiative has been

extended into 2017, so whether you are

looking to increase existing plan numbers,

or still haven’t ‘switched’ over those plans

with a competitor then you can still benefit

from a possible reward.

In addition, if you know of anyone who

might be interested in joining the ICP

family, because they don’t have a plan or are

possibly considering a switch of provider,

then please pass their details on.

So as another year draws to a close, thoughts

now focus on the year ahead and you might

already be considering a campaign to ‘kick

start’ 2017 by increasing activity to build

up plan registrations; so if you wish to

discuss how we can help and support any

associated plan activity, just get in touch.

Finally, I would like to take this opportunity

to thank all members for their continued

loyal support, and to wish everyone a very

Merry Christmas and both a prosperous and

successful New Year.


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consumables

Discount via online website

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based on the value ofconsumable purchases

Reduced charge out rate for our Service Engineers

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It was a sad day when I decided to hang up my boots and retire.

What made the process much more bearable was the care and

attention I always received from Michael, Kim and Nina. They are

all a credit to Thorntons and their profession, and I am truly grateful

that I had the pleasure of having them support me and guide me

through the process of selling my practice. A great team.

— Don Macleod

We both believe we’ve been extremely fortunate to have you

all assisting us with this sale. Your high level of expertise and

professionalism has turned a very stressful time to an enjoyable

and pleasant experience. We are extremely grateful.

— Omid Mowlawi

Understanding the unique needs of the Dental profession

www.thorntons-law.co.uk

Thorntons is a trading name of Thorntons Law LLP.

For specialist legal advice contact one of the partners in our Dental Law Team:

Michael [email protected]

Ewan [email protected]

Tel 01382 229111 @thorntonsdental

Our patient finance application works for both you and your patients. The application is available 24 hours a day 7 days a week and provides an instant decision, allowing your patients to book their treatment.

Please note that finance approval is subject to status and terms and conditions apply.

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Braemar Finance is a trading style of Close Brothers Limited. Close Brothers Limited is registered in England and Wales (Company Number 00195626) and its registered office is 10 Crown Place, London, EC2A 4FT.

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IndepenDent Care Plans UK Ltd, River House, Young Street, Inverness IV3 5BLt: 01463 223399 w: www.ident.co.uk e: [email protected]

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