Australasian Dentist Magazine March-April 2023

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

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