PRACTICE

IN BRIEF

There are a number of information security issues that should be taken seriously when
using the Internet.

Anyone using the Internet should follow recommended security procedures, such as
using an up-to-date rewall and software capable of protecting against viruses, worms,
trojans, spyware and adware.
With careful planning and the right mix of hardware/software, it is possible to work
online in an efcient manner and maximise productivity.

Safe and efcient use of the Internet

P. K. Downes1

A minority of people abuse the freedom of the Internet to the detriment of the vast majority. Many people feel that the
Internet requires more regulation to reduce the burden of hackers, viruses, hoaxes, adverts and spam that continue to
proliferate unabated. Until this ever happens, it is down to the individual person or business to protect themselves against
malicious attacks and to use the Internet in a safe and efcient manner.

THE INTERNET GUIDE FOR

DENTISTRY
1.

An introduction to the Internet

2.

Connecting to the Internet

3.

Introduction to email

4.

Effective use of email

5.

Introduction to the
World Wide Web

6.

Creating a practice website

7.

Power searching

8.

Dental resources on
the Internet

9. Safe and efcient use of

the Internet
10. Putting it all together;
dentistry and the Internet

1General

Dental Practitioner, Kelvin House

Dental Practice, 2 Nelson Road, Whitsta
ble, Kent, CT5 1DP
Correspondence to: Dr Paul K. Downes
Email: paul@pdownes.fsnet.co.uk
Refereed Paper

British Dental Journal 2007;

203: 11-22
DOI: 10.1038/bdj.2007.587

A. SAFE USE OF THE INTERNET

The Department of Trade and Industry sponsor
research into information security breaches, in
order to help UK businesses better understand
the risks they face. The surveys from 1998 to
2004 show that as businesses embraced the
Internet, there was a corresponding increased
exposure to information security issues. The
most recent Information Security Breaches
Survey of 20061 shows that the steep rise in
the number of businesses affected by security
issues appears to be levelling off. However,
the report stresses that it is certainly not a
time for complacency. As IT systems and
the Internet become increasingly important
to business operations, the stakes are being
continually raised and many UK businesses
are a long way from having a security-aware
culture. The proportion of all businesses that
encountered a security incident in 2006 was
62%, compared to 74% in 2004 and 44%
in 2000. The most common form of breach
(roughly half) was virus infection, while one
in seven of the worst malicious software inci
dents involved spyware. The sad reality is
that security problems have now become a
fact of business life, and not something that
just happens to other people.
This section looks at ways in which a person
can use the Internet safely; it is divided into

BRITISH DENTAL JOURNAL VOLUME 203 NO. 1 JUL 14 2007

three parts. The rst part deals with provid

ing a rewall to limit information going in
and out of the computer and protecting the
computer from being accessed by another per
son (a hacker). The second part looks at the
threats from such things as viruses, worms,
trojan horses and spyware. Installing software
that monitors and disarms such potentially
malicious les is discussed. The third part
describes how a user can recognise Internet
hoaxes/scams, tips on how to use passwords/
cookies and how to shop safely on the web.
1. Firewall
A rewall is used to protect a stand-alone
computer or home/business network from
offensive websites and potential hackers.
Attackers want access to your computer for
three main reasons. They may have a grudge
against you (or what you stand for) and want
to delete your les or obstruct your Internet
connection. They may believe that you hold
valuable copies of software, sensitive busi
ness information or details of your credit card
numbers. Or they may want to give themselves
anonymity while carrying out other illegal
actions using your computer as their base.
A rewall can either take the form of soft
ware (such as the popular ZoneAlarm 2 or the
rewall built into Windows XP) or hardware
11

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PRACTICE
Fig. 1 It is recommended that any
computer linked to the Internet
should have a rewall in place.
This screenshot shows the popular
ZoneAlarm rewall software

(such as an ADSL router with a built in re

wall). It is essential that any computer with
a connection to the Internet should have a
rewall installed. Without a rewall, you are
vulnerable to someone gaining access to your
system and damaging it.
A rewall controls the network trafc ow
ing both into and out off your computer (see
Fig. 1). The level of security you establish
determines how many of these threats can be
stopped by your rewall. The ultimate level
of security would be to simply block every
thing. Obviously that defeats the purpose of
having an Internet connection. For most of us,
it is probably better to work with the defaults
provided by the rewall developer unless
there is a specic reason to change them. A
common rule of thumb is to start with a high
level of security and then begin to select what
types of trafc you will allow. You can also
restrict trafc that travels through the re
wall so that only certain types of informa
tion, such as email, can get through. Figure
1 shows a screenshot from the Zone Alarm
rewall program.
The issue of wireless network security is dealt
with in an excellent article on the About.com
website.3 Simple procedures such as modifying
the default usernames and passwords provided
by the manufacturer and activating the WEP
(Wired Equivalent Privacy) are often neglected
by users. WEP is a form of encryption that
12

scrambles the messages over the wireless net

work and is good enough to deter a casual
snooper. However, to provide more robust secu
rity it really is important to use WPA (WiFi
Protected Access) or the newer WPA2.
2. Malicious code
A virus is a manmade computer program or
piece of code that is loaded onto your compu
ter without your knowledge and runs against
your wishes. A simple virus has the capabil
ity to produce copies of itself and to incor
porate them into other computer les and
system areas of a computer. By copying itself
over and over again, it quickly uses avail
able memory and brings the system to a halt.
More dangerous types of virus are capable of
transmitting themselves across networks and
bypassing security systems.
Here is an analogy: imagine a busy ofce
with a secretary sitting at her desk with a
stack of papers, each listing a set of tasks for
her to complete that day. She carefully goes
through each task and once completed, screws
up the paper and puts it in the bin. Someone
creeps into the ofce, and without her look
ing, puts in an additional paper that reads
Copy this page twice and put it into each of
your neighbours piles. Before the rst cof
fee break, mountains of such copies will have
overrun the ofce and proper work will have
come to a standstill. A more malicious paper
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PRACTICE
may read Copy this page twice and put it into
each of your neighbours piles. Check the cal
endar and if the date is Friday 13th, throw all
your papers into the bin!'
It is essential that every computer has an
anti-virus program installed that will period
ically check the system for all-known types
of viruses and then either isolate or delete
the malicious code. Because of the continu
ing need to upgrade the anti-virus program
and its database, most are sold as an annual
or bi-annual subscription service. Popular
anti-virus programs include Symantec Nor
ton,4 Network Associates McAfee,5 Grisoft
AVG,6 Kaspersky Lab7 and Panda.8 Prices for
anti-virus software range from about 20
25 and include 1-2 years of updates. The
major companies also bundle various pack
ages together to create a whole suite of secu
rity tools, eg rewall, anti-virus, anti-spam
and anti-spyware. At the time of writing,
Symantec Norton Internet Security 2007 at
49.99 for a single-user, one-year licence was
winning rave reviews.
Any anti-virus program is only as good as
the index of known viruses. Therefore it is
imperative that the program automatically
checks, downloads and installs any updates
from the company website. One should bear in
mind that the writers of computer viruses are
always one step ahead of the anti-virus indus
try, and because of this, no system of viral
defence can ever be totally foolproof. Since the
introduction of virus construction sets, it is
possible for anyone with minimal knowledge
of operating system and assembly language to
create viruses just for the fun of it.
A macro virus is written in a macro pro
gramming language and can be attached to
a document le (such as Microsoft Word or
Excel). When a document containing the
macro virus is opened, the virus runs, does
its damage and copies itself into other docu
ments. If prompted, always decline the facility
to run macros when opening such a le. Some
companies refuse to accept Word documents
as email attachments and request that the
sender uses the .rtf (rich text format) option
when saving and sending a Word le.
Worms are parasitic computer programs
that replicate, but unlike viruses, do not infect
other computer program les. Worms can cre
ate copies on the same computer, or can send
the copies to other computers via a network.
The Sasser virus that infected the computer
networks of the Coastguard and British Air
ways in May 2004 did not travel by email but
made its way around the Internet unaided.
It infected PCs running Windows 2000 and
Windows XP that were not protected against
a system loophole that it exploited. Anti-virus
software gives varying degrees of protection
against worms.
A trojan horse program is a malicious pro
gram that pretends to be a harmless or even
desirable application (hence the reference to

the legend of the wooden horse of Troy). Tro

jans are not viruses since they do not repli
cate, but they can be just as destructive. Trojan
horses can be designed to steal computer data,
while others give attackers unrestricted access
to your computer whenever you are online.
The attacker can perform activities such as
le transfers, adding or deleting les and even
controlling your mouse and keyboard.
Trojans can be distributed by email attach
ments or be hidden within infected downloaded
les. They are executable programs, which
mean that when you open the le it performs
an action. In Windows, executable programs
have le extensions such as exe, vbs, com
and bat (for example, one renowned trojan
horse was the le dmsetup.exe). By default,
Windows hides the le extension so there is
no way of knowing if you are clicking on an
executable le. To enable hidden les to be
seen, click on Start, Control Panel and Folder
Options. Click on the View tab and select the
option Show hidden les and folders. How
ever, even if you show the hidden extensions
using the above steps, you still cannot see cer
tain hidden extensions for les ending with
.shs, .pif and .lnk. Unfortunately these les are
executable, and are popular choices for many
trojan horses, such as AnnaKournikova.jpg.pif
which will appear as AnnaKournikova.jpg but
instead of being an image le, will actually be
a trojan. Anti-virus programs give some pro
tection against trojans.
Spyware is programming that is put in
someones computer to secretly gather infor
mation about the user and relay it to advertis
ers or other interested parties. Spyware can
get into a computer following a visit to a sus
picious website (often as a result of clicking
some option in a deceptive pop-up window)
or as the result of downloading and install
ing a free program. There are some data col
lecting programs that are installed with the
users knowledge, relying on the fact that no
one ever reads the small print in a licensing
agreement. It has been estimated that 90% of
all Internet-connected computers are infected
with spyware in one form or another.
Adware is software designed to serve
advertising banners and can be thought of as
spyware because it almost invariably includes
components for tracking and reporting
user information.
Other annoying code that may automati
cally install itself when you visit a website is
designed to hijack the way your web browser
functions. It may change your Internet start
page or change the default search service
that appears when you mistype a URL. Other
code may create a full-screen browser with
no apparent way of navigating away from the
page or even closing it. To close down the web
browser, hold down the Ctrl, Alt and Delete
keys to bring up Windows Task Manager.
Highlight the web browser from the programs
listed and then select End Task.

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PRACTICE
Spyware is often not stopped by either re
wall or anti-virus software and requires the
use of separate anti-spyware software either as
a stand-alone program or bundled in with an
Internet security suite. Webroot Spy Sweeper,9
Spybot Search & Destroy10 and Lavasoft Ad
aware11 are three stand-alone programs that
are often recommended as being efcient in
detecting changes to the registry, removing
the bad les and restoring the registry to its
original structure.
Symatecs Security Check12 is a popu
lar and useful online service for carrying out
a free Internet security check-up on any PC
connected to the Internet. It probes the exist
ing security measures in place and com
piles a detailed report on the vulnerability of
the connection.
3. Other aspects of safe use of the Internet
Hoaxes
A virus hoax is an annoying message that is
widely circulated by email, warning about the
presence of a non-existent virus. It encour
ages users to pass the warning on to their
friends and acquaintances, thereby causing
massive amounts of unnecessary email.
Messenger service box
This is a box that can pop up on your screen
asking you to phone a premium rate number,
apply for a diploma, etc. It could appear any
time you are connected to the Internet; you
do not have to have any particular software
open at the time. It is not a virus but a spam
message that uses the Windows XP (and
2000) Messenger service that runs behind
the scenes. This is a normal part of the oper
ating system that is used by network admin
istrators to send messages to other users on
a company network. To stop this happening
on a computer, go to the Start menu, select
Run and type in services.msc and click OK.
Now a new window will appear with a list of
services on the right hand side. Scroll down
and nd the Messenger service, select it, right
click it and choose Properties. Under Startup
Type select Manual (or Disabled). Then click
on Stop, Apply and OK.
Phishing
Phishing is a scam that uses email spam,
pop-up messages or fraudulent websites to
deceive people into disclosing their credit
card numbers, bank account information,
passwords or other sensitive information. The
message claims to be from a genuine business
or organisation for example, your Inter
net service provider, bank, online payment
service, or even a government body (Fig. 2).
Phishers typically include upsetting or excit
ing (but false) statements in their emails to
get people to react immediately. The email
address will appear to be genuine and it will
probably use the logos from the organisation
it is trying to imitate.
14

Legitimate companies do not ask for sensitive

information via email. If you are concerned
about a possible scam, contact the organisa
tion using a telephone number that you know
to be genuine, or open a new Internet browser
session and type in the companys correct web
address. DO NOT cut and paste the link in
the message into your browser. This is likely
to just lead to a bogus website masquerading
as the real thing; if you enter your sensitive
information here you will have been hooked!
Review credit card and bank account state
ments as soon as you receive them to determine
whether there are any unauthorised charges. If
your statement is late by more than a couple of
days, call your credit card company or bank
to conrm your billing address and account
balances. It has been reported that anywhere
from 5-40% of recipients respond to phishing
scams, making it big business for fraudsters.
Premium diallers
The premium rate dialler programme is a scam
affecting dial-up Internet users and it works
in the same way as spyware or trojans. The
programme is downloaded without the users
consent or knowledge and changes the way the
computer connects to the Internet, resulting in
a very large phone bill. The programme replaces
the chosen Internet dialler so that every time
the Internet is accessed, the user is charged at
a more expensive rate. If the computer is left
connected to a phone line, the dialler may also
access the Internet when you are using the
computer but are not online. This programme
does not affect broadband users, provided the
internal dial-up modem is disconnected from
the phone socket and the modem is not used to
make fax or voice calls. If you have any sus
picions that your computer has been infected
with a premium rate dialler programme, con
tact your telephone company immediately.
Protecting your identity
Do not use email to send personal informa
tion, especially your credit card details. Think
about creating disposable email addresses
for online purchases. Beware of Internet pro
motions that ask for personal information,
as identity thieves may use phoney offers to
get you to reveal this information. Your per
sonal email address may include your name,
eg fredsmith@aol.com. If you want a more
private email address use a pseudonym such
as madaboutgolf@aol.com. Set up your email
application so that the name and identity
elds are left blank, otherwise this informa
tion may be included in your email.
Teach children to keep their identities con
dential in chat rooms, bulletin boards or
newsgroups. Help them learn to choose screen
names that do not identify them and to under
stand that any information they exchange
on the Internet is not private. An excellent
tutorial on this topic can be found on the
MSN website.13
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PRACTICE
Fig. 2 This shows a typical phishing
email, suposedly from the Halifax
Bank. Notice the poor use of English
and punctuation. Clicking on the
Account Update hyperlink would take
you to a bogus website where the
phishers would capture your account
details and password. Notice that
the ISP has successfully recognised
and labelled this message as being
spam while the email program has
blocked the images within the mes
sage from downloading

Passwords
Hackers may try and break into an account
by using programs that guess passwords by
going through dictionary words in many lan
guages. Always avoid using guessable pass
words such as your login name (in any of
its forms), your rst or last name, your car
number plate, the brand of your car, telephone
numbers, your street name, the name of your
spouse, children or pets, acronyms, sequences
of letters like abcdef or qwerty, place names,
cartoon heroes etc.
A good password is:
Private; only known by you (in 2004, a UK
street survey found that more than 70% of
people would reveal their password for a
bar of chocolate!)
Secret; it does not appear in clear text in
any le or program or on a piece of paper
blue-tacked to your computer screen
Easily remembered, so there is no need to
write it down
At least eight characters long
A mixture of at least three of the follow
ing: upper case letters, lower case letters,
digits and punctuation
Not guessable by any program in a
reasonable time
Changed on a regular basis, ie whenever
you think that it may have been compro
mised and at least once per year
Different for every account, login
and program.

Here are some suggestions to help choosing

good passwords:
Choose a line or two from a song or poem
and use the rst letter of each word. For
example, baa baa Black Sheep have you
any wool? becomes bbBShyaw?'
Choose two short words (or a big one that
you split) and concatenate them together
with a number or one or more punctua
tion characters. For example: dog+UB40'
money4U! or com!!PUTER'
Use a common word but replace certain
letters with a number, eg change m into 3,

or s into 5 so that mypassword becomes

3ypa55word.
If you have a bad memory, then you could
use a password utility to store and encrypt
your various passwords. You would then only
need to remember one password to access all
of your other passwords. Some programs can
be stored on a oppy disk or memory device
so that your passwords are portable. There are
literally dozens of such programs available
free or cheaply on the Internet; one particu
larly good one is Access Manager.14
In the next few years we are likely to see
the widespread introduction of more techno
logical solutions to Internet security, such as
special card readers to generate unique codes
and biometric authentication.
Email
Always be suspicious of any email from an
unknown source. Never open an email attach
ment unless you know what it is even if it
is from someone you know and trust. Some
viruses will send out emails to every address
in a persons Outlook address book and even
include snippets of existing email text to make
it look as though it is coming from that person.
Keep your email program up-to-date, as older
versions may not be able to cope with security
breaches, such as overly long lenames or the
program showing a different name than the
actual attachment name. Although HTML email
messages look more interesting than simple text
messages, just be aware that they can contain
code and run scripts that may cause damage.
To enable Outlook Express (OE) to get around
potential security problems with HTML email,
click on Tools, Options, Read tab and check the
option Read all messages in plain text.
You can also give yourself added protec
tion by changing the directory where your
attachments are downloaded (when you leave
it as the default, it makes it easier for mali
cious people to guess where attachments they
sent you were stored, and then they can use a
script to force them to launch).

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PRACTICE
Internet Explorer web browser
When you rst install Internet Explorer (IE),
it puts all websites into a single zone called
the Internet zone. It gives this zone a medium
level of security by default. You can custom
ise the settings to make your browsing more
secure but it may make your browsing more
restrictive as it prevents certain code running.
It is all a balancing act between security and
usability. There are two other zones, Trusted
and Restricted, where you can place desirable
or undesirable website addresses. The secu
rity settings for websites in these zones are
set to lower and higher settings accordingly.
See the Microsoft website for more details. It
is important to keep up-to-date with security
patches for IE to shield the PC from vulnera
bilities as they are discovered. In 2004, Micro
soft released Windows XP SP2, which added
pop-up blocking to IE 6. IE 7 was released in
October 2006 and is intended to defend users
from phishing as well as deceptive or mali
cious software. It also features tabbed brows
ing, a popular feature that has been available
in competitors browsers for many years.
Cookies
Cookies are blocks of text placed in a le
on your computers hard disk. Websites use
cookies to identify users who revisit the site
and may contain login or registration infor
mation, shopping cart information or user
preferences. When a server receives a browser
request that includes a cookie, the server can
use the information stored in the cookie to
customise the website for the user.

While cookies in themselves may not iden

tify you in the way a name or address does,
a cookie can be linked with other identify
ing information. For example, if you provide
extra information about yourself to the web
site by buying something online or subscrib
ing to a free service, then the cookies can
be used to build up a prole of your buying
habits and what you are interested in. They
can then be used to tailor banner advertis
ing to your interests. Some web surfers object
to cookies as they feel that they invade their
hard drive without their permission. Firewall
software such as ZoneAlarm can be set to one
of three levels of cookie control and each level
can be customised. However, many shopping
sites will not work correctly unless cookies
are allowed.
Backup important les
This is probably one of the most important
and yet least followed security procedures
that dentists should be carrying out on a daily
basis. The value of a practices dental data is
often only appreciated once it is too late to
retrieve it. It has been estimated that there is
only a 30% survival rate for UK businesses
that suffer signicant data loss. Arrange a
thorough backup protocol that includes back
ing up across the practice network, backing
up onto removable media (such as tape drive,
removable hard drive, DVD etc), restoring
backups onto home computer and offsite
backup via the Internet (eg DataLifeline15
charges about 200 + VAT per year for 4GB of
uncompressed data).

Fig. 3 Use a table in Word to create

your own start or home page for
your browser. Right click on each
word to insert the appropriate
hyperlink and save the page as an
HTML document

16

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PRACTICE
Shopping on the Internet
Always do business with known, credible
companies, or companies to whom you have
been recommended by a satised customer.
Submitting your main email address may
result in you being sent spam; consider using
an additional free email account (eg Yahoo!
or Hotmail) for all online purchases. Make
sure to log into the second email account on
a regular basis (say once or twice a month),
just to make sure that you are not missing any
important information.
Consider devoting one credit card to all your
online purchases. This will help to minimise
the potential damage of an attacker gain
ing access to your credit card information.
Another idea is to open a credit card account
with a minimum credit limit and only use it
for online purchases.
Avoid using debit cards for online pur
chases credit cards usually offer some pro
tection against identity theft and may limit
the monetary amount you will be responsible
for paying. Debit cards do not offer that pro
tection; because the charges are immediately
deducted from your account, any attacker who
obtains your account information may empty
your bank account before you even realise it.
The Ofce of Fair Trading has a useful section
on its Consumer Direct website about online
shopping,16 while the banking industry have
compiled a website with tips on how to stay
safe online.17
Before giving your credit card number or
other nancial information to a business, make
sure that their website is protected and secure.
Look for a lock symbol located somewhere on
the browser, or make sure the URL begins with
https://. This ensures that the information is
encrypted before being transmitted.
Visa has a Veried by Visa service that
is free for Visa card-holders to sign up to. It
is a simple service that ensures that both the
retailer and the customer are genuine. Popu
lar sites such as Dabs.com and Tesco use this
scheme, but look for the Veried by Visa logo
on less well-known sites. MasterCard offer a
similar service called Securecode.
Before buying anything, read the delivery
and return policies that should be on the mer
chants home page. Can faulty items be sent
back? If the items are unsatisfactory, can you
get a refund or a credit note? The merchants
home page should also have information about
delivery arrangements and costs, currencies
they accept and taxes that apply. If you share
your computer, make sure you sign out of the
website after completing any sort of nancial
transaction online and delete your tempo
rary Internet les (Tools, Internet Options,
General tab).
Parental control software
Parental control software is basically a web
lter; it determines where a certain computer
user (eg a child or member of staff!) can go

inside a web browser. There are many products

available but they often suffer from the prob
lem of either under-blocking or over-blocking
objectionable sites. K9 Web Protection18 is one
of the best content control lters I have come
across and is free for home use.
Summary of safe use of the internet
It is possible to become paranoid about using
the Internet when there are so many potential
security aws associated with the technology.
However, by following some simple rules it is
possible to greatly reduce this risk. My advice
is to use the latest security software ( re
wall and anti-virus/adware/spyware), regu
larly update the Windows operating system
and browser software, use strong passwords,
backup important data and keep yourself up
to-date with new Internet security issues.
B. EFFICIENT USE OF THE INTERNET
Having established a safe and secure home/
business Internet connection, the next thing
to consider is how to work efciently. A com
mon complaint is that the Internet can be a
big time waster. This section will hopefully
provide some useful tips to make the use of
the web and email more productive.
Hardware and Internet connection
Speed up your dial-up, broadband or
mobile phone Internet connection by using
a service such as Onspeed.19 Costing 25
per year, it works by redirecting Internet
trafc to Onspeeds servers, which then
compress the data according to type.
The compressed data is then sent to your
browser. It works best with text, reason
ably well with pictures, but not so well
with les such as sound, video and
program les
It is possible to check the speed of your
broadband connection by following the
link from the ADSLGuide20 website; the
page also shows the typical upload and
download speeds you should expect from
any given quoted ADSL speed
Sharing an Internet connection has to be
the best value upgrade to any computer
network. This can either be carried out
using cables or wirelessly. Although wire
less transmission speeds are currently
slower than using a direct cable link, they
are still faster than a standard broadband
connection (the current wireless standard is
called 802.11g and it realistically delivers a
connection of about 15-20Mbit/s compared
to broadbands 512kbit/s-4Mbit/s)
Other wireless-enabled devices such as
laptops, tablet PCs and personal digital
assistants (PDAs) can also share a home/
business Internet connection. Synchroni
sation with the main PC means that such
things as contact details and calendars can
easily be shared and kept up-to-date. Their
mobility also enables them to connect to

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PRACTICE
the ever-increasing number of wireless
hotspots at cafes, hotels and airports
Keyboards now come with extra buttons
that act as shortcuts to such programs as
the web browser or email program
Use a mouse with a wheel to make it easier
to scroll web pages.
Software
Shortkeys21 is an excellent utility program
that enables you to use keyboard shortcuts
to place text into any Windows program.
Its real strength is when used with dental
system software to help with writing up
patients notes, but it is also extremely
useful for lling in forms on web pages.
For example, set up shortcuts such as
ad1, ad2, ad3 for each line of your home
address and ad5, ad6 and ad7 for your
work address
If you want to copy some text from a web
page to put into a Word document, rst
paste it into Notepad to get rid of any for
matting and hyperlinks
Use Notepad to create a to do list. Place
this document into the StartUp folder so
that it opens automatically every time the
computer is switched on. Use the to do list
to record things that you want to search
for on the web, websites that you want
to visit, or list people whom you want to
contact via email
There are certain plug-ins or helper pro
grams that are required to make the most
of the multimedia material available on the
web. These include video players to watch
videos in all their different video formats
(RealPlayer,22 Windows Media Player and
Quicktime23), audio players (all the video
players plus WinAmp24 ), 3D viewers to
enable movement in a virtual 3D environ
ment (Cortona and iPix), interactive plug
ins to show complex animations for
games, puzzles and tutorials (Adobes
Flash and Shockwave players25) and a
document plug-in to make sure that forms,
manuals and articles written in the pdf
format appear and print out exactly as
they were intended (Adobe Reader25). A
link to the downloadable plug-in is nor
mally available on web pages that include
multimedia material
The free RealPlayer plug-in, used to view
video media on the BBC website, has
developed a bad reputation because of the
annoying adware and spyware that gets
installed alongside the free player. Instead,
you could try Real Alternative,26 a free
ware program that is adware/spyware-free
If you want to distribute professional-look
ing documents via the Internet then you
really need to create your own .pdf les, or
convert an existing Word le into a .pdf.
PDF is a universal le format that pre
serves the fonts, images, graphics and lay
out of any source document. You could use
18

the powerful Adobe Acrobat which costs

about 250, but if you only need to create
one or two les then use the free web serv
ice from pdfonline27 that will convert an
existing Microsoft Ofce document into a
.pdf le. PDFCreator 28 is another program
that can be downloaded and run directly
from your PC as OpenSource software
If you do not have Microsoft Ofce
installed on a computer, you can still view
Word, PowerPoint and Excel documents by
installing the relevant free Viewer 2003
program, downloadable from the Microsoft
Ofce site.29 There are also free nonMicrosoft Ofce suite alternatives such as
OpenOfce.30
Web browser tips
Ctrl + Enter is a very useful keyboard
shortcut to use in IE. It puts http://web.
before the text in the address bar and
.com at the end. For example, in the
address bar, type in google followed by
Ctrl + Enter and you will nd that the
full address, http://www.google.com
will appear
The default setting in IE is for hyperlinks
to be underlined. This can often make
reading the text quite difcult. Change
the setting so that hyperlinks only appear
underlined when you hover the mouse
over the link. Click on Tools, Internet
Options, Advanced
The text on some web pages may appear
very small. To easily change the size of the
text, hold down Ctrl on the keyboard and
scroll the mouse wheel
The AutoComplete function in IE can be
useful when re-typing web addresses or
lling in forms, but if you do not want
AutoComplete to remember user names
and passwords you can uncheck the box
for User names and passwords on forms.
Access this option from Tools, Internet
Options, Content, AutoComplete
It can be annoying when websites open
multiple browser windows and pop-ups
without asking. To close all the browsers,
right-click on the IE6 icon on the Taskbar
and select Close Group
If you are using IE to show web pages at
an exhibition or as a presentation, you can
run it in kiosk mode, which will get rid
of any toolbars, menu, minimise or close
buttons. Go to Run on the Start menu, and
type iexplore-k (without the quotes) fol
lowed by the address of the page you want
to display. If you do not specify an address,
it will open with your home page. Use the
Alt + F4 shortcut to close the program
when you have nished, or Ctrl + N to
bring back the toolbars
Congure your browser so that the rst
page it loads (the home or start page) is
a web page, created by you, stored on your
hard disk. The advantages are that this
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PRACTICE
local page will load faster than any page
stored on the web and it also gives you the
opportunity to create your own spring
board page of links to favourite websites
and search engines. If you also host a copy
of this page on your website, it means that
you will have access to these links from
any other computer connected to the
Internet. There are three main ways of cre
ating your own locally-stored start page:
Use a program normally used for creat
ing web pages
Create a table in Word. Use a column
for each category of web links. Type the
name of a website into each cell. Select
the name and then click on Insert,
Hyperlink and either type or copy/paste
the URL for that website (see Fig. 3).
When the document is complete, click on
File, Save As, Web Page
Make an HTML le of your IE favorites
by using the exporting wizard. To run
the wizard, click on File, Import and
export and follow the instructions
To make this HTML le your start page,
open IE, type c: into the address bar, click
on the Go button and then locate and open
the le. Once the page is viewable in IE, click
on Tools, Internet options and from the Gen
eral tab, select Use Current from the Home
Page section.
Printing web pages
IE6 is notoriously bad at printing certain con
gurations of web pages:
Always use the print preview to check
what your printed page will look like. If the
print preview pane shows that the text will
not quite all t on one page, use the mouse
scroll wheel and the Ctrl key to resize the
text on the y. The other option is to select
landscape orientation rather than portrait
Make sure that the option Print back
ground colors and images is dese
lected from the Tools, Internet Options,
Advanced tab, Printing section
Go to File, Page Setup to see the differ
ent options for the amount of information
included in either the header or footer
of the printed page. For example, &w
will print the window title, &d will print
the date and &u will print the page
address (URL)
Consider updating to IE7 or using a differ
ent web browser, such as Opera or Mozilla
Firefox, all of which handle printing in a
more predictable fashion.
Browser toolbars
Installing a free browser toolbar can improve
your efciency in searching the web. The most
popular come from Google31 and Yahoo!32
Each adds a thin strip of tools to the top of
your browser, including a text entry box.
From this box, you can instantly query the
associated search site. Most of them include

Fig. 4 In Outlook Express, to

reduce the number of unwanted
spam emails, use the Message Rules
tool to set up lters on keywords.
(Microsoft Outlook Express screen
shot printed with permission from
Microsoft Corporation)

an Ad pop-up blocker. Google has some nice

touches such as the option to automatically
ll out online forms, to highlight in yellow
the search terms on the web page and the
ability to go up one level on the website with
just one click.
Copernic Agent Basic33 is a downloadable
metasearch engine that allows you to query
many search engines at the same time. Net
Snippets33 toolbar is a very useful tool for cap
turing online content (images and text from
web pages, whole web pages, screen captures,
email messages, links) and organising the
information for research projects and reports.
It all works in a user-friendly drag-and-drop
interface that appears next to the web browser.
You can download a free cut-down edition of
the software or pay $79.95 for a standard edi
tion single-user licence. (The new Microsoft
Ofce OneNote 2007, which is bundled in with
the Microsoft Ofce Home and Student 2007
suite, is another excellent way of gathering
and organising online information).
Email tips
If you use another computer, say a laptop,
to collect email when you are away from
home, it may make it awkward to remem
ber on which machine individual messages
are stored. To get around this problem, set
up Outlook Express (OE) to Leave a copy
of message on server. You can access
this from Tools, Accounts, select the mail
account, Properties and Advanced tab
Use the free mail2web35 service to access
any of your email accounts from anywhere
in the world via a web browser. The mes
sages can be left on the web server for you
to download onto your main PC for archiv
ing at a later date
A similar service, web2mail,36 can be set
up to send you your favourite web pages
by email on a regular basis. They are only
sent if they have changed since the last
time they were read. Many websites pro
vide a regular email newsletter service.
Use this to gather information from web
sites that focus on your particular topic
of interest

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2007 Nature Publishing Group

PRACTICE
Email alerts can be a very useful service.

For example on the British Dental Journal

website,37 whenever a newly published
article contains certain keywords or cites
an article you are interested in, an email is
sent to you with a hyperlink to that article
Most programs have the option of sending
the le you are currently working on as an
email attachment. For example, in Word,
click on File, Send To, Mail Recipient (as
attachment). This will automatically open
your email program with the Word le
ready to be sent as an attachment
If you want to archive a web page, do not
just store it in IEs favourite list, since that
page may one day be deleted or moved. A
more predictable way of archiving the page
would be to either click on File, Save As
to store the page on your hard drive as an
HTML le, or File, Send, Page by Email
and store it in an email folder
If you regularly need to email a group of
people (eg committee members, club mem
bers), set up an address for each group
of people. In OE open the Address Book
and click File, New Group. Then give the
group a name and select the addresses of
people whom you want to be in that group
from your address book, or create new
contact details
If you regularly need to send out a large
amount of text information to people who
may only have a dial-up connection, use
WinZip38 to compress the data before it
is sent (some les compress better than
others). WinZip currently costs $29.95;
JustZipIt 39 is an excellent free alternative
which is very easy to use. The other option
would be to store the data on a web page
and then email the location in a short
text message
If you access one of the popular dental
mailing lists from Yahoo Groups,40 but
do not want to retrieve the groups daily
discussions by email, adjust your member
ship settings to No email and just read
the postings via the Yahoo Groups web
site instead. Conversely, if you want to
receive the messages by email and want to
have them grouped together as conversa
tions, get a Gmail42 account and use it
exclusively for the mailing list. The other
advantage of doing it this way is that you
can then use the powerful search features
of Google to quickly search for keywords
within all past email messages. Some
people use the GDP-UK41 mailing account
as a depository of information rather than
actually reading email messages as they
arrive. Access to a Gmail account used to
be available only by invitation from an
existing user; since February 2007 it has
become openly available and provides
users with 2.8GB of email storage space
Web-based email accounts such as Gmail
are being increasingly used as databases,

20

as people use them to store data, calendars

and photos which they (or another invited
person) can access from any computer.
Controlling spam
Spam is unsolicited junk email, sent to large
numbers of people to promote products or
services, most of which are irrelevant to the
recipient. (Did you know that the term spam
is derived from the Monty Python sketch
where everyone in a caf was served spam no
matter what they had ordered?) Spam wastes
time, reduces productivity and the problem is
getting worse; research by IronPort Systems
Inc43 estimates that 55 billion spam messages
were sent in the month of June 2006 alone!
The end of 2006 saw a huge surge in the
amount of spam being sent worldwide. While
bulk emailers have, in the past, sent unwanted
messages from a single server, increasingly
the spam emanates from networks of compro
mised PCs, known as bot nets. These networks
commonly consist of tens of thousands of
compromised PCs.
Use keyword lters (such as $$, Viagra,
sex) in the email program to designate
spam to the trash can or a specially cre
ated Spam folder. You can nd this feature
in Outlook Express under Tools, Message
rules, Mail (see Fig. 4). Some email pro
grams automatically include sophisticated
Bayesian lters to do this job for you.
Unfortunately, this is becoming less effec
tive as spammers have now resorted to
using apparently personal salutations and
subject lines. Spam has also got smarter
by putting the body of the message as
an image (making it impossible for spam
keyword lters to recognise the text) while
adding large lumps of random text to try
to convince ltering systems that the mes
sage is legitimate
Cloudmark 9 Desktop44 is an award-win
ning anti-spam and anti-phishing appli
cation designed to run with Outlook and
Outlook Express. The software costs about
$40 for a one-year subscription
Mailwasher45 is a similar stand-alone pro
gram that scans incoming email against
a known spam database. The free ver
sion will only work with one POP3 email
account, while the pro version ($37) will
work with an unlimited number of email
accounts from POP3 as well as IMAP, AOL,
Hotmail and MSN accounts
If you are worried about having your email
address harvested from your web page,
then simply write your email address in
the format of someone at somewhere dot
co dot uk, rather than someone@some
where.co.uk. The harvesting program will
not recognise the text as an address
For your personal email address, you can
use lters to move authentic messages
from the inbox to a priority inbox. You
can do this by asking friends to put a
BRITISH DENTAL JOURNAL VOLUME 203 NO. 1 JUL 14 2007

2007 Nature Publishing Group

PRACTICE
specic keyword into the subject line or by
creating a lter rule for all the people in
your personal address book
Never open spam, just delete it. Email writ
ten in HTML can have hidden code that
can be used to send a message back to the
spammer to conrm that your address is
live (a web beacon). If you open the mes
sage, you are simply inviting even more
junk email
Hotmail and Yahoo! Mail have developed
a host of anti-spam features, some of
which are only available to their paid
premium service
Check with your ISP to see if they have an
anti-spam policy in place. ISPs have the
ability to block a large proportion of spam
yet few of them bother to implement a
ltering service
The Privacy and Electronic Communica
tions Regulations 200346 regulate the
sending of unsolicited direct marketing
messages from an identiable UK source.
Regulations 22 and 23 cover email, text
(SMS) and any other form of unsolicited
electronic message, which may only be
sent if the individual has asked for it.
There is an exception to this rule, known
as soft opt in. This applies in the
following circumstances:
The organisation obtained the contact
details as the result of a sale or the
negotiations for the sale of a product
or service
The messages are only marketing their
similar products or services, and
The individual is given a simple oppor
tunity to refuse the marketing when
their details are collected and is given
another simple way to do so in every
future message.

that wait even a week.1 See the various

options by clicking on Start, Control Panel,
System and then the Automatic Updates
tab. You can check to see if your operat
ing system needs updating by visiting the
Microsoft Windows Update website.47
If a piece of hardware or software does not
seem to be working correctly, try search
ing the web for up-to-date drivers or
software updates/ xes.

As most spam originates from outside the

UK, these regulations have limited impact
against spam. Indeed, the Information Com
missioners Ofce advises strongly AGAINST
replying to any spam thought to have origi
nated from outside the UK, unless you are
familiar with and trust the company.

Financial considerations
It is still true to say that the Internet can be
a great place for managing your money, nd
ing the best deal for services and online shop
ping bargains. It is possible to access bank
accounts, savings accounts, mortgage, shares
and other nancial services 24 hours a day.
There are many sites from where you can
compare the cost of loans, insurance, home
gas/electricity suppliers, TV subscription and
home/mobile phone tariffs.53
Before you make any signicant high street
purchase, always check the cost of buying
the same item via the web. Comparison shop
ping sites such as Pricerunner,54 Shopping.
com55 and Kelkoo56 are search engines that
are designed to save you time and money by
nding the best online deals for many hun
dreds of thousands of products. Most sites
show consumer reviews about the suppliers,
indicate whether of not the product is in stock
and specify the price of postage.
Cut electricity bills and help the environ
ment by the correct power management of

Organise your PC
Create a directory on your hard disk where
you can place any downloaded les from
the Internet. Just before you transfer the
data, create an aptly named sub-directory
in which you can store the les. Down
loaded les often have obscure lenames
and there is nothing more infuriating than
not being able to remember where you
placed an important le. Carry out a virus
check before running any les
To keep your PC running at peak perform
ance, have it check automatically for Win
dows operating system updates. Companies
that install critical patches within a day
report fewer virus infections than those

Digital photographs
If you want to share your digital photo
graphs with another person, simply email
them the le. However, if you have a lot of
photographs to share and/or a lot of people
to share them with, either upload them to
the free web space provided by your ISP
or store the photos on a free online album
service, such as Photobox.48 From here,
friends can view the photos, enter com
ments in a guest book and even order their
own prints
When sending an image by email as a le
attachment, take into account whether
the recipient uses a dial-up or broadband
service. A 1MB le would take under 20
seconds to download over a broadband
connection, but over three minutes on a
dial-up connection. When sending les
to a dial-up account, try to keep the total
le size to less than 300-400Kb. To reduce
the le size of an image, open it in an
image-editing programme such as Adobe
Photoshop Elements,49 Paint Shop Pro,50
Irfanview51 or Picasa52 and then crop and
resize. Rename the image before saving the
le so that it will be easy to identify at a
later date. When prompted, do not save any
changes to the original le so that none of
the original data is lost.

BRITISH DENTAL JOURNAL VOLUME 203 NO. 1 JUL 14 2007

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2007 Nature Publishing Group

PRACTICE
hardware, both at home and at work. The Brit
ish-designed OneClick Intelliplug57 automati
cally switches off and on attached peripherals
when you power up or down your PC. Con
trary to earlier opinions, it is quite sensible
to switch off the router when you do not
require an Internet connection. Indeed, many
ISPs now recommend switching off and then
reconnecting, particularly as some 8Mbit/
s ADSL services can get stuck at a much
lower bandwidth.
Summary of efcient use of the Internet
To be effective in using the Internet, you
must have the right hardware and software
installed. Find out how to set up and use
your web browser and email programs so that
you get the most out of them. Take proactive
steps to reduce spam email at work/home and
organise your computer so that it is using
the most up-to date software. Find timesav
ing and cost-cutting ways to maximise the
advantages of using the Internet compared to
more traditional services.
1.

2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.

Department of Trade and Industry. Information

security breaches survey 2006. London: Depart
ment of Trade and Industry, 2006. http://www.
pwc.com/extweb/pwcpublications.nsf/docid/
075A817C56CDCA678025711E005625AE
ZoneAlarm rewall software. http://www.zonelabs.com/
Mitchell B. Top 10 tips for wireless home network security.
http://compnetworking.about.com/od/wirelesssecurity/
tp/wisecurity.htm
Symantec Internet security software.
http://www.symantec.com/en/uk/index.jsp
McAfee Internet security software.
http://www.mcafee.com/
AVG anti-virus software. http://www.grisoft.com/
Kaspersky Lab. http://web.kaspersky.com/
Panda Internet security software.
http://www.pandasoftware.com/
Webroot Spy Sweeper. http://www.webroot.com/
Spybot Search and Destroy. http://web.safer-networking.
org/microsoft.en.html
Lavasoft Ad-aware. http://web.lavasoft.de
Symantec Security Checker. http://security.symantec.com/
Microsoft Security at Home.
http://web.microsoft.com/athome/security/default.mspx
Access Manager password program.
http://web.accessmanager.co.uk/
DataLifeline online backup. http://www.datalifeline.net
Consumer Direct website online shopping section.

22

17.
18.
19.
20.
21.
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23.
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27.
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31.
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57.

http://www.consumerdirect.gov.uk/before_you_buy/
online-shopping/
Stay safe online. http://www.banksafeonline.org.uk/
K9 Web Protection. http://www.k9webprotection.com/
OnSpeed.com. http://web.onspeed.com/en/index.php
ADSLGuide.
http://www.adslguide.org.uk/tools/speedtest.asp
ShortKeys text replacement software.
http://web.shortkeys.com/
RealPlayer. http://uk.real.com/
QuickTime. http://www.apple.com/quicktime/
Winamp. http://www.winamp.com/
Adobe Products. http://www.adobe.com/products/
Real Alternative video player. http://leforum.betanews.
com/detail/1054136293/1
K2pdf.com. http://www.k2pdf.com/
PDFCreator. http://www.pdfforge.org/
Microsoft Word Viewer. http://ofce.microsoft.com/
OpenOfce suite. http://www.openofce.org/
Google toolbar. http://toolbar.google.com/
Yahoo! Toolbar. http://uk.toolbar.yahoo.com/
Copernic Agent Basic. http://www.copernic.com/
NetSnippets. http://www.netsnippets.com/
Mail2web. http://www.mail2web.com/
Web2mail. http://www.web2mail.com/lite/welcome.php
British Dental Journal website. http://www.nature.com/
bdj/index.html
WinZip. http://www.winzip.com/
JustZipIt. http://www.download.com/JustZipIt/3000
2250_4-10222610.html
Yahoo Groups. http://groups.yahoo.com/
GDP-UK mailing list. http://health.groups.yahoo.com/
group/GDP-UK/
Gmail. https://www.google.com/accounts/SmsMailSignup1
IronPort. Spammers continue innovation: IronPort study
shows image-based spam, hit & run, and increased vol
umes latest threat to your inbox. [Press release].
San Bruno: IronPort, 2006. http://www.ironport.com/
company/ironport_pr_2006-06-28.html
Cloudmark 9 Desktop.
http://www.cloudmark.com/homeofce/
Mailwasher anti-spam software.
http://www.mailwasher.net/
The privacy and electronic communications (EC directive)
regulations 2003. Statutory Instrument 2003 No. 2426.
London: HMSO, 2003.
http://www.opsi.gov.uk/si/si2003/20032426.htm
Microsoft Windows and Internet Explorer security
updates. http://update.microsoft.com/
Photobox. http://www.photobox.co.uk/
Adobe Photoshop Elements. http://www.adobe.co.uk/
products/photoshopelwin/main.html
Corel Paint Shop Pro. http://www.corel.com/
Irfanview. http://www.irfanview.com/
Picasa. http://picasa.google.com/
Uswitch website. http://www.uswitch.com/
Pricerunner. http://www.pricerunner.co.uk/
Shopping.com. http://www1.uk.shopping.com/
Kelkoo. http://www.kelkoo.co.uk/
OneClick Intelliplug. http://www.oneclickpower.co.uk/

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