ADAQ Dental Mirror - Autumn 2022

Information Privacy for Practice Staff

Evolution of the Dental Team

CPD Calendar Jul-Sep 2022

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IT’S TIME TO RENEW WITH ADAQ

Renew your ADAQ Membership NOW and receive a 10% early bird discount!* Early Birds receive 10% OFF their ADAQ Membership before 23 25 June!

June!

Why renew with ADAQ? Keep up to date with COVID-19 updates Ongoing regulartory advice and support Discounted CPD courses and events Competitive PI insurance Advocacy for your profession Connection with the dental community

Your ADAQ Membership is due for renewal on 30 June, make sure you renew to maintain access to our benefits and resources.

Visit

adaq.org.au/RENEW

If you have any questions or need assistance with renewing for ADAQ Membership, please contact membership@adaq.com.au or call 07 3525 9866 and speak to the ADAQ team. *Early Bird offer closes 11:59 pm, 23 June 2022.

4 EDITOR

Dr Jay Hsing

CONTENTS

EDITORIAL TEAM Dr Matthew Nangle Dr Garry Smith Ms Lisa Rusten Ms Melissa Kruger

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PRODUCTION

Published by the Australian Dental Association (Queensland Branch)

CONTACT

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24 Hamilton Place Bowen Hills Qld 4006 PO Box 611, Albion Qld 4010 Phone: 07 3252 9866 Email: adaq@adaq.com.au Website: adaq.com.au

12

FROM THE PRESIDENT

Dr Matthew Nangle

Information Privacy in Dental Practices – A Team Approach ADAQ TRAINING

Teamwork in the Dental Practice

ADVERTISING KIT

Information on advertising, deadlines and artwork specifications are available in the ADAQ Advertising Kit: adaq.com.au/advertising

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ADAQ Study Clubs

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ADAQ EVENTS

GRAPHIC DESIGN

Kristen Willis, Tondo Creative

COVER ART DESIGN Zoe Edwards

26 30 34 DISCLAIMER ADAQ Dental Mirror is published for the information of Members only and is not for general distribution. Copyright is reserved throughout.

No part of this publication may be reproduced in part or whole without the written consent of the publisher. This publication is for the purpose of promoting matters of general interest to Members of the Association. The views expressed in this magazine do not necessarily reflect the views and policies of ADAQ or ADA. Publication of advertisements for products or services does not indicate endorsement by ADAQ. All material is positioned and published at the discretion of ADAQ.

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CPD Calendar July–September M E M B E R S P OT L I G HT

Dr Ryan Lee

M U S E U M O F D E N T I S T RY

History of Dental Assistants - The Indispensable Auxiliary OBITUARY

In Memory of Dr Robert Mabin

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ADAQ COUNCILLORS PRESIDENT

Dr Matthew Nangle

SENIOR VICE PRESIDENT

Dr Jay Hsing

JUNIOR VICE PRESIDENT

Dr Kelly Hennessy

COUNCILLORS Dr Kevin Ang (Peninsula)

Dr Oleg Pushkarev (Western)

Dr Jiten Rao (Northern)

Dr Joseph Nguyen (Burnett)

Dr Kaye Kendall (Moreton)

Dr Keith Willis (Moreton)

Dr Norah Ayad (Gold Coast)

Mr Andrew Waltho (Skills-based)

FEDERAL COUNCILLORS

Dr Angie Nilsson

Dr Martin Webb

IMMEDIATE PAST PRESIDENT

Associate Professor Alex Forrest AO

ADAQ SUB-BRANCHES Bundaberg Dr Paul Dever

Mackay Dr Peter Monckton

Toowoomba Dr Rob Sivertsen

Ipswich Dr Andrew Wong

Sunshine Coast Dr Peter Jorgensen

Gold Coast Dr Roslyn Grant

Kingaroy Dr Man Chun (Simon) Lee

Gladstone Dr Patrick Dohring

Rockhampton Dr Kelly Hennessy

Cairns Dr Brian James

ADAQ COMMITTEES Dental Practice Committee Convener: Dr Matthew Nangle

Oral Health Committee Convener: Dr Kaye Kendall

Recent Graduates and Students Committee Convener: Dr Malak Fouda

Dental History Preservation Committee Convener: Dr Gary Smith

Conduct and Honours Committee Convener: A/Prof Alex Forrest AO

Volunteering in Dentistry Committee Convener: Dr Jay Hsing

WINTER 2022

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FROM THE PRESIDENT: DR MATTHEW NANGLE

The World Health Organisation identifies oral health as a key indicator of health, wellbeing, and quality of life, highlighting the critical role that the profession of dentistry plays in the lives of all Queenslanders.

Ethical dental care is a personal commitment to patient autonomy, nonmaleficence, beneficence, justice, and veracity, that has far-reaching consequences for society at large. However, we must not rest on our laurels, and continue advocating for the profession on behalf of patients, dentists, and their staff.

ADA is aware of growing reports of member dentists struggling to employ qualified or otherwise appropriate support staff and fellow members of the dental team. It is essential of course that we gather and analyse relevant data to make appropriate decisions to help the profession going forward. Complexities in the job market include changing attitudes to health professions and various issues of work-life balance, such as working hours, holiday entitlements, childcare, shift flexibility, and so on. Decisions that might affect our working lives need to be considered and measured. Are these trends in the workforce transient, perhaps considering the COVID-19 pandemic, or a sign of things to come? That is a difficult question to answer without the benefit of hindsight.

More than three-quarters of dentists in Queensland are ADAQ members. This is an impressive statistic, but we must continue to support each other and attract new members.

ADAQ is the only state branch that is a registered training organisation, providing both Certificate III and IV qualifications in Dental Assisting. Over the last couple of years, the ADAQ staff have gone to a great deal of effort to transition the bulk of this training to an online format. We currently have more than 150 students enrolled but have the capacity to extend this further with online offerings; indeed, we are seeing an increase in the number of interstate students. In addition, as I have previously highlighted, ADAQ has recently introduced Dental Team Access, allowing nondentist members of the dental team to access relevant services and resources.

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7 This includes free access to ADAQ communications and wellness resources, as well as competitive indemnity or liability insurance cover through QBE, and regulatory advice when an insurance policy has been taken. I encourage all members to advertise this access to their colleagues, be they dental prosthetists, hygienists, therapists, technicians, assistants, or practice managers. You can find out more information here: www.adaq.org.au/dentalteam.

More than three-quarters of dentists in Queensland are ADAQ members. This is an impressive statistic, but we must continue to support each other and attract new members. We have seen membership increase by more than 500 over the last year to almost 3000 dentists. Furthermore, we have more than 1000 additional student members from Queensland’s dental schools. As the new financial year approaches, I encourage all dentists to obtain or renew membership to support the profession. In recognition of your growing support and loyalty, ADAQ Council has approved a 10% early bird discount on state fees for those renewing before June 25th, which will more than offset a modest increase in the federal ADA fee. It is worth noting that this net discount follows many years of federal and state member fees being static, i.e., not increasing.

ADAQ management and staff deserve praise for being able to not only streamline and improve but increase the number of services and resources for members during this time.

There is strength in numbers, and I envisage a future where ADA not only continues to be the peak professional body for dentistry but works closely with other dental and non-dental health professions to promote oral and general health.

There is strength in numbers, and I envisage a future where ADA not only continues to be the peak professional body for dentistry but works closely with other dental and nondental health professions to promote oral and general health.

Recently, I have held meetings with Queensland’s Chief Dental and Allied Health Officers, Ahpra and Australian Dental Health Foundation representatives, and have kindly been hosted by our Toowoomba and Gold Coast sub-branches. Not only do we need to maintain positive working relationships with our key stakeholders, but we should continue to seek new collaborative opportunities as they arise and build our external engagement.

As we have seen in the recent Australian Federal Election, dentistry has been a hot topic in the mindset of all Australians.

The Greens committed to a Medicare-funded dental care system as part of their election policy, pledging more than $77 billion dollars over a 10-year period. ADA advocated to “Stop the Rot”, highlighting the poor oral health of many of our oldest and most vulnerable citizens living in residential aged care facilities. This received particular interest from the Greens and Labor parties, who have agreed to work with the ADA on this vital issue.

Finally, on a personal note, I want to thank those that have helped me during the first of half my presidency, be they fellow members, ADAQ staff, and of course family. I have served on the Council of ADAQ since 2017, and in that time the Association has undergone a great degree of modernisation.

A lot of hard work and steadfast but informed decision making has culminated in what I believe to be a reinvigorated and dynamic professional body, that ultimately exists to serve you in both your professional and personal lives.

Best wishes, Matt

WINTER 2022

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BEWARE THE GUARANTEE IN PROVING DENTAL TREATMENT BRIDGET WALL

It was one of those hectic days, running late, tired and hungry, with patients waiting.

There has been an alarming rise in the number of claims for compensation being brought against dental practitioners which contain allegations of not only a breach of duty and negligence but also contain allegations of breaches of the consumer guarantees provided under the Australian Consumer Law (ACL).

Though not as prevalent as claims for negligence, the consequences of claims brought under the ACL can be just as detrimental to a dental practitioner and similarly may require a large allocation of resources to defend.

H O W B E S T TO L I M I T YO U R E X P O S U R E?

As with most ways to avoid complaints and claims by patients from escalating, the best way to limit your exposure to a claim for a breach of the consumer guarantees under the ACL is to: a.

Manage the patient’s expectations, explain the risks and limitations of the treatment and obtain fully and informed consent;

b.

Ensure your clinical records reflect the advice provided to the patient and meet the requirements of the Dental Board of Australia.

In terms of managing expectations, if a patient expressly or by implication makes known to the dental practitioner any particular purpose for which the services are being acquired by the patient, there may be a guarantee that the services, and any product resulting from the services will be reasonable fit for that disclosed purpose.

W H AT A R E T H E C O N S U M E R G UA R A N T E E S U N D E R T H E A C L?

The consumer guarantees apply to services (1) sold in trade or commerce, (2) that were purchased on or after 1 January 2011, and (3) were for goods or services of a kind ordinarily acquired for personal, domestic or household use or consumption. Whilst there has currently been no direct jurisdictional consideration of whether dental treatment falls within the definitions of ACL, if these three criteria are met, then dental treatment and services will fall for consideration in the ACL. Under the ACL, a dental practitioner guarantees the services (and any product resulting from the services) are: c.

Provided with due care and skill meaning to use an acceptable level of skill or technical knowledge when providing the services, and take all necessary care to avoid loss or damage.

d.

Fit for any specified purpose which is expressed or implied by the patient and that services (and any resulting products) are of a standard expected to achieve the desired results that the patient made known to the dental practitioner.

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e.

Provided within a reasonable time (which will ultimately depend on the nature of the services).

f.

These guarantees cannot be excluded or waived by the patient, even by agreement.

Any contractual waivers of the guarantees under the ACL which a dental practitioner may include in for example a patient consent form or intake form, will be void under section 64 of the ACL, insofar as they exclude rights under the law.

Whilst a dental practitioner could try and limit their liability, by inserting a clause into the patient consent form or intake form, for a breach of consumer guarantees by, with respect to services, the cost of supplying the services again or paying to have the services supplied again, if the services are of a kind ordinarily acquired for personal, domestic or household use then this limitation clause may not be successful.

E X A M P L E S O F D E N TA L P R A CT I T I O N E R E X P O S U R E TO A C L C L A I M S

Dental Practitioners can have exposure to ACL claims in everyday practice. For example, a patient with bruxism is seeking an occlusal splint for the sole purpose of ceasing all grinding and expressly tells the dental practitioner of this purpose. The dental practitioner fails to provide advice to the patient about the limitations of an occlusal splint and whether it can ‘cure’ bruxism. The treatment proceeds, an occlusal splint is made and the patient wears it at night time but their bruxism continues.

The patient is left dissatisfied with the treatment provided by the dental practitioner as they were of the view the occlusal splint would fix their grinding.

Another example, would be a patient requiring a permanent crown and advising the dental practitioner that as it is ‘permanent’ they expect it to last for forever.

If the dental practitioner had explained at the start to the patient the proposed treatment including the inherent limitations, what the likely outcome would be, what the risks of the treatment were and whether or not there is any guarantee of a particular outcome that could be achieved, the patient’s ultimate dissatisfaction would have been avoided.

We appreciate that dental practitioners are faced with many patients who are seeking a solution and are expecting that the treatment provided will come with a guarantee that the outcome will be 100% to the patient’s satisfaction and resolve all of the patient’s presenting complaints. However, in reality there are many variables which can contribute to the outcome of the treatment and what may look like success to the dental practitioner may not be the same as the patient.

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The advice should include a treatment plan as well as any other alternative treatments and why/ why not that is not recommended, the risks and limitations of the treatment, the likely outcome of the treatment and other factors which will contribute to the outcome of the treatment.

If the patient is fully informed about the limitations of the treatment and the patient’s expectations of the outcome of the treatment aligns with the advice provided by the dental practitioner, then this will go a long way to avoiding a future claim for a breach of a consumer guarantee under the ACL.

treatment plan as well as any other alternative treatments and why/why not that is not recommended, the risks and limitations of the treatment, the likely outcome of the treatment and other factors which will contribute to the outcome of the treatment. Any unrealistic expectations that the patient has about the outcome of the treatment should be dealt with at this time. Ideally this advice should be given in writing, via the consent form and have the patient sign and acknowledge that they have read the form. If the advice is given verbally, a detailed file note of the conversation with the patient should be recorded.

W H AT TO D O I F A C L A I M P U R S UA N T TO T H E A C L I S M A D E A G A I N S T M E?

If a claim for compensation alleging a breach of the consumer guarantees under the ACL is made against you, either verbally or in writing, you should immediately contact the ADAQ and seek assistance. If you are insured with QBE, the professional indemnity policy contains an extension which covers claims for compensation against a dental practitioner under the ACL provided that the act, error or omission by the practitioner giving rise to the claim is unintentional and arose solely during the conduct of the profession.

This leads onto the second way a dental practitioner can limit their exposure is by ensuring that their clinical records adequately reflect the advice given to the patient. The advice should include

ABOUT THE AUTHOR

BRIDGET WALL Bridget Wall is a Special Counsel at Hall & Willcox. Bridget specialises in general insurance litigation. She has over 10 years’ experience as an insurance litigation lawyer focusing predominantly on professional indemnity, medical liability claims and indemnity disputes.

WINTER 2022

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INFORMATION PRIVACY IN DENTAL PRACTICES — ­ A TEAM APPROACH In the age of emails and instant messaging, there is more private digital patient information now than ever before.

It is frequently teams of dental staff rather than solely the dental practitioner who have practical responsibility for patient information.

Legally, both dentists and their teams have obligations to protect patient data, as well a prior obligation to know and understand what the law requires.

Understanding and meeting these responsibilities can be daunting, but there are many resources available to make the task easier.

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T H E L AW

The Privacy Act requires dental practitioners and dental teams to take reasonable steps to protect the personal information they hold from misuse, interference, loss and from unauthorised access, modification or disclosure.

‘Personal Information’ is defined as “information or an opinion about an identified individual, or an individual who is reasonably identifiable”. The information need not be true, and it can be stored digitally or materially. For a dental practice, this includes emails, texts, scans, photos, records, screenshots and video and audio recordings.

THE TEAM APPROACH

Email is a vital part of teamwork in a dental practice. One requirement of the Privacy Act is that personal information is only used and disclosed to further the purpose for which it was collected. In short, in a dental practice, there should be no use or

11 disclosure of personal information that does not contribute to the team’s ability to provide dental treatment and advice.

One way to ensure that this obligation is met is by communicating to the patient when and what information will be shared with which team members. This can provide clarity for the team and minimise the likelihood of unnecessary use and disclosure of personal information. Another benefit is that it gives the patient an opportunity to understand and provide feedback on how their personal information is used. This is important because, if the patient raises any objections, sharing their personal information contrary to those objections can count as a breach of privacy obligations, even if it was unintended and even if information is shared for the right reasons. Once you have discussed this with your patient, there will be a reasonable expectation that health information will be disclosed within the treating team (provided the patient has not expressed concerns), and team members will not need to get the patient’s consent to uses and disclosures.

Another way to minimise the risk of a breach is to use a secure means of information sharing. Email is a quick and effective way for interdisciplinary teams to communicate, and it is used every

In short, in a dental practice, there should be no use or disclosure of personal information that does not contribute to the team’s ability to provide dental treatment and advice.

day around the world. However, email by itself is not a secure means of communication for the purposes of the Australian Privacy Act.

and password, two factor authentication usually requires the user to provide a secret only the user knows (like a passphrase or PIN) and something they have in their possession (like a onetime code sent to their mobile phone). One drawback is that these services often have minimum software requirements that may exclude members of the team, so it is worth checking that everybody is able to use the chosen provider.

For more information about patient privacy, there are several resources that can be accessed and shared by everyone in the team, regardless of legal training. The Office of the Australian Information Commissioner (OAIC) has created a Guide to Securing Personal Information. The Guide includes a section on IT, and it can be found online. The guide is not a source of law and is therefore not legally binding. However, the Commissioner regularly refers to it. The Australian Digital Health Agency (ADHA) has several online resources such as the Information Security Guide for Small Healthcare Businesses, and as well as long and short CPD videos on their website. Lastly, ADAQ members can access CPD on email security. Mediref has created a checklist of things to consider when assessing secure email software or secure messaging software. This checklist promotes the product sold by Mediref. but ADA has provided a similar checklist.

If you have questions about privacy and data security please reach out to our team assist@adaq.com.au.

ADAQ .COM. AU

One way to make email more secure is to employ password protection. This method can be used and improved by every method of the team. The first principle is that passphrases rather than passwords are becoming the standard across industries.

Passphrases are easier to remember but harder for malicious actors to crack. Passphrases can be generated by every member of the team as they access their own emails, and this variety itself provides further security.

Another way to enhance the passphrases used in email is to use a passphrase manager. By using a password manager, teams only need to remember two strong passphrases – one for their computer where the password manager is installed and one to access their password manager. All other passphrases are stored securely within the password manager. The disadvantage is that if the password manager is breached, all the passwords could be accessed.

A final passphrase enhancement for the team could be to use an authenticator service. This can protect against phishing and other passphrase attacks. Instead of just entering a username WINTER 2022

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TEAMWORK IN THE DENTAL PRACTICE Effective and productive teams can be developed through communication, leadership, shared goals, and a proactive approach to problem solving.

Workplace relationships in the dental practice are built on respect, confidence, and a demonstration of mutual trust. Without effective workplace relationships the team cannot successfully implement changes to policies and procedures.

Prioritising relationships and respect in the dental team will result in: •

Higher level of productivity and practice flexibility

•

Increased motivation and higher levels of job satisfaction

•

Opportunities to develop skill sets and engage in professional development

TEAMWORK COMES FIRST

Being a team player is one of the most important attributes in the practice. Everyone has a role to play in the day-to-day flow of the practice. It is important to think about what you bring to the team.

The most successful teams value:

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•

Open communication

•

Clear goals

•

Mutual trust, honesty and support

•

Combined group effort of all members

•

Continued learning and growth

•

Integrity and accountability

13 C O M M U N I C AT I O N I S K E Y

C O M M I T TO T H E S A M E G O A L

Communicate with your team. Put aside time to talk about the team’s progress. If your team is located at different practice locations, work out a way to communicate virtually. Include a schedule for communicating progress and adhere to it. Review the processes regularly and make necessary adjustments when needed.

You should all strive for the same goals and outcomes. Be enthusiastic and stay motivated and focused. Everyone is dependent on each person doing their role effectively. Ask questions and identify mistakes if they are made.

•

A team effort for relieving of staff when appointments go over the scheduled time and patients are waiting.

R E G U L A R C O M M U N I C AT I O N C O U L D LO O K L I K E:

•

Preparing other available surgeries for dental clinicians to work across two surgeries.

•

Morning huddles are an effective way to communicate prior to the commencement of each day.

•

•

Completion checklists for staff to monitor daily processes and procedures for compliance.

Prepare instruments and equipment for the daily case mix and support each other when a surgery is running late.

•

•

Rosters for staff rotation through the reprocessing area, surgeries and reception area each day.

Prioritise instruments in the reprocessing area for appointments and procedures and support each other when sterile instruments/equipment are low.

•

Register to monitor consumables and medicaments for continuity of the ordering process.

R E S P E CT I S M U T UA L

Respect each other. As a member of an effective team you should feel respected and in turn show respect for others. Being able to trust each other to do what is needed and having confidence in the way the team share ideas, needs and information is a key part of your successful team.

•

Regular staff meetings where staff are encouraged to share thoughts and ideas for quality improvement ideas.

•

Staff morning teas, staff birthday celebrations and supporting cultural diversity that may benefit practice moral.

•

Team building activities within the practice or outside work hours to encourage the development of effective working relationships.

U T I L I S E E A C H OT H E R’S AT T R I B U T E S

Manage the attributes of each person to enhance the team’s performance. Each team member will bring different talents and skills to the team. Work through how each staff member's experience and knowledge will contribute to team functionality.

•

Rosters should be developed to consider skill level and availability of each staff member.

•

Upskilling staff to enable every person to work across chairside duties, reception duties and the reprocessing of reusable medical devices.

•

Implement a mentor process, where each staff member takes time to support the development of skills in at least one other member.

I N C LU D E E V E RY T E A M M E M B E R

Delivering excellent care and treatment should be a priority for any dental practice. The dental assistant plays a big role in the patient’s overall experience. Dental assistants are known for providing emotional support and having excellent chair-side manner. But a stressed or nervous dental assistant, cannot be expected to deliver excellent service. Patients can tell if someone on the dental team feels unsettled, which could harm their trust in those providing their care.

A confident and capable dental assistant contributes to the productivity of the entire practice. Dental assistants provide valuable patient care and support for everyone in the dental team.

We believe it is important to encourage and support your dental assistant to advance their career with additional training and qualifications.

Having a calm and knowledgeable dental assistant makes for a better patient experience and happy patients will return for future treatments.

ADAQ Training offers qualifications in Dental Assisting to support a confident dental team.

Visit www.training.adaq.org.au to learn more about our dental assisting training programs.

WINTER 2022

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ADAQ TEAM SPOTLIGHT Get to know the Team Members who are here to help you.

DARREN TREDGETT T E L L U S A B O U T YO U R E X P E R I E N C E A N D W O R K H I S TO RY.

I have spent most of my career in non-profit membership associations and before ADAQ, I worked for AMA Queensland for just under two years as a membership officer, but before arriving in Australia I worked over 10 year in various different roles with the Royal College of Podiatry in the UK.

W H AT I S A D AY L I K E I N YO U R R O L E?

Each day is not the same at ADAQ and I enjoy the variety that my role gives me especially with the different interactions I have with our members and our further members may it be by email, phone or in person, working on our database ensuring our data and figures are up to date and correct.

W H AT D O YO U L I K E B E S T A B O U T W O R K I N G AT A D A Q?

For me it’s the interactions that I have with our Members, also how much ADAQ do offer our Members. I enjoy providing and ensuring that the members get the most out of their membership and they enjoy the whole Member experience, it is also great to know that ADAQ ensure staff are also at the forefront.

W H AT D O YO U E N J OY D O I N G I N YO U R S PA R E T I M E?

I really enjoy my paddleboarding, going to Pilates, hiking and trying to make cheese

F U N FA CT S

My guilty pleasure food apart from cheese has to be hot mud cake with vanilla ice cream

ZOE EDWARDS T E L L U S A B O U T YO U R E X P E R I E N C E A N D W O R K H I S TO RY.

I graduated with a Bachelor of Communications in 2019.

At the time I was working in data analytics and retail at Mecca Cosmetica, but quickly got a job at a beauty salon managing their social media. When the pandemic hit, that salon sadly had to close temporarily. In between watching Netflix and pretending to study law I found a Seek ad, advertising a position at ADAQ. I jumped at the chance to get back into marketing and was lucky enough to be offered a role.

W H AT I S A D AY L I K E I N YO U R R O L E?

My days always go quickly and are fueled by coffee. I start every day by checking emails and responding to messages on social media. Then I dive into anything from content creation, editing our Dental Mirror magazine, organising giveaways or taking photos at our CPD events.

W H AT D O YO U L I K E B E S T A B O U T W O R K I N G AT A D A Q?

I can be creative and have lots of support from the team.

I love seeing positive comments and watching people respond well to our social media content. Letting people know they have won socks is always fun.

W H AT D O YO U E N J OY D O I N G I N YO U R S PA R E T I M E?

Spending time with my dog Bruce, he's a Great Dane Cross. He is the sweetest.

F U N FA CT S

My 21st birthday was a garlic bread pub crawl.

WINTER 2022

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ADAQ STUDY CLUBS ADAQ is proud to support local Study Clubs and their Members.

Study Clubs offer an opportunity to delve into an area of interest and continue learning with a group of peers. Many Study Clubs host events and are a great way to meet members of the dental community. If you are new to your area, beginning your career or looking for a way to stay connected to the profession, a Study Club could be perfect for you.

For a full list of supported Study Clubs please visit the ADAQ website.

FEATURED STUDY CLUB – AUSTRALIAN ASSOCIATION OF LASER DENTISTRY (AALD) Responses from David Cox, Treasurer and Secretary

W HY WA S T H E A A L D F O R M E D?

A dentist must voluntarily embark upon a substantial level of education, not only to become proficient using the laser, but to make an informed decision about the best type of laser for the practice. The AALD has been formed to provide this education platform and a forum for laser users in general to meet, discuss and provide direction to regulators and professional associations regarding laser use, tapping into the wealth of knowledge our members have already at their disposal.

W H AT A R E T H E P L A N S F O R A A L D I N 2022?

Online webinars and Covid permitting study club meetings. We also support ADA with laser training CPD. We have a conference

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in Tangalooma Island, from 13-15 of May. Information to register is on our website.

W H AT I S A T Y P I C A L A A L D M E E T I N G L I K E?

Special topics with some hands-on experience. We also receive support from the ADAQ on laser accreditation days.

For more information and to join the AALD visit www.aald.asn.au

FEATURED STUDY CLUB – POGONION DENTAL STUDY GROUP BRISBANE Responses from Dr Laura Barbagallo, Secretary/Treasurer

W H AT TO P I C S D O E S P O G O N I O N D E N TA L S T U D Y G R O U P C OV E R?

The topics vary depending upon the field of expertise of the invited guest speaker. The majority of subjects cover general dentistry and specialist dentistry. In 2021 our topics included: oral pathology and oral medicine, oral surgery, tooth autotransplantation, head and neck cancer, stress management for dentists, ENT: skull base surgery, and periodontology: regenerative dentistry.

W H AT A R E T H E P L A N S F O R P O G O N I O N D E N TA L S T U D Y G R O U P I N 2022?

We usually meet at a Brisbane restaurant on the first Tuesday of every month, where a guest speaker talks and enjoys dinner and drinks with us.

17 We also have a dinner event in August, where the partners of dentists are also invited. In either September or October, we have a weekend away at a resort which has conference facilities.

Members of the study club collect and volunteer to present topics that may interest the rest of the group. Often partners of members will also volunteer to present.

FEATURED STUDY CLUB – CADMUS SOCIETY

How Pogonion Dental Study Group support its members?

The Cadmus Society was formed 60 years ago by a small group of dentists at a time preceding formal continuing professional development programs and study clubs. It served as a great opportunity for clinicians who predominantly worked in solo practices to come together and discuss cases and learn from one another. Over the years, it has expanded to involve more members and include an opportunity for members to attend a presentation to continue their professional development.

The Group was formed to facilitate dental colleagues to connect in a relaxed atmosphere. We help members by providing continuing education from the guest speakers. Members also learn from and support each other. New friendships and new connections with dental colleagues are created.

If you would like to get in touch and join our Study Group email: pogonionsecretary@gmail.com.

FEATURED STUDY CLUB – INFUSION STUDY CLUB Responses from Dr David Chen, Infusion Study Club Secretary

W H AT TO P I C S D O E S I N F U S I O N S T U D Y C LU B C OV E R?

Infusion Study Club covers a range of topics relating to the general dental practice, including but not limited to; Restorative dentistry, Endodontics, Paedotontics, Periodontics, Oral Surgery, and Orthodontics. Some of the topics covered in the past include Special Needs dentistry, Bisphosphonate and dentistry, stainless steel crowns for children, Enamel hypoplasia and early intervention orthodontics.

W H AT D O E S I N F U S I O N S T U D Y C LU B H AV E P L A N N E D F O R 2022?

We plan to host six meetings over the year: three with guest speakers from various fields of medicine and dentistry and another three with case study presentations from members of the study group.

A typical meeting consists of a presentation on a topic of interest or case study, a light meal and refreshments and general discussion.

W H AT D O E S I N F U S I O N S T U D Y C LU B O F F E R I T S M E M B E R S?

Infusion was formed in 2003 between a group of like-minded dentists to improve professional knowledge, share clinical issues encountered and foster bonding between colleagues.

The study club has helped the group members by providing opportunities to participate in talks from specialists from different fields of medicine and dentistry, interacting with colleague to discussion about clinical scenarios and share outcome of clinical work.

Responses from Dr. Richard Huynh, Treasurer and Secretary

T E L L U S A B O U T T H E H I S TO RY O F T H E C A D M U S S O C I E T Y?

W H AT TO P I C S D O E S T H E C A D M U S S O C I E T Y C OV E R?

Cadmus Society covers all aspects of dentistry from endodontics and prosthodontics to special needs dentistry and forensic odontology.

W H AT A R E T H E 2022 P L A N S F O R T H E C A D M U S S O C I E T Y?

We have our usual monthly meetings with presentations covering all aspects of dentistry. In addition, at the end of July, we’ll be holding our 60th anniversary dinner. It will be a wonderful opportunity to celebrate Cadmus’ history with current and past members. Finally in December, we’ll be having a Christmas dinner at a restaurant with members and partners invited.

H O W D O E S YO U R S T U D Y C LU B S U P P O RT I T S M E M B E R S?

Dentistry can be a very isolated career at times with few opportunities to interact with others in the profession. The Cadmus Society allows a comfortable environment where dentists can socialise with one another and discuss things with people in the same profession. It lets people interact with many friendly dentists with a wealth of knowledge and experience, including multiple specialists across a variety of different disciplines.

H O W W O U L D S O M E O N E G E T I N TO U C H TO J O I N YO U R S T U D Y C LU B? H O W M U C H D O E S I T C O S T TO J O I N?

Typically, the main way to join the Study Club is through invitation by an existing member. If you would like to attend as a guest, the best way would be to get in touch with our secretary Dr. Richard Huynh at cadmussecretary@yahoo.com.au.

Contact is Dr. David Chen, to learn more email devedo@hotmail.com.

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ADAQ EVENTS CALENDAR 2022 With CPD requirements due in November, now is the time to plan out the rest of your year.

Scan the QR codes with you mobile device to view the course page and register.

JUNE

01

Head and Neck Anatomy In General Practice (4part lecture series)

04

Extra Oral Radiography & Cone Beam Pre-licensing course

08

Evening Bites: Handpiece Maintenance

10

Oral Surgery – Module 3

11

Medical Emergencies in the Dental Practice

15

Infection Control Fundamentals Image.

Oral Surgery Module 1

A DAQ D E N TA L M I R RO R

S C A N TO LEARN MORE

19

S C A N TO LEARN MORE

17

Injectable Moulding Techniques in Everyday Dental Practice

18/19

Botulinum Toxin and Intraoral Dermal Fillers-Therapeutic Use

25

Dental Ergonomics

JULY

S C A N TO LEARN MORE

01

Treatment Planning

06

Evening Bites: Mental health in the workplace

08

Restoring the Worn or Broken Dentition

08

Anxiety Control in Dentistry

09

Anxiety Control in Dentistry

13 Image.

Understanding Cerec

Evening Bites: Growing Your Practice with Implant Dentistry

WINTER 2022

20

ADAQ EVENTS CALENDAR 2022

AUGUST

05

Recent Developments in Infection Control S C A N TO LEARN MORE

15

06/07

Oral Surgery – Module 1

Diagnosis and Management of Temporomandibular Disorders

16

17

22

19

23

20/21

First Aid & CPR Upgrade

Impress me!

Masterclass in Crown Impressions and Temporaries

Laser Training: Pre-Licensing Course

29

Treatment Planning

A DAQ D E N TA L M I R RO R

Evening Bites: Digital Dentistry

Anterior and Posterior Composites: Perfecting Your Technique

Botulinum Toxin and Intraoral Dermal Fillers-Therapeutic Use

24

Extracting primary teeth: tips and techniques

S C A N TO LEARN MORE

21

S C A N TO LEARN MORE

26

Restoring a Single Implant

SEPTEMBER

S C A N TO LEARN MORE

01

Advanced Local Anaesthetic

02

Oral Surgery – Module 2

03

Anxiety Control in Density

09

Advanced GP Molar Access, Prep and Obturate

13

Evening Bites: Item Numbers, Health Funds and Records

16 Image.

Oral Surgery Module 2

Trauma management in primary and young permanent teeth

WINTER 2022

22

ADAQ EVENTS CALENDAR 2022 17

Composite Restorations Aesthetics, Beauty and Colour

16/17

Oral Surgery - Cadaver Course - Module 4

30

Ready! Set! Prep!

Masterclass in Crown Prep Principles

Image.

Ready! Set! Prep! Masterclass in Crown Prep Principles

A DAQ D E N TA L M I R RO R

Image.

Ready! Set! Prep! Masterclass in Crown Prep Principles

23

IS YOUR CPD ACTIVITY FIT FOR PURPOSE The expectation that a professional should maintain lifelong learning is not new and regulatory bodies across most professions mandate minimum requirements to maintain professional registration.

In Dentistry the need for CPD activities generated by these requirements has resulted in numerous activities being offered by a range of providers. The types of activities include free activities linked to product promotion and more detailed courses requiring significant expense in both time and money.

So how do you choose which CPD course to attend?

Below is an excerpt from the Dental Board of Australia’s document.

G U I D E L I N E S: C O N T I N U I N G P R O F E S S I O N A L D E V E LO P M E N T

How do I choose appropriate CPD activities?

You must determine the appropriateness of the CPD activities undertaken.

You should choose activities that demonstrate the following characteristics: •

open disclosure about monetary or special interest the course provider may have with any company whose products are discussed in the course

•

the scientific basis of the activity is not distorted by commercial considerations. For example be aware of embedded advertising and direct commercial links

•

the learning objectives, independent learning activities and outcomes

•

articles from peer-reviewed journals and/or be written by a suitably qualified and experienced individual

•

address contemporary clinical and professional issues, reflect accepted dental practice or are based on critical appraisal of scientific literature

•

the content of CPD activities must be evidence-based

•

where relevant, select CPD activities where you can enquire, discuss and raise queries to ensure that you have understood the information

•

if the CPD activity includes an assessment or feedback activity this should be designed to go beyond the simple recall of facts and seek to demonstrate learning with an emphasis on integration and use of knowledge in professional practice, and an opportunity to provide feedback to the CPD provider from participants on the quality of the CPD activity

T W O O F T H E M O S T I M P O RTA N T A S P E CT S O F T H E D B A R E C O M M E N D AT I O N S A R E:

Learning Objectives:

Clearly articulated learning objectives will allow you to tailor your CPD selections to meet areas of need in your professional development that you identify by reflecting on your own practice.

Quality Assurance: Your CPD provider should be able to demonstrate a system of Quality Assurance. As a minimum this system should provide you with an opportunity to assess the CPD activity and feedback your assessment of how well the activity delivered the planned Learning Objectives. The provider should be able to demonstrate how they assess this feedback and use this information to continually improve the activity.

Don’t be afraid to ask the CPD provider how they provide quality assurance for their CPD activities. After all it is your time and money.

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MEDICAL AND DENTAL INDUSTRY ON HIGH ALERT FOLLOWING DETECTION OF INCREASED NON-COMPLIANCE ANGELA JEFFREY (This article is written with a particular perspective for Queensland Payroll Tax).

When it comes to the current borderline ‘hysteria’ concerning payroll tax, we have watched with concern regarding the growing fears of practice owners.

Australia’s medical and dental industries were put on alert as recently as last year when the NSW Civil and Administrative Tribunal handed down a decision in its Thomas and Naaz case, which ordered Dr Jawahar Thomas to pay close to $800,000 in unpaid retrospective payroll tax to NSW Revenue.

The Civil and Administrative Tribunal decided that while the doctors were providing services to patients, they were also providing services to the medical centre.

It also decided that the nature of the service agreements in place between the doctors and the clinics, and the requirements of the doctors, established a relevant contract for payroll tax purposes. This decision seemingly opened the gate for the imposition of payroll tax on contractors.

The practices being selected for audit are being chosen through a data matching process. Audits are triggered where information reported to other government agencies (the ATO and potentially Work-Cover) is outside the scope of what would reasonably be expected. Specifically, where lodged Tax Returns show patient fee income as revenue and payments to the doctors as subcontractor payments.

In some cases, these tax returns have been completed in a way that does not reflect the service fee type arrangement that most practices seek to implement. That is, the doctors were not even ‘contractors’ in the true sense and the return was completed incorrectly.

From an industry perspective, it is concerning that from the practices selected, it is being reported that there is a high level of non-compliance. Logically it is to be expected, if the tax return has been completed ‘incorrectly’, it follows those other aspects of the practice’s arrangements, such as cash flow and service agreements, may not be compliant. This may lead the OSR to increase their efforts in this sector if they see the industries as highly noncompliant. In the cases we have seen of practices selected for audit, the practices have not had the benefit of medical industry advisors assisting them. We emphasise the importance of seeking advice from accountants and solicitors who have an industry presence and do not just tout that they are ‘experts’ in this space.

If you’re concerned about your current arrangements or whether data-matching programs could leave you exposed, contact your local William Buck advisor. We can review your arrangements, enhance your compliance, and assist with your tax return to reduce your risk of an audit.

Please also read our previous article “Medical Industry Payroll Tax Ruling” which can be found at www.bit.ly/medicalpayrolltax

ABOUT THE AUTHOR

To confirm this, William Buck has spoken to a Senior Compliance Officer at Queensland OSR who advised that, while the Office is aware of the OSS Case and the Thomas and Naaz decision on payroll tax handed down in September 2021, “The spike in activity is directly related to data-matching programs and not due to the awareness of payroll tax issues in the industry.”

The officer said that while Queensland does not currently have any plans in place to extend the method on how their reviews are chosen (meaning that data matching will remain their primary selection method), the OSR cannot guarantee that the current activity, which is detecting high levels of non-compliance within the medical industry, will not lead to a wider, industry-focused compliance program.

A key takeaway is that we have a high level of confidence in knowing how practices are being selected for an audit. This then makes it a relatively easy process to review the practices income tax returns and confirm if they have a higher chance of being selected for a payroll tax review.

A DAQ D E N TA L M I R RO R

ANGELA JEFFREY Angela advises small to medium sized businesses in all industries on the most effective tax and business structures to help them achieve maximum results. Angela works extensively within the Medical and Dental Industries and therefore understands the unique issues faced by practitioners and those with private practice businesses.

adaq.org.au/join

Join Your Professional Home Become a member of ADAQ today to gain access to a wide selection of benefits and discounts.

Insurance & Regulatory Favourably-priced PI Insurance Insurance claims management* Legal assistance & dispute resolution* Regulatory advice & complaints assistance Health fund liaison & support Advocacy on policy that impacts the profession

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Clinical & Practice Discounted CPD delivered by leading speakers 50+ Practice Guides & Resources ADA HR Hub access – contracts, awards, & individual advice Pharma Advice hotline Dental Assisting Training – train your staff with ADAQ

News & communications Regular e-newsletters & communications COVID updates Quarterly Dental Mirror magazine

*insurance customers only

26

2022 ANDRÉ SCHROEDER RESEARCH PRIZE WINNER MEMBER PROFILE DR RYAN LEE

The André Schroeder Research Prize, awarded by The International Team for Implantology (ITI), recognises independent researchers who have made distinguished scientific findings in implant dentistry.

Image.

Dr Ryan Lee currently works at the School of Dentistry, the University of Queensland as the HDR Director & Discipline Lead (Periodontology) & Director of the post-graduate training program in Periodontology.

Image.

Dr Ryan Lee being awarded the André Schroeder Research Prize

Read Dr Ryan Lee's interview with ITI.

A DAQ D E N TA L M I R RO R

27

This year, the Research Prize was awarded to Dr Ryan Lee (School of Dentistry at The University of Queensland), for his study, ‘Reestablishment of macrophage homeostasis by titanium surface modification in type II diabetes promotes osseous healing’.

W HY D I D YO U P U R S U E D E N T I S T RY (P E R I O D O N TO LO G Y )?

Dr Lee graduated from the University of Sydney (BMSc & BDent), Australia and then completed his specialist training program in Periodontology (MCD) at the Eastman Dental Institute, UCL, London. Dr Lee returned to Australia to start an academic career, commencing a part-time PhD degree as well. In 2017, Dr Lee began a senior academic role at the School of Dentistry, University of Queensland. Currently, Dr Lee is a director of post-graduate specialist training program and discipline lead in Periodontology.

W H AT D O YO U E N J OY M O S T A B O U T P R A CT I S I N G A S A P E R I O D O N T I S T? A N D W H AT A D V I C E W O U L D YO U G I V E TO C L I N I C I A N S W H O A R E I N T E R E S T E D I N P O S T G R A D UAT E S T U D I E S I N P E R I O D O N TO LO G Y?

H O W D I D I T F E E L TO B E R E C O G N I S E D A S A WINNER OF THE ANDRÉ SCHROEDER R E S E A R C H P R I Z E (A S R P) A N D W H AT M A D E YO U A P P LY?

When I first heard of the news, I was extremely pleased as this was one research award I always dreamt of winning. I have first got to know of the award when I was a post-graduate student at the Eastman Dental Institute, UCL, UK. One of my supervisors, Dr Maria Retzepi won the ASRP in 2010 and I was inspired so much by her research achievement. I think that was my initial ‘naive’ motivation but later on it was more about its prestige and recognition in dental implant research.

A S A C L I N I C I A N, R E S E A R C H E R A N D E D U C ATO R I N D E N T I S T RY W H AT D O YO U T H I N K T H E F U T U R E O F D E N T I S T RY LO O K S L I K E? A N D W H AT I N F LU E N C E S D O YO U B E L I E V E T H E O U T C O M E S O F YO U R R E S E A R C H C O U L D H AV E O N F U T U R E T R E AT M E N T S?

There is an increasing trend of and emphasis on ‘personalised medicine’ in current medical research. I believe future research of dentistry would follow the same. In fact, it has already started.

Wound healing is an essential aspect of personalised medicine/ dentistry, and host-modulation by biomaterials has been our great research interest to improve clinical outcomes.

As clinicians, we are dealing with wound healing every day and every moment. The current study has provided a certain insight into the interaction between biomaterials and immunoinflammatory responses in a compromised systemic condition.

As this was a pre-clinical study, it warrants further research to confirm but it has highlighted the importance of inflammation response control at the initial phase of wound healing, including osseointegration, and the biomaterials we use daily have a capacity to modulate the immune responses.

I first was interested in periodontology when I was attending multiple periodontal and implant related conferences as a general dentist. I found it very exciting and challenging as this was a fastdeveloping discipline and there were huge amounts of pre-clinical and clinical research going on in every aspect. I think that was a moment when I realised that I had to be involved in periodontal and implant research. Ongoing learning is a key driving force for me to pursue periodontology and implant Dentistry.

To be honest, I enjoy all aspects of the profession: research, clinical practice, and education.

As a specialist, I do not think I can think of my job without considering all these aspects when I practice and teach periodontology.

We have been taught that clinical practice must be based on validated scientific evidence. But where do you get this evidence from in the first place? What if there isn’t substantial evidence?

One of the main educational goals of the specialist training programme is to develop a skill to acknowledge and identify gaps in knowledge and conduct appropriate research to fill the gaps, potentially translating to clinical practice. And more importantly, these gained knowledge/information should be disseminated and shared with our colleagues to improve the profession.

Post graduate specialist training programme in Periodontology is a mentally challenging course, but at the same time it is extremely rewarding as you will develop not only specialist level of clinical skills, but also gain other unique skills to be a leader in the field.

D O YO U H AV E A N Y A D V I C E F O R A S P I R I N G D E N TA L P R O F E S S I O N A L S, W H O A R E I N T E R E S T E D I N E X P LO R I N G C L I N I C A L R E S E A R C H?

I believe any good clinical research should have clear clinical end goal(s) in mind.

This keeps the research on track and makes it more clinically relevant. Clinical significance/relevance is one of the most important aspects of clinical research. Of course, not all research can be translational straight away.

You need multiple stepping stones before it reaches to a final goal. For example, you need different types of study (e.g. proof of principle and pre-clinical trials), before you finally move onto clinical trials. These types of study are not often clinically applicable due to their inherent limitations, but they are crucial for future advances in science. However, I have seen too many interesting and good research findings become irrelevant and do not progress further due to lack of clear clinical goals.

Thus, it is important to have clear objectives from the beginning and consider what clinical significance it has at the end, when you are planning to conduct clinical research.

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FINANCING YOUR FIT-OUT THROUGH ESCROW When financing a practice fit-out, dental professionals should consider the benefits of an escrow arrangement.

Managing the fit-out of a dental practice can be an incredibly stressful task, but it doesn’t have to be with expert guidance.

Starting out with the right contractors and financing options is crucial. While some people have broad knowledge of finance facilities such as a lease or chattel mortgage, most are unaware of escrow being an option.

BOQ Specialist’s Commercial Finance Consultant, Thomas Wald, says “when most people approach the bank for fit-out funding, they know how much they need for the project but they do not really understand the financing options, or the optimum way for making payments to builders and other suppliers. They often expect to negotiate a lease or chattel mortgage straight up.

“For these kinds of transactions, those facilities don’t have the flexibility of escrow,” Thomas says. “Escrow is an excellent option for fit-outs because it provides the client with flexibility while keeping the finance side of the project as simple and streamlined as possible.”

“The escrow facility allows the client to pay any supplier at their own discretion,” Thomas says. “They can pay additional funds to the same supplier or a new supplier as needed, and they are only charged for funds they use, when they use them.”

It is common, for example, for a client to take out a $500,000 limit and then only end up needing $400,000. “But they’re not going to be charged for that extra $100,000 unless they actually use it.”

An escrow facility can cover everything from dry walling through to payments for carpets, windows, paint and plumbing. What’s more, to make the process simple for you, BOQ Specialist can manage the payments to suppliers throughout the project under your instruction. Thomas says the facility “nicely wraps up” all the financial elements of a fit-out for dental professionals —payments are simplified as the invoices can come from all different vendors but the bank keeps a full record of all transactions and then issues one invoice to the client for tax purposes. “The facility takes away all the financial and accounting pain points you might encounter as a practice owner during a fit-out.”

ESCROW EXPLAINED

Fit-outs are a large investment for any practice and while it is important that you choose the right assets and equipment, it is equally vital that you choose the right kind of financing.

Escrow is an account held by a third party that acts as a shortterm line of credit which can be used during a fit-out. One of the key advantages for dental professionals fitting-out their practice or rooms is that it allows them to make variations or changes along the way, such as opting for higher-end furnishings or different office equipment to what was initially anticipated.

A DAQ D E N TA L M I R RO R

Fit-outs are a large investment for any practice and while it is important that you choose the right assets and equipment, it is equally vital that you choose the right kind of financing.

29 Another key benefit of an escrow facility is that you are not required to make any payments until the project is finished and the final amount loaned can be rolled into a longer-term agreement with fixed repayments. This key feature makes escrow a particularly attractive option for new practice owners, who won’t have to start paying off their fit-out until it is complete and their doors are likely open for business.

Having an escrow facility with a niche financier such as BOQ Specialist, means dental professionals can leverage their industry partners and access building companies that have proven fit-out expertise. Thomas says, “We deal with the same companies all the time who specialise in dental fit-outs. These longstanding relationships benefit the client as we can work with the fit-out companies to push the larger payments towards the end of the project to reduce the total amount of interest they accrue while in escrow.”

Once the project is finished, the escrow can be converted to a flexible repayment structure, which can be fixed or variable, or even have repayments that incrementally increase over time to meet the gradual increase in patients. If the escrow is converted to a loan or hire purchase product, you will generally have the ability to immediately claim back any GST payments made during the fit-out. “So if you spend $500,000, you can generally get 10 per cent back on GST when the escrow converts to a loan or hire purchase product” Thomas says.

BOQ Specialist can outline all the details and benefits of an escrow facility, and take dental professionals through the relevant repayment options. “Our clients really like the flexibility that escrow gives them and it’s specifically designed for fit-outs or construction projects, so it’s a great choice,” Thomas says.

As with any major financial transaction, it is important to receive specific advice that suits your business’s circumstances.

For instance, if you draw down on the largest fit-out payment in the last four days of the escrow phase, you will only be charged the annual rate for a period of four days. “So for people who are new to fit-outs, it adds industry knowledge and gives them peace of mind that they’re not paying too much too soon for the vendors.”

P O S I T I V E I M PA CT O N C A S H F LO W

Thomas says an escrow facility could also have significant benefits for a business’s cash flow.

TO FIND OUT MORE WAYS BOQ SPECIALIST CAN HELP YOU WITH FITTING OUT A PRACTICE,

“The beauty of the facility is that you don’t need to make any

contact one of their financial specialists today on 1300 160 160 or visit their website at boqspecialist.com.au

Having an escrow facility with a niche financier such as BOQ Specialist, means dental professionals can leverage their industry partners and access building companies that have proven fit-out expertise.

ADAQ .COM. AU

repayments until the fit-out has been completed, the practice is open and patients are walking through the door. So, in terms of cash flow it’s great. “This allows the client to focus on building their billings, rather than worrying about making repayments when they might not yet have that desired patient flow.”

Under the escrow arrangement, the bank pays all builders, contractors and suppliers, while you can also get reimbursement for any other payments that may be incurred from individual retailers, such as televisions, chairs or speakers for a reception area.

Disclaimer – The issuer and credit provider of these products and services is BOQ Specialist – a division of Bank of Queensland Limited ABN 32 009 656 740 AFSL and Australian credit licence no. 244616 (“BOQ Specialist”). Terms, conditions, fees, charges, eligibility and lending criteria apply. Any information is of a general nature only. We have not taken into account your objectives, financial situation, or needs when preparing it. Before acting on this information, you should consider if it is appropriate for your situation. BOQ Specialist is not offering financial, tax or legal advice. You should obtain independent financial, tax and legal advice as appropriate.

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HISTORY OF DENTAL ASSISTANTS — THE INDISPENSABLE AUXILIARY WORDS BY ADAQ DENTAL HISTORY COMMITTEE AND ALESSANDRA BOI

Is a day in the life of a Dental Assistant today much different from that of a mid-century dental attendant?

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Dentist and nurse at work - 1973 - Queensland State Archives - 41519993804_88292d0253_k A DAQ D E N TA L M I R RO R

31 Looking through the archives we found this lecture from 1958, which was presented as part of a Practice Administration Course.

While the description of the DA role shows that the core duties of a chairside assistant remain unchanged, the culture and value of a dental assistant has fortunately evolved significantly.

We share a section from this presentation to highlight how dentistry and dental teams have progressed.

PRACTICE ADMINISTRATION COURSE – 1958 L E CT U R E E I G HT – T H E U T I L I S AT I O N O F A U X I L I A RY P E R S O N N E L

(by JJ Mahoney, BA, BDSc)

“Years ago, before these days of high costs and efficiency, there was a tendency for the carefully nurtured girl, shunning the more mundane avenues of employment, to seek the prestige of a medical or dental office in the interim between school days and matrimony. Here she cast her charm over the flowers she arranged, the patients she ushered in and out, and the telephone she breathed into. Those days are past.”

What we require now is a highly trained, highly skilled person imbued with a career-girl enthusiasm, 1.

who will relieve the dentist of every possible non-professional duty;

2.

who will assist in all chairside procedures;

3.

who will be a valuable asset in public relations.

This means she must be equally competent as a dental assistant and dental secretary; she will be a radiographer and laboratory technician; and she will be as well a combination of hostess, housekeeper, telephonist, accountant, confessor and diplomat.

The particular skills can be added, human kindness, consideration, friendliness are the background on which you super-impose a self-confidence and a poise that spring from a thorough knowledge of your work, a pride in yourself, and a realisation of the dignity of your calling.

Let us examine the help we do, or, perhaps, could receive.

In the first place the attendant arrives sufficiently early to open and ventilate the rooms and to attend to all the housekeeping tasks that will make them spotless and attractive - tasks, of course, that will recur throughout the day.

Sets out clean clothes for the dentist. Sees to the surgery linen.

Switches on light, power, gas, water. Sets out the Day Sheet and Treatment Records in accordance with the Appointment Book order. Prepares the bracket table, setting out the appropriate instruments, being guided by the entries on the Appointment Sheet.

About this time the first patient arrives. She receives him, escorts him to the chair, having assisted him to dispose of hat or coat (a women patient has much more to dispose of), arranges him comfortably in the chair, adjusts the light, puts on a napkin, fills the tumbler and connects the saliva ejector. Everything is now ready for work to commence.

Towards the end of the appointment time she sets out the drugs the dentist uses for the cavity, prepares the re­storative material, and helps with its insertion. On its completion she clears the bracket table, sterilises instruments, and repeats the preparation procedure, ushers one patient out and the next in, and attends to the secre­tarial details involved. That sort of thing may be repeated as many as 20 times a day. Meanwhile she answers the door, or the telephone, writes receipts and so on.

It is easy to see how much depends on the competence of the dental attendant. She relieves the dentist of as many nonprofessional duties as possible (while undertaking them, his earning power ceases) and serves as his second pair of hands at the chair. She can also take over post-operative irrigations and dressings, removal of sutures, separation dressings and so on.

She must anticipate the dentist’s every requirement and eliminate for him every unnecessary movement. If he takes his eyes from the field of operation in conservative or surgical procedures he isn’t working, and if he isn’t working, he isn’t earning. And her great responsibility is to see that he is working for every moment during each working period.

INDISPENSABLE AUXILIARIES: THE EVOLVING ROLE OF DENTAL ASSISTING In the late nineteenth century and early decades of the twentieth, the presence in the dental surgery of a ‘lady in attendance’ gave female patients confidence to be seen by male dentists, without a husband or chaperone present. It was quite useful for the dentist’s business, especially when anaesthesia was involved.

This attendant role was usually performed by the dentist’s wife or another female relative.

Edmund Kells (1856-1928), the Texan dentist famous as pioneer of dental radiology and inventor of the suction apparatus, is also credited for being among the first in the world to employ a paid dental assistant to help him and his wife with managing the practice. In Europe, the use of dental nurses in Germany is documented as early as 1909 (Reed 2021), inspiring the Australian profession via the British.

Dental assistants, often referred to as dental nurses, became indispensable auxiliaries as infection control standards became more demanding to maintain, and modern technologies grew more complex: the dental assistant was seen as “the guardian of the dentist’s productive time” (Dental Assistants’ Manual, 1964).

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32 From the 1930s onwards there was a push for professionalising dental auxiliaries. The war took many male dentists away from civilian practice, and oral health and prevention became essential in dentistry. The autonomous figures of hygienist and dental therapist appeared in various countries, with New Zealand at the forefront.

In Australia, formal training of dental assistants started in New South Wales in the 1950s. ADAQ was involved from the start to ensure quality training in Queensland.

A joint committee between our organisation and the Dental Assistants Association of Australia devised and run a standardised course ran from 1964. The course run for 10 months and could be taken by correspondence with some in-person contact through the sub-branches offices. Lessons included waiting room decoration and flower arrangement:

It is preferable to bring a few flowers from home- either from that of the nurse or the dentist…

White camellias are effective with blue violas…Do not despise the old-fashioned geranium. This can be very bright in a pot brought into the waiting-room when in bloom.

Successful students received a certificate and a badge to be worn on their uniforms. A qualification often secured a higher pay (Report on the Dental Attendants Training Course and Award, 1966, ADAQ Archives).

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Image.

Dentist and nurse at work – 1973 – Queensland State Archives - CC-BYNC

Image.

Operative dental clinic Brisbane - 1970 - Queensland State Archive -

33

DID YOU KNOW?

The University of Queensland was the first university in Australia to offer a Bachelor’s Degree for dental auxiliaries, in 1998: the oral health therapist was a new professional figure trained in both a hygienist and s dental therapist’s skills.

In particular, do not confront the patient who is to have an extraction, with an awesome arrangement of instruments. Keep the somewhat fearsome looking extraction instruments out of sight behind the patient that they can be produced singly as required. (p.19, Dental Assistants Association of Australia, Dental Assistants’ Manual, 1964).

INTERESTING VIDEO SUGGESTION The dental assistant (1954) – Wellcome Library

The work of a dental assistant, Anne Bilham aged 17, is outlined in her own words: a young woman leaves her home in Hertfordshire and goes to the dental surgery where she welcomes patients, cleans and tidies and prepares a denture for a patient.

NOTE: There is no relationship between ADAQ and the Wellcome Library or linked web page. The content is subject to copyright of the owner/writer. You must not reproduce any part of the content without the consent of the owner.

Image.

Image: Dentist and Assistant operating on a patient; 1950s circa– State Library of Queensland CC-BY-NC - IE2781299 https://hdl.handle.net/10462/ photosdo/0931931)

REFERENCES 1.

Baltutis L, and M Morgan, ‘The Changing Role of Dental Auxiliaries: A Literature Review’, Australian Dental Journal, vol. 43, no. 5, 1998, pp. 354-358.

2.

Croker JM, Report of the Third Queensland Dental Convocation 26-27 March 1966: Dental Assistants Training Course, ADAQ, Brisbane, 1966.

3.

‘A Brief History of Dental Assistant Training in Queensland’, ADAQ Newsletter, May 1989, p. 12.

4.

Langland OE (October 1,72). “C. Edmund Kells”. Oral Surgery, Oral Medicine, and Oral Pathology. 34 (4): 680–,. doi:10.1016/0030-4220(72),0353-2. PMID 4560600.

5.

Reed, D. The history of dental nursing. BDJ Team 8, 48–51 (2021). https://doi. org/10.1038/s41407-021-0782-x

WINTER 2022

34

OBITUARY DR ROBERT MABIN

Born Maryborough Queensland 1941 – 2022

Dr Robert Mabin built small boats for the family, enjoyed gardening, hiking and their many British friends.

Born Maryborough Queensland 1941.

Attended primary school at Indooroopilly State School and completed his education at Brisbane Boys College.

Studied dentistry at University of Queensland and graduated in 1965.

Worked as a government dentist in Alice Springs 1966/7, after marrying Susan.

The couple travelled to the UK in 1967 and Rob worked in several practices in London.

Sons, Andrew and Rodney were both born during this period.

In 1970, Rob bought a dental practice in Dover, and the family moved to St Margaret’s Bay. Eight happy years were spent here, Rob sailed in cross channel races at weekends, built small boats for the family, enjoyed gardening, hiking and their many British friends.

On returning to Australia in 1978, Rob went into partnership with the late Dr. Paul Kelly at Maroochydore. A second practice was set up at Coolum and eventually Rob took over this practice independently.

In retirement, Rob and Susan enjoyed active travelling holidays including motor cycling, bicycling and walking, world- wide, as well as ballroom dancing on cruise ships.

He also now had more time for his beloved garden.

Sadly missed by Sue, wife of nearly 59 years, sons, Andrew and Rodney, grandchildren and many friends.

A DAQ D E N TA L M I R RO R

MUSEUM of DENTISTRY

Visit Queensland’s largest collection of dental artefacts Welcome to ADAQ Museum of Dentistry See how the art and science of dental practice has evolved over the years, with terrifying extraction keys and hand tools, ornate foot-powered drills in perfect working order, an 1870s Swan-armed recliner chair, a 1920s Ritter Model A x-ray unit, and much more.

VIEW ONLINE COLLECTION

Get involved Do you have an item to donate? Would you like to volunteer? Perhaps you have a dental story to tell? Email us at adaq@adaq.com.au to get involved.

FLIGHT OR FIGHT What would you do if you had someone with sudden onset chest pain? Would you wait, hoping it will go away? Would you call 000?

This is something many people must consider when they are dealing with sudden chest pain. When it comes to your heart, you don’t want to stall. You have only one heart, and you don’t want it to stop working – it keeps the rest of your body going.

Each year, more businesses are recognising the importance of defibrillators in the workplace. Australian workplace health and safety legislation specifies that first aid arrangements must be suitable and adequate for the type of work and the nature of the worksite. In a workplace where there is a foreseeable risk of sudden cardiac arrests, such as a clinic, hospital or other medical facilities, defibrillators would generally be considered as a standard item of equipment required.

AMBULANCE RESPONSE TIMES Response times have doubled, and the Queensland government has been slammed after statistics reveal an ambulance ramping crisis, almost half of all patients waited more than 30 minutes in an ambulance before being admitted to hospital, time is critical.

The brain does strange things during anxiety or panic attacks this is a very real thing when watching someone experiencing any form of chest pain. People either jump in and help, freeze or move away not knowing what to do. When jumping in to help it makes all the difference when you have the right equipment to deal with such an emergency.

an hospital situation when a defibrillator is not available •

It can happen anytime, anywhere and to anyone, even young athletes

•

Early defibrillation is the single most effective treatment for SCA, defibrillation within three minutes of collapse can increase the chance of survival by over 70%

No matter where or when SCA strikes, early use of a defibrillator can help to save lives.

The goal of Defibrillators Accessories Australia is to help you save a life through the supply of defibrillators. A cardiac arrest can happen to anyone and having a defibrillator on hand in your Dental practice could mean the difference between life and death.

They are easy to use and maintain and are proven to save a lives prior to the ambulance arriving.

D I F F E R E N T A N D W H AT I S T H E B E S T

Our range of automated external defibrillators offers security and the peace of mind that comes from knowing a defibrillator is available in your practice. They are easy to use and maintain and can save a life prior to the ambulance arriving. Are you prepared?

Choosing the right one can be confusing and overwhelming, the team at Defibrillators Australia make this process simple and an easy process.

525 people in Australia die each week out-of-hospital due to Sudden Cardiac Arrest. When Sudden Cardiac Arrest strikes is your practice ready? Sudden Cardiac Arrest (SCA) knows no boundaries.

This innovative technology is an integral component of emergency medical treatment. There are several different types of defibrillators, and they work in different ways, but all AEDS are designed to be easy to use.

•

In Australia approximately 30,000 people sustained a SCA outside of a hospital and are treated by emergency medical services (EMS) each year

•

An average of only 9% of its victims in Australia survive out of

We offer you the best equipment at a special ADAQ member price. Let us help you to choose your defibrillator to protect those around you. The defibrillator bundles are also fully tax deductable, call us now to discuss your options. 1300 33 11 93.

DEFIBRILLATORS AUSTRALIA We are the number one expert when it comes to defibrillators, proudly supporting dental professionals since 2014 in implementing defibrillator programs into practices across Victoria.

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38

A MATTER OF TRUST ALBERT GIGL

The intricacies of the recent tax changes regarding trust distributions to beneficiaries will have an impact on more than 500,000 trusts that are operating in Australia particularly for dentists who operate their business through a discretionary family trust which quite often operates as a service trust.

This article is not designed to be an in-depth review of these changes but more to make you aware of the potential issues and the need to discuss your particular circumstances with your accountant/financial advisors.

The proposed changes released on 23 February 2022 are contained in the draft taxation determination TD2022/D1 which should be noted that they are draft and awaiting commentary before being finalised. The changes are intended to commence from 1 July 2022 but it is unlikely that the draft will be finalised by then. The Federal Court decision handed down in the Guardian case which found against the ATO on similar issues is also likely to delay any finalisation.

The draft ruling (irrespective of whether or not it is finalised) means that all trustees have been put on notice as to what the ATO’s intentions are and that they should ensure that they have sufficient cash flow within the trust to physically make payment of any profits to individual/company beneficiaries. Trustees should also take the opportunity to review any existing unpaid present entitlements or exposure to Div.7A loans and ensure they are compliant with current legislation and rulings.

If you have any concerns about your trust distributions (past or present) and would like a confidential review of your trust structure, then please contact Albert on 07 5554 6400 or albert@ mwpartners.com.au

The distribution of trust profit provisions have been around for more than 40 years. There has only been one case in the past 13 years which the ATO lost and the complexity of this area has meant that the Tax Office has taken more than 10 years to provide any guidance since tax ruling TR 2010/3 and PS LA 2010/4 were released in 2010. The new tax determination is intended to replace these old rulings.

The profit that accumulates in a dental trust is usually distributed to beneficiaries who are family members and generally on a lower tax rate than the dentist. A company which is controlled by the dentist can also be a beneficiary and may receive distributions of profit and therefore only pay tax at 25%. The individual or company beneficiary will show the income from the trust in their tax return and then pay the appropriate amount of tax. Quite often the allocation of profit is merely that and the beneficiary doesn’t actually receive the money that they are entitled to. This creates what is known as an unpaid present entitlement.

This is the area that concerns the Tax Office the most because it believes the tax should be paid by the person or company that actually receives the profit or benefits from the profit. Companies that don’t receive the cash component of the profit can comply with the ruling by ensuring that they establish what is known as a Division 7A loan which means the unpaid cash is repaid over a seven-year period with interest charged on an arm’s-length basis at ATO approved rates.

Individuals could previously agree to have the unpaid amount remain outstanding or forgive the debt or reduce the debt by a reimbursement agreement. The ATO are now looking at these arrangements where there is an unpaid present entitlement for beneficiary children who are over the age of 18. The ATO considers that tax is being avoided on the net income of the trust by utilising the lower marginal tax rate applying to the (adult) children in circumstances where the benefit is actually being enjoyed by the parents.

A DAQ D E N TA L M I R RO R

ABOUT THE AUTHOR

ALBERT GIGL Albert Gigl is the founder of MW Partners, Specialist Dental Accountants. Over 35 years as a Chartered Accountant, Albert has spent the last 15 years specialising in providing taxation advice for dentists. Contact Albert on 07) 5554 6400 or albert@mwpartners.com.au for an obligation free consultation.

CL ASSIFIEDS Stay informed of opportunities and announcements exclusive to the ADAQ community MARKING 45 YEARS OF DENTISTRY UTILISING GENERAL ANAESTHESIA IN BRISBANE Dr Anthony Speed, in association with anaesthetists from the Wesley Anaesthetic Group, wishes to advise that they can facilitate treatment for patients requiring general anaesthesia in our outpatient facility at Holland Park. This is particularly useful for patients who have no private hospital insurance. With an extensive range of experience, the team is willing to undertake wisdom tooth removal, implant placement and perform routine restorative dentistry on all age groups including children aged 3 and above. Anxiety sufferers, local anaesthetic problems, severe gag reflex sufferers, special needs patients, and dementia sufferers have all been successfully treated over the years.

Additionally, we are now able to offer Cerec single visit crowns so that the patient does not have to return for subsequent cementation. Patients who are medically compromised can be treated at St Andrew’s private hospital by arrangement.

C O N TA CT

If this service can be of assistance to some of your patients, please phone the reception staff on 3397 1339 for further information. Referral booklets available on request

Email marketing@adaq.com.au to learn how YOU can advertise in the Dental Mirror.

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