Dental Tribune United Kingdom Edition

Periodontal Disease How do you measure success? Dentomycin abridged prescribing information. Please refer to the Summary of Product Characteristics before using Dentomycin 2% w/w Periodontal Gel (minocycline as hydrochloride dihydrate). Presentation: a light yellow coloured gel containing minocycline as hydrochloride dihydrate equivalent to minocycline 2% w/w. Each disposable application contains minocycline HCI equivalent to 10mg minocycline in each 0.5g of gel. Uses: Moderate to severe chronic adult periodontitis as an adjunct to scaling and root planing in pockets of 5mm depth or greater. Dosage: Adults – Following scaling and root planing to pockets of at least 5mm depth. Gel should fill each pocket to overflow. Applications should be every 14 days for 3-4 applications (e.g. 0,2,4 and 6 weeks). This should not normally be repeated within 6 months of initial therapy. Use only one applicator per patient per visit which should be wiped with 70% ethanol between applications to each tooth. Avoid tooth brushing, flossing, mouth washing, eating or drinking for 2 hours after treatment. Elderly – As adults, caution in hepatic dysfunction or severe renal impairment. Children – contraindicated in children < 12 years. Not recommended in children > 12 years. Contraindications: Hypersensitivity to tetracyclines, complete renal failure, children under 12 years. Precautions: Closely observe treatment area. If swelling, papules, rubefaction etc. occur, discontinue therapy. Safety in pregnancy and lactation not established. Side-effects: Incidences are low and include local irritation and very rarely diarrhoea, upset stomach, mild dysphoria and hypersensitivity reactions. Storage: 2°-8°C. Legal category: POM. Presentation and cost: Disposable applicator in an aluminium foil pouch. Each carton contains 5 pouches. Carton £103.02+VAT. Licence No: PL 27880/0001 PA1321/1/1. Product Licence Holder: Henry Schein UK Holdings Limited, Medcare House, Centurion Close, Gillingham Business Park, Gillingham, Kent, ME8 0SB. Telephone 020 7224 1457 Fax 020 7224 1694 Distributed by: Blackwell Supplies a division of Henry Schein UK Holdings Ltd, Medcare House, Gillingham Business Park, Gillingham, Kent ME8 0SB Tel 020 7224 1457 Fax 020 7224 1694 Date of preparation: February 2011 *Registered Trademark BLA/DEN 18 Dentomycin offers: • 42% reduction in pocket depth after 12 weeks1 • broader spectrum of antibacterial action2 with greater all round activity than metronidazole or tetracycline • conditioning of the root surface3 and enhanced connective tissue attachment4 • improved healing through inhibition of degradative collagenases5 • effective treatment of chronic periodontitis which has been associated with cardiovascular diseases6-9 1. van Steenberghe D, Bercy P, Kohl J, et al. Subgingival minocycline hydrochloride ointment in moderate to severe chronic adult periodontitis: a randomized, double-blind, vehicle-controlled, multicenter study. J Periodontol 1993;64:637-44 2. Slots J and Rams TE. Antibiotics in periodontal therapy: advantages and disadvantages. J Clin Periodontol 1990;17:479-93 3. Rompen EH, Kohl J, Nusgens B, Lapiere CM, Kinetic aspects of gingival and periodontal ligament fibroblast attachment to surface-conditioned dentin. J Dent Res 1993;72:607-12 4. Rifkin BR, Vernillo AT, Golub LM. Blocking periodontal disease progression by inhibiting tissue-destructive enzymes: a potential therapeutic role for tetracyclines and their chemically-modified analogs. J Periodontol 1993;64:819-27 5. Somerman MJ, Foster RA, Vorsteg GM, et al. Effects of minocycline on fibroblast attachment and spreading. J Periodontal Res 1988;23:154-9 6. DeStefano F, Anda RF, Kahn HS, et al. Dental disease and risk of coronary heart disease and mortality. BMJ 1993;306:688-91 7. Joshipura KJ, Rimm EB, Douglass CW, et al. Poor oral health and coronary heart disease. J Dent Res 1996;75:1631-6 8. Mattila KJ. Dental infections as a risk factor for acute myocardial infarction. Eur Heart J 1993;14 Suppl K:51-3 9. Morrison HI, Ellison LF, Taylor GW. Periodontal disease and risk of fatal coronary heart and cerebrovascular diseases. J Cardiovasc Risk 1999;6:7-11 Information about adverse event reporting can be found at www.yellowcard.gov.uk Adverse events should also be reported to Blackwell Supplies,Medcare House, Gillingham, Kent ME8 0SB or by telephone: 01634 877525 this is planning. It does not matter how well you prepare, an inspection is going to be a stressful event. You imagine that the practice manager won’t be able to find that one bit of paper that you both saw yesterday; or that they will ask the youngest and newest member of the team a question to which they give totally the wrong reply; or that the one patient they ask about the practice is the one you didn’t want them to ask! There is always the thought that you have overlooked something or that unbeknown to you, the nurse has been doing her own thing regarding the decon- tamination and sterilisation of instruments. I think it is fair to say that the inspector is not there to catch you out, but if the practice is failing in any of the outcomes, then it is their job to tell you. I would see an inspection as a positive thing, an opportunity for me to find out from someone who should know, how my practice could improve. The ‘Review of Compli- ance’ report arrives. I would not expect the practice to have satisfied everything that the in- spector was inspecting. I’d be very happy if we had, but not too disappointed if we hadn’t, unless it was something really serious. I’d then go through the report line-by-line and work out exactly what had to be done by the practice to fully comply. I would then hold a special team meeting in which all the concerns arising from the report would be discussed and an action plan for each one discussed and agreed. Writ- ten objectives would be given to each team member so that I know that what must be done is done and that it is done on time. The CQC would then be informed in writing when any compliance actions had been completed. Dentistry has come a long way from the scenario I out- lined at the start of this article. The safety of patients, you and your team through stringent cross infection control meas- ures is a good thing. Criminal record checks on employees are sadly a reflection of our modern risk aversion psyche. Improving the overall quality of dental care and treatment must surely make sense to everyone working in dentistry. Isn’t it about time that private practices were brought into line and that they too were in- spected alongside NHS practic- es? Some dentists might resent outside interference, but the fact is that CQC is here, and it is better to work with it than against it. Practices that are professionally and progres- sively managed, and who take a very positive attitude towards managing change, should have no or very little problem with CQC. I don’t think Genghis Khan would have shied away from the challenge, nor do I think he would have thought of CQC as a bad thing. DT ‘Improving the overall quality of dental care and treatment must surely make sense to everyone work- ing in dentistry’ About the author Michael Young is the author of the Diagram Prize winning Managing a Dental Practice the Genghis Khan way. He has over 20 years’ experi- ence of managing a dental practice. He taught clinical dentistry at two dental hospitals. He was forced to re- tire from clinical dentistry because of ill health. He is now a writer and busi- ness consultant. During his dental career he was a member of the Char- tered Institute of Management, the Chartered Institute of Marketing, and was the Secretary of the North East Region Committee of the Institute of Management Consultancy. Michael is a former Young Enterprise Busi- ness Adviser. He was also a member of the Expert Witness Institute. His practice was one of the first in the UK to be awarded the British Dental Asso- ciation’s (BDA) Good Practice. He was also an Assessor for the Good Practice scheme. Over the years he has pub- lished a large number of articles on various aspects of practice manage- ment and marketing in the dental press, and an article on report writing in the legal press. He is the author of How to be an effective expert witness, which is available on Amazon Kindle. Away from dentistry, Michael’s inter- ests include archaeology, history and the arts. Apart from his undergradu- ate and postgraduate dental degrees, he also holds a BA from the Open Uni- versity. Visit Michael’s web page www. thegenghiskhanway.com 9FeatureUnited Kingdom Edition February 27-March 4, 2012