Issue 64, march 2011, $5.95
Better business for dentists
Tools of the trade: Super fast anaesthesia guns, rotary systems that make endodontics easier, and much, much more … Working from home
What it takes to convert a residence into a practice (and it’s not as easy as you may think), page 31
Special report: All the latest and greatest dental units on the market right now—where to get ‘em and what they can do for you!
Talking it over
The difference between a job interview and a chat, page 27
How to keep your new year’s business resolutions
Is the NSW Labor dental plan just a hopeless, desperate, last grasp at power?
Changing the rules
What’s happening with the TGA’s review of regulations surrounding dental devices,
Taking the Kokoda Challenge, page 46
Print Post Approved no: 255003/07512
president’s mien Dr Shane Fryer, the ADA’s new President, talks about the Association’s next steps
Issue 64 / March 2011
photo g ra p hy: richa rd birch
Your world 14. Regulation nation
The road ahead The ADA has a new president. How does he see the current state of dentistry and what does he hope for his term?
The government’s review of healthcare technology assessment procedures is underway and an outcome is expected to affect a dental supplier somewhere near you very soon
Your business 22. The best of intentions
Is it really too late to dust off your New Years Resolutions for your business, or should they be added to the ‘mustdo’ list for next year?
27. Perfect match
Editorial Director Rob Johnson Sub-editor Lucy Robertson 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 email@example.com Suite 4.08, The Cooperage 56 Bowman Street Pyrmont NSW 2009
7,624 - CAB Audited as at September 30, 2010
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. Printing by Superfine Printing.
What’s the difference between a job interview and a casual chat?
31. Home work
Converting a residential property into a dental practice can be fraught with difficulty if you don’t get professional help
Your tools 10. New products
08 News & events 05. State of despair The NSW Labor government has promised dental relief if re-elected. ALSO THIS MONTH: A new study suggests that juices aimed at children contain too much fluoride; desperately seeking solutions for infant decay; less root than we thought needed for implants; and much more…
WaveOne™ by Dentsply; the ChemFil™ Rock; the world’s first LED curing light, without cord or charger and the Riav Self Cure HV are all covered
34. Chairs and dental units product guide
A guide to the best dental units on the market today
43. Tools of the trade
The gun that takes your patients’ pain away; two tools that make endodontics more fun and profitable; and more are all reviewed this month
Your life 46. Passions
Dr Tony Weir, of Tony Weir Orthodontics, in Brisbane, takes the Kokoda challenge!
46 Bite 3
Keneally promises dental relief if re-elected Is this a serious policy or a desperate grab from an unelectable government?
photography: stockxper t
ast month NSW Premier Kristina Keneally announced a $12.5 million plan to remove 20,000 people from the state’s dental waiting lists. But the plan has been criticised by the ADA and APOH as being inadequate, and Shadow Minister for Health Jillian Skinner said, “After 16 years of refusing to take action on dental care, a promise to do better at the eleventh hour is a token gesture.” The plan involves giving concession holders, pensioners and children a $400 dental voucher. In announcing the plan at a press conference in Sydney’s south west, Premier Keneally said dental costs were a burden to many families, and her plan was to ease the pressure of living costs: “Labor is determined to do what it can to take the pressure off families to maintain good dental health.” There are 120,000 people, including children, currently on the dental waiting list. The package would provide 10,000 extra vouchers, worth $400 each, for people eligible to receive free dental services. There will also be 5000 free new dentures for pensioners if the government is re-elected in March. The Government has also committed to investing in specialist dental equipment and continuing its water fluoridation program. APOH head associate professor Hans Zoellner said, “This Government has never even tried to do something for public dentistry. You need to look at what other states are doing and for this state to match the others, it needs to pour in $192 million a year, not $12.4 million over four years.” The Australian Dental Association NSW branch president Mark Sinclair said desperate families on low incomes would still miss out, and even though the extra money was welcome, it “won’t touch the sides of the significant need within the NSW community”.
Infant food may offer too much fluoride
Hands up who believes the Labor party’s funding promise for dentistry.
Shadow Health Minister Jillian Skinner described the plan as an ‘unfunded, eleventh hour Labor promise’: “There are 92,000 adults and 27,000 children on dental waiting lists in NSW,” she said. “People in NSW have been forced to pull out their own teeth because the state Labor Government has neglected dental care for sixteen years. “And now the same old state Labor Government is expecting those same patients to trust them to deliver an unfunded, eleventh hour Labor promise. The Australian Productivity Commission’s report on government services for 2011 found NSW has below-average availability of public dentists per 100,000 people, and a below-average availability of public dental therapist per 100,000 people. “Labor’s so-called dental announcement does nothing to address the serious staff issues that are plaguing the NSW dental sector. “For Kristina Keneally to offer an eleventh hour Labor promise to do better next time after 16 years of Labor failure simply isn’t believable.” £
Commonly consumed infant fruit juices contain fluoride, some at levels higher than recommended for public water supplies, which can damage teeth, according to research to be presented next month at the International Association for Dental Research annual meeting in San Diego. Ninety samples of three different flavors (apple, pear and grape) from three manufacturers were tested. All contained fluoride at concentrations ranging from 0.11 to 1.81 parts per million (ppm). “Children who consume excessive amounts of juice per day may be ingesting more fluoride than the recommended daily intake,” the researchers report. Recently, the US Department of Health and Human Services recommended lowering “optimal” water fluoride levels to 0.7 ppm. Safe fluoride intake could “be exceeded on a recurring basis when combined with other sources of fluoride intake such as fluoridated water, foods made with fluoridated water, and swallowing of fluoridated toothpaste,” write researchers, Fein and Cerklewski. £
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08 News bites Desperately seeking solutions to infant decay The head of dental services at Westmead Children’s Hospital, Associate Professor Richard Widmer, has called for parents to stop bottle feeding altogether in an effort to halt the rise in infant decay. Even as he made the call, researchers in the US announced the discovery of a new species of bacteria that may also cause caries. Associate Professor Widmer was quoted in newspapers as saying prolonged feeding with bottles of breast milk and infant formula can lead to early childhood caries. At night, if children suck on bottles in their cots for extended periods, Widmer said naturally occurring lactose was present in both breast milk and formula. When combined with plaque in a baby’s mouth, it could erode the enamel of primary teeth. “Ideally, children should go straight from breast to cup, avoiding bottles altogether,” Professor Widmer said. Paediatric dentists had noticed a pattern of decay on the back of the upper front teeth, indicating the cause was drink from a bottle that had been held between the child’s tongue and teeth for prolonged periods. “We see more kids with decay, and we’re struggling to get them all done,” Professor Widmer said. The waiting time for dental surgeries under general
anaesthetic is between nine and 12 months. Angus Cameron, the head of paediatric dentistry at Sydney University and Westmead Hospital, said tooth decay was so bad in some infants that they had to have every one of their primary teeth Ban them! removed. Meanwhile, as study in the February issue of the Journal of Clinical Microbiology suggests that a species of bacteria, Scardovia wiggsiae, can cause cavities, even when Streptococcus mutans (S. mutans) is not present. Up until now, S. mutans has been considered the primary culprit in caries formation. Researchers from the Forsyth Institute and Harvard, Boston and Tufts universities did the study. They looked at bacteria found in the dental plaque of 42 children who had
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09 News bites early childhood caries. Five types of bacteria were much more common in the children with decay than in decayfree children. Four of these types were already known to be associated with cavities. S. mutans was one of these four, with the other three thought to only lead to cavities in partnership with S. mutans, and not to cause cavities on their own. Scardovia wiggsiae was a surprise. It was found in children with decay even when S. mutans was not found. This suggests that it might cause tooth decay on its own. £
Less root needed for successful implants A new study in the current issue of the Journal of Oral Implantology has found that the crown-to-root ratio is not as important to the success of implants as previously thought. In the study, radiographs were used to examine 309 singletooth short-length implant-supported restorations in 194 patients. All the implants had been surgically placed between February 1997 and December 2005. The ideal crown-to-root ratio for a tooth to serve as an abutment for a partial denture is considered one to two— twice as much root as crown. But previous studies have given mixed results about ratios for implanted teeth. Excessive
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crown-to-implant ratios have been found to be as detrimental to the long-term survival of an implant, while disproportionate ratios have been noted in high rates of implant survival. The current study found an average crown-to-implant ratio of two to one. Natural teeth with such ratios would often be recommended for extraction and replacement. The authors found that stable implants could be produced with less of the tooth serving as root. £
A quick squirt eases pain Finally, justification for all those former smokers who believe they’re now addicted to nicotine replacement therapy. A study in the January issue of the Journal of Oral and Maxillofacial Surgery has found that using nicotine nasal spray before wisdom tooth removal may reduce pain after the surgery. Twenty patients were enrolled in the study. People reported significantly less pain with the nicotine spray than with the placebo spray. But they did not use less pain medicine. They also did not report less nausea. There was a small increase in heart rate after the nicotine spray was used, but no differences in blood pressure. An increase in heart rate is a common side effect of nicotine nasal spray. £
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10 New Products New-release products from here and around the world
WaveOne™ Australia is pleased to announce the release of the new and innovative WaveOne™ Endodontic root canal treatment system (including WaveOne rotary files, paper points, GP points and obturators) from DENTSPLY Maillefer. Manufactured using the advanced M-Wire™ thermal treatment process, WaveOne NiTi files shape root canals using a reciprocating motion in conjunction with the WaveOne motor, which is calibrated to work precisely with the geometry of the NiTi files. Requiring only one pre-sterilised WaveOne instrument to shape a canal in most cases, no time is wasted during the root canal shaping procedure. For more info, contact your local DENTSPLY Territory Manager or call 130055 29 29 (Australia) or 0800 DENTSPLY (33 68 77) (New Zealand). £
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ChemFil™ Rock Advanced Glass-Ionomer Restorative DENTSPLY Australia is pleased to announce the release of the new ChemFil Rock, an Advanced Glass-Ionomer Restorative that delivers simplicity and durability because of its unique zinc-reinforced chemistry. This new chemistry offers unparalleled mechanical properties and a simplified placement process. ChemFil Rock is up to 25 per cent stronger than other leading brands of GIC’s, offers superior fracture and wear resistance for reliable posterior restorations and requires no conditioning or coating. ChemFil Rock is available in five shades; A1, A2, A3, A4 Opaque and Contrast White. To compliment this range, DENTSPLY is also proud to offer a New and Advanced Capsule Extruder. For more information or a demonstration in your surgery, contact your local DENTSPLY Sales Specialist or Client Services on 1300 55 29 29 (Australia) or 0800 DENTSPLY (33 68 77) (New Zealand). £
Acteon Satelec provides high quality curing at an affordable price with the new Mini LED Black—the world’s first and only cordless LED curing light, powered by 3 AA batteries. Possessing a 10-second fast-cure mode, its power output of 1,250mW/cm2 combined with its wide spectrum of emitted light (420 to 480 nm) enables it to efficiently cure composites and other bonding material. The unit has the latest generation SMT electronics with a very high performance single LED built into a patented optic module. The Mini LED Black has a lightweight (135gm), ergonomic, pen style design with a 360° rotatable, multi-fibred light guide for ease of use. Built with no fan means this quiet unit also prevents the risk of cross-contamination. The handpiece is made of anodized aluminum so cleaning is easy. It is delivered with a light shield which also serves as a stand to prevent it from rolling when not in use. Mini LED Black—affordable perfection! For further information please contact Acteon Australia / New Zealand on 9662 4400 or email vanessa.roden@au. acteongroup.com. £
Sensodyne iso-active foaming gel
Sensodyne iso-active is a modern format with new gel-to-foam technology that is better suited for younger people with sensitive teeth • Penetrates hard-to-reach areas for a deeper clean1 • Delivers significantly more active agents (potassium and fluoride) for dispersion in the mouth2* • Provides all-round sensitivity protection, even in hard-to-reach areas3
Recommend Sensodyne iso-active to: ✔ The 1 in 3 people who suffer sensitivity 4 ✔ Sensitivity sufferers looking for an innovative delivery system ✔ Who are not currently treating their sensitive teeth References: 1. Gross RC et al. Presented at the General Session and Exhibition of the Pan European Federation of the International Association for Dental Research (PEF IADR) 2008, September 10–12. London, England. Poster 467. 2. Hall PJ et al. Presented at the General Session and Exhibition of the Pan European Federation of the International Association for Dental Research (PEF IADR) 2008, September 10–12. London, England. Poster 466. 3. Leight RS et al. J Clin Dent 2008;19:147–53. 4. Addy M. Int Dent J 2002;52:367–75. For the relief of sensitive teeth. Sensodyne® and iso-active® are registered trade marks of the GlaxoSmithKline group of companies. GSK0005/UC *Compared to a regular marketed toothpaste containing 5% potassium nitrate. Sensodyne® contains potassium nitrate.
12 New Products New-release products from here and around the world Riva Self Cure HV Riva Self Cure HV is a high viscosity, extremely strong self curing glass ionomer restorative, tough enough to resist surface indentation and strong enough to withstand substantial mechanical loads. Riva Self Cure HVâ€™s packability makes restorations easy to shape and contour. It can be bulk placed and does not adhere to your instruments. Riva Self Cure HV has free movement of fluoride, which provides benefits to surrounding and adjacent tooth surfaces. The significant fluoride levels released result in increased anti-cariogenic properties and improved longevity of the restoration. Riva Self Cure HV is available in shades A1, A2, A3 and A3.5. For more information, please contact SDI on 1800 337 003 or visit: www.sdi.com.au. ÂŁ
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So you can look after them Testimonial from Dr Fred Saggers NSW Dentist Since commencing my Dentistry career, I have been acutely aware of having the appropriate insurance cover. As a Dentist and a business owner I have had to be conscious of the impact my inability to work will not only have on me and my family, but also my staff and business commitments. Over my career, I have had several Insurance advisors and have always maintained a keen interest in the insurance industry. In recent times, I had noticed my Insurance premiums increasing and was concerned about the affordability as I continue to practice into the future. Upon requesting a review from my then Insurance advisor, I was told that the policies I had in place were competitive and I was advised to retain my existing policies. Not satisfied with this response, I was referred to Drew Burden, a partner of MBS Insurance. Following a thorough review of my circumstances and future aspirations, both personal and business, Drew was able to provide me with a full review of my existing policies, comparing them to the best the market has to offer on price and quality. Drew advised that I retain one of my policies, and implemented a replacement to my second policy, providing a significant saving and increase in quality of cover. I found MBS Insurance acted with a high level of integrity and professionalism. Their office processes ensured a smooth transition to my new insurance policy and their staff made this process a pleasant experience. MBS Insurance are committed to reviewing my needs on an annual basis allowing me the peace of mind that my insurance cover remains necessary and competitive as the years go on. I am more than comfortable in recommending MBS Insurance, as they were recommended to me. Kind regards
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Your world Regulation
Article Lucy Robertson
Regulation nation The government’s review of healthcare technology assessment procedures is underway and an outcome is expected to affect a dental supplier somewhere near you very soon
s most Australian dentists will now know, the Minister for Health and Ageing, Nicola Roxon, and then-Minister for Finance and Deregulation, Lindsay Tanner, last year released a report on healthcare technology assessment procedures, which made 16 recommendations to improve the provision of healthcare services across the country. Many of these were aimed at reducing the “unnecessary regulatory burdens on the sector”, including one recommendation that sought to address the difficulties of the Therapeutic Goods Administration (TGA) in approving and controlling the use of dental implants and other products manufactured overseas. The issues contained within these recommendations, and the processes for considering their future inclusion in the TGA’s regulatory standards, is undoubtedly complex. But one thing that became clear after the TGA released a set of its own proposals to address the government’s report is this: many dentists, suppliers and stakeholders in the Australian dental industry still believe the regulatory burden on local businesses is too great. Chief executive of the Australian Dental Industry Association (ADIA), Troy Williams, said his members were quick to voice their concerns about the TGA’s proposals. And, considering these members represent dental suppliers, importers and distributors of around 95 per cent of the dental products used in Australia, their views should have some clout. In a submission to the TGA in December, the ADIA claimed that Australia’s current system of medical devices regulation was already “first rate”, and was appropriately based on imposing regulatory barriers “in a manner that is commensurate with the risk”. 14 Bite
Indeed, in 2009, the ADIA spoke out about what the association considered to be a large number of dentists who were unknowingly exposing themselves to risks from importing dental products listed with the Australian Register of Therapeutic Goods (ARTG) but not approved for use outside of the exact registration environment they were imported for. Because of the confusion over the separate ARTG and TGA registration requirements, many dentists were unwittingly putting themselves and their patients at risk, the ADIA claimed. “There are several classes of products on the ARTG that are graded according to their risk factors,” said the ADIA’s then-executive director, Duncan Campbell, at the time. “So, for a Class One product like a probe or another basic dental instrument, there’s not much information that needs to be supplied for it to be added to the register. But if it’s a dental implant or a pharmaceutical, you have to provide a certain amount of information to verify it’s been manufactured in an appropriate way to ensure that it will be safe for use on a patient. “The risk-based system basically means that the greater the potential risk to patients, the greater the scrutiny that’s applied to make sure the product is appropriate,” he said. In its recent submission, the ADIA reinforced the point that a stricter regulatory framework should only be introduced for medical products that posed a risk to patients, rather than the bureaucratic approach to tightening the rules for all suppliers. “The attractive feature of the current regulatory regime is that it maintains a balance between regulatory requirements and risk, and also the commitment to a globally harmonised regulatory framework,” the ADIA argued. “These features are placed at risk in the proposals outlined in the TGA’s discussion paper. ADIA recommends a number of alternative solutions which allow the TGA to achieve the desired
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outcomes and maintains the attractive features of the current regulatory regime.” In their current form, the TGA proposals will “substantially alter” the regulatory provisions undertaken by dentists, the association claimed, and result in a “large initial one-off cost to business, as well as significant ongoing costs”.
he TGA has not clearly identified problems that warrant the proposed changes or demonstrated that the proposed regulations are necessary and beneficial,” the submission said. In a list of nine changes propsed by the TGA, the ADIA said it could not support four of them—including new ‘pre-market scrutiny’ measures for implantable devices; updated methods for including devices on the ARTG; changes to the way devices are identified; and the proposal to publish information about various devices online. These specific proposals would, according to the ADIA, significantly increase the regulatory burden on dental businesses, and in some cases, result in increased patient charges rolled on from greater compliance costs. Mr Williams also made the point that the TGA’s proposals do
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“There has been little demonstrated demand for many of the changes from either the public or healthcare professionals.” Troy Williams, ADIA
not come from industry-based evidence of problems with imported devices, but rather, from a government report dealing with a broader range of issues across the wider healthcare industry. “We note that there has been little demonstrated demand for many of the changes from either the public or healthcare professionals,” he said. The ADIA also noted that in the event the TGA’s proposals were adopted, the extra burden on local business could also delay the introduction of many dental devices to our market. “This is inconsistent with TGA’s own view of its role, which is to carry out ‘a range of assessment and monitoring activities to ensure therapeutic goods available in Australia are of an acceptable standard, with the aim of ensuring that the community has access, within a reasonable time, to therapeutic advances. [This framework] is based on a risk management approach designed to ensure public health and safety, while at the same time freeing industry from any unnecessary regulatory burden’.” The proposals would, the ADIA claimed, amount to a “technical barrier to trade” and contradict Australia’s participation in the Global Harmonisation Taskforce (GHTF), which aims to enable international parity of medical technologies and the subsequent protection of public health. The TGA declined to comment on its proposals while submissions were being assessed, but indicated it was expecting to have a preliminary response by the end of this month. Until then, the ADIA’s members will be beginning to calculate the cost of business under the potential TGA changes. £
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Your world Profile
Article Sharon Aris Photography Richard Birch
The road ahead
The ADA has a new president. How does he see the current state of dentistry and what does he hope for his term?
hane Fryer, new federal president of the ADA, has been thinking about dentistry his entire life, not the least because he grew up talking about the profession with his dentist father around the dinner table. Graduating from Sydney University in 1980, Fryer worked in private practice in Bankstown in south western Sydney for five years before returning to the university to study orthodontics full-time. The establishment of a practice in the regional city of Woollongong in NSW was also influenced by a family connection—his uncle, also an orthodontist, was based there—and Fryer went there intending to stay for two years while he worked towards his registration. He liked it so much he stayed. “It’s a very collegial group of dental professionals here,” says Fryer, “and the patients are very understanding people.” Being a keen surfer, he adds, the beaches were hard to beat too. Not long into his career Fryer become involved in the Australian Dental Association. He was elected to the ADA NSW Branch Council in 1991, later serving served as Branch President in 1997, as well as on numerous Branch Committees. “It’s something I enjoy doing,” he says. “You can do things and see results for what you’ve done. The interest in advocacy has grown since I’ve been involved in the ADA.” He could be described as somewhat of a serial joiner. In 1998 he became a Federal Councillor and again has been active on several committees as well as being the Federal Representative on the Australian Dental Research Foundation, the Australian Dental Association Foundation and the Oral 18 Bite
Health Foundation of the University of Sydney. All this experience has given him a clear idea on how to make the system work best for dentists. “You need to consult widely to come up with workable solutions that work for everyone. You always end up with a better result.” He adds, almost unique among health professions, consultation with ADA members is highly representative, with over 90 per cent of dentists being members. As for his current role, he states,
“You need to consult widely to come up with workable solutions that work for everyone. You always end up with a better result.” Dr Shane Fryer, ADA President
“The president is a servant to the Council and the Council is a servant to the profession.” So resolute a team player is he that when asked to nominate what advocacy he’s most proud of to date he initially demurs; “The ADA is never one person”. But he does allow that one of the things he’s most pleased about from his time as President of ADA NSW was when all the trouble was occurring with professional indemnity insurance: “We were able to steer the NSW dentists through that without any of the kerfuffle that occurred in other health areas. That wasn’t just a positive for the dental profession, it flows through to patients as well. If you control costs and keep your practice running
New Federal ADA president Dr Shane Fryer: a servant to the profession. Bite 19
Dr Fryer says the key challenges for the dental profession are how to best promote quality practice, access and affordability.
well, it helps to keep dentistry affordable.” Looking to the future, he says the key challenges for the profession come down how to best promote quality practice, access and affordability within an increasingly regulatory environment. Fryer observes that over the last few years there’s been a shift in the administration of health from state and territory governments to the federal government “so federally the ADA has acquired a greater focus”. The ADA, he notes, needs to keep pace with these changes and actively seek to respond to them so they effectively “advocate for dentistry and dental health and our members.” He points particularly to the need for the ADA to be part of managing the drive to regulate dentistry “so that doesn’t result in a system that over-regulates our practice”. He notes there is a danger that systems that work well in hospitals for instance, won’t necessarily be suitable for dental practice, but with a centralising health bureaucracy the temptation is there for one-size-fit-all approaches. There’s also managing the effects of the recent national registration and the compulsory continuing education that came with it. “One of the main jobs the ADA has to do is to continue to ensure services that members see as valuable. In particular the ADA wants to ensure it continues to provide goodquality, unbiased education to it’s members.” 20 Bite
Fryer says he’s heartened by the good lines of communication the ADA has established with the federal government, especially the Federal Minister for Health Nicola Roxon.
In negotiating and managing this, Fryer says he’s heartened by the good lines of communication the ADA has established with the federal government, especially the Federal Minister for Health Nicola Roxon and her department: “It’s important the ADA’s expertise in dental health is used for the advance of Australian dental care. The flipside is the government gets the best bang for their buck in terms of dental health.” He adds this first minority government changes the balance of the political agenda. The case in point is reforms aimed at improving access to dental care. While there are plenty of models around—with some urging the inclusion of dental treatment in Medicare or a Medicare-like model—the ADA remains firmly of the belief
that the best value for governments and patients alike will be achieved within a more targeted system. Noting the majority of the community already has access to good dental care, Fryer says “it’s the 30 per cent that don’t have access that need to be catered to” and he points to the ADA plan ‘Dental Access’. “If you spend public dental money over the whole community, you won’t provide good service to anyone. We want targeting so those without access get it.” Fryer adds that at the same time dental technology is improving and patients are demanding more and better treatment. “The wants, needs and demands of the public are much more sophisticated than in the past. Patients’ expectations are higher. A great challenge is to continue dentistry in an ever-changing environment that is being regulated without losing personal touch. Continuity of care is important.” With around six and a half thousand dental practices in Australia, and around nine and a half thousand dentists, “the vast majority of dentistry is provided in one- or two-man practices in offices. That works here extremely well.” He says this is likely to be the model for the foreseeable future, despite some new corporate models. Fryer believes the jury is still out on which of these models will be successful, particularly “because of the nature of the dentist-patient relationship. For instance, if you require a restoration of a filling there are a number of different ways your dentist can do that. It would be a sad thing if a corporation—driven by the money and return to shareholders—became the driver of what treatment is offered. But it’s early days and the profession is watching.”
In all, while the waters ahead may not be totally calm, the new president is optimistic the ADA can negotiate the waves just like he negotiates the waves in his ritual surf on a Sunday morning. And while he admits “As I get older I have to work harder to stay afloat and I tend to float more than I try at catch waves...” it’s fair to say he’s has the experience to read the waves and ride the crest to shore. £
e also notes that changing social demographics will influence the types of dental treatment on offer, but the key message is “dentists are trained for that. We know the different treatments. We learn them at dental school. The types of treatment a 60-year-old requires aren’t he same as a 40-year-old, 20-year-old, 10-year-old. Dentists are trained to provide that full range. That’s the message we’re trying to tell the government.” Of the much mooted coming crisis of an undersupply of dental professionals, Fryer happily points again to training, noting that in recent times the number of dental schools has gone from five to nine, with nearly all new schools located in regional areas. “The terminology we’re using has changed—now it’s about maldistribution. We’re not so worried about the numbers, but there’s an oversupply in metropolitan areas and an undersupply in rural and remote areas.” He’s hopeful that with the new schools, particularly Charles Sturt at Wagga Wagga in NSW, La Trobe at Bendigo, Victoria and James Cook in Townsville and on the Gold Coast, this is now being addressed. He notes while the figures aren’t in yet, “there has been some indications from Charles Sturt University pharmacy faculty [where preference was given in recruitment to graduates from regional areas] that this has led to a greater number of graduates staying in regional areas to work. So hopefully that will be reflected for dentistry there too.” Fryer also points out the ADA has for some time been doing its bit to improve the access of indigenous, regional and disadvantaged students to dentistry through offering them scholarships.
Dr Shane Fryer’s CV Dr Shane Fryer qualified as a dentist in 1980 with a BDS from the University of Sydney. He worked in a private practice in Bankstown, Sydney, for five years until returning to further full-time study in Orthodontics at the University of Sydney. In 1988, Dr Fryer commenced Specialist Orthodontic practice in Wollongong, NSW where he continues to practise. In 1989 Dr Fryer become a Fellow of the Royal Australasian College of Dental Surgeons (FRACDS) by examination and has also been award honorary fellowships in the Pierre Fauchard Academy (FPFA 2000), the Academy of Dentistry International (FADI 2001) and the International College of Dentists (FICD 2002). Shane was elected to the ADA NSW Branch Council in 1991 and served as Branch President in 1997. He has served on numerous Branch Committees and in 2002 was elected as an Honorary Life Member of the ADA NSW Branch. £
Your Business Management
Article John Burfitt
The best of intentions With New Years day a distant memory, the resolutions for 2011 are probably just as forgotten. But is it really too late to dust off those best intentions, or should they be added to the ‘must-do’ list for next year?
t all comes down to purpose. Simply, what are you really trying to achieve with the resolution, and most importantly, why?” Such are the words of wisdom from Vanessa Hall, the International Ambassador for Trust at the coaching consultancy Entente, explaining why most resolutions made for new year quickly become well-intentioned memories. Studies from the US claim 80 per cent of New Year’s resolutions fail within three weeks. Other research claims the failure figure is closer to 92 per cent, with the resolutions forgotten by the end of January. The tough reality is that for all the grand resolutions of ‘getting fitter’, ‘stopping smoking’ and ‘working smarter, not harder’ that people make every year, only eight-to-20 per cent of them will result in real change through the impending 12 months. With almost a third of 2011 having already passed, most people will have fallen into that category of having either dropped or forgotten what is was that they intended to change at new year’s. But, insists Hall, it is not too late to make changes, and she says those changes should start today. “It is never, ever too late, but the important thing that I would encourage is to understand what has happened and why you didn’t implement those things you were so clear about wanting to change,” she says. “Did you bite off more than you could chew, or was it a case that the resolution sounded good, but you did not have a real incentive to make the change? “In the March/April time, we as leaders within our organisa22 Bite
tions need to ask ourselves, ‘Did I make a real promise to the staff, or did I make ridiculous comments without the resources to pull it off?’ It is about now making an assessment of what you can actually do, and what is the mission and purpose for it. “Rather than dismissing the resolutions as something that was just never done, look at why they were not done. That is probably where you’ll find the answer of what really needs to be
“Whitening products in name alone create confusion for patients, who may start using such products without seeking advice from a health professional” Kos Sclavos, president of the Pharmacy Guild,
improved within the business.” Many business coaches agree that for resolutions to be pursued and put into operation, making a commitment to that change must be understood from the outset. In many cases, there is a process of feeling comfortable with being uncomfortable as changes are made. As a resolution is a change to the status quo, it will be a shift in direction from the usual way of doing business. Adapting to this might require the commitment of a couple of months for that task to become a regular part of the business operations.
Have the promises you made to yourself and your staff about your business become well-intentioned memories? Bite 23
Management Like all change, that can mean enduring a phase of being uncomfortable. Once that passes, it should be that everyone has adopted and become more comfortable with that activity. “There should be a bit of brain strain in making changes,” Dr Charlotte de Courcey-Bayley from St Leonards Dental Care clinic in Sydney, says. “You have to be honest with yourself through some soul searching about what needs to be done, and then most importantly, how you will get that done. Each one of those goals needs to have an action plan that creates a plan to improve the situation you are currently in. “And it needs to be a clear goal. That is where some people get caught-up—a resolution is not a goal. It needs be something that has an action plan attached
to it. A thought without an action plan is not going to achieve anything.” While making changes can be an intimidating concept, de Courcey-Bayley says any new goals should start small, and then be built on through the course of the year. She also says they require daily attention. “Once the goals have been defined and the action plan is set, then what I do every morning when I arrive at work is look at what my goals are and where I am in that process,” she says. “I also consider what do I have to do today to keep me and the business moving in that direction. Sometimes it can just be one piece of action that needs to be achieved that day.” And that can be, de Courcey-Bayley admits, a problem in most dental
practices. “The challenge in dentistry is that patients define our day; just dealing with them as they come through the door is our business,” she says. “So your new plan might be to turn
you work by the end of the year.” While taking time to determine a new set of goals and a clear action plan sounds like an easy way to start the process of change, going solo to do so is not
“You have to be honest with yourself about what needs to be done, and then most importantly, how you will get that done.” Charlotte de Courcey-Bayley, St Leonards Dental Care, Sydney
that on its head and decide that from this point on, you will set the appointment book in a more structured manner that works better for you and will provide the patients with much better results. Spending five to 10 minutes on that every morning could be all that is needed to change the way
the ideal route for every business person. Dr Phillip Palmer of Sydney consultancy Prime Practice says having a business coach helping guide the process can prove an invaluable investment in the business. “If you do this by yourself, then you could end up doing what you did last year
The reality of dentistry is patients define your day, which makes it difficult to implement any changes in the practice.
because you’ve probably already done everything you know how to do,” Palmer says. “Unless you enlist an outside person or consultancy, it probably is not going to happen. If it was your fitness, you would get a
fitness coach, or with golf, you would get an expert in the field. It has to be the same with business. Getting a business coach who understands dentistry can help you get better at what you do, and can also
challenge you to improve what you are providing. “A business coach can be that person who you set goals with every month, and then contacts you towards the end of the month to see what areas you might be
struggling with and need some direction. I think doing this on your own is way too hard.” Charlotte de CourceyBayley adds that enlisting a business coach to improve the practice of the practice could be an investment that profoundly impacts on the bottom line. “The investment you make in yourself and in your business by having someone hold you accountable to what you say you are doing to do can not be underestimated,” she says. “We track the profitability of the practices we work with, and they double within the first three years of making changes, and continue to grow. Developing that as the way you do business and developing your capacity just pays dividends beyond measure.” £
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Your business Human resources
Perfect match What’s the difference between a job interview and a casual chat?
O Article Louis White
ne of the hardest tasks for any organisation is recruiting the right staff. It doesn’t matter what level the position, getting the person with not only the right qualifications but also the right personality can be a difficult task. Before the interviewing process gets underway, the process of sifting through resumes can take time, and something you might not always have time to do properly. Nonetheless, it is an important process and one that you need to get right. “The reality is that your dental practice can grow or fail depending upon the personalities,” says Simon Palmer, managing director of Dentist Job Search. “I always say to dentists there are three questions you need to ask before you start interviewing potential staff members. They are: What do you need to have? What would be nice to have? What can’t you have? “Once you have answered those three questions you are on the path to recruiting the right people.” Dentist Job Search is the only national employment, prac-
tice sales and purchase service established exclusively for the dental profession in Australia. One of their tasks is to sift through resumes for dental practices requiring fellow dentists. “You can tell a lot from a resume and eradicate a lot of candidates based on what they do and don’t tell you,” Palmer says. “I don’t often call people and have a chat for an informal interview, I usually forward the selected resumes onto the client. “When it comes to the interview I think it starts from the time the person walks into the clinic and talks to the receptionist. Your whole professional manner is on display from the start. “Once the interview starts you need to clarify any ambiguities in the resume, if any exist, and then set expectations about the role. “The interview should be a two-way communication process and the practice should be aware of that. “When it comes to how many interviews are needed, I generally think one is enough. It is a competitive marketplace out there, and the longer you take to make a decision, the more likely the candidate is to go elsewhere.” Bite 27
Human resources Of course there may be times when you don’t even have the time to actually see the dentist you are appointing faceto-face, as recently happened to Dr Sandra Short. Dr Short, whose practice Dental Artistry is in Double Bay, Sydney, recently had to appoint a locum for three weeks while she was away and her original candidate pulled out at the last minute. “I advertised on www.seek.com.au and ended up having a chat on the phone with a dentist who happened to live nearby,” Dr Short said. “We clicked instantly and I could tell
If these people weren’t good on the phone, they wouldn’t have their current job.
he was the right person to fill the vacancy. It worked out really well and I was lucky because I actually didn’t have time to see him in person. “Normally, my staff filter the resumes and once I have checked all the qualifications and gone through the specifics of the job and I feel comfortable that they can fulfil the role it all comes down to personality. “To me that is the most important aspect of the filling the job—the personality. You can train the technique but you can’t train personality. “My interviews are to the point and focused.” DCA Dental has eight clinics throughout Melbourne. The clinics were started eight years ago, and co-founder Erica King has a lot of experience recruiting dentists, even though she is not one herself. “I fell into dentistry because of my human resources and psychology background,” King said. “I have been now working in the industry for 17 years.” 28 Bite
King has had a lot of experience recruiting dentists and has some noteworthy advice. “You must always ensure you are clear about the job,” she said. “Ensure that there are no misconceptions. It is essential that before someone even writes an ad that they are clear about the job they want to fill. “The next step is to think about what kind of personal characteristics you need for that particular clinic. “I have interviewed many people in the past who have had the right experience and qualifications but not the right personality to fit in with the existing staff at that practice. “You need to assess that from both the individual’s point of view you are thinking about hiring as well as the from the practice’s position.” King is adamant that an informal chat on the phone is the first step in the process to recruiting staff. “You can tell so much from people and the way they conduct themselves on the phone,” she said. “Whether they are courteous, professional, warm and what their personality is like. You also need to ascertain on the phone what exactly it is the candidate is looking for. What are their attitudes to work and if they are money focused? If it is the latter, I don’t follow up. “If people can’t display warmth and charm on the phone then they are going to struggle to do that in real life. “I would never get anyone in for an interview who I had not spoken to first on the phone.” When it comes to the formal job interview, King believes that one of the most vital things you look for is two-way communication. “I think it is important that you make it a professional envi-
“To me that is the most important aspect of the filling the job— the personality. You can train the technique but you can’t train personality.” Dr Sandra Short, Dental Artistry, Sydney
ronment but remember that you must respect their time and effort too,” she said. “It is important to clarify the role and ensure they have the right qualifications and experience but equally important you get the right fit for both the individual and the clinic. “You also need to let their personality come through. After all, I want people to enjoy their job. Sometimes you find the right person for the wrong environment but I have been lucky in that most times I have been able to find the right environment for them.” King believes more than one interview is necessary and says she often conducts three interviews for dentist appointments and normally two for other staff in the practice. “Each time you see someone you get to know them better and they get a better feel for the environment they may be working in,” King added. “But I do believe the key ingredient is the personality match. After all, you are going to spend a great deal of your day at work.” £
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Your business Design
Inside Dr Chris Orloff’s rooms in Perth: the end result was much better than he had expected.
Converting a residential property into a dental practice can be fraught with difficulty if you don’t get professional help Article Rob Johnson / Photography Courtesy Medifit
ou’re ready to open a practice, and have found the perfect spot: a growth suburb with no other dentists in it, a big shopping centre nearby, and a nice old residential house that would convert to the perfect surgery. A drive around the ‘burbs of most major cities will show you many dentists have had the same plan, but as Dr Chris Orloff found, the process of converting a house to a surgery isn’t as straightforward as you may first imagine. “The big issue was parking bays,” he says. “I thought I needed a fair number, without knowing exactly how many, but the council insisted we needed 14 car bays.” It wasn’t the first practice Dr Orloff (of Class 1 Orthodontics) had set up, but it was the first time he’d tried doing it in a residential property. “We placed the practice into a growth area of Perth around five years ago,” he explains. “But being a new area, there was limited commercial space, and what was there was expensive. So I needed to find a house which was close to the big local school, which was being sold as a development site.” Finding the site wasn’t the big issue, but accommodating the council’s demands for parking on the site was a surprise. The other surprise, he says, was the cost of necessary stormwater drainage in the parking area. “You end up spending $70,000 just in car parking,” he says. “But the council says you need to be ready for a 100-year storm.
Which is fair enough, but when you think of a renovation project like this, $70,000 is a fair amount of the budget.” It wasn’t a great surprise to Mark Evangelisti, national projects director at Medifit. “Depending on where a practice is located, the introduction of four surgeries with two practitioners can require five to ten parking bays. It also depends if it’s on a main street, near a shopping centre and so on—these are all taken into consideration by the planning department once an application has been submitted.”
“Depending on where a practice is located, the introduction of four surgeries with two practitioners can require five to ten parking bays.” Mark Evangelisti, National Projects Director, Medifit
In fact, he says, rule number one if you’re considering buying a residential property to turn into a dream practice is “Never buy a site if it’s not going to handle the parking bays required. That might have to be achieved by a partial demolition. But rarely does the existing house sit on the lot in a way that will allow you to meet the parking criteria.” Although it seems like the simplest thing in the world to gut an old house and turn it into a surgery, Evangelisti knows how complex it can be—and has often found himself explaining that to customers, and tradespeople working on a site. Bite 31
Design “It’s not unusual to have tradespeople on a project, and they’re saying ‘why didn’t they just knock the whole thing down and start again?’ What they don’t understand is planning approvals is for an existing residence to be maintained, and so it still has to look like a residence at the end. So that’s why they become as complex as they are, because they would never get a planning approval otherwise. “Of course, there are subtle differences between the states, but as a general rule, anywhere you do this in Australia, instead of losing twelve months in planning, it would take only three months to have an existing house approved.”
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 43. 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 email@example.com, and he’ll tell you what’s involved. 32 Bite
part from parking, Evangelisti says the key issues dentists face with a residential conversion are: the neighbours (and hence, the council’s) attitude towards the property; the structural integrity of the house itself; and its suitability in terms of disabled access requirements and the like. “One of the most important things to ask is, ‘Will council support a change of use application?’,” he says. “The reason that’s important is if you have houses on either side of your property, and over the road, when the change of use is advertised, the property owners may object. Often, neighbours may see it and think, ‘I’ll be living next door to a car park’. Although you may see a dental surgery as the most benign thing in the world, neighbours may not. “You must be sensitive to the neighbour’s requirements. They might have had a garden they’ve been looking out at for the last 30 years, and it’s going to be disrupted with a dentist moving in.” The other two most common issues are with the building itself. Says Evangelisti, “The issue of structural integrity is a similar set of concerns as you would have for a residential property, in that during the planning stages it makes sense to have a dilapidation report undertaken, especially on the floors—the stumping, bearers and joists. These are often degraded in residential properties, especially in Victoria and New South Wales. It’s less on an issue in WA, because we have properties built on slabs. But because of the wet and damp conditions in the eastern states, if the house has poor ventilation and drainage, the floor will have rotted. That alone can be a $25,000 exercise, which is significant. “And the final thing is suitability. It’s great to buy an old house, but if all the rooms and corridors can’t meet disabled access requirements, you may find internal walls need to be removed. If a dentist is committed to renovating an old house into a practice, they may have to remove every internal wall, have the required beams inserted to hold up the roof, and rebuild from there.”
oth council and neighbours were an issue for Dr Lloyd Saville, and his renovation ended up in front of the Victorian Civil and Administrative Tribunal (VCAT). “The building had a heritage overlay on it, but the council was more concerned about the issue of appropriate use than with things like parking,” he recalls. “We had neighbours concerned about the increase in traffic flow, but when the VCAT hearing came along, none of
the neighbours actually turned up. The council fought things though.” Dr Saville’s experience is actually a salutary lesson in why one should use a specialist builder for such renovations: He’s renovated two residential properties into surgeries. The first time, he used a residential builder who was cheaper than the professional dental builders. “The first experience was very difficult,” he says. “I was on site a lot, and helped oversee things from a dental perspective. It’s just emotionally taxing, and I’d never do it that way again. It was so much easier the second time around, having professionals to help us.” The first time around he had stuck with the basic footprint of the house. “And doing that gives you an average outcome,” he says. “We found we needed specialist plumbers and electricians as well, as most plumbers aren’t familiar
The real difficulty in a renovation is deciding what to keep.
with what you have to do to install a dental unit, for example. So there are all things we learnt.” The second time around he bought the house next door and joined the two properties together. The scale of such projects seem to belie the initial, simple desire—to have a residential-style practice. “At first clients are surprised at the extent of the conversion,” Mark Evangelisti says. “They find it hard to understand why it would cost as much as it does, but once they do a site visit they realise why it costs that much.” Certainly, from Chris Orloff’s point of view, the financial pain is worth it. “The end result is much better than we expected,” he says. “We’ve been able to open space up, and haven’t really been limited by the existing floor plan. And the light coming in to the main treatment area is exceptional. But to achieve this, an engineer had to come in and design a support to hold the roof up so we could move the interior walls around.” Actually, Dr Orloff thinks the real difficulty in a renovation is deciding what to retain—and if he had it to do over, he would have kept less. “A renovation costs more per metre than a new building, so you decide, ‘do I keep this window frame or this bit’, and so on and so on,” he explains. “Retrospectively, I should have replaced some of the sliding doors, which are sticking now. I would have replaced more if I had it to do over.” £
BEST PRACTICE As dental fitout specialists, best practice is something we take very seriously. Whether you require a design and build from the ground up or a renovation of your existing surgery, Medifit deliver inspired solutions that work for you. We create the operating environment that your patients and staff deserve. Call us today on (08) 9328 8349 or visit our website at www.medifitonline.com for more information.
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Bite 33 23/02/11 1:29 PM
Chairs and dental units product guide How to make the right choice You need equipment. But it pays to research the funding options before you make your purchase
ew equipment varies in cost from a few hundred dollars to many thousands of dollars. Sometimes, the expense can be a deterrent to making the purchase, but the purchase cost is not necessarily the real cost. For example, for a new dental chair costing $100,000, we can assess its real cost after considering your chosen payment method. Saving enough to purchase this piece of equipment outright seems
like a logical approach. The downside is you could get further with your cash by investing in growth assets, and receive a broad range of commercial benefits by entering a finance agreement for your business equipment. You can save your cash and instead finance your purchase with a chattel mortgage or asset purchase agreement. With a chattel mortgage, financing $100,000 over five years with no deposit and no residual at 8.25%pa would mean that your
monthly commitment is $2,025.70, but you may claim the interest portion of your payment in your tax return throughout the entire loan period. After five years, your total repayment of $121,542.20 includes a total of $21,542.20 in interest expense which is tax deductible. You may also claim equipment depreciation on the goods for the life of the asset. Lease payments on the chair would be about $1,720 before GST each month for five years, assuming a 10%
residual remains payable at the end of the term and there is no option to purchase. Rather than claiming depreciation as an expense, the entire lease rental becomes tax deductible. This amounts to $103,200 over five years. To get the best deal, discuss your needs with Investec. Contact 1300 131 141 or www.investec.com. au/professionalfinance. £
Brought to you by Medical Finance
Investec Experien Pty Ltd ABN 94 110 704 464 (Investec Experien) is a subsidiary of Investec Bank (Australia) Limited ABN 55 071 292 594 (Investec Bank). This editorial includes information of a general nature only in relation to the potential commercial benefits of asset financing. Taxation is only one of the matters that taxpayers should consider in making business decisions. This editorial does not constitute taxation advice and cannot be relied upon as such. The individual circumstances of each taxpayer may affect the specific tax implications of asset financing to that taxpayer. We recommend that independent professional tax advice is sought to confirm the specific tax implications of asset financing based on the particular circumstances of each taxpayer. Investec Experien is not offering financial or tax advice. All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. Information is current as at March 2011.
borrow up to 100% and buy the home you want, why wouldn’t you? At Investec, our mortgage products provide flexibility for owner occupiers to borrow up to 100% of the purchase price, or up to 95% of the purchase price for investment properties, without Lenders’ Mortgage Insurance. Enjoy the benefits of having a dedicated mortgage specialist who can offer competitive interest rates, offset facilities and a quick and easy approval process. Get into your home quicker. Contact your local banker, call 1300 131 141 or visit www.investec.com.au/medicalfinance.
Medical Finance Home Loans • Asset Finance • Commercial Property Finance • Deposit Facilities • Goodwill & Practice Purchase Loans Income Protection & Life Insurance • Professional Overdraft Experien Investec Experien Pty Limited ABN 94 110 704 464 (Investec Experien) is a subsidiary of Investec Bank (Australia) Limited ABN 55 071 292 594 AFSL 234975. All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. We reserve the right to cease offering these products at any time without notice. Investec Experien is not offering financial or tax advice. You should obtain independent financial and tax advice, as appropriate.
Chairs and dental units product guide Brought to you by Investec Medical Finance
Dental chair buying guide The purchase of a dental chair is one of the most important decisions a dentist needs to make, so it is essential to understand which type of delivery system is right for you.
t A-dec that choice is easy. A-dec’s legendary reputation for quality and reliability is backed by the widest range of delivery systems to suit the way different dentists work. A-dec equipment specialist, Daniel Bisiker, said there were three basic types of delivery systems suited to different dentists’ preferences— ‘traditional’, ‘Continental’ and ‘cabinetmounted’ delivery systems. He explained that the traditional delivery system featured chair-mounted instruments which could be easily positioned on either side of the chair for left or right-handed operators. “The advantage of this system is that the control head can be moved out of the way to give easy access to the chair, and then comfortably positioned within easy reach of the dentist during procedures. It is a well-known system, which many dentists have grown up with and find comfortable to work with.” Another popular style is the ‘Continental’ delivery system in which the instruments are placed on top of the delivery head and supported by spring-mounted arms under the delivery system tubing. “The advantage of this system is that the tubing is out of the way and the support arms on the delivery tubing mean it is impossible to drop an instrument. Many
operators prefer this style as they can pick up and replace instruments without looking. It’s particularly beneficial to those using loupes or working with microscopes.” The third type is a cabinetmounted delivery system, which has no instruments on the chair. This configuration is often used in conjunction with a ceiling mounted light, leaving the chair completely free of obstructions. “Many dental specialists prefer this configuration as the bare chair is much more accessible to the patient and the dentist, especially where dynamic instruments are not needed for every treatment. “Orthodontists and paediatric dentists do not want the instruments in the face of the patient. This reduces patient anxiety and is unnecessary when installing orthodontic appliances, adjusting bands or for case presentation. Of course, the cabinet mounted configuration—either to the side of the dentist or at the ‘12 o’clock’ position at the head of the patient, means instruments are always within easy reach when required. “Many specialists and general dentists are opting for this arrangement in conjunction with A-dec’s round assistant’s work surface at the head of the patient. This enables the doctor and assistant to position themselves close to the patient and reach all instruments, suction, chair
controls and consumables without unnecessary bending or twisting. “This is an important consideration in maintaining correct posture and for occupational health and safety reasons. A comfortable work position with minimal twisting or turning is essential to reduce the chance of workplace injury or repetitive strain syndrome.” The final and often overlooked consideration is the size and shape of the patient chair itself. Mr Bisiker said some dental chairs used thick padding in the belief it was more comfortable for the patient. “A-dec has re-engineered their approach through the use of ergonomic pressure points, to create a backrest which is very thin, yet extremely comfortable,
providing optimum shoulder and back support. This not only makes the patient comfortable, but provides superior access as the chair back moulds to the dentist’s lap, reducing unnecessary bending and straining of the back and neck. “Once again, A-dec has thought about the needs of both the doctor and the patient and has come up with superior, flexible solutions without compromise.” A-dec has taken the guesswork out of choosing dental equipment with a definitive new guide titled What To Look For When Buying Dental Equipment. Copies are available from A-dec Territory Managers in each state. Phone A-dec Australia on 1800 225 010 or see www. a-dec.com.au for details. £
Chairs and dental units product guide Brought to you by Investec Medical Finance
Anthos committed to excellence Careful design of individual components together with top-quality materials ensures Anthos dental units are both reliable and practical.
he renowned reliability of Anthos, hinges on the use of carefully selected, appropriate materials. Digital technology reduces wiring to a minimum, thus minimising the possibility of malfunctions. At Anthos in Australia, the concept of performance also takes in the aspects of ergonomics, user-friendliness and practicality because high performance means much more when the dentist is able to use it effortlessly. With simple, clear controls that make it easy to set up and control hygiene systems and unit/instrument programs, work can be carried out smoothly and practically. For us, performance comes first means improvement through integration of cutting-edge performance, ever-better hygiene systems and rapidly evolving multimedia systems. The entire Anthos product range is designed to offer efficient workstations on which all the technology we develop is reciprocally compatible and are supported. Thanks to this approach the dentist can upgrade his workstation as new improvements become available even if they haven’t been invented yet. All around you is a working philosophy that offers the dentist tools and technology, which maximise his skills. A
The Anthos Classe A9 dental unit: typical of Anthos’ committment to excellence.
workstation that incorporates the latest diagnostics technology and integrates it with the dental unit to provide a unit-mounted PC and multi-media screen where, thanks to immediate communication, the dentist is able to work efficiently, saving time and money. The market already offers quite comprehensive systems that have undoubtedly demonstrated their worth. Yet, as in all areas of technology, individual components are inevitably destined to evolve, to undergo a continual process of refinement. To take a set of
outstanding instruments and offer them individually is not difficult. Yet if we bring them together in an inimitable configuration, in which every single element works harmoniously with the other, we create a system that is both unique and autonomous: from camera to screen, from X-ray unit to digital sensor, from the unit-integrated PC to dedicated software. A thusdesigned set of instruments and technology offers an overview that is immediate and complete, providing the dentist with a tool with which to obtain the informed consensus of the patient as
regards both the clinical and economic aspects of the treatment plan. The Anthos Hygiene System uses materials ideal for dental unit cleaning and hygiene protocols, features systems which prevent, at source, the emergence of contamination problems, facilitates daily hygiene and safety procedures and ensures the dentist has a modern system that complies with international standards. In order to provide 360° protection, Anthos takes into account aspects related to active hygiene and passive hygiene. £
NEW CLASSE A MULTIERGONOMY, MULTIFUNCTION AND A LOT MOREâ€Ś
Bring together quality and aesthetics, practicality and design. Ensure lifetime service and reliability. New Classe A: the crossover concept by Anthos adds a new dimension to your professional development and offers the latest in technological progress.
NEW CLASSE A: VERSATILITY AND FREEDOM OF MOVEMENT.
Anthos outlets in all capital cities: Email: email@example.com
1300 881 617 www.anthos.com.au
H2C - Dentist Chair Sofa Style Dental Chair with flexible cart style delivery system.
K2U - Dentist Chair Knee-break Style Dental Chair with hanging arm and handpiece lines under the delivery tray.
All chairs include scaler, cu light, 3 handpiece lines fibre optic), Linak motors, quality air and water tubin dental stool.
uring (2 x high ng, &
All dental units $9,900 including GST
This offer is for a limited time as part of our 2010 stock clearance, conditions apply, call for details.
Limited stock available - call for details
K2D - Dentist Chair Our most popular model. Knee-break Style Dental Chair with space saving side mounted delivery system.
Upholstery colour options: apple green
Melbourne Head Office & Showroom Freecall 1800 837 566 2/125 Highbury Rd Burwood Vic 3125 Brisbane Showroom Call Allan on 0406 219 744 12 Fegen Drive Moorooka QLD 4105 Sydney Showroom Call Colin on 0414 912 423 182 Lilyfield Rd Lilyfield NSW 2040
ANZ Dental Pty Ltd
Australian Freecall: 1800 837 566 New Zealand Freecall: 0800 238 823 email: firstname.lastname@example.org
Chairs and dental units product guide Brought to you by Investec Medical Finance
PEGASUS Dental Services Supplying the world’s best equipment. Providing Australia’s best service.
egasus Dental Services are one of Australia’s newest A-dec dealers providing the full range of A-dec equipment, W&H Handpieces, sterilisation equipment as well as Acteon Dental Imaging. Pegasus Dental Services commenced as an equipment service repair company and still remains focused on servicing its customers. We have a strong belief in being able to provide equipment repairs to the products that we sell. This is why we have
specialised exclusively in A-dec, W&H, Cattani and Acteon product ranges. We have a dedicated service and sales team that will work with you from the initial sale to the installation and ongoing maintenance of your equipment. Please contact the friendly staff at PegasusDentalServices for all your equipment service, sales and installation needs. Don’t forget to check out our website at www. pegasusdentalservices. com for amazing monthly specials. £
The streamlined A-dec 500 is on offer at Pegasus Dental Services
offer the best care with the best equipment, why wouldn’t you? Equipment, fitout and practice assets are critical to the way in which you run your practice and care for your patients. Investec has a range of finance structures where you can select repayment options to suit your cashflow, enabling you to update your equipment now and be best placed to treat your patients’ needs. Be at the forefront of your profession. Contact your local banker, call 1300 131 141 or visit www.investec.com.au/medicalfinance.
Asset Finance • Commercial Property Finance • Deposit Facilities • Goodwill & Practice Purchase Loans • Home Loans Income Protection & Life Insurance • Professional Overdraft
Investec Experien Pty Limited ABN 94 110 704 464 (Investec Experien) is a subsidiary of Investec Bank (Australia) Limited ABN 55 071 292 594 AFSL 234975. All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. We reserve the right to cease offering these products at any time without notice.
Stronger... ...for greater peace of mind
NEW Up to 25% stronger for outstanding durability*
Superior fracture and wear resistance for reliable posterior restorations* Simple procedure – no conditioning or coating
For more information, contact your local DENTSPLY Territory Manager or visit: AU: www.dentsply.com.au • 1300 55 29 29 • NZ: www.dentsply.co.nz • 0800 DENTSPLY (33 68 77) *Data on file
Your tools Reviews
The gun that takes your patients’ pain away; two tools that make endodontics more fun and profitable, and more are under review this month
Tools of the trade
X-Smart by Dr Jack Obaid, Greenwood Dental, North Sydney, NSW The X-Smart is a rotary endo that is very compact and can be easily moved from surgery to surgery. It is a rechargeable unit that displays a set of bars—just like a mobile phone—to indicate at what level it’s charged. When it hasn’t been used for a period of time, it will shut itself off. What’s good about it I enjoy doing root canals and appreciate the small size and maneuverability of this handpiece. It can easily reach upper molars right at the back without too much effort. When using a normal handpiece in the past, I’ve had occasions where it has been extremely difficult to position a file correctly. The X-Smart has a number of presets for different files. You can also use other systems provided you know the torque and speed settings for that file. By using the presets the chances of a file breaking are very low. My surgery purchased a number of handpieces because we often have two or three root canals in a row. I can put one through the autoclave while using another one for the current patient. What’s not so good The more I do root canals, the more I find myself using different file systems, so it would be nice if every preset could be labelled. At the moment they are only numbered so you need to memorise the setting for each file. The handpieces tend to wear more quickly than I expected, making the shank a bit loose. I’ve gone through a couple but that’s a minor point compared to how well the X-Smart works. Where did you get it Dentsply. £
Protaper by Dr John Pohl, Hawsburn Village Dental, Melbourne, VIC When I purchased my practice five years ago, I decided to reward myself by making endodontics easier. I had reached a point where I dreaded doing root canal therapy with hand files as it gave me headaches, wrist aches and took a long time to complete. A friend of mine who is an endodontist was the speaker at a course and he was using the Protaper system. He’s a trustworthy source and I had watched him use this system in his own practice, so I purchased my own. What’s good about it The whole job is made more efficient because the rotary system does all the work for you. It comes with a specialised handpiece and an array of files in various sizes. Although it doesn’t include an apex locator, it is very efficient at recognising when it is approaching the apex or when it has reached a narrow area. The file detects the situation and automatically reverses itself while making a beeping noise to alert you. There is very little risk of fracturing the instrument as it will auto-reverse whenever the space is too tight. What’s not so good There are a few wires that can get in the way. You need to plug it into the wall socket, plug in your pedal and plug in the handpiece. This can make it difficult to place on my bracket table because the table is too small. Where did you get it Dentsply. £ Bite 43
Your tools Reviews
Ligmaject by Dr Patrick Colgan, Fremantle, WA Ligmaject is a gun-shaped syringe that injects small amounts of anaesthetic under high pressure. It has a very short needle that is introduced between the tooth and the bone. Once it has slipped down alongside the tooth, you deliver a drop or two of anaesthetic under pressure, and the liquid runs down the surface of the root to where the nerve enters tooth. Its application is only applicable to the mandibular posterior teeth. What’s good about it The anaesthesia is localised to an individual tooth and there is no carry-over numbness to the tongue or lips. Ligmaject has been around for a long time but did not seem terribly popular with dentists. However, with the advent of Articane Hydrochloride, it works a treat. It’s quick, convenient for the patient and is a very profound anaesthesia. Even though Articane is great anaesthetic, it’s not recommended for use in the lower jaw as a conventional block injection because there’s some risk of leaving the nerve with long-term numbness. By using it with the Ligmaject system, it works really well— particularly in emergency situations when you need to get the patient numbed quickly. I always show patients the gun and explain the needle goes between the tissue and the tooth.
Estelite Sigma Quick by Dr Paul Crichton, Brad Pearce Dental Surgery, Coffs Harbour, NSW I had been aware of Estelite Sigma for quite a long time but didn’t use it until we received some samples three years ago. I gave it a go and really liked the result. It’s now the resin I use with the majority of my patients. What’s good about it The ‘Quick’ version has a shorter setting time. It’s not sticky like a lot of other resins which means its handling characteristics are far superior to anything else I’ve used. It comes in 20 different colour shades but I find I only need to keep about three or four different shades on hand. It has a chameleon effect which allows it to blend in really well with the natural tooth. A lot of resins require you to be spot-on with their colour or the restoration is extremely obvious. With this product, a shade like A3 can be used with a large range of teeth. I use Estelite Sigma Quick for anterior and posterior fillings. In fact, I use it for pretty much everything. It’s easy to handle, it cuts curing time by a third, it polishes well, giving a natural appearance and, to top everything off, it’s cheaper than most other resins.
What’s not so good There is a bit of flow back up alongside the tooth and the patient gets the taste of the anaesthetic. It’s quite bitter but you simply flush that away. Also, because the anaesthetic is under pressure, it can be a little bit tender the next day. I explain these negatives to the patient but they have never knocked it back. They consider the lack of numbness and the profound onset of the anaesthesia much more important.
What’s not so good The two biggest problems with resin are manageability and the range of colours that can be supplied. This product solves both those problems so I use it in 99 per cent of cases. Estelite Sigma is a slightly more translucent resin than others so if I come across a really opaque tooth, then I might use a different product. Realistically though, those cases are rare.
Where did you get it Erskine Dental. £
Where did you get it Amalgadent.£
Smart Dentin Replacement
4 mm in a single cast. • • • •
Increments up to 4 mm without layering Excellent flow-like cavity adaptation1 Compatible with your current adhesive2 Up to 60% less polymerization stress3
24 month clinical trial results on SDR are in*. In summary: • No observations of recurrent caries • No failures attributable to SDR • Did not cause any post-operative sensitivity • No observations of interproximal wear after two years • No adverse effects on gingiva in contact with SDR • No adverse events reported throughout the trial
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Top WOW Product
For more information, contact your local DENTSPLY Territory Manager or visit: AU: www.dentsply.com.au • 1300 55 29 29 • NZ: www.dentsply.co.nz • 0800 DENTSPLY (33 68 77) In comparison to posterior and universal composites. Chemically compatible with methacrylate based adhesives and composites only. 3 Compared to conventional light-cured Polymerization. * Data on file. 1 2
Your life Passions
Dr Tony Weir
Tony Weir Orthodontics, Brisbane, QLD
If walking the Kokoda Track has ever slightly crossed your mind as something you’d like to do, I can confirm that it’s a completely overwhelming experience. Obviously it has the military history but people don’t tell you about the beautiful scenery. It’s incredibly green and jagged and there’s so much to see in the forest. I walked the track in 2008 with my wife and a friend—and we did the whole thing in three days. We walked all through the day and often into the night. “Last year I took part in a charity event called the Kokoda Challenge that is held each year at the Gold Coast. It’s 96 kilometres long—the same distance as the Kokoda Track—and has 5000 metres of vertical ups and downs to be traversed. You have a maximum of 39 hours to finish, which is in honour of the 39th batYou have talion who fought 39 hours to on the Kokoda finish, which Track. The event is in honour is only open to of the 39th teams of four so battalion, myself, my wife Sharon, our Kowho fought koda buddy Craig on the Chuddley and Kokoda Track a dentist called Andrew Borer made up the team. Invisalign sponsored us and we finished in 15 hours and 55 minutes. We were the fourth full team to make it across the line and the first mixed team. “The money raised goes towards the Kokoda Challenge Youth Program. It takes kids who are in a variety of difficult circumstances on a 14-month program. A lot of training, team building and community service is involved in which they work towards their ultimate goal—walking the Kokoda Track. “We’re planning on entering the Kokoda Challenge again this year with a goal of 14 hours or less. There’s also the Oxfam 100 in Brisbane that my wife and myself are going to enter as part of another team. It runs for 100 kilometres. We’ve been doing a fair bit of training—these are both challenging events. £
JUN-AIR COMPRESSORS. ENGINEERED TO PERFORM.
or 8000 hours
Jun-Air compressors are designed specifically to do one job - and do it well. Deliver clean, dry air to your surgery day in, day out, with the minimum of fuss or maintenance. With a five year parts and labour warranty, backed by the service and support from West Coast Dental Depot, your Jun-Air compressor will provide you with consistent, worry-free performance. So get a reliable workhorse in your surgery â€“ ask for Jun-Air.
For your local distributor contact West Coast Dental Depot on (08) 9479 3244, fax (08) 9479 3255 or email email@example.com
e t th ss s a gre e u on 21 Se A C and AD St
SMS Reminders and Recalls Save 15 hours* monthly administration
Find out more about EXACT Visit us at the 34th Australian Dental Congress Brisbane Convention & Exhibition Centre Thursday 31 March â€“ Sunday 3 April 2011 Booths 22, 23, 33, 34 Stand 21
Australia Oasis National Support Centre, Suite 11â€“37 Heatherdale Road, Ringwood, Victoria 3134, Australia Phone: 1300 889 668 Email: firstname.lastname@example.org New Zealand Unit A3, 34 Triton Drive, Albany, North Shore 0632, New Zealand Phone: 0800 930 171 Email: email@example.com *Based on statistics from recent case studies
Published on Mar 9, 2011
Bite magazine is a business and current affairs magazine for the dental industry. Content is of interest to dentists, hygienists, assistants...