4YEARS YEAR 40 ANNIVERSARY th YEAR 40 years as Australia’s leading full-service lab. We’ve changed a lot since 1983, but one thing remains the same, our customers are the focus of everything we do. Your full-service dental lab, your partner for growth. Let us help your practice thrive. scdlab.com Document Version: SCDA_CAM_40th_L_032023 Subscription $99.00 per annum No.97 MAR-APR 2023 Australia’s leading clinical, business, technology & lifestyle magazine for the dental professional
1800 806 450 www.amalgadent.com.au Visit our booth #265 Microlaser NV PRO3 Cordless Microlaser Features The NV Microlaser has set the bar for convenience, portability and ease of use among all dental soft-tissue diode lasers. Optimised for all of your periodontal, restorative and orthodontic procedural needs. • Wavelength: 808 nm • Light wireless soft-tissue diode laser, only 58 grams • 12 preset procedures for all Periodontal, Restorative and Orthodontic Procedures. • 30 minutes continuous operation at 1.2 watts of power, enough for 15 procedures before changing batteries • 2 watts of maximum power on continuous wave or pulse mode Normally $8950 Special $7950 12 preset procedures Wireless foot pedal Base charges up to 3 batteries Valid to 31/03/2023 18 0 806 450 .a algadent.co .au i i N Micr las r h s s t t b r f r c ie c , p rt ility a e s f us a a l d t l s ft-ti s dio las rs. O timis f r a l of y r rio t l, r st r tiv a ort tic pr c r l n s. • le t : 8 n • Lig t wir le s s ft-ti s dio las r, o ly 5 gr s • pr s t pr c r s f r a l P rio t l, R st r tiv a Ort tic r c r s. • min t s c tin s o r tio at 1.2 w ts of p r, e f r 1 r c r s b f r c in b t ries • w ts of m xim p r o c tin s w or p ls m r l $ i l 12 preset procedures irele s f ot pedal ase charges up to 3 ba teries Valid to 31/03/2023
Con ten t s 74 26 18 50 36 56 74 2 People 6 News 11 Innovations 28 Products 40 Profile 44 Cover Story 46 Events 56 Clinical 56 Part 5: The a-z of aligner attachments – what to use, when and why 60 Oral anxiolysis /sedation a new course: Certificate in Patient Care 62 Management of impacted teeth 70 The discussion aesthetic dentists need to have with their patients 72 A membrane is not a just membrane 74 Margin Call 82 Why every cosmetic practitioner should be using the ATP approach 84 Clinical Case Report of Misused Implant Componentry: Part 1 – Clarification of Definitions regarding Screw-Retained and Cement-Retained Prostheses 88 COMPLEX FACIAL ASYMMETRY: A Digital Approach to Corrective Jaw Surgery. 90 Aesthetic management of enamel hypoplasia induced by primary teeth avulsion – case report of a young adult 94 Implant placement with no bone to implant contact: innovative techniques and materials 98 Part 1: ‘Full Counselling’ during ‘Full Occlusal Therapy’ with case studies for habit modification, sleep posture analysis and instructions for delivering a splint to manage TMDs. 104 Tooth wear and the role of gastric acid 108 Aquisitions 110 Software 112 Is there life after Dental Practice ownership 114 Best Practices Q&A 116 Labs 119 Columnists 124 Finance 128 Retailing 129 Gamma Talk: Radiation Safety 130 Reality Bites 132 The Full Complement The Australasian Dentist publication has been independently audited under the AMAA's CAB Total Distribution Audit. Audit Period to June 2020 12,835 Publisher Great Australian Publishing PO Box 4230 Black Rock, Vic 3193 Amos Lang – Managing Editor Founding editor & publisher of Australasian Dentist and Implant Dentistry Today; editor and journalist. B.A. (Writing Majors) Advertising Tel: 03 9502 0792 Mobile: 0402 405 279 Editorial, subscription and mailing enquiries Tel: 03 9502 0792 Email: email@example.com PO Box 4230 Black Rock, Vic 3193 Material submitted: While every care is taken with solicited and unsolicited materials supplied for consideration and/or publication, neither the editor nor the publisher accept any liability for loss or damage however caused. The Publisher, Great Australian Publishing, accepts no responsibility for views expressed within supplied material. ©Copyright. This publication is copyright. No part of it may be reproduced in any form without the prior written permission of the publisher. Clinical Editors Dr Michael Stubbs B.D.Sc (Adel), M.D.S(Adel), M.D.Sc (Melb), F.R.A.C.D.S. Assoc/Professor Oral Medicine Latrobe University Consultant Oral Medicine Specialist Dr Geoffrey Hall Specialist orthodontist; teaching general dentists in the area of orthodontics, both nationally and internationally Director, BDSc (Melb) Cert Orth (Uni of Penn) MRACDS (Orth) Founder and Director of Complete Aligner Planning Service (C.A.P.S ) Feature writer Danny Chan
2 AUSTRALASIAN DENTIST PEOPLE Paul Baltas, founder and director of Innovative Medical Technologies, passed away peacefully in November 2022, aged 49, after a short and brave battle with lymphoma of the central nervous system. Paul and his wife Sylvia started IMT in 2007 and, under his direction and unwavering commitment, grew the business into the market leader it is today, as a provider of advanced, specialised, medical and dental equipment. Anyone who knew Paul would agree how dedicated he was to his family, the company, his staff, and his industry colleagues. He was also a devoted husband and father to two daughters. He was extremely generous and genuine and his passing will affect all who knew him. He is greatly missed and may he rest in eternal peace. Paul leaves a lasting legacy to family, friends and the industry. He created a thriving company, a leader in this field which maintained and will continue to maintain his personal high standards in service and innovation. u Should you wish to make a donation to the Cure Brain Cancer Foundation in his memory, you can do so at: www.curebraincancer.org.au/fundraising/in-memory/paul-baltas-b876278a Vale Paul Baltas In memory of Paul Baltas, Innovative Medical Technologies (IMT) Dr Terence Lau and Dr Alistair Steel have been announced as the recipients of the 2022 Australian Dental Association Victorian Branch (ADAVB) and BOQ Specialist Bursaries. Now in its eighth consecutive year, the ADAVB and BOQ Specialist bursary program provides recognition and funding for professional development to dental practices and recent dental graduates that demonstrate a commitment to excellence and quality learning. Dr Terence Lau from Sebastopol Dental has been awarded the Recent Graduate Bursary and will receive $5,000 to be applied towards ADAVB Continued Professional Development (CPD) courses. Dr Alistair Steel and his team at Dental Health Care Associates have been awarded the Practice Bursary and will receive $8,000 to be applied to CPD and training programs and $2,000 to be applied to ADAVB CPD courses. ADAVB President A/Prof Warren Shnider said, “Dr Lau and Dr Steel exemplify commitment to do their best for their patients. They achieve this by understanding and meeting their patients’ needs in a holistic manner. Their thirst to develop themselves and their dental teams culminates in better health care outcomes for their patients and their communities. “The ADAVB is proud to partner with BOQ Specialist to announce Dr Lau and Dr Steel as the 2022 bursary recipients,” said A/Prof Shnider. 2019 La Trobe University graduate, Dr Lau, said he was extremely excited to be named the recipient of this year’s Recent Graduate Bursary and very thankful for ADAVB and BOQ Specialist’s ongoing support of young dentists. “With the challenges all of us ADAVB and BOQ Specialist announce 2022 bursary recipients have faced over the past few years, in terms of both the pandemic and difficulties in accessing hands-on continuing professional development, the bursary will aid me tremendously in further developing myself, to provide better care for my patients,” said Dr Lau. Dr Steel andhis teamat Dental HealthCareAssociates impressed the judging panel with their holistic approach to professional development and were excited to be awarded the Practice Bursary after a challenging few years. “It means a lot to the team to be able to get back on track with our continued learning, after not being able to do much one-on-one training in the last few years. “As our practice is in the CBD, we were hit hard with lockdowns and the CBD workforce continuing to work from home. This bursary will get us back on track much sooner than expected,” said Dr Steel. BOQ Specialist CEO, Keith Strachan, concluded, “We are proud to partner once again with the ADAVB to recognise two outstanding recipients in Dr Lau and Dr Steel. Not onlydoes thismark the strengthof our longstanding partnership, but our shared commitment to supporting the professional development of the Victorian dental community. “Both Dr Lau and Dr Steel’s holistic approach to dentistry, combined with their passion for delivering the highest quality of care to their patients and their communities, make them both very deserving recipients of this year’s bursaries,” said Mr Strachan. Dr Lau and Dr Steel will be featured in the ADAVB’s Victorian Dentist magazine as well as BOQ Specialist’s Best Practice publication. u
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CATEGORY 4 AUSTRALASIAN DENTIST PEOPLE A-dec’s new technical specialist PROFESSIONAL DENTIST SUPPLIES - 3/8 NICOLE CLOSE BAYSWATER NORTH VIC AUSTRALIA - 03 9761 6615 - firstname.lastname@example.org - ABN 69 088 275 576 WWW.CHLOROFLUOR.COM.AU KEEP YOUR MOUTH AND BREATH HEALTHY & FRESH #SUPPORTAUSTRALIAN A-dec has announced the appointment of Dominic Connolly as technical specialist with the company, based in Sydney. Dominic is well respected in the dental community as a long-serving dental equipment technician and has extensive experience working on both A-dec and a wide range of dental equipment. He has a background as an equipment technician with a Sydney-based A-dec dealer before operating his own dental equipment servicing business for a number of years. His experience bolsters A-dec’s strong network of authorised A-dec dealers and A-dec Territory Managers, andwhile his position is largely an advisory role, he is able to ‘get on the spanners’ when required. Mr Connolly recently helped with the setup of A-dec’s large display at ADX Brisbane and is a great resource for A-dec and its Australian customers and equipment dealers. u He can be contacted at A-dec on 8332 4000 or via email at email@example.com Practice Sale Search team expands, with the appointment of a new National Account Manager Practice Sale Search has announced the appointment of a new National Account Manager, Michael Brivulis. Michael joins the Practice Sale Search team after working in dental practice acquisitions and practice builds for two major Australian dental corporate aggregators. Before this, he worked in the financial services sector for more than 15 years. Michael’s experience gives him a unique insight and knowledge into how buyers (both private and corporate) value and assess practices for purchase. Through his involvement in hundreds of practice purchases, he has seen many vendors miss opportunities to get the best terms and price for their practice, either by being poorly represented during negotiations, or not understanding the true value that their business holds for a buyer. Simon Palmer, Practice Sale Search’s Managing Director, says “Michael brings a wealth of business development and client relationship experience to his role at Practice Sale Search and will be an invaluable asset to our company and our clients”. u Michael Brivulis can be contacted at Practice Sale Search on 1300 282 042 www.practicesalesearch.com.au Dürr Dental’s new CBCT product specialist Dürr Dental has a new product specialist for CBCT and imaging in Australia & New Zealand, Mr Darius Rohanian. Darius is an oral health therapist, graduating from La Trobe University in 2012. Throughout his time at university, he completed a wide range of local and international placements, including clinical training in New York City. He graduated with the Australian Dental & Oral Health Therapist Association (ADOHTA) Award, and La Trobe University Dental Therapy Award, for excellence in both the education and treatment of children. Over the past 11 years he has worked in leading private practices across Sydney and Melbourne. He has also spent time working as a Clinical Educator at the University of Sydney. Darius will be responsible for the Dürr Dental imaging and software range, with a particular focus on the VistaVox S, the new state-of-the-art CBCT unit that boasts unparalleled image quality. While working closely with our distributors Darius will also be available to clients to help with their needs, and answer questions that they may have about the product range. u His contact details are 0484 708 940 and email is Darius.firstname.lastname@example.org
4YEARS YEAR 40 ANNIVERSARY th YEAR Quality customer care that’s more than just lip service. We make it easy. From the widest range of dental products in Australia, and fast, responsive customer service to our industry-first, easy-to-use customer portal, ordering your lab products is easy. We’re always there. Whether you need rapid pick-up or a fast response from our customer service team, or detailed technical support from our experienced technicians, we’re only a phone call away. 02 8062 9800 scdlab.com Document Version: SCDA_CAM_40th_CS_032023
CATEGORY 6 AUSTRALASIAN DENTIST PEOPLE Dr Rohan Krishnan has been elected president of the Australian Dental Association New South Wales (ADA NSW), the peak body for dentistry in NSW and the ACT. The owner and principal of a private dental practice in West Pymble on Sydney’s North Shore, Dr Krishnan has been ADA NSW vice-president for the last 12 months. Dr Krishnan, who is currently an Honorary Clinical Associate Lecturer at the University of Sydney, has been actively involved with the association since graduating with Honours in Dentistry from the University of Sydney in 2012. He also holds a degree in MSc Medicine in Orofacial Pain Management and is also currently a Board Member of the Australian Dental Council. “Being electedas President of ADANSW is a great responsibility and I’m looking forward to leading our organisation’s efforts to support and empower dentists to advance oral health in Australia,” Dr Krishnan said. “ADA NSW is honoured to represent a wonderful profession striving to improve New president of the ADA the health of all Australianswith a particular focus on the communities in NSW.” Dr Krishnan has also served as Chair of Filling the Gap, ADA NSW’s charity which provides pro bono dental services to those who cannot access mainstream programs. Volunteering in local communities is something he is incredibly passionate about and Dr Krishnan is also a regular volunteer dentist at the Cerebral Palsy Alliance. “Dentists are a vitally important part of the healthcare system,” Dr Krishnan said. “We work in providing diagnosis, prevention, surgical intervention, pain relief and rehabilitation with incredible benefits to patients and the community. “Ensuring that patients receive the highest standard of care with a preventative focus will lead to better long-term health outcomes.” “All Australians have the right to accessible health care and oral health is most definitely a part of that. As president, I look forward to leading ADA NSW’s advocacy efforts in promoting the importance of oral health care.” Dr Dominic Aouad, a general dentist and practice owner on Sydney’s North Shore, has been elected ADA NSW VicePresident. Dr Aouad is a current Director of Dental Compliance Australia, a dental education company looking at improving dentists’ understanding of regulation and compliance while improving patient outcomes. In addition to his involvement on other ADA Committees, Dominic has served as a Professional Officer for the Dental Council of NSW and is a Fellow of the Pierre Fauchard Academy and a Fellow of the International College of Dentists. Dr Aouad has also attained a Masters in Business Administration and is a graduate of the Australian Institute of Company Directors. “Being elected Vice-President of such a high-performing and trusted organisation as ADA NSW is a huge honour for me, “Dr Aouad said. “I am passionate about improving oral health outcomes and look forward to working with my fellow colleagues as we strive to maintain the highest ethical standards in a profession that is both humbling and rewarding.” u The hearing aid industry’s leading provider of AI CAD, H3D, enters the dental industry to address the shortage of CAD technicians. Copenhagen-based H3D has announced it is developing dental AI CAD in partnership with Modern Dental Pacific, Andent, and Orthodonzia Estense. H3D’s entry into dental follows their strong success in the audio industry where they have become the AI CAD market leader. Mimicking their successful approach in audio, H3D are focusing on dental labs rather than clinics. The company’s motto is “built with labs, for labs”, and there is a strong emphasis on quality. This is welcome news for dental labs, which have been increasingly neglected as dental CAD companies prioritize clinics and chairside. “Labs are the gold standard in terms of quality levels, and our ambition is to create the world’s best AI CAD, so partnering with them was a natural choice for us,” says Damian Png, Dental BU Director at H3D. The strategy is certainly working in the Audio industry. H3D’s AI CAD boasts an order acceptance rate of >90%, enthusiastic product reviews, and a 100% customer retention rate. They work with iconic brands, such as Sennheiser, Amplifon, and Formlabs. Such customer fanfare is in stark contrast to existing AI CAD solutions in dental, which have a reputation for poor quality and consistency. “H3D’s AI CAD designs look very promising – high quality standards, fast turnaround times, and competitive pricing,” explains Matt Smith, General Manager at Andent. Labs see H3D’s AI CAD as a solution to the labour shortage of CAD technicians, which will ultimately help them scale their businesses. Currently, CAD takes x1 CAD technician 10-20 minutes per order. However, there is an industry-wide shortage of CAD Dental AI CAD launches in dentistry technicians, so labs are forced to reject new business. “H3D’s AI CAD has the potential to be hugely impactful for our industry. It will enable us to significantly increase our production and overcome the capacity issues caused by the shortage of CAD designers. It will also facilitate the transition from thermoformed to digital splints, resulting in better quality products for dentists and patients,” says James Squirrell, CEO of Modern Dental Pacific. With H3D’s AI CAD, 100s of orders can be processed within 5 minutes. It’s been intentionally designed to be so simple that it can be operated by lab staff who aren’t CAD technicians. “I started working on 3d digital technology in 2009 and it changed the whole game – staffing, quality consistency, speed, costs – and it’s clear that AI CAD is the industry’s next big innovation,” says Stefano Negrini, KOL and CEO of Ortodonzia Estense. As the dental industry continues to embrace digital dentistry, H3D sees AI CAD further accelerating the trend towards intraoral scanners and 3D printing. “We’re regularly approached by 3D Printing companies, IoS companies and resellers. For them, CAD is holding back the industry, so solving this bottleneck is hugely important,” says Iain Mcleod, CEO at H3D. H3D’s AI CAD for splints will be released in Q3 2023, with crowns, dentures and aligners following shortly. The company is currently accepting expressions of interest for their Innovators program, which provides early access to the AI CAD product, as well as discounted pricing. u NEWS
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8 AUSTRALASIAN DENTIST NEWS PROFESSIONAL DENTIST SUPPLIES - 3/8 NICOLE CLOSE BAYSWATER NORTH VIC AUSTRALIA - 03 9761 6615 - email@example.com - ABN 69 088 275 576 WWW.PROFDENT.COM.AU Professional Teeth Whitening has never been so simple! #SUPPORTAUSTRALIAN With around 1.3 million NSW school students heading back through the school gates on 31 January, the ADA NSW has some tips for families who want to refresh their kids’ lunchbox contents and help improve their oral and overall health. “As parents and carers, we are busier than ever, and the daily grind of making and packing kid’s lunches means that often it can feel easier to reach for convenient options that are actually higher in sugar than you realise.” “As a father of two children who take a packed lunch to school, I know how hard finding extra time is, but setting kids up for good oral health starts early in life,” said Australian Dental Association New South Wales (ADA NSW) Vice President, Dr Dominic Aouad (pictured). “In my dental practice, I see firsthand the impacts of daily sugar consumption.We know thatmany popular and convenient lunchbox items are high in sugar, causing tooth decay or gum disease over time. This can lead to more invasive dental treatments for children such as fillings and early extractions and also contribute to greater hospitalisations and chronic diseases such as Type 2 diabetes later down the track.” Parents may be surprised to know that for example, a lunch that includes dried apricots, a flavoured yogurt, and a fruit juice box is delivering more than double the recommended daily amount of sugar. Limiting sugar consumption is the key to preventing tooth decay, which is the most common chronic disease in childhood. Around 1 in 4 (24%) Australian children aged 6-14 had dental caries in their permanent teeth, and around 1 in 10 (11%) had at least one permanent tooth with untreated decay, according to the Australian Institute of Health and Welfare (March 2022). The ADA NSW’s easy tips for tooth-friendly lunchboxes: u Include something from each of the five food groups including fruit/vegetables/legumes/beans, dairy, grain (cereal) foods and lean meats poultry/fish/eggs. E.g., cheese sticks hard-boiled eggs u Replace chips, chocolates, muesli bars, and sweet biscuits with items such as fresh fruit, celery and carrot sticks, and cucumbers. u Limit snacks that are high in sugar and/or saturated fats e.g. donuts u Pick whole fruit over fruit juice – the vitamins, minerals and fibre make it more filling and nutritious and reduce the sugar content per serve. Dental experts share easy tips to help parents avoid hidden sugars in school lunchboxes u Pack water as your school drink rather than sports drinks, juice, soft drinks, cordials or flavoured milk which are high in sugar. If your tap water is fluoridated even better! u Look for grain-based snacks with whole grains and high fibre, such as wholegrain bread and crackers. u Processed snack products such as muesli and breakfast bars, chips, and cookies should be limited to one item and ideally a low-sugar choice, such as rice crackers, popcorn and cheese. “As well as packing a tooth-friendly lunchbox, parents should ensure their child visits a dentist at least once a year for a check-up as maintaining good oral health improves overall health outcomes for your life,” said Dr Aouad. Brushing teeth twice a day, flossing and drinking tap water in place of other drinks are also easy ways to help protect oral health among people of all ages. Checking the labelling of packaged items before buying to see their real sugar content is a quick way to gauge what should be included or not in school lunchboxes. Added childhood oral health stats (Courtesy the Australian Oral Health Tracker): u Poor oral health in childhood is the strongest predictor of further dental disease in adulthood u About 70% of children aged 9-13 are consuming too much sugar u Oral diseases such as tooth decay, gum disease and oral cancer contribute to illness, disability and death in Australia. u Parents need to be aware of the hidden sugars lurking in their child’s lunch box. ADA NSW Vice President Dr Dominic Aouad and his dentist wife Dr Melanie Patney and their two children Leon aged 4 and Rohan aged 6.
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CATEGORY 10 AUSTRALASIAN DENTIST N WS Colgate has welcomed the appointment of two new members, dentists, Dr Arosha Weerakoon and Dr Isabel Evans to its Advocate Community, a group of dental and oral health professionals who have preventive oral care at the core of their professional beliefs. Entering its fourth year the Advocate Community supports and encourages young and established oral health professionals through the sharing of their knowledge on a range of relevant and topical issues based on their experience in the profession. Advocate content delivers practical information for young professionals to employ during university studies right through to the practice setting. It drives dialogue on a wide variety of topics including preventive oral health, social responsibility, career development, mental health, and sustainable dentistry, to name a few. Dr Evans says, “The community is u Haydyn Bathurst, Fifth Year Dental Student, NSW u William Carlson-Jones, Lecturer and Oral HealthTherapist, NSW u Dr Isabel Evans, Dentist, ACT u Dr Sam Koh, Dentist, VIC u ChristineMurthi, Oral HealthTherapist, NZ u Dr Kaejenn Tchia, Dentist, NT u Dr Emma Turner, Dental Registrar, VIC u Dr Arosha Weerakoon, Lecturer and Dentist, Qld Dr Sue Cartwright, Scientific Affairs & Public Health Manager, Colgate Oral Care says, “The Advocate Community, enabled by Colgate, continues to be such an important initiative to help support young professionals. The community’s collective voice provides peer-to-peer insights for young dental and oral health practitioners, helps to spark new ideas and encourages young practitioners in their career development. The community understands the challenges ‘new recruits’ may be facing and this initiative provides a valuable resource for them.” The community brings together young professionals to leverage their experience and perspectives for the benefit of the profession. u Working with Colgate, the Advocates’ articles are published on www.colgateprofessional.com.au/Advocates and shared via the Advocates’ social channels. Oral Health Advocate Community welcomes two newmembers Dr Arosha Weerakoon Dr Isabel Evans Visit our booth #265 Microlaser 1800 806 450 www.amalgadent.com.au SEE THE SPECIAL ADX23 SHOW OFFERS AVAILABLE Footer Ads #97.indd 5 20/01/2023 9:37:53 AM made up of dental practitioners who are dedicated and passionate about promoting preventive oral health practices. As a Wiradjuri-Ngunnawal woman this is so important for my mob which experience poorer oral health than other Australians, with higher incidence of tooth loss, decay and gum disease. I believe this discrepancy can be improved by promoting culturally safe oral health messages and practices. I’m excited to share some tips to improve cultural safety at dental practices, as well as oral health initiatives for our mob.” Dr Weerakoon adds, “It is an honour to be selected as the 2022/23 Colgate Advocate for Oral Health. As a dental practitioner involved in research, I wish to encourage my peers to do so as well. I look forward to promoting professionalism and create a discourse about enhancing patient care.” The community members include representation from across Australia and New Zealand, including (in alphabetical order).
AUSTRALASIAN DENTIST 11 PORTABLE DENTISTRY Portable dentistry is both practical and in demand Meet Dr Mark Wotherspoon, an experienced promoter of portable and aged care dentistry, and creator of a hygienic dental appliance product range. Inspired by patients that could no longer visit his dental office due to frailty or illness, Dr Mark Wotherspoon started to provide portable dental care – offering treatment in the comfort of the patient’s home. Learn his full story. Why did you decide to study dentistry? I really wanted to be a professional golf player, but I found out quite early that I wasn’t a great golfer (laughs). As a teenager, I had a part-time job working in a bar collecting glasses and washing dishes. One of the barmen was studying dentistry, and when work was a bit slow he’d be studying and I’d look over his shoulder at these fascinating textbooks. And the rest is history. How was dentistry perceived back then? Was it seen as an important profession? Yes, a very important one. In fact, at the university I went to, dentistry students and medical students studied together in the first year. And although it’s already a very well-respected profession, we would certainly like people to better understand the connection between oral health and their general health. “We would like people to better understand the connection between oral health and their general health.” What were your first steps after graduating from dental school? I’d been living in a very happy home, but when I graduated from dental school all I wanted to do was move as far away as possible. I applied for a job as a government dentist in the very remote Kimberley region of Western Australia. I was based at a small hospital in Wyndham, but every 6-8 weeks we would charter a light aircraft, pack up our portable equipment and fly out to isolated indigenous communities to set up short-stay dental clinics. I enjoyed that time very much. I was only 22, my dental nurse was 16 and the pilot was 19 – you can imagine it was quite an adventure. What was the state of oral health within Aboriginal communities? It was quite good, more gum problems than decay-type problems. Most of the work I was doingwas extracting teeth. If somebody was in pain, they’d come in and I’d take the tooth out, there was no comprehensive dental treatment. Were there any important moments from those days that have had an impact on your whole career? It taught me that checklists and systems are very important. I had to be super organised. If you left something behind, you couldn’t just turn around and get it out of the cupboard. As I was the only dentist within 800km of these towns, I felt an enormous responsibility towards the people who were relying on me to look after them. It instilled in me a great sense of responsibility towards my patients and my small team. It also proved to me that a portable surgery was both practical and in demand. Your CV also includes a period of military service in the Army Dental Corps. What was your role in the army? Military service in Australia is not compulsory, you volunteer for it. I joined the Australian Regular Army as a Dental Officer. Although I was only there for a few years, it was a wonderful experience and it had a profound effect on me. I learned to work within a large organisation and I became fitter and stronger, which is very important in our profession to reduce back and neck problems. In the end, I was treating a lot of very fit, young, healthy people, and providing a lot more preventive services than restorative services. I did enjoy my time in the military because I went from working on my own in a very isolated place to working in a larger clinic with more experienced dentists, hygienists and nurses. I was like a sponge and picked up many tips and tricks. Nowadays you run a few professional activities simultaneously. How is your work week divided into the different activities now? I spend one day a week going out with my portable dental clinic, Dentist to your Door, going to aged care facilities and providing care for people in hospitals and in their homes. I still work as a general dentist three or four days a week, and I spend one or two hours a day working on my other business, the Dr Mark’s HyGenie range of products. I need to be kept busy and I enjoy a busy lifestyle. Tell us more about Dentist to your Door. When did you start this service and what was your motivation? There were two reasons. One was personal and the other one was professional. My mother had a lifetime of health problems and I realised how much work went into looking after somebody with health issues. Any sort of assistance that we can give to such families is invaluable. I saw the value in being able to go out and help. Froma professional point of view, some of my long-termpatients who would seeme INNOVATIONS Dr Mark Wotherspoon
CATEGORY 12 AUSTRALASIAN DENTIST regularly, would one day just stop coming. They’d say, ‘’Look, we want to come, but it’s just too difficult.’’ It had simply become too hard or even impossible for them to attend the surgery due to ill health, frailty or both. I felt helpless and frustrated that I couldn’t do more for them. The situation was quite sad and often had significant consequences on both their oral and general health. “Some of my long-term patients would one day just stop coming. It was too hard for them to attend the surgery, and I wanted to do more.” So you decided to find a way to help them in a non-conventional way? I discovered that there are so many options for lightweight, portable dental equipment, available globally and in Australia, which can fit in the boot of the car. All that needed to be done was to develop some systems for working outside of the fixed surgery, and add some practical guidelines around time, logistics and fees to make the service practical and viable. Now this allows me to treat patients while they’re lying in their own bed or seated in their favourite chair, with their family member or staff member present. Do you go alone or do you work as a dental team? I work alone. I wanted to develop a service that was financially accessible and to do that, and keep costs down it is best to work solo. What’s the general situation regarding the oral health of the elderly in Australia? Many dentists from various parts of the world say that, in general, seniors and their dental health do not get enough attention. Can you relate to that? Very much so! In Australia, there was an investigation into the state of aged care nursing homes. One of the results that came out was that a lot more needed to be done for oral health. We have 250,000 people in nursing homes in Australia and we don’t have many dental professionals going in to provide services. However, the issue isn’t so much a person’s age, as age is simply a number; the issue is the individual’s ability to self-care. It’s everything from cognition, communication, diet, transport, personal hygiene and more. The patients I serve with Dentist To Your Door range from 25 to 95+ years in age. How do you motivate the elderly to take care of their oral health? Great question! The first thing to know about this group of patients is that they’re proud and will do almost anything to hang onto their independence. They say, ‘’Oh, I’ve just cleaned my teeth.’’ But when you look in their mouths, you can tell that the brushing is not done properly and that the dentures are not cleaned properly. moves to a different facility, the person continues to receive the correct care. Do you also train caregivers or employees at the senior homes on how to provide dental care? I’mgoing to start giving lectures and handson workshops utilising mannequins in the local technical colleges where they train nurses aged care workers. If we can improve daily cleaning and maintain regular visits from a dentist or a hygienist, that’s going to make a big difference. I would really love to see dental hygienists as part of the staff in every facility. At the moment, you have physiotherapists, speech therapists, dieticians, even podiatrists, optometrists, but I want a hygienist to be part of the staff at the facilities to make sure that everybody’s getting their mouths cleaned correctly on a daily basis. You have your own product range, Dr Mark’s HyGenie®. Why did you decide to focus on removable dental appliances? It comes down to my personal and professional experiences. Watching my dad have trouble cleaning my mum’s dentures was one factor. In addition, I have three children and they all had to wear a mouthguard to protect their teeth when doing sports. We need to understand that a dirty sports mouthguard collects mould, and this is related to lung infections and asthma. It’s very important to have your mouthguard cleaned and then stored dry. From a professional perspective, you only have to be in the dental profession five minutes to know that the home care of dentures, orthodontic aligners, splints and sleep appliances is well below standard. Oral hygiene instruction for the home care of these appliances needs to be taken far more seriously and I am not sure we always spend enough time educating our patients as to the reason “why” dental-appliance hygiene is so important, and then showing the “how” with regards to home care products that are easy to use and give a great result. So, I carry an intraoral camera with me. I put the camera in their mouth and take an oral photograph of what I see. I display the photo on the screen of my laptop, we look at it together and I say, ‘’Well, this is not up to your own standard. You need assistance, let me help you,’’ and normally they agree to be helped. “I want a hygienist to be part of the staff at senior homes to make sure that everybody’s getting their mouths cleaned correctly on a daily basis.” How do you approach patients with dementia? If the person suffers from dementia, then I show the photo to a family member and I demonstrate how to work with the correct toothbrushes, toothpaste and cleaning products, how to take the dentures out and how to clean them. While I’m doing this demonstration, I ask the family member to make a video using their smartphone, of me demonstrating how to clean the patient’s mouth properly. They can then share this video with other family members or staff. This also means that even if that patient INNOVATIONS
CATEGORY AUSTRALASIAN DENTIST 13 “We don’t always spend enough time educating our patients as to the reason ‘why’ dental-appliance hygiene is so important, and then showing the ‘how’ with regards to home care products that are easy to use and give a great result.” Did you develop the products on your own, or did you collaborate with anybody else? Our team consulted many dental professional experts, scientists and engineers, along with a number of consumer groups to design and test all six products. Let’s talk about your profession more generally. You are an experienced dentist. When you compare today’s dentistry with the field during your university studies, how much has it changed? And what do you hope will come next? Dentistry today is so much better! Digital technology, material science developments and the possible clinical results are truly breathtaking. The challenge is to keep the service affordable so most can enjoy these advances. We need to have a strong public service, so that people who can’t afford it can be looked after as well. In terms of future, a lot more oral health content needs to be included in all medical and paramedical training. Tele-dentistry will be an important tool to facilitate this integration. And what about the patients, do they care about their teeth more than they did in the past? Some people take their oral health seriously and others don’t care at all. I think just as many people care now as they did back then, and just as many people don’t. I wish I could say that people took the health of their mouths more seriously, but I think four out of five people care about their mouths, one in five just don’t. That’s why it’s important to keep educating the public about the relationship between oral health and general health. How do you work on your continuing education? I love to go to conferences. There’s also so much content online – webinars are a wonderful tool. I can listen to an expert in Japan, an expert in Germany and an expert in the USA, all in the same day. We owe it to our patients to stay up to date with the latest science, techniques and products as they deserve and expect this from us. What are the golden rules of your professional career? Respect your patient’s opinions, time and money. Respect your staff and display good manners, fairness and decency, and of course, respect yourself. “I believe we owe it to our patients to stay up to date with the latest trends because they expect it from us.” What about your future plans? 2022 promises to be an exciting year and I have already accepted a number of invitations to present and teach Portable Dentistry and Aged Care Dentistry. As I mentioned, I have also taken up a teaching role in a local technical college that trains aged care staff. I am a big fan of the iTOP philosophy and hope to continue my training and along with my colleague Dr Tihana Divnic-Resnik, we are in the development phase of an iTOP module tailored specifically towards aged care and seniors. How do you keep your work-life balance? What are your favourite ways to relax? Years ago, I was advised that “Nobody lays on their deathbed wishing they had spent more time at work”. I enjoy spending time with my family and friends and I’m still playing golf badly (laughs). In Australia we barbecue and picnic a lot, and now that Covid pandemic restrictions have lifted we will be heading to the beach. u Dr MarkWotherspoon is an accomplished dental practitioner, presenter and educator with 30 years of experience, based in Wagga Wagga, Australia. Mark has held government service appointments as a Dental Officer in Western Australia and in the Army Dental Corps. He is the founder of Dentist to your Door, specialising in portable dental services, and of Dr Mark’s HyGenie, a range of dental-hygiene products for removal dental appliances. 1800 806 450 www.amalgadent.com.au Visit Amalgadent Booth#265 for ADX23 special offers! Booth #265 Footer Ads #97.indd 2 19/01/2023 6:37:39 PM INNOVATIONS
CATEGORY 14 AUSTRALASIAN DENTIST INNOVATIONS During my discussions with over 2,700 dental practices in Australia, I have heard these and similar misconceptions repeatedly. As an industry, we seem content to leave millions of dollars on the table and miss the opportunity to provide a treatment that people really want. The teeth whitening market was recently valued at US$6.1 billion in 2021, and it is estimated to register compound growth of 4.95% yearly over the next five years. As a dental practice, whitening should be the cornerstone of your treatment plans. Most adults, including your patients, want white teeth. However, the majority of them are not seeking the help of dental professionals, preferring cheaper alternatives such as over the counter, or online options. So, how do you help to reverse this trend and start more whitening treatments without sounding salesy? My Whitening Project Training Program details all the elements used by the most successful practices to assist in your conversations with patients. Primarily, the proven technique of focussing on How to sell more teeth whitening (without feeling like a used car salesperson!) By Stephen Douglas, Creator of: The Whitening Project Boutique Whitening Australia the problem (staining) rather than the treatment (teeth whitening), means a conversation is based on offering helpful solutions rather than pushing a sale. Discoloured teeth cause both external pain (physical appearance) and internal pain (embarrassment), which means a person might not smile in photos or videos and lack confidence. If you start talking about the treatment first, you will sound like you are selling. However, if you can discuss the issues caused by tooth stains with empathy, you reach out to the patient’s pain points. Put yourself in the patient’s shoes and ask if they avoid social situations, photographs or cover their mouth when they talk. One thing you can implement immediately is to introduce a VITA shade check as part of your consultation process. At the consultation, either take a picture of the patient’s smile and put this on a large screen TV, or simply give the patient a mirror and let them look at their smile. Ask them to point out any issues they have with their teeth, in terms of shape, shade and position. Often, when faced with such an image, patients will write their own shopping list of treatments they want. You should then show the patient their teeth against the Vita shade guide and point out where on the scale they currently rank. Explain to them that with age, their teeth will get darker and move down the Vita guide. Conversely, show them the other end of the Vita guide and let them know that for $x per month, or one-off payment of $y, they can whiten their teeth for a more youthful and aesthetic smile. This is an easy way to begin a conversation about possible whitening and introduce the cost. It works just as well to introduce other treatments such as orthodontics or implants. If the patient does not want to proceed with whitening at this time, then take a record of their shade, so that you can compare in the future if the teeth begin to darken. Better still, if you can take a picture, this can be saved on their file for future comparison. We know from a survey conducted by the ADA, that 5% of adults are considering whitening their teeth. If you do not engage and empathise with them about the problem of stained teeth, they will seek help elsewhere, as we discussed earlier. The process described above, should take around two minutes additional time per patient … is it worth it? Our aim is to get you to start one whitening treatment per day. Five treatments per week is equivalent to $100,000 top-line revenue, so for most practitioners, it is most definitely worth the time. If you find teeth whitening challenging and lack clarity in how to approach and provide the treatment, The Whitening Project Strategy and Training program will teach you step-by-step how to whiten teeth more effectively, with less sensitivity to create a modern and efficient $100,000++ whitening business. To learn more or to sign up, scan this QR Code. Stop trying to ‘sell’ whitening. Engage with the problem (tooth stain). Stephen Douglas ‘I don’t want to sound pushy.’ ‘I don’t want patients to think I am selling them a treatment.’ ‘Whitening is cosmetic and not mainstream dentistry.’
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CATEGORY 16 AUSTRALASIAN DENTIST INNOVATIONS Efficient document management is a key component to running a quality healthcare practice. While more practices have gone ‘paperless’, many still store their digital documents inefficiently and unsecured on computers, which can lead to: u time wasted trying to locate the current version of a file u greater risk of data or privacy breaches if anyone can access a document u data loss if files aren’t backed up u human error with tasks being missed or performed incorrectly u interrupted workflows u not meeting compliance or accreditation requirements. Using a centralised document management system can help streamline your practice processes and ensures your practice and patient data is stored securely. Below are some benefits of an online document management system in more detail. 1. Better data security, privacy and back-ups A data breach can cost a business in excess of $2 million, depending on the severity. Using a centralised management platform like PracticeHub, practices can load and store all their confidential documents on to the system and can authorise certain employees to view specific documents depending on their role. Any amendments that are made to any documents can be tracked via an audit trail. By storing and managing your practice documents on a cloud-based platform, the hassle of manual file backups is often removed, and you can relax knowing that your documents are stored securely. It’s important to perform your due diligence on any supplierbeforemovingyourdocuments Improve practice efficiency and patient care with a document management system to a cloud-based platform. Understand what security protocols the supplier has in place, what location your data is stored and that it meets any regulatory requirements for your practice. 2. Improve workflow efficiency With a document management system, automation saves time and improves efficiencies in workflow. A platform like PracticeHub lets you link relevant tasks and documents to your practice policies and procedures. You can assign tasks to staff roles and monitor compliance and completion. Alerts and reminders ensure you meet compliance or insurance renewals and task deadlines. Policies are regularly and automatically updated in line with regulatory changes. PracticeHub’s audit history displays all the changes made to the policy, procedure or document. To ensure that the practice’s staff are continually up to date with any amendments made, staff are required to read, understand and agree to the changes. By having a singular and updated copy of documents loaded in the system, it can reduce the risk of human error or compliance breaches. 3. Improve collaboration, performance and off-site management Storing and managing your practice documents in one place online makes them more accessible to your team and you – wherever you’re working from. PracticeHub’s dashboard gives an overview of tasks and their status, for easy tracking. Centralised sharing of documents promotes efficiency and collaboration which can in turn enhance team building, morale and better performance – making staff feel like their input matters. 4. Save time, money and space Paper-based or inefficient digital filing can cost you more hours in staff wages which could be better spent on patient care and ensuring compliance. Utilising a document management system, enables practice owners and managers to spend less time on practice administration and more time on big-picture strategy to grow the business. You also save money on paper and printing costs. 5. Reduce error and risk Well managed practice policies and procedures improves the quality of your service to patients, and your regulatory compliance. This is easier with a document management system. The customisable policies and procedures templates in PracticeHub are written by practice management experts, providing bestpractice processes for patient care and business management. The integrated registers streamline insurance renewals management for clinicians and equipment maintenance tasks. PracticeHub also includes eight training modules on common risk areas. This saves you time and money on external training and ensures staff stay compliant in their roles. Ahpra Alerts features automatically update practitioner registration status helping to streamline regulatory compliance for a practice. 6. Simplify accreditation preparation and assessment We’ve seen how a document management system improves compliance, and it stands to reason that this helps make it easier for your practice to not only meet accreditation or quality requirements, but also to prepare for assessment. With PracticeHub’s Standards-aligned policies and procedures, task monitoring, training modules and audit trail, you have a record of what you need to prepare for, and meet accreditation – all in one place, for quick, easy access. u Discover how PracticeHub’s document management system streamlines your processes, saving you time so you can focus on improving patient outcomes. Visit the PracticeHub website www.practicehub.com.au or call: 1300 96 86 36.