Training Programmes - Review
Thomas O'Connor BDS
Tooth whitening has been in the news a lot lately, and not for the most positive reasons. With the continued controversy about dangerous procedures being carried out by non-dentists, some confusion over the concentrations of whitening agent that dentists can use, and so many different techniques available, I thought it was time to take a comprehensive look at the evidence-based facts and get the most up to date advice with some British Dental Bleaching Society approved teaching.
So, I booked for Dr Linda Greenwall's Advanced Bleaching Seminar and Hands-on two day course.
The course took place over two days at Dr Greenwall's practice in Hampstead Heath, and drew dentists from a wide geographical range, with varying levels of experience in tooth whitening. Day one covered the theory, with day two providing some excellent hands-on experience in all aspects of the subject.
The syllabus was comprehensive, and we hit the ground running with an overview of the history of dental bleaching, and the current legal situation, the position of the GDC, the professional indemnity bodies and The Trading Standards Institute. It was very reassuring to have the facts clearly spelled out by an authority in the area, and to learn of the ongoing successes in tackling the illegal practice of tooth whitening by non-dental professionals.
Dr Greenwall gave a well illustrated presentation on the diagnosis of the many and varied causes of tooth discolouration, the importance of history taking (medical and dental), and a systematic method of thorough patient examination (with particular emphasis on the correct approach to dealing with asymptomatic apical areas, in order to avoid potential disasters). Numerous slides and videos provided detailed examples of the classifications of tooth discolouration, correct shade recording techniques, photographic record taking and where tooth whitening lies within the overall treatment plan. I found the scientific explanation of the process very informative: especially the evidence from the literature on safety, efficacy and efficiency, and the chemistry of dental bleaching: many myths and misconceptions were dispelled. The fear of sensitivity can hold some dentists back from offering whitening to certain patients: but a clear explanation of the causes of sensitivity, how to avoid it and how to resolve it gave us the confidence to tackle the cases we might otherwise avoid.
Patient education is particularly important, and a video presentation of how a patient consultation is carried out at Dr Greenwall's practice covered all the areas that need to be addressed even before the clinical examination. This was followed with a role-play exercise of a "consultation" with a "new patient" so we could try out what we had learned.
After lunch there was a methodical explanation of home bleaching and in-surgery power bleaching: the procedures, the indications, the pitfalls, the differences in effectiveness and the outcomes. The emphasis was on a consistent approach, predictability of treatment, long term stability, and troubleshooting when things may not appear to be going to plan: which gel to use, when and why to use particular formulations and concentrations, and how to give your patients realistic expectations. The correct, evidence-based use of carbamide peroxide and hydrogen peroxide were discussed (along with some dramatic illustrations of the severe damage to enamel structure and appearance resulting from the use of chlorine dioxide - the preferred 'treatment' of non-dental professionals.) The specific management of the advanced problems of fluorosis, tetracycline staining, non-vital teeth and congenital dental defects provided for a fascinating set of clinical photographs with some highly impressive results; with detailed discussion of the selective adjunctive use of microabrasion, hydrochloric acid pumice, ACP products, opaquers, and composite bonding. The first day concluded with tips on how to deal with "bleachorexics", and a seminar on 'Building the Practice through Bleaching". We were given some real nuggets of knowledge on internal and external marketing, and how introducing written protocols within the practice can dramatically increase efficiency. In addition to the high-quality audio visual presentations throughout the day, a comprehensive set of bound notes was provided.
On Day Two, we rolled up our sleeves, with the hands-on sessions on home bleaching based over several surgeries (impression taking, model pouring, tray design and trimming, clinical photography, shade recording, tray fitting, and developing patient information packs) : and power bleaching (set-up, isolation, application, use of the light, removal, de-sensitisers, and risk management.) There was plenty of opportunity for discussion and revision of the previous day's theory, and the chance to sample the various products available from different companies. The wonderful atmosphere of group learning was enhanced by the presence of experienced dental technicians, dental therapists and company reps, who were available to assist and provide further insights.
Before I attended the course, I had hoped to come away with a more comprehensive and scientific understanding of tooth whitening, to clarify the conflicting and confusing advice from so many different areas, and to have the knowledge to be able to tackle advanced cases. I certainly achieved far more than that - and not only learned about the predictable, evidence-based approaches to the topic, but also learned a lot about leading a strong, confident and successful dental team. And as if that were not enough, the course fulfils all the requirements for Gold Membership of The British Dental Bleaching Society. A highly productive and fruitful two days.
Thomas O'Connor BDS
ADVANCED BLEACHING SEMINAR
AND HANDS-ON, 28-29 October 2010
by Dr Linda Greenwall
Some comments from our course participants:
'... Hi Linda,
I just want to thank you for the amazing course last week. It was honestly one of the most beneficial and inspirational courses I think I've have ever been on.
I hope to implement the advice you gave and hope my practice will run as well as yours one day.
Thank you again and I hope to cross paths with you in the near future.
Kind Regards, BT...'
'Dear Linda
Thank you so much for such an inspiring whitening course - informative and practical. I enjoyed meeting you and your delightful and enthusiastic team.
With kindest regards.
PT ... '
'... Just wanted to say I really enjoyed the theory & hands on bleaching sessions, and have already started applying what I've learnt. I found the session on photography both informative and enjoyable and can't wait to start clicking away! Please pass on my gratitude to Dr Greenwall and the rest of the team.
With kind regards, AK...'
One from a participant who came for a refresher course:
' Dear Linda
I would like to thank you very much for another very excellent day. You and your team are an inspiration to me. This extra day has given me even more energy to pursue a successful life.
Many thanks.
TH...'
