Western Articulator - Edition 2 2023

Rewards and challenges

Practice owners share their experiences of practice ownership

Dental rescue day

The generosity of many

Meet Dr Vanessa William

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President’s Report The

Dear members,

It was brought up, just the other day by a member at the 8th March ADAWA General meeting, that it has been almost one and half years into my presidency. Whilst reflecting on our many achievements over this period, it also drew into focus the next six months and the exciting work that we’ll be undertaking during this time including the launch of the ADAWA Strategic Plan 2023 - 2028.

But the truth is it’s not about the next six months, progress is an ongoing process. Supporting our members at all levels, having the resources to do it, doing it with proper governance in place, and preparing our next generation as part of succession planning is a progressive process. Our association is going to outlast us all and our job is to help build it one stone; or in my place one ‘presidency’ at a time.

We have hit the ground running this year. Under the leadership of our CEO, Trevor Lovelle, we engaged Andrew Hollow from Work Well Australia, who facilitated the ADAWA strategic workshop with our Councillors in February. The workshop started with consideration by Council of what we thought was important for our members. Council then identified the three planning phases on which we should be focusing, commencing with change readiness as the initial phase of a change management process, which the CEO describes in his update column.

At the committee level, the indemnity committee has been in discussion with our

indemnity insurance underwriters to ensure our premiums remain competitive. During these discussions it has come to light that there has been an increase in the insurance claims experience for wisdom teeth removal. The underwriters consequently have advised that a new category would be introduced regarding impacted wisdom teeth. We shall continue to keep you updated on this front. Our Recent Graduate and Student Liaison committee has started the year on a roll under Dr Gwen Chin, ADAWA VicePresident and Committee Chair. Along with the planned committee programmes, we have an upcoming joint venture with the UWA School of Pharmacy and the UWA Dental School to improve engagement between future professionals. All the other committees are getting their budgets ready for an exciting 2023 and we have a lot to look forward to.

I would like to sign off this report by saying that none of this ongoing work would be possible without the dedication and support from our ADAWA Councillors and ADAWA Committee Volunteers.

On behalf of the ADAWA membership, I would like to thank you all, for the time, dedication, and effort that you put into your association.

CEO Trevor Lovelle

President Dr Amit Gurbuxani

Editorial Brooke Evans-Butler

Designer Michelle Walker

mouths of members From the

I don’t think there are two ways about it; the ADA is where you get to meet colleagues and make friends, where you get to meet potential employers, where you get to continue your education and learn more. It is there you have support if you have any problems with patients or if you need any support or advice, so without the ADAWA you are really doing it by yourself.

Dr Ahmed Saleh membership

THE VALUE OF

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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.

All correspondence to E media@adawa.com.au A PO Box 34 West Perth WA 6872

CEO update

March 2023

In my introductory piece for the Western Articulator last year, I talked about the need for an efficient and sound governance framework for the organisation, which would oversight a strategic plan that is based on what members told us they want from, and of, their association. I further talked about the need to embrace organisational change, especially for a member-based association that seeks to remain relevant to its members.

Trevor Lovelle ADAWA CEO

from current state through a transformation phase to the desired state, and

• the continuum is balanced to ensure processes comply with the strategic direction of the organisation.

Preparation (or ‘readiness’) can include evaluating the existing culture of the organisation, understanding the organisation current vision and identity, auditing the current businesses processes, and communicating the objectives of the planned change to internal and external stakeholders.

In the context of increasing the functionality of the organisation, it is logical that the vision and identity (purpose) should be assessed, so too the business processes and the prevailing culture since these are the foundation attributes of the organisation on which the new business model will be developed.

Whilst it is generally accepted that there isn’t a ‘one-size-fits-all’ model for organisational change, there are nevertheless some principles that should be applied to achieve the desired outcomes:

• change actions are undertaken on a continuous basis;

• the process moves along a continuum

Over the last few months, we have undertaken three key planned change actions including a governance assessment process, a survey of members, and commenced a strategic planning process. These actions collectively underpin a process of continuous improvement, which is aimed at enhancing the business’s operations to meet our key strategic imperatives, that:

• our members highly value what we offer and promote the interests of ADAWA.

• ADAWA is a high profile ‘go to’ organisation that engages with and collaborates with all stakeholders.

• ADAWA is a high performing, sustainable and well-governed organisation.

As illustrated below, our approach to organisational change follows the principles mentioned above i.e. these actions are continuous and iterative, the organisation moves from its current state, and the interventions are informed by a robust strategic plan.

Recognising that organisational change is a process and not an event, the starting point is to prepare the organisation for change.

Continuous improvement requires courage from those charged with management and governance responsibilities. Courage to critically analyse processes, systems and performance, and courage to effect the required change that results in the desired outcome. As mentioned above, ADAWA’s change actions include governance assessment, member survey, and strategic planning. Importantly, these are not ‘one off’ events but will be undertaken on a continuous basis, however it is pertinent to review each action and ‘sense check’ the work undertaken to date to ensure alignment with key objectives.

Governance Assessment

ADAWA Council utilised the Australian Institute of Company Directors ‘Governance Analysis Tool™’ (the Tool) to assess current governance arrangements of the Association. The Tool focuses on specific quadrants including:

1. Individual directors – to understand Councillors’ role and duties, competence, leadership, behaviours, and the responsibilities and style of the chair.

2. Board – qualities and operation of the Council as a combined team of directors including use of committees, the effectiveness of meetings, group competencies, Council dynamics and the extent to which legal standards are understood and complied.

3. Organisational – how the Council’s governance practices permeate the organisation including systems and policies related to the organisation’s operating environment, reporting environment, the nature and role of the CEO and management, information flows, sufficiency of resources, strategy, risk management and performance outcomes.

4. Stakeholders – the approach taken by the Council concerning accountability to, and communication and engagement with, key stakeholders.

Councillors completed a survey of over 150 ‘good governance’ statements, related to the quadrants listed above, and assessed against ADAWA’s conditions. The responses were then benchmarked against leading practice in the not-for-profit sector.

Across all quadrants, the ADAWA average score indicated that Councillors considered there is scope for improvement and indeed key findings from the survey provide positive directions that Council should take to improve the governance arrangements of the Association. These findings include:

• Clear delineation of roles and responsibilities for Council and management.

• Defining strategic objectives for the organisation.

• Developing a risk assessment and risk register.

• Aligning Committees with compliance and reporting requirements.

• Developing an induction package for onboarding of Councillors.

Council is currently working through these findings and developing appropriate responses to address the required improvements. It is envisaged that Council will undertake similar assessments annually.

Member Survey

ADAWA undertook a member survey to understand the needs and expectations of members, which would then inform ADAWA strategic planning. In total 308 surveys were completed, representing a 12% response rate, which enabled statistical significance testing at 95% confidence level. Overall, 81% of respondents indicated they were satisfied with ADAWA (very satisfied + satisfied) with a third of all respondents being very satisfied, which compared to 75% satisfied nationally and 74% for WA in the 2016 survey.

The key ADAWA services that encourage people to join and demonstrate value to members are support and advice, CPD, insurance, and news and updates; therefore it is critical to maintain these services at a high quality.

Strategic Planning

The third of our planned change actions is strategic planning, which underpins the organisational change principles mentioned previously, is informed by both the governance assessment, and the member survey.

Council has undertaken the first steps in the strategic planning process with a facilitated workshop that identified our key strategic factors, our vision, and our identity (purpose and role). Importantly, and reflecting findings of the member survey, Council has identified that ADAWA’s support for oral health practitioners is underpinned by six key offerings:

• Education: to enhance quality and consistency of care

• Advocacy: to seek to influence

• Connecting: for professional collegiality

• Services: for prosperity and business risk mitigation

• Public awareness: for appropriate and timely access

• Volunteer efforts: for public value benefitting those disadvantaged and vulnerable.

The next steps in the strategic planning process include refinement of the draft Plan by the Executive Committee, sense checking of the draft plan by Council, socialising the plan with key internal stakeholder groups, ahead of launching the final ADAWA Strategic Plan by midyear.

Strategic responses to the members survey, and specifically those that are shown as ‘Industry Challenges’, will be addressed during the strategic planning phase.

I look forward to providing regular updates on this important and on-going work for the Association, and to hearing from members about how they perceive the work we are undertaking on their behalf.

Trevor Lovelle ADAWA CEO

WADA Golf

Royal Fremantle Golf Club

Opening Fixture 3 February

The first fixture of the year was held at Royal Fremantle Golf Club with Maven Dental being our Major Sponsor for the Day. Twenty-eight dedicated (but fun loving) golfers took to the course for our traditional opening game at the superb Royal Fremantle course – this year under very hot conditions (36 degrees) as the group teed off.

Stu Phillips managed the conditions well, finishing first with a terrific score of 38 stableford points. Rod White came in second on 36 points holding off Russel Gordon (36 points) in third place on a countback. Congratulations to those players.

WADA Golf acknowledges our corporate sponsors who have joined us again

Summary of results

for the new year: Maven Dental, Dentsply Sirona; Dentaurum Australia, Health Practice Brokers, Insight Dental Ceramics, Swan Valley Dental Laboratory and Healthlinc. The ongoing support of these corporate partners is greatly appreciated and the opportunity for both camaraderie and networking is welcomed by all. Our sponsored novelty events were equally shared amongst the group. Our next game is at Gosnells Golf Club on Friday, 24 March. All interested golfers are welcome to play. Please direct your interest to the email address below for a copy of our fixtures, or for any other information relating to a game with the WADA Golf group. Good golfing, Frank Welten WADA Golf Captain Dentistgolf@gmail.com

1st Stu Phillips 38 stableford points

2nd Rod White 36 stableford points

3rd Russel Gordon 36 stableford points

Nearest the pin Health Practice Brokers 3rd hole

Swan Valley Dental Laboratory

8th hole

Dentsply Sirona 12th hole

The Healthlinc

17th hole

Longest Drive

Insight Dental Ceramics 11th Hole

Alex Leggat

Craig Lewis

Alex Devellerez

Hugh Gillespie

Simon Tee

The generosity of many making Dental Rescue Days a success

2023 kicked off to a great start, with more than 40 patients helped at an ADHF Dental Rescue Day in January, with volunteers providing $19,285 of dental treatment.

Hosted by UWA Dental School and OHCWA, 15 volunteer dentists (including 8 new graduates) and 12 volunteer assistants gave up their time to provide pro bono care to clients referred to the Australian Dental Health Foundation from Salvation Army, St Bart’s, Foundation Housing, Headspace, Centrecare, Women’s Health and Family Services, Uniting WA, Ruah, 360 Health + Community (Street Doctor), and Crossways.

Co-organiser Dr Tracey Gold was thrilled a Dental Rescue Day was able to be held after a Dental Rescue Day had been on-hold for some time

due to COVID-19 restrictions and scheduling conflicts.

“There have been a lot of clients that have been desperate for dental treatment,” Tracey says. “People have been so busy in their practices and it was difficult to find the right time and venue to hold a Dental Rescue Day. Luckily, OHCWA was kind enough to donate the use of their Dental Student Clinic between student times, so we were finally able to find a window of time that meant we could hold the Rescue Day.

“It was the first time a Dental Rescue Day had been held in the Dental Student Clinic with UWA, with the

approval of clinical operations manager, Michelle Huang,” Tracey adds. “The clinic is massive, with about 50 chairs, so we could go larger scale next time but we wanted to ensure that this Rescue Day ran smoothly.”

As well as a number of experienced dentists who regularly volunteer, Tracey was thrilled that a number of new grads put up their hands to help on the day. “I thought it was incredible that a number of new grads volunteered,” Tracey says. “It was very brave of them, because a lot of them had not even started working yet after graduating and they were working alongside some volunteer dentists who had been their tutors.”

For Tracey, this enthusiasm from new grads was a highlight of the Rescue Day. “I think it is encouraging for the profession that there is so much enthusiasm amongst the new people coming through for volunteering,” she explains. “In the past we have always had the more experienced practitioners giving back. How good is it going forward that we have these new dentists that haven’t even started working yet and they are already volunteering?

“There seems to be a culture in this group coming through that they are so interested in volunteering and helping out where they can,” Tracey adds. “We had a great turn out of new grads, and there was a number

of others that were very interested as well but they were in their first week of work and couldn’t take a day off that soon.

these new dentists were and that they realised how important it was and what difference they could make. I think this is very positive for our profession.”

As always, it was a rewarding experience for all the volunteers involved. “The volunteers feel like they are part of something, and the patients are so thankful,” Tracey says. “I had feedback from new grads saying, ‘keep my name on file and let me know when it is happening again’, which is wonderful. We also had a number of current dental students who volunteered as assistants, and they also said they learned so much just by watching things they would not normally see.

”Tracey says the Dental Rescue Day could not have gone ahead without the generosity of OHCWA donating the use of their clinic,

“Often new grads think they need to get more experience first before volunteering, so it was great to see how comfortable

materials and equipment, the support of Daniel Hopkins and OHCWA staff and ADHF’s Andrea Paterson. She hopes the Dental Rescue Days can be held twice a year, fitting in with student breaks at UWA.

If you are interested in voluneeting for the next Dental Rescue Day on August 18, email adminwa@adhf.org.au

Thank you

Dentists

Lida Sayadelmi

to all the hardworking volunteers

Seerat Aneja

Ethan Lloyd

Le Xuan Chan

Deb Liddelow

Shanash Bishnulall

Ashlee Bence

Andrew Heap

Karen Hughes

Chandrama Banerjee

Manorika Ratnaweera

Rebecca Vo

Zeidri Rasmussen

Rachel Wu

Selina Kwok

Zara Torre Assistants

Alena Varonets

Ben Lundberg

Chris Marfici

Lisa Searle

Kanako Bird

Amy Chandler

Kristi Viitkar

Sandy O’Brien

Ella Chen

Monisha Morshed

Rewards and challenges

We speak to ADAWA members about the rewards and challenges of practice ownership.

Dr Louise Winters

Dr Louise Winters is relatively new to practice ownership – purchasing Southbridge Dental in April 2022. “I was approached by the previous owners Dr Simon Shanahan and Dr Millicent Woon around July 2020 right in the middle of the pandemic with the offer of a job as an associate and if things went well the option to purchase the practice,” she recalls. “I had known Simon and MIlly for quite some time as we had met through the Dental Study Group of WA and our ITI study group. We always got on really well and continue to do so! I think the pandemic caused us all to reflect on our careers and where our lives were heading. Luckily Simon and Milly's vision coincided with mine and I began working with them in early 2021 and then made the leap to purchase the practice in April 2022.

The South Perth practice with three chairs employs four dentists (including Louise), who practice all aspects of General Dentistry.

“COVID-19 has also thrown a few spanners in the works, and juggling staff illnesses and patient cancellations has been interesting,” she adds. “I took over just as WA's borders opened, which in a way was a baptism of fire".

The challenges

When asked about the biggest challenges of practice ownership, Louise says it is time management. “I have to keep reminding myself Rome was not built in a day,” she says. “There is always a lot to do, and I am slowly starting to get through everything, finding systems and processes that work for me. I have become much more comfortable with the knowledge that I still have a lot to do the next day, but that it's ok to stop and switch off. I could live at the practice if I wanted to!"

The rewards

Louise says having a wonderful team that works hard to provide a great quality service has been very rewarding. “It is truly a great joy to work with people who are talented and motivated, and to be able to provide them with a happy, supportive and flexible work environment,” she says.

Advice to others

To other dentists considering practice ownership, Louise suggests they reflect as to whether practice ownership is for them.

“If you want to be in control of everything and micromanage, then it is likely it is not for you,” she advises. “You can make a good living in dentistry without owning a practice. Once you are an owner, teamwork is everything. It is essential to be able to delegate and to empower your staff to take on responsibilities and to work with initiative. It's important to understand and learn the business (I am still learning and will be for a long time) but if you try to control every single aspect you will likely fall in a heap. Once the figures are out of the way, look for a practice with a good culture and ultimately, it's also important to go with your gut. If it feels right to pursue, then go for it.”

Future plans

Louise’s practice is currently updating their software and computer network, installing an OPG machine, and upgrading equipment. “My hope is that we continue to be a busy three chair clinic and potentially grow to a four chair practice with the aim of providing friendly and quality general family dental care to the South Perth community,” she says. “When feasible, the next transition will be to digital impressions/ workflow and continue to update processes to make our work more efficient. More importantly, I want to continue to foster a great work environment for myself and my staff.

“In April I will be taking three months of maternity leave to have my first child,” she adds. “It was not in my plans to have my first business and first child within 12 months, but life has its own plans for us sometimes! And it's a wonderful as well as busy time. They say that teamwork makes the dreamwork, and it is true for us. I am sure Southbridge Dental will continue running like a well-oiled machine in my absence. It helps that I also live five minutes up the road, so if there is a crisis, I am only a phone call away.”

Dr Zahida Oakley

Dr Zahida Oakley is a co-owner with friend and business partner Dr Amy Hope of Central Periodontics and Implants in Mount Lawley.

“Our practice is a specialist periodontal practice,” she explains.

“We specialise in all aspects of periodontics and implant surgery. We are in our newly fitted out premises with three surgeries since December 2022 and are loving our new place."

Amy and I each have clinics on three days per week and we also have a hygienist supporting us on four days per week. We have an all-female team of five staff who all work part-time to support us with dental assisting and reception tasks.”

The challenges

Zahida says she finds the biggest challenge of practice ownership is the difficulty in having a complete mental break or ‘time off’ from the business. “As opposed to clinical duties, business management tasks seem to continue after hours and on weekends,” she explains. “I am lucky to be able to share the load with Amy and my husband Paul. More recently, there have also been challenges in hiring a new staff member as there has been a real shortage of dental assistants.”

The rewards

When asked about the most rewarding part of practice ownership, Zahida says it is having the flexibility of choosing her working hours to fit the lifestyle of her family.

“We have a very hard-working and loyal team who also appreciate the flexibility of working part-time and prioritising work-life balance,” she adds. “I get a real sense of

achievement when the whole team gets together, and they genuinely enjoy each other’s company. We are lucky to have a great work culture and I take some credit for hiring the right staff who enjoy coming to work.”

Advice to others

“I have said it many times, I probably would not have entered practice ownership as a solo owner and a mum-of-two,” she says. “If you can choose to have a partner to share the load with, a colleague that you work well with, it gives you much more flexibility over your hours and taking leave. From a financial perspective, the costs of setting up a dental business are high and having a partner reduces the capital exposure. In addition, I would stress the need for getting appropriate financial and legal advice so the best decision can be made on the ownership structure, particularly when multiple parties are involved. "I recommend having the difficult discussions upfront with a business partner to align on how the workload of running a business and seeing patients will be shared and how each partner will be compensated if the workload and patient sessions are not always a 50/50 split.”

Future plans

In the near future, Zahida says they are hoping to attract another periodontist and a hygienist to the team. “Also, we would be looking for a practice manager to take the load off with business/administrative tasks so that we can focus on our clinical work more,” she adds. “We hope to have more social gatherings for our team this year to build on our great team culture.”

The challenges

Santo says the biggest challenges in a specialist practice are the same as those faced in general practice. “Namely staff shortages, increasing practice costs, government intrusions and compliance, corporate dentistry, search engine theft of your identity and ever diminishing private health fund benefits for their customers,” he says.

The rewards

Dr Santo Cardaci

Dr Santo Cardaci will be celebrating 40 years of graduation at the end of 2023, and has owned his own practice for 30 years.

He runs Churchill Endodontics on Churchill Avenue in Subiaco, where he is the sole practitioner.

When asked about the aspects of practice ownership that are most rewarding, Santo says he had never seen himself being a practice principal, and so just running the practice successfully all these years is rewarding in itself. “I see myself as a trouble shooter for the profession, trying to help dentists and their patients with difficult situations – and to this day there are daily small victories and cases that you cannot resurrect,” he says. “You can only do your best.

“I am most proud of the staff that have helped me over the years,” he adds. “Many have been with me for over twenty years and I have been blessed to see them progress with their lives, seeing many of them getting married, having children and even grandchildren. Many are still in contact with me and drop in from time to time to fill me in on their progress.”

DR SHAHRZAD NAZARI

“I started searching for a good opportunity to own a practice soon after I began working in Perth in March 2022,” she says. “However, I was not sure which area in Perth might be the best for me as an endodontist, whether it would be better to buy a practice or rent one, better to buy a practice from another dentist or start from scratch and whether I wanted to be in a suburb or in a central location. Thus, I took my time to think thoroughly, consult with some experts and consider many opportunities arising along the way.” Her practice, TEETHBYTWO-Endodontist Perth is a brand-new practice located at Adelaide Terrace in Perth.

“There are three surgery rooms, one sterilisation room, a small radiology unit with an onsite CBCT machine, a private consultation room, and a reception area.”

She adds the length of building the practice from buying, council approval and changing the use of the premises and choosing and receiving the dental equipment to seeing the first patient took less than four months.

The challenges

Shahrzad says many years ago, she would have said the biggest issue with owning a practice was branding and getting that brand recognised. “These days, the most challenging part of a practice ownership is employing staff, who can help the dentists running the practice efficiently and with limited amount of stress,” she says.

The rewards

In Shahrzad’s opinion, the most rewarding part of being an owner of a practice is being able to provide patients the best care possible.

“Sometimes, this care involves having freedom to reduce the cost of a treatment for a patient in need, or freely ordering a specific material for a case to improve the outcome of the treatment,” she says. She adds she believes being a practice owner can help dentists to grow freely in their lives and careers in many aspects including financially, legally and professionally.

Endodontist Dr Shahrzad Nazari’s experience as a practice owner spans two periods (and two continents), as a practice owner for 11 years in Iran, and her most recent venture as a new practice owner in Australia.

Top 5 Reasons

Physical practice of yoga or Asana

A regular physical practice of yoga can release mental and physical tension. It can help promote balance, strength and flexibility.

Mind

Many yoga practices counter the fight or flight response and invite the body to move in the opposite direction towards peace and calm. ‘Meditation is not a way of making your mind quiet. It is a way of entering into the quiet that is already there - buried under the 50,000 thoughts the average person thinks every day’Deepak Chopra

Breath

Yoga breathing slows your respiratory rate. Taking this practice off the mat can relieve stress.

Mindfulness

Yoga can help you unplug and focus on what’s going on in your body and mind in the present moment. Through a

consistent practice, you’ll learn to live in the present off the mat too.

Body awareness

Where you are today will be different to where you were yesterday and where you will be tomorrow. Yoga is accommodating; you can use it to benefit you for what you need in the moment. That could mean a strong fiery practice, it could mean a slower more passive practice.

Yoga in the House with Dr Unna Chidambaram is back!

Stretch away the stresses of the day at ADA House (54-58 Havelock St West Perth) at 7pm on:

Tuesday 4 April

Tuesday 23 May

Cost: $10 a session

BYO: Yoga Mat

No RSVP necessary

dentists should make yoga part of their day

Dr Unna Chidambaram shares why you should try out yoga.

Children’s Health Aid Team

The not-for-profit organisation running dental aid volunteering trips in the rural areas of southern Vietnam.

Children’s Health Aid Team (CHAT) is a not-for-profit organisation who run dental aid volunteering trips in the rural areas of southern Vietnam. The charity commenced operations in 2005 through the efforts of Dr David Booth (Oral and Maxillofacial Surgeon operating out of Perth). He found basic dental and medical needs were unavailable to many, as well as the presence of a large number of orphanages and underprivileged children.

Dr Booth arranged for a team of self funded voluntary dentists, medical doctors, oral health therapists and support staff to travel into the provinces of southern and central Vietnam for one week at a time. On the ground, alongside local interpreters, they treat orphans, children with special needs and their carers. By 2008, the charity was sending teams from Australia 4 times a year. More recently, the team was also supported by dental students from the University of Western Australia and La Trobe University.

In preparation for the week-long trip, teams convene at the charity headquarters in Ho Chi Minh City. Here portable dental treatment units, sterilisation equipment, consumables, oral hygiene kits and teddy bears are prepared and packed. All equipment, consumables and teddies are lovingly donated from organisations all over Australia and loaded into buses for the team to travel deep into the rural regions of Vietnam, often several hours outside the capital.

Mobile treatment centres are set up in different locations every day where up to 200 children attend for dental health education, dental checkups and treatment. Venues can range from local government halls, general

medical outposts, primary schools and orphanages. Tables and chairs are turned into makeshift treatment centres, while the waiting children are triaged and their general health screened by medical volunteers.

As a developing lower-middle income economy, the children in the regional areas of Vietnam have ready access to a sugar laden, highly cariogenic diet. Unfortunately, education regarding dental health and access to preventative dental care is limited leading to a high proportion of the children seen requiring extensive dental treatment. CHAT places great emphasis on dental health education, with all the children receiving tooth brushing demonstrations, interactive group dietary counselling and bags containing toothbrushes and fluoridated toothpaste.

It is not uncommon to see children requiring exodontia for some or all of their deciduous teeth. Many of the children also have been suffering from pain caused by long standing dental infections, but are often extremely brave and cooperative. Following some local anaesthetic, caring words from the local interpreters and gentle coercion from some forceps, they are usually happily running off with friends,

gauze in mouth and teddy in tow. At the end of a long, physically exhausting day, the mobile units are cleaned and packed into the bus, before travelling onwards to the next destination. Volunteers often comment at the end of the week that despite the gruelling conditions, they find great satisfaction in the impact made on the children’s lives. CHAT has been unable to send volunteers to Vietnam throughout the pandemic, with the majority of consumables having expired and dental equipment requiring repair and refurbishment. As the country continues to reopen, CHAT is hoping to run one to two trips in 2023 pending government approval. Acquiring such approval is an arduous process and updates on upcoming trip dates are posted on the CHAT website and social media accounts.

CHAT runs exclusively on the generosity of the Australian dental community, with donations of materials, equipment and tax-deductible gifts being used solely to ensure the underprivileged children in Vietnam are given as much care as possible. If you would like to offer to donate materials, equipment, funds or volunteer for an upcoming trip, please visit CHAT’s website (www.chatinc.org.au).

Dr Black Belt

Colm first got to Aikijujutsu (a traditional Japanese martial art that uses grips, throws, strangleholds, jointlocks and strikes) when he moved to Perth 15 years ago. “I had done karate for five years at university and still was interested in doing further martial arts training before I got too old,” he recalls. “I wanted to get out of the house, do something physically active and train in a club environment to meet new people.”

Colm received his third dan black belt two years ago, after 13 years of continuous training.

“It took eight years to achieve black belt, then once I was up and running two more for second dan and three more for third,” he explains. “In the old days, it was said black belt was attained by training long enough whereby the beginner’s white belt became more worn and battered to eventually

turn black. Nowadays, there is a specific syllabus for each level and a test of that knowledge and competency in a pressured environment called a grading.

“There is a very close analogy to Dentistry, where first black belt is like getting the dental degree – a broad understanding of the fundamentals – but it soon dawns there is still a lot to learn and put into practice,” he says. “From there, the other levels are equivalent to doing post-grad studies with fourth dan (which I am just starting to formally study for now, for the next two years) indicating a high level of proficiency, similar to completing a specialisation.” Colm currently trains three times per week and has the occasional seminar or get together of multiple cubs in Perth or overseas, and says training is a circuit breaker to all of life’s slings and arrows.

“Martial art clubs, despite how they may seem from the outside, are generally very friendly places so it is a good way to socialise with people outside of work/family circles and talk about things other than Dentistry,” he says.

Did you know there are similarities between martial arts and dentistry? We spoke to Dr Colm Harney about his passion for Aikijujutsu.

“I could have a horror day in practice or dealing with the witching hour of putting kids to bed but once I step on the mats, someone attacks and that all disappears.”

When asked what he enjoys most about this martial art, he says it is a very exciting and technical martial art. “It is based on having excellent posture, technique and timing –there are no short cuts which can be frustrating but is ultimately the challenge that keeps me going back for more,” he says.

“It is fascinating to have anatomical understanding, which gives a real appreciation on how clever the original exponents were to have worked out weak points of the body, such as how to manipulate joints the

‘wrong way’ or where various nerves run superficially to apply pressure to them.”

He would recommend other dentists and busy professionals to try it out. “Not for the obvious reason of ‘selfdefence’ – that is incidental really,” he says. “We sit most of the day, often in compromised postures so it is a good way to get moving, develop coordination, exercise mind and body and meet people. The grappling aspects involves lots of physical contact, which is challenging and fun in equal measures.”

Do you take part in a martial art or another sport? We would love to feature the passions and hobbies of more of our members. Email Brooke from the ADAWA Media Team, brooke@adawa.com.au

HIF Corporate Program

ADAWA members are entitled to a 12% discount on health cover each year when premiums are paid by direct debit. Existing HIF members need only call or email to have the discount applied to their membership.

Visit hif.com.au/adawa and use the access code ADAWA Alternatively call HIF on 1300 13 40 60 or email sales@hif.com.au

Dr Emma Perry

Dr Emma Perry has trained in Brazilian Jiu Jitsu for nine years.

“Brazilian Jiu Jitsu is a grappling martial art,” Emma explains. “That means it’s a little like wrestling, where no striking is allowed, (no punching, kicking, elbow or knee strikes). It involves lots of rolling around on the ground, with the aim of applying either a joint lock or a choke until your opponent ‘submits’ via a tapping motion or a verbal shout. (Or if you break/ dislocate their joint or they lose consciousness from a choke!). There is a saying in BJJ ‘tap early, tap often’. It’s expected that during training and competition that an opponent will choose to tap rather than experience the full consequences of the submission being applied.”

Emma was encouraged to first try out Brazilian Jiu Jitsu by her now husband. “He spent 10 years trying to convince me that I’d enjoy and appreciate the art, but I had misconceptions about the brutality and attitude associated with combat sports,” she recalls. “I thought it was for meatheads who like to fight and want to hurt people. I finally gave in and said I’d attend an introductory class, mostly to stop him nagging me. That experience showed me BJJ is not about hurting people, and has legitimately earned its moniker of ‘the gentle art’.

“The emphasis is on using leverage and body mechanics intelligently to submit an opponent, and it’s possible to subdue someone in a self-defence situation without causing any permanent harm.

This means it’s also possible to train ‘full tilt’ safely, unlike the striking martial arts where there’s a risk of CTE if the head is repeatedly struck. After that first class I was bitten with the BJJ bug and just had to learn more. To an inexperienced person, rolling with even a blue belt seems like they know some kind of magic.”

Emma is currently a 4-stripe blue belt, which means she is working towards her purple belt this year.

Emma says BJJ it is inherently difficult and complex, and surprisingly cerebral, sometimes referred to as ‘human chess’.

“Almost nobody is good at it right away, which means anyone who sticks with is has been forced to experience humility and check their ego at the door,” she says. “The origins of BJJ are in empowering a smaller person to overcome a larger opponent using leverage, balance, and timing. I was hooked when I was able to ‘sweep’ a 90kg person on top of me (60kg), using leverage for me to end up on top of them. I love the camaraderie and trust amongst teammates, who’ve all worked through the same challenges and are trusting each other to follow the rules and not hurt each other.”

Emma says she usually trains two to three days per week (her entire household trains, so since COVID they have set up mats for a training area at home), and her husband (who has his black belt) has become Emma’s main coach and training partner.

When asked about the benefit of BJJ in helping to achieve a worklife balance, she says there is a lot of talk about the importance of mindfulness in promoting mental health and she finds BJJ to be the ultimate in mindfulness.

“I also have a personal theory about the close personal contact of the sport, which explains why some people become essentially addicted. Particularly after COVID, physical contact with other people is limited in our modern lives. BJJ puts two people in intimate contact, which can be confronting at first, but once that hurdle is overcome there’s the potential for oxytocin release which is a fantastic mood booster and relationship enhancer.

My BJJ friendships are different. Enduring, non-judgemental, and with the shared experience of overcoming hardship. “As health professionals we are trained to appreciate and demand evidence for our practice,” she adds. “When the UFC was first conceived, it was intended as a way to determine which of the martial arts were most effective, and as such pitted boxers against wrestlers, BJJ practitioners against those who train in karate, and so on. It was quickly evident that BJJ was by far the most effective art, and now after 30 years of the UFC a competitor cannot get away without having significant BJJ skills in the context of Mixed Martial Arts. “I believe BJJ training serves as an excellent way to gain confidence, because it will actually work in close quarters, perhaps like in a dental clinic if the need arose to subdue an aggressive person without committing an assault."

Aside from the self-defence aspect, the fast-paced problem solving is well suited to a diagnostician’s brain, and the mindfulness provides welcome relief from the demands of everyday dentistry.

"It’s also an amazing workout. I thought I was fit when I started, regularly running 5km and lifting weights at the gym. I soon learned that ‘fighting fit’ is a whole new level, and the fittest I’ve ever been was when I was training several times a week. The benefits to mental health of vigorous exercise are well documented, I’ve found the workout just happens while you’re trying to survive a round, rather than forcing yourself to pound the pavement."

“When you’re being squashed down by a large opponent, trying to find ways to relieve enough pressure just to be able to breathe, it’s very hard to worry about whether or not you really found that MB2 canal yesterday.”

Meet Dr Vanessa William

Prior to her upcoming course in April, we caught up with Dr Vanessa William.

It shouldn’t be surprising that Paediatric Dentist Dr Vanessa William studied dentistry – it is in her blood. “My dad, Robert, is a retired dentist and has been my greatest influence in choosing dentistry as a career,” Vanessa says. “I have never looked back and am very grateful I fell into a profession I love.”

When it came to deciding to specialise in Paediatric Dentistry, Vanessa says you must be lucky to find a job you are passionate about and she feels fortunate to be one of those people. “I worked for five years in private practice, and also became a sessional dentist and ‘oncall’ after hours emergency dentist at Princess Margaret Hospital for children,” she recalls. “I received a lot of encouragement from the Paediatric Dentists in Perth at the time, particularly Drs Peter Gregory

and John Winters. It is through these experiences, I decided to proceed with studying Paediatric Dentistry in Melbourne.”

They say it takes a special person to work with children, and it is clear Vanessa is in the right specialty. She says she loves working with children, chatting to their parents, and seeing the children grow.

“There is so much positivity and energy that comes with working with children, seeing their confidence grow and getting to know their family,” she says. “It is rewarding to see apprehensive children become more confident with time; children who are happy or even excited about coming back for their next visit; helping the children with special needs who may need a little more time and a slightly different approach; and providing comprehensive restorative dental

care to children in their primary dentition and discharging them back to their dentist with a caries free dentition, reduced caries risk and arming the children and their parents with greater dental knowledge and greater dental appreciation.”

Vanessa will be presenting ‘The Primary Dentition: Pulp Therapy and Stainless Steel Crowns’ in April. The half-day course will take the participant through the indications for using stainless-steel crowns, a stepby-step guide for tooth preparation and its requirements for your dental practice.

Topics covered include

• Pulp therapy: diagnosis of pulp status, pulp treatment options (indirect pulp cap, pulpotomy), pulpotomy technique and current medicaments available.

• Stainless-steel crown restorations in the primary dentition: indications for use and technique guide.

• Hands-on practical session: pulpotomy treatment on two teeth using two different pulp medicaments followed by stainlesssteel crown preparations on three teeth.

Vanessa says the course is quite comprehensive. “I provide two lectures followed by a two and a quarter hour handson practical session,” she explains. “We have limited the course to a small group of approximately 18 participants. The advantage with having such a small group is that everyone has the opportunity to ask questions and gain as much information as they need to enable them to provide this treatment in their dental practice.

“My lecture style for this course is reasonably relaxed, where I encourage questions and discussion throughout,” she adds. “I believe this makes for a more interesting morning and more relevant for each participant. Following a quick tea break there is one or two more clinical tutors to assist in the hands-on component. Ms Wendy Walker from 3M provides the Stainless Steel Crowns and attends the course to assist the participants in any questions they have regarding the pricing of materials.”

Dr Vanessa William will be presenting The Primary Dentition: Pulp Therapy and Stainless Steel Crowns on April 1 at UWA Dental School.

5 minutes with Dr Vanessa William

What three words best describe you?

Meticulous, Positive, Creative.

If you weren’t in the dentistry field, what would you be doing for a living?

Playing tennis – just joking. Oh gosh, I can’t imagine doing anything different.

What do you enjoy doing in your spare time?

I think I spend nearly all my spare time with my family, especially my two boys, playing, riding bikes, swimming, going for trips in our caravan; when I have spare time during school hours, I play tennis.

Is there anything people might be surprised to learn about you?

(Perhaps a talent or unusual hobby?)

I love scuba diving and met my husband whilst scuba diving at Rottnest, and I love to play tennis, but wish I was better at it and would play five times a week if I had the time.

CALENDAR 2023

Bookings & Enquiries Additional information and bookings at adawa.com.au/cpd

Dr Trudy Lin ADA House

Drs Jee-Yun Leung and Trudy Lin

April

Dr Vanessa William

Drs Amanda Phoon Nguyen & Tom Huang Carlton Holtel, Singapore

Dr

Drs

UWA

Drs

JUNE

Dr Michael Chan

20 SAT Simple Predictable Posterior Composite Restorations

UWA Dental School

10 SAT Practical Oral Surgery

16-17 FRI-SAT

Oral and maxillofacial surgeons CTEC

Biomimetic Minimal Prep Restorations

Drs Paul Gorgolis & Asheen Behari

UWA Dental School

21 WED CPR Refresher

ADA House

23 FRI Simplified Clinical Endodontics

29 THUR

july

1 SAT

2 SUN

5 WED

6 THUR

8 SAT

21 FRI

W/Professor Paul Abbott

UWA Dental School

The Halitosis Pathosis: Diagnosis, Prognosis & More

Drs Amanda Phoon Nguyen & Melanie McAlpine University Club

Minimally Traumatic Tooth Removal and Socket Preservation

Dr Luan Ngo & Dr Cindy Nguyen

UWA Dental School

Crown Lengthening for the General Dentist

Dr Luan Ngo & Dr Cindy Nguyen

ADA House

ADAWA General Meeting

ADA House

Silver Diamine Fluoride: Use vs Abuse

Dr Jilen Patel University Club

Restorative Rubber Dam

Drs Bec Penco, Greg Crane and Maheer Shah

UWA Dental School

Hands-On Extraction

Professors Raymond Williams & Dieter Gebauer

CTEC UWA

COURSE OUTLINE

“It is necessary to relax your muscles when you can. Relaxing your brain is fatal.” Stirling Moss, British Racing Driver.

Did you know that your brain is a luxury (and yes, super essential) item? Your brain consumes about 20% of the body’s energy and all that thinking and processing that you do is very, very expensive in terms of energy use.

Wouldn’t it be handy to discover the Top 10 Tips on how to boost your brain power, using nutrition, movement, and sleep?

Learn how to do exactly this in a hands-on, practical way in this workshop with Julie Meek, Accredited Practising Dietitian and Performance Specialist.

Smart BrainNutrition Workshop

3.5 CPD

Friday 19 May 2023

Registration from 12.30 pm Course 1 pm to 5 pm

ADA House 54-58 Havelock St West Perth

Afternoon tea

$ 341 inc gst

MEMBERS

ABOUT THE PRESENTER

Julie Meek is a thought leader and keynote speaker in peak performance and has partnered with many top performers across business, elite sport, politics, health, medicine and many other industries, helping them achieve their highest levels of professional and personal success. In sport, some of Julie’s high-profile clients include the Fremantle Dockers football team, the champion Perth Wildcats team and many Olympic athletes across all sports at the Western Australian Institute of Sport.

She is a coach, Performance Specialist, qualified Sports Dietitian and is degree-qualified in Health Promotion.

Julie is the author of two books and the resident expert on a top rating Australian radio station.

Julie Meek is also the author of Truth, Lies and Chocolate (Finalist in the World Food Media Awards) and ‘Ready, Set…Go’. Julie loves to challenge herself by running marathons.

5HOURSFREECPD

WADU RETURNS IN 2023

Western Australia Dental Update

Join Dr Nabil Khzam at the 2023 Dental Update conference at ADA House on SUNDAY 18 JUNE 2023

9:00am - 5:00pm

PRESENTED BY:

Dr Janice Kan

Evolution from All on 4 to AUDENTES –Instant final full arch implant bridge at implant surgery

Dr Nabil Khzam

Lasers in Periodontics

Professor Camile Farah

Real-time digital biopsy: Endless possibilities

Dr Tim Silbert

A Simple Diagnositc Matrix and Tips and Tricks to make your endodontic treament easier

Dr Lee Kaing

Dentoalveolor Surgery: Clinical cases and discussion

RSVP TO reportsnkperio@gmail.com

Extracted natural teeth, including Upper Molars, Lower Molars and especially Upper Anterior natural teeth are needed for the production of Student Endodontic models for 2023 and WA Dental CPD endodontic courses.

The teeth will need to be saved in saline or bleach and can be dropped off when attending events at ADA House or OHCWA (marked for OPTECH). Alternatively, arrangements can be made for their collection.

For further details, please contact Christine Ludgwick | OHCWA christine.ludgwick@uwa.edu.au 08 6457 7679

COURSE OUTLINE

Halitosis, or oral malodor, is a relatively common complaint. Approximately 30% of the population complaints of this in some form. What should a dental professional know about bad breath, and what should the next steps be if it is a patient’s concern?

While generally felt to be a benign condition, halitosis can significantly affect a patient’s quality of life and self-esteem, and can cause significant distress. It may be caused by or associated with a host of diseases, including periodontal disease, infection, liver disease, kidney disease, diabetes and others. There is more than meets the eye with halitosis!

Periodontist Dr Melanie McAlpine and Oral Medicine Specialist Dr Amanda Phoon Nguyen have teamed up to talk about all things orally odorous, and will discuss what a dental professional should know in this interactive lecture on the causes of halitosis, pseudohalitosis, possible systemic contributors and further investigations required, and red flags. They will conclude by summarising their best management tips for this prevalent condition.

The Halitosis Pathosis: Diagnosis, Prognosis and More

3

CPD

Thursday 29 June 2023

Registration from 6.15pm Course 6.30pm to 9pm

University Club

Hackett Drive, Crawley

Three course meal

$ 308 inc gst MEMBERS

ABOUT THE PRESENTER

Dr Phoon Nguyen is a Perth Oral medicine specialist, Adjunct Senior Lecturer at the University of Western Australia, and Consultant at Perth Children’s Hospital. Amanda is Chair of the Australasian Sleep Association Dental Sleep Medicine Council, the Chair of the Oral Medicine Academy of Australasia Education and Scientific Committee, on the Board of Studies for Oral Medicine at the Royal Australasian College of Dental Surgeons and on the Expert Advisory panel for Head and Neck Cancer Australia. She is on multiple committees and not-for-profit boards in dentistry and health related causes. Amanda presents nationally and internationally and has an online presence.

Dr Melanie McAlpine is specialist Periodontist with a private practice in Perth. She lectures across Australia and has keen interest in developing interesting methods to educate patients. Melanie is an active member in local and federal societies, including the Australian Society of Periodontology, The Royal College of Dental Surgeons, and Women in Dentistry.

What to know about bad breath, and what should the next steps be if it is a patient’s concern?

To book, visit adawa.com.au/cpd

Partner Index

ADAWA works closely with a number of partners and affiliates, resulting in strong relationships with like-minded organisations and associations. We also work with partners to provide member benefits for ADAWA members, including discounts on advantageous products and services.

Dental Stock Photography

Access unique and accurate dental images for your presentations and all your practice marketing via Dental Stock Photos. ADAWA members are eligible for a 20% discount off the Recommended Retail Price to purchase photographs. Go to dentalstockphotos.com/pages/adawa to find out more.

Bunnings Trade

Bunnings Trade and ADAWA are delighted to announce a partnership which gives you the opportunity to join the PowerPass Membership Program. To sign up or link your existing PowerPass account, please contact OrganisationsWA@bunnings.com.au

WA Energy

Local company WA Energy is stepping up to offer ADAWA members big discounts on dental practice energy bills. ADAWA members are eligible for new energy pricing and to have smart solar installed for $0 upfront. Email

invedent

ADAWA wants to support your practice with an easy to use and easy to implement system that enables you to manage your supply ordering and stock hassle-free. That’s why you’ll get 10% off Invedent as an ADAWA member. Visit invedent.com

AMA FINANCE BROKERS

ADA members are eligible to receive up to $2,000^ cashback on top of the cashback offer from the bank or lender (if eligible) on home loans successfully settled between 1 January 2023 and 31 December 2023. Phone 1800 262 346 or email info@amafinance.com.au to find out more.

ONDA

As one of ADAWA's valued corporate partners, ONDA provide timesaving services to our members, which are tailored to the busy dental professional.‍ Until the end of the financial year, ONDA are offering our members a 15% discount on all new sign-ups to their financial admin services.

Contact george@ondagroup.com.au to book your free consultation.

VPG

Boutique commercial property company, VPG Property, is partnering with ADAWA to look after our members’ business and personal property needs. VPG Property is offering a free initial property consult to ADAWA members. vpgproperty.com.au

Is telehealth for oral medicine as good as a face-to-face consultation?

By Ramesh Balasubramaniam

OAM Associate Professor in Oral Medicine, UWA Dental School.

Telehealth in Oral Medicine is a relatively new concept that has revolutionised the delivery of Oral Medicine services. “TeleOralMedicine” allows patients to receive Oral Medicine services online, which is especially beneficial for those who live in remote, regional, or rural areas or are physically incapacitated. There are additional benefits and advantages of telehealth in Oral Medicine including improvements in patient outcomes, cost savings, flexibility, patient satisfaction, continuity of care, and levels of communication.

Despite telehealth being utilised globally by Oral Medicine Specialists during the Covid-19 pandemic and subsequent lockdowns, sectors of the Australian dental community remain apprehensive about telehealth services. Some concerns from the dental community related to telehealth include:

1. Quality of care: It is postulated the Oral Medicine Specialist may not have access to the same level of information and resources through telehealth as they would with an in-person consultation; leading to inaccurate diagnosis and treatment. There is a belief that video consultations limit the ability of the Oral Medicine Specialist to conduct a physical examination of the patient. This could lead to difficulty in establishing an accurate diagnosis and providing appropriate treatment, compromising quality of care. To alleviate this concern, the Oral Medicine Specialist must work with the referrer to gather information they would otherwise obtain from a face-to-face consultation. For example, the referral process must include high

quality photographs of the pathology in question. A head and neck examination to exclude lymphadenopathy must also be carried out by the referring dentist with findings outlined in the referral process. As such, concerns about quality of care are alleviated by collaborative care between the referring dentist and the Oral Medicine Specialist.

2. Privacy and security: Concerns exist regarding the potential for data breaches, hacking, and unauthorised access to patient data. This concern is largely unfounded. Telehealth services are required to adhere to the Privacy Act regarding patient information. Specialised purpose-built online platforms exist to conduct a secure telehealth consultation.

3. Access to care: Telehealth services may not be accessible to all patients, particularly those in very remote locations without access to the internet or the required technology. It may be true some very remote locations around Australia may not have access to the necessary technology and internet. However, it is also highly likely these individuals in need of Oral Medicine Services may be able to travel significantly shorter distances to access the necessary technology rather than having to travel to an Oral Medicine clinic in a major city. Unfortunately, if an individual is physically incapacitated, any travel may not be viable.

TeleOralMedicine offers a majority of patients options to reduce their barriers to access of care.

4. Reimbursement: Insurance reimbursement for telehealth services is still evolving and is yet to be recognised by all private health insurance schemes. This may discourage some referrers and patients from engaging telehealth services as patients may experience out of pocket expenses. Nevertheless, the cost of travel and loss of income to visit an Oral Medicine Specialist in a major city will be more significant than the out-ofpocket expense of telehealth services. With any paradigm shift, it takes time for patients and dental practices to adapt and adopt the change. Of relevance, the recently updated 13th Edition of “The Australian Schedule of Dental Services and Glossary” has recognised the importance of telehealth services in dentistry and included 3 distinct item numbers: 919, 920 and 921. As such, you are encouraged to familiarise with these item numbers and their applications.

5. Follow-up care: Follow-up care may be perceived as difficult for telehealth patients and may not be as easily scheduled as in-person visits to monitor patient progress. Telehealth services is an opportunity for dentists and dental specialists to collaborate in the interest of patient care. Consulting a patient via telehealth must include treatment planning for follow-up care via telehealth or a scheduled in-person visit. To avoid any failure in duty of care with followup appointments, the Oral Medicine consultation must include a detailed report with clear instructions on any necessary treatment and follow-up

appointments. This report must be sent to the referrer, the patient and other health practitioners involved in the patient’s care. Communication between the specialist and practitioners involved in their care should be mutual and timely.

6. Building trust: The lack of personal interaction and the inability to read body language and facial expression may make it difficult for the Oral Medicine Specialist to build trust with patients through telehealth services. It is probably true that a face-to-face consultation will likely facilitate building trust and rapport with patients. To facilitate trust and rapport, telehealth consultations should ideally include video. Guidelines exist to facilitate a highquality telehealth appointment including

good lighting, position of the camera, use of illustrations, delivery of patient education material, etc. Ultimately, trust and rapport are built by establishing an accurate diagnosis and treatment plan, and clearly communicating this information to the patient.

7. Access to diagnostic testing: Telehealth services may limit the ability for patients to access diagnostic tests, including blood tests, imaging, and biopsy. In cases where diagnostic testing is necessary, the Oral Medicine Specialist will work with the referrer to facilitate the relevant tests. For example, if a patient requires a lesion excised under general anaesthesia, the Oral Medicine Specialist will work with the referrer and if required the treating surgeon to coordinate the appointment.

There are now over a dozen studies and published scientific articles on telehealth for Oral Medicine. It is anticipated the demand for telehealth services will continue to grow. It is conceivable, in the future, travel for Oral Medicine services will be strictly limited to clinical situations that warrant an in-person appointment for services that could not be provided remotely.

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Role reversal

Have you ever noticed that the patients you go the extra mile for are often not those who value you and your skills the highest, but rather the quickest to complain? Have you ever wondered why? Dr Annalene Weston, Senior DentoLegal Consultation searches for answers.

Ms S was an irregular attender with chronic periodontal disease. She could not afford to see the specialist periodontist, and instead attended Dr B, for 3-monthly cleans, or rather she was treatment planned to. Dr B had suggested this recall pattern a compromise, to try to help Ms S keep her teeth, until such a time that specialist care was an option for her. Unfortunately, as Ms S was a single parent and a working mother of twins, the complexities of her day-to-day life often interfered with both her maintenance and attendance. This meant that when she did attend, her periodontal condition was far from stable.

Rather than highlight this to Ms S, and emphasise the issues her irregular attendance was causing, Dr B trod around the issue gently, as he was loathe to add to her mental load. Further, Ms S was almost always late, so Dr B started scheduling her before his lunch break or at the end of his working day, so he could run over and give her the time she needed. Many times, he worked through lunch altogether to see her, and he always discounted her fee as simply put, he felt deeply sorry for her.

Ms S would only be treated by Dr B, and he made sure he gave her the best care he could. In his heart, he knew that she needed more, but he also knew that it would be

many years before she would be in the position to get the treatment she needed, and he wanted to help.

I know that every person reading this knows what happened next...

Ms S felt one of her teeth was loose, and walked into a practice close to her work where examinations were offered at Health Fund rebate only during her lunch break to get it looked it. They were able to squeeze her straight in and she was quickly diagnosed with 50% bone loss on most of her teeth, and 70% on the tooth in question. Ms S was stunned – why had Dr B never told her things were so bad? Why had he never referred her to the specialist? Fueled by some well-meaning but unhelpful commentary from the treating dentist, who, took their obligations to outline the likelihood of tooth loss very seriously indeed, without considering the consequences to all, Ms S proceeded to make a vitriolic complaint against Dr B, both at the practice demanding compensation and to the regulator, questioning whether Dr B was even safe to practice. This diatribe continued on social media, through online reviews and Dr B could only wonder why had this person, who he had treated with such care, and really gone the extra mile for, turned on him. After all, the treatment had been provided

with her consent, and with her full knowledge of the limitations and the compromised nature of care. Why was she doing this to him?

Pleasingly the regulatory matter was relatively easy to resolve, as Dr B’s records, particularly relating the conversations he had had with Ms S were strong. The regulator did, however, question the appropriateness of not reaffirming the issues with Ms S at every visit, as they formed the view that by failing to do so, Dr B was not only in breach of his duty of care, but also essentially complicit in her decline, essentially making this a case of supervised neglect. He received a caution.

The damage to Dr B, however, went further than that. Not only had he to contend with the stressful regulatory matter, but the online hounding by Ms S and repeated demands for compensation as well. In time and with Dental Protection’s help each of these issues was resolved, but the toll on Dr B was great.

casts 3 roles to be filled – those of the persecutor, the rescuer and the victim. In a situation such as this, Ms S was the victim, a victim of disease and of circumstance. Cue Dr B in his role as the rescuer, wanting to help and wanting to heal. The role of rescuer comes naturally to many health care providers, particularly those who entered the profession with the primary driver to help others. So naturally in fact, that we may not even realise what is happened, or how we have been drawn in.

I feel that we have likely all met people who feel very comfortable in the victim role too. In many situations, this rescuervictim relationship is fine, right up until the point where it isn’t, as in this case, when Ms S flipped the narrative and moved from rescuer to persecutor, casting Dr B as the unwitting and unwilling victim.

This cycle is a social model of human interaction and was proposed by Dr Stephen Karpman an Assistant Clinical Professor of Psychiatry. The Drama Cycle essentially

Fascinating as the concept of the Karpman Drama Triangle is, is it inevitable? Or can we avoid it? Pleasingly we can, but first we need to recognize when we are dealing with a ‘victim’ and taking up the cudgels to be ‘their rescuer’. Rather than plunge headfirst into rescue mode, we can sidestep the drama triangle, and it’s inevitable consequences by empowering the patient to manage their own disease, and to find their own solutions. Had Dr B done that, rather than seeking to protect Ms S from bad news, she would more likely than not have found a way to get the treatment she needed, or, at the very least valued more highly all that he was doing for her. Remember, knowledge is power, and knowledge empowers our patients to make the best choices for them. If we truly wish to work in our patient’s best interests, this can be the only way.

1 https://karpmandramatriangle.com

Dr B is not alone. It has rightly been said that the road to hell is paved with good intentions, and we have all been in situations where we have given the patient our all, and more besides, only to be attacked. One possible explanation for this is described by the Karpman Drama Cycle.

Goodnews stories

Dental Rescue Day thank you

ADHF WA Coordinator Andrea Paterson received these beautiful flowers from the in-reach caseworker team at the Beacon after the recent Dental Rescue Day.

Member celebrations

Congratulations to Dr Luke Chow, who officially became an Australian Citizen in a ceremony on Australia Day. Congratulations Luke!

World Oral Health Day

UWA Dental School

Guiding the next generation at UWA Dental School as part of their Professional Development lectures. What a great collaboration between UWA Dental School/ADAWA/ADAQ/ADA and DPLA! Thank you to Mr Trevor Lovelle (ADAWA CEO), Dr Colm Harney (DPLA), Dr Martin Webb (ADA Federal) and Dr Amit Gurbuxani (ADAWA President) for taking the time to educate the final year Dental Graduates. A very big thank you to Dr Laura Dalton Ecker (UWA Dental School) for organising the session.

World Oral Health Day is back on March 20, with the campaign ‘Be Proud of Your Mouth’. It is a great opportunity to remind your patients about the importance of taking care of their oral health!

worldoralhealthday.org

campaign-theme-2021-2023

Media training

Our CEO Trevor Lovelle and President Dr Amit Gurbuxani completed media training recently with Clarity Communications. It’s another activity to help ensure our Executive are well equipped to spread the word about oral health and ADAWA advocacy to the community.

Mouthguard March

It is not too late to register for eviDent Foundation’s campaign to protect smiles with a properly fitted mouthguard! Register for Mouthguard March and your practice could benefit from an increase in business.

To find out more visit evident.org.au/get-involved/2023-mouthguard-march

Dr Jessica Kong - new addition to the team

Victoria Park Orthodontics is delighted to announce Specialist Orthodontist Dr Jessica Kong has joined Dr Frank Furfaro, Dr Angela Ross and Dr Christophe Duigou in our modern and newly expanded specialist orthodontic practice. Dr Jessica Kong is now accepting referrals for all aspects of orthodontic care, from early interceptive treatment to adult orthodontics.

Vision Periodontics – South Perth

We are pleased to announce that Specialist Periodontist Dr Anchalee Jennings-Lowe has joined Vision Periodontics. She is accepting referrals for all aspects of periodontics and implant surgery.

T +61 9361 0022

E reception@vicparkortho.com.au

A Level 1, 734 Albany Hwy, East Victoria Park 6101 W vicparkortho.com.au

T (08) 6430 0333

E admin@visionperiodontics.com.au

A Unit 1/26 Charles Street, South Perth

W visionperiodontics.com.au

FRIDAY 9 JUNE 2023

Relocation Announcement

Drs Amy Hope and Zahida Oakley are pleased to announce that their practice has moved to 47 Railway Parade in Mount Lawley. They are still accepting referrals for all aspects of periodontics and implant surgery. They will continue to care for their existing patients at the new premises.

Dr Laura Leask - new addition to the team

Smile Time Orthodontics are pleased to welcome Dr Laura Leask to the specialist team.

T (08) 9228 4737

E reception@centralperiodontics.com.au

A 47 Railway Parade Mount Lawley

W centralperiodontics.com.au

FREMANTLE

T (08) 9335 4031

E Fremantle@smiletime.com.au

A 45 Quarry Street, Fremantle

MT HAWTHORN

T (08) 9443 6188

E Fremantle@smiletime.com.au

A Unit 2/187 Scarborough Bch Rd, Mt Hawthorn

W smiletime.com.au

New Practice Announcement

Specialist Orthodontist, Dr Luke Chow is pleased to announce the opening of his start-up practice, ‘Inspire Orthodontics’ located in Floreat. He provides individualised orthodontics for children, teens and adults. Accepting new patient referrals, please email for business cards or referral pads.

T +61 457 253 102

E smile@inspireorthodontics.com.au

A 3/434 Cambridge St Floreat

W inspireorthodontics.com.au

New Practice Announcement

Dr Shahrzad Nazari is pleased to announce the opening of her new practice TEETHBYTWO-Endodontist Perth in the City of Perth. She will gratefully accept referrals for all aspects of Root canal treatments, including complicated RCT cases, Re-RCTs, traumatic injuries, root resorption and root-end surgeries.

T (08) 6118 4508

E info@teethbytwo.com

A Units 9-10, Level 1, 251 Adelaide Terrace Perth

W teethbytwo.com