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APRIL 2018 $5.95 INC. GST

SHOP TALK

Time to convert from film-based to digital imaging. See the latest ranges on page 33

Dr Sarah Raphael “We all have to work together to bring community change about sugar.” page 26

ON THE BALL Why sponsoring a local sporting team is a winning move page 21

Danger zone

Is voluntourism doing more harm than good? page 12

TAKE IT EASY Should you sell up or scale down? page 16


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Contents APRIL2018

Editor Kerryn Ramsey Associate Editor Kathy Graham Art Director John Yates Digital Director Ann Gordon Sales Director Andrew Gray Commercial Director Mark Brown Contributors Shane Conroy Kerry Faulkner Frank Leggett Sue Nelson Tracey Porter Chris Sheedy Editorial Director Rob Johnson For all editorial or advertising enquiries: Phone (02) 9660 6995 Fax (02) 9518 5600 info@bitemagazine. com.au

Bite magazine is published 11 times a year by Engage Media, Suite 3.06, 55 Miller Street, Pyrmont NSW 2009. ABN 50 115 977 421. Views expressed in Bite magazine are not necessarily those of the publisher, editor or Engage Media. Printed by Webstar.

News

Recycle and win Kids compete to reduce oral health waste; nation’s oral health assessed; and more.

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Your world

The truth about voluntourism 12 International volunteering is one of the most rewarding experiences for many dentists but is it doing more harm than good?

Your business

Winding down 16 Practice owners who want to work less have several options—sell up, scale down or maybe combine the two. Dental ergonomics 18 Dentists are at high risk for musculoskeletal disorders due to the nature of their work. Find out how such problems can be avoided. How to score with sports sponsorship 21 Sponsoring a local sporting team can deliver new business to your practice, but your objective should be community involvement before profit.

COVER PHOTO: ARUNAS KLUPSAS

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Cover Story

The career crusader 26 Following three decades at the top of her profession, there’s little that Dr Sarah Raphael has left to prove.

Your tools content

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Product guide 33 Bite’s guide to the best new digital imaging and radiography units. Tools of the trade Reviewed by your peers.

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16 21

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Your life 9,472 - CAB audited as at September 2017

A fine balance 50 When taking her unicycle out for a spin, Dr Genevieve Nawrot of Rutherford Dental thinks nothing of pedalling 80 or 90 kilometres. Bite Magazine

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*With the iTero 1.5 software upgrade, patient scans can be completed in as little as 60 seconds with the same accuracy and reliability that you have come to expect from iTero scanners. iTERO and iTERO ELEMENT amongst others are trademarks and/or service marks of Align Technology, Inc. or one of its subsidiaries or affiliated companies and may be registered in the U.S. and/or other countries. ©2017 Align Technology, Inc.All Rights Reserved. M20848-49 Rev A


NEWS Kids help give oral care waste a second life.

COME TOGETHER

Recycle and win Australian kids and students have the chance to win a recycled community garden set by diverting tens of thousands of oral care products from landfill, thanks to a recycling competition run by Colgate, Chemist Warehouse and TerraCycle. Until 31 October 2018, the Colgate Community Garden Challenge invites pre-, primary and secondary schools nationwide to collect all brands of oral care waste and send it to TerraCycle, which will give the waste a second life by creating new products. Five recycled community garden sets will be awarded to five schools, with each set including three garden beds, two custom-made

benches, one rubbish bin and one sign, plus a $500 gardening voucher to buy seeds and plants. Besides showing how recycled materials can be used as a sustainable alternative to virgin plastic, Colgate, Chemist Warehouse and TerraCycle hope the sets will promote gardening and healthy eating among schools. Schools are encouraged to visit terracycle.com.au/en-AU/brigades/ colgategarden to join the competition, access posters and resources, and watch their competition ranking on a digital leaderboard. Individuals can also vote for their nominated school at terracycle.com.au/en-AU/contests/ colgategardenvoting.

POOR SCORE FOR AUSSIES IN ORAL HEALTH To mark this year’s World Oral Health Day in March, the Australian Dental Association and Australian Health Policy Collaboration (AHPC) at Victoria University released their national oral health report card revealing that more than 90 per cent of Australian adults have experienced decay in their permanent teeth.

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Among the findings of Australia’s Oral Health Tracker were: • Tooth decay is the most common chronic disease in Australia. • Three out of four children and young people are consuming too much sugar. • Only 51 per cent of Australian adults brush their teeth the recommended twice a day.

• Risky drinking and smoking contribute to poor oral health. “Australia’s Oral Health Tracker highlights the remarkable cost of poor oral  health to individuals and to the health budget,” AHPC director Professor Rosemary Calder said. “In 2015-16, there were 67,266 potentially preventable

Two leading organisations representing dental product manufacturers and suppliers signed a cooperative agreement at last month’s ADX18 Sydney event. The Australian Dental Industry Association (ADIA) and the British Dental Industry Association (BDIA) cemented their close working relationship of more than 50 years through a new framework for information sharing and cooperation on issues of mutual interest. “The dental industry in Australia and Britain jointly understand the importance of the role that industry has in supporting dental professionals to deliver optimal oral health,” ADIA CEO Troy Williams said. “This is achieved through the investment by dental product manufacturers in new and innovative patient treatment options and in this area, there is so much that the ADIA and BDIA membership can learn from each other.” ADIA and BDIA share the policy objective of achieving convergence of the regulations for the market approval of medical devices. Given that in Australia and in Britain the regulatory framework for the approval of medical devices is based upon that of the European Union, there are many ways the two organisations can benefit from each other by having different perspectives on the same regulatory approach.

hospitalisations for oral health problems and almost one third of these were children under the age of nine years.” “Preventable hospital admissions are of concern to all governments,” Professor Calder added. “One in 10 preventable admissions are due to dental conditions, mostly untreated tooth decay.”


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NEWS

For sale in Oz

GUM DISEASE LINKED TO PANCREATIC CANCER The bacteria that cause periodontitis may also play a part in the onset of pancreatic cancer, according to new research coming out of Scandinavia. Researchers at the University of Helsinki and the Helsinki University Hospital, Finland, and the Karolinska Institutet, Sweden have been investigating the role of bacteria causing periodontitis in the development of oral and certain other cancers, as well as the link between periodontitis and cancer mortality on the population level. Their latest study, published earlier this year in the British Journal of Cancer, has for the first time proved the existence of a mechanism on the molecular level through which the bacteria associated with periodontitis, Treponema denticola (Td), may also have an effect on the onset of cancer.

The team found that the primary virulence factor of the Td bacteria, the Td-CTLP proteinase (an enzyme), also occurs in malignant tumours of the gastrointestinal tract, for example, in pancreatic cancer. They also found that the CTLP enzyme has the ability to activate the enzymes that cancer cells use to invade healthy tissue. At the same time, CTLP also diminishes the effectiveness of the immune system by, for example, inactivating molecules known as enzyme inhibitors. In another study, published in the International Journal of Cancer, the team found that on the population level, periodontitis is clearly linked with cancer—especially pancreatic cancer—mortality. Some 70,000 Finns took part in this 10-year follow-up study.

EthOss® Regeneration Ltd has announced the latest stage of its rapid global growth after receiving regulatory approval for its primary product to be sold in Australia. The company has obtained approval for EthOss®, an innovative synthetic bone graft solution for dental implants, from the Therapeutic Goods Administration (TGA). This means that EthOss® is now freely available to dentists and patients across Australia. In conjunction with TGA approval, EthOss® Regeneration has also signed up an exclusive Australian distributor W9 Pty Ltd which will be distributing EthOss® through its network of dealers across Australia. EthOss® has proved hugely popular with dentists across the world due to a number of benefits to both end-user and patient. “This is another milestone in the growth of  EthOss®  as a company and product,” said Dr Paul Harrison, managing director of  EthOss® Regeneration Ltd. “We are delighted to have achieved regulatory approval whilst simultaneously signing up a partner with substantial experience in selling into the dental market.”

Study assesses nation’s oral health Thousands of people across the ACT, QLD and WA is encouraged to take part in dental interviews and free dental examinations as part of the National Study of Adult Oral Health 2017-18—the first major study of its kind in Australia for more than a decade. Led by the University of Adelaide, the research will assess the level of oral diseases among Australian adults, and the effectiveness, sustainability and equity of dental service delivery across the country. Members of the community will be selected at random to take part in the study. In total, 15,000 Australians aged 15 years and over are expected to take part in the study, which is being conducted by the internationally recognised Australian Research Centre for Population Oral Health (ARCPOH), in the Adelaide Dental School, University of Adelaide. The study is being carried out in partnership with the

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Commonwealth Department of Health, and local health departments and dental services. Researchers have already completed their work in SA and TAS, and have started in VIC and NSW. “We’ve been incredibly happy with the support of the community in South Australia, Tasmania, Victoria and New South Wales, with a high participation rate and more than 10,000 people interviewed for the study so far,” said chief investigator Professor Marco Peres, director of ARCPOH and Professor of Population Oral Health at the University of Adelaide. The study will inform government policy-makers and dental service providers about the delivery of fair and effective dental services for all Australians over the next decade and beyond. For more information, find out more by visiting adelaide.edu.au/arcpoh/national-study.


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NEWS

CLOSING THE GAP

BIGGER FAMILIES LINKED TO TOOTH LOSS Having a larger family is connected to a heightened tooth loss risk for mothers, according to results of a European study published online in the Journal of Epidemiology & Community Health. Researchers from Germany and the Netherlands drew on data from Wave 5 of the Survey of Health, Ageing, and Retirement in Europe (SHARE). SHARE contains information on the health, educational attainment, and household income of more than 120,000 adults aged 50+ from 27 European countries plus Israel. Wave 5 was conducted in 2013 and included questions on the full reproductive history and number of natural teeth of 34,843 survey respondents from 14 countries. The average age of the respondents in Wave 5 was 67, and they reported an average of 10 missing teeth— normally adults have 28 plus four wisdom teeth in their mouth.

As expected, tooth loss increased with age, ranging from nearly seven fewer teeth for women in their 50s-60s up to 19 fewer teeth for men aged 80 and above. Higher levels of educational attainment were also linked to lower risk of tooth loss among women. The researchers looked at the potential impact of having twins or triplets rather than one child, and the sex of the first two children, on the assumption that if the first two were the same sex, the parents might be tempted to try for a third child. They found that a third child after two of the same sex was associated with significantly more missing teeth for women (but not men) if compared with parents whose first two children were different sexes. This suggests that an additional child might be detrimental to the mother’s mouth health—but not the father’s—said the researchers.

Treatment gets all clear The Center for Craniofacial & Dental Sleep Medicine (CFDSM), a Houston-based company, recently received FDA clearance on its innovative new treatment for obstructive sleep apnoea (OSA) and snoring. Traditional treatments for obstructive sleep apnoea offer limited results. Continuous positive airway pressure (CPAP) is a common treatment, featuring a mask and a pressurised breathing machine. The CPAP, however, is not monitored, is cumbersome, and users often become non-compliant, or stop using the CPAP altogether. Another common treatment for OSA is the mandibular advancement device (MAD)—a customised oral appliance created and modified by a dentist. MADs hold the lower jaw

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Bite Magazine

New data from Dental Health Services Victoria (DHSV) shows the dental decay gap is closing between Aboriginal and nonAboriginal children. In 2008-09, 59 per cent of those children presenting to Victorian public dental clinics with untreated dental decay were Aboriginal children. Those figures were significantly lower for non-Aboriginal children at 43.3 per cent. In 2016-17, those figures dropped from 59 per cent to 35.7 per cent for Aboriginal children. Figures were also down from 43.3 per cent to 24.1 per cent for nonAboriginal children. “We have worked hard to close the gap and our commitment to improving oral health is clear in the positive outcomes shown by these numbers,” said DHSV CEO Dr Deborah Cole. “Although Aboriginal children still have higher levels of oral disease, the gap between Aboriginal and non-Aboriginal children is closing. Part of that reason is improving access to dental care,” she said. A combination of health promotion initiatives and the important outreach work of DHSV’s Aboriginal Liaison and Community Development officers have contributed to the significant increase in the number of Aboriginal patients accessing treatment in public dental clinics, including children.

in a forward position keeping the tongue away from the back of the throat opening the airway. Over time though, this jaw position can lead to bite changes and jaw joint pain. In contrast, the Meridian PM oral appliance—which holds the lower jaw in a more comfortable position—eliminates potential jaw pain and changes in the patient’s bite often experienced with traditional oral appliance therapy. It also effectively treats snoring, OSA and associated breathing symptoms by stabilising the lower jaw and training the tongue to stay forward, maintaining a clear upper airway during sleep. The natural result is a decrease in the frequency and duration of apnoeic and hypopnea events, including snoring.


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COLUMNISTS CATEGORY

Serious dentists are seeking out the Halliday twins Here’s the reason … $50,000 a month in new revenue … By Scott T. Martin, Dental Business Writer u 83 consultation enquiries for highprofit procedures in 30 days in a small market. With results like these plus their unique fee structure, it’s no surprise that dentists across Australia have been seeking out the Hallidays and the services provided through Dental Marketing Australia. “We know what hard-working and serious dentists want,” says company principal Dan Halliday. “Dentists should be able to enjoy running their practice without having to worry about their marketing. They should also know the precise ROI of their marketing spend.”

How to get significant and measurable results … without the high fees … Ambitious dentists who want to attract new patients and increase profit are seeking out the Hallidays.

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dentist in Queensland was unhappy. He wanted to grow his practice. He wanted to fill empty chairs. He wanted more high-profit procedures. He wanted more interesting and challenging work. He wanted less stress plus more time with family and friends. In short, he wanted what most serious dentists want. But he had a pressing issue. He knew that people in his community were actively searching for dentists online. He fully admits he knew nothing about marketing online through Google and the other search engines. He was losing longterm and potentially lucrative patients to his competition. He thought he would solve the problem by finding a firm that specialised in online marketing. “I’d been through a few marketing firms and wasn’t getting the results that I wanted,” said the Queensland dentist. There were other problems like missed deadlines, high fees, poor service, plus a lack of results. Fortunately, the dentist found and hired Dan and Rory Halliday, twins who founded a company called Dental

Marketing Australia. In just a few weeks, the Hallidays were supplying the Queensland dentist with regular leads. Even better, Dental Marketing Australia was helping the practice convert those leads into long-term patients, many of whom were eager to discover more about cosmetic and restorative procedures. Finally … some straight talk about dental marketing Dental Marketing Australia specializes in helping Australian dentists grow their practice through online marketing. The firm provides a comprehensive “done for you” service where the practice owner can focus on their primary work and not have to worry about online advertising. The Hallidays also offer a unique fee structure that’s extremely attractive to dentists. Here are some of the results the Hallidays have achieved for their clients. u 148 additional implant, ortho, and general enquiries each month. u Over 1,000 new enquiries in just six months. u Booking conversion rate has improved by 25% … patient conversion rate up by 30% …

Halliday also believes, based on results with other practices, that every practice can generate an additional $50,000 in new revenue every month. What about fees? Most marketing companies charge a straight fee for their services. This can mean tens of thousands—without any accountability or guarantee of results. Dental Marketing Australia is different. There’s a low set-up fee. After that, the fee is based entirely on the number of new leads and enquiries generated. You pay the Hallidays based on results and there are no long-term contracts. Even better, the Hallidays help train your staff so they turn enquiries into patients with no additional charge.

A decision to make If you’d like to grow your practice and generate more revenue, it’s important to contact the Hallidays right away. Dentists are actively seeking them out and the Hallidays can only work with one practice in any given geographic area. Contact them before your local competition do. u Dental Marketing Australia provides a free initial consultation. 6417 5103 Call 03 9007 0572 or email Dan Halliday at dan@dentalmarketingaustralia.com.au new AUSTRALASIAN DENTIST 129


YOUR WORLD

International volunteering is one of the most rewarding experiences for many dentists but is it doing more harm than good? Kerry Faulkner reports

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truth The

about

voluntourism M

ahatma Gandhi said, “The best way to find yourself is to lose yourself in the service of others”—a sentiment that has compelled thousands of Australians, many of them wellmeaning young people, to travel overseas as community volunteers. Volunteer tourism or ‘voluntourism’ has grown from small, scattered health and education aid programs offered in poorer countries through churches, charities and nongovernment agencies, into a vast money-making industry estimated to be worth $2 billion globally a year. But the willingness of volunteers to pay for the experience has created problems, particularly in popular orphanage voluntourism which faces growing claims that it fosters human trafficking and child exploitation. There are growing calls internationally for it to be halted. However, there’s a huge range of volunteer projects outside orphanages from building schools to teaching English, correcting cleft palates and lending legal advice to poor landowners. Associate professor Stephen Wearing, author of Volunteer Tourism and a number of academic articles since, says it’s the commercialisation of the programs that has created many of their problems. He believes that in the drive to deliver profits, businesses often remove from the projects the essential elements that initially made them work so well. He cites as an example the experience of two sisters. One volunteered overseas through an organisation to help teach children English. After the teacher gave the lesson to the class, she worked individually with students and had a fantastic experience. However, when

Bite Magazine

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YOUR WORLD

“[Volunteering] encourages young people to be altruistic; to go and do things in other countries when they are starting to have a global perspective, particularly in Australia where we are isolated.” Dr Irmgard Bauer, QLD academic

her sister went on the same program three years later, it had been taken over by a venture capital company. It was more economical for the company to use a volunteer as the teacher than a trained professional, so the young Australian woman was the teacher, a role she didn’t feel qualified to fill resulting in an unfulfilling volunteering experience. “The tourism industry is very tight,” Wearing explains. “The only way to make money is to cut things in the program and that’s often in the program delivery. It’s probably happening in medical tourism to some extent. Volunteers who before were not actively engaged with patients but may have been observing or helping in other ways may now be actively engaged in dentistry, for example, and in someone’s mouth. “The problem is that no-one has been monitoring that. We have no research, no-one’s funding research to look at this, so we need much more factual-based research to look at these programs.”

Taking away local jobs

Practising beyond the scope of their expertise is just one of the negatives of medical volunteer programs detailed in a 2017 study by Queensland academic Dr Irmgard Bauer, who says over-zealous and underqualified practitioners in the health sphere can result in harmful treatments and a lowering of ethical standards.

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Her research shows international volunteering can also take away local jobs, create dependency on foreign aid and remove incentives for governments to invest in their own health care or preventative care programs. In addition, she says western volunteer services compete with local services, so the situation arises where patients would rather wait for the next round of overseas aid than use a local provider. However, Wearing says to see overseas volunteering end would be unfortunate. “The concept is good— it encourages young people to be altruistic; to go and do things in other countries when they are starting to have a global perspective, particularly in Australia where we are isolated.”

Word of mouth

Volunteers can find projects in a number of ways: some via offers while travelling, others through agencies, professional groups, religious or educational institutions. Wearing’s advice though is to listen to what others who’ve worked on the program say; word-of-mouth is the best recommendation and he suggests steering toward non-government organisations with strong links to other local groups already working in the area. Practice manager Elaine Lancaster in Morningside’s Richmond Road Dental in QLD is working on just such a project

and has done so since 2008 when she and her practice colleague, Dr Petrina Bowden, first landed in Cambodia with a huge 75kg of dental equipment. They work through M’Lop Tapang at Sihanoukville, a beach resort on the southern coast whose slums have swelled with the influx of people from poorer provinces looking for a better life. The organisation helps 5000 local children providing meals, shelter, medical care and education. Lancaster explains almost anyone can ‘put up a chair’ and call themselves a dentist in this part of Cambodia but even they are beyond the reach of these poorer kids. “Early on, we put a lot of teeth in buckets and did a lot of pain management. We’ve started charting kids and now when dentists return, we see kids come back. Several years later, the biggest thing we see is they’re learning oral hygiene,” she says. “For many, the only access they have to water is a well, so it’s hard to even have somewhere to keep a toothbrush. “After that initial trip, Petrina did a lot of fundraising and found room in the M’Lop centre to build a purposebuilt room, so now we have two modern chairs in addition to the old portable chair which can be taken out to the slums to treat people out there, so it really has grown into quite a concern.” Volunteers are welcome and are placed on a roster; two at a time will work in the Cambodian clinic, many incorporating this into a holiday to the pretty coastal resort area. Volunteers are vetted stringently.

Rewarding experience

Lancaster describes volunteering as one of the most rewarding experiences of her life, recalling being particularly moved by an elderly woman who’d lived through the torturous rule of the Khmer Rouge, and whose missing fingers and toes were a testament to that time. She only had a few teeth left and had walked kilometres to the clinic to have a painful tooth removed. She then wouldn’t leave because she didn’t believe they’d pulled it out. Only after looking in a mirror was she convinced—and thrilled that she’d had a pain-free extraction. “For a dentist of any age, it’s great. It’s one of the most rewarding things I’ve ever done; the Cambodian people are so appreciative,” she says.


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down winding

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Bite Magazine

Running a business can take its toll and that’s why some practice owners start to rethink their commitment. So, what options do they have—sell up, scale down or maybe combine the two? Chris Sheedy reports

F

rom a professional point of view Dr Tom Feehely was on top of the world when he decided to sell his business, but his personal life was a different story. He had grown his practice in Hastings, Victoria, tenfold in a decade but it had begun to consume his life. His marriage had broken down, he was always highly stressed and then he was diagnosed with prostate cancer. “It was a very dark time and it nearly broke me,” Dr Feehely admits. “I can tell you exactly what changed my life. My daughter, who lives with me, said, ‘Dad, if I don’t have you, I have no-one’.” In his late forties, Dr Feehely visited Simon Palmer, manager of Practice Sale Search, and organised a successful sale of the business. He took four months off, travelled with all four of his children to Europe and returned refreshed, happy to work 18 hours per week as an employee in the business. Dr Maura Devereux, also a client of Practice Sale Search, sold her business (on Hope Island on Queensland’s Gold Coast) when she was 57, after developing an autoimmune disease. Since the sale, her health has returned and, she says, she regularly wakes up happy “for no reason”. For two years, she worked for the dentist who purchased her business, then she retired permanently. Dental practice owners decide to sell up, scale down or shift sideways for a number of reasons. Some simply retire. Others burn out. Some have health issues and others plan their exit from the very beginning. In the cases of Drs Feehely and Devereux, they both managed to sell up and scale down at the same time, removing stress from their lives while rediscovering their passion for dentistry. But if a dentist scales down before


MANAGEMENT

a sale, or without a sale strategy, they risk losing value in their business as the practice scales down with them, says Palmer. “One of the main mistakes I see practice owners make is that they let a career worth of fatigue come into the practice a year or two before they sell,” he says. “So, even though their practice has been a fantastic business, none of that history matters because a business is judged most harshly on its most recent year or two.” What are the telltale signs of that ‘fatigue’ setting into a business? Palmer says there are several. “The first is the owner takes off more time per week,” he says. “They’ve made enough money along the way to be comfortable, so pushing themselves hard when they’re getting to the end of their career is hard to justify. They’re not as hungry. It becomes more important to be out the door at 5pm and to have that midweek game of golf. “Then some people start to clinically restrict themselves later in their career. They don’t do procedures they used to do because those procedures are more taxing. Others, if they find their passion for dentistry is gone, they will buy a very expensive piece of equipment, hoping it will reinvigorate their passion. They buy it and it gathers dust in the corner, and

all of a sudden they’ve got more capital tied up in the practice when they sell.” But of course, it is possible to scale down successfully without selling the business, Palmer adds. This involves ensuring you have found someone to replace you in the practice, both clinically and managerially, and that you have put standards, systems, processes and controls in place. However, the high level of recruitment, delegation, management and leadership that’s required by a dental practice owner who wants

“One of the main mistakes I see practice owners make is that they let a career worth of fatigue come into the practice a year or two before they sell. So, even though their practise has been a fantastic business, none of that history matters.” Simon Palmer, manager, Practice Sale Search

to extract him or herself from the business doesn’t always come easy to them, Palmer believes. “You can’t just abdicate the throne and let the business run itself because, in the absence of leadership, a lot of bad things happen,” he says. “There’s overordering, staff absences and lots more.” If a sale is decided upon, there are numerous options to consider, including a sale made internally to a partner, a corporate sale, a phased sale where the business is sold in increments over time or a delayed sale, which is typically an internal sale where the price that’s agreed on isn’t required to be paid until a later date. Palmer recommends selling 100 per cent of the business at once. “Partnerships are fantastic when everything is working, but they don’t always work,” he says. “And a sale is always more complicated and less secure if you are selling a bit at a time. “I also recommend that the seller stays on for a period of time to ensure a smooth transition for the staff and for the patients. That makes it a less risky proposition for a buyer. If the vendor is able to make introductions and hand over patients, it provides great continuity and a far greater chance for the selling dentist’s legacy to live on.”

How do you maximise your dental business’s sale potential and earn the best price? Here are the five top tips by Dr Phillip Palmer, chairman of Prime Practice. 1. Plan ahead by making your exit strategy a part of your business plan. If you’ve decided to sell in two weeks, or even two months, then there is little you can do to greatly influence the outcome. But if you plan to sell at age 65, then it allows you to begin shaping the business for a sale once you turn 60 or above. 2. Get your books in order so they show a clear profit and loss for the business you’re selling. If you have mixed various businesses into one set of books, they must be separated for several years before the sale to show clear and accurate historical data. 3. Make sure you’re not overpaying people. It’s easy over time to bump up the incomes of loyal staff

to a level that is well above market rate. This may seem good for you right now, but it is not a pleasant surprise for potential buyers and could negatively affect your sale price. 4. Cash doesn’t count. If you’re taking cash out of the business for any reason, then it is not considered business income. A buyer will not take your word for earnings that are off the books. 5. Don’t expect a buyer to be dazzled by high-tech equipment. Expensive equipment only makes business sense if it makes the business more profitable. A buyer won’t pay more just because a business has an expensive piece of technology.

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MANAGEMENT

Dental ergonomics Dentists are at high risk for musculoskeletal disorders due to the nature of their work. The good news is that by following some simple design rules, such problems can be avoided. By Sue Nelson

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ell-planned ergonomics are the key to a comfortable, functional practice space that keeps staff happy and injury-free, and puts patients at ease. But it’s important to take a holistic approach.

Engineered for safety

Dentists are particularly prone to occupational health and safety issues due to their constant exposure to blood and body fluids such as saliva, an array of fixed and moveable equipment that can present tripping and other hazards, and the injuries caused by the countless repetitive movements they need to make to carry out procedures. In addition, a lot of dentists suffer from musculoskeletal disorders and must give up practice because of poor posture, caused by hunching over patients for long periods. It’s clear that the workspace needs to be carefully planned. “Everything has to cater to this demanding environment,” says David Petrikas, a consultant to dental equipment manufacturer, A-dec, “from the stools the dentists and assistants use, to the patient chair, the equipment, the cabinetry and work surfaces, to the surgery and sterilisation room layout. “The likes of hands-free cupboard doors and taps can help, as can ‘passthrough’ and double-sided cabinetry, and even cabinetry with lead-lined doors to house the X-ray machine to shield radiation.” Surface areas in a dental practice need to be kept clutter-free and clean. “Filling the working zone with clutter and stock leads to a very uncomfortable and inefficient operation,” says Ronnie Earl of Optima Healthcare. “Invest in overhead storage, correct dispensing methods and a well-organised drawer system.” Architect Sam Russell of Create Dental adds: “Health and safety risks that we’d be looking to avoid through design would be things like minimising twisting in surgeries by having everything easily in reach for both the dentist and the dental assistants, especially with repetitive movements for things they regularly need to use. It’s just smart design.”

On the level

The ergonomics of disability access have changed the way dental practices are planned. “Requirements have progressed over the years,” says Russell. “We look at the circulation

spaces of the corridors and part of that is the reception area.” The popular-culture cliché of the formidable, uninviting dental surgery is long gone. “High reception counters are less popular now—there’s a preference for a seated desk height,” says Russell. “We think about the space underneath, ensuring it allows a person in a wheelchair to get close to the counter and to feel comfortable and welcome. It’s also a more comfortable space for able− bodied people to sit down and debrief at reception, to look over their treatment plans and book in for their next consult. “These sorts of spaces can be cleverly and ergonomically designed to welcome all people into spaces and make everybody feel comfortable.”

Less is more

While access areas should be roomy and able to accommodate a diverse patient base including wheelchair users, the workspace itself should be wellorganised, compact and accessible. “So, often we think that a nice big dental surgery would be ideal and feel so good to work in,” says Ronnie Earl. “However, there is only so much space that can actually be used effectively. When we try to use the large space, we position everything so far from the working zone that, in operation, we are constantly straining ourselves.” Sam Russell agrees: “It’s important not to put regularly used items down too low or up too high. We’ll design storage areas so that, rather than having floor-to-ceiling overheads, we just cut them off at a certain point so people can’t overextend themselves. It’s just not an option to do so.”

Let there be light

Dentists need strong colour-corrective lighting to ensure colour matching on shades of teeth, and there is, of course, very bright task-lighting coming off chairs in surgeries. Natural light can help balance the discomfort of this lighting for patients and staff, who are exposed to it for long periods. “The two biggest ways to improve the quality of space are ceiling height and natural light,” says Russell. “If there’s any way to maximise ceiling height or get in as much natural light as possible, that’s the way to go. “You can make otherwise quite boxy spaces feel light and airy. It’s not about having direct windows to outside— there are other smart ways you can do that such as through borrowed light, where you use internal glazing

to bring in as much light from the windows you do have through to the spaces that aren’t directly linked to the windows. Consider skylights to bring natural light into otherwise dark areas, and try to accommodate natural ventilation where possible. “We try to make surgeries into peaceful areas using a small private courtyard or a water feature to help patients relax into the space,” adds Russell. “This is in stark contrast to the dental surgeries of old.”

Renovation tips

Retrofitting old houses as practices can be tricky and costly, but the end result can be a useful, well-designed space that is enjoyed by staff and patients alike. It’s important to go into the project with your eyes open, and to consider ergonomics carefully. “Commercial and purpose-built properties are not as expensive as old houses to fit out, because they typically come with car parks and disability access,” says Russell. “If you’re converting from a house, you may incur enormous civil works for the car park and drainage and upgrades to the services you’ll require. You’ll need to consider disability access—installing ramps, widening of corridors and doorways—and fireproofing external walls and load-bearing floors. “It can be difficult when you’re knocking out walls and dealing with heritage overlays and very old structures, but you can meet all the requirements and get a nostalgic quality of space to the clinic that you just can’t get in commercial places. And just because it’s an old house doesn’t mean you can’t get a lot of natural light.”

Listen to others

Remember your team when setting up an ergonomically sound practice. “They too have had experience in different environments and will have invaluable feedback and suggestions,” says Ronnie Earl. “I’ve found that different dentists practise in different ways, so it’s about understanding how dentists use their space and designing accordingly,” he adds. “It’s so important to consider how they’re likely to use the space and minimise any potential risk.” Given the high stakes of dental practice health and safety, it’s also vital to speak to an expert—someone who has had experience setting up practice for other dental professionals.

Bite Magazine

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MARKETING

Sponsoring a local sporting team can deliver new business to your practice, but your objective should be community involvement before profit. By Shane Conroy

How to score

sports sponsorship with

Bite Magazine

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MARKETING

“We do get some benefits out of our sponsorships, but our primary driver is the desire to do something good in the community.” Dr Franck Page, owner, Coastal Dental Care

W

hen Dr Franck Page is not overseeing the operation of his network of thriving dental practices on the NSW North Coast, you might find him dressed as a giant tooth at a local soccer game. Coastal Dental Care sponsors local netball, soccer, rugby league and touch football teams, but for Dr Page, these sponsorships are about much more than signing a cheque once a season. “It’s about community involvement, and you can’t get involved unless you’re present and engaged,” he says. “The Big Tooth is a hit with the kids. Our dentists usually take turns in the costume. It’s a great laugh. There’s nothing funnier than watching a dentist getting pummelled by a soccer team while dressed as a giant tooth.”

A culture of giving

Dr Page first got involved in local sponsorships through his kids’ sporting club, and soon expanded his involvement when he saw the

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benefits of these relationships for his practices. “Like most dads, I got roped into volunteering at my kids’ club, and once I  was involved that was it,” he says. “I soon realised that what they needed most was money, so a sponsorship was a natural fit. “It just began as a feel-good thing. We do get some benefits out of our sponsorships, but our primary driver is the desire to do something good in the community.” Dr Page says one of the most valuable benefits of sponsoring local sporting teams is not so much about getting more patients in his chairs, but rather boosting staff morale at his practices. “I’ve found it’s an effective way to create a culture of giving at our practices,” he says. “We encourage our staff to get involved by attending club events and meeting people. But it can’t become a chore—it must retain an element of fun. That’s where the Big Tooth comes in. We draw straws to get into the costume and we all get a good laugh out of it together. It’s more or less a team-building exercise.”

The slow burn

While Dr Page’s motives are pure, there are also financial benefits associated with sponsoring local sports clubs. However, Dr Page is quick to warn other dentists not to expect a flood of new patients immediately after sealing your first sponsorship deal. “It just doesn’t work that way. It’s more of a slow burn,” he says. “Sponsoring a sports club gives you an opportunity to get out there and meet people in your community. You build relationships and trust over time, and while I’m sure our sponsorships have delivered more business, it certainly doesn’t happen overnight.” Dr Daniel Andrews at Hobsons Bay Dental in Victoria agrees. His practice also sponsors a range of local sports’ teams, and is the preferred dental partner of the Western Bulldogs AFL club. “There is a lot of social value to our sponsorships, but it requires a commitment to long-term relationship building,” he says. “It’s about being an active member of your community. You


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References: 1. GfK. Project Circus. 2015. 2. Addy M. Int J Dent. 2002; 52: 367–375. 3. Baker S et al. Longitudinal validation of the Dentine Hypersensitivity Experience Questionnaire (DHEQ). Poster presented at: IADR/AADR/CADR General Session & Exhibition; 2013 March 20–23, Seattle, Washington. 4. GSK Data on File (RH01897). 5. GSK Data on file Sensitive Teeth and Attitude Study. March, 2008. 6. GSK Data on file (207211). 7. Accepted for presentation at IADR 2017, Abstract no: 2635085. 8. Parkinson CR et al. Am J Dent. 2015; 28(4): 190–196. 9. Accepted for presentation at IADR 2017, Abstract no: 2631820. 10. GSK Data on file (NPD/EU/049/16). 11. Accepted for presentation at IADR 2017, Abstract no: 2634604. 12. GSK Data on file (161075). Trademarks are owned by or licensed to the GSK group of companies. ©2018 GSK group of companies or its licensor. GlaxoSmithKline Consumer Healthcare, 82 Hughes Ave, Ermington, NSW 2115, Australia. Auckland, New Zealand. McCann Health GLSE13534M. March 2018. CHANZ/CHSENO/0209/17c.


MARKETING

“It’s about being an active member of your community. You can’t just hand out a cheque and expect the benefits to come flowing in.” Dr Daniel Andrews, practice principal, Hobsons Bay Dental

work done, so you want to target your offers to these different groups that exist within the clubs.” Then it’s a matter of getting your message out there. Brown explains that you should consider leveraging the club’s communication channels, as well as your own. “Can you post on the club’s Facebook page? Do they send out a newsletter that you could potentially publish an article in? These types of communication channels are going to help get your brand out there,” he says. “And don’t forget your own social media channels and newsletters. Go beyond just announcing the sponsorship, and give your customers updates about how the team is going. People want to see that you’re engaged with the local community and are an active part of it.”

Show me the money

can’t just hand out a cheque and expect the benefits to come flowing in. We’re out at club functions getting to know people, and if people like us, the wordof-mouth advertising follows. “If you’re not interested in investing your time, then you’re better off just spending the money on advertising,” adds Dr Page.

Bringing in new business

Both Drs Page and Andrews are usually on hand at registration days to assist with mouthguard fittings for the players at the clubs they sponsor, but that’s just the tip of the iceberg when it comes to leveraging their investments.

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Mark Brown, chief content strategist of Engage Content, suggests putting some strategy behind your sponsorship plans. “You need to look beyond the players themselves,” he says. “Most kids will get a mouthguard and that’s that. It’s their parents and older siblings who are the ones that may need dental work, so you want to target them.” Brown suggests offering players’ family discounts, free check-ups, or targeted offers to get the ball rolling. “You need to think about your audience,” he says. “Mum might be interested in a whitening treatment, and an older brother or sister might be looking at getting some orthodontic

When it comes to determining the size of any financial investment you are going to make, Brown says it’s important to think about the potential return on investment. “You need to understand your goals,” he says. “If you think a new sponsorship might bring in half a dozen new families, you need to work out how much that is worth to your practice, and therefore how much you’re willing to outlay to bring in that business.” He also suggests putting a simple sponsorship agreement in writing that sets out exactly what you’re contributing and what you’ll receive in return. “It doesn’t have to be a complicated legal document, but just a few bullet points that clearly set out what you’re entitled to—like a presence at registration day and presentation dinners, and a specified number of social media posts or newsletter articles. This will just keep everything clear if your contact at the club happens to move on part way through your sponsorship.” With the details locked away, Dr Page says it’s hard to lose on a sponsorship. “You might get some more business, but at the very least you’ll be doing something positive for your community, so it’s a win-win situation.”


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COVER STORY

Sydney paediatric dentist Sarah Raphael is determined to improve oral health.

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Following three decades at the top of her profession, there’s little that Dr Sarah Raphael has left to prove. Yet when it comes to the race to eliminate sugar from children’s lunch boxes, the veteran practitioner feels she’s barely out of the starting blocks, as Tracey Porter discovers.

THE

CAREER CRUSADER

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PHOTOGRAPHY: ARUNAS KLUPSAS

t seems almost inevitable that dedicated paediatric powerhouse Dr Sarah Raphael would one day find herself at the forefront of children’s oral health best practice. Introduced to the dentistry sector courtesy of her late father, a GP dentist whose career spanned more than 50 years, Dr Raphael was still two years from finishing high school when she began nagging her parents to approve her absence so she could work as a receptionist-cum-dental assistant at her dad’s West Perth clinic. While her contemporaries vacillated about which direction to head, Dr Raphael set about achieving a Bachelor in Dental Studies from the University of West Australia. But forced to withdraw in her final year due to illness, and getting disillusioned with her prescribed course which required her to repeat her final year, she made the bold decision to transfer her studies to Adelaide University where her goal was to obtain her degree before moving on to another area of health.

Passion for paediatrics

It was here she had the good fortune to cross paths with two academics who reignited her passion for work and helped equip her for post-student life. Not only did the pair help restore her self-belief, they also taught her what good leaders look like, she says.

“The move showed me that I had skills that were valuable and that I could use for the good of oral health.” As a new graduate, her first job was for the South Australian School Dental Service where she was required to work from a dental caravan parked on the school premises in remote locations up to six hours north of Adelaide. Having determined that children’s oral health was where she belonged, in 1993 she moved to Sydney to complete a master’s degree in paediatric dentistry. “One of the things I loved most was trying to get a difficult kid to sit in the chair for an exam or simple treatment. When you have that responsibility, it can make or break people’s ‘dental experience’ for many years to come. To be part of the process of creating a good dental experience for people is very important,” she says. Dr Raphael, whose husband Dr Kareen Mekertichian is also a specialist paediatric dentist, says she felt drawn to this career because “children have no pretence and take everything at face value. It’s lovely seeing them get to an age where they get a sense of humour. But tiny tots are so innocent, vulnerable and have such great openness that it makes for very rewarding work.” Stints in the paediatric dentistry department at Westmead Hospital followed before Dr Raphael was invited to join the team at Colgate, focusing

on knowledge translation, advising its marketing, pharmacy, regulatory and consumer information service teams and assisting with its education, research and advocacy initiatives. It was a role she would hold on and off for the next 20 years and one which would see her gain a scholarship to attend the Senior Dental Leaders Course, a collaboration between Global Child Dental Fund, Harvard School of Dental Medicine and Kings College London.

Perfect platform

Today the 53-year-old mother of two (son Daniel aged 17 and daughter Sophia 15) has established an international reputation for being at the top of her game when it comes to knowledge translation, education and research consultancy. Recently, Dr Raphael has commenced as Advocacy & Policy Advisor at ADA NSW as well as continuing some research at the University of Sydney. ADA NSW provides the perfect platform for her work to improve oral health. The support from ADA NSW Board, CEO and colleagues in the communications team made it possible for her to be a voice advocating for good oral health. Having sat on numerous national and local committees for the past two decades—with the ADA NSW, the Australasian Academy of Paediatric Dentistry and the Alliance for a

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COVER STORY Dr Raphael’s crusade is to encourage parents to eliminate sugars from their children’s lunch boxes.

“[Dr Raphael] offers the general public evidence-based advice which will help children have a healthy disease-free smile. Her advice is simple, easy to understand and can be implemented by the average family without too much fuss or effort.” Professor Anthony Blinkhorn OBE, NSW Chair of Population Oral Health, NSW Health

Cavity Free Future among them— she has also found the time to collaborate with several university colleagues undertaking research and publishing papers on everything from Parental Awareness of the Emergency Management of Avulsed Teeth in Children to a systematic review of whether there is a place for Tooth Mousse in the prevention and treatment of caries. Of late it has been her crusade to encourage parents to eliminate sugars from their children’s lunch boxes which has not only seen her reputation as a formidable academic cemented but also led to accolades including an ADA NSW meritorious service medallion.

Meeting of the minds

Professor Anthony Blinkhorn OBE, the NSW Chair of Population Oral Health at NSW Health and a distinguished paediatric dentist, has known Dr Raphael for more than a decade. He describes her as a credit to the dental profession and attributes her with being at the forefront of offering advice on the prevention, rather than the treatment of, oral health disease. “She offers the general public, especially parents, evidence-based advice which if followed will help children have a healthy disease-free smile. She makes sure her advice is simple, easy to understand and can

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be implemented by the average family without too much fuss or effort.” A/Prof Richard Widmer is a leading Sydney-based paediatric dentist and is the head of Westmead Children’s Hospital dental facility. He says he has been impressed by Dr Raphael since the first time he spoke with her about the possibility of postgraduate training in paediatric dentistry. “I subsequently met Sarah some months later when she started her training. It was evident she was intelligent, determined, very organised and would embrace her paediatric training with passion. “Sarah, like all clinicians, especially paediatric dentists, has always focused her clinical work around prevention and treatment. Prevention naturally includes an understanding of how pervasive is the problem of added (or hidden) sugars in our diets.” Through her work at ADA NSW, Dr Raphael has become involved in the Western Sydney Diabetes Alliance and as a result has become ‘the face’ of the sugar moratorium movement. She says that while Australians like to think they’re in good shape when it comes to the state of the country’s oral health, overall the trends are not looking good. “This region of Sydney currently has one of the highest rates of type 2 diabetes in Australia and the projections for the next decade, if

there are no significant changes, are frightening. If you average out the whole of Australia, the oral health has improved a great deal over the past 50 years. In fact, one of the difficulties in aged care is that people are keeping their own teeth longer and often the required dental services in the aged care sector are not readily available. “However, we now have a situation where just over a third of five- to six-year-olds have decay in their primary teeth and almost 40 per cent of 12- to 14-year-olds have decay in the permanent teeth. The alarming thing is that the 10 per cent of teenagers with the most extensive decay have up to five times more decay than the average.” Dr Raphael says what this means is that there are groups of people who still suffer from very poor oral health, in particular rural and remote Australians and indigenous Australians.

Different pressures

She says there are many different pressures on families today which have contributed to these issues. She cites Western Sydney’s ‘food deserts’—localities where there are a high percentage of households without access to a car and where there is no supermarket within half a kilometre but usually at least one takeaway option within the half kilometre area—as an example. “It’s easy to talk about


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COVER STORY

“Once people hear the same message from all angles, appropriate resources are available and they become responsible for their own health, it will bring about the necessary changes.” Paediatric dentist Sarah Raphael, Advocacy & Policy Advisor, ADA NSW

laziness, lack of education or being time-poor but clearly for some, it is a battle to live a healthy lifestyle.” While there are some cases where simply raising awareness and providing good advice will make an incredible difference, there are many others that require a complete program to result in gains in health, she says. For its part, the Sugar Research Advisory Service (SRAS), a scientific education service group funded through the Australian Sugar Industry Alliance and New Zealand Sugar, agrees with the ADA NSW stance that poor nutrition and a sedentary lifestyle are closely associated with ill health.

Give teeth a rest

Mary Harrington, the group’s nutrition manager and program lead says there is no doubt that tooth decay is caused by consuming sugar but argues it is often forgotten that any fermentable carbohydrate can also have the same

For Dr Raphael, her main message to Australians is to take better control of their own oral health.

result. The less obvious non-sweet foods, such as hot chips or bananas, can also be a problem for teeth. “The real issue is the frequency with which sugary and fermentable carbohydrate foods and drinks are consumed,” says Harrington. “It’s easy to snack and sip all day long but you’re not doing your teeth any favours. Saliva is our body’s protection system and neutralises acid produced in the mouth. But you need to give it time to do its job. That’s why it’s recommended to give teeth a rest between meals and snacks (for around two hours). This allows the natural protective buffering of acids and repair of teeth by saliva.” Harrington says SRAS agrees with the ADA NSW and its advice to make sure diet doesn’t negatively affect teeth. This includes limiting sugary treats to meal times, rather than between meals. She says regular brushing with fluoride containing toothpaste and flossing removes dental plaque and decreases the risk of acids being made when eating and drinking. But the way forward, as Dr Raphael sees it, is to specifically target vulnerable groups with more awareness, education and resources, while at the same time continuing the message to all Australians to take better control of their own oral health.

Slow behavioural changes

“At the end of the day, we [peak bodies, professionals, governments] all have to work together to bring community change about sugar. Once people hear the same message from all angles, appropriate resources are available and they become responsible for their own health, it will bring about the necessary changes.” While on many days it can seem like an uphill battle, Dr Raphael remains optimistic that change can occur. However, she also acknowledges advocates such as herself need to be realistic in their approach because behavioural change “is always slow. “Ultimately, once we get credible celebrities on board with the message, it should start to get further traction. All you can do is keep consistent messages going and realise it takes time. I don’t think it’s a hopeless fight. I’m just one tiny part of the whole big picture and I’m happy to keep doing my part.”

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At Slater Dental Studio, we are committed to your business. In fact we like to think of your business as our business.


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Bite Magazine

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ADVERTORIAL

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Better imaging = better patient outcomes

Access to high quality images and a streamlined digital workflow improve the speed and accuracy of case diagnosis, producing more predictable outcomes for dentists and their patients. Acteon’s world-leading technology combines the sharpest 2D & 3D extraoral imaging; low radiation dose X-Mind X-ray generators with automatically controlled exposure (ACE) technology; advanced diagnostic intraoral cameras and the PSPIX—the world’s smallest and quickest phosphor plate scanner utilising Fibre to Pixel technology to produce excellent images every time. Acteon combines all these tools into an integrated digital imaging solution, with supporting software that improves diagnosis and treatment planning as well as greatly enhancing patient communication and case acceptance.

The X-Mind Trium (left) and SoproLIFE intraoral camera (above) are both part of the Acteon Imaging Suite (AIS) digital workflow solution.

Acteon Imaging Suite (AIS) comprises: l Acteon Imaging Suite 2D & 3D software with implant planning, implant library, bone density measurement, volumetric calculations & reporting l X-Mind Trium 2D & 3D Extraoral imaging solution: easily configurable and upgradeable to any configuration l SoproLIFE and SoproCARE fluorescent diagnostic intraoral cameras; l X-Mind Unity X-ray generator; l Sopix2 digital sensors; and l PSPIX2 digital phosphor plate scanner. Each Acteon digital imaging component works seamlessly together. The equipment is fully supported in Australia by both A-dec and Acteon product specialists and technicians so you’re never alone. In addition, Acteon Imaging products use an open architecture, which means any images can be easily exported or imported across third party platforms, including practice management and orthodontic software, while also working natively on both Windows and Mac. The X-Mind Trium is able to grow with your practice. It does so by simply adding CBCT and full cephalometric capability to

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automatically controlled exposure which reduces radiation by up to 50% according to patient morphology, ensuring excellent images and prolonged sensor life. The PSPIX is the fastest and most compact phosphor plate scanner available, processing images in just 12 seconds and being fully networkable throughout the practice. Acteon’s fluorescence technology SoproLIFE and SoproCARE diagnostic intraoral cameras with their unique caries and perio functions (which harness fluorescence technology to highlight problem areas) have proven to be real practice-builders. Sopro cameras add confidence to diagnosis and improve case acceptance, and generate powerful wordof-mouth referrals among patients. Let the imaging experts at A-dec and Acteon introduce your practice to the world of advanced digital imaging in an affordable, efficient way.  the base unit at a later time without the need to invest in a new imaging machine. The X-Mind Unity X-ray generator and inbuilt Sopix2 digital sensor features

For more information contact A-dec on 1800 225 010 or visit www.acteongroup.com .


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ADVERTORIAL

Product Guide Radiography and imaging

CBCT Technology & Education: Change the way you view dentistry Cone Beam CT technology (CBCT) offers clinicians and specialists a range of options for diagnosis, treatment planning and patient consultation within a seamless, efficient workflow. Also, CBCT offers unparalleled diagnostic image quality at the lowest reasonable dose, while being intuitive and easy to use. One of the challenges of CBCT imaging and diagnosis is lack of familiarity with the concept of multiplanar imaging that this technology offers. Diagnostic imaging in different planes is a fairly new concept and may require a novel view of the imaging data. While it offers the ability to increase diagnostic efficiency, the key to its success lies in education. It up to the dental professional to uncover and discuss with the patient the information related to each case. In other words, diagnostic efficiency is based on more than sound knowledge of anatomy, it depends upon skills to retrieve relevant diagnostic information. Maximising success through education Given that the implementation success of CBCT is closely linked to education, Dentsply Sirona has developed a two-step educational pathway which includes a CBCT Jumpstart and progresses to CBCT Radiography and Application course. Once a clinician or specialist invests in CBCT, a comprehensive range of training and education pathways is available. This includes in-house training on hardware and software. The key benefit of an introductory courses is that participants learn about Hands-on training is available to all clinicians who have invested in CBCT.

Inside the Dentsply Sirona Centre for Dentistry.

the anatomy within CBCT which gives them confidence in diagnosis and better case acceptance with patients. Educational tools including lifetime in-house training, training videos and access to libraries are cemented with the CBCT Jumpstarts which provide a basis to improve clinician confidence. This foundational course is hands-on and offered initially at the practice and subsequently for staff and new clinicians to a practice, and at Dentsply Sirona’s Centres for Dentistry in New South Wales, Victoria and Western Australia. In other geographical locations, support is available often in smaller groups where the focus includes integration and software application training. The additional benefit of having ongoing training for new staff ensures that the investment is protected and returns maintained at the same level. CBCT Anatomy and Application courses The CBCT hands-on training provides the foundation for extending the clinician’s knowledge and comfort through the delivery of foundational education content. This is supported by the CBCT Anatomy and Application Courses. This year, the program welcomes Prof. Don Tyndall, Professor of Diagnostic

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Sciences at the UNC School of Dentistry and the Director of Radiology for the School of Dentistry since 1988 who also serves as the Director for two predoctoral radiology courses. Prof Tyndall will be running the course along with Dr Hugh Fleming, key ANZ expert on CBCT Radiography and Application. Dr Fleming has been using CBCT for eight years and offers insights on a peer-to-peer level. Dentsply Sirona further cements its position as the leader in Dental Education by offering this opportunity to engage with a globally recognised clinical educator, as well as local experts in their world class Centres for Dentistry. Why is it important? Research indicates that education needs to be a part of your investment when you are moving into CB technology. This optimal solution ensures that an investment in CBCT accompanies by an investment in your own education will improve practice lifestyle, as patients understand and accept treatment recommendations and are more content with their experience.  View the range of Dentsply Sirona courses at www.dentsply.com.au


3D X-ray that puts you in control

TMD

AIRWAY

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ORTHODONTICS

IMPLANTOLOGY ENDODONTICS

Dentsply Sirona Pty Ltd

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19/39 Herbert Street, St Leonards, NSW 2065

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ABN 87 111 950 602

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www.dentsplysirona.com.au

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Australia-info@dentsplysirona.com

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1300 747 662


ADVERTORIAL

Product Guide Radiography and imaging

World’s smallest wall-mounted panoramic X-ray/OPG – NOW in 3D CBCT

The MYRAY* Hyperion X5 family has now evolved into 3D CBCT and is now available from ANTHOS in Australia. It is available for individual purchase or in conjunction with an equipment package from the large ANTHOS/MYRAY (Cefla) product portfolio. The X5 is perfect for anyone looking at adding OPG/3D CBCT to an existing practice or as the centrepiece of a practice establishment/refurbishment. In a short space of time, the MYRAY HYPERION X5 2D version has established itself as a favourite among dentists looking for the latest in 2D panoramic imaging. Offering advanced 2D features and benefits while retaining true to its design brief of a compact footprint, it’s easy to install, easy to operate and offers  excellent image detail. This has now been translated into a 3D Cone Beam version: MYRAY Hyperion X5 3D/2D: with a 10 x 10 CM Field of View. With 16-bit capability, it achieves better image quality than previous technology and offers you options for both 2D and 3D capabilities. The X5 3D/2D’s Morphology Recognition Technology (MRT) calculates the size/volume of the patient and automatically adjusts the radiation dose for maximum safety. It also features 3D SMART (Streak Metal Artefacts Reduction

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Technology) function, which efficiently removes the typical metal-caused artefacts from 3D images, greatly improving the diagnostic ability of the image. Given that the X5’s iRYS software platform is compatible with other surgery management tools or processing/storage software, it’s easy to see how the original Hyperion X5 2D won a Red Dot Design Award for Product Design soon after its release. Hyperion X5 is an open system: the virtual console, available both for Windows systems and as iPad app, enables a remote control of the machine and a visualisation of the images acquired on the tablet. Managing and archiving the images is practical and quick. Because of that, MYRAY has conceived a powerful platform capable of interfacing with third-party systems, thanks to the DICOM protocols and other communication methods.  Please consult ANTHOS in Australia on 1300 881 617 or info@anthos.com.au, to see why using the MYRAY Hyperion X5 means you no longer need to refer OPG or 3D CBCT out of your practice. *MYRAY is a worldwide name in image-assisted diagnostics, a brand that has earned the trust of dental professionals and radiologists all over the world. ANTHOS Australia maintains Australia’s longest standing distributorship of MYRAY products and support.


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ADVERTORIAL

Product Guide Radiography and imaging

Carestream Dental Cone Beam CT: Diagnose and treat with greater confidence When patients come to Dr Shank with a dental problem, they typically don’t have to wait long for a solution. That’s because Dr Shank prefers a workflow that enables him to present treatment plans to his patients while they are still in the chair. Instead of referring them out for a scan and waiting for a follow-up visit to review it, Dr Shank has the capability in-house to see all the anatomical detail necessary to make a diagnosis, thanks to the Carestream Dental CS 9300 CBCT and panoramic imaging system. “The pathology that is visible with this system is remarkable,” said Dr Shank. “I am able to see the full extent of a problem and diagnose accordingly with complete confidence.” His patients find the CS 9300’s images to be very impressive, informative, and persuasive. They can see for themselves the status of their clinical situation and quickly comprehend Dr Shank’s treatment plan. “After using CBCT for over a year now, I am able to clearly see so many things I could not see on my 2D images, like missed canals in endodontic-treated teeth, unpredictable and hard-to-see root-canal anatomy and difficult-toidentify pathology.” With multiple selectable fields of view, the Carestream Dental CS 9300 covers a broad range of clinical applications. Dr Shank can capture the area of interest that he needs to confidently diagnose even the most difficult cases. “We had a patient who was thrown from a motorcycle, and we were able to identify a fractured maxilla,” said Dr Shank. “Our 2D images didn’t show the

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Dr Kyle Shank, D.D.S.

The Carestream Dental CS 9300.

full extent of the fracture, but with 3D imaging, we were able to more accurately diagnose the condition and go in with a much more definitive game plan for how to treat this patient. “Before I had the CS 9300, I didn’t attempt certain cases due to a lack of detailed information. Now with more information in three dimensions, I know that I can do some of those cases.” Since he acquired the CS 9300, the number of implant surgeries Dr Shank performs has increased dramatically. He chalks this up to one thing: confidence. “I am more confident going into the surgery because I’ve already seen the bone three-dimensionally and planned the case out ahead of time, and my patients are more confident because of what they’re seeing” he said. When asked what his patients think

of the new system, Dr Shank said, “They are very impressed by the technology we have incorporated into our office. It sets us apart from other practices in the area and demonstrates our desire to provide the highest quality of care possible. Purchasing the Carestream Dental CS 9300 system has been the single best technology purchase I have made since I’ve been in practice, from both a medico-legal and profitability standpoint.”  To learn more about how Carestream Dental Cone Beam CT Solutions can benefit your practice, call 1300 486 252 or visit ivde.com.au Below (from left): Examples of the detail you can see with the Carestream Dental CS 9300.

1


COMPLICATED PROCEDURES INTEGRATED SIMPLY

Accurate digital X-ray

Enhanced communication

Fast intraoral scanning

Low dose CBCT

Intuitive software

Faster and better outcomes

WORKFLOW INTEGRATION I HUMANISED TECHNOLOGY I DIAGNOSTIC EXCELLENCE

Carestream Dental systems give you a fast, safe and efficient clinical workflow When every piece in the chain is designed to work together, your workflow, practice and patients all benefit. Carestream Dental’s digital software and systems offer infinite options for diagnosis, treatment planning and consultations—ultimately expanding your range of services and ability to treat patients with more confidence.

© Carestream Dental LLC 2018

For more information visit ivde.com.au

Ivoclar Vivadent Pty Ltd 1 - 5 Overseas Drive, Noble Park, Vic. 3174, Australia Tel : +61 3 9795 9599 | Fax: +61 3 9795 9645 | Freephone: 1300 486 252 www.ivoclarvivadent.com.au

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26/03/18 11:12 A


ADVERTORIAL

Product Guide Radiography and imaging

Threedimensional views for safe diagnostics: Dürr Dental launches VistaVox S 3-D X-ray system Whether for implants, root or jaw fractures, hyperplasia or dysplasia, the demands of dental routine confront the therapist with situations for which he requires a safe 3D X-ray diagnosis. Dürr Dental, a producer of diagnostic system solutions, has completed its successful VistaSystem family with the new CBCT. Presenting its new VistaVox S: the developer from Bietigheim has come up with an innovative approach to producing top-end CBCT and panoramic images, and which can be used by implantologists, oral surgeons and general dentists alike. With its jaw-shaped Ø 100 x 85 mm, the Field of View of the volume tomograph has been designed to ensure the capture of the complete mouth area, including the rear molars. This provides the best preconditions for almost every 3-D finding with a single positioning of the patient. The anatomically adapted volume covers a diagnostic area for which conventional 3D technology would otherwise require an expensive unit with a volume of 130 mm in diameter. In addition to this, VistaVox S will feature 10 volumes of Ø 50 x 50 mm, 5 in the upper arch and 5 in the lower, in 80 and 120 µm voxel sizes. Every VistaVox S sold since its market launch in autumn 2016 can be upgraded. Supplemented

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by the 17 panoramic programs in the tried-and-tested S-pan technology, this provides dental practices with excellent imaging diagnostics in both the 2D and 3D areas. The USP of the VistaVox S is located in the ideal 3D imaging volumes which it provides, oriented to the human anatomy. The highly-sensitive CsI sensor contributes to a reduction of the radiation exposure, achieved via a smallscale sensor geometry and elaborate kinematics. As with all products from the Vista System, the VistaVox S is extremely easy to use: for example, through the face-to-face positioning of the patient— with a single (3D images) and three (for 2D images) positioning light lines. The 7” touch-display enables extremely intuitive operation for the practice team and is assisted by the ergonomic image processing software VistaSoft 2.0, even for 3D imaging. The VistaVox S from Dürr Dental represents high-end technology for 3D practice use at an affordable price and excellent value for money.  For stockists and information, please call Louis Manera on 0412 959 525 or e-mail: manera.l@duerr.com.au Dürr Dental, PO Box 2067, Woonona East, NSW 2517, Australia


COMPRESSE D AIR | SUC TION | IM AGING | DE NTAL C ARE | HYGIE NE

VistaVox S: 3D imaging from Dürr Dental.

arch As shown in M at 18 X D A ng ri du , ur bo ar Darling H ey dn Sy

Improved diagnostic capability – with reduced radiation: As the imaging volume of VistaVox S is based on the human anatomy, patients only need to be positioned once for a full image of both dental arches. Operation is both ergonomic and intuitive using the 7“ touch screen. In addition, thanks to S-Pan technology, VistaVox S can also produce perfect 2D images. More at www.duerrdental.com

Dürr Dental, PO Box 2067, Woonona East, NSW 2517, Australia For stockists and information, please call Louis Manera on 0412 959 525 or e-mail: manera.l@duerr.com.au


ADVERTORIAL

Product Guide Radiography and imaging

Financing for radiography equipment BOQ Specialist explains the choice of options available for dentists wanting to purchase imaging equipment. There has been a dramatic increase in the range and quality of digital radiography in recent years. Never before have dentists had such a choice of options, brands and styles in the field of dental X-ray imaging. The downside is that all this new technology comes at a cost. Fortunately, BOQ Specialist has a number of different finance options that can be tailored to each dentist’s individual needs “Our first step is to engage the client in a needs analysis where we discuss exactly what they want to achieve,” says Nicole Mortimer of BOQ Specialist. “There are many finance options to consider

but one of our most popular options for digital radiography is a chattel mortgage.” A chattel mortgage is similar to hire purchase except that you own the asset from time of purchase. This creates a favourable GST situation for tax purposes.

pay interest on what you actually spend. “BOQ Specialist is a relationship financier who has vast experience helping dentists,” says Mortimer. “We understand your profession and are here for you at every stage of your private practice life cycle.” 

Some of our other finance options are: l Hire purchase loan: You hire the asset from us but don’t own it until the loan and interest are paid in full. l  Finance lease: We own the asset and you pay monthly lease payments. l  Professional overdraft: You have the choice of making interest-only repayments or paying the overdraft down. You only

Credit provider is BOQ Specialist – a division of Bank of Queensland Limited ABN 32 009 656 740 AFSL and Australian Credit Licence no. 244616 (BOQ Specialist). BOQ Specialist is not offering financial, tax or legal advice. You should obtain independent financial, tax and legal advice as appropriate. The information contained in this article (“Information”) is general in nature and has been provided in good faith, without taking into account your personal circumstances. While all reasonable care has been taken to ensure that the information is accurate and opinions fair and reasonable, no warranties in this regard are provided. We recommend that you obtain independent financial and tax advice before making any decisions.

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

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

Car loans | Commercial property | Credit cards | Equipment finance | Fit-out finance | Foreign exchange | Home loans | Personal loans | Practice purchase | Practice set-up | Savings accounts | SMSF | Transaction accounts | Term deposits | Vehicle finance The issuer of these products and services is BOQ Specialist - a division of Bank of Queensland Limited ABN 32 009 656 740 AFSL no. 244616 (“BOQ Specialist”).

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YOUR TOOLS

Tools of the trade

This month, our dentists review a soft tissue laser, an intraoral camera, a George gauge and a digital television. CARESTREAM CS 1500 WIRELESS INTRAORAL CAMERA

by Dr Andrew Louey, Icon Dental Group, Yeppoon, QLD I think that every practice should have an intraoral camera. It’s a great way to educate patients and it also improves documentation. The Carestream CS1500 is a reliable unit that takes very clear images.

What’s good about it

EPIC DIODE LASER

by Dr Matthew Fleming, Hartwell Dentistry, Camberwell, VIC We’ve been using Biolase soft tissue lasers in our practice for years. We purchased the Epic to upgrade from an earlier model. I don’t think any dentist can work appropriately without an instrument that does what this does.

What’s good about it

This laser is simple to use and quick to set up. It certainly makes life a lot easier when a patient has bleeding gums or you’re working on a restoration or a crown. It allows you to remove inflamed infected tissue in order to get clear access and restore the tooth appropriately. It also reduces contamination. When placing a filling or fitting a crown it’s imperative that there is no bleeding or contamination. Using the Epic removes the damaged tissue, cauterises and leaves a sterile environment behind. It creates a clean field in which to work. The Epic can also be used when doing gum lifts or loosening a crown. It’s very handy when releasing tongueties and ties around the lips. Patients tend to like the fact that I’m using a laser because it’s controlled, sterile and they don’t feel any pain. It’s a very easy piece of equipment to master. Any dentist with a couple of years of experience will find it very straightforward.

This camera connects to our computer system over bluetooth so no wires get in the way when using it. Once the photos are taken, they instantaneously appear on the screen for the patient to view. We don’t need to move files around or do any editing. The camera is about the size of a toothbrush and can easily access all areas of the mouth. It’s battery powered and once I’m finished with it, I just place it in the charging cradle so it’s ready to go again. The images are of a very high quality and show every little detail clearly. The contrast is also very even, and the photos have a nice natural look. Once the patient has viewed the photos, they understand what’s going on in their mouth. There is no confusion or contention about what is being said or what problems they may have. It also helps with treatment acceptance because they can see the problem without having to trust someone they don’t really know. I keep all the images in the patient file as it documents exactly what I’ve done. When treating a future patient with a similar problem, I can use these images to show how the procedure progresses. Our town is pretty touristy so people move on all the time. Each patient’s photos can be emailed to their next dentist so they are completely informed about what work has been completed.

What’s not so good

This is such a nice piece of equipment that I really don’t think it has a negative. It would be nice if it was cheaper but that’s true of every piece of dental equipment on the market!

We purchased two of these cameras about three years ago and we’re starting to have issues with the batteries not holding a charge. It doesn’t matter how long they sit in the charging cradle; they both seem to run down quite quickly.

Where did you get it

Where did you get it

What’s not so good

Dental Axess (dentalaxess.com).

Ivoclar Vivadent (www.ivoclarvivadent.com.au).

Bite Magazine

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YOUR TOOLS

HISENSE 40-INCH DIGITAL TELEVISION by Dr Ammu Ruby, Cranbourne North Dental, VIC

We had this TV mounted in the ceiling directly above the patient chair. It’s quite large so when the patient is reclined, they can see the screen easily. It’s also been angled so even if the light is bright and we’re working right in front of their face, they can still see a pretty sizeable portion of the TV.

What’s good about it

GEORGE GAUGE

by Dr Rachael Pantin, The New Dentist, Applecross, WA My father, Dr Christopher Pantin, is an Associate Professor at the University of Western Australia where he developed a graduate diploma in Dental Sleep Medicine. Our practice deals with a lot of sleep apnoea problems and I find it an enjoyable part of dentistry. The George gauge is an essential part of addressing those problems.

What’s good about it

The George gauge is used in the fabrication of mandibular advancement devices to help reduce snoring and sleep apnoea. It measures the protrusive range of the mandible, as well as taking the bite registration at the same time. There is a forked attachment that the patient bites and by moving the mandible forwards and backwards, you can measure the protrusive range. It is very accurate even though it doesn’t need to be too specific because it’s measuring a range rather than a precise figure. Using the George gauge is absolutely painless so there are never any issues with patients. It’s a very straightforward, simple tool that does its job extremely well which is probably why it hasn’t been modernised.

What’s not so good

The maxillary centrals sit in a little notch on the George gauge fork. Sometimes, depending on a person’s anatomy and malocclusion, they don’t seat perfectly. This can be rectified chair-side with some adjustment. The fork portion is disposable but the lower incisor guide plane is reusable with a limited lifespan. It also can’t be autoclaved so needs to be cold sterilised.

Where did you get it

Henry Schein Halas (henryschein.com.au).

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Patients love watching the TV as it takes their mind off the procedure. We have a range of DVDs but the favourite is undoubtedly Mr. Bean. It works really well because no sound is required. I’ve had occasions when I thought patients were seizing up but they were just laughing at Mr Bean. The television is particularly useful when seeing children. It calms them down and they are not concerned with what we’re doing to their teeth. We have a range of the newer animated movies and we usually give the kids a choice. It’s essential that the television be positioned properly in the ceiling. I’ve worked in another practice where the patients could barely see the screen. Another practice had a cornermounted TV that was of no use to anyone. Watching a show or a movie effectively takes the patient’s mind off the procedure. I believe that every practice should have a ceiling-mounted TV. It’s a relatively cheap way to add a little ‘wow’ factor and patients genuinely appreciate it.

What’s not so good

Sometimes, when I’m explaining something to the kids, they don’t listen because they’re watching TV. There are also times when it can be a bit difficult to get the kids out of the chair because they want to finish a movie.

Where did you get it

The Good Guys (www.thegoodguys.com.au).


That moment when she sees her own smile for the first time in years

T

here’s nothing else like that moment when she smiles. When she first came to you, she wouldn’t even open her mouth. Then she read about the right way to fix the problem on your blog. She made an appointment. And today, she’s here. They’re the stories you’d like to tell every day. The stories you’d like to be best known for in the community. A regular blog post for your business

can tell that story to new and existing patients. Nowadays, a blog is the new word-of-mouth people use. A blog helps you talk to patients when they’re not in the chair. It gives you a chance to counter the wild opinions of Dr Google. And more than anything else, it helps new patients find you quickly and easily. And it does that by telling good news stories. Your good news stories.

Go to yourblogposts.com, or call us on (02) 9660 6995 to find out more.

yourblogposts.com We’ll help you tell your best stories


YOUR LIFE

A fine balance “Each year, a Sydney to Wollongong bike ride raises money to fight MS. I put together a team of unicycles but we were unsure if we would be welcomed. The organisers said unicycles are allowed but not recommended so we figured, no worries! We raised over $2000 for the charity. “During this time I was also preparing for a 750km two-week unicycle tour around the South Island of New Zealand. After the Sydney to Wollongong ride, I had been training for about four months. I had done much longer rides than the MS charity event, though nothing quite as hilly. It took us just over five hours to roll into Wollongong. “I started unicycling after signing up for circus skills as a school sport.

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Learning to ride a unicycle isn’t easy. You have to try, fall off, try again, fall off and keep repeating until you eventually get it. “In my final year at uni I purchased my first good unicycle. It’s a bit like riding a bike from Kmart then upgrading to a racing bike. I started covering greater distances and kept purchasing more unicycles. I have quite a collection now. “I contacted other unicyclists through the internet and now we’re an unofficial Newcastle unicycle group. There are only four main members but we have other tag-alongs. There’s a 90km loop that goes around Lake Macquarie that we’re planning to undertake soon. “The unicycle I ride for commuting has a 29-inch wheel—it’s like a standard

mountain bike wheel. I also have a 36-inch wheel that’s really tall. The seat comes up to my chest. It’s a great unicycle for long-distance events as the 36 will go further with every pedal rotation. However, if you hit a hill, it’s very hard to maintain your pace. “Unicycling is more of a challenge than two-wheel biking and I’ve met lots of interesting people from different parts of the world doing it. There are also different facets to the sport—you can do trails unicycling, you can do tricks, you can go mountain unicycling or you can ride long distances. And a unicycle fits easily in a car boot. “The only negative is passersby who shout, ‘Where’s your other wheel?’ I’ve only heard that about 600 times.”

PHOTOGRAPHY (MAIN IMAGE): KEN LOOI, WWW.ADVENTUREUNICYCLIST.COM

When taking her unicycle out for a spin, Dr Genevieve Nawrot of Rutherford Dental in New South Wales thinks nothing of pedalling 80 or 90 kilometres. By Frank Leggett


There’s no corner of your business that we haven’t examined very closely We’ve been working with your profession for over 25 years so we’re keenly aware that dentistry is extremely precise work. It requires knowledge, skill, experience and an unflinching devotion to detail. So we’ve applied those same principles to designing a full range of financial services for your business. Each is the product of careful examination and has been shaped and refined to meet the needs of your profession.

Come in for a check up or visit us at boqspecialist.com.au or call 1300 131 141

Equipment and fit-out finance / Credit cards / Home loans / Commercial property finance / Car finance / Practice purchase loans SMSF lending and deposits / Transactional banking and overdrafts / Savings and deposits / Foreign exchange The issuer and credit provider of these products and services is BOQ Specialist - a division of Bank of Queensland Limited ABN 32 009 656 740 AFSL and Australian credit licence no. 244616 (“BOQ Specialist”).


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Bite April 2018  
Bite April 2018