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The General Dental Council (GDC) has announced plans to overhaul its Overseas Registration Exam (ORE) booking system following widespread technical issues experienced by candidates.

The regulator told Dentistry that the new portal would be in place for exams scheduled in 2027, as part of the new ORE contract with UCL Consultants.

This comes as dentists reported payment issues, errors and overloaded servers during the booking process for the next sitting of the ORE Part 1. The 30 June booking window was the first time candidates were able to book ORE sittings through their MyGDC accounts.

Unable to get in contact with the GDC in the aftermath of the crash, some applicants were left unsure if they had successfully secured a space, despite payment having been taken in many cases.

The GDC said it has now resolved the majority of the issues experienced by candidates. It has been working through bookings and payments individually to ensure each candidate’s record is accurate.

It said: ‘We’re confident this gives candidates the certainty they need ahead of the next booking window on 14 July.’

Acknowledging the 65% increase in the ORE Part 2 fee announced in May, the GDC clarified that the additional funds would not be used to reform the booking system, but instead recover ‘the cost of delivering a complex clinical exam at scale’.

Announcing the fee increase, the GDC said: ‘The new fee rates reflect the cost of the new contract, including the costs which come from expanding capacity. We expect them to remain broadly stable over the next five years.  

‘The increase in exam spaces is a positive step forward, but we are very conscious that the increased cost is a burden for candidates to bear.’

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For private practice physicians, particularly those in primary care and internal medicine, the structural constraints of the broader healthcare economy are less binding than they are for large health systems. Independent practices have the flexibility to differentiate and tailor their services, build direct relationships with patients, and create value that patients can actually perceive and act on. The practices that recognize and exploit this opportunity now are, in addition to improving near-term financial performance, building strategic positions that will be extraordinarily difficult for competitors to replicate.

To understand how to leverage this opportunity, it helps to first understand the distinction between two fundamentally different modes of competition: competing on price and competing on value.

Value Competition vs. Price Competition

Price competition is the most familiar form of market rivalry. When firms compete primarily on price, the competitive dynamic is straightforward: whoever can deliver an acceptable product or service wins business, and whoever does it the cheapest wins at the bottom line. Over time, pure price competition tends to compress margins, reward operational efficiency and scale, and push markets toward commoditization. Industries characterized by price competition (e.g., commodity manufacturing, certain retail categories, bulk logistics, etc.) are marked by thin margins, heavy consolidation, and relatively little differentiation between competitors. The product or service itself becomes largely interchangeable in the eyes of the buyer, and price becomes the primary basis of decision-making.

Value competition operates on a different logic entirely: firms compete to deliver what buyers are willing to pay a premium to access. The competitive dynamic here is about who can do it best, and more importantly, who can make “best” visible and credible to buyers. Value competition rewards differentiation, expertise, reputation, and innovation. For the service industry, professions like law, consulting, architecture, and medical specialties in cash-pay environments all exhibit value competition characteristics: the best practitioners command meaningfully higher prices than their peers, and clients actively seek them out rather than defaulting to whoever is cheapest or most convenient. For value to translate into price, buyers must be able to perceive the difference in quality among providers, have genuine options to choose between them, and be the ones making the purchasing decision. When any of these conditions break down, the value signal is severed from the price signal, and the market defaults toward something closer to cost competition, and high quality, even if desired, is not rewarded, or even disincentivized. This is what has happened in healthcare.

Barriers to Competition in the Healthcare Economy

Healthcare economics, particularly in the United States, are unusual in ways that systematically undermine the conditions for value competition. The most fundamental structural problem is what economists call the three-party system, where the party receiving the service is not the party paying for it. The insurer pays the provider, the patient pays the insurer through premiums, and the employer often pays the bulk of the premium, creating a web of misaligned incentives.

The insurer’s primary economic interest cannot be the quality of clinical care because their bottom line comes down to diversifying risk across a large patient population, hence why they pay higher rates to provider organizations with bigger footprints. In the aggregate, higher quality indirectly produces lower downstream costs in the future, but that association is too diluted and untraceable to have any impact at the transaction level. The patient, who experiences the quality of care directly, has no way of discerning quality they are paying for when choosing a health plan, and in most cases, is not even one making that choice.

Compounding this structural problem is pervasive information asymmetry. Patients can observe certain proxies of care quality (e.g., everything around a service), but they generally cannot reliably assess the quality of that service itself like how they can assess a financial advisor’s investment recommendations through their own performance or through the advisor’s historical performance. The dimensions that matter most are also the least visible. Physicians making referrals face a version of the same problem: even among clinicians, evaluating a peer’s clinical quality across institutional lines is genuinely difficult.

The result of these structural conditions is that the healthcare market defaults to cost competition rather than value competition, but in unique form. The competitive advantage that accrues to large health systems is negotiating leverage rather than clinical excellence, and it hits both the revenue side and the expense side, as size is what both an insurer and a vendor tend to value most. This dynamic explains one of the most counterintuitive findings in healthcare economics: consolidated health systems, on average, command higher prices than independent practices while delivering the same or lower quality of care. In a normally functioning market, a higher price for lower or equal value doesn’t make any sense; it would drive buyers to competitors.

Value-based care models have attempted to address this misalignment by creating financial incentives for insurers and large provider groups to improve clinical quality and reduce the aggregate cost of healthcare. The theory is sound in principle: if both insurers and providers can profit from keeping populations healthy versus volume alone, then the incentive structure should begin to approximate a value-competitive market. In practice, however, the results have been more modest than the theory would suggest. The causal chain between a clinical intervention today and a measurable cost outcome years later is long, indirect, and easily confounded by factors outside any single provider’s control. Measuring quality in ways that are both meaningful and resistant to gaming has proven exceedingly difficult. For individual practices, the administrative burden of participation often consumes a significant share of any financial benefit anyway.

Perhaps the aggregate system will eventually shift to a form with true economic mechanisms that drive prices down and quality up, but business owners seek success now, not eventually. This is the water you’re swimming in, and deliberate strategy is what it takes to stay afloat. And for private practice physicians willing to invest in that strategy, the opportunity is substantial.

The Opportunity For Private Practice

Healthcare economics are also unusual in a way that strengthens the ability to compete on value: geographical containment. A consultant, a software company, or a retailer competes nationally or globally and faces a market where every differentiation strategy has likely already been deployed somewhere by someone. By contrast, a physician practice competes in a radius where the number of direct competitors might be five to fifteen. The question then shifts from “what is everyone in the industry doing” to “what are the handful of practices and / or groups in my area doing, and what are they not doing.” That’s a much more manageable pool to differentiate from and doesn’t necessarily require complete originality.

The opportunities present are naturally more prominent in areas where the patient relationships are of a more recurring, longitudinal, rather than episodic, nature. The clearest evidence of how cash-pay value competition can function in healthcare comes from the specialties where it already operates. Dentistry, elective cosmetic surgery, dermatology, direct primary care, and concierge medicine have developed robust value-competitive markets in which people will pay meaningfully more for providers they believe are better in one way or another.

For private practices considering how to compete on value rather than on volume or cost, the starting point is a pair of diagnostic questions:

1. What inherent characteristics of the practice already exist and can be better leveraged?
2. What valuable capabilities do not currently exist but can be deliberately built?

Strategies for Enhancing Value… And The Bottom Line

Scope Differentiation

One of the most direct ways a private practice can distinguish itself from competitors is through the breadth and depth of services offered. The standard primary care visit, optimized for volume and insurance reimbursement, tends toward a narrow and reactive scope: address the presenting complaint and chronic conditions, order the appropriate preventive screenings, and move to the next patient. This model leaves significant unmet patient demand on the table.

Practices that essentially do more for each patient in their panel create a meaningfully different value proposition and contribute to continuity of care. This could take the form of services a patient might otherwise seek elsewhere or services addressing patient needs that the standard insurance-reimbursed model systematically underserves, the latter case typically lending itself to cash-pay pricing, which breaks the fixed-price constraint and allows the practice to price in proportion to the value delivered. A patient paying out of pocket for a comprehensive metabolic assessment, a personalized nutrition consultation, or a proactive longevity evaluation is making a direct purchasing decision based on perceived value

What does this signal to the patient population? It states, “this group operates differently from the rest; they’re built around comprehensive health.” Consistently reinforcement across the patient experience, in turn, contributes to durable competitive positioning.

Credibility

Professional credentials, training pedigree, and clinical expertise are among the most underutilized competitive assets in medicine. In virtually every other professional services industry (e.g., law, management consulting, investment banking, architecture, etc.), practitioners invest heavily in communicating their credentials and experience, and sophisticated clients use those signals when making selection decisions. Reducing the buyer’s uncertainty about the quality they are purchasing commands higher fees and / or attracts more volume. Therefore, a physician who trained at a nationally recognized program, who has clinical expertise in areas of genuine patient demand, or who has published research or received recognition in their field, has an inherent and meaningful competitive asset that is often underleveraged.

Making credentials legible to patients requires translation. Board certification, fellowship training, and academic affiliation mean relatively little to most patients in their raw form. The strategic task is to communicate what those credentials mean in practical terms: why a specific training background makes a physician better equipped to handle complex diagnostic challenges, or why a particular area of expertise or experience is relevant to the health concerns of the target patient population. Doing this well avoids self-promotion and reads as reassurance and specificity. That signals enhanced value.

Convenience

Convenience goes beyond geographic proximity, which is largely limited outside of startup practice territory, and encompasses the entire patient experience, from the initial phone call to the moment they walk out the door, and even intra-visit communication. Digital scheduling, same-day or next-day availability for acute issues, direct communication channels between patients and their care team, ease of payment, and streamlined administrative processes beat the standard model of weeks-long appointment lead times and phone trees.

Finding and maintaining the optimal balance between productivity and quality of experience can differentiate a private practice substantially from a competing organization built around throughput and cost-control. The signal: “this group respects patients’ time and values the relationship.” That kind of positioning can go a long way for reputation-building.

Reputation Compounding

Reputation is the most powerful competitive asset available to a private practice, and it is one of the few assets that compounds over time in ways that new entrants and large competitors cannot easily replicate.

Building reputation requires deliberate attention to dimensions that many practices allow to develop haphazardly. A few common examples: the physical environment, the aesthetic, the consistency of patient experience, the visual and tonal identity of communications and marketing materials, and the community presence. While often viewed as superficial, these qualities make a difference over the long term by creating an image in people’s minds. Once that image is established, it’s extremely “sticky,” so getting it right is crucial.

For practices with multiple physicians, this means being intentional about culture and ensuring that the experience a patient has with any member of the team reflects the standards and personality of the practice as a whole. For solo practitioners, the physician’s personal brand and the practice’s brand are largely synonymous, which concentrates both the opportunity and the risk. Either way, reputation must be actively cultivated, communicated, and protected.

If You Have It, Leverage It

A common strategic failure in private practice is the failure to communicate competitive advantage that already exists in ways that patients and referral sources can actually act on. A practice with excellent clinical outcomes, a great facility, a physician with exceptional training, and a genuinely differentiated service model is not competing effectively if none of these qualities are visible to the people making decisions about where to seek care. Competitive advantage that is not communicated is not, in any economically meaningful sense, an advantage at all.

The goal expands beyond marketing in the transactional sense of generating patient volume through promotion to the deliberate, long-term construction of a practice identity that is specific, coherent, and credible. The distinction is significant. Marketing aimed at volume tends to look and sound like everything else in the market: generic claims about compassionate care, convenient locations, and experienced physicians. Image-building aimed at positioning creates a distinct and recognizable practice identity that accumulates value over time and becomes progressively more difficult for competitors to replicate.

Every patient interaction, every piece of written communication, every visual element of the practice environment, and every presence in the community contributes either positively or negatively to this identity. Practices that approach these elements with intentionality build reputational assets that compound. Practices that treat these elements as afterthoughts leave value on the table and remain vulnerable to competitive displacement.

For specialty practices, the referral relationship is the primary channel through which both volume and reputation flow, and it deserves the same deliberate attention. Referring physicians make recommendations based on confidence. A specialist who communicates effectively with referring physicians and has a visible and specific clinical reputation in their area of expertise generates referral volume that is far more durable than volume generated by proximity or default. Building these relationships deliberately, and maintaining them with consistency, is among the highest-return activities available to a specialty practice.

Positioning For the Future of Private Practice

The structural barriers to value competition in healthcare are significant but not permanent. The past decade has seen the emergence and gradual expansion of direct primary care, concierge medicine, bundled payment systems, and increasing consumer demand for healthcare experiences that feel more like the rest of the professional services economy: transparent, responsive, and oriented toward the individual patient rather than the aggregate population. These trends are not yet dominant, but their direction is clear, and the practices that have already built value-competitive positioning are disproportionately well-prepared to benefit from a market that is slowly moving in their direction.

Building value-competitive positioning in private practice is an overall orientation: a commitment to delivering and communicating superior value across every dimension of the practice, consistently and deliberately, over time. For physicians with the clinical excellence, entrepreneurial instinct, and business acumen to pursue it, the opportunity is substantial.

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Lactation experts Ashana Gupta and Sarah Oakley analyse the case of a dentist who was suspended for failing to gain adequate consent while treating an infant’s lip and tongue ties.

The terms tongue and lip tie refer to congenital conditions whereby the frenulum connecting the lip or tongue to the mouth is too tight. In newborn babies, they can cause challenges with latch, milk transfer, maternal discomfort during breastfeeding, or prolonged feeding times.

While accusations of overdiagnosis have led lip and tongue ties to be the subject of controversy in recent times, it was not the procedure itself that caused the issue in this case. Instead, the dentist was found to have failed to obtain informed consent for some aspects of the treatment.

We spoke to Sarah Oakley, a lactation specialist and tongue tie practitioner, and Ashana Gupta, an oral surgeon and lactation consultant, to gain some insight into what went wrong.

Communication and consent

Both experts stressed that the dentist in question was not criticised for their management of the patient’s tongue and lip tie. Ashana said: ‘The key themes from this case relate less to whether tongue tie release itself is an appropriate treatment, and more to the importance of transparent communication, informed consent and shared decision making throughout the entire patient journey.’

The dentist was also found to have obtained valid consent for the initial tongue tie procedure, informing the parents of the potential risks and even sending them an information pack that they had to sign prior to treatment.

However, the GDC concluded that they did not gain sufficient consent to reopen the wounds at a follow-up appointment.

For Sarah, this raises an important debate around what adequate consent is and how it is perceived by professionals and patients or their parents.

She said: ‘Parents frequently come to practitioners in a heightened state of stress, having experienced significant feeding difficulties for a sustained period of time. They are also often recovering from a traumatic birth experience. Most parents have little experience of surgical procedures, and many have accessed misleading information online and conflicting information and poor support from other healthcare professionals in relation to frenotomy and infant feeding.’

Addressing misconceptions can be very difficult, but is often key to managing expectations and ensuring patients fully understand their treatment.

What misconceptions surround tongue ties?

Sarah has found that many parents believe tongue tie treatment is a ‘quick snip’ which will result in instant improvement. In this case, reopening wounds caused the patient to bleed, which they and their parents found distressing.

She said: ‘Where practitioners are doing anything for which the evidence base is limited or conflicting, parents need to be made aware of that, along with the risks, benefits and alternatives prior to intervention.’

There is strong evidence that tongue tie can lead to reduced tongue mobility and feeding issues in young babies. However, Ashana notes that the evidence is less straightforward surrounding other possible effects of tongue ties such as speech impediments.

She continued: ‘Beyond infancy, a restricted tongue movement may, in some individuals, be associated with functional concerns such as difficulty producing certain speech sounds (for example, some “th” sounds), although the relationship between tongue tie and later speech difficulties is complex and not every child with a tongue tie will experience these problems.

‘This is why assessment should focus on function rather than appearance alone, and decisions should be made based on the individual child’s needs.’

How can consent for treatment of tongue ties be properly established?

Ashana believes that creating an environment that feels safe for the patient and their parents is crucial in tongue tie assessment and treatment. She said: ‘Parents should feel supported with clear, balanced information so they understand the diagnosis, the available options, the potential benefits and risks, and are able to make an informed decision at every stage of care.’

Checking that patients or parents have understood the information provided and keeping detailed records are both central to proving that consent has been established. Ashana advised a thorough explanation of what is being proposed, why it is being considered, the risks and the alternatives – ensuring these conversations are clearly documented.

The suspended dentist informed the patient’s parents that they were going to ‘apply some pressure to release the wound as it looked a bit tight’, and received a nod by way of agreement. This was not considered sufficient by the GDC.

Sarah said: ‘Practitioners offering division, or any surgical procedure, need to ascertain that the parents have fully understood the implications of proceeding with surgery, but this is not always straightforward and overwhelmed, sleep-deprived parents may not assimilate or recollect everything that is said to them.’

Ideally, parents would be given time to consider their options and do further research after an initial consultation. However, Sarah notes that many parents travel to access tongue tie treatment and may be reluctant to delay a procedure while coping with acute feeding issues.

Another crucial precursor to adequate consent is the practitioner’s own understanding of current professional discussions around lip and tongue ties.

What do dental professionals need to know about tongue ties?

Appropriate training is essential for any dental professional undertaking assessment and treatment of oral ties in newborns. According to Ashana, this might include:

• Understanding infant feeding
• A strong grounding in neonatal oral anatomy,
• Knowing the indications for intervention
• Appropriate consent processes
• Aftercare
• Recognising when referral or additional support is required.

There are a number of different techniques for treating tongue and lip ties, including sterile scissors and laser therapy. Ashana said: ‘Laser can provide a precise approach and may offer some haemostatic benefit by coagulating small blood vessels during treatment. As with any procedure, appropriate patient selection, clinical skill, consent and aftercare planning remain fundamental.’

The two experts agreed that the suspended dentist’s approach to treatment went against current thinking at times. While Ashana cited the Association of Tongue Tie Practitioners’ statement that releasing an upper lip tie is not supported for managing feeding difficulties to the same degree as with tongue ties, Sarah explained that reopening wounds after a tongue tie procedure is not a widespread practice as it could promote the formation of more scar tissue.

Sarah concluded: ‘I think all practitioners involved in tongue tie division – be they dentists, doctors, surgeons, nurses or midwives – can learn from this case and we can all take steps to improve our practice as a result.’

Overall, the specialists advised ‘careful assessment and appropriate discussion of the evidence base’ where tongue and lip tie management is concerned.

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Leo Briggs explains how understanding both the ethical and legal duty of candour helps dental professionals respond appropriately and maintain patient trust.

Most patients accept that mistakes can happen but they won’t forgive any attempt to cover them up. The duty of candour is key to retaining their trust. 

The ethical duty of candour

The GDC says dental professionals have a duty of candour ‘when something goes wrong which causes, or has the potential to cause, harm or distress’ (GDC, 2019).

It expects Professional Conduct Committees to ‘take very seriously a finding that a dental professional took deliberate steps to avoid being candid with a patient or to prevent someone else from being so’.

The legal duty of candour

Alongside this individual duty is a legal duty of candour about ‘notifiable patient safety incidents’, which applies to NHS and private dental practices in England and Scotland and to practices providing NHS services in Wales (Northern Ireland plans similar legislation).

This requires practices to notify patients about patient safety incidents that meet the relevant threshold.

For example, in England, this is something unintended or unexpected which already has, or might lead to death, severe or moderate harm.

There is specific guidance about the legal duty of candour threshold and process for England, Scotland and Wales.

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Joseph Sabbagh shares a practical application of root canal treatments using GenENDO instruments and BioRoot Flow in daily practice.

Root canal treatment (RCT) is a common endodontic procedure aiming to preserve a tooth through proper cleaning, shaping and obturation of the root canal system. When properly performed, root canal treatment has an estimated success rate of 90.3% (Ricucci et al, 2011). For retreatments, the success rate is between 65.5% and 77.6% (Stueland H et al, 2023).

Recent innovations in endodontics are revolutionising root canal therapy by integrating advanced imaging, precision instruments and enhanced disinfection methods, making the treatment easier and more predictable. Three-dimensional imaging – particularly cone-beam computed tomography (CBCT) – enables detailed visualisation of complex canal morphologies and guided access.

Cleaning and shaping of a root canal system relies on using flexible nickel-titanium (NiTi) files, simplified sequences, and improved alloys, together with apex locators and enhanced rotary motors, to facilitate efficient shaping of curved canals while minimising procedural errors. This enables subsequent steps, including coronal flaring, creating a reproducible glide path, determining the working length, and carrying out biomechanical preparation and disinfection of the root canal system.

Ultimately, the procedure aims to achieve effective obturation, ensure the longevity of the restoration, and preserve as much of the natural tooth structure as possible (Elmatary et al, 2025; ESE, 2006).

The gold standard in root canal treatments

The dental community has understood that an adequate endodontic treatment does not mean enlargement of the canals, but rather a proper disinfection of the root canal system combined with a three-dimensional seal. Several techniques using gutta-percha, delivered in different modes, are used for the obturation phase.

For several years, the warm vertical technique, described by Schilder in 1972, was considered the gold standard in endodontics. Although showing good clinical outcomes, this technique is complex and involves several steps. Recent development in biomaterials has led to a new category of products called bioceramics, based mostly on calcium silicate (CSCs). They can be used as cements in restorative dentistry for pulp vitality preservation, or as sealers in endodontics (Dong and Xu, 2023).

During the obturation step, the use of bioceramic sealer combined with a single gutta-percha cone makes this phase easier and more predictable.

The following clinical case report details a root canal treatment of an upper molar. The root canal preparation was completed with two NiTi files in continuous rotation (Revo-S+, GenENDO, Septodont). The obturation was done using a recent bioceramic sealer (BioRoot Flow, Septodont).

Clinical signs and symptoms

A 59-year-old male patient presented to the dental clinic to complete a root canal treatment after severe spontaneous pain localised at the upper right posterior quadrant. The pain had persisted for five days and intensified with hot stimuli. Consequently, the patient went to a hospital offering an emergency dental service. They created an access cavity in tooth #17 to relieve the pain, placed a temporary restoration, and asked him to continue the treatment with an endodontist.

A preoperative periapical radiograph revealed an apical lesion on the palatal root of tooth 17 (upper right second molar) with a widened periodontal ligament space around the mesial root. No swelling or sinus tract was visible.

Diagnosis

Based on the patient explanations, clinical and radiographic findings, the tooth was diagnosed with a necrosis following an acute irreversible pulpitis. A non-surgical root canal treatment was planned to complete the emergency procedure initiated at the hospital.

Procedure and treatment

Following administration of local anaesthesia (Septanest,1:200.000, Septodont, Saint-Maur-des-Fossés, France), the temporary cement was removed using a diamond bur and a carbide tungsten bur was used to finalise the access cavity. Three canal orifices were identified: mesiobuccal (MB), distobuccal (DB) and palatal (P). The working field was isolated using a latex rubber dam fixed with a Softclamp (Kerr, Orange, USA) to avoid any gingival fluid contamination or accidental instrument swallowing.

A manual stainless steel 010 K-File (GenENDO, Septodont) was used to scout the canals’ patency. Final working length was determined using an apex locator and confirmed radiographically.

Cleaning and shaping

Cleaning and shaping were initiated using a crown-down technique with rotary files GenENDO Revo-S+ (Septodont) SC2 and SU. There was no need for coronal flaring due to the size and the straight form of the canals.

The shaping of the canal was done with two NiTi Files: GenENDO Revo-S+ SC2 (25/0.4 symmetrical design) was used first, centered downward on the canal in two or three motions. Once the length was obtained with the SC2, a final shaping was done with the GenENDO Revo-S+ SU (25/.06 asymmetric  design)  for  a  uniform  taper  and optimal preparation following one centred downward and one upward movement with selective wall support, finishing at working length.

Copious irrigation with 3.5% sodium hypochlorite was performed throughout instrumentation, and canals were irrigated with EDTA on a final flush flow to remove the smear layer. Rechecking of canal patency was regularly ensured using a GenENDO K-File 010 between each instrument. Figure 5 shows the access cavity with the three cleaned and prepared canals.

Obturation

In the absence of swelling and after complete drying of the canals, contemporary endodontic strategy recommends the obturation of the canal system during the same session. After final irrigation, the canals were dried using one or two paper points to avoid over-drying. BioRoot Flow (Septodont), a recently introduced bioceramic sealer, was injected into each canal with low pressure.

Using a single-cone technique, one master cone of gutta-percha, previously calibrated and confirmed radiographically, was inserted into each of the canals. The gutta-percha points were then cut using a heat-cutting device and compacted with an endo plugger. A Teflon pellet was placed in the access cavity and covered by a temporary cement. Postoperative radiography of the canal system showed it was properly shaped, cleaned and homogenously filled to the radiographic apex.

Follow-up and outcome

At the one-month follow-up, the patient reported no pain or discomfort. Clinical testing showed no tenderness, and radiographic examination revealed resolution of the periodontal ligament widening and signs of periapical healing. The tooth remained functional and symptom-free.

Endodontic treatment of molars can be challenging due to variations and complexities in root canal morphology. Use of magnification, electronic apex location, and simplified rotary instrumentation enhanced the precision of canal shaping. The obturation phase was performed with a bioceramic sealer and a single gutta-percha cone, which is being used more and more in endodontics.

Successful root canal treatment depends on adequate diagnosis, canal disinfection, and hermetic obturation. Early intervention prevented the progression of periapical disease and preserved the natural tooth structure, avoiding extraction. This case highlights the importance of comprehensive diagnostic and clinical protocols in the endodontic treatment of maxillary molars. With proper technique and patient compliance, even complex molars can be predictably treated, resulting in long-term tooth retention and functional restoration.

References                                                                                                                                                     

1. Ricucci D, Rutberg M et al, 2011, A prospective cohort study of endodontic treatments of 1,369 root canals: results after 5 years. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 112(6) : 825-42.
2. Stueland H, Ørstavik D, Handal T. 2023 Treatment outcome of surgical and non-surgical endodontic retreatment of teeth with apical periodontitis. Int Endod J ; 56 (6) : 686-696.
3. Elmatary, A., Moawad, E., Heidarifar, O. et al. Endodontic access cavity preparation: challenges and recent advancements. Br Dent J 238, 469–475 (2025).
4. Dong X & Xu X. 2023 Bioceramics in Endodontics : Updates and future perspectives. Bioengineering: 10. 354.

This article is sponsored by Septodont.

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Anna Najran shares her experience of navigating endometriosis and adenomyosis alongside a career in dentistry, plus her advice for others who are suffering.

As a general and cosmetic dentist, I have cared for thousands of patients, helping them through everything from routine examinations to smile makeovers. Behind the scenes, I was pushing through intense pain, living with an undiagnosed chronic illness while balancing the demands of life as a busy working mum.

Looking back, I had struggled with my menstrual health since my teenage years, but over the last decade my symptoms progressively worsened. I experienced a range of symptoms, from intense pelvic pain and back pain to bloating, chronic fatigue and migraines. Despite seeking medical advice, my symptoms were repeatedly dismissed.

Like many women, I accepted this for a time. But I knew something wasn’t right and I kept advocating for myself. Eventually I was referred for an MRI and then on to an endometriosis specialist.

It was only when I underwent complex surgery that I was finally diagnosed with stage 4 endometriosis and adenomyosis and truly understood just how much I had been living with.

I am sharing this because I know I am not the only dental professional living with this invisible condition.

What is endometriosis?

Endometriosis is a chronic inflammatory disease in which tissue similar to the lining of the uterus grows outside the uterus. It is increasingly recognised as a systemic disease with effects extending beyond the reproductive system. Adenomyosis, which often co-exists with endometriosis, occurs when similar tissue grows within the muscular wall of the uterus.

Around one in 10 women are affected, yet diagnosis still takes an average of eight years. Symptoms can vary widely and may include severe period pain, chronic pelvic pain, lower back pain, pain during or after sex, heavy menstrual bleeding, bloating, bowel and bladder symptoms, chronic fatigue, nausea and fertility struggles. Because many symptoms overlap with other conditions, diagnosis is often delayed.

When dentistry masks the disease

Dentistry is physically demanding at the best of times. We work in fixed positions for long periods, often leaning forward with a level of precision and concentration that leaves very little room for pain or discomfort. For someone living with endometriosis, where pelvic pain, lower back pain and fatigue are already part of daily life, those demands become even harder to bear.

My appointments range from routine examinations to smile makeovers lasting four or five hours. During those appointments there is little opportunity to move or relieve discomfort. Like many dentists, I assumed the headaches, back pain and exhaustion simply came with the busy clinics. It never occurred to me they could all be connected.

Dentistry can also be emotionally consuming. In a single day, we may see patients of all ages and backgrounds, each carrying their own anxieties, expectations and life circumstances. Some need reassurance, others empathy, while some simply need someone to listen. We instinctively adapt our communication, our tone and our approach to meet each patient’s individual needs before resetting and doing it all again for the next person.

When you are living with chronic fatigue, being fully present for every patient takes energy. Yet, as healthcare professionals, we become incredibly good at masking what we are experiencing so that every patient receives the same level of care, compassion and attention.

Managing GP and specialist appointments around a busy clinic diary is one of the less visible challenges of living with a chronic condition as a dentist. Moving or cancelling patients, even when necessary, carries its own weight of guilt, something many of us feel disproportionately.

What changed after my endometriosis diagnosis

Receiving my diagnosis did more than answer years of unanswered questions; it validated my symptoms and changed the way I think about health altogether. I threw myself into researching the disease and grew much more aware of my own triggers and flare-ups. The more I learnt about endometriosis and adenomyosis, the more empowered I felt to take an active role in my own health. Whilst my diagnosis gave me clarity, knowledge empowered me.

Endometriosis is complex. The causes of endometriosis are not fully understood, but hormones, inflammation, gut health, immune function and nervous system regulation can all play a role. That is why there is no single solution, and why managing it well often requires looking at the bigger picture.

Coping strategies

These are some of the things that have helped me:

• Adopting a more anti-inflammatory lifestyle, with a focus on nutrition, movement, sleep and recovery
• Focusing on gut healing, including high fibre foods and managing insulin resistance
• Using targeted supplementation to support my symptoms
• Reducing toxic load and switching to low toxin products where possible
• Optimising liver health to support hormone regulation and detoxification
• Tracking my symptoms to better understand my triggers, flare-ups and symptom patterns
• Being more intentional with my clinical diary, avoiding multiple long cases on consecutive days to allow adequate recovery
• Building short movement breaks into the day
• Using practical measures such as heat pads, a TENS machine and appropriate pain relief medication when needed
• Learning to adapt my exercise to how my body is feeling, recognising that recovery can be just as important as movement
• Incorporating mindfulness, meditation and complementary wellbeing practices, such as reflexology, into my routine
• Building a support network, whether that is a partner, close friends or a trusted member of your clinical team and leaning on them on the difficult days.

One of the biggest shifts has been learning to listen to my body rather than constantly pushing through. Having a well-trained clinical team around me has also made an enormous difference. When your nurse can independently handle tasks such as digital scanning, radiography, clinical photography and patient education, it meaningfully reduces both the physical and cognitive demands of a busy clinical day, and on the more difficult days, that support is invaluable.

Advice for colleagues living with endometriosis

If you are living with endometriosis or any chronic illness, the first thing I want you to know is that you are not alone.

Seek medical help and do not accept dismissal. If something feels wrong, advocate for yourself. Push for an MRI and ask for a referral to an endometriosis specialist. You deserve the same thoroughness of investigation that you would want for your patients.

Do your own research and explore what works for your body. Everyone’s experience of this condition is different and finding what helps you manage your symptoms is a personal journey.

Lean on the people around you, a partner, a close friend, a trusted colleague or your nurse. You do not have to carry this alone.

Final reflections

Living with endometriosis and adenomyosis has undoubtedly changed my life, but it has also changed the way I practise dentistry. It has made me more intentional with my health, more aware of the importance of recovery and even more empathetic towards the patients I care for every day. It has also reminded me what it feels like to sit on the other side of the consultation.

As dentists, we spend our careers educating and empowering our patients, encouraging them to understand their health and make informed decisions about their care. My diagnosis reminded me how powerful that knowledge can be. If sharing my experience helps just one dental professional feel seen, seek answers sooner or realise they are not alone, then telling my story will have been worthwhile.

Looking after ourselves is not a distraction from patient care; it is what allows us to continue providing it.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

The newly published Oral Health Index, which draws on data amassed by Hello Pearl, highlights significant differences in oral health outcomes between the UK and the US and reinforces the importance of identifying dental disease before symptoms develop.

Based on 737 million tooth observations from 26 million dental visits across both countries, the Index found that UK patients in the full-mouth radiograph cohort had an average of 6.36 missing teeth, compared with 2.16 in the US. Around 31% of affected teeth in the UK had been extracted, versus 14.5% in the US.

These findings should not be viewed as a criticism of clinicians. Rather, they reflect how access to care, funding models, appointment pressures and available treatment options can influence whether teeth are restored, monitored or extracted.

The data also highlights an important message: the absence of pain does not necessarily mean good oral health. Early carious lesions, periodontal disease and mineral loss frequently develop without symptoms and may remain undetected without radiographic assessment.

Interpreting radiographs can also be challenging for patients, who often rely solely on verbal explanations from clinicians. Hello Pearl’s Second Opinion platform aims to bridge this gap by analysing dental radiographs and highlighting findings such as suspected caries, periodontal bone loss and calculus deposits directly on the image. The technology is designed to support, not replace, clinical judgement by improving consistency and helping patients better understand their oral health.

Early detection can make a significant difference. Enamel demineralisation identified early may be managed with preventive measures, whereas disease detected later may require restorative treatment or even extraction.

Younger adults carrying a high burden of untreated disease

One of the most striking findings concerns younger adults. Among those aged 18-24, 52% of identified dental disease was untreated, the highest proportion of any age group. In adults aged 75 and over, the figure was 28%, despite a greater overall burden of dental disease. This suggests that older adults are more likely to have had previous treatment, including fillings, crowns and extractions, whereas younger adults may be accumulating untreated disease.

Several factors may contribute to this trend. Young adults often lose continuity of care when leaving home, fail to register with a new practice or deprioritise routine dental visits due to competing financial pressures. Without symptoms, disease progression can easily go unnoticed.

The Index also identified first permanent molars as particularly vulnerable. Although they represent only 14% of the dentition, they accounted for 24% of detected carious lesions and 31% of restorations. Evidence of decay in first molars appeared from around age 17, considerably earlier than in lower incisors, highlighting where preventive efforts may be most beneficial.

Access to care remains a key determinant

The findings suggest that oral health outcomes are influenced as much by access to care as by individual behaviours. Importantly, all individuals included in the dataset had attended a dental practice and undergone radiographic examination, meaning the true burden of undiagnosed disease among those who do not access care is likely to be even greater.

The Index ultimately reinforces a simple message: pain should not be the main reason for seeking dental care. The period between feeling well and being clinically well is often when preventable disease progresses. By helping clinicians identify and communicate pathology earlier, Hello Pearl aims to support interventions when conditions can still be monitored, managed or potentially reversed.

To request a demo, visit hellopearl.com/getdemo.

This article is sponsored by Hello Pearl.

Welcome to The Week in Dentistry, a regular round-up of dental sector updates from across the UK and Ireland.

This week’s edition includes the launch of an artificial intelligence receptionist for dental practices, the sale of a West Midlands practice, community support work in east London and a statement from a UK-based Venezuelan dentist following the earthquake in Venezuela.

Venezuelan dentists at LOC & ODL respond to earthquake

Venezuelan dentists at London Orthodontic Clinic (LOC) and ODL Dental Clinic have responded to the earthquake in Venezuela, highlighting the humanitarian impact on communities across the country.

Alex Seijas, founder of Mission Beyond Smiles and founder and clinical director of LOC and ODL, said many Venezuelans living abroad had spent recent days trying to contact family and friends.

He said: ‘At moments such as this, international solidarity and humanitarian support become more important than ever. My thoughts are with everyone affected by this disaster, particularly those who have lost loved ones, homes or livelihoods.’

Mission Beyond Smiles recently took a team of Venezuelan dental professionals from the UK to the Venezuelan Amazon to provide dental care and support to underserved Indigenous communities.

Dentally launches AI-powered Dentally Pulse

Dentally has unveiled Dentally Pulse, an artificial intelligence (AI) intelligence layer designed to reduce administration and support dental practice teams.

The platform is designed to sit across Dentally and turn conversations, clinical observations, patient interactions and operational data into practical outputs. Dentally said the first feature available through Dentally Pulse is an enhanced AI clinical notes tool, which can summarise appointment conversations into clinical records without storing the original audio.

Duncan Leslie, director of product and technology at Dentally, said: ‘Our approach to AI is simple: it should assist, not replace. Clinicians remain firmly in control, while technology works in the background to help practices work more efficiently and focus more time on patients.’

Dentally Pulse will be rolled out progressively throughout 2026, with additional capabilities expected during the third and fourth quarters. Practices can register interest through Dentally.

Savona Dental supports homeless community

Savona Dental partnered with SameDayDoctor and Nishkam SWAT to provide care packages for people experiencing homelessness in east London.

The Canary Wharf practice helped prepare and distribute bags containing toothbrushes, toothpaste and warm socks. SameDayDoctor also contributed feminine hygiene products, while Nishkam SWAT volunteers distributed the packages in Stratford.

AI dental receptionist Greeta launched

Conversico launched Greeta, an artificial intelligence (AI) dental receptionist designed to support practices with missed, overflow and out-of-hours calls.

The system answers calls, books directly into the practice management system and gives reception teams a clear next step. Greeta launched on 30 June 2026 and is now live, with a public demo available through Conversico.

Dudley dental practice sold after owner retires

Andrew Hargreaves Dental Practice in Dudley, West Midlands, was sold after its founding owner retired from clinical dentistry.

The three-surgery mixed-income practice was founded by Andrew Hargreaves in 1996. Christie & Co handled the sale, and the practice was purchased by Nazim Shah, an experienced dentist with previous practice ownership experience. The sale price was undisclosed.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends. 

The General Dental Council (GDC) was challenged over the lack of formal quality assurance for Overseas Registration Examination (ORE) preparatory courses at a Dental Leaders Network event exploring how the growing number of internationally qualified dental professionals can be better supported in UK dentistry.

The event, held on 30 June, brought together regulators, educators, employers and professional support organisations to examine a workforce issue that is becoming increasingly central to NHS access, practice recruitment and patient care.

The informative and collaborative day opened with scenario modelling from Stefan Czerniawski, executive director of strategy at the GDC, showing how the make-up of the dental register could change if current and planned registration patterns continued. Under one scenario, fewer than a third of new dentists joining the register could be UK trained by 2029, with UK-trained dentists becoming a minority of the overall register by 2034.

Czerniawski stressed that the figures were scenarios rather than predictions, with future patterns dependent on factors including ORE and Licence in Dental Surgery (LDS) capacity, European registrations, retention and candidate behaviour.

He said this was not a negative trend, stressing that internationally qualified dental professionals made an ‘enormous and invaluable contribution’ to healthcare in the UK. However, the changing workforce raised questions about foundation training, supervised practice, support needs and how the UK remained attractive to internationally qualified dentists.

ORE preparation

One of the most noteworthy exchanges came towards the end of an afternoon panel discussion, when Fiona Sandom, senior lecturer and programme lead for dental hygiene and dental therapy at Bangor University, challenged Czerniawski and the GDC on oversight of ORE preparatory courses.

She asked whether the regulator quality assured ORE educational providers in the same way it quality assured other GDC-registered qualifications.

Czerniawski confirmed there was quality assurance of the ORE itself, but not of the courses candidates take to prepare for it. He said the ORE was structured as a self-contained assessment, with the regulator historically focused on the assessment rather than how candidates prepared for it.

However, he acknowledged that some form of accreditation or standard setting for preparatory courses could be valuable, adding that whether this should be done by the GDC, or under what powers, remained a separate question.

The exchange captured a wider theme running through the day: the ORE remained a central route into UK registration for many overseas-qualified dentists, but the journey around it was often fragmented, expensive and inconsistently supported.

Consistency and cost

Another panellist, Gauri Pradhan, honourable trustee of International Dental Organisation UK (IDO UK), said registration was often the first major hurdle for internationally qualified dentists, with some candidates unsure how to navigate the system despite recent improvements to the ORE booking process.

She said candidates could spend between £15,000 and £18,000 from the point they started the registration process to joining the register, with some paying thousands of pounds for preparatory support without clear validation or accreditation.

Kaushik Paul, clinical director at mydentist, used an earlier talk to discuss how course providers played an important role in preparing candidates, but argued that the profession needed more consistency. Given the cost of the ORE, he said more should be done to help candidates ‘get it right first time’.

Building support

The event, which featured a number of speakers who had come through the ORE pathway, also highlighted the scale of practical support needed after candidates pass the ORE, which has seen a significant rise in cost.

Sam James, overseas resourcing manager at mydentist, said more than 50% of clinicians working with the organisation had qualified outside the UK, and that 474 international dentists had started their journey with mydentist over the previous three years. This aligned with GDC figures released in May showing overseas registrants outnumbered those from the UK for the first time.

He said the company’s approach included overseas training partnerships, recruitment support, help with National Health Service (NHS) performer number applications, visa and relocation support, induction and mentoring.

But speakers were clear that support needed to go beyond formal onboarding. Paul said mentors often helped candidates with practical parts of settling into UK life, such as finding local shops, opening bank accounts, accessing accountants and settling families into new communities. He noted that you can’t just drop a dentist from Mumbai into Makerfield and expect it to work.

Mostafa Hassaan, deputy chief dental officer for Wales and an internationally qualified dentist, said passing the ORE was only the first stage of a longer journey. He argued, with specific examples from his own practice, that integration was fundamentally a leadership issue, with international dentists needing fair first opportunities, clear NHS pathways, mentoring, communication support and help understanding UK patient expectations.

NHS performer number

The NHS performer number process was repeatedly raised as a barrier. Hassaan described it as a major bottleneck, arguing that dentists could pass the ORE, join the register and still face delays before treating NHS patients.

Paul also called for a more consistent approach to NHS performer list systems, arguing that requirements varied between regions and nations.

The panel discussed whether a national induction programme could help internationally qualified dentists move into NHS practice more consistently. Pradhan suggested this could include structured training on NHS systems, local expectations and support from a buddy or supervisor.

However, panellists warned that a short induction alone would not be enough. Sandom said support needed to include tacit learning and mentorship, rather than becoming a tick-box exercise.

Culture and safety

The discussion also moved beyond dentists. Sandom said internationally qualified dental hygienists and dental therapists needed support, while questions were also raised about dental technicians and other registered titles.

She said integration was too often treated as something individual clinicians had to solve on their own, when many were entering complex systems where expectations were rarely spelled out. Clearer pathways, explicit expectations and consistent support, she argued, would allow internationally qualified professionals to contribute fully.

Speakers also raised concerns about exploitation. Neda Irani, restorative clinical teacher at King’s College London, used her lightning talk to highlight that many overseas dentists did not realise they were being exploited because they had not yet had time to learn UK workplace norms, contracts, regulation or professional support structures.

She said support needed to cover practical issues such as contracts, indemnity and professional expectations, as well as the emotional pressures of moving country and starting a career again.

Paul also warned that internationally qualified dentists could be treated as cheap labour, disrespected or discarded when they raised concerns about poor conditions.

Asked who should be responsible for regulating employers and tackling exploitation, Czerniawski said the GDC’s remit covered professional standards, but identifying and acting on exploitation was a wider responsibility shared across the profession.

He suggested that where leaders and colleagues were aware of exploitation, they needed to be prepared to act or provide enough detail for concerns to be followed up.

GDC ORE fee increase

Speakers also linked support for internationally qualified dentists directly to patient access and safety. They said overseas-qualified professionals brought much-needed capacity and clinical experience to areas struggling to recruit, but this needed to be matched with support around communication, consent, complaints handling and cultural expectations.

Biju Ramachandran, honorary secretary and immediate past president of the Indian Dental Association UK, said registration gave dentists permission to practise, while integration helped create belonging.

He also urged the GDC to reconsider its recent ORE fee increase, arguing many candidates were already stretched financially before they sat the exam.

Closing the event, Brid Hendron, postgraduate dental dean at the Northern Ireland Medical and Dental Training Agency, said the day’s central message was to ‘act now and act together’ in preparing for the incoming non-UK qualified workforce.

She said international dentists were an essential part of the workforce solution, with responsibility shared across regulators, employers, support organisations and practice teams.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

Nigel Jones considers why a more trusted, collaborative GDC could shape not only regulation, but the future of the UK’s dental workforce.

The language surrounding the launch last November of the GDCs strategy to become viewed as a ‘trusted and effective’ regulator was encouraging, even if, for many years, the profession will have heard similar intent expressed at various intervals in various forums. This time, however, it feels different. 

I doubt anyone is under the illusion that the damage done to the relationship between the profession and its regulator will be repaired quickly. The mindset shift has to percolate right through the organisation itself and old habits die hard. Even after the operational changes are delivering a new approach consistently and reliably, it will be a while before the perception of the GDC as a body to be feared is shaken off.

But the early signs and feedback are good so there are definite grounds for optimism which is just as well given the key contribution the GDC may play in influencing dentistry over the coming years. As Dr Helen Phillips, chair of the GDC, put it in the foreword to the new strategy: ‘Collaboration is key. We have shared interests in making dentistry work across the UK and we all have a role to play.’

Why trust matters

Take, for example, the issue of the dental workforce planning and the part the GDC plays in the number of clinicians on the register. I’ve often expressed the view that the restricted supply of clinical services relative to demand from patients has been the main driver of change over the past. 

An inability to recruit or retain associate dentists has often been cited by the owners of NHS practices as the straw that broke the back of their hesitation about ‘going private’. Indeed, we are increasingly seeing it is associate dentists, having concluded that NHS contractual arrangements (old or new) are not for them, that are driving the decisions about a practice’s commitment to the NHS.

Resisting such requests is not easy, especially when there are so many vacancies in private practices offering better financial packages, career development opportunities and pace of work. The latter is of particular importance when private practice can offer the chance of longer appointments, leading to better communication and stronger relationships with patients as well as more time for note taking, all of which lessen the fear of getting on the GDC’s radar for the wrong reasons.

And while there are obviously significant regional variations, the drift to private practice exacerbates the lack of access to NHS dentistry, boosting the confidence of the remaining NHS dentists. With limited options available to patients, a move to purely private is feasible and so it goes on.

The wider consequences

In both NHS and private environments, the lack of clinicians can lead to downward pressure on practice income at the same time as the pressure on running costs is relentlessly upwards. The resulting financial pressure can bring in to play behavioral matters relevant to the tension between commercial and ethical considerations.

Indeed, the CMA’s look at private dentistry, while likely to pick up on the supply and demand imbalance in the dental market, is almost certain to be influenced by their work in the veterinary field. In a provisional report, issues such as price transparency and rising private treatment costs were called out as was the concentration of veterinary practice ownership in a few large companies. The BBC even ran a story in January about vets reporting being under corporate pressure to increase revenue.

The GDC has no remit to get directly involved in workforce planning, CMA recommendations, dental business models or NHS contractual arrangements.  However, the way in which it handles concerns about professional conduct is linked to the appeal of private dentistry. More significantly, the rate at which it opens or closes the tap on new dentists joining the register can have indirect impacts on many aspects of UK dentistry which in turn could lead to the kind of professional and ethical issues that are definitely within the GDC’s remit.

A regulator for the future

So, it is with all that in mind that the early signs of the GDC being true to the words of its strategy are to be highly welcomed. A regulator that is seen as supporting the profession it regulates and gives deeper consideration to the wider environment in which dental professionals work will be essential in the years ahead.

This article is sponsored by Practice Plan.

Simran Bains reflects on the 19th annual Vaisakhi celebrations in Parliament and explains why faith leaders and healthcare professionals must unite to tackle oral health injustice.

I was honoured to be invited to mark Vaisakhi 2026 through my work with the British Academy of Cosmetic Dentistry (BACD) and the College of Dentistry, as the British Sikh Consultative Forum convened parliamentarians, faith leaders, health professionals and community organisations at the Speaker’s State Rooms, House of Commons. 

The 19th Annual Vaisakhi at Westminster united celebration with civic purpose, bringing together voices from across the UK to address one of the most pressing issues facing communities today – health inequalities.

Vaisakhi is one of the most significant dates in the Sikh calendar, marking renewal, gratitude, equality and the creation of the Khalsa in 1699.

It is a celebration of faith, service and community, values that continue to resonate far beyond religious observance. 

Central to Sikh teaching is seva; selfless service for the benefit of others.

For those working in dentistry, the theme should resonate strongly. Oral health inequalities remain among the clearest and most preventable examples of wider health injustice. 

Dentists see every day how deprivation and delayed access translate into pain, untreated disease and avoidable extractions.

The social gradient of oral disease

Too often, dentistry is discussed separately from mainstream healthcare policy.

Yet oral disease follows the same social gradient as many chronic conditions, with those who have the greatest need often facing the greatest barriers to care. 

Children in deprived communities continue to experience higher rates of decay, adults under financial pressure frequently delay treatment until symptoms become acute, and older patients can struggle with access, transport and affordability. 

These inequalities affect communities across the UK and are closely linked to wider health outcomes. 

Oral health does not exist in isolation; it is strongly connected to conditions such as type 2 diabetes, cardiovascular disease and respiratory illness. 

When prevention is limited and access to care is delayed, the cumulative impact on both oral and general health can be substantial. 

The discussions at Westminster also highlighted the important role dentistry can play in reducing wider health inequalities.

Dentists are not only treatment providers, but trusted healthcare professionals with an important voice in prevention and community wellbeing.

That means continuing to advocate for:

• Sustainable NHS dental access
• Prevention-led commissioning
• Targeted services for high-need communities
• Integration of oral health into wider healthcare pathways
• Partnerships with trusted community organisations.

Bridging the gap through faith

What made this year’s event especially notable was the recognition that faith institutions and community organisations are already helping to bridge healthcare gaps. 

Gurdwaras, charities and local community hubs across the UK frequently provide health awareness sessions, screening events, mental health support, food programmes and signposting into statutory services. 

They are trusted spaces with local reach, often engaging people who may not respond to traditional healthcare channels.

This year’s Vaisakhi at Westminster was therefore more than a cultural celebration.

It was a timely challenge to policymakers to recognise that fairer healthcare must include oral healthcare.

For dentists, the question is not whether we have a role in reducing inequalities. It is how we choose to lead it.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

Welcome to The Week in Dentistry, a regular round-up of dental sector updates from across the UK and Ireland.

This week’s edition includes the launch of an artificial intelligence receptionist for dental practices, the sale of a West Midlands practice, community support work in east London and a statement from a UK-based Venezuelan dentist following the earthquake in Venezuela.

Venezuelan dentists at LOC & ODL respond to earthquake

Venezuelan dentists at London Orthodontic Clinic (LOC) and ODL Dental Clinic have responded to the earthquake in Venezuela, highlighting the humanitarian impact on communities across the country.

Alex Seijas, founder of Mission Beyond Smiles and founder and clinical director of LOC and ODL, said many Venezuelans living abroad had spent recent days trying to contact family and friends.

He said: ‘At moments such as this, international solidarity and humanitarian support become more important than ever. My thoughts are with everyone affected by this disaster, particularly those who have lost loved ones, homes or livelihoods.’

Mission Beyond Smiles recently took a team of Venezuelan dental professionals from the UK to the Venezuelan Amazon to provide dental care and support to underserved Indigenous communities.

AI dental receptionist Greeta launched

Conversico launched Greeta, an artificial intelligence (AI) dental receptionist designed to support practices with missed, overflow and out-of-hours calls.

The system answers calls, books directly into the practice management system and gives reception teams a clear next step. Greeta launched on 30 June 2026 and is now live, with a public demo available through Conversico.

Savona Dental supports homeless community

Savona Dental partnered with SameDayDoctor and Nishkam SWAT to provide care packages for people experiencing homelessness in east London.

The Canary Wharf practice helped prepare and distribute bags containing toothbrushes, toothpaste and warm socks. SameDayDoctor also contributed feminine hygiene products, while Nishkam SWAT volunteers distributed the packages in Stratford.

Dudley dental practice sold after owner retires

Andrew Hargreaves Dental Practice in Dudley, West Midlands, was sold after its founding owner retired from clinical dentistry.

The three-surgery mixed-income practice was founded by Andrew Hargreaves in 1996. Christie & Co handled the sale, and the practice was purchased by Nazim Shah, an experienced dentist with previous practice ownership experience. The sale price was undisclosed.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends. 

Dentists hoping to secure a spot to sit the Overseas Registration Exam (ORE) reported payment issues, errors and overloaded servers preventing them from completing the process.

Accessing a place in ORE examinations has previously been compared to buying Glastonbury Festival tickets, with applicants flooding the General Dental Council’s (GDC) MyGDC portal as new dates are released. International dentists must pass both parts of the exam to practise in the UK.

On 30 June, 600 places were released for the ORE Part 1 at 2:30pm. One dentist told Dentistry that they were unable to log in for 10 minutes, at which point they were met with a blank page. They were eventually taken to a payment page, though this refreshed and showed an error before they could enter their details. After two hours of refreshing, they regained access to the website which informed them that the exam slots were full.

Another ORE hopeful said they were able to enter their payment details but were told the payment had failed, despite the total fee being deducted from their bank account. Following several failed attempts, they tried to contact the GDC but were unable to get through.

Many applicants reported a similar difficulty in contacting the regulator since the website crash. With no confirmation email but payment taken, dental professionals have been left unsure if they were successful in booking an exam place. Others were unable to secure their spot despite correctly completing the booking process.

The GDC told Dentistry it was aware of the difficulties candidates had faced. It said: ‘We apologise for the uncertainty and inconvenience this has caused. We understand how much preparation goes into this exam, and candidates deserve confidence that their booking and payment have gone through correctly.’

Affected applicants are encouraged to contact examinations@gdc-uk.org.

‘The ORE booking process has become a lottery’

The booking process for the exam has long been criticised as a ‘lottery’. Speaking to Dentistry, dentist Mohammed Ghafoor said: ‘For many, that one-second difference between pressing the button before or after someone else decides the course of their entire professional life. Those with faster internet connections, quicker reflexes, or sheer good fortune secure a slot. Others, equally deserving and equally prepared, are locked out yet again.

‘This is not meritocracy. This is not fairness. This is chance masquerading as order. The ORE booking process has become a lottery.’

In March 2026, the GDC announced changes to the ORE which could allow five times more dentists to qualify each year through the exam. It estimated that Part 1 capacity would increase from 1,800 to 2,400 annually, and Part 2 from 720 to 944 initially – eventually increasing to 1,500 per year.

These changes follow a new contract with UCL Consultants announced last year, which the GDC said ‘allows the exams to run at a larger and more planned scale, increasing capacity in a controlled way rather than reacting to pressure year on year’.

The regulator stressed that capacity could only be increased to a level that maintains patient safety and candidate experience, saying it ‘will not compromise’.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends. 

Warning: This story contains comments of a racist nature and references to sexual violence

A High Court ruling has exposed conflicting positions within the GDC fitness to practise process after a dentist found to have made repeated sexualised and discriminatory comments to junior female colleagues and racist remarks was allowed to return to practice under conditions.

The dentist had been suspended for six months by an independent Professional Conduct Committee (PCC) in July 2025, but the GDC later supported a Professional Standards Authority (PSA) appeal arguing that the sanction was insufficient and that they should have been erased.

The PCC found that the dentist, between 2020 and 2023, had engaged in repeated inappropriate, sexualised and discriminatory behaviour towards junior female colleagues, alongside comments about female patients’ bodies and discourteous behaviour towards patients.

Staff at the practice reported having comments such as ‘I have my rape eye on you’ directed at them, and being told about a ranking system for women the dentist wanted to ‘shag’. They were asked in detail about their sex lives and threatened with ‘dick pictures’, with one colleague reporting that the registrant stroked their arms inappropriately on multiple occasions.

The clinician also commented on the bodies of female patients, including that it was a ‘shame’ that their patient had ‘a pretty face but such a small chest’. More generalised comments that women ‘belong in the kitchen’ were also reported.

Racist and homophobic remarks were also noted. For example, the dentist was quoted saying that they would ‘pour acid’ on their own daughter if she brought home a black man. They also told a colleague: ‘I hate gays, but I like you.’

What sanctions did the GDC impose?

Initially, the PCC imposed a six-month suspension after finding that erasure would be disproportionate. In reaching that decision, it took account of mitigation including previous good character, some evidence of reflection and remediation, and developing insight. However, it also found that the registrant’s insight and remediation remained limited, and did not treat some comments as sexual in nature.

Discussion of patients’ bodies, for example, was seen to be inappropriate but with ‘nothing to suggest that it was made in a sexual manner’.

In September 2025, following a review by the GDC’s Quality Assurance Group, the GDC wrote to the Professional Standards Authority (PSA) to alert it to concerns with the original decision. The PSA then began an appeal process in October, which the GDC confirmed it would not oppose.

Explaining the referral to the PSA, the GDC told Dentistry that it took the view that ‘the sanction imposed was insufficient to protect the public and maintain public confidence in the dental professions.’

At a review hearing in February 2026, a separate PCC found that the registrant’s fitness to practise remained impaired and that it could not be satisfied that a risk of repetition was highly unlikely. However, it revoked the suspension and imposed conditions for 18 months, allowing the registrant to return to practice under restrictions including workplace reporting and notifying the GDC of any disciplinary action. The PSA appeal was acknowledged during this process, though the committee said it did not affect its task or powers at that review hearing.

The result was a unique sequence in which the GDC argued that the dentist should have been erased, while a separate committee within its fitness to practise process allowed them back into practice under conditions despite finding that a risk of repetition remained.

The PSA argued that erasure was the only appropriate sanction, a position supported by the GDC.

The dentist argued before the High Court that the PCC was entitled to consider the steps they had taken since the concerns were raised, including relevant CPD, reflection and the fact that there had been no further incidents reported since referral.

However, Mr Justice Sweeting found that the original committee had placed too much weight on limited evidence of insight and remediation, despite its own findings that the registrant’s insight was partial, their understanding of the impact of their behaviour was incomplete and a risk of repetition remained.

Why has the decision been questioned?

Justice Sweeting found that the original committee had materially underestimated the seriousness of the dentist’s misconduct and failed to grapple with the cumulative gravity of the conduct it had found proved.

Although the High Court had the power to substitute erasure, Justice Sweeting said sanction in a case of this kind involved a ‘multifactorial evaluative exercise’ that was usually best carried out by a specialist tribunal. The case was therefore sent back to a newly constituted PCC to reconsider sanction.

The registrant has given an undertaking to continue practising under the same conditions until the Interim Orders Committee imposes any restrictions while they await a new hearing. 

The GDC said: ‘We were firmly of the view that the original sanction imposed in the case of [redacted] was insufficient to protect the public.

‘The GDC welcomes the decision of the High Court where the court has made clear the seriousness with which persistent sexual misconduct is taken in the context of fitness to practise proceedings for regulated professionals.

‘Where our standards are not met, we will ensure that we take appropriate and proportionate action.’

GDC back in the High Court

It is the second time in recent months that the High Court has been involved in an erasure case. In April, the High Court overturned the erasure of a dentist who had sent ‘racially-motivated’ emails. The dentist in question emailed their former employer asking for their name to be removed from the practice website as they did not want to be associated with ‘Indian dentistry’. As a result, they were erased from the GDC register with immediate suspension.

The judge felt that while the dentist’s actions were a ‘serious departure from the professional standards expected’, they did not show ‘an entrenched or enduring refusal to acknowledge wrongdoing’. 

The erasure was therefore overturned and replaced with a six-month suspension. The court suggested that the PCC’s approach to interpreting sanctions guidelines was ‘flawed’ and had been ‘misapplied’ in this case.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends. 

Failure to diagnose or appropriately manage periodontitis remains one of the most common and highest value categories of dental negligence claims encountered in legal practice.

In this article, Sabrina Mahmood, associate at Keoghs LLP, explores the key legal issues that frequently arise in such claims and outlines practical risk management strategies for dental practitioners.

Why periodontitis claims?

The British Society of Periodontal Disease and Implant Dentistry (BSP) describes periodontitis as ‘one of the most widespread diseases in the world’. Against that backdrop, it is unsurprising that claims in this area are increasingly common. The condition often presents with subtle clinical signs, which may not be immediately apparent without a thorough periodontal assessment. This can create particular challenges in the busy, time-pressured environment of general practice, where many of these claims arise.

Common allegations include inadequate assessment and treatment planning, the provision of inappropriate or suboptimal therapy, insufficient patient communication regarding aetiology and risk factors (including smoking and oral hygiene), and a failure to make timely and appropriate referrals. Another level of complexity is that these claims often involve multiple practitioners as they can span extensive time periods, usually anywhere between five to 25 years.

Below we set out some of the key risk factors in more detail and consider practical steps that can be taken to mitigate these risks in everyday practice.

Risk factor one: assessment and treatment planning

Effective assessment and treatment planning can be a great way to ensure that many of the key risk areas are minimised. What we often see in legal claims are missing/regular BPE scores and where scores are three or higher, in-depth periodontal charting has been omitted, contravening the recommendations by the BSP (2019).

Another common issue is the failure to take radiographs at appropriate intervals. Radiographic assessment is often essential in identifying early bone loss and periodontal disease, particularly where clinical signs are not readily visible to the naked eye.

It is important to clearly document in the clinical records when radiographs are due, and to record any instances where a patient declines them, including the reasons for doing so. This provides important protection in the event of a later allegation that radiographs were not taken when clinically indicated. Patients may decline radiographs for a variety of reasons, including concerns relating to health or pregnancy, dental anxiety or phobia, concerns about radiation exposure, as well as general cost considerations given that they may incur an additional expense.

Finally, a clear discussion and documentation of the appropriate recall period will be important as patients with periodontal disease often need to be seen more frequently to help manage their disease, and allegations can arise where recall periods are too long.

Risk factor two: suitable treatment and onward referral

Many patients can be managed within the general dental setting with non-surgical therapy carried out by the dentist or hygienist at regular intervals. A common allegation is that appropriate therapy with non-surgical root surface debridement (RSD) has not been provided, and where treatment has been provided, it has been inadequate due to a failure to undertake subgingival debridement or supragingival plaque removal.

From experience, where a practitioner considers that a scale and polish is the most appropriate course of treatment, it is helpful for the clinical records to clearly set out both the decision taken and the reasoning behind it. In addition, where RSD has been carried out, this should be clearly documented including whether sub/supra gingival scaling has been undertaken.

An effective early treatment plan can help to ensure that appropriate therapy is provided, and where practitioners in the general dental practice setting feel that the patient’s needs are more complex or that surgical therapy is required, onward referral should be discussed and documented within the records. Failure to provide suitable referrals is another area where negligence allegations are common. Where periodontal disease is advanced, unresponsive to treatment, or beyond the practitioner’s scope, referral to a specialist should be discussed, offered and documented clearly in the records.

Risk factor three: oral hygiene and smoking

On nearly every periodontal claim, we see allegations that appropriate oral hygiene and tooth brushing advice was not provided, nor was smoking cessation discussed with the patient. Often, practitioners will notify us that they have discussed this but not documented it within the records.

Recent experience suggests that allegations in this area have become increasingly sophisticated. As patients have greater access to information, it is now commonly alleged that the aetiology of periodontal disease was not adequately explained, preventing patients from understanding how the condition develops and how factors such as poor oral hygiene and smoking may contribute to its progression.

Many smokers further allege that, had they been properly informed of the detrimental impact smoking can have on periodontal health and bone levels, they would have ceased smoking. In practice, we frequently see such allegations advanced even where smoking cessation advice has already been provided in primary care settings, often with limited evidence of patient engagement or compliance. In a number of cases, claimants have continued to smoke or use electronic cigarettes, even where they have subsequently received specialist periodontal input.

Financial implications

Legal costs in periodontal disease claims can escalate quickly. Independent expert evidence is often required, not only from a general dental perspective, but also from specialist periodontal and restorative experts. In addition, there is frequently a need for a detailed review of dental records, including both historic records and those from the index period. This is necessary to identify any pre‑existing disease, assess compliance with oral hygiene and smoking cessation advice over time, and consider whether gaps in attendance may have contributed to the outcome in question.

Claimants commonly allege that multiple teeth have been lost, or that tooth loss has been significantly accelerated, as a result of the alleged negligence. Claims often include the cost of extensive remedial treatment, including implants and complex restorative work, which can substantially increase the value of a claim. Defence experts will typically examine whether the proposed treatment is clinically appropriate and achievable, particularly where a patient’s oral hygiene remains poor.

In practice, many patients are not suitable candidates for the treatment claimed unless and until meaningful improvements in periodontal health are demonstrated, although there are cases where patients do engage positively and achieve sufficient improvement to proceed with restorative care.

Periodontitis treatment planning

From a risk management perspective, the most critical factor in limiting financial exposure is robust treatment planning supported by clear, documented discussions with the patient. Clinical records should demonstrate not only that an appropriate periodontal assessment was undertaken, but that the diagnosis, treatment options, risks, and prognosis were fully discussed and understood. Records should also reflect ongoing review and monitoring, including patient compliance or a lack of compliance with oral hygiene and smoking cessation advice. Where patients fail to attend, decline recommended treatment, or do not adhere to advice given, this must also be clearly and consistently documented.

From an indemnity perspective, early notification to insurers is critical where concerns arise regarding the management or progression of periodontal disease. Early involvement allows insurers to provide timely guidance, secure relevant records, and obtain early expert input which can support a robust defence of the allegations or otherwise inform an appropriate resolution strategy. This proactive approach can significantly reduce overall claims spend and improve prospects of a successful defence as well as preserving important evidence.

Summary and practical takeaways

Periodontal disease claims can involve scrutiny of many aspects of clinical care. However, practitioners can take reassurance from the fact that many of the associated risks can be mitigated through thorough assessment, clear and structured treatment planning, and well‑documented contemporaneous records of discussions and decision‑making.

While the financial exposure arising from periodontal disease claims can be significant, early notification to insurers plays a critical role in effective claims management. Prompt engagement allows for timely advice, early evidential review, and a more proactive approach to limiting both liability and overall claims costs.

If you have any questions or would like advice on dental negligence matters, please contact Louise Jackson, Keoghs partner and England and Wales regional lead for healthcare and sport, or Sabrina Mahmood, Keoghs senior associate and dental claims specialist in healthcare and sport.

For robust dental indemnity cover, contact Densura.

References

1. https://www.bsperio.org.uk/assets/downloads/Patient_Information_Leaflet.pdf
2. https://www.bsperio.org.uk/assets/downloads/BSP_BPE_Guidelines_2019.pdf

This article is sponsored by Densura.

DeNovo Dental Partners explains why its innovative partnership model is the best option for those who want to retain a sense of individuality when considering selling their practice.

In many areas of life, individuality is celebrated. People are encouraged to be themselves, while businesses are recognised for doing things differently, challenging convention and building something distinctive.

Keep what makes you, you

DeNovo Dental Partners believes dentistry should be no different. Practice principals should have the freedom to shape their businesses in ways that reflect their values, strengths and ambitions – building distinctive practices they are proud to lead. Individuality should be celebrated and actively encouraged, not standardised away.

DeNovo also believes that a practice’s identity should endure beyond a change in ownership. The success of your business is built on the legacy, relationships and reputation you have created over many years, and those qualities deserve to be protected as your practice enters its next chapter.

This belief is one of the reasons DeNovo created a different approach to practice ownership. It actively seeks out practices with strong identities and principals looking for a more collaborative, forward-thinking path for the next stage of their career.

The shared ownership model is designed to protect practice autonomy, enabling partners to retain control over day-to-day operations, their team, patient experience, community relationships and the future direction of the business. Rather than changing what made a practice successful, the team helps build on those foundations and support future growth.

Partners also have access to central support services, which are flexible and provided on your terms. You decide where support adds value, when you need it and how involved you want DeNovo to be.

You remain in control – DeNovo simply provides additional expertise, infrastructure and support to help you move the business forward.

Financial differentiators

The approach is different financially, too.

Traditional practice sales can often leave principals feeling disconnected from the future value of the business they spent years building. Complex structures, restrictive terms and uncertain future payments do not always reflect the contribution, commitment and legacy behind a successful practice.

DeNovo was designed to offer a different path.

The shared ownership model is built around alignment, long-term value creation and mutual benefit for both individual partners and the wider organisation. DeNovo pays full practice value upfront, with the majority delivered in cash and the remainder through equity in the parent company – enabling partners to continue participating in future group growth.

Importantly, tje model is designed to create opportunities beyond the initial transaction. Partners can benefit from ongoing value creation linked to practice and group performance, reflecting our continued investment in growth, innovation and the long-term success of the portfolio.

Delivering on promises

DeNovo is proud that its vision for a different kind of dental partnership model has already resonated with so many principals across the UK. A growing number of practices have joined the DeNovo community, embracing an approach centred around autonomy, shared ownership and long-term value creation.

For many partners, joining DeNovo is not about stepping away from the practice they have built, but about gaining the support, expertise and community needed to help take it further while protecting everything that made it successful in the first place.

Here’s what Dr Stephen Pitt from The Dental Studio had to say about his experience:

‘With DeNovo, it wasn’t about handing the practice off to a new owner, but rather introducing an extra pair of hands to help steer the practice on the next stage of its journey. I also appreciated that DeNovo sought practices with unique quirks and individuality. They embraced the things that we did a little differently. For example, I love teaching, and while other potential buyers were sceptical about the income this would continue to generate – despite its 10 years of success – DeNovo had a far more positive approach. They were honest, friendly, and transparent at every turn. From the moment I made the decision, the transaction moved rapidly and completed in just two to three months.

‘DeNovo is perfect for anyone who wants to continue working clinically for several years, but seeks expertise and support to unlock further practice growth. If you love the practice that you have built and wish to remain a part of its journey for a bit longer, DeNovo could be the answer you’re looking for.’

Find out more about how you could protect your practice’s individuality with DeNovo – arrange a confidential, no-obligation chat today!

This article is sponsored by DeNovo Dental Partners.

Do your toes cross or hurt with every step?

A bunion may start as a small bump near your big toe. Over time, it can make shoes harder to wear, walking less comfortable, and daily movement more frustrating.

If you're dealing with bunions, understanding your treatment options is the first step toward finding relief.

To help answer some of the most common questions about bunions, OrthoUnited foot and ankle specialist Dr. Daniel Charlick shares his insights on what causes them, when they become a problem, and the treatment options available.

What Is a Bunion?

A bunion forms when the bones around the big toe joint gradually shift out of alignment. As the big toe begins to lean toward the second toe, a bony prominence develops along the inside of the foot.

Many people assume a bunion is simply extra bone growth. In reality, a bunion is a structural change in the alignment of the foot and toe joint.

The bump is only part of the problem. Bunions can also cause:

• Pain near the big toe joint
• Redness or swelling around the bump
• Pressure and irritation from shoes
• Trouble walking comfortably
• Corns or calluses where toes rub together
• Stiffness in the big toe
• Changes in how your foot bears weight

Many patients notice symptoms improve when barefoot or wearing open-toed shoes and worsen when wearing tighter footwear.

Bunions often develop slowly over time. Some people notice mild pressure at first, while others experience soreness, burning, or pain after standing or walking for long periods.

Why Are Bunions More Common in Women?

Footwear plays a significant role in bunion development and symptoms.

According to Dr. Charlick, narrow toe boxes, pointed shoes, and high heels can increase pressure on the front of the foot and contribute to bunion progression. Research has also shown that many women regularly wear shoes that are too small for their feet, which may increase the risk of foot pain and deformity over time.

Family history, foot structure, arthritis, and how the foot functions can also contribute to bunion formation.

Why People Put Off Bunion Care

"Many patients with bunions assume the problem is painful and difficult to fix. But, there are often several options to treat these deformities, and even when surgery is the answer, it has come a long way from your Mother's bunion surgery."  —Dr. Daniel Charlick

Many patients try to manage bunions on their own before seeing a specialist. However, bunions can gradually worsen. As pain increases, people often change the way they walk without realizing it.

You may begin shifting weight to the outside of your foot, avoiding certain activities, or limiting how much you walk. Over time, this compensation can lead to discomfort in other areas, including the smaller toes, arch, ankle, knee, or hip.

You do not need to wait until your pain becomes severe. A visit with one of our foot and ankle specialists can help determine whether your bunion is mild, moderate, or more advanced.

How We Diagnose Bunions

A bunion evaluation typically begins with a conversation about your symptoms, activity level, footwear, and medical history.

Dr. Charlick will examine your foot to better understand how it functions and where it is painful. X-rays are used to evaluate the alignment of the bones, measure the severity of the deformity, and determine whether arthritis or other joint problems are present.

This information helps guide treatment recommendations and determine whether non-surgical care or surgery is the best option.

Non-Surgical Treatment Options

"Bunions that do not hurt do not require surgery, and the initial treatment for painful bunions is often non-operative."  —Dr. Daniel Charlick

Many bunions can be managed without surgery, especially when symptoms are mild or intermittent. While conservative treatment will not straighten the bunion, it can often reduce discomfort and improve daily function.

Non-surgical options may include:

• Shoes with a wider toe box
• Padding to reduce pressure and rubbing
• Custom or over-the-counter orthotics
• Ice to reduce swelling after activity
• Anti-inflammatory medications when appropriate
• Activity modifications during flare-ups
• Toe spacers or splints for comfort in select cases

If pain improves and you are able to remain active and comfortable, surgery may not be necessary.

Choosing Better Shoes for Foot Health

One of the simplest ways to reduce bunion pain is to choose footwear that fits properly.

Dr. Charlick recommends:

• Having your feet measured when purchasing new shoes
• Trying on shoes later in the day when feet are naturally more swollen
• Trying on both shoes before making a purchase
• Choosing shoes with a wide toe box
• Selecting lower heels whenever possible
• Leaving adequate room between the longest toe and the end of the shoe
• Making sure your toes can move freely

Comfort is often a better guide than the size printed on the shoe. If a shoe feels tight when you try it on, it is unlikely to become significantly more comfortable with wear.

When Surgery May Be Necessary

Bunion surgery may be considered when pain continues despite conservative treatment or when the bunion begins interfering with daily activities.

Surgery is typically recommended because of pain and loss of function, not simply because of appearance.

Many patients are surprised to learn that bunion surgery involves more than removing the visible bump. In many cases, the procedure requires realigning the bones and correcting instability within the joint to address the underlying cause of the deformity.

Because every bunion is different, there is no single procedure that works for every patient. Dr. Charlick carefully evaluates the structure of the foot, severity of the deformity, and patient goals before recommending a surgical approach.

What About Lapiplasty^®?

Dr. Charlick is also trained in the Lapiplasty^®? procedure.

Lapiplasty is a surgical technique designed to correct the bunion in three dimensions by addressing the underlying instability that contributes to the deformity. Rather than focusing solely on the visible bump, the procedure aims to restore alignment at the source of the problem.

Like all bunion procedures, Lapiplasty is not the right choice for every patient. A thorough evaluation and imaging help determine whether it is an appropriate option.

What Recovery Looks Like After Bunion Surgery

Recovery varies depending on the procedure performed, though many modern bunion surgeries allow patients to bear weight immediately in a specialized surgical shoe or after a short time using a walking boot.

Patients should understand that swelling often lasts longer than expected. Some swelling may persist for several months after surgery as the foot continues to heal.

Additional recovery considerations may include:

• Wearing a surgical shoe or boot during early healing
• Gradually returning to normal activities
• Waiting several months before returning to certain dress shoes
• Temporary or mild long-term stiffness in the big toe joint

Following post-operative instructions and footwear recommendations can help support the correction and reduce the risk of future problems.

Dealing With Bunions? Schedule an Appointment With Dr. Charlick

A bunion does not always mean surgery. It also does not have to be something you continue to ignore.

If your foot hurts, your shoes no longer fit comfortably, or walking has become more difficult, Dr. Charlick can help you understand what's causing your symptoms and what treatment options may be right for you.

With specialized training in foot and ankle care, Dr. Charlick takes a practical, individualized approach to bunion treatment. Together, you can determine the best path forward to help keep you moving comfortably.

Schedule an appointment online or contact your nearest OrthoUnited campus to learn more about your treatment options.

The post Bunions: Causes, Symptoms, and Treatment Options with Dr. Charlick appeared first on OrthoUnited.

Every second, cells throughout the body are sending signals that help regulate hunger, energy use, and blood sugar. Understanding those hidden conversations has become the life’s work of Katrin Svensson, PhD, whose research is opening new doors in the fight against obesity and diabetes.

The Endocrine Society recognized Svensson as one of its 2026 Laureates, honoring her with the Richard E. Weitzman Outstanding Early-Career Investigator Award. The annual award recognizes an exceptionally promising young clinical or basic investigator whose work is poised to make a lasting impact on the field.

Svensson is an associate professor in the Department of Pathology at Stanford University, as well as the Metabolic Core Director and Affinity Group Leader at the Stanford Diabetes Research Center. She earned both her MS and PhD from Sweden’s Lund University and completed her postdoctoral training at Harvard Medical School, before joining the Stanford faculty in 2018.

Her research focuses on how cells communicate to maintain metabolic homeostasis. Svensson’s laboratory discovered Isthmin-1, a secreted protein that regulates glucose uptake and lipid metabolism independently of insulin, as well as the non-incretin anti-obesity BRINP2-related peptide (BRP). Her group has also developed computational methods to predict new peptides and ligand-receptor pairs, advancing the discovery of novel endocrine pathways. She has two patents licensed to Merrifield Therapeutics, a biotech startup company she co-founded that focuses on translating biological endocrinology discoveries into therapeutic targets for obesity and diabetes.

Svensson recently spoke with Endocrine News about the promise of intercellular communication research and what continues to drive her scientific curiosity.

Endocrine News: What did hearing the news of winning the Early Investigator Award mean to you?

Svensson: It’s really a tremendous honor because I’ve been working with the Endocrine Society for a long time and this award really recognizes the overall body of work rather than a single study. Since I started at Stanford, much of my work has focused on identifying endocrine signaling systems that were not previously identified, which requires pursuing biology that is poorly understood. It’s hard to get funding and it’s hard to get traction for this kind of work because of that. So, receiving this award is quite meaningful for me because it reflects the efforts of many trainees and collaborators, and it’s encouraging to see that the field really values curiosity-driven discovery and fundamental mechanistic science.

EN: Your research program is built around understanding how cells communicate with one another. What first sparked your fascination with the intercellular communication and metabolism?

Svensson: I have been studying cell communication in a tumor microenvironment since I started my PhD in 2007. So, I looked at angiogenesis and how cells are communicating within a tumor. That led me to be more interested in how these molecules are regulated physiologically within the body. Different organs are communicating with each other all the time and while much is known about the classic hormones, biology is full of secreted peptides, signaling molecules, and metabolites, where we know extremely little about their functions.

When I moved to my postdoc in 2013 at Harvard with Bruce Spiegelman, PhD, I was interested in understanding how these peptides and hormones regulate physiology across the entire body. So, I became interested in the idea that there are “hidden” endocrine systems that can regulate metabolism and feed inter-organ communication. Finding these pathways could fundamentally change how we think about disease and therapy and physiology in general.

EN: Looking back on your career so far, who has been the biggest influence on you as a scientist and a leader?

Svensson: I’ve been very supported by many, many people in my field as an early-career scientist, but I would say the biggest influence has been Bruce Spiegelman, my mentor as a postdoctoral fellow at Harvard. He really inspired me in thinking about novel biology and discovering something new. That is what I learned in his lab and that’s what I’ve continued to build on since then. I don’t think I could have done it if I hadn’t been in his lab.

EN: Now that you’ve received this Early Career Investigator Award, what do you think is the biggest scientific question that you’re hoping to answer in the next 10 years?

Svensson: I think that there’s a lot still to be discovered in endocrine signaling pathways. There are many peptides, not just the ones that we have identified. But the field, in general, has recognized peptide therapeutics with the GLPs and the different variants that are coming along now. It is now generally understood that peptides are useful for regulating many different types of physiological functions.

“You can organize, not just practically, but in your thinking. What is the most interesting and critical biological question? What are the critical experiments to answer those questions? Is this really what you need to do, or are you just doing it because you can? If you’re organized in your thinking, everything else will follow.” – Katrin Svensson, PhD, associate professor, Department of Pathology, Stanford University; Metabolic Core Director and Affinity Group Leader, Stanford Diabetes Research Center, Stanford, Calif.

We are really on a good path to understanding how they are physiologically regulated and how we can try to use them therapeutically to target various diseases. I think that there are many other types of endocrine system issues where these peptides could prove to be therapeutically useful.

EN: Looking at your lab website, I see you lead a very diverse team of postdocs, graduate students, and undergrads. What keeps you motivated when experiments fail or when progress comes more slowly than expected, and what do you impart to your team about this to keep them motivated as well?

Svensson: I talk with them a lot about this because our projects are so exploratory, and I think it’s important to be excited about discovering something genuinely new and be willing to pursue questions that are not fully validated by the field, and not being too focused on working on safe or already validated problems, although you know it’s going to work out.

People have different interests, so the people who are joining my lab are very aware of this and they know that pursuing this exploratory project can really open new directions. I’ve been very fortunate to work with trainees and collaborators who are very dedicated, and we talk a lot about persistence, which is super important to keep following the path that you believe in without being stubborn.

Sometimes it works differently than you expect. So, follow the data honestly and be willing to adapt when the biology tells you something unexpected, which often happens, and just keep going. You know, there’s a lot of things to be found and if you follow the science, it’s going to be fun! It’s very fun and that is what I’m trying to instill in my trainees.

EN: Is there any advice you give your team that you wish someone had told you when you first started your lab?

Svensson: I’ve been very lucky to work with great trainees, and I would say there are pretty much two things. First, find people who are interested in the science and are dedicated and want to do this. You don’t need to have a huge lab, necessarily, in the beginning. You need a few trainees who are really dedicated in trying to solve the problems.

“Receiving this award is quite meaningful for me because it reflects the efforts of many trainees and collaborators, and it’s encouraging to see that the field really values curiosity-driven discovery and fundamental mechanistic science.” – Katrin Svensson, PhD, associate professor, Department of Pathology, Stanford University; Metabolic Core Director and Affinity Group Leader, Stanford Diabetes Research Center, Stanford, Calif.

The second thing, I think, is very boring, but it’s being organized. I think all these other things about what you need to do in your career and publishing and getting grants, all these things will follow if you have good ideas. You can design great experiments and then being organized is really the key to pretty much everything. We talk about this in the lab. You can organize, not just practically, but in your thinking. What is the most interesting and critical biological question? What are the critical experiments to answer those questions? Is this really what you need to do, or are you just doing it because you can? If you’re organized in your thinking, everything else will follow.

—Shaw is a freelance writer based in Carmel, Ind. She is a regular contributor to Endocrine News and writes the monthly Laboratory Notes column.

The post Endocrine Pathway Trailblazer: Q&A with Katrin Svensson, PhD appeared first on Endocrine News.

The healthcare industry has become increasingly competitive. Patients today have more choices than ever before, and their expectations continue to evolve. Whether you are a primary care practice, specialty clinic, surgical group, or independent physician practice, relying solely on referrals is no longer enough to sustain growth.

Successful medical practices understand that marketing is not simply advertising, it is about building trust, enhancing patient experiences, and creating a strong presence in the communities they serve. At our consulting firm, we work with practices across the country to develop strategic marketing plans that increase patient volume, strengthen brand recognition, and improve long-term profitability.

Here are the most effective ways medical practices can market themselves in today’s competitive environment.

1. Build a Strong Online Presence

For many prospective patients, your website serves as their first impression of your practice. A modern, professional website should clearly communicate who you are, what services you provide, and why patients should choose your practice.

An effective medical practice website should include:

• Mobile-friendly design
• Easy online appointment scheduling
• Provider biographies
• Patient testimonials
• Service descriptions
• Contact information and directions
• Search engine optimization (SEO)

A website that loads slowly, looks outdated, or lacks important information can drive potential patients directly to a competitor.

2. Invest in Search Engine Optimization (SEO)

Search engine optimization remains one of the most cost-effective medical practice marketing strategies available. When patients search for terms such as “dermatologist near me,” “primary care physician,” or “orthopedic surgeon,” your practice should appear prominently in search results.

Medical practice SEO focuses on:

• Optimizing website content
• Improving local search rankings
• Creating service-specific pages
• Managing online reviews
• Developing educational blog content
• Maintaining accurate business listings

The goal is simple: make it easier for patients to find your practice when they need care.

Practices that consistently invest in SEO often experience sustained growth because they attract patients who are actively searching for healthcare services.

3. Manage Your Online Reputation

Online reviews significantly influence patient decisions. Studies consistently show that patients trust online reviews almost as much as personal recommendations.

Medical practices should actively monitor platforms such as:

• Google Business Profile
• Healthgrades
• Vitals
• Facebook
• Yelp

Encourage satisfied patients to leave reviews while ensuring all efforts comply with HIPAA and applicable regulations.

Responding professionally to reviews demonstrates that your practice values patient feedback and is committed to providing excellent care.

A strong online reputation can become one of your most valuable marketing assets.

4. Leverage Social Media Strategically

Many healthcare providers underestimate the impact social media can have on patient engagement and brand awareness.

The most successful practices use platforms such as Facebook, Instagram, LinkedIn, and YouTube to:

• Share educational content
• Highlight providers and staff
• Promote community involvement
• Announce new services
• Showcase patient success stories (with proper consent)
• Provide healthcare tips

The key is consistency. Posting valuable content regularly helps establish your providers as trusted experts within their specialties.

Patients are more likely to choose a provider they recognize and trust before they ever schedule an appointment.

5. Create Valuable Educational Content

Content marketing has become one of the most effective ways to attract new patients.

Educational content helps answer common patient questions while improving search engine rankings. Examples include:

• Blog articles
• Videos
• FAQs
• Downloadable guides
• Webinars
• Infographics

For example, a dermatology practice might publish articles about skin cancer prevention, acne treatment options, or Mohs surgery. An internal medicine practice could create content about diabetes management, hypertension, or preventive care.

High-quality educational content positions your providers as experts while helping prospective patients feel more comfortable choosing your practice.

6. Strengthen Referral Relationships

While digital marketing is essential, physician referrals remain a critical source of patient volume for many medical practices.

Practices should actively cultivate relationships with:

• Referring physicians
• Urgent care centers
• Hospitals
• Physical therapists
• Community healthcare providers

Regular communication, educational events, provider meet-and-greets, and timely referral reporting can help strengthen these relationships.

Many practices lose referral opportunities simply because they fail to maintain ongoing communication with their referral sources.

7. Focus on Patient Experience

One of the most powerful marketing tools is delivering exceptional patient experience.

Patients who have positive experiences are more likely to:

• Return for future care
• Refer friends and family
• Leave positive online reviews
• Become long-term advocates for your practice

Evaluate every touchpoint in the patient journey, including:

• Phone interactions
• Appointment scheduling
• Wait times
• Clinical encounters
• Billing processes
• Follow-up communication

Marketing can attract patients, but a superior patient experience helps retain them.

8. Utilize Targeted Digital Advertising

Digital advertising allows medical practices to reach highly targeted patient populations.

Effective advertising channels include:

• Google Ads
• Facebook Ads
• Instagram Ads
• YouTube Advertising
• Retargeting Campaigns

Targeted advertising can be particularly effective when promoting:

• New providers
• New locations
• Specialty services
• Seasonal healthcare needs
• Elective procedures

A properly managed advertising campaign can generate measurable patient acquisition while providing valuable insights into marketing performance.

9. Engage with Your Local Community

Healthcare remains a relationship-driven industry. Community involvement can significantly strengthen brand awareness and trust.

Consider participating in:

• Health fairs
• Community events
• School programs
• Charity initiatives
• Employer wellness programs
• Educational seminars

These activities position your practice as a trusted healthcare resource and create opportunities to connect directly with potential patients.

Community engagement often generates goodwill that translates into patient growth over time.

10. Measure Results and Adjust Your Strategy

One of the biggest mistakes medical practices make is investing in marketing without tracking performance.

Successful practices monitor key metrics such as:

• New patient volume
• Website traffic
• Conversion rates
• Referral sources
• Cost per acquisition
• Online review growth
• Advertising ROI

Data-driven decision-making allows practices to allocate resources effectively and maximize marketing results.

Healthcare marketing should be viewed as an ongoing process rather than a one-time initiative.

Final Thoughts

Marketing a medical practice in today’s competitive environment requires a combination of digital strategy, reputation management, patient engagement, and community involvement. Practices that proactively invest in marketing are often better positioned to attract new patients, retain existing ones, and achieve sustainable growth.

At our consulting firm, we frequently find that the most successful organizations are not necessarily the largest; they are the ones that consistently communicate their value, deliver exceptional patient experiences, and adapt to changing patient expectations.

A well-executed marketing strategy can help your practice stand out in a crowded marketplace and create a foundation for long-term success.

Contact Us

The post How to Market Your Medical Practice in a Competitive Industry appeared first on DoctorsManagement.

DoctorsManagement’s Consultants specialize in Medical Practice Management and can offer a myriad of solutions to effectively and efficiently manage administrative and operational tasks by performing a practice assessment, however, this article would like to focus specifically on the area of credentialing.

Credentialing inefficiencies can cause thousands of dollars in lost revenue per physician. It is estimated that inefficient credentialing costs the healthcare industry over $2 billion annually, with delays causing approximately $9,000 in lost revenue per provider, per day. A 3-month delay in credentialing a new physician can result in over $100,000 of lost revenue. A single provider missing 12 weeks of patient visits can cost a practice, while specialists or surgeons may lose over a 120-day delay. Those losses add up quickly.

Common Results of Credentialing Inefficiencies

• Revenue loss due to services that cannot be billed
• Higher claim denial rates
• Cash flow disruption
• Costs of administrative rework

Common Reasons for Credentialing Inefficiency

Manual Processes

While we recognize that most credentialing software systems may not be in the budget for many small practices and have limitations, there may be other ways available to streamline the process. Something as simple as using MS Forms and MS 365 Agents to help collect and organize credentialing onboarding information can assist in reducing data entry error mistakes as well as improving data collection times.

Fragmented Systems or Processes

Many health systems rely on four or more systems to manage provider onboarding workflows, leading to duplicative effort, lost time, and limited visibility (Kaufman Hall).

Having multiple systems in place in a small practice is probably not typical, however, it is still important that credentialing processes be streamlined and consolidated. Creating a list of standard credentialing onboarding processes and procedures can improve workflows and reduce duplicative efforts.

Some top suggestions to get started would be:

• Use a standardized onboarding application for every provider
• Standardize onboarding task tracking and management
• Create a standardized filing system for storage of credentialing onboarding information, documentation, applications, contracts and correspondence
• Create a standardized follow up schedule for status updates

Payor Complexity

Requirements differ for each payor and a lack of knowledge regarding each payor’s unique requirements and timelines can lead to delays and application rejection. Evolving requirements and processes from payors often slow down the process. In an effort to stay abreast of technological advances and reducing credentialing administrative burdens often caused by staffing shortages, healthcare payors often update their credentialing processes and it is important for credentialing experts to stay abreast of various payor updates.

Provider Credentialing and Enrollment is an ever-changing process that challenges even the best credentialing teams. Medical credentialing services can institute organization, accountability and knowledge to a complex process. Outsourcing credentialing services to an organization with the tools, skills and knowledge to complete the credentialing process correctly can reduce the burden placed on the practice caused by inefficient practices. DoctorsManagement’s credentialing staff have extensive knowledge, experience and tools to successfully complete the credentialing process. If your organization needs assistance with credentialing and onboarding, whether it be with new practice startups, existing practices adding new providers, or credentialing maintenance, DoctorsManagement is here to assist.

Contact Us

The post Is Credentialing Software the Right Fit For Your Practice? appeared first on DoctorsManagement.

Periodontitis remains a major global health challenge, says Varkha Rattu, but better outcomes depend on consensus in diagnosis, collaboration around referral and clear communication with patients.

Periodontitis is the sixth most prevalent health condition globally. According to the Global Burden of Disease study (2017), severe periodontitis affects approximately 11% of the world’s population – around 743 million people – while milder forms affect more than half of all adults (The Economist Intelligence Unit, 2021). The global prevalence of severe periodontitis exceeds that of cardiovascular disease (7%), making it a public health challenge that demands serious clinical attention.

Bridging the gap between evidence and practice requires three things: Consensus on how we diagnose and classify disease; Collaboration in recognising when cases need specialist input; and Co-operation in communicating effectively with patients and colleagues.

Part one: consensus

Diagnosing and classifying periodontitis

In periodontology, consensus takes the form of internationally agreed classification systems and clinical practice guidelines – the foundation of good clinical decision-making.

Diagnosis is underpinned by criteria established by the European Federation of Periodontology (EFP, 2019).

Once confirmed, staging and grading characterises severity, complexity, and rate of progression. The 2017 World Workshop Classification (WWC) introduced complexity factors that shift a case to a higher stage (Papapanou et al, 2019). For example, furcation involvement Class II or III, probing depths ≥6 mm, and vertical bone loss ≥3 mm escalate from Stage II to Stage III.

These complexity factors are especially useful because they identify which clinical features are most likely to make treatment more demanding, and therefore more likely to warrant specialist input.

Part two: collaboration

Complexity factors as a framework for referral

From clinical experience, the following complexity factors should prompt serious consideration of referral following initial non-surgical periodontal therapy (NSPT):

1. Residual probing depths ≥6 mm

Subgingival instrumentation is the cornerstone of active periodontal treatment. Where residual pockets of ≥6 mm persist following NSPT, this signals the need for more advanced intervention. The EFP S3 guideline confirmed that hand and powered instruments can be utilised effectively, and adjunctive measures such as systemic antibiotics may be considered in specific categories such as generalised Stage III/IV periodontitis in younger adults (Sanz et al, 2020).

2. Vertical/Infrabony Defects ≥3 mm

Angular bony defects carry significant prognostic weight. Papapanou and Wennström (1991) found that deep intrabony defects were associated with 68% tooth loss at 10 years, compared with 13% for horizontal bone loss (Papapanou, 1991). The EFP S3 guideline gives a strong recommendation for periodontal regenerative surgery at residual deep pockets with intrabony defects ≥3 mm, supported by 22 RCTs in 1,182 teeth (Sanz et al, 2020). Techniques include barrier membranes and enamel matrix derivative, with papilla preservation flaps strongly recommended.

3. Furcation Involvement Class II and III

Furcation involvement is not, in itself, a reason for extraction (Sanz et al, 2020). For mandibular Class II furcation, regenerative surgery carries a strong recommendation supported by 17 RCTs in 493 patients. For maxillary buccal Class II, regeneration is suggested. While for Class III presentations, tunnelling, root separation, or root resection may be considered.

4. Complex rehabilitation requirements (masticatory dysfunction, secondary occlusal trauma, severe ridge defects, bite collapse, drifting or flaring, fewer than 20 remaining teeth)

Secondary occlusal trauma – occlusal overload in the context of reduced periodontal support – is a Stage IV complexity factor. Temporary splinting and/or selective occlusal adjustment may be considered throughout therapy (Sanz et al, 2020), and cases of Grade 2 mobility with fremitus can be successfully stabilised through targeted occlusal adjustment, avoiding extraction.

Ridge defects (Siebert Class I–III) represent a further indication for specialist involvement, particularly where implant rehabilitation is planned. Horizontal augmentation options include GBR, ridge splitting, and onlay grafts (Naenni et al, 2019). Vertical augmentation encompasses GBR, distraction osteogenesis, onlay block grafts, and sinus floor augmentation (Urban et al, 2019).

Part three: co-operation

The final pillar concerns communication: with patients and with colleagues. Evidence-based care is only effective if patients understand and accept the pathway offered.

When explaining the need for referral, language matters, and helping patients understand the systemic dimension is equally valuable. Periodontitis is an immune-inflammatory condition – the body’s response to persistent bacterial challenge. The inflammatory mediators generated in the periodontium can travel systemically, with established associations between periodontitis and diabetes, cardiovascular disease, rheumatoid arthritis, and Alzheimer’s disease. Framing the mouth as the gateway to the body – and periodontal treatment as an investment in overall health – can meaningfully shift patient engagement.

Taking these factors into consideration, managing periodontitis effectively demands:

• Consensus: applying internationally agreed diagnostic criteria and classification systems rigorously in every patient encounter
• Collaboration: recognising the complexity factors most likely to warrant referral, and acting on them decisively
• Co-operation: communicating openly with patients, framing advanced care as an investment in their long-term health.

Periodontitis remains a disease of significant global public health impact. With the right clinical framework, dental professionals at every level are better placed to improve outcomes for this patient group.

References

1. The Economist Intelligence Unit. Time to take gum disease seriously: The societal and economic impact of periodontitis. Report commissioned by the European Federation of Periodontology, 2021.

2. Guidance for clinicians: Periodontitis: clinical decision tree for staging and grading, European Federation of Periodontology (2019).

3. Papapanou, P. N., Sanz, M., Buduneli, N., et al. (2018). Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of clinical periodontology, 45 Suppl 20, S162–S170. https://doi.org/10.1111/jcpe.12946

4. Sanz, M., Herrera, D., Kebschull, M., Chapple, I., Jepsen, S., Berglundh, T., Sculean, A., Tonetti, M. S., & EFP Workshop Participants and Methodological Consultants (2020). Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline. Journal of clinical periodontology, 47 Suppl 22(Suppl 22), 4–60. https://doi.org/10.1111/jcpe.13290

5. Papapanou PN, Wennström JL. The angular bony defect as indicator of further alveolar bone loss. J Clin Periodontol. 1991 May;18(5):317-22. doi: 10.1111/j.1600-051x.1991.tb00435.x. PMID: 2066446.

6. Naenni, N., Lim, H. C., Papageorgiou, S. N., & Hämmerle, C. H. F. (2019). Efficacy of lateral bone augmentation prior to implant placement: A systematic review and meta-analysis. Journal of clinical periodontology, 46 Suppl 21, 287–306. https://doi.org/10.1111/jcpe.13052

7. Urban, I. A., Montero, E., Monje, A., & Sanz-Sánchez, I. (2019). Effectiveness of vertical ridge augmentation interventions: A systematic review and meta-analysis. Journal of clinical periodontology, 46 Suppl 21, 319–339. https://doi.org/10.1111/jcpe.13061

This article is sponsored by NSK.

• Why sometimes resting isn’t an effective injury prevention strategy
• The science behind substitutions in football
• The mysterious green whistle at the World Cup

Why sometimes resting isn’t an effective injury prevention strategy

A recent study on load management has revealed some fascinating insights. It investigated whether NBA players who missed games for rest or load management were less prone to injuries later in the season. The study utilised nine seasons of audited NBA medical records—from 2014–15 to 2022–23—covering 1,233 player-seasons and over 1.5 million player-minutes.

On a positive note, the data showed that the number of games missed for rest and load management had surged by 125% over the nine years. This trend reflects a significant shift among medical and support staff, indicating they are more informed and proactive about managing player workloads, feeling empowered to rest players in favour of prioritising their welfare.

However, the study found that despite the increase in games missed, injury rates did not drop. One of the most compelling discussions in the paper revolves around the concept of the workload–injury paradox. The authors suggest that while rest can reduce fatigue, it might also reduce the chronic exposure needed for athletes to build resilience. In essence, while too much load can increase injury risk, too little load may reduce physical preparedness. Therefore, resting alone isn’t an effective injury prevention strategy.

If you would like to learn more about load management, you should definitely check out our relevant blogs:

• How load management can help reduce injury risk in youth athletes
• Training load monitoring: How coaches can effectively monitor multiple variables
• 4 Ways to Monitor an Athlete’s Load on a Budget
• A multi-dimensional approach to training load and performance monitoring
• Is there a relationship between workload, the athlete’s state of recovery, and injury?

The science behind substitutions in football

While many of us are likely absorbed in the ongoing FIFA World Cup, a recently published study has shed light on an important aspect of the game. Researchers examined over 250 substitutions made in top division male professional football matches.

Their findings revealed that substitute players covered up to 75% more relative distance and exerted 90% more relative high-intensity efforts than those who played the full match or were replaced. Additionally, substitutes were 3 to 4 times more likely to improve the match score than to worsen it.

This research clearly indicates that substitutions are playing an increasingly crucial role in elite football, demonstrating that they are essential for sustaining or enhancing physical performance throughout the course of a match.

The mysterious green whistle at the World Cup

In an earlier World Cup match between Canada and Qatar, Canadian midfielder Ismaël Koné caught the spotlight when he was stretchered off the field with a broken leg while inhaling from a small green tube that resembled a whistle. This incident sparked widespread speculation on social media about the nature of the device.

The device in question is called Penthrox, a handheld inhaler designed for quick pain relief. It contains methoxyflurane, a non-opioid pain reliever that works swiftly. One of the key advantages of Penthrox is that it provides immediate pain relief while keeping the athlete awake and alert. However, it’s crucial to note that the device should only be used for short-term relief under medical supervision due to potential side effects, including drowsiness, dizziness, and nausea.

If you would like to learn more about pain management, check out our excellent course, The Science of Pain Management.

From us this week:

>> New course: Female Physiology
>> New podcast: Creatine’s Next Chapter with Steve Jennings
>> New infographic: Wingate Anaerobic Test
>> New article: Hydrotherapy

Access to a growing library of sports science courses

SFS Academy is an all-access membership to premium sports science education.

With SFS Academy, you’ll learn from some of the best coaches around the world as they teach you how to apply the latest research and practice with your athletes.

The post Is Resting An Effective Injury Prevention Strategy? appeared first on Science for Sport.

Join Mark Topley and Gagan Kumar on 8 July at 7pm as they discuss how to step back with confidence for a practice that runs without you.

This webinar will show practice owners and principals what it actually takes to build a practice that doesn’t depend on them sitting in the middle of every decision, standard and patient conversation. The session covers two halves of the same picture: the team structure that gets people taking real responsibility, and the mindset, communication and revenue thinking that lets the principal step out of the middle without the numbers slipping. The aim is to give attendees a clear, honest read of where their own practice sits today, and a sensible first step if they want to change it.

Learning outcomes

• Understand why most ‘team problems’ are really clarity, structure or confidence problems – and what to do about each
• Learn the three things that turn a busy practice into one that runs without the principal in the middle: purpose, clarity and rhythm
• Discover where revenue quietly leaks when the principal is the only person who can hold a high-stakes patient conversation
• Build communication, conversion and ownership across the whole team, so the numbers aren’t carried on one set of shoulders
• Consider what the shift from doing to leading actually asks of the principal – and how to make it stick.

The speakers

Mark Topley

Mark Topley is a leadership and team performance consultant who works with dental practice owners and their teams on the structures that get people taking responsibility, delivering to a consistent standard, and being a pleasure to work with. He has more than 25 years in the dental industry, has been a judge for the Private Dentistry Awards for over a decade, and speaks regularly for organisations including Portman Dentex, the BDIA, the BDA, the Dentistry Show and FDI World Dental. He writes and consults under the brand Exceptional Team Performance.

Gagan Kumar

Gagan Kumar is an international business coach and the founder of Limitless Coach, where he works with principal dentists, aesthetic clinics and other service-based businesses on the shift from operator to leader. He has more than 20 years of experience advising established businesses across healthcare, hospitality and education, and built his own companies from the ground up before moving into coaching. His work combines practical strategy, operations and ethical sales with the mindset and identity work that makes those changes stick – helping clients build the kind of revenue, freedom and leadership that doesn’t depend on them being in the middle of everything.

Catch up on previous on-demand webinars:

• ‘I need an implant mentor!’ Everything you need to know
• Your waiting list isn’t the problem. Your triage is
• Finishing your orthodontic cases: essential tips for anterior composites
• Advancing vital pulp therapy: clinical applications and predictable outcomes using MTA vpt
• From enquiry to treatment start: the patient journey most practices have never mapped.

You can sign up for the webinar here.

On May 29, the Office of Management and Budget (OMB) proposed sweeping changes to the rules governing all federal grant funding.

If finalized, this rule would fundamentally reshape how biomedical research, including endocrine science, is funded in the U.S. The proposed rule would give political appointees the power to block grant awards that do not align with current administration priorities, allow federal agencies to terminate grants at any time without a formal appeals process, and impose restrictions on publication costs and international collaborations, among other disruptions. Taken together, the proposed rule directly threatens the foundational principles of merit-based science.

The OMB is seeking to implement its proposed changes this year, and the Endocrine Society is opposing the rule, calling for its withdrawal, and urging Congress to intervene.

The proposed rule would give political appointees the power to block grant awards that do not align with current administration priorities, allow federal agencies to terminate grants at any time without a formal appeals process, and impose restrictions on publication costs and international collaborations, among other disruptions.

There are three ways you can make a difference:

• Contact Congress: Your representative and senators need to hear from you about the threat to research posed by the proposed rule. The Endocrine Society has created a new advocacy campaign where you can send a message to your elected representatives urging them to intervene and protect federal research funding. This is the quickest and most effective way to make an impact now.
   
• Submit Comments to Regulations.gov: Comments submitted to regulations.gov will have an impact as part of the public record. Substantive, original, and specific comments carry real weight in the rulemaking process, but it is critical that you personalize your submission. The Endocrine Society has prepared detailed guidance to help you submit a comment before the Monday, July 13 deadline.
   
• Join Our Virtual Hill Day this Summer: We are organizing virtual meetings for our members and their Representative & Senators to give you the opportunity to share how federal research funding has advanced endocrine health and patient care—and what is at stake if this rule is finalized. Training and talking points will be provided. If you are interested in participating, please contact advocacy@endocrine.org.

We have developed comments on behalf of the Society urging the withdrawal of the rule but it is also essential that policymakers hear from you — the scientific and medical professional community.

INSULIN Act Gains Momentum; Society Leads Effort to Urge Senate HELP Committee to Advance the Legislation

Increasing access to affordable insulin is a top policy priority of the Endocrine Society and we continue to urge Congress to pass the INSULIN Act, bipartisan legislation that would cap out-of-pocket costs for insulin at $35 a month for people with private insurance and create a pilot program for the uninsured in 10 states. Although the likelihood for passing the INSULIN Act this year originally was small, our advocacy is helping build momentum for the legislation in the Senate and now there are 28 bipartisan senators supporting the legislation introduced by Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME).

The Society will continue working with the bipartisan co-chairs of the Senate Diabetes Caucus to pass the legislation out of the HELP Committee this summer.

Last week, the Senate Health, Education, Labor, and Pensions (HELP) Committee considered several pieces of health-related legislation. Prior to the markup, the Endocrine Society sent a letter to the HELP Committee urging the committee to consider and pass the INSULIN Act. The Society developed the letter and invited other diabetes advocacy organizations to sign. As a result of increasing interest in insulin affordability, Senator Bernie Sanders (I-VT) introduced an amendment that would have added the INSULIN Act to another bill under consideration. Although the Sanders amendment was approved by the HELP Committee in a bipartisan vote, Senator Bill Cassidy (R-LA), Chairman of the Senate HELP Committee, canceled a final vote on the overall bill, saying he needed more information about the cost of the legislation. Chairman Cassidy indicated that he is open to considering the legislation at a future markup in July.

The Society will continue working with the bipartisan co-chairs of the Senate Diabetes Caucus to pass the legislation out of the HELP Committee this summer. We urge all Endocrine Society members to take action through our online advocacy campaign and ask your Senators to cosponsor and pass the INSULIN Act. 

Medicare Bridge Program To Expand Access to GLP-1 Medications Launches July 1

On July 1, the Centers for Medicare and Medicaid Services (CMS) will launch the Medicare Bridge Program to provide eligible Medicare Part D beneficiaries with access to certain GLP-1 medications for weight loss for a $50 co-pay. To qualify for the program, Medicare beneficiaries must meet certain clinical criteria, and the provider must submit a prior authorization request attesting that the beneficiary has met these criteria. More information about the Bridge Program, including the clinical criteria, information on submitting a prior authorization request, and other FAQs for providers can be found on the CMS website. 

The Endocrine Society has urged Congress and the Administration to expand access to GLP-1 medications for people living with obesity, and we are pleased that CMS is initiating this program. We will continue to provide information as the Bridge Program is implemented in the coming months. We will also share additional educational information about the Bridge Program during our advocacy session to be held at the Clinical Endocrinology Update (CEU) meeting later this year.

The post Advocacy Update: July 2026 appeared first on Endocrine News.

I’m grateful the Endocrine Society provides many different communications channels to generate useful and practical knowledge on every aspect of endocrine science and care. I’d like to highlight some of them.

Endocrine News

The Society’s longstanding magazine has been a pilar of our field, not only for sharing the latest research and best clinical practices, but for highlighting the achievements of our members and featuring our organization’s many products and services. The publication is marking a milestone this summer as it fully transitions to online-only. As the Executive Editor Mark A. Newman notes, the greatest strength of the magazine “is its access to amazing Endocrine Society members.”

EndoForum

This unique communications and networking platform is designed exclusively for our members. In EndoForum, you can find the latest information and alerts on upcoming Society meetings and events, as well as connect with members from around the world. This networking is achieved through several online discussion channels, including the “Discussions” section, where members regularly pose clinical questions to their peers, and the “Groups” section, where our 12 Special Interest Groups (SIGs) gather. By joining a SIG, you can communicate with colleagues who share your same interests and passions.

Endocrine eNews

Delivered to your inbox each week, Endocrine eNews provides a quick-read, executive summary of the Society’s many activities, including awards, webinars, meetings, advocacy, podcasts, and featured research. The newsletter also provides timely reminders about such things as membership renewal deadlines, and store offerings.

Endocrine Briefing

Our unique e-newsletter uses artificial intelligence (AI) to bring you the latest endocrine research and practice headlines in a way that’s personalized for your specific interests. As you click on stories that interest you, the platform uses that data to select related content for future issues tailored specifically for you.

Endocrine Signals

Our Society blog takes a monthly deep dive into the inner workings of the organization. Here you will find stories from Society team members who head up advocacy, education, meetings, publications, clinical practice guidelines, membership, awards, and more.

Society Website

Certainly not to be overlooked is the Society’s website itself. I invite you to visit this site often, where you’ll find the full breadth and depth of our organization’s activities and programs. The homepage and Latest sections offer a quick view of the latest happenings. Our Society Calendar provides a view of Society events, as well as events throughout our field. The Our Community tab provides a pathway to member-oriented content, including more on the SIGs and career development programs. The Advancing Research tab allows scientists to quickly pursue our offerings, including fellowship programs, research grant opportunities, and scientific statements. The Improving Practice tab leads to sections on our Clinical Practice Guidelines, education, and training. And our Advocacy tab features a wealth of information on campaigns, letters, testimony, and position statements. This is just the tip of the iceberg.

But not every communications channel involves words on paper or screen. The Society in recent years has taken major steps to boost its presence in podcasting and video.

Endocrine Feedback Loop Podcast

This monthly journal club podcast is a must-listen for members who want to hear an in-depth discussion on recently published research. Each episode features an expert educator and a topical specialist dissecting recently published journal articles and discussing implications for clinical practice. Recent episodes included topics on infrequent zoledronate in low fracture risk, taste changes with semaglutide, and dosing strategies for remission in Graves’ disease.

Endocrine News Podcast 

Our membership podcast casts a similarly wide net, focusing on the latest research and clinical advances from experts in the field. Recent episodes include discussions on the SABRE Project and its significant impact on osteoporosis clinical trials and addressing the endocrine workforce shortage.

Endocrine Society’s YouTube Channel

This is another excellent communications vehicle for members who prefer to consume visual media. On the YouTube channel, you can hear — and see — our members discuss a wide range of topics, including previews of upcoming meetings and summaries of published research.

Social Media

The Society curates a lively conversation about endocrine topics on major social media platforms. Here you can get the latest information about the organization’s programs, initiatives, and members, and weigh in with your own thoughts. Our platforms are:

• X (formerly Twitter)
• Facebook
• Instagram
• LinkedIn
• BlueSky

Through these channels and more, the Society aims to keep you armed with the latest knowledge that will help you achieve your professional and personal goals. What you’re reading now, in fact, is a perfect example of the Society’s aim to keep you well informed. I look forward to sharing more knowledge in this letter over the coming 12 months.

The post Society Offers Many Ways for Members to Stay Informed and Make Connections appeared first on Endocrine News.

For dentists getting started in implant dentistry, supervised clinical experience can teach what textbooks cannot – Patric Aria Saraby shares his insights.

When I enrolled on my implant master’s programme, I knew there would be a steep learning curve. However, nothing prepares you for placing multiple implants over consecutive days in a busy setting.

Earlier this year, I joined a dental mission in Fortaleza, Brazil, at ICEO, where I had the opportunity to place 20 implants under the supervision of experienced implant surgeons. Although I had spent countless hours studying CBCTs, drilling protocols and prosthetic principles, the clinical experience taught me lessons that textbooks simply cannot.

These are the five lessons that changed the way I think about implant dentistry.

1. Implant placement is far more about soft tissue than drilling bone

Before my first case, I was focused almost entirely on the osteotomy.

• Implant diameter
• Implant length
• Insertion torque
• Primary stability.

What surprised me was how much of the procedure depended on flap management.

A poorly reflected flap immediately reduces visibility, increases tension and makes every subsequent step more difficult. Conversely, a well-designed full-thickness flap with careful tissue handling transforms the surgery.

I quickly realised that experienced implant surgeons often appear ‘fast’ not because they drill quickly, but because they manage soft tissue exceptionally well.

The implant is only one part of the surgery, the flap determines how smoothly everything else proceeds.

2. Bone has a personality

On paper, drilling protocols look identical. In reality, every patient feels completely different.

Some osteotomies almost guide the drill naturally. Others require constant tactile feedback.

The difference between dense cortical bone and softer cancellous bone becomes obvious within seconds.

One of the biggest surprises was learning to trust tactile sensation rather than relying solely on depth markings or drilling sequences.

Primary stability isn’t simply measured by insertion torque, it’s something you begin to feel. That tactile confidence only develops through repeated clinical exposure.

3. Guided surgery cannot replace surgical judgement

Planning software is remarkable. CBCT planning allows accurate implant positioning before the patient even enters the surgery.

However, once the flap is reflected, reality doesn’t always match the virtual plan.

Bone contours vary. Extraction sockets appear different. Soft tissue thickness changes perception.

The surgical guide remains valuable, but it is exactly that – a guide.

Clinical judgement is still essential for deciding whether small adjustments are necessary while maintaining restorative principles.

The digital workflow enhances decision-making; it doesn’t replace it.

4. Grafting is not the difficult part – knowing when to graft is

Before the mission, bone grafting seemed intimidating.

Mixing particulate graft, placing collagen membranes and stabilising the material looked technically demanding.

In practice, the mechanics are relatively straightforward.

The real challenge is recognising when grafting is required and understanding what outcome you’re trying to achieve.

Sometimes the objective is contour preservation. Sometimes it’s filling a dehiscence. While sometimes it’s simply protecting exposed implant threads.

The indication is far more important than the technique itself.

5. Implant dentistry is a team sport

One of the biggest lessons had nothing to do with implants.

Watching experienced surgeons work alongside assistants, nurses and mentors highlighted how much good implant dentistry depends on teamwork.

The assistant anticipates every instrument, the supervisor notices details you have missed, and the nursing team maintains efficiency throughout the procedure.

As the operator, you remain responsible for every decision, but successful implant surgery is rarely an individual achievement.

Learning from clinicians with decades of experience accelerated my own learning far more than practising in isolation ever could.

Final thoughts

Leaving Fortaleza, I realised I hadn’t simply placed 20 implants.

I had learned to respect the complexity of implant surgery.

The experience reinforced that implant dentistry is not about placing fixtures into bone, it is about careful planning, precise execution, biological understanding and continual learning.

Perhaps the biggest lesson was also the simplest.

The more implants I placed, the more I appreciated how much there is still to learn.

That, in my view, is exactly what makes implant dentistry such a rewarding career.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

The Dentistry Top 50 has returned once again – now we need you to nominate the best and brightest in the profession to help us compile the list.

Each year, the Top 50 highlights the individuals making the biggest impact across UK dentistry – from influential leaders and innovators to those driving meaningful change within the profession.

As in previous years, the Dentistry team will curate a list recognising the people who are shaping the dental profession in 2026. More than simply a ranking of influence, the Top 50 is intended to celebrate dedication, progress and the lasting contributions being made across the profession.

As part of this process, we encourage you to nominate anyone you feel deserves recognition. Using the form below, submit their name along with details of how they have made a difference to dentistry and why they should be considered for this year’s list.

This year, Denplan has offered its support to help the Dentistry Top 50 achieve its mission of celebrating dentistry’s brightest stars.

Matthew Nolan, head dental officer at Denplan, said: ‘I’m incredibly proud to support the Dentistry Top 50 because I’ve seen firsthand the passion, dedication and kindness that exists throughout our profession. Every day, dentists and their teams go above and beyond for their patients, support one another, mentor future colleagues and continually strive to improve the standard of care we provide. Taking the time to recognise these individuals is so important, not only to celebrate their achievements but also to inspire others and showcase the very best of dentistry.’

When will the Dentistry Top 50 be announced?

The final Top 50 for 2026 will be revealed in July, with a more interactive online celebration than ever before.

Guy Hiscott, content director at FMC, said: ‘As we relaunch the Top 50 for another year, it feels more important than ever to recognise the breadth, resilience and diversity of talent across UK dentistry.

‘Even as the government begins its long-promised process of NHS contract reform – while navigating its own political and economic turbulence – dentistry refuses to wait passively for salvation. Up and down the country, the profession is busy forging its own path: rethinking access, embracing new technologies, building stronger teams, improving the patient experience and finding more sustainable ways to deliver care.

‘The profession has never had such a range of different perspectives on how to move things forward, and that’s what makes the Top 50 so compelling. It’s not designed to recognise one type of career, one model of success or one narrow definition of influence. Rather, it reflects the profession as it really is: varied, ambitious, inventive and full of people finding different ways to push dentistry forwards.’

The 2025 Top 50 list can be found here.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

The litigation team at Medical Protection Society (MPS) – which Dental Protection is part of – has won the gold award for team of the year (operational excellence) at the 2026 Industry Eagles Awards.

The MPS cases team also won the bronze award for team of the year (innovation and transformation).

The International Industry Eagles Awards honour outstanding achievements and innovation across diverse sectors, including legal services. The specialised Legal Services Eagles Awards specifically celebrate past achievements and future innovations by law firms, legal departments, and technology providers in the legal sector.

The judges recognised the MPS teams for demonstrating outstanding teamwork, dedication, and innovation in achieving their goals, as well as their significant contributions to the success and advancement of MPS and the legal services industry.

Karen Miller, chief executive of Medical Protection Society, said: ‘The focus, determination and expertise of our legal services teams are invaluable in our commitment to defending our members with confidence and protecting them at moments when their professional standing matters most.’

Dr George Wright, dental director at Dental Protection, said: ‘These awards are a great recognition of the exceptional support that Dental Protection members receive. We are proud of how our legal services department has reimagined how they work across the organisation and with members to provide a gold standard service.’

The Industry Eagles Awards were hosted by Andy Hodgson on Thursday, 4 June 2026 at The Bentley Hotel, London. MPS was nominated for team of the year (operational excellence) alongside Sodexo Live! and Frenkel Topping Limited, and for team of the year (innovation and transformation) alongside Swanborough House Care Home and Frenkel Topping Limited.

This article is sponsored by Dental Protection.

Empowering dental practice managers: Lisa Bainham explores the benefits of the Association of Dental Administrators and Managers (ADAM) and why you should join.

The role of a dental practice manager (PM) is complex and varied, demanding a unique blend of skills to ensure smooth operations, compliance, and exceptional patient care. Recognising these challenges, the Association of Dental Administrators and Managers (ADAM) is dedicated to providing comprehensive support and resources tailored specifically for dental practice managers and those involved in dental practice management.

Understanding the challenges of dental practice management

Dental Practice Managers often find themselves at the intersection of clinical and administrative responsibilities. The team expects them to have answers to all questions, while practice owners rely on them to keep the practice running seamlessly. This dual pressure can lead to feelings of isolation and overwhelm, especially when faced with unique challenges that vary from one practice to another. Whether it’s managing staff, ensuring regulatory compliance, or improving patient satisfaction, the PM’s role is indispensable yet demanding.

ADAM: your partner in practice management

ADAM understands these pressures and is committed to supporting dental practice managers every step of the way. With a wealth of resources from industry experts and a supportive community, ADAM offers an array of benefits designed to make your role more manageable and rewarding:

Expert support and advice

Gain access to industry experts who provide practical advice and solutions tailored to the unique challenges of dental practice management. Whether you need guidance on compliance issues or strategies for enhancing practice efficiency, ADAM’s experts are here to help.

Exclusive members-only website

Our members-only website is a treasure trove of resources, including templates, guides, and industry updates. This centralised hub helps ensure you have the tools and information you need to excel in your role.

Closed Facebook group

Connect with fellow PMs in a supportive, private environment. Share experiences, seek advice, and build a network of peers who understand the intricacies of your role.

Member magazines

Stay informed with our regular publications, featuring articles on the latest trends, best practices, and insights from leading professionals in the dental industry.

Monthly compliance clinics and webinars

Stay ahead of regulatory changes and enhance your skills with our monthly compliance clinics and webinars. These sessions are designed to keep you informed and equipped to handle the evolving landscape of dental practice management.

Industry discounts

Enjoy a wide range of industry discounts that far outweigh the cost of membership. From supplies to services, our partnerships with leading companies mean you save money on essentials for your practice.

In-person events

Attend exclusive in-person events free of charge. These events provide opportunities for networking, professional development, and staying abreast of industry innovations.

Affordable membership options

We believe that every dental practice manager should have access to the support and resources they need. That’s why we’ve made ADAM membership as affordable as possible. For just £120 per year, or convenient monthly payments of £10, you can access all the benefits of ADAM membership. This modest investment in your professional development can yield significant returns in terms of efficiency, compliance, and job satisfaction.

Join a community that understands you

One of the most significant benefits of ADAM membership is the sense of community it fosters. As a dental practice manager, you are not alone. ADAM brings together professionals who understand the unique pressures and responsibilities you face. Our community is here to support you, share insights, and help you navigate the complexities of your role.

Supported by industry leaders

ADAM is proud to be supported by a range of industry companies that appreciate the critical role of the dental practice manager. This support allows us to offer valuable resources and services to our members, ensuring you have everything you need to succeed.

Dental practice managers play a crucial role in the success of dental practices, but the challenges of the job can often lead to feelings of isolation. ADAM is here to provide the support, resources, and community you need to thrive in your role. Join us today and discover how ADAM can make a difference in your professional life.

Visit www.adam-aspire.co.uk to learn more about our membership options and how we can support you in your journey as a dental practice manager. Together, we can navigate the complexities of dental practice management and achieve excellence in all aspects of your role.

This article is sponsored by the Association of Dental Administrators and Managers (ADAM).

The Royal Society, one of the world’s oldest and most prestigious scientific institutions, includes some of the most influential scientists in history, such as Isaac Newton, Charles Darwin and Albert Einstein. APS is the the oldest learned society in the United States, founded in 1743 by Benjamin Franklin.

Woodruff served as president of the Endocrine Society from 2013 to 2014, and as editor-in-chief of Endocrinology. In 2021, Woodruff received the Endocrine Society’s Gerald D. Aurbach Laureate Award for Outstanding Translational Research for “seminal discoveries about gonadal structure, function, and hormones, as well as female fertility and its regulation.”

Currently, Woodruff is an MSU Research Foundation Distinguished Professor at Michigan State University in the Department of Obstetrics, Gynecology and Reproductive Biology in the College of Human Medicine and the Department of Biomedical Engineering in the College of Engineering. She served as MSU provost beginning in August 2020 and is currently president emerita of the university.

“Today, young cancer patients can expect a consult from an oncofertility specialist, and I am honored to have worked with so many caring scientists and clinicians to make these real-world outcomes a reality.”

 Reflecting on her election to the Royal Society and to the APS, Woodruff said she was “surprised and humbled,” adding that it reflects the work of her lab and colleagues over many years, as well as the urgent need that led to her founding the field of oncofertility. She coined the phrase to describe the merging of cancer and fertility research and translating that work into an internationally recognized medical discipline. The field helps cancer patients preserve their ability to have a family after fertility-threatening treatments.

“This is the 20th anniversary since I coined the term ‘oncofertility,’” she says. “Today, young cancer patients can expect a consult from an oncofertility specialist, and I am honored to have worked with so many caring scientists and clinicians to make these real-world outcomes a reality.”

In this work, she leads the global Oncofertility Consortium, an international network dedicated to advancing fertility preservation worldwide.

Her research has produced landmark discoveries in reproductive biology, including the identification of the “zinc spark” at fertilization with MSU Research Foundation Distinguished Professor Tom O’Halloran and breakthroughs in maturing ovarian follicles outside the body, contributing to new fertility preservation strategies.

Woodruff has received numerous honors for her scientific leadership, including the National Medal of Science, the Presidential Award for Excellence in Science Mentoring, election to the National Academy of Medicine, the American Academy of Arts and Sciences and the National Academy of Inventors.

For Woodruff, the impact on patients remains the most significant measure of her work. “I believe the promise of fundamental science in medicine is that tomorrow’s patient is treated better than today’s,” she says. “That is the distinction that matters most.”

Looking ahead, Woodruff continues to lead active research at MSU. Her lab is focused on uncovering the mechanisms behind zinc’s role in egg development, building on the discovery of the zinc spark. She adds, “There is tremendous excitement around where this work can lead.”

The post Teresa K. Woodruff, PhD, Elected to Fellowship of the Royal Society, American Philosophical Society appeared first on Endocrine News.

Join Pat Langley and Bobby Bhandal on 7 July at 7pm as they discuss what dental practices need to know about changes to CQC registration.

This webinar will provide guidance on the recent updates to the CQC process for registering as a new provider.

Attendees will learn how to comply with the new requirements.

Learning outcomes

• Understand what the changes involve and why the new guidance matters
• Understand the financial implications of the new CQC registration process
• Learn the requirements for registration applications to be considered urgent
• Avoid the pitfalls of the new process.

The speakers

Pat Langley

Since qualifying from Manchester University, Pat’s career has included more thqn 30 years in general practice, oral surgery teaching positions at Guy’s and Manchester, deputy chief dental officer at Denplan, group clinical director at Oasis Dental Care, course director at the FGDP(UK), and chief dental officer at Dentex.

In 2010, Pat founded Apolline to provide compliance and regulatory support to dental practices and groups. She is passionate about compliance and has lectured widely on all compliance-based subjects. In 2023, Apolline partnered with FMC to form an integral part of the Dentistry Practice Services division.

Bobby Bhandal

With his unrelenting passion for dentistry, Bobby wanted to find a way to bring pioneering dental services within the reach of his local community. It all started with a dream and a burning desire to make a positive impact on people’s lives through exceptional healthcare.

Following on from this, he has extended this reach further in teaching and mentoring dentists all over the UK in building their own successful dental practices.

Catch up on previous on-demand webinars:

• Finishing your orthodontic cases: essential tips for anterior composites
• Advancing vital pulp therapy: clinical applications and predictable outcomes using MTA vpt
• From enquiry to treatment start: the patient journey most practices have never mapped
• Dealing with patient complaints: real cases, real solutions
• The first 100 days of marketing for a new practice owner.

You can sign up for the webinar here.

The finding points to a broader health care transformation grounded in medical excellence: using advanced tools and richer data to personalize disease detection. It also helps move medicine closer to the goals of value-based care: delivering the right care to the right patient at the right time.

“Breast cancer risk tools can help identify high-risk women who are most likely to benefit from more frequent breast cancer screening or risk reduction with medications,” said lead author Vignesh Arasu, MD, PhD, a research scientist at the Kaiser Permanente Division of Research and a radiologist with The Permanente Medical Group. “Our study shows that each of the 3 tests identifies a unique group of women, and that when all 3 risk tests are used we increase our ability to differentiate high-risk and low-risk women and provide more personalized screening recommendations.”

Related health care innovation story: Why health care innovation is essential during uncertain times

Combining risk scores strengthens breast cancer risk prediction

Published in the Journal of the National Cancer Institute, the study is one of the largest and most diverse to evaluate how well 3 scores predict breast cancer risk. Those scores included:

• Mammography AI algorithm, which predicts 5-year breast cancer risk based on the presence of imaging biomarkers. The technology assists radiologists by scanning mammography images in seconds to identify tiny, subtle lesions or calcifications that might be missed by the human eye.
• Polygenic risk score, which is determined by the presence or absence of 313 single nucleotide polymorphisms (SNPs) that prior studies have found to be associated with breast cancer.
• Clinical risk score, which considered factors such as age, race or ethnicity, family history of breast cancer, breast density, and body mass index.

The study included 82,957 women enrolled between 2003 and 2020 in the Kaiser Permanente Research Bank, a national biobank that includes medical records, survey, and genetic data from more than 400,000 Kaiser Permanente members. All study participants had a recent mammogram with no signs of breast cancer and no known genetic mutation or prior diagnosis that increased their risk.

Over a decade, 2,471 or 3% of the women in the study were diagnosed with invasive breast cancer or abnormal, cancerous cells in the lining of the milk ducts, but that had not spread to surrounding breast tissue. The model that combined all 3 risk scores was the most accurate, with a Concordance Index score of .70, indicating the predictive model has good accuracy. A score of .5 is equivalent to a coin flip, while 1.0 represents perfect accuracy. By comparison, the clinical risk tool scored .62, the polygenic test scored .61, and the combined clinical and polygenic risk scores reached .66.

Among women at the highest risk of developing breast cancer, the clinical risk score alone identified 19% of the women who developed breast cancer over a decade while the combined model identified 26% of these women.

Related value-based care story: How value-based care improves breast cancer survival rates

Personalized screening advances health care transformation

That ability to better match screening intensity to individual risk reflects a meaningful shift in health care transformation — one that brings together new tools, prevention, evidence-based medicine, and a commitment to improving care quality. It is also central to value-based care, where innovation is used to make care more precise, proactive, and personal.

The new research builds on prior research led by Dr. Arasu showing that AI-based mammography risk assessment more accurately predicted a woman’s future breast cancer risk than a clinical risk model.

“Our previous study showed that an AI risk score was slightly more accurate than a clinical risk score,” said Dr. Arasu. “This new study shows that by combining them, and by adding a polygenic risk score, we make a substantial improvement in accurately assessing risk.”

Read the full story on the Kaiser Permanente Division of Research website.

The post Study: AI, genetics, and clinical data improve breast cancer risk prediction appeared first on Permanente Medicine.

Could shade matching be simpler than ever? This article uncovers why shade selection remains one of the biggest challenges in restorative dentistry – and how advances in digital workflows and simplified restorative systems may finally be making the process easier, more predictable and more efficient for clinicians.

Sometimes it’s getting the patient to say ‘yes’ to life-changing treatment, or it may be crafting the perfect tooth shape. For many, shade selection is the most challenging stage when crafting a perfect restoration (Hardan et al, 2022).

Perception depends on a light source, the object and the detector, which could be the human eye or new pieces of technology (Adebayo et al, 2022).

Understanding what can affect the shade matching process, and how modern solutions optimise restorative routines for more predictable, successful outcomes, is key for every dental professional. It can lead to greater confidence in their workflows, and seamless restorations that blend into their patients’ existing smiles.

Can we trust our eyes?

Shade matching for dental restorations has traditionally been completed with the naked eye, but this is a subjective process. It is therefore up to the clinician’s eyesight, past training, and lighting conditions within the practice when making an appropriate decision.

Complications can include colour vision problems or colour blindness, the changing of eyesight in tandem with ageing, fatigue, the influence of medications, binocular difference (the contrast of visual quality between the left and right eye), and the backgrounds or surroundings of a tooth influencing perception (Alayed et al, 2021).

To mitigate issues with the last complication, patients are often advised to not wear makeup or colourful eyewear, and a grey background is typically preferred.

Achieving accurate shade selection

Between clinicians, accurate shade selection can vary greatly. One study brought together a dental surgery technician, a specialist restorative dentist and a dental surgery intern to assess 26 teeth across 24 patients, comparing their assessments for shade selection. The VITA classical shade guide was used.

It found that inter-examiner reliability was very low for conventional shade selection, with all three professionals agreeing on a tooth shade unanimously on just one occasion – and there was complete disagreement in 42.3% of cases (Adebayo et al, 2022).

This isn’t an indictment on clinicians being inaccurate; rather, it displays the clear subjectivity of the process. Minimising this effect can lead to a more predictable, uniform aesthetic outcome that best suits a patient.

It’s therefore important to understand how modern solutions have changed the shade selection routine to achieve this.

When shade selection went digital

Modern shade selection routines may include contact-based instruments and non-proximity devices to aid the process. The former includes spectrophotometers and colorimeters, which are thought to be a gold standard in some approaches to care (Rashid, Farook and Dudley, 2023).

A 2024 study compared the use of dental guides to a spectrophotometer for shade selection and found a reduced variance with the digital solution, creating more reliable and reproducible results (Alvarado-Lorenzo et al, 2024).

Non-proximity devices will include professional digital cameras, intraoral cameras, and smartphone cameras. They have been found to produce more reliable clinical outcomes due to shade-matching results than conventional shade selection methods, but this is notable in that this is under controlled environments (Rashid, Farook and Dudley, 2023).

These have grown in popularity due to the increased acceptance of digitalisation and, in particular, automated diagnostic tools in dentistry. Intraoral scanners have been a leading aspect of this trend (Rashid, Farook and Dudley, 2023).

The latest stage of development is the use of digital imaging systems alongside artificial intelligence, which can create efficient, streamlined analysis of high-quality images.

Even the use of mobile phones as a shade selection aid is rising, in part due to their quality, and also the difficulties facing accessibility and handling of alternative adjuncts (Zilpilwar et al, 2025).

But what if the most optimal change, which would lead to enhanced aesthetics while balancing treatment efficiency and cost, lies in the restoratives used?

Clinical case

In the following clinical case, Dr Chris O’Connor restores form and function in extensive root caries with Solventum Filtek Easy Match Flowable Restorative.

A 38-year-old male was referred for comprehensive treatment to improve aesthetics and to try to salvage as many teeth as possible. He previously worked as a chef with high incidence of energy drink consumption. Extensive root caries noted.

The challenge was to restore form and function, provide an easy to clean surface and reduce risk factors.

The case was completed with Filtek Easy Match shade Bright in paste and flowable preparations. Dr O’Connor said: ‘The matrixing was challenging in places but the versatility and simplicity of the composite used certainly helped produce the result. I am most proud of the aesthetics and polish produced with a single shade restorative approach.’

Change your materials

Composite materials have typically been made available in shades corresponding to popular shade selection aids, such as the VITA shade guide.

The range of colours that a tooth may be – from cusp to gingival margin – is so varied that many composite systems are available in countless shades. A clinician may feel the need to have these available in many, if not all, available shades in order to feel adequately prepared to support every patient.

However, this has drawbacks. Firstly, if shades go unused, inventory space is being used unnecessarily, and the solution could be considered a poor investment.

In everyday care, decision-making between four or five similar shades of composite may increase treatment time, reducing opportunities to support a wider variety of patients.

A smaller selection of restorative materials streamlines the selection workflow, but this should not be at the compromise of aesthetic outcomes.

This problem is compounded when considering the types of restoratives needed. A standard composite material will be ideal in many clinical indications, but there are circumstances where a flowable or bulk fill material is preferred; if a wide array of shades is needed in each modality, the inventory challenge grows.

Combine this further with blockers, and the headaches for dental teams only expands too.

Simple shade selection with Filtek

The most straightforward answer to simplifying shade selection workflows is choosing a versatile, effective composite selection when procuring items.

This includes the Filtek Easy Match range from Solventum. The 3M Filtek Easy Match Universal Restorative uses a three-shade system to enable a more intuitive process, while increasing confidence in aesthetic outcomes.

The Bright, Natural and Warm shades match the entire classical VITA shade guide, suiting almost any patient’s restorative needs. Natural is appropriate in a majority of cases, with its appearance adapting to the structures around it.

A naturally adaptive opacity ensures this happens at each aspect of a tooth, with a natural appearance achieved without an additional blocker. Instead, clinicians can create a dentine-like opacity by creating a material thickness greater than 2mm. For the incisal edge and bevel, an enamel-like translucency can be crafted by using just 0.5-1mm of material.

The result means a refined inventory, and confidence in more intuitive shade selection.

In cases where it is more difficult to judge – ‘could this patient be a bright shade, or natural?’ – clinicians need only place a button of material on the tooth, light-cure, and choose the appropriate solution.

Not only is this convenient, but it can also be an effective opportunity to show the patients an aspect of the final result before treatment is carried out.

Benefits for wider workflows

Not all restorative cases can be managed effectively with a standard composite material, however. Instead, a flowable solution may be preferred.

The Solventum Filtek Easy Match Flowable Restorative utilises the same versatile three-shade system, but can be applied in many more cases, for true confidence in every case.

Once again, no blocker is required, but the innovations do not stop here. An improved syringe design means that application is virtually bubble-free, without run-on, when compared to a common Luer lock design. As a result, clinicians have increased confidence in both aesthetics and restorative longevity.

Excellent polish retention and wear resistance is achieved with both solutions, ensuring aesthetics last over time.

Application is made even simpler with the addition of the Solventum Filtek Composite Warmer Kit.

Once an appropriate shade of composite is chosen for a patient, effective application is paramount. The Solventum Filtek Composite Warmer Kit is fast, portable and easy to use. It is designated specifically for use with Filtek composite restoratives, and creates improved flow and adaption for chosen materials, while reducing extrusion forces.

When optimising restorations through shade selection, material warming is the next step to more confident placement.

Flowable restorative poll: what do you use and what would make you switch?

Summary

There are many ways a clinician can change their shade selection workflow to improve restorative outcomes for patients. Changing the shade matching process can help dental teams find more accurate results, but selecting a versatile restorative material could have additional benefits.

Aside from enhanced aesthetics, clinicians could find knock-on effects in inventory management and streamlined treatments, creating a wider range of benefits – certainly something to smile about.

References

• Adebayo GE, Gbadebo OS, Ajayi MD (2022) The tooth shade matching ability among dental professionals: A comparative study. Annals of Ibadan Postgraduate Medicine 20(1): 65
• Alayed MA, Alnasyan AS, Aljutayli AA, Alzaben MM, Alrusayni WM, Al Hujaylan AA (2021) Considerations and implications in shade selection for dental restorations: a review. Journal of Pharmacy and BioAllied Sciences 13(Suppl 2): S898-S902
• Alvarado-Lorenzo A, Criado-Pérez L, Cano-Rosás M, Lozano-García E, López-Palafox J, Alvarado-Lorenzo M (2024) Clinical comparative study of shade measurement using two methods: Dental guides and spectrophotometry. Biomedicines 12(4): 825
• Hardan L, Bourgi R, Cuevas-Suarez CE, Lukomska-Szymanska M, Monjaras-Avila AJ, Zarow M. … & Haikel Y (2022) Novel trends in dental color match using different shade selection methods: a systematic review and meta-analysis. Materials 15(2): 468
• Rashid F, Farook TH, Dudley J (2023) Digital shade matching in dentistry: a systematic review. Dentistry Journal 11(11): 250
• Zilpilwar N, Nimonkar S, Godbole S, Belkhode V (2025) Efficacy of artificial intelligence-assisted appliances in the selection of tooth shade: protocol for an observational study. JMIR Research Protocols 14(1): e68160

Solventum, the S logo and Filtek are trademarks of Solventum or its affiliates. 3M is a trademark of 3M company.

For clinical sample offers, please read terms and conditions on order form.

We hear from British bobsleigh athlete, three-time champion shot putter and Olympian Adele Nicholl on decision making under pressure, resilience and why high performance is built through self-awareness, accountability and adaptability.

In this episode of Dentistry Talks, Adele explores what elite sport can teach dental professionals about handling pressure, making difficult choices and staying calm when plans change. Drawing on her Olympic career, psychology background and experience speaking to business leaders, she explains why good decision making is a skill that can be learned, practised and improved over time.

Adele reflects on the importance of taking responsibility for how we respond to setbacks, why self-belief matters when others do not understand your path, and how developing a ‘pencil plan’ can help professionals remain flexible without losing sight of long-term goals.

The conversation also explores resilience, confidence, delayed gratification and the value of knowing yourself well enough to make decisions from clarity rather than fear.

You can now watch on YouTube and listen on Spotify.

Topics include:

• Decision making under pressure
• What dentistry can learn from elite sport
• Resilience, setbacks and self-awareness
• Accountability and taking ownership
• Why adaptability matters in high-performance environments
• Trusting your gut while making considered choices.

Listen to other episodes below:

• Burnout, balance and building a brand: lessons from the Singing Dentist
• Ageing as a dental professional: how to maintain purpose and identity
• What every dentist needs to understand about trauma and dental anxiety 
• From pitchside to practice: lessons from sports dentistry
• Lessons from the business guru behind Kinky Boots.

Dentistry Talks podcast is powered by Sensodyne.

You can find out more here.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

Neil Woodhouse explores why many orthodontists are investing in in-house aligner production using two key case studies.

Clear aligner demand across the UK shows no sign of slowing. As patients continue to prioritise discreet, comfortable orthodontic treatment, practices are under increasing pressure to deliver faster results, greater flexibility and a more personalised experience.

In response, a growing number of clinicians are shifting away from fully outsourced systems and investing in in-house aligner production. By combining digital workflows with modern thermoforming techniques and advanced materials such as Iconic Align, practices are gaining more control over both treatment and business performance. So, what’s driving this shift – and is it the right move for your practice?

Taking back control of aligner treatment

Outsourced aligner systems offer convenience, but they can also limit clinical input. Treatment planning is often completed remotely, which may restrict control over staging, biomechanics and appliance design. In-house aligner production changes that dynamic entirely.

By bringing manufacturing into the practice, orthodontists can directly manage every aspect of treatment – from initial setup through to final detailing. This includes full control over attachment placement, trim lines and force application, allowing treatment to be tailored precisely to each patient.

For clinicians who value autonomy and precision, this level of control is a major advantage.

Speed as a competitive advantage

Turnaround time is one of the most immediate benefits of in-house aligners. Rather than waiting days – or even weeks – for external production and delivery, practices can design, print and thermoform aligners within hours. This means faster treatment progression, fewer delays and the ability to respond quickly to refinements – ultimately improving both efficiency and patient satisfaction.

Improving profitability and accessibility

Cost remains a key consideration in aligner therapy. Many outsourced systems operate on fixed pricing models, which can limit flexibility – particularly for minor cases or short-term alignment. In-house clear aligner production offers a more scalable alternative. By reducing per-case costs, practices can:

• Improve profit margins
• Offer more competitive pricing
• Expand access to aligner treatment for a wider patient base.

This is particularly valuable for relapse cases, cosmetic alignment and hybrid treatments.

Case study one: adult alignment

A 50-year-old female with mild to moderate upper and lower crowding was efficiently treated in seven months using in-house aligners. No attachments or IPR required.

Case study two: functional correction

Functional correction: A 16-year-old male with Class II Division 2, deep bite, and arch crowding/spacing was treated with Neyo Pro in-house aligners with mandibular advancement blocks for 10 months, followed by six months of fixed appliances for final detailing.

Building a digital orthodontic workflow

Successful in-house aligner systems rely on a well-structured digital workflow. While this requires initial investment, the technology is now more accessible than ever.

Typical components include:

• Intraoral scanning for accurate digital impressions
• Treatment planning software for aligner staging
• 3D printing for model production
• Thermoforming equipment for aligner fabrication.

With the right setup, practices can create a streamlined, repeatable process that integrates seamlessly into daily workflows.

Why material choice matters

Not all aligner materials perform equally. For predictable tooth movement, consistency and durability are essential. Iconic Align has been developed to deliver controlled, light forces while maintaining flexibility and clarity. Its resistance to deformation supports accurate tracking throughout treatment, while its transparency meets patient expectations for aesthetics. From a clinical and operational perspective, ease of thermoforming and finishing also plays a key role – helping teams maintain efficiency without compromising quality.

Expanding what’s clinically possible

One of the biggest advantages of in-house aligners is the ability to go beyond simple cases. With full control over design and production, clinicians can adapt treatment as it progresses and combine aligners with other orthodontic techniques. This opens up new opportunities for managing more complex cases, offering a level of flexibility that can be difficult to achieve with outsourced systems.

Are there challenges?

Adopting in-house aligner production is not without its hurdles. Practices must commit to training, workflow development and ongoing quality control. A skilled and engaged team is essential, particularly when it comes to digital design and laboratory processes. However, many practices find that these challenges quickly translate into strengths. Teams often take greater ownership of treatment, leading to improved consistency and better patient outcomes.

A shift in modern orthodontics

In-house aligners are no longer a niche concept – they are becoming a key part of modern orthodontic practice in the UK. By combining speed, control and cost efficiency, this approach enables clinicians to deliver highly personalised treatment while strengthening their practice offering. For those willing to invest in the technology and training, the rewards are clear: greater clinical freedom, improved workflows and a better overall patient experience.

In-house thermoforming with Iconic Align provides orthodontists with a high level of control, flexibility and efficiency. While implementation requires investment, commitment and a focus on clinical excellence, the long-term benefits are significant – including improved treatment outcomes, greater cost efficiency and the ability to deliver truly personalised care. For clinicians who value precision in planning, staging and innovation, in-house aligner production represents more than an alternative – it marks a progressive step forward in modern orthodontic practice.

Discover Iconic thermoforming materials from DB Orthodontics – precision-engineered for consistent performance and trusted by technicians, clinicians and patients worldwide.

This article is sponsored by DB Orthodontics.

Dr. Ben Zellner, OSMS Hand-to-Shoulder Specialist, was a guest contributor for The Business News. The article, “Rethinking Workers’ Compensation” discusses how independent practices follow a model of care that not only helps reduce healthcare costs but improves employee outcomes and the employer’s bottom line in work comp cases.

The right care includes:

• Early access to specialty care leading to early diagnosis and treatment
• Avoiding unnecessary imaging and procedures by prioritizing conservative care
• Clear work restriction plans

Learn more about how collaborating with independent practices like OSMS can lead to measurable benefits by reading the full article: Rethinking workers’ compensation – The Business News

The post In the News: Rethinking workers’ compensation appeared first on Orthopedic Sports Medicine Specialists (OSMS).

Does whitening always need to come before Icon resin infiltration? Not necessarily, but knowing when it does can be the difference between a predictable result and sealing discolouration into the tooth.

It was one of several practical clinical questions dentist Cat Edney answered during a Dentistry Live question-and-answer session following her live Icon demonstration. After the procedure, she worked through the decisions that shape real cases: whitening, rubber dam, composite combinations, orthodontic patients and the growing role of interproximal Icon.

Does whitening always come first?

On whether whitening should always come before Icon, Edney was clear: ‘Actually, no, it doesn’t have to.’

However, she said it could make treatment more predictable by revealing the full extent of the lesion before infiltration.

‘It can make the results more predictable if you whiten before Icon, purely because you’re seeing the full extent of a dehydrated lesion,’ she said.

Colour changes the calculation. Edney said tooth whitening was ‘absolutely mandatory’ before Icon resin infiltration if there was ‘any color involved in the lesion’. Placing a clear resin over brown, white or orange discolouration risks sealing that colour into the tooth.

Why rubber dam is essential

Moisture control was another key theme.

‘Moisture control is absolutely essential, because if we have any liquid in that air bubble, it’s going to disrupt our light refractive index once we resin infiltrate,’ Edney said.

She explained that even ‘humidity from breath’ could alter the result and make it less predictable, particularly if the tooth dehydrates later.

When Icon needs composite

Edney also explained when Icon may need to be combined with composite, including darker lesions, cases requiring a small enamoplasty, or teeth where previous composite masking has to be removed.

‘Obviously, with Icon, we’re talking about enamel only, we never go into dentine,’ she said.

Where Icon resin infiltration fits beyond white spots

Orthodontic patients were identified as strong candidates, particularly where white spot lesions had developed around brackets or attachments. Edney said these cases were often straightforward to treat, usually requiring ‘one, maximum two rounds of etch’.

She also highlighted interproximal Icon for early carious lesions.

‘It’s very rewarding,’ she said. ‘We see time and time again patients who are not suffering with progression of decay, because we’ve managed to treat early enough that we’ve avoided putting a drill into that patient’s tooth.’

Watch the full Dentistry Live session, including the complete Icon procedure, clinical workflow and question-and-answer session with Cat Edney, on demand now.

Follow Dentistry.co.uk on Instagram to keep up with the latest news and trends.

The self-employed associate model remains a central pillar of UK dentistry, says Alicja Zajac, providing a vital equilibrium between clinical autonomy and operational flexibility.

For decades, the dental associate contract has supported this arrangement. Associates trade the traditional safety nets of employment for higher degrees of independence, while principals gain a professional workforce without the administrative and financial burdens of a standard payroll.

However, recent developments in employment law suggest this balance is becoming increasingly fragile. As judicial scrutiny of worker status intensifies, the profession faces a mounting compliance risk that could threaten the model it relies upon. The survival of this structure now depends on rigorous alignment between contractual theory and the daily clinical reality of the surgery.

The control paradox

This challenge is rooted in what can be termed the control paradox. In an effort to ensure patient safety and brand consistency, many practices have implemented highly structured operational systems. While these measures are clinically justified, they introduce a significant legal tension.

The landmark Supreme Court ruling in Uber BV v Aslam established that contractual wording is not the final word in determining status. Instead, courts will examine the reality of the working relationship, focusing on control and subordination.

In a dental context, this requires a granular examination of day-to-day practice. If a principal dictates the appointment book, limits the associate’s ability to refuse specific tasks, or insulates the clinician from the financial risks of their own clinical errors, the relationship begins to mirror one of employment.

The successful worker-status claim in Sejpal v Rodericks Dental Limited offers a sobering illustration of this shift. In that case, the tribunal found that the clinician was not merely a tenant of a room but was ‘integrated’ into the practice’s business. The court examined the lack of a genuine, unfettered right to substitute and the degree to which the practice controlled patient flow and financial terms.

Crucially, the tribunal concluded that the associate was not ‘in business on her own account’, but was instead part of the principal’s business. This distinction is vital: if an associate is prevented from marketing themselves independently or is tied to a practice through restrictive covenants and rigid ‘house rules’, they are increasingly likely to be seen as a worker rather than a self-employed contractor.

Substitution and independence

For associates, it is essential to recognise that independence is not a passive status delivered by a contract; it must be actively demonstrated in the surgery. One of the most significant, yet often overlooked, vulnerabilities lies in the substitution clause.

The right to provide a substitute is a primary indicator of genuine self-employment: the clearest evidence that the contract is for ‘services’ rather than ‘personal service’. However, if this right is fettered by administrative barriers, arbitrary vetting, or a principal’s veto that makes substitution practically impossible, the clause becomes a legal fiction.

This principle was central in Pimlico Plumbers Ltd v Smith, where the Supreme Court held that a highly restricted right to substitute does not satisfy the requirement for self-employment. When a substitution clause cannot be exercised in practice, the associate loses their primary lever of clinical and financial independence, and the validity of the model for both parties is called into question.

Associates must therefore operate with the mindset of a separate commercial entity. This means asserting meaningful control over working days, hours and clinical methods. If an associate cannot decide when they work or who covers their absence, their legal autonomy is compromised.

Even when associates behave independently, their autonomy can still be compromised by the systems around them. Risk often emerges through operational creep: the slow, cumulative erosion of independence caused by routine practices such as mandatory meetings, dictated laboratory lists and rigid protocols that leave little room for independent clinical judgement.

These systems are often introduced for efficiency, but they can inadvertently create a relationship of dependency. When an associate is indistinguishable from an employee to the patient, they may eventually be indistinguishable to a judge.

The financial risk

If practices do not evolve how clinicians are instructed to work, the model faces the weight of its own contradictions. If the associate model is used to avoid the costs of employment while maintaining the control of an employer, the legal gap will inevitably close, often with serious financial consequences.

A finding of worker status can trigger backdated liabilities for areas such as holiday pay and pension contributions, sums that could jeopardise the stability of a mid-sized clinic. Separately, His Majesty’s Revenue and Customs (HMRC) may scrutinise arrangements where the working relationship does not mirror genuine self-employment, including pay as you earn (PAYE) and National Insurance obligations.

This is not a hypothetical concern; it is a live financial risk that grows every day the operational reality remains out of sync with the contract. Beyond the financial impact, reputational damage can make future recruitment more difficult in an increasingly competitive market.

Ultimately, protecting the associate model requires precision over paperwork. Authentic independence demands a culture that respects autonomy as much as it respects the contract. This may require a shift in practice culture, where systems designed for efficiency are balanced against the need to preserve the associate’s independence.

Principals may need to reconsider certain managerial controls over the how and when of clinical work to protect the legal status of the relationship. The question for the profession is whether the current level of operational control is worth the potential liability it creates.

Without a move toward genuine professional partnership and a rejection of performative compliance, the model may be less stable than many assume. The contract may say one thing, but the daily reality of the surgery says another, and it is the latter a judge will believe.

What associates should check

This is not only a principal’s issue. Associates should also ask whether their working reality reflects the independence described in their agreement.

That means reviewing whether they can exercise a genuine right of substitution, control their diary, make appropriate clinical decisions, choose materials and laboratories where clinically relevant, and carry meaningful financial responsibility for their own work.

Associates should also consider how they present themselves to patients and whether they are able to operate as a recognisable independent practitioner within the practice. If the contract says one thing but the day-to-day working arrangement says another, both parties may be exposed.

The compliance blueprint: next steps for the surgery

This legal vulnerability creates a clear need for guidance that supports both parties in maintaining the independence the model relies on.

To move from apprehension to action, practices must transition toward honest, active compliance. Preserving the associate model requires protecting the operational independence that gives the framework its legal foundation. Both parties should audit three core operational areas.

One: de-regulate the diary

Review daily scheduling workflows. If booking software, rigid appointment templates or fixed timing allocations strip the clinician of autonomy over pacing and clinical judgement, these systems should be reviewed. A self-employed associate must retain meaningful control over how they manage their time and treat patients at the chair.

Two: document genuine financial risk

True self-employment demands financial exposure. Practice accounts and internal records should clearly demonstrate where financial responsibility lies for remakes, failed treatments and clinical errors. If the practice absorbs or dilutes this risk, a court may view the relationship as closer to employment.

Three: review front-of-house communication

Control often begins at the reception desk. Front-of-house teams should understand how to communicate the associate’s role accurately, framing them as an independent practitioner utilising the clinic’s facilities rather than simply as an internal member of staff.

This must be done carefully and transparently, without confusing patients about responsibility for care, fees, complaints or records. Small, consistent shifts in daily language can help prevent patients from confusing an independent contractor with an integrated employee.

The principal-associate model remains valuable, but it cannot be protected by paperwork alone. Its future depends on whether the profession is willing to align contracts, culture and daily working reality before a court is asked to do it instead.

References 

1. Halsbury’s Laws of England. Employment (Vol. 39). 5th ed. London: LexisNexis; 2020.
2. Uber BV and others v Aslam and others [2021] UKSC 5.
3. Sejpal v Rodericks Dental Limited [2022] EAT 91.
4. Pimlico Plumbers Ltd and another v Smith [2018] UKSC 29.
5. British Dental Association. Associate agreements and employment status. London: BDA; 2024.

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‘NHS dentistry is broken.’ Not my words, but those of the government when it entered office back in July 2024. As a dentist, it is impossible not to agree with this analysis. Is NHS dentistry beyond repair? Far too many, sadly, would say yes, that the problems are far too big and the will just isn’t there to fix it.

However, I am optimistic about the future of NHS dentistry and I truly believe that it can be rescued and that with action and campaigning, this goal can be achieved.

Promises have been made to implement a new NHS dental contract by the end of this parliamentary term, and I believe it is imperative that we, as a profession, hold parliamentarians to account, to ensure that this happens.

Taking the case to Labour conference

I make no secret of the fact that I am politically active and I believe in the positive impact that governments can exercise in order to enact change. In September 2025, I took my experiences in NHS dentistry to the floor of the Labour Party’s annual conference in Liverpool and proposed a motion to the health ministry, MPs and party members.

The message was simple. NHS dentistry is a system that is not, in its current form, fit for purpose. In order to fix it, fundamental change is needed. Tinkering around the edges will not cut it and a new NHS dental contract must be implemented.

Alongside this, there must be a general focus on prevention and education as part of a wider public health approach. This motion was passed unanimously. In order to get the changes that the profession needs, a laser focus on the need for progress is essential and this led me to the Houses of Parliament.

Bringing NHS dentistry to Westminster

The inboxes of all MPs have been flooded in recent years with emails from constituents who have been unable to access NHS dental care and I understand that, in order for MPs to be able to use the full weight of their positions to influence change, they need to be fully informed on the issues that exist within the system and what can be done to begin to resolve them.

After considering what I could do as a general dental practitioner (GDP), I approached my local MP Connor Naismith, who agreed to sponsor an event in Parliament where I would bring a team to do just this. I wanted to build a team of all talents and expertise from within dentistry who could draw on their experience to give that complete, rounded view.

This team was composed of myself, Dr Shiv Pabary, chair of the British Dental Association (BDA) General Dental Practice Committee (GDPC), Professor Zoe Marshman, professor of dental public health at the University of Sheffield, and Dr Sarah Weston, clinical development adviser at {my}dentist.

On 22 June 2026, our team travelled from different areas of the UK to Westminster to hold this event. It was a very eventful day as, not only were we hosting the session, but there was a heatwave and the Prime Minister had just resigned only a few hours earlier.

Despite the day’s circumstances, we had a constant and steady turnout of MPs of most parties and parliamentary staff, including Sarah Russell, Jonathan Brash, Adrian Ramsay, Diane Abbott, Jim Shannon and more, who were keen to chat and understand what changes are possible to make NHS dentistry a service fit for the future. Andrew George member of the Health Select Committee also came.

What MPs asked about a new NHS dental contract

We stressed the importance of contract reform to a weighted capitation model with urgent care and prevention built in, alongside a wider public health approach, with the need for oral health to be treated with the same seriousness as general health.

Concerns raised by MPs ranged from how much more funding would be needed in any new contractual arrangements to why there is such a high rate of general anaesthetics in children for dental treatment. It was explained that the BDA estimates that £1.5 billion is needed to bring NHS dentistry back from the brink and many of the MPs who attended, were surprised at this number, expecting it to be far larger.

We unanimously concluded that there is the will to enact positive change and that all understood the absolute urgency to reach workable solutions. To support our work, professionals can contact their MP to ensure that our voices are heard from all parts of the UK and to all political parties.

What happens next?

We will continue this work to maintain momentum, as it will be through a collaborative approach, while also holding politicians’ feet to the fire, that I truly believe NHS dentistry can be saved. The demise of NHS dentistry is not inevitable and we are a pivotal part in rebuilding a system that we can all be proud of.

The NHS was once the envy of the world and by working together it absolutely can be again.

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Treeline Dental Care has never been a group that stands still, and its first-ever Company Kick-Off Event proved exactly that.

Bringing together around 35 team members from across all Treeline practices, including every lead, every practice manager, and 15 clinicians, the day marked a new milestone in the group’s commitment to development, collaboration and culture-building. Led by co-founder Dr Jimmey Palahey, alongside operations director Nav, the event blended structured learning with hands-on clinical training – and a rare opportunity to take to the pitch at Lincoln City Football Club on a gloriously sunny day.

The purpose of the Kick-Off event was clear: to invest in Treeline’s people. While the group already runs its well-established Growth and Development Day each year, this new event was designed as a dedicated staff development day, giving both clinical and non-clinical teams the chance to sharpen their skills, strengthen relationships and align on the year ahead.

What happened at Treeline’s Company Kick-Off Event?

The morning opened with a welcome address from Jimmey and Nav, setting the tone for a day built around shared purpose and professional growth. After the introduction, the group split into two tailored training streams. Clinicians took part in a hands-on composite bonding and whitening session delivered by SDI, who brought their expertise directly into the room. Meanwhile, Treeline’s head office team led a programme of managerial and leadership training for practice managers and leads, covering topics such as operational excellence, communication, team development and the evolving expectations of modern dental leadership.

Dr Jimmey Palahey, co-founder of Treeline Dental Care, said: ‘Launching our first Company Kick-Off Event felt like a natural next step in Treeline’s journey. We wanted to create a day that not only strengthened clinical and managerial skills, but also reinforced the sense of unity that runs through every one of our practices. Our aim was to bring people together, give them space to grow, and set a clear direction for the year ahead. Seeing our teams so engaged, energised and connected has confirmed just how powerful days like this can be.’

This dual approach ensured that every attendee, whether clinical or managerial, received training that was directly relevant to their role. It also reinforced Treeline’s belief that excellence in dentistry is built not only on clinical skill, but on strong leadership, cohesive teams and a shared understanding of what great patient care looks like.

Unexpected football talent

A new annual tradition

Feedback from attendees was overwhelmingly positive. Staff described the event as informative, energising and well-balanced, praising the mix of structured training and relaxed team-building. Many commented on how valuable it was to spend time with colleagues from other practices, strengthening relationships and gaining insight into how different teams operate. Others highlighted the quality of the SDI clinical training and the practicality of the leadership sessions, noting that they left with new skills they could apply immediately.

For Treeline, the success of the first Company Kick-Off Event signals the beginning of a new annual tradition. It also reflects the group’s ongoing commitment to investing in its people and creating opportunities for growth, connection and shared purpose.

Discover more about Treeline Dental Care here.

This article is sponsored by Treeline Dental Care.

Adam Thompson explains practice owners can protect and strengthen the value of their business with succession and exit planning, getting ahead on retirement, sale or partnership transitions.

Succession and exit planning are often pushed to the bottom of a dentist’s to‑do list. But for private practice owners, they’re essential for long‑term financial security.

Unlike NHS‑contracted practices, private practices are valued on their commercial performance, meaning the decisions you make today directly influence the price you’ll achieve when you retire, sell or bring in a partner.

Whether you’re five or twenty-five years away from stepping back, a clear plan can help to protect your investment, strengthen your practice’s value and ensure a smooth transition for your team and patients.

How does private practice affect the value of your business?

As a private dentist, you’ll benefit from greater autonomy and earning potential than working in the NHS. However, this places more responsibility on you to build and maintain your practice’s value.

In fact, because private practices are not underpinned by NHS contract income, buyers will place greater emphasis on the commercial strength and sustainability of the business.

Several factors can influence valuation:

Patient base stability

A loyal, well-retained patient base (particularly those on membership plans) shows a reliable revenue stream and reduces perceived risk.

Treatment mix and recurring revenue

Practices with a mix of general dentistry, hygiene services and higher-value cosmetic treatments typically achieve stronger goodwill multiples.

Brand reputation and digital presence

Online reviews, website quality, visibility in local search ranking and social media presence all contribute to perceived value and patient acquisition potential.

Quality clinical team and staff retention

A skilled, stable team reduces reliance on the principal dentist and reassures buyers that the practice can operate smoothly post-sale.

Compliance, governance and financial record keeping

Strong systems, clear documentation, and clean financials can streamline due diligence and help to increase buyer confidence.

Planning for retirement, sale or partnership transitions

Exit planning isn’t a quick task. It’s a phased process that takes time. So, whether you intend to retire, sell outright or transition to a partnership model, early preparation will be key.

Retirement planning

Ideally, you should start your retirement planning 5-10 years before your intended retirement date. This allows enough time to:

• Align personal financial goals with the projected value of the practice
• Optimise tax-efficient profit extraction
• Reduce reliance on the principal dentist by delegating clinical and managerial responsibilities
• Strengthen the practice’s financial performance ahead of valuation.

A well-structured retirement plan can help to ensure you’re able to step back with confidence and on your own terms.

Selling your practice

If you’re thinking of selling, preparation will be key. You should consider:

• Preparing for due diligence – buyers will scrutinise financials, compliance records, contracts, and operational processes. Clean, organised documentation accelerates the sale
• Improving EBITDA and reducing reliance on the principal – a practice that performs well without the owner’s constant involvement is more attractive and commands a higher price
• Choosing the right buyer – options include corporates, private buyers, or existing associates. Each route has different implications for valuation, culture, and handover expectations
• Negotiating handover periods and earn‑outs – many sales involve phased transitions. Understanding the commercial and personal impact of these arrangements is essential.

Partnership transitions

For dentists looking to bring in new partners or associates, structured planning helps maintain stability:

• Clear buy‑in and buy‑out agreements
• Defined roles, responsibilities, and profit‑sharing arrangements
• Cultural alignment and continuity of care
• Legal documentation that protects all parties.

Protecting your investment and ensuring a smooth handover

Beyond financial preparation, a successful transition relies on protecting the practice’s reputation, team and patient relationships. Practices with higher valuations are usually those that can operate well without the principal dentist, supported by clear systems, a stable team and consistent, clear patient communication.

Ensuring compliance, maintaining strong governance and putting appropriate financial protections in place all help to reduce risk and reassure future buyers or buyers.

By planning early and taking measures to strengthen the practice’s resilience, you’re not only safeguarding its value, but also making any eventual handover smoother for everyone involved.

The role of professional advice

Seeking expert advice can be invaluable when navigating succession and exit planning. A specialist adviser can help you to model different exit scenarios to support your decision-making and optimise any available tax efficiencies.

If you’re ready to start planning your own exit strategy, speak to a dental specialist financial adviser by visiting wesleyan.co.uk/dental or calling 0808 149 9416.

Please note: Charges may apply. You will not be charged until you have agreed to the services you require and the associated costs. Learn more at www.wesleyan.co.uk/charges. 

This article is sponsored by Wesleyan Financial Services.

Mark Topley helps dental practice owners and managers identify who is responsible for burnout and its consequences to build calm, high-performing teams.

Most practices have a wellbeing initiative of some kind.

A wellbeing lead, a mental health first aider, a fruit bowl in the staff room nobody quite trusts.

And most owners have a frustration running alongside it, usually about a younger team member who’s off the odd Monday, increasingly with the explanation that they need to protect their mental health.

The two feel unrelated, but they’re the same problem – nobody’s quite sure who’s responsible for a team’s energy.

Wellbeing isn’t a programme you bolt on. It’s a by-product of two things, how a place is led, and how the people in it look after themselves, and it has two owners. 

The conditions are the leader’s job. The choices are the individual’s. 

Almost all the confusion comes from collapsing it to one, either the leader who tries to fix everyone single-handed and burns out doing it, or the cynic who calls it all personal and none of their business.

Both are wrong, in opposite directions.

This isn’t a soft issue

A 2025 Dental Protection survey of more than 1,600 UK dental professionals found 63% frequently burnt out and exhausted.

Most of the cost isn’t dramatic, it’s the slow grind of a tired team doing slightly worse work, and research links poorer staff wellbeing to worse patient safety.

Your team’s energy and your patients’ experience are the same conversation.

Let’s take the leader’s half first, because it’s the bigger lever.

It comes down to four conditions you actually control.

Clarity

People burn enormous energy guessing what good looks like and whose job a thing is. Clear expectations don’t constrain a team, they relax it. Clarity is kindness.

Capacity

An honest look at the diary, rather than a permanent state of slightly too much. You can’t recover from a week that was never survivable.

Safety

Whether someone can say ‘this isn’t working’ without it becoming a thing. Psychological safety is the early-warning system, the way problems surface while they’re still small.

Recovery

Whether rest is modelled from the top or punished. If you’re answering emails at 11 at night, you’ve set the standard, whatever the wellbeing poster says.

All four are structural, not reactive. A wellbeing day is a nice gesture aimed at a problem the structure created across the other 51 weeks.

The real work is building conditions that don’t drain people in the first place.

Then there’s the other owner, and the Monday frustration is the clearest example of the half that isn’t yours to fix.

It’s real, and it’s still their responsibility. Real first, because that’s the bit the eye-rollers get wrong – anxiety and depression in working-age adults has risen sharply since the 90s, and now peaks in the mid-20s rather than the late 40s.

When a 24-year-old says they’re struggling, the odds they actually are have gone up.

But younger workers take fewer total sick days than older ones, so this was never about volume, and much of what shows up as Monday fatigue isn’t a condition at all.

It’s social jetlag, the body-clock whiplash from late nights and lie-ins all weekend, then a Monday start.

Real and measured, but largely self-made, driven by weekend bedtimes and late screens, both within a person’s control.

Health is health. A body clock you wreck every weekend isn’t a problem your practice created, and saying so isn’t unkind, it’s honest.

A smaller group are truly unwell and need proper support, but that isn’t most of what shows up on a Monday morning.

How does it work?

You don’t police people’s weekends, and you don’t absorb the gaps in silence. 

You’re clear that reliability matters and the team carries the cost when someone’s repeatedly missing, you make it safe to tell you when something real is going on, and you treat the recurring Monday as a conversation, not a crime.

The person who’s truly unwell will be relieved you noticed, while the person who needs to sort their sleep out gets the message without you being heavy about it.

The trap is asking ‘is it the practice’s fault or theirs?’ because the honest answer is usually some of each.

What’s mine to fix is the conditions. What’s theirs to own is their health and the choices that protect or wreck it.

Sort your half first, because it’s the bigger one, and it earns you the right to ask about theirs.

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Minesh Patel breaks down the hidden legal and lifestyle risks that can quietly undermine long-term financial autonomy in dentistry.

In my first article, we addressed financial foundations: tax reserves, compliance and financial protections.

I then examined advanced tax mechanics and increasing income retention: the £100,000 threshold, student loans, pension relief and the nuances to incorporation. 

This final instalment confronts the risks that most dentists and dental care professional (DCP) do not see coming, and these do not arise from poor Individual Savings Account (ISA) or Self-Invested Personal Pension (SIPP) investment choices. 

Instead they stem from risks such as unplanned incapacity, premature death, gradual lifestyle inflation and inadequate legal and estate planning.

The legal blind spot of capacity and control

Financial safeguarding extends beyond income and taxation.

Many professionals either do not give it a second thought or operate under the assumption that family can act on their behalf.

This assumption is common, dangerously optimistic, and legally incorrect.

The solution is both simple and crucial; a lasting power of attorney (LPA). 

An LPA allows an attorney ie a trusted individual(s) to act on your behalf if capacity is lost. There are two types:

• Property and financial affairs LPA – covering bank accounts, investments, bills, property and business interests
• Health and welfare LPA – covering decisions relating to medical treatment and care.

Without an LPA, your family cannot automatically act for you. They must apply to the Court of Protection specifically. 

Family members may be unable to access funds, pay bills or even make routine enquiries to service providers during this time.

For practice owners, the absence of an LPA can have immediate operational consequences; delayed staff payments, stock shortages, revenue disruption and disruptions to patient care. Like a ship without a captain, a practice without leadership can quickly drift into difficulty. 

Legal safeguards are not expressions of pessimism; they are instruments that provide clarity, protection, and control.

Wills and the reality of statutory distribution rules

A Will determines how your assets are distributed after death, who looks after your children (under 18s), and who manages your estate (executors).

Many assume that family members ‘sort things out’; an assumption that is inaccurate. This process can also result in lifetime family disputes leaving an unintended legacy behind. 

Intestacy rules are rigid and do not account for personal nuance. Drafting a clear Will ensures:

• Control over asset distribution and decision-making authority
• Appointment of trusted executors and guardians
• Avoidance of prolonged legal processes and disputes.

For practice owners, the absence of a Will introduces further complexity. Business shares may transfer in ways that disrupt continuity.

Planning ahead for life’s uncertainties

In an era of increasing life expectancy, estate planning is no longer something that can be left to chance.

The greatest risk is often not complexity, but inaction. Without formal legal arrangements in place, decisions do not fall to you but to the state and the courts:

• The court decides who manages your affairs
• The state decides who inherits 
• Your family carries the prolonged stress, delays, and financial burden.

A common pattern emerges: assumptions replace verification, paperwork is postponed, and the rigidity of UK law is underestimated. 

Proactive individuals anticipate risk and act early.

Reactive counterparts, by contrast respond only once events have already occurred.

Lifestyle inflation as a silent constraint

Financial risk does not arise solely from catastrophic events.

More often, it develops in a far less obvious way; through the gradual expansion of fixed costs and lifestyle inflation. As income increases, expectations naturally adjust. 

Larger mortgages, higher rent, premium vehicles. Each step appears reasonable in isolation. 

Collectively, however, these commitments reduce financial flexibility. 

A clinician may wish to reduce sessions or change direction, only to discover that fixed costs anchor them to workloads they no longer enjoy. 

This phenomenon, commonly referred to as lifestyle inflation or lifestyle creep, can lead to ‘golden handcuffs’; the inability to reduce clinical hours without experiencing financial strain.

The antidote lies in disciplined spending, early investing, and prioritising long-term independence over short-term status.

Depreciating assets satisfy present consumption; purchase of appreciating assets create future opportunity.

The annual financial examination

Modern dental careers are rarely linear. NHS commitments may gradually reduce while private income increases. 

Associates may become equity holders within a practice, and DCPs may progress into lead clinical or managerial roles. Each transition subtly alters cash-flow, tax exposure, and lifestyle dynamics.

Dentistry is grounded in prevention. Patients are routinely advised to attend recall appointments every six to 12 months in order to identify problems before complications arise.

Personal finances require the same structured approach.

At regular intervals, dental professionals should conduct a structured financial review, examining: 

• Tax reserves and projected liabilities
• Pension contribution levels and tax efficiency
• Protection policies
• Estate planning documents, including Wills and Lasting Powers of Attorney
• Cash-flow and expenditure patterns
• Emergency fund reserves
• Signs of emerging lifestyle creep.

Financial oversight should be planned and scheduled, not reactive. 

Setting aside one dedicated financial review day each year, and treating it as non-negotiable creates a simple discipline that will pay dividends.  

Consolidating the lessons

Regular financial review may not feel urgent early in a career.

Yet, much like periodontal disease, which progresses silently without monitoring and intervention, financial inefficiencies can accumulate unnoticed. 

Across this three-part series; from pensions to protection planning, a consistent pattern emerges.

When issues arose, assumptions had replaced verification, paperwork and advice were deferred, and financial structures remained unreviewed.

In many adverse scenarios, warning signs were present, but overlooked.

Several practical lessons follow:

• Strong foundations matter; income alone does not create wealth
• Headline earnings can obscure true net income
• Responsibility for financial efficiency ultimately rests with the individual 
• Protecting income for both yourself and your immediate family; insurances are foundational and should not be regarded as optional.
• Structures and lifestyle determine long-term independence
• Legal safeguards preserve your intentions when you cannot act.

The systems governing finance are rule-based. The legal system operates on documentation, not intention. HMRC operates on legislation, not assumption. Insurers operate on policy wording, not discretion.

Professional freedom

Dentistry offers exceptional earning potential and a high degree of professional autonomy. Yet autonomy within the surgery means little without financial independence beyond it.

Crisis-driven decision making, whether in dentistry or finance is rarely optimal. 

Effective financial management is not merely about accumulating wealth alone. Rather, it is about preserving the ability to choose your clinical hours, your working environment, and ultimately when you step away from the chair, on your own terms. 

That is the essence of genuine financial freedom.

Income is the tool, not the goal.

Disclaimer: This article is intended for general educational purposes only and does not constitute personalised financial, legal, or tax advice. Individual circumstances vary, and readers should seek professional advice before making or implementing financial decisions.

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Sanofi’s Tzield Approved in the U.S. for Patients with Stage 3 Type 1 Diabetes

On June 13, Sanofi announced that the US Food and Drug Administration (FDA) has granted accelerated approval to Tzield (teplizumab-mzwv) to delay the decline in endogenous (own) insulin production in children aged eight to 17 years recently diagnosed with stage 3 type 1 diabetes. Tzield is not effective as a disease-modifying therapy in non-autoimmune dysglycemic conditions.

“We now have a novel therapy that targets the autoimmune and progressive nature of stage 3 type 1 diabetes,” said Aaron J. Kowalski, PhD, CEO of Breakthrough T1D. “Approximately 64,000 people are diagnosed with T1D every year. We are excited that the approval of Tzield in this indication provides a treatment option for certain patients diagnosed in stage 3 T1D, which is when many start experiencing common symptoms of the disease.”

The approval was supported by data from the PROTECT phase 3 study (clinical study identifier: NCT03875729), evaluating beta cell function as assessed by significantly slowing the decrease in mean C-peptide levels (area under the curve after a four-hour, mixed-meal tolerance test; difference in least-squares means 0.13 pmol/mL; 95% confidence interval: 0.09-0.17; p<0.001) at trial completion, compared to placebo, as well as data from the broader clinical development program that included over 900 patients who received Tzield. Adverse events observed in the PROTECT phase 3 study were consistent with previous studies.

The most common adverse reactions were lymphopenia, vomiting, rash, leukopenia, diarrhea, neutropenia, increased liver transaminase, and headache. Serious events such as cytokine release syndrome and life-threatening cases of viral reactivation have been reported with Tzield. Patients who are immunocompromised are at increased risk for viral reactivation.

This indication is granted under accelerated approval based on evidence of reduced C-peptide decline. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory study(ies).

Medicines that receive accelerated approval are intended to treat serious conditions that fill an unmet medical need, based on a surrogate endpoint reasonably likely to predict clinical benefit. In line with this, the confirmatory BETA-PRESERVE phase 3 study (clinical study identifier: NCT07088068) was initiated and is currently enrolling participants.

“We welcome this accelerated approval by the FDA, which recognizes the potential of Tzield to delay the progression of recently diagnosed stage 3 T1D in children aged eight to 17 years,” said Christopher Corsico, global head of development, Sanofi. “Tzield will now offer a new pathway in the treatment paradigm of stage 3 T1D, one that we hope will further enable healthcare providers in the US to take a more proactive approach to disrupt the underlying autoimmune attack against insulin-producing beta cells.”

Prior to this approval in recently diagnosed stage 3 T1D, in April 2026, the FDA expanded the indication to delay the onset of stage 3 T1D in adults and children eight years and older with stage 2 T1D, to include children aged one year and above. It is also approved to delay the onset of stage 3 T1D in adults and children eight years and older with stage 2 T1D in the UK, the EU (under the name Teizeild), China, Australia, Canada, Israel, Saudi Arabia, the UAE, Kuwait, Brazil and Switzerland. Regulatory reviews are ongoing in other jurisdictions around the world. Tzield was previously designated by the FDA as breakthrough therapy and was granted orphan drug designation, for investigational medicines that treat rare diseases affecting fewer than 200,000 people in the U.S.

TRYNGOLZA® (Olezarsen) Approved by the FDA as the First and Only Treatment to Reduce Triglycerides and the Risk of Acute Pancreatitis in Patients with Severe Hypertriglyceridemia (sHTG)

Ionis Pharmaceuticals, Inc. on June 24 announced that the U.S. Food and Drug Administration (FDA) has approved TRYNGOLZA® (olezarsen) as an adjunct to diet to reduce triglycerides (TG) and the risk of acute pancreatitis in adults with severe hypertriglyceridemia (sHTG: TG greater than or equal to 500 mg/dL). TRYNGOLZA is available in a 50 mg or 80 mg dose and is self-administered once monthly via an autoinjector. sHTG is characterized by an increased risk of acute pancreatitis, which causes debilitating abdominal pain that often leads to repeated and prolonged hospitalization, permanent organ damage and can be life-threatening.

“The approval of TRYNGOLZA marks an historic advance for people who have long struggled to control their dangerously high triglycerides, providing the only approved therapy for sHTG to dramatically lower triglyceride levels and significantly reduce acute pancreatitis events,” said Brett P. Monia, Ph.D., chief executive officer, Ionis. “TRYNGOLZA reflects the strength of Ionis’ innovative science and our commitment to transforming patients’ lives. As our first independent launch in a prevalent disease, this milestone builds on our success in familial chylomicronemia syndrome, a rare form of sHTG, and marks a defining moment for Ionis as we bring our groundbreaking medicines to even more patients in need. We are deeply grateful to the clinical trial participants, investigators, the Ionis team and many others whose dedication made this achievement possible.”

“As a physician, I have seen firsthand how challenging it can be for patients with sHTG to lower their triglycerides below 500 mg/dL, despite background lipid-lowering therapies and lifestyle changes, which leaves them at risk of a devastating and potentially life-threatening acute pancreatitis attack,” said Archna Bajaj, M.D., assistant professor of clinical medicine, University of Pennsylvania. “TRYNGOLZA is a transformational new therapy that showed unprecedented, clinically meaningful outcomes for sHTG, with the potential to redefine the treatment paradigm.”

The FDA approval was based on positive results from the Phase 3 CORE and CORE2 studies, which were published in The New England Journal of Medicine.

In the CORE and CORE2 studies, TRYNGOLZA demonstrated rapid and consistent triglyceride control, lowering fasting triglyceride levels by up to 72% compared to placebo at six months and sustaining those reductions at 12 months. Additionally, TRYNGOLZA significantly reduced acute pancreatitis events by up to 91%. Among patients treated with TRYNGOLZA with baseline and 12-month data, 86% achieved triglyceride levels below 500 mg/dL, a critical threshold for reducing acute pancreatitis risk. The number needed to treat (NNT) over one year to prevent one episode of acute pancreatitis was 20 in the overall cohort and four in patients with triglycerides ≥880 mg/dL and a prior history of acute pancreatitis, indicating a strong clinical benefit across the spectrum of sHTG patients and an exceptional clinical benefit in the highest risk subgroup.¹

Across the clinical program, TRYNGOLZA demonstrated a favorable safety and tolerability profile. The most common adverse reactions in patients with sHTG (incidence ≥2% higher than placebo) were injection site reactions and liver enzyme increases.

“With limited options to lower triglycerides, people living with sHTG often face a constant and real fear that a debilitating acute pancreatitis attack could strike at any time without warning,” said Emily Draud, interim executive director, National Pancreas Foundation. “The availability of TRYNGOLZA for sHTG represents an important new option for this community, offering hope for people who have been waiting for a new treatment to reduce the risk of acute pancreatitis by significantly lowering their triglyceride levels. It also underscores the urgent need for continued innovation and improved care for patients living with this serious condition.”

Ionis is committed to helping people access the medicines they are prescribed and will offer a full suite of services for people prescribed TRYNGOLZA through Ionis Every Step. Ionis Every Step offers personal support, including nutrition information and injection training, insurance support and financial assistance programs. Visit TRYNGOLZA.com for more information.

TRYNGOLZA will be available for sHTG in the U.S. in July.

*Inclusion in Pharma Fridays does not suggest an endorsement by Endocrine News or the Endocrine Society.

The post Pharma Friday – June 26, 2026 appeared first on Endocrine News.

What Is Teeth Spacing?

Teeth spacing refers to visible gaps between teeth. These gaps may appear as a small space between the front teeth or as multiple spaces throughout the smile.

Spacing can affect children, teens, and adults alike. In some cases, it’s simply a cosmetic concern. In others, it may be linked to bite alignment or jaw development. An orthodontist can help determine whether the spacing is minor or part of a larger issue.

Common Signs of Teeth Spacing

Teeth spacing can appear in several noticeable ways, affecting both the look of your smile and how your teeth function day-to-day. Recognizing these signs early can help you determine whether the spacing is primarily cosmetic or warrants an orthodontic evaluation. 

Common indicators include visible gaps between teeth, food frequently getting trapped, and changes in how your teeth fit together when biting or chewing.

What Causes Gaps Between Teeth?

Teeth spacing can develop for several reasons, including:

• Differences in tooth and jaw size can contribute to spacing. When teeth are smaller in proportion to the jaw, extra space may appear between them
  
• Missing teeth can lead to gaps as surrounding teeth shift into the open space over time
  
•  Certain childhood habits, such as thumb sucking, prolonged pacifier use, or tongue thrusting, can influence how teeth align
• In adults, gum disease or bone loss can reduce support around the teeth, which may cause new gaps to develop or existing spaces to widen
  

Are Gaps Between Teeth a Problem?

Not all gaps require treatment. Some spacing is purely cosmetic and does not affect oral health. However, larger or worsening gaps can lead to:

• Difficulty chewing properly
• Bite imbalance
• Speech concerns
• Increased risk of gum issues
• Food trapping between teeth

An orthodontic evaluation can help determine whether treatment is recommended.

How an Orthodontist Evaluates Teeth Spacing

During an orthodontic evaluation for teeth spacing, the orthodontist reviews the position and spacing of your teeth, how your bite aligns, and the relationship between your upper and lower jaws. They also assess your overall oral health. This helps identify the cause of the spacing and determine the most appropriate treatment.

The orthodontist may use photos, digital scans, X-rays, or impressions to better understand the cause of the spacing. Identifying the underlying issue is key to creating an effective treatment plan.

Teeth Spacing Treatment Options

Treatment depends on the cause of the spacing, the size and location of the gaps, the patient’s age, and whether other alignment issues are present.

Braces for Closing Gaps Between Teeth

Braces gradually move teeth into better alignment and close gaps over time.

They are often recommended when spacing occurs alongside crowding, bite problems, or more complex alignment concerns. Braces are effective for children, teens, and adults.

Clear Aligners for Teeth Spacing

Clear aligners can be a good option for mild to moderate spacing, gradually moving teeth into proper alignment to close gaps and create a more balanced, healthy smile.

Retainers After Spacing Treatment

Retainers help maintain your results and prevent gaps from reopening after treatment. Because some spacing issues are more prone to relapse, wearing your retainer as directed is essential for keeping your smile aligned long term.

Other Treatments for Gaps Between Teeth

In some cases, orthodontic care may be combined with other dental treatments, such as:

• Bonding or veneers for small or uneven teeth 
• Tooth replacement for missing teeth 
• Treatment for gum disease 

Orthodontics may be one part of a broader plan to improve both function and appearance.

Can Braces or Aligners Fix Gaps in Teeth?

Yes, in many cases, braces and clear aligners can successfully close gaps.

The best option depends on the cause and severity of the spacing. Larger gaps, missing teeth, or bite-related issues may require a more customized approach. An orthodontist can recommend the most effective solution after an evaluation.

Teeth Spacing in Children vs. Adults

Teeth spacing can vary by age and stage of development. In children, some spacing is normal as baby teeth fall out and permanent teeth come in, but it should still be monitored. In teens, gaps that persist or become more noticeable may indicate alignment or bite concerns and could benefit from orthodontic guidance. In adults, spacing is often treatable, but new or widening gaps should be evaluated to rule out underlying issues such as bite changes or gum health concerns.

When Should You See an Orthodontist for Teeth Spacing?

It’s a good idea to schedule an orthodontic evaluation if you notice visible gaps between your teeth, food frequently getting stuck, discomfort when biting, or changes in speech. Gaps that seem to be increasing over time should also be evaluated.

For children, it’s important to monitor spacing as permanent teeth come in. Early guidance can help determine whether treatment is needed or if the spacing can simply be observed as their smile continues to develop.

Schedule an Orthodontic Evaluation for Teeth Spacing

Teeth spacing is common and often treatable with the right approach. A personalized orthodontic plan can address both cosmetic concerns and functional issues.

If you’re concerned about gaps in your teeth or your child’s smile, consider visiting an orthodontist through the American Association of Orthodontists. An AAO orthodontic practice can identify the cause of spacing, explain your options, and guide you toward the best next step. Find an AAO orthodontist near you and schedule your consultation today. 

The post Teeth Spacing: Causes, Concerns, and Treatment Options appeared first on American Association of Orthodontists.

This article explains what an underbite is, why it happens, when it may need treatment, and what your options are. An orthodontist can evaluate the severity of your underbite and recommend the right treatment plan for your specific situation.

What Is an Underbite?

An underbite is a type of malocclusion, a clinical term for teeth and jaws not lining up the way they should. In a healthy bite, the upper front teeth sit slightly in front of the lower teeth when you close your mouth. With an underbite, that relationship is reversed — the lower front teeth end up overlapping or sitting ahead of the upper front teeth.

Underbites range from mild (barely noticeable) to severe (where the lower jaw visibly juts forward). The cause can be:

• Dental — a tooth positioning issue
• Skeletal — related to jaw structure
• A combination of both

That distinction matters a lot when it comes to figuring out the best treatment approach.

Common Signs and Symptoms of an Underbite

Some underbites are obvious at a glance. Others are subtle enough that only an orthodontic exam will catch them. Common signs include:

• Lower teeth that sit visibly in front of the upper teeth when biting down
• A lower jaw or chin that appears more prominent than the upper jaw
• Difficulty biting or chewing comfortably
• Speech issues, like a lisp or trouble pronouncing certain sounds
• Jaw discomfort or pain, especially around the joints
• Uneven or accelerated tooth wear
• Difficulty closing the mouth fully without strain

If any of this sounds familiar, it’s worth getting an orthodontic evaluation to understand what’s going on and whether treatment makes sense.

Factors That Can Influence How the Teeth and Jaws Develop

A variety of factors can affect the way the teeth and jaws develop, including:

• Genetics. Jaw shape, size, and bite patterns tend to run in families. Some people are simply born predisposed to an underbite.
• Jaw development differences. If the upper jaw grows more slowly than the lower, or the lower jaw grows more than expected, the teeth can end up out of alignment.
• Childhood habits. Prolonged thumb sucking, extended pacifier use, tongue thrusting, and chronic mouth breathing can all influence how the teeth and jaws develop during the early years.

How Is an Underbite Diagnosed?

An orthodontist evaluates an underbite by looking at the full picture: teeth, bite, jaw position, and facial structure together. The process may include:

• A clinical exam to assess how the teeth fit together and how the jaws align
• Digital X-rays to evaluate bone structure and tooth roots
• Photos, 3D scans, or impressions to capture the complete bite

From there, the orthodontist determines whether the underbite is primarily dental, skeletal, or a mix of both. That classification directly shapes which treatment options are most likely to work.

Underbite Treatment Options

Treatment depends on your age, how much jaw growth remains, and how severe the underbite is. Here’s an overview of the most common approaches.

Braces

Braces are a reliable choice when the underbite is primarily related to tooth positioning. They apply steady, controlled pressure to gradually shift teeth into better alignment. In many cases, braces are paired with elastics or other appliances to help guide jaw position.

Clear Aligners

Clear aligners can work well for mild underbites where the issue is largely dental rather than skeletal. Because they move teeth incrementally, they tend to be best for patients whose bite can be improved through tooth movement alone. Your orthodontist can assess whether aligners are a good fit for your specific case.

Palatal Expanders In Combination with Reverse-Pull Headgear

For children who are still growing, early treatment can be effective. When an underbite is related to jaw development, a palatal expander may be used along with reverse-pull headgear to encourage forward growth of the upper jaw and improve jaw alignment. Because children’s bones are still developing, growth-guiding treatment can help address skeletal issues before they become more severe. The American Association of Orthodontists recommends that children receive their first orthodontic evaluation by age 7, as early intervention can reduce the need for more complex treatment later.

Jaw Surgery

When an underbite involves a significant skeletal discrepancy, meaning the jaws themselves are substantially out of position, orthodontic treatment alone may not be enough. In those cases, orthognathic surgery (jaw surgery) may be recommended. It’s typically performed after the jaw has finished growing and is almost always combined with orthodontic treatment before and after the procedure.

Can an Underbite Be Fixed Without Surgery?

For many people, yes. Mild underbites, when caught early, are often treated successfully without surgery. Surgery is generally reserved for more severe skeletal cases in adults where jaw structure can’t be corrected through tooth movement alone.

The only reliable way to know what applies to your situation is a thorough orthodontic evaluation.

Underbite Treatment for Children vs. Adults

Children tend to have more options available because their jaws are still growing. Growth appliances can guide jaw development in ways that aren’t possible once the bones have matured. An early evaluation, ideally by age 7, gives orthodontists the best chance to catch issues and intervene at the right time.

Adults can absolutely receive underbite treatment and get excellent results. More severe cases may involve a more involved plan since jaw growth is complete, but it’s never too late. Adults are successfully treated for underbites every day.

Visit an AAO Orthodontist to Address Underbite Concerns

Underbites are common, well understood, and very treatable. But the right approach is different for every person, which is why an evaluation from a qualified orthodontist matters.

If you’re concerned about an underbite, whether it’s your own or your child’s, don’t put it off. Find an AAO orthodontist near you and schedule your consultation today. An AAO orthodontic practice can evaluate the bite, walk you through your options, and recommend the next step that makes the most sense for your situation.

The post Underbite: Causes, Symptoms, and Treatment Options appeared first on American Association of Orthodontists.

Robbie Stewart explains how perfectionism is holding back talented clinicians and highlights the importance of confidence for both dental professionals and the patients they treat.

A conversation I had recently with a fellow clinician has stayed with me. We were reviewing composite bonding completed at another practice. The clinician was dismissive – critical of its quality and quick to suggest it needed replacing.

My perspective was different. The work was not flawless, but it was functional, the patient had accepted it, and it appeared appropriate for that clinician’s stage of development. When I raised this, the response was: ‘If I couldn’t do it to the standard I wanted, I simply wouldn’t do it.’

That statement got me thinking. Because I believe that mindset – however well-intentioned – is doing real harm to our profession.

Perfectionism as a barrier, not a standard

There is an important distinction between striving for excellence and demanding perfection before you begin. The former drives growth. The latter prevents it. When clinicians refuse to offer treatments until they feel they have mastered them, the result is not a higher standard of care – it is a reduction in access to treatment and a stalling of professional development.

I have spoken with talented dentists, dental therapists, and hygienists who hold back from offering certain treatments not because they lack the clinical foundation, but because they do not feel ‘good enough’ yet. They are waiting for a level of confidence that can only come from doing the very thing they are avoiding. This reluctance does not only affect the clinician – it affects the patient who does not receive treatment they need from someone perfectly capable of delivering it to an appropriate standard.

The role of social media

The cases shared online are, understandably, the best ones. The flawless composites, the striking transformations, the technically demanding cases executed with apparent ease. What we rarely see is the learning curve – the early work, the cases that did not go as planned, the mistakes that shaped the clinician we are looking at today. The result is that clinicians at every stage of their career are comparing their reality to everyone else’s highlight reel, which distorts expectations and fuels impostor syndrome across the profession.

Senior clinicians have a particular responsibility here. The work they share is the product of years of practice and countless corrected mistakes. If that journey is never made visible, newer clinicians are left with the impression that excellence is innate or arrived at effortlessly. Neither is true.

The Sainsbury’s principle

When you do your weekly shop, you do not expect the food to be Michelin-starred. You expect good quality at a fair price. Sainsbury’s does not apologise for not being a fine dining restaurant. The same principle applies in dentistry. If a clinician is transparent about their experience, pricing appropriately, and delivering clinically sound treatment, that is a legitimate and ethical transaction. Perfection is not the standard we are contractually or ethically obliged to meet. Competence, honesty, and appropriate care are. Refusing to offer treatment because you cannot guarantee a perfect outcome is not protecting the patient – in most cases, it is protecting yourself from the discomfort of imperfection.

Where real learning happens

I recently ran my own Excellence in Exams, Treatment Planning, and Digital Dentistry course for dental therapists and was struck by something unexpected. The delegates were knowledgeable clinicians who could articulate their reasoning clearly – yet when asked to make autonomous clinical decisions, many hesitated. There was a persistent fear of missing something.

Many described feeling as though they should not be doing work that sits squarely within their scope, despite performing similar tasks every single day. That gap between what they could do and what they believed they were permitted to do was rooted entirely in perfectionism. Structured learning environments like this exist precisely to close that gap – to give clinicians the space to try, reflect, and build genuine confidence.

Professional groups and mentorship communities serve the same function. Communities such as The Modern Therapist by Cat Edney, DRMR’s Mentorship Programme by Dr Manrina Rhode, Simplifii by Dr Albert Gajdos, and Avant Garde by Dr Robbie Hughes are spaces where clinicians (me included) share work at all stages of development and receive honest, constructive feedback. These communities allow the kind of professional reflection that a public Instagram feed cannot, and they deserve far greater recognition as a serious component of continuing professional development.

A call to the profession

To those who are experienced and established: be more open about how you got to where you are. Share the early cases. Talk about the treatments that did not go as planned. Show the next generation that clinical excellence is not a straight line.

And to those earlier in their careers: stop waiting until you are perfect before you begin. Price your work honestly, be transparent with your patients, work within your competence, and then push that competence incrementally. That is how skills are built and how confidence is earned.

Perfectionism dressed up as standards is still just fear. And fear, ultimately, serves no one – not the clinician, and not the patient.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

Unforgettable design has become as important as clinical excellence in private dentistry – Aneka Khaira shares the story behind the iconic Rex Mirror that has become a central part of the branding at Vogue Dental.

For me, the Rex Mirror by Timothy Oulton has become an iconic part of Vogue Dental.

From the moment patients walk through the door, it acts as the centrepiece of the practice – bringing glamour, warmth, and light into the space.

It is more than just a mirror; it creates an immediate sense of occasion.

Whether a patient is checking their outfit, admiring their new smile, or capturing a selfie, the mirror adds a touch of instant sophistication and makes a lasting impression.

Every time I see the mirror, it reminds me not only of the vision I had for Vogue Dental, but also of that exciting chapter in my life – building a business, becoming a mother, and creating a space that feels both elegant and deeply personal.

A bit of background

The Rex Tall Mirror by Timothy Oulton has developed something of a cult following among celebrities, influencers including and luxury interior designers.

At nearly eight feet tall, illuminated with 24 warm bulbs, and priced at around £9,595 in the UK, it is designed to be a true statement piece rather than a functional mirror. 

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

Raman Aulakh explores how synergistic and antagonistic tooth movements influence clear aligner predictability, offering GDPs practical staging principles to improve tracking, reduce refinements and plan more efficient treatment.

This is the third and final article in our series exploring the principles of clear aligner biomechanics.

In Part 1, we discussed why evidence-based predictability should guide aligner staging rather than relying solely on protocols, while Part 2 translated the predictability hierarchy into practical chairside biomechanics.

In this article, we move beyond individual tooth movements and focus on how movements interact with one another. Some movements work together to improve aligner efficiency and predictability, while others compete against each other and can increase the risk of poor tracking, anchorage loss and refinements. By understanding which movements are synergistic and which are antagonistic, clinicians can make better staging decisions and create more predictable treatment plans for their patients.

A recent review by Martínez-Lozano and colleagues explored this concept in detail through the idea of staging and biomechanics in clear aligner therapy. While the original paper provides a comprehensive and highly technical discussion, there are several practical lessons that every GDP providing aligner treatment can apply immediately in practice.

It’s not just where teeth end up – it’s how they get there

When reviewing a digital setup, many clinicians focus on the final result.

Will the teeth end up in the right place?

A more important question is: How will they get there?

Aligners work by delivering a series of small, controlled movements. If those movements support each other, treatment tends to be efficient and predictable. If they oppose each other, the aligners can struggle to express the programmed movement, leading to poor tracking and additional refinement stages.

Simply put, some movements create favourable conditions for other movements. Others create resistance.

What are synergistic movements?

Synergistic movements are movements that assist each other biomechanically.

When planned together, they tend to improve aligner efficiency and increase the likelihood that the planned movement will be expressed clinically.

Example one: expansion and anterior retraction

A common clinical scenario is a patient with mild crowding and proclined upper incisors.

When posterior expansion is combined with anterior retraction, space is being created posteriorly while being utilised anteriorly. These movements complement one another and often produce more predictable outcomes.

Rather than fighting for space, the aligner is working with the available arch form.

Example two: distalisation and incisor proclination

Another example is molar distalisation combined with mild incisor proclination.

As posterior teeth move distally, space becomes available within the arch. At the same time, slight proclination of the incisors can assist alignment and crowding relief.

These movements work in harmony and frequently demonstrate better predictability than attempting more complex combinations of movement.

Example three: posterior intrusion and anterior extrusion

In selected deep bite cases, posterior intrusion combined with anterior extrusion can help improve vertical relationships.

Because these movements contribute towards the same occlusal objective, they tend to be more efficient than attempting contradictory vertical movements elsewhere in the arch.

A practical rule for GDPs

When reviewing a ClinCheck or digital setup, ask yourself three simple questions:

1. Does this movement create space or consume space?

Movements that create space, such as expansion or proclination, are often best completed first.

Movements that consume space, such as compression, retraction or certain vertical movements, are often easier once adequate space already exists.

2. Am I trying to achieve too many difficult movements at once?

Aligners are highly effective, but they still have biomechanical limitations.

If a tooth requires rotation, extrusion and root torque simultaneously, consider whether these movements would be better staged.

3. Could I simplify the plan?

One of the biggest mistakes made by newer aligner providers is trying to achieve every correction at the same time.

Often the most predictable treatment plans are the simplest.

Create space first.

Align teeth second.

The value of staging

As clinicians become more experienced with aligners, they begin to think less about individual aligners and more about the sequence of treatment.

Successful aligner therapy is not simply about knowing what movements are required.

It is about understanding when those movements should occur.

By recognising which movements are synergistic and which are antagonistic, clinicians can improve predictability, reduce refinements and deliver more efficient treatment for their patients.

Complete difficult finishing movements last.

By creating space first, aligning teeth second and reserving finishing movements for the final stages of treatment, clinicians can improve aligner tracking, anchorage control and overall predictability.

Further reading

The concepts discussed in this article are based on the review by Martínez-Lozano D, Castellanos-Andrés D and López-Jiménez AJ, Staging of Orthodontic Tooth Movement in Clear Aligner Treatment: Macro-Staging and Micro-Staging – A Narrative Review (Applied Sciences, 2024). Readers with a particular interest in aligner biomechanics are encouraged to review the original publication for a more detailed discussion of staging strategies and clear aligner biomechanics.

To learn more or arrange a no-obligation call with course director Dr Raman Aulakh, visit alignerdentalacademy.com/clear-aligner-therapy-diploma or reach out to diploma@alignerdentalacademy.com and discover how the SAFE Clear Aligner Diploma can take your career to the next level.

This article is sponsored by Aligner Dental Academy.

New capsule-based dental 3D printer that integrates printing and curing delivers same-hour ceramic permanent restorations in a device smaller than a shoebox.

SHINING 3D Dental has announced the global launch of the Ceramix-Nano, a chairside dental 3D printer that produces permanent ceramic crowns, veneers, inlays, onlays, and Maryland bridges in a single appointment. Powered by patented APS (adaptive pneumatic stereolithography) technology, the Ceramix-Nano completes the full scan-to-restoration cycle in as little as 30 minutes.

Weighing 4.5lbs and measuring 3.43×5.16×10.87 inches (WxDxH) the device is smaller than a standard shoebox yet integrates both printing and curing in a single unit. It requires no dedicated lab space, no secondary equipment, and integrated with an AI Cloud Design, following the workflow wherever it happens.

Powered by SHINING FLOW, crown design takes under two minutes. Combined with a eight- to 11-minute print cycle and three-minute curing, the full scan-to-cementation workflow completes in as little as 30 minutes.

Its capsule-based material system ensures a user-friendly, highly intuitive user experience. Each capsule (or cartridge) of resin contains a pre-measured quantity of ceramic-filled resin. Scanning its QR code is all it takes for the printer to configure itself automatically, stir the resin, and start printing. A single capsule yields up to three restorations.

Fully integrated with SHINING Flow, SHINING 3D’s cloud-based scan-design-print platform, restoration files move from design to print without leaving the platform.

The Ceramix-Nano is available in North America and Asia through authorised SHINING 3D Dental distributors from June 18th, 2026. Availability in the EU and other regions will follow shortly.

About SHINING 3D Dental

Founded in 2004 in Hangzhou, China, SHINING 3D has built its reputation on high-precision 3D vision technologies across industrial metrology, digital dentistry, and reverse engineering. SHINING 3D Dental provides dental clinics and laboratories with a complete Scan-Design-Print digital workflow, enhancing practice efficiency and clinical outcomes. Its mission is to make innovative, precise, and accessible 3D digital solutions available to professionals worldwide, regardless of industry, scale, or geography.

This article is sponsored by SHINING 3D Dental.

10 Surprising Facts About Teeth

Your teeth are busy most of the day, helping you bite, chew, smile, and talk. Unless something starts to hurt or goes wrong, you probably don’t give your smile a second thought. But the more you know about your teeth, the better you can take care of your smile. Here are 10 surprising facts about teeth that you may not know.

1. A Tooth Can Emerge With a Cavity

While rare, this phenomenon is typically associated with the conditions known as natal and neonatal teeth.  According to a study done in 2023, “approximately 1 in 289 newborns are born with natal teeth, and 1 in 2,212 had neonatal teeth.”

Natal teeth are present at birth, while neonatal teeth emerge within the first two months of a child’s life. When a baby tooth develops a cavity, it is typically due to underdeveloped or weak enamel, making the tooth more vulnerable to decay.  

In some cases, these early teeth might have developed in conditions that increase the risk of cavities, such as a mother’s high sugar intake or certain medications taken during pregnancy. 

2. A Cavity is One of the Few Things Your Body Cannot Heal

The human body has an amazing ability to heal itself. For example, when you get a cut or break a bone, the body naturally begins repairing the damage. 

However, teeth are different. While early-stage tooth decay can be reversed through remineralization, once a cavity has fully formed, the tooth cannot heal itself and requires professional treatment. This is why flossing and developing good oral hygiene habits at a young age is important.  

Most people know what a cavity is, but how it gets there is less understood. To put it simply: bacteria in your mouth feed on sugar, those bacteria then produce acid as a byproduct, and that acid slowly eats away at your enamel. Once it breaks through the enamel, you have a cavity. 

Since your enamel contains no living cells, a requirement for healing to take place, it cannot regenerate or repair itself once the damage is done. And because cavities are caused by acid, without treatment they can keep growing, which is why a dentist needs to remove the decay and insert a filling in its place. 

3. A Tooth Can Grow Upside Down, Sideways, or Backward

While these growth patterns aren’t extremely common, they can significantly affect oral health and treatment. If you’re experiencing abnormal growth patterns, an AAO orthodontist can properly align your teeth to mitigate speech or bite problems.

• Upside-Down Growth: This is commonly seen with impacted teeth, particularly wisdom teeth. When a tooth develops upside down, it can lead to complications like misalignment of adjacent teeth, pain, and potential infection.
  
• Sideways Growth: Sideways tooth growth is frequently seen in wisdom teeth but can also occur in other teeth. It causes the tooth to grow at an angle instead of vertically. A tooth growing sideways can cause crowding, misalignment, and even damage to adjacent teeth.
  
•  Rotations:  There are instances where teeth can rotate 90 or even 180 degrees (backward) as they come in.  This can cause crowding, misalignment and changes in bite.
  

4. Baby Teeth Hold Space for the Permanent Teeth That Follow

One of the primary functions of baby teeth is to serve as placeholders for permanent teeth.

Each baby tooth reserves a specific space in the mouth for its corresponding permanent tooth, and maintaining this space is essential to guide the permanent tooth into the correct position. 

If a baby tooth is lost too early, the adjacent teeth can shift into the space, potentially leading to misalignment or crowding.

5. Baby Teeth are Also Known as Deciduous Teeth

Baby teeth have a formal name you might not know: deciduous teeth. The word comes from the Latin word decider, which means to “fall off”, the same root word behind “deciduous trees,” the trees that shed their leaves every fall. It is a fitting name for teeth meant to be temporary. 

Here’s a basic timeline: baby teeth start coming in around 6 months old, and most kids have all 20 by age 3, 10 on top and 10 on the bottom. These temporary teeth are very important for child development, helping kids chew, learn to speak, and hold space for permanent teeth to follow. Around age six, baby teeth begin to fall out one by one, with the process wrapping up around age 12. 

6. Teeth by the Numbers: We Get Two Sets, 20 Deciduous (Baby) Teeth and 32 (Usually) Permanent Teeth

Most people have two sets of teeth in their lifetime. The first set, baby teeth, consists of 20 teeth: 8 incisors, 4 canines, and 8 molars. The permanent set consists of 32 teeth: 8 incisors, 4 canines, 8 premolars, and 12 molars.

Not everyone ends up with the standard amount, though. Some people are born missing one or more teeth that never develop, while others may develop extra teeth beyond the normal number, known as supernumerary teeth.

Missing or extra teeth are more common than people realize, and both affect spacing and bite alignment in ways that orthodontic treatment can address.

7. Vaping and E-Cigarettes Pose a Real Risk to Your Teeth

If the highly addictive nicotine content wasn’t enough, vaping carries significant risks for your oral health, and the research has grown significantly stronger in recent years. While vaping devices are usually marketed as safer alternatives to traditional tobacco products, studies now show that people who vape are significantly more likely to have untreated cavities than non-vapers. Here’s what’s happening in the mouth:

• Sweet flavors feed harmful bacteria. While many flavoring agents in e-liquids used in e-cigarettes and vapes do not contain sugar, they do contain other sweeteners that can promote the growth of cavity-causing bacteria in the mouth. Whether it’s leaving a sticky residue on teeth that contributes to more plaque build-up or shifting the environment in your mouth in ways that favor harmful bacteria, these ingredients can increase the risk of tooth decay. 

• Liquid base causes dry mouth. Propylene glycol, the common solvent used as a base in many vapes and e-cigarettes, is what contributes to the common side effect of intense dry mouth. Not only is having a dry mouth uncomfortable, but it also creates an environment for a host of oral health issues. This is because saliva is one of your most powerful natural defenses against cavities. Anything that decreases the amount of saliva in your mouth can impact your oral health.

8. Not All Back Teeth Are Called “Molars”

While molars are responsible for grinding and crushing food during chewing, premolars are the teeth that sit between your canines (the pointed ones) and your molars. Most adults have 8 premolars, four on top and four on the bottom.  They are sharp enough to tear through food, yet flat enough to grind it down. 

What makes premolars interesting is that they are the only permanent teeth that don’t replace a baby teeth. A baby’s teeth don’t include premolars. When their molars fall out, premolars move into their place. 

Since the permanent teeth that replace baby teeth aren’t the same size, this transition period is when crowding or spacing issues can often first appear, which is why AAO recommends a check-up by age 7. 

9. Diet Soda and Sports Drinks Can Be as Tough on Teeth as Regular Soda

While diet sodas and beverages may have less sugar than regular soda, they can be just as detrimental to oral health as the non-diet versions. The main reason: high acidity. 

Diet soda and sports drinks still contain acidic compounds such as phosphoric and citric acids. While these are added to enhance flavor and shelf life, they can also erode tooth enamel over time. Frequent consumption of acidic beverages also reduces salivary flow, which is important for oral health. Saliva plays a crucial role in neutralizing acids and remineralizing enamel, so anything that reduces it removes a natural line of defense against tooth decay.   

A few simple tricks for consuming these beverages include using a straw to reduce contact with teeth, rinsing the mouth with water after drinking, and chewing sugar-free gum to stimulate saliva production.

10. The Part of the Tooth You See, the Crown, Is Only About a Quarter to a Third of the Entire Tooth

When you smile in the mirror, you’re only seeing part of your teeth. The visible portion of a tooth, the crown, makes up just one-quarter to one-third of the tooth’s total length. The rest of your tooth is called the root, which is anchored in the jawbone beneath your gums, where you can’t see it. 

The root also does more than hold the tooth in place. A network of tiny fibers surrounds it, called the periodontal ligament. It’s what cushions your tooth against chewing forces, and it’s what makes orthodontic tooth movement possible. When braces or aligners apply gentle pressure, it’s this ligament that allows teeth to move safely through the bone over time. 

Create a Healthy Bite with an AAO Orthodontist

Your teeth do a lot more than you think, and now with these facts, you can amaze your friends and family with your dental trivia knowledge. But knowing about your teeth is just the start. 

Healthy, properly aligned teeth are critical contributors to your overall health in ways that go well beyond a great smile. If you have concerns about misalignment, bite problems, or how your teeth have developed over time, an AAO orthodontist can help.

AAO Orthodontists are specialists who not only complete dental school but have completed additional years of training in orthodontics and dentofacial orthopedics. This extra training makes a real difference in the quality of care you receive. Use our online locator to find an AAO orthodontist near you and schedule your consultation today.

The post 10 Tooth Facts That May Surprise You appeared first on American Association of Orthodontists.

Every year, so many new memories are made at ENDO so I thought it might be fun to hear from some Endocrine Society members about their most memorable annual meetings from the past. A dozen or so of your fellow endocrinologists shared with me their most meaningful ENDO memories in “Looking Back: Unforgettable Moments from ENDOs Past.” Not only have many of you found ENDO to be the highlight of your year as you comingle with thousands of like-minded people from all across the globe, but ins some cases ENDO has literally been life changing. Find out which future Endocrine Society president decided to become an endocrinologist once they attended their very first ENDO. No doubt, a few lives will be impacted forever by what they encountered at ENDO 2026 in Chicago!

Another significant highlight at every ENDO occurs when the Endocrine Society releases a new Clinical Practice Guideline and ENDO 2026 is no different; on Saturday June 14 a special session heralds the publication of “Central Precocious Puberty: An Endocrine Society Clinical Practice Guideline.” Senior Editor Derek Bagley speaks to the guideline authors in “They Grow Up So Fast: Endocrine Society Releases Central Precocious Puberty Guideline” who discuss the new recommendations that will be elucidated on stage after its publication in The Journal of Clinical Endocrinology & Metabolism.

Glenda Fauntleroy Shaw interviews this year’s Transatlantic Alliance Award winner, Anna L. Gloyn, DPhil, FMedSci, in “Cultural Exchange.” Having conducted research, literally, on both sides of the Atlantic, Gloyn talks about  about what this award means to her, how a friend in college helped determine the future of her research, and the profound impact of doing research in both European and American labs. But, she says, the differences are more common AWAY from the bench, from her experiences: “The differences between labs in the U.K. and U.S. are not to do with the country you are in, they are to do with the lab culture which is set by the lab PI. That said, there are some obvious cultural differences,” she says. “I remember arriving as a post-doc fellow in Dr. Franz Matchinksy’s lab at the University of Pennsylvania and realizing that going to the pub for a beer after work on a Friday was a very British behavior!”

As usual, feel free to reach out to me at: mnewman@endocrine.org if you have any story suggestions or other ideas for Endocrine News!

The post Breezing Into the Windy City for ENDO 2026 appeared first on Endocrine News.

Understanding what’s in vapes, how those ingredients interact with your teeth and gums, and the side effects they can cause is key to protecting your smile before, during, and after treatment.

Why Vaping Is Hard on Your Mouth?

While vapor products may lack tobacco, they still contain high levels of nicotine and other chemicals that can cause damage to the gum tissue and teeth. Here are some of the ways vaping is hard on your mouth.

Propylene Glycol, a Main Ingredient in Vape Liquid, Can Cause Dry Mouth

One of the most common side effects of vaping is dry mouth. The main culprit: propylene glycol. 

Propylene glycol plays a few roles in e-liquids, but its main job is to serve as a carrier liquid. Since it does a great job of absorbing water and maintaining moisture, it helps all the ingredients in a vape liquid heat up and be inhaled. It’s this same water-attracting property that causes dry mouth for vape and e-cigarette users. Dry mouth is such an issue because you need saliva to wash away food particles and neutralize acids produced by bacteria in the mouth. While saliva is important for protecting against decay and gum disease, reduced saliva, or dry mouth, can increase the risk of cavities and gum disease.

Vaping Chemicals Can Contribute to Gum Disease and Inflammation

The chemicals in e-cigarette vapor can irritate gum tissue, leading to inflammation, redness, and swelling. What enters your mouth when you vape isn’t just “water vapor” but an aerosol made up of a cocktail of solvents and chemicals like propylene glycol, glycerin, flavoring agents, and other compounds that lead to many issues. 

Over time, this can cause or exacerbate gum disease (periodontal disease), characterized by receding gums, chronic bad breath, and even tooth loss if left untreated. 

High Nicotine Intake Can Impact Blood Flow to Your Mouth

Blood flow and healthy circulation are important for maintaining your oral health. Healthy circulation delivers nutrients, oxygen, and immune cells to tissues and gums, helping them heal after irritation or treatment. 

Over time, nicotine, a vasoconstrictor, can narrow blood vessels and reduce blood flow to the gums, making it harder for them to heal and stay healthy.

Those Sweet Vape Flavors May Not Be So Sweet to Your Teeth

The sweet flavors added to e-liquids might make your e-cigarette taste good, but they can also contribute to the decay of your teeth. Although most don’t contain sugar, the flavoring agents can still promote the growth of bacteria that produce acids that eat away at the tooth enamel. Combined with dry mouth, this significantly increases the risk of cavities.

Why Oral Health Matters Before Orthodontic Treatment?

Healthy teeth and gums are essential for successful orthodontic treatment. Because vaping can contribute to gum inflammation, dry mouth, and tooth decay, it may increase the risk of complications during treatment.

If you currently vape or have vaped in the past, here are a few factors your orthodontist may consider during treatment planning.

Are Your Teeth and Gums Healthy Enough to Start Orthodontic Treatment?

The health of the teeth and gums is the key factor in determining whether a person is a good candidate for orthodontic treatment. A periodontal (gum) check-up with a periodontist or general dentist is imperative to ensure your mouth is a good candidate before beginning treatment. If there is existing gum or tooth damage, your dentist or periodontist should treat it before beginning active orthodontic treatment.

How Well Will You Respond to Orthodontic Care if Damage is Present?

Additionally, the acceleration of gum damage caused by vaping reduces the ability of teeth and gums to respond to orthodontic treatment. There is also a tendency for teeth to relapse into previous positions post-treatment due to an increased risk of gum disease and weakened support systems that help hold teeth in place. 

Because of these risk factors, your orthodontist will likely recommend reducing or stopping vaping during and after treatment to improve results and oral health.

Vaping and Orthodontics: The Takeaway

Vapes and e-cigarettes may not contain tobacco, but they can still cause significant damage to your gums and teeth. The good news is that the risks associated with vaping are entirely preventable.

If you’re thinking about orthodontic treatment, you’re considering investing a lot of time and effort in creating a healthy smile. Don’t risk damaging it. AAO recommends staying away from harmful e-cigarettes and vaping products, both for successful orthodontic treatment and your overall oral health.

If you use e-cigarettes and are exploring your options for orthodontic treatment, we also recommend visiting a general dentist or periodontist before your consultation. They can examine your teeth and gums, identify potential oral health issues, and treat them before receiving orthodontic care.

Trust an AAO Orthodontist for a Beautiful, Healthy Smile

The American Association of Orthodontists (AAO) is exclusively open to orthodontists who complete the necessary dental school and additional orthodontic residency programs. You can work with an AAO Orthodontist to achieve a healthy, beautiful smile at any age. Orthodontists are experts in orthodontics and dentofacial orthopedics – properly aligned teeth and jaws – and possess the skills and experience to give you your best smile. When ready to achieve a healthy, beautiful smile, find an AAO orthodontist near you.

The post The Impact and Hidden Consequences of Vaping on Oral Health appeared first on American Association of Orthodontists.

Dental units are one of the most critical investments for practices, directly influencing workflow efficiency, practitioner health and patient experience. Explore how KaVo dental units address three critical considerations – longevity, ergonomics and innovation.

Imagine sitting in your car for eight hours a day – that’s effectively what you’re doing with your dental unit. With increasing demands – from higher patient expectations to evolving digital workflows to clinic design and overall ambience – the choice of treatment centre has become a strategic decision for every dental practice.

Beyond the initial purchase price, factors such as longevity, ergonomics and innovation play a critical role in determining a dental unit’s long-term value. Established manufacturers such as KaVo have helped shape these priorities through decades of development in dental equipment design.

While often associated with the premium end of the market, KaVo units are competitively positioned, with complete, ready-to-use surgery packages available from around £12,500+VAT.

This article explores how these three considerations influence modern practice, and what dental professionals should look for when investing in a new dental unit.

A central investment in modern dentistry

The dental unit is more than just a chair – it is the operational hub of the surgery. Every procedure, from routine examinations to complex restorative work, depends on how effectively the unit supports both clinician and patient.

In today’s climate, dental practices face increasing pressure: tighter margins, higher patient expectations and a growing awareness of clinician wellbeing. Against this backdrop, the choice of dental unit becomes a strategic decision rather than a purely functional one.

Known for German engineering precision and forward-thinking design and with more than a century of innovation in dental technology, KaVo has established itself as a benchmark for quality, ergonomics and reliability in dental units. Its units are built to support long-term performance while enhancing everyday workflows.

KaVo has long positioned itself at the premium end of the market in terms of quality, but is now more competitive on price than ever before, with a focus on engineering quality and clinical usability.

For dental practices considering a new investment, three factors stand out as critical:

1. Longevity
2. Ergonomics
3. Innovation.

Longevity: investing beyond the initial purchase

For many practices, the true cost of a dental unit is not measured at the point of purchase, but over its lifetime. Reliability, durability and serviceability all contribute to long-term value.

Ergonomics: protecting clinicians and enhancing workflow

Musculoskeletal disorders remain one of the most significant occupational risks in dentistry. Prolonged static postures, repetitive movements and awkward positioning all contribute to long-term health issues, making ergonomics a key consideration in equipment selection.

‘Dentistry remains a profession where physical strain is extremely common,’ says cosmetic dentist Devisha Patel. ‘Often, the focus within a practice is understandably centred around efficiency, productivity and patient flow, but ergonomics can sometimes become secondary.

‘Too often, clinicians only begin addressing ergonomics once pain or injury develops, rather than embedding healthy working practices from the outset of their careers.

‘Ultimately, supporting clinician wellbeing should be viewed as an investment, not only in the individual practitioner, but in the quality and sustainability of patient care.’

According to the manufacturer, the KaVo ESTETICA E70/E80 Vision are the only dental units on the market that are accredited to support healthy working postures.

Innovation: enabling the modern digital practice

As dentistry continues to evolve, innovation in dental units plays a key role in supporting new technologies, improving workflows and enhancing patient care.

Dartmoor Dental’s units

‘In the modern dental landscape, the dental unit is the undisputed heart of the surgery,’ says Michael Hesketh, dentist and owner of Dartmoor Dental. ‘When we looked to upgrade our facilities four years ago, we weren’t just looking for chairs; we were looking for a long-term investment in our clinical workflow and our practice’s brand identity.

‘Today, our practice operates a suite of nine KaVo units, and the impact on our efficiency and patient satisfaction has been profound.’

For Michael, the decision to partner with KaVo was driven by peer recommendations. He says: ‘In the UK, KaVo has earned a reputation for “made in Germany” engineering that translates to minimal downtime. After four years of heavy clinical use, we can attest that the build quality is second to none. The units remain as reliable as the day they were installed.’

Dartmoor Dental currently utilises three distinct models from the KaVo range, each selected for a specific strategic purpose:

• KaVo ESTETICA E50 Life: ‘These are our standard units across five surgeries, says Michael. ‘Known for its reliability, we chose E50 because they offer a perfect balance of sophisticated technology and intuitive operation. They look exceptional and, crucially, they are built to last – a sentiment echoed by many colleagues who recommended them for their high ‘value for money’ over a long lifecycle’
• KaVo ESTETICA E30 Life: ‘We have two of these, specifically chosen for our training surgeries used by our foundation dentists. The standout feature here is the E30’s ability to switch from right-handed to left-handed operation in under two minutes. This flexibility is vital for a teaching environment, ensuring we can accommodate any trainee without compromising on ergonomics’
• KaVo uniQa: ‘For our latest two surgeries, we moved up to the KaVo uniQa. This unit represents the next evolution in dental excellence, offering enhanced facilities and a sleek, sporty design that immediately signals a high-end clinical environment to the patient.’

Balancing priorities in practice

While longevity, ergonomics and innovation are all important, the challenge for many practices lies in balancing these factors within budget and operational constraints.

Different settings may prioritise these elements differently:

• High-volume environments may emphasise durability and efficiency
• Patient-focused practices may prioritise comfort and experience
• Specialist clinics may require advanced integration and flexibility.

Manufacturers with broad product ranges, including KaVo, often offer configurable options that allow practices to tailor units to their specific needs.

Making the right investment decision

When evaluating a dental unit, practical considerations remain essential:

• Surgery layout and space planning
• Installation requirements and infrastructure
• Training and onboarding for the dental team
• Ongoing service and support availability.

Hands-on demonstrations can be particularly valuable, allowing clinicians to assess ergonomics and usability in real-world scenarios.

Ultimately, the decision should align with both clinical priorities and long-term business goals.

Summary

Selecting a dental unit is a long-term investment that influences clinical performance, practitioner wellbeing and patient experience.

Longevity ensures reliable operation and reduces lifetime costs, ergonomics supports healthier working practices and improved efficiency, and innovation enables integration with modern technologies and evolving standards.

Manufacturers such as KaVo have contributed significantly to advancing these areas, helping to shape expectations across the profession.

By carefully considering these factors, dental professionals can make informed decisions that support both immediate clinical needs and future growth, ultimately enhancing the sustainability and success of their practice.

Choose your next dental unit like you choose your car. The KaVo configurator will show you what’s available and how it looks!

With Keir Starmer resigning as prime minister and Andy Burnham expected to take over, NHS dentistry is entering another period of political uncertainty.

Labour came to power promising to rebuild NHS dentistry, increase appointments, fill dental deserts and reform the dental contract. But almost two years into government, the profession is still waiting for the full contract reform process to begin.

That delay has created political space for Reform UK, which has continued to rise in the polls while attacking Labour’s record on public services, migration and the cost of employment.

But what would dentistry look like under a government led by Nigel Farage?

Dentistry does not feature directly in Reform UK’s manifesto, and requests for detail from Dentistry.co.uk to the party have gone without reply. However, the party’s wider policies on immigration, employment, tax and the National Health Service (NHS) could have significant implications for dental practices.

What could Reform’s migrant labour levy mean for dentistry?

Robert Jenrick, Reform UK’s Treasury spokesperson, said in June that the party would scrap Labour’s rise in employer National Insurance contributions for British workers only.

He also proposed a ‘migrant labour levy’ on firms employing overseas workers, with full details to be set out nearer the next general election.

Jenrick suggested a charge of around £3,750 for a full-time worker on the national living wage. He said the policy could raise billions of pounds to fund employment tax cuts for British workers.

For dentistry, the proposal would raise questions about recruitment costs, staffing pressures and access to care. General Dental Council (GDC) figures published in May showed that more than half (53%) of dentists who joined the register in 2025 were internationally qualified.

The Association of Dental Groups (ADG) has previously described allowing more overseas professionals to practise in the UK as the ‘low hanging fruit’ solution to the workforce crisis.

Reform UK has also pledged to scrap indefinite leave to remain and replace it with a five-year renewable visa with higher salary thresholds, mandatory English fluency and stricter character requirements.

The current skilled worker visa threshold sits at £41,700, a level that already effectively excludes most dental nurses. Raising it further could affect dental therapists, hygienists and technicians currently on skilled worker visas.

What has Reform UK said about NHS dentistry?

Reform has not set out any specific commitments on dental access or NHS contract reform, however it has vowed to:

Farage has previously addressed the access crisis in public statements, acknowledging that ‘people are pulling out their own teeth’. Responding to the widely reported queues outside a Bristol dental practice in 2024, he attributed pressure on services partly to migration-driven population growth.

Labour leadership change raises dental questions

Starmer’s resignation has raised fresh questions over whether NHS dentistry will remain a political priority under his successor.

Following his recent win in the Makerfield by-election, Burnham confirmed that he would stand to replace Starmer as Labour Party leader. If no other candidate comes forward, Burnham could become prime minister by 17 July.

As mayor of Greater Manchester, Burnham’s priorities for dentistry included tackling childhood oral health inequalities and supporting healthcare devolution to build local preventive dental programmes. However, he has yet to specify how he would approach dentistry at parliamentary level.

The profession will now be looking for clarity on whether he would keep Labour’s existing dentistry commitments, retain the current ministerial team and accelerate dental contract reform.

Speaking to Dentistry.co.uk in May at Dentistry Show Birmingham, British Dental Association (BDA) chair Eddie Crouch expressed concern about the amount of time Labour had left to reform NHS dentistry.

He said: ‘Unless we get that consultation and make progress on this, their ambition to reform the contract during this parliamentary term is going to be under pressure.’

However, he also suggested there was support for dentistry in the wider government, saying: ‘What I hope is that a minister that I’ve built up a relationship with over the last two years, who I believe has got the right motives, will continue in post, irrespective of who eventually ends up leading the Labour Party.’

Political pressure to act

A public consultation on dental contract reform had been expected in spring but slipped to summer.

Crouch said there was a direct electoral incentive for Labour to act.

‘There’s a huge percentage of Labour MPs who get mailbags full of dental problems, who get told on the doorstep that dentistry is important to them. If they don’t fix NHS dentistry by the end of this term, I think they’ve got no chance at the ballot box. And the investment needed is not an awful lot in the grand scheme of things, dentistry is about 3% of the NHS budget.’

The next UK general election must be held by 15 August 2029, unless one is called earlier.

Reform UK won five seats, had 609 candidates and received 14.3% of the vote in the 2024 general election. But Farage has called for a general election ‘at the soonest possible date’ following Starmer’s resignation, arguing that the country ‘cannot afford to waste another week drifting from crisis to crisis’.

For Crouch, the more important point is that the political will to fix NHS dentistry transcends any single party.

‘I believe that there is a parliamentary will to actually improve dentistry, and that’s across all parties, whether I meet the Greens, the Liberal Democrats, the Conservatives or Labour. Everyone wants NHS dentistry to be resolved. With that political will, we have reason to be optimistic,’ he said.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends. 

The University of Sunderland will open a new dental academy that will offer courses in dental hygiene, dental therapy and dental technology starting in September 2027.

NHS data for 2024/5 suggests just 41% of adults and 55% of children in Sunderland had been seen by an NHS dentist in the past 12 months. The new courses will help to provide free dental care to the underserved local population.

Rachel Elliott, associate head of School for Biosciences and Dental Education at the University of Sunderland, said: ‘We know how difficult it can be for many people in our region to access dental care, especially in areas where NHS services are been limited. That is why our new Dental Academy is so important. By training skilled dental professionals locally, we can help people get seen sooner and improve the focus on preventative care.’

The academy will allow students to train in brand new facilities, graduating in an area with high demand for dental professionals.

Rachel Elliott continued: ‘It also means we’re building a stronger local workforce, with more qualified dental care practitioners ready to meet growing NHS demand. Our programmes are designed to give students real hands-on experience, so they leave ready to deliver high-quality care to patients.’

Is demand for dental training being met in the UK?

The new dental academy is the latest in a series of developments intended to increase dental training capacity throughout the UK.

In 2023, more than 10,000 applicants competed for just 940 dentistry places in UK dental schools. The Dental Schools Council warned the UK faced a critical shortfall in meeting dental need, with growing regional disparities in access to care.

The University of Gloucestershire is also set to launch a dental hygiene programme from 2027, while the University of Lincoln is campaigning to open a full dental school as it puts plans to begin offering dental hygiene and therapy training into action for September 2026.

Meanwhile, the UK’s dental academic workforce has fallen to just 550 full-time equivalent roles, with 40 roles lost within a single year.

Professor Chris Vernazza, head of Newcastle University School of Dental Sciences, said: ‘Without intervention, we risk a profound loss of capacity across research, education and clinical leadership. The future of dental education, the sustainability of our research environment and the quality of NHS patient care depend on a strong and well-supported clinical academic workforce.’

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

A miniature intraoral robot could allow dentists to complete crown preparations in a single visit, potentially eliminating the need for additional appointments.

Developed by researchers at the Department of Biomedical Engineering at the University of Basel, the robot is roughly the size of a cork and designed to fit comfortably inside the patient’s mouth. Its controls are located outside of the robot and connected with flexible cables.

How does the robot carry out crown preparation?

First, the intraoral robot uses a wide drill to reduce the tooth surface by removing material from above. It then uses a finer drill to work on the sides of the tooth.

This process was tested on tooth models made of synthetic resin and on a ceramic material with a hardness similar to that of tooth enamel. The margin of positional error was less than 0.2mm, which will be reduced further once positional sensors are integrated into the design.

The force generated during drilling was also tested, and found to be less than five newtons – comparable to the weight of a 500ml bottle of water. The robot’s noise levels are being assessed further to determine its suitability for use in practice.

Once further testing has been completed and sensors have been added, the researchers hope it could be implemented into dental workflows.

Yukiko Tomooka, first author of the paper, said: ‘Even after a power outage, [the miniature intraoral robot] would know where it is and where it needs to continue based on the sensor data.’

Dental robotics remains largely experimental in UK clinical dentistry, though robot-assisted implant systems are already being used overseas.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

A visit to an orthodontist is often the first step towards achieving a beautiful and healthy smile. Orthodontists play a pivotal role in helping individuals find the perfect solution to oral health problems. This article explains what an orthodontist and dentofacial orthopedist is, the journey to becoming one, and how they can help you achieve the perfect smile and healthy, functional bite you’ve been searching for.

Everything You Need to Know About Your Orthodontist

Ready to start your smile journey? The first step is understanding the professional who will guide you. Watch the one-minute video below to learn the specialized role of an orthodontist, the advanced education they complete, and the unique skills they use to correct everything from crowded teeth to complex jaw issues.

What is a Dentofacial Orthopedist?

An orthodontist is a dental professional who has pursued advanced specialized training to become an expert in diagnosing and treating irregularities of the teeth and jaws. Their role is crucial in helping individuals achieve better oral health through orthodontic treatment. Expanding upon their foundational dental knowledge, orthodontists engage in additional education and training, concentrating exclusively on the field of orthodontic care. This specialized training allows them to correct misaligned teeth and jaws, improving a person’s smile and their bite for healthy, effective function.

Orthodontists and dentists collaborate within the field of oral health. While general dentistry addresses a wide spectrum of dental concerns, orthodontists specialize in straightening teeth and aligning jaws. Orthodontists use a variety of tools and appliances, including braces, clear aligners, and retainers to achieve the best outcomes. The partnership between the orthodontist and dentist ensures comprehensive care, where each professional’s expertise complements the other to improve patients’ dental well-being.

One of the primary objectives of orthodontic treatment is to correct malocclusions or misaligned bites, which can interfere with eating and speaking. Orthodontists also work to prevent potential problems by examining a patient’s teeth and jaws and monitoring their development. This allows orthodontists to identify issues early on and provide timely treatment to correct current issues and prevent future problems.

A straight, well-aligned smile can significantly impact an individual’s self-esteem, making orthodontic care valuable in promoting overall well-being and confidence.

Defining Dentofacial Orthopedics

Orthodontists are also considered dentofacial orthopedists. Dentofacial orthopedics focuses on guiding the growth of the face and jaws, how the bones and tissues of the face work together, and how they impact function and appearance. AAO orthodontists’ expertise in dentofacial orthopedics allows them to effectively correct malocclusions and monitor jaw growth in its early stages.

How to Become an Orthodontist

Becoming an orthodontist is a challenging yet rewarding journey that requires years of education, training, and dedication. It begins with an undergraduate college education, and many aspiring orthodontists focus their studies on pre-dental or science-related fields such as biology, chemistry, or health sciences. The next step is to attend an accredited dental school, which typically requires four years of study. Their education culminates in a two to three-year orthodontic residency program that combines advanced coursework with hands-on clinical experience treating patients under supervision.

What Services Do Orthodontists Provide?

Orthodontists help with problems like crowded or spaced teeth, abnormal bites, and jaw issues. Using diagnostic records, orthodontists create customized treatment plans for their patients to achieve the best results. These treatment plans also outline what tools or orthodontic appliances may be used.

Why You Should Choose an AAO Orthodontist for Treatment

Orthodontists are extensively trained specialists renowned for their expertise in delivering orthodontic and dentofacial orthopedic care. With over a decade of rigorous higher education and practical experience, orthodontists stand as the sole professionals equipped to safely and efficiently address misalignments of teeth or jaws, fostering both aesthetic beauty and optimal functionality for their patients’ smiles and overall oral health.

The American Association of Orthodontists (AAO) is a professional organization open only to qualified orthodontists. By choosing an AAO orthodontist for your treatment, you are ensuring that you receive care from a specialist with the expertise and experience to deliver the best possible results.

The post Understanding Orthodontics: What is an Orthodontist? appeared first on American Association of Orthodontists.

• Is GPS being replaced?
• Djokovic’s infrared sleeves
• Is VoltOnoSprint reliable?

Is GPS being replaced?

There has been a great deal of discussion online regarding the wearable tracking device developed by the Italian company, TalentPLAYERS. Some people have suggested that this device, worn on the players’ lower legs under their shin guards, could replace GPS technology.

While the device offers multiple advantages over GPS—such as eliminating the need for an uncomfortable vest, avoiding hefty software subscription fees, operating indoors, and providing better measurements of acceleration and deceleration—it’s unlikely to replace GPS anytime soon, despite some online theories.

GPS has been backed by numerous validation studies, years of normative data, and well-established thresholds for high-speed running and sprinting. Although the TalentPLAYERS device shows promise, it won’t be taking the place of GPS in the near future. What may happen down the line is a synergy between the two systems, where teams might integrate GPS for positional tracking with devices like TalentPLAYERS to assess lower limb loading and movement quality.

If you would like to learn more about GPS, check out our extensive relevant blogs and courses:

• GPS (Wearables): Part 1 – Technology, Validity, and Reliability
• GPS (Wearables): Part 2 – Metrics and Application
• GPS analysis: How coaches and athletes can get the most out of it
• GPS Devices
• Catapult GPS
• Integrating GPS in Team Sports

Djokovic’s infrared sleeves

Have you ever wondered why Novak Djokovic often wears knee and arm sleeves? A recent YouTube video by Alec Grawe from Playbook HQ sheds light on this topic.

The sleeves Djokovic uses are made by a brand called “Incrediwear,” which has developed a bioactive infrared fabric. This technology is designed to activate the body’s own heat, which may enhance circulation, reduce pain, and boost performance. Following his meniscus tear in 2024, Djokovic wore Incrediwear sleeves on his knee, and he recently sported them on his arm at the Indian Wells tournament.

It’s also interesting to note that Djokovic has invested in Incrediwear and holds a significant stake in the company. This raises the question of whether he genuinely believes in the benefits of Incrediwear’s products or if his use of them is more about promoting his business interests. Regardless, more research is needed to determine if Incrediwear really stands out compared to regular compression sleeves.

To find out more, check out Grawe’s YouTube clip here.

Is VoltOnoSprint reliable?

VoltOnoSprint is an electronic timing gate system that pairs with a smartphone, enabling coaches and practitioners to measure sprint times with greater precision than handheld stopwatches, at a relatively low cost compared to other speed timing systems. However, it’s important to note that VoltOnoSprint is primarily used in Asia, leading to some scepticism regarding its reliability in countries outside the region.

However, a recent study published in the Journal of Strength and Conditioning Research has cast a positive light on VoltOnoSprint. This study compared its performance to that of a radar gun system, the industry gold standard, during 30-metre sprint tests. Remarkably, VoltOnoSprint closely matched the radar gun’s results and demonstrated excellent reliability.

Given the findings from this study, VoltOnoSprint should definitely be on your radar (pardon the pun!) if you’re considering investing in timing gates and seeking real-time sprint force and velocity data for your athletes. Will it only be a matter of time before VoltOnoSprint breaks into the European and American markets? We’ll certainly be keeping an eye on its progress!

From us this week:

>> New course: Programming for ACL Reconstruction
>> New podcast: Building Sports Science Systems That Coaches Use
>> New infographic: Plant-based Diets for Athletes
>> New article: Hydrotherapy

Access to a growing library of sports science courses

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Since ENDO 2026 in Chicago is fresh in our minds, Endocrine News quizzed Endocrine Society members to see what their favorite memories of past ENDOs have been. From professional connections to new job leads, lifelong friendships, and even some unforgettable meals, ENDO is the only place to be for the international endocrinology community.

Every year, thousands of endocrinologists descend on ENDO from around the world, one thing is certain: this event will be like no other. If you’ve only attended one meeting, you know that there’s no other endocrinology-focused conference quite like it. It is the only place for clinicians and researchers in the endocrinology field to get their collective batteries charged, regardless of where they are in their careers.

“ENDO continues to be a space where science and community intersect in a powerful way. It is not just about presenting data, but about forming connections that shape the direction of your research and career,” says Antentor Othrell Hinton, Jr., PhD, Ernest E. Just Early Career Investigator; Chan Zuckerberg Initiative Science Leadership Investigator; Burroughs Wellcome Fund Career Awards at the Scientific Interface Investigator; assistant professor in the Department of Molecular Physiology and Biophysics at Vanderbilt School of Medicine Basic Sciences, Vanderbilt Diabetes Research and Training Center in Nashville, Tenn. “This would not have happened without the nominations and support from senior leaders who are always paying attention to and uplifting junior investigators. I truly appreciate the opportunity.”

In fact, many endocrinologists anticipate ENDO the same way that a child might anticipate their birthday or Christmas! Just ask Lauren Fishbein, MD, PhD, MTR, assistant professor at the University of Colorado School of Medicine in the Division of Endocrinology, Metabolism and Diabetes in Aurora: “I look forward to ENDO all year long,” she says. “What I value most are conversations with collaborators, colleagues, and friends from around the world. This networking can only occur in person at the annual meeting – a video call is not the same.”

We agree! So, we decided to ask these Endocrine Society members about what ENDO memory stands out to them the most: Andrew Agabaje, PhD; Estelle M. Everett, MD, MHS; Lauren Fishbein, PhD, MTR; Andrea Gore, PhD; Antentor Othrell Hinton, Jr., PhD; Eiman Ibrahim, MD;Milay Luis Lam, MD; David Lui, PhD; Michael Morkos, MD, MS, MHI, ECNU; John Newell-Price, MD, PhD, Alicia Diaz Thomas, MD, MPH; Shehzad Topiwala MD;and Joy Y. Wu, MD, PhD.

A Career Milestone at ENDO 2024

ENDO 2024 in Boston was an interesting experience, particularly because I was selected to give my first-ever press conference. I also received an outstanding abstract award for publishing the first study in the world which showed that device-measured sedentary behavior from childhood was an independent and longitudinal risk factor for liver steatosis and fibrosis assessed with transient elastography in mid-twenties.

The press conference offered an opportunity to share my research with health journalists from major news outlets like (New York Times, etc.), and the subsequent collaboration forged with the media has been incredibly helpful in disseminating my research in the last two years.

I met a colleague based in the U.S. who was invited to speak at a symposium on the last day of ENDO 2024. We discussed the possibility of a research collaboration in childhood metabolic health research and are looking forward to finalizing the project commencement soon.

My participation at ENDO 2024 also enabled networking and invitations to serve in different communities and task forces within the Endocrine Society. All these opportunities from the Endocrine Society were a significant boost to my CV and increased my chances of receiving the highly competitive inaugural Flemming Quaade Award for Innovative Approaches to Childhood Obesity research grant of $70,000 and a travel stipend to present a lecture at NUTRITION 2025 in Orlando. – Andrew O. Agbaje, MD, MPH, PhD, FACC, FESC, FAHA, FNYAM, Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland

Shaping an Academic Journey

ENDO 2023 marked my first in‑person ENDO meeting and remains one of my most memorable professional experiences. I arrived expecting a rich scientific program, but I left with so much more — new connections and a deeper sense of belonging to the endocrine community.

ENDO has offered several “firsts” for me, including oral presentation and press conference at ENDO 2022, which took place virtually during the challenging time of the COVID‑19 pandemic. My first oral presentation focused on safety of COVID‑19 vaccination among patients with hypothyroidism, also highlighted in the press conference. Presenting our research to mass media was an eye‑opening experience, underscoring the importance of communicating science beyond academic circles.

Another highlight was learning from the now Endocrine Society President‑Elect, Joy Wu, PhD. She shared insightful perspectives on how to build our professional profiles on social media platforms, using them for knowledge dissemination, and connecting with colleagues who share similar research interests. I vividly recall we first met in person when I attended her Meet the Professor session at ENDO 2023 on managing bone health in breast cancer survivors, followed by a brief discussion and a photo together. She encouraged me to leverage real‑world electronic health records to address key research questions in osteoporosis — advice that continues to shape my work on bone fragility in diabetes. We reconnected this year, three years later, when she visited the University of Hong Kong, allowing us to exchange updates in person.

At ENDO 2023, I also reunited with Jenni Gingery, Director of Communications and Media Relations of the Endocrine Society, and Mark Newman, Executive Editor of Endocrine News. Their support and collaboration have continued over the years, including in this very issue.

ENDO 2023 was not only a scientific milestone but also a formative moment in shaping my academic journey and professional community. — David Lui, PhD, Clinical Assistant Professor, Division of Endocrinology and Metabolism, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, China

Celebrating Three Decades of Inclusion

One of my most memorable ENDO experiences was the CODI (Committee on Diversity and Inclusion) 30th Anniversary Celebration and Mentoring Poster Reception at ENDO 2025. The event brought together students, trainees, early-career investigators, and senior leaders in a way that truly reflected the spirit of the Society.

The panel of guest speakers which included Endocrine Society past presidents and former CODI chairs was particularly meaningful. Hearing reflections on CODI’s 30-year journey, its role in advancing diversity, equity, and inclusion in the Society, and its tangible impact on careers and the field, offered both perspective and inspiration. Several trainees shared with me afterward that the conversations they had that evening led to new mentorship and connections.

For me, the event reinforced what makes ENDO unique: it is not just a scientific meeting, but a place where community, mentorship, and opportunity intersect. The CODI anniversary celebration captured that perfectly and served as a powerful reminder of how intentional spaces can shape careers and strengthen our field. — Estelle M. Everett, MD, MHS, assistant professor, Division of Endocrinology, Diabetes, & Metabolism, Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine, Los Angeles, Calif.

An Early Career Boost at ENDO 1998

I’ve been to so many ENDOs and have so many memories, but most are only interesting to me! I think what may have been most memorable is the ENDO 1998 meeting in New Orleans, La.. I was invited to give a symposium talk on GnRH, and as a new assistant professor I was very honored but also very nervous.

The other speakers were luminaries in the field and the room was packed. Having that opportunity gave me a real boost early in my career and also made me a loyal attendee of nearly every ENDO meeting thereafter! -Andrea Gore, PhD, Vacek Chair of Pharmacology, Division of Toxicology and Pharmacology, University of Texas, Austin, Texas

Feeling Visible, Welcomed, and Supported

One of my most memorable ENDO meetings was my very first. As a first-year fellow in pediatric endocrinology, I was both excited and uncertain about where I belonged in a large national meeting. That year, my poster was selected, and I was introduced to what was then called the Minority Mentoring Reception. Walking into that space was transformative. I met senior faculty and mentors whose work I admired, many of whom took the time to introduce themselves, ask about my career goals, and offer genuine encouragement. For the first time at a national scientific meeting, I did not feel like an outsider looking in; I felt visible, welcomed, and supported. That experience fundamentally shaped how I approached ENDO going forward, not just as a meeting to attend, but as a professional home.

Walking into that space was transformative. I met senior faculty and mentors whose work I admired, many of whom took the time to introduce themselves, ask about my career goals, and offer genuine encouragement. For the first time at a national scientific meeting, I did not feel like an outsider looking in; I felt visible, welcomed, and supported.

My second most memorable ENDO meeting was the most recent one, which celebrated the Endocrine Society’s enduring commitment to diversity and inclusion through the 30th anniversary of CORE and its many incarnations. Seeing so many trainees and early-career faculty, Endocrine Society staff, faculty leaders, past presidents, and board members gathered together to honor this legacy was deeply meaningful. For me, it underscored how intentional efforts in mentorship and inclusion can shape careers, communities, and the future of our field. Standing in that room, I reflected on the full-circle nature of my own journey — from being mentored and uplifted at my first ENDO to helping advance those same values for the next generation. – Alicia Diaz Thomas, MD, MPH, senior associate dean, Institutional and Faculty Affairs; professor, Department of Pediatrics, University of Nevada, Reno School of Medicine, Reno, Nevada

ENDO 1998: Where Joy Wu Decided to Become an Endocrinologist

By far the most impactful ENDO in my career was my very first one! In 1998 I was an MD/PhD student at Duke in the lab of Anthony Means (who would go on to become Endocrine Society president in 2004) studying the role of calmodulin-dependent kinases in male germ cell development

At the time I wanted to become a physician scientist but hadn’t yet decided on a clinical specialty. Tony suggested that I attend the Endocrine Society meeting, which will be held in New Orleans that year, to present my thesis work. Of course I jumped at the chance to go to New Orleans!

It was a wonderful meeting, in part because I got to watch Tony receive the Fred Conrad Koch Lifetime Achievement Award, the Society’s highest honor. And at the meeting I was so inspired by the interactions between basic scientists, clinical investigators, and physicians interested in endocrinology that I decided then and there to become an endocrinologist.  — Joy Y. Wu, MD, PhD, Gerald M. Reaven, MD Professor of Endocrinology; chief, Division of Endocrinology; vice chair of basic science, Department of Medicine, Stanford University School of Medicine, Stanford University, Stanford, Calif.

An Egyptian Class Reunion at ENDO 2023

ENDO 2023 will always hold a special place in my heart. At the time, I was an internal medicine resident, just beginning to seriously pursue my goal of applying to endocrinology fellowships. I attended the meeting filled with excitement, curiosity, and quiet hope about the future.

In the midst of the scientific sessions and conversations about cutting-edge research, I experienced a moment that felt deeply personal. I ran into Michael Morkos, MD, a classmate from my medical school in Egypt — someone who had already become an endocrinology attending. Seeing him there, established in the very field I aspired to join, was both surreal and inspiring. We were no longer just former classmates; we were colleagues walking parallel paths shaped by the same early foundation.

The most unforgettable moment, however, came when we both met one of our endocrinology professors from the same university in Egypt, Samir Assaad, MD, PhD. Standing together — former students now training and practicing in the United States — felt like a true full-circle moment. This professor had not only taught us endocrinology years before, but he had also supervised my master’s degree in obesity and endocrinology. He shaped the way I think about metabolism, research, and patient care.

At ENDO 2023, we were no longer students in his classroom. We were physicians shaped by his mentorship, united by the same passion he helped ignite. There was pride in his eyes, gratitude in ours, and an unspoken understanding that mentorship transcends borders, generations, and continents.

Endocrinology is not just a specialty. It is a legacy — one passed from teacher to student and carried forward with gratitude.

Now, as I near completion of my endocrinology fellowship and prepare to become an attending at the University of Missouri, I often reflect on that moment. ENDO 2023 was more than a scientific meeting — it was a reminder of where I began, the mentors who shaped me, and the community I am honored to now fully join.

It was the moment I realized that endocrinology is not just a specialty. It is a legacy — one passed from teacher to student and carried forward with gratitude. — Eiman Ibrahim, MD, MSc, second year, chief fellow, University of Missouri, Columbia, Mo.

Opening Doors to New Ideas and Collaborations

One of my most memorable ENDO experiences was at last year’s meeting in San Francisco. I had the opportunity to chair a session titled Muscle as an Endocrine Organ at the Moscone Convention Center. The session brought together an outstanding group of speakers and highlighted how skeletal muscle functions as a dynamic endocrine tissue that communicates with multiple organ systems. The energy in the room was incredible, and the discussions that followed pushed new ideas about metabolism and inter-organ communication.

What made the experience especially meaningful was the chance to connect with leaders in the field. It was truly special to be in a space where so many of the people whose work has shaped the field were present and engaged. As I often say, “These are the moments that remind you science is not just about data, it is about people, ideas, and the conversations that move everything forward.” I had the opportunity to meet several investigators whose work I have followed for years, including Dr. Jonathan Long from Stanford, whose work on Lac-Phe, a recently identified signaling metabolite involved in exercise induced signaling, has been very influential. Those conversations opened the door to new ideas and potential collaborations that I am still thinking about and building on today. – Antentor Othrell Hinton, Jr., PhD, Ernest E. Just Early Career Investigator; Chan Zuckerberg Initiative Science Leadership Investigator; Burroughs Wellcome Fund Career Awards at the Scientific Interface Investigator; assistant professor, Department of Molecular Physiology and Biophysics, Vanderbilt School of Medicine Basic Sciences, Vanderbilt Diabetes Research and Training Center, Nashville, Tenn.

Earning a “Place at the Table”

Since my days as an Internal Medicine resident (I’ll keep the exact year a secret to protect my age!), the Endocrine Society meeting has been a constant in my life. I’ve only missed a few: the year my son was born and those “blurry” years of virtual meetings during the pandemic.

Each year, I leave ENDO energized by new knowledge and the joy of reconnecting with old colleagues. Yet, alongside that excitement, I often grapple with “the imposter.” A voice whispers: Are you actually this good? Was it just luck that they invited you? Are you still relevant enough to present?

But every year, I return. I talk, I meet new people, and I watch former trainees transition into confident attendings. In doing so, I recognize my own growth. This year was a milestone: I returned to EXCEL, but this time as faculty. Was there luck involved? Definitely. But was it also the result of years of personal career growth? Absolutely.

It has been a whirlwind year, including four webinars for the Early Career Special Interest Group and a new talk at the Early Career Forum. As I head back to ENDO in a few weeks, I hope that “luck” stays by my side — but I’m starting to realize I’ve earned my place at the table. — Milay Luis Lam, MD, division chief and medical director, Meritus Endocrinology, Meritus Medical Center, Hagerstown, Md.

Improving Practice Through ENDO

ENDO has become one of the constants I look forward to most each year. The programming is so rich that every hour presents a genuine dilemma, multiple sessions worth attending simultaneously, and I have learned to simply buy the recordings so I can listen to what I missed. But the most transformative moments have come not from the sessions themselves, but from the people in them.

At a professional development session a few years ago, I listened to a senior endocrinologist share his career journey. In the middle of his talk, almost in passing, he said something that quietly changed how I practice: that a clinical visit doesn’t need to be long. If the patient’s needs can be addressed in five minutes, there is no need to extend it. It sounds simple. But internalizing it, letting go of the habit of filling time rather than serving the patient, reshaped my approach to clinical efficiency in ways I am still discovering. We exchanged numbers after that session, stayed in touch, and he later offered invaluable guidance as I prepared my books for publication. That is the kind of connection ENDO makes possible.

In recent years, I have had the privilege of contributing back. I have spoken at the Early Career Forum on the academic-clinician pathway and at the Endo Expo on clinical efficiency and productivity, topics close to my heart. This year, I return to the ENDO Expo with an expanded session, and I could not be more excited.

ENDO has made me a better clinician, a more thoughtful academic, and part of a community I am genuinely proud to belong to. — Michael Morkos, MD, MS, MHI, ECNU, co-director, IUH Thyroid and Parathyroid Center; Associate Professor of Clinical Medicine, Department of Endocrinology, Diabetes, and Metabolism, Indiana University School of Medicine, Carmel, Ind.

An Arduous Journey to Make Mom Proud at ENDO 2007

Over two decades ago, as a fresh medical graduate from Mumbai, India, I aspired to pursue a career in Endocrinology in the U.S. However, my previous U.S. visa applications had already been rejected a total of eight times between 2002 and 2006. 

Then in 2007, Dr. Paresh Dandona, distinguished professor of endocrinology at State University of New York, Buffalo, graciously interacted with me at an Endocrine Conference in Mumbai. Under his mentorship, we submitted an award grant application to the Endocrine Society for the annual Endocrine Scholars Award. The theme was Hypogonadism in Type 2 Diabetes. We won!  

I prayed for this exceptional chance to go to America to propel my career forward to make a living and support my family, yet deep down I was fearful of another visa denial. Dr. Dandona kindly supported my J1 Research Exchange visa paperwork, and during my nerve-wracking visa interview, the U.S. Consular officer seemed particularly delighted over the $47,000 grant from the Endocrine Society and decided to approve my visa!   

So, the award ceremony was at ENDO 2007, interestingly being held in Toronto, Canada (the only time ENDO had been held outside U.S. in the last 20 years!).* Now I had the herculean task of getting a Canadian visa next! In excitement and anxiety, I sped on my motor bike through the congested streets of Mumbai to reach the Canadian Consulate, only to realize I had forgotten my passport! I accelerated recklessly toward home to return before the consulate closed for the day, even knocking down a pedestrian on the way (fortunately, I had strong brakes)! Finally, application submitted.  

And I got my first ever Canadian visa approved. I inferred ENDO had done good networking with the Canadians. I arrived for the big day at ENDO 2007 in Toronto, on June 1 accompanied by my late mother. She witnessed the formal bestowal ceremony where the legendary Leonard Wartofsky, MD, presented me with the coveted award. During another day of the same ENDO meeting, he recognized my mom and I from a distance, as we were nervously negotiating hopping on an escalator, while he was already exiting at the top. To my mother he exclaimed, “YOU did good!” with an ebullient thumbs up! We were thrilled. Love you, Mamma! And I love you, ENDO!  — Shehzad Topiwala MD, director, Institute of Endocrinology, Atlanta, Ga.

How a Hallway Chat Led to Research Funding

When I was a fellow and postdoc starting on the interview trail for academic physician-scientist jobs, it was the connections I made through the Endocrine Society that allowed me to reach out to leaders in the field to discuss career opportunities.

Later, my first R01 grant idea took shape through conversations held in the hallways at ENDO. A colleague told me I was not crazy to try to get this idea funded, and ultimately, it was funded! Another highlight each year is speaking with early-career scientists and physicians at their posters. Their curiosity and enthusiasm for all things endocrinology is energizing and reinforces my confidence in the future of endocrine science and medicine.

To me, ENDO is a welcoming community to hear and discuss great science and medicine and catch up with friends. – Lauren Fishbein, PhD, MTR, assistant professor in medicine at the University of Colorado School of Medicine in the Division of Endocrinology, Metabolism and Diabetes, Aurora

From a First Oral Presentation to Endocrine Society President

I attended my first ENDO in 1995, and I was blown away by the sheer size and scale of the meeting – I had never witnessed anything like it. I was giving my first oral communication as a junior fellow and as I approached the podium my palms were sweaty and I was simply terrified! I shouldn’t have been, as I was greeted with incisive yet supportive questioning and much interest. This, and the whole experience of ENDO, from the huge poster sessions to the incredible plenaries, other symposia talks, and the Meet the Professor sessions really cemented the fact that this was the meeting and society for me!

Thirty years later in 2025 and I find myself in the improbable position of being president of the Society and introducing yet another fabulous ENDO meeting in San Francisco. I am hugely proud of all the work that the wonderful Annual Meeting Steering Committee, its chairs, and all the staff did to bring the meeting to fruition. ENDO 2025 took place in a very different world, one where fear and uncertainty predominated, and yet one where a palpable sense of collegiality, warmth and ‘family’ pervaded the whole event. One notable, but simple illustration of this was the almost deafening ‘hubbub’ of ongoing conversations from crowds of people in the public areas and escalators, especially when travelling between sessions – the endocrine community sharing, connecting and flourishing!  – John Newell-Price, PhD, Endocrine Society Past-President; Clinical Research Director, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K.

Lives changed. Destinies decided. Friendships launched. Collaborations created. All thanks to simply attending ENDO. No doubt history was made numerous times throughout the session rooms, hallways, and the exhibition floor of McCormick Place in Chicago this month.

*EDITOR’S NOTE: For the first time since 2007, ENDO 2027 will be held in Toronto, Canada, once more June 5 – 8, 2027.

The post Looking Back: Unforgettable Moments from ENDOs Past appeared first on Endocrine News.

Hosted by Harry Morris at 30 Euston Square, London on Friday 2 October 2026, the GBT Summit returns with keynote speaker Dr Nighat Arif and a new theme that asks the dental profession to think differently about what prevention means in 2026.

The GBT Summit London 2026 returns on Friday 2 October at 30 Euston Square, London, with a programme designed to push the conversation about preventive dentistry into territory the profession has been slow to address. Under the theme ‘Prevention reimagined: hormones, biofilm, AI and the modern dental practice’, GBT Summit 2026 will bring dental hygienists, therapists, periodontists, dentists, practice owners and students together for a single day of education, evidence and practical insight.

The speakers

Morning

Hosted by Harry Morris of EMS UK, the day opens with keynote speaker Dr Nighat Arif, whose work bridging clinical medicine and public health has made her one of the most recognised voices on women’s health in the UK. Her keynote explores why menopause and hormonal change are reshaping the conversation in healthcare – and why the dental team is so often the first to see the signs.

Her keynote is followed by Ben Tighe and Claire Berry, the duo behind the Dental Besties platform, where their conversations about menopause and oral health have consistently been among the most engaged content the profession has shared, who will bring the discussion directly into the dental chair, helping clinicians understand what to see, what to say and what to do when treating patients going through menopause. It is a conversation the wider profession has barely begun, and one GBT Summit 2026 is putting front and centre.

The clinical programme keeps prevention at its core. Dr Payvand Menhadji will challenge the idea that implants are the finish line, looking at the risk, biology and long-term maintenance that determine whether implants succeed or fail over a patient’s lifetime. Louise Warden, SDA trainer for EMS, will follow with a focused fifteen-minute case study showing GBT implant maintenance in practice – one patient, one protocol, in real clinical time. Dr Devan Raindi will then explore MINST, biofilm and the modern perio pathway, drawing the morning to a close with an evidence-led look at how non-surgical periodontal therapy continues to evolve.

Afternoon

After lunch, the charity Bridge2Aid will take the stage to share the work they do to expand access to oral healthcare in low-resource settings, with ticket proceeds donated in support. The afternoon then turns to the technology shaping the next decade of clinical practice, with Dr Simon Chard and Dr Christian Leonhart asking whether AI in dentistry is hype, threat, or the biggest opportunity in a generation.

The day closes with Celso Da Costa exploring the business of dental hygiene – how prevention translates into clinical value and practice growth – followed by a closing panel on what prevention-led dentistry could look like in 2030, featuring Dr Payvand Menhadji, Louise Warden, Dr Devan Raindi, Dr Simon Chard and Celso Da Costa.

The GBT Summit is the premier event dedicated to the advancement of preventive dentistry and Guided Biofilm Therapy. It offers a platform for education, inspiration and community, bringing UK dental professionals together with international thought leaders and the evidence base that underpins modern prevention.

Tickets are available now from £105 (early bird) and £50 for students, with a returning delegate rate of £95 for those who attended GBT Summit 2025. Group bookings of four or more are available at £100 per person. The early-bird rate is available until the end of June 2026, after which tickets are priced at £125. With GBT Summit 2026 expected to sell out, early booking is advised.

Tickets are available at www.eventbrite.com/e/gbt-summit-world-tour-london-2026-tickets-1988991277453.

This article is sponsored by EMS.

SHINING 3D Dental announces the launch of AccuFab-Aris, a chairside dental 3D printer designed to support a full range of clinical applications while making digital dentistry more accessible, efficient, and practical for everyday clinical use.

Featuring intelligent automation, reliable precision, and one-click operation, AccuFab-Aris brings streamlined chairside production into daily workflows with minimal learning curve and workflow complexity.

Designed around the philosophy of ‘just print it’, the AccuFab-Aris simplifies traditionally complex setup procedures so clinicians can focus more on treatment and less on printer operation. Weighing under 10 kg and measuring 257 x 236 x 364 mm, the printer boasts a footprint smaller than a laptop, making it an ideal fit for any clinical space. Engineered for rapid delivery, it significantly accelerates daily workflows by producing a restoration in just 19 minutes, dental models in 25 minutes, and splints in 30 minutes.

Key features of the 3D printer

AccuFab-Aris ensures clinical excellence through an ultra-fine 34µm pixel size and 4K high resolution with ±50µm printing precision, delivering reliable prints with an accurate fit and minimal chairside adjustments. Print consistency is further enhanced by a thermostatic build platform that automatically maintains a stable 30°C printing environment to reduce resin warping, minimise detachment risks, and improve overall success rates. Built for long-term durability in everyday clinical use, this stable performance is backed by a hard-anodised aluminium construction.

Ease of use remains central to the AccuFab-Aris experience. One-click auto-levelling and automatic Z-axis calibration minimise manual setup, while smart fail-safe sensors with real-time residue detection and NFC resin tank monitoring help ensure stable, reliable operation. Flexible USB, Wi-Fi, and Ethernet connectivity also allow seamless integration into everyday clinical workflows.

Maintenance is equally streamlined for long-term ownership. The quick-release screen system enables replacement in as little as 10 seconds, while the integrated Aris Health Dashboard provides real-time monitoring of resin tank and light panel status to support stable printer performance over time.

Powered by SHINING FLOW, SHINING 3D’s unified scan-design-print end-to-end solutions, AccuFab-Aris seamlessly connects intraoral scanning, cloud-based order management, AI-powered and expert-guided design services, and chairside 3D printing into one connected workflow. The cloud platform automatically handles nesting, orientation, and slicing, enabling one-click printing across a wide range of applications including All-on-X, crown and bridge, dentures, orthodontics, and implant restorations.

About SHINING 3D Dental

Founded in 2004 in Hangzhou, China, SHINING 3D has established itself as a global innovator in high-precision 3D vision technologies across digital dentistry, industrial metrology, and reverse engineering. SHINING 3D Dental provides clinics and laboratories with a complete scan-design-print digital workflow designed to improve efficiency, accuracy, and clinical outcomes. Guided by the mission of making innovative and precise 3D digital solutions accessible worldwide, SHINING 3D continues to empower dental professionals with connected, intelligent, and practical solutions.

This article is sponsored by SHINING 3D Dental.

In a ‘pivotal moment’, NHS England has released updated standards for children’s oral health which prioritise uncomplicated care in the most local setting possible.

Replacing the 2018 NHS England clinical standard for paediatric dentistry, the new document is a structured, level-based model of oral healthcare for children and young people.

The guidance applies to all paediatric oral healthcare providers across primary dental care, community dental services, hospital dental services and tertiary paediatric centres.

Oosh Devalia, president of the British Society of Paediatric Dentistry (BSPD), said: ‘This standard is a pivotal moment for children’s oral health in England. For the first time, we have a single, coherent national document that supports every professional, from a newly qualified dentist in general practice to a consultant leading a tertiary team. It sets the benchmark not just for clinical care, but for equity, safety and accountability.’

However, the new guidance met with a degree of skepticism from some dental experts. Martyn Cobourne, dean of the Faculty of Dental Surgery (FDS) at the Royal College of Surgeons of England (RCS England), said: ‘With tooth decay the leading cause of hospital admissions among five- to nine-year-olds in the UK, and wide variation in decay-related extractions across the country, it is right to see a renewed focus on prevention and improving access to dental healthcare for children.

‘However, these standards will only make a difference if there are enough dental professionals to deliver them. This means investing in a strong NHS dental workforce and ensuring that reforms to the NHS dental contract go far enough to support appropriate care for children. Without that, NHS dentistry will continue to struggle to meet demand and deliver these standards in practice.’

What are the new standards for children’s oral health?

Localisation

‘Paediatric dental services should be planned and delivered in alignment with the neighbourhood health direction set out by NHS England, working as part of integrated neighbourhood teams to support holistic management of children and young people in the community.’

The news standards say that care should be provided in the least complex and most accessible setting that is appropriate for each child. Oral healthcare providers should work closely with health visitors, school nurses, GPs, paediatrics, social care, safeguarding teams, early years providers and families.

Virtual pathways should also be used to support the delivery of care closer to home.

Prevention first

‘Clinical care for children and young people should be grounded in minimally invasive, outcomes-focused principles, prioritising tissue preservation, early intervention, and child-centred approaches that support long-term oral health.’

Every contact with a dental professional should include preventive advice such as on toothbrushing, fluoride, diet, sugar intake, and tobacco or alcohol where relevant.

All care should be evidence-based and minimally-invasive where possible, with an emphasis placed on reducing the need for operative dentistry.

Care plans should also include caries and periodontal risk assessment in line with up-to-date guidelines.

Child- and family-centred care

‘The child’s best interests must remain central to all decision making, with their views heard and given weight in line with their age, maturity and understanding.’

The guidance says that the child and their family should be placed at the heart of care with an emphasis on shared decision making.

Communication must be developmentally appropriate and inclusive of parents or carers, including those with additional needs, communication difficulties or non-native English speakers.

Safeguarding duties also require dental teams to identify, document and respond to concerns about neglect, abuse or vulnerability.

Levels of care

The standards define a stepped model for levels of care:

• Level 1a: general dental practice for low-complexity care
• Level 1b: enhanced child-focused primary care for low-to-moderate complexity, mainly acute dental disease without major modifying factors
• Level 2: intermediate care for moderate complexity, behaviour management needs, or sedation
• Level 3a: specialist-led care for high complexity, complex trauma, developmental anomalies, medical or behavioural complexity, and some general anaesthetic care
• Level 3b: consultant-led or tertiary care for very high complexity, rare conditions, craniofacial cases, and complex general anaesthetic-dependent care.

It is intended that commissioners, providers and managed clinical networks can use the standard to update local service specifications and pathways. Where services are not yet compliant, implementation should be phased with agreed timelines. The standard will be reviewed every five years, or sooner if policy changes.

The full standards can be found here.

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Colgate explains how treating dentine sensitivity can be as instant and simple as a flick of a switch with Colgate SENSITIVE.

Dentine hypersensitivity is a chronic problem, affecting up to 57% of patients (Davari et al 2013; Dam et al, 2022; Berg et al, 2021). Many patients do not report DHS at the dentist’s office and their sensitivity burden remains unresolved (Colgate-Palmolive, 2009).

The impact of sensitivity goes beyond just pain (Mason et al, 2019; Bekes et al, 2009; Gillam, 2021). Patients often adopt coping strategies that can lead to daily limitations or lifestyle adaptations which may include eating on just one side of the mouth, changing eating habits and oral hygiene limitations. This could even have a detrimental impact on social interactions, which may seriously impact a patient’s quality of life (Bekes et al, 2009; Gillam, 2021).

Support your patients and recommend Colgate SENSITIVE REPAIR & PREVENT + MULTI PROTECTION with PRO-ARGIN technology.

PRO-ARGIN is the most clinically proven desensitising occluding technology^#. The technology seals open tubules and builds a strong calcium-rich layer to deliver instant (Ipsos, 2019)* and long-lasting relief (Lai et al, 2015)^†.

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#Based on the amount of relevant clinical studies in Meta-Analysis 2023 of toothpaste occluding technologies only (Pollard et al, J of Dent. 130 (2023) 10443: 1-13).

*For instant relief, apply directly to the sensitive tooth with a fingertip and massage gently for 1 minute, up to twice a day and for children six to 12 years once a week or less frequently.

^With continuous use.

†With continued use two times per day. For lasting relief, apply with a gentle toothbrush making sure to brush all sensitive areas of the teeth.

References

1. Davari AR, et al. Dent Shiraz Univ Med Sci. 2013;14(3):136-45.
2. Dam VV, et al. Open Dent J. 2022;16:e187421062201130.
3. Berg C, et al. J Funct Biomater. 2021;12:27.
4. Data on file. Market research through Zapera, Colgate-Palmolive, 2009.
5. Mason S, et al. BMC Oral Health. 2019;19:226.
6. Bekes K, et al. J Oral Rehabil. 2009;36(1):45-51.
7. Gillam DG. Clin Oral Sci Dent. 2021;4:1.
8. Ipsos, Patient Experience Program elmex SENSITIVE PROFESSIONAL REPAIR & PREVENT, 175 respondents, Germany, 2019
9. Lai HY, et al. J Clin Periodontol. 2015;42:S17

This article is sponsored by Colgate.

As Prime Minister Keir Starmer announces his resignation, the dental profession is left asking what its political future holds.

Today (22 June) the Prime Minister said he accepted with ‘good grace’ that he was no longer best placed to lead his party into the next general election. He said: ‘Every decision I’ve taken has been about putting the country I love first. That is why I will resign as leader of the Labour Party.’

Labour came to power promising to rebuild NHS dentistry, including more appointments, filling dental deserts with new graduates, and reform of the dental contract to encourage more dentists to offer NHS care.

But nearly two years into government, the profession is still waiting for the full contract reform process to begin. Starmer’s departure now raises fresh questions over whether dentistry will remain a political priority under his successor, and whether Labour can deliver meaningful reform before the next general election.

The next UK general election must be held by 15 August 2029, unless one is called earlier.

Who will replace Keir Starmer?

Following his recent win in the Makerfield by-election, Andy Burnham has confirmed that he will stand to replace Starmer as Labour Party leader, promising ‘stability, seriousness and a continued focus on the issues that matter most’ going forward.

As mayor of Greater Manchester, Burnham’s main priorities for dentistry were tackling childhood oral health inequalities and healthcare devolution to build local preventive dental programmes. However, he has yet to specify how he would approach dentistry on a Parliamentary level.

The profession will now be looking for clarity on whether he would keep Labour’s existing dentistry commitments, retain the current ministerial team and accelerate dental contract reform.

Former health secretary Wes Streeting made a statement backing Burnham’s leadership bid. He said: ‘We could spend the summer exaggerating small differences, or we can roll up our sleeves and help him to deliver the change our party and our country needs. That is the choice that I am making and I hope that everyone else will back Andy, too.

‘We were elected change our country, to show that politics can be a force for good, and to spread opportunity for everyone. With Andy, we still can.’

How will this impact dentistry?

Speaking to Dentistry.co.uk at Dentistry Show Birmingham, British Dental Association (BDA) chair Eddie Crouch expressed concern at the amount of time that Labour had left to reform NHS dentistry.

He said: ‘Unless we get that consultation and make progress on this, their ambition to reform the contract during this parliamentary term is going to be under pressure.’

However, he also suggested that there was support for dentistry in the wider government, saying: ‘What I hope is that a minister that I’ve built up a relationship with over the last two years, who I believe has got the right motives, will continue in post, irrespective of who eventually ends up leading the Labour Party.’

He concluded: ‘I believe that there is a parliamentary will to actually improve dentistry, and that’s across all parties – whether I meet the Greens, the Liberal Democrats, the Conservatives or Labour. Everyone wants NHS dentistry to be resolved. With that political will, we have reason to be optimistic.’

How has the opposition responded to Keir Starmer’s resignation?

Reform Party leader Nigel Farage described Starmer as ‘the most incompetent Prime Minister this country has ever had the misfortune of having’. He called for a general election ‘at the soonest possible date’ as ‘the country cannot afford to waste another week drifting from crisis to crisis’.

Farage also said it would be ‘ridiculous to pretend that Andy Burnham has any kind of meaningful mandate to lead the country’. He concluded: ‘Britain needs change – real change, not another washed-up has-been shoved into place by the uniparty.’

Find out more about what a Reform Party government would look like for dentistry here.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

Join Tony Rickwood on 29 June at 7pm as he discusses why your triage is the problem, not your waiting list.

In this webinar, delegates will learn how remote triage is transforming NHS orthodontic contract performance. Using real data from Tony Rickwood, this session covers how to clear waiting lists faster, protect specialist chair time, and drive private patient growth alongside NHS delivery.

Learning outcomes

• Understand why traditional in-chair triage is a contributor to NHS contract underperformance and waiting list growth
• Learn how to implement a remote digital screening pathway that filters patients before they occupy specialist chair time
• Apply a structured case flagging system (green, purple, OH hold) to manage patient readiness and protect clinical capacity
• Identify how removing triage burden from the specialist chair creates the conditions for consistent NHS contract delivery and early completion
• Recognise the commercial opportunity that efficient NHS triage unlocks, including conversion of waitlisted patients into self-funded private starts.

The speaker

Tony Rickwood spent 25 years managing large-scale retail operations for Tesco before moving into dentistry in 2015. Joining Pallant Orthodontics as business manager, he helped grow the practice from six to 30 staff across two sites, including building a second specialist practice from the ground up. Over 11 years he led NHS contract management, practice rebranding, treatment coordinator integration and in-house 3D printing. He now runs TDBM, an orthodontic consultancy supporting practices across the south with operational strategy and practice management training.

You can sign up for the webinar here.

Catch up on previous on-demand webinars:

• Advancing vital pulp therapy: clinical applications and predictable outcomes using MTA vpt
• From enquiry to treatment start: the patient journey most practices have never mapped
• Dealing with patient complaints: real cases, real solutions
• The first 100 days of marketing for a new practice owner
• Is your practice quietly losing £100,000 a year?

You can sign up for the webinar here.

A few months into his role as senior editor of Dentistry.co.uk, Patrick Johnston comments on one theme that keeps coming through in almost every conversation: dentistry talks about prevention constantly. The harder question is whether patients and families are hearing us.

At the Birmingham Dental Show, Bupa Dental Health Is Live and the General Dental Council (GDC) Future Dental Leadership Network event, prevention was continually recognised as a priority. The message was clear. Dentistry cannot keep relying on treatment-led models and expect oral health outcomes, access pressures or National Health Service (NHS) costs to improve.

Research published in Frontiers in Public Health underlined the scale of the challenge. It projected that annual NHS treatment costs linked to dental caries and periodontal disease in the United Kingdom (UK) adult population could rise from £4.418 billion in 2020 to £5.301 billion by 2050, a 20% increase. It also projected that people aged 60 and over will bear 69% of caries-related costs by 2050, with untreated caries costs in that group growing by 168%.

That is the economic case. But prevention will not be achieved by repeating the same messages more loudly. It will depend on whether dentistry can communicate in ways that fit people’s real lives.

That distinction matters because so much public health messaging fails on delivery rather than content. An oral health session run by a local authority during midweek working hours, for example, may have the right subject and the right intention. But if the format excludes many of the working parents it is meant to reach, the message is already weakened before it lands.

What does oral health education done right look like?

That is why the industry examples that cut through deserve attention. Bupa’s The Dentist’s Apprentice, story showed how oral health education can be made memorable for children. Kev the Dentist’s toothbrush giveaway campaign turned a simple preventive tool into a visible public message.

Dr Rakhee Patel’s work with Tottenham Hotspur and the Give Up Loving Pop programme, which encourages children and families to reduce sugary drinks, showed the value of taking oral health education into trusted community settings.

These initiatives work because they start with the audience. They ask where people are, who they listen to and what will make the next healthy action easier.

That should be the test for prevention. Not whether the profession has said the right thing, but whether the message has reached the patients and families it is meant for, in a form they can understand, trust and act on.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

Chris Nicholson explores the parallel between the FIFA World Cup tournament and dental practices thinking about stepping away from the NHS.

As the World Cup gets underway, it’s a good reminder that success at the highest level of football is something that requires preparation and planning. The teams that go deep into the tournament have been building towards it for years.

When it comes to success in football, the strongest teams will have figured many of the important things out long before the kick-off. The tough calls such as investing in the right players, refining their system, and being clear on how they want to play will all have been sorted well in advance so that, by the time the referee blows his whistle they’re prepared and putting all of that into action.

It’s not too much of a stretch to say that for many dental practice owners, the situation for them isn’t too different. Rising costs, ongoing recruitment challenges and the limitations of the NHS contract are putting increasing pressure on the model. At a certain point, it stops being about short-term fixes and becomes a bigger question: is this still the right direction long term?

That’s when taking stock becomes essential. Just as a manager would be looking at their squad before a major tournament, practice owners need a clear, honest view of where they are now regarding their finances, how they are coping operationally and their team capacity and morale. They also need to decide where they want to be in a few years’ time.

What can the FIFA World Cup teach us in dentistry?

Building a successful team takes time. They need to learn the system their manager wants to employ. That’s something that always works better if they understand why they’re being asked to do things in a particular way. Likewise, moving away from the NHS isn’t something that works well as a sudden shift. The team and patients need time to adjust.

The practices that handle it best tend to treat it as a transition rather than an instant switch. They plan it properly, phase changes in, bring their team with them, and give patients time to understand what’s happening. It’s more measured, but it’s also far more sustainable.

That same idea applies when it comes to planning the next phase of a practice. As well as deciding whether to move away from the NHS, there’s a need to understand what that move will look like in practice. That will entail taking a proper in-depth look at your patient base, your numbers, and where the real opportunities are. The greater the clarity at this stage, the easier it is to make decisions that hold up over time.

Make sure you have support

Support matters too, and this is where many practices either gain momentum or lose it. Behind every successful football team is a lot of work that never gets seen. The so-called ‘backroom staff’ of coaches, analysts, physios and other medical staff. These people are all focused on making sure the conditions are right so the players can perform when it counts.

A conversion from NHS to private dentistry is no different. Whether you’re thinking about introducing a membership plan, adopting a mixed model, or making a full move to private, having the right guidance can make a huge difference to your success. Having support in place helps shape your planning, how you bring your team on board, how you communicate with patients, and the confidence you will feel about the whole process. Ultimately, this one decision will shape the whole future of your business.

Preparing a firm foundation for the future

The most successful teams are built to perform consistently rather than simply to win one match. Generally, they have a clear identity, a system that works, and the flexibility to adapt when things change. That’s what practice owners should be aiming for too.

You’re aiming to do more than simply survive the current pressures. This is all about building something more stable, profitable and with a lower admin burden in the long term all while maintaining the quality of care.

There’s no single route from NHS to private. As each practice is unique, they will approach it slightly differently, depending on their patients, team and long-term goals. However, the common thread is preparation.

The practices that get the best results are usually the ones that take the time to think it through properly, rather than reacting under pressure or leaving decisions until they have no choice. That’s the important takeaway here.

Success, whether in football or in business, rarely comes from last-minute changes, although, as in practice, there is often a need for substitutions. However, with planning, having a clear direction, making considered decisions, and backing yourself to follow them through most scenarios can be covered.

Consider your options

If you’re starting to question what the future looks like for your practice, it might be time to take that first step and look at your options properly.

There’s never been a safer time to leave NHS dentistry. If you’re considering your options away from the NHS and are looking for a plan provider who will hold your hand through the process at a pace that’s right for you, you’re in safe hands with Practice Plan.

You can start the conversation today by calling 01691 684165 or booking your one-to-one NHS to private conversation at a date and time that suits you, just visit practiceplan.co.uk/nhsvirtual.

This article is sponsored by Practice Plan.

Eddie Scher, a defining figure in UK implant dentistry and former ADI president, has died after a career in clinical education.

A specialist prosthodontist and oral surgeon, lifelong educator and one of the architects of the Association of Dental Implantology, Eddie helped guide implant dentistry from its pioneering years towards the respected discipline it is today.

Pioneering implant dentistry

After qualifying from University College Hospital in 1973, he moved from general practice into the more complex restorative and surgical work that would define his career.

His name was synonymous with implant dentistry for a reason. From as early as 1985, his own clinic – the Walpole Street Dental Practice in Chelsea – was dedicated to prosthodontics and implant dentistry, years before the discipline became mainstream.

For decades, his clinical focus was dedicated to complex treatment, helping restore function and smiles for patients with the most challenging problems.

In a world of guided surgery and digital implant planning, it is easy to forget that implant dentistry did not arrive fully formed in the UK. It needed advocates, champions, devotees. Eddie was all of these and more – a clinician who adored his craft and shared that passion with others, never losing the wonder over the difference that dental science could make for patients on the receiving end.

He was pivotal in the inception of the Association of Dental Implantology in 1987, helping formalise it from a study club to a UK-wide professional organisation.

Together with its other founding members – Barry Edwards, Vivian Freiberger, Ashok Sethi, Norman Mills and Philip Freiberger – he helped move implant dentistry away from the suspicion that once saw its practitioners dismissed as ‘the cowboys of dentistry’, and towards a field increasingly defined by training, standards and peer accountability.

Eddie would later serve as ADI president and, in 2013, was made an honorary member – a recognition he regarded as one of the great honours of his professional life.

Birthright and legacy  

Dentistry itself was a birthright as much as a calling for Eddie, who was part of a dental lineage that stretched back two generations.

The first signs appeared early: he made his first set of dentures aged 10 in his father’s laboratory. His three uncles were all dentists. His grandfather, Israel Scher, helped found the very dental school – University College Cork – that his father Leslie would go on to be dean of.

Eddie’s later appointment as visiting professor at UCC carried enormous meaning. To him, it was the return of a Scher to Cork – validation and acknowledgment of his own inheritance.

But if he felt the responsibility of his legacy, he shaped his own path. His philosophy was one of putting people first: starting always with the person in the dental chair.

He spoke of the treatment planning conversation as the moment where dentistry became properly human: when the science, the patient’s hopes and the clinician’s responsibility had to meet.

Becoming Professor Eddie Scher

Despite often referring to dentistry as his hobby, his commitment to implant dentistry was serious. It went far beyond institutions and science. For Eddie, the field had to be explained and shared, and that same energy carried him into lecture halls and dental schools around the world.

He founded and led the Osseointegrated Year Course, helping demystify implant dentistry for generations of clinicians at a time when formal pathways were still developing. He also taught extensively in the UK, at University of Salford and the Eastman Dental Institute, but his influence as an educator extended far beyond domestic shores.

His long relationship with Temple University in Philadelphia began in 1994, when he became associate professor in its prosthodontic and implant department, and continued for the rest of his life through a visiting professorship he held dear.

His academic journey took him to France, and to Israel, where advisory and institutional roles with Tel Aviv Dental School and Tel Aviv University carried deep professional and personal significance.

Speaking with purpose

Eddie’s teaching took him across the world, but his purpose remained strikingly consistent: to make complex implant dentistry understandable, responsible and clinically useful.

His long-standing partnership with FMC, publisher of Dentistry, became another extension of that mission, allowing him to bring implant dentistry to a wider audience of general dentists than ever before. As editor-in-chief of Implant Dentistry Today, he brought the same insistence on scientific rigour, clinical relevance and real-world application.

As his involvement with Alpha Omega also grew, he ushered his network of colleagues and alumni into pages and onto stages, gently insisting they too share their expertise with his growing audience.

That gentle insistence could become more forthright when the occasion demanded it. He had a strong sense of justice that appeared early. As a boy, he once lured local bullies onto a garage roof and left them stranded there – a tale that sums up his fighting spirit and the impish humour that never left him.

Many years later, that same refusal to accept unfairness would surface in a very different context, when he challenged the impact of the GDC’s fitness to practise processes on clinicians.

The complaint that took him through that process was found to be baseless; ultimately dismissed with ‘no case to answer’. But the experience left its mark.

No sooner had the dust settled than he set about campaigning on behalf of the others who had experienced the same challenges. Eddie spoke and wrote openly about the fear and uncertainty it caused. He was determined to challenge a process he believed could do profound damage to professionals – and to stop others enduring the same experience.

Loyalty, influence and generosity 

If anything remained constant through Eddie’s long career and longer list of titles, it was the irrepressible spirit of that boy whose teachers had once suggested he ‘wouldn’t amount to much’.

A talented sportsman in his youth, he developed an enthusiastic love of golf in later years – one that sustained him even through illness, when he practised putting in his hospital room. New friends were swiftly made among the clinical staff. But then, that was so often the case with Eddie.

Behind the professorships and titles was a man of deep loyalty, fierce family feeling and instinctive generosity. Eddie never simply spoke to people: he took an interest. He remembered families, names, anxieties, ambitions and small details even as he shared the achievements of his own family.

The loss of his first wife, mother to his sons Laurie and Robin, shook the foundations of his life. In Belinda, whom he would later marry and often described with profound gratitude, Eddie found love, steadiness and joy again.

He is survived by Belinda, his sons, and his grandchildren.

Many will remember Professor Eddie Scher as a pioneer of implant dentistry, a teacher of rare influence and a clinician who helped change the course of his field.

Those who knew Eddie will remember something more intimate: his loyalty, his mischief, his pride in the people he loved, his belief in the people he taught, and his ability to make others feel braver than they had before.

A mentor, a teacher and, above all, a friend.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

Crinetics Presents Full Results From Phase 2 Trial of Atumelnant in CAH at ENDO 2026

On June 14, Crinetics Pharmaceuticals, Inc.  presented data from the open-label, Phase 2 congenital adrenal hyperplasia (CAH) adult study of investigational atumelnant, a novel, once-daily oral adrenocorticotropic hormone (ACTH) receptor antagonist candidate being developed for the treatment of classic CAH and ACTH-dependent Cushing’s syndrome.

The findings were included in an oral presentation titled “Once Daily Atumelnant (CRN04894) Enables Lowering of Glucocorticoid Doses with Sustained Androgen Reduction in Adults with Congenital Adrenal Hyperplasia” at ENDO 2026.

“Atumelnant is designed to block the effect of excess ACTH, the fundamental driver of symptoms and complications of CAH and ADCS,” said Alan Krasner, MD, Chief Endocrinologist, Crinetics. “Based on promising results from phase 2 clinical trials presented today, we are advancing atumelnant into late phase clinical development. The data suggest atumelnant could represent a uniquely effective and simple to use oral therapy for many patients who need new options.”

“It’s exciting to see that glucocorticoid dose reduction did not impact the atumelnant-induced decline in androstenedione in adults with classic CAH who participated in this Phase 2 trial,” said Umasuthan Srirangalingam, MD, consultant physician in endocrinology and diabetes at University College London Hospitals NHS Foundation Trust and TouCAHn Investigator. “We are looking forward to learning more about the full potential of atumelnant in the treatment of CAH from adult and pediatric Phase 3 trials that are already underway.”

At ENDO 2026, findings from Cohort 4 of the Phase 2 CAH trial were presented for the first time, including the percent change from baseline in morning serum A4, 11-OHA4, and 11-KT with GC reduction. Participants in Cohort 4 received dosing of 80 mg once daily in the morning. Beginning at week 2 of treatment, each participant’s previous GC dose was reduced stepwise by 5-10 mg HC equivalents, independent of A4 measurement, to target <11 mg/m²/day HC equivalents.

Phase 2 CAH Cohort 4 Results

• At week 12, the mean percentage change from baseline in A4 morning serum levels in Cohort 4 was -67%.
• Seven out of eight participants (88%) who completed 12 weeks of treatment achieved a physiologic daily dose of GC.
• Reductions in pre-GC serum 11-OHA4 and 11-KT were rapid and sustained, with mean change from baseline of -64% and -56% at week 12, respectively.
• Morning dosing of atumelnant resulted in similar androgen reductions as seen in previous cohorts with evening administration.

Atumelnant was generally well tolerated with no treatment-related severe or serious adverse events to date, irrespective of disease severity or dose level.

Initial findings from the adult Phase 2 trial in CAH, including A4 reduction levels compared to baseline for cohorts 1-3, in which participants did not change previous GC doses, were presented at ENDO 2025.

Topline results from Cohort 4 were announced in January 2026.

Previously Reported A4 Reductions for Cohorts 1-3 (no GC reduction)

New Phase 1b/2a ADCS Trial Results

Data presented at ENDO 2026 include findings from a cohort dosed with atumelnant 40 mg once daily (n=6). Findings include:

• Atumelnant rapidly lowered early morning serum cortisol in all participants.
• Atumelnant also rapidly lowered UFC. At the end of the 10-day dosing period, UFC remained ≤ upper limit of normal (ULN) in 3/6 participants.
• Most AEs were mild to moderate and consistent with symptoms of adrenal insufficiency.  Most improved with initiation of GC replacement.

Atumelnant ENDO 2026 presentations can be found at: https://crinetics.com/news-events/endo-2026/

About Atumelnant

Atumelnant, Crinetics’ second investigational compound, is the first once-daily, oral adrenocorticotropic hormone (ACTH) receptor antagonist that acts selectively at the melanocortin type 2 receptor (MC2R) on the adrenal gland. Diseases associated with excess ACTH can have significant impact on physical and mental health. Atumelnant has exhibited strong binding affinity for MC2R in preclinical models and has demonstrated suppression of adrenally derived glucocorticoids and androgens that are under the control of ACTH. Data from a 12-week Phase 2 study demonstrated compelling treatment benefits of atumelnant, evidenced by the rapid, substantial and sustained statistically significant reductions in key CAH disease related biomarkers, including androstenedione and 17-hydroxyprogesterone, in a diverse population. Atumelnant is in development for congenital adrenal hyperplasia and ACTH-dependent Cushing’s syndrome, with the Phase 3 CALM-CAH trial and a Phase 1/2b trial in ADCS currently enrolling patients.

About the Phase 2 TouCAHn Trial (CAH)

The TouCAHn trial is an open-label, global, Phase 2 study designed to evaluate the efficacy, safety, and pharmacokinetics of atumelnant when administered for 12 weeks in people with classic CAH (21-hydroxylase deficiency). A total of 38 participants were enrolled, with a median A4 of 980.8 (range=116-2755) ng/dL were enrolled in four cohorts: (40 mg, n=11; 80 mg, n=11; 120 mg, n=6; 80 mg morning dosing with GC reduction, n=10).

Primary endpoints included change from baseline in morning serum androstenedione (A4) levels and incidence of treatment-emergent adverse events. Percent change-from-baseline in GC daily dose was an exploratory endpoint for Cohort 4.

About the Phase 1b/2a Study in ACTH-dependent Cushing’s Syndrome

The Phase 1b/2a, is the first-in-disease, open-label, multiple-ascending dose exploratory study to evaluate safety, tolerability, pharmacokinetics, and pharmacodynamic biomarker responses associated with atumelnant over a 10-day inpatient treatment period in participants with ACTH-dependent Cushing’s syndrome.

The study is being conducted in collaboration with the National Institutes of Health and led by Dr. Lynnette Nieman. Participants received oral atumelnant once daily for 10 days, followed by monitoring during four wash-out days.

Crinetics Presents Long-Term Data at ENDO 2026 Confirming PALSONIFY^TM (paltusotine) Provides Durable, Consistent Acromegaly Control

Also on June 14, Crinetics Pharmaceuticals, Inc. announced new long-term data from its clinical development program evaluating novel PALSONIFY^TM (paltusotine) in acromegaly during an oral presentation at ENDO 2026.

Notably, pooled data from the open-label extension (OLE) trials of PATHFNDR-1 and PATHFNDR-2 show that after two years of treatment, PALSONIFY was effective and well-tolerated in patients who were switched from standard-of-care monthly injectable somatostatin receptor ligands (SRLs) and those who were medically untreated, respectively, when oral, once-daily PALSONIFY was initiated.

“To assess acromegaly disease control while on medication, endocrinologists carefully monitor control of IGF-1 levels, control of acromegaly symptoms, and stabilization of pituitary tumors,” said Alan Krasner, MD, chief endocrinologist, Crinetics. “At this year’s ENDO meeting, long-term safety and efficacy data from the PATHFNDR OLE trials will be presented. These studies indicate that Palsonify is well tolerated and maintains control of all three aspects of disease control with long-term follow-up. Since its launch late last year, we are learning that Palsonify is already making a meaningful difference in the lives of many people with acromegaly, and we hope these data will be helpful for patients and for their health care providers.”

Pooled OLE Efficacy and Safety Results

PATHFNDR-1 Data

The PATHFNDR-1 Phase 3 trial enrolled adults with acromegaly who were biochemically controlled on monthly injectable SRLs. Following a 36-week randomized, placebo-controlled period, 53 of 57 participants (93%) entered the ongoing single-arm open-label extension (OLE) trial.

Baseline mean IGF-1 levels for OLE participants (n=53) was 0.91x Upper Limit of Normal (ULN). These levels remained stable at both 48 weeks (n=50) and 96 weeks (n=47) of the study: 0.82x ULN and 0.81, respectively. Symptoms associated with acromegaly, as measured by the Acromegaly Symptom Diary (ASD), remained stable from baseline at assessed timepoints. Additionally, pituitary tumor volumes were reported as stable in all patients at week 48, relative to OLE baseline.

PATHFNDR-2 Data

The PATHFNDR-2 trial evaluated once-daily oral PALSONIFY in adults with biochemically uncontrolled acromegaly (baseline IGF-1 > 1.3 × ULN). After a 24-week randomized controlled (RC period, 103 of 106 completers (97.2%) entered the ongoing OLE, along with 11 additional patients who were eligible for the RC phase but enrolled directly into the OLE.

Baseline mean IGF-1 levels for OLE participants (n=114) was 1.64×ULN. These levels decreased from baseline at both 48 weeks (n=98) and 72 weeks (n=78) of the study: 1.06×ULN and 0.96×ULN, respectively.

Relative to OLE baseline, pituitary tumor volume was reduced by >20% in 7 of 83 PATHFNDR-2 patients with available MRI scans at OLE Week 24. Tumor volume was reported as stable in the other 76 participants.

In both OLEs, median ASD scores were stable at the timepoints assessed. Symptoms associated with acromegaly, as measured by the Acromegaly Symptom Diary (ASD), remained stable from baseline at assessed timepoints.

No new safety signals were found. In the pooled OLE population (n=167), the most common adverse events (incidence>10%) were diarrhea (15.6%), arthralgia (11.4%), headache (11.4%), and urinary tract infection (10.2%). Four patients (2.4%) discontinued from an OLE due to adverse events as of this analysis.

These results were included in an oral presentation at ENDO 2026 titled “Efficacy and Safety of Once-Daily Oral Paltusotine in Patients with Acromegaly: Up to 2 Years in the PATHFNDR-1 and PATHFNDR-2 Open-Label Extension Studies.”

Additionally, an analysis was presented at ENDO 2026 that evaluated the safety and efficacy of PALSONIFY in combination with oral cabergoline in patients with acromegaly who have been followed for up to four years in ACROBAT Advance, an ongoing, single-arm, open-label extension phase 2 study. IGF-I levels on paltusotine monotherapy were similar to parent study baseline values (on injected SRL), but for those in whom IGF-1 had not yet normalized, it further improved when oral cabergoline was added. Combination therapy was well tolerated.

Crinetics’ ENDO 2026 presentations can be found at: https://crinetics.com/news-events/endo-2026/

Marea Therapeutics Presented Data Supporting Potential Best-in-Disease Profile Acromegaly Treatment at ENDO 2026

On June 15, Marea Therapeutics, Inc., highlighted data from its first-in-human Phase 1 study of MAR002 at ENDO 2026 in Chicago, Ill. MAR002 is a first-in-class allosteric monoclonal antibody targeting the growth hormone receptor (GHR).

Marea Therapeutics, Inc., is a clinical-stage biotechnology company harnessing the latest advances in human genetics to develop first-in-class, next-generation medicines for cardioendocrine diseases,

Data from the Phase 1 study support a potential best-in-disease profile of MAR002 across safety, tolerability, pharmacodynamic effect, and dosing convenience – with deep, durable IGF-1 suppression that may enable dosing as infrequently as once every two weeks, compared to the daily subcutaneous injections required by the current standard of care.

“The Phase 1 data presented at ENDO provide compelling proof-of-mechanism for MAR002 and strengthen our confidence as we advance into a Phase 2/3 study in patients with acromegaly expected to begin in the coming weeks,” said Rebecca Juliano, PhD, chief development officer of Marea Therapeutics. “MAR002 demonstrated deep and durable suppression of IGF-1, a validated biomarker and regulatory endpoint in acromegaly, while exhibiting pharmacokinetic properties that may support convenient dosing as infrequently as every two weeks. By directly blocking growth hormone signaling at the receptor level, MAR002 has the potential to deliver meaningful biochemical control for a broad population of patients and establish a new standard of care in acromegaly.”

“Acromegaly remains a disorder of significant unmet need, with fewer than 35% of patients achieving optimal disease control on first-line medical therapy,” said Shlomo Melmed M.D., Distinguished Professor and Dean at Cedars-Sinai. “The depth of initial IGF-1 suppression reported with MAR002 of up to 64% is particularly notable, as it appears to exceed levels seen with previously reported therapies in acromegaly. Based on these early findings, and if proven safe, MAR002 has the potential to become a significant advancement in both efficacy and treatment convenience for patients with acromegaly.”

Presentation Highlights

• The first-in-human, randomized, blinded, parallel-group, placebo-controlled Phase 1 study enrolled healthy adult male volunteers and single ascending doses of MAR002 demonstrated a favorable safety and tolerability profile, with no serious adverse events or dose-limiting toxicities.
• Treatment with MAR002 resulted in robust and durable dose-dependent reductions in circulating insulin-like growth factor-1 (IGF-1) with up to 64% peak suppression.
• Favorable pharmacokinetic (PK) profile support bi-weekly to monthly dosing.

Recordati Rare Diseases, Inc., Presents Data Analyses at ENDO 2026

On June 15, Recordati Rare Diseases, Inc., announced new data analyses at ENDO 2026 from four poster presentations featuring the company’s endocrinology portfolio.

The data presented include outcomes with ISTURISA® (osilodrostat) across the LINC clinical program, drawing on pooled clinical trial and real-world analyses to assess patient-reported quality of life, biochemical control, and clinical outcomes across a range of Cushing’s syndrome populations, including those with milder disease, as well as ongoing evaluation in studies such as LINC CARE. 

“Engagement with the endocrinology community at ENDO 2026 highlighted the importance of continuing to build robust, long-term evidence for patients living with Cushing’s syndrome to support long-term management,” commented Milan Zdravkovic, executive vice president, head of R&D and CMO, Recordati. “Analyses from the LINC programme support previously established sustained efficacy and further assess meaningful improvements in quality of life with ISTURISA®, reinforcing its role as an important long-term treatment option.”

Melissa Koomey, president and General Manager North America, Recordati Rare Diseases, added, “The response to our data presentations at ENDO 2026 highlights the growing commitment across the US endocrinology community to advancing care for people living with rare endocrine diseases. We are encouraged by the strong interest in the expanding body of evidence supporting ISTURISA® and remain committed to working alongside clinicians, researchers, and patient communities to help address ongoing unmet needs and improve patient outcomes in Cushing’s syndrome.” 

Key Data Presentations at ENDO 2026

Martin Reincke, MD, LMU Hospital, Ludwig-Maximilians-Universität, introduced the LINC CARE Phase IV study evaluating the efficacy and safety of osilodrostat in patients with hypertension caused by hypercortisolemia due to Cushing’s syndrome despite medication.

• Poster number: MON-105
• This study addresses an important unmet need in Cushing’s syndrome patients with mild elevations in cortisol, a population often underrepresented in research despite substantial cardiometabolic burden, including high baseline rates of hypertension and dysglycemia observed in prior LINC 3 and LINC 4 analyses

Antoine Tabarin, MD, from CHU de Bordeaux and Centre de Référence des Maladies Rares de la Surrénale, presented promising results from LINC 7, a retrospective observational study, which assessed the safety and effectiveness of osilodrostat in adrenal and ectopic Cushing’s syndrome.

• Poster number: SAT-036
• In this secondary analysis of the LINC 7 retrospective observational study, osilodrostat reduced cortisol levels across all Cushing’s syndrome etiologies and severities, including mild benign adrenal Cushing’s syndrome, mild malignant Cushing’s syndrome, and moderate-severe Cushing’s syndrome

Eliza B. Geer, MD, from Memorial Sloan Kettering Cancer Center, presented an ad hoc analysis of the ongoing LINC 6 study which is assessing the long-term safety and efficacy of osilodrostat in patients with endogenous Cushing’s syndrome during 3 years of routine clinical practice.

• Poster number: SAT-013
• Improvements in quality of life were observed in patients with Cushing’s syndrome during osilodrostat treatment. Biochemical and clinical parameters improved or remained stable over time in most patients

Beverly Biller, MD, from Massachusetts General Hospital, presented an analysis of patient reported outcomes from the Phase III LINC 3 and LINC 4 studies.

• Poster number: MON-026
• Patients treated with osilodrostat in the pooled analysis showed improved Health-Related Quality of Life (HRQoL) across all reported HRQoL instruments, with sustained, clinically meaningful improvements observed to week 72. Improvements were consistent across the disease-specific CushingQoL and generic EQ-5D-5L and BDI-II questionnaires. The greatest improvements in HRQoL occurred in items/domains with the greatest burden at baseline. 

Ethyreal Bio Presents First Preclinical Data on ETHY-001 Demonstrating Complete Blockade of Autoantibody Activation of TSHR and Differentiated Activity in TED

Ethyreal Bio, a biotechnology company developing precision therapies for thyroid diseases with high unmet need, today reported preclinical data for its lead program, ETHY-001, in an oral presentation at ENDO 2026 on June 15.

ETHY-001 is an internally discovered, half-life-extended monoclonal antibody designed to block autoantibody-mediated activation of the thyroid stimulating hormone receptor (TSHR), the shared pathogenic driver of Graves’ disease (GD) and thyroid eye disease (TED).

“The data presented today underscore the promise of ETHY-001 for the treatment of TED and GD,” said Niranjan Kameswaran, PhD, chief executive officer of Ethyreal Bio. “The depth and consistency of signaling blockade across all tested patient sera samples, combined with its differentiated activity compared to IGF-1R antagonism in TED models, reinforce our conviction in ETHY-001’s product profile. We believe that ETHY-001’s unique combination of potent receptor blockade, subcutaneous administration, and extended half-life supports a best-in-class, convenient, single-agent approach for both conditions. We are excited to advance ETHY-001 into the clinic this year.”

Key preclinical results for ETHY-001 shared in the oral presentation include:

• Potent binding with high specificity for TSHR. ETHY-001 binds TSHR with sub-nanomolar monovalent affinity and no off-target binding in a membrane protein array of over 5,000 membrane proteins.
• Complete, consistent, and broad blockade of TSHR activation. ETHY-001 completely blocked autoantibody-driven TSHR activation elicited from all patient samples tested to date.
• Differentiated activity versus anti-IGF-1R in TED patient-derived orbital fibroblasts. In primary TED patient-derived orbital fibroblast cultures stimulated by M22, a potent stimulating antibody of TSHR, ETHY-001 produced complete inhibition of both HA and IL-6 secretion. An IGF-1R antagonist comparator inhibited HA secretion but not IL-6 secretion. These observations demonstrate ETHY-001’s potential for more robust inhibition of pathogenic signaling in comparison to anti-IGF-1R in TED.

Together, these data support the advancement of ETHY-001 into clinical development for TED and GD, with potential to be a single, best-in-class, mechanism-driven therapy. Ethyreal plans to initiate a first-in-human trial in the second half of 2026.

Rezolute Highlights Results Presented from Natural History Outcomes Studies and its Ersodetug Clinical Program in Hyperinsulinism at ENDO 2026

On June 17, Rezolute, Inc., a late-stage ultra-rare disease company focused on treating refractory hypoglycemia caused by a congenital or any acquired form of hyperinsulinism (HI), highlighted four data presentations delivered at ENDO 2026.

Two poster presentations highlighted results from systematic analyses of the natural history and adverse neurologic and health-economic outcomes resulting from congenital HI, using a meta-analysis of the literature as well as a claims-based approach to quantifying congenital HI complications, respectively. This is an important step toward consolidating and quantifying the disease-impact and informing future health economics and outcomes research that will facilitate the development and potential future launch of the company’s therapy, ersodetug, in this indication. A third poster presentation highlighted favorable outcomes from a case series report of 9 patients with refractory hypoglycemia due to malignant insulinoma and non-islet cell tumors (tumor HI), demonstrating that 75% of the patients receiving IV dextrose/total parenteral nutrition (TPN) in the EAP achieved a complete discontinuation of IV dextrose/TPN.

In an oral presentation, Huseyin Demirbilek, MD, professor, Department of Pediatric Endocrinology, Hacettepe University Faculty of Medicine, Ankara, Turkey, and Principal Investigator of the Phase 3 sunRIZE study of ersodetug in congenital HI, reviewed previously reported sunRIZE results.

“We were pleased to have the opportunity to present at ENDO and to continue showcasing progress across our two late-stage programs in congenital and tumor HI,” said Brian Roberts, MD, chief medical officer of Rezolute. “Deeper analyses of the sunRIZE data demonstrate the meaningful therapeutic benefit of ersodetug, further supported by the positive outcomes observed in both our EAP and recently announced interim and preliminary Phase 3 upLIFT study observations in tumor HI patients. Additionally, the natural history outcomes studies further underscore the significant clinical outcomes impacts of this disease, and the urgent need for improved treatment options.”

Each of the company’s full data presentations from ENDO can be found on the Publications and Presentations page of the Rezolute website here.

*Inclusion in Pharma Fridays does not suggest an endorsement by Endocrine News or the Endocrine Society.

The post Pharma Friday – ENDO 2026 Edition – June 19, 2026 appeared first on Endocrine News.

With skill mix being hailed as the new way of working for the NHS, does dental therapy really benefit? Or is it a wolf in sheep’s clothing?

On one hand, we are hearing more than ever about prevention, access, workforce pressures, skill mix and reform. Dental therapists are finally being recognised within NHS policy conversations as a vital part of the future workforce. New contractual changes now allow therapists to open and close courses of treatment, prescribe under exemptions legislation and work more independently than ever before.

And yet, many dental therapists still find themselves trapped in repetitive, low autonomy workflows.

Check-up. Scale. Polish. Repeat.

I recently spoke with a dental therapist working predominantly within the NHS system. Like many therapists, he had a strong educational background, excellent clinical potential and a genuine passion for patient care. Yet his diary had become heavily weighted towards examinations and repetitive maintenance appointments, with very little opportunity to develop restorative confidence or expand his clinical role.

This conversation is not unique. In fact, it reflects exactly where many NHS therapists currently find themselves.

The problem is not capability: it’s structure

For years, therapists have been working within systems that were never truly designed for them to thrive independently. Even after direct access arrived in 2013, significant practical barriers still existed within NHS dentistry. Therapists could diagnose and treatment plan within their scope, but operationally many still relied heavily on dentists for prescriptions, workflows and referrals.

Over the last few years, however, there have been important changes.

Therapists can now open courses of treatment on Compass, provide care independently within scope and close courses of treatment where they are the sole provider. Exemptions legislation has also transformed practical delivery of care, allowing therapists and hygienists to administer and supply certain medicines such as local anaesthetic and fluoride varnish without requiring a prescription from a dentist.

Alongside this, recent NHS reforms are increasingly encouraging wider use of skill mix. New contractual guidance has widened opportunities for preventive care delegation, including fluoride application pathways involving appropriately trained dental nurses. For the first time in many years, NHS systems are beginning to acknowledge what many of us have known for a long time: modern dentistry cannot function efficiently if every aspect of patient care depends solely on the dentist.

And yet despite these changes, many therapists remain underutilised because practice workflows have not evolved alongside the legislation. Where is the operational guidance? Do dental practices have the capacity to re-organise and re-structure alone or should there be operational models made available for willing participants?

Pitfalls of NHS dental therapy

One of the biggest frustrations dental therapists describe to me is becoming trapped in diagnostic monotony. Ironically, this often happens at the exact moment therapists gain more autonomy. Practices suddenly realise therapists can perform examinations, so the diary becomes saturated with check-up appointments, but without the restorative workflow, prevention structure or referral pathways needed to make the role clinically rewarding.

The result is therapists diagnosing far more than they are actually delivering treatment.

Over time, this creates a very real problem. Restorative confidence begins to reduce. Clinical fulfilment declines. Therapists become increasingly reliant on referring work back to dentists because they are simply not getting enough repetition to maintain confidence in practical procedures.

If dental therapists only diagnose but rarely treat, we risk creating a generation of clinicians who slowly lose confidence in the very skills they trained for.

Dental practices need to consider not only the capabilities of their dental clinicians but also how to structure the diaries to ensure that care can be delivered at an appropriate time and by the most appropriate clinician for the job. If diaries become overly check-up heavy dental therapists risk losing confidence and reducing their skillset.

Confidence is not built through theory alone. It is built through repetition. Therapists do not suddenly become confident restorative clinicians because they attended one composite course or watched a webinar. Confidence develops through repeatedly diagnosing, isolating, restoring, reviewing, photographing and refining work over time.

This is where NHS systems often unintentionally fail therapists. Diaries become entirely reactive and volume driven rather than developmental. There is little protected space for clinicians to grow.

The evolution of NHS dental therapy

Instead, practices should be actively creating opportunities for skill development. Diarising restorative sessions, encouraging photography, supporting rubber dam placement, reviewing cases collaboratively and protecting time for learning all help clinicians progress safely and sustainably.

The therapists who thrive within NHS practice environments are usually the ones working within clear systems. Defined referral pathways, collaborative communication with dentists, efficient note templates and agreed restorative protocols create consistency and reduce anxiety for the whole team. Without systems, therapists are left relying entirely on confidence alone, and confidence fluctuates.

One of the biggest cultural shifts NHS practices need to make is moving away from the idea that therapists are simply there to ‘help with workload’. Therapists should not function as overflow clinicians. They should function as integrated clinicians with clearly defined responsibilities that complement the wider dental team.

We are currently at a hugely important point in the evolution of dental therapy within the NHS.

The legislation is changing, contracts are changing, workforce pressures are increasing and the profession is evolving. But if practice culture and workflows fail to evolve alongside those changes, we risk wasting (yet another) generation of highly trained clinicians.

The future NHS therapist cannot simply be the ‘scale and polish clinician who also checks teeth’. The modern therapist must become a prevention lead, a stabilisation clinician, a restorative clinician, a patient educator and a key part of shared care delivery.

Because the NHS does not simply need more dentists: it needs clear operational systems that allow every clinician to work at the top of their scope.

Catch up with Cat’s previous columns:

• Communication as care: the role of the modern dental therapist
• Dental therapy at a turning point: entering the new era
• How is dental therapy utilised differently around the world?
• Building a shared care model for the modern dental practice
• Dental therapy in 2026: a profession coming into its own.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

Oliver Smart and Cat McLennan discuss how MiSmile Treatment Planning Services help Invisalign clinicians improve predictability, reduce refinements and save valuable time through specialist orthodontic support.

With increasing demand for clear aligner treatment, clinicians are looking for ways to improve efficiency, confidence and predictability in their cases. We spoke to Oliver Smart, clinical director of MiSmile Treatment Planning Services (TPS), and operations director Cat McLennan about how the service works, what sets it apart, and how dentists can get started.

Introducing MiSmile Treatment Planning Services

Oliver Smart (OS): I’m a dentist with more than 20 years’ experience and hold an MSc in restorative dentistry. I’ve been providing Invisalign treatment for around two decades and currently serve as clinical director of MiSmile, MiSmile Treatment Planning Services and the MiSmile flagship practice in Birmingham.

Cat McLennan (CM): I’m operations director for both MiSmile Network and MiSmile TPS. My role focuses on the day-to-day running of the business, while Oliver leads on the clinical side. I’ve been involved with Invisalign since 2007, initially working with Align Technology before joining MiSmile in 2017. More recently, I’ve been part of the team that launched MiSmile TPS around 18 months ago.

OS: Treatment Planning Services provides clinicians with expert support when planning Invisalign cases. Whether it’s an Invisalign Go, Go Plus, Smile Architect or comprehensive case, we offer an additional layer of clinical input from specialist orthodontists.

Typically, clinicians receive their treatment plan within three working days. We can provide multiple treatment options where appropriate, including different extraction protocols or varying levels of interproximal reduction (IPR), helping dentists choose the most suitable route for their patient.

Ultimately, the service is designed to give clinicians greater confidence and predictability in their cases while reducing the need for additional aligner orders – something that benefits dentists, patients and Align Technology alike.

The benefits for clinicians and patients

OS: One of our biggest differentiators is that every case is reviewed and planned by specialist orthodontists. To my knowledge, we’re the only treatment planning service provider globally offering that level of specialist expertise across every case.

Our orthodontists are trained not only by the MiSmile team but also directly by Align Technology, ensuring they are working with the latest aligner protocols and techniques.

Another key advantage is that every plan is bespoke. While treatment is naturally tailored to the patient, it’s also customised to the individual clinician’s preferred approach. Dentists have different philosophies around IPR, attachment placement, elastics and tooth movement, and we work closely with them to ensure the treatment plan reflects how they want to practise.

Creating more time in practice

OS: Time is one of the most valuable resources in dentistry. Many clinicians are balancing patient care with business management, team leadership and regulatory responsibilities.

Having a dedicated team of specialist orthodontists handling treatment planning removes a significant administrative and clinical burden. That might mean fewer evenings spent reviewing ClinChecks, more time with patients during the working day, or greater focus on developing the practice and supporting the team.

For larger providers especially, that additional support can make a significant difference to both efficiency and patient experience.

Getting started

CM: We’ve made the process for getting started with TPS as straightforward as possible. Because of our affiliation with Align Technology, everything is integrated into the Invisalign Doctor Site. Clinicians don’t need to learn a new platform or manage separate systems.

There are two ways to get started. Dentists can email us directly at tps@mismile.co.uk, where I can answer any questions and arrange a call to discuss the service in more detail.

Alternatively, they can access the TPS section directly within the Invisalign Doctor Site. There, they can select MiSmile TPS as their preferred provider and begin the onboarding process.

Once enabled, they’ll receive a welcome email explaining how to submit cases, set up notifications and communicate directly with our orthodontic specialists. From there, they’re ready to start using the service.

Try your first case for free

CM: Because treatment planning services are still relatively new to many UK dentists, some clinicians may be unsure about what to expect. That’s why we offer a complimentary first case.

Over the past 12 months we’ve planned more than 20,000 Invisalign cases, making us one of the most experienced Invisalign planning providers available. The free case gives clinicians an opportunity to experience the service first-hand, understand how we work and see the quality and efficiency of our planning process.

After that, cases are priced at £50 each, with discounted case bundles available for clinicians managing higher volumes.

Looking ahead

As clear aligner treatment continues to grow, efficient treatment planning is becoming increasingly important. By combining specialist orthodontic expertise with streamlined digital workflows, MiSmile TPS aims to help clinicians deliver more predictable outcomes while freeing up valuable time to focus on patients and practice growth.

Find out more about MiSmile Treatment Planning Services here.

This article is sponsored by MiSmile.

That’s not necessarily a bad thing. Many of these tools can reduce workload and help overstretched teams stay afloat. However, the problem most organizations are quietly running into is that AI is already being used inside your practice, whether you’ve approved it or not.

And in many cases, it’s happening through free tools, personal devices, and well-meaning staff who don’t realize the risk they’re creating.

Why AI Adoption Feels Out of Control

Most healthcare organizations didn’t roll out AI through a formal project plan. Instead, it’s creeping in organically.

• A front desk employee finds a free tool online.
• A provider tries an app a colleague mentioned.
• Someone uses their phone to “quickly clean up” a note at the end of the day.

None of this goes through IT. None of it goes through compliance. And often, leadership doesn’t know it’s happening until something triggers an alert, or worse, a problem.

At the same time, locking everything down isn’t realistic. Providers depend on internet access for clinical references, payer portals, labs, and communication tools. Over-restricting access can interfere with patient care. So, organizations end up stuck in the middle:

• Too much restriction slows care
• Too little oversight increases risk

What’s Actually Happening Inside Practices

The biggest AI-related risk today isn’t a hacker. It’s everyday workflow decisions. Here are a few scenarios that reflect what’s really happening:

Scenario 1: “I Just Needed Help with the Message”

A front desk employee receives a frustrated email from a patient about a billing issue. Wanting to respond clearly and professionally, they paste the message into a free AI chatbot and ask it to draft a reply. The original message includes:

• The patient’s full name
• Appointment dates
• Details about services and insurance

The response they get back is polished and helpful. They send it and move on. What they don’t realize is that they may have just shared protected health information (PHI) with a third-party platform the organization has never evaluated and may have no agreement with.

Scenario 2: “I’ll Fix My Notes Later”

A provider is running behind and uses a personal device at home to clean up documentation. They paste parts of their visit notes into an AI tool to summarize and generate instructions. It saves time. It feels efficient, but:

• The tool wasn’t approved by the organization
• No Business Associate Agreement (BAA) exists
• The provider used their personal account

Now PHI may be stored, processed, or even retained by a vendor the practice has never vetted, and IT has no visibility into it.

Scenario 3: “It’s Just for Drafting”

A team member in billing or administration uses AI to help draft appeal letters or explain denials. To get accurate output, they include specific patient cases with diagnoses, dates of service, and payer details. They assume this is low risk because it’s “not clinical care,” but it’s still PHI. Again, it’s being entered into tools the organization hasn’t approved or configured for compliance.

Scenario 4: The Invisible Risk, Personal Devices

This is the one many practices underestimate. Even if you restrict tools on your network, staff can:

• Use AI apps on their personal phones
• Log into web-based tools from home
• Copy information into personal accounts

From the organization’s perspective, this activity is completely invisible. From a compliance perspective, it’s still your responsibility.

The Core Issue: Visibility and Control

Most organizations aren’t struggling because they allow AI. They’re struggling because they don’t know where or how it’s being used.

A few patterns are showing up consistently:

• Staff are using free, public AI tools without understanding data handling
• AI use is happening outside approved systems
• Personal devices are being used for work-related tasks
• There are no clear guidelines, so people make their own decisions

And importantly, these actions are almost always well-intentioned. People are trying to:

• Work faster
• Communicate better
• Keep up with workload

But without guardrails, those shortcuts can create real exposure.

HIPAA Still Applies – No Matter the Tool

Some organizations mistakenly believe that because AI technology is new, HIPAA regulations have not yet caught up. That assumption is incorrect.

HIPAA’s Privacy Rule, Security Rule, and Breach Notification Rule apply regardless of the technology being used. Healthcare organizations remain responsible for:

• Protecting the confidentiality of PHI
• Limiting disclosures of patient information
• Implementing appropriate administrative, physical, and technical safeguards
• Managing workforce access and training
• Assessing risks associated with new technologies

If PHI is entered into an AI platform, the organization must evaluate whether the vendor is acting as a Business Associate and whether HIPAA requirements are being met. The introduction of AI does not eliminate compliance obligations.

It doesn’t matter if the tool is new, popular, or widely used. If PHI is involved, your obligations don’t change. That means:

• You must know where PHI is going
• You must ensure vendors meet HIPAA requirements
• You must have appropriate agreements in place
• You must train your workforce on what’s allowed and what isn’t

“Everyone is using it” is not a compliance strategy.

Cybersecurity Risks Associated with AI

AI introduces additional cybersecurity concerns that practices should understand.

• Data Exposure: employees may unknowingly submit sensitive information into unsecured AI platforms.
• Unauthorized Data Retention: some AI vendors may retain submitted information to improve their systems or train future models unless specific protections are in place.
• Phishing and Social Engineering: cybercriminals are increasingly using AI to create convincing phishing emails, fraudulent messages, and impersonation attempts.
• Shadow AI: “Shadow AI” refers to employees using AI tools without organizational approval or oversight. Just as shadow IT created security concerns in previous years, shadow AI is becoming a significant compliance challenge for healthcare organizations.
• Inaccurate Information: AI-generated content can sometimes produce inaccurate or fabricated information. Healthcare staff should never rely solely on AI-generated clinical, compliance, legal, or operational guidance without appropriate review.

Risk Assessments Matter More than Ever

The HIPAA Security Rule has always required covered entities and business associates to conduct an accurate and thorough assessment of potential risks and vulnerabilities to electronic protected health information (ePHI). Historically, organizations have focused their Security Risk Analysis on:

• Electronic health record systems
• Practice management software
• Email platforms
• File sharing systems
• Network infrastructure
• Mobile devices

Today, AI tools deserve the same scrutiny.

Unfortunately, many organizations have not updated their risk assessment process to account for rapidly evolving AI technologies. As a result, AI may be operating within the organization without ever being evaluated from a privacy or security perspective, and that creates unnecessary risk.

The Proposed Security Rule Updates Raise the Bar

The Department of Health and Human Services has proposed significant updates to the HIPAA Security Rule that place greater emphasis on formalized risk analysis, technology inventories, vulnerability assessments, and ongoing reviews. Among the concepts emphasized within the proposed changes are:

• Comprehensive technology asset inventories
• Formal risk analyses of systems and technologies affecting ePHI
• Regular reviews and updates to risk management activities
• Enhanced documentation requirements
• More structured cybersecurity oversight

While organizations should continue monitoring the final rulemaking process, the direction is clear: regulators expect healthcare organizations to maintain a current understanding of technologies that impact patient information and to evaluate associated risks on an ongoing basis. For many practices, AI represents a newly emerging technology that should be incorporated into those evaluations.

A More Practical Approach to AI Governance

Organizations do not need to prohibit AI entirely. In fact, many AI solutions can improve efficiency, patient experience, and operational effectiveness. Instead, they should create a framework that supports innovation while protecting patient information. Every practice should consider implementing a written AI Use Policy that addresses:

• Approved AI tools
• Prohibited uses
• Requirements for handling PHI
• Workforce responsibilities
• Security expectations
• Documentation requirements

1. Start with Clear, Simple Rules

Your staff doesn’t need a 20-page policy, they need clarity. At a minimum:

• Do not enter PHI into unapproved AI tools
• Use only approved platforms for AI-assisted work
• Do not use personal accounts or devices for AI involving patient information

Make it easy to understand and easy to follow.

2. Assume AI Is Already in Use

Instead of asking if AI is being used, assume that it is. Then:

• Ask departments what tools they’ve tried
• Look for patterns in workflows where AI might be helpful
• Identify where risk already exists

You’ll get much further acknowledging reality than trying to prevent it entirely.

3. Approve Safe Alternatives

If you tell staff, “Don’t use AI,” they’ll find workarounds.

If you give them approved, secure tools, they’re far more likely to stay within boundaries. Focus on:

• Vendors willing to sign a BAA
• Clear data handling practices
• Administrative controls and audit visibility

4. Address Personal Device Use Directly

This is uncomfortable, but necessary. You don’t need to eliminate personal device use entirely, but you do need guardrails:

• Define what work can and cannot be done on personal devices
• Prohibit entering PHI into AI tools outside approved systems
• Reinforce that “off network” doesn’t mean “off responsibility”

5. Train with Real Examples

Generic training doesn’t stick as well as real scenarios do. Use situations like:

• “You’re answering a patient email…”
• “You’re catching up on notes at home…”
• “You’re drafting an appeal…”

Help staff recognize when they’re about to cross a line, not just what the rule is.

Final Thought: This Is a Workflow Problem, Not Just a Technology Problem

AI adoption in healthcare isn’t slowing down. If anything, it’s accelerating faster than policies can keep up. The organizations that will manage this well aren’t the ones that lock everything down, they’re the ones that:

• Accept that AI is already in use
• Create clear expectations early
• Give staff safe ways to use it
• Address personal-device risk head-on

Because at the end of the day, this isn’t just about technology. It’s about how work is getting done and making sure it’s done in a way that protects your patients, your staff, and your organization.

Key Takeaways

• If AI is being used, it should be evaluated. AI tools should be assessed just like any other system that may impact electronic protected health information.
• You cannot manage risks you have not identified. Developing an inventory of approved and unapproved AI tools is often the first critical step.
• Risk assessments are becoming increasingly important. Proposed Security Rule updates reinforce the expectation that organizations maintain ongoing awareness of technologies affecting ePHI.
• Annual reviews should become standard practice. AI technologies change rapidly, requiring regular reassessment of risks and safeguards.
• Governance starts with documentation. A documented risk assessment demonstrates due diligence and provides the foundation for AI policies, training, and security controls.

AI Readiness Checklist for Healthcare Practices

Discovery and Inventory

• Identify all AI tools currently being used
• Document approved and unapproved applications
• Create and maintain an AI technology inventory

Privacy Review

• Determine whether PHI is entered into AI systems
• Evaluate permitted uses and disclosures
• Assess Business Associate Agreement requirements

Security Review

• Review vendor security documentation
• Verify encryption and access controls
• Assess data retention practices
• Evaluate cybersecurity risks

Workforce Review

• Assess employee understanding of AI risks
• Identify shadow AI usage

Governance

• Written AI policy established
• Leadership approval and oversight defined
• Acceptable-use standards communicated

Compliance and Risk Assessment

• AI included in Security Risk Analysis
• HIPAA implications evaluated
• Business Associate Agreements reviewed and executed when applicable
• Approved AI tools inventoried
• Data retention practices reviewed
• Encryption and access controls verified
• Incident response plan updated
• Ongoing monitoring established

Workforce Training

• Staff educated on AI risks
• Employees trained not to enter PHI into unapproved systems
• Reporting procedures communicated

Ongoing Review

• Annual AI governance review scheduled
• Emerging threats monitored
• Policies updated as technology evolves

DoctorsManagement helps medical and dental practices evaluate emerging technologies like AI as part of a thorough Security Risk Analysis, develop a written AI use policy, and train their teams on safe, compliant workflows. If you would like help bringing AI into your practice in a way that protects patient information, contact us to learn more.

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The post AI in Healthcare: Innovation Is Here, But So Are New Risks appeared first on DoctorsManagement.

New data shows that just 49% of the population of Northern Ireland was registered with a health service dentist as of March 2026, with the British Dental Association (BDA) warning that these figures were the mark of a ‘disappearing service’.

Registration has plummeted since 2023 when it stood at 70% – the current lows have not been seen since 2009. In just one year, registration numbers dropped by 95,000 patients, a 9% reduction.

In contrast, figures recorded at the same time in Scotland estimate that 95.1% of its population is registered with an NHS dentist. This disparity is likely due to Scotland’s formal registration system which is not in place throughout the rest of the UK. Registration levels in England and Wales stand at roughly 40% each.

The data also revealed stark variation in registration levels between different areas of Northern Ireland. Fermanagh and Omagh had the lowest adult registration rate at 30%, though its child registration rate was actually higher than the national average at 70%.

Children in more deprived areas were found to be 18% less likely to be registered with a health service dentist than those in the least deprived regions, with levels dropping to 55% in the poorest areas.

These findings were released by the Business Services Organisation (BSO) today (18 June) as part of its General Dental Services Statistics.

How many health service dentists are there in Northern Ireland?

The report found that there were 351 dental practices and 1,180 dentists registered to provide health service treatment in Northern Ireland. This equates to 61 dentists per 100,000 residents.

The authors estimate that 94% of the population of Northern Ireland lives within five miles of a health service dental provider. However, they warn that proximity does not necessarily equate to access.

In fact, the number of patients seen had decreased by 4% since the previous year. The number of dentists in the service had also decreased by 2% in the same period, the first reduction since 2021.

However, the average cost of dental services per registered patient rose by 11% to £118.70 for a total national cost of £134.4 million.

‘The writing really is on the wall’

In April, Northern Ireland health minister Mike Nesbitt confirmed the full details of an £8 million investment in general dental services, including six additional Dental Foundation Training (DFT) places and a new emergency dental clinic.

However, the BDA warned that the BSO data showed the industry is ‘struggling to maintain its sustainability in the face of rising costs and wholly inadequate fees’.

Ciara Gallagher, chair of the BDA’s Northern Ireland Dental Practice Committee, said: ‘New figures show that the writing really is on the wall for health service dentistry in Northern Ireland.

‘The minister knows what needs to be done. Underfunded and overstretched, practices are on the brink and cannot be expected to continue delivering care at a loss.’

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

Pat Langley looks at what entrepreneurial dentists wanting to start up a new squat practice need to know in light of the recent changes to the CQC registration process. 

Opening a new dental practice has never been a small undertaking. Between securing premises, fitting out surgeries, recruiting the right team, and building a patient base, the squat start-up journey demands energy, resilience, a very good spreadsheet and clear, comprehensive and accurate professional support in all areas from advisors and suppliers who understand the dental industry.  

Another very important factor for prospective practice owners to consider in their plans is that the Care Quality Commission (CQC) has tightened its approach to new provider registration applications. 

This change means CQC registration must sit at the centre of the launch plan from day one. 

What has changed in CQC registration? 

From 5 May 2026, new dental provider applications must include additional supporting documents, as well as a new oral health service form, alongside the standard CQC application paperwork. 

This is a significant shift in emphasis. Historically, applicants have usually submitted the core paperwork first and dealt with further evidence later in the process. The CQC’s new approach is much more front-loaded. Applicants are now expected to provide a complete, relevant and up-to-date evidence pack at the point of application. 

For new dental providers, that means the application must do more than describe the proposed service. It must demonstrate that the practice is ready, safe and properly governed before registration can be granted. 

The CQC says the changes are designed to help it process applications more quickly. In practice, they also raise the stakes for applicants. If required documents are missing, incorrect, out of date or not relevant to the service being registered, the application is likely to be rejected. If that happens, the provider will need to resubmit, and the resubmission will be treated as a new application rather than holding its original place in the queue. 

For anyone working to a planned opening date, that distinction matters. 

What dental providers now need to include 

All new provider applicants must submit the standard CQC documents, including policies covering complaints, consent, equality and human rights, governance and quality assurance, infection prevention and control, medicines management, recruitment, safeguarding and a statement of purpose. A financial viability statement may also be required.  

For dental practices, there is now a further set of dental-specific requirements. These include critical examination and acceptance test reports, a fire risk assessment, evidence of registration with the Health and Safety Executive in line with the ionising radiation regulations, a health and safety risk assessment, a legionella risk assessment, LOLER lift safety certification where applicable, and a radiography risk assessment and local rules documentation. 

In addition, the CQC may ask to see other evidence during the assessment process. This could include a floor plan, electrical installation certificate, emergency lighting completion certificate, gas safety certificate, medical emergencies and resuscitation policy, serious incident policy, fit and proper persons policy, and relevant installation or calibration certificates for equipment such as decontamination units, suction, compressors, ventilation or amalgam separators. 

In other words, this is not just a paperwork exercise. It is a readiness test. 

The building control point 

Another important change affects any location that requires building regulations approval. Where this applies, the applicant must include a building control final certificate with the application. 

This could be particularly relevant for squat practices, where premises are often undergoing significant refurbishment or conversion. Dental fit-outs can involve changes to room layout, plumbing, ventilation, electrical systems, radiation protection and accessibility. If the project needs building control approval, the final certificate is now part of the CQC registration process. 

That means timing is crucial. Practice owners should speak early to architects, contractors and compliance advisers to understand when certificates and commissioning documents will be available. The CQC application timeline should be built around evidence being complete, not around optimism about when the builder might finish. 

Financial considerations and planning 

The change is not just ‘more paperwork’. For squat practice owners, it can affect the whole financial model. The owner may be carrying rent, loan repayments, fit-out costs, staff recruitment costs, equipment finance and professional fees before they can legally start treating patients and generating income. 

This commercial reality should not be overlooked. Most squat practices operate on tight budgets, particularly in the final stages before opening, when cash is flowing out, but income has not yet begun.

If a new provider cannot submit a complete CQC application until the premises, equipment, certificates and supporting documents are effectively ready, this can create a difficult funding gap. Rent, loan repayments, equipment finance, contractor invoices, staff recruitment costs and professional fees may all be falling due while the practice is still waiting for registration and is unable to treat patients. For new owners, this makes financial planning every bit as important as compliance planning.

Contingency should be built into the business plan, lenders should understand the registration timeline, and opening projections should allow for the possibility that a rejected or incomplete application could delay the first day of trading. In the new registration environment, cashflow planning is not separate from CQC readiness; it is part of it. 

Can a dental squat be treated as urgent? 

Some new providers may wonder whether their application can be fast-tracked, particularly where a completed practice is ready to open but cannot yet trade. The CQC’s urgent registration route is, however, narrow. Applications are usually assessed in the order they are received, and urgent consideration is reserved for cases where registration is critical to increasing capacity in the health and social care system or reducing pressure on the NHS or social care. 

This means that an NHS squat may have a route to urgent consideration if local commissioners support the case, but a purely private squat is unlikely to qualify simply because the owner is under financial pressure or ready to open.  

For a private squat to be considered urgent, the CQC would require formal evidence from an appropriate commissioner or senior public body representative, and financial hardship alone would not be enough. 

This reinforces the need for owners to plan conservatively. Urgent registration should not be relied upon as part of the opening strategy. For most start-ups, the safer assumption is that the application will proceed through the ordinary registration process, and the business plan should allow for that. 

Tight cash flow may make the application feel urgent to the owner, but that does not necessarily make it urgent in CQC terms. 

The CQC’s changes have made the registration process more exacting for new dental providers. But for those who prepare early, personalise their documents and treat compliance as part of the business plan rather than a bolt-on, the route to opening a new practice remains very achievable. 

Dentistry Practice Services provides CQC registration support and full compliance support to dentists wanting to open a new squat practice. For more details, please contact ryan.hall@fmc.co.uk.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

The rise of minimally invasive cosmetic dentistry has transformed patient expectations, particularly among adults seeking Invisalign and tooth whitening.

Invisalign and other clear aligner systems have become increasingly popular because they offer discreet, removable, and digitally planned orthodontic solutions. At the same time, tooth whitening remains one of the most requested aesthetic procedures worldwide.

Traditionally, clinicians delayed whitening until orthodontic treatment was completed due to concerns that aligner attachments could interfere with peroxide penetration, create uneven bleaching, increase sensitivity, or compromise treatment outcomes. However, recent evidence suggests that whitening during Invisalign therapy can be both safe and effective when carefully supervised (Silva et al, 2022).

Why whitening works during aligner therapy

Tooth whitening relies on hydrogen peroxide or carbamide peroxide gels that penetrate enamel and dentin to break down chromogenic molecules responsible for discoloration (Joiner, 2006). Because peroxide diffuses beyond the direct contact area, whitening is not simply a surface phenomenon.

This explains why Invisalign attachments generally do not prevent effective bleaching. Clinical studies by Levrini et al demonstrated that whitening outcomes using clear aligners were comparable to traditional whitening trays, even without customised reservoirs. Clinical observations also show that any minor shade discrepancies usually resolve after attachments are removed.

Additionally, a 2023 study evaluating 10% carbamide peroxide found no significant negative effect on Invisalign material properties, suggesting that supervised whitening protocols do not compromise aligner performance.

Clinical benefits of simultaneous whitening

Integrating whitening during aligner treatment offers several clinical and psychological advantages.

Increased patient motivation

Patients who observe visible shade improvement during treatment are often more motivated to comply with aligner wear and oral hygiene instructions. Early aesthetic improvement may enhance patient engagement throughout lengthy orthodontic treatment plans.

Improved oral hygiene awareness

Whitening protocols frequently encourage better plaque control and cleaner aligner maintenance. Peroxide-based agents may also provide mild antimicrobial effects that contribute to improved gingival health.

Better restorative planning

Whitening before definitive restorative procedures such as composite bonding or veneers allows clinicians to achieve more predictable shade matching. However, because residual oxygen from bleaching agents may temporarily reduce resin bond strength, most clinicians recommend delaying adhesive procedures for approximately two weeks after whitening.

A report published in the Journal of Clinical Orthodontics also highlighted improved patient satisfaction when whitening was incorporated into clear aligner therapy.

Recommended whitening protocols

Contemporary protocols favour a gradual and carefully monitored approach to aligner-based whitening. A commonly recommended protocol includes whitening the upper arch for two weeks using overnight bleaching, reviewing sensitivity and shade response, then whitening both arches for an additional two weeks with regular monitoring.

Lower peroxide concentrations, particularly 5-6% hydrogen peroxide systems, are often preferred because they provide effective whitening while reducing sensitivity risk.

Managing tooth sensitivity

Sensitivity remains the most common adverse effect associated with bleaching treatment. Patients with gingival recession, exposed dentin, enamel defects, or a history of sensitivity are more likely to experience discomfort.

Management strategies may include reducing application frequency, temporarily discontinuing whitening, prescribing fluoride or desensitising toothpastes, and using potassium nitrate gels. Potassium nitrate is particularly beneficial because it reduces pulpal nerve activity and improves patient comfort during bleaching treatment.

Considerations for younger and complex cases

Whitening in adolescent Invisalign patients requires additional caution. Therapeutic whitening may be useful in cases involving fluorosis, trauma-related discoloration, molar-incisor hypomineralisation (MIH), developmental enamel defects, or post-orthodontic white spot lesions. Because younger patients are generally more prone to sensitivity, lower peroxide concentrations and gradual protocols are recommended.

Not all forms of discoloration respond equally to conventional whitening. Intrinsic staining, enamel hypoplasia, tetracycline staining, and non-vital teeth may require prolonged treatment or interdisciplinary management. Some patients may ultimately require resin infiltration, composite bonding, veneers, or endodontic treatment to achieve optimal aesthetic outcomes.

To learn more about integrating tooth whitening into aligner treatment, you can watch a webinar available on the Aligner Dental Academy platform.

Conclusion

Modern evidence increasingly supports whitening during Invisalign treatment as a predictable and effective component of comprehensive aesthetic dentistry. Contrary to previous assumptions, attachments do not appear to significantly interfere with whitening outcomes, and clear aligners can successfully function as bleaching trays (Levrini et al; Silva et al, 2022). When professionally supervised, simultaneous whitening may improve patient motivation, enhance oral hygiene awareness, support restorative planning, and deliver highly satisfactory aesthetic outcomes.

References

1. Joiner A. The Bleaching of Teeth: A Review of the Literature. Journal of Dentistry. 2006
2. Levrini L, et al. Dental Bleaching during Orthodontic Treatment with Aligners
3. Silva A, et al. The Effectiveness of Dental Bleaching during Orthodontic Treatment with Clear Aligners: A Systematic Review. Applied Sciences. 2022
4. Alhendi A, et al. Effect of 10% Carbamide Peroxide on Invisalign Aligners. 2023
5. Tooth Whitening in Association with Clear Aligner Treatment. Journal of Clinical Orthodontics.

This article is sponsored by Aligner Dental Academy.

• Fitbit vs Whoop
• Can poor coaches hide behind the constraints-led approach?
• Hill sprints, farmer carries, and overspeed treadmill training

Fitbit vs Whoop

A recent YouTube video by Rob ter Horst, known as “The Quantified Scientist,” has sparked an engaging debate among Fitbit and Whoop users. In his video, Horst compares the Fitbit Air to the Whoop Strap, drawing insights from the latest research and testing available.

When it comes to sleep tracking accuracy, Horst noted that the Fitbit Air consistently outperformed the Whoop Strap, which tends to overestimate both deep sleep and REM sleep. For heart rate monitoring, both devices did an excellent job while running and during indoor cycling. However, they each faced challenges during weight training, primarily because wrist tension and the act of gripping weights can affect their accuracy.

In terms of user experience, Horst suggested that the Fitbit app appeals more to casual health users, while the Whoop app is favoured by athletes. He also pointed out that the Whoop’s battery life is significantly superior to that of the Fitbit.

Ultimately, choosing between the two devices is tough. Horst believes that for most people looking for reliable tracking data, the Fitbit Air is the smarter buy. However, for those who seek coaching, recovery insights, strain targets, and motivational nudges, the Whoop Strap justifies its higher price tag.

Can poor coaches hide behind the constraints-led approach?

Experienced cricket coach Tom Flowers recently stirred up discussion with a controversial post on LinkedIn regarding the constraints-led approach (CLA). While he acknowledges the value of CLA and incorporates it into his coaching, he strongly believes it has led to an increase in what he calls “frauds” in coaching. According to Flowers, this approach gives poor coaches an “opportunity to hide behind deficiencies”.

He argues that those who implement the CLA often take a step back, with their “arms folded,” claiming they have created an environment where players are encouraged to “self-organise” and find solutions themselves. However, while Flowers recognises the importance of giving players time for self-exploration, he insists there are moments when the coach must “step in and actually coach.” He emphasises that players need feedback, technical understanding, and someone who can help them identify and solve problems.

In Flowers’s words, “the best coaches aren’t loyal to one methodology alone. They’re loyal to player development, knowing what works for them, and not being afraid to ‘coach’ players, expecting them to stand, listen and be patient”.

So, do you agree with Flowers? Are there too many poor coaches who lack technical understanding and communication skills, and hide behind the CLA?

If you would like to learn more about this topic, check out our courses Skill Acquisition and Cueing & Coaching Methods.

Hill sprints, farmer carries, and overspeed treadmill training

In a recent YouTube video, renowned S&C coach Chris Barnard of Overtimeathletes explored some training techniques he feels are either overrated or underrated.

He kicked things off by discussing hill sprints, which Barnard argues are underrated. He believes this age-old training method is exceptional for teaching acceleration mechanics but is often overlooked in favour of more high-tech training methods.

Next up was overspeed treadmill training, which Barnard considers overrated. He points out that it can actually hinder proper max velocity mechanics, leading to undesirable effects.

Finally, when asked about farmer carries, Barnard firmly stands by their value. He praises them as a fantastic total body exercise and notes that they are relatively safe, making them a worthy addition to any training regimen.

So based on Barnard’s views, we should keep hill sprints and farmers carries and stop doing overspeed treadmill training. Do you agree with Barnard?

From us this week:

>> New course: Socially Supporting Athletes
>> New podcast: The Unseen Work of S&C and Sports Science
>> New infographic: Stretch Shortening Cycle
>> New article: Hydrotherapy

Access to a growing library of sports science courses

SFS Academy is an all-access membership to premium sports science education.

With SFS Academy, you’ll learn from some of the best coaches around the world as they teach you how to apply the latest research and practice with your athletes.

The post Fitbit Vs Whoop appeared first on Science for Sport.

A new report has revealed the extent of increased financial pressure for Scottish dental practice owners resulting from rising costs, with the average practice seeing just 30p of profit for every pound they earn.

The National Association of Specialist Dental Accountants and Lawyers (NASDAL) Scotland annual Benchmarking Report has been released for the financial period 2024-25.

The report suggests that gross profit margins are under significant pressure – around 70p in the pound is being spent on costs.

However, private practices are seeing a large increase in net profit per principal dentist from £206,276 to £253,200. Associates also saw an increase to £93,098, up from £80,558 in 2023-24, representing a profit increase of around 43% in four years.

Mixed practices also saw a sizeable increase in net profit per principal from £199,471 to £217,624. On the other hand, the same figure in NHS practices dropped to £176,556 from £180,018 the previous year.

‘Costs are definitely on the rise’

Roy Hogg, specialist dental accountant and chair of NASDAL Scotland said: ‘Costs are definitely on the rise and laboratory costs have continued to grow in the latest results. This sees total expenses of all types at 68.1% in 2024-25. A percentage we will continue to monitor. It is good to see that profits are up for private and mixed practices although they did fall back slightly for NHS practices. However, in regard to private practices, this comes off the back of a big drop in average net profit per principal in 2023-24.

‘In regard to the NHS figures, fees for NHS practices have increased by only around £40k year on year, margins are being squeezed and this may explain the slight shortfall compared to 2023-24. This also reflects that NHS practices are paying 21.5% on associate fees, compared to 15.2% in private practices – potentially reflecting a more principal-led model in private practices.’

The annual Benchmarking Survey statistics are gathered from the accountant members of NASDAL across Scotland and the UK. The basis of the survey figures is 2025 tax returns and accounts with year ends up to 5 April 2025.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

Nina Farmer details how a deeper understanding of patient nutrition can elevate clinical outcomes through the use of a simple diet diary.

It is well known that diet plays a central role in oral health. We know that sugar is a substrate for the bacteria that cause dental caries, acidic foods and drinks contribute to dental erosion; and it is becoming well known that the Western diet increases inflammation in the body, leading to problems with the host response and patient healing, which in turn impacts patient outcomes.

The diet can also be protective. Certain foods can help to support the oral cavity – for example, calcium and phosphate in dairy products support remineralisation. Fibrous foods help to stimulate saliva flow, which supports the buffering capacity of saliva, and foods high in nutrients support the immune system and inflammatory pathways, helping the host response.

It isn’t just about looking at foods that cause disease, but also what supports health.

Tracking and frequency

Then there is the timing and frequency. This will highlight patterns such as frequent snacking, sugary drinks, and acidic foods. These patterns will highlight risks and allow for personalised, evidence-based advice to minimise them, whilst showing patients how their own habits are impacting their oral health and creating a powerful moment of awareness.

A diet diary is more than just a record; it is a conversation starter. As helpful as a diet diary can be, it is important to note that it does need to be handled carefully by a dental professional, as the advice given is tailored to the patient but mostly generic due to scope and time restrictions. A nutritional therapist, nutritionist, or dietitian would spend an hour getting to know the client and their relationship with food, and it is important that advice is safe and doesn’t contribute to any disordered eating habits.

My advice as a nutritional therapist is never to take any foods away, but to look at what can be added to make it better or how it can be improved to decrease risk. For example, keeping sugary foods to mealtimes is a great example of this.

Here are some tips for getting a patient started with a diet diary:

Gain informed consent from the patient

Explain the purpose to them and let them know that it is about understanding, and not about judgement. Educate on the relevance and give examples. Give the patient a choice. If the patient is unsure, alternatives that could be offered are – a verbal 24-hour recall, discussing a typical day, or just focusing on specific areas such as sugary drinks and building on this at future appointments.

Timeframe

Ask the patient to complete the diet diary over three days and ensure one of these days is at the weekend, so you can see what they do when they are out of routine.

Record

All food and drinks should be recorded, ensuring details such as anything added to foods or drinks (such as sugar in tea/coffee) are included, as well as how long it took to drink a fizzy drink – small sips over an hour or drunk quickly. Ask them to record the timings also.

Review together

• Look at the frequency of sugar/acid
• Highlight high-risk times such as late-night snacking, grazing, and sipping
• Look for protective habits, ie, healthy snacks, meals versus grazing, hydration, and nutrition
• Avoid terms like ‘good’ and ‘bad’ foods, and do not restrict items, to avoid risking food anxiety
• Focus on patterns, not perfection.

Give personalised advice

Keep the conversation supportive and stay within scope. Keep it positive and champion the patient where possible. Watch for red flags and be alert for any anxiety, distress, mention of restrictive behaviours, bingeing, or feelings of guilt around food. If this happens, stop the process and consider a different approach and signposting.

Reinforce and follow up

This can help to track progress and support behaviour change. This can be at routine appointments, or consider getting the patients back in earlier if they need more support.

Signposting

Always signpost to the patient’s doctor if you have any concerns regarding disordered eating or eating disorders. You can signpost to a nutritional therapist, nutritionist, or dietitian in your area to support your patients. Find someone local that you can refer to, and who could also refer to you; or you can go onto directories such as the ‘find a practitioner’ search on the British Association for Nutrition and Lifestyle Medicine (BANT).

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

In June, Oarline ran the 90-second test a private patient quietly runs on every practice they consider across the first 50 practices a patient would find across Leeds, Newcastle and Manchester. Half failed. And the failures were not the lazy ones. Here is the test, so you can run it yourself.

The NHS-to-private conversation is no longer happening behind closed doors. At the British Dental Conference and Dentistry Show in May, Practice Plan ran an entire Dental Business Theatre for it. The BDA keeps saying, more plainly each time, that private income is what holds much of mixed-practice economics together. And April’s contract changes in England have sharpened the question for many Principals from whether to grow private care to how.

So the interesting question has moved on from ‘should we?’. When a prospective private patient looks your practice up tonight, will they find a reason to choose you?

Oarline wanted a number rather than a hunch. So in June it scored the first 50 practices a patient would find searching ‘dentist’ on Google Maps in Leeds, Newcastle and Manchester, against 10 pass-or-fail checks across the three things a patient sees first: the homepage, the Google listing, and the most active social feed. Of the 48 it could fully verify, 24 failed. Not because the dentistry is weak, but because the patient cannot tell.

What you see is not what they see

Inside the practice, a principal sees a team they trust, decades of training behind every treatment plan, and patients who have stayed for 15 years.

Here is what the patient sees. Only 13 of the 50 homepages opened with a real photo of the practice or its people. 42 of 50 opened with a headline that could sit on any practice’s website, and eight of those literally began with the word ‘welcome’. One, with a sort of accidental honesty, read: ‘Welcome to dentist in Leeds.’ Over on Google, 39 of 49 listing cover photos showed no real people at all. Among NHS-mixed practices, that was 14 out of 14.

Money does not buy a pass. Private-only practices did better than mixed ones, but not by nearly as much as their fees imply, and their headlines were, if anything, more generic. Every national chain location we could verify failed the test outright, and two locations of the same chain, in two different cities, open their homepages with the identical stock photo of a laughing woman. The best performers in the sample were independents.

The patient is not asking whether you have a website, a profile and a social feed. They are asking whether what is on them feels like a real, current place run by real people. Mostly, it does not.

90 seconds, three questions

The private patient most mixed practices are courting is not the classic cosmetic buyer. Many arrive reluctantly, because they could not find an NHS dentist. They are cautious, price-aware, and quietly weighing whether paying privately will mean a better experience or just a bigger bill.

And they scan. They do not study. Before the phone ever rings, a prospective patient gives a practice roughly 90 seconds: half a minute on the website, half a minute on the Google Business Profile, half a minute on whichever social channel you use most. In that time they are working through three questions, in order. Out of the practices I am comparing, why would I pick this one? Is this a place I would actually walk into? And if I had seen this practice sooner, would I have chosen it over the one I go to?

Run the test on your own practice

It is the same test we ran, and it takes a minute and a half.

First 30 seconds: your homepage

1. Is the first image a real photograph of your practice, or stock?
2. Do the opening words say something specific, or ‘Welcome to ABC Dental’?
3. Can the patient actually see the dentist on the page?
4. Is there anything here that only your practice could say?

Next 30 seconds: your Google Business Profile and main social feed

1. Is the featured photo you and your team, or an empty surgery?
2. When was the most recent review? When was the last post?
3. Could any of those posts have been published by another practice without changing a word?

Final 30 seconds: all three together

1. Does the website match the practice the Google profile is selling?
2. Does the social feed look like the same place?
3. If a private patient saw all three tonight, would they have enough to call you?

Scoring is simple. If two or more answers point the wrong way, that is your starting point. It is not a verdict on your dentistry. And for calibration: nobody in Oarline’s 50 passed all 10 checks. The best four practices in three cities failed exactly one.

The right things in the wrong order

The homepage is where the test was lost. 41 of the 50 practices failed that block, the first thing a patient sees.

Yet the failures were not the practices doing nothing. Every verifiable listing in the sample had a Google review less than a year old, so the patients are holding up their end. 17 of the 50 had posted to Instagram within 48 hours of the audit. 13 of those 17 still failed their own homepage.

That is the whole problem in one statistic. Practices are not failing online because they are absent. They are failing while being busy, because the effort happens in the wrong order. The proof that a practice is real, current and run by people patients like already exists, in the feed and in the reviews. It just never reaches the three things a patient sees first.

Most principals build from the top down: run the ads, keep posting, sort the website later. The patient experiences the practice from the bottom up. They land on the homepage, open the Google profile, scan the recent reviews, and within thirty seconds decide whether this is a real place worth calling. More traffic to a weak online presence does not solve the problem. It simply makes more people aware of it.

The order that works is unglamorous. Foundation first: a homepage and profile that give a comparing patient a reason to pick you. Presence second: the reviews, content and faces that confirm the place is real. Visibility last, once the first two can carry it. Often it does not even take new material.

In Oarline’s sample, most practices with an active feed were already posting real people from the practice. The proof exists. It has just never been moved to the hero image, the headline and the cover photo, where a patient actually looks. None of this needs a rebrand. It needs specificity.

‘Your first private appointment is 45 minutes, not squeezed between two check-ups’ tells a patient more than a paragraph of high standards ever will. Until the online presence does that work, the business is asking patients to believe something the marketing is not yet proving.

Your starting point

If you ran the test while reading, you have already started. Whatever you saw is a starting point, not a verdict. Half the practices around you are starting from the same place.

The next step is seeing what a pass looks like. On 2 July, Oarline is hosting a free 45-minute webinar, ‘Would a private patient choose you?’, where it runs the 90-second test live on real practices, walks through what the 50-practice audit found, and takes questions in a live Q&A. No pitch, no countdown clocks. Register for free here.

This article is sponsored by Oarline.

In digital dentistry, a well-considered plan is only half the story. For dental laboratories and clinical production teams, the real test comes later: can that plan be translated into a device that performs accurately, consistently and predictably once it reaches the patient?

That question runs through the work of 21D, the full-mouth rehabilitation lab founded by Rajesh Vijay. A dentist with more than 30 years’ experience, including 27 years focused on full-mouth implants, Vijay has built 21D around a demanding view of precision. In his world, accuracy has to be engineered into the workflow from the beginning.

Engineering precision into full-mouth rehabilitation

As he explains: ‘It’s all well and good having an idea and a plan, but if you haven’t got the right tools that are going to deliver that plan, you’re going to have a great plan, and you’re going to have terrible execution.’

That is the thinking behind 21D’s investment in Stratasys DentaJet multi-material 3D printing technology. For Vijay, the decision was not driven by a desire to adopt 3D printing for its own sake. It was about finding a production platform capable of meeting the bioengineering standards he believes are essential for ultra-accurate surgical guides.

21D treats patients with complex needs: those who are terminally dentate, have advanced periodontal disease, have already lost more than half of their natural dentition, or are full denture wearers. Their workflow has to account for safe biology, implant positioning, load mechanics and long-term function, with manufacturing tolerances tight enough to support the clinical plan.

Vijay describes this as an engineering mindset. His view is that dentistry should move away from ‘yeah, that looks about right’ and towards measurable, auditable quality assurance. As he puts it, nothing is ‘fix and forget’; it is ‘fix and maintain’. Start with quality, and the maintenance burden will be lower over time.

That principle is reflected in the way 21D works. Designs are checked by both AI-supported systems and human expertise before moving into production. Once made, devices are scanned and overlaid against the original design to check whether they remain within the required tolerance. If they do not, they are remade.

From treatment planning to measurable quality assurance

The final kit sent to the clinical team brings together the surgical guide, prosthetics, implant components, and instructions in one box. For the clinician, the process is designed to be clear and repeatable: the start point, the end point and the route between the two have all been defined in advance.

Stratasys DentaJet technology plays a central role in that workflow. Vijay describes 21D’s asymmetric anatomical guides as ‘ultra, ultra, ultra customised’, enabling implant placement with discrepancies of less than 100 microns or ‘less than the width of a human hair’.

What makes the 21D story particularly striking is not only the level of accuracy being pursued, but the scale at which the business is now applying it. After first encountering the J5 DentaJet abroad, Vijay immediately ordered one machine. Today, 21D has four Stratasys machines, supported in the UK by SYS-UK Systems.

That support matters when 3D printing moves from being an occasional lab tool to part of a high-throughput production environment. Vijay describes SYS Systems as ‘great’ at managing the machines and supporting the wider 21D team with advanced application support, highlighting the value of local service and technical support when advanced additive manufacturing becomes embedded in day-to-day clinical production.

At 21D, the J5 DentaJet is used for stackable surgical guides, case models, and asymmetric anatomical guides, with applications including try-ins, temporary restorations, and dentures. Vijay also points to the large build plate as essential for scalable production of highly customized dental applications. For his technicians and bioengineers, the appeal is practical as much as technical: the system is a cartridge-based multi-material jetting printer and, in Vijay’s words, ‘plug and play’.

Why connected workflows matter in digital dentistry

For dental laboratories, the wider message is that successful digital dentistry relies on more than software, scanners or printers in isolation. It depends on a connected workflow in which planning, production, QA and support all work to the same standard.

At 21D, Stratasys DentaJet platform provides the production capability behind a highly precise, scalable workflow. SYS-UK provides the support needed to keep that capability running in a demanding real-world environment.

Vijay’s enthusiasm is hard to miss, but it is not simply enthusiasm for a machine. It is excitement about what becomes possible when precision-led dentistry, additive manufacturing and service support come together, and when a digital plan can be delivered with the accuracy it deserves.

Watch the full video above to hear Vijay’s story first-hand, from discovering the J5 DentaJet to scaling 21D’s precision workflow with four Stratasys machines, supported in the UK by SYS Systems.

This article is sponsored by Stratasys.

Our orthopedic experts answer questions about surgery, driving, medications, and more.

Driving is an activity that gives many of us a sense of independence. It’s how we get to school, travel to see friends and family, and see the world. But if you have an upcoming orthopedic surgery, you might be wondering how long after surgery you can get back in the driver’s seat. We get that question a lot—you’re not alone in wondering! Let’s talk about it.

How long after surgery can you drive?

When looking at returning to driving after surgery, there are several factors to consider. For minor surgeries, you need to ensure anesthesia has worn off, and that takes at least 24 to 48 hours. For more involved procedures, it really varies based on the kind of surgery you have.

Does the type of surgery impact how long you need to wait before driving?

Yes, the type and location of your procedure can influence how long you need to wait before getting behind the wheel. Some surgeries are more intensive than others, and procedures for a lower-extremity fracture (leg bones, knee, hip, or ankle) might mean you’ll be in a cast, boot, or brace, making driving more difficult while you’re healing.

A note on left vs. right side injuries

The chart above lists guidelines for returning to driving based on the assumption that you drive a vehicle with an automatic transmission, which relies solely on the function of the right side of your body.

However, if you drive a vehicle with a manual transmission, your left side may need to be more engaged to drive safely. Manual transmission drivers, you will need to talk to your doctor to get a more accurate recovery timeline.

Why is it a bad idea to drive after surgery?

As we discussed above, it takes a while for anesthesia and any surgical pain medications to wear off (24–48 hours). While those substances are still in your system, they can influence your reaction time and decision-making. You may also have limited strength or range of motion, which can make it harder to operate a car safely. Pain can play a role, too. If discomfort causes you to hesitate, guard your movements, or avoid reacting quickly, driving can be dangerous.

How long after surgery are you at risk for blood clots?

Blood clots can occur after surgery for a couple of reasons, including patients having reduced mobility and damage happening to blood vessels during surgery. When a blood clot forms, it can block blood flow to essential tissues and organs, causing health emergencies.

After surgery, blood clots may form within days or weeks. Luckily, there are ways to prevent blood clots from forming after surgery, including:

• Wearing compression stockings, especially if you are going to be going on a long car, bus, or plane ride
• Taking low dose aspirin or, if prescribed by a doctor, blood thinners
• Starting to walk again when you’re able to safely

What kind of driving restrictions are there when you’re taking post-surgery medications?

When it comes to post-surgery medications and driving, it all depends on the patient and what they have been prescribed. Some medications, like pain relievers and muscle relaxers, may make it unsafe to drive. It’s important to talk to the healthcare provider who prescribed your medication about how it may affect your ability to drive.

At OSMS, we encourage patients to also explore alternative or supplementary pain management techniques. Ice, elevation, rest, and gentle movement can all help. There’s a lot to be said about the power of finding a distraction, too, whether it’s talking to a friend or watching your favorite TV show.

How can I get around if I can’t drive?

Luckily, most communities offer public transit like buses and ridesharing. Green Bay Metro, for instance, offers affordable, efficient, and convenient shared rides near residential neighborhoods. Valley Transit has similar options for Appleton, Kaukauna, Menasha, Neenah, and more. Plus, ride apps like Uber also have ride sharing options, making it more cost-effective to get where you need to go.

Final Thoughts

In Wisconsin and around the country, drivers are responsible for making sure they can operate a vehicle safely before getting behind the wheel. While your doctor can offer guidance, there is no official medical clearance that removes a driver’s personal responsibility in the event of an accident. Ultimately, the decision to return to driving should be made carefully and based on your comfort, mobility, state of mind, medication use, and capacity to react safely.

About the Author

Dr. Joseph McCormick is a board-certified orthopedic surgeon. He is currently seeing patients in Chilton and the Fox Valley. Schedule an appointment with him here.

This blog was originally written in February 2020. It was updated in June 2026.

The post How Long After Surgery Can You Drive? appeared first on Orthopedic Sports Medicine Specialists (OSMS).

When preparing for surgery, the medical team and the patient will often focus on the physical things: what the surgery is for, how the patient will feel physically after the procedure, and what bodily recovery will be like.
But surgery can affect patients in all aspects of their lives. Luckily, there are proven ways to cope and heal. This article will share how surgery can affect the mind, body, and a patient’s lifestyle, plus ways to make recovery successful.

Emotional and Psychological Effects of Surgery

After surgery, it’s normal to feel overwhelmed by the experience. Pain, limited mobility, anesthesia, medication, disrupted sleep, and uncertainty about recovery can all take an emotional toll. Some patients may feel anxious, sad, irritable, or disconnected. These feelings mean you’ve been through something significant, and these feelings are normal.

Emotional and Psychological Post-Surgical Symptoms

Post-surgical depression, also called post-operative depression, can happen in some cases. Symptoms might include:

• Excessive sleeping
• Trouble falling asleep or staying asleep
• Irritability or mood changes
• Fatigue
• Loss of interest in things you normally like
• Feelings of helplessness or hopelessness
• Loss of appetite

Post-surgical traumatic stress occurs more frequently than you might think. Studies show that post-operative traumatic stress may occur in 20% of patients. Symptoms vary from person to person, but they sometimes include:

• Intrusive memories: Upsetting dreams or nightmares about a difficult event; emotional distress in response to something that reminds you of the event
• Avoidance: Going above and beyond to avoid anything to do with the event, like avoiding places or conversations
• Negative changes in thinking or mood: Negative thoughts about yourself or others, memory problems, having a hard time feeling happy, or feeling emotionally numb
• Hyperarousal: Feeling on edge or being startled easily

Tips for Recovering

Recovery looks different for everyone, but here are some strategies to try:

• Talk to your doctor and ask for support
• Stay connected to friends and family
• Limit alcohol consumption
• Try to stick to a routine
• Prioritize hobbies and passions
• Seek help from organizations like NAMI

NAMI, the National Alliance on Mental Illness, is the nation’s largest grassroots mental health organization. They provide free resources, including a HelpLine and support groups. The NAMI HelpLine is confidential and offers one-on-one emotional support and mental health information.

If you or someone you know is struggling with mental health concerns, call 1-800-950-NAMI (6264) or text “NAMI” to 62640.

Physical Challenges After Surgery

Many patients ask us whether surgery is a serious physical event for the body, and the answer is yes. When an operation is performed, the body experiences a “controlled injury.” The important word here is “controlled,” as surgeons are skilled, board-certified experts who know how to diagnose and repair injuries while also minimizing harm.

However, even though we do our best as healthcare providers to minimize damage, even the least invasive procedures still have a measurable effect on the body. That’s why recovery needs to be taken seriously, no matter what type of operation you have.

Physical Post-Surgery Symptoms

For the first 48–72 hours after a procedure, these symptoms are normal:

• Reddening of the skin around the incision
• Minor swelling
• Bruising
• Tenderness
• Clear or light-yellow drainage (liquid)

There are also symptoms to watch out for if they appear, such as:

• Redness that expands or appears with red streaks
• Thick, cloudy, or foul-smelling drainage (liquid)
• Pain that increases over time
• A fever of 100.5°F or higher

If you experience any of these symptoms, your body may be fighting an infection. Contact your doctor as soon as possible.

Tips for Recovering

To help your body heal after surgery, we recommend:

• Ice: Cool temperatures can help reduce swelling and bleeding, which may also help manage pain and muscle spasms
• Elevation: Keeping the injured or surgical area raised (above your heart) can help limit swelling and improve comfort as you heal; sitting in a reclining chair is not an effective method for creating elevation
• Sleep: Rest gives your body the time and energy it needs to heal; sleep supports tissue repair and can also help your body ward off infection
• Incision care: Your provider will give you specific instructions, but in general, keep the incision clean and dry and always wash your hands before/after caring for your wound
• Nutrition: Eat simple meals with protein and vitamins; they support healing and help prevent nausea; take medications with food (unless your provider says otherwise)

Lifestyle Changes After Surgery

Surgery can change your lifestyle, including your routine, work, and relationships. That’s why your healthcare provider may ask questions about your lifestyle before surgery, such as who you live with, what your daily routine looks like, what your job is like, and what activities matter most to you. These questions help identify what are called “resilience factors,” which are the strengths and resources that can support a smoother recovery.

Tips for Coping

Here are things you can do to build your “resilience factors” and ensure your lifestyle is less impacted by surgery:

• Prioritize relationships with empathetic, understanding people
• Practice mindfulness through activities like journaling or meditation
• Try to follow a set routine (with modifications as needed for comfort)
• Avoid negative outlets like alcohol and recreational drugs
• Speak to your employer about your procedure
• Keep asking questions, because the more you understand what to expect, the more prepared you’ll feel

Get on the Path to Total Recovery with OSMS

At OSMS, recovery means more than healing the physical injury. We look at the whole you—how you’re feeling, what questions you have, and what support you need along the way. If you’re prepping for surgery or struggling after a procedure, reach out to an OSMS provider. We’ll listen, talk through what you’re experiencing, and help develop a recovery plan.

Schedule an appointment today.

This blog was originally written in October 2018. It was updated in June 2026.

The post Post-Surgery Recovery: Addressing Emotional, Psychological, and Physical Challenges appeared first on Orthopedic Sports Medicine Specialists (OSMS).

The General Dental Council (GDC) has opened the 2026 annual renewal period for dental care professionals (DCPs), reminding them to pay the increased fee and complete the process on time to retain their registration.

DCPs must complete three steps to remain on the GDC register:

• Pay the Annual Retention Fee (ARF) of £108 by 31 July 2026
• Declare that they have appropriate indemnity or insurance cover in place no later than 31 July 2026
• Submit a CPD statement by 28 August 2026.

This year, renewal must be completed through MyGDC, the online portal which replaced eGDC in March 2026.

Anthony McNally, head of customer services at the GDC, said: ‘This year, dental care professionals are completing their annual renewal via MyGDC for the first time, and we want that experience to be as straightforward as possible. If you have not yet logged in, please do so and reset your password before you renew. It only takes a few minutes.’

When did the ARF increase?

In October 2025, it was announced that the ARF would now stand at £698 for dentists and £108 for DCPs. This is roughly a 12.5% increase for all dental professionals.

The GDC confirmed that it would adjust the ARF ‘as needed’ from 2027 onwards. However, it said that further rises would not exceed the rate of the consumer price index (CPI) except in ‘exceptional circumstances’.

Since 2024, the GDC has collected working patterns data alongside the annual renewal process.

Anthony McNally said: ‘We also want to encourage as many dental care professionals as possible to complete the working patterns survey alongside their renewal. The data is becoming increasingly valuable to the dental sector, and every additional response helps build a clearer picture of the workforce.’

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

OAKLAND, Calif. (June 16, 2025) — National health care leaders from Kaiser Permanente and the American College of Physicians will present a free Permanente Live webinar on Thursday, July 2, 2026, to explore how clinicians can stay grounded in evidence, navigate conflicting guidance, and maintain patient trust in an increasingly complex health care environment.

Amid rising misinformation, deepening public mistrust in science, shifting federal policy, and the rapid evolution of clinical research, physicians today face mounting pressure to make high-stakes decisions while preserving patient trust and protecting time to focus on patients. Delivering clear, evidence-based guidance increasingly requires new strategies to identify reliable sources of information, respond to uncertainty with confidence, and focus on what matters most: caring for patients.

This webinar will address timely questions about public skepticism, the evolving role of medical associations and states, and what health care leaders can do to reduce confusion for both physicians and patients.

Who:

• Jason M. Goldman, MD, MACP, immediate past president, American College of Physicians; internal medicine physician
• Letitia Bridges, MD, MBA, executive vice president and chief quality officer, The Permanente Federation
• Stephen Parodi, MD, executive vice president, The Permanente Federation (moderator)

What:

“Evidence under pressure: Medical excellence in an era of misinformation” webinar attendees will learn:

• Where physicians look for trusted guidance as confidence in federal agencies shifts
• What’s driving public skepticism and how physicians can approach conversations with patients
• Steps federal institutions can take to regain the medical community’s trust

When:

• Thursday, July 2, 2025
• 10:00 a.m. PT / 12:00 p.m. CT / 1:00 p.m. ET

Where:

Register to attend this complimentary virtual one-hour event and for access to the recording.

Join the conversation on social media using the tag #PermLiveLeadership.

To learn more about Permanente Medicine, visit permanente.org.

About the Permanente Medical Groups

Permanente Medical Groups provide award-winning care to Kaiser Permanente’s 12.6 million members. More than 25,000 primary care physicians and specialists are dedicated to the mission of providing high quality, affordable care to all our patients and communities. Our ethical, compassionate approach to value-based care is physician-led, patient-centered, and evidence-based. We work collaboratively, supported by state-of-the art facilities and technology, to provide world-class primary, complex, and chronic care in 8 states — from Hawaii to Maryland — and the District of Columbia. Find out more at permanente.org.

About The Permanente Federation

The Permanente Federation is the national leadership and consulting organization of Permanente Medical Groups, which provide high-quality, affordable health care to the members of Kaiser Permanente. The Federation works to spread the ethical and compassionate value-based care we call Permanente Medicine. Our model of care is physician-led, patient-centered, and team-delivered. We foster and accelerate medical research, clinical innovation, and performance improvements. With Kaiser Foundation Health Plans and Kaiser Foundation Hospitals, we’re expanding the reach of Kaiser Permanente’s unique approach to integrated care delivery, transforming health care in America. Find out more at permanente.org.

The post Permanente Live webinar – Evidence under pressure: Medical excellence in an era of misinformation appeared first on Permanente Medicine.

Zirkonzahn.Implant-Planner and Bone Doctor: implant planning software approved as a medical device and new software module for precise surgical planning.

With the Zirkonzahn.Implant-Planner software, the cooperation between dentists and dental laboratories can be taken to new levels, reconciling the planned aesthetic design of a prosthetic restoration with the planned implant situation (backward planning).

Based on digitally merged patient data (such as DICOM data, model scans, intraoral and facial scans), the dentist can determine the optimal implant position in terms of function and aesthetics, taking bone structure into account.

The software is available in two versions: Zirkonzahn.Implant-Planner as the full version for implant planning and the production of surgical guides, and Zirkonzahn.Implant-Planner Practice, which includes all essential functions exclusively for implant planning.

The user-friendly interface guides the dentist step by step through the entire planning process, enabling a straightforward data transfer to the dental lab. This allows the dentist to receive all components required for an implant case simultaneously (immediate loading). Production is carried out within the Zirkonzahn CAD/CAM system, from surgical guides to prosthetic restorations, or, thanks to the open data exchange function, also with CAD/CAM systems from other manufacturers or with 3D printers.

Bone Doctor software module

For even more precise implant planning, the 3D objects generated with the new Bone Doctor module of the Zirkonzahn.Modifier software can also be imported. This module significantly simplifies the digital analysis of the bone situation: by importing the patient’s DICOM data, the module allows users to analyse the different cranial bones and generate the corresponding 3D files.

The software is capable of autonomously segmenting the desired anatomical structures, such as the lower jaw, mandibular nerves, individual teeth, maxillary sinuses and other anatomical parts. Additionally, the extracted maxilla can be combined with the patient’s Real Movement data to analyse the condylar movements. Extracted teeth can also be used to perform orthodontic movements based on their actual root and crown morphology.

This article is sponsored by Zirkonzahn.

Colgate discusses plans for the Bright Smiles, Bright Futures programme to help 1.7 million British children smile in 2026.

Inspiring and educating British children on oral health

In 2026, Colgate will help, inspire and educate 1.7 million children through Colgate’s professional and schools oral health education programmes. By providing the tools needed to motivate behaviour change, we can get children excited about maintaining their oral health and making it a routine part of their day.

Dental practice programme 2026

Colgate will be sending Bright Smiles, Bright Futures packs to UK based dental practices to help them to support parents in maintaining their children’s oral health. The packs will provide engaging activities and product samples including Colgate Little Smiles 3+ toothpaste to over 1.5 million children. Colgate knows that as a dental professional, you are key to helping give Britain’s children the best start possible.

Don’t miss out – register your practice by Friday 19 June

Make sure your practice doesn’t miss out by registering to receive enough practice packs to cover the number of surgeries within your practice.* Practice packs will be distributed to engage with young children and their families visiting your practice during the summer holidays. 

Click this link to register.

*Subject to availability  

This article is sponsored by Colgate.

Hannah Walsh discusses a study linking overbearing ‘helicopter parenting’ to children’s behaviour in the dental chair and explains why the issue may be more complex than it first appears.

A Dutch cross-sectional study recently claimed that ‘helicopter parenting’ – or overprotectiveness – can lead to a risk of tooth decay in children. It explored how overprotective parenting styles may relate to children’s behaviour during dental treatment and their toothbrushing habits.

The study reports an association between higher levels of overprotective parenting and more disruptive child behaviour during dental treatment. Children whose caregivers scored higher on measures of overprotection were more likely to display uncooperative behaviours, such as anxiety, resistance, or distress, when undergoing dental procedures. In contrast, no significant association was identified between overprotective parenting and children’s toothbrushing frequency or the likelihood of skipping toothbrushing.

Can the study be trusted?

While this study suggests an association between overprotective parenting and children’s disruptive behaviour during dental treatment, I do not fully support these conclusions for a number of reasons:

Firstly, the study population was drawn from a referral paediatric dental practice, which limits the generalisation of the findings. Referral settings, both in the Netherlands and comparable paediatric referral services in the UK, typically treat children with more complex dental needs, higher levels of anxiety, or behavioural challenges. As a result, the sample is not representative of the general paediatric population, nor of the broader range of parenting styles which may be seen in primary care. This introduces selection bias, as children who already struggle with dental treatment are overrepresented in this study, making it difficult to confidently attribute behaviour solely to parenting style.

Secondly, the study design involved separating children from their caregivers during dental treatment. As a specialist paediatric dentist, I do not routinely use parental separation as a behaviour management technique, and its effectiveness remains debated. Observing children, particularly those as young as four years old as in this study, without their caregiver present may significantly alter their behaviour, potentially increasing anxiety or distress irrespective of parenting style.

Therefore, attributing disruptive behaviour to overprotective parenting alone may oversimplify a more complex interaction between the child, caregiver, and clinical environment.

Support versus judgement

It is important to recognise that parenting styles are diverse and influenced by cultural, social, and individual family factors. Categorising parenting as ‘overprotective’ may inadvertently lead to judgement. As clinicians, our role is not to label or critique parenting approaches, but rather to support caregivers in promoting their child’s oral health in a non-judgemental and inclusive manner.

The British Society of Paediatric Dentistry (BSPD), the UK’s leading charity advocating for children and young people’s oral health, has some excellent resources which you can use to signpost and help support children and their caregivers. A Practical Guide to Children’s Teeth emphasises the importance of supporting families with practical, evidence-based prevention advice to help children achieve optimal oral health, rather than focusing on parenting style itself.

In relation to behaviour management during dental treatment, it is widely recognised that a child’s response is influenced by multiple factors. As a clinician, I find creating a positive, supportive atmosphere is essential. Caregivers should be encouraged to model calm and confident behaviour, as children often take cues from their parents in unfamiliar situations. As professionals, we have a responsibility to help reduce anxiety and build trust. The BSPD resource Oral Health Advice for Parents and Carers of Autistic Children and Young People is a great resource for those children with additional needs, highlighting the importance of tailoring support to the individual, particularly for children who may find dental care more challenging.

Strategies for young patients’ caregivers

I find the optimal way for parents to support children’s engagement with oral health is through early involvement and building a consistent routine. Caregivers should be advised to begin toothbrushing as soon as the first tooth comes through and establish it as a twice-daily routine using fluoride toothpaste.

Early engagement with dental visits is also important – BSPD recommends a child is first seen by a dentist around the time the first tooth comes through or by the age of one. The purpose is to use these early visits for simple acclimatisation to the dental environment, giving the opportunity to reinforce prevention advice to prevent tooth decay and starting a habit of dental visits for life.

At the same time, caregivers can help children by creating calm, positive, and predictable environments for toothbrushing. Make toothbrushing fun. Sometimes playing music or using apps like Brush DJ or the BSPD Kids Vids can help make brushing fun and more engaging for children. For children who find oral care more challenging, especially those with additional needs, targeted support is essential, and resources such as www.autismtoothcare.com can provide practical strategies to help families improve oral health in a supportive and individualised way.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

The role of preventive oral healthcare and links between periodontal disease and systemic health were the focus of Bupa Dental Care’s Dental Health is… Live conference.

Held at the International Convention Centre in Birmingham on 8-9 June 2026, the two-day event brought together more than 1,200 clinicians, practice managers, receptionists and practice teams from across Bupa Dental Care’s UK network.

Professor Iain Chapple MBE, professor of periodontology and consultant in restorative dentistry at the University of Birmingham and Birmingham Community Health NHS Foundation Trust, delivered a keynote on periodontal care and the relationship between gum disease and wider health conditions.

He said: ‘Oral health cannot be viewed in isolation. The connections between periodontal health and systemic conditions, such as diabetes, cardiovascular disease, chronic kidney disease, rheumatoid arthritis and Alzheimer’s disease, underline the need for more integrated approaches to care.’

The conference also included continuing professional development (CPD) workshops on genomics, diagnostics, communication, connected healthcare and performance. Suppliers and partners also exhibited dental technology and equipment.

Mark Allan, general manager for Bupa Dental Care, said the event gave teams the opportunity to ‘build skills and gain insight they need to help shapethe future of dental care’.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

Ashley Byrne reflects on 20 years of surviving the threats that were supposed to kill dental technology – and why the best is still to come.

Twenty years. Two decades of early mornings, late nights, difficult conversations, and genuinely incredible moments. It’s a milestone I’m proud of – but more than anything, it’s made me reflect on just how many times someone told me we were finished. And I mean that quite literally.

The threats that never came

Cast your mind back. Overseas laboratories were going to wipe us out. Why would any dentist pay UK prices when they could send work abroad for a fraction of the cost? I heard it constantly. It kept a lot of lab owners awake at night, myself included.

Then came digital dentistry. Intraoral scanners, CAD/CAM, milling machines – the narrative shifted. Why would labs survive when dentists could design and mill restorations chairside? The technology was supposed to make us redundant overnight.  

But here we are. Still going. Not just surviving, either – genuinely thriving.

Why the threats never materialised

Overseas labs took some work. I won’t pretend they didn’t. But the quality issues, the communication barriers, the turnaround times and the increasing demand from patients for British-made, high-quality restorations brought a lot of that work back. Patients started asking questions. Dentists started caring about the answers.

Digital dentistry didn’t kill labs – it transformed them. Yes, some of the simpler, more commoditised work moved elsewhere. But labs that evolved with the technology found themselves doing more complex, more interesting, and frankly more rewarding work than ever before. Today, 90% of the work coming into my lab arrives as an IOS file. That’s not a threat. That’s an opportunity I’m grateful for every single day.

Chairside milling? It has its place. Single-unit same-day restorations in certain clinical situations – absolutely. But there is a ceiling to what chairside can achieve, and above that ceiling is where skilled technicians live. Complex full-mouth rehabilitations, implant-supported restorations, high-end aesthetics – no milling unit in a practice corridor is replacing that.

So why do we keep panicking?

Honestly? Because fear sells. A headline that says ‘dental labs are evolving and adapting well’ doesn’t get clicks. ‘AI will replace dental technicians’ absolutely does.

I understand the anxiety. I’ve felt it myself. When you’ve invested years into learning a craft, built a team, a client base, a reputation – the idea that it could all be disrupted is genuinely frightening. That fear is human and it’s valid. But it becomes dangerous when it stops you from moving.

The labs that struggled through those so-called existential threats weren’t the ones who faced the most disruption. They were the ones who stood still waiting for the worst to happen.

What’s coming next

I’m not going to pretend the landscape isn’t changing again – because it is, faster than ever.

The newest shift is a genuinely impressive one. Tech-driven lab models are emerging that offer slick digital interfaces, free scanner placements, automated crown production, and yes – technical advice and clinical support too. These aren’t corner-cutting operations. Some of them are very good at what they do, and they’re making it easier than ever for a dentist to access consistent, efficient restorative work. I say that with no sarcasm. We should respect what these companies have built.

But here’s the question it forces every traditional lab to ask: if someone else is offering all of that, what are you offering?

Think outside the box

This is where I think the real opportunity lies – and it requires us to be honest about whether we’re genuinely adding value, or just assuming our relationships will carry us through. The labs that will thrive aren’t the ones who simply match what these new models offer. They’re the ones who go further. The ones who embed themselves so deeply into a practice’s clinical workflow that the relationship becomes genuinely irreplaceable.  

What does that look like in practice? It means understanding a dentist’s patient base well enough to anticipate problems before they arise. It means being proactive about scan quality, not just reactive to a bad impression. It means helping to reduce chair time – fewer adjustments, fewer second appointments, better-fitting restorations first time. It means being a clinical partner, not just a manufacturing service.

It might also mean offering things that fall completely outside the traditional lab model. Training days. Workflow consultations. Being present in the practice, not just at the end of a courier run.

AI-assisted design, automation, advanced materials – we should be embracing all of it too. The best version of our industry isn’t us versus the new models. It’s us using the same tools, while offering a depth of partnership that a standardised platform simply isn’t designed to provide.

I’ve heard the ‘this will finish us’ story before, and I know how it ends. The labs that invest in thinking creatively, that build genuine clinical partnerships, that ask ‘what else can we do for this practice?’ – those are the ones that will look back at this moment the way I look back at the ‘overseas labs will kill you’ era. With a quiet smile.

What I’d say to any technician reading this

Your skills matter enormously. But in the current climate, technical skill alone isn’t enough. You need to be curious, creative, and genuinely invested in the success of the practices you work with. Get closer to your clients. Understand their challenges. Don’t wait for the phone to ring – pick it up first. Find out where they’re losing time, where cases are going wrong, and work out how you can help fix that. Go to shows. Try new things. Talk to people who are doing it differently. The best ideas often come from outside your comfort zone. And stop waiting for the industry to collapse. It won’t.

Twenty years in, I’m more optimistic about the future of dental technology than I have ever been. The work is better, the science is better, and the people coming through are extraordinary.

Change isn’t the enemy. Staying still is.

Follow Dentistry.co.uk on Instagram to keep up with the latest news and trends.

New data showing 46% of working parents have to work extra hours on evenings or weekends to make up for children’s dental appointments has highlighted the impact of the childhood oral health crisis on productivity.

A further 45% of parents said they had missed vital work commitments, deadlines, or meetings because of their children’s dental issues, with four in 10 saying their child’s oral health had directly disrupted their work days. For almost one in five (19%), the disruption had occurred more than once.

Of 1,000 parents surveyed, 12% said that their child had taken more than six days off school specifically for dental issues in the past 12 months. For 18% of them, needing to work on evenings or weekends to catch up on time lost to children’s dental appointments or emergencies has become a regular occurrence.

These figures were published by Bupa Dental Care as part of a new campaign to help families tackle oral health anxiety early and curb the knock-on effects on UK businesses.

Bupa’s director of dentistry, Neil Sikka, said: ‘These findings clearly show that children’s dental health is no longer just a domestic issue, it is a workplace productivity issue. When a child suffers from dental pain or misses school, the operational burden heavily shifts to the parents, forcing many to miss critical meetings or log on during weekends just to catch up. 

‘By managing children’s oral health proactively, we can prevent the acute pain and dental emergencies that lead to sudden absenteeism, ultimately helping parents maintain a healthier balance between family life and their professional commitments.’

Why are children’s dental visits becoming more disruptive?

Further research by Bupa Dental Care found that more than half of young children in the UK admit to fibbing to parents about brushing their teeth.

It showed:

• 56% of children admit to fibbing about brushing their teeth
• 41% brush for a minute or less, despite guidance to brush for two minutes, twice a day
• 13% of children feel anxious about visiting the dentist, rising to 22% of parents.

Nearly half of parents (46%) said they worry their child is not brushing effectively. An additional 29% were concerned that their child is not brushing for long or often enough.

Among children who reported feeling anxious about visiting the dentist, common triggers included:

• Dental equipment (52%)
• Loud noises (46%)
• Bright lights (34%)
• Fear of the dentist themselves (27%).

Parental anxiety was also found to play a role. Nearly one in five children (18%) said a parent’s nerves make them feel more anxious, while 22% of parents admitted they felt nervous too.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

We often talk about the dental team as a well-oiled machine, but behind every successful clinic is a collection of human beings balancing immense pressure.

In recent years, the way the dental profession is regulated has shifted dramatically. The industry has moved away from simply fixing problems after they happen, focusing instead on a highly proactive culture of ‘risk management’.

While keeping patients safe is everyone’s top priority, this constant focus on managing risk can quietly change how the system views the clinician.

The bedrock of justice is the presumption of innocence. Yet, in the arena of clinical regulation, this principle is quietly supplanted by what can be described as a ‘presumption of risk’.

Because the General Dental Council’s (GDC) primary statutory mandate is public protection, the administrative machinery must treat allegations seriously from the outset. But for the clinician involved, the moment a complaint is made, no matter how small or unfair it may feel, they can immediately feel treated as a potential compliance liability that needs to be monitored, restricted and managed.

The presumption of risk

To understand how modern regulation functions, we can look to classic legal theory. In criminology, the ‘Crime Control Model’ represents a system driven by the priority of repressing misconduct with maximum efficiency.

It operates like an assembly line, prioritising swift processing, societal protection and a functional presumption of guilt over individual procedural rights.

When applied to dentistry, the regulator functions less like a source of professional reassurance and more like a system designed primarily around public protection. That distinction matters.

The GDC is not a representative body for dentists; its role is to protect patients and maintain public confidence. However, when practitioners are viewed mainly through a risk-management lens, the system can create an environment where clinicians feel they are not colleagues to be supported, but potential risk vectors to be contained.

The assembly line must keep moving, and if an innocent clinician is ground down by the process, that becomes a serious unintended consequence in the name of public safety.

Fitness to practise investigation delays

This shift is felt most painfully in the sheer length of modern investigations. The GDC has itself acknowledged the problem. In its Fitness to Practise Statistical Report 2025, it said investigations can ‘take too long’, feel overly complex and negatively affect the mental health and wellbeing of those involved.

The same report showed that the average time from initial receipt to final assessment decision was 78 working weeks in 2025.

On paper, these long timelines are defended as thorough due process, ensuring that every detail is properly and transparently reviewed. That thoroughness matters, particularly where clinical records, expert advice, medical reports, police information or other evidence must be gathered.

But for a dentist sitting alone in a practice, a prolonged waiting window is not a neutral pause. It is an exhausting period of invisible professional stress.

When an administrative process takes many months, or longer, to resolve, a fascinating paradox emerges. The system treats a dentist’s emotional and mental endurance as if it were an infinite resource.

It assumes a clinician can maintain perfect focus at the chair, cutting micrometres of tooth structure with absolute precision, while carrying a massive cloud of regulatory uncertainty over their head every single day.

When the process becomes the penalty

While these lengthy investigations are technically categorised as neutral administrative steps, for the practitioner they can operate as a de facto sanction.

Carrying an unresolved allegation for many months can inflict reputational, psychological and financial damage without a single shred of guilt ever being proven.

When the process itself becomes the penalty, the system risks abandoning the foundational principles of fairness in favour of bureaucratic attrition.

The complaint process under pressure

A major compounding factor in this timeline is the system’s ability to efficiently triage incoming complaints. Because the regulatory net is cast so wide, vexatious, retaliatory or purely consumer-driven disputes can be drawn into the same heavy machinery as genuine clinical negligence.

By treating notifications with significant bureaucratic weight, the system can inadvertently make the complaint process feel weaponised. An unreasonable demand for a refund or a subjective disagreement over aesthetics can trigger the same multi-month anxiety as a major safety breach.

For the practitioner, knowing that an accusation can stall career progression, affect indemnity premiums and trigger extensive paperwork is a source of significant psychological strain. The system does not just investigate wrongdoing; it can validate hostility by treating allegations as credible risks until proven otherwise.

Fairness and reasonable time

This is where standard professional fairness comes into play.

Under Article 6 of the European Convention on Human Rights, incorporated into UK law through the Human Rights Act 1998, clinicians are entitled to a fair hearing within a reasonable time when their ability to practise is at stake.

Courts have repeatedly confirmed that a professional’s right to work is a protected civil right, most notably in Kulkarni v Milton Keynes Hospital NHS Foundation Trust, where the Court of Appeal recognised that disciplinary processes must meet Article 6 standards of fairness.

The law recognises that time is not a neutral variable; when things drag on for too long, the delay itself begins to distort the truth.

When a dental investigation disappears into a prolonged loop, it strains the ‘reasonable time’ standard. Clinical teams change, dental nurses move on, patient memories of a specific appointment fade, and the clinician’s practical ability to defend themselves naturally degrades.

Notes can only capture so much; the nuance of human interaction evaporates with time. Therefore, the delay itself becomes a structural factor that actively erodes the fairness of the eventual outcome. It is a legal axiom that justice delayed is justice denied, because a stale trial can never be a fully fair trial.

The wellbeing catch-22

This creates a difficult catch-22 when compared to the industry’s own guidelines.

The rules explicitly state that dentists must be honest and step away from work if their health is affecting their clinical judgement. Yet, the culture rarely offers a safe space to do so.

Independent data has repeatedly pointed to the impact of regulatory investigations on clinicians’ mental wellbeing. If a dentist admits they are struggling with severe anxiety caused by a long-running investigation, the system does not always pause to offer a supportive hand; it may simply log that anxiety as another clinical risk variable to be managed.

The single-operator vacuum

This pressure is made significantly worse by the intense isolation built directly into the day-to-day work of a dentist. Professional culture demands that the dentist acts as an infallible, all-knowing leader of the surgery.

They are expected to carry the entire financial, clinical and legal weight of the business on their shoulders, often while trapped inside the ‘single-operator vacuum’ of a tiny treatment room.

When a toxic complaint or a regulatory notification hits their inbox, they rarely have a safe, internal corporate network to turn to for legal or emotional triage. Instead, they absorb the shock entirely alone, managing intense consumer-driven hostility while attempting to preserve an impossible standard of clinical perfectionism.

Because the system treats dentists as independent commercial pillars rather than vulnerable human service providers, they are forced to mask their distress. They suffer in silence at midnight, checking emails and trapped in cycles of rumination, because the culture has taught them that seeking help is a sign of professional vulnerability.

Protecting the protectors

A healthy dental sector relies entirely on the psychological wellbeing of the people holding the handpieces. If our regulatory frameworks and workplace cultures become so slow and heavy that the process itself becomes an occupational hazard, we risk burning out the very professionals we need.

Public safety will always be the baseline of dentistry. The GDC’s statutory role is public protection, not professional representation. But public protection and procedural fairness should not be treated as competing aims. A process designed to protect patients should not become so prolonged or burdensome that it creates additional risk for the professionals working within it.

Justice delayed might eventually arrive, but it should not cost a professional their peace of mind just to get to the finish line.

References

1. General Dental Council. Fitness to Practise: Guidance for the practice committees. London: GDC.
2. Packer HL. Two Models of the Criminal Process. University of Pennsylvania Law Review. 1964;113(1):1-68.
3. Professional Standards Authority (PSA). Performance Review: General Dental Council. London: PSA.
4. Human Rights Act 1998, c. 42. Schedule 1, Part I, Article 6: Right to a fair trial. London: The Stationery Office.
5. Kulkarni v Milton Keynes Hospital NHS Foundation Trust [2009] EWCA Civ 789.
6. General Dental Council. Standards for the Dental Team. London: GDC.
7. Dental Protection Limited (DPL). Annual Member Survey: The Psychological Impact of Regulatory Investigations. London: DPL.

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

It was having to borrow money to pay for clawback that was the final spur for Jonathan Preece of Newport Dental practice to say ‘enough is enough’ and look to make the move from NHS to private dentistry.

Although he had considered the move for more than a decade, fear of the unknown had held him back. However, as staff recruitment became an issue on top of clawback moving to private dentistry became inevitable.

Conscious of the enormity and complexities of the move he was about to make in relation to his own business, Jonathan was keen to find support as he underwent the change. Crucially, he wanted a plan provider that would could continue to support him after the dust had settled and who would help his business thrive.

Practice Plan was recommended to him by colleagues, and he was guided through the transition by his regional support manager, Josie Hutchings. he has been happy with his choice ever since. His practice manager works closely with Josie to ensure the plan works well for his practice and now he is able to, as he puts it, ‘Just rock up and do the dentistry.’

What are the benefits of an NHS to private transition?

He now has a diary where he has time to see patients when they need to be seen. Should someone need immediate treatment, with few exceptions, he is able to fit them and do the work. However, it’s the change to his life outside work that Jonathan values most. He is now able to have a lunch break, go home and spend time with his family or pursue his hobbies. Life is more relaxed and his evenings are no longer consumed by paperwork.

His only regret is one Practice Plan hears frequently: that he hadn’t made the move sooner.

There’s never been a safer time to leave NHS dentistry. If you’re considering your options away from the NHS and are looking for a plan provider who will hold your hand through the process at a pace that’s right for you, you’re in safe hands with Practice Plan.

You can start the conversation today by calling 01691 684165 or booking your one-to-one NHS to private conversation at a date and time that suits you, just visit practiceplan.co.uk/nhsvirtual.

This article is sponsored by Practice Plan.

Cheap handpieces can be deceptive – Trigiene explores the unexpected costs that can occur in the lifecycle of a dental handpiece.

Dental handpieces are the workhorses of every dental practice. Used continuously throughout the day, subjected to intensive decontamination cycles, and expected to perform with precision every time, they are fundamental to both clinical outcomes and patient experience.

Yet despite their importance, many practices struggle to answer some basic but critical questions:

• How much has this handpiece actually cost us over its lifetime?
• At what point does repair become more expensive than replacement?
• Where can we access a complete service history for each asset?
• How are warranty periods and service intervals being tracked?

The reality is that the true cost of ownership for dental handpieces is often hidden within fragmented records, paper-based systems, and reactive maintenance processes.

The challenge of tracking lifetime costs

While the purchase price of a handpiece is easy to identify, the ongoing costs associated with servicing and repairs are often much harder to measure.

Over several years, a handpiece may require multiple turbine replacements, gear set repairs, fibre-optic replacements and preventative maintenance. Individually, these costs appear manageable. Collectively, however, they can exceed the original purchase price several times over.

Without a centralised system linking every repair to a specific serial number, practices have little visibility of the true financial performance of each asset. As a result, repair decisions are often made based solely on the latest quotation rather than the cumulative investment already made in that handpiece.

When does repair become a false economy?

One of the most common questions practice managers face is: ‘Should we repair it or replace it?’

There is no universal answer. A premium handpiece from a leading manufacturer may justify several repairs if the core body remains in good condition. Conversely, repeated repairs on an ageing handpiece may indicate that replacement is the more economical option.

Many industries use a repair threshold model, replacing assets once repair costs reach a predetermined percentage of the replacement value. However, this approach relies on accurate historical data.

Without access to previous repair costs and service records, practices are often making decisions without seeing the complete financial picture.

The quality of repairs matters

Reducing lifecycle costs is not simply about finding the cheapest repair option. The quality of the repair can significantly impact future reliability and performance.

Practices should consider three key factors when selecting a repair provider:

• Membership of recognised industry bodies such as the BDIA
• Quality control certification such as ISO9001
• Manufacturer-trained engineers with specialist knowledge of specific handpiece brands
• The use of genuine OEM parts wherever possible.

While non-genuine components may reduce the immediate repair cost, they can increase the risk of premature failure, reduced performance and additional repairs in the future. In many cases, the cheapest repair becomes the most expensive over the lifetime of the asset.

Preventative maintenance reduces long-term costs

Many avoidable repairs stem from poor maintenance procedures.

Correct lubrication, cleaning and sterilisation processes are essential to maximise handpiece lifespan. Practices should ensure reprocessing teams are properly trained and follow consistent procedures, including:

• Using manufacturer-approved lubricants
• Using the correct oiling adaptors
• Completing full sterilisation drying cycles
• Storing handpieces correctly after processing
• Undertaking regular refresher training.

Simple improvements in maintenance procedures can significantly reduce repair frequency and improve equipment longevity.

The hidden administrative burden

The cost of maintaining handpieces extends beyond repair invoices.

Tracking warranties, service histories, maintenance schedules and repair records manually can be time-consuming and prone to error. For larger practices or DSOs operating across multiple sites, maintaining visibility becomes even more challenging.

When service records are spread across emails, spreadsheets and filing cabinets, answering basic questions about an asset can take considerable time and effort.

In an increasingly regulated environment, maintaining accurate equipment records is also an important compliance requirement.

A smarter approach with the Trigiene Handpiece Repair Tracking Portal

To help practices gain greater control over their equipment, Trigiene has developed the Handpiece Repair Tracking Portal.

The portal provides a centralised digital asset register where practices can record, manage and monitor their handpiece inventory throughout its entire lifecycle.

Instead of relying on disconnected paperwork and historical invoices, practices gain instant access to a complete asset history in one location.

Key benefits include:

• Register and manage all handpiece assets by serial number
• Book free repair collections online in seconds
• Track repair progress in real time
• Access complete service and repair histories
• Monitor cumulative repair expenditure against individual assets
• Record warranty expiry dates and service intervals
• Generate management reports to support budgeting and replacement decisions
• Identify recurring faults and equipment performance trends.

By creating a complete lifecycle record for every handpiece, the portal enables practices to make informed decisions about whether to repair, replace or retire equipment.

The result is greater visibility, improved compliance, reduced administration and better control of maintenance budgets.

From reactive repairs to strategic asset management

As dental practices face increasing pressure to improve efficiency, profitability and compliance, managing equipment through spreadsheets and paper records is no longer sufficient.

The Trigiene Handpiece Repair Tracking Portal provides the data needed to understand the true cost of ownership of every handpiece within the practice. It transforms maintenance from a reactive process into a strategic asset management function, helping practices maximise equipment lifespan while controlling costs.

Ultimately, the question is no longer whether a handpiece can be repaired. The real question is whether it should be repaired.

With accurate lifecycle data at your fingertips, that decision becomes significantly easier.

For more information about the Trigiene Handpiece Repair Tracking Portal, contact the team on 01642 442910 or mail@trigiene.co.uk.

This article is sponsored by Trigiene.

PFAS chemicals seem to be everywhere these days: at the top of Mount Everest, in umbilical cord blood, in breast milk, and in the news. In  2022, the U.S. Environmental Protection Agency announced new health advisories for PFAS in drinking water. My Green Doctor explains why PFAS are important and how your patients can avoid them.

PFAS  is an acronym for the chemical group Per- and PolyFluoroAlkyl Substances.  The first was  invented in 1938.  A few have been banned or are being phased out in the European Union or the United States but several hundred PFAS are being manufactured currently. These molecules are both water and oil repellent, making them useful in products such as microwave popcorn bags and pizza boxes; as stain repellents on carpets, furniture, and clothing; for non-stick cookware; in cosmetics and sealants; in many construction materials that are in our homes and offices; and as firefighting foam.  Annual U.S. sales of PFAS as stain repellents alone is over $1 billion.

Unfortunately, global environmental contamination has resulted over the decades as the result of PFAS being discharged in industrial air emissions, released from products in our homes, from sewage treatment plants, from municipal landfills, and from firefighting operations.  PFAS are found in all 50 US states in lakes, streams, and groundwater. They are common in our drinking water and in some of the foods we eat. PFAS are in the blood of people globally, including 99% of Americans.

These molecules are toxic. Thousands of peer-reviewed research articles link PFAS to health effects that include kidney and testicular cancer, thyroid disease, liver damage, decreased infant fetal growth, pregnancy-induced hypertension (including pre-eclampsia), dyslipidemia (children & adults), ulcerative colitis, and immune dysfunction (vaccine unresponsiveness). Clinicians need to be alert for these conditions in individuals with high PFAS exposure.

In June 2022, the US EPA set new drinking water health advisory limits for two major PFAS: PFOA and PFOS. The new safety limits are 3,500-17,500 times lower than the 2016 advisory levels! The new limits are derived from studies of how PFAS impair immune responses in children. These safety levels are so low that few commercial water testing companies can measure them. Municipalities nationwide are scrambling to test their water and make the data available to the public.

Physicians may remember from their college chemistry class that the carbon–fluorine bond is extremely stable. PFAS are sometimes called “forever chemicals” because they do not readily break down in nature and they bioaccumulate in our tissues to augment their toxicity over time.

Most people do not know how to protect themselves from PFAS. Certain jobs are high risk for exposure: firefighters, fluorochemical industry workers, those in the carpet industry, and those in the military. These workers should be counseled to seek advice from their workplace’s occupational safety experts.

Health professionals can tell their patients other steps to take (see table). Drinking water is how most people are exposed.  All types of water filters remove PFAS but reverse osmosis filters are the best. Bottled water is not an answer because some bottled water has very high PFAS levels and water companies are not required to test their products. Choosing “organic” or “natural” foods has not been shown to help.

If your community water supplies contain PFAS levels above the new EPA advisory, or if there are fluorochemical industries in your area, your patients should drink filtered water and avoid eating local wild game, locally caught fish, and local dairy products. PFAS is found in breast milk but also in the water used to mix infant formula so there are no recommendations against breast feeding.

Look for labels saying PFAS-free or “certified non-toxic.” 

Consumers should only buy microwavable popcorn that uses PFAS-free packaging because of the risk of PFAS contamination from popcorn bags. They should buy fast-food and takeout foods only from restaurants that have announced, as some have, that they use only PFAS-free wrappers and containers.

Certain products are particularly worth avoiding: clothing with waterproofing (including Gore-Tex), certain non-stick cookware (including Teflon), clothing treated with waterproofing chemicals (such as Scotch Gard), and carpets and furniture with stain repellents. Many cosmetics contain these toxic chemicals. Look for labels saying PFAS-free or “certified non-toxic”.

Health professionals and consumers can ask governments to fund more research on the health effects of PFAS, to perform more testing of food and water, and to require that PFAS chemicals be displayed prominently on product labels. We all can ask manufacturers and stores to “get the PFAS out”!

About the Authors:

D.M. Axelrad, PhD is a retired Professor of Environmental Health and environmental toxicologist at Florida A&M University, Tallahassee, Florida, USA.  He serves on the Board of Directors of the Florida Chapter of Physicians for Social Responsibility.  His email address is daxe@comcast.net.

Todd L Sack MD FACP is Executive Director of the My Green Doctor Foundation.  His email address is mygreendr@gmail.com.

Further Resources:
1. PFAS in food: https://www.fda.gov/food/chemical-contaminants-food/questions-and-answers-pfas-food Accessed 11.6.2022
2. Human exposure & health effects: https://pubmed.ncbi.nlm.nih.gov/30470793/ Accessed 11.6.2022
3. Understanding the new drinking water advisory: https://pubmed.ncbi.nlm.nih.gov/23597293/ Accessed 11.6.2022
4. Human toxicity: https://www.atsdr.cdc.gov/pfas/health-effects/index.html Accessed 11.6.2022
5. “Guidance on PFAS Exposure, Testing, and Clinical Follow-Up (2022)”, U.S. National Academy of Sciences, http://nap.nationalacademies.org/26156 p 111-112.

Image Credits:
1. Logo: Copyright Florida Medical Association, with permission.
2. PFAS model: https://www.freep.com/story/news/local/michigan/2019/05/31/pfas-contamination-forever-chemical/3770012002/
3. Family: US Department of Agriculture 2021
4. Table: https://pfas-exchange.org/how-to-reduce-your-exposure-to-pfas

The post PFAS: Toxic Chemicals To Understand & Avoid first appeared on My Green Doctor.

The Endocrine Society is pleased to welcome Santoro, of the University of Colorado School of Medicine in Aurora, Colo., as its 2026 – 2027 president. She will take office in June 2026 at ENDO in Chicago, succeeding Carol Lange, PhD.

Santoro has served as E. Stewart Taylor Chair of Obstetrics & Gynecology at the University of Colorado School of Medicine since 2010. She is a well-recognized practitioner, dedicated mentor and leading researcher on studies of women with premature and age-appropriate menopause.

She has held many roles with the Endocrine Society, including serving as vice president of clinical science, an author on two women’s reproductive health Clinical Practice Guidelines and chair of the Society’s Scientific Statement on bioidentical hormones. She also won the Society’s 2016 Laureate Award for Outstanding Mentorship.

“The Endocrine Society was the first society I joined as a fellow,” Santoro says. “This is really a highlight for me.”

“The Greatest Field”

Santoro originally thought she wanted to be a writer; she won the Joyce Carol Oates Award in high school for a short story but enrolled in a six-year medical program out of high school. Since she would be a first-generation college graduate in her family, she thought if she could almost fast-track her education, it would be less of a financial burden on her loved ones.

“I loved writing, so I applied to the six-year program, and I decided I was going to try to become a professional writer and a novelist, or I was going to be a doctor,” Santoro says. “If I didn’t get into medical school, then I was just going to go into writing.”

“I foresee a lot of advocacy that’s really necessary to keep endocrinology in the game here, to make its presence known how important endocrine conditions are, and how it touches on so many areas of science that it’s really critical that their voice is heard.”

Santoro was accepted to the six-year BS/MD program at Rensselaer Polytechnic Institute and Albany Medical College, where she developed an interest in endocrinology. She completed her residency at Beth Israel Medical Center, where she met one of her role models, Nelly Szlachter, who was a reproductive endocrinologist. [Szlachter] had done her training at NYU and told Santoro, “[Reproductive endocrinology] is the greatest field.”

From there she got a fellowship at Massachusetts General Hospital, working in the Reproductive Endocrine Unit and she admits she didn’t know much about biomedical science or the whole research enterprise, because she had only had a brief introduction to those fields in medical school.

“It was an incredibly exciting time to be there because stuff was just happening left and right,” Santoro tells Endocrine News. “The science was fantastic. It was all new, exciting knowledge. Once the pulsatile nature of GnRH secretion was established, all of these applications just kind of fell out of that work and it was a matter of just doing it, learning from it, and then going on to the next problem.”

A Big Finding

Santoro says she also belongs to the Menopause Society and the American Society for Reproductive Medicine, but the Endocrine Society is her first home. “It’s the best forum for the kind of research that I do,” she says. “I will often save my best work where I need the most feedback from the smartest people for the Endocrine Society. If I have really gnarly endocrine problem, it’s coming to ENDO.”

One of those problems to solve was that perimenopausal women. With help from colleagues, Santoro did urinary assays to do daily sampling of women. “I wanted to look at premature menopause,” she says. “That was the problem I decided I was going to take with me from the Reproductive Endocrine Unit. “

Santoro says that Robert W. Rebar, MD, former executive director of the American Society for Reproductive Medicine, had advised her to analyze data from perimenopausal women, and when Santoro and her colleagues looked at hormone levels, they were all over the place – some way up, some way down. “I said, ‘I’ve never seen anything like this. We’ve been doing normal menstrual cycles for years at Mass General. What is this? Repeat them all,’” she says.

So, they repeated the tests. A few times, actually. Santoro knew she was on to something. She says: “I went home the day I saw that data and I said to my husband, ‘I think this is a big deal. I think this is a big finding. That’s going to really influence what I do and how I think.’ Just seeing those erratic patterns that had really just only intermittently been reported before was something that I really seized on and that led to a lot of other things.”

Pointing the Way

Santoro says that another one of the highlights of her career has been mentoring, just as she was mentored. She gives the example of Rebecca Thurston, PhD, a former president of Menopause Society. Thurston’s background is in epidemiology and psychology, but she had career development award from the National Institutes of Health (K award) and asked Santoro to teach her about hormones.

In fact, Santoro is mentoring junior-level faculty from other specialties – psychology, epidemiology, physiology – at institutions across the United States, meeting over Zoom to discuss hormones and funding opportunities. “I’m also a mentor for Building Interdisciplinary Research Careers in Women’s Health (BIRCWH), a NIH K12-funded career development program,” Santoro says. “That’s another venue where I can mentor junior faculty along research lines.”

“Even though a lot of the change seems adverse, there’s always opportunity. We need to find that, and we need to open up the window because we need to show people that this is a field that really is vital. It’s fascinating. It’s so important in people’s lives, and there’s a lot of good that can be done.”

“As a fellow,” she continues, “you’re mentoring at a very granular level, teaching people the details. One of the most challenging groups that I mentor are my general OBGYNs because it takes you 30 years to become really an expert when you’re really covering the entire field. That’s the opposite of my own career path, which was I really wanted to drill down onto something small and learn as much as humanly possible about that.”

Change and Opportunity

Santoro takes the helm of the Endocrine Society in turbulent times, and she’s very aware of that fact. “I foresee a lot of advocacy that’s really necessary to keep endocrinology in the game here, to make its presence known how important endocrine conditions are, and how it touches on so many areas of science that it’s really critical that their voice is heard,” she says. Santoro is also aware of the clog in the endocrinology pipeline, saying it needs to be revitalized, especially in this time of change. “Even though a lot of the change seems adverse, there’s always opportunity,” she says. “We need to find that, and we need to open up the window because we need to show people that this is a field that really is vital. It’s fascinating. It’s so important in people’s lives, and there’s a lot of good that can be done.”

The post Meet Incoming Endocrine Society President Nanette Santoro, MD appeared first on Endocrine News.

A new study has found that temporarily restricting calorie intake could improve the inflammation associated with gum disease, building on previous research which linked fasting with reduced inflammation.

The team at King’s College London divided periodontitis patients into two groups, one following a five-day restrictive diet and the other continuing as normal.

The patients on the fasting diet ate 1,100 calories for two days, then 750 calories for three days, with their diet returning to normal by day seven. This process was repeated three times within six months.

After this period, blood and gingival crevicular fluid were taken from the patients and analysed. The fasting patients were found to have reduced inflammation markers in both samples than those in the control group. This includes both C-reactive protein – a general marker of bodily inflammation – and specific indicators of gum disease.

How does fasting improve gum disease?

Senior author Professor Luigi Nibali said there could be many reasons why fasting is beneficial for periodontitis patients. ‘Fasting reduces oxidative stress in the body, a common cause of inflammation, which can damage cells and DNA.

‘Intake of high calorific foods and refined carbohydrates, for example in cakes and biscuits, can also cause inflammation – so restricting these foods also reduces oxidative stress in the body.

‘It may also be that fasting has beneficial effects on the microbiome – the body’s community of bacteria that help to keep it healthy. However, further research is needed to confirm this relationship.’

Dr Giuseppe Mainas, first author of the study, said it suggests lifestyle modifications could be important alongside proper tooth brushing for patients with gum disease.

He said: ‘Now we have established this relationship, we would like to do a larger study, before potentially incorporating into gum disease treatment in the future. There may be patients where restricting foods can be dangerous, such as those with diabetes, so the advice will need to be targeted to specific patient groups. We are currently investigating how we could implement these benefits in high-risk groups who may not be able to fast.’

Gum disease and wider health

The study is the latest addition to King’s College London’s growing body of research into the relationship between gum disease and wider health.

In November 2025, King’s researchers found an association between root canal treatment and a reduced risk of heart disease and diabetes. Just two months prior, the college released a study which found that following a Mediterranean diet could improve gum health.

Professor Luigi Nibali said: ‘There is emerging evidence about the role that a balanced diet might have in maintaining a periodontal healthy status. Our research shows the potential effect that a nutrient-dense, plant-rich diet could play in improving the nation’s gum health. Nevertheless, more investigation is needed to develop personalised approaches to help people manage their gum health.’

Follow Dentistry on Instagram to keep up with all the latest dental news and trends.

Early puberty can affect a child’s adult height and is associated with long-term physical and emotional health risks, including psychosocial stress, heart disease, and some cancers later in life. 
 
According to the guideline authors, puberty-pausing medication, which temporarily pauses the brain signals that start puberty, can be an effective treatment and has the potential to increase adult height as well as improve psychosocial and long-term health outcomes among children with early puberty.  

“Some subgroups of children may not need the same level of testing or treatment. For example, older girls with slowly progressing precocious puberty often have normal adult height without intervention,” said the guideline’s writing group co-chair Stephanie Roberts, MD, of Boston Children’s Hospital in Boston, Mass. “We give clinicians suggestions that avoid unnecessary or invasive testing and treatment, such as sometimes initially using a period of observation by their health care provider, using simpler testing methods and individualizing treatment when indicated.” 
 
Suggestions from the guideline include: 
 

• Monitoring girls with early breast development with physical exams every 4-6 months before initiating diagnostic testing. 

• Observing girls under seven years old for four to six months to distinguish slowly vs. rapidly progressing puberty, since slow progression often results in normal adult height without treatment. 

• Using simple first-line testing with a basal luteinizing hormone (LH) blood test rather than GnRH agonist stimulation testing. 

• Avoiding routine brain MRIs in older children (> six years in girls and > seven years in boys) without neurological symptoms. 

• Not routinely doing genetic testing, especially for cases without a family history of early puberty. 

• Starting treatment with longer-acting puberty-delaying medications (rather than shorter-acting medications) whenever it is expected that longer-acting medications will be used for long-term therapy. 

• Not routinely using growth hormone therapy. 

• Not routinely doing frequent lab monitoring during treatment unless treatment failure is suspected. 

• Discontinuing therapy by early adolescence (about 10 – 11 years in girls, 11 – 12 years in boys). 

Other members of the Endocrine Society writing committee that developed this guideline include: Morgan Alonzo of Children’s Hospital Colorado in Aurora, Colo.; Jesús Argente of Niño Jesús University Children’s Hospital, the Autonomous University of Madrid, the Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, IMDEA Food Institute, and CEIUAM+CSI in Madrid, Spain; Ana Pinheiro Machado Canton of the University of São Paulo; Jean-Claude Carel of Paris Cité University in Paris, France; Fernando Cassorla of the University of Chile in Santiago, Chile; Evangelia Charmandari of Athens Medical School in Athens, Greece; Erica Eugster of Indiana University School of Medicine in Indianapolis, Ind.; Anna Grandone of the University of Campania, Luigi Vanvitelli, Vico L. De Crecchio in Naples, Italy; Louise C. Greenspan of San Francisco Medical Center in San Francisco, Calif.; Elizabeth Hawse of Commonwealth Pediatrics in Lexington, K.Y.; Anders Juul of the University of Copenhagen in Copenhagen, Denmark; Paul Kaplowitz of Children’s National Hospital in Washington, D.C.; M. Hassan Murad of Mayo Clinic in Rochester, Minn.; Maria Street of the University Hospital of Parma in Parma, Italy; Vayana Walker of the Community Health Network in Indianapolis, Ind.; and Christopher McCartney of West Virginia University in Morgantown, W.V. 
   

“Central Precocious Puberty: An Endocrine Society Clinical Practice Guideline,” was published online and is being presented Saturday at ENDO 2026, the Society’s annual meeting. 
 
The guideline will appear in the September print issue of The Journal of Clinical Endocrinology & Metabolism (JCEM). 

The Society established its Clinical Practice Guideline Program to provide endocrinologists and other clinicians with evidence-based recommendations in the diagnosis, treatment, and management of endocrine-related conditions. Each guideline is developed by a multidisciplinary panel of topic-related experts in the field using a rigorous methodology.  

Guideline writing panels rely on evidence-based reviews of the literature when developing guideline recommendations. The Endocrine Society does not solicit or accept corporate support for its guidelines. All Clinical Practice Guidelines are supported entirely by Society funds. 

This Clinical Practice Guideline was co-sponsored by the American Academy of Pediatrics (AAP), the Brazilian Society of Endocrinology and Metabolism (SBEM), the European Society of Endocrinology (ESE), the European Society for Paediatric Endocrinology (ESPE), the Latin American Society for Pediatric Endocrinology (SLEP), the Pediatric Pharmacy Association (PPA), and the Pediatric Endocrine Society (PES).  

The post Endocrine Society Guideline Addresses Different Subgroups of Central Precocious Puberty  appeared first on Endocrine News.

At ENDO 2025 in San Francisco, researchers from Taiwan reported that consuming certain sweeteners found in some foods and beverages may increase the risk of early puberty in children. Aspartame, sucralose, glycyrrhizin, added sugars – all bad things, triggers especially in children with certain genetic traits. The more of these sweeteners the teens consumed, the higher their risk of developing central precocious puberty. The risk is even higher for girls.

The same ENDO, researchers from Atlanta discovered that certain chemicals in both the mother’s and father’s blood were linked to when their descendants began puberty, with stronger effects seen in the granddaughters’ than in the daughters’ generation. Some chemicals such as phenoxyethanol, a common preservative in personal care products and foods, were linked to earlier puberty, especially when both parents had similar exposures.

A 2023 study published in the Journal of the Endocrine Society revealed that the number of girls diagnosed with precocious puberty increased during the COVID-19 pandemic due to potential risk factors such as increased screen time and less physical activity. Researchers in Italy found 72 cases of precocious puberty before the COVID-19 pandemic (January 2016 — March 2020) and 61 cases between March 2020 and June 2021 — four new cases per month.

Central precocious puberty (CPP) is relatively rare, but it’s becoming increasingly more common and can lead to emotional distress, shorter adult height, and increased risk of future metabolic and reproductive disorders. But pediatric endocrinologists and other researchers and providers are becoming more aware that some kids, especially girls, might just be literally growing too fast.

This month the Endocrine Society published a Clinical Practice Guideline in The Journal of Clinical Endocrinology &Metabolism titled, “Central Precocious Puberty: An Endocrine Society Clinical Practice Guideline,” arguing for a more conservative approach in some patients.  

“In recent decades, cross-sectional data from the United States and Europe have suggested that pubertal milestones are being reached earlier than in prior decades, raising the possibility that the currently employed definition of CPP could be outdated,” the Guideline authors write. “Additionally, in some girls, puberty may be slowly progressive, with a longer duration between thelarche and menarche and achievement of a normal adult height, suggesting that not all patients with CPP as it is currently defined would benefit from aggressive clinical evaluation or treatment.”

“The guideline development process highlighted important knowledge gaps and the substantial need for additional research. Therefore, we expect that the new guideline will have an impact in the evaluation and management of children with precocious puberty as well as in the future research of human pubertal development.” — Ana Claudia Latronico, MD, PhD, Sao Paulo Medical School, Sao Paulo University, Sao Paulo, Brazil

Moving Target

According to Fernando Cassorla, MD, emeritus professor at the University of Chile and president of the Chilean Academy of Medicine, variations in the age of onset and progression of the pubertal process can be a source of significant anxiety for both patients and parents, because comparison with peers and relatives are quite common. This is complicated by the fact that the physiological pubertal process has experienced some changes over the last few decades, as earlier development has become more prevalent, particularly in girls. Thus, pediatric endocrinologists have been discussing whether we should maintain the cut-off point for a chronological age of eight years as the youngest age for the first signs of normal puberty in girls. 

“This has led to a more conservative approach for the management of girls who present with breast development between the ages of seven to eight years, since some of these patients exhibit a variation of the physiological pubertal process, and do not require an extensive work-up and will not benefit from GnRH analog therapy,” Cassorla says.  “This is based on the fact that a complete evaluation for central precocious puberty requires a number of laboratory tests and imaging studies, which should be performed in a selected group of patients.  In a sense, the age for normal pubertal development has become a ‘moving target,’ with many normal girls around the world experiencing their first signs of puberty slightly before their eighth birthday.”

In girls who present with thelarche (Tanner B2) between seven and eight years old, the guideline authors suggest “watchful waiting via periodic physical examinations rather than immediately performing evaluation with laboratory testing and/or radiologic imaging.” Providers should take care to differentiate between thelarche and lipomastia, especially if the girl has overweight or obesity. Providers should also use that watchful waiting time (four to six months) to determine unsustained or slowly progressive puberty from rapidly progressive puberty before starting diagnostic evaluation.

Controversial Clinic Questions

These guidelines will be presented this month at ENDO in Chicago (you may be reading this piece right as you sit to listen to the presentation), and they will be published in JCEM. The authors agree that they should have quite the impact on the field of pediatric endocrinology; an experienced group of pediatric endocrinologists from around the world asked each other several questions, but as the paper states, because of limited resources, they had to narrow it down to 10 of the most controversial.

“[T]he Guideline Development Panel (GDP)’s primary goal was to create a new clinical guideline for CPP with a focus on diagnostic evaluation and treatment considerations,” the authors write. “The GDP recognized the many important clinical questions regarding the diagnosis and management of CPP; however, due to limited resources, 10 of the most controversial clinical questions were prioritized, and three to seven health-related outcomes were selected for each.”

“A complete evaluation for central precocious puberty requires a number of laboratory tests and imaging studies, which should be performed in a selected group of patients.  In a sense, the age for normal pubertal development has become a ‘moving target,’ with many normal girls around the world experiencing their first signs of puberty slightly before their eighth birthday.” — Fernando Cassorla, MD, emeritus professor, University of Chile, Santiago; president, Chilean Academy of Medicine

Ana Claudia Latronico, MD, PhD, professor of endocrinology and metabolism at the University of São Paulo in Brazil and first author of the guidelines tells Endocrine News that the GDP set out to create a new clinical practical guideline for CPP with a focus on diagnostic evaluation and treatment considerations. “Our goal was to create a new clinical practical guideline for CPP with a focus on diagnostic evaluation and treatment considerations,” she says. “A multidisciplinary panel of clinical experts, along with experts in guideline methodology and systematic literature review were involved to answer 10 relevant clinical questions related to the diagnosis and treatment of CPP. Systematic reviews of health-related benefits and harms were conducted for each clinical question.”

Latronico goes on to say that clinical recommendations of the new guidelines were developed to address important uncertainties in the diagnosis and treatment of children with central precocious puberty. They were based on the best available scientific evidence regarding clinical outcomes judged to be most important to patients and families.

“In the current guideline, we suggest diagnostic and therapeutic strategies that will most likely provide net clinical benefits while simultaneously considering important contextual factors such as cost and feasibility,” Latronico says. “The guideline development process highlighted important knowledge gaps and the substantial need for additional research. Therefore, we expect that the new guideline will have an impact in the evaluation and management of children with precocious puberty as well as in the future research of human pubertal development.”

The Need for Shared Decision Making

Gonadotropin-releasing hormone (GnRH) agonists can effectively suppress premature activation of the hypothalamic–pituitary–gonadal (HPG) axis and have the potential to increase adult height as well as improve psychosocial and long-term health outcomes among patients with CPP. “However,” the authors write, “as secular trends have continued to shift toward earlier age of pubertal onset, some subpopulations of children with CPP as it is currently defined may not require the same extent of diagnostic evaluation and treatment.”

The guideline authors take care to point out that GnRH therapy is not some silver bullet to fix CPP. The authors do suggest that GnRH therapy is appropriate for many children with CPP, but they recognize that some patient subgroups might not benefit from the treatment (including girls ages seven to eight years who have slowly progressive puberty and those who at or beyond the peak of their pubertal growth spurt).

“The guideline development panel emphasized the importance of shared decision making for all patients with central precocious puberty, which should include a careful weighing of anticipated benefits and potential harms of medication use in the context of each patient’s clinical presentation and patient/caretaker values.” — Ana Claudia Latronico, MD, PhD, Sao Paulo Medical School, Sao Paulo University, Sao Paulo, Brazil

“In addition, the guideline suggested against the routine addition of growth hormone to gonadotropin-releasing hormone agonist therapy based on the potential benefits in the adult height demonstrated by previous retrospective studies,” Latronico says. “Given that GH therapy would likely have high costs and that it is not an approved indication for CPP worldwide, the guideline concluded that the intervention could exacerbate health inequities. The guideline development panel emphasized the importance of shared decision making for all patients with central precocious puberty, which should include a careful weighing of anticipated benefits and potential harms of medication use in the context of each patient’s clinical presentation and patient/caretaker values.”

Bagley is the senior editor of Endocrine News. In the May issue, he wrote about the ENDO 2026 session, “The Year in Bone” in “Boning Up.”

Central Precocious Puberty: An Endocrine Society Clinical Practice Guideline

Saturday, June 13, 2026, 4:30 PM – 6:00 PM, Room W375C

Clinical Practice Guideline Chairs: Stephanie Roberts, MD, Boston Children’s Hospital/Harvard Medical School, Boston, Ma.; and Ana Claudia Latronico, MD, PhD, Sao Paulo Medical School, Sao Paulo University, Sao Paulo, Brazil

Moderator: Roma Gianchandani, MD, Cedars-Sinai Endocrinology, Los Angeles, Calif.

Speakers: Christopher McCartney, MD, West Virginia University School of Medicine, Morgantown, W.V; Erica Eugster, MD, Indiana University School of Medical Indianapolis, Ind.; Anders Juul, MD, University of Copenhagen, Denmark;  and Fernando Cassorla, MD, Hospital San Borja-Arriaran, Santiago, Chile

The post They Grow Up So Fast: Endocrine Society Releases Central Precocious Puberty Guideline appeared first on Endocrine News.

Consultant orthodontist Dr Karen Juggins, founder of KeepStokeSmiling, and former British Dental Association committee chair Shawn Charlwood were both awarded MBEs for services to dentistry in the King’s Birthday Honours list.

Charlwood was recognised for a career spanning more than three decades, including his work representing general dental practitioners during the COVID-19 pandemic.

Dr Juggins, a British Orthodontic Society member, was recognised for her work in public oral health, including the campaign, which grew into the national Keep Britain Smiling movement.

‘I am truly honoured and delighted to receive an MBE in The King’s Birthday Honours for services to dentistry,’ said Juggins. ‘As a Consultant Orthodontist, it is a real privilege to help transform the smiles and confidence of so many patients, whilst working alongside some truly exceptional colleagues.

‘I am particularly proud that this honour also recognises the collective work behind the KeepStokeSmiling campaign. By bringing together healthcare, schools, colleges, football clubs and local businesses across our community, we set out to show that improving young people’s oral health requires more than traditional NHS campaigns alone.’

KeepStokeSmiling later developed into Keep Britain Smiling, a social media-led oral health campaign endorsed by the Royal College of Surgeons of England, the British Dental Association (BDA) and BOS.

From Stoke to national impact

The campaign includes contributions from patients, students, community groups and sports teams. There are now 18 KeepSmiling groups across the country.

Through a partnership with Stoke City Football Club, dental health workshops and roadshows were delivered to more than 40,000 primary school children. The project won the English Football League Community Project of the Season 2023 and received a commendation from the House of Commons.

Following its success, the Premier League Charity developed a dental health resource for football clubs through Premier League Primary Stars. Clubs including Manchester United, Arsenal and Liverpool have since implemented similar initiatives.

BOS president Robbie Lawson said: ‘The British Orthodontic Society is delighted to learn that Karen has been awarded an MBE in the King’s Birthday Honours for Services to Dentistry.

‘Her innovative leadership has reshaped dental public health messaging, showing that creative partnerships can make a real difference in public health.’

Dr Juggins has previously received the Colyer Gold Medal from the Royal College of Surgeons of England, the BOS Distinction Award, the BDA Award for Excellence and fellowship ad hominem of the Royal College of Surgeons of Edinburgh.

Follow Dentistry.co.uk on Instagram to keep up with the latest news and trends.

A UK healthtech company has raised $15 million in Series A funding and commercially launched the platform behind 32Co and Aerox Health, allowing dental practices and practice groups to license the technology for the first time.

01Health, founded in 2022 by former NHS doctor Dr Sonia Szamocki, developed the platform to enable clinicians with additional expertise to support wider networks of general dental practitioners remotely.

The company said the platform combined clinical oversight, protocols, artificial intelligence (AI)-powered patient acquisition, communication tools and operational systems in a single infrastructure.

Until now, the technology has operated behind 01Health’s own dental brands: clear aligner provider 32Co and dental sleep medicine service Aerox Health.

Following a 12-month pilot with enterprise partners, it is now available to practices, practice groups and dental service organisations in the United Kingdom (UK) and United States (US), where trials were already underway.

The round was led by Gresham House Ventures, with participation from existing investors Balderton Capital, Eka Ventures and Wavemaker360, along with angel investors including Blockchain.com co-founder Nicolas Cary.

Dr Szamocki said: ‘The biggest bottleneck in healthcare isn’t cost; it’s access. Specialists are concentrated in a handful of postcodes; patients aren’t.’

01Health said 90% of the UK population lived within 30 minutes of a 32Co dentist using its platform. The company has raised $25 million to date and employs more than 100 people, with a clinical team led by Professor Ama Johal.

Follow Dentistry.co.uk on Instagram to keep up with the latest news and trends.

Experts have warned that cuts to dental public health roles could weaken prevention work in some of England’s most deprived communities, despite the government reducing the scale of its original plans.

An initial government consultation proposed significant cuts to dental public health consultant positions across the UK. For example, the south west was due to see 1.85 whole-time-equivalent posts reduced to just one. This has now been increased to 1.35 following the release of the consultation outcome report.

The reduction in staff is part of the government’s plan to abolish NHS England and bring its functions under the Department of Health and Social Care. In the midlands, three dental public health positions will be carried over into the new system out of the current seven. While the initial consultation proposed that only two posts should remain, one additional post was retained by converting a public health position into a dental public health role.

Defending dental public health

The British Dental Association (BDA) said the reductions in cuts ‘don’t do enough to protect this strategically essential function’.

BDA chair Eddie Crouch said: ‘We have argued forcibly to defend and expand the vital dental public health role. We’ve made NHS England exercise some restraint here, but it does not go far enough to protect a vital function.

‘There is a loss of 58% in the midlands dental public health workforce, which has some of the most deprived communities in the country where prevention programmes are paramount.

‘We’ve curbed these plans, but cuts still run deep, and any protection here shouldn’t be at the expense of public health colleagues. These are distinct specialities, and this is not a game of either/or.

‘The government likes to talk the talk on prevention. It will not be able to deliver on that agenda without a serious, long-term commitment to and investment in these expert roles.’

‘The same challenges remain’

The decision to bring NHS England under the government is estimated to result in a 50% reduction in staff, aiming to avoid duplication across the two organisations.

Announcing the abolition, prime minister Keir Starmer said: ‘I can’t, in all honesty, explain to the British people why they should spend their money on two layers of bureaucracy. That money could and should be spent on, nurses, doctors, operations, GP appointments. So today, I can announce we’re going to cut bureaucracy across the state, focus government on the priorities of working people, and shift money to the front line.’

Thomas Reynolds, director of policy and communications at the Medical Defence Union (MDU), said: ‘Regardless of where control of the NHS sits in England – with central government or another body – the same challenges remain. 

‘From ensuring the workforce is properly supported, to having regulatory frameworks which enable healthcare professionals to get on with the job of caring for patients, to tackling unsustainable costs facing the NHS such as those associated with clinical negligence: all require urgent attention. They cannot be sidelined in this latest health service structure.’

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

With an extensive program covering a broad array of topics, various networking opportunities, poster sessions, updates on new products and technologies at the ENDOExpo, and more, attendance at ENDO is essential for enhancing your professional development and building your reputation. Register now to attend ENDO 2026 in Chicago and come early or stay late (or both!) to explore all The Windy City has to offer.

Heart and Soul

Chicago is bursting with world-class, big city culture. But at its heart, it’s a Midwestern city — which means a warm welcome and genuine hospitality. No matter who you are or what you love, you’ll fit right in exploring famed restaurants, world-renowned museums, a jaw-dropping waterfront, Tony Award-winning theatres, iconic architecture designed by legendary architects, and 77 vibrant, ethnically diverse neighborhoods that are the heart and soul of Chicago. Whatever your travel style, Chicago has something just for you.

New Kid on The Block

If you’ve never been to Chicago, there are a few rites of passage every first timer absolutely must experience. You’ve undoubtedly seen pictures of Cloud Gate but may not know this monumental work of art by its official name. Better known as “The Bean,” Cloud Gate is one of the world’s largest outdoor public art installations. This sculpture, located in Millennium Park, reflects the Chicago skyline and the surrounding greenspace. While you’re in Millennium Park (above), make sure to visit Chicago’s “secret garden.”  Lurie Garden blends Chicago’s past, present, and future with bold design, dramatic form, and intimate spaces. Even amid a bustling city, birds, bees, and butterflies abound here during the summer months. Millennium Park is also home to Jay Pritzker Pavilion and The Great Lawn, Frank Gehry’s one-of-a-kind bandshell. During June, you can catch the Summer Music and Summer Film Series here.

Whether you’re a sports fan or not, seeing the Cubs play at Wrigley Field is a Chicago experience everyone will enjoy. Known for its unique traditions and charm, Wrigley Field, which was built in 1914, has been the beloved home of the Chicago Cubs for more than a century. The area around the stadium is known as Wrigleyville, and it offers an atmosphere that won’t be found anywhere else. No matter the time of year, this area is always bustling. Locals flock to the area’s many bars and restaurants, even when it’s not baseball season.

And you can’t mention Chicago without acknowledging its iconic food. The origin of the deep dish, Chicago is home to the best pizza joints serving up layer upon layer of gooey cheese, tangy tomato sauce, and sausage, pepperoni (or both) baked atop a thick, salty crust in a cast iron skillet. Lou Malnati’s is considered the original when it comes to pizza in Chicago, while other staples like Giordano’s and Pequod’s serve up their own versions of the city’s famous deep dish. And Chicago even has its own hot dog. The Chicago dog, served throughout the city, features yellow mustard, dark green relish, chopped raw onion, pickle spear, sport peppers, tomato slices, and topped with a dash of celery salt and served in a poppy seed bun. The Vienna Beef Factory was started by two Austrian-Hungarian immigrants, Emil Reichel and Samuel Ladany, who began selling their franks at the World’s Fair in Chicago in 1893. Today, Vienna manufactures most of the franks sold across the city. You can still get the original by visiting their own stand located right across the street from the Vienna Beef Factory on North Damen Avenue.

Last but not least, take in the most iconic views of Chicago from more than 100 stories above the city. Willis Tower, formerly known as the Sears Tower, held the title for the world’s tallest building for 25 years, and remains the highest spot in Chicago and the third tallest building in the Western Hemisphere. Visit the Skydeck (right), located on the 103rd floor of the 110-floor building. Take in spectacular views spanning up to four states from the Viewing Tower; or if you’re a thrill seeker, check out The Ledge, a glass balcony extending four feet outside Willis Tower’s 103rd floor. At 1,353 feet in the air, its glass boxes extend out 4.3 feet from the Skydeck, offering unmatched views of the bustling city underneath. No matter how you look at it, the Chicago skyline is breathtaking.

Like a Local

Maybe you’ve already seen all the attractions the Windy City is known for, or you just prefer to see the city from a different point of view. Instead of spending time taking in Chicago as a tourist, enjoy the city like those who call it home. In a city known for its major museums, the locals suggest a trip outside of downtown to discover the offbeat spots and quirky collections unique to Chicago.

Take a step off the beaten path and head to the Pilsen neighborhood. A hub of Mexican culture and home to one of the city’s best collections of street art and murals, Pilsen is home to the National Museum of Mexican Art. Immerse yourself in the richness of Mexican art and culture as you explore one of the largest Mexican art collections in the country. In a vibrant corner of funky West Town, you’ll discover Intuit: The Center for Intuitive and Outsider Art. This museum displays the work of artists who steer away from mainstream art influences while focusing on their personal, unique visions. The biggest draw here is the Henry Darger Room, an exact replica of the Chicago native artist’s Lincoln Park home filled with his personal documents, fixtures, furnishings, and of course, his art. The International Museum of Surgical Science, McCormick Bridgehouse & Chicago River Museum, and the American Writers Museum are just a few of the other unique museums located across Chicago that are favorites among the locals.

While Chicago is home to well-known cocktail hotspots and swanky rooftop bars, the city also has its fair share of hidden gems – literally. A green painted door marked the entrance to an undercover speakeasy during prohibition. Today, the Green Door Tavern continues the tradition. Find the nondescript door in the basement which leads to The Drifter, an authentic speakeasy that takes you back to the authentic speakeasy known as The Drifter. The Coco Club is another spot that takes some searching to find. Uniquely positioned above LaCoco’s Pizza and Sports Club, is where you’ll find this late-night speakeasy. Just tell the doorman “I’m with the club,” and you’ll be whisked into a sophisticated and inviting space that draws inspiration from the 1920s and 1930s. Head to Uptown Chicago, home to Green Mill Cocktail Lounge, which is considered one of Chicago’s best bar experiences, and is known for three things – it was Al Capone’s hangout, it’s said to be haunted, and its unspoken rule – don’t talk when performers are on stage at this Chicago jazz club. It’s the kind of dark, smokey place with music and cocktails that will transport you back in time.

After a night out on the town, you’re going to need a strong cup of coffee. Locals suggest heading to Café Jumping Bean in Chicago’s Lower West Side for reliable coffee, fresh bakery items, and specialty sandwiches like molletes, traditional Mexican open sandwiches topped with refried beans and melted cheese served with salsa (perfect for breakfast or lunch for those who felt the need to sleep in). This quaint spot invites customers in with its brightly colored décor and friendly staff – both guaranteed to brighten your mood at the start of a new day. While you can have an incredible trip to Chicago without leaving downtown, venturing off the beaten path has unmatched perks of its own!

Kids of All Ages

Bring the family along – there’s something for everyone in Chicago. Kids (and kids at heart) will love Maggie Daley Park, one of Chicago’s newer green spaces which is connected to Millennium Park in the heart of downtown. While one of the park’s most beloved features, the Skating Ribbon, is closed in the summer months, there’s even more to enjoy when it’s warm out. Take it to the next level on the rock climbing and bouldering walls before playing a round of miniature golf. Picnic groves offer the perfect spot to rest and fill hungry tummies before continuing to explore the park. No visit to Maggie Daley Park is complete with a trip to its three-acre Play Garden, the first of its kind in Chicago. Built in the spirit of Alice in Wonderland and Charlie and the Chocolate Factory, the Play Garden integrates landscapes with custom-designed play structures and sculptures. Play and plantings are intentionally different from usual garden and park settings, capturing the imagination, engaging different senses in all seasons of the year.

Undeniably one of Chicago’s most popular attractions, Navy Pier (above) is a year-round destination that truly comes to life during the summer. This time of year brings boat cruises, bike tours, fireworks shows that light up the night, and live entertainment throughout the day and night. Here, you will find Centennial Wheel which takes riders nearly 200 feet in the air, offering unmatched views of Chicago. You can even book a VIP Centennial Wheel experience in a glass-bottomed, plush-seated gondola. But that’s only the beginning. Thrill seekers of all ages will enjoy Pier Park, home to the Pepsi Wave Swinger, a 1920s-inspired musical carousel, and other nostalgic fairground rides — all with breathtaking skyline and waterfront views. But that’s not all – the beloved Chicago Children’s Museum and Tony Award-winning Chicago Shakespeare Theater are also located at Navy Pier.

And don’t worry about your little ones going hungry. You’re in the city known for pizza and hot dogs! Plus, Chicago has an unusual number of themed restaurants that aren’t just fun – they’re tasty too. At the spy-themed restaurant, SafeHouse Chicago, you’ll need a password to enter or else undergo a series of “tests” to prove you’re not a spy. There’s more than just dessert at Sugar Factory (including an elaborate drink menu for the adults). Created by a team of world-class chefs, the menu selections include everything from pancakes and sweet and savory crepes to salads, burgers, steaks, and shakes, all available throughout the day. Chicago really does have something for everyone!

Plus One

Your significant other won’t mind that you’re traveling for work when you bring them along. Chicago is an ideal romantic getaway with one-of-a-kind date night experiences, exceptional entertainment, and world-class dining. Snuggle up as you take in the views during a sunset cruise – an ideal way to see Chicago’s famed architecture. Hop aboard your open-top vessel in the heart of the Magnificent Mile, then cruise along the Chicago River, where your guide will point out architectural highlights. As you head further down the river to Lake Michigan where you’ll catch the sunset, watch the skyscrapers light up and the skyline awaken. Another great destination for a date is Chicago Botanic Garden, but not just for walking around taking in the beautiful greenery–though that’s not a bad idea.

Spend a carefree night laughing at Second City, the world’s premiere comedy theatre offering the best in Chicago-style sketch and improv comedy every night of the week. Since its premiere in 1959, Second City has consistently been a starting point for many comedians, award-winning actors, directors, and other big names in show business. For music connoisseurs, you can’t miss Chicago-style blues. The amplified urban blues sound was born in Chicago and there are plenty of spots here to hear it live. Buddy Guy’s Legends is a bucket list stop for blues fans from across the globe. The legendary Buddy Guy, a Rock and Roll Hall of Fame inductee and a multi-GRAMMY Award winner, is known to take the stage on occasion, but no matter who plays, you’re in for a treat. Stop by during lunch and dinner hours for a free acoustic show.

And for the most iconic date night in Chicago, options are endless for a dinner date. Geja’s Café (right) is a Chicago spot known for romance. Since 1965, this cafe offers fondue paired with flowing wine in an intimate space. Enjoy Swiss gruyere fondue and sizzling meats for dinner, following by chocolate for dessert. For a classic Chicago date night, head to Gibson’s, an icon that has been satisfying diners – from locals to celebrities – since the 1980s. The classic American steakhouse is the first in the country to be awarded its own USDA certification program, but it also serves up fresh seafood, porkchops, and more. If you’re looking for something a little less filling, head to City Winery (below) for wine flights paired with a cheese and charcuterie board or shared plates like parmesan truffle fries and Asian wine glazed wings. Snag a seat on the patio where you’ll enjoy scenic views of the Chicago River, the city skyline, and Midwest sunsets. You’re sure to earn brownie points by extending your trip to ENDO while enjoying all Chicago has to offer alongside that special someone.

See You in Chicago!

In the words of Frank Sinatra, Chicago is “one town that won’t let you down. It’s my kind of town, Chicago is.” And apparently a lot of people agree with him, as Chicago was voted the best big city in the U.S. for the sixth year in a row according to Condé Nast Traveler. But don’t take our word for it. Come see for yourself! Make your reservations now as ENDO returns to Chicago for the first time since 2023. We can’t wait to see you there!

Carson is a Birmingham, Ala.-based freelance writer, who wrote about Atlanta’s varied points of interest last year. She writes a variety of articles and features for Endocrine News including EndoGear and Dashboard. 

The post Take Me Back to Chicago: ENDO 2026 Returns to the Windy City appeared first on Endocrine News.

Environmental responsibility can go beyond the choices made at home. You may already recycle, drive an electric car, avoid unnecessary plastics, bicycle or walk when possible, and make thoughtful purchasing decisions that support both personal and planetary health.

But healthcare professionals and clinic leaders often overlook another important opportunity: where their money is invested. Many retirement accounts, institutional funds, and personal investments are supporting investment sectors that conflict with our personal values, such as fossil fuel companies closely tied to pollution and climate change. Increasingly, investors are examining whether their financial choices or those made by their financial advisors align with the healthier future they want to help create.

Environmental responsibility can extend beyond daily habits and into the financial decisions that shape society’s future. For more than a decade, many investors are choosing to divest from fossil fuels and explore more environmentally sustainable investment options.

The Waning of Fossil Fuels
The fossil fuels sector, while occasionally a top performer, has experienced long periods of underperformance. Its volatility has been on full display over the past year, but it was also the most volatile of any S&P sector over the previous decade (2015-2024). Geopolitics are a key driver of the fossil fuel sector’s unpredictability and are likely to continue to be so. For investors looking to minimize sudden or dramatic fluctuations, it makes sense to avoid the fossil fuel industry.

Numerous years of evidence indicate that this strategy may be particularly beneficial for long-term investors who are planning for their futures. Of course, markets and sectors can be unpredictable, and past performance does not guarantee future results. But as world economies and consumers gradually and inexorably shift in this century from a dependence upon fossil fuels towards energy efficiency, renewable energy, and energy storage, it makes sense for long term investors to move their money away from the old paradigm.

Fossil Fuel Underperform
The Institute for Energy Economics and Energy reported that during this same period since 2015, the “fossil fuel sector has underperformed the S&P 500 in seven of the last 10 years, delivering the lowest performance of any S&P sector” and stated that “oil, gas, and coal have often been unreliable and inconsistent contributors to long-term investment portfolios.”

Investing Without Fossil Fuels
A fossil fuel free portfolio typically holds 0% in the Energy Sector, thereby avoiding companies involved in the exploration, production, transmission or management of coal, oil and gas, as well as companies that service these industries. Clean and renewable energy companies are not in this sector. Instead, they are categorized in several other sectors, including utilities, industrials, and technology. A clean technology company, for example, might even be listed in the manufacturing sector. A decision to abandon the fossil fuels sector is often accompanied by a decision to direct a portion of one’s portfolio towards the clean energy sector, which might include a range of industries such as solar, wind, and  geothermal energy development or generation, electric vehicles, electricity transmission, sustainable agriculture and construction, recycling companies, and many more options.

Fossil Fuel Free Investing Today
Green investing is no longer a fringe movement. There are hundreds of options such as individual stocks, private equity firms, mutual funds, and exchange traded funds (ETFs). For busy health professional, a wise choice is to find a financial advisor or fund manager with deep experience.  Green Century¹ has been a champion of fossil fuel free investing for decades, offering individuals and institutions a way to invest without supporting the world’s most environmentally harmful industries.

If your funds already are professionally managed, ask that advisor to tell you whether your money is supporting the fossil fuel industry. Coal, oil and gas companies — key drivers of air pollution, water contamination, and climate change — top the list of corporations damaging our health and environment. With your simple instructions, your advisor will responsibly shift your assets to be aligned with your values and your long-term financial goals.

Contact the Green Century team at info@greencentury.com.

About the Author: Leslie Samuelrich is President of Green Century, a pioneering investment firm focused on environmentally responsible investing with more than $1.3 billion in managed assets. With nearly 40 years of experience spanning corporate engagement, environmental leadership, and public health initiatives, she is a leading voice in sustainable finance and shareholder advocacy.

Notes:
This material is for informational and educational purposes and is intended for a U.S. audience. It should not be considered investment advice, nor is it a solicitation to buy or sell any specific investment or strategy. No guarantees are made regarding the accuracy or completeness of the information provided. 
 
Green Century is a trade name for Green Century Capital Management, Inc., an SEC-registered investment adviser. Some products are distributed by Distribution Services, LLC, an unaffiliated broker-dealer. Green Century Funds are available only through a prospectus and to U.S. residents.

The post Sustainable Investing: Aligning Your Values and Your Money first appeared on My Green Doctor.

Welcome to sustainable investing!  Some investors believe one of the largest market inefficiencies is a failure to factor in non-financial factors into investment decisions. Impact investing or ESG investing means to consider environmental impacts, social benefits, and corporate governance factors when making investment decisions. Though this has not been traditionally how investments are considered, this lens is useful for screening for big risks and to find opportunities missed by others. All ESG issues have financial ramifications and should be evaluated diligently.  For example, a company with a record of water pollution, a bad reputation in the community, or accused of treating its workers unfairly might have its stock underperform in the long run.

In 2025, Bloomberg Professional Services reported the total and risk-adjusted returns for global public equities (stocks) and found that companies with higher Bloomberg ESG Scores outperformed those with lower ESG scores between February 2017 and March 2025. (1)  Sustainability was a top-three priority for C-Suite business leaders surveyed by Deloitte in 2025, with 66% of executives saying their sustainability actions have a positive impact on revenue generation. (2)

Responsible investing for a portfolio can achieve specific financial and impact goals by investing in marketable securities as well as with alternative investments. I encourage investors to begin with their own portfolio, but also to consider the portfolios of any family foundation, non-profit, or other organizations that they admire. For health professionals, this could mean asking the health system where you work to align its investment portfolio with its day-to-day efforts building healthy communities. Could your church, synagogue or mosque align its portfolio with its message of love and kindness? Could the climate justice and social equity themes that are important to health and wellness be incorporated into the portfolios of the people and organizations you care about?

Here are some things you can do:

• Learn what you own. Consider researching your mutual fund holdings to learn how well your funds are rated.  Your financial planner or advisor can point you to websites of commonly used ESG rating organizations.
• Ask your financial planner or advisor what options are available to you for sustainable investing.
• Consider getting a second opinion from an advisor who has a track record of solid financial returns and responsible investing.

Here are some questions to ask your advisor:

• How do you approach responsible investing for the environmental and equity?
• How can I integrate these themes throughout my portfolio?
• How do I maintain a diversified asset allocation?
• How will sustainable investing affect my financial returns?
• What are the tax implications based on my existing holdings?

About the Author:  Michelle Schiro is a First Vice President and Financial Advisor in the SRI Wealth Management Group at RBC Wealth Management. SRI consults on $4 billion of assets owned by foundations, non-profits, and families. Their clients wish to meet their financial goals while having their portfolios aligned with their mission or values. SRI assists as well with wealth planning, intergenerational wealth management, estate and trust planning, strategic philanthropy, and legacy planning. Michelle can be reached at 415.445.8232 or michelle.schiro@rbc.com.

Sources:
(1) https://www.bloomberg.com/professional/insights/sustainable-finance/are-esg-scores-relevant-for-portfolio-returns/

(2) https://www.deloitte.com/global/en/issues/climate/c-suite-sustainability-report.html

At RBC Wealth Management, Responsible Investing is an umbrella term encompassing the approaches used to deliberately incorporate environmental, social and governance (ESG) considerations into an investment portfolio. The application of certain approaches may cause a strategy to forgo investment opportunities available to strategies that do not use such approaches. This may cause those strategies to underperform a benchmark that does not consider ESG factors. There is no single definition for the use of ESG data therefore terminology may be different across the industry.

The information contained herein has been derived from sources believed to be reliable, but no representation or warranty, express or implied, is made by RBC Wealth Management, its affiliates, or any other person as to its accuracy, completeness, or correctness. All opinions and estimates constitute the author’s judgment as of the date of this publication, are subject to change without notice and are provided in good faith but without legal responsibility.

Past performance is no guarantee of future results.

Neither RBC Wealth Management, a division of RBC Capital Markets, LLC (“RBC WM”), nor its affiliates or employees provide legal, accounting or tax advice. All legal, accounting or tax decisions regarding your accounts and any transactions or investments entered into in relation to such accounts, should be made in consultation with your independent advisors. No information, including but not limited to written materials, provided by RBC WM or its affiliates or employees should be construed as legal, accounting or tax advice.

The post Investing For a Better World first appeared on My Green Doctor.

Where we bank and invest is an often-overlooked way to help the natural environment. Financial institutions play a significant role in shaping the global economy. The capital they manage is used to fund infrastructure, energy systems, and industries that directly influence environmental and public health outcomes. For the healthcare community, aligning financial decisions with sustainability goals is increasingly practical and does not sacrifice financial performance.

Why Banking Choices Matter
Traditional banks may finance a wide range of industries, including fossil fuel extraction and high-emission infrastructure. In contrast, a growing number of financial institutions and funds are prioritizing renewable energy, climate solutions, and sustainable development when making loans.

Few of us have examined how our deposits ae used by banks. According to the Rainforest Action Network’s  2024 Banking on Climate Chaos report, the world’s 60 largest banks have provided more than $6.9 trillion in fossil fuel financing since the Paris Climate Agreement was adopted in 2015.

At the same time, the market for sustainable investing continues to expand. A recent report from Morningstar found that sustainable funds continue to attract long-term investor interest despite market volatility:

For healthcare professionals, this raises an important question: do our financial institutions align with the health outcomes and environmental values we promote in our practices?

Competitive Returns Are Still Achievable
One of the most common concerns is whether “green” banking or investing leads to lower returns. Increasingly, the data suggests otherwise.
A 2024 analysis from the Morgan Stanley Institute for Sustainable Investing found that sustainable funds modestly outperformed traditional funds during the first half of 2024. The report noted that sustainable investing continues to attract substantial long-term interest from investors globally, even amid market volatility.

Sustainable funds posted a median return of 1.7% compared to traditional funds’ 1.1%.

In addition, a 2023 Morgan Stanley “Sustainable Reality” report found that sustainable funds outperformed traditional peers across major asset classes and regions, generating median returns of 12.6% almost 50% ahead of the 8.6% for traditional funds. For clinics, group practices, and individual healthcare professionals, this means financial decisions can support both long-term returns and long-term health outcomes.

Practical Steps for Healthcare Professionals
Transitioning to more responsible financial options does not need to be complex. It can begin with a few targeted actions:

• Review whether your bank’s annual report or website for its sustainability commitments or climate-related financing disclosures.
• Explore local or regional banks and credit unions that support renewable energy, community health, and sustainable development.
• Ask your financial advisors to include sustainability-focused investment options in your portfolio, and to remove businesses that drill, mine, transport, or sell fossil fuels such as coal, natural gas, gasoline, and diesel fuel.
• Consider starting gradually by reallocating a portion of savings or investments into more climate-conscious funds.
• Ask whether your bank has published targets for reducing carbon-intensive lending.
• Ask your employer, professionals societies, houses of worship, and medical centers to look at their portfolio as well.

The Collective Power of the Healthcare Community
Healthcare is one of the most trusted and influential sectors globally. When healthcare professionals and organizations make aligned financial decisions, the impact extends far beyond individual portfolios.

Environmental sustainability is increasingly recognized as a determinant of health. Air quality, climate stability, and resource availability all shape patient outcomes. Financial systems influence each of these factors. By choosing where to bank and how to invest, healthcare professionals can extend their impact beyond the clinic—supporting systems that promote both environmental and human health.

My Green Doctor supports healthcare professionals with practical guidance and tools to integrate sustainability across operations, patient education, and decision-making. Financial alignment is an emerging and powerful part of that journey.

Further Reading:
1. https://www.bankingonclimatechaos.org
2. https://www.morningstar.com/lp/global-esg-flows
3. https://www.morganstanley.com/ideas/sustainable-funds-performance-first-half-2024
4. https://www.morganstanley.com/ideas/sustainable-funds-performance-2023-full-year

The post Responsible Banking & Investing: A Practical Next Step for Healthcare Sustainability first appeared on My Green Doctor.

Healthy Summer Travel: Lower Emissions, Better Health

Summer travel offers restoration, connection, and exploration. But it also comes with environmental and health tradeoffs that are increasingly important to address. How we travel matters: transportation is responsible for nearly a quarter of global energy-related carbon emissions.

For outpatient healthcare professionals, this presents a clear opportunity: to model healthier, lower-emission choices that support both personal wellbeing and planetary health.

Choose Lower-Emission Transportation Options
When possible, prioritize trains, buses, or direct flights rather than multi-stop trips. Aviation remains one of the most carbon-intensive modes of transportation, particularly for short trips. According to the International Energy Agency, rail travel can produce up to 90% fewer emissions than short-haul flights.

For domestic travel, consider combining fewer, longer trips instead of multiple short ones.

Stay in Walkable, Health-Oriented Locations
Choosing accommodations in walkable neighborhoods or near public transportation reduces reliance on rental cars and taxis. It also creates a built-in opportunity for healthy walking while on vacation.

Walking is one of the most accessible and effective ways to support health. Regular walking has been shown to improve cardiovascular function, support healthy blood pressure, enhance circulation, and reduce the risk of chronic conditions such as heart disease and type 2 diabetes. Even moderate daily walking—10 to 20 minutes at a time—can help regulate blood sugar levels, improve digestion, and strengthen the immune system.

Walking also plays a meaningful role in mental wellbeing. Time spent walking outdoors can reduce stress hormones, improve mood, and support better sleep patterns. For healthcare professionals experiencing burnout or fatigue, integrating walking into travel routines can provide a simple but powerful reset.

Minimize Plastic and Medical Waste on the Go
Travel often increases reliance on single-use plastics—from water bottles to takeout packaging. Bringing a reusable water bottle, utensils, and small containers can significantly reduce waste. Healthcare professionals are uniquely positioned to recognize the broader impact. A growing body of research links plastic production and exposure to adverse health outcomes across the lifecycle.

A recent analysis published in The Lancet Planetary Health highlights the scale of the issue: “The life-cycle impacts of plastics—from extraction to disposal—pose substantial risks to human health, contributing to disease burdens globally.”
This reinforces that reducing plastic use during travel is not just an environmental choice—it is also a preventive health action.

Maintain Healthy Routines While Traveling
Disrupted sleep, dietary changes, and dehydration are common during travel. Simple strategies—such as maintaining hydration, prioritizing whole foods, and scheduling time for rest—can significantly improve wellbeing.

Further Reading:
Plastics: https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(23)00146-8/fulltext

The post Tips for Healthy Summer Travel first appeared on My Green Doctor.

The post Healthy Summer Travel Checklist first appeared on My Green Doctor.

Introduction by Dr. Todd Sack.

About the Author: Leslie Samuelrich is President of Green Century, a pioneering investment firm focused on environmentally responsible investing with more than $1.3 billion in managed assets. With nearly 40 years of experience spanning corporate engagement, environmental leadership, and public health initiatives, she is a leading voice in sustainable finance and shareholder advocacy.

The post Green Practice News – June 2026 first appeared on My Green Doctor.

Matt Everatt details what dental 3D printing, artificial intelligence and platform models tell us about the next three to five years in the lab sector.

We all know the Blockbuster story, or we think we do. The market leader, nine thousand stores, a brand so dominant that ‘renting a film’ and ‘going to Blockbuster’ were the same sentence. They were offered the chance to buy a small upstart called Netflix for an insignificant amount and showed it the door. Only to end up bankrupt within a few years.

The usual moral is ‘adapt or die’, and it’s true, on the whole, dental labs are agile. This is perhaps the least interesting part of the story, nobody in this profession thinks they’re Blockbuster. The useful lessons are in the other two companies.

Let us start with the one we forget. Before most of us had heard of Netflix, Britain had LoveFilm. Founded here in 2002, it grew into the biggest DVD-rental service in Europe. The ‘Netflix of Europe’, with well over a million UK subscribers.

Crucially, LoveFilm was not asleep, it was a pioneer. It saw streaming coming and was offering films online from 2010, two years before Netflix even arrived on these shores. It had the right model, the right timing and a commanding lead in its home market.

It no longer exists. Amazon took full control in 2011, folded the streaming side into what became Prime Video by 2014, and quietly closed the DVD-by-post business in 2017. LoveFilm did almost everything right and still vanished, not because it failed to adapt, but because a far bigger platform with deeper pockets simply absorbed it. Being early and being right were not enough. It lacked the scale to stay standing on its own.

So, we have three fates, not two. Blockbuster, who didn’t see it. Netflix, who changed the model and won on scale and LoveFilm, who saw it perfectly, moved early, and was swallowed anyway. Every lab in the country is somewhere on that triangle right now, whether the lab owners have noticed or not.

What is happening in the current market?

Let me be specific about what I mean, because vague talk of ‘disruption’ or a ‘disruptor’ is easy to nod along to and ignore.

The first wave is chairside.

Same-day milled crowns have been a reality in dental practices for many years. 3D printing is now doing the same but much cheaper, with high-quality results and it is now moving over to the appliance manufacturing element.  A practice with an intra-oral scanner, design software and a desktop resin printer can produce a growing list of items in-surgery. Models, retainers, occlusal splints, sports mouthguards, and increasingly the trickier flexible work too. Every item a practice makes in-house is an item that never reaches a lab. This is not ‘the future’. It is here, and it is getting cheaper and better by the day.

The second wave is the platform.

A fully-digital, venture-backed laboratory has now set up in the UK on a model that should make every lab owner sit up. The business model is to give practices a scanner and software for nothing, in exchange for a committed monthly volume of work down its own pipe. Read that as an owner, not a technician. It is not competing on the quality of a single unit. It is removing the moment a dentist chooses a lab at all. Once the scanner, the software and the workflow belong to the platform, the relationship you spent many years building is controlled by someone else.

The third wave is agentic AI.

This is the accelerant under the other two. An AI ‘agent’ is not a chatbot that answers a question, it takes a goal, plans the steps, acts across software, and only escalates to a human at the exceptions. Companies such as Movix are building exactly this for our part of the dental profession. Agents to run the workflow from scan to manufacture, openly aimed at the shortage of skilled technicians. On the practice side, diagnostic and treatment-planning AI is moving the same way. The destination is a stack where software flags the problem, proposes the plan, and routes the work and whoever owns that software owns the order flow.

Why this is a three to five-year conversation, not a 10-year one

I sat in a meeting recently where the working assumption was that something we were making would still be current in ten years. Ten years! In a market where a disruptor can incorporate a whole new business in November 2025 and be on the exhibition floor by spring 2026, where the hardware costs are falling, and where the technology and AI capability improves daily.

Blockbuster assumed it had ten years too. It had about three before the curve turned, and by the time the threat was real, the decisions that would have saved it were no longer available to make. Disruption is slow, and then it’s sudden. The window to act is always before it’s obvious, which is exactly why it gets missed, acting early always feels like overreacting or being dramatic.

My honest read is that the lab arena has three to five years before this changes in earnest. Not the end of the profession but a reordering of who does what, and who gets paid for it.

Don’t be LoveFilm

Here is the part that matters, and it’s why the third company belongs in this article. Avoiding Blockbuster’s fate is the easy bit, buy a printer, sign up to the software, go digital. My thoughts are that plenty of labs will do exactly that and still not survive, going digital is not a strategy anymore, it’s the bare minimum any dental lab has to do. LoveFilm was digital. LoveFilm was early. LoveFilm is gone.

What protects a lab is not whether it adopts the technology, but whether it owns something the profession and platform want or can take. Three things decide that.

The first is the relationship. The whole strategy of the platform is to get between you and the clinician. The labs that survive will be the ones the dentist won’t let go of, not a supplier of units, but a clinical partner whose judgement is part of how that practice works. The closer you are to the chair, the harder you are to cut out. I believe this is where the UK will be harder to crack as rapport and those close ‘sticky’ relationships have a value, we are a much smaller profession in the UK and familiarity is a big part of the culture.

The second is the work that doesn’t commoditise. Simple, printable, high-volume items are the first to go in-surgery or onto a pipeline. The complex clinical, the full-arch and top end aesthetic work, anything where finishing quality and the cost of getting it wrong are real, is far more defensible. As the routine work falls away, that work becomes more valuable, not less. The trap is staying on the commodity treadmill and trying to out-price a machine or cheap outsourcing.

The third is honesty about scale. LoveFilm’s lesson is that being good is not the same as being safe. If your defensible position is genuine craft and relationships, build the lab around that and price it properly. If your game is volume, understand that you are in a ‘capital and automation’ race against people with more of both, and plan accordingly. The fatal position is the middle, too big to be a craftsman, too small to win on scale.

The question worth asking

Blockbuster didn’t fail because it couldn’t see Netflix. It saw it perfectly well and chose to believe its model was still relevant and that its size was such that it was too big to be shaken. LoveFilm failed the opposite way: it saw everything, did everything right, and still got swallowed because it wasn’t built to stand alone.

The profession isn’t going to disappear. Teeth will break, appliances will be needed, and skilled hands will always have a place. But the shape of who provides it, and who captures the value, is going to change inside the next five years.

The lab shelves still look full today. The order book still looks healthy. That is precisely the moment to decide which of the three companies you intend to be, while you still have the years to choose. Do you become the lab the future dental market needs, or do you settle for running a very good video shop?

Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.

A dentist who denied leaving a dental bur in a patient’s mouth and told her it would not cause harm if swallowed has been erased from the General Dental Council (GDC) register.

The Professional Conduct Committee (PCC) also found repeated clinical failings involving 39 patients, including failings in radiographs, diagnosis and treatment, prescribing, consent, referrals and aftercare. In total, the case involved four dishonesty findings.

The dentist, who qualified in the 1980s, did not attend the hearing and was not represented. The committee was satisfied that notice had been properly served and decided it was fair to proceed in the dentist’s absence.

Concerns raised by colleagues

The case related to care provided between 2018 and 2023. The determination said the dentist was one of the directors of the practice at the time and had no previous fitness to practise history.

Concerns were first raised with the GDC following a patient complaint in November 2022. Further complaints were later received from an anonymous source at the practice, including concerns raised by dental colleagues. The determination said this included a dental hygienist who had worked alongside the dentist for around 14 years.

The committee found that the clinical failings involved ‘basic aspects of dentistry’ and concluded that a number of them fell far below the standard expected of a reasonably competent dentist.

Dishonesty findings

The committee found that the dentist had breached professional standards requiring registrants to obtain valid consent, provide good quality care based on current evidence and guidance, and act honestly and with integrity.

The dental bur incident formed part of four dishonesty and probity findings relating to four patients.

The committee also found that the dentist gave an incomplete account of a specialist practitioner’s comments, provided misleading advice about healing after extraction, and attributed previous root canal treatment to another dentist when he had provided it himself.

Erasure ordered

In deciding sanction, the committee noted that the dentist had no previous fitness to practise history. However, it also identified aggravating features including actual harm or risk of harm to patients, misconduct sustained over a period of time, attempts to cover up wrongdoing, dishonest conduct and a lack of evidence of insight.

The committee said conditions would not be sufficient and concluded that suspension would not protect the public or meet the wider public interest. It also noted information suggesting the dentist had not been practising since February 2024, but said he could return to practise at a later date if able to do so.

It said: ‘Anything less than erasure would fundamentally undermine public confidence in the profession and fail to declare and uphold professional standards.’

The dentist’s registration was suspended immediately to cover the appeal period. Unless the appeal is lodged, the erasure will take effect 28 days from the date notice is deemed to have been served.

Follow Dentistry.co.uk on Instagram to keep up with the latest news and trends.

High-quality care is not defined by the number of services delivered or the speed of a single appointment, but by how effectively care is connected across time, teams, and settings. The best systems, Dr. Davidoff wrote, are built around prevention, coordination, and a deep understanding of each patient’s needs, creating a continuous care experience rather than a series of disconnected transactions.

“Achieving this requires a value-based care approach that aligns financial incentives across the entire health care system – including care teams, health plans and hospitals – so that all decisions are made with the patient’s best interests at the center,” he wrote.

Related value-based care story: Why physician-led, value-based care leads to better outcomes

The high cost of a system built for volume, not value

Dr. Davidoff contrasts this model with traditional fee-for-service medicine, which rewards volume over value and leaves patients to navigate a maze of specialists, appointments, repeated tests, and separate bills.

In these fragmented systems, data is scattered, communication breaks down, and patients often shoulder the burden of coordinating their own care. The result is not only frustration, but rising costs and lower-quality outcomes. He notes that total U.S. health care spending has climbed from about $3.6 trillion in 2016 to a projected $5.9 trillion in 2026, underscoring the unsustainability of a system designed around more interventions rather than better ones.

To show what value-based care looks like in practice, Dr. Davidoff highlighted Kaiser Permanente’s AI-powered patient portal, the Kaiser Permanente Intelligent Navigator. The tool helped identify a postpartum patient’s chest pain and shortness of breath as a medical emergency, prompting her to seek immediate care rather than schedule a routine visit. She was later diagnosed with a heart attack and treated in time.

Related value-based care podcast: Why the best integrated health care systems are built for health care’s future

How strengthening relationships improves long-term health

He also emphasizes that value-based care supports stronger, longer patient relationships, which in turn improve prevention and chronic disease management. Because physicians in these models can follow patients over many years, they are better positioned to intervene early, prevent complications, and improve health over time.

Dr. Davidoff points to Kaiser Permanente’s 2025 HEDIS® performance — leading the nation in 71 effectiveness-of-care measures — as evidence that better-designed systems can produce measurably better results. The closest national competitor led in only 30.*

“This is why I am deeply committed to investing in a value-based approach to care,” he added. “To set an example that benefits the patients we care for, the communities we serve, and other health care delivery systems across the country and the world.”

Read the full commentary here.

*Kaiser Permanente 2025 HEDIS® scores. Benchmarks provided by the National Committee for Quality Assurance (NCQA) Quality Compass® and represent all lines of business. Kaiser Permanente combined region scores were provided by the Kaiser Permanente Department of Care and Service Quality. The source for data contained in this publication is Quality Compass 2025 and is used with the permission of NCQA. Quality Compass 2025 includes certain CAHPS data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass® and HEDIS® are registered trademarks of NCQA. CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality.

The post The life-saving power of connected, value-based care appeared first on Permanente Medicine.

Join Wail Girgis, Manoj Bhatia, John Carney and Sahar Ahmadiani on 17 June at 7pm as they discuss everything you need to know when searching for an implant mentor.

This webinar will provide an overview of how structured mentoring supports clinical decision making and skill development in implant dentistry.

It will examine the impact of mentoring on patient outcomes, complication reduction, and risk management to highlight its importance in ensuring dentists work within their competence and in line with professional standards set by the General Dental Council.

It will also promote the integration of mentoring into continuing professional development (CPD) and personal development planning (PDP) and encourage a culture of reflective practice, peer support, and continuous improvement in implant dentistry.

Learning outcomes

• Critically evaluate how mentoring improves case selection, risk assessment, and treatment planning in implant dentistry
• Recognise how mentorship supports safe progression from straightforward to complex implant cases
• Apply principles of reflective practice and supervised learning to reduce complications
• Describe how mentoring enhances patient communication, expectation management, and consent processes in implant cases
• Identify common communication pitfalls in implant dentistry and how mentorship mitigates them
• Explain the role of mentoring in improving team-based implant workflows (GDP-specialist-lab)
• Demonstrate how structured mentoring contributes to leadership development and safer delegation
• Recognise the mentor’s role in fostering clinical governance and peer learning environments
• Evaluate the ethical responsibilities of undertaking implant dentistry with or without mentoring
• Understand how mentoring supports working within competence, indemnity requirements, and patient-centred care
• Reflect on how mentorship strengthens professional accountability and patient trust
• Develop a framework for incorporating mentoring into a PDP
• Apply the plan–do–reflect–record cycle to implant training pathways.

The speakers

Manoj Bhatia

Manoj has completed his initial dental education (BDS) in 1995 and his MSc (implant dentistry) in 2011. His work is exclusively limited to implant dentistry, and he has been placing and restoring implants since 2001.

Dr Bhatia’s special interest is implant dentistry. He has completed his diploma (2009) and master’s (2011) in the same from the University of Central Lancashire (Preston, UK) and is an associate fellow of the College of General Dentistry. In addition, he has attended various advanced courses nationally and internationally including the master’s course in bone grafting and sinus lift from the University of Bern (Switzerland).

Dr Bhatia is one of only a few dental surgeons to hold an MSc in implant dentistry. He has placed and restored many implants from the straightforward to more complex cases. His case portfolio includes a complete range of cases including full mouth rehabilitation, sinus lifts and bone grafts.

He is a senior clinical teacher (implant dentistry), a clinical supervisor and an examiner at the University of Central Lancashire. Additionally, he runs a referral unit for implants in Rugby and Halesowen and is involved in mentoring clinicians in their practices in dental implant placement. He is an implant mentor for VSS Academy, Rodericks Dental, Osstem UK. Finally, he is a visiting implant dentist in Kinver, Kenilworth, Solihull, Croydon and Aldridge. He is a key opinion leader for Osstem UK.

Through his company MB Implants Limited, he runs an Implant mentoring program and has trained and supported many dentists and dental practices in the field of implant dentistry. He has mentored dentists starting in the field of dental implantology to those who need advanced case mentoring (full arches and sinus lifts). He runs courses in dental implants and is involved in implant research.

In the field of general dentistry, he has been a FD trainer with West Midlands Deanery.

His other interests away from dentistry include travelling, golf and swimming. He is also involved in alternative healing and is a trained reiki master.

Wail Girgis

Wail is a clinical director at Devonshire House and a specialist prosthodontist. He provides general dental care for a broad patient base and, as a specialist prosthodontist, is especially skilled in the replacement of missing teeth, the restoration of natural teeth and in complicated and simple restorations of the whole mouth.

Wail trained at King’s College Hospital Dental School, London and went on to complete an MSc degree in conservative dentistry at the Eastman Dental Hospital, London where he taught thereafter as a clinical lecturer. Wail went on to teach at the International Centre for Excellence in Dentistry on the implant certificate course. He is a member of the International Team for Implantology for whom he is a clinical lecturer. Wail joined Devonshire House in 1998 and is now a clinical director.

John Carney

John Carney is a highly accomplished clinician with a distinguished career spanning dentistry, maxillofacial surgery, implant dentistry and dental education. He graduated from the University of Liverpool with first class honours in physiology in 2006 before completing his BDS in 2010. His commitment to advancing his clinical expertise led him to undertake maxillofacial senior house officer training at Aintree University Hospital between 2011 and 2012, during which he also achieved his MFDS in 2012.

Driven by a passion for surgical excellence, Dr Carney continued to expand his skills through advanced postgraduate training. He completed his MSc in clinical implant dentistry in 2023 and subsequently earned a diploma in periodontal surgery in 2024 under the mentorship of the renowned Professor Massimo De Sanctis in Paris.

From 2023 to 2025, Dr Carney served as co-lead of the ITI Study Club in Preston, fostering a collaborative learning environment for clinicians and promoting best practices in implant dentistry. He has also contributed significantly to the development of early-career dentists through his work as a foundation trainer, supporting newly qualified practitioners as they transition into clinical practice.

Alongside his clinical development, Dr Carney has been an active contributor to the profession. He has served on both his local British Dental Association (BDA) section committee and the national Young Dentists Committee, advocating for professional standards, education, and mentorship.

Clinically, he gained extensive experience as an associate dentist across multiple practices in Cumbria before taking the significant step of purchasing his first practice in 2019. His leadership and commitment to high-quality patient care have been central to his work as a practice owner.

In 2025, Dr Carney joined VSS Academy as educational lead, where he plays a pivotal role in shaping advanced clinical training and supporting the next generation of dental professionals. His blend of academic achievement, surgical expertise, and dedication to teaching positions him as a respected figure within the dental community.

Sahar Ahmadiani

Sahar Ahmadiani (DDS) is a highly experienced cosmetic dentist and Invisalign provider based in London, specialising in smile design and minimally invasive dentistry. She is a principal dentist at Melo Dental Aesthetics in Acton and has a history of dental practice ownership, including the Harleston Dental and Aesthetic Clinic in Norfolk.

Her specialties include advanced cosmetic dentistry, smile design, and Invisalign (over 1,000 cases completed) with over 6 years in dentistry, focusing on tailored, natural smiles.

You can sign up for the webinar here.

Catch up on previous on-demand webinars:

• From enquiry to treatment start: the patient journey most practices have never mapped
• Dealing with patient complaints: real cases, real solutions
• The first 100 days of marketing for a new practice owner
• Is your practice quietly losing £100,000 a year?
• The five hidden HR risks in dental practices and how to prevent them.

• The concern of playing in the heat
• The science behind the secret star of the World Cup
• The ball that needs to be charged as well as pumped!

The concern of playing in the heat

There have been growing concerns regarding the heat during the upcoming World Cup. A recent article by Reuters highlighted some significant worries about this issue. It references an analysis by the climate research group World Weather Attribution, which suggests that approximately a quarter of the 104 matches at the World Cup are likely to be played in conditions that exceed the safety limits. It’s also worth noting that over a third of matches are scheduled in stadiums lacking air conditioning. Some researchers even predict that up to five matches could take place under unsafe conditions where postponement is recommended.

In response, FIFA has assured fans that they are implementing various mitigation strategies to safeguard the players. These measures include three-minute hydration breaks during each half, cooling facilities for both fans and players, and heightened medical readiness.

Interestingly, experts quoted in the article suggest that widespread medical emergencies from heat exposure are unlikely, as the players are elite athletes generally acclimated to warmer temperatures. However, what fans might notice is a more conservative tactical approach, potentially leading to less thrilling matches.

It will be fascinating to see how the heat affects this World Cup and the tactical approaches teams adopt.

The science behind the secret star of the World Cup

A fascinating YouTube video recently unveiled the unsung hero of the World Cup: the grass! The video highlights FIFA’s impressive investment of 5 million US dollars and the involvement of expert Dr John Sorochan, who was brought in to ensure that the grass across all 16 stadiums in three different countries performs consistently.

Dr Sorochan and his team dedicated five years to researching and developing the perfect grass surfaces. Once cultivated and harvested, the grass was transported in refrigerated trucks to each stadium. It was then meticulously installed on a combination of soil, peat, and a plastic structure, along with a waterproof liner to protect the stadium floors. Sensors placed in the root zones allow stadiums to saturate and drain the fields in just three minutes. Additionally, the grass must be kept precisely at 22 millimetres in height; cutting it any shorter can put unnecessary stress on it.

So, when you’re watching the World Cup, take a moment to appreciate the incredible science behind the pitch. Without this finely-tuned grass, superstar players might struggle to showcase their remarkable football skills!

If you are interested in pitch surfaces, be sure to check out our blog Natural grass vs. artificial turf: which surface poses an increased injury risk? and our previous newsletter edition, Artificial Turf And Injuries!

The ball that needs to be charged as well as pumped!

The Adidas official World Cup ball, named “The Trionda,” cleverly blends the prefix “tri” (representing the three host nations) with “onda,” the Spanish word for “wave.” This reflects the unique hosting of the tournament by the United States, Canada, and Mexico.

According to a recent video from “The Sports Geek” YouTube channel, this ball will be a game-changer, and as the video puts it, it will be the first ball that will be required to be “charged as well as pumped”. Inside the ball, there is a motion sensor capable of tracking the ball’s movements an impressive 500 times per second! This innovative tracking technology is expected to assist VAR and referees in making quicker offside and handball decisions.

Additionally, the ball’s design boasts the fewest panels in World Cup history, resulting in less stitching. This streamlined construction aims to give players greater control and allow for a smoother flight through the air.

It will certainly be interesting to see how The Trionda performs in this World Cup and whether its advanced technology positively influences referee and VAR decisions. However, it is worth noting that thinner air may change ball flight characteristics, so the Trionda ball could travel faster and more unpredictably in matches played in high altitude locations like Mexico City.

If you are looking forward to the World Cup, check out our podcast episodes Preparing for the World Cup: Physical Performance Under Extreme Pressure and The Performance Demands of a World Cup with Dr Dave Hancock.

From us this week:

>> New course: Socially Supporting Athletes
>> New podcast: The Unseen Work of S&C and Sports Science
>> New infographic: Stretch Shortening Cycle
>> New article: Hydrotherapy

Access to a growing library of sports science courses

SFS Academy is an all-access membership to premium sports science education.

With SFS Academy, you’ll learn from some of the best coaches around the world as they teach you how to apply the latest research and practice with your athletes.

The post The World Cup: Heat, Science, & Technology appeared first on Science for Sport.

The question might seem simple enough: Should we treat low testosterone in men with obesity? Yet the questions only accrue from here. The field remains divided not only on whether to treat it but also on how — and even on what to call it. This standoff is why an upcoming ENDO session in Chicago promises to be one of the meeting’s most spirited exchanges. On Sunday, June 14, two leading experts in andrology will face off in a structured debate, moderated by a physician who says he is “fortunate to know them personally” and anticipates a lively morning.

“They are both extremely intelligent and know their field well,” says moderator and Endocrine Society Past-President Stephen Hammes, MD, PhD. “They also have larger-than-life personalities that I think will lead to a fun and spirited debate.” Hammes is the Louis S. Wolk Distinguished Professor of Medicine, chief of the Division of Endocrinology, Diabetes and Metabolism, and executive vice-chair of the Department of Medicine at the University of Rochester, in New York. He has been attending the Endocrine Society meeting for over 20 years and has moderated many debate sessions.

“How do you even define low testosterone in individuals with obesity, who have physiologic reasons to explain some of the lab results? If you think testosterone is indeed low, do you give testosterone to everybody or just those who are symptomatic? Or do you focus on lifestyle changes or prescribe weight loss drugs? Ask five endocrinologists and you will get 10 answers.” — Stephen Hammes, MD, PhD, Louis S. Wolk Distinguished Professor of Medicine; chief, Division of Endocrinology, Diabetes, and Metabolism; executive vice-chair, Department of Medicine at the University of Rochester, Rochester, N.Y.

Franck Mauvais-Jarvis, MD, PhD, professor of medicine, Price-Goldsmith Professor of Nutrition, Tulane University School of Medicine, in New Orleans, La., argues for the treat side. David Handelsman, MBBS, PhD, FRACP, of the ANZAC Research Institute at the University of Sydney, in Australia, argues the opposite: don’t treat. The two have already engaged directly in print on this topic with an Approach to the Patient paper, a Letter to the Editor on that paper, and an author’s response to the letter published in the Journal of Clinical Endocrinology & Metabolism in the fall of 2025, and the live debate promises to be every bit as pointed.

What is the Controversy?

The “whether to treat” question raises questions of its own that the two debaters answer very differently: What is happening hormonally in a man with obesity and low testosterone? And is the relationship bidirectional (and if so, which direction carries the greater clinical weight)? The answers determine everything else.

For Handelsman, the phenomenon has both a name and a clear physiologic explanation. “Pseudohypogonadism describes the hormonal state of simple obesity — low testosterone proportionate to low serum sex hormone–binding globulin (SHBG) with normal serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH), verifying the eugonadal state,” he says. In other words, the hypothalamic–pituitary–testis (HPT) axis is functioning normally; the low testosterone reading is a downstream consequence of obesity-related SHBG suppression, not a sign of gonadal failure. “That must be distinguished from genuine pathologic hypogonadism, which usually warrants testosterone treatment,” says Handelsman.

Mauvais-Jarvis takes issue with this framing as well as the terminology. “Pseudohypogonadism is a concept that has no scientific foundation,” he says, preferring the term “testosterone deficiency (TD).” “I don’t use the term ‘hypogonadism’ because gonadal function involves sperm and T production, but in most patients, we don’t measure spermatogenesis, we measure T.”

“Misguided testosterone treatment often arises from inadequate patient evaluation by measuring serum testosterone in isolation on the erroneous belief that this can diagnose androgen deficiency. Such overprescribing of testosterone for obesity has been a major driver of excessive testosterone prescribing, which rose 100-fold over recent decades, without a single new approved indication.”  — David Handelsman, MBBS, PhD, FRACP, emeritus director, ANZAC Research Institute at the University of Sydney, Australia

He uses the framework of “functional” TD, a concept that acknowledges that some forms of TD are reversible, as opposed to organic hypogonadism due to structural abnormalities. He also pushes back on the implication that reversibility makes a condition benign. “In reality, ‘functional forms’ of TD caused by obesity or chronic disease are rarely reversible and represent over 95% of patients today.”

Hammes, true to his moderating role, frames the definitional problem as the very reason this debate is worth having. “How do you even define low testosterone in individuals with obesity, who have physiologic reasons to explain some of the lab results?” he asks. “If you think testosterone is indeed low, do you give testosterone to everybody or just those who are symptomatic? Or do you focus on lifestyle changes or prescribe weight loss drugs? Ask five endocrinologists and you will get 10 answers.”

What Does the Literature Tell Us?

The definitional divide is not merely semantic; it reflects a genuine divergence in how each side reads the evidence (or lack thereof).

“Using testosterone to treat obesity is widely practiced but lacks objective evidence of efficacy or safety, as well as being fundamentally mistaken in treating a symptom (low testosterone) rather than the underlying disease, if any (often none),” explains Handelsman. He points to what he sees as a diagnostic problem upstream: “Misguided testosterone treatment often arises from inadequate patient evaluation by measuring serum testosterone in isolation on the erroneous belief that this can diagnose androgen deficiency.” He also situates the debate within a broader pattern he has tracked across his career. “Such overprescribing of testosterone for obesity has been a major driver of excessive testosterone prescribing, which rose 100-fold over recent decades, without a single new approved indication.”

Mauvais-Jarvis takes a different view: “If you have to pick one marker that best summarizes the health status of a man, it’s T,” he says. “TD in men is not solely a problem of sexual dysfunction; it’s the best predictor of chronic disease, including metabolic syndrome, visceral obesity, type 2 diabetes, osteoporosis, anemia, depression, cognitive decline, cardiovascular disease, and overall mortality. In addition, it’s a cause of marital dysfunction and professional loss of productivity. It is a public health problem.”

His case for treatment draws on his clinical research into testosterone’s role in metabolic function as well as direct patient experience with treating hundreds of male veterans with TD.

Hammes, for his part, declines to adjudicate between the camps, at least in advance. “Overall, the level of evidence that treatment with testosterone helps patients with obesity-related low testosterone long-term is low but not zero,” he observes. “Then again, evidence that treatment with testosterone is harmful is also low. During this debate, we will hear about many of these studies.”

What’s a Clinician to Do?

The sharpest fault line between the two sides is whether low testosterone in men with obesity constitutes a condition that warrants treatment in its own right.

Handelsman’s position is categorical: “Valid testosterone treatment should be reserved for pathologic hypogonadism due to structural or genetic disorders of the HPT axis, not for reversible functional states (like obesity) accompanied by lowered serum testosterone.” For him, “the threshold for testosterone treatment is whether there is or is not pathologic hypogonadism, regardless of obesity status or testosterone level.”

He argues for treating what is actually wrong. “Serum testosterone is a dynamic hormone that is lowered by non-gonadal conditions like obesity and sleep apnea, for which there are better, effective treatments, rather than testosterone.”

Most patients with TD caused by obesity or chronic disease have a condition that is “rarely reversible,” counters Mauvais-Jarvis, and the treatment gap has real consequences for patients who are suffering now. His position is that testosterone therapy combined with a proper lifestyle program is the most effective approach, addressing both the hormonal deficiency and its metabolic context simultaneously.

Wondering what the harm would be in just going ahead and treating the low T? “‘Don’t treat’ obesity with testosterone because valid and established therapies can be used, whereas testosterone treatment of obesity is not effective and conveys undefined safety risks including accelerating cardiovascular and prostate disease as well as iatrogenic androgen dependence,” warns Handelsman.

“If you have to pick one marker that best summarizes the health status of a man, it’s T. TD in men is not solely a problem of sexual dysfunction; it’s the best predictor of chronic disease, including metabolic syndrome, visceral obesity, type 2 diabetes, osteoporosis, anemia, depression, cognitive decline, cardiovascular disease, and overall mortality. In addition, it’s a cause of marital dysfunction and professional loss of productivity. It is a public health problem.”   — Franck Mauvais-Jarvis, MD, PhD, Professor of Medicine, Price-Goldsmith Professor of Nutrition, Tulane University School of Medicine, New Orleans, La.

Hammes sees the treatment question as genuinely still open. “I think everybody focuses on weight loss as the best overall treatment,” he says, “but where people differ is in defining what it means to have a low testosterone in the setting of obesity, and then whether treatment with testosterone is appropriate or effective.” There are, he notes, few absolute contraindications — but also few absolute indications. “Our job as physicians is to mitigate these uncertainties as best we can for each individual patient and their unique situation.”

What Role Might GLP-1 RAs Play?

No discussion of obesity treatment in 2026 is complete without accounting for glucagon-like peptide 1 (GLP-1) receptor agonists, so what might these agents mean for the testosterone question?

On the “treat” side, Mauvais-Jarvis is skeptical: “GLP-1 RAs do not decrease body weight enough — approximately 10% — to improve TD in obese men with symptomatic TD.” He also raises a separate concern: “In addition, they cause a loss of lean mass that persists after discontinuation, although fat mass rebounds.” Thus, GLP-1 RA therapy may further complicate the metabolic picture.

Although Handelsman did not specifically address this issue, implicit in the “don’t treat” argument is that if effective weight loss is achieved, testosterone should organically normalize. However, the mechanism of weight loss (e.g., lifestyle changes, surgery, pharmacotherapy) might well have other known or as-yet unknown effects.

What Should Attendees Expect?

Handelsman is direct about his objectives: “My hope for this session is that it will reinforce the good practice that testosterone treatment should be used for pathologic disorders of the HPT axis and that testosterone treatment for obesity is futile and overlooks effective treatments with better defined efficacy and safety.”

Mauvais-Jarvis has a slightly different goal for attendees: “If they like boxing fights when one gets a knockout, they’ll enjoy,” he jokes. “Just kidding.”

For his part, Hammes is hoping for something the literature has not yet provided: A clear look at all the relevant evidence, argued by two people who know it better than almost anyone. “I would like to listen to these two very intelligent and experienced physicians discuss all points of view regarding low testosterone in obesity,” he says, “starting with the pathophysiology that leads to low testosterone, then discussing how we diagnose low testosterone in this population, and finally what options we have for treatment, along with the evidence to support these options.”

For any clinician who has ever faced a symptomatic, overweight patient with a low testosterone level and no clear roadmap for what to do next, which is to say, nearly all of them, the session should represent a long overdue conversation. “Right now, in my opinion, there is no specific standard of care for low testosterone in obesity,” Hammes says, “which is why this will be a wonderful debate as well as a great education session for the audience.”

As for his own position? Hammes, for now, is “doing a little sidestep,” in his words, but if the debate delivers what he’s hoping for, the audience will be able to draw their own conclusions about whether to T or not to T.

Horvath is a freelance writer based in Baltimore, Md., and a frequent contributor to Endocrine News. In the May issue, she wrote about two ENDO 2026 sessions: “Weight Loss: Friend or Foe for Bone & Muscle?” and “’Hot and Flashy’: Topics in Menopause.”

The post To T or Not To T: Should We Treat Low Testosterone in Men with Obesity? appeared first on Endocrine News.

Following the landmark news that Stratasys’ Truedent has received CE-mark certification as a class IIa medical device, we sat down with Shoshana Glickman and Negar Movahed to discuss why this regulatory milestone is a game-changer for UK labs.

Could you both briefly introduce yourselves and your roles at Stratasys, and for our readers who may be new to the brand, tell us a bit about the Stratasys mission?

Negar Movahed: I am the head of product at Stratasys Dental.

My role sits at the intersection of customer needs, technology innovation, and long-term market direction. 

Essentially, my goal is to bring valuable products to the market that solve real problems for lab technicians, clinicians and, ultimately, the patients.

Shoshana Glickman: I’m on the dental marketing team at Stratasys, where we focus on getting the word out to dental labs about what our 3D printing technology can do – from improving lab efficiency and reducing labour to enabling scalability and delivering consistent, reliable quality.

At Stratasys, we are global leaders in additive manufacturing.

While many know us from the industrial or aerospace sectors, our mission in dental is to deliver fully validated, end-to-end solutions, opening the door to scalable, high-quality production for dental labs.

We’ve just seen the news Truedent has received CE-mark certification as a class IIa medical device. For technicians, what does this actually mean?

Shoshana Glickman: It’s a major milestone.

It means we’ve been held to a much higher level of scrutiny regarding technical documentation, biocompatibility and mechanical properties.

For the lab, it provides peace of mind. They know the entire material lifecycle – from raw materials to the final product in the patient’s mouth – is verified.

The class IIa certification also allows us to move into expanded indications like removable partial dentures (RPDs) with our new Truesnap workflow.

Truedent is an especially ideal material for RPDs as it enables close, highly customisable shade matching to existing dentition, a level of precision that is difficult to achieve with other three-dimensional printing solutions, such as the single colour DLP printing.

Negar Movahed: It also gives labs the green light for long-term intraoral use with expanded indications. 

When a lab fabricates these medical devices for the dentist, they can do so with absolute confidence that the clinical safety and performance have been verified by an independent body.

There are a lot of bargain resins or counterfeits on the market right now claiming to be compliant. How does this certification separate Truedent from the ‘wild west’ of unverified products?

Negar Movahed: I love this question because it speaks to the heart of our discipline.

Stratasys is a conservative company in the best way possible.

As a large, public tech company with a dental vertical and relatively new to the medical device world – rather than a traditional dental medical device company – our approach is different, we make an intentional choice not to pursue risky loopholes.

Our leaders gave us a clear mandate to be conservative when it comes to safety, quality and patient safety.

Biocompatibility tests are incredibly expensive and they take time. That’s why some companies choose to use literature references instead of testing new formulations. 

We completed the full battery of tests defined by an independent toxicologist, based on the device type, contact type and exposure duration, in accordance with ISO 10993, rather than selecting only a subset.

Partial testing can introduce unnecessary risk to the patient. You rarely see that level of commitment from other resin manufacturers.

A lot of these bargain companies you mention market a resin and say: ‘Put it in any printer, use any setting, the result is up to you’. That is a dangerous situation.

We take a different approach. We validate every single step of the workflow-material, printer, parameters and process – because patient safety and clinical reliability are non‑negotiable.

Why is that trust factor so critical right now for a lab manager looking to scale their business?

Shoshana Glickman: If you scale your production up to hundreds of units a month and then find out your material was non-compliant or has been pulled from the market, that can be a catastrophe for your business.

This certification gives labs the confidence to embark on scalable production of dentures and RPDs, knowing they have a recognised global standard behind them.

It reduces their legal liability and protects their reputation with the dentists they serve.

Can you pull back the curtain on the certification process? What hoops did you have to jump through to get the class IIa stamp?

Negar Movahed: It’s an exhaustive process.

Beyond the mechanical property testing (ISO 20795-1), we have to create a massive technical file. This includes an independent toxicologist – someone totally unaffiliated with Stratasys – reviewing our formulations and the size of the part going into the patient’s mouth. They define the testing plan, not us.

Then there is the quality management system (QMS) scrutiny.

Everything from our manufacturing process to our marketing claims has to be reviewed and approved.

It’s a level of oversight that ensures the product isn’t just ‘good’ from the manufacturer’s perspective, but consistently safe and effective with a stamp of approval from an independent third party.

Truedent is famous for its monolithic 3D printing – printing teeth and gingiva in one go. How does the technology itself help with the labour shortages in UK labs?

Shoshana Glickman: Polyjet technology is essentially like inkjet style 3D printing.

We print tiny droplets of different resins simultaneously.

This allows us to combine five base-colour resins in various ratios to create incredible, multi-shade aesthetics in a single print run.

Because it’s a monolithic print, there’s no manual assembly of teeth into a base. 

Any time you introduce a human into that assembly process, you inevitably get variations.

With Truedent, the accuracy is locked in digitally. Plus, our J5 Dentajet has a large print tray but a small footprint.

You can set an overnight print, the nesting is automated with one click, and you walk in in the morning to find finished dentures ready for a quick water-wash.

It’s designed for labs that need to do more with fewer people.

Negar Movahed: It also fundamentally changes the try-in experience.

Historically, a try-in looked like a ‘white block’. With Truedent, the patient sees a highly aesthetic, full colour preview of the final denture.

It builds immediate trust between the clinician and the patient and gives the patient an instant gratification which you don’t get with other technologies.

Aside from eliminating the labour-intensive assembly of the denture teeth to the base, from a function perspective, monolithic printing addresses a known pain point: the risk of decoupling of the two during its useful life with the patient.

Because Truedent is printed as a single, integrated structure, patients do not have to worry about such failures during use.

With Truedent since it is printed all together, patients don’t experience losing a tooth on their denture!

LM: For the younger generation of technicians, how does this digital-first approach change the ‘art’ of the craft?
Shoshana Glickman: For the digital natives, this is incredibly exciting.

We use software called Grabcad, which is much more than just a slicer.

Technicians can design in Exocad or 3shape, and then apply characterisations and aesthetics digitally in Grabcad.

We are constantly releasing new software updates – which are free, by the way – that add new shades and features.

The art is still there; it’s just moved from the physical brush to the digital screen.
Negar Movahed: We have just launched our next‑generation advanced aesthetics capability with Truevoxel, taking Truedent polychromatic printing to the next level.

With enhanced translucency and characterisation built directly into the digital workflow, technicians can design truly life-like aesthetics with the simplicity of a click.

This launch gets us even closer to mimicking the natural smile that every denture patient wants to achieve.

Finally, is there anything else you’d like to add for the UK lab community?

Negar Movahed: We truly believe we’ve found the holy grail of dental 3D printing.

We’re not just launching a product; we’re launching a beautiful smile that gives patients the confidence to show it off. 

With the launch of Truedent as a class IIa medical device, we have planned a dedicated roadshow for our European resellers and customers.

This means we are heavily investing in training the industry, from understanding the technology itself to mastering Truedent’s digital design techniques and clinical requirements, so labs can integrate Truedent into their workflows with confidence. 

Our goal is long‑term success, not just adoption.

We have a strong roadmap of innovation ahead, and we are excited to continue sharing what is next with our industry partners.

Shoshana Glickman: Stratasys is fully committed to dentistry.

We are here to bring reliability, efficiency and trust to UK dental labs. Watch this space! 

For more information contact Stratasys Dental at dental@stratasys.com or visit stratasys.com/dental. 

This article is sponsored by Stratasys.

That future is already taking shape. Over the next decade, $1 trillion in annual spending is expected to shift from fragmented, transactional health care systems to more efficient, digital-first, value-based care models. Dr. Ansari and Dr. Davidoff wrote that leading this transition will require a safe, supportive environment where clinicians are heard and empowered to help reshape the industry.

Drs. Ansari and Davidoff wrote that the shift to value-based care will succeed only if physicians and care teams deliver meaningful value for patients and the health system. To support that effort, the co-CEOs outlined five strategies physician leaders can use to help clinicians lead this transformation.

1. Listen first, then lead. Earning trust through servant leadership starts with listening to clinicians’ perspectives then using their feedback to implement meaningful changes, such as the deployment of ambient AI for notetaking during clinic visits. Such ambient AI listening has been shown to save doctors up to an hour a day at the keyboard and reclaim valuable time otherwise lost to manual data entry. This shift helps reduce administrative tasks that contribute to burnout.
2. Build trust through transparency. By sharing the data and the reasons for evolving policies, and by openly acknowledging uncertainties, leaders can provide concise, relevant communication to demystify policies. This transparency empowers clinicians to share accurate, evidence-based information with patients.
3. Ensure safety to enhance care quality. Maintaining calm and safe clinical environments requires training in de-escalation techniques, security measures, community outreach, and prompt responses to safety concerns, enabling clinicians to focus on what matters most: patient health.
4. Cultivate resilience, advance career growth. Reducing administrative burdens and offering mental health and leadership development programs can strengthen clinician well-being and improve retention. It also supports value-based care leadership, which is a key driver for system transformation.
5. Empower clinicians to tackle tough challenges. Physicians and clinicians who feel supported and empowered have shown they can lead innovation such as cancer screening programs, point-of-care testing, remote patient monitoring, and AI-driven patient communication tools that improve patient experience and care efficiency.

As health care shifts to value-based care, success will depend on building systems that harness physician expertise and use technology to refocus care on patients.

Read the full commentary here.

The post Drs. Ansari and Davidoff on leading the shift to value-based care appeared first on Permanente Medicine.

Join Jeff Dumbrell on 16 June at 7pm as he discusses clinical applications and predictable outcomes using MTA vpt for advancing vital pulp therapy.

The aim of this lecture is to provide clinicians with an understanding of the clinical applications, composition, handling, and benefits of MTA in vital pulp therapy.

It will focus on how its properties support pulp healing and how correct clinical use can help achieve predictable outcomes and support pulp preservation.

Learning outcomes

• Describe the composition and properties of MTA and its role in vital pulp therapy
• Explain the mechanism of action of MTA in promoting pulp healing, tertiary dentine formation, and preservation of pulp vitality
• Identify the clinical indications for using MTA in direct and indirect pulp capping procedures
• Demonstrate understanding of the correct handling, placement, and clinical protocol for MTA vpt
• Recognise the importance of material handling characteristics, including consistency, setting behaviour, and moisture tolerance
• Evaluate the clinical advantages of MTA compared with traditional pulp capping materials such as calcium hydroxide
• Identify the key clinical factors that influence the success and predictability of treatment when using MTA
• Apply evidence-based knowledge to integrate MTA into clinical practice to support minimally invasive dentistry and improved patient outcomes.

The speaker

Jeff Dumbrell is the special markets manager and north east territory representative for VOCO UK. He qualified as a dentist in 2006 in Cape Town, South Africa, before spending 14 years as a successful private practice owner. During his clinical career, Jeff developed an interest in digital dentistry, particularly single-visit restorative workflows using CEREC technology.

After relocating to the UK with his wife, a dental hygienist, and their three sons, Jeff transitioned into the dental industry.

In his current role at VOCO UK, he works closely with clinicians and organisations to support innovative treatment approaches and drive growth across special markets. Outside of work, Jeff has a keen interest in all sport and enjoys spending time with his family.

You can sign up for the webinar here.

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• Is your practice quietly losing £100,000 a year?
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