Western Articulator Edition 3, 2026

AUSTRALIAN DENTAL ASSOCIATION WA

EDITION 3 2026

Renovating a practice

Part 2 of our series

The power of a smile

Dr Simone Mustac

Congratulations Dr Kathryn Braysich

THE RECOGNISED VOICE OF ORAL HEALTH IN WA

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Scan to explore the program and speaker lineup

RACDS WA Regional Committee

Annual Scientific Meeting Theme: The Dental Nexus - Where Care and Clinical Skills Meet

Join leading clinicians at the RACDS WA Annual Scientific Meeting and gain practical, evidence-based insights across disciplines.

6.5 CPD HOURS For General and Specialist Dentists and Oral Health Professionals!

Keynote Speaker

Friday, 24 July 2026 8:15AM – 5:00PM (AWST) Perth Convention and Exhibition Centre

Meet your presenters Dr Erin Mahoney (RACDS President) | Paediatric Dentist Dr Graham Carmichael | Prosthodontist Dr Dayea Oh | Oral and Maxillofacial Radiologist Dr Kelly Oliver | Paediatric Dentist Dr Amanda Phoon-Nguyen | Oral Medicine Specialist Dr Armand Putra | Prosthodontist Dr Ahmed Saleh | Periodontist Dr David Thean | Oral and Maxillofacial Surgeon Elena von Rosenberg | Physiotherapist Dr Annalene Weston | Dentolegal Advisor Dr Chris Wholley | Orthodontist Dr Jee Yun-Leung | Special Needs Dental Specialist

Prof Lara Friedlander Endodontist MDS(Endo) PhD(Otago) FRACDS FICD FPFA

Photos courtesy of Rachael Safet Photography

contents. report 4 President's Dr Tim Crofts comment 5 CEO Mr Trevor Lovelle a practice 6 Renovating Part 2 of our series advertorial 12 Medifit Designing for privacy in dental practices

14 Congratulations Dr Kathryn Braysich 16

The power of a smile Dr Simone Mustac

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CPD Spotlight Dr Julio Rincon

20 CPD Calendar

numbers – do’s 22 Item and don’ts ADAWA Peer Advisor, Dr Tony Poli

Specialist advertorial 24 BOQ Apex Orthodontics feature 26 DPL There’s nothing wrong with the filling

article 32 Clinical Sjogren’s Syndrome

36 Member news 39 Professional notices 42 Directory

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The President's report Dr Tim Crofts, ADAWA President

This month I wanted to give an insight in to some of the work that has been undertaken recently to improve our workforce issues and support our community in Western Australia.

training. If anyone has any input into these qualifications, please advise us and visit their website for further information as there is an upcoming workshop on the issue.

At the start of every new year, we have discussions with Community Skills WA and provide a submission and survey to the WA Jobs Education and Training Consultation, which is vital to ensure we have adequate dental staff to support our practices.

We also requested again for the Dental Assistants to be placed on the Designated Area Migration Agreement (DAMA). This will hopefully allow overseas trained staff to work as Dental Assistants due to the critical shortages we are experiencing.

The Workforce and Country Committees have also been busy collecting data on the staff shortages, including from advertising and surveys, as these provide evidence we can then use in our submissions.

We have provided both State and Federal submissions for the migration lists, highlighting a critical shortage of Dental Assistants, Regional and Government Dentists, and Therapists.

We have also been engaging with an organisation called Human Ability.

They are tasked with undertaking a national review of the following qualifications: Dental Assistant, Dental Technician, Dental Prosthetist, Dental Lab Assistant, through TAFE level

CEO Trevor Lovelle

President Dr Tim Crofts

Editorial Brooke Evans-Butler Designer Michelle Walker

Another important submission that occurs yearly, at this time, is the Occupation Shortage List Stakeholder Survey. Again, the data gathered is incredibly useful to back up our reports of staff shortages.

In the last edition, we reported on the Consultation for Experienced Overseas Practitioners, which we supported to a limited extent to get more dentists to fill our chronic regional shortages.

So, much has been going on and continues every week to improve the workforce situation in WA. It also relies on our members providing feedback and giving us data to work with so please keep contributing.

Thank you!

Advertising Business Development Manager Shaden Kanaan

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.

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CEO comment Trevor Lovelle

Updates to Professional Indemnity Categories for FY27 Late last year, ADAWA’s Professional Indemnity Committee met with MDA National to discuss potential changes to the dental practice category guide for FY27. While ADAWA recommended several adjustments to improve clarity in the category descriptors, MDA National’s economic modelling showed that the proposed structural changes would create unacceptable premium impacts across multiple categories. As a result, the broader changes were not adopted.

However, several important enhancements will be introduced in FY27 to improve flexibility, accuracy, and fairness in practitioner categorisation.

Key Category Enhancements • Transition from hours to days for part-time categories including E2D, YDTR and RMA. The basis of classification will shift from hours worked to days worked. This provides greater flexibility for practitioners with variable schedules and strengthens MDA National’s competitive position.

• Introduction of a Non-Clinical Category A new category will be available for practitioners with no clinical contact who work exclusively in dento legal reporting, academia, research, or administration. This ensures more accurate risk assessment and fairer premiums for non-clinical roles.

• Introduction of the YD5 Category The new YD5 category will create a more gradual premium progression for early career dentists, supporting practitioners as they transition from graduation into established practice.

Why Broader Structural Changes Were Not Adopted A key strategic focus remains achieving a more nuanced risk rating, particularly in higher risk areas of dentistry. Currently, separate categories exist for practitioners performing implants (YDI), surgical removal of third molars (YDM), and those performing both (YDX).

An initial proposal suggested modifying the YDX structure so that practitioners performing both implants and third molars could instead opt for a combined YDMI category, reserving YDX for those undertaking sinus lifts or bone augmentation. However, analysis showed that most practitioners in YDX are there because of their implant and third molar work and not because they perform sinus lifts or augmentation. Claims data also confirms that premiums in this category are primarily driven by these two procedures.

Introducing the proposed YDMI category would have resulted in significant premium reductions for a high risk group, creating substantial under funding at the pool level.

It would also have required steep premium increases in other categories—changes that would not be commercially or reputationally sustainable.

This process highlights an important distinction: clinical complexity does not always correlate with claims risk. ADAWA will continue working with MDA National to refine categories in a way that reflects real world risk while maintaining fairness and stability for members.

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Renovating a practice: Part 2

In part 2 of our renovation series, we look at considerations when renovating a practice.

Renovation case study WA Dental Dr Marc Nalder from WA Dental Ellenbrook, who renovated with UDPM, shares his practice renovation experience.

Why did you decide to extend your practice?

We found ourselves consistently fully booked and simply couldn’t keep up with the growing patient demand.

By expanding the practice quite significantly, we’ve not only met our current needs but also future-proofed our capacity. This means we can continue to grow without hitting a bottleneck again anytime soon.

What did the renovation entail?

We expanded into neighboring units, allowing us to create a purposebuilt environment with 15 treatment rooms: eight for general dentistry, five for orthodontics and two for surgical procedures. Each area of dentistry now has its own dedicated space, which has streamlined our workflow and made everything more efficient.

How long did the renovation take?

The longest part was the council approval and planning stages because we wanted to optimise every square meter. Once that was sorted, the renovation itself was completed in about six months.

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Where did you take inspiration from for the practice design and layout?

It was a blend of approaches. For the general rooms, the design was straightforward, but for surgical and orthodontic spaces, we combined ideas from various clinics and then customised them to fit our unique setup. We had to be creative since there wasn’t really a template for a practice combining all three areas of dental under one roof.

What are your thoughts about the results? How has it changed or improved your practice?

The results have been incredible.

Our team loves the improved workflow and patients notice the wow factor we’ve gone for. It’s not just about day-to-day improvements, this renovation has future-proofed our practice, ensuring we can keep expanding without outgrowing our space.

Are there any other additions or changes you are planning on making to the practice in the future?

Right now, we’re just focused on fitting out the remaining two general dental chairs as we grow. We’re excited to see how things evolve and we’re always looking for new innovations to keep things fresh and ensure our patients have the best experience.

How did you and your team manage the continuing running of your practice during the renovation process?

We worked closely with the builders and got creative with space, turning dental rooms into temporary offices and using the surgical area as a temporary reception. Our patients were really understanding and even excited to see the transformation happen in front of them.

As a practice owner who has gone through an extensive renovation, what would your advice be to others considering it?

Get multiple quotes. It can save you a lot. Also, plan for the long term so you don’t have to renovate again soon.

Build a space that can grow with you.

Was there anything you would change if you were undergoing the process again?

Not really! It was a fun experience, and I’m thrilled with the results.

If anything, I just wish we’d captured

more progress photos along the way - it would be nice to look back and see how far we’ve come.

Renovating and Expanding a Dental Practice Castlegate Dental Renovating or expanding a dental practice presents a valuable opportunity to enhance clinical efficiency, improve patient experience, and strengthen long-term operational sustainability.

Successful outcomes, however, rely on early collaboration between all stakeholders, including practice owners, project managers, equipment suppliers, and specialist contractors. A recent renovation project at Castlegate Dental, led by Principals Jilen and Michael, Practice Manager Jane, builder Simon Coyle and the team at United Design and Project Management (UDPM), together with equipment supplier West Coast Dental Depot, demonstrates how structured planning and coordinated communication can support complex practice upgrades.

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Project Overview and Key Outcomes The renovation involved a comprehensive redesign and expansion of the clinical and administrative layout to support future growth and improve workflow efficiency. The practice temporarily ceased operations for eight weeks to allow the construction works to be completed safely and efficiently.

Key project outcomes included: • Increasing treatment room capacity from two to three surgeries, enabling the practice to accommodate higher patient volumes and reduce waiting times • Creating a combined Practice Manager office and consultation space, incorporating a shared “hot desk” arrangement for the principals.

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air-conditioned, and acoustically dampened enclosure to improve internal environmental conditions.

• Providing a dual-function staff room incorporating an administrative workspace to support operational flexibility.

• Redesigning the patient reception and waiting area with integrated backlit architectural features and seating elements to enhance the overall patient experience.

These improvements were developed through detailed consultation with the practice to ensure the new layout supported both current operational needs and future service expansion.

Equipment Integration and Technical Coordination

• Delivering a newly designed ergonomic sterilisation area, including stacked autoclave configuration to optimise spatial efficiency.

From an equipment planning perspective, early engagement between the project team and West Coast Dental Depot ensured that clinical workflow requirements were incorporated into the design phase rather than addressed retrospectively during construction.

• Relocating the plant room externally to a purpose-built,

Director Greg James and Sales and Projects Manager Wayne Young

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worked closely with the practice and construction team throughout the planning and delivery stages to ensure equipment requirements remained aligned with the evolving design. This collaborative approach supported informed decisionmaking around spatial planning, service infrastructure, and installation sequencing.

This approach enabled: • Early confirmation of equipment positioning and spatial allowances.

• Coordination of mechanical, electrical, plumbing, and data services with construction trades.

• Alignment with manufacturer specifications and regulatory compliance requirements.

• Streamlined installation and commissioning following completion of building works.

• Reduction of potential downtime through structured planning and sequencing.

Through close collaboration between the practice, builder, and equipment supplier, equipment service requirements were fully integrated into the construction programme, enabling efficient installation and handover upon project completion.

Sterilisation considerations At a dental practice, it is important to take into account sterilisation considerations. Hayley Avery, Managing Director of STS Group Australia (STS Health & Mocom Australia), shares her considerations: 1.

Plan a one-way instrument workflow from the outset Renovation layouts should

allow instruments to move from dirty to clean, receiving, cleaning, inspection, sterilisation, then storage, without crossover.

Designing zoning early avoids compliance issues and workflow constraints later.

2. Design joinery and services around equipment requirements Sterilisers, washer disinfectors, and ultrasonic cleaners have specific space, ventilation, drainage, and service access needs. Confirming equipment footprints and services before joinery design prevents costly rework.

3. Check AS/NZS 5369 and ADA guidance before finalising plans Current standards influence zoning, sinks, storage, ventilation, and reprocessing flow. Reviewing requirements during planning helps ensure the renovated space supports compliance from day one.

4. Specify cleanable, infectioncontrol compliant finishes Benchtops, cabinetry, and splash zones should be smooth, impervious, and resistant to cleaning chemicals and disinfectants. Minimal joins, sealed edges, and wipeable surfaces reduce contamination traps and support effective cleaning.

5. Allow space for heat, ventilation, and future capacity Modern sterilisers generate heat and require airflow and servicing clearance. Planning for ventilation and potential additional equipment ensures the sterilisation room remains functional as the practice grows.

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Top tips from Sam Koranis, Medifit Design and Construct Top tip for a practice owner who is looking at a building a new practice Planning with purpose is crucial to success. When you’re starting from scratch, the most valuable step is to invest time in defining your clinical and business objectives before design begins. Everything from your site selection and spatial flow to compliance and intended patient experience should be guided by those goals. Engaging a specialist healthcare design and construction team early to guide you through the process can avoid costly redesigns or compliance issues later.

A well-planned design should enhance efficiency, reflect your brand values, and support the way you want to practice.

Top tip for a practice owner who is looking to expand their current practice - expanding number of rooms Expanding your practice is the ideal time to future-proof your layout and infrastructure for emerging technologies and evolving models of care. It’s not just about adding more rooms, it’s also a chance to improving operational flow, patient throughput and staff experience. Look for opportunities to not only increase your footprint but improve the productivity of your existing space.

Top tip for a practice owner who is looking to refresh their current practice.

Consider how patients experience your practice. Their comfort,

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confidence and perception of quality all begin from the moment they walk in your doors. If your practice looks tired, what sort of message does that send to your patients? How do patients move through your practice?

Is there a defined flow? finishes, lighting, and better ergonomics can transform the feel of a space while maintaining your current footprint.

Finance tips Josh Van Bruchem from BOQ Specialist, shares his top tips: • When planning a renovation, it’s important to engage your banking partner early to help ensure funding is structured appropriately and available when you need it, reducing the risk of delays during the build.

• One common challenge is using a funding structure that isn’t well aligned to the timing and nature of renovation costs, which can place unnecessary pressure on cash flow over the life of the project.

• When considering where to invest, look beyond aesthetics and think about whether the upgrade will improve efficiency, increase capacity or support smoother patient flow, all of which can contribute to stronger business performance over time.

• It’s also important to factor in cash flow impacts during the renovation period. If the practice needs to temporarily close or reduce appointment volumes, consider how ongoing fixed costs will be managed while revenue is affected.

A new level in oral hygiene New PerioPlus+ from Curaprox combines the treatment benefits of chlorhexidine (CHX) with CITROX® for great taste and reduced impact on your patient’s sense of taste.

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17A Wheeler Street, Belmont WA 6104 • Phone (08) 9479 3244 • Fax (08) 9479 3255 • Email sales@westcoastdental.com.au

Designing for Privacy in Dental Practices: Building Trust from the Ground Up

In a dental practice, privacy isn’t just about compliance, it’s about trust. Every day, your patients share personal information, sit through vulnerable procedures, and rely on your team to provide care in a setting that feels safe and discreet. Getting the design right plays a bigger role in that experience than many practitioners realise.

At Medifit, we understand that privacy in a dental environment needs to work on multiple levels, from protecting patient information to ensuring conversations and treatments remain confidential. It’s not an add-on; it’s built into the way we design your space.

Well-considered design creates a sense of calm and professionalism. It allows patients to speak openly, supports better clinical outcomes, and reinforces the quality of care you provide. It also ensures compliance with Australian privacy requirements, including the Privacy Act 1988.

Why Privacy Matters in Dentistry

How Medifit Designs for Privacy in Dental Practices

Dentistry is inherently personal. Whether it’s a routine check-up or a more complex procedure, patients are often anxious and highly aware of their surroundings. If they can overhear conversations at reception, or feel exposed in a treatment room, it undermines their confidence in the practice.

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Acoustic Control Where It Matters Most One of the most common issues in dental practices is sound transfer, particularly between treatment rooms and reception.

We address this early in the design process through wall construction, insulation, door seals and acoustic materials that reduce sound leakage.

We also consider adjacencies carefully, separating consultation and treatment zones from hightraffic areas. The result is a quieter, more controlled environment where conversations stay private.

Layouts That Protect Patient Dignity Good planning eliminates direct sightlines into clinical spaces.

Patients in the waiting area shouldn’t be able to see into treatment rooms, and movement through the practice should feel natural without exposing private areas.

We carefully position reception, waiting, and circulation paths to create subtle layers of privacy. Even small decisions, like the orientation of chairs or the placement of screens, can make a meaningful difference to how comfortable patients feel.

Discreet and Secure Front-of-House Design Reception is often where privacy can break down. We design reception areas so conversations can happen without being overheard by the entire waiting room. This might include spatial separation, acoustic treatments, or simply ensuring enough distance and flow within the space. It allows your team to communicate clearly with patients while maintaining discretion.

Secure Handling of Patient Information With digital systems now standard across dental practices, privacy

extends beyond the physical space.

We incorporate designated zones for administration and records, ensuring screens, storage and workflows are positioned to limit visibility and access. This supports both compliance and operational efficiency, without compromising the look and feel of the practice.

Flexible Solutions for Different Treatment Types Not all treatments require the same level of privacy. We design practices that can adapt, whether through sliding partitions, privacy screens, or zoning strategies that allow areas to operate independently when needed.

This is particularly valuable in multichair practices or those offering a mix of general and specialised services.

Designing a Practice that Patients Trust Privacy isn’t something patients consciously notice when it’s done well, but they absolutely feel it. It shows up as comfort, confidence, and a willingness to return and refer.

At Medifit, we design dental practices that support not just compliance, but the overall patient experience.

By integrating privacy into every stage of planning and delivery, we help you create a space that reflects the quality of care you provide.

Because ultimately, the right environment doesn’t just protect your patients, it strengthens your practice. medifit.com.au

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Congratulations Dr Kathryn Braysich

WA Rural Health Excellence Awards

Congratulations to Dr Kathryn Braysich, who was named Allied Professional of the Year at the 2026 WA Rural Health Excellence Awards.

Dr Kathryn Braysich has a long history of providing care for rural communities.

JCU in Cairns and supervising UWA dental students in Geraldton,” she says.

“My first job was with DHS based in Meekatharra but also providing a service to Wiluna, Mt Magnet, Cue and Sandstone in a mobile van, I worked for DHS for two years,” Kathryn recalls.

Kathryn says she enjoys the challenges and the autonomy of working rurally – adding the rewards of working rurally are the satisfaction of being able to provide a muchneeded service to a rural community and the recognition and gratitude that community gives you.

“After that I worked on Groote Eylandt in the NT for 18 months, which involved going to several communities on the island and occasionally flying to the mainland of East Arnhem to communities there.

To dentists considering working rurally, Kathryn “I then worked in Wongan Hills in says to go for it. “There Wheatbelt WA for three years and are many opportunities moved to Geraldton in 1998.” for a dentist working Kathryn did a brief locum stint at Carnarvon Aboriginal Service, before rurally and you get buying a Practice in Geraldton in 2002, to become part of a where she worked for 20 years. wonderful community,” “Since I sold my Practice, I have been working as a locum in several she says. places including Arnhem Land in the NT, Broome, Derby, Kununurra and Geraldton with DHS, also one year with Geraldton Aboriginal Medical Service and supervising dental students at

She said she was very honoured to have been recognised for her work in rural and remote areas.

Congratulations Dr Braysich!

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Photo courtesy of Rachael Safet Photography

The power of a smile

Specialist Orthodontist Dr Simone Mustac is giving back via the ADA Dental Health Foundation’s (ADA DHF) Rebuilding Smiles program.

Orthodontist Dr Simone Mustac wanted to give back but wasn’t sure if there would be much need for orthodontics via dental volunteerism programs.

Her practice, Ellenbrook Orthodontics, was already involved with the Give a Smile program (the charitable arm of the Australian Society of Orthodontists), when Simone reached out to Andrea Paterson at ADA DHF.

“I was inspired to do some more volunteer work after hearing stories of hardship from our patients," Simone says.

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“One patient that really stayed with me was a mum who became quite emotional while we were discussing her son’s treatment plan,” Simone recalls. “She told me her husband had recently passed away and treatment just wasn’t financially possible at the time. The patient was very self-conscious, and the treatment I recommended was best done while he was still young, so I offered to do the treatment pro bono.

Then I thought it would be nice if we could do that more for people who really need it via a formal volunteering program.

Andrea did not have a patient requiring orthodontics for some time, but Simone was happy when a needy patient was referred via the ADA DHF’s Rebuilding Smiles program.

The patient is now part way through her treatment with the team at Ellenbrook Orthodontics.

“The patient is a teenager who, unfortunately, has a history of domestic violence in her household,” Simone explains. “She was very selfconscious because her teeth were very protrusive and as a result she was being teased at school.

“She has been an amazing patient,” Simone adds. “We had a few issues at the beginning with irregular attendance due to her challenging home situation, and she once presented with a family member who was disruptive in the reception area.

Whenever we had any issues, we contacted Andrea, and Andrea was excellent and communicated directly with the patient and her family establishing clear expectations.

every single day, there are times you can get focused on the day-to-day negatives.

Having that volunteer experience and realising what a difference your job can make to a patient’s confidence is great for all involved.”

Simone says it has also been rewarding seeing the patient’s self-esteem improve at every appointment.

“Now when she attends her appointments she is often smiling, whereas before she was covering her mouth,” Simone says. “Seeing her confidence increase in the clinic is very rewarding. She now chats to the staff and tells us about her school and other aspects of her life.”

To another dentist considering volunteering, Simone recommends getting involved. “Particularly for orthodontics, once they get those braces on, they are such short appointments. It isn’t like you are taking up your only clinical room for hours at a time. I would love to continue being part of this volunteer program.

“But despite these hiccups, the patient has always been very respectful and appreciative,” Simone says.

“Andrea makes it so easy,” she adds.

“At one point in treatment, her oral “There isn’t much administration or hygiene was very poor, but when I anything like that – she does all that asked why this was the case, she work. I don’t see any downside to it. was very honest and said she no “If this is something you want to be longer had access to a toothbrush, involved in, reach out and offer your so we provided her with another one services. I didn’t think the program and that resolved the issue. She is would use an orthodontist, and very mature for her age, and travels although it took Andrea a bit of a significant distance via public time to find a patient, it shows that transport to attend her appointments.” whatever service you can offer will Simone says it has been a positive benefit a patient.” experience for the practice team.

If you are interested in giving back via “The team loves the feeling that we a program with the ADA DHF, please are helping people,” Simone says. contact WA state coordinator, Andrea “I think when you are working in a job Paterson at wa@adadhf.org.au

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Meet Dr Julio Rincon

In the lead up to his course, ‘Hands-on Basic Periodontal Instrumentation’ in July, we caught up with Dr Julio Rincon.

For Dr Julio Rincon, dentistry is in the family (his brother is currently a maxillo-facial surgeon in Colombia).

It was during his compulsory social service year in Colombia, that Julio was drawn to the field of Periodontics.

“I was often exposed to severe periodontal cases and realised that not many dentists were willing to treat them, including myself,” he says. “That sparked my interest in the specialty and fortunately I was able to get into the program a few years later.”

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Julio will be presenting his course Hands-on Basic Periodontal Instrumentation, on July 25.

“Most general dental routine periodontal debridement are completed in a single session with the use of sonic/piezo electric scaling,” he explains. “From my perspective the use of manual periodontal instrumentation is underestimated.

Attendees will identify universal and site-specific periodontal curettes.

They will review how to use both universal, site-specific curettes, hoes and advanced instruments. They will be shown how to sharpen periodontal instruments for proper maintenance.

We will be providing brief lectures followed by demonstrations from the presenters and then a hands-on tutorial where attendees will be able to complete all practical exercises.

“I will be having Mrs Carol Nevins joining me for this course,” Julio says.

“She has ample clinical and teaching experience training dentists and hygienist. We have both organised this hands-on course many times.”

He says any dental clinician with an interest in fine-tuning manual periodontal debridement skills, hygienist, dentist, students and any dentist interested in getting into a postgraduate program should attend this course.

He hopes attendees walk away from the course with a good refresher on how to identify calculus deposits and hold/adjust universal and site-specific instruments against root surfaces up to the base of the periodontal pockets.

Julio, who has a history as a senior lecture at UWA, enjoys being able to share his experience of cases that would not normally be encountered with the students.

“Students in clinic would always remember me being able to retrieve calculus deposits on my review despite the use of manual and sonic instrumentation,” he says. “My initial approach was to search for calculus with an explorer first then with manual instruments and was very keen on getting them to realise that sonic instrumentation was not always as efficient as it may initially appear to be.”

Dr Julio Rincon will present ‘Hands-on Basic Periodontal Instrumentation’ on July 25.

To book your seat, visit our website, cpd.adawa.com.au

5 minutes WITH DR JULIO RINCON

What three words best describe you?

Joyful, Calm and Loyal.

What do you enjoy doing in your spare time?

Travelling, working on at home projects, as well as spending time with my wife and two sons.

What is your favourite book?

The Little Prince.

What is your favourite place in the world?

Australia, anywhere.

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

I am a bit of a handyman. I love fixing/building things at home just like the timber decking that I installed as well as the woodfired pizza that I have where I have according to my family perfected making pizza dough from scratch.

I also enjoy decorating the house with custom pictures.

What future plans are on the horizon for you?

I am looking forward to my son’s wedding as well as the opportunity to have my mother and two brothers come all the way from Colombia for the wedding.

Professionally to be able to start practicing at the new upgraded location for Perio Perth and to further enjoy the art of periodontics.

Who knows maybe in the future I may return to academia?

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CALENDAR 2026 may Oral Medicine Essentials: Practical Skills (and AI) for Everyday Practice A/Prof Ramesh Balasubramaniam ABBEY BEACH RESORT

9 SAT

12 TUES

CPR Refresher Australian Resuscitation Council ADA HOUSE Management of Medical Emergencies in the Dental Practice Cynergex Group ADA HOUSE

16 SAT

22-24 FRI

27 WED

Advanced Digital Implant Reconstruction: From Single Tooth to Full Arch Drs Aqeel Sajjad Reshamvala and Nishant Vaishnav ADA HOUSE When the Red Doesn't Stop: Bleeding Disorders and Dentistry (FREE EVENT) Dr Jee-Yun Leung ADA HOUSE

june 9 TUES

27 SAT

JULY 22 WED

25 SAT

Endodontics 12-13 Comprehensive Dr Gaurav Vasudeva

8 SAT

15 SAT

WED

21 FRI

FRI

OHCWA

22

17

Basic Practical Infection Control - How to do it Dr Roslyn Franklin and Mr Steve Lines ADA HOUSE

SAT

WED

18 THUR

Surgical Mishaps: Prevention, Recognition and Response Various ADA HOUSE

19 FRI

24 WED

20

What to Cement or When to Bond? Or is the question When to Cement and What to Bond?

Dr Joshua Graieg UNIVERSITY CLUB

Clinical Application of Lasers in Hard Tissues (FREE EVENT) Dr Ajitha Kanupuru ADA HOUSE

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Artificial Intelligence in Dentistry Dr Yulianna Shiikha ADA HOUSE Hands-on Basic Periodontal Instrumentation Dr Julio Rincon OHCWA

AUGUST

19 Periodontal Regeneration: Exploring the Latest Science and Clinical Strategies (FREE EVENT) Dr Eman Elhassan ADA HOUSE

Injection Moulding Technique in Everyday Dental Practice Dr Joshua Graieg OHCWA

The Therapeutic Uses of Botulinum Toxin and Intraoral Dermal Fillers in General Dental Practice Dr Mohammed Meer ADA HOUSE Paediatric Dentistry in General Dental Practice Dr Udit Bhatnagar OHCWA Basic Practical Infection Control - How to do it Dr Roslyn Franklin and Mr Steve Lines MANTRA BUNBURY LIGHTHOUSE Hands-on Dental Laser course with a Laser Safety course Dr Pradeep Koppolu, Ms Anita Reed ADA HOUSE Practical Oral Surgery Various CTEC

September 5 SAT

19 SAT

Anxiolysis and Relative Analgesia (N2O) in Modern Dental Pracfice Dr Vivian Mascarenhas OHCWA Composite to Restore Shape and Form Drs Glen Liddelow, Joshua Graieg, Sally McMullen OHCWA

S C A N Q R TO B O O K

october to Teens 10 Tots Dr Lisa Bowdin SAT

14 WED

23 FRI

29 THURS

31 SAT

RYDGES HOTEL KALGOORLIE

Patient-centred Contemporary Peri-Implantitis Treatment Professor Lisa Heitz-Mayfield UNIVERSITY CLUB

PUBLIC HOLIDAYS 2026

PUBLIC SCHOOL HOLIDAYS 2026

1 Jun - WA Day

4 Jul – 19 Jul

28 Sept - King's Birthday 25 Dec - Christmas Day 26 Dec - Boxing Day

26 Sept – 11 Oct 18 Dec - 31 Jan

Restore My First Implant Drs Graham Carmichael and Glen Liddelow THE BRANEMARK CENTER Hands-on Clinical Photography Dr Graham Carmichael THE BRANEMARK CENTER Practical Oral Surgery Various CTEC

november 9 MON

14 SAT

No Roots Left Behind: Hands-On Surgical Extraction Techniques Dr Frank Chang CTEC Conservative Ceramic Restorations, when to do what Drs Asheen Behari and Paul Gorgolis OHCWA

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Item Numbers – Do’s and Don’ts

By Dr Tony Poli, ADAWA Peer Advisor DO – Always use the current edition of The Australian Schedule of Dental Services and Glossary, currently the 13th Edition. This is free to download for ADA members. Be on the lookout for availability of the 14th edition.

Adequate written description of the service is required.” Schedule (13th Edition), eg Use when noting Bite relation (MMR or Rels) taken if not added as a practice specific “Item Number”.

DON’T – Use an older version because you could be using an Item Number that has been either deleted or the description amended. If you use a deleted or amended Item Number, the health fund will not give a rebate.

Also, you could run afoul of an Ahpra investigation or a health fund audit on the basis of incorrect treatment or charging.

# Indicates services that may not be GST-free as they may not be ‘necessary for the appropriate treatment' of the patient, for example, services for medico-legal or cosmetic purposes (see paragraphs 44 and 45 of the Class Ruling - Schedule (13th Edition).

DO – Read and check the Amended Item Numbers, the Deleted Item Numbers and the New Item Numbers section on Page 5 of the Schedule. It is important to use the new or amended numbers and not to use deleted numbers.

DO – Use the Item Number that describes what you have done.

If unsure which Item Number is most appropriate, contact ADAWA or the ADA Peer forum and tag Schedule and Item Number Committee. These are the only people who can provide the correct interpretation of an Item Number.

DON’T – Use Item numbers that are not in the Schedule. For example, in D4W there is Item Number 9999 – Dental treatment, see Treatment Notes. Only use this to describe treatment you are not charging for, preferable to use 990 “Treatment not otherwise included (specify) # An item number used to identify dental treatment not elsewhere described.

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DO – It is a good idea to write your notes pertaining to each Item Number next to that item number and not to write the notes for all treatment carried out at that visit under the one number. For example, if you do 531 on 46 and 531 on 47 write the treatment notes under each tooth. It is advisable not to write notes for both teeth under the 46 only or if using D4W in 9999. “It is often clearer to make notes under each item number. In some instances, for example, in itemising a partial denture, or multi-canal endodontic procedure, recording a single note is practical and acceptable.”

ADA Schedule and Glossary Q&A #2: Item Number Use, Billing and Fees | Australian Dental Association. Also, if you have a health fund audit or Ahpra investigation, there can be no dispute as to the existence of clinical notes for each procedure for the relevant tooth/teeth and you won’t have to justify and show that you have written the notes – they are there and easy to see. Make life easy for yourself.

WHAT TO CEMENT OR WHEN TO BOND? 3 CPD 18 june

6.30pm - 9.30pm

UNIVERSITY CLUB

COURSE OUTLINE CAD-CAM, biomimetics and adhesive bonding, but does it work? What is the best way to restore a structurally compromised tooth? What material should you use? And how is the best way to make it stay and last?

This evening lecture will cover: 1. Bonded vs Cemented Approach to Dentistry 2. Different Restorative Materials 3. Modern Ceramics, Hybrids, and Printed materials 4. Cementation Protocols including rubber dam

$403 members

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 BDSc from the UWA and a Doctor of Clinical Dentistry in Prosthodontics from the University of Sydney. He is 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.

Josh is in private practice in West Perth.

5. Overview of Biomimetic concepts – IDS and DME 6. Surface treatment and Bonding Protocols for different materials SCAN QR TO BOOK

FOR MORE INFORMATION GO TO CPD.ADAWA.COM.AU

Dr Tapiwa Gwengo & BOQ Specialist’s Aaron Montoro. Source: Pixel Factory

Apex Orthodontics: personalised care supported by the right financial partner

Every smile tells a different story, and at Apex Orthodontics, this belief shapes everything they do. Founded on clinical excellence, advanced technology and personalised care, Dr Tapiwa Gwengo’s specialist practice is quickly establishing itself as a trusted destination for patients of all ages.

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Built with purpose, Apex Orthodontics was designed to feel accessible, supportive and genuinely patientcentred. Founder and specialist orthodontist, Dr Gwengo, set out to create a space where innovation, specialist skill and warmth combine to elevate the orthodontic experience. Dr Gwengo brings extensive experience to the practice, having completed five years of general dental training at the University of Otago, followed by specialist orthodontic training at the University of Queensland. His ongoing professional development enables him to offer a full spectrum of orthodontic solutions, from early intervention to complex cases requiring surgical collaboration.

Launching a new specialist practice also requires strong foundations beyond the clinic. From the outset, Apex Orthodontics partnered with BOQ Specialist, a lender with more than 30 years of experience supporting medical and dental professionals. With tailored financial solutions, including an escrow facility, full funding for equipment and fit out, and streamlined invoice funding — BOQ Specialist helped provide the stability and flexibility needed during the critical early stages.

Looking ahead, Dr Gwengo plans to grow Apex Orthodontics through continued investment in technology, team development and patient care.

With a clear vision, strong community engagement and the right financial support, the practice is well positioned for long term success.

BOQ Specialist - a division of Bank of Queensland Limited ABN 32 009 656 740 AFSL and Australian Credit Licence no. 244616 The issuer and credit provider of these products and services is BOQ Specialist. Terms and conditions, fees and charges and lending and eligibility criteria apply. Should you wish to obtain a copy of the Terms and Conditions relating to this product, please contact BOQ Specialist to obtain a copy before making any decision about whether to acquire the products. We reserve the right to cease offering these products at any time without notice.

Find out more at boqspecialist.com.au

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There’s nothing wrong with the filling. When a defensive response turns into a formal complaint.

Dr Colm Harney, Dentolegal Consultant at Dental Protection discusses the risks associated with treating deep caries.

Tooth sensitivity following a deep restoration is one of the most recognised post-operative complications in general dental practice. It is also, paradoxically, one of the most frequent triggers for patient complaints – often not because of the sensitivity itself, but because of insufficient patient understanding of the situation prior to treatment and how it is handled when the patient returns in pain, upset and often questioning what happened.

The clinical reality is well understood by clinicians. When dental caries is close to or has encroached on the pulp, placing a restoration in close proximity to vital tissue carries a notable risk of post-operative sensitivity, and in some cases, irreversible pulpitis or pulp necrosis.

These outcomes are not always avoidable, and most patients, when properly informed prior to treatment, will accept them as part of the treatment process. The problem

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arises when that informed consent conversation is ineffective, did not happen and sometimes, in the pressure of a busy clinical day, is documented poorly or not at all.

The dental environment adds additional texture to this challenge.

Patients arrive in varying states of anxiety, with different health literacy levels, and with expectations shaped by what they might have read online or simply what they hoped to hear.

When a tooth begins to ache after a filling, the natural human response is to ask, “Did something go wrong with the procedure?” And if that question is met with dismissal, defensiveness, or clinical jargon delivered without empathy, goodwill and trust erode – and sometimes, it erodes all the way to a complaint.

Case study Dr H had been practising for ten years at a busy suburban general dental practice when Ms S presented as a

new patient. She had avoided the dentist for five years due to cost and a generalised dental anxiety from a negative childhood experience.

She came to Dr H after she felt a dull aching sensation in her lower left jaw a few days previously and since then, she had been experiencing transient sensitivity to cold drinks.

Her objective was simple: she wanted the pain gone.

Dr H carried out an examination, and radiographs revealed deep interproximal caries in the lower left first molar, extending close the pulp.

Dr H recommended a composite restoration, and the appointment was booked for the next day in an emergency slot, as he explained it was deep and was likely to become more painful if left untreated.

On the day, it took longer than anticipated to get profound anaesthesia. Eventually all the caries was removed, and having noted evidence of a pulp shadow Dr H placed an appropriate medicament before restoring with a large Class 2 composite which took considerably longer than the allocated time. The clinical notes from the treatment appointment record "LA x 2 ligno IDB + long bucc, slow to numb, deep caries removed close to pulp – restored with composite, indirect pulp cap, patient tolerated well."

There was no documentation of informed consent regarding the

possibility of irreversible pulpitis prior to treatment, along with the possible consequences such as potential need for RCT and associated costs. There was also no post-treatment advice given to the patient at the time of discharge (including discussion about potential for pulpal sensitivity and what to do).

Two weeks after the filling, Ms S returned to the practice. The tooth was now sensitive to biting (Ms S was avoiding it), with a thermal sensitivity lingering for thirty seconds or more after stimulus. She had poor sleep the previous night, reported significant discomfort and was upset. She questioned Dr H directly: “I had hardly any pain and since the filling it is really getting worse. Did something go wrong with my filling?”

Dr H, who had fitted her in during his lunch break and had a full afternoon ahead of him, responded in a way he would later deeply regret. “This is completely normal with a deep filling,” he said, without making eye contact and before even inviting Ms S to sit in the chair. When he did check the restoration, he found it appeared intact. He then took a radiograph and showed it to Ms S - “You should have expected some sensitivity with decay that deep. There’s nothing wrong with the filling.” He placed some fluoride varnish, issued a sensitivity toothpaste sample, told her to return if it hadn't settled in a further two weeks, and moved to his next patient.

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Ms S left the practice feeling dismissed and patronised. She had not been told to expect sensitivity and how was she supposed to know it was a deep filling (and what did that even mean anyway?). The person she had trusted with her care had, in her words, “made me feel stupid for asking a question.”

The complaint Six weeks later, having since developed signs of irreversible pulpitis requiring root canal therapy (started by an endodontist she was referred to by another practitioner), Ms S lodged a formal complaint with AHPRA. The Dental Board of Australia's Code of Conduct sets out the professional standards that all registered dental practitioners must meet. Section 4 of the Code addresses the practitionerpatient partnership and sets out that practitioners must communicate clearly and in a way that patients can understand, obtain informed consent, and respond honestly and openly when things do not go as expected.

This must all be documented to the expected standard.

Her complaint raised three concerns: first, that she had not been informed of the risks associated with the deep restoration; second, that when she raised her concerns post-operatively, she was dismissed without adequate explanation; and third, that the progression to irreversible pulpitis could have been identified and addressed sooner if her concerns had been taken seriously. She had lost three days of work when the tooth became acutely infected and

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was requesting that Dr H cover the treatment costs and her lost earnings.

How Dental Protection assisted Dr H contacted DPL shortly after receiving notice of the AHPRA investigation. He was, by his own admission, in both a defensive and distressed state – convinced the complaint was unfair (and inclined to respond in kind) and overwhelmed by concerns about action that might be taken against him.

The adviser acknowledged the clinical reality – that postoperative sensitivity following a deep restoration is a known and accepted complication – but helped Dr H understand that the complaint was not primarily about the clinical outcome. It was about communication, consent, and the way Ms S felt she had been treated when she was in pain and didn’t understand what was happening.

On recommendation of the adviser, Dr H completed some CPD on the DPL online learning platform relevant to the issues arising from the complaint.

By this time Dr H was better placed to understand the view of Ms S and why the complaint had been made.

The adviser helped Dr H draft a response that was factual, professional, and importantly, not defensive and showing willingness to appreciate the patient perspective. It did not attempt to deflect or minimise.

The adviser also supported him in implementing practice changes such as a standardised consent protocol for deep restorations and improved

post-operative instructions (including what to do if problems occur). Dr H was also able to implement a formal practice complaint handling policy for the whole practice team. This was included in the response.

The matter was ultimately resolved without any action being taken and no conditions on Dr H's registration, with the regulator citing the reflection

by Dr H, the CPD completed and steps enacted to help prevent an issue like this occurring again.

Learning Points Informing the patient before is seen as an explanation, after, it is an excuse.

For deep restorations approaching the pulp, the conversation about post-operative risk must happen before treatment, and it must be documented in the clinical notes. This does not require a lengthy consent form for every procedure, but it does require a contemporaneous record that the patient was advised of the possibility of sensitivity, irreversible pulpitis, and the potential for further treatment including root canal therapy (and associated costs).

When a patient returns with concerns, the clock restarts.

A patient who returns post-operatively with a concern about their treatment is not an inconvenience – they are a clinical (and risk management) priority. Conduct and document a

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proper review from first principles. Take an updated clinical history, examine the tooth, perform objective tests where indicated, explain your findings clearly, and record everything. Even if the outcome is “watch and wait”, the patient should leave feeling heard, informed, and with a clear plan if things change.

This was not an inevitable complaint The clinical decisions made were defensible and the filling was procedurally sound (as evidenced by the post-op radiograph). The communication (and associated documentation) was not.

The complaint that followed was not about a bad filling – it was about a patient who felt she had not been treated as an informed partner in her own care at any step along the way.

In a profession built on trust and relationships, the way we communicate – before, during, and after a procedure – is as much a part of the clinical encounter as the instrumentation and skill we use.

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The Intergalactic Patient By the team at Centre for Prosthodontics

In clinical practice, complexity does not always present in radiographs or occlusion.

Sometimes it presents in the patient narrative.

Every now and then, a patient arrives whose history goes well beyond the usual medical questionnaire and presenting complaints.

This was one of those cases.

Case History - The Intergalactic Patient The Triggering Event According to previous clinical notes, a dental fracture was allegedly caused by a close encounter of the third kind. Additional concerns included possible “space dust” between the teeth, sensitivity attributed to mysterious cosmic waves, and a lesion linked to an unidentified flying object.

There are, to our knowledge, no published guidelines and research on trauma originating from outer space.

Treatment Considerations Amusing as these details may seem, cases like this carry a familiar clinical lesson. These consultations can be deceptively challenging. Not because they are rare, but because they ask us to do several things at once: listen respectfully, avoid reinforcing unsupported causation, maintain professional boundaries, and still move the patient towards safe care.

Clinical Reflection A useful distinction is to separate three things: • the patient’s experience, • the patient’s interpretation of that experience, • and the observable clinical picture.

The experience is real and deserves to be heard. The interpretation may or may not be clinically supported. Our role is to clarify, not to adopt the narrative as diagnosis, and to assess carefully, document objectively, and explain what canreasonably be concluded.

For dentists, this is where communication becomes part of clinical care. Beyond technical challenges, these cases present a different kind of complexity. In some cases, additional input is helpful where diagnosis is uncertain, expectations are difficult to align, or the narrative itself is shaping treatment risk.

Ultimately, even when the story seems to come from another galaxy, our role remains the same: to be a steady point of reference, with our feet firmly on Earth. adawa.com.au

Sjogren’s Syndrome: main considerations for general dental practitioners

Luiz Viegas Costa - Oral Medicine specialist, MSc in Oral Pathology, MSc in Biomedical Sciences, DDS, FRCDC

In Australian oral healthcare, evidencebased practice is central to improving patient outcomes, although translating research into daily clinical decisionmaking can be challenging for general dentists. Non-specific presentations frequently result in delayed or inaccurate diagnoses, reinforcing the need for thorough assessment and adherence to Australian clinical guidelines. Many autoimmune conditions are multifactorial and commonly misdiagnosed, leading to unnecessary investigations, inappropriate management, and increased costs. This highlights the importance of a structured differential diagnosis in patients with persistent oral or systemic symptoms.

Sjögren’s syndrome (SS) is a chronic autoimmune condition affecting the salivary and lacrimal glands, resulting in xerostomia and dry eyes (sicca syndrome), with potential systemic involvement. It predominantly affects females (~9:1) and typically occurs between ages 40 and 75. From a dental perspective, reduced salivary flow leads to functional impairment, altered taste, and significantly increased risk of dental disease, particularly caries on root surfaces and incisal edges, as well as periodontal inflammation, oral discomfort, and candidiasis.

Because oral manifestations often occur early, dentists are well placed to recognise SS. The primary role of the general dentist is early detection, risk assessment, and appropriate referral. Diagnosis is complex and relies on a combination of clinical findings, salivary and tear testing, serology (ANA, RF, anti-SSA/SSB), and minor salivary 32

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gland biopsy. No single test is definitive, making careful clinical evaluation essential.

Early recognition of sicca symptoms and atypical caries patterns allows timely referral, helping prevent systemic complications and reducing the risk of serious outcomes, including malignancy.

Evolution of Sjögren’s Syndrome (SS): Clinical History & Modern Standards For general dentists, the evolution of SS is relevant in understanding its progression from a local glandular disorder to a systemic autoimmune disease. Early descriptions of dry mouth, dry eyes, and salivary gland enlargement date back to the late 1800s, but it was Henrik Sjögren who, in the mid20th century, defined the condition as systemic rather than localised.

Therapeutically, early management of xerostomia relied on the Jaborandi plant, which later led to the use of pilocarpine.

By the mid-1900s, medications such as hydroxychloroquine were introduced, and in subsequent decades, understanding expanded of serological markers, systemic associations, and lymphoma risk. The introduction of minor salivary gland biopsy in the 1970s and the identification of antiSSA/SSB antibodies in the 1980s significantly improved diagnostic accuracy.

Modern concepts emphasise immune dysregulation and genetic predisposition, with advanced therapies such as rituximab reserved for severe disease. The 2016 ACR/ EULAR classification criteria now provide a standardised framework for diagnosis, reinforcing a multidisciplinary approach.

Sjögren’s Syndrome: Burden of Illness and Psychosocial Impact Sjögren’s syndrome carries a substantial health, psychosocial, and economic burden.

In addition to sicca symptoms, patients commonly experience fatigue, chronic pain, sleep disturbance, dermatological issues, and psychological distress, all of which significantly reduce quality of life.

From a dental perspective, patients with SS have markedly increased treatment needs, with oral healthcare costs approximately three times higher than those of unaffected individuals. This is driven by higher rates of caries, more frequent restorative care, and ongoing management of mucosal disease, including candidiasis and burning mouth symptoms. Patients often present with oral soreness, erythema, and discomfort, contributing to both physical and emotional burden.

Indirectly, the condition is associated with reduced productivity and impaired daily functioning. These impacts highlight the importance of early recognition and management. By identifying oral manifestations early and contributing to multidisciplinary care, dentists play a key role in reducing both patient morbidity and broader healthcare costs.

Clinical Evaluation and Diagnosis of Sjögren’s Syndrome: A Guide for Australian Dentists General dentists are often the first clinicians to assess patients with xerostomia, making awareness of the diagnostic complexity of SS essential. Diagnosis requires

integrating patient-reported symptoms with objective clinical findings, serology, and histopathology, typically in collaboration with rheumatologists and ophthalmologists.

SS may present as a primary disease or as a secondary condition to other autoimmune conditions, such as rheumatoid arthritis, lupus, or systemic sclerosis. Although dry mouth and dry eyes are common, atypical presentations are not uncommon and may include fatigue, musculoskeletal pain, salivary gland swelling, Raynaud’s phenomenon, or neurological symptoms. Therefore, SS should remain a consideration even in the absence of classic sicca symptoms.

In the Australian context, ageing and polypharmacy are the most common mimics. Medication-induced xerostomia, particularly from antihypertensives, antidepressants, antihistamines, and opioids—must be excluded, along with systemic conditions such as hepatitis C, HIV, IgG4-related disease, and nutritional deficiencies.

Key clinical approach • Differentiate local causes (e.g. sialolithiasis, duct obstruction) from systemic causes.

• Assess medication history, hydration, and associated symptoms.

• Identify combined dry mouth and dry eyes, especially in patients with autoimmune disease.

Maintaining a high index of suspicion is critical. Early referral supports definitive

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diagnosis and prevents progression to severe systemic involvement or lymphoma.

A structured clinical checklist is useful to distinguish medication-related dryness from autoimmune disease.

Oral and Facial Clinical Features of Sjögren’s Syndrome Recognition of oral and facial manifestations is essential for both symptom management and identification of underlying systemic disease.

Hyposalivation and xerostomia are the hallmark features. Hyposalivation is defined as unstimulated salivary flow ≤0.1 mL/min, although subjective dryness does not always correlate with measured flow. Symptoms are often underreported, and significant gland dysfunction may occur before patients recognise reduced quality of life, making active enquiry essential.

Oral mucosal and soft tissue changes are common due to reduced lubrication and antimicrobial function. Patients may present with mucosal dryness, ulceration, burning sensations, dysphagia, impaired speech, denture intolerance, and angular cheilitis.

Candidiasis is frequent, typically presenting as erythematous (atrophic) forms rather than pseudomembranous infection.

Illustrative features include

Periodontal and caries risk is significantly increased. Plaque accumulation and gingival inflammation are common, although evidence for advanced periodontitis is variable. A key diagnostic feature is rapid, atypical caries, often affecting: • Incisal edges • Smooth surfaces • Root surfaces This reflects loss of saliva’s protective, buffering, and cleansing functions.

Non-carious tooth surface loss and dentine hypersensitivity are also frequently observed.

Salivary gland involvement includes sialomegaly, most commonly affecting the parotid glands. Glands may produce thick or reduced saliva on expression. Clinicians should assess for obstruction or infection; purulent discharge suggests bacterial sialadenitis, and sialolithiasis may also occur.

Persistent or unexplained swelling warrants further investigation, including imaging.

Malignancy risk is a critical consideration.

Patients with SS have a markedly increased risk of non-Hodgkin B-cell lymphoma, particularly MALT lymphoma. Persistent, painless salivary gland enlargement is a red flag and requires urgent referral.

• Atrophic or depapillated tongue (glossitis) • Angular cheilitis • Chronic erythematous mucositis • Burning mouth symptoms Chemosensory disturbances (taste and smell) may also occur and are multifactorial, involving salivary, neurogenic, and inflammatory mechanisms.

Fig 1: Amazonian Jaborandi (Pilocarpus microphyllus) - first recognised phytotherapeutic used for SS

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Fig 2: Labial vermilion and mucosal alterations in SS

Fig 3: SS lobulated/atrophic tongue a) b)

Fig 4 (A) Common findings in SS patients Large, shallow chronic erosion/ulceration, along with diffuse mucosal erythema, due to lack of lubrication

Fig 4 (B) acute traumatic ulcer on a severely dry mouth

Fig 5: Angular cheilitis in SS - a combined bacterial and candidal infection, with linear ulcers, desquamation, and occasional bleeding

Fig 6: Despite excellent hygiene levels, this SS patient developed cervical caries and other dental tissue losses

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member news

Dental Rescue Day Diamond Smiles Dental, Carramar, recently hosted an ADA DHF Dental Rescue Day. With 3 volunteer dentists: Drs Garrie, Faraz and Lilian, plus Oral Health Therapists: Emily and Saba, they provided urgent dental care to clients referred by: Foundation Housing, Ebenezer Aboriginal Corporation, Mercy Care, Homeless Healthcare, Neami National and Australia Red Cross.

Many thanks to Practice Manager, Fozia, the delightful Reception Team, and Dental Assistants, who went above and beyond, expressing warmth and compassion towards the patients, in a safe and calm environment.

50 years of the WA School Dental Service The State Government-funded School Dental Service (SDS) recently celebrated 50 years! More than 1 million Western Australian children have received free dental care through the WA School Dental Service since 1975, and the service provides dental care to more than 110,000 students every year.

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PBC Expo The ADAWA Oral Health Education Committee recently attended the PBC Baby Expo at the Perth Convention and Exhibition Centre and were thrilled to provide oral health education to parents, so their children grow up with healthy smiles!

A huge thank you to: The members of the Oral Health Education Committee that attended (Drs Ash Bence, Brigitte O’Brien and Zarni Shakibaie) and the UWA DMD volunteers (Monisha, Shantelle and Ksenia).

The Committee would also like to thank Colgate for the supply of products for the Expo, and to ADAWA’s Andrea and Brooke for their support of the Committee.

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member news National Volunteer Week May 18-24 is National Volunteer Week! We wanted to acknowledge the amazing work of every single dentist who volunteers, either via one of the dental volunteerism groups in Western Australia, or via another charity outside of dentistry. You all make a difference!

If you are not currently volunteering but would like to, it’s a great time to do so, as 2026 is the United Nations International Year of Volunteers for Sustainable Development.

Case competition The National Osteology Group Australasia is proud to announce its inaugural Case Competition. This prestigious initiative will showcase excellence in oral regeneration, and the three best cases will be selected for live presentations at the Australian Society of Periodontology’s Biennial Federal Conference, to be held in Perth from 24-26 September 2026.

The most outstanding case and presentation will be recognised with a prize. To find out about the competition details, visit the following link: https://www.osteology.org/en/ nog-australasia-case-competition

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National

18-24 MAY 2026

Volunteer Week Your Year to Volunteer

Join us

General Meeting Wednesday 1 July Join us at the General Meeting, with a lecture to follow by Dr Jennifer Chantler on: “Body dysmorphia patients”.

ADA House

54-58 Havelock St West Perth

6.15pm

7.15pm

Eat and Meet

Meeting Followed by Lecture

RSVP to

adawa.com.au/adawa-general-meetings RSVPs must be received one week prior to the General Meetings for catering purposes Country members ONLY who would like to join via Zoom, please email: adawa@adawa.com.au

Professional notices

Dr Aaron Wong – new addition

Centre for Prosthodontics is pleased to welcome Dr Aaron Wong to our practice, commencing in February 2026. A proud West Australian, Dr Wong completed both his undergraduate dental degree and Doctor of Clinical Dentistry in Prosthodontics at UWA. He will be consulting at our South Perth location, bringing fresh expertise and a commitment to advanced restorative care to our community.

T (08) 9368 0888

Dr Lyndon Abbott – new addition

We’re delighted to share that Dr Lyndon Abbott has joined our paediatric dental team at Toothbuds.

Dr Abbott brings a wealth of experience in paediatric dentistry, with a particular passion for preventive care and building trust with young patients and their families.

His calm, empathetic approach and clinical excellence make him a wonderful addition to our values-led practice. Dr Lyndon is accepting referrals for our Canning Vale, Morley and Midland clinics.

E info@centreforpros.com.au

Canning Vale (08) 6155 9899

W centreforpros.com.au

Midland (08) 6155 9899

A 20 Lyall Street, South Perth

Dr Amelia Hemmati – new addition

Morley (08) 6155 9899

W toothbuds.com.au

Dr Christophe Duigou - new addition

Dr Robert Childs and the entire team at Perth Specialists

Smile Time Orthodontics warmly welcomes Dr

and Cambridge Periodontics are pleased to announce

Christophe Duigou to our clinical consulting team.

Dr Amelia Hemmati, Specialist Periodontist, has

Dr Duigou completed both his undergraduate

commenced practice at Cambridge Periodontics.

dental degree and Doctor of Clinical Dentistry in

Amelia provides comprehensive periodontal

Orthodontics at UWA. He has extensive clinical

care including periodontal disease management,

experience in all aspects of Orthodontics. Dr Duigou

mucogingival surgery, implant therapy and peri-

brings highly personalised orthodontic care, excellent

implant disease management. She has a strong

clinical results and a genuine commitment to

interest in soft tissue management, evidence-based

excellence to our practice. Dr Duigou will be consulting

treatment planning, and multidisciplinary care, and

in our Dunsborough, Fremantle and Mindarie offices.

welcomes referrals for assessment and ongoing management of periodontal cases.

Mindarie (08) 9407 9944

T (08) 9388 3453

Dunsborough (08) 9750 5787

E reception@perthspecialists.com.au

A 174 Cambridge Street, West Leederville

Fremantle (08) 9335 4031 W smiletime.com.au

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Professional notices

Western OMS – new practice location

Dr Franc Henze and his team are pleased to announce

Dr Sanjana Baksi – new addition

Drs Howard Holmes and Arti Dyett are pleased to

the relocation of our practice in Nedlands. With over

welcome Dr Sanjana Baksi to the team at Carousel

25 years of experience and a special interest in the

Orthodontic Centre. Dr Baksi joins the practice as

management of complex wisdom teeth, we look

an Associate Orthodontist and is now accepting

forward to caring for your patients and thank you

referrals for comprehensive orthodontic care for child,

for your continued trust.

adolescent and adult patients. She brings a strong

T (08) 9344 3907

E info@western-oms.com.au

A Suite 2 /1 Hampden Road Nedlands W western-oms.com.au

academic background and clinical experience, sharing our commitment to delivering high-quality, evidencebased orthodontic treatment and excellent patient care.

T (08) 9258 8440

E info@carouselorthodontics.com.au

A Suites 3 & 4, 7-9 Pattie St, Cannington W carouselorthodontics.com.au

Dr Supeetha Suntharamoorthy – new addition

Dr Supeetha Suntharamoorthy has joined the team at Perth Oral Medicine and Dental Sleep Centre. She delivers patient-centred, evidence-based care across a broad spectrum of conditions, including oral mucosal disease, orofacial pain, temporomandibular disorders, and dental sleep medicine. She is known for her clear communication and compassionate approach, and works closely with referring practitioners to support high-quality, collaborative care. Supeetha is consulting at our Jandakot, West Leederville, and Padbury locations, with appointments readily available.

T (08) 9376 6789

E admin@pomds.com.au

A West Leederville, Jandakot and Padbury W oralmedsleep.com.au

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Dr Mark Teo - new addition

Dr Mark Teo is now consulting at West Perth Prosthodontics and Forrest Avenue Dental Centre, providing specialist prosthodontic care in Perth and the South West. He has returned to his hometown, Perth, after graduating from the University of Melbourne (Prosthodontics). Mark has a special interest in removable prosthodontics, implant prosthodontics, and complex restorative care. He is accepting referrals for all aspects of prosthodontic care at both locations.

West Perth (08) 9322 4775 Bunbury (08) 9792 5299

A West Perth, Bunbury

W westperthpros.com.au fadc.com.au

Dr Yasmina Andreani – new addition

New Endodontic practice

Western Endodontics is pleased to welcome

Dr Nilesh Jadav, Specialist Endodontist, is delighted

Dr Yasmina Andreani who has joined the practice this

to announce the opening of his new practice, Perth

February, and is taking new referrals. She completed

Endodontics, conveniently located on Cambridge Street

her dental degree at the University of Sydney in 2008

in Wembley. With over 20 years of clinical experience

and became a fellow of the Royal College of Dental

dedicated exclusively to endodontics, Dr Nilesh Jadav

Surgeons in 2016. She furthered her education with a

has undertaken advanced endodontic training in both

Masters of Science in Endodontics from King's College

the UK and Australia. He brings extensive expertise

London and a Doctor of Clinical Dentistry from UWA.

in the diagnosis and management of complex root

She taught Endodontics at the University of Sydney for

canal conditions, providing patients and referring

14 years prior to relocating to Perth in 2023. She is fluent

practitioners with a high standard of specialist care.

in English, and French. With her extensive experience

Dr Jadav is committed to remaining at the forefront

and dedication to the profession she is looking forward

of modern endodontic practice, utilising the latest

to treating the local patients.

techniques and technology grounded in evidence-

E reception@westendo.com.au

to deliver precise, compassionate care and optimal

W westendo.com.au

referring dental colleagues.

T (08) 9388 9656

A Unit 21 / 127 Herdsman Parade Wembley

based dentistry. Through Perth Endodontics, he aims treatment outcomes for the local community and T (08) 9388 7999

E office@perthendo.com.au

A 8/178 Cambridge Street, Wembley W perthendo.com.au

Dr Renae Alford - new addition

Western Oral Medicine Group is pleased to welcome Dr Renae Alford, joining specialist Dr Janina Christoforou.

Dr Alford is committed to providing empathetic, patient-centred, and evidence-based care, with a strong focus on achieving optimal patient outcomes.

She is now accepting referrals across the full scope of oral medicine.

T (08) 9257 8500

E admin@westernoralmed.com.au

A 47 Railway Parade Mount Lawley A 182 Canning Rd Kalamunda W westernoralmed.com.au

adawa.com.au

Directory Premium Partners Panetta McGrath Lawyers

Smith Coffey

We are excited to offer a member benefits program exclusive to ADAWA members. As a member of ADAWA, the member benefits program entitles you to an initial 30-minute consultation in person, by phone, or via video conference. ADAWA members are also eligible for a 15% discount on our standard hourly rates.

ADAWA referral required. pmlawyers.com.au

For over 50 years, Smith Coffey has specialised in providing financial services for dentists. We offer expertise in taxation, superannuation, mortgages, and personal risk insurance. Trust us to help you achieve financial freedom while you focus on patient care.

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Medifit

STS Group Australia

Medifit is an award-winning dental design and construction company, providing a comprehensive solution for dentists and dental specialists looking to build new premises or renovate their existing practices. Established in 2002, the company has designed and built hundreds of successful practices across Australia from their Head office in Perth. Contact Medifit and get the practice you deserve. medifit.com.au

STS Group Australia is a family owned, WA business and industry leader in infection control and we have been serving the WA dental community for over 30 years. You’ll know us as Mocom Australia, offering a range of infection control and reprocessing equipment in Australia and New Zealand, STS Health, providing service and education throughout WA and STS Professional, manufacturer of infection control testing devices and related consumables. sts-group.com.au

Plus Partners BOQ Specialist At BOQ Specialist, we understand that a highly personalised service is what dental professionals need. We offer a full range of finance products and services, tailored to your needs no matter where you are in your career.

With over 30 years of experience in dental finance, our focus is on building long-term relationships with our clients so that you can make financial decisions that are right for you. boqspecialist.com.au

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EDITION 3 ∙ 2026 western articulator

Commonwealth Bank At CommBank Health, we’re focused on delivering financial services for Dental Professionals at every stage of their careers. Services designed to increase productivity and enhance the patient experience. Tailored banking by experienced Health Bankers ensure your ambitions are fully supported.

Flexible lending and insights enable business growth, Smarter payments can unlock efficiencies. commbank.com.au/healthcare

Member Benefits and Lifestyle Partners

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ADAWA’s Peer Advisor Member Service

The ADAWA Peer Advisor Member Service is designed to support you through the complexities of dental practice.

Your ADAWA Peer Advisor, Dr Tony Poli, is here to provide confidential, professional guidance to fellow dentists.

How Dr Tony Poli Can Help You As your Peer Advisor, Dr Poli offers confidential, one-on-one support to ADAWA members navigating professional challenges, including: • Understanding AHPRA policies • Interpreting DBA regulations • Clarifying dental procedures • Navigating Professional Indemnity Insurance • Responding to Private Health Fund Audits • Managing patient complaints • and much more Whether you’re facing a difficult situation or simply need a second opinion, Dr Poli is here to help – dentist to dentist.

Contact tony.poli@adawa.com.au or phone 08 9211 5600