ADAWA April Western Articulator by adawa.com

APRIL 2020 12

Treating Patients on the Autism Spectrum

The Dentist who Trumped Lawrence of Arabia

We acknowledge our Defence Dentists on ANZAC Day

page 22

COVID-19 Special Practical Advice and Support to Help you Navigate the Current Pandemic

pages 07-10

Opinion piece by Dr Josephine Drewett

AUSTRALIAN DENTAL ASSOCIATION WESTERN AUSTRALIA

1 April 2020 Western Articulator | adawa.com.au adawa.com.au

We’re probably the only bank who knows that 48 stands for wisdom

Don’t worry, we’re not suggesting that we could even begin to do what you do. However, after 25 years of working closely with dental professionals, we’ve done more than pick up some of the language. We have designed products and services that meet your unique and specific needs. While you’ve been honing your skills to help your patients, we’ve been honing our know-how to help you. Visit us at boqspecialist.com.au or speak to your local finance specialist on 1300 131 141.

April 2020 Western Articulator | adawa.com.au

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contents features

covid-19 special

12 Treating Patients on the Autism Spectrum

07 Tele-Dentistry

Acknowledging World Autism Awareness Day on April 2

The Dentist who Trumped Lawrence of Arabia

A Narrogin dentist who took Damascus

Defence Dentists

To commemorate ANZAC Day weâ&#x20AC;&#x2122;re respectfully acknowledging our service personnel

A Periodontist and a Gentleman

We celebrate ADAWA member for more than 50 years, Dr Rob Bower

Opinion Piece

By Dr Josephine Drewett

Legal Feature

Autism: discrimination and inclusivity in employment

How to conduct virtual consultations during COVID-19

COVID-19: Financial Support & Stimulus Packages

Information on the financial support available to individuals and businesses during the COVID-19 pandemic

COVID-19 Health & Wellness

Keeping busy and prioritising your health during COVID-19

this month 05 24 25 27 30

CEOâ&#x20AC;&#x2122;s Comment Social Pages Dental Volunteering Activities The Value Hunter WADF Golf

April 2020 Western Articulator | adawa.com.au

Australian Dental Association Western Australian Branch Inc All correspondence to: PO Box 34, West Perth WA 6872

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T: (08) 9211 5600 F: (08) 9321 1757 E: media@adawa.com.au President Dr Sean Archibald Chief Executive Officer Dr David Hallett Editorial Team Brooke Evans-Butler Lisa Shearon Designer Carmen Collings Cover Photography Carmen Collings

Closing Date for Bookings: Ads: The 7th day of the prior month or the nearest business day before.

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All advertising must be submitted by the due date either by email. Advertisements received after the due date cannot be guaranteed to appear in that issue. Members’ free classified ads (minimum details format) will automatically appear in two issues, after which time they will be removed. Please contact the editorial team if you wish to have your ad continue in additional issues. (‘Allied Services’ ads are excluded from ‘free’ classification). Please supply display advertisements as a highresolution PDF file (embed all fonts) or a JPEG file to media@adawa.com.au. Please ensure any graphics are of a high quality. Articles should be submitted as a WORD document with any graphics attached as separate files. ISSN 2207-9351 (Online)

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DISCLAIMER: The views and opinions expressed in this publication and its attachments by advertisers and contributors are not necessarily endorsed by The Australian Dental Association (WA Branch) Inc. The Branch, its members, employees and agents do not assume any loss or damage which may result from any inaccuracy or omission in this publication, or from the use of the information contained, and make no warranties, express or implied, with respect to any of the material contained herein.

Connect with us @adawaoralhealth @adawa_perth Australian Dental Association WA 4

April 2020 Western Articulator | adawa.com.au

CEO’S COMMENT D R D AV I D H A L L E T T, A D AWA C E O

Through no fault of our own, COVID-19 has been unforgiving and soul destroying to the dental profession. As for so many Australians, it has stolen your employment, business and financial security and poses a real threat to you and your family’s health and wellbeing. Despite being a rhetorical message, it is so very important that as individuals and collectively as a profession, we not resign ourselves. We must be resolute and fight through every difficulty together. I have been personally inspired by the selfless efforts of ADAWA President Dr Sean Archibald and the Executive members, Drs Amit Gurbuxani, Amanda Phoon Nguyen and Jenny Ball. All four of them have ignored their own professional and personal circumstances for the betterment of ADAWA members. Similarly, I thank the ADAWA office staff who have taken a range of cost-saving measures to the Branch that includes acceptance of forced annual leave, wage reductions and a loss of workplace entitlements. With no demands from ADAWA, members have too displayed many significant self-sacrificing acts of generosity and kindness, including: •

Responsibly managing those distressed patients requiring urgent and emergency care.

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Donations of PPE to frontline COVID-19 health care services.

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A willingness to provide their professional services in any capacity to WA Health.

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Casting aside their own adversity by reaching out to support their colleagues and friends.

In a somewhat lighter vein, you have all had a significant impact on me. I now find myself regarding all past prejudices, disagreements, grudges and petty politics as nothing more than embarrassing and ridiculous memories. Please be assured that ADAWA is doing their upmost to support all members in any way possible. We are endeavouring to enhance services, particularly in relation to health and wellbeing, as quickly as possible. Unfortunately, every professional association is clambering for the same limited services available. If you need support in any way, you are to call Sean or me (in-confidence) at ADA House on 9211 5655. Alternatively, I can be contacted via mobile 0427 514 616. This edition of the Western Articulator was well into production last month. It has since undergone much change and re-editing. I hope you enjoy the digital format and find the great content a welcome distraction. As always, I welcome your feedback: ceo@adawa.com.au

April 2020 Western Articulator | adawa.com.au

WA Dental CPD Update: Teleconference

Medical Emergencies in the Dental Practice Presented by Dr Tom Cooper Saturday, 18th April 2020 8.30am to 12.30pm Delivery via Zoom Register online adawa.com.au/cpd

URS

3 CPD HO

$198

18th Ap

8.30am

ril

- 12.30p

Course Outline: This course will cover: 1. Principles of emergency management 2. Common emergencies in the dental setting

About the Presenter: Dr Tom Cooper is a Registrar in Oral and Maxillofacial Surgery currently based at Fiona Stanley Hospital in Perth. He worked for five years as a general dentist in locations throughout rural and urban Queensland prior to pursuing medical training. His interests outside work include running, cycling, drone photography as well as spending time with his young family.

Due to the current COVID-19 situation and in the best interest of our members, upcoming WA Dental CPD courses have either been postponed or offered via alternate online formats. Please visit adawa.com.au/cpd for some of the common questions being raised in relation to the current changes and regularly check the List of Courses page for the latest updates. If you have any questions regarding the course changes please contact the ADAWA office on (08) 9211 5600 or via email cpd@adawa.com.au

April 2020 Western Articulator | adawa.com.au

COVID-19 Tele-dentistry Feature

Read full article online

Tele-dentistry: how to conduct virtual consultations during COVID-19 In these challenging times, dentists are having to rethink the way they consult with patients. Enter tele-dentistry …

With tele-dentistry now a reality for Australian practitioners, it’s a pertinent time to ask the where, what and how questions of this vital form of IT.

What is tele-dentistry? Simply explained, tele-dentistry is the use of Information Technology, such as phone or video call application, to conduct a dental consultation. During COVID-19 restrictions, it is an ideal way to conduct a consultation, without breaching any social-distancing restrictions.

Setting up tele-dentistry Phone call: Telehealth appointments can take place via a phone call. If you are calling from a number that you do not want to share with patients, simply type #31# before you dial, and your number will be hidden. FaceTime or WhatsApp: These are easy-to-use free platforms, however, keep in mind that your phone number must be used. Zoom: Zoom is an excellent platform for telehealth consultations. Free accounts are available – although limited to 40 minutes per appointment. To understand how to invite a patient to call, click here. Please refer to https://support.zoom.us/hc/en-us/ articles/201362723-Encryption-for-Meetings for information on encryption.

How to conduct a tele-dental consultation To begin: •

Advise the patient how to access the platform you are using

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Ensure that you have at least 3 correct patient identifiers such as their name, age, date of birth or address

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Once you have checked that you have the correct patient on the phone, check that you have their contact number to phone them back should the line be cut off

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Please refer to https://www.oaic.gov.au/privacy/privacyfor-health-service-providers

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Have a list of phone numbers and addresses handy should you wish to on-refer the patient to an appropriate tertiary service

Seek patient consent: •

You should obtain consent before collecting a patient’s health information

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The patient should be aware about the limitations of tele-dentistry and that dentists are providing the best advice possible in the absence of face–to–face consult

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If there are any charges for the phone consult, the patient should be made aware prior to the consult commencing

Please write down contemporaneously what was discussed with the patient as this forms part of their clinical record. This applies whether or not a consult fee was charged. Set up a phone message Include: • Where they have rung. •

If you are open during this time.

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If you are available via tele-dentistry at this time

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An alternative number for the patient to contact such as the closest dentist who is available for tele-dentistry, or the nearest emergency department.

Example voice message: Thank you for calling Little Giant Dental Centre. We are closed during this time. If this is a dental emergency, please contact the Emergency Department of the Little Giant Village at 987654321 or phone Big Giant Dental Centre should you require a tele-dentistry consult. Their phone number is 123456789. It is also recommended you familiarise yourself with guidelines and advice from Dental Protection around the provision of telehealth.

Professional presentation It is important to remember that even if you are not meeting a patient face-to-face, you need to still look professional if you are communicating via a video platform. Make sure you are still showing the grooming standards expected if you were meeting a patient at a practice. Ensure your hair is tied back and wear what you would usually at your practice. April 2020 Western Articulator | adawa.com.au

COVID-19: FINANCIAL SUPPORT AND STIMULUS PACKAGES Although the financial landscape is constantly changing, weâ&#x20AC;&#x2122;ve attempted to compile the key points here. For up-to-the-minute financial information and website links for more information about these supports, please visit the ADAWA website Listed here is the support available to companies, sole traders and individuals. Please use this as a guide only and look into the links provided for further detail about your eligibility and terms and conditions. Ensure you talk to your financial adviser or financial institute about the best financial support and decisions for your individual situation.

JobKeeper payment (for companies/trusts/sole traders) The newly announced JobKeeper payment is for businesses significantly affected by COVID-19 to allow them to keep paying their employees. JobKeeper allows businesses to access the subsidy to continue paying their employees a fortnightly payment of $1,500 per employee for a maximum of six months. To be eligible, businesses must have a turnover of less than $1 billion, with a turnover that has fallen by more than 30 percent. Also applicable to businesses with a turnover of $1 billion, with a turnover that has fallen by more than 50 percent.

Low-interest small business loans (for companies/trusts) The banks have been given extra funding by the RBA to extend low-interest loans to small businesses as well as offer a six-month freeze on repayments. The interest that continues to accrue on loans is likely to be capitalised on the balance of the loan during the freeze period and repayments are likely to increase after the freeze period or balloon payment placed at the end of the loan.

April 2020 Western Articulator | adawa.com.au

Freeze on loan repayments (for companies/ trusts/individuals) Talk to your bank or financial institution about the terms and conditions regarding the freeze on any loan payment and other support or relief that can be offered for business or personal loans at this time.

Contact the ATO to defer payments for PAYG instalments (for companies/trusts) The ATO is implementing options to assist businesses impacted by COVID-19, including deferring the payment date of amounts through business activity statement, PAYG instalments and income tax assessments.

Instant asset write-off (for companies/trusts) The instant asset write-off has been increased from $30k to $150k and relates to the purchase of capital assets such as equipment, vehicles and computers, for example. The cost of the asset can be expensed immediately as a deduction rather than depreciated over a number of years. Assets must be purchased before 30 June 2020.

JobSeeker payment (for sole traders/ partnerships/individuals) The JobSeeker Payment has replaced the Newstart Allowance and is for people looking for work, or those who cannot work temporarily because of injury or illness. The fortnightly payment an individual receives from the JobSeeker Payment will depend on the individualâ&#x20AC;&#x2122;s circumstances.

COVID-19 Feature

Visit adawa.com.au/covid-19-financial-support

For the latest information on financial support and stimulus packages, visit: GOVERNMENT ECONOMIC RESPONSE TO COVID-19: https://treasury.gov.au/coronavirus

BOOSTING CASHFLOW FOR EMPLOYERS:

$750 stimulus payment (for sole traders/ individuals) Eligible individuals will receive this payment automatically.

Coronavirus supplement of $550 per fortnight (sole traders/individuals) A temporary fortnightly $550 Coronavirus supplement payment is available for eligible individuals. The supplement is for individuals who are getting a payment, such as JobSeeker Payment, Widow Allowance and Youth Allowance for job seekers and students. People who are eligible will receive this payment automatically from April 27.

Withdrawing from your superannuation (for sole traders/individuals) Individuals affected by COVID-19 can access up to $10,000 of their superannuation in 2019-20, and an additional $10,000 in 2020-21. To be eligible, an individual must meet criteria, which can include being unemployed, eligible to receive Job Seeker payment, Youth Allowance or if your work hours or turnover (for sole traders) has been reduced by 20 percent. People who are eligible are to apply through myGov.

https://www.ato.gov.au/Business/Business-activitystatements-(BAS)/In-detail/Boosting-cash-flow-foremployers/ Support available: https://www.ato.gov.au/

AUSTRALIAN GOVERNMENT https://www.australia.gov.au/ Support for businesses: https://treasury.gov.au/coronavirus/businesses Support for individuals and households: https://treasury.gov.au/coronavirus/households https://treasury.gov.au/coronavirus

FINANCIAL UTILITIES Financial Utilities is an accounting and business advisory firm that works with ADAWA. They have their finger on the pulse of COVID-19 relief options for individuals, information on stimulus packages and employee and financial considerations. Their COVID-19 webpage has a range of useful resources to keep an eye on: https://www. financialutilities.com.au/covid19

ADA FEDERAL https://www.ada.org.au/Campaign/COVID-19/FinancialSupport

April 2020 Western Articulator | adawa.com.au

KEEPING BUSY AND PRIORITISING YOUR HEALTH DURING COVID-19 These times are unprecedented – and we know for many dentists who have had to close up practice or go into social isolation after travel or illness, times are hard. We know how busy dentists like to be! As such we’ve created a “keeping busy” list for dental professionals

Connect

Eat well

It’s important to stay connected to family, friends and colleagues, so we recommend you check out video communication tools such as Skype, Zoom or Houseparty. Also remember the value of peer support during these times – no one will understand the changes and challenges to your workplace better than your colleagues and other dental practitioners. Join the ‘ADAWA members’ Facebook group to network and connect with other ADAWA members, or for a supportive mental health-focused group for dental practitioners, join The Mental Block on Facebook.

Keeping your energy levels up with good, healthy food, is important. This is not the time to try out a crash diet or drastic eating plan. A good place to start for some information on healthy eating is the Dietitians Association of Australia. Their website has a section on good nutrition, tips and recipes from Accredited Practising Dietitians to try: www.daa.asn.au/smarteating-for-you/

Learn something new Have you considered doing CPD from home? Be sure to log on to ADA’s CPD portal and check out what is on offer: www.ada.org.au/CPD-Portal/Resources Once you have ticked off some CPD hours, why not learn something outside of dentistry? There are many courses online, so consider taking a course in something you have always wanted to learn. Check out Masterclass, where you can learn acting from Helen Mirren, directing from Ron Howard, cooking with Gordon Ramsay or writing with Margaret Atwood, to list just a few options. Go to www.masterclass.com

Stay physically fit If your exercise regime has been lacking as you rush between patients, this is the time to adopt some good habits. Get some exercise – go for a jog (remembering social-distancing practices) or consider an online fitness class. •

FitOn, www.fitonapp.com/

•

Les Mills on Demand, watch lesmillsondemand.com/athome-workouts/

•

Surge Fitness on Demand, www.surgefitness.com.au/ on-demand/

•

PE with Joe provides daily workouts on YouTube during COVID-19. Adults get just as much benefit from these free workouts as the kids!

10 April 2020 Western Articulator | adawa.com.au

Find some quiet time Finding some quiet time is important during stressful situations. Find a few minutes’ a day (even just before you go to sleep) to do a guided meditation. Headspace has some great resources to try: www.headspace.com

Look after your mental health Dental Protection offers counselling to any members experiencing work-related stress, or stress that they feel could impact their practice. The counselling service is provided by trusted partners ICAS, who offer a personalised and professional service tailored specifically to your requirements and delivered by experienced, qualified counsellors. ICAS’s telephone counselling provides immediate access to support 24 hours a day, 7 days a week, and face-to-face counselling sessions can be arranged near to you and at your convenience, all funded by Dental Protection. The service is entirely independent and confidential. Call ICAS on 1800 808 374 or +61 7 3211 8919 from overseas and quote your Dental Protection membership number to book a free session.

Weâ&#x20AC;&#x2122;re here to help To support our members during the COVID-19 crisis we have created a WA specific resource page on our website. The information hub is here to help you navigate the current dental industry challenges www.adawa.com.au/covid-19-updates

Managing COVID-19 Guide to managing the impacts of the COVID-19 pandemic including managing potential exposure to suspected or confirmed cases, employee management and infection control.

Dental Services Restrictions To help you understand what this means for your practice and how to implement level 3 restrictions.

Dental Treatments Guidance

Level 3 Practice Restrictions

A framework outlining the ADAâ&#x20AC;&#x2122;s recommendations in relation to the continuation of dental services.

Practical examples to help guide dental practices in the application of level 3 restrictions.

Referrals Pathways

Financial Support

HR Support

WA Emergency Dental Map

ADAWA have developed the following resources to help you manage patients that may contact you through the COVID-19 period.

Information on the financial support available to individuals and businesses during the COVID-19 pandemic.

The ADA HR hotline and resources to support you through during the COVID-19 pandemic.

The ADAWA database of dental practices who have indicated that they are currently treating emergency patients during the COVID-19 pandemic.

April 2020 Western Articulator | adawa.com.au

Kathrine Peereboom with one of her sons. Photo credit: Peta Cormack from Cormack Photography

Treating patients on the autism spectrum Treating a patient on the autism spectrum needn’t require longer appointments and specialist referrals; a little knowledge, patience and understanding can go a very long way. In acknowledgement of World Autism Awareness Day in April, Brooke Evans-Butler discovers the simple methods that can be used to get great treatment outcomes No matter if you work in a public or private practice, it is highly likely some of your patients will be on the autism spectrum, as Grace Lazurardi, policy and planning director at the Autism Association of Western Australia, explains. “One in 100 people are on the autism spectrum, and just like anyone else, they need access to a good dental service,” she says. “So the more we can do to improve autism awareness for dentists, the better the health outcomes will be for people with autism.” Last year, the Autism Association of Western Australia partnered with the WA Health Sector to develop training packages and resources to increase autism awareness amongst health professionals. The trial face-to-face program for dental professionals was received with great enthusiasm, with the program set to go online on April 2. Danielle Aubrey, specialist project officer at the Autism Association of Western Australia, says the training covers not only technical information, but many strategies needed to support people with autism that can be put into practice by dentists and other dental professionals, including dental

12 April 2020 Western Articulator | adawa.com.au

nurses and reception staff. “We found people in the dental profession want to help but are not sure what to expect or how to respond,” she says. According to Danielle, the most common question by dental professionals is how to work with an ASD patient who is nonverbal. “My answer is, they are a person first and will be just as anxious as anyone in an unfamiliar environment, not knowing what to expect,” she says. “Sometimes, a medical professional will speak ‘over’ the person, or just interact with the carer instead. Remember, it is important to talk to the person and explain or show them what you are going to do. “The dental environment is very challenging for the best of us,” Danielle continues. “For a person with autism, the bright lights, smells and sounds immediately put their senses under pressure. “Because of this, we recommend familiarisation appointments where necessary. In this way, they experience the clinic and know what to expect. This reduces a lot of the stress associated with an unfamiliar environment and its sensory

Feature Article

overload. The more familiar the person with autism is with the environment, the more resilient they will be in undergoing a dental procedure.” When it comes to treating patients on the autism spectrum, Danielle says, it is best to be flexible with expectations. “A filling they require, may need to wait until the second appointment until they feel less anxious in an environment that is new for them,” she says. “Getting into the chair and opening their mouth for the dentist to have a look may be sufficient for the first visit. However, this might not be the case for all people with autism. Some might come well prepared because of past visits to the dentist.” Continuing with an appointment when anxiety levels are increasing should definitely be avoided. Also “ultimatums and telling of consequences do not work” Danielle points out. “They only increase anxiety and a negative response. Simply accept that you might not get everything done in that one appointment.” A final piece of advice from Danielle is to listen to the patient’s carer who knows the person, whether it is their parent or a support person. “They will know the patient’s likes, their dislikes and the things that make them anxious,” she says. “They will help you because they will know how to put the person at ease. They will know that the patient might need headphones or want to wear their own sunglasses instead of the glasses you give.” It doesn’t take much, according to Danielle, for a patient with autism to have a positive experience at the dentist. “We have many families who regularly go to the dentist and who love their dentist,” she says. “It is not an unachievable goal if you can see the situation through their eyes and make some small adjustments.”

THE SENIOR DENTAL OFFICER It is very important for a dentist to have an understanding of autism in order to have a successful patient-clinician relationship, according to Dr Tamarai Selvam, senior dental officer at the Special Needs Dental Clinic. “There is usually an element of elevated anxiety for ASD patients caused by overstimulation of lights, sounds, smells, movement and strange equipment in a dental clinic,” she explains. “Many autistic patients also have high pain tolerance, and it’s not uncommon to find advanced stages of dental issues by the time they get to a dentist!”

AUTISM ASSOCIATION OF WESTERN AUSTRALIA TRAINING FOR DENTAL PROFESSIONALS The online training course is set to launch on World Autism Awareness Day on April 2. The course is divided into short modules, which are very strategy heavy, so upon completion, you will have strategies and skills to use immediately. The free course includes all the resources and visuals recommended for you to print off to use in your practice. The course will be available through the Autism Association of Western Australia website, https://www.autism.org.au/

TOP TIPS FOR DENTISTS Senior Dental Officer Dr Tamarai Selvam makes the following suggestions for treating patients with autism:

Prepare a detailed questionnaire on the patient’s communication style, and types of sensory stimuli that may “trigger” a flight, fight or fright response.

2. Book desensitising appointments. Go through

the same routine as the last visit and introduce one new element at every subsequent visit. Always end the appointment on a positive note.

3. Take your time and have no expectations on how the appointment is going to play out.

4. Show, demonstrate and explain procedures.

Let the patient touch and feel the equipment.

5. Use a confident, calm, firm voice with minimal distraction in the surgery. Talk to the patient instead of “at” the patient.

Tamarai believes that patients with autism don’t necessarily need to see a special-needs dentist. They simply need to visit a dentist who is calm, patient and understanding of their needs. “If the patient is identified with ASD, talking to the carers prior to the appointment about the patient’s red and green buttons might help them prepare for a successful dental visit,” Tamarai advises. “Sensory overloads, communication methods, special-interest topics that are unique to the patient are areas to focus on. Desensitising appointments are a great way to introduce chair-side dental treatment for an ASD patient.”

April 2020 Western Articulator | adawa.com.au

USE A SOCIAL STORY

Social stories go a long way to helping curb anxiety in a patient who has autism. DHS recently developed a social story about providing dental care to patients with autism; available on the DHS website: http://www.dental.wa.gov.au/publications/ maggie-goes-dentist

Tamarai notes that one of the most common mistakes a dentist makes when treating a patient with autism is assuming that all ASD people are alike. “There is a saying that if you know one ASD person, you know one ASD person,” she adds, laughing.

THE PSYCHOLOGIST Paediatric psychologist Amanda Abel believes it is important for dentists and other health practitioners to realise that children (and adults) on the spectrum can become very anxious about going to the dentist, especially if it is somewhere they haven’t been before. “A lot of children will find a medical consulting suite quite provoking,” she says. “If it is somewhere new, I always recommend preparing them prior. If the practice can provide the parents with some pictures of the practice or the treatment rooms, provide the name of the dentists the child is going to see, or give a sequence of events so they know what to expect, this can really help. We have social stories that includes this sort of information that we send to patients who might be anxious.” Giving patients with autism some extra time can make a big difference. “If the practitioner knows they are not in a rush, they are not going to be stressed – which the kids will pick up on,” she says. “Another thing that can be very helpful is to offer the family the chance to come and look at the practice a week prior to their appointment so the child is then familiar with the surroundings.” Amanda says it is helpful for a dentist to know their patient has autism prior to the appointment so the dentist can be prepared to have a longer appointment if necessary. “I would recommend the information that a person has autism is on intake forms so parents have a little reminder to disclose it so the dentist can be prepared,” she says, adding that being prepared to help a person with autism feel less anxious in the dental chair can make a big difference to their care. “You are doing everything you can to set the child up for success,” she says. “It literally can mean the difference between the child receiving further dental care or not. “I have worked with kids who have been unable to go to the dentist because of their anxieties, and their teeth are in such a bad way. It could make a really big difference for their overall health outcome.”

ADVICE FROM PARENTS Randa Habelrih is an author, founder of Autism MATES and mother of a young man on the autism spectrum. She says dentists and other medical practitioners taking the time to make a patient with autism feel comfortable is very important for the success of their overall treatment. “We take my son Richard to the dentist every six months and he has never had a fear of dentists,” she says. “We talk him through the situation, and we have been very lucky that all the dentists he has seen have always been very accepting and very gentle in their processes.” Simple things such as being given a choice of sunglasses or goggles to wear, being told what is going on before it 14 April 2020 Western Articulator | adawa.com.au

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happens, letting him look at or touch the equipment and giving him time to get used to the environment, are all important in helping Richard cope. “I think it would be really handy for dentists to have some noise-cancelling headphones on hand,” she says. “Or ask if the patient can bring their iPod or phone to play some music of their preference. A stress ball the child could squeeze could also be helpful. For Richard, he doesn’t like when medical professionals are too serious, so smile and be jovial. “It is really not rocket science,” she continues. “It is being patient, explaining things step-by-step beforehand, and having a smile on your face.” She stresses it is important to talk to patient, not the parent. “So often, people will talk to me like Richard isn’t there,” she says. “Don’t treat them like they are invisible. They fully understand what is going on; even the non-verbal autistic patients. Talk to them first, and if the response is inadequate, say: ‘Do you mind if I ask your mum or dad?’ There is nothing worse than someone talking about you as if you weren’t there, so remember they are the patient. “A lot comes down to some common sense; a little bit of empathy and patience,” she adds. Autism MATES, www.facebook.com/AutismMATES

MAKE THE MOST OF DESENSITISATION APPOINTMENTS Kathrine Peereboom is the founder and CEO of Spectrum Support and mum of three boys on the spectrum. She says one of the first thing she asks prior to a medical consultation, especially if the family is going somewhere new, is if they can have a desensitisation appointment. “This involves us going when it is quiet, usually the first appointment of the day or the last appointment of the afternoon and just walking around,” she explains. “We see what reception looks like, we meet the dental team, go into the treatment room or see if the kids are allowed to sit on the dental chair,” she says.

dental treatment, some basic cards that say ‘Yes’, ‘No’, ‘Good’ and ‘Bad’ are a fantastic tool because if the patient is hurting or needs a break they can point to those visuals.” Kathrine also says for dentists not to underestimate the difference some understanding and compassion can make. “I can tell you that most parents are anxious about taking their special needs child to a medical appointment, so just be human,” she says. “Show empathy and human decency and compassion. You never know the situation that the parent and child or disability worker and teen have come from. The days can be really, really hard even before 7am, so if parent or carer is frazzled and the child is starting to stress out, please just be kind.” Spectrum Support, www.spectrumsupport.org

Amanda Abel, paediatric psychologist, offers her advice for making children on the autism spectrum more comfortable in a dental setting: Allow children to bring their own glasses to wear. Allow the child to hold something in the chair to make them feel a bit calmer (such as a fidget toy or stress ball). A weighted blanket over the child might help calm them. Encourage the child to wear headphones with some preferred music or noise-cancelling headphones so the noises don’t bother them.

“I always ask for the very first appointment of the day and come prepared with their favourite thing. In my children’s case it’s their iPads,” she adds. “Having to sit in the waiting room can be a very unpleasant experience. My kids will become more and more anxious as the time ticks over, especially if the previous appointment has run late. “Also, for my kids, the morning is when they are in their most happy place.” Kathrine suggests to dentists to have visuals for children and adults on the spectrum. “Even photos on the practice website of the dentist, what the car park looks like, the treatment room and perhaps some of the equipment can be very helpful, especially for people who can’t get to a desensitisation appointment,” she says. She adds that visual cards can be very helpful during an appointment for children and adults, both verbal and nonverbal. “If your mouth is numb or you are needing a filling or

April 2020 Western Articulator | adawa.com.au

THE DENTIST WHO TRUMPED LAWRENCE OF ARABIA We have no shortage of stories from the First World War; tales of heroism amidst the horror. Yet one of the most fascinating – and the story we’re celebrating this ANZAC Day – is a little-known one of a Narrogin dentist who took Damascus. By Brooke Evans-Butler There are many tales of heroism from the First World War that are part of many family histories; of young men, sent far away to strange lands to fight in a brutal war. They are remembered on ANZAC Day, Remembrance Day and at Christmas gatherings, when families look back at old photographs and war medals. Arthur Olden’s descendants have his medals, as well as a very unique piece of historic memorabilia – a document surrendering the city of Damascus to their ancestor. Olden was born in Ballarat, and in 1904 was registered by the Dental Board of Western Australia. He set up practice in Narrogin – treating the people in and around the township. Kay Weaver, manager of library services for the Shire of Narrogin, says Olden was a community-minded man who was a founding member of the local golf club, member of the town’s first polo club, and town councillor. Olden enlisted in the First Word War 1914 and joined the 10th Light Horse Regiment. He was twice wounded at Gallipoli. Tony Park, former Australian Army Major and bestselling author of 17 novels (including Ghosts of the Past, a military history thriller), says whether most Australians know it or not, they’re probably more aware of the actions of the 10th Light Horse than any other ANZAC unit. “These were the young men from Western Australia whose slaughter at The Nek formed the basis for the climax of Peter Weir’s iconic film, Gallipoli,” he says. “Raised to fight as mounted infantry, the unit’s squandering in an ultimately futile offensive at Gallipoli symbolises, in many ways, the horror and wastefulness of the war. There’s no doubting the courage of the men of the 10th Light Horse, but Australians should be as equally aware of their successes as well as their losses on the ANZAC peninsula.” One of the successes involves Olden who led his troops into Damascus and accepted the city’s surrender – inadvertently

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Re-enactment Photos Barry Corke. Olden’s grandson Brad during a re-enactment of the surrender beating Lawrence of Arabia to the prize. “The great Megiddo Offensive, which had begun on the night of 18-19 September was drawing towards its conclusion at Damascus a little over a week later,” explains Michael Kelly, historian at the Australian War Memorial. “On the 30th of September, the Australian 5th and 3rd Light Horse Brigades were involved in smashing a retreating Ottoman and German column in the Barada Gorge to the north-west of the city.” Ordered to cut the Damascus-Homs Road to the north of the city, Olden’s scouts found no viable way around the Barada Gorge. “The only option therefore was for the 3rd LH Brigade to advance down the Barada Gorge in the early hours of 1 October, through the carnage they had helped to wreak on the Ottomans and Germans the day before, then enter the city from the north-west before turning north-east towards Duma,” Michael says. Taking the initiative, Olden knew that the only way through was via the city. In doing so, Olden’s troops beat TE Lawrence into Damascus by a couple of hours. However, the claim of who first entered Damascus is often disputed – with Lawrence being credited, including in David Lean’s film Lawrence of Arabia. “It hadn’t been the intention for the Australians to stop and accept the surrender; it was one of those events that could

Image Courtesy of the Australian War Memorial B00814. Group portrait of officers of the 10th Australian Light Horse Regiment. Back row, left to right: Captain (Capt) Reginald William MacCallum; Lieutenant (Lt) Astley Bertram Cornelis Hamersley; Lt Charles Foulkes-Taylor MC; Lt Alan Herbert; Lt Henry Rodney Kingdon; Lt Albert Robert Strutton; Lt Harrison Claude Ainsworth. Middle row: Lt Albert Hopkins; Lt John Gordon Finlay; Lt Arthur Wyatt Miles Thompson MC; Lt Edgar Frank Richardson MC; Lt Alexander Urquhart Martin; Lt Ernest Ruse; Lt Alan Bell Gollan; Capt Henry Geoffrey Palmer. Front row: Capt Leonard Tilsley Baker (Medical Officer); Major (Maj) Richard Achilles Capron; Lieutenant Colonel (Lt Col) Arthur Charles Niquet Olden DSO; Lt Col Thomas John Todd CMG DSO and Bar (DOD 23 January 1919); Maj Lewis Clayton Timperley; Maj Charles Gilmour Dunckley; Maj Herbert Bowen Hamlin DSO (DOD 30 May 1919).

have been very different had Lawrence and his Arab force actually arrived first,” Michael explains. “Olden, following orders, moved on quickly and the 10th Light Horse Regiment led the rest of the 3rd Brigade out of the city in pursuit of the retreating Ottomans and they had left the city by 7am.

“Also, where the 3rd Brigade had advanced through the city on horseback and had not stayed to enjoy the victory celebrations Lawrence arrived by Rolls Royce car, making a great spectacle of his entering the city. This was part of that self-promotion and pro-Arab propaganda.”

“The surrender of Damascus to the Australians was significant to them as they had fought a long campaign through the Sinai and then Palestine,” Michael adds. “Although the casualties were nowhere near those suffered on the Western Front, the Australians had been prominent in many significant actions during the long advance. The capture of Damascus, without a casualty, was the crowning glory of the Australian Light Horse campaign. Lieutenant General Harry Chauvel called the capture of Damascus the ‘high water mark of the Desert Mounted Corps’ endeavours.’

In reality, revolver in hand, Olden accepted the surrender, cut short the Emir’s speech and declined refreshments, and issued instructions for the restoration of civil order, before setting off again on his primary mission.

“The Australians had not intended to occupy Damascus, but the ANZAC Mounted Division remained around the city and was responsible for restoring order that had so quickly crumbled under the mis-management of the new Arab governing body,” Michael says. “The local Damascenes were thankful indeed that the Australians were present to restore and then maintain order. “Lawrence wanted to ensure that the Arabs had a prominent position not only in the governance of Damascus, but in post-war negotiations regarding their self-determination,” he adds. “Lawrence was also a shameless and tireless selfpromoter. The fact that the light horsemen reached Damascus first, ruined Lawrence’s narrative of an Arab victory. He downplayed the role of the Australians in his Seven Pillars of Wisdom.

Tony says the fact that the Australians entered Damascus first speaks volumes about their tenacity and the fact that in so many engagements during the war they were at the front of the front line. “The other significance, for all Australians to ponder, is that most people will never have heard of the campaign, let alone the fact that Australians were first into Damascus,” he adds.

OLDEN STREET If you visit Narrogin, look out for Olden Street, which was named for the dentist. When a street naming was originally suggested to Olden, he objected because the suggested street ended at the sanitary depot, so another street was chosen with a more pleasant smell and fewer flies.

April 2020 Western Articulator | adawa.com.au

“As a nation we seem fixated on our heroic defeats, such as Gallipoli, rather than our military successes. Even in today’s military, it’s not done to brag about victories, but rather just do the job well and get on with it, and that’s what Olden did, without the attendant fame. “As a story it has it all – wide-eyed young men from rural Western Australia traversing holy lands they would have only read about in the Bible, finding themselves part of the largest military column to traverse the Middle East since Alexander the Great, and then using grit and determination to defeat a dogged foe on home ground,” Tony says, when asked what it is about the Surrender of Damascus that makes it such an interesting story. “We lionise our military, in the past and the present, and ascribe characteristics to the average digger that he or she might not deserve, but in Olden we see a commander leading from the front and a force of mounted soldiers who, unlike so many in the First World War, were able to put their training to good use and achieve a strategic victory with not much more than rifle, bullet, horse and guts. “War is not glamourous or romantic, but in times of conflict the best, as well as the worst, of mankind will be thrust to the fore,” Tony adds. “In Olden and his men entering Damascus, as at the charge at Beersheba, we see all the elements that a novelist could wish for – conflict, danger, a ticking strategic clock, a wily enemy and a stunning exotic backdrop. “The very fact that Olden was a dentist makes the story somehow even more poignant – here was a man who had military training, but he was also just one of us, an everyday man with a normal practice who was thrust into tumultuous events and acquitted himself well.” In recognition of his services, Olden was awarded the Distinguished Service Order in October 1918. When Olden returned to Australia, after having taken part in quelling the 1919 Egyptian independence rebellion, he married and moved to Perth, to continue practising as a dentist. For a short period

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during the second World War, Olden served briefly in the Australian Army Medical Corps (Dental) and died in 1949. In contrast to Lawrence, Olden was known to be a very happy and humble man, demonstrated by the book he wrote about his regiment, Western Cavalry in the War, 10th Light Horse AIF by Lieutenant Colonel Olden DSO. “When Arthur talks about anything, he hardly mentions himself,” Kay says. “I think he was a very modest man. An upright, good man, who was a very active member of the community but not very boisterous. He was a fascinating man and I wish I could have talked to him. I think he would have great stories to tell. Although I think it would have been difficult to get him to tell you about his part in them because his book is about everyone else.” This is clearly shown in Olden’s own account after the Surrender of Damascus. The excitement of the people was clearly evident, but he doesn’t mention himself: “The advanced troops then proceeded to make their way through the city, the rest of the column following in close order. The march now assumed the aspect of a triumpful procession, the dense masses of people rapidly becoming hysterical in their manifestations of joy. They clung to the horses’ necks, they kissed our men’s stirrups; they showered confetti and rose water over them; they shouted, laughed cried, sang and clapped hands. From the windows of high buildings, Moslem women, raising their dark veils, called out, ‘Meit allo wesahla! Meit allo wesahla!’ (A hundred welcomes). The cry was taken up and carried along the line of march in one continuous chant.” (from Westralian Cavalry in the War) “I think the story captures the imagination because Arthur was a small-town dentist, a very good man, with a long history of community service,” Kay adds. “Although the freeing of Damascus was probably accidental because the troops were not meant to go through Damascus but around it – the story shows an adventurous spirit,” she says. “I also think we see a lot of Arthur’s personality that

A story, perhaps apocryphal, was of a cannon loaded with white feathers arriving in front of Olden’s dental surgery. There are two theories of the motivation behind this: one is that it was a message for Olden that he had not enlisted quickly enough. The second theory is that it was intended for a German resident, but the cannon rolled away and ended up outside the dental surgery.

having arrived by accident and people surrendering to him, he organised everything very quietly and just carried on. He was very capable – and very cool, calm and collected.” The surrender document (which referred to Olden as: “The first British officer to enter Damascus, in the bravest manner known to the Saxon race”) is still in the possession of Olden’s family – and was used in a recent re-enactment ceremony in Narrogin for the 100-year anniversary of the surrender. “I got in contact with Arthur’s grandson Brad, and he was excited about coming over and being part of the ceremony,” Kay says. “In the meantime, we had managed to get some of the 10th Light Horse from Albany to be a part of the ceremony, so we had a troop of people on horses – and because Brad can ride, they got him a horse and he dressed up in uniform and wore his grandfather’s medals. Brad carried the actual surrender document in his pocket, so it was very special. It was a nice way to commemorate the anniversary because Arthur enlisted from here and was a valued and active member of the community. “Arthur was one of those people who felt that you had to be friendly to your previous enemies to make sure that there was no future conflict,” Kay adds. “It is clear he was a person of great moral character.”

Have you seen the memorial plaque outside the Ellie J Ladner lecture theatre? It is dedicated to the memory of those dentists who were killed while on active service World Wars I & II, including: JFP Burnett, JA Galvin, SV Selby and KH Slatyer

The ‘Saraya’ (Government offices) in the city of Damascus, where the surrender of the city was made by the acting governor to officers of the 10th Australian Light Horse regiment. Courtesy of the Australian War Memorial (J02477)

April 2020 Western Articulator | adawa.com.au

DEFENCE DENTISTS To commemorate ANZAC Day, we’re respectfully acknowledging our service personnel – including the past and current Australian Defence Force Dental Officers who look after the oral health of defence-force serving members COMMANDER PHILIP MA (RAN)

Commander Philip Ma enlisted in the Royal Australian Navy (RAN) in 1996, during his second year of Dental School at the University of Western Australia, following a Defence presentation. “The presentation detailed the Undergraduate Dental Officer scheme, the benefits of enlisting, the varied travel experiences, the challenges of leadership and management, and the Navy values and traditions, which convinced Commander Ma that this was a career pathway worth considering,” a Defence spokesperson told us. “Commander Ma is still serving as a full-time commissioned Officer and is currently the Senior Dental Officer at the Stirling Health Centre, HMAS Stirling, Garden Island in Western Australia. His duties and responsibilities also extend to the management of all military dental clinics in WA. He is also the Head of Profession of the Royal Australian Navy Dental Branch. “As a dentist in the Australian Defence Force, Commander Ma’s clinical work is very similar to general practice dentistry in the civilian sector. In addition to this work, he also is responsible for assessing the dental fitness of uniformed members to deploy or serve in different environments. As a Senior Dental Officer, he is responsible for the mentoring, leadership and guidance of staff, who can be made up of a mixture of uniformed, public service and contract health practitioners.” Navy dentists are first and foremost commissioned Naval Officers. “All Naval Officers have duties and responsibilities in regard to managing, leading, looking after the wellbeing of subordinates, and living the Navy values. As a military member he is also expected to maintain his own medical, dental and physical fitness and be ready to deploy on short notice. “Commander Ma has served on various Navy surface fleet

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vessels, visiting numerous countries in North East Asia, South East Asia, the Middle East, North America and the Pacific Islands such as Hawaii and Guam. He has also deployed to Timor-Leste as part of INTERFET, the Solomon Islands, Afghanistan and Iraq during Operation Slipper 2001 to 2003, and Australia’s commitment to border protection.” For Senior Dental Officer Commander Philip Ma, there have been many memorable moments in his defence career. “My first was during my deployment to Timor-Leste when I was embarked in HMAS Sydney as the Fleet Dental Officer,” he recalls. “At that time Timor-Leste was under the protection of International Forces East Timor (INTERFET) and we were stationed off the tiny enclave of Oekussi. Myself and the Ship’s Medical Officer joined forces with the medics of the Royal Gurkha Regiment and provided humanitarian assistance to the people of Oekussi. I was the only available dental support in the area, and when word got out that a ‘Doktor Gigi’ was present, the line of patients to see me kept increasing on a daily basis. The majority of the dental treatment required were extractions in a very basic clinical set up in what used to be the local school.” He says another memorable moment was being awarded a Maritime Commander Australia Commendation for outstanding conduct and professionalism in the performance of his duties during Operation Slipper. “In addition to the provision of sterling service in the delivery of dental services to Ship’s Company and embarked forces, I also was in command of a KANIMBLA Steaming Party where I took charge of detained vessels in the Middle East Area of Operations,” he says. “I was extremely proud of the citation which stated that the dedication and initiative demonstrated by myself embraced Navy’s core values and were in the finest traditions of the Navy. “I have thoroughly enjoyed my career in the Royal Australian Navy as a Dental Officer and would highly recommend it to anyone who is interested.”

DR AMANDA PHOON NGUYEN

Our ADAWA treasurer Dr Amanda Phoon Nguyen served as a Lieutenant in the Royal Australian Navy for three years. She first met representatives of Defence Force Recruiting when she was a dental student in Melbourne. “They would

host certain university functions such as quiz nights and sporting fun days, and when I became secretary of the University Dental Students’ Society, I started spending more time with them to organise the events,” she recalls. “I became interested myself and enlisted. “Also, all the males in my family had completed military service (compulsory in Singapore), and so it was something I had always considered.” After graduating from dental school, Amanda joined Officer Training School in New South Wales, and following that, was posted to Sydney, where she lived on base. “My day-to-day duties after officer training, which was purely military, were mostly clinical, with mandatory times for military duties and fitness training,” she recalls. “The Australian Defence Force (ADF) was also very generous with providing adequate mentorship and continuing education, so I was able to assist senior clinicians and specialists with their cases and attend CPD courses, thus beginning my interest in oral medicine.” Amanda says she felt many of the challenges of being a defence dentist were related to personal circumstances, such as being away from loved ones. “But on the flip side, I felt the ADF was supportive of their members, and many of the friends you make in the service are lifelong as you have a unique bond,” she says, adding that there were many memorable moments, especially her first ANZAC parade. “It was very special to march with your division, meet the veterans and have a meal and drinks with everyone after,” she says. “The streets were lined with throngs of people commemorating past and present servicemen, and that was probably the most proud, yet daunted, I ever felt wearing the uniform.” For others considering a defence dentistry role, Amanda cautions that flexibility is very important. “You may not have a say in where you are posted, so it’s something you should consider before joining. I would also recommend speaking to someone in the service with the job you would like. Defence Force Recruiting can help put you in contact. Like any job, there are ups and downs, but a career in the ADF can be very special, fulfilling and rewarding. I am glad to have been part of it,” she says, adding that she doesn’t miss the ironing.

DR GREG GEE

Prosthodontist Dr Greg Gee served as a dental officer in the Royal Australian Navy for a total of 40 years (21 years as a full-time uniformed dentist, and 19 years as a reservist). He is now retained by the Australian Defence Force (ADF) as a consultant in prosthodontics. Greg says he entered Defence dentistry to fund his final two years of undergraduate study. “My wife was pregnant and we were broke, with two years of dentistry to complete. I had a brother-in-law who was in the Navy and he told me the Navy had an undergraduate scheme, so I applied and got in,” he recalls. “My wife was happy, as was my father. He was in the Navy during the war and saw a lot of action in the Pacific. He always wanted one of his four sons to join but we weren’t interested, but as it happened, I ended up joining and he was thrilled about that.” Greg’s return-of-service obligation was three years, which was doubled to six when he was funded to complete a

Masters in Prosthodontics. “I had to stay in the Navy for six years but ended up doing 21 years, which tells you how much I enjoyed it.” When asked what he enjoyed most about Defence dentistry, Greg says that it is a great supportive environment, with good facilities and clinical freedom to practise quality dentistry. “You also get to do many things outside of dentistry, so you never get bored. You get given other duties to perform depending on what your supervisor and the commanding officer want you to do. You may be a divisional officer, who looks after the welfare of your people, or act as a public relations officer or a helicopter control officer. There are many and varied duties that you get the opportunity to do.” The variation in posting locations at sea and ashore was also an attraction. “Navy bases are always in good spots, close to the ocean with excellent facilities. We enjoyed postings to Melbourne, The Naval College in Jervis Bay, Darwin, Sydney, Adelaide and finally Perth. My wife, Anne, and our four children loved the lifestyle and still miss it today.” Greg has fond memories of his time at sea. “Any sea time was good time. As dental officers we don’t get too many opportunities over a career to go to sea, so when you get it you enjoy it.” His sea time highlights include multinational maritime exercises such as RIMPAC, a two-month long exercise held every two years out of Hawaii, which involves numerous countries around the Pacific Rim, aimed at strengthening international maritime operability, capabilities and partnerships. Other service and career highlights include graduating from the Naval Staff College (1989), being the first service dental officer posted on exchange (RAAF Edinburgh, 1990-1), completing a MDS in Prosthodontics (1994) and Fellowship in RACDS (1998) with Navy support. Greg notes that within the limitations of the ADF Health policies, a great advantage of Defence dentistry is that you can do your best for your patient. “The patient doesn’t pay for the treatment, so you are not constrained by what they can afford,” he explains. “You get a lot of clinical satisfaction by doing optimal dentistry and your patients appreciate that. The troops certainly value their entitlement to free dental care.” Greg cites the example of his time at HMAS Stirling, Rockingham WA, when the Commanding Officer of the base brought in customer satisfaction surveys for all departments. The Dental Department consistently came out on top. “How can this be?” the Commanding Officer would say. “No one likes going to the dentist.” Greg says the answer was simple: “We looked after our Navy people very well and we looked after the ADF. We ensure that our sailors and officers personally received the best possible dental care and that the Navy had sailors and officers dentally fit to deploy to sea.” Greg’s advice to dentists is that Defence offers one of the best careers in dentistry, “a supportive environment, varied employment, clinical freedom, job satisfaction, professional development, and the camaraderie that is so unique to the armed forces. As a start to or as complete career it’s hard to beat”.

April 2020 Western Articulator | adawa.com.au

A Periodontist and a Gentleman A member of ADAWA for more than 50 years, Dr Rob Bower has given much to the dental profession. An accomplished periodontist and educator, our members have been fortunate to have had access to Rob’s expertise as a case manager for the Dental Cases Panel since 2013. By Brooke Evans-Butler

quick scan of Dr Rob Bower’s CV reveals something quite striking: this is a man who shuns “routine”. While he could have easily focused his career on his work as a periodontist, he instead chose to see and experience many, many different things. “I resolved that every five years I was going to get away and bring myself up to speed,” Rob says. “Certainly, when I was in London, I found that my MDSc from Perth was well up to speed, so that is what I kept to.” 22 April 2020 Western Articulator | adawa.com.au

His five-yearly getaways also included charitable work – including a number of trips to Cambodia in the 1990s in conjunction with Bob Hotinski, in an effort to rebuild the Dental School and to educate the dental educators after the ravages of Pol Pot and the Khmer Rouge. “I don’t know how many professors were at the Dental School around that time but only two were not murdered and they retreated to France,” he says. “The library had been

burned and all the dental equipment had been thrown out on to the street and was rusted. There was some donated equipment from the UK, but it was terribly ancient. A bucket on a tripod passed as a spittoon. The conditions were just shocking.” The trip saw Rob think on his feet – using MacGyver-like skills to get the equipment working. “To show you just how primitive it was, they would get chest x-ray film and cut it up into little rectangular pieces in the dark room, then repack the pieces to make up their intraoral film,” he recalls. “The x-ray unit (“liberated” from a destitute private clinic) had a pointed cone and was dangerous as it would scatter radiation. So, I took the collimator off and got some plastic water pipe. I asked a ‘dental radiographer’ there named Pok Nun if he could come up with some lead for a diaphragm. I’m pretty sure they pinched a battery overnight and came back next day with this lead sheet, which I used to make the circular diaphragm, using a Swiss Army knife. I took test x-rays to check the beam diameter and scatter and it worked a treat. “The next time we went to Cambodia, we enquired whether there was any fighting going on near Angkor. There was still fighting in the countryside but not close by so Bob and I went up to Angkor Wat and it was beautiful. There was next to no one at the site, and we soon found out why – we could hear machine-gun fire. But we kept on, and it was an absolutely amazing experience.” On top of his stints overseas, Rob’s impact locally was also great, with nearly 40 years spent as a consultant periodontist at Princess Margaret Hospital for Children. “The main work I did there was with the oncology kids and particularly those in the bone marrow transplant program,” he says. “During a bone marrow transplant (stem cell rescue), patients are rendered completely immune incompetent for a while and during that time they are susceptible to oral infections. I was asked if I could look after these kids. In the first 100 transplants we had, no one died of an oral infection.” His achievements are many – although the ones that stand out for him are passing his BDSc with unexpected honours when it was largely unheard of, and being offered a senior full-time and tenured position at the Department of Periodontology at the University of Michigan. He also found teaching very rewarding, with a history lecturing on dental radiography and periodontology at UWA. Retirement will certainly not mean slowing down for Rob, who will be continuing the examination of Abrolhos Island skulls from 1629, along with forensic pathologist, Dr Steve Knott, to get a snapshot of dental health in Dutch seafarers

and travellers in the 17th century. Rob, who has dived on the wreckage of the Batavia site, is keen to see what else they will discover from the story the skulls will tell, which he says is a “glacial” project. “The skulls are kept at Fremantle and the anthropology department at UWA gets out about four or five skulls at a time out of the 22 discovered to date. They have taken CT studies of the skulls and we are taking intra-oral radiographs. There is some interesting information coming up – we can already refute one published study on these skulls.” His research accomplishments also extend beyond dentistry, with one project examining the North African paintings of Australian impressionist, Emanuel Phillips Fox. Creating a virtual map using postcards of Bou Saâda, where the paintings are set, Rob realised that the names of some of the paintings were confused. He suggested title changes for five works of Phillips Fox, and also suggested reattributing one of the paintings to Fox’s wife, Ethel Carrick. Rob presented his study to a capacity audience at Lawrence Wilson Art Gallery a few years ago. Pursuing his love and appreciation of art, Rob is about to become a Gallery Guide at the Art Gallery of Western Australia: “I will be the guy who gives people the background on the artworks,” he says. “I hope to fertilise and nurture an interest in art for others. I was very lucky at the Royal Dental Hospital in London because the school was almost back-toback with the National Gallery, so I used to often not eat lunch and go to the gallery. There were some fantastic gallery guides there. “So, when I heard that there were positions at the local gallery, I made an enquiry and was encouraged to apply. I have to do about 12 months training, but I will be very happy to give something back because art has done a lot for me.” An interest in art, encouraged by his mother and his art teachers at Perth Modern School, continues to be a passion for Rob, who urges new dentists to pursue a hobby outside of work. “When I finished my master’s degree, I did an evening course in fine-art printmaking at Perth Tech,” he recalls. “I was anonymous once I pulled on an old pair of ink-stained jeans and left the surgery. I had a great teacher in the late Judith Chambers, who really inspired me. It was very important to have something else outside of dentistry because you have to have that balance – otherwise you’d go nuts.” For a man with such a varied career in dentistry, it’s interesting to wonder what he’ll miss most as he enters retirement. “Oh,” he says, laughing. “that’s easy. The free toothpaste, but also many of my colleagues.”

April 2020 Western Articulator | adawa.com.au

SOCIAL PAGES DENTAL STUDENTS COMPETE IN THE ROTTNEST CHANNEL SWIM Well done to Tom, Francis, Anthony and Kevin on swimming in the Rottnest Channel Swim. It was touch and go whether the final year dental students would be able to compete, with them finding a boat at the 11th hour – but goodness they did us proud! They completed the swim in 08:34:24, with the help of skipper Ron and the two paddlers – Zoe (a dental student) and Cassie (a physiotherapy student). We are so proud of your efforts and can’t wait to see you do it again next year!

WOMEN IN DENTISTRY EVENT On the cusp of International Women’s Day, Women in Dentistry held a special fundraising event at the Cheeky Sparrow in West Perth, with proceeds donated to the Kangaroo Island Mayoral Relief & Recovery Bushfire Fund. New graduate Dr Zenatella Ibrahim presented ‘Richness in Resilience’ at the event.

NEW PRACTITIONER PROGRAM The New Practitioner Program kicked off in February, for dentists who have graduated within the last five years. Dr Clarence Tam presented at the first event, which was a great success. Look out for regular Zoom catch ups during the COVID-19 isolation.

24 April 2020 Western Articulator | adawa.com.au

DENTAL OUTREACH PROGRAM NEEDS VOLUNTEERS Are you a student who wants to make a difference to the oral health of young people? The Australian Dental Students’ Association (ADSA) has established a structured dental outreach programme to provide oral health education to primary-school-aged children to combat the high prevalence of caries in areas of low socioeconomic advantage. With the guidance of the WA Dental Health Services and UWA Paediatric Dentistry Department, dental student volunteers have been leading interactive and thought-provoking classroom activities in low ICSEA primary schools to communicate the importance of oral health, to reinforce oral hygiene practices and to need to minimise the intake of cariogenic foods. As the programme was churning through consumables, they’re very grateful to The International College of Dentists (WA branch), who recently provided 1,000 plaque-disclosing tablets. Now, the students’ association needs more volunteers. If you are a student or recent grad who would like to be involved (either by helping with the programme or being part of a ‘crafternoon’ to make typodonts) please get in touch with The Australian Dental Students’ Association, by emailing community@adsa.org.au

OTHER VOLUNTEERING OPPORTUNITIES Tzu Chi Foundation, Perth – contact Lydia See at timaperth@gmail.com

Bridge2Aid Australia – contact Jeremy Keating at info@bridge2aid.com.au

Kimberley Dental Team – contact Jan & John Owen AM on 0407 998 215

Australian Dental Health Foundation – contact Andrea Paterson (WA State Co-ordinator) at admin@adhf.org.au

Equal Health Inc – contact Simon Shanahan at info@equalhealth.org.au

April 2020 Western Articulator | adawa.com.au

OPINION PIECE: Dr Josephine Drewett

arly in December I had the privilege of attending the graduation ceremony for the UWA Dental School’s Class of 2019. As I looked down upon the faces of these freshy minted dentists, full of hope and eager anticipation, I thought back to when I was in their position, attending my own graduation in the late 80s. There have been many innovations in our dental world but also much that has not changed. Patient care is at the centre of all that we do, and our raison d’etre. Unlike earlier days when a patient was told what treatment was needed, no questions asked or expected, now a careful informed consent is obtained, with often much lively discussion on both sides. One aspect of practice that is still unfortunately all too prevalent is the propensity for patients (usually the nervous, anxious variety) to walk in and inform the practitioner: “No offence, but I hate the dentist”. It is unnerving as a young dentist to hear that repeated day in and day out but now I joke back to patients that if I had a penny every time that I heard the phrase I would now be retired, wealthy and happy. The prevalence of computer software now dominates every aspect of our practice life. Before the advent of computerised booking systems, we used the quaint system of writing patients’ appointments with pencil in an oversized diary. Now patients can book appointments from the comfort of their own homes. Digitalised radiographs enable us to send information instantly to specialists rather than relying on snail mail and most recently we have seen the rise of digital scanners replacing conventional impressions. Greater knowledge of material science has enabled us to move beyond the staples of amalgam and gold and better bonding systems allow us to bond in places we never thought possible in my student days. All high-speed handpieces now carry fibre-optic lights allowing us to see what we are drilling and many dentists wear loupes and or personal light sources. There are some wonderful ergonomic saddle chairs around (which I personally find very uncomfortable) but looking back to my own childhood dentist, he spent his working life standing up with a hot water steriliser bubbling away in the corner. Progress and changes within professions are normal and necessary. Perhaps the two biggest changes within our 26 April 2020 Western Articulator | adawa.com.au

profession in Australia has been the rise of the corporates and the oversupply of dentists. The surplus of dentists means more of us chasing fewer patients, which reduces profit margins. It could also be argued that the rise of corporate-owned practices has a similar effect, as patients are enticed away by low fees and expensive marketing campaigns. In a conversation with a final year student who had attended a recent job interview, I heard a term I never thought would be associated with dentistry – KPI or Key Performance Indicator. I confess that I had never actually heard this term before. Oh, ignorant bliss. Dentistry is now big business; all about the bottom line and the hallowed dollar. And following hard on the heels of money come the lawyers. Where once a contract was sealed with a handshake rather than a signature, now a prospective associate receives a large, unwieldy document, written in lawyer gibberish and asked to sign in the appropriate place. Despite all the lofty ideals laid out in the contract, there is still a power imbalance between principal and associate. If an associate decides to move on, then a principal, if so inclined, can simply refrain from booking further appointments and the associate has the choice of sitting in an empty surgery twiddling his or her thumbs or simply leave earlier than planned. Thankfully for our profession there is still honour shown on both sides in what can be a tricky situation for all parties. My advice to the latest cohort of dentists, now with their trainer wheels off, ready to hone those hard-won skills on the unsuspecting public is stay in touch with your peers, connect with the wider dental community and don’t be shy in asking for advice. Both the local members of ADAWA and your former tutors, now colleagues, are delighted to share their knowledge. Between us, dare I say, we have amassed hundreds of years of experience; forged in the furnace of coal face dentistry and tempered by age and, hopefully, wisdom.

The author works part time in private practice and part time as a clinical tutor at the UWA Dental School. She has had articles published in the BDJ and other UK publications

The Value Hunter

TWO FAT INDIANS

Dr Amanda Phoon Nguyen reviewed 2 Fat Indians prior to COVID-19 social distancing and dining restrictions. Luckily, 2 Fat Indians is offering a takeaway service, so you can still put your Frequent Values card to good use With a creative name such as “2 Fat Indians”, you know you must be in for a culinary delight when you dine at the restaurant. After all, 2 Fat Indians must know their Indian food, right? Intrigued by the name, it was one of the first things I asked about, as I tucked into some of the fresh, piping hot naan on the table. This caused a little of consternation, as none of the employees were sure who were the original two fat Indians (or if they even existed!). But we were soon distracted by the aromas and sights to behold as the tables around us started to fill with mouthwateringly beautiful dishes. Eager to order, we got to it, perusing the extensive menus placed in front of us. We ordered a good selection: the butter chicken, saag paneer, goat curry, chicken biryani, garlic naan and dahl makhani. The food was plentiful for a table of five, and as you may have guessed from the name, the portion sizes from this restaurant were generous. For the more adventurous amongst us, I recommend trying the goat curry as it was a real hit around the table. The goat was tender with good bite and was one of the first dishes to be heartily devoured. A staple on Aussie tables, the mild butter chicken was rich, sweet and creamy, all good things for this dish. I was told by the service manager that this was the most popular dish at the restaurant. The saag paneer was my favourite dish of the night. Well balanced and refreshing, it paired perfectly with the fragrant biryani. And of course, I have never met a garlic naan that I did not like. The version from here was served piping hot in all its garlicky goodness; we ordered seconds (and maybe thirds… but who’s counting?). “There might be ‘naan’ better,” I sniggered, chuffed with the pun I came up with, as I ate with gusto. My dinner companions were somewhat less impressed, concentrating on mopping the last of the sauces up with their naan bread. In my opinion, one of the best things about 2 Fat Indians is that they do not water down their dishes (unless you request so, of course). Their authentic, spicy dishes are appropriately hot, and as someone who loves a heat punch in their food, I appreciate this. For the non-chilli lovers, 2 Fat Indians have a plethora of dishes which are low on the burn but high in the flavour stakes. While no expert in Indian cuisine, I have it on good authority from friends that 2 Fat Indians is indeed worthy of a visit. And it seems that people agree, with the restaurant busy on a Wednesday night, and several branches open Perth wide. Should you go, please use your ADAWA Frequent Values card at the Mount Lawley branch for 20% off your total bill, up to $25, available at http://adawa.frequentvalues. com.au or via your Frequent Values card.

Address: 524 Beaufort Street, Mount Lawley Phone: (08) +61 8 9228 0720

Till next time!

April 2020 Western Articulator | adawa.com.au

Autism: Discrimination and Inclusivity in Employment On April 2, we celebrated Autism Awareness Day. Not only does this day recognise the uniqueness of those with Autism Spectrum Disorder (ASD), but it also highlights the barriers faced by autistic individuals. ASD is a developmental disability that is characterised by varying difficulties in social interaction and communication, as well as repetitive behaviours and a restricted selection of activities and interests. Some individuals also have sensory sensitivities. These attributes can become barriers to entering the workforce as difficulties with communication or dealing with change prevents these individuals from entering the labour market and remaining employed. One in every 100 Australians has ASD. Unfortunately, the unemployment rate for people with ASD is 31.6%, which is almost six times greater than the rate for individuals without a disability (5.3%). Furthermore, 53.9% of unemployed Australians with autism have never held a paid position despite a desire to join the workforce, and the skills and qualifications to do so. The social and financial benefits to joining the workforce are equally applicable to ASD individuals, and they deserve an opportunity to contribute to the business community. By employers making reasonable adjustments that promote equality and eliminate discrimination, individuals with ASD may be able to obtain employment and be productive employees.

ENTITLEMENT TO REASONABLE ADJUSTMENTS

Employers in Western Australian are covered by both State and Federal discrimination legislation.

State Legislation Currently, the Equal Opportunity Act 1984 (WA) does not contain any express reference to an employer’s obligation to implement reasonable adjustments. However, the existing provisions prevent employers discriminating either directly or indirectly against impaired individuals, and requires them to

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take all reasonable steps to obtain relevant information about an employee’s ability to perform.

Federal Legislation In comparison, the Disability Discrimination Act 1992 (Cth) does contain an express obligation to make reasonable adjustments for those with an impairment. Under section 5, an employer will directly discriminate against another person on the ground of a disability if, by reason of that disability, the employer treats an impaired individual differently to an unimpaired person, in circumstances that are not materially different. This includes an employer failing to make or refusing to make reasonable adjustments for an individual with ASD, which has the effect that the autistic individual is treated less favourably than another employee without the disorder. Additionally, under section 6, an employer will indirectly discriminate against an individual with ASD if they impose a condition, which the individual is unable to comply with unless a reasonable adjustment is made, and that adjustment is not made resulting in a disadvantage. Note, it is not unlawful discriminate against an impaired individual on the basis of their disability if it relates to particular work, that because of their disability, the aggrieved individual would be unable to complete the inherent requirements of, even if reasonable adjustments were made.

What is a reasonable adjustment? An adjustment is ‘a reasonable adjustment unless making the adjustment would impose an unjustifiable hardship on the person’. In determining, whether a particular hardship is unjustifiable, all the relevant circumstances of the case must be taken into account, including: •

The nature of the benefit or detriment likely to accrue to, or be suffered by, any person;

•

The effect of the disability of any person concerned;

•

The financial circumstances, and the estimated cost required to be made, by the employer; or

•

The availability of financial and other assistance to the employer.

If measures are too expensive or difficult, then reasonable adjustments need not be made.

Examples of a reasonable adjustments The bar for unjustifiable hardship is high, with most common adjustments unlikely to reach that standard. Reasonable adjustments may include: •

Providing clear instructions on roles and expectations, with direct but sensitive feedback.

•

Providing routines for an employee who has repetitive tendencies will allow for more efficient time management.

•

For an individual who has a sound sensitivity, placing them in a quiet room may ease their discomfort.

•

Flexibility in working hours may relieve stress for someone with ASD who has restrictions in their daily activities.

SELLING or BUYING

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Many of the above suggestions are of no cost to the employer and would be expected to be provided to those without an impairment. As such, the Australian business community can make a conscious effort to provide reasonable adjustments and prevent barriers arising between autistic individuals and the workforce. This will close the gap between ASD individuals and the rest of the population, promoting employment equality.

Please email ADAWA for references. Contact Panetta McGrath Lawyers if you wish to know more about privacy obligations, or any consumer protection issues, affecting you or your patients.

April 2020 Western Articulator | adawa.com.au

WADA GOLF 2020 ROYAL PERTH GOLF CLUB We welcome our sponsors for 2020 Dentsply-Sirona: Vic Baronas and Russell Redpath Health Linc: Brad Potter Swan Valley Dental Laboratory: David Owen Maven Dental: Chris Williams Empire Dental Devices: Jeff Clohessy Truefit Golf: Adriaan Dorhorst AMA Insurances (Danby Sequeira) have kindly donated vouchers The first WADA golf fixture of the year was again played at one of WADA Golf’s favourite clubs, Royal Fremantle, on Friday, February 28. The wet and windy morning conditions cleared and the afternoon became hot and windy. The winner on the day was Kris Thyer, who scored a fantastic 43 points, followed by John Scully on 40 points and Rohan Jagota on 39 points. Great round, Kris.

WADA GOLF GOSNELLS 2020 Gosnells Golf Club hosted the March WADA Golf event sponsored by Truefit Golf and represented on the day by Adriaan Dorhorst. Thank you for your support Adriaan. Some interesting swing speeds were recorded by the launch monitor set up by Adriaan on the first tee! The weather was ideal for golf and the course was in great shape on the day. John Ntoumenopoulos (playing off a handicap of three) was in great form and put us all to shame, winning with a score of 38 points, followed by Kris Thyer on 33 points and John Scully on 32 points. Well played John, fantastic round.

FEBRUARY NOVELTIES

MARCH NOVELTIES

NEAREST THE PINS: 3rd Hole 3M - Wendy Walker Paul Tan

NEAREST THE PINS:

8th Hole WADA Golf John Scully

7th Hole WADA Golf C Lewis

12th Hole D entsply/Sirona - Vic Baronas & Russell Redpath John Moran 17th Hole HoleHealth Linc - Brad Potter Rohan Jagota LONGEST DRIVE: 11th Hole Swan Valley Dental Laboratory - David Owen Michael Welten Lucky Draw AMA Insurances - Danby Sequeira Terry Fenn

30 April 2020 Western Articulator | adawa.com.au

John Scully WADA Golf Captain 2020 dentistgolf@gmail.com

8th Hole WADA Golf M Welten

9th Hole AMA Insurance – Danby Sequeira J Ntoumenopoulos 11th Hole Dentsply/Sirona – Vic Baronas R Gordon 14th Hole Swan Valley Dental Laboratory – David Owen J Ntoumenopoulos LONGEST DRIVE: 18th Hole Health Linc – Brad Potter A Dorhorst

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April 2020 Western Articulator | adawa.com.au

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32 April 2020 Western Articulator | adawa.com.au