Bite September 2015 by Engage Media

SEPTEMBER 2015 $5.95 INC. GST

THINK ABOUT IT

Our guide to dental education Australiaâ&#x20AC;&#x2122;s leading dental magazine

On the go

Prepare your business for the mobile era

Dr Who?

Google is changing the way patients seek medical advice

Bright idea

Ways to reduce energy in your dental practice

The age issue To deal with an increasingly ageing population, Dr Janet Wallace is revolutionising oral health care for seniors

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CONTENTS

COVER STORY

September 2015

YOUR BUSINESS

28 ON THE COVER Ageing issue

As Australia’s population ages, we must change the way we administer dental health care to the elderly. Dr Janet Wallace is leading the charge.

YOUR TOOLS

YOUR LIFE

Contents NEWS & EVENTS

The dentistry profession unlocked The ADA and AMA take on Medibank, a decline in public patients, over-the-counter mouthguards prove risky, and more.

YOUR WORLD

The new doctor Patients are increasingly consulting Google over their dentist as a means of diagnosis.

YOUR BUSINESS

Mobile makeover As we take to our phones more and more, it’s important your website is mobile-ready.

Bright idea Dental practices are inherently energyconsuming, but there are ways to limit your electricity usage.

New products All the latest and greatest gear for your dental practice.

Product guide Bite presents the latest educational initiatives and courses in dentistry.

Tools of the trade The best and brightest professional equipment, as reviewed by your peers.

YOUR LIFE

On the ball 58 With a job that’s taken him around the world, Dr Stephen Tangney signs up for soccer as a way of making friends and keeping fit.

24 34 Editor Mitchell Oakley Smith

Sub-editor Kerryn Ramsey

Digital Director Ann Gordon

For all editorial or advertising enquiries: Phone (02) 9660 6995 Fax (02) 9518 5600 info@bitemagazine.com.au

custom content 9,502 - CAB Audited as at March 2015

Part of the furniture Innovative interior design can change the way your practice is perceived.

YOUR TOOLS

16 20

Art Director Lucy Glover

Editorial Director Rob Johnson

Sales Director Andrew Gray

Commercial Director Mark Brown

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 Webstar.

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References: 1. GSK Data on File, L2630368, October 2006. 2. Kiesow A et al. The potential damage from denture cleansing methods. Presented at IADR General Session and Exhibition. June 25–28, 2014; Cape Town, South Africa. 3. GSK Data on File, Lux R. 2012. 4. Charman KL et al. Lett Appl Microbiol 2009;48:472–477. 5. Bradshaw D. Microbiological effects of household remedies vs toothpastes and denture cleansers. Presented at the IADR General Session and Exhibition. June 25–28, 2014; Cape Town, South Africa. Polident is a registered trade mark of the GlaxoSmithKline group of companies. GlaxoSmithKline Consumer Healthcare, 82 Hughes Avenue, Ermington, NSW 2115. GSK1560/UC March 2015 CHANZ/CHPOLD/0003/15.

NEWS & EVENTS

COVER STORY

YOUR BUSINESS

YOUR TOOLS

YOUR LIFE

ADA and AMA take on Medibank

he Australian Medical Association [AMA] has publicly criticised Medibank Private for dismissing established safety and quality guidelines for their own standards. The criticism comes within a dispute between Medibank and Calvary’s private hospitals. Back in July, Medibank Private announced it would end its contract with private hospitals operated by Calvary after the two parties were unable to agree on rates and quality. Now the Australian Dental Association [ADA] has come out in support of the AMA, with president Dr Rick Olive applauding colleagues for sounding the alarm “about profitdriven private health insurers’ [PHI] increasing interference in the practice of dental care for patients; warning that such practices will spread into and impact on the hospital sector”. The dispute stems from a request from Calvary to Medibank for an increase in rates for services which the insurer said was unsustainable. Bite covered the story at the time. In that story, Medibank spokesperson

Andrew Wilson explained, “We believe it is essential, as a private health insurer, to encourage hospitals to maintain a focus on quality health outcomes for our members.” Dr Rick Olive said: “We applaud the Australian Medical Association’s take up of our warnings about the increasing threat to quality health care that for-profit private health insurers pose to the Australian community. The president of the AMA, Professor Brian Owler’s recent protests over Medibank Private’s attempts to impose penalty provisions as part of its contract negotiations with Calvary hospitals reflect that the health professions are coming to realise the gravity of the situation. “Australian Government policy effectively provides a permanent revenue stream and subsidies for Australia’s private health insurance industry to the tune of more than $6 billion through the Private Health Insurance Rebate, the Medicare Levy Surcharge and Lifetime Health Cover loading. However, the ADA has consistently called out a private health insurance industry that provides

policies that do not deliver value for money for consumers. The private health insurance industry’s policies in the dental sector impose lifetime limits, annual limits and exclusions that have no clinical basis. In fact, policy holders each year on average pay higher premium increases yet the rebate for dental care under these policies has not been revised to reflect the increased health CPI. “In other words, PHIs have been gradually skimping on their obligations to assist patients with accessing the care that they need. We can see these practices transfer over to Medibank Private’s recent contract terms they are seeking to impose on Calvary hospitals. “Although couched in the language of ‘quality’, these proposals are not based on evidence-based clinical best practice. If Calvary hospitals and medical practitioner groups are saying these provisions are not going to maintain safety and quality of healthcare of patients, one must question why Medibank Private continues to insist that these provisions be included." 

What underlies oral cancer metastasis?

n abnormal immune response or ‘feedback loop’ could very well be the underlying cause of metastases in oral cancers, according to Dr Marco Magalhaes, Assistant Professor at the University of Toronto and lead researcher in a study published in the journal, Microscopic image of squamous cell carcinoma (oral mucosa). Cancer Immunology Research. A/Prof Magalhaes has unearthed on neutrophils, immune cells commonly a significant connection between found in saliva and the oral cavity but the inflammatory response of a very not widely researched in relation to specific form of immune cells, neutrophils, oral cancer. Like other immune cells, and the spread of this deadly disease. neutrophils secrete a group of molecules, “There’s a unique inflammatory including TNFa that regulates how the response with oral cancers,” he explains, body responds to inflammation. citing the growing body of evidence The study noted that oral cancer cells between cellular inflammation and secreted IL8, another inflammatory cancer, “because the oral cavity is quite mediator, which activates neutrophils, unique in the body. A great many things effectively establishing a massive are happening at the same time.” immune-response build-up. A/Prof Magalhaes focused attention

Ultimately, the researchers found, the immune-response loop resulted in increased invasive structures known as ‘invadapodia’, used by the cancer cells to invade and metastasise. “If we understand how the immune system interacts with the cancer, we can modulate the immune response to acquire an anti-cancer response,” A/Prof Magalhaes said. While the study points to the possibility of one day creating targeted, personalised immunotherapies for patients with oral cancer that could effectively shut down the abnormal immune response, the team is currently expanding upon their study of inflammation and oral cancer. Approximately 3600 cases of oral cancer are diagnosed in Canada every year, yet the survival rates—approximately 50–60 per cent over five years—has remained stagnant for decades. 

Bite magazine

NEWS & EVENTS

COVER STORY

YOUR BUSINESS

Are we removing too many wisdom teeth?

n dentistry, it is common practice to remove impacted wisdom teeth, but a paper in British Dental Journal argues that dentists shouldn’t remove wisdom teeth unless the patient is reporting symptoms, such as inflammation or pain. The researchers stated that the typical impulse to remove wisdom teeth is financially driven rather than what’s best for the patient. Professor Marc Tennant of the University of Western Australia notes that in the United Kingdom, where evidencebased criteria was applied to wisdom tooth extraction, the number dropped dramatically. The UK National Institute for Health and Care Excellence guidelines state that only patients with symptoms should undergo wisdom tooth extraction, with unnecessary surgery potentially

leading to complications such as nerve damage and infection. In the paper, Professor Tennant calculated savings of up to $513 million per year in Australia—which includes indirect costs—if admission criteria to wisdom tooth extraction was applied. These guidelines would include steps such as X-rays every two years. At the time of writing, a number of research initiatives into wisdom tooth extraction was underway, with dentists on both sides of the argument. 

Rural dental services to continue

built semi-trailer, the service can provide ental health care by the everything from a simple check-up and Royal Flying Doctor Service clean through to an extraction or an X-ray. for remote communities in The service is due to visit communities in western New South Wales Blackall, Sapphire, Theodore, Collinsville and Queensland is set to continue. and Monto before the end of the year. The QCoal Foundation and the Meanwhile in western New South Queensland section of the Royal Flying Wales, the Royal Flying Doctor Service Doctor Service announced that its QCoal has announced the expansion of The Community Dental Service will remain in Outback Oral Treatment & Health place, marking a successful conclusion to [TOOTH] Program, which similarly offers this year’s Dental Health Week. patients in rural communities—including Having provided more than $2 million Bourke, Lightning Ridge, Collarenebri worth of free dental services to thousands and Goodooga—fly-in, fly-out services. in rural and remote communities across The organisation is set to employ an central and western Queensland since additional dentist and dental assistant 2013, the coal mining company’s following private financial donations initiative is a positive step in bettering from the western region, providing the dental health of those traditionally funding for a full year.  without the access afforded to those in metropolitan areas. “Thanks to this service, those living and working in rural and remote communities can now get the quality care they need on their doorstep, free of charge,” said QCoal Foundation chief executive officer Nino Di Marco. A QCoal Community Dental Service Delivered by two dental purpose-built mobile surgery. surgeries in a purpose-

6 Bite magazine

YOUR TOOLS

YOUR LIFE

Pacific Smiles Group formalises partnership with National Dental Foundation

ental care operator Pacific Smiles Group has announced a three-year partnership with the charitable organisation, National Dental Foundation, which provides free dental care to disadvantaged people. To date, more than 5000 patients have benefited from the National Dental Foundation’s care through the sponsorship of various foundations and companies and the support of volunteers. With the support of Pacific Smiles Group, the foundation will continue its work through alignments with charities including Salvation Army, St Vincent de Paul and Anglicare. “Our approach is to be both broad and localised at the same time, so we actively work to connect with organisations like Pacific Smiles Group and the Australian Dental Association to provide ongoing support at the macro level and allow us to connect with as many people as possible right around Australia,” said National Dental Foundation board chair David Digges. “This is complemented by our localised approach, where our State coordinators work together with individual dentists, practices and referring charities to deliver muchneeded dental services to some of our community’s most disadvantaged.” As a major sponsor, Pacific Smiles Group’s portfolio of dental centres —numbering nearly 50 throughout NSW, Victoria, Queensland and ACT —will help in the ongoing delivery of pro bono dental care. “Many of our people already give their time willingly and freely to support and provide dental services on Dental Rescue Days, while our organisation also provides facilities and consumables at no cost,” said Pacific Smiles Group chief executive officer John Gibbs. “This next step in formalising our support is one I am very proud of and which I look forward to developing over the next three years.” 

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COVER STORY

NEWS & EVENTS

YOUR BUSINESS

YOUR TOOLS

YOUR LIFE

Australians unaware of dental risks posed by sports drinks

mechanism against erosion, if teeth are ew Australians are aware of exposed to the acids in sports drinks, the dental health risks inherent too often saliva doesn’t have enough in the consumption of sports time to repair the damage. drinks, new research indicates. The ADA study suggested that greater In a study by the Australian Dental educational initiatives Association [ADA], the are needed to ADA suggests the following findings showed that half combat the high rate steps to help ensure greater of active Australians are of tooth decay from dental health: unaware of the damage sports drinks. “Over • Drink water where possible, sports drinks can do to the last few decades, which not only has no acid their teeth, with one-third the oral health of or sugar, but its fluoride of parents admitting to Australians has protects teeth. allowing their children to started to deteriorate • Avoid sipping sports and consume sports drinks and, in particular, we intra-workout drinks for at least once per week, are seeing higher a long duration. unaware of the dangers. levels of dental • Use a straw so teeth are One in three active disease,” said Dr less exposed to sugar Australian adults consume Peter Alldritt, chair and acid. sports drinks, which of the ADA’s Oral • Brush teeth twice daily with contain a high level of Health Committee. fluoridated toothpaste teeth-eroding acid, at In Australia, three • Chew a sugar-free gum to least once per week when in 10 adults have help stimulate saliva flow exercising. While saliva is untreated tooth to help protect teeth.  a powerful natural defence

decay and one in two children under the age of 12 have experienced untreated tooth decay in their permanent teeth. Alarmingly, one in five participants in the study admitted that they would not change their behaviour upon learning of the potential damage of sports drinks. In response to the research, the ADA has suggested the following steps [left] to help ensure greater oral health. 

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COVER STORY

Over-the-counter mouthguards pose risks

he Australian Dental Association has issued a warning against the potential dangers of over-the-counter mouthguards. Following a horrific dental injury, the Australian Dental Association [ADA] has reaffirmed its stance on the importance of customised mouthguards. Struck in the mouth with a hockey stick during a game in Tasmania last month, veterinary graduate Christina Johnson suffered severe trauma to the mouth, with one of her front teeth being knocked out, the fracture of another, the displacement and pushing back of multiple teeth, and lacerations to her lips and gums. “I hadn’t thought about getting a custom-fitted mouthguard from a dentist to wear when I play sport,” Johnson said. “I though the mouthguard I was wearing in the game was good enough. One girl on my hockey team wears a dentist-fitted mouthguard but the rest of us use the ones you buy in stores. I really want to get the word out about how important it is to use a custom-fitted mouthguard when playing sport.” Now facing extensive dental reconstructive surgery, Johnson is an example of ADA’s recent research, which found that three in four active Australians use an overthe-counter mouthguard rather than one custom-fitted, a detail highlighted during its recent Dental Health Week. The figure for children is one in two. “The ADA emphasises once again to active Australians, schools, sporting clubs and associations that as much thought needs to be given to the type of mouthguard worn as any other piece of sporting equipment,” said Dr Peter Alldritt, chair of the ADA’s Oral Health Committee. “Over-the-counter mouthguards are often difficult to wear and don’t provide the same level of protection as custom-fitted mouthguards.”  Patient Christina Johnson following a sports injury involving an over-the-counter mouthguard.

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NEWS & EVENTS

COVER STORY

YOUR BUSINESS

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NEWS & EVENTS

COVER STORY

YOUR WORLD

YOUR TOOLS

YOUR LIFE

The new do Patients are increasingly turning first to the internet when dealing with health issues, but as John Burfitt writes, Dr Google can confuse truth with conspiracy.

16 Bite magazine

tories traded between dentists of the extreme cases of patients diagnosing themselves by Dr Google are surprising, unusual and in some cases, hilarious. Run a Google search on the topic of Dr Google and watch the horror stories roll in, such as the patients who ‘diagnosed’ cancer from symptoms associated with infected toenails and acne on the arm. The dental cases about Dr Google are not much better, with claims including that root canal therapy will cause cancer, rubbing teeth with strawberries will whiten them, and that pregnant women should avoid the dentist’s chair. About a decade ago, a British newspaper dubbed the phenomenon ‘cyberchondria’—a term that has now

entered the medical lexicon. But rather than providing just funny tales to trade, it has become a point of serious concern for practitioners. Patients are accessing more information than ever about health conditions from a wide range of sources—from the Australian Dental Association’s website through to random conspiracy blogs. The information age that arrived with the digital revolution means that patients can make their own conclusions about all the possible reasons behind those sore gums or discoloured teeth. And in doing so, they can often misdiagnose common ailments or feel empowered to challenge well-researched clinical trials or medically based opinion. The process adds weight to the adage of British poet Alexander Pope that

ctor ‘a little learning is a dangerous thing’. “What we are seeing with all of this is a complete generational shift,” says Adelaide practitioner Dr Peter Alldritt, chair of the Australian Dental Association’s Oral Health Committee. “In our parents’ era, it was always a case of ‘doctor knows best’ and it would never cross a patient’s mind to go anywhere but a doctor for medical advice. “But with so much information now available, we are in a world where people no longer assume what they are told is best and will do their own research, either before or after an appointment.” Among the more extreme scenarios presented to Dr Alldritt by some well-read patients is that root canal therapy is linked to pathology in the body and must be avoided, and often pregnant women

are misinformed about the safety of dental procedures during pregnancy. Then there was the patient who informed Dr Alldritt that implants don’t work and he should not consider them. “I have piles of medical research that proves implants can be very successful and root canals are a great treatment option, but if you are dealing with a pessimistic patient who has spent a little too much time online, then you

Quote

have to be ready for that,” he says. “Then you need to explain what they are saying is not evidence-based at all and that you can only make recommendations based on scientific fact. There is a level of educating the patients that needs to be adopted.” One of the main concerns stemming from random online research by patients that Dr Michael Foley, director of the Brisbane Dental Hospital and member of the Australian Dental Association’s Oral Health Committee, encounters is about the safety of water fluoridation. There are myriad easily-found online reports linking fluoridation in drinking water and cancer, with some of the more extreme theories including the claim that the process originated with Nazi Germany’s attempt to control society. “I shake my head in disbelief at that one, but it is a theory I have heard again and again,” Dr Foley says. “Often, patients who come out with that have an agenda and have spent a lot of time looking for those particular outcomes, but I just say to them there is simply no real evidence to support those claims.” Dr Foley says one of the best ways to combat misinformation is to instead direct patients to reliable online resources containing accurate and upto-date research, such as the websites

Dr Peter Alldritt, Australian Dental Association

“In our parent’s era, it was always a case of ‘doctor knows best’ and it would never cross a patient’s mind to go anywhere but a doctor for medical advice.”

Bite magazine

YOUR WORLD

Quote

Dr Michael Foley, Brisbane Dental Hospital

“I find if they can see the difference between something that is healthy and something that is not, then that makes the point.” for the Australian Dental Association, Australian Medical Association and American Dental Association. “Having all that information out there is by and large a great thing, and I do encourage my patients to read up on their conditions, but there is also a lot of rubbish out there,” he says. “Issues arise as health professionals know how to sort the wheat from the chaff with misinformation, but patients have not had that kind of training and can be easily convinced of what they find.

I just try to add a dose of reality and common sense to those situations.” Common sense is the first tool Dr Nick Sheptooha says he reaches for when dealing with some patients in his Brisbane practice who arrive having already spent too long with Dr Google. He cites the case of the patient certain they had a problem with gum disease, when the reality was they had a piece of popcorn stuck between their teeth and had not flossed properly. “If their diagnosis is wrong or way

off the mark, I spend time on the camera and show them what is actually happening in their mouth and let them see the reality of what they are dealing with rather than letting their imagination run wild,” he says. “I find if they can see the difference between something that is healthy and something that is not, then that makes the point. I will always encourage people to take an interest and be informed about their dental wellbeing, but directing them to the best place to get real information can solve some problems for yourself later on.” It’s this point that Melbourne dental management consultant Julie Parker says makes up the core of her philosophy about dentists adopting a process that goes beyond maintenance and includes a more active role in educating patients. “My theory is to embrace a more educated and more healthresponsible public and play an active role in guiding them to better care for themselves,” she says. “Dental providers treat patients for the maintenance of their oral health, and part of this care is to educate patients—it always has been. In fact, it has been a challenge in days past to motivate dental patients to care more about their oral health. A more educated society has better chances of thriving.” 

As clients increasingly turn to Google for medical diagnosis, education and explanation at the clinic is becoming of greater importance.

18 Bite magazine

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NEWS & EVENTS

COVER STORY

YOUR BUSINESS

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Individualising the interior design of your dental practice sets you apart from the pack while creating a memorable experience for clients, writes Frank Leggett.

Part of the

furniture

he design of your practice speaks volumes about who you are as a professional and the nature of your business ethos. While it can be tempting to play it safe in regard to design—white walls, neutral furniture, maybe an aquarium or framed pastel artworks—there can be a distinct advantage in pushing the design envelope. Memorable design adds impact and acts as a point of difference to other dental practices. It becomes the memory that sticks in the minds of clients. When Drs Paul and Jacqueline Hanks purchased a dilapidated old house to set up Hanks Orthodontics in Mt Eliza, Victoria, they knew there was a lot of work to do. The seaside location made them think of flowing curves, natural light and interesting materials—and all these ideas appeared in the brief given to Sam Russell, director of Create Dental.

20 Bite magazine

“They had a beautiful, but run-down, old house that they wanted to convert into something modern and filled with light,” says Russell. “So, we proposed gutting the house, adding an enormous skylight and transforming the heart of the building into a huge light well.” “The minute we saw Sam’s idea of a central atrium, we loved it,” says Dr Jacqueline Hanks. “It was just the creative touch we were searching for and it adds so much light to the interior space. It’s an uplifting place to work.” And that was just the start. A sinuous spiral staircase is at the centre of the space around which is a treatment room with three chairs, a consult room, staff room, office and sterilisation room. All these spaces are open plan and exposed—even the sterilisation room looks like a display piece. Double-height glass goes all the way through the light well and all the rooms

front onto this area. It bathes the practice in natural light that transforms it into a stylish, contemporary space. Some of the walls have a rippled effect. “They are three-dimension panels inspired by sand dunes,” says Russell. “The downlights create interesting shadows on these feature walls, the curved glass walkways and joinery add to the fluidity of the design, and the wood grained tiles bring warmth to the practice.” Dr Hanks decided to leave the unassuming exterior of the building in its original state. “When people walk in, they really get a shock. There’s a sense of walking into something very special,” says Russell. “Utilising exciting design was a very good business decision. Hanks Orthodontics has been open for less than 12 months but I understand they are going flat out.” Dr David Cowhig owns Dental Wellness,

Left and above: An elegant spiral staircase anchors the light-filled atrium of Hanks Orthodontics, which features double-height glass for natural light.

a holistic practice at The Gap, a leafy suburb in Brisbane. This surgery integrates evidence-based anti-ageing medicine with up-to-the-minute dental technologies and techniques. During set-up, it was important to Dr Cowhig that the repurposing of his premises created an environment that reflected the philosophy of the practice. “I wanted to attract the wellness community to a boutique-style experience so as they entered the space, they knew they had found the dental choice for themselves, their friends and their families,” says Dr Cowhig. “I believe it’s important to have a clear picture of the clients you want to attract. Their first visit should be a visual, tactile and calm sensory experience.” Dr Cowhig used fit-out specialist company Elite to turn his holistic vision into reality. “The design of your practice reflects who you are as a person and what you are trying to achieve,” says Elite’s Ian Shapland. “Dental Wellness embraces its natural instincts by using dark timber tones and a simple palette of

Dental Wellness’s soothing tones.

greens and browns. While most practices strive for a look that’s efficient and clinical, this space is warm and relaxing.” To complete the look, a wall-sized panel that shows a cool, green forest of bamboo was added to the waiting area. The space is so Zen that it’s hard to imagine any client feeling nervous or apprehensive. “Individualised practices stick in the memory of new clients,” says Shapland. “It’s important that the balance is just right and clients feel comfortable when they walk in. At present we are designing another practice in Sydney where the owner wants absolute glam. While both of these practices are very different in their approach to the interior, they are each honest in the reflection of their respective characters.” Sometimes, one simple element of a design can characterise an entire

A wall-sized rendering of a bamboo forest creates a relaxing atmosphere in the waiting room of Dental Wellness.

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“We achieved a contemporary and

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Sam Russell, Create Dental

5/02/2014 10:39:56 PM

practice. Carrum Downs Dental Care in Melbourne’s south-east is a modern, contemporary surgery that features televisions on the ceiling and has embraced the latest in digital cameras, X-ray units and animations programs. “It was important to us that the aesthetics of our clinic matched our state-of-the-art technology and equipment,” says practice manager, Nicole Brown. They also turned to Create Dental to bring their design vision to life. “They wanted a warm and friendly environment with a modern edge to complement their dental technology,” says Russell. “We achieved a contemporary and streamlined look but felt it needed something else to lift the space out of the ordinary. The addition of a green floral wallpaper was the final piece of the puzzle.” This simple pop of colour—so different to the usual four white walls—is featured throughout the practice. It runs from the reception area all the way through the building, creating a feature wall in each room throughout the practice. They even mounted the X-ray units on it. “The green tone of the wallpaper is repeated in the upholstery of the dental chairs and it all ties together beautifully,” says Russell. “The bright green colour appears in their logo and the wallpaper pattern features on their website. When people walk in, they feel comfortable and relaxed, but their interest is engaged at the same time.” Individualising the design of a dental practice takes a deft hand. It needs to engage clients quietly without being too over the top. “A dental practice should be sleek, uncluttered and modern with a point of interest,” says Russell. “If you can get the balance just right then people will remember you, return to you and talk about you—and word of mouth is the strongest point of referral for your business.”  A pop of coloured wallpaper runs throughout the practice of Carrum Downs Dental Care.

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Mobile

makeover Google recently changed its ranking system for mobile searches, so it’s now essential that your practice’s website is mobile-friendly, writes Kerryn Ramsey.

24 Bite magazine

ix months ago, a ‘mobilegeddon’ took place, all thanks to Google’s new formula. The search engine had tweaked its search algorithm. While that may not sound like a life-changing event, think again. Websites are now viewed on different devices, be it a smartphone, tablet, laptop or desktop screen. Despite this, many websites aren’t mobilefriendly—the text is tiny, sites take a long time to load, with too many graphics. So, it’s essential that your dental practice website can be displayed effectively on multiple screen sizes or it will quickly drop to the bottom of Google’s rankings.

numbers—not to mention a dip in sales. So, to make sure your patients can view and navigate your content, find your phone number and location and book an appointment, it’s time to give your tired website a facelift. Responsive web design is now a necessity for businesses, says Michael Marler of Advisori, making the features and functions on your site accessible on a patient’s mobile device. “The beauty of this is that each time your practice manager changes an opening time, or adds some cosmetic before-and-after images, it will fit the screen perfectly on any computer or device.” This appealed to one of Marler’s clients, Dr Steven Slowgrove—a dentist who has run his own practice in the Sydney suburb of Miranda for the past 20 years but had never had a website.

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images and graphics, they need to be responsive—in other words, they need to be resized to work on each device. In fact, if a practice has a website that’s more than three- or four years old, according to Marler, it’s probably easier to start from scratch. “For older websites, it takes a lot of time to make all of the content work responsively across different screen sizes. Most of the time, a brand new website will save time and deliver better results.” This was a case for Rosebery Dental, which is located in one of Sydney’s fastest growing suburbs. The practice turned to web designer Chris Harold to make its website more dynamic and to improve its presence online. “They realised that search engine optimisation and having a ranking within Google is imperative these

Michael Marler, Advisori

“If your website doesn’t pass Google’s official mobile-friendly test, you’ll likely be pushed below other, more mobile-friendly sites.”

Over the past five years, there’s been a shift in the way consumers—including patients—search for information online. These days, people are surfing the web from mobile devices rather than desktop computers. In fact, mobile web traffic overtook desktop usage in 2014, with around 60 per cent of online traffic now generated by mobile devices, according to research firm ComScore’s report mid-last year Embracing this change, Google’s new algorithm changes the mobile search results, giving preference to mobileready websites. In other words, if your practice’s site isn’t fully optimised for mobile, it’s likely to dip in user

“Basically, our practice is 85 per cent word-of-mouth, but my wife suggested it was time for a modern approach,” he explains. “We realised that a lot of younger people were searching for dentists online, so setting up a website wasn’t a bad idea.” Launched just over six months ago, Slowgrove Dental’s website had a responsive web design from the outset. For Dr Slowgrove, the website needed to show the business’s family feel. “That’s the basis of the practice,” says the dentist, who selected images of the practice’s interior, its staff, and even some fun artworks by young patients. “That’s why we took our own photos, and luckily, Michael was happy to turn this into a professional website.” When it comes to managing

days,” said Harold, who revitalised the site and provides the practice with a monthly report. “I’ve implemented a premium site for the practice but it still has a relatively simple layout.” The website’s responsive design went live more than a year ago and, according to Harold, the traffic continues to rise. So, if your dental practice has a website that doesn’t meet Google’s mobile standard, it’s time to turn to your nearest web consultant or your website host. “Responsive design involves creating one website that dynamically changes how the information is displayed according to the screen size of the user,” Marler explains. “You will normally start with the ‘full version’ of the website and then decide what the most important

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elements are for viewing on different devices. This is also a great time to ensure that potential customers can find all of the information they need quickly and easily on your website. “An example of this would be making the phone number more prominent when a customer views your site from a phone. It makes the customer’s life easier and makes it more likely they will convert by removing friction from the process.” In terms of maintenance, a responsive design is more cost effective as your practice only needs to work on one platform. “I was amazed at how swift and simple it is to run,” says Dr Slowgrove, who is happy for his staff to maintain the site. According to Harold, it’s worth refreshing your website every two or three years. The Rosebery Dental website is on a content management system [known as a CMS] that makes content and images easy to update. “Making quick changes to copy takes virtually no time at all,” he says.

If you’re wondering if your practice’s website is mobile-friendly, Google offers a free 30-second test. Visit https://google.com. au/webmasters/ tools/mobile-friendly/, then enter the URL of your website (for example, slowgrovedental.com.au). It will instantly return whether that website passes all of Google’s tests. This is the factor that affects how sites are ranked in Google’s search from mobile phones. Common problems include texts that are too small to read, content is wider than the screen, and mobile viewport is not set (that makes sure viewers don’t have to scroll horizontally on your website to see everything). “If your customer is searching from a mobile device and your website doesn’t pass Google’s official mobile-friendly test, you’ll likely be pushed below other more mobile-friendly sites,” explains Marler.

Websites today need to function on a number of devices.

“Even if you’re a well respected site with positive reviews, your rankings will still take a significant hit.” For some websites, a few minutes of online tweaking may be all that’s required, but be prepared—a full redesign may be necessary. Before you contact your web specialist, take time to view your website on different devices, then figure out which elements should be prioritised. Once your site is responsive, it will be more appealing to both prospective clients and regular patients. 

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28 Bite magazine

COVER STORY

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Ageing issue Faced with an ageing population, Dr Janet Wallace is finding new ways of offering oral health care to the elderly, writes Samantha Trenoweth.

r Janet Wallace wants to revolutionise the way we provide oral health care to older Australians. “There is a dire need for oral health services in residential aged care facilities, particularly preventative oral health services,” she explains. Dr Wallace, a registered oral health therapist with qualifications in dental therapy, dental hygiene, business management, tertiary teaching and a PhD in oral health, acknowledges that many have tried and failed to deliver better oral health to Australia’s increasing population of elders. However, with the help of her students and colleagues at the University of Newcastle, she believes she has devised a system that’s inexpensive, efficient and, most crucially, works. Dr Wallace wasn’t always a revolutionary. Born in Brighton, United Kingdom, she was the eldest of four children. She moved to Sydney with her parents at age 11 and was, she concedes, perhaps a little bossy—“a kid who liked to take control” —but never one to overthrow a system. “I’ve always liked to find a solution to things though,” she admits. “I don’t like it when people say that something isn’t possible. I tell my students and my family [of two children and three grandchildren] that there’s only one thing in life you can’t fix and that’s death. To every other problem, there is a solution.” It was while she was working in a conjoint position at University of Newcastle, in 2008-’09, that Dr Wallace first understood the immensity of the oral and dental health problem facing older Australians—particularly those in residential care—and she resolved to fix it.

She was setting up a student placement program in aged care facilities on the New South Wales Central Coast and, she says, “because of the feedback the students provided and because of what I saw myself in the facilities, I realised there was an enormous need for preventative oral health care with links and referral pathways to dentists, and I became passionate about trying to provide this”. “Good oral care reduces the risk of aspirational pneumonia, it can reduce admissions to hospital, it makes residents more comfortable, it enables them to eat a wider variety of foods and enjoy their food more,” she explains. “It’s about quality of life. It has the potential to create a lot of positive outcomes.”

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studies that investigated and evaluated the student placement program over five years. She identified the challenges that the program faced and came up with some innovative solutions. “An aged care facility is a challenging environment to be a student in,” she points out. “Imagine being a very young person, who possibly doesn’t have any elderly relatives in their immediate family, walking into a facility where people have dementia and Alzheimer’s, where people are sick and dying. It can be very confronting and some students had huge issues, initially, with nervousness and feeling overwhelmed by it.” Dr Wallace realised that if the placement program was to succeed,

Dr Janet Wallace, University of Newcastle

“I tell my students ... that there’s only one

thing in life you can’t fix and that’s death. To every other problem, there is a solution.”

However, in spite of good intentions, there was not a lot of good oral care in evidence in the facilities she visited. The staff needed help and the student placement program was a start in assisting them. It rolled out to around 17 local facilities with the aim of “addressing some of the significant issues that we knew existed in residential aged care and also giving the students an experiential learning opportunity to increase their knowledge and skills”. Determined to investigate the problem further, Dr Wallace undertook PhD

students needed to be better prepared not just for the technical aspects of work in these facilities, but for the emotional impact as well. In response, she developed a day-in-the-life training DVD to help them. The DVD made a world of difference. Students who watched the DVD settled into the placement in half the time, felt comfortable with the work and valued the experience more than those who didn’t. “These placements are still part of our Bachelor of Oral Health Therapy degree here at Newcastle,” she says,

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Dr Janet Wallace is revolutionising the way we provide oral health care to the elderly.

“and now all students watch the DVD.” A number of her students have also gone on to work in aged care facilities after graduation. “Working in aged care is not for everyone,” Dr Wallace admits, “but if you’ve been on a student placement and you’ve had some firsthand experience, then I think you’re more likely to pursue that after you graduate.” And that is crucial to Dr Wallace’s revolution because she ultimately wants to see an oral health therapist or dental hygienist in every aged care facility in Australia. She has already made a start. In 2013, she received a grant from Medicare Local Erina to put a qualified hygienist into five facilities on the Central Coast and investigate the results. “That research project was very successful,” she says. “It showed us that we need someone in these facilities who has an oral health background with a preventative focus—that we need dental hygienists and oral health therapists—because, without them, oral health in a lot of facilities is still managed in an ad hoc fashion.” Out of that research, Dr Wallace has developed what she calls the Senior Smiles model. The linchpin of the model is the dental hygienist or oral health therapist who she describes

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Dr Janet Wallace, University of Newcastle

“It showed us that we need someone in

these facilities who has an oral health background with a preventative focus.”

as a “boundary spanner” and who becomes the link between centre staff and management, residents, their families and public and private dentists outside the facility. “In the Senior Smiles model, the hygienist or oral health therapist only needs to visit the facility perhaps once a week. They do oral health education, risk assessments and care plans. They look at what sort of toothpaste the residents need, check whether they need something for dry mouth, whether they are in pain, whether they need a referral to a dentist, and so on. Once they’re embedded in the facility, they can manage things like consent, medical history, appointments, even transportation, and that makes the dentist’s role so much smoother. “The oral health therapist will have a referral pathway set up to a private practitioner within the area and to the

public sector if the resident qualifies for public sector dentistry.” The Senior Smiles model is already up and running in a handful of Central Coast and Hunter Valley facilities, and negotiations are underway with health funds in the hope of introducing the model more widely. Dr Adam Barrett at Seascape Dental at the Entrance, also on the Central Coast, has been working with the program. Dentists from his practice have travelled to the facility, with portable equipment, to see residents who couldn’t be transported to the surgery. For those who could travel, Seascape Dental provided a transport service to and from the practice at no cost to the resident. “He has been fantastic,” she says. Dr Wallace speaks highly of a previous model, Better Oral Health in Residential Aged Care, which provided training resources for carers, and Senior Smiles

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Dr Wallace intends to roll out her Senior Smiles program nationally.

32 Bite magazine

still uses many of those resources today. However, she believes the ‘train the trainer’ model was only partially successful because “there are many, many demands on staff in residential aged care facilities and they do their best but they can’t do everything”. “My model goes one step on from that,” she insists. “Facilities have physiotherapists and podiatrists who go in. To manage oral health, we need oral health practitioners to go in too. We need professional people who are trained in that area.” The Senior Smiles model is much needed now and, she points out, demand is going to escalate quickly in years to come. “There is already a huge demand and we have an ageing population. That is something we need to look at and plan for on a long-term basis. Senior Smiles is a model that works and can be transported anywhere. It’s just a matter of getting those key people involved, especially practitioners who are interested in oral health for the elderly. “Elderly people are in their most vulnerable stage of life and being able to provide them with a level of preventative oral health care in the facility is of great benefit because we know that oral health is linked to good general health. “By enabling that on a day-to-day basis, by getting the residential care facility staff trained up to sustain that, and giving oral health a higher profile within the facility because you’ve got someone in there regularly, and then by building that link with private and public sector dentists, it creates a complete model of care.” In the immediate future, Dr Wallace is negotiating with more centres and health funds to take on Senior Smiles, and has just expanded the student placement program to the geriatric rehabilitation ward at Woy Woy Hospital. “I really am committed to getting oral health practitioners into all aged care facilities and hospital wards,” she says. “It’s my job but it’s also something I’m passionate about. There are so many things I want to achieve that I can’t imagine ever retiring. I’ll probably be the oldest academic in history.” 

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Bright idea Electricity generates a significant cost to dental practices, but as Angela Tufvesson details, there are ways to reduce your spend.

Upgrading from fluorescent to LED lighting will help reduce energy consumption.

34 Bite magazine

unning a dental practice is implicitly energy intensive thanks to the lighting, air-conditioning and, of course, dental equipment required to operate a successful business. But as electricity bills and consumer awareness of environmental issues continue to rise, reducing your carbon footprint is becoming greatly more important. So, what’s the best method for practice owners looking to curb electricity costs? Decreasing usage, installing energy saving equipment and investing in renewable energy—in that order—will help to reduce your bills by as much as one third. “In my business, I guarantee that if the property hasn’t had an energy audit or any work done, I can reduce their energy bills by 20 per cent with no capital outlay—or there’s no fee,” says River Bradshaw-Milnes, managing director of energy efficiency consultancy Thinq Tanque. “There’s such a margin that I can say unequivocally that if the proper work is done on any property, they should be able to reduce their energy bills by at least 30 per cent.”

Understand your usage

Switch off

In order to cut back, it’s important to understand your electricity usage. Bradshaw-Milnes estimates that in a typical dental practice, about 30 per cent of the energy consumed powers heating and air-conditioning, 20 per cent goes towards lighting, 10 per cent keeps computers running and the remaining 40 per cent is chewed up by dental equipment and other miscellaneous uses. Your electricity bill will detail the amount of kilowatt hours used by your practice, and many energy companies also offer nifty online tools that chart usage patterns. For a more accurate picture of your consumption, BradshawMilnes recommends an energy audit, which typically costs about $1500. “An energy audit will tell the business how much energy is being consumed by which items,” he says. “So, if there are five computers in the practice, an energy audit will be able to tell you the amount of watts per day that they’re using over 365 day of the year. After that, it’s possible to calculate the monetary value as carbon emissions of the devices.”

After you’ve looked at usage patterns, the next step is to get practice staff into the habit of switching off lights, computers and equipment that is not being used. This includes equipment left on stand-by mode, especially overnight, which can amount to 10 per cent of your electricity bill. “Look around the practice—is there anything running that doesn’t need to run?” asks Barbara Albert, director of Sustainable Business Consulting. “Anything that gives off light or heat probably consumes electricity. This is the easiest way to reduce your energy bills because you don’t need to change anything. It’s simply a matter of turning things off.”

Look to your electricity bill to better understand the breakdown of your practice’s energy consumption.

Savings of up to 10 per cent can be made simply by switching off equipment.

Upgrade equipment Next, look at upgrading your equipment Sustainable Business Consulting —including heating and air-conditioning units, lighting, computers and dental equipment—to energy-efficient models where possible. Surprisingly, making the switch now rather than waiting until equipment becomes faulty can lead to significant savings. “If you’re running a really old air-conditioner, throw it out and get a new one as they run 30 to 40 per cent more efficiently,” says Bradshaw-Milnes. Albert agrees that upgrades that focus on the total cost of ownership —the acquisition and running costs combined—will lead to long-term savings. “For example, upgrading from fluorescent tube lighting to LED tubes will reduce energy consumption. It’s more expensive to purchase

LED tubes but the running costs are so much better. They might also give you better output from the light as LEDs are brighter, meaning less lights are needed.” After completing the upgrade, establish a maintenance schedule to protect the efficiency of your equipment, and make sure it’s operated correctly. “If you have five split-systems in the property and each is running at slightly different temperatures, each of those systems is fighting each other to maintain a specific temperature,” says Bradshaw-Milnes. “So, it’s recommended that each split-system is set to the same temperature. The recommendations are to have your air-conditioning set to 24 degrees during summer and your heater set to 18 degrees in winter.” And to make sure your air-conditioning units aren’t working too hard, consider passive design upgrades to your building to help it stay cool in summer and warm in winter. Shade windows during summer, and install ceiling insulation and draught-proof windows and doors. Ceiling insulation alone can reduce your electricity bill by 20 per cent.

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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 51. 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 the Editor at info@engagemedia.com.au, and she’ll tell you what’s involved.

36 Bite magazine

Barbara Albert, Sustainable Business Consulting

“Solar panels are beneficial for dental practices because production peaks around lunchtime and starts revving up at around 9am.”

Invest in renewables Once you’ve reduced your energy consumption to the smallest possible amount, consider generating your own electricity rather than buying off the grid. For most dental practices, this means installing solar panels, which Bradshaw-Milnes says can reduce electricity bills by 70 per cent and offer a three-year return on investment. Solar panels are well suited to dental practices because peak harvest times coincide with the daytime opening hours of most practices. “Solar panels are extremely beneficial for dental practices because production peaks around lunchtime and starts revving up at around 9am,” says Albert. “There’s not a lot of maintenance, either—the system gets installed, connected and just runs. It’s very simple. If you have the option, the roof needs to be ideally north-facing and can’t be obstructed by trees or other obstacles.” Due to low feed-in tariffs—the payment per kWh made to businesses and households generating their own electricity—Albert says there’s little value in exporting excess electricity to the grid, which means practices will need to fork out for electricity outside of peak harvest times and on cloudy days. But the good news is on-site storage systems are expected to come onto the market within the next two years, says Bradshaw-Milnes. “This means dental practices will be able to go off grid,” he says. “The future is really bright. There is the potential for 100 per cent savings within the next three to four years.” 

Solar panels offer great reductions in purchased electricity.

Custom made mouthguards. THE ONLY WAY.

Provide your patients with the right protection. A recent survey by the ADA shows 75% of active adults who wear mouthguards wear uncertified, over-the-counter products. Not all mouthguards provide adequate protection. Custom made mouthguards are the most effective way to avoid injury. 03 9650 9779 / proformaustralia.com.au

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Paper giants Education is the underpinning of the dental profession. Here, discover the best and brightest courses and initiatives in Australia today.

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Education guide Educating for prevention

uring the latter part of the 20th century tooth decay among Australian children was in decline. When dental graduates finished their education in the 1970s, dental caries was present in the majority of children and the adult population expected the same edentulous retirement as their parents. Dental education and the common perception teeth could last a lifetime did not exist. The decline in dental decay during the 1970s can only be attributed to better education. While fluoride played some part, improved dental care and hygiene along with diet modification, driven by the dental profession, must be given credit. Unfortunately, once again the frequency of dental decay has started to increase, particularly in young children. However, while the prevalence of tooth decay has increased and is one of the main reasons children are admitted to hospital, the vast majority of dental disease is easily preventable. According to a study conducted by the London School of Hygiene and Tropical Medicine, which analysed the effect of sugars on tooth decay, sugars are the sole cause of tooth decay in children as well as adults. With their greater consumption of highly processed high sugar content foods as well as soft drinks, cordial and fruit juices coupled with lower consumption of whole foods such as fruit and vegetable and tap water it stands to reason that modern children will be experiencing increased dental disease. Unfortunately, this decline in the quality of diet and nutrition is not only responsible for oral health issues; it is also causing a wide range of other health problems. These problems include diabetes, obesity, malocclusion and sleep disorder breathing. However, despite concern regarding this upwards trend in dental caries and malocclusion as well as sleep disorder breathing (SDB) and the challenges this presents to the

40 Bite magazine

dental profession, there also exists an opportunity for dental professionals today to provide educationally focused and preventive solutions for these issues. Myofunctional Research Co. (MRC) has recognised the vital role education must play in reducing dental decay as well as SDB and has integrated a significant diet and nutrition educational package into the Myobrace® Pre-Orthodontic and myOSA® myofunctional sleep treatment systems. By presenting a child focused digital video series in a format designed to be interactive, engaging and easily applied, the animated diet and nutrition program aims to help children and their parents recognise that the causes of tooth decay, which also directly impact growth and development of the jaws and face, are preventable. Once a patient’s dietary and nutritional deficiencies have been addressed and they understand how a healthy diet provides a vital building block for their overall wellbeing, malocclusion and SDB can then be more effectively treated in growing children. MRC’s patient educational media place a wealth of information regarding how to address then overcome the causes of malocclusion and SDB in the hands of the patient. In addition to helping overcome diet and nutritional factors limiting growth and

development, the apps, which work in conjunction with MRC’s myofunctional appliance systems, educate patients about why it is necessary to correct any poor myofunctional habits. Through education these digital programs empower patients to play an active role in their own treatment and provide the potential for superior treatment outcomes. When taking into account the wellpublicised oversupply of dentists and corporatisation of the industry along with diminishing returns the possibility for modern dentists to offer preventive health solutions becomes particularly timely. In addition to maintaining a child’s dental health, there exists an opportunity for dental professionals with a focus on education to enhance a young patient’s facial development as well as long-term general health and quality of life. Preventive paediatric dentistry along with preventive or pre-orthodontic treatment, with an emphasis on empowering the patient through education offers the industry a growing, potentially lucrative new treatment avenue.  To find out how to begin implementing these programs as well as the Myobrace® and myOSA® myofunctional treatment systems into your practice visit the courses section at myoresearch.com.

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Education guide A plethora of new courses through ADA

ow that we are in the final year of the current three year CPD cycle, we recommend booking courses well in advance to avoid missing out on your course of choice during the general rush to obtain the full 60 hour CPD quota by 30 June 2016. Dental practitioners must complete 60 hours of continuing professional development within three years, with 80% of CPD to be clinically and scientific-based. At ADA NSW Centre for Professional Development we provide a range of clinical and non-scientific programs with constant additions throughout the year. Our calendar for 2016 is already actionpacked with a variety of topics by a terrific lineup of expert local and international presenters. Our distinguished speakers provide up-to-date clinical tips and share their best methods they have acquired through their many years of dental practice. Our courses are followed up with a reading list of articles available through our ADA National Library for further study. The ADA National Library resides in the ADA NSW CPD building, so while you are attending one of our courses take the time to visit the library to see what other additional resources are available to you. Our friendly library staff will assist you in accessing all information relevant to your study. ADA members throughout Australia can access the ADA National Library services for free as part of their member benefits. Email library@ada. org.au for further information or visit the ADA National Library website at ada.org.au.

42 Bite magazine

At CPD we like to keep our systems up-to-date to align with the fast changing technology; at the beginning of this year we launched the ‘CPD Learn’ app. This app has many advanced features including notification alerts informing you of newly added courses and updated news and information, the ability to mark your favourite courses, set your own calendar reminders and retrieve directions to any course venue directly on your device. The app is available free from the Google Play and iTunes app stores. In our Clinical Training Centre we have developed a new touch screen

system that provides x-ray images directly to your workstation, maximising your hands-on time and minimising wait periods for our endodontic programs. When you register for one of our courses, a personal account will be set up on our website which gives your ability to keep track of your CPD hours completed with ADA NSW CPD. After each course a certificate will be available for download and your CPD transcript will be updated for all hours attained through us. This information will be available for you to access at any time and can be downloaded instantly.  To view a current list of upcoming programs for 2015 and 2016 visit adacpd.com.au. Don’t forget to book in early and keep up to date with your professional dental development.

CPD courses keep a step ahead, so you won’t be left behind.

Dental clinic in the 1900’s.

ADA NSW Centre for Professional Development delivers programs with the most up-to-date dental clinical skills, techniques and research. We help dental practitioners develop new skills, or improve existing skills, through high quality, engaging courses by leading practitioners. Our comprehensive range of courses will keep you informed of the latest materials, techniques and technologies. To see our current list of program visit www.adacpd.com.au

CPD. What’s next? www.adacpd.com.au

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Education guide Getting to know the CEREC

he Sirona Centre for Dentistry is a dental technology training and education centre, showcasing Sirona’s many innovations, comprising a 20 station simulation clinic for hands-on training, lecture and conference rooms for small and large groups, four fully functional surgeries, a hygiene and sterilisation room, digital dental laboratory, 2D/3D X-ray and more, all taking training and education to another level. The centre allows trainers and educators to interaction with Sirona’s product specialists, share in their passion for dentistry and to provide professional technology training and on-going support to all of Sirona’s customers across Australia and New Zealand. As an example, the purchase of a CEREC begins with the practitioner receiving in surgery training and support by a team of CEREC specialists from day one. Part of the package is a comprehensive training program which includes a ½ days initial orientation followed by a two-day program for new owners focusing on posteriors restorations. At the end of each training, the CEREC specialists follow up with the clinicians. Once new owners have familiarized themselves clinically and applied CEREC restoratively for a period of time, they are invited to a two-day clinical workshop with Dr David Roessler (Prosthodontist) at the Centre for Dentistry in Sydney. Clinical workshops are limited to 12 participants, giving each clinicians the ability to engage with Dr Roessler on a one-on-one basis as opposed to a large lecture environment. David addresses clinical best practice, challenges in addition to addressing latest bonding, preparation and finishing protocols amongst others.

44 Bite magazine

Furthermore, the Centre offers a two-day jumpstart course.With two clinicians to a machine, the group covers the entire concept of using the system, ensuring that at the end of training, the clinicians feel empowered and confident to start treating patients. These courses are not only for dentists who have inherited a practice with a CEREC, or joined a practice with a CEREC or bought a pre-loved CEREC, but also for those who are interested in chairside single appointment restorative dentistry. The two-day course takes the clinician through the whole CEREC procedure in a very comprehensive way. During the course, two CEREC specialists are also present to assist as support staff, giving the clinicians the attention they require. In addition to the training courses throughout the year, Stephen Beckedahl, CEREC Technical Support Manager is also the Hotline support person for remote assistance. Due to the high demand, CEREC Jumpstart courses are now available

bi-monthly at the Centre. At Sirona, the delivery of new technology initiates the start of a longterm relationship and on-going training and support. “I have had clients for the last 10 to 15 years who will call me for a chat which turns into a training session, in which we at no additional costs share knowledge. It really is on-going with new materials, software and applications coming about every day, be it restorative, orthodontic or implant CEREC related!” said Martin Capstick, CEREC Specialist NSW and Clinical Training Manager.  For information email info@sirona. com.au or phone 1300 747 662.

DATE

COURSE

21 Oct

Laser Workshop

2 Nov

CEREC ACCEPT – Hands-on Workshop

3 Nov

3D X-Ray ACCEPT – Hands-on Workshop

11 Nov

NSW Sterilisation, Instruction Processing and Tracking Course

20 & 21Nov

CEREC Jumpstart Course – L2

24 & 25 Nov

CEREC Clinical Workshop with Dr David Roessler

4 & 5 Dec

3D X-Ray Radiography & Applications course

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THIS PAGE CONTAINS STEP 1 STEP 23 STEP 3 2 HOW HOW IT WORKS: IT WORKS: Download the free Open the Layar app, Hold your phone INTERACTIVE CONTENT, 1 been ine have tal giapp for iPhone hold the phone above above the page to di n USE YOUR SMARTPHONE The pages in thLais yamagr anazlayar ai d cont g your d with ew usin enriche can vior u yo Android. the page and tap to view the interactive at th FOR SCANNING: content ne. smartpho : scan it. content. WORKS HOW IT e Step 1: Download Step 1:the Download free Layar the free Layar Step 2: Look Step for 2: pages Lookwith for pages with Stepthe 3: Open Step the3:Layar Openapp, the Layar Step app, 4: HoldStep your4:phone Hold your above phone above one abov Call 1300 747 662 or email info@sirona.com.au tothearrange an appointment to see the incredible ld your ph teractiveof this system. Hofeatures app for iPhone app or forAndroid. iPhone or Android. Layar logo. Layar logo. hold the phone hold above the phone the page above the thepage page tothe view page theto interactive view the interactive Step 4: w the in view this page

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Education guide Join the leaders in innovation and diversification AADFA—the first, best and most respected

ix years ago a dynamic and progressive organisation emerged on the Australian dental scene that radically changed what it meant to be a dentist. That same organisation continues to evolve and grow the profession in new and exciting ways today. The Success Story The Australasian Academy of DentoFacial Aesthetics (aadfa.net), was founded on the premise that in today’s modern world, dentists need to be innovative and continually grow the types of services they offer to their patients in order to survive, remain relevant and, more importantly, thrive through increasingly tougher times. AADFA pioneered the concept of “complete dento-facial aesthetics” in Australia and began to lobby regulators for the right of dentists to blend extraoral aesthetic treatments, like botox and dermal fillers, with their existing intra-oral therapies for better patient outcomes and increased ractice profits. While other groups have been unsupportive, AADFA was the only organisation willing to stand up for the rights of the profession and to offer extensive training and support to dentists entering this field. As a result, AADFA is responsible for successfully having these procedures accepted as part of a dentists scope of practice and have now trained more than 2000 dentists in the use of botox and dermal filler therapies.

But AADFA didn’t stop there. Continuing to raise the bar in quality education, AADFA has been engaged to write the new facial aesthetics module as part of the Masters of Aesthetic Dentistry at Kings College London and are now the only botox and dermal filler training provider, recognised and accredited in eight countries. AesthetiCon—Australia’s first aesthetic dental conference After achieving success in lobbying for change in the profession, AADFA then set it’s sights on overhauling the stale concept of a dental conference. Realising that traditional dental conferences in Australia rarely included a focus on progressive technologies, materials and techniques, especially in regard to aesthetic dentistry, AADFA developed the concept of AesthetiCon, which has just been held in Sydney and received rave reviews. AesthetiCon was the most exciting event to hit our shores in many years. It lived up to it’s promise to be as entertaining as it was educational with some of the world’s leading names in aesthetic dentistry gathered under one roof to participate in a circus-themed extravaganza. Don’t miss the next AesthetiCon, scheduled for 2017. What next for AADFA? AADFA continues to offer support for existing trainees and now offers free ongoing practical training and clinical mentorship across the country from a team of trainers in each state.

Lobbying continues on a number of issues within the realm of aesthetic dentistry, including the abolishment of shopping centre teeth whitening booths and AADFA is excited to focus on developing new opportunities for dentists to broaden their horizons, to be progressive, innovative and diversify their practices in order to thrive well into the future. As such, AADFA is launching a vast array of brand new training courses in 2016. These new courses will focus on further developing the ability of dentists, hygienists, therapists and auxiliary team members to offer in-demand facial aesthetic and therapeutic procedures within their practices. Everyone knows that offering more to your existing patient base is a more certain path to success than trying to recruit new patients for the same old service and AADFA is excited to be introducing the following opportunities in 2016: • Platelet Rich Plasma (PRP) and Concentrated Growth Factors (CGF) for intra-oral and extra-oral use; • PDO thread lifts; • Cadaver dissection for implants and facial aesthetic procedures; • Intra-oral and extra-oral laser rejuvenation techniques. AADFA looks forward to meeting many more dentists in 2016 and to helping them achieve greater success, more personal and profession satisfaction, as well as thriving practices full of very happy patients that are cared for as more than just a set of teeth.  Complete dento-facial aesthetics —a smile doesn’t end with beautiful teeth, nor do dentists.

46 Bite magazine

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Education guide

Penthrox® (methoxyflurane) —an effective analgesic agent1,2

enthrox (methoxyflurane) is manufactured by Medical Developments International (MDI) in Melbourne and has been used as an analgesic agent in Australia for over 30 years1. Penthrox is also currently registered and available in New Zealand, South Africa, Guatemala, Azerbaijan, Kazakhstan, Georgia, Moldova, Ukraine and Armenia. MDI expects Penthrox to be registered and available in the major markets of Europe over the next 12 months, starting with the UK and Ireland where preparations are well advanced for a launch during 2015 and followed shortly after in France and Belgium, subject to mutual recognition regulations. Over the last 30 years, methoxyflurane has been safely selfadministered by patients through the Penthrox inhaler, supervised by trained and authorised staff1,2. Benefits of Penthrox include a rapid onset of analgesia with patients simply inhaling the agent under their own control1,2. The gradual offset preserves the methoxyflurane effect for a few minutes after administration has stopped3. A randomised, double-blind, multicentre, placebo-controlled study was carried out at six hospital emergency department sites in the UK between August 2011 and July 2012. A total of 300 patients presenting with acute pain due to injuries were randomised 150:150 to receive either Penthrox or placebo (saline). Penthrox was described as well tolerated with

the majority of adverse events mild and transient1. The authors concluded Penthrox is “an efficacious, safe, and rapidly acting analgesic”1. Penthrox in the dental practice can be used as an analgesic option2 in various situations, such as initial examination, patients in pain, emergency situations, prior to the administration of a local anaesthetic, removal of temporary crowns or bridges, extractions, ultrasonic or hand scaling, suture removal and so on. In 2014, the Dental Board of Australia updated its guidelines on conscious sedation (DBA, 2014). The guidelines show that dentists performing conscious sedation must be endorsed under the Standard. However, importantly no endorsement is required under the Standard and Guidelines for dental analgesia with Penthrox. Access to Penthrox administration

training has recently been enhanced by the inclusion of Penthrox in the “Pain and Anxiety Control in Dentistry —Module 2” in this year’s ADA NSW CPD course. Plans are in place for a course in WA, with Qld also looking to this for next year. Another valuable asset is the MDI on-line training course to be found at medicaldev.com/register.  W9 Pty Ltd, Unit 1, 27-29 Salisbury Road, Hornsby, NSW 2077 T +61 (2) 9987 4224 F +61 (2) 9476 6629 E info@w9.com.au W w9.com.au

References: 1. Coffey et al. (2014): A randomised, double-blind, placebo-controlled study of the efficacy and safety of methoxyflurane for the treatment of acute pain. Emerg Med J. 31(8):613-8. 2. Penthrox Approved Product Information. 3. Penthrox Consumer Medicine Information.

Before prescribing please review the PBS and Product Information in the primary advertisement in this publication. Penthrox is a registered trademark of Medical Developments International. Prepared Aug-2015.

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FOR DENTISTRY

RAPID AND EFFECTIVE PAIN RELIEF IS ONLY A FEW BREATHS AWAY1,2* *84.6% of patients experienced pain relief within 6-10 breaths2 Relief of pain during surgical procedures1 including extractions, scaling, suture removal, dry socket and pain associated with admistration of local anaesthetic

Emergency relief of pain1 Well tolerated with the majority of adverse events mild and transient1,2 Safety profile established over 30 years of experience1,2

For more information on how Penthrox can benefit your patients call W9 Pty Ltd on 02 9987 4224 or visit the MDI website medicaldev.com/register References 1. Penthrox® Approved Product Information 2. Coffey et al. (2014). STOP!: a randomised, double-blind, placebo-controlled study of the efficacy and safety of methoxyflurane for the treatment of acute pain. Emerg Med J. 31(8):613-8.

PLEASE REVIEW PRODUCT INFORMATION BEFORE PRESCRIBING Product information is availabe from 1800 PENTHROX (1800 736 847) or www.medicaldev.com/wp/wp-content/uploads/2015/07/Penthrox-PI-v12.pdf PBS Information: Emergency Drug (Doctor’s Bag) Supply Only For Emergency pain relief MINIMUM PRODUCT INFORMATION – Penthrox® (methoxyflurane) Inhalation INDICATIONS: For emergency relief of pain by self administration in conscious haemodynamically stable patients with trauma and associated pain, under supervision of personnel trained in its use and for the relief of pain in monitored conscious patients who require analgesia for surgical procedures such as the change of dressings. CONTRAINDICATIONS: Use as an anaesthetic agent; renal impairment; renal failure; hypersensitivity to fluorinated anaesthetics (including familial history of hypersensitivity) *or any ingredients in Penthrox®; cardiovascular instability; respiratory depression; head injury or loss of consciousness; malignant hyperthermia. PRECAUTIONS: Not to be used as an anaesthetic agent; liver disease and liver damage after previous methoxyflurane or halothane anaesthesia; diabetic patients (may have an increased likelihood of developing nephropathy); daily use of methoxyflurane is not recommended; treatment with enzyme inducing drugs (e.g. barbiturates); cautious use of adrenaline or nor-adrenaline during methoxyflurane administration; use in pregnancy, the elderly and regular exposure to health workers. INTERACTIONS: Antibiotics including tetracyclin, gentamicin, kanamycin, colistin, polymyxin B, cephaloridine and amphotericin B; subsequent narcotics administration; ß-blockers. ADVERSE EFFECTS: *Very

common: Dizziness, headache; Common: Dry mouth, nausea, toothache, vomiting, feeling drunk, influenza, nasopharyngitis, viral infection, fall, joint sprain, increase alanine aminotransferase, increase aspartate aminotransferase, increase blood lactate dehydrogenase, back pain, amnesia, dysarthria, migraine, somnolence, dysmenorrhoea, cough, oropharyngeal pain, rash, hypotension, euphoria, diaphoresis, dysgeusia, flushing, hypertension, anxiety, depression, sensory neuropathy, confusion, musculoskeletal.

Hepatic toxicity in association with methoxyflurane is rare. DOSAGE AND ADMINISTRATION: Up to 6 mL per day, vaporised in a Penthrox® Inhaler. The total weekly dose should not exceed 15 mL. Administration on consecutive days is not recommended. *Please note changes in Product Information Penthrox is a Registered Trademark of Medical Developments International Prepared Aug-2015

W9 Pty Ltd Unit 1, 27-29 Salisbury Rd Hornsby NSW 2077 Ph: (+612) 9987 4224 Fx: (+612) 9476 6629 E: info@w9.com.au W: www.w9.com.au

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Education guide

Primed for success

he divide between being a dentist and the task of owning and running a dental practice is vast and often greatly underestimated. Educational courses for dentistry tend to focus on the clinical aspect of the profession rather than business management, despite the high rate of dentists who aspire to and inevitably end up purchasing their own practices. That’s why, in 1995, Prime Practice was established. Created by dentists specifically for dentists, Prime Practice has firmly established itself as a leader in dental practice management support over the past 20 years, expanding from Australia to service client demand internationally with its range of services, which has grown to offer dentists everything they need from graduation through to retirement, including marketing, recruitment and HR support.

Having worked with Prime Practice Through its training workshops, for more than 15 years, Dr Hymer has management tools and business high praise for the organisation’s ability coaching, Prime Practice tailors its to help manage his staff, allowing him Programs to where you are up to, to focus on being a dentist rather than whether you are a new practice owner a manager. “I do a lot of lecturing, but learning how to run a practice, an I know that the team established owner is managing itself,” in growth mode, the more mature practice “Prime Practice helps he explains. “Prime Practice helps us owner, or even us to create selfto create self-managed corporate business managed teams so teams so the practice —Prime Practice introduces dentists that the practice still still functions without me.” to tools, systems functions without me.” But more than and innovative ways that, Prime Practice’s to successfully run advice on business their business and organisation means that when Dr supports them through implementation Hymer is away from his practice for, helping to create a successful practice. on average, one week out of each “It’s impossible to nominate just month, he is still just as productive as one thing that they’ve contributed to if he was present for the full period. my practice,” says Dr Agim Hymer of “Because we implemented all the Melbourne practice FirstBite Dental.

From graduation to retirement Prime Practice is here to support you! $$ $ $ $ Graduation

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50 Bite magazine

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Tools to grow your practice

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Systems, training and tools for a team managed practice

Maturing

Tools to automate your practice

Selling

Getting the value you deserve

systems, what I previously did in a month, I can now do in three weeks. The appointment book is expertly organised.” Dr Craig Duval of the Brisbane practice, Sherwood Dental, agrees that the coaching is highly beneficial, but in his case, it’s helping him to grow his business. Dr Duval had worked with Prime Practice between 2006 and 2008, and when he purchased Sherwood Dental last year, he was keen to re-establish the Prime Practice systems he had come to rely upon. “The practice is [currently] part-time and I want it to grow, so it’s really useful to have the metrics measured,” he says. “For my part, having the sense of accountability is important. The coaching is great, as are the reviews to make sure we do all that we plan.” He says that while working with Prime Practice in this growth period and all that comes with it—the implementation of a number of tools, as well as ongoing coaching—actually creates more work, his team will eventually take on more and thus free up his time. “Having [worked with Prime Practice] once before, I see the real value in having a coach to whom you’re accountable, in being able to share ideas outside the practice with someone who has great experience, as well as the camaraderie that comes with the courses.” When Dr Alex Lee was planning to

Get the business fundamentals for a successful practice at Practice Owner’s Workshop

20% discount for BITE readers Register online in the month of September at primepractice.com.au/owners using code BITE09. Applicable for Practice Owner’s Workshop courses in 2015 and 2016. purchase Switch Dental in Auckland, New Zealand, last year, he sought out Prime Practice’s support to help him prepare for being a business owner. “When you’re a dentist, you think you know how to run a practice because it seems quite easy from the outside, but there are a lot of things to keep track of and to think about and I didn’t fully realise the extent of it,” he says. Dr Lee began his relationship with Prime Practice after attending their Primespeak Seminar and when he decided to purchase a practice, engaged Prime to help him set up his business. “The preparation before I bought the practice has turned out to be really valuable for me,” says Dr Lee. “The coaching, the tracking of revenue and expenses, the ways to measure the health of your practice … I think things might have moved a lot slower, and there would have

been a lot more trial and error [without Prime Practice].” For the staff of Switch Dental, the bonding that comes from Prime Practice’s courses is invaluable, too. “It keeps everyone motivated and on the same page,” says Dr Lee. Dr Hymer agrees, adding that his staff enjoy attending all courses, especially Primespeak Seminars. “Prime Practice is involved in every aspect of our business and it means our staff can do everything,” he says. “I can concentrate on someone’s mouth and know that everything else is taken care of.”  Prime Practice can support you at any stage of your dental career. Visit primepractice.com.au for more information, contact info@ primepractice.com.au or phone 02 9327 3060 to find out how we can help your practice.

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Education guide Dentists reap benefits from business study

ince inception in July 2013 dentists in all states are enjoying the benefits of Australia’s first formal postgraduate business course. Feedback from participants is overwhelmingly positive. Says Anisha Sanghavi, principal dentist at Adelaide’s St Clair Dental, “as a relatively new practice owner the information provided, and the access to committed and experienced teachers is already proving invaluable.” Indeed the very rationale behind the formation of the Australian College of Dental Education (ACDE) is to fill what is seen as a yawning gap in the education and subsequent skill set of dentists. ACDE Director Geoff Parkes explains further. “Our catch-cry is to provide dentists with ‘everything they don’t teach you at dental school’, and better prepare dentists who have recently or who are intending to in the future, enter into private dentistry.” “We recognised that most business information provided to dentists is largely premised and driven by CPD, and what is missing is a more formal, more intense and comprehensive level of education.” Thus what differentiates ACDE’s courses from other non-clinical dentist education is that dentist’s coursework not only meets CPD requirements but is of such a level that subjects completed are able to articulate into formal qualifications if so desired. As Parkes explains, “coursework is assessable and the volume of work and the standard of content is equivalent to what is offered in typical post-graduate MBA programs. This way we provide dentists with a real win-win; valuable learning at a critical time in their careers, along with the ability to come away with a recognized post-graduate qualification should they desire.” Melbourne dentist Sang Lee Kaing

52 Bite magazine

Australia’s first formal postgrad business course for dentists is increasingly popular.

agrees, “what was a real eye-opener for us was to discover how little we actually know about business and how much more we need to do to be properly prepared for private practice.” Flexibility for participants is also a major benefit. Students can elect to study individual subjects (nonaward) or later seek to apply these against qualifications such as a Graduate Certificate, Graduate Diploma or Masters of Business. Study is undertaken in a flexible manner which suits individual dentist’s needs. Content delivery is on-line, using an interactive web portal, which has proven to be a great learning mechanism for students. To ensure the highest quality experience for students, teaching is delivered by vastly experienced dental and business professionals, blended with some of Australia’s best postgraduate lecturers. “This is another feature which provides extra value for our participants”, confirms Parkes. “Because of our background in dentistry and business we have been able to design the course so that it is neither too academic nor too ‘nuts and bolts’.” “With a number of students now

having completed or undertaking study, the delivery system established, and positive word of mouth spreading, ACDE continues to offer more new business subjects and, in 2016, plans to introduce a post-graduate clinical stream. Clearly, whilst enjoying its initial success, ACDE is not resting on its laurels and has some lofty aims. “Ultimately we envisage a scenario where it becomes commonplace or ‘industry standard’ for young dentists following graduation to enter the workforce as employed dentists, perhaps spend a year or two consolidating their clinical skills, and then undertake post graduate business study”, explains Parkes. “Study which is delivered in a flexible and tailored way to fit easily into their schedules and which provides dentists with both a grounding in general business disciplines, and also prepares them specifically for private dental practice.”  Further details on ACDE post-graduate business courses are available at www.acde.com.au or by contacting info@acde.com.au.

We are a leading provider of CPD courses for the whole dental team, with programs available throughout the year. Life-long learning with the University of Sydney is maintained through the provision of independent, clinical/scientific and evidence-based courses.

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Tools of the trade Direct ceramic restorations, a rechargeable, cordless laser, and much more … Cerec Omnicam by Dr Stephen Carapetis, GP Dental Partners, Warradale, SA The Cerec Omnicam allows me to create direct ceramic restorations in my clinic without having to worry about taking impressions or sending things out to laboratories. The process is very fast and can be completed in just one appointment. What’s good about it The Cerec creates an aesthetically pleasing restoration that strengthens the tooth and is completed within an hour and a half. When patients need a ceramic crown due to a weak, cracked or heavily filled teeth, the process used to take weeks. I would shave down the tooth, take an impression and send that off to the laboratory. I would then place a temporary crown, the patient would return in two weeks, and I would cement the permanent crown into place. Patients love the fact that they can now have a crown or inlay fitted in one appointment. As well as the Omnicam, I have the Cerec MC X milling machine. From a block of ceramic, this machine creates a restoration that fits exactly into the tooth. We’re using a new type of ceramic—available through Sirona—that has a chameleon effect. Once it’s cemented into position, it adopts the original colour of the tooth. The results are fantastic. I’ve been using the Cerec for 18 months now and the inlays show no signs of discolouration or staining. I’m certain this technology is the way of the future as a longterm alternative to large bonded composite resins. What’s not so good The only negative is that the Cerec Omnicam and milling unit are very expensive to purchase. I have three practices and each have an Omnicam and milling unit, so the capital outlay was considerable. However, they are used multiple times a day by eight dentists across those three practices. Where did you get it Sirona (sirona.com.au). 

Osstell ISQ Implant Stability Meter by Dr Bruce Gray, Wingewarra Dental, Dubbo, NSW This is an electronic device for measuring the stability of implants. I use it with every implant I place. What’s good about it The Osstell ISQ works on resonance frequency analysis. A sensor is screwed into the implant and a wand is placed in close approximation to that sensor. A reading of between nought and 100 is displayed on a screen and the higher the number, the more stable the implant. A reading of 65 or better means that the implant is adequately stable. I like this system as I can take multiple readings throughout the implant procedure. I take a reading at the time of placing the implant and at the time of uncovering if I’m doing a two-stage surgery. I take another reading at the time of the impression for the prosthesis and at the time of its placement. This gives me a quantitative measurement of the increasing or decreasing stability of the implant in the patient’s bone. Prior to that, it was all qualitative. We would simply wait a period of time and assume that because six months had passed, it must be right. There was no quantitative way of measuring whether a certain degree of torque could be placed on the implant without harming the bone/implant surface. I’ve been using the Osstell ISQ for four years with no problems. It’s a well-designed, robust piece of equipment that works accurately. It’s been a great adjunct to my implant surgery. I highly recommend it. What’s not so good The only downside is that the magnetic sensor that attaches to the implant is single use and each one is quite expensive to purchase. Where did you get it Henry Schein Halas (henryschein.com.au). 

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(continued from page 55)

iLase by Dr Vas Srinivasan, Invisible Orthodontics, Hervey Bay, QLD The iLase is a cordless laser that runs off a rechargeable battery.

3M ESPE Sectional Matrix Plus by Dr Jess Manuela, Dental South, Margate, TAS I like the 3M sectional matrix system because it has a small lip area that can be positioned subgingivally. It’s very versatile and can be used on just about every tooth. What’s good about it I’ve used other matrix systems in that past and found that the bands are often too malleable. The 3M matrix bands are rigid and they also have wellshaped anatomical curves. I always get a nice contact when I use them. Other matrix bands need to be placed in the right spot straight away or they will bend and become useless. While other systems work fine if the contact is pretty open, if the contact is in a more challenging position, it can be difficult to position them properly without bending. The 3M system is very consistent and the bands have just enough rigidity so they don’t bend under pressure. They allow me to treat a range of cavity sizes, even if it goes a bit sub-gingival or is just a small, proximal cavity. This is a very versatile system and you don’t need a range of different band sizes. Very occasionally, I may use a pre-molar band but essentially you can use these bands on all restorations. What’s not so good I’ve mixed and matched a couple of systems to create my ideal solution. I had used the V-Ring system but found their bands were too soft. So, I started using Garrison rings and their matrix bands. I happened to run out of the Garrison bands but had 3M matrix bands on hand. By accident, I came across my preferred combination—a 3M matrix band secured by a V-ring or Garrison ring. Where did you get it Henry Schein Halas. 

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What’s good about it When the gum is covering a tooth and you need to do an orthodontic bracketing or attachment, the iLase can get the job done in 10 minutes using only topical anaesthetic. You just numb the patient and clean up the gingival margins straight away. There is no need to use a scalpel and very little bleeding. Healing is tremendously fast and post-operative pain is negligible. Patients usually comment about the lack of pain after their procedure. There’s no need for any antibiotics and patients can return to work or school straight after the appointment. This laser allows a dentist to perform procedures that would have been referred to a surgeon in the past. It means that complicated cases can be completed in one sitting. This, of course, works out cheaper for the patient. The only pain for Queensland practitioners is the need to get a licence from Queensland Health to own and operate a laser or X-ray equipment. It adds a ridiculous amount of paperwork and cost, and is not required in any other state in Australia. Despite this, it’s a no-brainer. I believe that every practice should have a laser. What’s not so good If you’re working on a significant exposure of a tooth, the handpiece can overheat and will just stop until it cools down. We don’t book long appointments to do the exposure —usually only 10 or 20 minutes—so it would be great if I could keep working non-stop. Where did you get it Dental Axess (www.dentalaxess.com). 

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On the ball My big claim to fame from when I played soccer at University College Cork in Ireland is that I hold the record as the all-time top goal scorer. During that period [2003-’08], we went on two tours to the USA where we played a number of universities in New England. It was great fun. “I was born in the village of Foynes on the southwest coast of Ireland and as soon as I could walk, I was kicking a ball around. I’ve been involved with soccer my whole life and have played at the highest amateur level. “I lived in London for a few years and set up a soccer club there. We had some American and English guys involved but it was mainly just my Irish friends. The team was based in South London and played in the Wimbledon and district league. The club still exists to this day. “I left that club in 2011 when I moved to the Sunshine Coast in Queensland. On arrival, I joined a soccer club before I found accommodation. Actually, that seems to be the case wherever I live. “I played for Coolum and eventually became captain of the team. I then moved down to Kingscliff in northern New South Wales and played for Burleigh Heads. I took some time off, went travelling overseas and ended up living and working in Cambodia. Of course, I played soccer in Phnom Penh. For me, soccer has been a great way to meet people, make friends and have fun no matter where I am. “I moved back to Australia about 12 months ago and now live and play soccer in Caloundra. My team has had a very successful season. “What I love about soccer is that—just like life —you get out of it what you put in. I also enjoy the team aspect and the fact that the team is bigger than any individual. One of my favourite sayings is, ‘Fail to prepare, prepare to fail’ and that’s true in soccer and life. Soccer teaches that if you want to achieve something, you have to put in the effort. If you don’t then the score will reflect that, and there’s no hiding from the fact. However, if I lose a match but I’ve given my all, I can be happy with that. “When I really think about it, I just love to get out on the field and play. That probably trumps everything else. 

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INTERVIEW: FRANK LEGGETT

Wherever he is in the world, Dr Stephen Tangney of Avenue Dental in Caloundra, Queensland, finds a soccer team to join.

1,2

Sensodyne® Repair & Protect contains NovaMin®, an advanced calcium and phosphate technology.3–7 Activated by saliva, the compound forms a hydroxyapatite-like layer that is up to 49% stronger than dentine.1 The extra protective layer blocks sensitivity triggers. This helps to prevent related discomfort or pain, so your patients can enjoy the food and drinks they love again.

*Compared with fluoride toothpastes containing either arginine/calcium carbonate, casein stabilised amorphous calcium phosphate (CPP-ACP), or potassium nitrate.1,2 Based on tubule occlusion scores.1,2 References: 1. Parkinson CR, Willson RJ. J Clin Dent 2011;22(3):74–81. 2. Salian S et al. J Clin Dent 2010;21(3):82–87. 3. Burwell A et al. J Clin Dent 2010;21(3):66–71. 4. Earl JS et al. J Clin Dent 2011;22(3):62–67. 5. Efflandt SE et al. J Mater Sci Mater Med 2002;13(6):557–565. 6. LaTorre G, Greenspan DC. J Clin Dent 2010;21(3):72–76. 7. West NX et al. J Clin Dent 2011;22(3):82–89. For the relief of sensitive teeth. Sensodyne® Repair & Protect contains NovaMin®. Sensodyne®, the rings device and NovaMin® are registered trade marks of the GSK group of companies. GlaxoSmithKline Consumer Healthcare. Australia: 82 Hughes Avenue, Ermington NSW 2115. New Zealand: Level 11, Zurich House, 21 Queen Street, Auckland 1010. GSK1476/UC CHANZ/CHSENO/0092/14 June 2014.

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100% WHOLE MOUTH HEALTH^ ^Antibacterial protection for 100% of your mouthâ&#x20AC;&#x2122;s surfaces (e.g. teeth, tongue, cheeks and gums) for a healthier mouth. 1. Fine et al (2006), Journal of the American Dental Association, 137: 1406-1413; funded by Colgate-Palmolive Co, New York