Interview: “It’s simple: all dentistry should be cosmetic”

Brendan Day, DTI

Tue. 28. July 2020

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Dr Simon Chard has fast become one of the UK’s most influential dentists. He is a proponent of minimally invasive techniques and sits on the board of the British Academy of Cosmetic Dentistry (BACD). In this interview, he discusses his patient-centred, sustainable approach and how his embrace of all things digital has helped steer Rothley Lodge Dental, the dental practice he co-owns with his wife, Dr Meghan Chard, through this tumultuous COVID-19 period.

Dr Chard, thank you for talking to us. Firstly, could you explain your approach to treatment and what the phrase “ethical cosmetic dentistry” means to you?
This is a term that is used as a hashtag by the BACD. It’s something that is really important to me—when I came out of university in 2012, cosmetic dentistry had been very much demonised by the faculty, and many students had gained a very negative opinion of it, and so my goal has been to change this attitude. For me, it’s simple: all dentistry should be cosmetic, since no patient wants his or her teeth to look unnatural.

As a dentist, it is very important for me to be ethical when treating patients. What this means in practice is being minimally invasive in my approach, having treatment plans that are tailored to each individual patient rather than using a standardised approach. Every case is different, and though it takes more time to explain to patients all of the relevant options available, I regard it as our ethical duty to provide them with these choices so that they can maximise their long-term oral health outlook.

How important is sustainability to you in your approach to dentistry?
It’s incredibly important. I used to get very frustrated at the plastic waste that we create in our profession, though we’re obviously quite limited, because of infection control, by which items need to be single-use, which items need to be wrapped in plastic, and so on. Though these elements are unfortunately out of our control, I think it’s up to us, as a profession, to try and work with the governing bodies and reduce the plastic waste that we are producing.

I’m very passionate about sustainability in my private life and am always looking for ways to reduce my own plastic usage—switching to a reusable water bottle, for example, can end up making a big difference in this regard. When I started looking at the environmental impact of toothpaste tubes, I didn’t initially realise that they’re made of single-use plastic and that, ultimately, about 1.5 billion tubes of toothpaste go into landfills or into the ocean each year. This is where the idea for Pärla toothpaste tablets came from.

In a nutshell, these dehydrated toothpaste tablets are packaged in a glass jar with an aluminium lid. If you opt for a refill after your initial Pärla purchase, the tablets arrive in a compostable, plant-based bag and can easily be popped into the glass jar. The whole production chain is plastic-free from start to finish. As far as the ingredients go, things like sodium lauryl sulphate, which can cause irritation and is derived from palm oil, have deliberately been left out to make Pärla preservative-free and natural, while still being extremely effective at removing plaque and tooth stains.

How long have you been back at work now after the COVID-19 lockdown, and how difficult has it been to return?
We’ve been back for a bit over a month now, and we’re already operating at about 75% of our usual capacity. It’s been very good to get back—there’s a lot of additional PPE [personal protective equipment] that we now have to wear, which can get a bit claustrophobic at times during longer procedures, but I’m happy to be back in the practice.

How have your patients responded to your practice’s reopening?
The response has been great. Like everyone, my patients have wanted to get back to a sense of normality, and the majority of them seem to feel very safe coming in to the practice.

How has the lockdown affected the way you practise dentistry? Have you integrated any teledentistry services into your practice?
Virtual consultations are something that I wasn’t doing before COVID-19 hit, but we’ve since integrated them, and it has proved to be a very good decision. Most patients are quite well educated about what I’m able to offer with my dentistry, probably because they often discover me through my Instagram page, where there’s already a lot of information about what sort of procedures I carry out. These virtual consultations will definitely continue to be part of our services going forward, since they work really well.

In regard to how it’s affected the way I practise dentistry: I’m a Slow Dentistry ambassador, and a lot of the measures that have been brought in to combat COVID-19—things like using rubber dams for restorative work and spending enough time with your patients to ensure proper disinfection—are what I’ve already been doing. In that way, it hasn’t been that big of a change for me in my clinical approach.

“Virtual consultations are something that I wasn’t doing before COVID-19 hit, but we’ve since integrated them, and it has proved to be a very good decision”

Given your technological proficiency, do you think it has been easier for you to integrate COVID-19-related changes than it may have been for other dentists?
Certainly. I have a very effective communication tool in social media that allows me not only to communicate with my existing patients, but also to find new patients. This has really been a benefit, since COVID-19 has limited the tools that we can use to bring in new patients.

I think many of my patients have already become more accepting of virtual consultations and discussions. For example, if we consider my workflow for an Invisalign case, I would normally bring the patient in to the practice to discuss his or her treatment plan and to obtain his or her consent. Now, I’ve had to switch that to a virtual face to face for all of my Invisalign patients, no matter what their age is, and they’ve proved to be more than happy to jump on a Zoom call and get it sorted out. It’s easier for the patients, and it allows us to be more efficient with our time; it’s a win–win situation, as far as I’m concerned.

Has your focus on digital dentistry likewise helped out during this difficult time?
Whereas it’s always been good for both the patient and the dentist to be able to have things like restorations delivered in a single visit, it’s taken on even more importance during these COVID-19 times, where prolonged exposure to others should ideally be kept to a minimum. For example, the fact that I’m using tools such as Dentsply Sirona’s CEREC system for intra-oral scanning, rather than taking traditional impressions, is definitely helping to reduce chair times, among other benefits.

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