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The X-files Lise Slack invented the X-Floss, X-Ribbon and X-Threaders. Now she has channelled the fruits of her entrepreneurial labours into helping needy children around the world

SPECIAL REPORT: Ergonomic design and products, starting on page 30 Denticare vs reality

Why Dental Corporation decided to open an outpost in Canada

Seachange

Meet the dental team who realised if you want to build a thriving practice, follow the coast, page 36

Passions:

The train enthusiast dentist and his ultimate ‘big boy’s toy’. Print Post Approved no: 255003/07512

Northern exposure

Can the Greens’ vision for Denticare ever work in the real world? Page 26


03

This month

December 2011/ January 2012

Features

20 Cover story

Your business 16. Going north

The X-factor

photo g ra p hy: ea mo n g a lla g h er

Contents

Following its successful expansion into New Zealand and partnership with Fortis, Dental Corporation has announced an expansion into Canada

Lise Slack’s innovative range of dental products— X-Ribbon, X-Threaders and X-Floss—are helping the dental care of Australians and changing the lives of orphans in Asia

26. Denticare vs reality If the government pursued the Greens’ vision of Denticare, what would it really cost, and how would they fund it?

36. Coasting Editorial Director Rob Johnson Sub-editor Kerryn Ramsey Contributors Sharon Aris, Nicole Azzopardi, Kerryn Ramsey, Lucy Robertson, Maureen Shelley, Gary Smith Creative Director Tim Donnellan Commercial Director Mark Brown For all editorial or advertising enquiries: Phone (02) 9660 6995 Fax (02) 9518 5600 info@bitemagazine.com.au Suite 4.08, The Cooperage 56 Bowman Street Pyrmont NSW 2009

7,736 - CAB Audited as at September, 2011

Bite magazine is published 11 times a year by Engage Media, ABN 50 115 977 421. Views expressed in Bite magazine are not necessarily those of the publisher, editor or Engage Media. Printed by Bright Print Group

16

Want to set up shop in a growing area, but without the tcompetition? Follow the retiring dentists

06

26

Your tools 14. New products

Our regular round-up of the best new gear and gadgets from suppliers you can trust

36

30. Ergonomics solutions guide

12 News & events 04. Give a Smile gives a thousand smiles

Give A Smile has treated it’s 1000th patient. ALSO THIS MONTH: The Australian Council for Social Services puts its wish list to the government; the Australian Consumer and Competition Commission takes on takehome tooth whitening kits; the ADA takes on health funds; and much more …

Everything you need to know about ergonomic products and equipment starts right here

39. Tools of the trade

This month we’re featuring a great little endodontic unit; the joy of simple microbrushes; the perfect tissue punch; and much, much more

14

Your life 42. Passions

Dr Paul Rollason of Taringa, QLD, has a threegarage train set, a license to drive steam trains and his own real train carriage

42 Bite 3


04

News bites ACOSS wants national scheme

Dr Ted Crawford of Give a Smile™.

Give a Smile™ treats 1000

With hospital waiting lists tipped to get worse, one not-for-profit organisation is giving Australians something to smile about

ive a Smile™, a charitable arm of the Australian Society of Orthodontists (ASO) treated its 1000th patient recently. The family of 16-year-old Samantha Lynch was unable to afford orthodontic treatment, until the Give a Smile™ initiative came along. Samantha is one of 12 children. “I was a little nervous about having braces put on but I can’t wait to see my new smile and not have to cover my teeth,” said Samantha. “Patients accepted into the Give a Smile™ program are offered full orth-

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odontic care for no fee. Their treatment takes approximately two years,” said Give a Smile™ founder, Dr Ted Crawford. “Since our foundation in 2005, we have been able to save the public health system almost $9 million,” he said. Currently there are more than 250 Give a Smile orthodontists across the country offering their skills to help patients in need. Founded in 2005, Give a Smile™ has assisted families by providing pro bono care for children who would have otherwise had to go without. 

Australian Council for Social Service (ACOSS) has called on the Government to tackle waste while giving priority to those who struggle the most in the next Federal Budget. It has also called for a national population-based oral health program, in place of the Medicare Chronic Disease Dental Scheme and Teen Dental Program. “There are glaring gaps in our national policy efforts to reduce poverty and exclusion, including the inadequacy of income support and employment assistance for unemployed people, sole parents, young people and people with disabilities who rely on payments such as Newstart and Youth Allowance,” said ACOSS acting CEO Dr Tessa Boyd-Caine. “There is no question that, through good economic stewardship, Australia has fared relatively well during the recent global economic downturn and our unemployment rate remains relatively low. However, it is also clear that, at the beginning of 2012, structural changes in the economy pose social challenges as well as economic ones.

 “The solution to the tension between resources and need is not to retreat from reform but to pursue it more comprehensively, with a sustained attack on wasteful expenditure and tax breaks, while continuing social and economic reforms to improve support for those who continue to struggle to make ends meet,” said Dr BoydCaine. “In addition to long overdue reforms to the lowest income support payments such as Newstart, the absence of a national scheme to guarantee affordable basic dental treatment for people on low incomes, and the growing crisis in the supply of affordable, secure housing are also key priorities.” 


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06 News from our partners Real-life lessons Dr Rita Goulart writes that EODO’s mini residency in orthodontics is an eye-opener. ’m finishing the Mini Residency in Orthodontics for general dentists at the Dental Educational Centre. This course is held by Dr Derek Mahony (Specialist Orthodontist). The course is very comprehensive and is focused on promoting the basis for correct diagnosis in orthodontics. It is based on assessing the patients cranio-facial growth, verifying the stage of maturation of the individual, and using the most modern method of cephalometric tracing. It’s an eye-opener which transformed me from the state of a general dentist to an oral physician. The course emphasises the diagnosis and cause of the malocclusion, such as breathing, sleeping and muscular disorders. It’s definitely a more holistic approach, taking a look at the whole individual. There’s a great demand in the dental community for a more integrative approach with the medical community. Throughout the mini residency several medical professionals present lectures in diverse areas such as ENT sleep and respiratory medicine. Dr Mahony’s mini-residency also provides you with great clinical experience which allows students to apply the new techniques straight away to their practices. The students are equipped with enough knowledge to start the majority with fixed appliance cases, with confidence. I have done previous orthodontic courses for general dentists, which have only focused on prescription of brackets, positioning of the brackets, and the changing of arch wires.

Dr Derek Mahony (centre) with students from his mini-residency in orthodontics.

This is a much more comprehensive course as it deals with early treatment of malocclusions such as functional jaw appliances for severe Class II problems. We also learned the early correction of mid-face deficient Class III problems, using expanders and reverse pull face masks. What I have liked most about this course has been the ability for doctors to bring their cases for discussion, and then present stage records of these cases, throughout the two years. This gives the general dentist, that has no experience in orthodontics, more confidence in starting cases and ensures that the end result is of a high standard. Doctors completing these seminars are able to sit the examination for the Fellowship in the International College of Continuing Dental Education as well as sit the examination for the International

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Board of Orthodontics. The lecturer, Dr Derek Mahony, is a highly sought after speaker around the world and has been a keen note speaker at many of the FDI annual meetings. He brings to this course, not just great clinical experience with a busy specialist practice, but also an enthusiasm to teach general dentists. This is rare to find among the specialist orthodontic community. I whole heartedly recommend this course to any general dentist who wishes to incorporate orthodontic treatment in their practice. Not only will you learn straight wire techniques for adults, but you will learn interceptive techniques for young children, as well as the preventive approach to malocclusion and a thorough understanding of the interrelationship between dental problems, snoring/OSA, maligned jaws, and other medical/dental interactions. 

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09 News bites ACCC takes on unsafe teeth whiteners

Reporting season

The Australian Competition and Consumer Commission (ACCC) has announced it has acted to stop the supply of do-it-yourself (DIY) teeth-whiteners containing unsafe concentrations of peroxide. “The ACCC is concerned that high concentrations of peroxides used in these products has resulted in injuries such as chemical burns to gums and the mouth,” ACCC commissioner Sarah Court said. “The ACCC has identified a number of products which exceed safe peroxide limits, and has negotiated recalls to remove these products from the marketplace.” To date, the ACCC has negotiated recalls of nine home-use teeth-whitening products available nationally. Three products supplied by White My Bite have been recalled including: White My Bite Sensitive; White My Bite Professional; and White My Bite Advanced kits. Four products supplied by WhiteSmile Pty Ltd have been recalled including: DayWhite Teeth Whitening Gel; NiteWhite Teeth Whitening Gel; Sunshine Health Teeth Whitening Gel; and Crest Teeth Whitening Strips. Two products supplied by DaVinci Elite Pty Ltd have been recalled including: DaVinci Elite tooth whitening pen; and DaVinci Elite take-home teeth whitening kit. The ACCC indicated that further recalls are likely. 

Two new reports show demand for oral health services is outstripping supply, and that the cost to the economy of poor dental health among disadvantaged people sits at more than $1.3 billion. The Australian Institute for Health and Welfare report, Oral health and dental care in Australia: key facts and figures 2011, summarises the most up-to-date information available in Australia today on the oral health and dental visiting of the Australian population. Data have been sourced from surveys managed by the Australian Research Centre for Population Oral Health (ARCPOH) and administrative data sets managed by the Australian Institute of Health and Welfare (AIHW). A copy of the report is available online. The report said the capacity for the dental labour force to supply dental visits is expected to range between 33.0 and 40.1 million visits by 2020, compared to a projected demand for between 33.6 and 44.1 million visits. Meanwhile, a report by the Brotherhood of St Laurence has found that millions of people are financially locked out of Australia’s expensive dental health system, undermining their capacity to gain and keep employment and at an annual cost to the economy of more than $1.3 billion. 

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10 News bites Nanocrystals make dentures shine

A different dental rort?

The hardest substance in the human body is moved by its strongest muscles. When we heartily bite into an apple or a schnitzel, enormous strengths are working on the surface of our teeth. “What the natural tooth enamel has to endure also goes for dentures, inlays or bridges,” glass chemist Professor Christian Rüssel says. After all, these are worn as much as healthy teeth. Prof Rüssel and his colleagues of the Otto-Schott-Institute for Glass Chemistry succeeded in producing a new kind of glass ceramic with a nanocrystalline structure, which seems to be well suited to be used in dentistry due to their high strength and its optical characteristics. Glass ceramics on the basis of magnesium-, aluminium-, and silicon oxide are distinguished by their enormous strength. “We achieve a strength five times higher than with comparable denture ceramics available today,” Prof Rüssel explains. The secret of the Jena glass ceramic lies in its consistence of nanocrystals. “They are too small to strongly disperse light and therefore the ceramic looks translucent, like a natural tooth,” Prof Rüssel says. 

The Australian Dental Association (ADA) has accused health funds of lowering their coverage on ‘extras’ such as dental expenses to increase profits, which then subsidise the funds hospital coverage. The ADA has made a submission to the Australian Competition & Consumer Commission’s annual inquiry into private health that points out the proportion of coverage of dental bills has dropped from an average of 54 per cent to 48 per cent.“Rebate increases have not kept pace with or even approximated the annual private health insurance contribution increases,” says the ADA. It adds that insurers should be forced to justify the decrease in benefits. In 2009-10, health funds made a profit of almost $1bn or 23.62 per cent on ancillary cover. “Given that the rising cost of healthcare is promoted as the principle explanation for rising health insurance premiums, the ADA believes it is important for health funds to ensure that benefits paid as a percentage of care do not continue to decline,” the association says. 

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Decisions, Dilemmas & Dramas in the Treatment of patients with Snoring/Sleep Apnea/Bruxism/TMD The Top Clinicans in the field give you their clinical protocol Dr. John Jorgensen

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12 News bites Oral bacteria linked to risk of pneumonia A new study has found changes in bacteria in the mouth preceded the development of pneumonia, and lead author Dr Samit Joshi of Yale University School of Medicine concluded this process “suggests that changes in oral bacteria play a role in the risk for developing pneumonia”. Although further research is required to determine the exact relationship between oral health and pneumonia, it is not the first time the two diseases have been linked. Poor oral health has been associated with respiratory diseases for a number of years, as bacterial chest infections are thought to be caused by breathing in fine droplets from the throat and mouth into the lungs. This can cause infections, such as pneumonia, or could worsen an existing condition. Studies have even suggested a higher mortality rate from pneumonia in people with higher numbers of deep gum pockets. The research, presented last October at the Infectious Diseases Society of America annual meeting in Boston, looked at 37 subjects who were followed for a one-month period. The subjects included 19 healthy adults with an average age of 60; and those at risk for healthcare-associated pneumonia and eight mechanically ventilated ICU patients. 

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A new study has linked oral bacteria to pneumonia.


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14 New products New-release products from here and around the world Introducing the new Oral-B® Triumph® 5000 with SmartGuide™ Independent study shows Oral-B OscillatingRotating power toothbrush technology reduces more plaque than power brushes that move laterally side-to-side. The Cochrane Collaboration, an independent healthcare research group, recently announced the results of a systematic review of power toothbrushes, evaluating the impact different cleaning technologies have on plaque reduction. The analysis concluded that, in the short term (four to twelve week period), power brushes with rotating-oscillating technology, pioneered by Oral-B, reduce plaque more than power brushes that move laterally from side-to-side. Furthermore, the analysis reiterated that no other powered designs are consistently superior to manual toothbrushes. “Oral-B continuously aims to provide consumers and professionals with products that meet their needs and deliver superior oral health benefits,” said Dr. Leslie Winston, Global Director of Professional and Scientific Relations, P&G Oral Care. “The Collaboration’s conclusions that oscillatingrotating technology reduces more plaque than both manual brushing and side-to-side power brush technology are a testament to the innovation and research occurring at P&G Oral Care and Oral-B.” The company’s flagship model, the Triumph 5000 with SmartGuide, incorporates many compliance-enhancing features that maximize brushing performance and increase compliance by tracking how long a person brushes and guiding users through the four quadrants of the mouth as they brush. Patients who use the Triumph 5000 with SmartGuide are, on average, five times more likely to adhere to the two minutes twice a day brushing recommendations and are less likely to use excessive brushing force . Research has shown that 92 percent of patients will significantly improve their brushing thoroughness in 30 days with the Triumph 5000 with SmartGuide. 

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Powerprox - six month braces technique Powerprox, a US supplier of orthodontic systems for 14 years, announces the debut of their Six Month Braces technique in Australia. To introduce this technique to Australia, Powerprox (represented in Australia and New Zealand by Six Month Braces Australia) are running lectures and workshops for dentists and dental professionals in the 5 largest capital cities. The key benefit for dentists is that they can now offer patients predictable ,efficient, , profitable cosmetic orthodontic treatment that on average takes about 6 months The Powerprox six month braces technique utilises simple diagnostic principles to teach you the 70% of cases that can be treated and a through ideal bracket placement utising a computer imaging system ,the use of reproximation in a very simple fashion,shape memory archwires and mechanical tricks-patients achieve an excellent cosmetic result in a very short period of time Lecture/Workshop dates are as follows:  Sydney – Friday 10th - Saturday 11th February & Friday 1st - Saturday 2nd June  Melbourne – Friday 30th - Saturday 31st March  Brisbane – Friday 20th - Saturday 21st April  Adelaide – Friday 18th - Saturday 19th May  Perth – Friday 22nd - Saturday 23th June Included in the fee is 2 days of lectures and hands on courses, Morning tea, lunch and afternoon tea, a cocktail party, a detailed manual, first year subscription to the website, treatment planning services for 2 cases and the first 2 arches of laboratory indirect bonding at half price. Dentists and their assistants can book at least 4 weeks before the workshop date to receive a 10% early bird discount. Further information is available on the website www. sixmonthbracesaustralia.com.au Spaces are limited, to reserve places, email enquiries@sixmonthbracesaustralia. com.au or call (03) 9524 8995. 


16

Your world Dental Corporation

Article Rob Johnson

Going north Following its successful expansion into New Zealand and partnership with Fortis, Dental Corporation has announced an expansion into Canada

anada’s interesting,” says Mark Evans, executive chairman of Dental Corporation (DC). That observation gains greater resonance when you realise Dental Corporation, has expanded into Canada through the establishment of Dental Corporation Canada (DCC) as a joint venture between Dental Corporation, Dr Andrew Meikle and Graham Rosenberg. DCC has initially partnered with 17 practices in the Toronto region and is in discussions with further practices across Canada. Dental Corporation’s foray into Canada started when the organisation was looking for private equity investors as an alternative to publicly listing. “Before Fortis came and bought into Dental Corporation (in December 2010), we looked at the alternatives of either an IPO or private equity. In the end the vast majority of private equity is over in the US,” Evans explains. “We had offers from private equity, and we had money in trust for an IPO—and in the United States there is a deep level of understanding of the field, but one of the problems for them is Australia is a long way away.” He was, however, referred to some groups in Toronto, one of which was a dentist—Dr Andrew Meikle—who was investigating similar ideas. “The interesting point is our model is unique,” he continues. “Between 15 and 20 per cent of the US market is controlled by corporations, but not like ours. In Canada it’s very limited, but our model works because we don’t get involved with the practice which fits well with the regulatory environment.” After six months working together, during which time Fortis invested in DC, Evans realised how well his existing model fitted into the Canadian market. “Our model goes over to their market very well,” he says. “Also we found they could execute it without us having to be there. It’s an amazing market. The spend-per-head on dentistry is much higher than it is here. Canada is an $11 billion 16 Bite

spend with one third more people than us. Their level of expectation is higher. About 60 per cent of the population have medical insurance that covers dental, and it provides around $1500 per year that needs to be used. The patient is free to use that in any dental practice.” But one of the most appealing aspects, he says, is that there was a strong, on-the-ground management team which would need limited input from the Australian office, while all the backoffice work could still be completed in Australia.

“This strategy adds to our expansion plans for the business while we remain focused on continuing our local expansion.” Dr Ray Khouri, executive director at Dental Corporation

Upon announcing the new venture, Dr Ray Khouri, executive director at Dental Corporation said, “We are delighted to announce our plans to partner with premium dental practices across Canada and we will be working closely with Andrew and Graham, aiming to achieve the same growth in Canada as we have experienced in Australia and New Zealand. This strategy adds to our expansion plans for the business while we remain very focused on continuing our expansion in Australia and New Zealand.” Dental Corporation is already Australasia’s largest provider of dental services owning 172 practices, including 16 in New Zealand. Annualised revenue for the business now exceeds $300 million. The last year’s buy-in from Fortis and now the Canadian expansion does appear to point to Dental Corporation becoming

Opposite: Dental Corporation’s executive director Dr Ray Khouri addressing shareholders at the company’s annual retreat last year.


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Dental Corporation a global player in the profession, but Evans denies that’s the case. “One of the things that doesn’t come out well in Asia is trying to count returns into Australian dollars … it’s a lot of effort for not much return,” he explains. “But it’s also not about being the biggest. We’re very conscious of not spreading ourselves too thin. We’re looking at Asia still, but only if it’s the right opportunity. “Dentistry around the world is still very controlled. We are five per cent of the Australian market, and when you add the other operators, all the corporate groups here would add up to three or four per cent or the market—so it is still under 10 per cent. Canada would be less than one or two per cent. Those numbers will increase pretty dramatically. “The level of investment required to set up a practice means younger dentists have less of a desire to set up their own business. I think that’s happening across the world. And dentistry is a complicated small business, as a dentist tries to write revenue, run staff and run substantially IT requirements and running a day surgery. There are lots of small transactions and tasks going through a practice, and that takes away from what a dentist should be doing. That complexity will just increase. Our model works because dentists are independent thinkers, but would still like help with those complexities running their practice. In dentistry, it’s not one size fits all—that partnership is the key, where we take away the complexity but leave the dentist in charge,” says Evans. But even if the plan is to expand selectively within Australia only, without any particular target, DC looks to become a significant presence within the profession. Evans again demurs, and points to the limited horizons of their current rate of growth: “Every year

Executive chair Mark Evans: “In dentistry it’s not one size fits all.”

we grow at 40 to 50 practices a year,” he explains. “So in 10 years we’d have 650 practices. Average turnover is about $1.8 million, so that would extrapolate to $1.2 billion turnover. By contrast, turnover in Australia and New Zealand at the moment is $6 billion and growing at three per cent a year, so in 10 years, at best, we’d have 13 per cent of the market. Could we have more than 20 per cent? It’s unlikely.” But it’s a big world. 

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“If you look at the whole part of something, it can look enormous and impossible, but if you take it one step at a time, then things are possible.� Lise Slack

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21

Your World Profile

X factor

Article John Burfitt Photography Richard Whitfield

Lise Slack’s innovative range of dental products— X-Ribbon, X-Threaders and X-Floss—are helping the dental care of Australians and changing the lives of orphans in Asia

hen it comes to staying on top of the game in a career she has been in for a quarter of a century, Lise Slack admits she likes working with the philosophies of people who have inspired her. So it is a telling revelation when the dental hygienist reveals it is the wisdom of Saint Francis of Assisi that has provided her with the greatest philosophy of her life. The St Francis saying claims, “Start by doing what’s necessary; then do what’s possible; and suddenly you are doing the impossible.” It has to be said the dental hygienist from the Sunshine Coast seems to be doing her

best in following the sage words, all while keeping her eye on the bigger prize. “What I have taken from that is if you look at the whole part of something, it can look enormous and impossible, but if you take it one step at a time, then things are possible,” she says. South African-born Slack, 50, is a woman with no shortage of ideas, hopes and plans, and it seems it is only the 24 hours in the day that stand in her way of achieving everything on her list. Slack emigrated from South Africa eight years ago with her engineer husband Sam and their two daughters. They now operate four dental practices across southeastern Queensland—Diamond Dental Care, Foundation Dental Services, Currey & Jorgenson and Golden Beach Dental. The main dental issue in Slack’s line of fire is the teaching of proper dental care

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Medicare Dental to children. So dissatisfied by the current standard of children’s dental care, she is now lobbying for it to be introduced as a full-time subject in schools. She is also taking her push for better dental care to the market with a new range of dental products through her company, iDontix. In June, she launched X-Ribbon, XThreaders and X-Floss. Portion of the profits from the innovations fund the charity, i-Hope, which supports an orphanage in Myanmar (Burma). And Slack is not done yet. “I’ve got many more ideas, at least five more product ideas,” she says. “All I can say at this point is they will be all you need, but be simple and effective products. “My interest in this area has just never waned because the field of dentistry and dental hygiene expands all the time. For example, when I graduated in 1982, there wasn’t teeth whitening. Now, the whitening of teeth has become very popular. “Another instance is when I qualified, we were not allowed to do local anaesthetic, and then years later, that was added to dental hygienist’s work. “Then there is my work in periodontics. We often get people irritated when they learn they are about to start losing their teeth and yet they have had no pain or discomfort. So that takes a lot of work as well. “You just always have options. There are so many directions you can follow and learn so much from each of them.”

U X-Floss Australian invented, developed and owned. Applications: Patients with implants, bridges, braces, single posterior implants, splints and tilted teeth Benefits: X-Floss has a firm threader which makes it very easy to use and the flexible woolly floss makes for effective cleaning. This product makes flossing easy.

X-Ribbon Australian invented, developed and owned. Applications: Behind implant denture, large gaps due to missing teeth, perio ‘long teeth’, behind last molar, diastemas and tilted teeth. Benefits: X-Ribbon is a broad strip of gauze floss which allows for good grip and the broad coarse texture grabs the plaque for excellent cleaning.

22 Bite

pon moving to Australia in 2003, Slack discovered the dental health of the population was of little difference to what she had left behind in South Africa. “Very similar, actually,” she states. “South Africa has incredibly well-qualified dental professionals and I found the standard very similar here. The standard of sterilisation techniques are also very good. “But the biggest issue I still see is the teaching of proper dental care for children. If we can start teaching kids from an early age how to look after their teeth and how to care for them, then we would be more successful in slowing down dental decay and gum infection. “If something could be started with children at an earlier age, that would be good. I feel this is something that could be included as a full-on subject at school, because at that time of their learning there is a lot more emphasis on health, sport, being active and learning how to look after yourself. “I am concerned about this because a lot of infections in the mouth can be linked to other diseases and problems in the body. An infection in the mouth can mean one has a much higher incidence risk of stroke or heart attack, as well as incidences of arthritis and respiratory conditions.” The desire to take action earlier rather than later is what lead Slack to developing her X-Floss and X-Robbins products through the iDontix company. But the idea for them also came from the health conditions she saw patients presenting with. “I do a lot of work with implants and I was constantly coming across these complicated cases where people were struggling to clean the implants properly,” she says. “With that, I kept getting confirmation there was a real need for these products.


Children and staff of the orphanage in Yangon, Myanmar, which is being constructed by i-Hope.

“It is not just a case that these are another floss product. It is not just like another shampoo. What I am doing is keeping hygienists, dental professionals as well as patients informed and educated about what all the applications of these products are,” explains Slack. iDontix was founded with a vision that the profits raised by

“When the four of us came together with iDontix and i-Hope, we were so thrilled as this was a lifetime dream for the four of us to become involved in helping kids, especially the orphans who have no control over being chucked out onto the street.” Lise Slack

new products would go towards funding the charity activities of i-Hope. The goal of i-Hope is to build orphanages in places wherever children are at risk. The first orphanage in Yangon in Myanmar, where an estimated one million people are homeless and tens of thousands of children are orphans. i-Hope supports the Graceworks organisation in Myanmar, which is in the process of building a new home for 18 orphans. i-Hope was established by Andre and Charlotte Venter, close friends of Lise and Sam Slack, who are both on the board of directors. “We’ve always known there is a greater purpose than just day-to-day living and that we have a

tremendous desire to make a different to kids who are in dire straits,” Slack says. “When the four of us came together with iDontix and i-Hope, we were so thrilled as this was a lifetime dream for the four of us to become involved in helping kids, especially the orphans who have no control over being chucked out onto the street. “When we met up with Graceworks, we realised they already had responsible, reliable people and all the systems set up to help. The new building is not complete yet and it is slow because they’ve got so few people to help them, but the foundations are done and the building is underway, so it is happening.” While the iDontix business is still in its initial growth stage, Graceworks will remain the priority target for the charity works of i-Hope. With the other product ideas in the pipeline, Slack hopes to expand the number of projects they can support in the coming years. But she admits the new business has provided some of her biggest business lessons of her career. “I now know why so many people keep their good ideas locked up in the garages because it (getting the products released) has been much harder than I ever thought it would be,” Slack reveals. “What has kept us going when it all seemed too hard is knowing that there are kids out there who are suffering and that we have the opportunity to help and do something to change that. “It is just a matter of being persistent, and more than a little tenacious.” Bite 23


Profile

When it comes to Slack’s ongoing passion for dentistry, there is another philosophy that could also be added to her list. That one could be, “Father knows best.” It was her father, Cape Town dentist Dr Paul Prinsloo, who instilled in his daughter a love of the profession from an early age. It created a profound impact, which still resonates. “As a little girl dressed in pyjamas, I would jump in the car with him and look forward to the adventures of an after-hours emergency,” she recalls. “To this day the sharp smell of Kalzinol (eugenol) reminds me of him in his white surgery tunic with the removable buttons. “My dad gently but firmly guided me in that direction. Dad had the insight of knowing me and knowing the dental hygiene profession and knowing that the two of us would go well together. And to be honest, I am extremely grateful because I haven’t regretted it for a day. Not one.” But it was one piece of direction from her father, which continues to inform her approach with patient care. “Dad used to always say to me, ‘You are not only treating the mouth and the teeth, and you are treating the whole person’. “He would also say, ‘With the care you are providing, it is a lot deeper than just looking into their mouth. You have to consider that patient’s background and their life.’ I still work with that—thinking about what the person as a whole needs, not just the person’s teeth.” 

Reviewers wanted We want you to write for Bite! Every issue we’re asking dentists to review their tools—telling us in a couple of paragraphs what they love about them and what they don’t like. Check out the reviews starting on page 39. There’s only two rules—you have to be a practicing dentist, and it has to be something you use. The whole idea is to start a conversation between our readers. We don’t want to tell you what to buy. We want your peers—the people actually using the equipment—to guide you to what’s good and what isn’t. If you’d like to write a review, email Rob Johnson at rob@engagemedia.com.au, and he’ll tell you what’s involved.

24 Bite

The groundworks being laid for the new orphanage.


Science in every Smile Position your practice to grow Dental professionals across Australia recognise that Invisalign produces more than just outstanding clinical results – it also presents new opportunities for business growth. Invisalign can benefit your practice in a number of ways:

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• Generates new business opportunities • Requires less chair time, which means more patients through your doors • Encourages patient regeneration by offering a new treatment modality. This enables you to reach out to a new market of patients who are not willing to undergo treatment with traditional braces • Results in healthier dentition and better periodontal health1 • Invisalign’s 96% patient satisfaction rating2 means dependable referrals from happy patients! More opportunities. More rewards. Visit www.invisalign.com.au or call us on 1800 468 472 to find out how you can position your practice to grow with Invisalign today. 1 2

Ong et al., 1998Boyd and Baurind, 1992, Zachrisson and Zachrisson, 1972 US survey data 2009, Align Technology, Inc.

invisible


26

Your business Denticare

Article Mary Banfield

Denticare vs reality If the government pursued the Greens’ vision of Denticare, what would it really cost, and how would they fund it?

ust over 12 months ago with much fanfare the Australian Greens announced their ambitious plan to introduce a universal dental scheme, Denticare. At the end of last year the Greens released further details that now provide a snippet more information on how Australia could emerge as one of the few countries to provide affordable dental care as an entitlement of all citizens. Based on financial estimates provided by the National Health & Hospitals Reform Commission, the Greens have budgeted for annual injection of between $4.3 – $6 billion annually to fund Denticare. Yet with Europe facing financial calamity and the burden on Government to work towards a balanced budget, the question remains, how will Australia find an additional $6 billion, and is it worth it? Increasing government debt is one solution, but as an alternative, Greens health spokesperson Senator Richard Di Natale is suggesting a .75 per cent increase in the Medicare levy, which would cover the expenditure, that is, if the Greens’ estimates are on track. “The Australian Dental Association will suggest that the costs are in the order of $10 billion annually to fund a universal Medicare dental scheme. There, what we think, are more creditable estimates of between $4 to $6 billion,” says Di Natale. With at minimum a $4 billion and at most a $5.7 billion variance, this may be a major hurdle to introducing the scheme and it won’t help that other experts in the field are hesitant to cost a universal 26 Bite

system, at all. “Look, I think the truth is that no-one is really sure what exactly will happen. No-one can precisely model what will happen (legislating Denticare), we haven’t got the proper data.... we sort of have to play it by ear,” says Associate Professor Hans Zoellner, Faculty of Dentistry, University of Sydney. To control unexpected costs, Zoellner has welcomed the Greens’ initiative to take the current Chronic Disease Dental Scheme (CDDS), alter the eligibility, and slowly introduce a universal scheme over five years. “Let’s begin by overhauling the CDDS. Also, we’ll make the scheme means tested. Then we also can look at whether we put some limitations on some of the high-end services that are currently available, that being crowns,” says Di Natale. In 2008, when the legislation was passed, for the first time Australia offered free dental services to those with a chronic health problem to the value of $4250 over two years; that was funded through Medicare. Since its inception around one million people have used the CDDS with 20 per cent of patients not holding a Health Care Card (HCC) and therefore considered high income earns. After placing a means test on the scheme in the first five years, this group would be ineligible for the Denticare, cutting a significant amount of the current expenditure. “In a phased implementation of Medicare funded dentistry we would be starting with ultra-low income earners then moving towards all Health Care Card holders,” says Di Natale. Initially, even the majority of the five million HCC holders would be exempt from the scheme. Only those receiving rent assistance


Greens health spokesperson Senator Richard Di Natale believes ADA costings of universal dental care are inaccurate.

“In a phased implementation of Medicare funded dentistry we would be starting with ultra low income earners then moving towards all Health Care Card holders.”

Photography: Gary Ramage/Weekend Australian

Greens health spokesperson Senator Richard Di Natate

would be eligible. By the third year all HCC holders would be absorbed, and only by the fifth year would all Australians be eligible for free dental services. That would allow for two significant elements of uncertainly to be monitored; the demands on the dental services and the financial burden. So what will influence the costs as the scheme is introduced? In a piece of interesting research Zoellner has analysed the CDDS from data provided by Medicare, to conclude that people are using far less than they’re entitled to. In fact the average cost of treatment is just $1808. What’s more significant is that the expensive treatments are limited to the initial phases, when the patient needs complex treatment, but after that the cost of services reduces astronomically. Why? It comes down to the self-limiting theory. When there is an emergency, people will turn up banging on the dentist’s door, and this is the cost drain.

Once the high-level needs are met you’d be lucky to see patients other than for the occasional clean and fluoride treatment. “Are people really going to line up for more crown and bridge work than they need? I’ve had a few crowns and honestly I don’t enjoy the experience at all. Oh, yes, everyone loves root canal therapy: get real!” says Zoellner. Australia still has an unmet demand for dental services with 35 per cent of people stating that they are not getting treatment as costs are prohibitive. It’s an enormous problem and Zoellner believes with the introduction of Denticare, initially the demand for high-end work will soar particularly from those who have delayed treatment. After this rush, demand will dwindle to mainly for preventative and cheaper work. “I think the Greens are making an estimate of $4.5 billion per year and that’s probably reasonable; that’s as much dentistry that the workforce can physically produce,” says Zoellner. So with a huge injection of funds into the industry, if demand outstrips supply, will there be price pressure, and will the price of dentistry increase? Not under the Greens’ program. “You contain prices essentially the same way as we do it through Medicare, which is to determine a scheduled fee for a particular service ... you could potentially limit co-payments,” says Di Natale. That may not even be necessary, according to Zoellner, as the cost of medical services since the introduction of Medicare have in fact reduced. Most people today consider low-cost medical services as an Bite 27


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Denticare entitlement. We pay a levy, so the idea of paying a co-payment, when the doctor down the road bulk bills, will keep prices competitive. The same is predicted to happen under Denticare.

“We have failed profoundly in the public health and the private service and to fix such profound failure requires pretty profound change.” Associate Professor Hans Zoellner, Faculty of Dentistry, University of Sydney

Y

et a universal system may change the entire dentistry landscape. “Over time, a decade or two, the needs of the community won’t be to have large numbers of dentists but a large number of oral therapists who do preventative work when things break down. You need a dentist to do the high-level and complex stuff, but in the future you don’t need too many actual dentists,” says Zoellner. As we remap the dental profession first we should ask, does this proposal have any chance of being passed through parliament? For the Greens, Denticare is one of their three top priorities, according to Di Natale. Still, for it to become law, the Greens either must win the support of either of the major parties. Will the Liberal Party support the Greens? Probably not. “The Government has blown billions of dollars on all sorts of schemes and by the Government’s own admission that makes it very difficult to find the money to spend on a universal dental program,” says Peter Dutton, Shadow Minister for Health and Ageing. Minister for Health Tanya Plibersek remained silent on the subject. “There are so many objections to a universal scheme because we are talking about a profound change to dentistry. But the truth is, we have failed profoundly in the public health and the private service, and to fix such profound failure requires pretty profound change,” says Zoellner. 

FREE weekly news from Bite Stay in touch... Receive a free weekly email bringing the latest dental news and product reviews striaght to your inbox. News Bites brings you the same high quaility content you’ve come to expect from Bite the magazine via our weekly email newsletter. Simply visit www.bitemagazine.com.au and enter your email address in the subscribe box to subscribe. If you have any feedback or enquiries just give us a call on (02) 9660 6995 Bite 29


30

Advertorial

Ergonomics product guide Sitting pretty

From an ergonomic point of view the operatory stool is possibly the most important piece of equipment in the surgery.

I

t is no secret that back (and related) issues are a major problem for dentists. It is also no secret that saddle sitting is very beneficial to dentist’s and assistant’s wellbeing.

Main disadvantages of traditional sitting  The back is rounded in bad posture and shoulders droop forward, which causes tension in the upper back muscles and shoulders.  Microcirculation in the lower back weakens and deterioration of the vertebrae begins.  Lumbar vertebrae are in the wrong angle, ligaments stretch, and the deep back muscles weaken.  Bad posture causes poor breathing, which leads to a lack of oxygen and tiredness.  Moving around with the chair and reaching from it is clumsy, since the feet are in front of the center of gravity.  Sharp angles in knees and hips affect the joints.  When sitting in a poor posture, the abdominal cavity and the intestines are pressed between the ribcage and the pelvis, disturbing the intestinal functions.  Pelvic area tissues When sitting on and internal organs, in addition to the genitalia, are a saddle chair the compressed and the blood spine is almost in flow into these areas is the same position reduced as when standing.  Continuous sitting There is a small with bad posture causes curve in the lower disturbance in the vertebrae back and the of the spine, and that can vertebrae is not cause reflect ailments in pressing the discs. other parts of the body.

This position

is natural and Effects of quality ridingtherefore easy to like sitting Riding-like sitting differs maintain. greatly from the traditional way of sitting. The change affects the whole body: all large tissue groups and all body parts. In almost all cases a ridinglike sitting position is a change for the better as it disturbs the metabolism to a much lesser extent than traditional sitting. The aim of ergonomics is to disturb the natural vital functions of the human body as little as possible, and to reduce health risks. The main positive effects are to the spine, starting from the lower back and ending in the neck vertebrae. The sitting position affects posture, circulation in the lower limbs and joints, genital area, pelvic muscles, and intestines. Circulation in the head also increases, positively affecting the activity level of the brain and the eyes. Riding-like sitting enables you to easily roll around on the 30 Bite

The right sort of chair forces you to maintain a good posture while sitting all day.

chair, move and reach, and to tilt the seat. Sitting becomes active, and the effectiveness in work increases. When you start to improve your sitting, it makes you aware of your circulation, muscle tension, back, posture, metabolism and sitting position. When sitting on a saddle chair the spine is almost in the same position as when standing. There is a small curve in the lower back and the vertebrae is not pressing the discs. This position is natural and therefore easy to maintain. Sitting on a saddle chair reduces tension in the back and sciatic-type pains, enhances circulation, makes breathing deeper, keeps the hip joint in the optimal 135 degree angle and makes it easy to move around on the chair. The two-part seat does not press the genital area, which is beneficial to genital health. On a twopart chair, men can also comfortably tilt the pelvis forward to create the curve in the lower back that enables good posture. A Salli saddle stool used in conjunction with a quality set of loupes may just change your life and extend your career. For more information contact Fairway Dental on 1300 229 706 or visit www.fairwaydental.com.au/salli and www.salli.com. 


R

For more detailed information regarding Salli’s health benefits, to book a demo, or to purchase, call 1300 229 706 or visit www.fairwaydental.com.au/salli

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Ergonomics solutions guide

33

BRUMABA – The flexible surgery bed for many specialist fields Perfect conditions for professionals

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Primus: n the daily routine The Brumaba OP “PRIMUS” of treatment and is our top candidate for all operations, theory is head surgery operations. Its a poor partner. This special feature: the additional is why the medical bed longitudinal axis tilting of systems by Brumaba the patient surface. With its are based on practical patented dual telescopic experience: namely column, the “PRIMUS” model your practice! For 25 is, of all surgery tables on years we have been the market, the one that can developing surgery be adjusted to the lowest tables, treatment beds position. This means that it and patient transport is also easy for patients with chairs for professional restrictions of movement use. In a continuous to get on the table. The dialogue with our especially high maximum customers, solutions position shows its qualities are created that are above all in treatments in convincing down to which the surgeon has to the smallest detail. We work in a standing position. have pursued many of these until they are Caddy: ready for a patent, and Whether sitting, reclining or then distributed them Primus Surgical Table transporting, the caddy gives worldwide, with great you the option to modify the success. position. The patient can get You can recognise into and get out of this comfortable, well designed chair Brumaba products from their well thought out technology, both easily and safely. their aesthetic design, and their unbeatable quality. The caddy is the perfect choice for the safe transportation of patients. Even longer periods in Surgery tables from Brumaba the caddy are pleasant and relaxing. The caddy has Multifunctional, individual and hard-wearing – these also demonstrated itself to be robust and suitable for attributes distinguish surgery tables from Brumaba. In 25 emergency situations.esign were the years of continuous development, the product programs GENIUS, PRIMUS and CADDY were created. With their Suitable Specialists Fields: different features, they cover nearly all surgical subject  MCG surgery areas.  ENT surgery This, along with a wide range of accessories, makes  Dental surgery them the perfect partner for surgeons in hospitals and  Opthalmology practices.  Plastic surgery  Aesthetic surgery Genius:  Dermatology With the GENIUS, we are presenting a surgery bed that  Hair transplantation can be used in practically all medical fields. As with all Brumaba products, the GENIUS convinces Contact: through the precise finish of high-quality materials, Ph No: 1300 363 830 extreme flexibility and ergonomic design made in www.williamgreen.info Germany.


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Advertorial

Ergonomics solutions guide Bambach Saddle Seat: The best choice for dentists

A

staggering 86% of Dental professionals have experienced pain in their lower back, neck or shoulders. Dentistry involves working with extreme precision, as a result the body remains rigid and often unsupported. This tension can eventually lead to posture related musculoskeletal problems. Dentists often spend a large sum of money on dental equipment ensuring their patients comfort whilst forgetting their biggest asset of all.....themselves!!! With a Bambach you can protect your investment and

Dr SJ Semaan of Clear Smiles Orthodontics, Robina, Qld.

prevent risk of injury or worse still, early retirement. Why the Bambach? The Bambach is the original Saddle Seat shape, designed and patented from extensive research. It has been tested to Australian standards and recommended by health professionals worldwide. It is the only Saddle Seat available in four seat top sizes to suit your height, body shape and gender and in a wide variety of colours. We are 100% Australian made and owned. How the Bambach Saddle Seat will help you; Using a Bambach Saddle Seat not only maintains optimal spinal function, it can improve your productivity at work by: Promoting shoulder stability and correct posture, improving dexterity, precision and decreasing fatigue. Due to the unique patented design of the Bambach Saddle Seat, your pelvis is supported in its natural position even when leaning forward. Over 50,000 Bambach Saddle Seats are used by Dental professionals worldwide. To find out more see us at ADX12 stand 188 or contact us now. 

The Perfect Ergonomic Answer t h e b a m b ac h s a d d l e s e at • Assists in maintaining natural spinal curves • Helps prevent musculosketetal disorders • Helps reduce neck, shoulder and back pain • Encourages an upright posture • Designed and manufactured in Australia

30 Day money back guarantee Phone 02 8966 4800 • Fax 02 9948 9834 4b 3-9 Kenneth Rd, Manly Vale 2093 NSW

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Advertorial

Ergonomics solutions guide

35

Don’t forget ergonomics when buying equipment

Ergonomics is a critical, yet often overlooked consideration when purchasing new dental equipment.

T

oo often dentists, who are clinical experts, are mesmerized by equipment features and options, not to mention the price of their dental equipment.

Why are ergonomics important? Dentistry is a physically demanding occupation involving long hours chair-side working over the patient. Many dentists develop back and neck complaints as a direct result of poor work positions. This may affect their productivity and enjoyment of dentistry and shorten their working life. Most often this is the result of poor design of the dentist stool and the patient’s chair. Dental assistants who have to bend and twist—or get up constantly from their position to reach materials are also at risk of fatigue and other workplace injury, compared to those who materials and instruments are within easy reach from a seated position. In recognition of this, A-dec has developed dentist’s and assistant’s stools and work surfaces, together with patient chairs and operatory furniture to maximize ergonomic efficiency. Back to basics Dental staff should maintain a work position where their arms and upper legs are parallel to the floor and their back is supported. In the case of the assistant, who must be seated higher and therefore has to lean forward, a front torso support arm is required, together with a foot support ring, like that fitted to the A-dec assistant’s stool, to alleviate back strain. Often patient chair design prevents dentists working in an ideal position, especially if the chair has a thick backrest or if it cannot be positioned low enough for shorter or more petite operators. In recognition of this, the A-dec® 500 and A-dec® 300 chairs have ultra-thin contoured backrests which give extra legroom, enabling dentists to position the oral cavity several centimetres lower and closer to their lap for an optimum working position. The A-dec 500 also features a ‘gliding’ headrest that automatically follows the motion of the patient when the chair is raised and lowered, meaning fewer adjustments for the operator and more comfort for the patient. A-dec’s unique double articulating headrest is easily adjusted to provide optimum access to the oral cavity and to suit patients with varying needs, including those with disabilities. Similarly, the armrest needs to remain comfortable during recline and should be easily reached by the dentist and moved out of the way for better patient access. Complementing the patient chair and dentist and

What to look for when buying dental equipment —A-dec has written a book on it.

A-dec’s double articulating headrest gets you closer to the oral cavity

assistant’s stools, is a range of A-dec Preference™ dental furniture designed to streamline materials management throughout the dental surgery and sterilization area. For help in selecting equipment suitable for your practice, contact A-dec for a free copy of their useful booklet: What To Look For When Buying Dental Equipment available by phoning A-dec Australia toll-free on 1800 225 010. 


36

Your business Design

My Dental Team, from left: Dr Abhishek Aggarwal Dr Ramesh Sivabalan Corinne Herbert Katerina Tankoska Kelly Schwegler Christine Mackay Dr Shabbir Kermali Dr Roger Lee

Article Amanda Lohan

Coasting Want to set up shop in a growing area, but without the competition? Follow the retiring dentists 36 Bite


Opposite page, above left: The elevated café-style seating area with district views. Above: Surgery with views of Kangaroo Valley.

or Ramesh Sivabalan of My Dental Team, the planning process for the new $1.5 million state-of-the-art practice began even before graduation. After researching a number of regional areas and assessing growth potential, the team running the practice settled on Shellharbour on the South Coast of New South Wales. The location for My Dental Team was carefully chosen on the basis of a demographic study for viability, “The demographic study was easy in Shellharbour because the council website already had a lot of the stats on the growth in the area and the number of young families, dual income families and mortgage stress levels, which helped us determine disposable income in the area,” says Dr Sivabalan. From a demand and supply point of view, Sivabalan believes that the area needed something new and fresh in the area of dental care: “There are a lot of retiring dentists in the area. Our idea was to set up early so that when it becomes a full-blown city we will already be established”. The site itself is located adjacent to a shopping centre currently undergoing a multi-million dollar upgrade, with another couple of hundred million being injected into the nearby marina, indicating immense growth potential. The complex boasts a medical centre with nine GPs, a skin clinic, a vitamin store and a psychiatrist, “The medical centre was excited about us opening. We’d only been open for two-and-a-half weeks and they were already referring a couple of patients a day.”

Designed for Comfort “The key thing from a design point of view is definitely the cafestyle seating area,” says Sivabalan. “It was a bit of an issue to start with—the area was over a massive garage door and we had to build a concrete block around it. So, we thought ‘why not use the space and make a seating area?’” My Dental Team spent an extra $8000 converting the dead space into a functional area, and with amazing sweeping views of Kangaroo Valley it is now a stand out feature. The surgery layout, designed with the assistance of Perfect Practice, incorporates a consult room and three fitted-out surgeries, with a fourth plumbed and cabinetry installed ready for planned growth. A dedicated sterilisation area and barcoding system mean that staff don’t have to spend their time peeling stickers and typing numbers, while the in-house lab allows the dentists to mill crowns onsite so that patients can finish their treatment in one day. Patients also have access to a wash area to brush their teeth before their appointment, and staff enjoy a large break room with a shower for those who wish to exercise. A large six-by-five metre seminar room rounds out the practice, and has been pegged as the base for a series of 20-minute oral hygiene seminars targeting local schools and parents, as well as a dental education facility for the practitioners to attain their 20 hours of nationally accredited Continuing Professional Development training each year. While Dr Sivabalan expects that this facility will help My Dental Team remain competitive, he also believes there is “enough of the pie to share around”, with other local dentists being invited to join in on the convenient CPD training. The neighbouring medical centre and other local businesses have also been invited to use the facility for their own purposes, and My Dental Team have already Bite 37


Design

Making Dentists Smile

played host to a working meeting of 20 local businesses, which they believe will help establish a sense of goodwill. To get the brand right at the right price, My Dental Team registered with Logo Tournament, offering a US$300 prize for the best logo design. The winner, selected from over 200 submissions from 32 designers across the world, was a Brisbane designer. “Basically we went with a blue and apple green theme because we wanted to keep it fresh,” says Dr Sivabalan, “Everything stemmed from this concept when we started and originally we wanted to call it ‘Fresh Dental’. Another company was already using this name so we came up with ‘My Dental Team’. It sounded corny and American, but it made more sense. Patients often expect to see the same dentist all the time. We wanted to educate patients that they would be looked after by a team rather than an individual.” The team have invested in 3D animation software that allows the dentists to select from 200 videos on the surgery’s iPad to help patients understand their planned treatments. Some of the more common treatment videos are available online at www. mydentalteam.com.au, and are currently being translated into text form to optimise Google searching. A vigorous marketing campaign supporting the new practice centres on a two-pronged approach of a local radio campaign

From greenfield sites and ground up builds to renovations and redesigns of exisiting surgeries, Medifit creates original dental practices that are state of the art in both form and function. Since 2002, Medifit’s “one stop shop” operation has consistently delivered excellent results for dentists and specialists throughout Australia. Working within clients’ timeframes and budgets, our design and construction team is unrivalled in producing the finest outcomes. It’s been the backbone of our success and the standard our competitors aspire to. To experience the Medifit difference, contact us today for a no obligation consultation. Your patients won’t be the only ones smiling. SITE ASSESSMENT SPACE PLANNING INTERIOR DESIGN & FITOUT ARCHITECTURAL DESIGN BUILDING CONSTRUCTION & RENOVATION CORPORATE BRANDING

www.medifit.com.au

1300 728 133 38 Bite

The surgery also boasts a play corner for young patients.

featuring a sponsored surf report and advertising, and direct mail of 135,000 flyers and 57,000 branded magnetic calendars right across the Illawarra region. “The calendars are timely for this time of year,” says Dr Sivabalan. “Even if only one per cent kept the calendar we would consider that a success, and it sounds like a lot more are actually keeping it.” My Dental Team also sponsors select local events that align with a sense of community spirit, such as the Girl Guides and recent clean-up day at the lake. “We’re trying to get some sort of intrinsic value out of being part of the community.” Every person that comes to the practice is given a goodie bag with toothbrush, paste and floss, and the kids receive a My Dental Team colouring in book with crayons. Sivabalan says this stems from the desire to achieve a “before and after focus” that is often neglected in dentistry. “You can tell someone you’re a good dentist, but it doesn’t mean they’re going to come to you. In fact, trying to convince them that you’re a good dentist might actually scare them off… We can’t really sell ourselves—we just have to do a good job and hope the word of mouth sells it for us.” 


39

Your tools Reviews

This month, a great little endodontic unit; the joy of simple microbrushes; the perfect tissue punch; and much, much more

Tools of the trade

Topdent Microbrushes Dr Wayne Ottaway, Pickup and Associates, Launceston, TAS

Satelec Suprasson P5 Booster Dr Nick Stanley, Lauriton, NSW This is a great little ultrasonic unit for scaling teeth and for endodontics. I would use it about 10 times a day—with every patient that has a scale and polish. What’s good about it Compared with other scaling units, it’s quiet, gentle on the teeth but very effective. In the past, I’ve used other ultrasonics that emit a lot of noise and tend to rattle against the teeth. This unit offers a much more comfortable experience for our patients. It’s a small and compact piece of equipment that’s easy to use. The whole unit is only 15cm by 8cm by 3cm high. It takes up very little space in the surgery. There are also tips available for endodontics. I use these for smoothing the openings to the canals and for irrigating. It’s a really nice piece of equipment. It’s comfortable for the patients and just as comfortable for the dentist. What’s not so good Great care must be taken when fitting the tips. If you over-torque then the unit will break. It’s a little bit delicate in that regard. Where did you get it Gunz Dental.

These are simple little brushes that I’ve been using for years. There’s nothing high-tech about them—they’re just a thin plastic handle with a fuzzy end. I use them for the precise application of various materials onto teeth. What’s good about it The small compact brush prevents too much material being used and allows for the accurate placement of liquid onto the tooth. They also come in different colours and brush shapes. The neck of the brush can be bent to allow access to all the difficult nooks and crannies. When placing a restoration on a tooth, I use three different coloured microbrushes and disposable plastic mixing wells. I use a red microbrush for the acid etch, a green one for the dentine primer and a blue brush for the bond. This ensures there’s no mixing of materials, particularly when doing multiple fillings. It also means that the dental assistants know at what stage I’m working by the colour of the brush. It’s a simple little system that works very well. By reversing the brush and using the handle end, the microbrushes can also be used when mixing other dental materials such as self-cure acrylic. They come in boxes of 100 and are cheap as chips. They’re also useful around the house if you need to mix cements such as Araldite. What’s not so good They are such a simple device it’s hard to find any negatives. Where did you get it Henry Schein Halas. Bite 39


Your tools Reviews

LuxaForm by Dr Paul Close, Close Dental, Clayfield, QLD I use LuxaForm to take a moulding of teeth as a template to make a temporary crown or bridge. It has enabled me to do away with alginate in a little quad tray, which was a more time-consuming and messy process. It’s been around for a while but I didn’t think it was such a good thing until I used it. Now I think everyone should give it a go. What’s good about it LuxaForm is a thermoplastic material that is placed in hot water to get it to a mouldable state. So if you’re doing a crown prep, it’s placed over the adjacent teeth and then patted into place with a moistened 2X2 gauze. By coupling LuxaForm with a metal triple tray, it enables me to do crown work without any use of alginates. There is no need to pour up any opposing models and LuxaForm sets in a minute. This system helps make my working day easier, faster, better—and a whole lot less messy. When you first use it, the tab appears not to be large enough—the size of a piece of chewing gum—but it works well for a single unit case. LuxaForm is predictable, less messy and helps get the job done faster. What’s not so good It takes a bit of practice to use properly. The tab needs to be at just the right temperature and then moulded into the correct shape. I use a moistened piece of 2X2 gauze to pat it down over the tooth so it doesn’t stick to my gloves. The wet gauze also cools and sets the thermoplastic material faster. It must be lifted slightly on and off the teeth just as it finally hardens so as not to engage undercuts. Where did you get it Henry Schein Halas.

Nobel Biocare Tissue Punch by Dr Michael Fong, Oakhill Dental Surgery, Castle Hill, NSW Traditionally, when inserting a dental implant into the jawbone, you cut open the gum, expose the bone and then place the titanium screw. The beauty of this tissue punch is that it creates a perfect-sized hole in the gum. You then 40 Bite

A nice tissue punch makes this who experience a little less anxious for patients. insert an implant that is the same diameter as the hole you have just created. The punch is attached to your surgical drill. It’s only 2cm long and you need to ensure the tissue punch is well irrigated with saline while using it. What’s good about it It’s less traumatic for the patient and they heal much quicker. This is very good for people who have a health condition like diabetes where they might take a bit longer to heal. It’s quite useful when operating further back into the mouth where access with a scalpel isn’t very easy. You can create multiple holes with a tissue punch and insert multiple implants. This is a great time saver. A lot of patients get a bit anxious when you talk about surgery and this helps eliminate some of that anxiety. No-one likes to see a scalpel going into their mouth. What’s not so good One problem when using a tissue punch is that you don’t get the natural contour of the gum such as the interdental papillae. I don’t use it much in the front area of the mouth as this can produce small dark interdental shadows. When using a scalpel, one can stitch the incision and reproduce close to the ideal shape of the gum. With a tissue punch, you can’t do that. Where did you get it Nobel Biocare.


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42

Your life Passions

photography: Richard whitfield. Interview: Kerryn Ramsey

Dr Paul Rollason Absolute Dental Care, Taringa, QLD My interest started when I was three years old and my dad gave me my first train set. I started collecting and over the years, it has gotten bigger and bigger. I now have an extensive collection of model trains from Germany but it’s still a work in progress. My model railway covers three-and-a-half garages at home. Most of the track is down and it’s powered but there’s a lot of scenery to go yet. There is still years of work in front of me. “My hobby grew from playing with models to playing with bigger toys. In 1992, I became interested in driving steam locomotives. The Australian Narrow Gauge Railway Museum in Woodford [Queensland] runs two-foot gauge diesel and steam cane locomotives. “I also own I did a course, an ex-NSW racked up hours of stainlessexperience while steel sleeper volunteering and carriage sat two exams built in 1970. to run the boiler It’s 75-feet and operate the steam engine. I long, weighs now have my 49 tons.” steam train licence. “If you’re not careful, a steam train can explode. The boiler has 150psi and a lot of things can go wrong. It’s not like getting in a car and driving. It takes four-to-six hours to go from a cold state until a train is ready to drive. It’s odd, but a steam locomotive is really like a living, breathing beast. If you listen to them, they tell you what they need. Only steam drivers can appreciate this strange phenomenon. “I also own an ex-NSW stainless-steel sleeper carriage built in 1970. It’s 75-feet long, weighs 49 tons and is off the old Gold Coast Motor Rail. It was decommissioned in 1991. I had it shipped to Brisbane and I’m going to fully restore it so she will be operational once again. I keep it in a depot in Ipswich [Queensland] and every second weekend, my mates and myself are out there working on it. My train obsession started with those few trains my dad gave me and I can still remember thinking, ‘Gee, it would be nice to have a big train set one day.’ Now I have the ultimate ‘big boy’s toy’. 

42 Bite


Who else... has finance specialists dedicated to dentists?

L-R: Melinda Goddard, Michael Fazzolari, Richard Curia, Tony Kalmin, Ryan Raymond, Sandy Constanti, Adrian Raath, Paul Richardson, Angela Warren, Kelly Gall, Craig Spiegel, Debbie Kiely.

Investec offers specialised financing for dental professionals including: • • • • • • •

Equipment, fit-out and motor vehicle finance Commercial property finance Protection and life insurance Call and term deposits Home loans Professional overdraft income Goodwill and practice purchase loans

On call 1300 131 141 or visit www.investec.com.au/medicalfinance Investec Professional Finance Pty Limited ABN 94 110 704 464 (Investec Professional Finance) is a subsidiary of Investec Bank (Australia) Limited ABN 55 071 292 594 AFSL 234975. Income Protection/Life Insurance is distributed by Experien Insurance Services Pty Ltd (Experien Insurance Services) which is an authorised representative of Financial Wisdom Limited AFSL 231138 (AR No.320626). Experien Insurance Services is part owned by Investec Professional Finance Pty Ltd.


Did you know? People with diabetes are more susceptible to gum disease.1 Diabetes & Dental Health

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It is recommended that people with diabetes make regular visits to a dental professional to detect and treat gum disease. The twice daily use of an antimicrobial toothpaste is also recommended to minimise the progression of gum disease.2

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Fight gum disease with Colgate Total toothpaste Visit www.colgate.com.au for further details Always read the label. Use only as directed. See your dentist if symptoms persist. 1) Taylor and Borgnakke, (2008). Oral Diseases, 14: 191-203; Khader, Albashaireh and Hammad, (2008). La Revue de Sante de la Mediterranee orientale, Vol 14, No.3: 654-661; 2) Blinkhorn, et al. (2009), British Dental Journal, Vol 207, No.3: 117-205; funded by Colgate-Palmolive Pty Ltd, Australia. 3) Fine, et al. (2006). Journal of the American Dental Association, 137: 1406-1413; funded by Colgate-Palmolive Co, New York.


Bite February 2012