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Dream catcher Dr Vandana Katyal on fixing the invisible OSA threat to our children
Dr Geoffrey Speiser shines a light on dry mouth, page 8
How to introduce aÂ successful loyalty program into your practice, page 13
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Contents NEWS & EVENTS 4. Scope of practice reviewed The Dental Board of Australia has published its revised scope of practice registration standard; the Dental Hygienists’ Association of Australia says budget cuts will worsen oral health; the winner of Koolin Balit Aboriginal Learner Award and much more...
YOUR WORLD 8. Breath of fresh air Smelly breath can signal something more sinister than what you ate for breakfast. Sydney dentist, Dr Geoffrey Speiser, gets to the bottom of what causes bad breath
COVER STORY 22. Raising hope
Dr Vandana Katyal is breaking new ground in the research of sleep apnoea in children and aims to raise awareness about the cause and treatment
YOUR BUSINESS 13. Loyal flush An effective rewards program can be win-win: happy patients and more business. But not all loyalty schemes work—in fact, one that doesn’t can have the opposite effect. Learn how to keep your patients coming back 16. Mighty moose When designing his practice, Dr Hanno Venter stayed true to his vision and used a very unusual motif to brand his business
31. The ultimate set-up You’ve got some experience under your belt and you’re keen to go it alone, but the decision remains: to start from scratch or buy an existing practice? The experts weigh in with their advice
YOUR TOOLS 35. Product guide Bite magazine’s guide to the best finance products for dentists on the market today 43. Tools of the trade A handy digital camera, a minimally invasive microscope ideal for younger patients, a new way to use a whiteboard marker and more are in the spotlight
YOUR LIFE 46. Paper jams An ordinary piece of paper is transformed into something wonderful when Dr Jonathan Louie of Camden Dental Surgery in NSW uses his origami skills
Editorial Director Rob Johnson
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20 Editor Nicole Hogan
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Bite magazine is published 11 times a year by Engage Media, Suite 4.17, 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 Bright Print Group
NEWS & EVENTS
Scope of practice reviewed The Dental Board of Australia has released its revised scope of practice standard, and it has been cautiously welcomed by the profession
he Dental Board of Australia has published its revised scope of practice registration standard, coming into effect from 30 June 2014. To help practitioners prepare for the revised standard, the standard and associated guidelines have been published on the Board’s website (www.dentalboard.gov.au). The debate around aspects of the standard has been fierce, with concern from some dental practitioners that the old standard did not reflect the real role and value of dental auxiliaries, and with others concerned that a change may undermine the position of the dentist as head of a dental team. Both the Australian Dental Association (ADA) and the Dental Hygienists’ Association of Australia (DHAA) Inc have welcomed the new standard, although at first glance they appear to be welcoming different aspects of it. The Australian Dental Association has welcomed the retention of the dentist as
the clinical team leader in the delivery of dental care to the community. The DHAA has also welcomed the updated wording pointing out the Dental Board has removed the term “supervision” from the standard. A release from the Dental Board stated, “The standard has been revised to be clearer, improve consumers’ access to oral health services and provide certainty to dental practitioners on the scope of practice for the different dental divisions, and level of education and training expected for each division. Dental Board of Australia chair, Dr John Lockwood AM, said all dental practitioners are required to use sound professional judgement to assess their own (and their colleagues’) scope of practice—and only work within their areas of education, training and competence. “Each individual dental practitioner is responsible for the decisions, treatment and advice that they provide,” Dr Lockwood said.
Aboriginal dental assist wows at awards ceremony Dental assistant (DA) Melissa Stevens has won Victoria’s top honour for Indigenous Australian health professionals in training: the Koolin Balit Aboriginal Learner Award, part of the People in Health Awards. Accepting the award at a recent gala dinner, Stevens said she was surprised and humbled by the honour. “It’s a massive privilege to be able to stand here proudly, and be recognised for the hard work I’ve done over the last two years,” she said. Stevens’s impressive resumé stood out among the nominations, due to her unwavering commitment to improving oral health in Victorian Indigenous
Dentist assistant Melissa Stevens.
communities. Having joined Dental Health Services Victoria (DHSV) as a DA trainee in 2012, Stevens graduated last year, and has gone on to become a tireless advocate for Aboriginal and Torres Strait Islander people’s health ever since. “I have to say the traineeship has opened a lot of doors and really
The DHAA has said, “The standard and guidelines now emphasise a preventive model with direct access to primary preventive dental providers such as dental hygienists and oral health therapists working in unsupervised community settings. Dental hygienists and oral health therapists must still work in a structured professional relationship with a dentist.” ADA president Dr Karin Alexander said the revised scope and guidelines “provides consumers with assurance that they will continue to receive high quality dental treatment, in an environment where patient safety is paramount”. She said the decision warranted some further detailed work, but felt it was clearly positive for the dental profession and for consumers. The current registration standard remains in place until 30 June 2014 when the revised standard comes into effect.
put me where I am today,” said Stevens. “I am really grateful to the coordinators and the hospital more broadly, for providing me the support to do my job.” The importance of the win has not been lost on Stevens who said that her work in juvenile justice centres servicing troubled teens and those most in need is a story that needs to be told throughout the community. “Over the last couple of years the numbers of Indigenous patients have jumped significantly in Victoria, and doing the rounds in the clinics and community centres really makes that hit home.” “People in our community need positive mentors and role-models to face the future. I really want this win to show our community that it is really possible to go back to study, work hard, and succeed.”
MENTORING THE NEXT GENERATION OF PRACTIONERS AND REALISING MY DREAMS.
Mentoring dentists and seeing them grow personally and professionally has been a truly rewarding experience. Dental Corporation’s development and training programs contribute to the effectiveness of dentists working at my practice, thus ensuring the success of Sailors Bay Dentistry into the future.
Dr Chris Watt Sailors Bay Dentistry
To hear more about Dr Chris Watt’s experience with Dental Corporation visit www.dentalcorp.com.au/BiteVideos or phone +61 3 8602 7005
NEWS & EVENTS
Budget cuts will worsen oral health
The Dental Hygienists’ Association of Australia (DHAA) Inc has expressed frustration with cuts to dental funding in the Federal Budget and argued updating the scope of practice of dental hygienists and oral health therapists is now more necessary since the Abbott government proposes no way to address need. The Federal Government has deferred the National Partnership Agreement for adult public dental services until July 2015, ceased reward funding to states and territories under the National Partnership Agreement on Improving Public Hospital Services, and axed the National Partnership Agreement on Preventive Health. Dr Melanie Hayes, DHAA Inc’s National President, said, “We’re disappointed the government has abandoned investment in preventive oral health, demonstrating contempt for those Australians who rely on public dental services.” According to data from the Australian Institute of Health and Welfare, Australia’s lowest income earners are more likely to experience complete tooth loss, live with toothache, or avoid food due to pain. Reduced uptake of preventive services by marginalised groups leads to costlier interventions at a later date. It’s estimated 750,000 consumers visited general practitioners with dental issues in 2010
Advertising guidelines updated
Approximately nine per cent of hospital admissions were classified as preventable dental disease.
and the cost in hospital admissions was $84 million; approximately nine per cent of total admissions were classified as preventable dental disease. “At present, there’s no direct access to dental hygiene services. Patients must see a dentist and wait for a referral to a dental hygienist or oral health therapist, in order to receive preventive services. Yet we can all make our own appointments to see a range of other health care professionals. “Allowing direct access to preventive care professionals such as dental hygienists and oral health therapists would assist in ameliorating the impact of these budgetary initiatives.”
Warning following ‘crazy’ DIY dentistry claims An oral health charity is warning people against do-it-yourself (DIY) dentistry after an alarming number of people revealed they wouldn’t visit the dentist to remove a tooth. In a British survey, one in five said they would attempt to remove a tooth either on their own or ask a friend if they could not afford the dental treatment, prompting the British Dental Health Foundation to issue a stark reminder of the potential problems this could cause. Dr Nigel Carter OBE, chief executive of the British Dental Health Foundation, said the research highlights the desperate measures some will go to and issues a strict warning to those thinking about performing DIY dentistry. “DIY dentistry is both dangerous and unnecessary. There are too many
senseless examples of people either pulling out the wrong tooth or ending up with an infection. It is all too easy to make the problem worse, which could result in more invasive and expensive treatment,” said Dr Carter. “The scandal of these results are that access and affordability of good quality NHS (National Health Service) dentistry has never been better.” Latest figures show more than 29 million patients in England have been seen and given a dental examination in the past two years— around 56 per cent of the population. Many experts forecast this to increase further following the introduction of ‘direct access’, giving patients the chance to see a dental care professional such as a hygienist or therapist without having to be seen by a dentist.
The Dental Board of Australia (National Boards) has acted on feedback received about the Guidelines for advertising regulated health services released in March and have published an update. No requirements have been added from the previous version, and the update comes in to effect straight away. Anyone who advertises a regulated health service must meet the requirements of the National Law. This includes registered health practitioners, individuals who are not health practitioners and businesses. The updated Advertising guidelines were edited to make them clearer, particularly that: * Under the National Law, testimonials are not allowed when advertising a regulated health service * The obligations of the National Law about advertising only apply when a regulated health service is being advertised, and * The National Law is not intended to stop members of the community and patients from discussing their experiences online or in person. National Boards would like to thank everyone who provided feedback on the guidelines. Much of the feedback that was received was about the ban on using testimonials in advertising a regulated health service. This is a requirement of the National Law, which is something National Boards are required to implement. The Terms of reference for a scheduled review of the National Registration and Accreditation Scheme (the scheme regulating registered health practitioners in Australia) include a point relating to advertising, and interested members of the public and health practitioners are able to provide feedback about the legislation. More information is available on the AHMAC website.
NEWS & EVENTS
New products iOptima Bien-Air Dental and Apple® reunite to boost the performance of dental surgeries with iOptima, a unique pneumatic-toelectric transformation solution Bienne (Switzerland) Bien-Air recently launched a unique system that will substantially boost the performance of dental surgeries. With the iOptima, any practitioner can transform a traditional pneumatic system into a modern electric unit equipped with a brushless and sensorless micromotor and an iPod touch interface from Apple®. All at an unrivalled price. The iOptima is perfect for all your restorative and endodontic interventions. Benefits for practitioner The functionalities of the iOptima application and the performance of Bien-Air electric instruments combine to drastically reduce the time taken for your interventions. Restorative and endodontic interventions can be preprogrammed. Simply indicate the type of operation and select tools from the best-known manufacturers to access the preset speed and torque parameters. iOptima is upgradeable: new functions are regularly added to it. Your air-driven installation will be transformed into a formidable electric system in an instant.
Innovative features The iOptima allows practitioners to program custom operations from A to Z and to modify them at any time. In addition, the Auto-reverse and Auto-forward functions mean that you can carry out endodontic treatments in complete safety. The iOptima comes with the Bien-Air MX2 LED micromotor, which offers the best performance on the market. The MX2 micromotor and Micro-Series contra-angle combination significantly reduces the effort required to use the instrument, thanks to perfect balance and a reduction in size. This allows for more accurate movements, and less fatigue at the end of the day. For more information on Bien-Air, contact Marco Gallina, V.P. Product Management, at Marco.Gallina@bienair.com. Tel: +41 32 344 64 64; www.bienair.com.
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before, resulting in conservative and functional restorations with excellent longevity and aesthetics. Other uses for the system include patient mock-ups (a great marketing tool), all cases of Class IV and V restorations, and indirect veneer applications, including temporaries for porcelain. For more information, contact Dental Art Innovation on (03) 9527 2273 or visit uveneer.com.
new invention from Australia—Uveneer, a clear template system comprising ideal tooth sizes and proportions—produces glossy, contoured direct composite veneers … just like natural teeth. Simply lay the selected composite on the tooth, press the Uveneer template onto the bonded, roughened buccal surface, then light cure. The result will be a highly polished surface (with no oxygen inhibiting layer). This process saves time because there is no need for polishing or carving. The Uveneer system produces predictable and reliable outcomes, with little need to rely on great dexterity or artistic ability, and its templates are autoclavable. By combining improved composite materials with an innovative and unique delivery technique, dentists can now create goals that were not possible
NEWS & EVENTS
Breath of fresh air Smelly breath can signal something more sinister than what you ate for breakfast or dinner. Sydney dentist, Dr Geoffrey Speiser, gets to the bottom of what causes bad breath. By Duncan Horscroft
alitosis, or bad breath, can be very embarrassing for the sufferers of the condition—and it’s not restricted to those with teeth or gum problems. The condition is caused by a breakdown of the sulphur compounds in the mouth which limits the flow of saliva and is also associated with what is known as 'dry mouth'. Dry mouth, or xerostomia, happens when the mouth produces little or no saliva, which is critical in neutralising acids to prevent tooth decay. Sydney dentist Dr Geoffrey Speiser graduated from the University of Sydney in 1980 and, after treating all facets of dentistry and also working as an emergency dentist on weekends, noticed that many people suffered from bad breath. In 1997, he sought advice from experts in the United States to see how they were dealing with the halitosis problem. After using their techniques, however, he found he was not happy with their methods and decided to develop his own product line, called Breeze, to combat the increasing problem. He has since become a pioneer in bad breath and dry mouth treatment in Australia using catechins which are found in green tea, together with gas chromography technology which measures the level of bacteria causing the bad breath by analysing compounds in the mouth.
Through his research into bad breath, Dr Speiser also became aware that dry mouth needed to be addressed, especially with the ageing population where medications contributed to the flow of saliva. The dentist explains that almost 65 per cent of dry mouth episodes are associated with medication.
set up a specialised clinic until I was completely confident,” Dr Speiser says. “There was no chronograph machine available then but I discovered there were machines in Japan and I got one. “I developed what is now known as Halicheck after consulting with various specialists around the world. I then developed the clinic protocol with a
Dr Geoffrey Speiser
“We made the revolutionary discovery that the anti-oxidants in catechins promoted saliva and that led up to developing the range of gum and mouthwash products.” “Other dry mouth episodes come from illness such as Sjogren’s syndrome, cancer, diabetes, or tobacco use, alcohol, medical treatments and just simple ageing. Everyone is a candidate for dry mouth as they age—those over 50 years old are especially at risk.” Dr Speiser started the Dry Mouth Clinic in 2012 after consulting with Dr Stephen Hsu from the medical and dental faculty at Georgia Regents University in the USA. This collaboration led to the development of a range of green tea and xylitol products called DryGuard. “I had been doing bad breath products for some time but did not want to
Japanese company that makes medical grade gas chromographs. These machines are considered the gold standard in measuring odours. “Halicheck is an accurate measuring method for breath and is 100 times more sensitive than the human nose. “There are around 1000 gas chromograph machines in the world and Australian Breath Clinic has three of them. We are the distributors in Australia and there are six or seven dentists using them as well as dentists in Malaysia, New Zealand and the United Kingdom. “When my patients come in I give them a quiz to fill in which determines
Phot ogr aphy: Nick Sco tt
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things like if they floss, have they any gum disease or nasal issues, what kinds of food do they eat or if they're on any medication. I then take a reading from the gas chromograph and together with the analysis from the clinical examination, I know what to expect.” Dr Speiser says his practice now comprises about 10 per cent dentistry while the Breath Clinic makes up 90 per cent of his work. “The demand has been extraordinary,” he says. “Most of my patients have their own dentists, but they tend to seek an outside source because of the embarrassment associated with having bad breath. We are very ethical and are not looking to take over from regular dentists.” As well as the chromograph technology, Dr Speiser has developed a unique range of products—the KFORCE K12 Probiotic range—which is also based on catechins and recognises that bacteria need to live in the mouth. “We did a study with the Georgia University and made the revolutionary discovery that the anti-oxidants in catechins promoted saliva and that led to developing the range of gum and mouthwash products,” Dr Speiser says. “The catechins play a major role in easing the problem of dry mouth.” He says that his home treatment range has also been highly successful because many people were embarrassed about visiting a specialist regarding their breath problems, preferring to treat the problem in the privacy of their own home. “We discovered this treatment after working with BLIS Technologies in Otago, New Zealand, and have found the success rate is almost as high as the successful Halicheck personal visit,” he says. “K12 only lives on the tongue and also flushes the throat of mucous collections.” Three simple steps—how the Halicheck works: STEP 1: Halicheck—gas chromograph mouth air measurement A sample of air is taken from the mouth and put into the Halicheck machine. This air is broken down to over 50 different mouth gases, helping to identify the volume of the main bad breath gases. The test takes 10 minutes and gives a measurement of bad breath coming from the tongue surface, teeth and gums and from the back of the throat at the gag reflex line. Halicheck is the Gold Standard in measuring halitosis. STEP 2: Lifestyle quiz—in-depth analysis of foods, medicines, daily activities and hygiene habits Once the area where the bad breath bacteria are living has been determined, you need to work out why this imbalance occurred. Normally this is due to a lifestyle issue. It may be a cleaning error, or it can be overuse of mouthwash. It can even be foods or diets. Dr Speiser has developed an in-depth quiz that examines all aspects of hygiene protocol, medicine intake, illnesses, and food intake during the day. What is revealed in this quiz goes a long way to solving the patient’s halitosis problem. STEP 3: Clinical examination—periodontal and dental examination The final step of the bad breath consultation is to do a full examination and verify the findings of both the Halicheck gas chromograph and the in-depth lifestyle quiz. This examination also helps determine if there are any dental issues that may be causing problem, such as old restorations, impacted teeth or gum disease.
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NEWS & EVENTS
An effective rewards program can be win-win: happy patients and more business. But not all loyalty schemes work—in fact, one that doesn’t can have the opposite effect. Here’s how to make yours keep your patients coming back. By Natasha Phillimore
ustralia’s two largest airlines’ long-running stoush is playing out on the ground, not in the air. The fight for flight supremacy isn’t in the amount of planes, the mechanics of planes, route maps, frequency, air-hostess smiles, certainly not the food—it is in loyalty. Qantas has for many years flown the lion’s share of Australia’s business travellers, signed up to its Frequent Flyer program, but Virgin Australia’s Velocity scheme is gaining on that number every single day. Last year’s groundbreaking report For Love or Money? was the first survey of Australians’ loyalty-program habits.
This year’s follow-up, Share the Love (find it at www.theloyaltypoint.com. au), showed equally surprising results. Both were commissioned by marketing company Directivity and digital agency Citrus, and conducted by First Point Research and Consulting, and found that loyalty programs are far-reaching, with 88 per cent of consumers over the age 16 belonging to one. Consumers buy more from brands with loyalty programs, and in fact choose brands that reward them in some way over ones that don’t. This all comes with an important caveat, however—less than half feel more loyal to the brand despite being a member of a program. “The studies highlight who in Australia are members, the difference between men and women, how engaged they are,” explains CEO of Directiv-
ity and co-author of the study Adam Posner. “However, loyalty programs do not necessarily engender loyalty. Only 46 per cent of users felt more loyal to a brand or a business because they were a member. There are a lot of things to get right, whether you’re a dentist or other business, before you start a program. It’s not a band-aid.” A quality loyalty program can do positive things for any business. It rewards the customer, making them feel valued. It creates positive word of mouth, the most powerful of marketing tools. It boosts business, with regular, more frequent visits and potentially a whole new group of customers. In short, it’s a marketer’s dream. But, warns Tricia Mikolai, director of Solution Design & Delivery at marketing agency BI Worldwide, it’s not as easy
If you surprise and delight your customers, you will earn their loyalty for years to come.
as it looks. “Don’t think that if you build it they will come,” she says. “That never happens. You might build the best program in the world, but if no-one’s aware of it, it’s useless.” Mikolai specialises in creating loyalty schemes for businesses, particularly those in the health sector. “Health care has its own set of challenges,” she admits, “as it’s something people only seek out if they absolutely have to.” In this way, a dental loyalty scheme is a tricky thing to manoeuvre. Posner’s study identified two different kinds of loyalty: the kind that influences purchasing behaviour—spending more, more often, and coming back more often— and one that’s engendered by belief and emotion. “Changing an attitude; that drives loyalty,” says Posner. “Making something, say, fun and exciting can change attitudinal behaviour.” Similarly, all loyalty programs fall into one of two camps: collector programs— basically any points-based, ‘earn and burn’ type program; think fly buys—and then what Posner has dubbed the “connector” schemes, where businesses strive to keep the customer front of mind, ensuring they don’t go elsewhere. The two loyalty types and programs are symbiotic, and dental practices fall into the latter camp for both. “There’s no reward that will get people
coming in more frequently than they have to,” points out Mikolai. “It has to be about the experience once they are in there.” She has three golden rules when it comes to implementing any loyaltyengendering program. Firstly, create and maintain a really good database, and keep it up to date—which means that dentists are already ahead of the game. Secondly, utilise that meticulous database. “Plan when you are going to reach out to all the people in it,” explains Mikolai.
coat and having a beautiful waiting area, maybe even an interactive one. “Also, make sure the staff are brand ambassadors,” advises Mikolai. “They are not just healthcare providers or administrative staff —they’re part of the experience. Give them empowerment and ownership in the patient experience.” Simple, right? But sometimes simple is the hardest—a lesson Southern Cross Dental laboratories learnt the hard way. The laboratories’ CEO, Chris Aughton, explains: “Last year, we made it too complex—multiple reward levels based on spend, with each tier offering additional reward points and a redemption process that was not clear. So this year, we are completely simplifying it.” He echoes the key piece of advice both Posner and Mikolai both stress: know your customer. “It’s important to offer rewards that have real value to the customer,” says Aughton. “Study your customer base, what’s important to them. Listening to that, learning from that and modifying our program to that is crucial.” One of the most common issues Mikolai sees happen with unsuccessful programs is complacency. “A lot of companies will get a lot of programs off the ground, get some engagement, but then everything phases out,” she says. “You have to be in it for the long haul. You can’t have a three-month launch plan, and just assume that it will all keep going.” She suggests looking at it every quarter or half-year, and if it’s not working, not to be afraid to tweak it.
Tricia Mikolai, BI Worldwide
“There are many low or no-cost things a dental practice can do to create a memorable or at least a personal experience.” Thirdly, create a great experience for the patients who come in. “Going to the dentist for most people is not a pleasant experience,” points out Mikolai. “There are many low or no-cost things a dental practice can do to create a memorable or at least a personal experience.” These include remembering the person’s name, greeting them in a particular way, designating a nice place to hang a
And just in case it all seems like too much work, Posner is here to reassure the loyalty-scheme sceptics. “You can expect a lot if you’re committed,” he says. “They can be valuable to your business and practice. If you do them well, you don’t need any more marketing as your customers become your marketing. Surprise and delight them—and you will get loyalty.”
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NEWS & EVENTS
Mighty moose When designing his practice, Dr Hanno Venter stayed true to his vision and used a very unusual motif to brand his business. By Kerryn Ramsey
hat you call your practice is one of the most important decisions you can make in regard to branding. The name should be unique, memorable and have a visual appeal. One dentist to really embrace this concept is Dr Hanno Venter. His new practice in Bundaberg, Queensland, is called Orange Moose Dental. South African-born Dr Venter moved to Australia six years ago, settling in the regional town of Bundaberg. For four years, he worked in private practice while embarking on extra study. He quickly grew
to love the town, the Australian lifestyle and the opportunities at his fingertips. When the job finally ended, he decided to make Bundaberg his permanent home and open his own practice. Empty premises were found in a newly built building right in the middle of a medical precinct. The building was just a shell so there was the opportunity to create the exact layout he wanted. “I wanted to inject my personality into the practice but I was also determined to make it unique. I already had a lot of weird and quirky ideas.” This is the point where the happy collision between moose and dentistry took
place. “I’ve always been fascinated by the moose,” says Dr Venter. “The symbolism behind these animals is amazing. They are known for their strength and independence and I secretly thought that if I am ever reincarnated, I will probably come back as a moose.” Dr Venter approached Medifit Design & Construct to help in the design and fitout of his new practice. “Initially, Hanno presented us with a more conservative name and branding approach,” says Sam Koranis, managing director of Medifit. “During further discussions, he mentioned he was open to being a bit more adventurous. He suggested a name
Orange Moose Dental in Bundaberg, Queensland, is a visual feast—memorable, unique and fun, thanks to the vision of owner Dr Hanno Venter.
using the word ‘moose’ as it was an animal with which he strongly identified.” Medifit loved the idea and Orange Moose Dental was born. “We immediately felt it had the potential to be a memorable brand and to give the practice a unique personality,” says Koranis. The unusual name gave Medifit free range to play with ideas and push the boundaries. Dr Venter recalls, “It stimulated their imagination and they enthusiastically ran with the concept.” Within a couple of weeks Medifit had created a presentation for a one-of-a-kind practice. Dr Venter loved their concepts but was still hesitant to commit. “It was
such a big risk,” he says. “Bundaberg is a rural area and I was concerned how people would react. It was an all-ornothing moment for me. I was investing my life’s savings into a new practice with no track record. Was I really going to call it Orange Moose?” Realising this was probably his only opportunity to fulfil his vision and have everything he wanted in the practice, Dr Venter decided to take the gamble and gave Medifit the go-ahead. Seven months later, Orange Moose Dental was opened for business. The dental practice features clean, uncluttered lines with a simple, almost
modernist feel. The effect is professional and contemporary with a touch of humour. The colour palette is neutral greys, timber and whites with pops of orange to keep things interesting. The moose motif is a recurring theme and includes life-sized cut-outs in the hallway and surgeries. There are moose facts presented on the walls—’Moose have six pairs of molars. Ahead of those are six pairs of pre-molars to grind up their food’—and even complimentary Orange Moose Dental brand bottled water is given to patients. Medifit’s Koranis explains that the aluminium panels along the hallway rise up
Making Dentists Smile
Dr Venter's gamble has paid off handsomely—his patients love the stylish interiors as it doesn't look like a dental practice.
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from the floor, over the ceiling and back down the opposite walls, all printed with a leaf pattern in a contemporary take on a forest walk. “The panels have been CNC-machined with the silhouette of the moose to reinforce the brand and create a unique experience for patients,” he says. “The timber veneer continues the natural theme and ties together the various sections of the practice.” Dr Venter was also proactive in regard to marketing his new practice. Being relevant and tapping into the local residents’ love of four-wheel driving, he gave his Jeep Wrangler an Orange Moose Dental themed makeover. “I have had many patients come here after seeing the car,” he says. He also has an unusual billboard outside of town. “I think I’m one of the only practices in Australia that uses a picture of a beautiful, smiling lady who is not showing any teeth,” he laughs. “It’s quite a talking point but I prefer to take a different angle in regard to advertising.” Koranis has also had numerous enquiries based on the practice design. “We have had several new clients approach us asking, ‘Are you the guys who did Orange Moose Dental?’. Most new and potential clients like the fact that we don’t have a cookie-cutter approach with our design projects,” he says. So, has Dr Venter’s gamble paid off? Since opening in December 2012, the four-surgery practice has gone from strength to strength. Residents have embraced this stylish business that is so unlike a typical dental practice. “They love the idea that it doesn’t smell like a dental practice, it doesn’t look like a dental practice and it’s so different to what they have come to expect.” While customers are drawn to the unique look of the practice, they soon realise that it’s well equipped with the latest technology. For example, it’s the only dental practice in the region to have a 3D CT cone beam machine. On top of this, it’s run by a consummate professional with a real interest in his patients’ wellbeing. “I like to take the time to talk to my patients and get to know them. That way we can connect, which is really important to me, and I can give them a wide range of treatment options,” says Dr Venter. “I often sit with patients in the front and have a bit of a chat. In fact, people often come in just to have a coffee and say hi.” It would appear the mysterious Orange Moose Dental has found a happy home in the town of Bundaberg.
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NEWS & EVENTS
hope Dr Vandana Katyal is breaking new ground in the research of sleep apnoea in children and aims to raise awareness about the cause and treatment. By Nick Carne
andana Katyal was inspired by a number of teachers, but it was a friend who helped set her career direction. That friend happened to be a paediatrician who had an interest in childhood sleep disorders and was astounded at the paucity of literature looking at the problem from an orthodontic perspective. She also knew the people in Adelaide to talk with. For an orthodontics student who was looking for a research project—and had an abiding interest in working with young people—that was too good an opportunity to pass up. And it appears to have been a sound decision all round. In little more than a year, Dr Katyal has graduated from the University of Adelaide, won the ABOS/NZAO prize for best postgraduate presentation, co-authored two papers in the American Journal of Orthodontics and Dentofacial Orthopedics and another in the Australian Orthodontic Journal, and presented at Australian and international orthodontic conferences. She has also worked as an adjunct lecturer for the University of Western Australia’s online Graduate Diploma in dental sleep medicine and was awarded the prestigious Sam Bulkley–AB Orthodontics Travelling Fellowship to continue her research in Germany later this year. More importantly from her perspective, however, she has been part of developing a multi-disciplinary approach to studying paediatric sleep disorders in Adelaide that is gaining some traction, and is now involved with a similar initiative in Sydney. That should make her uncle back in India pretty proud. It was while helping out in his New Delhi dental surgery as a schoolgirl that Dr Katyal decided dentistry was the
PHOTOGRAPHY: RICHARD BIRCH Photography: credit
Dr Katyal has collaborated with the Sleep Disorders Unit at Adelaide’s Women’s and Children’s Hospital.
way her interest in science should be directed. “I just found the whole thing fascinating,” she says. Arriving in Australia with her parents as an 18-year-old, she started applying to dental schools, and the University of Sydney said yes. After graduating in 2001 she spent nine years in a private practice while also studying part-time for two of those years to earn a Master of Science in Medicine (Clinical Epidemiology). “I really enjoyed general dental practice and I think it was valuable having that experience before moving to orthodontics because by then I knew that was what I really wanted to do and I had a better idea of what the possibilities were,” she says. This time the University of Adelaide said yes to her application (the “best thing that could have happened”, Dr Katyal says, thanks to a supportive
professor and Adelaide’s collaborative nature) and the possibilities for her emerged when the paediatrician friend urged her to read more about obstructive sleep apnoea (OSA). “I was shocked by what we know about its impact on young people and by how little research had been done on possible treatments,” she says. “There were lots of studies into adults but no more than a handful of papers on children, even though we’d known children have it for 10 years.” Dr Katyal’s contribution to expanding that body of literature has come in collaboration with the Sleep Disorders Unit at Adelaide’s Women’s and Children’s Hospital and paediatricians at the University of Adelaide, led by Associate Professor Declan Kennedy. Their recent published work has focused on craniofacial and upper airway morphology in paediatric sleepdisordered breathing (SDB), an area that to date has been, in their own words, “poorly understood and contradictory”. The first aim was to evaluate the
prevalence of children at risk for SDB, particularly OSA, and to examine associations with their craniofacial and upper airway morphologies. In a case-control study, 81 children aged eight to 17 were grouped as either high risk or low risk for SDB based on the scores from a validated 22-item paediatric sleep questionnaire and the ‘Obstructive Sleep Apnoea—18 Quality of Life’ questionnaire. Results showed the frequency of palatal crossbite involving at least three teeth (suggesting a transversely narrow maxilla) was 68.2 per cent in the highrisk group, compared with just 23.2 per cent for the low-risk group. Average quality of life scores in the high-risk group indicated reduced quality of life related to sleep-disordered breathing by 16 per cent compared with children in the low-risk group. That snoring and SDB are strongly linked to a narrow palate is an important finding, one Dr Katyal acknowledges “is obvious when you think about it. “I’m not sure why this has not been
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An estimated 10-12 per cent of Australian children have chronic snoring or sleep apnoea.
looked at before,” she says. “It might be because most research to date has been retrospective and based around the use of X-rays, which only show two dimensions—the vertical and the anterior/posterior. “Our work is prospective, studying children in a clinical setting, and this has allowed us to take account of the transverse dimension, where we have found an even greater correlation. “A lot more work is still needed, but this is an important step up the ladder.” So, too, were the results from the second phase of the study, which was designed to assess the change in quality of life for affected children undergoing rapid maxillary expansion (RME) to correct a palatal crossbite or widen a narrow maxilla. Ten children from the study group who underwent RME were followed longitudinally until the appliance was removed about nine months later. Children in the high-risk group showed an average 14 per cent improvement in quality of life compared with those in the low-risk group. Again this is just another step up the ladder, but it raises hope that an orthodontic approach may be an alternative to surgery for children with a narrow palate. Preliminary results from subsequent research in Sydney and Italy add weight to this proposition. “While removing the tonsils is the first line of treatment for children with OSA, up to half of those who have their tonsils out continue to suffer,” Dr Katyal says. “Exploring RMEs first in appropriate malocclusions could be a valuable option.”
She cautions, however, that it is too early to claim RMEs could be “a cure” and that orthodontists have to be wary of overstating its value until more research has been completed. Dr Katyal says while the robust nature of the Adelaide team’s research was one of its strengths, it had also created the main complications. “It was easy to enrol people and easy to get ethics approval because our
are continuing the study, and is excited to be a part of a new multi-disciplinary paediatric sleep clinic planned for Westmead Children’s Hospital. Again a friend helped make it happen. Associate Professor Kennedy put her in touch with the hospital’s Professor of Paediatrics & Child Health, Karen Waters, who is the driving force behind creating a team that will include orthodontists, speech pathologists and respiratory, sleep and ENT physicians. While the research gains momentum, Dr Katyal believes an important priority is to raise awareness among the medical and dental communities and the broader population. Estimates are that 10 to 12 per cent of Australian children have either chronic snoring or sleep apnoea, she says, with some research suggesting it is as high as 25 per cent. The message for parents is that snoring is not normal for children, unless they have a cold or some other influences are at play, so if their children snore regularly—more than three times a week—this may be an indication of OSA. “They need to speak up,” she says.
Dr Vandana Katyal
“While removing the tonsils is the first line of treatment for children with OSA, up to half of those who have their tonsils out continue to suffer.”
research was not invasive. The hardest part was keeping all the records and keep everything on track,” she says. “Children don’t always co-operate and we had to bring them back in to see us, which can be quite draining for them.” The research sample was primarily orthodontic patients who were referred by their local school dentists. Orthodontic data and sleep screening questionnaires were collected over a year, the 10 children who had RME were followed for an additional nine months. With the research required for her degree completed, Dr Katyal returned to Sydney late last year and is now working as an orthodontist in private practice. However, she stays in regular contact with her former colleagues who
“Research shows that 80 per cent of kids with these problems aren’t diagnosed or reported.” The message for doctors, dentists and orthodontists is that they are on the front line and have an obligation to do a thorough assessment if they have any reason to believe their young patients may be suffering from SDB. She believes the aim should be to screen every child who shows signs of air obstruction, with a view to insuring that each child is assessed and treated individually. “What we really need is to develop a protocol—a consensus on what to do first and who should do it,” Dr Katyal says. Perhaps that’s the cue for a future PhD.
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NEWS & EVENTS
Buying an established practice is very different from starting up your own dental practice from scratch.
The ultimate set-up You’ve got some experience under your belt and you’re keen to go it alone, but the decision remains: to start from scratch or buy an existing practice? The experts weigh in with their advice. By Amanda Scotland
or most, training to become a dentist involves many years of intensive study in the practical field of oral health, with very little instruction on how to successfully run a business. Paul Freeman, CEO of Medfin Finance, acknowledges the special challenge associated with being a small business owner in a highly regulated environment. He says that while the process can often be easier for those with more experience, even the most professional and competent dentist in the world will find they need a completely different skillset to set up a practice.
For this reason, buying an existing practice is a popular choice, and Dr Toni Surace of Momentum Management says it has led to a shortage of practices, and the demand is pushing higher prices. “As soon as a practice goes on the market, they’ll have a good 10 to 15 people looking at it,” says Dr Surace. “You need to have your name with an agency or someone who sells practices to be advised about upcoming sales.” Whether a person is more entrepreneurial or risk-averse will play into their choice, however Freeman emphasises the need to focus on the discipline of due diligence regardless of personal risk appetite. “With a start-up it’s a different type of risk. It doesn’t mean you can’t handle
it or analyse it, but the thinking and approach is different.” Practically speaking, the difference in risk is the difference between forensic analysis and forecasting. For an established practice, you’ll need to analyse financial statements, forecasts and past tax returns at a minimum. You’ll want to know if the business is making money, but it’s likely you’ll also want to consider its capacity for growth and the need for any short- and long-term investment into new equipment. When starting from scratch, you’ll instead need to forecast these things using what you know about the market in general. You’ll need to consult with trusted advisers and scope out the
competition. Most importantly, you’ll need to make some critical assumptions about demand for your services in the area and factor in the inevitable ramp-up period. Stafford Hamilton, State Manager NSW—professional finance at Investec, says that sufficient cash flow to get you through those critical first months will be essential. “It can be very unnerving when you start to see the cash flow declining if you haven’t planned for it,” he says. “You need to have a particular temperament to withstand that but when its planned it becomes less stressful.” Setting a realistic budget will further ease the transition and Hamilton says that when you’re working for yourself, it’s vital to combine the analysis of your personal budget alongside your business budget. “Everybody’s got a desire to set up something complete from day one and have every piece of equipment to look after their patients, but you can end up spending a lot of money and the day you open the door, there aren’t any patients or cash flow. There has to be a careful balance—some things can be integrated later on.”
Seek out sound financial advice to avoid setting debt levels too high.
Dr Surace adds that it can take a typical metropolitan practice 12 to 24 months to become fully productive. The location is one thing you won’t be able to easily change once everything is up and running. It’s therefore one of the earliest decisions you’ll need to make. Hamilton advises keeping around six or seven postcodes in mind when shopping for a location. Are there existing practices for sale in your chosen area? If not, the decision to start from scratch may be the
only local option. Regardless of location, Dr Phillip Palmer of Prime Practice recommends opting for a relatively shorter lease with lots of option periods. Freeman says that the so-called ‘flood’ of new dentists has received a lot of press. However, it won’t necessarily have a negative impact on you if you structure your business correctly. “In some parts of Australia you could easily argue there’s an undersupply of dentists and an unmet need,” says Freeman. “In more densely
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“The value of goodwill you purchase can be conserved and enhanced through an agreed transition plan with the incumbent.” populated areas, a higher number of trained professionals will increase your choice as the owner of a practice.” How successful you are will ultimately hinge on your ability to compete in your market. If you decide to take over an established practice with a solid track record, Dr Surace says you can expect a patient drop-off rate of up to 20 per cent. However the value of goodwill you purchase can be conserved and enhanced through an agreed transition plan with the incumbent. If this kind of partnership model is right up your alley, it may be worth considering a partial purchase. Dr Palmer says this model allows you to “try before you buy”. But he warns to never enter into such an arrangement on a handshake. “There’s an
old saying: ‘A partnership built on a handshake isn’t worth the paper it’s written on.’” According to Hamilton, one of the biggest considerations you’ll need to factor in is whether you’ll be willing to compromise. “You’re the incomer so will you be willing to live with the way they run the practice and are you being realistic about what you will and won’t be able to change?” He advises getting to know the person or people you are going into business with and determining early in the process whether you have a similar or complementary style. For whichever model you choose, Freeman recommends surrounding yourself with a team of partners who’ll provide the expertise in three main areas: accountancy, advice, and banking and
finance. It is important to recognise the distinction between the three specialties. While accountants can help establish financial and management reporting, tax effectiveness and risk management practices, a financial adviser will be able to assist on suitable levels of income protection and key person insurance to protect your interests. What you really want is to make sure your professional business partners have previous experience with other dentists so they can help establish realistic assumptions about the future of your business. Once your plans are in place, your banking or finance partner can provide the backing to make it all happen. However, Freeman warns against setting debt levels too high. “If you over-extend yourself, you leave yourself without a buffer if your assumptions don’t pan out. It’s a strong industry and people who are successful have very prosperous careers,” he says. “Don’t skimp on sound analysis and advice because you’re making choices and decisions you’ll have to live with as a business owner over a long period of time.”
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“U-Veneer is an excellent aid in restoring anterior teeth and provides an enormous benefit in terms of shaping, angulation and proportioning of the anterior teeth when undertaking labial veneer restorations”.
The U-Veneer is a great innovation that solves many problems associated with delivering direct composite veneers. The operator can produce composite veneers that require less dexterity requirements and adjustments are simple so time is saved in giving the patient an incredible smile. I think the U-Veneer is an incredible invention and offers the Dentist another feather in his/her bow.”
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NEWS & EVENTS
Financial Solutions product guide Bite magazine’s guide to the best financial solutions for dentists on the market today
NEWS & EVENTS
Finance product guide Manage, don’t minimise At the end of the financial year it seems sensible to minimise your taxable income. But that’s not necessarily the best idea.
nvariably, dentists all have high taxable incomes, so they are always looking for extra deductions around this time of year—it’s very rare that somebody would not need or want that,” explains Investec’s Andre Karney. “So our role comes in when they’re looking to purchase assets or stock or anything to get them those extra deductions. We can offer financial products and help structure those facilities to maximise their tax efficiency. Obviously, we don’t offer tax advice—that’s the job of the individual dentist’s accountant or financial adviser—but we will say to them, ‘Here are some structures you might want to consider’.” A possible example could be where the dentist might want to take out a loan to buy some stock, then immediately pre-pay the interest on that loan. If that was the case, there would be a range of products available to them, says Andre. “In that particular example, we could offer an unsecured product, or one secured against the practice, or against commercial property or residential property. That’s an example of where we can be really flexible compared to other banks.” A strategic approach to managing your income can pay dividends, but it’s important to plan, says Investec’s Stafford Hamilton. A strategic approach means investigating which costs you can prepay, such as leases on equipment, interest on loans and any other expenses you might like to pay that relate to the coming financial year. It’s a strategy that doesn’t just apply to practice owners, says Hamilton. “When it comes to employees, or those that don’t have large practices, prepaying investment properties or car loans, or interest on any commercial property they can prepay may be worth considering,” he explains. “And don’t forget superannuation—depending on your circumstances, you may not have used this year’s allowance for concessional contributions to super.” To take advantage of these strategies generally, you’ll need access to cash, says Hamilton. But if that proves difficult, using an overdraft, then paying it back over the next six or twelve months, can prove useful. “Some people do find that idea a bit weird—taking on debt in order to pay down debt, but we often see clients adopt this strategy so they can prepay some loans to gain the tax advantages,” Hamilton adds. “If you’re looking at a big tax bill and you can manage that liability forward a year, that’s an extra 12 months you can hang on to your tax money.”
Buying a new car in the end-of-financial-year sales may open up some deductions, even if you buy the car on the last day of June, says Investec’s Stafford Hamilton (opposite page, bottom). Opposite page (top): Investec’s Andre Karney.
An alternative to taking on an overdraft may be to use your credit card for purchases, which can have a similar effect of spacing repayments across the financial year. Of course there might be expenses associated with that strategy, but they may be balanced out if your card offers generous incentives such as frequent flyer points for eligible spend If they’re not thinking of cash flow, some people may be planning to take advantage of various end-of-financial-year sales to do a bit of shopping. It’s often the best time of year to buy a new car, for example, and, “there are commonly concessions for buying a new car,” says Hamilton. “With cars it may be that you can claim some deductions even if you buy the car on the 28th June. When you’ve only owned it for two days. And if you finance and prepay a lease, you might realise $10– to– $15k worth of deductions.” If you own a larger practice, other opportunities present themselves, including purchasing equipment on a lease agreement and prepaying twelve months in advance: “For a $100k purchase you might get $24k+ worth of deductions almost immediately on a well-structured lease agreement,” Hamilton explains. “And further benefits come into play with interest rate reductions: prepaying a lease can mean a one or two per cent saving on the effective interest rate which can result in a significant benefit.” Many financial institutions will allow you to prepay interest on property, but not all of them will, so if your property
loan is with a lender who doesn’t, you may want to investigate refinancing—which brings us back to the issue of planning ahead. If you looking to refinance your property, planning ahead will help and it is worth speaking to us as early as possible. But Investec’s speed and efficiency generally means the business comes their way, says Andre Karney. “We have people calling us up in the morning to get a car in the afternoon,” he says. “They’re used to that, and we do it. It can be the same day. If you’re talking about a mortgage, of course there’s a process. People use us because of our speed and efficiency, because we go to see them, we’re very flexible and competitive because we specialise in lending to this market.” In general, says Hamilton, “We say to people every year, plan early because until you have an idea of what your income may be, it’s very hard to do any planning to manage your income.” 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.
ADVERTORIAL NEWS & EVENTS
Finance product guide Cyber Crime part and parcel of a digital age
hen it comes to a data security breach or privacy loss, it isn’t a matter of if it will happen but when it will happen. One in four businesses have experienced a cyber crime, says PWC’s 2014 Global Economic Crime Survey. Small players are not immune from the threat, and are often used as soft targets or as entry points for tapping into bigger businesses. How prepared is your practice for: Identifying theft resulting from lost or stolen financial information? Protecting against theft of sensitive medical information? A lawsuit alleging invasion of privacy? Hacker damage or viruses causing damage to your client database?
Gaps in Traditional Insurance The World Wide Web has no boundaries and is continually evolving so it is important that traditional insurance programs also evolve. Dental Practices may be operating under the belief that their existing insurance policies are enough to
Quote Some practice insurance policies have added benefits for hacking and virus attacks
cover their data security and privacy exposures. Unfortunately this is not the case and traditional insurance policies may be inadequate to respond to the exposures organisations face today. Fortunately there are now various products available to protect against emerging cyber risks. Some practice insurance policies have added benefits for hacking and virus attacks or for those with greater risk a stand alone cyber risk policy might be more suitable. It is important to review your cover and ensure that is evolving with your practice needs. Talk to Dental Essentials about the Practice Insurance options available for you.
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ADVERTORIAL NEWS & EVENTS
Finance product guide Independent dentists – secure your future
any dentists in private practice are struggling to cope with the number and the speed of changes in the industry. Dentistry has gone from a comfortable and secure industry with wealth almost assured to an industry that is fast being re structured on basis of an oversupply of dentists, strong competition from an increasing number of corporate entities and visible discounting of fees. Dental Innovations is receiving calls from dentists asking how can we help them cope with the emergence of high quality and aggressive marketing from dental corporates that is now appearing in their marketplace offering discounted fees , no waiting times and seven days a week service. They also have to cope with patients who see advertised fee discounts and are asked if they can match the same reduced fees. For a small business owner with limited time and resources these pressures can be overwhelming and can cause of lot of stress and confusion as to how to react. The solution is to recognise that independent dentists need to come together under a common umbrella to achieve a critical mass that enables them to act and
Quote Dentistry has gone from a comfortable and secure industry with wealth almost assured to an industry that is fast being re structured on basis of an oversupply of dentists
compete in the same way as corporate entities i.e. focus buying power, spread the cost of sophisticated modern marketing, achieve lower operating costs and have a head office support team. Dental Innovations is the established vehicle to meet that need -established for 15 years and a proven record. Join your independent dentist peers and meet change on the front foot.
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ADVERTORIAL NEWS & EVENTS
Finance product guide The Finlease factor
Specialist independent finance advocate Finlease offers a fresh approach to finance that respects your time.
ndependent research has shown that customer satisfaction with the major Banks has plummeted; especially since banking Relationship Managers (RM’s) have replaced the old style Bank Manager. Unfortunately RM’s spend the majority of their time on paperwork, and often see their RM role as a mere stepping stone to other roles within the Bank. RM “churn” remains at high levels. Dentists are tired of having to re-educate their new RM’s and are moving to Specialist Independent Finance Brokers. Specialist Independent Finance Advocates such as Finlease are knowledgeable and experienced in the Dental field, and they use a number of financiers. Information is gathered from the client ONCE and the ongoing process is managed holistically. They act for the Dentist to source the best funding options in the market. These are specifically tailored each client’s situation. Finance documents are signed in person at a time and place that is suitable to the client, often after hours or on weekends. The best thing about money is that, (once you’ve got it),
finance advocates acting for you
Westpac’s money, Bank of Queensland’s money or CBA’s money is just as good as NAB’s or ANZ’s. So why don’t I just call all of the Banks myself? Four reasons. 1. Recorded messages and wearing out your fingernails pressing “ONE” either costs Practice time or Family time. 2. Credit departments within Banks require detailed and compelling business cases in their own language. 3. Finlease introduced $350M in 2013 and sources the best solutions in the market 4. There is true wisdom in spreading your debt across a range of funders A good Specialist offers a single point of contact so that clients never have to talk to the Bank. Finlease visits each client to gain a full understanding of their practice and then reverts with a proposal. If it’s acceptable the client may proceed. If not, the client may decline with no obligation, sure in the knowledge that all details are archived for the next purchase. Article provided by Steve Daley, Finlease – 0448 480 405.
ADVERTORIAL NEWS & EVENTS
Finance product guide Dentists, Alarm Bells and Self Managed Super
larm bells go off when I hear a client say, “I am going to borrow some money in my Self Managed Super Fund to buy a property”. What I prefer to hear is, “I have found an ideal property. How can we best purchase it?” Ideal property first. Investment mechanism second. If there’s a fit between the property’s characteristics and the client’s long-term plans, then we can evaluate the ownership and funding options. Why is investing through an SMSF so popular right now? The main advantage is you’re able to access the cash in your super fund now, rather than at retirement. On top of that, it is now possible to borrow through your SMSF. This allows you to gear up and build a larger real estate investment portfolio. Another possible long-term advantage of the SMSF is that the tax rate is only 15% on rental income, and if the property is sold after you retire there will generally be no tax on the capital gain. That’s very attractive. But are there possible disadvantages? Yes. There are typically two items that seem to get glossed over by SMSF-focused advisors when talking about using your super to borrow. First, the set up costs. These will be higher than if you borrowed outside of the super fund. Secondly, there are some restrictions. Let’s say, for example,
Quote “Another possible long-term advantage of the SMSF is that the tax rate is only 15% on rental income.” that the property is a beach house. You are not allowed to use the house while it is owned by your SMSF. You will need to buy the property from the fund before you can live in it, which means capital gains tax would be payable by the SMSF and you will have to pay stamp duty on the transfer of the title. Ouch. The rules are strict. Breaching the superannuation rules could result in the fund losing half of its entire value—not just of that property’s value—in penalty tax. Am I saying that you should avoid buying property in your super fund? No. What I am suggesting is that you should know that you have bought the best property you can, and then seek advice on how to fund the purchase in the most tax effective way.
DO YOU NEED A NEW ACCOUNTANT? Are you getting the service you deserve? Are they accessible when you call? If you think you would benefit from prompt, professional and personalised service call us now. We have been providing dentists and specialists with taxation, accounting, and strategic business advice for over 30 years. If you are not happy with the service and advice you are getting from your present adviser call us now. Call Scott Davis on 02 9957 3233 for an appointment or visit www. williamsdavis.com.au
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NEWS & EVENTS
Tools of the trade A handy digital camera, a minimally invasive microscope ideal for younger patients, a new way to use a whiteboard marker and more are in the spotlight
The Isolite features an attached light.
Canon EOS 600D digital camera by Dr David Norcross, Kelmscott Dental, Kelmscott, WA
by Dr Rick Spencer, Spencer & Day Dental, Strathfield, NSW Isodry is a fantastic isolation product that keeps teeth clean and dry during procedures. It also reduces humidity in the mouth and stops contamination. Isolite is exactly the same product with an attached light. What’s good about it It’s a small bite block with a tongue and cheek guard that works like a dental dam. The whole thing is connected to high-speed suction and can be fitted and removed in a few seconds. I use it for placement of restorations when the area needs to be really dry and clean. It’s also very effective when placing fissure seals, particularly with children. I can fissure seal upper and lower teeth simultaneously as that whole mouth is kept isolated and dry. It’s impossible to use a dental dam when cementing a crown but the Isodry works fantastically well. It also eliminates the patient swallowing the crown if it’s dropped. Taking impressions is easier and quicker. It’s perfect for lower arch impressions when using half-quadrant trays. Isodry comes in five sizes for different sized mouths. It’s very cost effective and a real time saver. It can also be used by dental hygienists—the Isodry will look after all the isolation and suction.
I import pictures into PowerPoint to create a treatment plan presentation for our patients. The photos illustrate different parts of the mouth and I can show what work is needed. It helps make each case understandable, especially for cosmetic work or implants. What’s good about it It’s a basic camera compared to some others. I use it with a Sigma ring flash. The images help the patient to see what’s required. For example, if a patient needs an implant, I will illustrate on the photo where they have bone missing, the ideal shape of the tooth and the correct positioning. I can even add a virtual tooth to show them what the final result will look like. The photos can also be used to clarify the costs involved. They might have been told an implant costs $6000. However, upon examination, they might also need a bone graft, connective tissue graft, and there may be a period where a temporary restoration is needed. All these are additional costs and my presentations explain exactly what’s involved. We also use the camera to take photos of all our crowns, veneers and bridges. I often send these to the lab so they get some positive feedback about their work.
What’s not so good About five per cent of my patients end up having a gag response to it.
What’s not so good You have to take the time to sit the patient up, prepare them with retractors and mirrors, then take the photo. The camera is also quite bulky.
Where did you get it Henry Schein Halas.
Where did you get it Harvey Norman.
NEWS & EVENTS
Tools of the trade
(continued from page 43)
Seiler Revelation Zoom microscope by Dr Tim Johnston, iKids Specialist Paediatric Dentistry, North Fremantle, WA
The one thing that really sets our practice apart from others is our combined use of a microscope and a laser. Thanks to these instruments, we are a minimally invasive dental practice. I believe this is unique in the paediatric dental field. What’s good about it I was a clinical consultant to the company that was selling these particular microscopes so I definitely got a sweet deal when buying the equipment. I no longer have any allegiance to any particular company but I believe it’s important that dentists use some kind of magnification. I have three Revelation microscopes. As a paediatric dentist, I wasn’t convinced that a microscope would be suitable for kids and babies as they can’t keep still. It was a pleasant surprise to discover how successful the microscope can be. The kids do keep fairly still but you have to accept that there’s going to be a bit of movement and live with it. When I first sat down at the microscope and looked through it, I knew immediately that this is what had been missing from my practice. I took to it straight away and have never had any problems using it. It was exciting to see what I was doing so clearly and to be able to perform a better standard of dentistry. What’s not so good The cost of a new microscope is so prohibitive that some dentists will just stick with what they are doing rather than outlay such a large amount of cash. This means that they miss the opportunity to radically improve their dental technique. When using the microscope, you also need to rely on your chair side assistant a lot more than you would otherwise. Where did you get it Mint Devices (www.mintdevices.com.au).
White board marker by Dr Edward Boulton, Paul Beath Dental, Newcastle, NSW I showed the other dentists in our practice how I use a whiteboard marker when fitting a crown and now they all use the technique. It works a treat. I can’t even remember where I picked up this little trick. What’s good about it If a crown is not seating properly and it feels a bit tight then I reach for a whiteboard marker. The black ink of the marker works really well when checking the interproximal contacts during the placement of a crown. In the past I used articulating paper but I found that quite fiddly. Now I just take the crown off the tooth, dry it and mark the mesial and distal contacts with a bit of whiteboard marker ink. I then dry it with a triplex and replace the crown. Wherever the contact is too tight, the ink will be worn off in that exact spot and I can adjust it using a polisher. The remainder of the ink can be easily wiped off and the crown fitted. After use, the nurse wipes down the marker in the same way she wipes down the light handles. It never really gets contaminated as I use an over bag when picking up the marker. It’s probably the cheapest dental product we use in our dental practice. What’s not so good On the rare occasion, a patient sees me using the marker and asks about it. I just explain that it works really well. Noone has ever shown the slightest bit of concern. Generally, though, they don’t even notice. I only use the tiniest amount of ink on the interproximal contact. Where did you get it Stationary shops and supermarkets.
NEWS & EVENTS
Paper jams A piece of paper is transformed into something wonderful when Dr Jonathan Louie of Camden Dental Surgery in NSW uses his origami skills
I’ve only been doing origami for about 10 months. When I started I used to go to Parliament on King [a cafe in the inner-west suburb of Newtown] to practise and have a few coffees. “Ravi, the owner, saw me folding for a few weekends in a row and suggested I host an origami workshop in his cafe. He even promised to give everyone free tea. So we did that for a few weekends and we had a pretty good turn-up. “I think most dentists would enjoy origami. They have a good background in working with their hands. It’s a creative, rewarding hobby that you can share with other people. I give many of my creations to friends and family. My work also adorns the local cafe though a lot of pieces get
‘borrowed’ by locals and their children. “Certain folds are extremely difficult if you haven’t seen someone do them. For example, an Elias fold is very counterintuitive. It is a good idea to join a club or learn from someone who has done the design before. A lot of people try to follow instructions in a book but, without seeing how it’s done, it’s hopeless. That’s why most people give up. “I recently saw some designs for origami molars on the internet that I must get around to folding. They would be a great addition to the practice. I have already folded a lot of designs—roses, chairs, fish, foxes, dogs, boxes, boats— and displayed them at work. “Origami is a very visual and lingering work of art. Each piece is unique in
regards to colour, size and shape. Once you have finished the basic structure, there’s a sculpting element to it. You shape the piece so it has unique characteristics all of its own. The most intricate design I have made is the three-headed dragon. It took me three hours to complete and I was really happy with the end result. “The main thing I like about origami is that it’s a meditative practice. It’s quite relaxing if you get in the right mental space. It’s an interest that offers a significant reward that persists after you have finished. I played piano when I was in high school and one of the disappointing things about that is once you have finished playing, it’s gone. Origami creations are still there to enjoy later.
INTERVIEW: FRANK LEGGETT
Imagine a bank that thinks like you Not as unthinkable as you may think
Why is it that, whenever you talk to a bank, it feels like something is lost in translation? We understand your frustration – at Investec, we look at the world from your point of view. Investec is Australia’s leading specialist bank offering a full range of financial products and services, from highly sophisticated business solutions through to personal banking, credit cards, home loans, deposits, foreign exchange and much more. You won’t have to waste your time with someone who doesn’t get you. We’ll listen carefully to understand what you need, and then we’ll simply make it happen. You’ll like Investec’s impeccable service, too – you can call us any time, from anywhere, 24/7. Find out more about our unconventional approach to banking at investec.com.au or call 1300 131 141.
Specialist Banking Equipment and fit-out finance | Practice purchase loans | Credit cards | Home loans | Commercial property finance | Car finance | SMSF lending and deposits Transactional banking and overdrafts | Savings and deposits | Foreign exchange Investec Bank (Australia) Limited ABN 55 071 292 594, AFSL 234975, Australian Credit Licence No. 234975 (Investec Bank). All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. Information contained in this document is general in nature and does not take into account your personal financial or investment needs or circumstances. We reserve the right to cease offering these products at any time without notice. You should review relevant disclosure documents and obtain independent financial and legal advice, as appropriate.
why settle for
Ordinary anti-cavity toothpastes only protect the 20% of the mouth that is hard tissue.1 80% of the mouth is soft tissue where bacteria can lurk even after brushing. These bacteria may act as a reservoir to recolonise teeth and gums, putting your patients at risk for gingivitis.
the unique formula of colgate total®
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vs non-antibacterial fluoride toothpaste. Defined as fluoride for cavity protection plus 12-hour antibacterial protection against gingivitis. References: 1. Collins LMC, Dawes C. J Dent Res. 1987;66:1300-1302. 2. Xu T, Deshmukh M, Barnes VM, et al. Compend Contin Educ Dent. 2004;25(Suppl 1):46-53. 3. Fine DH, Sreenivasan PK, McKiernan M, et al. J Clin Periodontol. 2012;39:1056-1064. 4. Amornchat C, Kraivaphan P, Triratana T. Mahidol Dent J. 2004;24:103-111. 5. Davies RM, Ellwood RP, Davies GM. J Clin Periodontol. 2004;31:1029-1033.