In recent years, private dentistry has risen in popularity with patients and professionals compared to NHS options1 with that percentage only expected to rise in the future. Through personal experiences, I can see the psychological mindset shift from NHS to private, with an abundance of possible reasons as to why the population’s opinions and actions may be changing. Some prefer the increased care and attention to treatment and outcomes; some prefer having less restrictions to increase profits, and some simply feel they have no choice but to join the movement in fear of being left behind. Although it’s not my area of expertise; whatever the reasons, I believe dental technicians must find a way to benefit and evolve with this drastic revolution.
Many of us know the strain COVID-19 had on dental laboratories. Whether you are a lab owner or employee, we were all affected by the government’s decision to exclude us from funding, which in my opinion had a detrimental effect on NHS dentistry as a whole. Now the UK economy is pushing for more private dentistry, it is up to us to make sure we are part of the change. Clinicians are looking for new ways to add premium options for patients who willingly want to receive the best and we must be able to accommodate this.
Patients are convinced to pay higher fees but expect, and rightly so, that the service, treatment, and restorations match the price they are paying. Sure, clinicians can take courses to advance their skills and improve their practice’s aesthetic and patient journey, but without a talented dental technician to create that same level of standard in their restorations, they are missing a crucial piece to the puzzle. Let’s be honest, why shouldn’t we be able to increase our profit margins alongside our clinical partners?
When it comes to dental restorations and appliances, function should never be compromised, no matter the price. Aesthetics, however, is the first thing everyone notices, right? It can allow you to stand out from the crowd and catch the eye of patients and talented clinicians. Gingival composite is something I introduced into my work two years ago and would never look back when it comes to natural-looking dentures. Don’t get me wrong, there are some instances where it wouldn’t be the most favourable solution. Immediate dentures or patients with bad oral hygiene are cases where I usually would advise against gingival composite, as dentures may need to be remade or altered in the near future, making it more difficult to execute when an extra material has been added. Similarly, patients with medical problems such as dementia may not benefit from a change in material due to their cognitive decline, so it’s important to recognise that although this is a great aesthetic modification, it’s not right for every case.
Benefits of gingival composite
1. The result is more reliable than other options such as adding coloured acrylic at the flasking stage. Composite is applied in the order you want the colours to be seen and does not change during curing, meaning you can be more accurate with how you want the final dentures to look.
2. There are varied shades available to help match individual patients’ natural soft tissue in a way that blends seamlessly. Clinicians can also use pink shade guides and photographs to help relay this information to the lab.
3. The results achievable with pink composite give restorations depth that acrylic cannot. You can recreate tooth root pressure on soft tissue, blood supply in the vestibule using stains and the illusion of free and attached gingiva.
4. Because of these possibilities, it means less bulk on the dentures through the means of contouring. Natural gingiva is not often as bulbous and exaggerated as technicians contour them. With acrylic, the ways in which to characterise is limited and in turn creates unrealistic outcomes.
5. I hear many technicians and clinicians say that because you cannot see pink most of the time in the mouth, it’s pointless, but I don’t believe that’s true. There are many instances where patients have high lip or smile lines, partial cases where it needs to be less noticeable or simply those who want the full experience of luxury. Apparently, ‘88% of people say they remember people with beautiful smiles and 75% believe your smile can help or hurt your career’3, so why are we still limiting the enhancement of aesthetics when it comes to dentures and full arch restorations?
6. It’s a cost-effective aesthetic solution for full arch hybrids and temporaries. Patients who pay for full arch treatment spend a lot of money and therefore should receive the best functional and aesthetic outcome everyone can provide. Gingival composite compares more closely to ceramic shades and finishes, meaning if the patient is upgrading post-healing, there is not as big of a leap in appearance.
7. Gingival composite is not just for patients. Sure, they get the final appliance, but clinicians appreciate the results and skills needed to produce such high-end work too. Adding this ability to your list builds professional relationships, a respect for your craft and positions you as a knowledgeable artist in your field.
8. Many competitors are diving into this new material, gaining new skills, and paying clients are heading their way, so why not get ahead of the curve before it becomes standard practice?
9. It gives us more creative license to individualise our work and be proud of the things we produce. I know from experience that if I feel monotonous in my everyday work, I lose that passion and fire I have for the career I fell in love with.
It’s no secret that clinics and laboratories are swaying more to towards digital and I’m all for it. Since working in a digital full arch laboratory in Australia, I have seen just how much we can do to make everyone’s lives easier and more predictable. This is just another area where gingival composite is under-utilised. We are now able to design, mill or print dentures and full arch cases and although the accuracy and precision is there, I don’t believe the aesthetics has developed enough to replace traditional finishing methods just yet.
The hybrid solution that we incorporate in at The Hive Dental Laboratory means we can use the pros of digital alongside the handmade final touch using gingival composite, to provide the best of both worlds.
1. Dentistry (2022) A brief history of private dentistry.
2. David Westgarth (BDJ 2020) Dental labs and technicians: The last ones to fall?
3. Charles. E. Scholler (2023) Will a more attractive smile make a difference in your life?
About Bethany Brown
Bethany Brown MSc RDT is founder of TPE and Tech Talk; Dental Technology continued education and community platforms. Prosthetic and digital dental technician at The Hive Dental Laboratory.