Delighted to re-connect
The first IDA Annual Conference post Covid was a great opportunity to learn and socialise.
The atmosphere at the IDA Annual Conference in May was fantastic, as members, speakers and trade representatives mingled and celebrated the opportunity to get together at the first in-person conference since 2019. As ever, the Galmont Hotel in Galway provided a super venue for pre-conference courses, trade show, lectures and socialising.
Thursday’s pre-Conference courses covered a wide variety of topics. Drs Aisling Donnelly and Greg Creavin took delegates through the best ways to maximise success in endodontic treatment. Prof. Markus Blatz offered cutting-edge research on CAD/CAM ceramics in aesthetic dentistry, and Dr Jim Grisdale gave a course on crown lengthening for predictable aesthetic and functional restorative results. Digital photography for the dental practice was covered in focus:RAW, a course given by Drs Minesh Patel and Ambrish Roshan, while Dr Nik Sethi took delegates through Flow – a posterior composite simplified workflow presented by Bioclear. Compliance in the increasingly regulated world of dentistry was also covered by Drs Ahmed Kahatab, Michaela Dalton and Marie O’Grady, ably chaired by Dr Eamon Croke.
Setting the agenda
The Association’s AGM on Thursday evening set the agenda for the coming year, passing motions on issues of importance to dentistry and oral health. Incoming President Dr Caroline Robins set out her priorities, and Dr Eamon Croke introduced the theme for the 2023 Conference, ‘Shining brightly’, which will celebrate the Association’s Centenary.
Our colleagues from the dental trade were also back this year, and delegates had plenty of opportunities to chat with them and see the latest innovations in dental equipment and technology, and to relax at the trade show party on Thursday evening.
Friday evening of course is reserved for the Annual Dinner, and this year’s felt particularly special, as the first chance to come together, eat, drink and be merry for the first time in so long.
The best of international and homegrown dentistry
On Friday and Saturday, the parallel lecture programme offered a superb line-up of speakers from home and abroad, covering a wide range of cutting-edge topics.
Prof. Walter Renne is a full-time professor and Assistant Dean of Innovation and Digital Dentistry at the Medical University of South Carolina. He is director for the preclinical CAD/CAM course and has published several studies on scan and milling accuracy using various systems. He spoke at length about the use of 3D printers and how he uses them. He uses both an SLR camera and an intra-oral scanner prior to the CAD/CAM smile design work itself. He noted that for restorations, it is possible to 3D print a crown for 50c (US) and that some 3D crowns wear better than milled materials, but not as well as ceramics.
Prof. Markus Blatz of the University of Pennsylvania School of Dental Medicine sought to bust the myth that you can’t bond zirconia. He outlined his APC (air-particle abrasion, primer with MDP, and composite) concept as a method that can create long-term success in restorations, buying time for patients who are not ready for implants or can’t afford them. He explained how his method works, and gave advice on materials and techniques to get the best results. Ultimately, he said, the combination of the best scientific evidence, clinical expertise, and an awareness of the patient’s needs and preferences, guarantees the best outcomes.
Oral surgeon Dr Niamh Boyle talked about keeping things simple when it comes to dental extractions. She outlined some of the reasons why dentists refer patients to her for complex extractions, including patient anxiety, a need for multiple extractions, and multiple complications. She pointed out that the aim should always be minimal pain and tissue trauma, and a good result. She discussed ways of dealing with common problems that can arise, such as failure of anaesthesia and dental anxiety. She spoke of the importance of taking a detailed patient history that includes all medications. She encouraged delegates to improve their extraction skillset, saying ‘if you can’t sew, don’t cut’!
Prof. Lars Rasmussen of the University of Gothenburg in Sweden spoke on osteoporosis and the risk factors for medication-related osteonecrosis of the jaw (MRONJ). Osteoporosis is a systemic disease that is very common in ageing populations, and more common in women than men. There are a range of treatments for osteoporosis, but he focused on bisphosphonates, which are a significant risk factor for MRONJ.
Dental care for people taking bisphosphonates must take into account the length of time a patient has been on the drug, and what they are taking it for (osteoporosis or malignant disease). Prof. Rasmussen also gave tips on managing treatment to reduce risk, such as checking soft tissue closure after extractions. He also outlined some research on implants in patients taking bisphosphonates, which shows that implant survival rates are better than previously thought.
Dr Slaine McGrath, a dentist based on London, finished the day on Friday with a fascinating presentation on growing the dental practice using social media. Slaine uses Instagram to promote her practice, and has been extremely successful in building patient numbers, enabling her to choose the treatments she likes to do, and even move locations without losing patients. She said that making social media work for you means putting in the work – uploading ‘before and after’ photos regularly, responding to messages, and keeping the account up to date. She talked about identifying a target audience and tailoring content to suit them, and the techniques and equipment needed. She also showed dentists how to use Instagram analytics to track usage and followers, and make the most of your account. She advised people to start a business profile, engage with others on the site, start posting, and showcase your best work.
The lectures continued on Saturday, as Dr Marielle Blake, a consultant orthodontist in the HSE and in private practice, spoke on her experience using Invisalign in practice. She gave advice on scanner type and technique, saying that the initial learning curve when scanning is very steep. She also spoke about the importance of explaining what’s involved to the patient, including what is expected of them in terms of fitting and cleaning aligners. She said that the benefit of scans is that you can explain the treatment plan stage by stage, but that it’s important to be realistic with patients about what their expectations should be. She showed clinical photographs of several of her cases, explaining what she had learnt from each.
She said that Invisalign is the way of the future, and that in 10 years’ time, 50% of cases will be aligners.
Dr Grace Kelly of Cardiff University School of Dentistry outlined a number of techniques to manage dental anxiety, from behavioural management, and technology such as virtual reality modelling, to hypnosis, acupuncture, and sedation. She used real-time audience polls to find out what techniques delegates had used/found helpful, and how confident they felt dealing with anxious patients. Research shows that up to 20% of patients in Ireland experience dental anxiety, on a wide spectrum from mild anxiety up to dental phobia, so this is something all general dentists need to be aware of. She advocated for more training in managing anxiety, especially at undergraduate level.
Drs Gillian Smith and Jennifer Connolly gave a shared presentation on removing the barriers for autistic patients in general practice. Jennifer spoke of her experience as a parent of an autistic child, the importance of inclusion, and the need for dentists to take a progressive approach. Gillian has adapted her practice to specialise in caring for patients with additional needs, and she outlined some of the changes she has made, which begin with the first phone call to the practice, and continue right up to the dental visit and treatment. She emphasised the need for a team approach to find a plan that works for each individual patient. They finished by talking about work that is currently taking place in collaboration with AsIAm on an autism-friendly accreditation system for dental practices (which would make dentists the first healthcare group in Ireland to adopt such a system).
Dr Saoirse O’Toole is a Clinical Lecturer in King’s College in London, a visiting Associate Professor at University College Dublin, and is in private practice in Dublin. In a two-part lecture, Saoirse first gave some updates on the medical comorbidities, diagnosis and monitoring of tooth wear. She focused particularly on the latest evidence regarding gastro-oesophageal reflux disease (GORD), outlining research on its links to bruxism, sleep apnoea, obesity and asthma. She also discussed her own work to develop a diagnostic tool for extra-oesophageal reflux to be performed in the dental surgery. In the second part of her presentation, Saoirse spoke about the opportunities and caveats of digital monitoring to track tooth wear. She discussed the accuracy of intra-oral scanners for measuring tooth wear, and said that while scanners have improved significantly, the software involved has not, but better software will hopefully resolve problems in the future. She introduced WearCompare, a free digital software she has developed to quantify tooth wear, which she hopes will contribute to improving the situation.