Full mouth reconstruction

Rob Muirhead shows how to perform a full-mouth reconstruction of a heavily worn and broken down dentition with Cerec 3D.

Since detailing a full arch Cerec reconstruction case carried out in one day in a previousDentistry article (April 2004), I have carried out many similar cases. Not every restoration has been a Cerec as in that case, but many have been at an increased vertical dimension.

I would like to share with you another reconstruction case at an increased vertical dimension, to get across how easy it is to do with a good working knowledge of occlusion and a Cerec 3 machine.

The real beauty of this treatment is its simplicity. With no complicated communication with a highly skilled and expensive lab utilising articulators and so on, you can reduce hassle and recalls for the patient and reduce chair time.

The treatment is consequently less expensive and more easily affordable for the patient, resulting in a greater acceptance of treatment. It is also very profitable for the dentist as it is very time efficient, and does not result in any lab bills.

Case study

‘Jim’ was a new patient with a very broken down dentition with severe attrition of the anteriors. He did not arrive requesting treatment for this. I guess in retrospect his teeth had been steadily disintegrating for a long time and he was just accepting it as simply a part of the ageing process. But, always on the look out for these satisfying and enjoyable cases, I suggested a full mouth reconstruction and he went for it.

Treatment plan

• Step 1: Mount some study models on a ‘Denar’ articulator in centric to decide which teeth to restore and how. Some would need Cerec restorations and some would need composite, while other teeth might just need simple composite build-ups or a little judicious grinding.

• Step 2: Splint therapy with a CRA to reduce inflammation of the TMJs, as there inevitably would be in a grinder like this patient. Also, it was necessary in order to make sure he could tolerate an increased vertical dimension.

• Step 3: Once splint therapy had been completed an initial appointment was booked to restore and build up the posteriors at the increased vertical dimension as well as to create canine guidance. From studying the mouth, radiographs and mounted study models, a morning/afternoon session was deemed suitable for this.

• Step 4: The treatment involved carrying out two Cerec restorations and three composite restorations as well as two small composite build ups, all with centric stops. I left him this way with anterior guidance coming from his canines also.

• Step 5: Two days later, a whole day was booked to carry out four Cerec crowns on his upper incisors, six Cerec veneers, and to make sure everything was equilibrated with canine and anterior guidance. Two weeks later a short appointment was required to check equilibration and tidy things up if necessary.

Everything went according to plan with the exception of our decision to do a Cerec restoration instead of a composite on the 7 , which we carried out on the last appointment.

The upper incisors were stained and glazed in a furnace after milling, while the lower veneers were simply shaped and polished after placement as is normal with posterior Cerec restorations. Cerec blocks are made from a dense ceramic which enables them to be polished very nicely; allegedly, ‘as good as a glaze’.

Obviously, care must be taken not to over-heat the teeth but this is easier when polishing multiple units. I use ‘ceraglaze’ diamond impregnated rubber cups from Prestige Dental (0800 591175) which I find brilliant. Shaping the lower makes the creation of perfect anterior guidance very simple.

The patient was very happy with the result and there have been no problems. His jaw is nice and loose and his teeth come together with a satisfying ‘clack’ indicative of an equilibrated dentition.

Slow but safe

Experimenting with periodontal therapies is simply too risky these days. What we need instead, says Dr Ian Peace, is a step-by-step approach...

I was watching a fascinating series on television about the

pioneers of surgery a while ago and was amazed at the

discussions on the development of transplant surgery.

What soon became clear was that the pioneers of transplant surgery were willing to take risks on the outcomes of treatment to learn, and eventually provide a form of care that now benefits so many people. Many of the early patients would have died without this care, so the overall risk to them of having the treatment was limited, perhaps even justified.

But I am not sure such surgical experimentation would be allowed in today’s ethical and medico-legal climate. We now have to take things very carefully, step by step, which makes mewonder where the next medical leap will come from.

In the field of periodontal therapy this issue brings a dilemma. As patients demand more exotic treatments from us our skill levels must be such that we know what treatments are available and can deliver them.

Clearly we do not want to make mistakes but often one of the most effective ways to learn something is by doing it – in the knowledge that if we do make any mistakes we can learn from them. Yet in our growing culture of blame and subsequent litigation we dare not make mistakes, even honest human ones.

So how else do we learn and therefore progress in the field of clinical excellence and innovation? How do we learn the clinical and surgical skills necessary to perform periodontal therapies and implant surgery in a risk-free way? I think the answer is slowly and under guidance from people who know what they are doing.

The first step is to gain a full understanding of the scientific and clinical principles underpinning any therapy. By learning about and understanding the biological principles, classifications and natural history of periodontal diseases we can develop and institute appropriate treatment plans.

By understanding the theory and then developing the clinical skills we can then provide treatments based on those underlying principles. It will also allow us to identify suitable cases for referral.

But we must still be able to accept minor – hopefully reversible – mistakes occasionally and learn from them. Above all, we must all be professional and carry out only those procedures that are within our competence.

We must push the boundaries of our skill levels and

competence bit by bit. We may not make immediate leaps

forward but we will be developing skills slowly and safely that will ultimately benefit patients while keeping our

credibility intact.

Financial times

When is it best to seek advice on financial planning? As soon as possible, says Anne Alexander, who also explains what the main forms of inv...

A junior colleague recently asked me when she should start seeking financial advice – should she speak to an adviser early in her career or wait until she has accumulated some savings? It is question many people ask. I have worked in the financial services industry for more than 20 years and, having been an independent financial adviser for many of those years, I have met and managed the funds of people who have saved and those who have not. As you can imagine, the savers look forward with confidence to retirement while the non-savers do so with fear and trepidation.

As dentists, you will know that regular check-ups are essential to maintain oral health. The same is true of your finances. So my answer to when to seek financial advice is the earlier the better.

The starting point for any financial adviser is to create a profile of you, the client. This is done by collecting information about your personal circumstances and current financial situation. From this profile a financial plan is created to help you achieve your desired lifestyle – allowing for any disasters, of course, that may arise. Your adviser can then make recommendations as to how to use your finances.

They will cover your assets, investments, liabilities and income. The way you spend your money is also a vital aspect of the analysis, so a review of your short- and long-term expenditure will help establish the plan’s robustness.

‘Wealth management’ is not just about investing available cash in pensions or, indeed, any single source. Its primary function is to make the best use of available assets given the restraints of liquidity and tax efficiency. It is also about putting these assets to the best possible use, as and when opportunities arise and when needs must. Investment is a means to an end. It is about using your capital to create more money, either through income or capital growth.

The long-term capital growth and income associated with investing in equities has, on average, outperformed returns from the investments that rely on interest rates. Over periods of sustained economic growth, investors in equity-based investments have seen their capital increase substantially. Also, equity-based investments have proved to be a good defence against inflation. There are four main aspects to increasing capital growth.

Inflation protection

Inflation is normally the most serious threat to the long-term capital value of savings. Inflation protection is usually achieved with asset-based investments, which historically have offered the best prospect of growing income and capital.

Spreading them thin

You can protect your investments by spreading them across various investment vehicles such as unit trusts, investment trusts, and open-ended investment companies and managed funds of insurance companies, all of which are widely diversified. Full-time fund managers have sources of market information, resources and investment skills that few individuals can match.

Importance of time

One of the most fundamental aspects of any equity-based investment is that of time. While a particular fund’s past history should not categorically be taken as read, the long-term overall performance has to be seen in the context of short-term fluctuations.

And while excellent short-term gains can sometime be made, the fundamental principle of any equity-based investment is to accumulate good quality capital growth over a period of time, not one or two years but five to if necessary.

Attitude to risk

Any investment capable of capital growth also has the potential for capital loss. The extent to which you are prepared to expose your capital to risk is an important factor in determining potential growth. So before you make any investment decision you should consider the level of risk you are willing to take.

When building an investment portfolio, inflation, risk, the time scale of the investment and the tax element all have to be considered. Achieving a balance between the four is essential and none of them should be considered in isolation.

With the relevant importance of each factor likely to change over time, regular reviews of your financial affairs are essential, so seek independent financial advice. Also, while the reduction of tax – or indeed its avoidance – is important, the tax element is probably the most distorting of these factors and should not be allowed to dominate the investment decision.

Remember that while a particular investment may look impressive; it is unwise to ‘put all your eggs in one basket’. The best philosophy for prudent fund management is to split the funds between different types of investments, not only to achieve the ultimate goal of good quality growth but to mitigate risk factors as well.

Allocating assets

Different types of assets, such as equities or bonds, behave in different ways. The first step in forming any investment strategy is to achieve the right balance between the major asset classes. This ‘asset allocation’ is fundamental to meeting your investment goals in the medium and long term. In fact, asset allocation can be as important as the choice of individual funds themselves.

As dentists, you are eligible for membership of the NHS pension scheme, so this is the first port of call for your disposable income. As a member of this scheme you will be entitled to pension benefits at retirement which depend on your length of service and salary.

Regular savings

In the dental industry, where remuneration is high, your pension will form a substantial part of your retirement income. But will it be enough to maintain your standard of living at the level of income you enjoyed during your career?

One starting point here is simply to save regularly. To make this tax-efficient you could consider using your Individual Savings Account (ISA) allowance. With an ISA you can save up to £7,000 in a tax year (6 April to 5 April) and not pay tax on the income you receive from the plan or the gains it achieves. This is an excellent way to save.

ISAs can be split into two components – a Mini ISA and a Maxi ISA. Any ISA can be made up of an investment in cash, or longer-term investments such as stocks and shares. In each tax year you can invest either in one Maxi ISA, which can include all of these types of investments, or two Mini ISAs – one for cash and one for stocks and shares.

There are two types of Mini ISA – a cash ISA, and a stocks and shares ISA – and you can open each ISA with a different ISA manager if you wish. The amount you can invest in each tax year is fixed – up to £3,000 in a cash ISA and £4,000 in a stocks and shares ISA. But you cannot invest in more than one Mini cash ISA or more than one Mini stocks and shares ISA in the same tax year. This would be a good starting point for regular monthly savings.

A Maxi ISA can include both cash and stocks and shares. Whichever way your investment is split, it counts as one Maxi ISA, so you can open only one Maxi ISA in each tax year. The total amount you can invest is £7,000 a year and you can invest up to £3,000 of this in the cash element. By using your ISA allowance on an annual basis you have the scope to build a substantial fund for retirement or, before then, use it to help fund such things as school fees. I have found this to be a great source of providing tax-efficient income for clients, particularly at retirement. When pension levels bring them into the higher-rate tax bracket, tax-free income of any sort is very welcome.

Investment trusts

You could also consider investment trusts. These are public limited companies whose shares are listed on the London Stock Exchange. Investment trusts enable you to spread your risk by holding a wide range of investments in hundreds of companies.

Each investment trust company employs fund managers who use specialist research facilities to help them decide which shares to buy, when to buy and when to sell. The managers keep abreast of investment opportunities in stock markets in London and around the world. They are accountable to the directors of the investment trust company who in turn are accountable to the shareholders.

Because of their structure and because their costs are low, investment trusts have particularly good long-term potential for growth. This makes them ideal investments when planning years ahead. I often recommend regular and lump-sum investments in unit trusts as part of a financial portfolio. Unit trusts are investment vehicles which pool contributions from their investors and the total fund is then managed by specialist fund managers, whose task it is to manage the ‘investments’ of the fund to make investment profits. These profits increase the value of the fund, increasing the value of each investor’s share. Of course if the fund suffers losses then the value of investors’ shares falls, as does the price of the units.

In general, unit trusts invest primarily in equities and often specialise in a particular sector or geographical area. Dividends are paid to unit holders that reflect the dividends received on the underlying investments. The dividends are liable to income tax and are subject to the same tax treatment as dividends on direct share-holdings. The unit trust does not itself pay tax on its capital gains, but on encashment any gain made by the investor is subject to capital gains tax (CGT), under normal CGT rules, including the annual exemption and taper relief.

Direct equities

Most reputable financial advisers have good working relationships with firms of stockbrokers and, where

appropriate, give advice on the investment of direct equities as a means of building an investment portfolio.

One of my main reasons for recommending a portfolio of investment trusts, equities, unit trusts and OEICs is that by placing funds in such holdings my clients have scope to use their CGT annual allowance in years to come by way of disposals of these holdings, which makes this an efficient investment vehicle to consider within an overall investment portfolio.

It is a common feature of tax planning, that individuals should, where possible, aim to use their CGT annual exemption (£8,500 for 2005-6) because it cannot be carried forward and, if unused, is just wasted. Married couples have even greater scope to make tax savings because more than £16,000 worth of gains can be realised without a tax liability on jointly owned assets – clearly a beneficial feature and one that could be exercised in years to come.

What I have discussed here is only a small area of investment planning and does not take into consideration the many areas or types of investment vehicles. But what I hope I have been able to highlight is that financial planning should not just be dealt with at retirement but should be considered throughout your career to take account of accumulating wealth, ensuring sufficient life/protection cover, inheritance tax planning, investment planning, mid-career planning and retirement planning.

When seeking advice, however, look at your overall financial position so that your adviser has a clear picture of your financial affairs, aims and objectives. This makes for prudent and efficient financial planning, as it looks not only at your immediate needs but your long and short term needs too. Perhaps you should think about arranging your own financial check-up soon.

Anne Alexander is associate director and head of investments at Campbell Dallas Financial Services. Call 0141 942 6060 or email anne.alexander@campbelldallas.comfor further information.

First impressions count

Richard White explains how putting a lot more effort into marketing your practice can positively influence what your patients think of you.

Ask most dentists how much they spend on marketing each year and the response is likely to be a few hundred pounds on Yellow Pages advertising, and maybe a bit extra to keep the website going. But in reality, an average practice expenditure is around £30,000.

So why the big discrepancy? It’s all about how we see marketing. To most dentists, marketing is synonymous with advertising. But marketing is the means of establishing you’re practice’s image in the minds of your existing and future customers.

Refurbishing the practice, for example, isn’t just for the benefit of the staff – it’s to improve the patient’s image of your practice. Investing in new technology isn’t just about buying the latest dental gadgets – it enhances the services you offer, and helps your patients to perceive you as being a modern practice.

Let’s take a look at all the aspects of your practice through your patients’ eyes, and how the application of a little marketing will affect the way that they think of you.

Successful, modern practices know they need to create an excellent first impression. The first thing their patients see is the outside of their practice, so they make sure it always looks clean, smart and attractive. They realised long ago that an exterior with peeling paint, rubbish in the front garden and an old-fashioned, unpolished brass plate by the front door, gives the impression of a dental practice, which has a similar old-fashioned approach and little pride in its work.

The same theory should be applied for the inside of the practice. Stained carpets and old-fashioned décor gives a bad impression, so make sure that the reception area is light and airy with comfy, modern seating.

Your reception area offers you a great opportunity to create some ‘wow’ factor for your practice. More and more of our clients are putting a huge amount of effort into making their reception area really special, by anticipating the needs and desires of their particular type of client. For example, some family oriented practices with lots of young patients have invested in Playstations and buy in the latest games. As long as headphones are also supplied, this keeps both the children and their parents happy! Similarly, practices with a holistic view of dentistry have made their reception area calm and relaxing areas to be, by installing low lighting, comfortable chairs and a soothing water feature.

When it comes to the treatment room, your patients are unlikely to know enough to judge whether the equipment is modern or not. But they will be able to tell if it is clean and well-looked after. They will also form opinions based on your manner towards them, how gentle you are while treating them, and even how you and your dental nurse interact together.

Your patients are unlikely to know much about dental equipment, but they will notice if you get in a piece of equipment that makes a real difference to their treatment. They’ll appreciate the fact that you have invested in something which helps to make their dental treatment less painful or more convenient, and are quite likely to tell their friends and family about it, therefore marketing it for you.

The way you and your staff interact with your clients strongly influences their image of your practice and can make or break the business. Successful practices are those which realise that their receptionists are their public face, and so ensure that they are knowledgeable and informative, polite and friendly, as well as looking smart and presentable. Your staff need to know that having a bad day is no excuse for being rude or impatient – even if it is a one-off the client won’t know that, and will not appreciate being treated badly.

All the points mentioned will help to form an overall impression of your practice, one that will stay with the patient until you do something pretty radical to change it, and one that they will also pass onto their friends and family. So, given the original aim of marketing – which is to build a reputation and image that appeals to your target clients – it seems clear that marketing is at the core of your business, reflected in everything that you and your staff do each day, and without it you wouldn’t have a business.

To gain the most benefit from the £30,000 that you already spend on marketing, you need to let people know about it. You need to make sure that your patients know that you have invested in new equipment and explain to them how it will improve the standard of dental care they receive. You need to let them know about training courses you and your staff have attended, and what difference it will make to the services you offer.

And you should let them know when you refurbish the practice – don’t just assume they will notice, tell them you have done it and let them know what the benefits will be. If you want to attract new patients, you also need to let them know about your practice – what services you offer, what your ethos is, and why they should choose you above any other dentist in the area. The way you communicate will play a key role in your success, and further influence the perception that customers have of you.

This is why the most successful practices set aside some extra marketing budget – to pay for your methods of communication. We’re not talking about the difference between spending £500 and £5,000 on marketing. We’re talking about the difference between the £30,000 you currently spend and £35,000. And that £5,000 – just 15% extra – can make or break your practice.

Patient newsletters can be a successful marketing tool. They provide a perfect vehicle for keeping your patients informed about what is happening in the practice. Patients will feel valued because you have taken the time and trouble to communicate with them. They are more likely to ask about new services and procedures that you have featured in the newsletter. And your practice will rise in their estimation, which will often prompt referrals to friends and family.

In fact, for practices which are happy with the size of their patient lists, but that want to encourage uptake of higher-income treatments, a patient newsletter is the ideal way of achieving their goals. Practice leaflets, websites and patient welcome packs have a similar effect.

Professionally produced, comprehensive patient welcome packs that include a patient information/treatment leaflet, fee guide, payment plan description, medical history form and smile analysis, all housed in a high quality folder, are likely to cost around £5,000 for 2,000 copies (£2 to £3 each).

They are usually sent to anyone who calls to enquire about joining your practice, and can encourage the ‘wow’ factor, which strongly influences the recipient, prompting them to choose your practice above others they have contacted.

Many dentists regularly complete detailed clinical audits, but the most successful also regularly carry out marketing audits. They make sure they ask new and existing patients how they heard of the practice or treatment, and log the answers. They regularly look at the results of their marketing activity, and adjust it if necessary to reap the maximum rewards. And they regularly give their marketing communications a fresh look, making sure their brand image is kept up to date and on message.

Many dentists still find it hard to justify spending so much on a pack, and yet a look at the figures below makes it clear that welcome packs can still more than pay for themselves. These figures assume that the proportion of new enquirers who become loyal new patients is currently 40%, rising to 70% after introduction of the new patient pack.

There are also lots of hidden benefits in attracting new business through marketing. Your investments in equipment and training, for example, are put to better use and therefore cost less per patient. Staff morale is likely to rise as the business becomes more successful, and you ensure a brighter future for your practice. So, the next time you start thinking about marketing in terms of cost or income generator, remember – you are already investing thousands of pounds in marketing.To make sure that expenditure reaps the maximum benefit for the practice, you just need to spend a little extra on communication – the results will speak for themselves.

A private affair

Attracting private patients to your practice is no different to offering the right type of pizza in the right premises – it’s all in the...

Before I talk about what I think constitutes a private patient, I have to tell you about a recent lecture I gave to a group of 60 postgraduates in the north of England, the majority of whom were principals or associates delivering NHS dentistry.

However, before I was due to speak, I spent an hour eating and chatting with my prospective audience. The conversation didn’t revolve around patients, prices, marketing or business practice – nothing new there. What surprised me was that the conversation didn’t once steer towards the subject of teeth. I found this unusual, because dentists usually tend to enjoy a good old natter about clinical issues while they tuck into a good meal.

The sole topics of conversation were golf (OK – that happens) and UDAs. It was 20% golf and 80% UDA’s – targets being negotiated and existing targets renegotiated. Then it was UDAs, UDAs, UDAs – for a whole hour. I even listened to an interesting debate about how to legitimately massage the UDA figures to keep the PCT happy while not killing yourself (and losing valuable golf time). It would appear that some training courses are appearing on the market that will show you how to manipulate those UDA’s and keep the grey-suited PCT officials happy in their ignorance. Such is progress.

Anyway – on with the show – ideas to make sure that your patients request and appreciate private dental treatment: Practices that are considering offering more private treatment options or a full conversion fall into two categories, each requiring a different approach. The first category looks at practices where the physical facilities and the team are below average. It looks at tired or scruffy premises, poor decoration and equipment and staff who are jaded by the ongoing pressure of keeping a busy NHS practice alive, tolerating poor performance and behaviour by clinicians and patients alike.

In this case, you have to smarten up your premises and your act before offering private treatment options and expecting a viable and profitable response. To do this, you will either have to invest or borrow money to improve facilities and to provide team training on customer service and communication skills. All of which assumes that you are simultaneously going to stop tolerating poor behaviour by patients.

Once you have completed that process (which will take maybe a year or more), you can join the second category of practices, those with good-quality facilities and a strong team, delivering an attractive customer service experience and great dentistry.

If you are either introducing or converting to private dentistry, there is a key phrase that must be incorporated into your team’s language: ‘In order to maintain our standards of customer service and clinical care we have decided to offer dentistry on a private basis in the future.’

This isn’t about the NHS being a poorer offer, it’s not about you having to change because of the Government’s new proposals – it’s simply a business decision that you have made, the objective of which is to keep practising customer service and clinical skill at the same level as before.

Expanding on the last point, a client recently announced at one of our dental workshops that, after a year of business coaching he had finally realised that the year had been spent converting the patients’ attitudes, not the practice. It’s about changing the expectations and the mind set of the right type of patients, allowing the rest to walk away and some of them to drift back over time.

Let’s take a look at pizzas.

• If I want to fill my stomach at half-time, I’ll ring Dominos. I’m not too bothered about what’s on the pizza; I just want it edible and delivered.

• If I want to take the kids out on a Saturday afternoon, I’ll go to Pizza Hut. Still not too bothered about the pizza and I’ll tolerate the staff and the surroundings because I just want the kids entertained.

• If I’m travelling on business, I’ll go to Pizza Express. I know that wherever I walk through the door, if it’s in Edinburgh or Bristol, I will get the same standard of customer service, the same patient journey, the same tables and cutlery, the same standard of good-quality pizza.

• If I’m out for a romantic dinner for two – it will be at a privately owned trattoria, where the owner will dance around us when we arrive, the waiters will be personalities and the food and wine will be outstanding. You get exactly what you want and exactly what you pay for.

Is dentistry any different? I don’t think so.

• Domino’s dentistry – shabby premises, tired staff, harassed dentists, dipping sheep all day.

• Pizza Hut dentistry – it’s OK but that’s all – and you are not sure whether the other people in the waiting room are your ideal companions.

• Pizza Express dentistry – efficient, clean, good customer service, good dentistry – consistency.

• Trattoria dentistry – a five-star experience with lovely premises, caring and attentive staff, great dentists/hygienists, great dentistry.

Which dental practice do you currently offer to your community – and which would you prefer to offer?

I don’t believe that you can mix and match – serving a Domino’s pizza in Pizza Express surroundings or a trattoria pizza (at trattoria prices) in a Domino practice. The buying public are going to get annoyed and confused by that mixed marketing message.

This philosophy convinces me that there is room in the market for a Pizza Express dental franchise in the UK. As I’m not a dentist, I cannot initiate such a business under current legislation but if any dentist reading this article has the interest and a best friend with a few million to invest, please give me a call – I’d love to help build that business! In the meantime, there are enough patients everywhere in the UK to support each of these business types – so just decided which one you want to own and/or work in.

I recently visited a practice in the East Midlands that was bought from a retiring dentist by a husband and wife dental couple, three years ago. They proudly showed me photographs documenting the renovation of a tired 1970s configuration into a more modern and funky establishment – lots of light oak and smoked glass – you know what I mean. I sometimes call this a ‘wine-bar’ practice – very popular and trendy at the moment.

So far so good – the team all have nice navy blue uniforms and are enjoying the new look. Then they brought out the price list and I nearly fainted – half-price dentistry in private surroundings. The cost of an initial consultation was exactly 50% of what I had seen in a rural practice down in the South West the week before. Closer examination revealed similar cheap dentistry offered across the treatment board.

The rationale? ‘We didn’t want to frighten off the patients when we bought the practice so we decided to keep close to the original price scale, in line with NHS prices, while we refurbished.’ So they have transitioned from the category one to category two practice, have completed the refurbishment and retraining, and are still too scared to put their prices up to a realistic level.

I’m talking here about moving from the equivalent of £90 per hour towards our clients’ average of £180 an hour over the next two to three years. But they haven’t even taken the first steps yet and are afraid to do so. This creates an interesting paradox – they are attracting a steady flow of new patients into the practice – but there is a high proportion of ‘messers’ among them.

This may be an interesting new breed of patient – private ‘messers’ who don’t want to mix with the riff raff at the local NHS practice (or tolerate the customer service) but don’t want to pay realistic prices – so they are taking advantage of this funky wine bar practice but messing them about at prices they can afford. Needless to say, my coaching is about raising prices and firming up on patient behaviour.

遼、改造中スイングに自信持てず悪循環…ショットメロメロ出遅れ

2011年07月28日19時01分




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順位 選手名 スコア1 平塚　哲二 -7
2 池田　勇太 -6
3 K・アフィバーンラト -4
4 宮里　優作 -3
横田　真一 -3
孟　東燮 -3
キム・ヒョンテ -3
J・チョイ -3
上田　諭尉 -3
藤島　豊和 -3


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初日から大きく出遅れてしまった石川遼（撮影：岩井康博）








＜サン・クロレラ クラシック　初日◇28日◇小樽カントリー倶楽部(7,471ヤード・パー72)＞

　国内男子ツアー「サン・クロレラ クラシック」が北海道にある小樽カントリー倶楽部で開幕。09年チャンピオンがいきなりつまづいた。石川遼は前半4番でボギーが先行すると、続く5番ではティショットのミスからダブルボギー、さらに6番、7番とボギーを叩きこの4ホールで5つスコアを落としてしまう。その後9番、10番、13番とパー5でバーディを3つ奪ったものの、最難関の16番、最終18番とボギーを叩き5オーバーでホールアウト。123位タイと大きく出遅れてしまった。

「石川遼1打速報」で全ストロークを振り返る

　先週から改造を始めて手ごたえを掴みつつあったショットが曲がりに曲がった。スタートから3ホールこそ静かなゴルフだったが、4番パー3では「自分の思ったところより10メートルは左に行ってしまった」というミスショット。続く5番では「4番ではクラブが外から入ってしまったので、それだけは避けようと思って手先で打ってしまった」ボールは右の林に入りセカンドは出すだけ。3打目、アプローチのミスも重なって悪循環のままスコアをズルズルと落としてしまった。

　曲がる原因はわかっている。「スイングアークが小さいとサイドスピンが多くなってしまう」しかし、修正は最後まで出来なかった。「序盤でティショットが曲がってスイングに自信を持てなくなって大きなスイングアークで打てなくなる悪循環でした」その後も思うようなボールが打てず、最終18番のティショットも右に大きく曲げて隣のホールのフェアウェイ。そこからボギーを叩きこの日を象徴するようなフィニッシュとなった。

　「スイングを変え始めている途中なので。例えばパターを変えた直後は入るようになったりしますが、それは長続きしない。スイングもこれからが大切。徐々に右肩上がりになっていければ」。結果が出ないことには満足出来ないが、このスイングに大きな伸びしろを感じることが出来るのが救いだ。

　「今は頭の中がスイングのことでいっぱい。2、3年前に戻った感じで新鮮ですね」。2年前はドライバーを真っ直ぐ飛ばすことだけを考えて大会制覇。もう一度あの頃に戻ってどこまでもスイングと向き合う。

【初日の順位】
1位：平塚哲二(-7)
2位：池田勇太(-6)
3位：キラデク・アフィバーンラト(-4)
4位T：宮里優作(-3)
4位T：横田真一(-3)
4位T：メン・ドンソプ(-3)
4位T：H・T・キム(キム・ヒョンテ)(-3)
4位T：J・チョイ(-3)
4位T：上田諭尉(-3)
4位T：藤島豊和(-3)
4位T：井上忠久(-3)
12位T：薗田峻輔(-2)他9名

61位T：※松山英樹(+1)他19名
123位T：石川遼(+5)他11名
※はアマチュア

難コースで持ち味発揮！勇太、6アンダー単独2位発進！

2011年07月28日19時13分




リーダーズボード
順位 選手名 スコア1 平塚　哲二 -7
2 池田　勇太 -6
3 K・アフィバーンラト -4
4 宮里　優作 -3
横田　真一 -3
孟　東燮 -3
キム・ヒョンテ -3
J・チョイ -3
上田　諭尉 -3
藤島　豊和 -3


順位の続きを見る





久々に好スタートを切った池田勇太（撮影：岩井康博）








＜サン・クロレラ クラシック　初日◇28日◇小樽カントリー倶楽部(7,471ヤード・パー72)＞

　北海道にある小樽カントリー倶楽部で開幕した、国内男子ツアー「サン・クロレラ クラシック」。池田勇太が6アンダーと好発進を見せた。池田は序盤の2番こそセカンドを池に落としボギーとするも、5番のバーディを皮切りに怒涛の巻き返しをスタート。続く6番バーディの後、9番パー5ではセカンドを7メートルにつけイーグルを奪取。後半さらに3つのバーディを積み重ね、6アンダーでホールアウトした。

遼、改造中スイングに自信持てず悪循環…ショットメロメロ出遅れ

　全英オープンからの連戦に疲れは溜まってきている。それでも、精密なプレーを要求する難コースにショットメーカーの血が騒いだ。

　「コース的にはタフ。ショットが重視される中で、グリーンにも見えづらい傾斜があって、それを読んでいく。コースに挑む本当の自分がいる中で、もて遊ばれないように戦う自分もいるのが楽しい」。好きなコースだという小樽CCの戦略性のあるレイアウト、洋芝、地面の固さ、すべてが池田好み。アイアン、パターなど試行錯誤はまだまだ続いているが、マネジメントとショットの精度で攻略していく持ち味が光ったラウンドだった。

　久々の好スタートにも油断はない。「ガマンすること。ボギーの一つや二つはある。このあとの3日間試練はあると思うが、ガマンしてバーディが来るまで待てるかだと思う」と気を引き締めた。来週からは「WGC-ブリヂストン招待」「全米プロゴルフ選手権」と米ツアー遠征が控えているが「今週は今週。来週は来週」。一戦必勝体勢ですべてを出し切り今季初の栄冠を目指す。

【初日の順位】
1位：平塚哲二(-7)
2位：池田勇太(-6)
3位：キラデク・アフィバーンラト(-4)
4位T：宮里優作(-3)
4位T：横田真一(-3)
4位T：メン・ドンソプ(-3)
4位T：H・T・キム(キム・ヒョンテ)(-3)
4位T：J・チョイ(-3)
4位T：上田諭尉(-3)
4位T：藤島豊和(-3)
4位T：井上忠久(-3)
12位T：薗田峻輔(-2)他9名

61位T：※松山英樹(+1)他19名
123位T：石川遼(+5)他11名
※はアマチュア