Western Articulator - Edition 6, 2023

A lot to gain

Dr Unna Chidambaram's volunteering journey

CPD spotlight

Meet Dr Barbara Woodhouse

Rottnest Channel Swim

Members who have conquered the challenge

Chairside beginnings

Members who started their careers as dental therapists and assistants

The President's report

Dr Amit Gurbuxani ADAWA President

Advocacy… advocacy… advocacy

That’s been the theme for your ADAWA on behalf of its members and the community these last few months.

Advocacy on behalf of the members

All of you would have received our email update in the last few weeks about the advocacy that has been ongoing by ADAWA since January this year in relation to IV sedation in dental practice. ADAWA's ongoing work under the stewardship of our CEO, Trevor Lovelle, on this matter, which included retaining a government relations firm to assist with developing advocacy strategies to engage Government, has borne fruit.

I would also like to take this opportunity to thank all the individual members who showed interest in this matter and made it a point to engage with ADAWA. This just reiterates my belief that our association is a family where we look out for each other. This result also highlights the importance of our ADAWA Strategic Plan, which your Council has been engaged in preparing for the first time in ADAWA history, in which advocacy is a top priority on behalf of its members.

Advocacy on behalf of the community

Our own capital city Perth was the first to host the public hearings for the Senate

Select Committee into the provision of and access to dental services in Australia. To be given the opportunity this week, to advocate and bring about change at a national level, for oral health to be integral part of general health was another achievement towards the priority list in our recently formulated strategic plan.

Trevor Lovelle and I were grateful to Senator Jordon Steele-John, Senator Fatima Payman and Senator Ross Cadell to allow us to address the committee on behalf of Australian Dental Association, along with outstanding representatives from other stake holders of Oral Health. We hope it brings us one step closer to provision of oral health care for those who need it the most.

Advocacy for the art and science of dentistry

FDI World Dental Congress 2023 is just around the corner. With an impressive selection of speakers and topics both nationally and internationally plus the chance to see all the new equipment and materials under one roof at the exhibition is not a chance to be missed. We hope to see you in Sydney from 24-27 September.

Editorial Brooke Evans-Butler Designer Michelle Walker CEO Trevor Lovelle President Dr Amit Gurbuxani

CEO's report Trevor

Lovelle

Amid continued challenging business conditions over the last twelve months, it is gratifying to see members continue to recognise the value and importance of their ADAWA membership. With the completion of the ‘23/’24 ADAWA membership renewal campaign, the Council’s focus turns to key performance indicators as a measure of member satisfaction and engagement. Typically, renewal campaigns are assessed by two key metrics: retention rate – the percentage of members who stayed with ADAWA over a certain period e.g. ‘22/’23 – ‘23/’24, and renewal rate – the percentage of members who chose to rejoin at 1 July.

The retention rate for this year’s renewal campaign was nearly 3% higher than the previous year, while the renewal rate is comparable with previous years at approximately 1.5% churn. These results clearly indicate that members value the services provided by ADAWA. However, the success of the renewal campaign does not mean that we shouldn’t maintain our program of continuous improvement. ADAWA exists so that oral health of the WA community is improved because our members flourish, hence it is vital that we strive to provide the highest quality of services to our members.

Regulation of private dental clinics

Since January this year ADAWA has strongly advocated against the WA Department of Health’s intention to license private dental clinics “performing services under anesthetic or IV sedation” under the Private Hospitals and Health Services Act 1927 and within the scope of the Health Services (Day Hospital Facility) Determination 2016.

The Department of Health’s reinterpretation of the Determination meant that private dental clinics would need to be licensed as a Day Hospital Facility, despite the then Minister for Health determining in 2005 that private dental clinics are not required to be licensed as a Day Hospital Facility.

Our advocacy work resulted in the WA Department of Health recently clarifying the planned change to licensing requirements. The Department now defines “services under anesthetic or IV sedation” as being dental clinics carrying out deep sedation and not clinics carrying out procedures under conscious sedation. However, it is vital that the State Government’s new definition is reflected in the proposed new licensing arrangements and for this reason ADAWA is meeting with the Minister’s office to ensure that conscious sedation is not included within the scope of the Determination. At the recent Senate Select Committee hearing into dental services in Australia, at which ADAWA appeared and gave evidence, the opportunity was taken to strongly recommend that regulators carry out rigorous due diligence, before commencing regulatory change, to avoid unnecessary confusion and anxiety for service providers.

The Senate Committee noted that the WA Department of Health’s intended action would have resulted in private clinics being burdened with additional regulatory imposts, high capital and recurring costs, potentially limit access to dental services at a time when current arrangements relieve the burden on the public health system, and potentially limit private dental clinics from providing dental sedation services.

Conquering the Rottnest Channel Swim

Are you looking for a challenge?

Clinical Associate Professor

Dieter Gebauer

Oral and maxillofacial surgeon

Dieter Gebauer has long been a keen swimmer and water polo player and you’ll usually find him at the pool in the mornings, supporting his children. But did you know, Dieter won the Open Men’s division of the Rottnest Channel Swim at the tender age of 14?

“I did solo swims in Year 9 and Year 10 and it was in Year 10 that I won the Open Men’s division of the Rottnest Channel Swim,” he recalls. “My name is on the board at the Rotto pub.”

Dieter says at the time of his win, he was in the Australian Open Water swimming team and competing nationally. He has competed in the Rottnest Channel Swim in the duos

(he was also a winner in that category several times) and has taken part in some recreational team swims, recently alongside his nephew and brother (who he says is a loyal supporter of his and always generously allowed the use of his boat).

Competing in the swim has seen Dieter experience some memorable moments, including having to wait to let a Collins-class submarine go past him and the sighting of a large tiger shark. “My support crew didn’t believe me at the time that I had seen a shark,” he laughs. “The shark then appeared further down the pack, and it was announced on the radio. Then they believed me.”

Swimming has been and continues to be a valuable activity for Dieter for health and work-life balance. “My son

Training for the Rottnest Channel Swim might be the perfect event. We spoke to some members who have completed the 19.7km open water swim from Cottesloe Beach to Rottnest Island.

is starting open water swimming and has had a couple of races,” he says. “I’m more going into the coaching role with the kids now, although I still swim and play some water polo to keep my fitness up.

“Swimming is a good family pursuit,” he adds. “We go to the beach and swim, we go to the pool and I don’t think about work when I am doing all that. I have been finding a lot of enjoyment hanging out with my children and getting them on the path of being healthy, active and up early in the morning.

“My dad used to say when the sun gets up, you get up. His work ethic was you didn’t want to waste the day – and I think swimming is a good way to start the day as it is healthy, you don’t get any major injuries and it is a great family activity.”

To others thinking about giving the Rottnest Channel Swim a go, Dieter warns it is important to prepare. “It is not something you can pick up six weeks before the event; you need to train,” he advises. “You need to be able to be swimming a decent volume of kilometres to prepare to make the distance.”

Dr Fleur Creeper

Specialist Periodontist Dr Fleur Creeper completed a solo crossing in the Rottnest Channel Swim in 2011.

“I had always been a swimmer (never very fast), and taught swimming as a summer job while at Dental School, but enjoyed long distance swimming,” she recalls. “I got into open water swimming and half-ironman triathlons with friends, and it went from there. I started seeing the cars around Perth with those RCS plates and decided I wanted some. The only way to get them is to do the solo Channel Swim…. so I did.

“I felt proud to get the plates and now when I pass the cars on the road it’s like a special club that you belong to. I have been a member since 2011 when I completed my solo crossing. I then repeated the feat in a team swim the following year (Team TopGums).”

Fleur says the lead-up to the event was great – swimming in various water bodies around Perth, including the Busselton Jetty Swim, Champion Lakes Regatta Centre and Lake Leschenaultia.

“It’s amazing how different the water feels and affects your swimming buoyancy and style,” she says. “The camaraderie of training and events leading up to the day was amazing. Nothing can be more bonding than a bus ride into the city in your bathers with fellow swimmers, to swim back to Matilda Bay for the Swim Thru Perth.

“The day itself was gruelling and I am not sure I even remember it and the aftermath,” she adds. “I felt so emotional and exhausted wading out of the water after 7 hours and 20 minutes but looking back I am glad I did it. My dad, past ADAWA member Dr Ken Creeper (dec) skippered the boat, and I had a great support crew with me so it’s a team achievement, even though it was a solo swim. Without them I couldn’t have achieved it.”

When asked if swimming has encouraged work-life balance, Fleur says preparing for the swim gives you something else to focus on. “The repetitive nature of swimming and staring at that black line (or the ocean floor) is a very good form of meditation and helps you think things over and let the stress of life and work go,” she says. “The sound of the water and your breathing has a calming effect for me. I am not swimming as much as I used to but have replaced that with Pilates. The focus needed has a similar effect on your mind and helps strengthen your whole body at the same time. It is great for preparing your body for a day in clinical practice. I am tempted to get back into the pool more regularly as the lure of the Port to Pub registration plates is starting to creep up like the RCS ones did many years ago. Time will tell!”

To others who are considering taking on a challenge like the Rottnest Channel Swim, Fleur says to go for it. “Either as a team, duo or solo – it’s a great challenge,” she says. “Join the solo club if you can! Just be prepared for wet hair – I felt like I had wet hair for an entire summer!”

Dr Emma Lewis

Oral and maxillofacial surgeon Dr Emma Lewis has taken part in the Rottnest Channel Swim three times. “One being unsuccessful, one taking a VERY long time and this year a slightly better time,” she says. “I had completed team events prior to that, but felt I needed to challenge myself with a solo. Plus, how cool would it be to look over to Rotto and say: ‘I swam there’!”

When asked what she enjoys most about competing, Emma says enjoyment is probably not a word that features highly when talking about a Rottnest Channel Swim solo. “It is many hours of swimming preparation to swim an event of many hours on a day with unpredictable conditions,” she explains. “There is no doubt that it is a team event with each swimmer requiring a skipper and boat plus a paddler alongside all the way – this is a huge commitment on their part. “For me, the enjoyment comes from the gratitude you

have towards your support team when you make it across. It is an amazing day with so many people involved, which creates a real buzz and to think that we have this world-renowned event on our doorstep.”

Emma says she normally swims three times per week in a squad throughout winter and then cranks things up if preparing for the Rotto swim.

“I think any form of regular exercise keeps you sane; being part of a squad gives you added incentive and accountability, which is sometimes needed on those cold, dark winter mornings.”

To anyone considering doing the swim, Emma says if you are thinking about it, just do it! “Starting with a team event can give you an idea as to what’s involved and then it just sucks you in!”

THE BEST OF DENTISTRY ALL IN ONE PLACE!

Meet dentistry’s top companies and learn their newest technologies in our most expansive exhibition yet!

View details of the programme on our website and register now.

world-dental-congress.org

DR TINA MORRIS

What first attracted you to a career as a dental therapist?

I was nearing the end of Year 12 and really wanted to study dance at university. It was a new concept then! My Dad was against it, so being a normal teenager I didn’t apply for anything. My high school guidance counsellor suggested speaking with the visiting School Dental Therapists who were doing a recruitment drive, so I did. I had never once considered working in a field dental or medically based, but I loved it as soon as I started.

How long were you working as a dental therapist before you decided to study dentistry?

I worked as a School Dental Therapist for five years before studying Dentistry.

Why did you decide to study dentistry?

Whilst I loved the work, at the end of three to four years I

Chairside beginnings

was feeling limited by my scope of treatment, and I wanted to be able to provide comprehensive treatment for my patients. Were the dental staff you were working with as a dental therapist supportive of you studying dentistry?

I worked as a Dental Therapist with ACT Health. They, the Senior Therapists and Dentists, were very supportive of me furthering my studies.

How do you believe your background as a dental therapist has benefited you as a dentist (not only during your studies but also as your work as a dentist)?

When I studied Dental Therapy it was a certificate course, so I received no credits in units for my Dental degree. Obviously already knowing how to sit, speak with patients, knowing the teeth numbers etc all helped in my studies. However, the

depth of knowledge of the Dental Degree was a lot more in-depth and I really enjoyed gaining so much extra knowledge. After graduation it was definitely easier for me to work with children than others may have found. I also found communicating and delivering treatment plans with patients, carers and parents much easier. Time management was also a lot easier than some of my peers found in the beginning. What would your advice be to a dental therapist considering studying dentistry?

If you love what you are doing stay where you are – Dental Therapy is a great profession. However, if after a few years you feel limited and can’t imagine doing those same things for years to come – go and study dentistry. Your background knowledge will hold you in good stead and you won't look back!

A number of dentists and specialists begin their careers in the dentistry profession as dental therapists and assistants. We spoke to members about their experience.

“I had an interest in dentistry from the age of about six-years-old when I sustained significant dental trauma.”

DR ARNA-LEE JENSEN

DR ARNA-LEE JENSEN

DR TINA MORRIS

DR IRIS MESSMER

DR ARNA-LEE JENSEN

What first attracted you to a career as a dental therapist? Can you tell me about this journey? Why did you decide to study dentistry?

I had an interest in dentistry from the age of about sixyears-old when I sustained significant dental trauma. I knew at that age I wanted to become a dentist but wasn’t confident I could make it. I later went to do work experience at a dental clinic. I never formally trained as a dental nurse but found it a good way to practice skills whilst studying Dental Therapy. I enrolled in dental therapy as I wasn’t sure I could commit fully to five years of dentistry so I figured this was a pathway to obtain the experience that could be useful if I wanted to study further. But if I didn’t want to progress to dentistry, I still had a job in the dental field. How long were you working as a dental therapist before you decided to study dentistry?

By the time I finished

Dental Therapy I knew I either wanted to study dentistry for the variety of work and autonomy, and I didn’t want to work as a dental therapist forever. I worked as a dental therapist whilst studying science to enter dentistry and then the actual dental degree. Working as a therapist worked well at allowing me

to practice before I was in first year dentistry. Were the dental staff you were working with as a dental therapist supportive of you studying dentistry?

The staff I worked with over the years were encouraging of me becoming a dentist but there were significant figures that felt dental therapists should not or could not ever become dentists. There were barriers that had to be broken down and expectations of me were different to other undergraduate entry students, luckily Dr Iris Messmer had made a significant impact. Do you believe your background as a dental therapist has benefited you as a dentist (not only during your studies but also as your work as a dentist)?

Dental therapy taught me patient skills and competency as an individual and to this day I use the paediatric clinical management strategies I developed. Often as a therapist you don’t have a nurse, so you learn to be very organised. Why did you decide to specialise? Did this wealth of experience in different areas of dentistry has helped you as a specialist?

I decided to specialise as I wanted to choose the area

of dentistry that I found the hardest and master it. I figured if I found it hard so would other dentists thus there would always be a need and endodontics is a great skill, we all need to have to maintain patients’ natural teeth.

I feel the experiences I have had made me see things from a different perspective, having experienced different roles in different practices and this gives you a unique insight. My nurse always says I can still do all the jobs in the practice efficiently, which is apparently annoying! I felt like I had gone back to previous days recently when the power went out and I found myself hand mixing IRM –it still is like riding a bike. The experiences help when I need to teach someone various roles within the practice as you have done it yourself and can see what the role entails from both sides.

My experiences have shaped me as the practitioner I am. These experiences have helped me think outside the box and apply principles learnt as not much in specialist endodontic practice comes out of a textbook, so the more varied cases and practices you work in, the more insight you gain, which makes you become a better practitioner.

DR IRIS MESSMER

What first attracted you to a career as a dental nurse and hygienist?

I first worked in a dental surgery at the age of 16 and loved the work and interaction with people. I worked as a dental nurse from 1977 until 1985. My husband and I migrated to Australia in 1983 and I attended Curtin University and after TEE at night school and completed the Associated Diploma in Dental Therapy in 1988. I lasted in that job only until 1991 as I was bored and needed more of a challenge, and I wanted to be my own boss. I then enrolled into Science at UWA after passing Chemistry TEE and finished with my BDSc in 1997.

How do you believe your background as a dental nurse has benefited you as a dentist (not only during your studies but also as your work as a dentist)?

l always felt that dentistry was my vocation and having the dental nursing background helped immensely especially since English is not my first language and there

was a steep learning curve just with terminology. It also helped with running a business since I’ve managed this as a nurse prior to the tertiary studies. As a boss I understand the challenges faced by staff and I treat my girls like they are part of my family.

I literally went from university straight into my own country surgery and I’ve just clocked up 25 years still very much enjoying the profession. In reality, I will need to find a successor in the next few years as I would hate to sell to a corporate entity. This town has been lucky to only have had two dentists in 63 years and I owe it to my community to find the right person to step into my shoes. I look forward to mentoring a young professional for a fabulous work-life balance away from the big smoke and stress of city life.

What would your advice be to a dental nurse considering studying dentistry?

I would encourage any dental assistant/nurse and hygienist/ therapist to trust in his/her ability and give dentistry go. The reward is amazing and fulfilling.

Annual Scientific Meeting and CE 2023

Temporomandibular Disorders: something to chew on Multi-disciplinary approach to Assessment

The Australian and New Zealand Academy of Orofacial Pain (ANZAOP) is the peak body in the field of Orofacial Pain in Australia and New Zealand, and is dedicated to advancing scientific knowledge about Orofacial Pain and promoting evidence-based, person-centred care The academy consists of dental specialists, dentists, physiotherapists and other health practitioners sharing a strong professional interest and clinical focus towards treating patients suffering from Orofacial Pain and Temporomandibular Disorders (TMDs)

This event is suitable to general and specialist medical, dental, physiotherapy, psychology, pharmacy practitioners as well as those involved in research and teaching of pain in the Orofacial region

Consider joining ANZAOP as a Guest Member for reduced meeting fees and other membership benefits (see anzaop.org for membership application and membership benefits)

Venue: Hilton Adelaide, 233 Victoria Square Adelaide, SA 5000

Day 1, Oct 20th, Open day: Non members $400, ANZAOP members $200 Day 2, Oct 21st, Members and invited guests: ANZAOP members no charge, Invited guests: $400

Management

Friday

Dr Tim Semple

What to do when pain persists?

Dr Bronwyn Jenkins Headache assessment for TMD patients

Professor Chris Peck

Diagnosing TMD in primary care

A/Prof Robert Delcanho Splints and Botox: Facts and fiction

A/Prof Tom Wilkinson TMJ biomechanics and articular disorders

Andrew Clarkson and Giancarlo Sossi Taking an active approach to management

Dr May Lam

The role of imaging in Orofacial pain

Andrew Clarkson and Dr Karen McCloy Diagnosis under the Biopsychosocial paradigm

Josephine To Pharmacotherapeutics in Orofacial pain

Professor Dan Clauw Nociplastic pain

Professor Mark Hutchinson Pain in 4D

Professor Stuart Brierley

The Gut Brain Axis in Chronic Pain

Dr Frederic Van der Cruyssen Optimizing Trigeminal nerve injury care

A/Prof Meredith Craigie Goverment direction in pain education and management

A/Prof Tasha Stanton Advances in exercise-based virtual and mediated reality for chronic pain

Dr Alexander Sweetman Comorbid Insomnia and Obstructive Sleep Apnoea CBT for insomnia

Scan the QR code to register

Mark Hutchinson Dan Clauw

Meredith Craigie Bronwyn Jenkins Chris Peck

May Lam Tasha Stanton Alex Sweetman

Frederic Van der Cruyssen

Robert Delcanho

Tom Wilkinson Andrew Clarkson

Stu Brierley

Tim Semple Josephine To

Growing up, Dr Unna Chidambaram was involved in fundraising for charity with her parents and the experience seeded a love of interacting with like minded people and giving back.

“I really liked the way it made me feel,” she recalls. “When I became a dentist, I really wanted to give back doing something which I was skilled at, so for me, volunteerism dentistry was something easy to do.”

Unna has since given back via multiple dental volunteerism groups, including Kimberley Dental Team, Healing Smiles and overseas dental volunteering trips.

Kimberley Dental Team

Unna’s first experience with the Kimberley Dental Team was as a final year dentistry student. Unna says the team became very close and the trip was an incredible experience.

“It was on that trip I met my (now retired) boss, Dr Andrew Heap and that is how I got a job; I have been at the practice for eight-and-a-half years now,” she says. “Volunteering trips like the Kimberley Dental Team give you a great opportunity to network and meet other dentists and like-minded people. It is a very collegial environment.

A lot to gain

Dr Unna Chidambaram says there is nothing to lose and a lot to gain by giving up some time to volunteer.

“I went back two years later, as a graduated dentist, which gave me the opportunity to do more than I was able to do as a student, which was very rewarding. Jan and John (Owen) go above and beyond and are so caring and nurturing on these trips; you get a vibe that you are in a big family and that is testament to them and how they created the program.”

Overseas dental trips

Unna has also volunteered further abroad – travelling to Cambodia in 2014 and to India with Equal Health in early 2020. “In 2014 a dental friend of mine asked if I wanted to do a dental

volunteering trip in Cambodia so I went along as I am always up for a challenge and different experiences,” she recalls. “I got to meet some other young graduates and it was an amazing experience.” Unna says volunteering overseas and in rural areas is challenging, but the experience was amazing.

Volunteering with Equal Health came about when Dr Andrew Heap asked if Unna would be interested in going, as he was unable to attend.

For Unna, aside from the enjoyment of doing things like giving oral hygiene instructions to children in the local

schools, it was also a rewarding personal experience. “We went to a part of India where my grandparents are originally from,” she says. “I have a good understanding of the language but struggle to speak it, so it was a great experience because it was the first time I had gone without my family, and it gave me the opportunity to improve my language skills.”

For overseas volunteerism, Unna says a highlight is being able to experience the culture authentically. “I have been to India a few times, but I had never been without my family, so it was great to have a different experience. We had home cooked meals and we walked to the local tea shop – those things are what you remember. You also quickly develop a bond with the people you volunteer with because you spend a lot of time with them.”

Healing Smiles

Closer to home, Unna has been volunteering with Healing Smiles for a number of years, and says her current boss, Dr Steve Hollander, kindly provides the practice and materials for her to treat the Healing Smiles patients.

“Volunteering with Healing Smiles is very rewarding because it is about empowering women,” she says. “Many of these women unfortunately have had negative experiences in their life and my role is to do a little bit to help them feel more confident and empower them to take the next step.

“Treating them can be challenging but immensely rewarding because usually at the end of the treatment they are very grateful, and a few tears are shed. Sometimes there are hugs and sometimes it might be a gentle smile. I think that says a

lot because often they come in in a very broken state and for them to show any acknowledgement is amazing.”

With Healing Smiles, Unna says a lot of the treatment involves providing pain relief and things like replacing broken teeth, dentures and treating stress-related bruxism.

“We provide the full range of treatment for these patients,” Unna explains. “Often you get to communicate with the other female specialists in Perth as well; it is a great community and everyone is very giving with their time and their experience.

“I really like that we can offer the full coverage of treatment and the best care. The patients can see an endodontist for root canal treatment, an oral surgeon for extractions, an oral medicine specialist for splint construction and a general dentist for fillings and dentures and crowns. It is great that we can pull our own expertise together and is a rewarding initiative to be part of.”

Dental Rescue Days

Unna also volunteered at a Dental Rescue Day with her practice a few years ago and says it was also a great experience. “15 staff came together on a Saturday and we had the opportunity to make a number of people feel better,” she says. “It was all organised by ADHF (the Australian Dental Health Foundation), who gave us a list of patients, and it was a great team building experience for the practice.”

A lot to gain

To other dentists considering volunteerism opportunities, Unna says to give it a go. “You don’t have anything to lose and a lot to gain,” she says. “You get a lot of self-satisfaction from doing something that in my opinion is very simple, using the skills you already have, with a little bit of time.”

Meet Dr Barbara Woodhouse

It has been a long time since oral and maxillofacial surgeon Dr Barbara Woodhouse has presented a WA Dental CPD course (she was due to come to Perth to present Oral Surgery – Learn Practical Skills to Enhance Your Clinical Techniques back in 2020, which had to be cancelled due to COVID restrictions).

Barbara is looking forward to coming to Perth to connect with ADAWA members for her course that covers the practicalities of everyday oral surgery – from extraction to impactions, breakages to biopsies, instrument and suture selection, exposures and closure of oro-antral communications.

What to expect

“The course attempts to provide something for everyone – basic guidelines for those who want to start to do more surgery in their practice, and some ‘tips and tricks’ and alternate approaches for those already doing it,” Barbara explains. “I emphasise case assessment and demonstrate how this can result in predictable, successful outcomes rather than unexpected failure. I recommend and demonstrate instruments and techniques covering most of the surgery that can be performed in the chair – as well as some tips for those who have access to general anaesthesia for their patients.

“As well as the removal of teeth, roots and impacted teeth, I teach tooth exposure, biopsy, closure of oro-antral communications and some suturing techniques, and finish with an update in post operative pain control. Participants are welcome to bring along radiographs and photos of their own cases for discussion.”

Barbara says the course is suitable for all dentists who have an interest in surgery, from those who feel very inexperienced, to those who are more comfortable with oral surgery, and looking to extend their boundaries. She hopes attendees take away from the course an understanding of how to avoid unexpected difficulties and achieve a successful outcome. “Of course, sometimes things are not predictable, but most of the time, proper assessment of both the patient and the proposed operation will prevent things going wrong.”

Barbara is a passionate and interesting lecturer, who has been awarded the University of Queensland’s vice chancellor’s Award for Excellence for Teaching.

“I had the opportunity to learn under some generous-spirited and encouraging mentors, who inspired me to continue their efforts, and it has been very fulfilling to watch emerging surgeons grow in confidence and expertise as they progress through training.”

“I truly believe that unless they eclipse me, I have failed in my duty as a teacher!” she says.

Giving back

As well as her busy teaching schedule and clinical work, Barbara gives back as The Chair of Operation Interface, an NGO affiliated with the International Association of Oral and Maxillofacial Surgeons (which has initiated and supported training programs for local surgeons in Bangladesh, PNG, Cambodia and Vanuatu).

In the lead up to her anticipated course, Practical Oral Surgery for Your Practice, we caught up with oral and maxillofacial surgeon, Dr Barbara Woodhouse.

“Even throughout COVID we were supporting our most recent trainees in Phnom Penh with webinars and zoom meetings and emailed advice regarding cases. Thankfully the groundwork we put in prior to 2020 meant that by then, we had four newly trained local consultants in OMS who were able to take on another six trainees and support them on the ground whilst we could not visit,” she says. “We went back for the first time last October with a group of three surgeons, an anaesthetist and three nurses. It was a wonderful collegial experience and very different to previous trips which have sometimes been a bit lonely when it has been just me and a nurse! Two more trainees are ready to sit their final exams

later in the year, and we run tutorials by zoom, once per week, and will be joining a panel of other external examiners later in the year for the real thing!”

Her dedicated service was recently recognised when she was named the Queensland nominee Australian of the Year 2023. “I was deeply honoured and very surprised,” she says. “I knew that I had been nominated by a colleague, but never expected to be shortlisted! It is a huge acknowledgement of our endeavours in dental and medical education, and especially the effort that the team puts in on overseas missions in Bangladesh, PNG, Fiji, Vanuatu and Congo as well as Cambodia.”

Away from the clinic

When she’s not doing clinical work, teaching or volunteering, you’ll find Barbara practising underwater photography. “I took up underwater photography when I could no longer scuba dive, so I do all my photography on snorkel and skin diving,” she says. “I am very amateur, and only have a point and shoot – but a good one! Good enough that a still from a video of two parrot fish fighting won a competition on a Mike Ball Coral Sea expedition 18 months ago, and was subsequently used on their promotional brochure.”

For the near future, she says she is planning lots of travel (at last) with her long-suffering and infinitely supportive husband.

Practical Oral Surgery for Your Practice

will be held at ADA House on Friday October 13. For details or to book, visit our website, https://www.adawa.com.au/product/practicaloral-surgery-for-your-practice

COURSE OUTLINE

This course will cover the practicalities of every day oral surgery – from extractions to impactions, breakages to biopsies, instrument and suture selection, exposures and closure of oro-antral communications.

TOPICS INCLUDE

• Clinical and radiographic assessment

• Instrumentation and technique

• Extraction of teeth, roots and wisdom teeth

• Biopsy techniques

• Oro antral fistula repair

• Exposure of teeth

• Suture types, techniques and uses

• Optimising post-operative pain control

Practical Oral Surgery for Your Practice

6.5 CPD Friday 13 October 2023

Registration from 8.45 am Course 9 am to 5 pm

ADA House 54-58 Havelock Street, West Perth

Lunch, morning and afternoon tea

$

704 inc gst

MEMBERS

ABOUT THE PRESENTER

Dr Barbara Woodhouse is a specialist in oral and maxillofacial surgery from Queensland. Barbara has presented numerous courses across Australia and has a great passion for teaching her speciality.

Dr Woodhouse regularly travels overseas to extend her skills and training and is the Chair of an NGO affiliated with the International Association of Oral & Maxillofacial Surgeons, which coordinates the supply of surgical expertise to Bangladesh, PNG, Cambodia, and Vanuatu; and initiates and supports training programmes for local surgeons in these areas. Dr Woodhouse has been awarded the University of Queensland’s Vice Chancellor’s Award of Excellence for teaching, and a Distinguished Service Award from the Australian and New Zealand Association of Oral and Maxillofacial Surgeons.

COURSE OUTLINE

There are many options for the restoration of worn or unaesthetic anterior teeth, however composite resin can often be an excellent minimally invasive and economical solution. This course is designed to give dental practitioners a greater understanding of treatment planning direct composite resin veneers as and some hands-on experience comparing the different techniques and materials available.

COURSE TOPICS

• Basic smile design, tooth form and occlusal considerations

• Comparing direct techniques –free hand, layering techniques and injectable composites

• Bonding protocols

• Composite resin selection

• Isolation techniques

• Finishing – anatomy and polishing

Direct Veneers

6.5 CPD Saturday 21 October

Registration from 8.45am Course 9.00am to 5pm

UWA Dental School

17 Monash Ave, Nedlands

Lunch, morning and afternoon tea

$ $1,100 ADA Members

$1,650 Non Members

$1,100 OHT, Hygenists, Ancillary Staff

ABOUT THE PRESENTER

Dr Joshua Graieg is a Specialist Prosthodontist at the Brånemark Center in West Perth and Cottesloe Dental in Peppermint Grove. He completed a Bachelor in Dental Science from The University of Western Australia and a Doctor of Clinical Dentistry in Prosthodontics from the University of Sydney. He is also a Fellow of the Royal Australasian College of Dental Surgeons, a Consultant Prosthodontist with the Craniofacial Unit at Perth Children’s Hospital, and a Key Opinion Leader for Kerr/KaVo. His main interests are biomimetic dentistry, aesthetic dentistry, minimally invasive prosthodontics, and both tooth and implant based prosthodontic rehabilitation.

Clin A Prof Glen Liddelow is a Specialist Prosthodontist at the Brånemark Center in West Perth and the Director of the Branemark Center Osseointegration training program in dental implants. Glen is a lecturer and online expert advisor for the University of California, Los Angeles (UCLA) Global Institute for Dental Education (gIDE) program. He is a Consultant Prosthodontist at Perth Children’s Hospital and Royal Perth Hospital. Glen has presented over 300 papers and lectures both nationally and internationally and is a member of numerous university and industry boards concerned with dental education.

adawa.com.au/cpd

This course is designed to give dental practitioners a greater understanding of treatment planning for direct composite resin veneers, as well as hands-on experience with the different techniques and materials available.

To book, visit

You’re notified of a complaint – what next?

Dr Kiran Keshwara

Most people have experienced a range of emotions over the past few years with COVID affecting all of us in different ways. On top of this, imagine if you were to open your emails and see an email from a law firm with the heading:

(PATIENT NAME) - NEGLIGENCE - (YOUR NAME)

How does this make you feel?

What if it’s an email from the Dental Board advising that a complaint has been lodged against you?

In this article, we look at how you may feel if you were to get such unexpected communication, what may happen and what steps you can do to mitigate factors.

The emotional rollercoaster

In our profession, we pride ourselves on providing the best level of care to our patients. Our sense of responsibility can sometimes make us sensitive to any suggestion of a deviation from that standard of care. It is our sense of personal and professional integrity that can feel attacked, and we can feel unduly guilty and responsible for the patient’s alleged suffering. You may feel a whirlwind of emotions, everything from shock and fear to shame and anger. These emotions can manifest into physical symptoms which may include insomnia and shortness of breath. We may start to doubt our abilities and second guess every action we undertook when performing the procedure that is now being complained about. Some members have expressed a reduced sense of self-

worth and they may question dentistry as a career as the complaint indicates to them that they are not competent; the patient’s suffering weighing heavily on their minds. It can be quite easy to start envisioning worst-case scenarios, which may include de-registration, going to trial, public exposure and reputational damage, and enduring a large financial loss. Remember, most of the time these worst-case scenarios are not as common as you may think they are. We have to be very careful with how we manage our stress and how we view ourselves, as it can spill over into our personal and professional lives. Constant bouts of anxiety may impact our physical health and we may start to isolate from our strongest support networks, such as our friends and family.

We may also exhibit irritability and frustration at our teams and patients, which can impact morale and lead to further mistakes happening. This can then start a feedback loop where we get more complaints, leading us to getting more agitated - recycle and repeat. Now that you’ve imagined the worst possible scenarios, let’s see what the process actually entails.

Timelines

If it’s a law firm contacting you with a claim for compensation, it may drag on for months or even longer as it can range from letters between lawyers, to mediation, to a court hearing.

Dental Protection will assist you by reviewing all your records, analysing the communications from the law firm, and taking the management of the case for you. We will also appoint one of our panel law firms to assist you with the process. You may need to appear in a court setting, but this situation is very rare and restassured, we will be there to assist you with our dental and legal expertise.

If it’s a Dental Board complaint, you usually have two weeks to respond. We will assist you with your submission, ensuring you address the complaint effectively. You may also need to appear before the Dental Board, and we will help prepare you for this situation, should it arise.

Keep in mind that a response from the Dental Board may take many months, and you will be notified accordingly. Unfortunately, due to the time lapse, receiving a notification that you are to present your case in person, may re-ignite the same feelings you experienced when you first received communication that a complaint has been made. Whether it be with a claim for compensation with a law firm or a Dental Board submission or hearing, after the initial shock of the complaint has worn off, many members report bouts of anxiety from time to time. Understandably, many of our members also feel uncomfortable in the legal sphere as we spend most of our time in clinical settings. They also report feeling stressed and “judged” if appearing before the Dental Board as this usually consists of a panel of our peers.

How are matters resolved?

With a claim for compensation from a law firm, there are a few ways this can be resolved:

• the claim is dropped

• early negotiation occurs

• the case settles at mediation, or

• the case goes to trial.

Rest assured, it is very rare that a case will go to trial where you have to present in front of the court.

For complaints made to the Dental Board, there a range of outcomes that can occur, in isolation or in combination:

• complaint is dismissed

• a caution is issued (a warning)

• undertakings are made

• conditions are imposed on your practice (additional CPD, audits,

working under supervision, engaging a mentor, or on-site performance review), or

• de-registration.

A good perspective to adopt is that a vast majority of Dental Board/ Dental Council complaints are simply dismissed, and it is very rare for a clinician to be de-registered.

Helpful strategies short term Breathe

Studies show that slowing down your breathing and taking deep breaths helps relax your body. Box breathing is an excellent technique that can help mitigate the instant rush of stress you may be feeling upon receiving the communication of a claim or notification. It’s easier said than done, but don’t take it personally. Complaints can happen regardless of whether negligence has actually occurred. In 2018, Dental Protection undertook an analysis of complaints our members had received over a ten-year period and found that instances of complaints had increased exponentially since 2008. In 2008, 1 in 50 of our members received a complaint, compared to 2018, where that number decreased to 1 in 10. We are not “bad clinicians” because we make a mistake, and the Dental Board does not perceive it this way either. Also, it is vital to remember that oftentimes, a patient (and their lawyers) do not understand the nuances of dental treatments and so are bringing a case forward without merit.

Use your support network

A support network is always helpful, and this includes family, friends, colleagues, your indemnity provider, and counselling. Dental Protection

provides a free counselling service to all our members, regardless of whether a complaint has been made.

Understand the process of complaints

This process is a foreign environment to that in which we work in, and we can feel uncomfortable, anxious, and unsure of how to conduct ourselves. This is not our clinic where we are in control and in charge of our professional reputation. Therefore, if we take the time to understand the process, we may get a sense of clarity and a sense of control over the actions we can take. Dental Protection, along with our panel of lawyers, will guide you through this process. We will be there with you for any appearances before the Dental Board or the courts.

Helpful strategies long term

Clinical aspects

Being a good clinician entails knowing your strengths and weaknesses in the clinical space.

You should always work in scope, continue to update your training and experience, and refer procedures that you are not comfortable or experienced in. Good relationship with patients

Develop a patient centred approach in your communication where you are honest and collaborative. You should continue to engage in effective disclosure and apologise when mistakes are made.

Excellent record keeping

Ensure your records are accurate, legible, and detailed. Your aim is to capture your conversation with your patients, including the proposed procedures, prevention strategies, financial concerns, medications, and other relevant information. You should also include any scans and photos you take during the appointment. When using auto-templates, please ensure that you customise it for each patient and only include what was done/discussed

in the appointment. Good record keeping will protect you if a complaint is made. The Dental Board accepts that mistakes happen in clinical settings, however, what is not acceptable, are poor records.

I have received the email - what next?

Breathe, gather your records and gather your thoughts, then contact Dental Protection. You will be feeling a range of emotions and in these circumstances, it is very useful to have us look over the complaint and give an objective view of it.

We can help manage the matter and guide you through the process. As clinicians ourselves, we understand that things can and do go wrong, and we can understand the emotions you feel.

Better clarity on payroll tax obligations for dental practices in Western Australia

David McMullen, Panetta McGrath Lawyers

In two 2019 and 2021 decisions from the Victorian Court of Appeal and New South Wales Civil and Administrative Tribunal, it was held that an optical dispensary and a medical practice were liable for payroll tax on earnings passed through to optometrists and medical practitioners who had been operating under facilities and services agreements.

These decisions have sparked concern that health practices in this State (including dental practices) might face similar unexpected payroll tax liabilities on practitioners’ earnings where (by virtue of those practitioners being on ‘facility and services’ or independent contractor type arrangements) it had been believed that their earnings would not incur payroll tax.

The WA Government, however, has recently issued advice (by way of a letter from Deputy Premier and Treasurer Rita Saffioti to the Royal Australian College of General Practitioners WA Chair) confirming that there will be no change to the way payroll tax is applied to general practitioners (and by extension, one would therefore also hope,

dental practices). In this article we explain what the issue is all about.

Payroll tax legislation in WA

The Payroll Tax Assessment Act 2002 (WA) (WA Act) generally imposes payroll tax on ‘taxable wages’. In order to determine what constitutes ‘taxable wages’, regard must be had to:

• which payments are ‘wages’;

• whether payments that are wages are exempt from payroll tax; and

• whether non-exempt wages are taxable based on:

• where the wages are earned;

• where the employee is based; or

• where the employer is based.

Both Victoria and NSW – as well as South Australia, Queensland, the Australian Capital Territory, Tasmania and the Northern Territory – are all part of a payroll harmonisation agreement for the treatment of contractors. Their legislation contains ‘contractor deeming’

provisions that have paved the way for payroll tax in respect of health practitioner earnings that historically were not thought of as ‘wages’ in the usual sense.

The other States’ and Territories’ legislation, however, is materially different to the WA Act; in that here, our legislation does not contain equivalent contractor deeming provisions.

Remaining uncertainty for WA dental practices

Although some comfort might be drawn from the WA Government’s recent advice, there is still no absolute clarity for WA dental practices.

First, there has been no announcement in relation to dentistry specifically, or the health sector beyond GP practices. Second, Government positions can change over time; and under the WA Act, there is power to make regulations about the classes of contracts under which payments attributable to labour will be treated as ‘wages’ attracting payroll tax. For the time being, it remains as important as ever for dental contractor agreements, and facility

and service agreements, to be appropriately structured. This mitigates the risk not only of unexpected pay roll tax liabilities should the law in WA gravitate towards the east coast position. It also guards against accidental liability for other benefits and entitlements.

Interpretation of contractual arrangements

The Victorian and NSW payroll tax decisions serve as a reminder – in WA as well as the rest of Australia – that ‘labels’ alone are not determinative. Contracts and working arrangements may be labelled or structured as one thing, but their interpretation by a Court or tax office may be something else. Two fairly recent High Court decisions illustrate how a person’s true legal status an employee or a contractor is determined:

• In Construction Forestry, Maritime, Mining and Energy Union & Anor v Personnel Contracting Pty Ltd [2022] HCA 1 , the Court held that in determining whether a person is an employee or a contractor, it is appropriate to look for indicators of whether the relationship is employment or

contractor solely within the terms of the written agreement, and not the subsequent conduct of the parties (unless the written agreement is held to be a sham, is incomplete or has been varied).

• In ZG Operations Australia Pty Ltd v Jamsek [2022] HCA 2, the Court clarified that although the test for determining whether someone is an employee or contractor is to characterise the relationship by reference to the terms of the written agreement between the parties, practical evidence of how the parties conducted themselves is both admissible and may be practically useful in determining the nature of the relationship.

The importance of good contracts

Good contracts are essential for dental practices who have dentists on independent contractor agreements, or facility and service agreements. Payroll tax is the latest issue under the spotlight, but there are a range of obligations, and liabilities for benefits and entitlements, that practices would not wish to take on unintentionally.

WADA Golf Lake Karrinyup

This fixture was a hark back to the past glories of Long Lunches. Due to lack of daylight at this time of year we decided to have an early start and enjoy a long lunch after the game held at the spectacular Lake Karrinyup Country Club, where a field of 29 golfers gathered to contest the ADA Cup, sponsored by Garry Bishop and Health Practice Brokers. This is a long-standing trophy, dating back to 1936, which is contested as a stroke event, with the winner determined by the best nett score.

We were joined at the lunch this year by retired ADA dentists who came at the invitation of both the ADAWA and the WADA Golf Society for a chance to share memories and renew friendships and to introduce some ‘younger’ players to esteemed past members of the ADAWA.

The course was once again magnificent, and the wind and rain added to the drama of the day. Jay Vaddagiri produced some great steady golf to take the best gross score on 81 and is the 2023 WADA Golf Club Champion for 2023. The day belonged to another young golfer in Patrick Douglas who scored a brilliant Nett score of 67 Strokes to take the ADA Cup for 2023 and receive a generous first prize from our major sponsor in Garry Bishop and Health Practice Brokers.

Nearest the pin

3rd hole

Long drive Michael Welten Insight Dental Ceramics

5th hole

NTP John Scully Health Practice Brokers

8th Hole NTP Michael Welten Dentsply Sirona

12th Hole NTP Patrick Douglas Healthlinc

14th Hole NTP Patrick Douglas WADA

17th Hole NTP Jay Vaddagiri Swan Valley Dental Laboratory

Our placegetters

• 3rd place on 73 strokes, Jannie Pieterse

• 2nd place on 72 Strokes, Jay Vaddagiri

• WADA Golf Champion 2023 - gross score of 81, Jay Vaddagiri

• ADA Cup winner on 67 strokes, Patrick Douglas

Our next day out is Kwinana Golf Course on September 15. If you’re interested in playing with ADA colleagues, let me know!

Good golfing

Frank Welten

WADA Golf Captain

Dentistgolf@gmail.com

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.

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

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

good news stories

ADA House upgrades

Upgrades of building services at ADA House is continuing. The upgrading of fire services has been completed, with electrical upgrades to follow. This will also lead to changes in the foyer of ADA House. Watch this space!

Guess who is coming for dinner?

Have you heard about the incredible food at our dinner courses? The menu from our recent sold-out Halitosis dinner course was mouthwatering! Join us for delicious food, networking and learning at our dinner courses.

Visit our website to book upcoming dinner courses, adawa.com.au/cpd

Supporting dental assisting

ADAWA is proud to support the dental assistants of the future, by sponsoring student graduate awards for Excellence in Certificate IV in Dental Assisting at DNA Kingston Training.

UDSS t-shirt

Spot the ADAWA logo! We are pleased to support students who are the dentists of tomorrow and the work of the UWA Dental Students’ Society.

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

Australian Dental Association Governance Summit

It was a historic day with leaders of every state and territory coming together for the inaugural Australian Dental Association Governance Summit – discussing imminent board and governance changes to our federal body.

Our ADAWA President, Dr Amit Gurbuxani says he is proud to be serving his presidency along with such a great group of leaders.

Business Development Manager

Shaden Kanaan recently joined the team as our Business Development Manager. She will be working on Corporate Partnerships, advertising and much more behind-the-scenes. If you would like to discuss any partnership, advertising or sponsorship opportunities with Shaden, please email shaden.kanaan@adawa.com.au

Thanks Dr Steven Parker

Dr Steven Parker recently came to Perth to share his advice at his always popular hands-on course about nitrous oxide and oral sedation. Did you miss out on this course? Steven will be back next year! Make sure you keep an eye on our website for new course announcements. adawa.com.au/cpd

Relocation announcement

Dr Janina Christoforou

Dr Janina Christoforou will be providing specialist oral medicine services at the following locations:

KALAMUNDA and MOUNT LAWLEY.

Change in scope of practice announcement

Periodontics & Implants wish to advise of an imminent change in our scope of practice.

We plan to open our books entirely to Periodontics and will no longer be taking new patients for placing dental implants. We will trade under the new business name of Southside Periodontics. We look forward to continuing caring for your patients for managing periodontal and peri-implant diseases.

MOUNT LAWLEY

47 Railway Pde, Mount Lawley

KALAMUNDA

Perth Hills Specialist Centre

182 Canning Rd, Kalamunda

T (08) 9257 8500

E admin@westernoralmed.com.au

W westernoralmed.com.au

T (08) 9417 3008

E blueswimmer50@gmail.com

C Peter Kerrisk

New Practice Announcement

Dr Fleur Creeper is excited to be returning to practice in her new periodontal studio. She looks forward to supporting your patients with their periodontal needs and is gratefully accepting referrals.

New Practice Announcement

Specialist Orthodontists, Dr Jippy Buck and Dr Lloyd Buck are delighted to announce the opening of their new practice ‘Smile Arc Specialist Orthodontics’ in Doubleview. Providing a full range of orthodontic care in a new and modern setting. Accepting referrals for children, teens and adults.

T (08) 6184 4754

E hello@thegumstudio.com

A 252 Stirling Street, Perth

W thegumstudio.com

T (08) 6246 6957

E hello@smilearc.com.au

A 255 St Brigids Tce, Doubleview 6018

W smilearc.com.au

Dr Soon Leng Saw - new addition to the team

We are pleased to announce that Dr Soon Leng Saw has joined the Class 1 Orthodontics team. Dr Soon is an Australian Board Certified Orthodontist and an active member of the Australian Dental Association and the Australian Society of Orthodontists (ASO). Dr Soon speaks five languages (English, Malay, Mandarin, Cantonese and Hokkien) and will practice out of our Cockburn, Rockingham and Busselton Clinics.

Dr Udit Bhatnagar - new addition to the team

Toothbuds Paediatric Dentistry is happy to announce the addition of Specialist Paediatric Dentist Dr Udit Bhatnagar to the team. Dr Udit offers years of experience in all aspects of paediatric dental care, and is happily accepting referrals at our Morley and Midland locations.

MORLEY MIDLAND

43 Wellington Road 8 The Avenue

BUNBURY

114 Clarke Street

T 1300 922 722

E prm@class1ortho.com.au

W class1ortho.com.au

New Practice Announcement

Dr Shelley Greenway is pleased to announce the opening of her new practice (just across the road from the previous practice) in Karrinyup. With a new name, Face to Face Orthodontics, Shelley and her team continue to provide the same high standard of care now in an entirely new space that presents with a relaxed and comfortable interior design. Dr Greenway and her outstanding team welcome both existing and new patients for all their orthodontic treatment.

T (08) 9446 2313

E admin@facetofaceorthodontics.com.au

A Unit 3-4, 184 Karrinyup Road, Karrinyup 6018

W facetofaceorthodontics.com.au

T (08) 6155 9899

E admin@toothbuds.com.au

W toothbuds.com.au