GAP Australasian Dentist Sept Oct 2020

Category 102 Australasian Dentist T he turning point that changed Associate Professor Michael Stubbs career, professional life and mindset on how to treat a patient happened back in 1996. And luckily for the thousands of patients he’s treated since, the skills he was forced to learn as a result of this experience have created an oral medicine specialist like no other. Michael has generously shared his experiences with us including his gradual evolution into a provider of choice for patients and medical specialists alike. We talk to Michael about everything from how he started out, what his core interests and focuses are and how impactful this turning point was in his mindset in treating patients well. We ask Michael how the Respiratory Dental Institute started and why now is the best time for dentists to start thinking about dental sleep medicine in their practice. Q How did you get into dentistry? It was actually just by chance, I’d originally looked at doing medicine but didn’t get the score I wanted so went down the list and found dentistry and thought: That will do! And I realised once I got into the program I actually liked it. Q Where did you go when you first graduated? When I first graduated I headed to Hobart and ended up staying for two years. I was actually thrown in the deep end big time. My first day I had a patient that didn’t believe I was old enough to be a dentist and wouldn’t let me treat her. So the owner had to come in and treat the patient. When I went to Tassie it was the first time I’d been away from home and it was a really good experience. That’s the reason I opened my specialty clinic there. I really enjoy my time there. Q From Hobart where to from there? I returned back to Adelaide to work in the hospital. I really enjoyed working with Becoming a master “The patient was in severe chronic pain, on their knees in front of me, begging me to help them. And there was nothing I could do, and I felt absolutely useless.” challenging patients so that was the right move for me. It was in 1991 and we had just started to see the immersion of AIDS in the community. At the time a good friend of mine, a colleague, and myself started treating patients with AIDS (which not many were doing), then it progressed to head and neck cancer patients; then to bleeding disorders like haemophilia. We actually invented a lot of our own protocols for these patients as not much existed back then. A lot of the patients we treated back in those days died. It was scary and we didn’t even have a name for the virus (HIV). So we were developing our protocols as we went and that’s really where I fell into the Oral Path (Pathology) training. As fate would have it, I loved Oral Pathology, but I didn’t want to spend all day in the lab. So I decided to move into Oral Medicine. Then I just did both. Q When was the spark, the turning point to focus on Oral Medicine and help this group of patients rather than typical general dentistry? I can tell you the exact time actually, it was in 1996. I had a patient whom I was treating and had done some restorations for and removed some wisdom teeth. And she had a lot of pain post operatively. I didn’t know a lot about chronic pain back then. At one point she was on her knees and begging me to help. And I felt absolutely useless. And that was the turning point. Q It’s interesting how some people have that powerful moment and it really pressures you or gives you a responsibility to solve these difficult problems I think the thing is it’s just that sense of not knowing what to do and feeling useless. I remember thinking I never want to be in another situation like this. I look back on it and know exactly what I would do but it really is what motivated me to move into Oral Medicine, which is one of my great loves. Q So you had this moment of change and the motivation to move into oral medicine at what point did you evolve into a dental sleep medicine practitioner? Well that’s an interesting one, I had a patient turn up with a dental device and the patient had TMD. We didn’t know a lot about sleep devices in 2003. And I started thinking there’s got to be a better way to deal with these patients rather than deal with them at end stage after they’ve had so many problems. So that’s when I started getting into it. Learnt how to treat patients and actually diagnosed myself as having sleep apnoea. I made my own device and started going to conferences and interacting with other colleagues. And it just evolved from there. Q With the momentum of CPAP and the prevalence of it as a treatment option we find that dentists seem really self conscious about treating and even screening patients for sleep apnoea, do you have any advice for those reluctant to get started in DSM? The first thing is having a sense of confidence about yourself. As dentists you are an expert in the upper airway. Because company profile Dr Michael Stubbs