The Bulletin - Issue 43 Jun / Aug 2017

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The Dental Hygienists Association of Australia are holding their 2017 National Symposium in the beautiful city of Adelaide.

Registrations are open at symposiumadealide.com.au

Register today!

Early-bird booking closes 31 August

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Where next for scope?

The waters are muddied since the DBA’s removal of endorsement for courses that

E

arlier this year the Dental Board of Australia (DBA) announced that they would be removing the Board’s endorsement of courses to increase scope of practice for hygienists, and oral health therapists. This really muddied the water in terms of our understanding of where our profession was headed.

In March 2017, the DBA released the communique of their most recent meeting where they reviewed the list of “Programs to Extend Scope”. The main conclusions were the reduction of the number of approved courses for 2017 and 2018 with the intention to ultimately phase out the approval and accreditation of these courses after 31 December, 2018.

One reason cited for phasing out their “Programs to Extend Scope” was that most topics are now incorporated within study that leads to registration as a dental practitioner; in regards to

hygienists and oral health therapists this includes things like in-office whitening, administering local anaesthetic and the knowledge to assist in orthodontic treatment.

Although the details are still being reviewed by the DBA on how they might acknowledge future growth within our scope, they have alluded that continuing professional development (CPD) will be able to be used to increase scope within our professional role, in a similar way to that which dentists have done for many years.

So what does this ‘muddiness’ mean?

In some ways, we can probably take a little bit of solace from the fact this recognises our autonomy as health professionals. Initially this means being given the responsibility to choose thorough and well-rounded CPD that is relevant to our core program of study hygiene and/or therapy.

Obviously this doesn’t mean you can

pop off to a CPD course about porcelain veneers and, eureka - it’s in your scope to practice! Relevance to your core program is the key to deciding on whether a CPD course will be used as complementary information within the dental field or as a procedure you can effectively use to practice on your own patients.

Most of us know where our boundaries lay as part of the dental team. The aim of increasing scope is not to sneak outside of these boundaries

“ The main conclusions were the reduction of the number of approved courses for 2017 and 2018 with the intention to ultimately phase out the approval and accreditation of these courses.”

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increase scope of practice but to extend our knowledge to support our team and our patients, while leading a fulfilling career.

The second consideration to take for using CPD courses to build on our foundation knowledge, and in turn our scope of practice, is to choose courses that provide good quality training and are credible.

In my mind, I relate it to how I choose evidence-based information to give my patients. Consider the source, the legitimacy of the evidence and the number of hours required to have enough information and training to comfortably exercise that new skill.

A good example is the in-office whitening course – previously an approved course. According to professional indemnity insurance advice; if the course you choose is credible, and the quality of information is good, you will be able to comfortably prove that you are wellequipped to add this procedure to your scope of practice.

If you have already completed the course, or were planning to, do not be concerned. Whether or not the course has been approved, or endorsed by the board, does not prevent you from using that skill.

Ultimately, it will be our responsibility to prove that our CPD course choices are credible and relevant if required. Although this change has been a little confusing, we can expect more information to come before the complete removal of accredited courses but consider that these changes will improve the prospects of our growing profession rather than limit it. n

Special Service Award for Steffens Margie Steffens receives recognition for her dedication THE DHAA IS proud to announce that Margie Steffens, Chair of our Aged Care Committee, was the recipient of a Special Service Award from the Pierre Fauchard Academy.

Awarded at the recent ADA Congress in Melbourne, this distinguished award is a great recognition for Margie and the valuable work she does as a dental hygienist with underserved populations.

The Pierre Fauchard Academy is an honorary dental service organisation founded in 1936 by Minnesota dentist Dr. Elmer S. Best. His passionate concern for the search for knowledge and the raising of professional standards laid the ground work for the beginning of the Academy. This attracted outstanding dental researchers and teachers to its ranks, and led to a continuing role in fostering dental science.

The Academy is named after Pierre Fauchard of France (1678-1761), who is recognised as the “Father of Modern Dentistry” for raising dentistry to a profession. He wrote a book named “Le Chirurgien Dentiste au Traite des Dents” – the first true textbook of dentistry.

The Constitution of the Pierre Fauchard Academy laid out a series of objectives honoring Dr. Best’s focus on integrity and ethics. An objective adopted by the Academy award’s distinguished members and role models for their contributions to the field of dentistry. A primary objective at the time of its founding, to help the profession take control over its own literature, still remains an important activity of the Academy. This includes the publication of “Dental Abstracts. “ The Oral Health Foundation is the arm of the organisation which supports grant applications for noteworthy projects that improve oral health and quality of life for underserved populations.

Margie has successfully obtained grants for the past two years from the Foundation, supporting growth and opportunity for her Community Outreach Dental Program. This program is now in its sixth year and has improved oral health outcomes by providing comprehensive dental care for some of Adelaide’s most vulnerable and marginalised people.

The program not only provides much-needed dental care for these people, but provides education for final year dental, oral health and dental hygiene students, mentored by volunteer dental professionals offering personal growth, encouraging philanthropy and engagement with community. n

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PRODUCT

REVIEW

Whitening done right!

Joanna Mohammadi puts the Cavex Bite&White ABC Masterkit to the test I’M SURE MANY of us working in the dental profession have effective. Only requiring 30-60 minute treatments, the gel’s tried multiple brands of whitening products- gel, strips and perfect viscosity flows under pressure without threads or toothpastes. Late last year the team at CareDent sent me mess. The addition of sodium fluoride helps to reinforce the their Bite&White ABC Masterkit enamel, while potassium nitrate helps whitening kit to try. avoid sensitivity.

From previous experiences with Condition: Cavex Bite&White ExSense take-home whitening I have found is a revolutionary post-whitening that they can make my teeth very conditioner. It offers fast, long-lasting sensitive. Even inhaling suddenly relief from sensitive teeth thanks to the through my mouth is enough to send blend of hydroxyapatite and a ‘hydroelectric shocks down my teeth. dispersing clay.’ With the synergetic I was pleasantly surprised by composition of Cavex Bite&White the product. My teeth weren’t left ExSense, the hydroxyapatite penetrates sensitive and it didn’t taste as deep into the tubules and microterrible as other products I’ve tried cracks in the enamel. This seals off in the past. the areas that may cause sensitivity, Cavex explain that the ‘ABC’ helping restore micro-hardness and stands for ‘Activate’, ‘Brighten’ and accelerating the re-mineralisation ‘Condition’. They claim that by process. following these steps you will The kit contains; 3 x 3ml Cavex be guaranteed an effective, safe Bite&White syringe; 1 x Cavex and, most importantly, painless Bite&White StainLess; 1 x Cavex whitening treatment.

Bite&White ExSense; 1 x retainer So how is it supposed to work? case; 1 x shade guide and full usage Well let’s follow the ABC. instructions.

“My teeth weren’t left Activate: Cavex Bite&White The product is available wholesale sensitive, and it didn’t taste as StainLess is a refreshing prefrom Ark Health. The price is quite terrible as other products I’ve whitening toothpaste. It helps to competitive, allowing your practice to tried in the past” remove surface stains and plaque pass on the savings to your patients. allowing the whitening product to If your interested in getting your be in direct contact with the enamel surface. Cavex Bite&White hands on some, or want to find out more, then contact Jana StainLess also creates the perfect whitening environment by Mckenzie at Ark Health (jana.mckenzie@arkhealth.com.au) safely increasing the pH to the optimum level.

Brighten: Cavex Bite&White 16% carbamide peroxide (equal Please note: The review of this product is from the viewpoint of an to 6% hydrogen peroxide) whitening gel is both safe and individual and not the direct views of the DHAA.

INCORRECT ADDRESS Our cover story in Bulletin 39 we incorrectly addressed Professor Eric Reynolds as ‘Professor Emeritus’ which would indicate that he had retired. The correct term is ‘Laureate Professor’. The Bulletin would like to apologise to Professor Reynolds for any embarrassment that this error may have caused.

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Ask DHAA...

Your opportunity to ask the questions, check the rules and share your knowledge Dear DHAA... Symposium has come to the home of hygiene, how does the SA chapter feel about this? Why has the SA team put their hand up for this event?

The last Symposium was held in Adelaide in 2009. Since then the whole DHAA experience has evolved and grown. As you point out, SA is the “Home of Hygiene” and Adelaide will be like a “homecoming” for a lot of hygienists and OHTs who studied here. We know of at least three groups planning to have their own reunions whilst they are here. Many of the DHAA founding members are still around Adelaide so we hope to see them too!

symposium website www. symposiumadealide.com.au.

We plan to introduce the custom Symposium app in a couple of months, so that people can download it and familiarise themselves with it for use during the event. We will be encouraging delegates to use the app, before, during and after SA17.

For those who have yet to register, please remember the end of the early bird price ends on August 31. Single day attendance may also be purchased.

For pricing details, visit www.symposiumadelaide. com.au

Dear DHAA... What can we expect from Adelaide after the success of last two events?

Dear DHAA... Workshops are becoming a regular feature at DHAA symposia. Can we expect to see them on the Adelaide calendar?

The last two symposia in Sydney and Hobart were indeed awesome.

We have taken on feedback, and incorporated some longer scientific presentations.

Several local, expert SA speakers will bring their presentations and evidencebased content to the wider DHAA audience.

A full breakdown of all speakers is available on the

At the time of writing we have 2x three-hour workshops planned with two of our keynote speakers – Shirley Gutkowski and Stavroula Zandes. Both of these vastly experienced, professional presenters come with established points of view, and support their information with current science and research.

Workshops will be held before Symposium starts so if people

wish to attend and accrue an additional three CPD hours on top of their symposium hours they will get a grand total of 19 hours for the event!

Details of the content of the workshops can be found on the Symposium website at: www.symposiumadelaide. com.au Dear DHAA... The social calendar at Symposium is becoming as big as the event itself, what can delegates expect for Adelaide?

This year’s theme for our Gala Dinner is “It’s all about the swing.” Take note and bring your dancing shoes!

The band is renowned for getting people up and moving and we hope for other entertainment to get people in the mood – watch this space.

The National Wine Centre is a divine location, so for those who have not been before, just wait for the wow factor!

We have listed on the website many ideas for people who are looking for things to do before or after their days at Symposium – live music shows, food and beverage tours, a “pedal pub”, ghostly tours, seeing a movie at the Adelaide Film Festival, or a visit to the world famous Adelaide Oval.

We have also arranged exclusive tours of the new research facility SAHMRI (bookings through our website are essential). Not to be missed!

We have also introduced a Farewell Drinks session this year, so that delegates to Symposium can come along to say goodbye to friends and colleagues.

Dear DHAA... Will we see any international speakers at this year’s event?

We are welcoming Professor Sam Samaranyake (currently Hong Kong, formerly Qld, London, Edinburgh, Saudi Arabia, China and the USA) and Ms Shirley Gutkowski from the USA. Many delegates will know Sam’s name from international research in microbiology and oral candidiasis, and from over 400 publications that he has authored. Some may know Shirley from a previous speaking tour to Adelaide around 12 years ago or from her online radio show at www. crosslinkradio.com.

We are very much looking forward to hearing our globe-trotting colleagues, and learning their new, evidencebased concepts, as well as scientific research updates.

11 YOUR CHANCE TO GET SOMETHING OFF OF YOUR CHEST

Are you burning out?

Dear DHAA... Trade displays at symposium feel like they just keep getting bigger, who are we expecting this year?

Many of our loyal exhibitors will be back, with different options available to them this year, as well as a large array of booths and displays.

Principal sponsors include Oral B, Colgate and Curaden Swiss. Our Sponsorship Officer Shida Taheri is working closely with companies, and the final list of confirmed sponsors grows weekly.

Most sponsors offer door prizes for our Symposium delegates so you may walk away with something special.

Dear DHAA... Can you tell us a bit about the venues we will be visiting this year?

The Adelaide Convention Centre has undergone a major transformation in the last couple of years, and with our section in the West Building being completely finished, delegates will love the comfort and style as well as the panoramic views, and also the proximity to the Riverbank precinct Got something you want to ask? Send your email to bulletin@dhaa.info

D

ental hygienists are many things. I could sit here and list them but we don’t have the time. One thing for certain, is that we are all hard workers.

In my experience, as both a hygienist, and as an assistant, the hygienist is one of the first to arrive and the last to leave. Often making sure that everything is ready for, not only themselves, but also their team-mate the dentist.

Why am I bringing up your morning ritual?

Well, just like a Ryan Gosling meme, I’m here to say: “Hey girl, are you working too hard?”

Could you possibly be in danger of burning out because of it?

Five years ago, which was also five years after my graduation, I found myself in this exact position. Recently I have found myself in it again.

I am passionate about my career and my whole life revolved around dentistry. I went to work early, and left late, before heading home to start on my volunteer work before crawling into bed, to start over again the next day.

Not everyone’s the same, but read on to see whether your own work-life mix might be burning you out.

1. You can’t give your all, all of the time. It’s impossible! There has to be a piece of you left for yourself at the end of the day. Imagine you had a cake, and every day you give half to work, and half to your family. Surely you’d stop and say: “Hey! Where’s my cake? Please don’t do the same with yourself.

2. When you’re burnt out you can’t be your best. You’re tired and drained, but still think you’re achieving your usual level of work. Not so, my friend. The fresh vibrant you is always going to perform better. If you fear you’re burning out then it’s time to stop. It’s not good for you, or your patients.

RANT! 3. I dentify that you are burning out. So many times we keep soldiering on. We think it shows how strong we are, and that it’s appreciated. In reality we are a shell of our former selves – a hygiene zombie. If this is you then take the opportunity to stop, recharge, and get back to being an awesome hygienist.

4. Please ask for help. If you feel like things are getting too much, then talk to someone!

It may feel trivial but why should you cope alone? Friends and family are there to support you. Let them in and get back to being that ball of sunshine and dental knowledge that you know you can be.

I do not intend to diagnose, or treat, depression/anxiety. These are also things that can contribute to burn-out, but if you identify yourself as having a mental health concern then it’s imperative that take yourself to a medical professional. What I’m trying to highlight is that burn-out happens. It can be you or maybe a colleague in the surgery next door, and it’s okay!

All professionals have this thing with saving face, and not being seen as weak. What we’re really covering up, is that we are human, and patients like to be treated by happy healthy humans. Do yourself a favour. Use that extra 10 minutes you’d normally leave early for work, to make sure you have everything perfect for your patient. Sit your butt down with a cuppa, or trot around the block for some fresh air, or better still, use some of that annual leave you have sitting there. Charge your battery to its fullest.

You, your patients and your work mates will thank you for it.

Rant! Is supplied by an independent contributor and is not an expression of the view of the Dental Hygienists Association of Australia.

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O FE R P

SSIONA L

MNIT DE Y N I

O FE R P

SSIONA L

MNIT DE Y N I

We’ve got you

covered

If it’s time to renew your professional indemnity insurance then there’s a new option for you to consider

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Peace of mind is even more affordable with the new professional indemnity insurance package from the DHAA

DHAA professional indemnity insurance is only $200 per year. Why is it so cheap?

The secret is in the relationship of the insurance provider with the DHAA as a professional association.

BMS is a Lloyd’s insurance broker, meaning it leverages its access to numerous insurance markets, allowing for competitive and sustainable premium rates. Members of professional associations abide by a professional code of ethics, and overall, our patient-focused care and preventive scope of practice means that complaints are uncommon.

Furthermore, the DHAA provides high quality continuing professional development to its members, and through this relationship will be able to provide targeted CPD on risk management, based on enquiries through BMS. As an Association, we also have group buying power with insurers, which also reduces the premiums.

What can members do if they’re already signed up with another insurer?

Most professional indemnity insurance runs for a financial year (1 July – 30 June). If your current professional indemnity policy expires on 30 June and you would like to take out

a DHAA policy, all you have to do is let the current policy expire. Make sure you purchase the DHAA policy before 30 June. What is important is that you choose a policy that meets your needs, so members should make sure they read up on what each policy covers and compare the cover and the costs.

If someone has an active membership, won’t renewing cost them more money?

Not at all. We have provided a credit for all existing members, when renewing before June 30. In fact, this credit is slightly more generous than the actual credit, given the inconvenience of having to renew again before the 12 months is up.

Other professional indemnity insurers provide online CPD - is this something that the DHAA are considering?

Absolutely. The DHAA will work closely with BMS to provide high quality risk management CPD for its members. Using the information gathered from member enquiries, we will be able to target any CPD to focus on current and relevant issues for the dental hygiene and oral health therapy professions. The DHAA see an opportunity to provide CPD both faceto-face and using electronic modalities.

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CASE STUDY

“ Having adequate professional indemnity insurance cover is essential for us to have peace of mind while we get on with our job.”

Can people still be a DHAA member and not opt for the insurance?

Of course! We respect each members right to choose their own professional indemnity insurance policy.

While we think we have the most comprehensive and affordable policy on the market, if you decide you would rather get your insurance elsewhere we would still love to have you as a member. When you sign up there is an option to have membership without the insurance component.

The choice is still yours Having adequate professional indemnity insurance cover is essential for us to have peace of mind while we get on with our jobs.

It’s certainly comforting to know that the Association is working hard on behalf of it’s members, and trying to save you money. It’s also refreshing that there is the option to stay with your preferred insurer while still being rewarded with all the benefits of DHAA membership.

If you woud like more information on the DHAA Professional Indemnity package, then you can check out the pages on the DHAA website, or visit the dedicated BMS/DHAA information site at dhaa.bmsgroup.com.

If you would prefer to talk to someone then you can call toll-free on 1800 940 762 or email dhaa@ bmsgroup.com. n

Be Aware. Be Protected.

DHAA Has You Covered.

HELEN IS A DENTAL HYGIENIST working in a local clinic. After years of practice without any formal client complaints or allegations of professional liability, Helen has recently been notified of a Regulatory investigation stemming from a complaint alleging unprofessional treatment. Specifically, Helen’s former patient is alleging that she behaved unprofessionally and provided poor treatment, which resulted in increased pain to the patient’s lip.

Although Helen maintains that she did nothing wrong, anyone has the right to voice such concerns to a regulatory body. This is by far the most cost-effective way for a client to lodge a complaint against a healthcare provider, and patients are doing this. The legal expense costs for defence alone can be crippling for an individual. Defence protection through insurance will provide legal representation in the event of potential discipline such as suspension of practice.

Fortunately, Helen receives professional indemnity insurance coverage with her annual DHAA membership and is adequately covered. She has access to specialised legal representation protecting her interests throughout this process. The DHAA program provides superior coverage for regulatory complaints. It is also linked with specialised, appointed legal counsel to ensure that members are protected most when they need it.

With the DHAA program, Helen has access to pro bono legal services and the expertise of one of the most highly recognised legal firms in medical defence and professional indemnity in the country, through Lander & Rogers.

Helen’s legal representation is provided at no cost; she does not have to pay a deductible or any fees. She will also be able to recoup more in lost wages compared to any other policy through the loss of earnings provision within the DHAA insurance program, as she attends meetings and hearings pertaining to this claim. In this case, the total cost of defence was just over $17,000, which was covered under Helen’s DHAA insurance protection. She was cleared by the Regulatory body of any wrongdoing.

This scenario is based on a real claim, and that the person has the current DHAA policy in place. The person’s actual name/image has not been used.

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O

ne way to imagine the community of bacteria that exist within human bodies and, in particular, their digestive tract, is to think of them like animals and plants within an ecosystem.

Significant environmental changes impact the natural balances of flora and fauna. Animal and plant species either thrive or perish based on environmental conditions. Dramatic changes in conditions can cause irreparable damage to the balance of plants and animals within ecosystems.

A current example of this, and one that may be relevant to our east coast readers who have encountered these birds, is the much maligned ‘bin chicken’.

The bin chicken is scientifically known as Threskiornis Molucca, or more commonly, the Australian White Ibis. It’s explosion in numbers within urban centres has caused it to become the subject of unsavoury media attention. Small numbers of ibis have traditionally been found in cities such as Sydney and Brisbane.

However, due to prolonged droughts in Australia, inland ibises have migrated to more favourable territory. They have clustered in coastal towns and cities and have since thrived and flourished by subsisting on a steady diet of discarded food and waste, often out-competing their other feathered counterparts and creating a generally unwanted presence. This has lead to their objectionable reputation as consumers of used cigarettes and garbage. Their presence, however, is said to be directly related to climate change and the damaging impact this has had on their natural wetland habitat.

Now take this scenario and apply it to the microcosm of bacteria that dwell within the human digestive tract – you’ll start to see some similarities.

Drastic changes to the body’s ‘environment’ can lead to an imbalance of the bacteria that exist within the gut and oral cavity. If flocks of stinking, bin chickens sound unappealing, imagine their bacterial equivalent overrunning your gut and mouth.

In the same way that environmental changes have lead to the white ibis reaching pest proportions within urban centres, changes in your body’s ecology cause an increase of bad pathogenic bacteria, often at the expense of healthy bacteria.

This mirrors the way that ‘pest’ animal often out compete their native or non-pest counterparts.

Once conditions are favourable, pathogenic bacteria often out-compete healthy bacteria in a process known as ‘dysbiosis’, where the levels of pathogenic bacteria far outnumber the levels of healthy bacteria. Once this dysbiosis occurs, it is seemingly impossible to restore the ideal distribution of bacteria required for health.

Gut bacteria, said to constitute roughly three kilograms of an adult’s weight, is now sometimes considered one of the body’s organs. Communities of gut bacteria live within the human digestive tract and aid in digestion. Highly processed foods, not encountering enough microbes in infancy and extended antibiotic use, are said to cause damage to the balance of gut microflora. It is thought that our altered relationship with food over recent decades, has had a detrimental effect on our digestive tracts. You only have to look at a cookbook from the 1970’s to see that people no longer wanted to acknowledge their food had come from any natural source, but rather another shiny, sterile parcel to be ingested.

As such, food in the post WWII era started to take on a rather ‘un-foodlike’ quality. Industrialising the cooking process meant mass sterilisation and prophylactic antibiotic use in animals in order to prevent outbreaks of salmonella.

The much The knock-on effect was human maligned gut bacteria being thrown completely Australian Ibis out of whack, and having a host of or ‘Bin Chicken’ problems associated with major public health issues.

This gut dysbiosis has been linked to not only digestive issues, but higher inflammatory markers.

Emerging research has linked poor gut health to obesity, type 2 diabetes, cardiovascular diseases, certain types of cancers, poor mental health and allergies such as Suman and Padmini.

One example of the impact of gut health on overall and systemic health, can be found in the research between gut health and mental health. One study in mice, found that the introduction of a lactobacillus probiotic reduced the stress levels and outlook of the mice. Mice were assessed on their behaviour in stressful situations. Divided into a control group and a group that were fed a lactobacillus reuteri probiotic. The mice were then subjected to ‘swim tests’, whereby the mice are placed into water with no escape and retrieved once they have given up. The purpose of a test is to see how quickly a mouse yields and falls into ‘despair’. Giving up more easily is associated with depression and stress. The mice that were

A beautiful flower? No, this is Salmonella under the microscope

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FLYING THE FLAG

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DHAA President, Dr Melanie Hayes, reports on her recent professional development tour of the USA

ith the support of the DHAA Ltd, University of Melbourne and the Global Children’s Dental Fund, I had the great privilege of undertaking a professional development tour in the USA in March this year.

The three week experience allowed me to participate in a leadership course, conferences and business meetings in Boston, Chicago, Long Beach and San Francisco in a period of intense learning, professional development and personal growth. Here I share a little of my experience and how this opportunity will help me continue to meaningfully contribute to the oral health profession here in Australia. Further, I will hopefully encourage some of you to consider enhancing your professional or personal growth by expanding your horizons!

Senior Dental Leaders Program A partnership between Harvard University, Kings College and the Global Children’s Dental Fund, the Senior Dental Leaders Program brings together dental leaders from across the globe for six days of learning and development.

This year it was held in Boston, and gathered together leaders from the US, Australia, the UK, Tanzania, China, South Africa and Brazil.

The focus of the program was two-fold; delegates develop their leadership skills but also learn to use them effectively to advance oral health agendas and improve the dental health of children. It was clear to me that dental hygienists as preventive oral health practitioners are perfectly poised to meet the global challenge which

is children’s oral health, and we have the networks – our real problem is that we are not always seen as part of the solution, and this emphasised for me the importance of promoting the dental hygiene profession.

The program gave me insight into my personal leadership strengths but also encouraged more ‘big sky’ thinking, which I think is important in a growing profession such as oral health.

Also, I had the pleasure of meeting some employees who had been working in the factory for over 40 years! It really spoke very highly of the positive work environment and it is evident that this loyalty is integral to the professional regard of Hu-Friedy. I also had the pleasure of meeting with key staff members do discuss my ergonomic research interests and instrumentation design and education.

Meeting with the American Dental Hygienists Association

International Dental Hygiene Educators Forum

It was fantastic to meet with ADHA CEO Ann Battrell and her team at their office in chilly Chicago. We had a very productive meeting discussing professional promotion, scope of practice and career development for hygienists. There are definitely opportunities for the DHAA to work closely with the ADHA on shared messaging, however it was clear to me that this cannot be achieved on volunteers alone! The growth and development of the DHAA employee team will ensure that the Association can implement its strategic plan and advance with the profession.

Next stop was sunny Long Beach, for two conferences focusing on dental education. At this first forum, I had the opportunity to reconnect with my colleagues at the ADHA and Canadian Dental Hygienists Association, as well as network with educators from the US and Japan. Dental Hygiene educators have developed such a great collegial network in the US, and although it is much smaller here in Australia, we need to foster the ongoing development of our educators to ensure that all future dental hygiene professionals are well equipped for the workforce.

Hu-Friedy Factory tour

American Dental Education Association Annual Session

While in Chicago I also had the opportunity to have a personalized tour of the Hu-Friedy factory, where all of the dental instruments are manufactured. I was surprised to learn that many of the instruments are still manufactured by hand; the process of manufacture is arduous and it was clear that their quality assurance procedures are top-notch, which gave me a new found appreciation for my instruments!

The theme was “Beyond Boundaries”, with the aim of challenging dental educators to transcend the familiar and explore the unexpected questions behind more effective learning, scholarship, teaching, professional development and patient care.

Attending the main program, I had the opportunity to learn more about some innovative strategies in the US which could easily be translated to

25 For all the latest info on DHAA events near you please visit www.dhaa.info/events

sleep disordered breathing, common with enlarged adenoids and tonsils.

Breathing during sleep is disturbed and there is evidence to support that sleep fragmentation can lead to cancers. The risk of pancreatic, lung and kidney cancer and melanoma are significantly higher in patients with Obstructive Sleep Apnoea. “ Sleep perturbations similar to those in OSA can accelerate tumor growth and invasiveness”. “The biological plausibility linking OSA to cancer is now quite firmly established.” David Gozal MD. MBA at the American Academy of Cranio-facial Pain, meeting in Sydney, March 2017.

In addition, mouth breathing is associated with hypoxia and they “now have research about intermittent hypoxia, its

effect on the brain, sleep fragmentation and links to cancer.” In animal studies “Intermittent hypoxia increased melanoma tumour size and metastases from the primary subcutaneous tumor to the lung.” SLEEP vol 31, No 8, 2008.

As hygienists, we are in an excellent position to note any anatomical and functional features that can contribute to sleep disorders related to airway obstruction.

If we see the need, we can then speak with the children and their parents and refer these children on to an Orofacial Myofunctional Practitioner, Speech Pathologist (trained in myofunctional practice) or ENT so these issues are then addressed and dealt with.

There is so much more information that Sharon has to impart and we look

forward to having her speak with us again in the not-toodistant future.

Then on 31 March we headed up to the very stately and elegant Peppers Craigieburn in Bowral for the DHAA NSW/ACT Combined CPD Day. “Practical Periodontics for Outstanding Clinicians” was presented to fifty five delegates over the course of the day by periodontists Dr David Grossberg, Dr Kevin Todes and Dr Alex Kalos.

The day began with Dr Grossberg presenting ‘Periodontal Examination – Am I doing it right?’, followed by ‘Mouthwashes and Antibiotics - what works and what doesn’t’ with Dr Kalos.

After a delicious morning tea, we had a sponsorship presentation by Dr Annamaria Sordillo, promoting the popular Guided Biofilm

Therapy for EMS. EMS also gave away a bottle of Moet as the lucky door prize and ran a draw to win a bottle of Mumm champagne.

“Treatment Planning, what should be the Hygienists role?” with Dr Grossberg and “Subgingival Debridement - Techniques and instruments” with Dr Kalos lead onto a delicious lunch and a chance to catch up with fellow hygienists and friends from the trade.

Before afternoon tea Dr Kevin Todes gave presentations on ‘Gingival Recession – when should it be treated?’ and ‘ Limitations of Subgingival debridement and Periodontal Surgery’ Afternoon tea gave us one last chance to mingle and see what›s new and popular with EMS, GSK and Healthy Gums.

The day wrapped up with “Peri Implantitis – What is the best way to treat it?” by Dr Alex Kalos and “Periodontal Maintenance - What’s expected and how often should we see our patients?”

Wishing you all well over the next few cold winter months - hope to see you all out our way in 2018 for the DHAA Ski Weekend at Lake Crackenback.

Dahlia Kruyer ACT State Committee Member

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Western Australia

Northern Territory

“ Feedback was that it was really worthwhile meeting our local/visiting specialists.”

OUR EVENING EVENT with maxilla-facial surgeon Dr Leon Smith was held at the Darwin Sailing Club. A great night with an interesting discussion from gingival pathologies to osteonecrosis.

Feedback was that it was really worthwhile meeting our local/visiting specialists, either because they were not aware of what they could refer to them or that they now felt like they knew who they were referring to.

Upcoming events include a half day in Alice Springs on 12 August and a half day in Darwin on 10 September.

Both great reasons to come and explore the NT at the same time as receiving some valuable CPD. Visit the website for more info.

If you are interested in joining the NT committee in any capacity feel free to get in touch via email at directornt@dhaa.info Leonie Brown NT Director

“ Wendy Wright’s WA Model of Care 0-4 year old program has been implemented and so far two pilot sessions have been presented.”

I HAVE BEEN gradually settling into the role of WA Chair with much help and thanks from our WA committee.

Wendy Wright’s WA Model of Care 0-4 year old program has been implemented and so far two pilot sessions have been presented. The first with children 0-4 and their parents. The second with new mothers and their babies. The parents filled out an evaluation survey form to give the program needed feedback.

The voucher given will enable the parents to attend the Oral Health Focus Centre for a complimentary clean for the parent and a dental screening and ride in the child friendly dental setting.

So far the response has been encouraging.

More sessions have been scheduled within the next fortnight, endeavouring to encourage parents to attend an appointment and introduction to a friendly child orientated dental visit.

Rhonda Kremmer (WA Director) Carmen Jones (DHAA member) and myself also attended a Leadership Day in Melbourne on Saturday 6 May. Rhonda and I also attended the Board meeting with all

27 For all the latest info on DHAA events near you please visit www.dhaa.info/events

DHAA Directors, Chairs and President.

WA has two scheduled CPD events. A dinner meeting at the George Hotel Perth on 11 August with two scientific hours of CPD. Speaker and topic to be announced.

Our one day event in the town of Busselton “Through the Looking Glass” on the 3 June, has just happened.

With very interesting talks on Hypnotherapy, St John Ambulance Managing Medical Emergencies, Digital Photography and Ultrasonic Debridement-Tips and Techniques.

WA membership interest has increased, and our WA Director Rhonda Kremmer attended the OHT Curtin University Students awards night and had success in promoting membership.

It is encouraging to see past members re-joining and new members coming on board.

The WA DHAA committee are calling on all members that maybe interested in joining the committee at any stage whether for the remainder of 2017 or for the start of the new year, expressions of interest are most welcome to inject new talent and contributions.

Aileen Lewis Western Australia State Chair

Victoria

“ Each registrant received a sample bag of goodies, including a new range of biodegradable toothbrushes, made in Melbourne.”

THE VICTORIAN CPD calendar is under way for 2017 and the first event was held at The Kent Hotel in March. It always draws a good number of attendees as it’s close to the city and the Melbourne University.

It’s a cozy pub with great food and this year we had some second year BOH students attend which was great to see. The event was sponsored by Orien who launched some new products on the night and each registrant received a sample bag of goodies, including a new range of biodegradable toothbrushes, made in Melbourne. Please contact Karryn Ellis at Orien if you would like more details.

Orien supplied a door prize, which was won by Heidi Liu and the presentation for the evening titled “What Do We Need to Know as Health Professionals” was delivered

by Michael Jovanovic who

works at St. Vincent’s Hospital in Melbourne. His enthusiastic and charming presentation gave us an update on new and commonly used drugs and the protocol for AB cover.

The first weekend in June will see our first full day event to be held in Daylesford where we will have special guests from interstate committees, so great to have them along!

The day will be sponsored by Colgate and GSK. The next event is to be held in Albury in August, followed by the National Symposium in Adelaide and then our annual half day event will be held on Saturday, 2 December at the Kooyong Lawn Tennis Association. Check the DHAA website for all details.

Keep warm everyone, best wishes to you and your families.

Anne DiPaolo Victoria State Chair

28

Queensland

“ Carol Tran will be presenting at CQU on the 15 July on the topic of Ultrasonics and Air polishing – hopefully it will get your debriding in the fast lane!”

A LOT HAS been happening in Queensland over the last few months.

On 24 March we held our first supper meeting for the year which was a great evening of learning and fun! Our delegates enjoyed the presentation by Dr Sven Bohnstedt on the topic of periodontal surgery.

Our next event for the year is on the 3 June – A hands-on sharpening workshop and presentation on Oral Health Care for Baby Boomers. This event has sold out now, and we are hoping to do some more hands on workshops in the future. A big thank you to Colgate, Hu-Friedy and Henry Schein Halas for bringing this event together.

Registrations are open and filling quickly for our next two upcoming events.

Carol Tran will be presenting at CQU on the 15 July on the topic of Ultrasonics and Air polishing – hopefully it will get your debriding in the fast lane!

Our ever popular half day seminar is on 5 August.

The theme is cancer and we can now confirm Dr Neil Savage (Oral Pathologist) is amongst the line up of speakers. Also, as part of this event is the opportunity to

CQU - First-year students

March 24 – Supper Meeting

update your CPR skills with a refresher course to end the day. So make sure you have registered!

A big congratulations to Liza Pretorius who is the CQU Bachelor of Oral Health degree 3rd year student

DHAA prize recipient! Karen Smart presented the award to Liza on the 18th of May on behalf of the DHAA at the awards and prize night. Karen also presented to the 1st year students on the behalf of the DHAA in April.

29 For all the latest info on DHAA events near you please visit www.dhaa.info/events

New South Wales

Karen Smart and Liza Pretorious

Don’t forget to keep up to date with all the latest news on our website www.dhaa. info.

We hope to see you at our next event,.

Carlene Franklin Queensland State Chair

“ Overall Tamburlaine donated $300 to the DHAA which we in turn are donating to a local Newcastle charity who provide assistance to victims of domestic violence.”

THE BUSY START to the year has continued. Our most recent event was a sell out in the Hunter Valley with over a 100 people in attendance.

Thank you to everyone who came along on the day and a very special thank you to our sponsors – Colgate, EMS, Phillips, GSK, and GC. We were also very proud to host a DHAA member Kelly- Jean Burden who was there with her company Let’s Talk Teeth. They are raising money for the Queen of Hearts Foundation by making “sparkle” kits for victims of domestic violence. To find out more about this cause visit www. letstalkteeth.com.au Tamburlaine Winery came along and provided a wine tasting at the end of the day along with a donation, from wine purchased on the day, of $300 which we in turn are donating to a local Newcastle charity who provide assistance to victims

of domestic violence.

We also collected toothbrushes and toothpastes to donate to the Gosford and Wyong mental health units to help those admitted for emergency care, a very big thank you to all of those who contributed and we have two large boxes which will make a huge impact for those who need them.

We have written the 2018 diary and we are excited to be heading back to Byron Bay for the Australia Day long weekend again and a Ski weekend in August 2018, make sure you visit the DHAA website to find more information www.dhaa.info Our next big event is our full day seminar in Sydney on Orthodontics with Dr Derek Mahony, this day is relevant for all members of the dental team and we hope to see many of you there.

Tabitha Acret NSW State Chair

COULD THIS BE

Motor Neurone Disease?

Alison Mudie of MND Australia tells the Bulletin how to spot the early stages of this debilitating disease

M

otor neurone disease (MND), a progressive and ultimately fatal neurodegenerative disease, is often clinically difficult to diagnose with insidious onset and different combinations of upper and lower motor neurone findings including changes in speech and swallowing.

Dental professionals who are at the frontline of identifying early dysphagia and dysarthria now have access to a diagnostic tool developed for GPs and other health professionals by MND Australia.

Painless, progressive weakness – Could this be motor neurone disease? highlights MND ‘red flags’ and aims to prompt early recognition of potential MND symptoms during health examinations and treatments.

There is no single investigation specific to MND (also referred to as Amyotrophic Lateral Sclerosis or ALS) and no sensitive diseasespecific biomarker, so diagnosis is based on symptoms, clinical findings and the results of electrodiagnostic, neuroimaging and laboratory studies.1 In reaching a confirmation of MND, the diagnostic period is often lengthy. On average, the time from first symptoms to diagnosis is 14 months while, for people diagnosed with MND, the time from diagnosis to death is just 2.5 years.

Rapid and accurate diagnosis is crucial in ensuring the needs of people living with MND are met from the earliest possible stage.

Painless, progressive weakness – Could this be Motor Neurone Disease?

1. Does the patient have one or more of these symptoms?

Bulbar features

Limb features

• Dysarthria • Slurred or quiet speech often when tired

• Focal weakness

• Dysphagia • Liquids and/or solids • Excessive saliva • Choking sensation especially when lying flat

• Loss of dexterity

• Tongue fasciculations

• Falls/trips – from foot drop • Muscle wasting • Muscle twitching/fasciculations • Cramps • No sensory features

Respiratory features

Cognitive features (rare)

• Shortness of breath on exertion

• Behavioural change

• Excessive daytime sleepiness

• Emotional lability (not related to dementia)

• Fatigue

• Fronto-temporal dementia

• Early morning headache • Orthopnoea

2. Is there progression?

Supporting factors

Factors NOT supportive of MND diagnosis

• Asymmetrical features

• Bladder/bowel involvement

• Positive family history of MND or other neurodegenerative disease

• Prominent sensory symptoms

Note that MND can present at any age.

• Double vision/ptosis • Improving symptoms

If the answer is YES to questions 1 and 2 – query MND and refer to Neurology.

If you think it might be MND please state explicitly in the referral letter.

Common causes of delay are initial referral to ENT or Orthopaedic services.

Accepted clinical resource

Bulbar features

Limb features 70% of patients present with limb symptoms

25% of patients present with bulbar symptoms • Dysarthria • Quiet, hoarse or altered speech • Slurring of speech often when tired

• Dysphagia – more often liquids first and later solids. Initially can be sensation of catching in throat or choking when drinking quickly.

• Excessive saliva • Choking sensation when lying flat • Weak cough – often not noticed by the patient Consider referral to neurologist rather than ENT if painless, progressive dysarthria is present.

• Focal weakness – painless with preserved sensation • Distal weakness • Falls/trips – from foot drop • Loss of dexterity e.g. problems with zips or buttons

• Muscle wasting – hands and shoulders.

Typically asymmetrical.

• Muscle twitching/fasciculations • Cramps

Respiratory features

Cognitive features

Respiratory problems are often a late feature of MND and an unusual presenting feature. Patients present with features of neuromuscular respiratory failure:

Frank dementia at presentation is rare.

Cognitive dysfunction is increasingly recognised, as evidenced by:

• Shortness of breath on exertion

• Behavioural change such as apathy or lack of motivation

• Excessive daytime sleepiness

• Difficulty with complex tasks

• Fatigue

• Lack of concentration

• Early morning headache. Patients often describe a ‘muzziness’ in the morning, being slow to get going or as if hung over.

• Emotional lability (not related to dementia) Ask specifically about a family history of these features.

• Un-refreshing sleep • Orthopnoea • Frequent unexplained chest infections • Weak cough and sniff • Nocturnal restlessness and/or sweating Consider MND if investigations for breathlessness do not support a pulmonary or cardiac cause.

MND Australia thank the MND Association of England, Wales and Northern Ireland for permission to amend and reproduce this publication for distribution in Australia.

Accepted clinical resource

The Motor Neurone Disease diagnostic tool has been officially recognised as an Accepted Clinical Resource by the Royal Australian College of General Practitioners.

MND Australia resources for health professionals: www.mndaustralia.org/gp To contact the MND association in your State or Territory call: 1800 777 175 Reviewed for use in Australia by: Neurology Dr William Huynh MBBS BSc (Hons), PhD, FRACP; Neurologist, Brain and Mind Centre, University of Sydney, Camperdown, NSW. Prince of Wales Hospital, Randwick, NSW. Professor Matthew C. Kiernan MBBS (Hons), PhD, DSc, FRACP; Bushell Professor of Neurology, Royal Prince Alfred Hospital. Co-director, Brain and Mind Centre, University of Sydney, Camperdown, NSW. Dr Susan Mathers MB ChB, MRCP (UK), FRACP; Clinical Director of Neurology, Calvary Health Care Bethlehem, Caulfield South, Victoria. Consultant Neurologist, Monash Medical Centre, Clayton, Victoria.

General Practice Dr Catherine (Kate) George BMed, DCH (Dip Child Health), FRACGP; General Practitioner, The Leichhardt General Practice, Leichhardt, NSW. Clinical Editor, HealthPathways Sydney.

Creative proudly sponsored by DesignLogic Australia. designlogic.com.au

Dr Lara Mihaljevic MBBS, DCH (Dip Child Health), GradDip Public Health; General Practitioner DMC Medical Centre, Drummoyne, NSW. Clinical Editor, HealthPathways Sydney.

© Copyright 2016

MND Australia, State MND Associations.

Painless, progressive weakness – Could this be motor neurone disease? aims to assist health professionals in their referral to a neurologist thereby speeding up the time to an accurate diagnosis.

There are a proposed handful of key clinical features on examination which, in the presence of a history of progressive weakness, should prompt suspicion for a diagnosis of MND. These include widespread fasciculations that may be visible as brief twitching under the skin or in the tongue and wasting of the tongue margins. Lower motor neurone weakness affecting bulbar muscles may present as slurred, nasal or hoarse speech, dysphagia or drooling while upper motor neurone involvement may present as slow and spastic dysarthria.2 Painless, progressive weakness – Could this be motor neurone disease? outlines MND signs and symptoms including bulbar and limb features, respiratory and cognitive features as well as supporting factors that point towards a diagnosis of MND. Dental professionals can download the red flags diagnostic tool from the MNDcare website www.mndcare.net.au Painless, progressive weakness – Could this be motor neurone disease?

All MND enquiries can be made via the toll-free number: 1800 777 175 Reference: 1. Andersen PM, et al. Eur J Neurol 2012;19:360-375. 2. Huynh W, Kiernan M. Motor neuron disease Australian Doctor 29 April 2016: 17-24.

31

Tasmania

“ We the event was a sell-out, attracting members from far and wide, including Dubai!

IT’S ALL SMILES on the Apple Isle as we look forward to some exciting CPD events in our state!

Since our last State of the Nation report, we held an exclusive Hands on Periodontal Instrumentation Workshop sponsored by Hu-Friedy in Hobart. With limited ticket sales on offer, the event was a sell-out, attracting members from far and wide, including Dubai! Delegates were refreshed on their basic and advanced instrumentation techniques, posture and ergonomics. Special thanks to Periodontist Dr Alex Du Bois, the Hu Friedy Team: Judy, Robyn and Deb and also Jennie our Tas Henry Schein Halas representative, for sharing their wealth of knowledge and experience!

Pack your thermals for our July full day CPD event in Launceston; why not extend your stay and take advantage of the Winter Warmer Specials at Cradle Mountain! Then, join us in November for an early Christmas Afternoon High Tea in Hobart before the silly season starts!

We are working on the 2018 CPD calendar and encourage you all to email

Delegates really enjoyed the hands-on workshop

me: taschair@dhaa.info, if you are interested in becoming involved on the committee or have any topic suggestions.

Details of all upcoming events can be found on the

DHAA members website and also via the Eventbrite website. I look forward to seeing you at our upcoming events.

Rachelle Johnson Tasmania State Chair

34

DHAA Year Planner - 2017...

The 2017 CPD Events calendar is already filling up. Full details at www.dhaa.info/events

MONTH

DATE

EVENT

LOCATION

JUN-17

14 June

DHAA NSW CPD “Lasers in Dentistry” Dinner Meeting

North Sydney Harbourview Hotel, Sydney, NSW

14 June

DHAA ACT CPD Dinner Meeting “Hepatitis C and HIV”

TBC

17 June

DHAA NSW Half Day Wollongong

TBC

23 June

DHAA SA Dinner Meeting

Adelaide Oval, Ian McLachlan Room, SA

24 June

DHAA NT/ADOHTA joint event

TBC

TBC

DHAA TAS CPD Full Day

Peppers Seaport Hotel, Launceston, Tas

15 July

DHAA QLD Ultrasonics and Airpolishing

CQU

22 July

DHAA and ADOHTA CPD Full Day Orthodontics

Airport function Centre, Sydney, NSW

29 July

DHAA TAS CPD Full Day

Launceston, NT

5 August

DHAA QLD half day event + CPR

Brisbane, Qld

11 August

DHAA ACT PD Day “Better Together”

TBC

11 August

DHAA WA Dinner meeting

George Hotel, Perth, WA

12 August

DHAA NT Half day CPD

Alice Springs, NT

17 August

DHAA and ADOHTA Dinner Meeting

Newcastle, NSW

19 August

DHAA NSW/VIC CPD event

Ceccanti Kiewa Valley Wines (near Mt Beauty)

2 September

DHAA VIC

Albury, Vic

9 September

DHAA QLD Brunch Meeting

Sunshine Coast, Qld

9 September

DHAA NSW “Perio Masterclass”

Novotel Coffs Harbour Pacific Bay Resort, Coffs Harbour, NSW

JUL-17

AUG-17

SEP-17

10 September

DHAA NT Half day CPD

Darwin

OCT-17

12-14 October

DHAA 2017 National Symposium

Adelaide Convention Centre, Adelaide, SA

NOV-17

18 November

DHAA VIC Christmas drinks

TBC

19 November

DHAA QLD Christmas Breakfast Meeting

Brisbane, Qld

25 November

DHAA TAS Christmas afternoon high tea

Hobart

TBC

DHAA QLD Homeless Connect

TBC

3 December

DHAA SA Christmas Breakfast

The Function’ at the Beachhouse, Glenelg

DEC-17

...and onto 2018

The 2018 CPD Events calendar is taking shape. Full details at www.dhaa.info/events

MONTH

DATE

EVENT

LOCATION

JAN-18

27 January

DHAA NSW Full Day CPD

Byron Bay, NSW

FEB-18

3 February

DHAA TAS CPD half day CPD

Food Festival, Launceston, Tas

6 February

DHAA SA New graduate social event

TBC

16 February

DHAA NSW New graduate cocktail party

Sydney, NSW

MAR-18

21 March

DHAA SA Supper Meeting

TBC

APR-18

7 April

DHAA NSW Full Day CPD

Hunter Valley, NSW

MAY-18

5 May

DHAA and ADOHTA half day event

TBC

JUN-18

23 June

DHAA NSW Full Day CPD

Sydney, NSW

29 June

DHAA SA Formal dinner meetingw

TBC

4 August

DHAA NSW CPD Ski Weekend

Perisher, NSW

AUG-18

11 August

DHAA SA Destination CPD event

Wine Country, SA

SEP-18

7 September

DHAA SA Full day CPD

TBC

OCT-18

Oct

National Symposium 2018

TBC

DEC-18

2 December

DHAA SA Christmas Lunch

TBC

Key to the state colours n ACT

nN SW

n NT

n Qld

nS A

n Tas

n Vic

nW A

Develop Empower Support www.dhaa.info

STRIVING FOR EXCELLENCE