Support for dental students from Dental Protection Limited (DPL)
in this issue Hello from the DPL team! 2 Hello from the ADSA 2 News from DPL 3 This article carries a health warning! 4–5 School reports 6–8
Amalgam 9–10 Elective in paradise 11 2010 ADSA Convention Melbourne 12
Dental Student Australia
Look before you leap DPL supports dentists throughout their career
Left to right Arunesh Beharee, Amar Beharee, Jasmine Goh, Chieh Chun Gan, Amin Kolahdouzan. Read about their recent elective in Mauritius on page 11
Hello from the DPL team!
Thank you so much to everyone who has contributed, and helped to make this another packed edition of Dental Student Australia. Inside this issue you can find an overview of from the ADSA conference, topical articles and news and photos from events that have taken place over the past few months. We hope the publication helps you to picture the wide range of events and activities that have been taking place across the country. As you will see, the committees have all been very busy arranging fun social events and there are some great photos. Yearbook time again It’s been a busy time in the DPL office too. We have just completed two graduation yearbooks for Western Australia and Adelaide. The yearbook committees have worked really hard to create two distinctive and individual books which are a great memento of the five year course. I am looking forward to seeing you in November, when DPL is hosting yearbook events to hand out the books. We will also be holding graduate events at other dental schools during November. DPL produces eighteen dental school yearbooks in the UK and Australia. We use an online system to gather the information, which makes compiling all the information much simpler. This is the second year that we have produced the graduate yearbooks in Australia and we hope to extend the amount of yearbooks we produce next year. If you are due to graduate next year and you would like us to produce your university yearbook please get in touch with me for more details.
No stress Good luck to everyone who is currently taking exams. I know it is a particularly busy time of year for everyone. I hope you are not finding it too stressful and the hard work is paying off. There are some hints and tips on dealing with stress in the article on page 4–5, which some people may find quite handy. Starting work? Anyone who is due to graduate, remember to organise your indemnity insurance before starting work. DPL offers a great graduate membership which gives you 18 months insurance from when you start work, for just $55. As a member of DPL you are able to apply for a Professional Indemnity Insurance Policy with $20m of cover underwritten by MDA National Insurance Pty Ltd (MDANI). Our team of over 40 dento-legal advisers is made up of knowledgeable and experienced dentists with a wide range of different professional backgrounds - so they can readily empathise with the situations you may face through different stages of your career. DPL also operates in 70 countries, so if you are thinking of working abroad it is likely your membership can travel with you. Not a member yet? Membership with DPL whilst you are a student is free and you receive a whole range of benefits. Plus you will be sent the next edition of this magazine Dental Student direct to your door. Please visit our website to join DPL as a free student member www.dentalprotection.org Best wishes and enjoy! Rebecca Lupton Dental Marketing Manager firstname.lastname@example.org
Hello from the ADSA
Welcome to the fourth edition of Dental Student Australia, which is a biannual publication produced by Dental Protection Limited (DPL) in conjunction with the Australian Dental Students Association (ADSA). ADSA is the only national body to represent all dental students in Australia. We aim to foster communication between the schools, support you through your course and keep all dental students informed of issues that affect student life and our profession. Look out for our current students, advocacy and forum pages on our website. They will soon be up and running! Thank you to all who attended the Melbourne Convention this year. We know everyone had a riot and we were so thrilled to host a record number of students for an amazing week of intellectual debate and celebrations! Don’t miss the convention wrap-up article at the end of this magazine and please please don’t forget: what happens on convention stays on convention (wink)! For those of you who missed out this year or are suffering from convention withdrawal, fear not! In 2011 the Convention will be held in sunny Brisbane and your friendly ADSA committee is already starting preparations is choosing cocktails! However, ADSA is not just about convention. We are only an email or phone call away if you need support tackling a problem with your course or faculty, or if you have a new initiative for Australian dental students. Our details can be found on the ‘Contact Us’ page of the website.
Our executive committee recently attended the National Health Students’ Forum in Canberra to discuss clinical training of all health students. This will see the funding of an additional 1,196,733 training days for all health students and a significant increase in the number student places for dentistry, dental hygiene and therapy over the next three years. It was also a unique occasion to discuss student welfare, rural health, national accreditation and interprofessional education with student representatives from a range of health sciences. You can read about the outcomes of this weekend on our website. ADSA may only be two years old, but we are growing fast! In Melbourne this year, we introduced three new positions: Sponsorship Officer, Media Officer and Website Officer. At our next AGM (to be held during the Brisbane convention), we will be proposing changes to our constitution to increase the number of roles on our general committee and increase our scope. We hope you will come along to vote on these changes, or nominate yourself to be a part of this exciting committee! Check out the website for descriptions of our committee and details on how to nominate. We still haven’t worked out how ADSA can do your homework for you, so till then... study hard and take care of yourselves. See you in Brisbane next July! The ADSA Committee www.adsa.org.au
News from DPL
The ‘Get Festive’ photo competition is back! We’re sure you have lots of fun activities planned in the run up to Christmas, so why not capture those events and win some fun prizes?! We’ve got a sack full of prizes and we’ll be handing these out in the run up to Christmas. Simply email your photos (maximum 5) to email@example.com or get in touch if you have any questions. Good luck and happy snapping! Closing date: 14th of January
About to graduate? Graduation may seem some way off but we just wanted to remind you that we offer a great graduate membership so you can get your membership sorted before you start work. 18 months indemnity insurance is only $55. This gives you DPL membership and indemnity insurance from the time that you graduate up until 30th June 2012. As a member of DPL you are able to apply for a Professional Indemnity Insurance Policy with $20m of cover underwritten by MDA National Insurance Pty Ltd (MDANI). For more information about graduate membership with a difference simply visit the: ‘About to graduate’ section of our website. www.dentalprotection.org/au
We’re pleased to welcome Dr Annalene Weston and Dr Yong Kho as a new additions to the DPL team
Your future starts here Check out the new ‘Your Future’ section of our website. It’s packed full of useful articles, top tips on the job application process, information on working abroad and other free educational resources to help during your early years in dentistry. Simply visit the Young Dentist section of our website.
Are you a budding journalist? Dental Student Australia is a biannual publication and we’d love you to get involved and submit an article. You may like to write about your elective, or experiences during your course? If you would like to write an article for future publications please email: firstname.lastname@example.org
Dr Annalene Weston
Dr Yong Kho
Dr Annalene Weston DPL dento-legal adviser Annalene recently joined our Brisbane team as dento-legal adviser. A Cardiff graduate in 1999, Annalene completed vocational training in the UK and then worked in General Practice until migrating to Australia in 2003. Starting out with Dental Health Service Victoria, both School Dental and adult services, Annalene worked her way up the East Seaboard practising in a mixture of public and private dental practices adding a Masters in Health Law to her dental qualifications. Until recently, Annalene was practising in Central Queensland and serving on the HCC, however she currently resides in Brisbane, working from our new Wickham Terrace Offices.
Since graduation, Yong has been involved in clinical dentistry, dental education and dental research. He is a board member for the South Australian Foundation for Dental Education and Research, and is a member of the public relations and recent graduates committees of the Australian Dental Association South Australia (ADASA) branch.
Dr Yong Kho DPL Young Dentist Representative Dr Yong Kho is a recent graduate from The University of Adelaide, where he served as President of the Adelaide University Dental Students Society. He also served as the national dental student president in the lead up to the formal foundation of ADSA. Yong has won state and national prizes for excellence in service, leadership and ethics. In the past, he has contributed to this publication, which is circulated to dental students throughout Australia.
Yong is a visiting tutor at the Adelaide School of Dentistry and a mentor in the ADASA mentor scheme. He serves as an Army Reserve Captain with the 3rd Health Support Battalion at Keswick Barracks, Adelaide. In his ‘spare time’, he practises general and emergency dentistry in private practice. His previous jobs have included public dentistry and managing facial swellings and dental trauma in a public hospital environment. At the start of this year, Yong commenced graduate medical studies in Adelaide with a longterm aim of a career in oral and maxillofacial surgery. He has dabbled in medical student society committee work, but thinks that the dental student societies are a lot more fun. Yong is pleased to take on the role of DPL Young Dentist Representative, where he will use his keen awareness of the challenges that dental students and young dentists face and the difficult decisions that they must make. He is interested in providing risk management and personal development material targeted for dental students and young dentists in the near future.
This article carries a health warning! Ignore it at your peril warns Ros Edlin
Putting the title another way and to totally misquote that revered gentleman, Mr. Buzz Lightyear, by paying heed to the information contained in this article you could ensure that you avoid the ill effects of stress throughout your working life and beyond So, whether you are a student, or young graduate in employment or about to enter one of the most rewarding and challenging professions, it is worthwhile considering that dentistry has also been identified as one of the most stressful of the health professions. So why are dentists so susceptible to stress? Not only are they required to work in an intricate manner in a sensitive and intimate part of the body, sitting in the same position for long periods of time, but they also have to be responsible for the smooth and seamless management of their patients on their day list. Added to this may be the everincreasing demands and expectations of patients and a constant awareness of not running behind schedule. As if this wasn’t enough, they have to ensure that they maintain the clinical excellence expected by their patients, colleagues and their regulatory body. Faced with all these factors, and for the most part, not having received any particular training in, for example, people skills or financial management, it is little wonder that dentists can fall victim to stress related illnesses, either mental, physical or both.
Are you ill? Stress itself is not an illness but is, ‘the adverse reaction people have to excessive pressure or other types of demand placed upon them’. This definition which comes from the UK’s Health and Safety Executive, ‘makes an important distinction between the beneficial effects of reasonable pressure and challenge (which can be stimulating, motivating and can give a ‘buzz’) and work- related stress, which is the natural but distressing reaction to demands or ‘pressures’ that the person perceives they cannot cope with at a given time’. The concept of individual perception is particularly relevant in that, faced with the same situation, eg. a difficult procedure or a demanding patient, one dentist may relish the challenge and yet the other be trembling in their shoes! Two other factors which can generate stress in dentists are control and change. Keeping control It is clear that we function best when we are in control of our circumstances; when we feel we are responsible for our successes or failures due to our own personal attributes. This could also include the responsibility of the welfare of both patients and staff. As is often the case however, bureaucracy can on occasion, militate against this feeling of control which can then result in work-related stress. It also illustrates the importance of involvement in the process of change for the best results to be achieved. ‘Today’s dental environment is not going to change to accommodate the individual. It’s the individual who needs to learn to accommodate to the environment if s/he does not want to pay the price of 1 chronic stress.’
Achievement There is no doubt that we all need pressures and challenges in our lives to get us up in the morning and to keep us going. These can galvanise us into achieving great things; to work at our most productive level, but we have to be aware that having unrealistic goals or expectations can possibly result in the ‘law of diminishing returns’ ie. the more we push ourselves to reach that elusive goal, the less well we can sometimes perform. Indeed, in a study examining the sources of stress for Australian dental students it was suggested that the high levels of stress reported could be explained by an ‘underlying tendency towards perfectionism’. Typically, students enter dental school as high achievers with powerful expectations of scholastic excellence. Once immersed in an environment where academic excellence is the norm, their self- concept is adjusted, and a new norm of competitive perfectionism can 2 emerge.’ This is not to underestimate the thrill of achievement, but it is worth paying heed to the warning signs, and to ensure we remain in control. Reading the signs These warning signs are like traffic lights in our lives. Green means that everything (or nearly everything) is going well with us. We are enjoying our work; the practice is flourishing; we have a great team and the patients are appreciative. Home and social life is good; and the sun is shining. Then perhaps things start to go slightly awry a valued chairside assistant leaves, creating extra work for the rest of the staff, and leaving you feeling is if you’ve lost your right arm. You find yourself staying later at the surgery to catch up and you are aware that you are feeling more tired than usual. At the surgery you feel your concentration slipping slightly and you are becoming tense and irritable. This situation may carry on for a while with perhaps other events occurring to add to the mix – a complaint or family illness for example. At home, your evening glass of wine is turning into two or
three. You are sleeping badly, relationships are suffering and you are starting to feel that you can’t cope. The red light is beckoning! If the symptoms continue to intensify to the extent of absolute exhaustion, ill health and the inability to cope it could be advisable to seek help. Running on empty Burnout is one of the possible consequences of chronic work related stress, and is sometimes described as the gradual erosion of the person. It occurs when the person feels they are ‘running on empty’ on an emotional, physical and mental level and can manifest itself by a loss of enthusiasm for work, lateness and irritability towards staff. Other manifestations such as cynicism, negativity and indifference towards patients and others are not uncommon. This is known as ‘depersonalisation’ or ‘dehumanisation’. Lastly, a tendency develops in the person which makes them feel dissatisfied with their achievements and accomplishments and to view themselves in a negative light. Burnout tends to occur less in people who are cynical and uncaring, but as dentists are mainly dedicated and compassionate professionals, they can try endlessly and futilely to improve the situation. Solutions to burnout include the following strategies: ‘admit the problem; assume responsibility for solving it; decide what can be changed and what cannot; and take time off to allow more objective analysis of the problems. Burnout can be avoided by taking time off regularly; making time to ‘decompress’ after work; keeping work and home life separate; creating a social life that is truly satisfying; establishing good personal and professional networks; and searching out people who will actively listen in a nonjudgemental manner. Feelings of burnout can be used as motivators in changing priorities and improving the quality of 3 life.’
Which type are you? Personality can also have a bearing on the dentist’s ability to cope with stressful situations. A study carried out by Professor 4 Cary Cooper et al suggested that dentists had a tendency to exhibit ‘Type A’ behaviour. People with ‘type A’ personalities tend to be driven, highly ambitious, impatient, aggressive and intolerant. They have high expectations of themselves and those around them. ‘Type B’ personalities although they may be equally ambitious and successful, are able to perform in a calmer and more relaxed manner. People can fluctuate between these two behaviours which are said to be on a continuum. Ideal situation A successful practice is one where effective stress management strategies are firmly in place. This contributes to the atmosphere of well-being and competence within the practice. Its positive effect emanates throughout - the staff feel valued and motivated and the patients feel more relaxed and welcome. It’s a ‘win-win’ situation for all concerned. Achieving this ideal situation does not come naturally to many practitioners who may require guidance. It may be necessary to consider what your goals and aspirations are in relation to both yourself and your practice. Hopefully some of the coping strategies that follow will be of assistance. Practical steps In terms of individual stress, try taking a step back and assess where the stress is coming from. Writing a list of causes from the most stressful down to the least stressful will help you gain some perspective of the problem and may inspire you to tackle some of the issues raised. It is even possible that you could be the cause of the stress! You may need help in dealing with some of these issues. Try not to let pride stand in the way of getting the help you need.
It could also be useful to employ this technique with your chairside assistant and receptionist by asking them to identify the sources of stress. ‘By airing and discussing grievances, concerns and new strategies, the various members will feel part of the dental team and provide mutual support in 5 time of stress.’ Relaxation techniques Although it is often thought that relaxation is not compatible with working in a dental surgery, with organisation and planning it is feasible. (Some European countries manage successfully to incorporate this into their working day.) A prerequisite would have to be a competent receptionist who would not fill your appointment book so full that you do not have time to breathe, let alone try some deep breathing (which is excellent for calming you down.) Take in a deep breath (don’t hold it) and count one, two three as you exhale slowly. In your every day life having a period of relaxation is vital. It could be as basic as taking breaks in the day or going out at lunchtime to listening to music or having a relaxing bath. The importance of relaxation is that it enables you to switch off and recharge your batteries!
Manage your time (and yourself) efficiently. Again, taking a step back and reviewing your working practise is essential. Do you have an allotted time for dealing with emergencies and administration? Are you constantly running behind schedule causing your stress levels to escalate? Developing leadership and organisational skills will enable you to feel more in control of you working environment. Ensure that your staff have been properly trained (and, if not, ensure they are!) and are aware of their individual roles and responsibilities. Encourage a culture of mutual support, whereby asking for help (say from your practice principal or a more experienced colleague) is not viewed as weakness. Talking over your problems with someone you trust can be such a help! Dentists often relish being asked for advice by their younger colleagues and being able to share with them their own years of experience in managing stressful situations. As mentioned previously, some dentists may be excellent practitioners but sadly lacking in interpersonal skills. An ability to listen is a gift .If you feel you need some training in communication, there are a number of courses and modules available from Dental Protection.
By incorporating at least some of these strategies into your everyday life and your working life, you could create an environment which is stress free and an environment in which it is a pleasure to work. It could make the difference between a good practice and an outstanding one. Who wouldn’t want that?
Ros Edlin is a freelance stress management and relaxation trainer. This article is copyright of the author email@example.com References 1 Mark Hillman, Ph.D, Article. Stress and Dentistry: Better Practice Through Control 2 Sanders et al-Journal of Dental Education. Volume 63 (9). September 1999 3 Pride J. Journal of the American Dental Assoc. 1991 4 Sutherland V J, Cooper C L, Understanding stress: A psychological perspective for health professionals. London: Chapman & Hall, 1990 5 R. Freeman et al, Occupational stress and dentistry: theory and practice Part II Assessment and control, BDJ, 1995; 178:218-222.
Equally important is physical exercise. Exercise burns up the excess adrenaline resulting from stress, allowing the body to return to a steady state. It can also increase energy and efficiency. Do find an exercise which you enjoy that will motivate you to continue doing it. Exercise also releases endorphins, which give us the ‘feel good factor’ and make us nicer to our patients and staff! Balance your diet. Eat a proper breakfast, drink sensibly and include lots of water to rehydrate the system. Include complex carbohydrates (wholemeal bread, jacket potatoes) in your diet, to counteract mood swings, and fruit and vegetables to provide vitamin C to support your immune system.
Adelaide: AUDSS It is my pleasure to offer this warm greeting from the Adelaide University Dental Students’ Society (AUDSS). Here is a little summary of all of our activities in Semester 2! Events The AUDSS seeks to connect all members through a wideranging, all inclusive events calendar. Our premier showcase events in Semester 2 has included the Grand Dental Ball, Half-BDS Ball and the Graduation Ball, seeking to celebrate friendships formed, and consolidates professional affinity by providing contacts in a casual setting to various external organisations that function within the dental profession. The annual Talent Show connects students and staff in a unique event that showcases the hidden talents of our fellow colleagues. In addition, the AUDSS has continued its tradition of holding quarterly Basement Parties, which see approximately 200250 students party to endless DJ beats, pizza and obligatory drinks in the very home of the Adelaide dental and oral-health students-the basement of the Adelaide Dental Hospital. Student affairs In 2010 AUDSS has developed a new initiative called the AUDSS Academic and Professional Development Programme and the AUDSS Industry Talks. The two programs have continued in semester 2 with growing popularity, covering topics in periodontics, orthodontics, cosmetic restorations, pathways to specialising, risk management, to name a few.
Charles Sturt Griffith: GUDSA University: CSU SDA Community aid The AUDSS has led in action through joint-initiatives with local dentists and the Global Health Group of the Adelaide University – Insight. In September 2010 the AUDSS ran its inaugural Trivia for Timor, a charity trivia and auction night to raise funds for the Rotary/ Lions East Timor Dental Project. In addition, the AUDSS has supported the annual Insight Amazing Raise to fundraise for the Cambodia World Family Dental Project, providing clinical service for orphans and medically- compromised children in Phnom Penh. As a take on the popular reality TV show, the annual AUDSS & Insight Amazing Raise invited 25 teams of 4 exploring all corners of Adelaide and the nearby suburbs to see the best team arrive first. Media We have continued to supplement the undergraduate curricula with various student services in Semester 2 via our professionally produced publications including the annual magazine, ‘Probe’, monthly print and e-newsletters and eventbased e-notices. For further information on the AUDSS or to contact any of the Committee visit www.audss.org We are encouraged in combined efforts through the ADSA to represent the interests of dental and oral-health students and look forward to our paths crossing in the near future. Jennie Han AUDSS President
Hi all Our second year of the CSU dental program was even more successful than the first. We look forward to welcoming another 40 students in the New Year. Our success was not limited to academia, the inaugural Roland Bryant Cup was played between Sydney Uni Dent and CSU Dent. This is a sporting day designed to get more social interaction between the two Dental Faculties. It is named after Prof Bryant, a very influential figure in the modelling of dental student from both universities. There were three sports played mixed touch football, girls netball and boys basketball. Touch was played first with a convincing win to CSU however the next two sports were a lot closer. Our girls play extremely well but went down by one goal in extra time. So it came down to the boys’ basketball. It was played at a high level with both teams not giving an inch but as time ticked down CSU prevailed by only one point. Both heads of school where present which showed the enormity of the event. Prof Bryant made the trophy presentation and history made. The events success ensures a tradition that will continue for many years to come. There were a number of students who attended the annual conference in Melbourne and returned with glowing reports. Well done to the organising committee for such a good event and I am sure next years’ conference can emulate the efforts in Melbourne. Hope all your exams go well. Adam Barrett CSU SDA President PS Sydney Uni we are waiting for you all next year!
As expected, 2010 has flown by at Griffith Uni Dental School. The year has definitely been a busy one for all year groups, and especially one to remember. We kicked off the year with our annual GUDSA Meet and Greet, to introduce the shiny, new first years to the rest of the Dental School and hopefully make them feel welcome! The night was a success with plenty of pizza, merriment and friendshipformation. The first years had a chance to meet the whole school, and you could see their little eyes gleaming up in desire and admiration at our fifth years! If only they knew what was to come over the next five years! The next event was a new one to our calendar, the GUDSA Keg Party! As expected, the party was a triumph and there were plenty of amusing stories and photos that emerged! I will never forget a point in the night when a first year walked up to me and said ‘I thought all you dental students would be boring... but you all know how to party!’ to which I looked up, only to see one of our most valuable fourth years riding a dining chair as though it was a horse in the middle of the dance floor. Another new event to our calendar was the GUDSA touch tournament. Every year group submitted at least one team and we played numerous games throughout the day. The semi finals saw a rematch between the third and fourth year teams, and the fifth years take on the second years. It then proceeded onto a nail-biting final between the fifth and third years. The game went into extra time after two halves of nil-nil score, until the fifth years finally clinched victory and scored a champion tri.
Despite the third years being very disappointed, we thought it was best the fifth years got to win something before they left. The next event was the annual Halas Cup where we, once again took on UQ dental in a powerdeifying soccer match. As expected, Griffith took home the trophy after a fantastic goal in the last seconds of the almost three hour match. Better luck next year UQ! This semester, the girls of second and third year got together to create and sell some delicious baked goods. Our GUDSA bake sale was a real hit, and we managed to fill the bellies of plenty of hungry students (and staff!). The brand new Trade Show was a hit this semester. All our sponsors came to the campus and delighted the students and staff with freebies and plenty of information regarding, not only benefits once we have finished our degree, but how we can look after ourselves during our time at uni. Our last event of the semester is the Annual GUDSA Ball and we are all eager and excited about the event. It will be a great way to relax just before we have to knuckle down and study for our end-of-semester exams. The event is being held at the Gold Coast Convention Centre and it looks to be a great night as always with a great turn out. Finally, we would like to wish good luck to all of the graduating Oral Health Therapy, Dental Technician and Dental Science students of 2010. All the best. Victoria Sole GUDSA committee
Western Australia: UDSS
Halfway through the year and still UDSS is going strong throwing the wackiest events on the university calendar for our beloved stressed out dental kiddos.
Let me give you an insight into what the Melbourne Dental Students’ Society calendar was like for 2010. The definite highlight was the chance to meet, learn and party with our counterparts from around Australia! ADSA worked in conjunction with MDSS to organise a jam-packed schedule showcasing all Melbourne has to offer. Without a first year dentistry intake, 2010 was a year for Melbourne dental students to focus on consolidating intra-course relations. The year started with our annual orientation camp and pub-crawl - with dental nerds terrorising Melbourne’s pubs in clinical gowns and adhering to full Universal precautions.
First up Netsketball - our mix up event of basketball and netball whereby you realise how fat and unfit you’ve become since starting dentistry. As always there were the dodgy few who realised this was their prime opportunity to release their anger on the other students for pushing in line in lab or for stuffing up that survey crown which you’re meant to make a denture on before the end of the year. It’s fair to say that at the end of the day, everyone’s even. For all those lovers of the tooth that had nothing better to do on a Friday night (you know it’s the truth) embarked on a quizical quest held at the beloved UWA tavern. Teams were dressed up in themes including the teen mothers, bogans, moustachios, and gym junkies to answer questions on our famous lecturers, the Miss Universe contest and the Olympics. Needless to say, everyone had an awesome time especially once the amber fluid started flowing. On the charitable front, again most dental students attended the famous red party held at the Paramount nightclub with thousands of dollars of proceeds going to Oxfam’s HIV/AIDS Child Nutrition Project, hopefully the educational message got through to not only those in Africa but to a couple of dental students as well. Also a huge big shout out has to go to Vivian Chin in 2nd year who shaved her head for Cambodian children caught up in the sex trade. She has raised almost $2000 to date, a great effort.
GV Black’s 174th birthday was also celebrated a few weeks ago with students and staff getting together to celebrate this man’s great life and how he’s made ours a living hell. Coming up for the rest of the year are Beach Volleyball - sun, sand, dental babes, leftover UDSS food that we need to get rid of, what else could you wish for? And finally we will finish off the year in style with our Annual dental dinner this year themed Cirque du Soleil to be held at the famous Burswood resort. Kav Caldera
We proved to ourselves that we aren’t all nerds, by participating in sporting competitions throughout the year; netball, soccer, basketball and badminton. MDSS also organised vocational nights which focused on themes that aren’t traditionally taught at dental school - such as job prospects, financial management and resume/ interview techniques. The 3rd years’ organisation skills were tested when they organised their own mid-way celebratory Cocktail Ball. It was a successful night filled with fun, laughter, drinks, dancing and hazy memories the next morning!
La Trobe University: BOHDS
The highlight event of the year the Grand Dental Ball was held at the lavish location of Melbourne’s Docklands. With a couture/avant-garde/spring fashion theme, the students’ creativity and panache shone through their outfits. The night was laced with models performing a fashion show, opulent food, free flowing beverages and first class entertainment - a memorable night inded.
We have achieved so much this year as the student association for the University of Sydney, Faculty of Dentistry; cruises, three balls, a table tennis tournament, to name just a few. We also held the inaugural Rowland Bryant cup which pinned the dental students from Charles Sturt University toe to toe with the dental students from University of Sydney. It was an epic battle and when all the smok cleared Charles Sturt topped us by a single point in the Basketball match. Thank you Adam and the students from CSU for making the trip, and for your profound sportsmanship in all the days’ events.
The Bendigo Oral Health and Dentistry Society (BOHDS) is a student organisation that maintains a vision of uniting all dentistry and oral health students through social, academic and community events. In semester two, BOHDS represented the student body at high speed with enthusiasm and with several events. First up was Laser tag. With more than 60 people on the laser tag battlefield (30 during each battle), an exhilarating night was had by the students from the dentistry and oral health cohort as well as other faculties.
2010 has kept the Melbourne Dental Students’ Society busy with a wide range of events catering to the diverse crowd that is Melbourne Dentistry. We look forward to more opportunities for Dental Students around Australia to meet! - if you’re lucky, you may even snatch a photo with Melbourne’s infamous Backteeth Boys! Visit our website www.mdss.org.au for more information, pictures and updates! Leighton Phu MDSS President
I would like to thank ADA, Oral B, and to Professor C. Peck (Dean of University of Sydney, Faculty of Dentistry) and Professor D. Wilson (Professor in Dentistry, Charles Sturt University) for showing up to offer support to both sides. We look forward to this events growth in the future. As I prepare to pass the mantle to my successor I would like to thank all the students who commit their precious time to the association. I have had such a profound experience working with each and every one of you. To the social and year reps, the committee members and chairs, and the executives, thank you. And, to all the sponsors thank you for all that you have endowed us with. To the future success of SUDUA and all dental students Australia-wide. Kendall W. James President
Bows and bow ties... check, red carpet... check, limousines... check. Indeed, the glitz and glamour had reached Bendigo, in the form of ‘The Floscars. In the spirit of Dental Health Week, BOHDS had organised a week of festivities and events to showcase the importance of oral health; and what better way to kick-off the week than an exquisite cocktail party. BOHDS ‘Floscars’ Cocktail Party 2010 provided the perfect opportunity for students of all year levels of dentistry and oral health to mingle and socialise. It allowed students to exchange advice and talk about previous experiences regarding clinical and pre-clinical work.
During Dental Health Week, we organised a stall to coincide with dental health week focusing on tooth erosion. The stall was held in the Student Union (SU) on campus and ran for approximately one and a half hours. The students managed to have many students/lecturers approach them with some very interesting questions and hence, we were able to provide sound and practical advice through samples and brochures. BOHDS also decided to organise a dodgeball event for its members. An afternoon filled with laughter, fun, entertainment, a bit of violencebut most of all a lot of flying balls. Behind the scenes, the society has continued with the Student Consultative Committee (SCC) meetings. The SCC involves executive members along with the year and course student representatives meeting with senior lecturers and the faculty co-ordinators to discuss issues of relevance to the progression of our newly formed dentistry and oral health courses. Progress made has included uniform modification, study resources being made available to students outside allocated class times, and enhanced communication about the courses between students and staff. BOHDS has made a strong and continuing contribution to the life of the students at La Trobe University and aims to continue providing such opportunities to help further enhance the university experience of our future dentists and oral health therapists. Andrew Sproll President- BOHDS
Annalene Weston Annalene Weston is a dento-legal adviser based in DPLA’s Brisbane office
Amalgam Annalene Weston looks at the debate
Amalgam has as many advocates as it does critics, with countries such as the UK and the USA lobbying for a phase-down approach should a ban become enforced through anticipated UN 1 legislation . The Governing Council of the United Nations Environmental Program has agreed on the need to develop a globally legally binding instrument on mercury, and have requested the input of many countries in order to 2 action this In the absence of legislation, the current guidelines can be viewed 3 on www.unep.org but these again are environmental focused, predominantly considering the disposal of waste amalgam. They do however include the recommendation; ‘When possible for precautionary reasons, do not use amalgam fillings with people who have impaired kidney function. It is also recommended that amalgam fillings should not be placed in or removed from the 3 teeth of pregnant women.’ One of the cornerstones of being a practitioner is the principle of ‘do no harm’. Amalgam is still believed to have a valuable place in practise as the material of choice in many circumstances, and although its future appears uncertain, none of the arguments applied are new. As practitioners, we have a duty to keep up to date with developments and abide by legislation governing our profession, but at this time amalgam still has a future.
A dentist’s clinical judgement is the product of training (both undergraduate and postgraduate), experience, professional development, and influences from both from within and outside the dental profession. Some dentists experience a gradual shift in their views, values and clinical orientation, while others experience an overnight conversion or step-change as a result of a specific occurrence or experience. When choosing which dental materials to use in a particular clinical situation, a clinician will usually take many factors into account. In addition there may well be financial considerations to take into account, reflected in the fees charged to patients for different materials and different techniques. However, although the law varies from one part of the world to another, it is essential that any material used in a patient’s treatment is ‘fit for the purpose for which it is used’. Whatever material is chosen, the clinician needs to understand the properties of the material and its indications, and staff members need to be familiar with its proper storage, handling and use. Many dentists take a conscious decision to avoid the use of mercury-containing restorations and many such dentists believe passionately that this decision is in their patient’s best interests. It is important to understand, however, that this strength of conviction alone can lead to a range of professional problems unless the clinician remains aware of the associated dento-legal risks, and how to manage them.
4 issues arising from amalgam-free practice • Duty of care • Patient information and consent • Treatment alternatives • Professional colleagues • Records • The Patients Duty of care The dentist has a duty of care to each and every patient, which on the one hand requires the exercise of reasonable skill and care in the recommendation and provision of treatment, and on the other hand, demands that the dentist’s first priority should always be to act in the best interests of the patient. There needs to be a scientific basis for the provision of any treatment, which is accepted by a responsible body of other clinicians in the field. In the area of amalgam-free dentistry, a range of issues can arise including: a) The appropriateness of the choice of material for the clinical situation. b) The evidence for and against the use of mercury-containing restorations. c) The question of whether the recommendation to avoid the use of mercury containing fillings has been made because of the patient’s needs and wishes, or solely because of the dentist’s personal beliefs and preferences. d) Whether the dentist’s personal wish to avoid the use of amalgam over-rides other clinical considerations that a reasonable dentist, acting competently, would have taken into account when planning the treatment.
Each side of the amalgam debate will point to a number of oftenquoted scientific papers from various parts of the world, and there is no doubt that there is a respected body of scientific opinion on both sides of the argument. The FDI and the World Health Organisation have both issued policy statements over the years, as have most national dental associations, and the net outcome of these respective positions is that the body of international scientific opinion probably still supports the continued use of silver amalgam as being safe. In some parts of the world, health departments and similar bodies have advised dentists to avoid removing or placing amalgam fillings for patients who are pregnant or breast feeding. In making such recommendations, it is often stressed that this advice is purely precautionary, there being no definitive scientific evidence that using amalgam in such circumstances in inherently unsafe. Patient information and consent It is a prerequisite of the consent process that the clinician should make the patient aware of all treatment alternatives, and how they compare in terms of what they involve, what the advantages and benefits, risks and limitations may be, (for example, in terms of longevity or possible complications) and of course how much the treatment will cost.
Amalgam Many amalgam-free practices provide a variety of printed material to inform their patients, explaining the clinician’s approach to the choice of restorative materials, and the basis for it. A common pitfall is that the chosen material presents a very one-sided picture, rather than presenting the range of available options to the patient in an objective and balanced fashion, and then leaving the patient to choose. While it may well be the case that mercury-containing restorations are simply not offered to patients attending the practice in question, and it is important to point this out for the avoidance of any misunderstanding, the patient does need to be made aware that such restorations could well be available elsewhere, from other dentists. Unless this option is explained to the patient, the validity of any consent obtained will be severely compromised. The patient information material used by a practice can be pivotal in demonstrating the messages that were (and were not) being conveyed to the patient before the treatment was carried out.
Treatment alternatives Making the decision to avoid the use of mercury-containing fillings is one thing; deciding what to use instead is another issue altogether. Many of the problems encountered in the amalgam-free practice arise from failures associated with the use of other materials, and in particular, failures of large posterior composite resin restorations when placed directly.
Many of the cases which involve dentists, who chose to practice in an amalgam-free environment, relate to the management of treatment alternatives. An awareness of this fact makes it easy to understand that written treatment plans, and correspondence with patients explaining the treatment alternatives, can become an important part of the records, if problems arise.
Many of the available alternative materials do not have the same longevity as silver amalgam and this is another issue that may need to be discussed with the patient as part of the consent process.
Records Because of the propensity for problems to arise in an amalgamfree practice, for the reasons explained above, the need to keep meticulous clinical records is paramount. Records should be kept of conversations with patients, discussions of alternative treatment options, the patient’s stated preferences and any warning/limitations the clinician may have stressed to the patient.
Amongst the available alternatives, are some proven techniques involving intracoronal and extra-coronal restorations, and there is a wealth of scientific evidence to support their use. Many of these options are, however, considerably more costly than (for example) direct composite restorations and perhaps for this very reason a patient might be led to choose the cheaper option that is actually more likely to fail prematurely. Patients need to appreciate the possible consequences of each treatment choice they make and in this respect they will understandably need to rely upon the clinician to explain these important differences to them. Patients are unlikely to appreciate these technical advantages and limitations for themselves.
In an amalgam-free practice, a range of investigations are often undertaken which may not take place in a ‘conventional’ practice. These investigations, whenever carried out, either within the practice or externally by specialist laboratories, are an integral part of the treatment and a comprehensive record of them (including any documentation) should become an integral part of the clinical notes. Where you have reason to believe that the patient is expecting results that may not be achievable and/or where they may be hearing only what they are hoping (or choosing) to hear, a sensible precaution is to write to the patient, clearly explaining what is being done and why.
Any such letter should confirm any explanation, warning or other advice that the patient needs to be aware of and ideally, the patient should be reminded that the treatment you have recommended is only one way of approaching the patient’s care and that the patient is welcome to seek the opinion of any other dentist, which may well be different. If the demand for the treatment has come from the patient from the outset, this fact should be made very clear in the letter, a copy of which is kept in the clinical records. The amalgam-free clinician should guard against the allegation that they have sought to manipulate patient demand by means of misleading advertisements or patient information leaflets or similar publications that contain statements that are not true, or which might not be capable of substantiation. These simple precautions would anticipate and avoid many of the difficulties that arise from this area of dentistry. Patients seeking the removal of their mercurycontaining fillings, or other ‘alternative’ treatment, have been known to have very selective memories of what they were and were not told before they went ahead with the treatment. Summary It is perfectly reasonable for a clinician to have strong views either for or against the use of amalgam. However, the fact that an individual dentist opposes the use of amalgam in their own practice, is no justification for deprecating the continued use of the material by others. It would generally be considered unethical and/or unprofessional to criticise colleagues merely because they happen to hold a different clinical opinion. On the issue of the use of silver amalgam in clinical dentistry, clinicians and patients each have the right to choose for themselves. References 1 Swedish Government report on Dental Amalgam, Maths Berlin, http://www.robertgammal.com/ AmalgamDocs2/SwedishGovtReport. html 2 www.ada.org/news/4616.aspx 3 UNEP Module 4. Mercury use in Healthcare Settings and Dentistry, pg 10. www.unep.org
Free indemnity for your elective with DPL student membership
Elective in paradise
A group of Melbourne dental students* explain how something that started out as a joke eventually turned out to be one of the best times of their lives
In Feburary 2010, group 511 embarked on an unforgettable adventure to the beautiful island of Mauritius (Ile Maurice) a multicultural island nation off the southeast coast of the African continent. The island is sometimes called paradise of earth We were greeted as kings (and queen) – no.. no.. no.. scrap that – as GODS!! We were lucky in the sense that two of us are Mauritian (and actually brothers) so food and accommodation was provided throughout our trip by the Beharee family. In fact we were treated as members of their family. Amar and Arun’s cousins treated us as one of theirs and we already had our own inside jokes by the third day! One of them even fell in love with Jasmine – though he was only 14! The trip was hectic from the moment we stepped off the plane. Amin was stopped by immigration officers! Luckily, it was all a misunderstanding. Or was it?! The plan for the two weeks was packed – no space to breathe! A typical day was as follows: Dentists by day and beach-combers by night.
First up we were invited as special presentation speakers to support an oral health promotion project at a local high school around the corner. On most days, we gained invaluable clinical experience in a rural setting (compliments to Dr Beharee), consisting of numerous extractions, emergency treatment, endodontics, prosthodontics and cosmetic dentistry. We also spent some time at the maxillofacial department of the local Ear, Nose and Throat hospital, where we observed some surgical procedures (including the excision of a pleomorphic adenoma under GA) and gained knowledge on oral medicine and surgery. It was kind of a culture shock to most of us but good experience nonetheless. We also had the opportunity to meet the Minister of Health for a casual Sunday dinner as ambassadors for public health. Life was simple... life was perfect. There were endless adventures to experience, including fishing, visiting old forts, island hopping, snorkelling, sailing and water skiing. At night we would have ‘amazingly cheap’ (Gan’s own words) beer (Phoenix Beer) and enjoyed the moonlight and stars on the roof-top.
We covered half of Mauritius during the two-week visit, immersing ourselves in the local food, language and culture of this small yet amazing African island. The fortunate timing of our visit also gave us the opportunity to experience the holy day called ‘Holi’ or ‘Festival of Colours’ where we painted ourselves with coloured powder, flour and water. To quote something that we read on a bottle of local rum (African Star): ‘You gather the idea that Mauritius was made before heaven; and that heaven was copied after Mauritius – Mark Twain’ Our group of eleven went to this island as classmates, we came back as best mates. *Arunesh Beharee, Amar Beharee, Jasmine Goh, Chieh Chun Gan, Amin Kolahdouzan
One of the benefits of free student membership with DPL is that you receive indemnity and support for your elective. DPL is an international indemnity organisation, operating in 70 countries. This gives us a unique, wide experience of dental cases. Electives can be an exciting time but if you are going abroad you also have to be prepared for the challenges they can present, for example, communication and cultural differences, different standards of risk management, infection control and adapting to time challenges. DPL operates internationally and so we are in a unique position to support you, wherever you go in the world. As a student member DPL offers you: • Full indemnity if your elective is outside of Australia • 24 hour international dentolegal helpline • Indemnity for ‘Good Samaritan Acts’ To become a student member of DPL or to find out more about free indemnity for your elective visits: www.dentalprotection.org.au
Following the hugely successful 2009 Perth convention, we witnessed the birth of ADSA. New and improved, the weight of expectation was immense. Could ADSA deliver? Would Melbourne be the perfect host city? Would dental students congregate once more for further celebrations? Yes, yes - good heavens above - yes!
With over two hundred delegates from nine different dental schools across the nation converging in cosmopolitan Melbourne, the excitement was palpable. The scene was set for a costumed Meet and Greet of epic proportions. Graceful lions hunting amidst outer space invaders, with Ron Burgandy and his news team reminding everyone they’re ‘kind of big deal’. It wasn’t long before the Pugg Mahones dance floor was set alight and convention had kicked off with a bang! With many a little worse for wear the next morning, delegates saw the start of an interesting academic programme that would delve into dentistry in Israel, life after graduation and the link between oral cancer and sex!
When lectures finished in the morning, those more athletically inclined took to the sports field for some friendly inter-school competition. Luckily, no student was too exhausted to be whisked away from the safety of Australian shores and dumped in the mix of Tijuana, Mexico. What followed was a mix of sombreros, tequila and a strange donkey lurching amongst the crowds. The Mexicana pub crawl was a great success and showcased the wide variety of hip bars throughout Melbourne’s backstreets. It also afforded a small crew of Mexican janitors the chance to make some extra coin cleaning car windscreens between venues. Waking up on Thursday morning we were thrown onto buses to venture out to Victoria’s newest regional dental school in Bendigo. Touring through the new school’s facilities and listening to some interesting lectures from the school academics, it was time for a break. The crowds were treated to some of Victoria’s finest food and wines. Thursday night saw delegates go native, with a tribal themed adventure to Fun City! Here students battled it out in laser tag, raced rings around each other on the go kart track, and as for the sumo suits... let’s not go there. The academc programme stepped up again on Friday morning with an interesting look into new techniques in endodontics and a rather graphic look into maxillofacial surgery (many students were happy their stomachs had settled after a night of partying).
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After an afternoon off to explore the city of Melbourne, it was time to get real and dial 000. The 000 emergency cruise combined with the Melbourne dental students association saw 400 dental students cruising down the magnificent Yarra river. With the DJ’s tearing up the 1 and 2’s all over the boat and the drinks flowing, it was easy to look past the bandaged and bloody. When things did start to heat up, we were glad the firemen were onboard! One escaped inmate decided he’d use all means to evade the po-po, even diving in to the depths of the Yarra River to escape conviction! Suddenly it was Saturday, where much of the day was spent mentally preparing for the penultimate event; a cocktail ball at Melbourne’s Aquarium. The gentlemen were suited and ladies dressed to the nines and everyone involved had a night to remember! Tearing up the dance floor whilst mingling with the fish, this glorious setting was a fitting end to the delicious social programme at this year’s convention. As the battered and weary gathered for the AGM on Sunday morning the new executive was elected and three new positions added to the general committee. With ADSA growing, we look forward to adding a further three new positions to next year’s general committee and we are sure that if the past two years are anything to go by, next year’s convention in Brisbane is going to be huge! So get involved and rememberstay classy.
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© Dental Protection Limited November 2010
2010 ADSA Convention Melbourne
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