Issue 50 Mar-Apr 2019

The official newsletter of the Dental Hygienists Association of Australia Ltd

Periodontal disease & Alzheimerâ€™s We discuss the reports of an oral bacterial connection

Supporting #Thirsty Backing the Rethink Sugary Drink campaign

Happy with your job? Exploring the variety of career opportunies for our profession

STATE ROUND-UP Find out whatâ€™s happening in your local area

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Welcome to 2019 – we’re off to a flying start WE’RE GEARING UP for an exciting year here at the DHAA and we hope you like what we’ve got in store. Firstly, I would like to thank all committee members who have stepped down at the end of 2018. The Association wouldn’t be what it is without the hard work and dedication of our volunteers so a massive round of applause and thank you from all of us. Also, a big welcome to all of our new volunteers who have come on board for 2019. We are so excited to hear your fresh ideas and perspectives and watch you bloom in your new roles. Over the Christmas period we also said goodbye to our CEO, Dr Melanie Hayes, who has moved on to pursue an opportunity at Sydney University. We wish Mel all the best in her new role, and look forward to seeing her at a DHAA event soon. Following on from this we welcome our new CEO Bill Suen. who comes to us from the Pharmaceutical Society of Victoria and brings years of knowledge and experience in association management. We look forward to working with him to continue the positive growth of the Association. As you know we are hosting the International Symposium on Dental Hygiene in Brisbane this August. The local committee have planned an absolutely cracking symposium filled with scientific presentations, wonderful networking opportunities and, of course, a fabulous social program. Make sure you head over to the website at www.isdh2019.com to get registered. Your state committees have planned an amazing CPD program this year; with events based on the feedback you gave us in the planning survey last year. Next up is our first ever nation-wide event for World Oral Health Day on 20 March, with events running simultaneously in every state. Jump onto the DHAA website to see what is planned near you, or maybe plan a sneaky weekend away to see what’s happening across the border. Finally, it gives me great pleasure to introduce your new Bulletin Editor, Marcy Patsanza. Many of you may recognize Marcy as a regular feature writer in the Bulletin, and I know you will all join me in wishing her all the best in this new role. Personally, I cannot wait to spend the year with you here at the DHAA and I look forward to seeing you at an event soon.

Contents 04 All the best... Mel Hayes

We bid adieu to Dr Melanie as she starts a new chapter.

07 Feedback

Your letters - answered.

09 The Future of Fluoride

An update on the future of new fluoride guidelines.

10 Making a Difference

Members working hard in the name of research.

12 Volunteer for Good

Traveling to Sister Lucille’s orphanage in Mongolia

COVER STORY

14 Periodontal Disease & Alzheimer’s Discussing the reports of an oral bacterial connection.

18 #Thirsty

Supporting the call for a sugar tax in Australia.

24 The trouble with sleep

How sleep disordered breathing affects oral health.

28 Happy in your job?

What else is there for you besides clinical practice.

30 Strive to be better

Self development focusing on being a better you.

32 State of the Nation

Your local state round-ups.

Cheryl Dey DHAA National President

Key Contacts PRESIDENT Cheryl Day CONTACT

ADMINISTRATION & EVENTS OFFICER Patricia Chan CONTACT

IT REP Josh Galpin CONTACT

BULLETIN EDITOR Marcy Patsanza CONTACT

The Bulletin is an official publication of the DHAA Ltd. Contributions to The Bulletin do not necessarily represent the views of the DHAA Ltd. All materials in this publication may be readily used for non-commercial purposes. The Bulletin is designed and published by eroomcreative.com

All the best... Mel Hayes Dr Melanie Hayes has been a major influence on shaping how the DHAA is today. As she takes on a new challenge away from the Association we look back at some of her major achievements by Margaret Galvin

he resignation earlier this year of Melanie Hayes (Mel) as CEO of the DHAA, reminds me a bit of ‘The Muppet Show’ theme song. A “most sensational, inspirational [tenure worth having a] celebrational” look back over as Mel moves on to her next career challenge. I first met Mel in 2012 when I was an oral health student. Her lectures were always interesting, and I found her enthusiasm for the subject was infectious. She carried this same enthusiasm over to her presidency of the DHAA, and further on to her tenure as CEO. Mel’s presidency had a significant effect on the DHAA and how it is currently organised. She provided sound leadership during a time when the association was undergoing a major restructure to a single, nationwide, entity. She was also instrumental in facilitating the 2017 DHAA Leadership Day, introducing annual reports and initiating better governance practices. This was continued during her CEO tenure with further development of DHAA policy and procedure, as well as improved staff performance management. Mel also worked hard for the members’ benefit as President by consulting with an industrial relations advocate on maintaining the award-free status of our profession and being the driving

force behind the introduction of the professional indemnity insurance package. Mel’s obvious passion for aiding in the development of outstanding dental hygienists (DH) and oral health therapists (OHT) can be recognised throughout her CEO tenure with the development and implementation of a range of initiatives. These include study clubs, a student leadership programme, a mentoring programme, a career development programme, the new Oral Health Awards and webinars. One of the hardest jobs an OHT or DH has is explaining to patients what it is we actually do. It is never ‘just a clean.’ Mel’s facilitation of a range of professional promotions for National Volunteers Week, International Women’s Day, and Dental Health Week has helped raise our professional profile. And who can forget the brilliant team effort of teaching ‘Troy’ from ‘Married at First Sight’ how to brush his teeth correctly? The word is that Kathryn Novak was behind the idea, successfully implemented by Mel and carried out by Shida Taheri! Kudos to all three for that effort. The DHAA Bulletin reached out to friends and colleagues of Mel in order to give Mel an understanding of what sort of personal and professional impact she has had on their lives.

“ Mel has always been an inspirational figure to me. I look up to her calm demeanour and professionalism.” Jacquie Biggar “ I’ve always been inspired by Mel’s leadership. She encouraged us to take ownership of our role, giving us autonomy and respect for the job we did while gently offering suggestions, other perspectives and insights. She was a wonderful sounding board and had a great work ethic. I will miss her approachable and friendly demeanour and wish her the very best for her next exciting challenge.” Aneta Zielinski “ Mel is an absolute inspiration. Her achievements during her time as CEO at the DHAA are uncountable and so valuable to our association. I have grown significantly both professionally and personally during her mentorship in my role and I will be endlessly grateful.” Shida Taheri “T ough, but sweet. Cool, but unique. A loud spirit but a quiet achiever. She’s beautiful contradiction.” Lyn Carman

“ I had the pleasure of meeting Mel in the inaugural year of Bachelor of Oral Health, graduating in 2007. Mel was a dental assistant working part time, studying full time and being a terrific mum. She has continued on studying and learning ever since. Mel has worked giving back to the dental field with her teaching and with her amazing leadership role with the DHAA. I feel Mel inspires people without even knowing it.” Melinda Alchin “ I first met Mel back in the days of DHAA Inc. when we were both on National Council. It has been a pleasure to work with her during the transition to DHAA Ltd and to have the honour of being the inaugural CEO/president team. Our weekly meetings were an insight into the hard work she did for the association. She was very tolerant of my “I have an idea” schemes, (some of which paid off) and was a measured and thorough professional.” Kathryn Novak “ Mel has been an inspiration to me in the DHAA. I have admired her ability to make clear headed decisions and have enjoyed sharing many laughs over the years. I would like to thank Mel for helping me to have the confidence to grow within the Association and achieve things I would not have thought possible for myself. Her hard work and achievements are undeniable.” Cheryl Dey “ Mel has been such a great asset to the DHAA and myself personally. She led us as president and then CEO. Mel helped transform the association from state branches to a national association, she has worked so hard for years for the DHAA and also personally helping

many members. She will be very much missed for her leadership and mentoring. I personally have sought advice and help from Mel on many occasions and I know that in her new role she will continue to be a leader and mentor to many new people. Thank you, Mel, (aka Becky with the good hair) for everything you have done for the DHAA and myself, you will be missed.” Tabitha Acret “ I appreciate how approachable Melanie has been since first meeting her at a National Board meeting in 2007.Melanie showed me a “tooth draw app” (smart phone app), which confirmed her easy-going nature, and confirmed that a new Era of DHAA members were joining Board commitments and contribute to national standards. Melanie has made significant contributions to the profession of dental hygiene over the years. I wish her well, and Congratulate her on the role at Uni of Sydney. “ Samantha Stuart

I had to look up the difference between the ‘President’ of a company and the ‘CEO’ of a company. In short, the President focuses on the present whereas the CEO focuses on the future. The legacy achieved by a company is the way to measure the CEO’s work and efforts. Mel, you should be proud of the legacy you have left the DHAA with. Thank you. I would like to thank all contributors to this article. Your words and time writing them, are much appreciated. Thank you to the DHAA website author who wrote about Mel’s achievements. The differences between a President and CEO were found at the following website: https://keydifferences.com/differencebetween-president-and-ceo.html .n

Did you know

Look out for interesting facts with each new issue! nA ustralians aged 15 years and

over have an average of 12.8 decayed, missing or filled teeth. n I n 2016–17, about 70,200

hospitalisations for dental conditions may have been prevented with earlier treatment. nA round 89% of the Australian

population have access to fluoridated drinking water. These stats nicely support the launch of the new Rethink Sugary Drinks “Thirsty” Campaign – let’s educate our patients and advocate for the consumption of fluoridated tap water!

2019 ADHF STUDY GRANT APPLICATIONS ARE NOW OPEN THERE ARE FIVE $5000 grants on offer from the Australian Dental Health Foundation (ADHF) and supported by the DHAA. These grants include mentoring by a qualified dental hygienist during the year. For further info please contact the Foundation Officer on (02) 8815 3333

Vaping is not as bad as it gets portrayed Dear Bulletin

I write in response to the Vaping article in Issue #49. Firstly congratulations on pulling this confusing topic to the forefront of DHAA members attention. I have researched vaping extensively and would like to reframe the message expressed from one of abject danger and illegality to one of encouraging moderation and stepping stone to harm minimisation. Numerous studies have demonstrated vaping is overall less harmful than traditional smoking practices due to the removal of tobacco, associated chemicals and lower burning temperature. While there exists a risk of nicotine dosing being abused with this delivery method, studies show high dosing has minority involvement and adverse nicotine impact is dose related. The popularity of vaping in preference to cigarettes has risen dramatically in the past two years globally. A new UK study has found users are nearly twice as likely to quit using vaping than other nicotine replacement products eg gum or patches. The primary solvents propylene glycol (PG) and vegetable glycerin (VG), are similar to xylitol, and are safe, commonly used food additives, although do promote dry mouth unlike xylitol. Many synthetic flavourings have questionable safety with heated byproducts a potential health risk long-term. Some companies produce flavourings from natural products like fruits or herbs that are much safer to use. A good example is nudenicotine.com. As an oral stimulatory and stress reduction habit I leave you with this question: is vaping worse than sugar, caffeine or alcohol consumption for oral and overall health? Dr Christine May Sydney, NSW

Hi Dr Christine. We are always welcoming and appreciative

FEED

BACK We want to hear from you! For your views and ideas email the Editor at bulletin@dhaa.info

of feedback. Articles featured in our Bulletin serve to be informative on current engaging topics in the industry so as to spark interest and initiate further research into the topic by our readers. They are not intended to be a substitute for published journal articles. They are mostly written by members of the Association sharing on their experiences and encounters supported by some pieces of research they may have come across. You have provided a wellresearched view point on this engaging topic. I believe this will definitely be beneficial to our readers to provide another view point and a further platform for discussion within the profession. Thank you again for the time taken to write back to us. It is at the best interest of our readers to be provided with opportunities for broadening their views especially on matters concerning the patients they encounter. Below are 12 links to articles provided by Dr Christine for further reading: Ed. ➜ Link #1

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How can I get involved? Dear Bulletin

I’m interested in volunteering in some way and the DHAA seems to be a natural choice as it is my professional association! I see a lot of volunteers at CPD events (keep up the great work guys!) but event planning is not really something I’m interested in. I’m sure I could help in some other way but I’m not really sure where to go or who to ask. Can you help? Rosalie Canberra, ACT

The DHAA is always interested in volunteers! I am happy to assist with linking you with someone in your state or particular field of interest if you email me at bulletin@dhaa.info . The Bulletin team is currently inviting members to join us in working together in compiling this informative Bulletin. It is quite casual; teleconference meetings are only quarterly. It feels quite rewarding to be part of a team and be able to use some of one’s time to give back in an enjoyable manner which benefits many. If you enjoy casual writing or just have great ideas and want to be part of a team by all means please do join us! Ed.

Line Of Choice Dear Bulletin

I enjoyed Lyn Carman’s feature about the ‘line of choice’ and how our decisions place us on either side of the line. It’s a good reminder to stop and think about our actions rather than just going into default mode, both in our work lives and at home. Thank you for your feedback! Lyn has a great interest and background in personal, team and leadership coaching. We sure have a lot we can learn from her articles and even share with our patients. We have now introduced a regular Self – Development Column with each issue so look out for more of these characterbuilding articles. Ed

World Oral Health Day Dear Bulletin

With World Oral Health Day just around the corner on 20 March I would love to use some promo material around my practice and maybe on social media. Do you have anything available or some links I could follow? Emily Brisbane, Qld

More information on how to get involved in a campaign can be found on the official FDI World Federation website. A complete starter campaign toolkit can be accessed on this link. Don’t forget to attend a CPD session in your state this World Oral Health Day, 20th of March 2019. Great opportunity to share a story with a fellow hygienist of how you are playing your part! Ed.

Aged Care Dear Bulletin

I have the utmost regard and respect for those in our profession who work in an aged care setting. The elderly in our community have already done their part in contributing to society, and deserve to be treated with kindness and care when they can no longer look after themselves. I’m sure we will hear some sad tales coming out of the Royal Commission hearings that are happening at the moment, but hopefully this will lead to some positive changes in this space. I applaud the DHAA for always being supportive of this area of our profession and take my hat off to all oral health professionals working in aged care. Nathan Perth, WA

We certainly applaud our colleagues who have a passion for geriatric dentistry and are currently helping out in that area. I am sure they will appreciate reading your kind words. We hope to be featuring any updates of the Royal Commission in our next issue. Be on the look-out! Ed.

From the Big chair New Bulletin editor Marcy Patsanza speaks

I AM HUMBLED and delighted to be taking up this challenge as your new DHAA Editor. I am a clinical Dental Hygienist working in private practice and in Aged Care settings. I have enjoyed contributing to the Bulletin as a writer for the past two years before being appointed to this new role. My hope is that with each publication you read, you may find an opportunity for growth; in knowledge and skill as well as an individual. To allow for this, the Bulletin will continue to address some views on current topics within the industry. I am also excited to be introducing regular columns addressing areas such as Career Development and Self-Development which will feature articles written by some of our fellow colleagues with great expertise and insight in these fields. A community spirit page will continue to be featured as a platform for members to get involved and be motivated to reach out into the community and make a difference. This will feature the great work being done by members, including the DHAA Community Oral Health and Research Grants available to members, to help aid you in your initiatives. Remember your purpose as a professional may be the answer to a problem that plagues a society! This Bulletin issue also introduces an on-going opportunity to write and submit a “Letter to the Editor” for your views and initiatives to be shared. Look out for some letters I recently received and have featured in this issue. These letters have certainly been beneficial and have provided interesting viewpoints! The previous editors, Joanna Mohammadi and Danielle Gibbens have played an outstanding role behind the scenes in ensuring the Bulletin was always of high standard. Their diligence paved way to deliver flawless issues each time. They have indeed left me with big shoes to fill! A big thank you to both of them for the hard work they have put in through the years and setting an example in which I hope to follow. Your work for the DHAA is greatly appreciated and all the best with your endeavours. Fellow members, the success of the Bulletin is made possible by your support, I would love to constantly hear from you. Your views deserve to be shared. If you are also interested in joining the Bulletin team, please write to me at bulletin@dhaa.info or marcy.patsanza@ dhaa.info As you go about your day, remember to visualise the best version of yourself and show up as that! Have a good read and remember: “Knowledge has a beginning but no end. – Geeta Iyengar Marcy Patsanza DHAA Bulletin Editor

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The Future of Fluoride A Bulletin update on the future of new fluoride guidelines in Australia By Ian Epondulan

LYN CARMAN AND Ian Epondulan represented the DHAA at the third twoday workshop on ‘The Use of Fluorides in Australia’ held on the 7-8 February 2019 in Adelaide. This workshop was hosted by the Oral Health Promotion Clearinghouse (Australian Research Centre for Population Oral Health – ARCPOH). Representatives from the professional associations, state oral health departments, universities and industry gathered to discuss the current guidelines which were initially developed at the 2006 workshop and updated at the 2012 workshop. The aim of the workshop was: n To highlight the importance and use

Professor Murray Thomson opens the National Oral Health Promotion Clearinghouse Workshop on ‘The Use of Fluorides in Australia’

of fluorides as the cornerstone in the prevention of dental caries n The need to monitor the use of fluoride vehicles in terms of their potential benefit (caries protection) and risk (causing dental fluorosis). Moderated discussion and Q&A sessions covered five themes: 1 Oral Disease – Statistics on the caries experience and fluorosis in children and adults in Australia over the years 2 Evidence update on the effect of Water Fluoridation on Dental Human Health based on the National Health and Medical Research Council (NHMRC) Review 2017 3 Discretionary Fluorides – Industry

update and reaction on the home use of toothpastes. 4 Fluoride as a nutrient – Nutrient reference values for fluoride and optimum fluoride intake 5 All other discretionary fluorides – Fluoride varnishes, silver diamine fluoride, topical fluoride gels, CPPACP and other novel fluorides or adjunctive treatments After the two days of discussions during the workshops, representatives now wait to be updated on the outcomes for 2019 and will be able to make further comments before being published as a new set of guidelines. We will keep you informed.

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10 members working A A H D n o e at d p An u hard in the name of research THE DHAA ENCOURAGE growth within the profession and opportunities for social responsibility. On a regular basis The Bulletin will feature the contributions of DHAA grant and award recipients as well as association members using their profession to make an impact in society. More information on how to apply for grants/ funds can be found on the DHAA website. Please send in the good work you are doing in your communities so as to share and encourage everyone. We would love to hear from you. Email the editor on bulletin@dhaa.info

2018 DHRF RECIPIENT

Kelsey Ingram The Economic Impact of Oral Health LINKS BETWEEN POOR oral health and non-communicable diseases (NCD’s) are well documented with preliminary research showing that poor oral health increases an individual’s risk of developing cardiovascular diseases, diabetes and cognitive impairment (WHO, 2017). In the absence of a cure for these diseases, modifiable risk factors need to be addressed. Preventing or treating poor oral health has been shown to influence the development of some NCD’s. Therefore, a preventive focus could potentially lessen the economic impact. My research is focusing on the effects poor oral health has on cardiovascular disease, diabetes and cognitive impairment as well as the impact this has on Australian healthcare resources. Policies are part of an approach which address the health impact related to managing NCD’s. Currently, I am assessing Australia’s policies regarding the impact of oral health on these diseases. Disturbingly, when Australia is compared to other countries with a

similar epidemiological profile, it staggers in comparison with its investment toward prevention of NCD’s (Lui et al, 2018). Given the increasing costs of NCD’s, the effect that dental professionals and early intervention could have on the quality of life of patients while diminishing the economic burden for society strongly supports further investigation. (Borgnakke, W, 2015). I am excited to continue this research and discover more on the economic impact of oral health. Research in this area is relatively limited. It is encouraging to have received the support of the DHAA through this grant. 2018 DHRF RECIPIENT

Karen Smart Comparative Study of Dental Practitioners and Speech Pathologists working collaboratively. IN 2018 I was the recipient of the DHAA Dental Hygiene Research Fund (DHRF). A comparative study of Speech Pathologists and Dental Practitioners from Central Queensland (CQ) and Central Coast of New South Wales (NSW) working in collaboration– “Interprofessional Practice”

(IPP) was undertaken. The last year has been rewarding and provided a research opportunity for which I am thankful. I urge DHAA members who have a research question and a passion for research to consider applying for a DHRF. Dental practitioners (DPs) and speech pathologists (SPs) share an interest and expertise in the stomatognathic system yet there is scant information as to how or in which settings DPs and SPs work together to manage disorders of this system. How they perceive each others roles in collaborative practice is also lacking. The aim of the research was to gather an understanding of regional SPs’ and DPs’ experiences and perceptions in an interprofessional partnership. For the purposes of the study ‘Dental Practitioners’ refers to dental specialist, dentists, oral health therapist, dental hygienists, therapists and prosthetists as defined by the Dental Board of Australia (2014). Speech Pathologist are allied health professionals who assess, diagnosis and treat communication and swallowing disorders across the lifespan (Speech Pathology Australia, 2015). An anonymous online survey was selected as part of a cross-sectional study design to gain an understanding of CQ and CCNSW speech pathologists’ and dental practitioners’ perceptions, knowledge

11 and experience in IPP and compare the data between the two geographic areas in Australia. A thematic analysis of the qualitative component identified common themes and barriers to engaging in IPP. In CQ and the Central Coast of NSW majority of surveyed SPs and DPs had not engaged in a specific Speech Dental IPP. In both regional areas there was an incomplete understanding of respective roles and what each profession could offer the other despite the majority of respondents indicating the importance of IPP. Limitations around expertise, scope of practice and knowledge were identified as barriers. The majority of participants indicated willingness to engage in IPP and reported workplace support was available. The sample size was small and may not be representative of a larger participant group or a metropolitan area. SPs and DPs recognise the benefit of IPP to improve differential diagnosis and intervention designs for clients. They do not however, appear to fully understand how their roles can intermesh for best use of respective knowledge, despite willingness to engage in IPP. A larger study would be beneficial to gain clarity for this type of partnership. Further data analysis and comparison is being completed and will be presented as a poster presentation at the ISDH in August 2019. Thank you to Ms Jenni-Lee Rees, Dr Barbra Zupan, Associate Professor Leonie Short and Dr Janet Wallace for your guidance and support, and the DHAA for funding the research. Look out for Karen’s completed poster at the ISDH in Brisbane this October! .n References: Borgnakke, W. (2015). Does Treatment of Periodontal Disease Influence Systemic Disease? Dental Clinics of North America. 59 (4) 885–917. DOI: http://dx.doi. org/10.1016/j.cden.2015.06.007 Lui, H., Muhunthan, J., Ananthapavan, J., Hawe, P., Shiell, A., Jan, S. (2018). Exploring the use of economic evidence to inform investment in disease prevention – a qualitative study. Australian and New Zealand Journal of Public Health, 42(2) 200206. doi: 10.1111/1753-6405.12748 World Health Organization. (2017). Mortality and global health estimates. Retrieved from http://www.who.int/ gho/mortality_burden_disease/en/

Aiming for a cavity-free future Reporting from the World Cavity-Free Future Day 2018 by Cathryn Carboon

THE ALLIANCE FOR a Cavity-Free Future (ACFF) is a worldwide group of experts who have combined to increase global awareness of dental caries. On 14 October, 2016, the ACFF launched World Cavity-Free Future Day (WCFFDay) with the aim to engage with communities around the world and to send a ‘wake-up call’ to those with the ability to make social, economic and political changes to encourage action towards achieving a cavity-free future. To celebrate WCFFDay in 2018, Colgate-Palmolive and the DHAA teamed up with ACFF to provide ‘Cavity Free Future’ oral health promotion boxes to assist dental hygienists to hold WCFFDay events. A DHAA & ACCF ‘Cavity Free Future’ box was put “Colgate-Palmolive and the DHAA to good use by the Carevan Foundation’s Sun Smiles teamed up with ACFF program to support two key components of their to provide ‘Cavity program; Oral Health Literacy and Nutrition. Sun Free Future’ oral Smiles partnered with the Wangaratta High Country health promotion Library to showcase #WCFFDay on the 14 October, boxes to assist dental with oral health literacy activities continuing till the hygienists to hold end of National Water Week. WCFFDay events” A pull-up banner, developed from the children’s picture book “Who is the Tooth Fairy’s best friend?” written by Cathryn Carboon and published by the DHAA, featured the Fluoride Fairy and encouraged children to drink fluoridated tap water, which complimented National Water Week. Books were made available in the library for families to borrow and read. The books were also incorporated into the library’s “Storytime Sessions”. A highlight of “Storytime” was a new book reading stage complete with giant tooth stools and the ‘biggest’ toothbrush in Australia! Community members who visited the library were able to enter a Fluoride Fairy drawing competition to win #WCFFDay packs, including WCFFDay water bottles, toothbrushes and fluoride toothpaste. It is never to early to start planning for WCFFDay for 2019! Head to the WCFF Day website for more inspiration and resources. Don’t forget to share your story with us at bulletin@dhaa.info .n

Did you know?

The goal of the ACFF is that children born after 2026 should remain cavity free for life!

PIRIT NITY S COMMU

MONGOLIA Aileen Lewis and her sister travel to the Sister Lucille’s remote orphanage and provided much-needed oral health education to the residents

n the 23 June last year my sister Jo and I travelled to Mongolia. Our intention was not only to tour this amazing country but to help Sister Lucille with her Summer Camp and the Catholic Caritas Church Orphanages. For the first month we travelled 4000km from the capital Ulaanbaatar heading south to the old capital Baya Nur then north-west to Erdenet. We also travelled to the Siberian border and to Hatgal and Khuvsgul Lake. The journey took us to the most remote places that I have ever seen, with Ger Camps scattered over the countryside like white mushrooms. Most people in the rural parts of Mongolia are herders and are nomadic so their family home moves two or three times a year, mainly in May and October and then relocate from November to April to a winter camp with stone shelters for their yaks, cows, sheep and goats as the winter temperatures can drop to -45˚C. We were privileged to help a family put their “Ger” up for their holiday at White Lake near a geothermal spring

and spa, with five adults and one 10 yearold girl. It took us only an hour to put up their family home. We visited the colossal statue of Chinggis Khan (Genghis Khan) which is 54km east of the capital. The statue is made entirely of stainless steel and is 40 metres tall. We were lucky to travel in the season of the Naadam festival (Mongolia’s Independence Celebrations 11-15 July) with traditional horse racing, wrestling, eagles, archery, Bactrian camels, yaks and many different wildflowers. The food in Mongolia consists mainly of mutton, goat, yak, horse and fish (if you’re lucky to catch one!) potatoes, a cabbage salad like coleslaw, yoghurt, lentil/beans and of course vodka and fermented mare’s milk (I was not fond of this). The Mongolians will make vodka out of anything; fermented milk, vegetables you name it and it is almost 70% proof. This probably explains the rosy cheeks on so many of the adults. We saw a lot of poverty in the capital particularly with the Ger district cramped, no running water and sanitation that

“We saw a lot of poverty in the capital particularly with the Ger district cramped, no running water and sanitation that was restricted to a usual four-metre drop toilet with generally two wooden planks to stand on, definitely not for the faint-hearted!” was restricted to a usual four-metre drop toilet with generally two wooden planks to stand on, definitely not for the fainthearted! We certainly went through the hand sanitiser at a rate of knots and used refresher towels over our noses. On our arrival at Sister Lucille’s Orphanage my sister handed out the knitted teddies her church ladies had made. I delivered oral hygiene instruction

The mobile dental unit took centre stage

An evening of insight into the world of rural dentistry

complete with plaque disclosing solution, much to the children’s amusement when I demonstrated on an adult’s teeth first. Next, the children watched the toothbrush instruction with one of the teeth in my models falling out on the floor. My interpreter, Ider, joked to the children if they did not brush morning and night and correctly like I showed them their adult teeth would fall out just like the model. We toured the new orphanage and school in the capital and have since donated funds to help finish off the roof. We continue to fundraise to support a teacher. Serdamba is from the Reindeer tribes in north-western Mongolia. Two or three times-a-year he delivers school supplies, toiletries and clothing to the families of this area; a trip that takes him two weeks in his 4x4 vehicle. We took heart that families in the areas that we met across the steppes of Mongolia took a little bit of cheer from our visit. We hope their oral hygiene practices have been improved thanks to the generosity of Colgate and the 200 toothpastes and toothbrushes that we distributed. n

ON THURSDAY 27 SEPTEMBER, 2018, an evening of insight into rural dentistry was held by Spinrphex in coorperation with DHAA at FJ Clark lecture theatre complex and Hollywood primary school in Nedlands, WA. The evening started with a showcase of the mobile dental unit courtesy of dental health services of WA and one of our speakers Amber Sabien (a Dental Therapist) out in rural WA. Attendees along with guest speakers then enjoyed some light meals and refreshments before heading into the first lecture. Professor Marc Tennant, talked to us about future careers in dentistry and future innovations, including exciting opportunities of different career paths not limited to only a clinical physician position. He explored the options of dental careers in Telehealth in WA and discussed the robotic lingual orthodontics wire bending innovation – which not only can bend arch wires but also can place brackets on teeth! Dr. Josh Oversby then spoke of his own experience working in rural and remote areas of WA. He talked of the obstacles and challenges that he overcame working in Meekathera, the beauty of this little country town and why everyone should aim to experience the rural work environment at least one time in their career. The evening concluded with Amber Sabien sharing her experience of working in a mobile dental unit and what rural work life involves. She enlightened the audience on the advancements of the dental health services. The evening was interactive and engaging for all attendees – many of who were students. We also had a few oral health therapists attend the evening and the feedback has been fantastic. A big thank you to Rhonda Kremer and Wendy Wright for supporting the event on DHAA’s behalf and Laura Ward, Reshmeta Moses and the OHT students from Curtin University who volunteered their help for the evening. Finally, a very big thank you to all our wonderful speakers Professor Marc Tennant, Dr. Josh Oversby, Amber Sabien, and Katelyn Gardiner. n

Can periodontal disease be linked to Alzheimer’s? Recent news reports have suggested that an infection initiated by a bacterium found in the oral cavity could be a predisposing factor or an initiator of Alzheimer’s disease. The Bulletin takes a closer look at the evidence By Margaret Galvin

lzheimer’s disease (AD) is the most common type of dementia, causing problems with memory, thinking, and behaviour. Dementia affects approximately 160 000 Australians, with Alzheimer’s disease accounting for 50-75% of dementia cases. The most important risk factor of Alzheimer’s disease is the increase of age. Other predisposing factors thought to contribute to Alzheimer’s include genetics, chromosomal factors, diet, and aluminium. As you may well know, periodontal disease is an inflammatory disease which affects the soft and hard structures that support the teeth, or as I tell my patients, it is a disease that destroys the structures that help hold your teeth in your head! Porphyromonas gingivalis (P. gingivalis), the pathogen which contributes to the pathogenesis of Chronic Periodontitis, has been found in the brains of deceased Alzheimer’s patients. Could it be that periodontal disease is also a predisposing factor or an initiator of Alzheimer’s disease?

The Science The following is what researchers have found through one particular scientific study – Ilievski, V. Zuchowska, PK. et al 2018:

n 10 mice in a study group were exposed orally to

P. gingivalis over 22 weeks and another 10 mice were in a control group n Brain tissue health was studied in both groups after 22 weeks n Significantly higher amounts of accumulated amyloid beta (peptides found in the plaques of brains affected by AD) was found in the study group n Increased brain inflammation and fewer intact neurons due to degeneration were also found in the study group n DNA of the bacteria was found in the brain tissue of the study group n Bacterial protein was noted inside their neurons

“Researchers state their results strongly suggest that chronic oral infection of P. gingivalis can be an initiator of the development of neuropathology that is consistent with that characteristic of Alzheimer’s disease in humans”

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17 n Researchers state their results strongly suggest

that chronic oral infection of P. gingivalis can be an initiator of the development of neuropathology that is consistent with that characteristic of Alzheimer’s disease in humans Another study – Dominy, Lynch, Ermini, Benedyk et al 2019 – found the following: n The analysis of brain tissue, spinal fluid, and saliva from AD patients (both living and deceased) found evidence of P. gingivalis n Gingipain (a protease secreted by P. Gingivalis) was shown to be neurotoxic to Tau (a protein needed for normal neuronal function) n It is thought the P. gingivalis and/or its product gingipain travel to the brain and acts in AD pathogenesis to promote neurone damage n The presence of P. gingivalis increased the production of amyloid beta, a component of the amyloid plaques, whose build-up contributes to Alzheimer’s disease n Small-molecule inhibitors were designed and synthesised targeting gingipains to block neurotoxicity n The inhibition of gingipain reduced the bacterial load of an established P. gingivalis brain infection, blocked amyloid beta production, reduced neuroinflammation, and rescued neurons in the hippocampus (the part of the brain thought to be the centre of emotion, memory, and the autonomic nervous system) n The researchers state “Our identification of gingipain antigens in the brains of individuals with AD and also with AD pathology but no diagnosis of dementia argues that brain infection with P. gingivalis is not a result of poor dental care following the onset of dementia or a consequence of late-stage disease, but is an early event that can explain the pathology found in middle-aged individuals before cognitive decline” However, Dr David Reynolds, the Chief Scientific Officer from Alzheimer’s Research UK, states that: “While some studies have found higher levels of References: • Alzheimer’s disease https://www.myvmc.com/ diseases/alzheimers-disease/ Accessed 17Feb19 Bacteria behind gum disease linked to Alzheimer’s https://www.alzheimersresearchuk.org/bacteriabehind-gum-disease-linked-to-alzheimers/ Posted on 23rd January 2019. Accessed 17Feb19 Dominy, S. Lynch, C. Ermini, F. Benedyk, M. et al. (2019). Porphyromonas gingivalis in Alzheimer’s

bacteria in the brain during Alzheimer’s, it has been difficult to tell if they have played a direct role in the development of the disease. We know diseases like Alzheimer’s are complex and have several different causes, but strong genetic evidence indicates that factors other than bacterial infections are central to the development of Alzheimer’s, so these new findings need to be taken in the context of this existing research.

“While some studies have found higher levels of bacteria in the brain during Alzheimer’s, it has been difficult to tell if they have played a direct role in the development of the disease” Dr David Reynolds Chief Scientific Officer, Alzheimer’s Research UK

Maintaining good dental health is an important part of a healthy lifestyle, and while we don’t yet fully know the extent to which it can affect our dementia risk, the presence of a single type of bacteria is extremely unlikely to be the only cause of the condition.”

What does all this mean for oral health professionals? We should all be keeping an eye on the developing literature on this subject as it comes to light and sharing it with our colleagues for discussion. I also think it provides an opportunity to reiterate to our patients that they can do so much for their general health by taking their oral health seriously. The information provided in this feature was acquired from the sources referenced below and has been published to raise awareness of these research finding. This article does not serve as a substitute for a journal research article. We encourage further research by readers and if you find anything else of interest about the topic, please feel free to share it by writing to the editor at bulletin@dhaa.info. n

disease brains: Evidence for disease causation and treatment with small-molecule inhibitors, 5 (1) Science Advances: eaau3333. DOI: 10.1126/sciadv.aau3333 • Ilievski V, Zuchowska PK, Green SJ, Toth PT, Ragozzino ME, Le K, et al. (2018) Chronic oral application of a periodontal pathogen results in brain inflammation, neurodegeneration and amyloid beta production in wild type mice. PLoS ONE 13(10): e0204941. https://

doi.org/10.1371/journal.pone.0204941 • Periodontal Disease Fact Sheet 2018 Accessed 17Feb19:// www. perio.org/newsroom/periodontal-disease-fact-sheet University of Illinois (2018, October 4). Periodontal Disease Bacteria May Kick Start Alzheimer’s. NeuroscienceNews. Retrieved February 17, 2019 from http://neurosciencenews.com/periodontal-diseasealzheimers-9955/

Supporting the call for a sugar tax in Australia DHAA are putting their weight behind the new Rethink Sugary Drink ‘Thirsty’ Campaign. We look into what it’s all about... By Ian Epondulan DHAA Chair of Oral Health Promotion/Public Health Special Interest Group

Watch the ‘Thirsty’ campaign now

he Rethink Sugary Drink Alliance launched a drink consumption and switch to water, reduced-fat milk or new campaign on 22 January, 2019 to combat the unsweetened options. overconsumption of sugary drinks. Spokespeople As part of the Rethink Sugary Drink Alliance, the DHAA including Clinical Associate Professor Matthew has jumped on board to support the campaign by re-tweeting Hopcraft, CEO of the Australian Dental Association posts from its partners such as the Obesity Policy Coalition, Victorian Branch, spoke on ABC Breakfast about the new LiveLighter and Cancer Council Victoria. It has also been shared campaign which focuses on dental health and targets young on the DHAA’s Facebook page which reached 173 people and 20 people who are high consumers engagements during the launch. of sugary drinks. Graphic imagery All of this is part of a much of the dental effects of sugary larger campaign to call for: n A levy on sugary drinks to drinks such as tooth decay is being used to prompt young increase prices by 20 percent n A government-supported people to realise that sugary drinks are not worth losing your social marketing campaign to teeth over. highlight the health effects of Jane Martin from the Obesity sugary drinks n Restrictions to reduce children’s Policy Coalition continued the messages on ABC Radio and exposure to marketing of Triple J as well as Craig Sinclair sugary drinks n Restrictions on the sale of from Cancer Council Victoria on “Graphic imagery of the dental 2CC Radio. Members of the public sugary drinks in schools, in Victoria were invited down to government institutions and at effects of sugary drinks such St Kilda foreshore to watch the children’s sport events as tooth decay is being used to n State and local government advertisements and challenge prompt young people to realise their views on sugary drinks. You policies to reduce the availability that sugary drinks are not worth can see their vox-pops on the of sugary drinks in workplaces, next page. healthcare facilities and other losing your teeth over.” The Rethink Sugary Drink public places n Promotion and easy access to Alliance is an initiative comprising of 19 national and fluoridated tap water state-based like-minded health and community organisations concerned about the amount of sugar in sugary drinks and So why is there such a call for a levy/sugar tax on their overconsumption by Australians leading to chronic health sugary drinks? conditions. It aims to raise awareness among all Australians The current environment shows that sugary drink consumption on the amount of sugar in sweetened beverages (such as soft is a major public health issue. It has been associated with several drink, energy drinks and sports drinks) and the associated health health consequences such as the increased prevalence of weight risks, with young Australians being the primary target. The gain and obesity, dental caries and dental erosion, elevated blood partnership encourages Australians to rethink their sugary pressure and higher serum uric acid levels, insulin resistance and ☛

lower bone mineral density in girls. According to the Oral health of Australian children: The National Child Oral Health Study 2012-14, “Half of all children (50.9%) usually drank one or more glasses of Sugar Sweetened Beverages (SSB’s) on a usual day and this increased from 41.5% in children aged 5–6 years to 58.7% in those aged 13–14 years. For all ages, the proportion was higher for Indigenous children (73.1%) and lowest among children from high income households (36.5%).” It is also noted that, “One in four and one in ten Australian children had untreated dental caries in their primary or permanent teeth, respectively.” (https:// www.adelaide.edu.au/press/titles/ncohs/ncohs-ebook.pdf) Roughly 28 countries around the world, and seven USA cities, currently have a sugar tax, where different outcomes have occurred; including a decrease in sales of sugary drinks, reinvestment of funds into health promotion or preventive health programs, and reformulation changes by soft-drink manufacturers. There is a call for Australia to join in with countries which have the sugar tax such as the UK, Ireland, cities in the USA, and South Africa to name a few. The sugar tax is only part of the solution but in conjunction with other strategies, reducing the burden of disease is made possible.

#Thirsty Vox Pop The Rethink Sugary Drink campaigners took to the streets to record the effects of their ‘Thirsty’ by showing it to members of the general public. Take a look at people’s reations...

What can you do to create more advocacy and awareness about this campaign? n Visit the dedicated campaign website. n Use social media to share the campaign with your friends and family and use the hashtag #rethinksugarydrink. n Discuss with your patients, especially young adults, about their sugar consumption, and show them visually the dental impacts of overconsumption of sugary drinks.. n Advocate that tap water is the best drink as it contains no calories and contains fluoride which makes teeth stronger and prevents cavities. It is planned that the campaign will lead to World Oral Health Day which will be celebrated internationally on 20 March 2019 (www.worldoralhealthday.org ). The theme this year is “Say Ahh: Act on Mouth Health” where we are asked to motivate people to take action in protecting their oral health. There will be dinner meetings across the state branches to celebrate the day so don’t forget to check the DHAA CPD events page to see which one you can attend! .n

About Rethink Sugary Drink nR ethink Sugary Drink is a a campaign intended to raise awareness of the amount of sugar in sugar-sweetened beverages and

encourage Australians to reduce their consumption. nT he supporting partners are: Apunipima Cape York Health Council, Australian Dental Association, Australian Dental and Oral

Health Therapists’ Association, Cancer Council Australia, Dental Health Services Victoria, Dental Hygienists Association of Australia, Diabetes Australia, Healthier Workplace WA, Kidney Health Australia, LiveLighter, The Mai Wiru Sugar Challenge Foundation, Nutrition Australia, Obesity Policy Coalition, Royal Australasian College of Dental Surgeons, Stroke Foundation, Parents’ Voice, the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) and the YMCA. nV isit rethinksugarydrink.org.au for more information.

21st INTERNATIONAL SYMPOSIUM ON DENTAL HYGIENE

LEADERSHIP EMPOWERMENT ADVANCES DIVERSITY 15-17 AUGUST 2019 | BRISBANE AUSTRALIA

Are you a lamp, a lifeboat, or a ladder?

Four dental hygienists will join forces and prompt you to think differently about your profession. Dagmar Else Slot, Mario Rui Araujo, Ron Knevel and Melanie Hayes hope to inspire delegates as they share the stories that can empower us to be our best selves.

DAGMAR ELSE SLOT

MARIO RUI ARAUJO

Assistant Professor, Department Adjunct Professor, Portalegre of Periodontology & Health School, Portugal Department of Oral radiology, Academic Center for Dentistry, Amsterdam

RON KNEVEL

Senior Lecturer, La Trobe University, Australia

MELANIE HAYES

Senior Lecturer in Interdisciplinary Education, University of Sydney ,Australia

You’re in for a real treat! We have one of Australia’s best loved comedians – Anh Do. He has an incredible life story to share… www.isdh2019.com

A D V E R T O R I A L

The Orthodontic Patient From Hell to Heaven by Tabitha Acret

f you’re anything like me, my heart would sink a little when I would see that a teenage patient in active orthodontics was booked to see me. Who would walk through the door? Would it be a mouth full of food debris stuck in what looked like moldy orthodontic brackets and profusely bleeding gums? Would I see impossible to reach staining around the brackets or think my patient just ate a packet of Cheezels™. I used to loath this type of patient because I was never satisfied with the results I’d achieved after I’d finished their clean. Far too often, I felt under pressure to get their teeth cleaned in the “child” timed appointment slot, never feeling like I had removed everything. I was always feeling frustrated trying to manoeuvre my ultrasonic tip around brackets, trying to use a prophy handpiece and gluggy prophy paste to remove tenacious sticky mature plaque from modules and on the gingival side of the bracket. As I frantically worked away, I would be loathing the patient in the chair; blood, sweat and tears from both of us were going into the appointment with a lacklustre result!

Good oral hygiene vital for orthodontic patients Good oral hygiene is paramount to successful orthodontic treatments. Without good oral hygiene, a patient’s outcome will be compromised. In a journal article by Lovrov S, et al (2007)1, it was shown that “despite improvements in materials and preventative efforts, orthodontic treatments continue to carry considerable risk of enamel demineralisation. Each patient’s prophylactic efforts, including fluoride use are of paramount importance in preventing white spot lesions”. Knowing how important it is that the professional clean be good and all biofilm be removed just added to my stress. I knew that I could never remove all the biofilm and that there would be areas around the brackets my ultrasonic or prophy cup just couldn’t get to. Then, if you add in the mix that the patient already has some demineralisation of the enamel where the ultrasonic couldn’t be used, then the frustration and difficulty of the appointment just doubled again.

In search of a better solution Combining all of the above problems made me want a better solution. After initially discovering success with AIRFLOW® (EMS) for implant patients, I was interested in what it could offer my orthodontic patients. What I discovered is that by using AIRFLOW in combination with Guided

Biofilm Therapy, I was getting amazing results. If you had asked me before AIRFLOW to plaque disclose my ortho patients, I may have thought you were either crazy or you hated me. I now plaque disclose every single one of my patients as part of the “8 steps” of the Guided Biofilm Therapy protocol.

Guided Biofilm Therapy By using the Guided Biofilm Therapy protocol, you achieve predictable biofilm removal with 100% and 360 degree accessibility. It’s safe and effective around the sulcus, there is no change in the surface of the appliance and it is more comfortable for the patient. It is clinically proven that using a plaque disclosing solution to guide biofilm removal shows better outcomes for the patient. In Botti et al 20103, Bastendorf et al 20164, and Viorica et al 20135, all confirm higher efficiency in professional prophylaxis when done with the use of a disclosing agent. In the study by Viorica et al, Dental Plaque - Classification, Formation and Identification5, it was shown that “dental plaque diagnosis using coloured solutions is one of the easiest and fastest ways to diagnose dental plaque, which favours its subsequent removal under permanent control during the intervention. Using AIRFLOW, removal of dental plaque approaches a ratio of 100%”.

More than cleaning brackets By using AIRFLOW technology combined with AIRFLOW PLUS powder, I know that I am providing the least damage to the patients enamel and orthodontic appliances. In A clinical comparison of the efficacy and efficiency of two professional prophylaxis procedures in orthodontic patients6, Ramaglia et al show that “In orthodontic patients, use of AIRFLOW polishing is a lot safer, efficient and effective to remove stains and dental plaque in comparison to rubber cups and pumice”.

A D V E R T O R I A L

I now had time to finish within the appointment time. I wasn’t feeling so under the “pump”. I used to find that I was always running late in these appointments and now I was finishing easily within the time allocated. In Effects of an air-powder polishing system on orthodontically bracketed and banded teeth7, Barnes et al show that “Air polishing around orthodontic brackets and bands was not only effective but time efficient. There were no detrimental effects to any composite material or cement in comparison to rubber cup and pumice”.

Conclusion By using Guided Biofilm Therapy with AIRFLOW technology combined with appropriate home OHI instructions and motivation, I am providing the best treatments possible for my patients. I love Guided Biofilm Therapy; it’s changed my attitude toward treatment, my treatment results and my patients’ long term outcomes. Guided Biofilm Therapy is evidence-based dentistry; it is the new standard of care we should all be looking to reach. For information on EMS and Guided Biofilm Therapy, visit www.emsdental.com. Check our latest courses by visiting our Facebook page www. facebook.com/emsAusNz. To test drive this revolutionary protocol in your practice today, book a free in-practice Guided Biofilm Therapy demonstration by phoning your local Henry Schein Representative or calling 0405 095 867.

Tabitha Acret Tabitha has a passion for community dentistry, preventative care and implant maintenance. She has volunteered clinically both within Australia and overseas and volunteers on a regular basis for the Dental Hygienist Association of Australia. She is the current DHAA National Vice-President, Northern Territory Director and Chair of Continuing Education nationally. Implant maintenance is her passion and Tabitha has travelled extensively overseas to obtain more knowledge on the subject including the Malo Clinic in Portugal. She is currently undertaking her Implant Maintenance certification in Washington DC, USA. Tabitha is currently working in private practice in the Northern Territory and has just started her Master’s in Public Health at Charles Darwin University. She also splits her time working as a Clinical Educator for EMS Oceania, helping to pass on her knowledge and passion.

References 1. Lovrov S, Hertrich K, Hirschfelder U. Enamel Demineralization during Fixed Orthodontic Treatment - Incidence and Correlation to Various Oral-hygiene Parameters. J Orofac Orthop. 2007 Sep;68(5):353-63. 2. Ren Y, Jongsma MA, Mei L, van der Mei HC, Busscher HJ. Orthodontic treatment with fixed appliances and biofilm formation - a potential public health threat? Clin Oral Investig. 2014 Sep;18(7):1711-8. 3. Botti RH, Bossù M, Zallocco N, Vestri A, Polimeni A. Effectiveness of plaque indicators and air polishing for the sealing of pits and fissures. Eur J Paediatr Dent. 2010 Mar;11(1):15-8. 4. Schwarz F, Becker K, Bastendorf KD, Cardaropoli D, Chatfield C, Dunn I, Fletcher P, Einwag J, Louropoulou A, Mombelli A, Ower P, Pavlovic P, Sahrmann P, Salvi GE, Schmage P, Takeuchi Y, Van Der Weijden F, Renvert S. Recommendations on the clinical application of air polishing for the management of peri-implant mucositis and peri-implantitis. Quintessence Int. 2016 Apr;47(4):293-6. doi: 10.3290/j.qi.a35132. 5. Chetrus V, Ion I.R. Dental Plaque Classification, Formation and Identification. Int J Med Dent. Apr-Jun 2013, Vol. 17 Issue 2, p139-143. 5p. 6. Ramaglia L, Sbordone L, Ciaglia RN, Barone A, Martina R. A clinical comparison of the efficacy and efficiency of two professional prophylaxis procedures in ortho-dontic patients. Eur J Orthod. 1999 Aug;21(4):423-8. 7. Barnes CM1, Russell CM, Gerbo LR, Wells BR, Barnes DW. Effects of an air-powder polishing system on orthodontically bracketed and banded teeth. Am J Orthod Dentofacial Orthop.

T E R H OU T We take an in depth look at how sleep disordered breathing can affect oral health and what can be done about it Story by Sahil Bareja

ental professionals, including Dental hygienists, Dental therapists, Oral health therapists, play a crucial role in identifying the link between a patient’s oral and systemic health. Chronic conditions like Diabetes, Arthritis and Cardiovascular disease have been studied extensively in respect to their connection with oral health. Obstructive Sleep Apnea and the oral health connection has been studied for a number of years, yet very little training is available in dental schools or CPDs to make dental professionals aware of risks associated with sleep apnea and oral health. An average person living for 75 years and sleeping for eight hours-a-day, would have spent 25 years of their life sleeping. This is equivalent to 9,125 days of 219,000 hours, and yet we continue to give very little importance to sleep. Sleep disordered breathing (SDB) refers to a range of breathing disorders while asleep, however for the purpose of this article, we will be referring to three main categories: Obstructive Sleep Apnea (OSA), Central Sleep Apnea (CSA) and Complex (mixed) Sleep Apnea. Research has shown that individuals are 24.1 % more likely to visit their dentist for an annual check-up, as compared to a general physician. Thus, dental professionals are crucial in assessment, identification and in some cases, management of sleep disordered breathing. Dental hygienists/therapists and oral health therapists need to be aware about the effects of SDB on oral health and other potential side effects. The sleep disorder that is closely related to oral health is Obstructive Sleep Apnea (OSA). By definition, OSA is partial or complete cessation of breathing during sleep due to an obstruction in airways. This obstruction can be both soft tissue obstruction (large tongue, reduced muscle tone, deviated septum, enlarged turbinates and tonsils) or craniofacial/skeletal obstruction (narrow maxilla, constricted maxilla, retrognathic mandible and deviated septum). A normal human sleep cycle comprises of two states – Rapid Eye Movement (REM) and Non-Rapid Eye Movement (Non-REM)

BLE W

“An average person living for 75 years and sleeping for eight hours-a-day, would have spent 25 years of their life sleeping. This is equivalent to 9,125 days of 219,000 hours, and yet we continue to give very little importance to sleep”

WITH S L E E P

sleep. A humans’ sleep cycle is comprised of different cycles that alternate between Non-REM and REM stages throughout the night, depending on various factors, including age. During middle age, the sleep cycle is a complex mixture of 3-5 cycles of Non-Rem and REM cycles distributed across the night, lasting on an average 90-100 minutes. A typical middle aged sleep cycle comprises of a stage of wakefulness, stage Non-REM (70-80% approximately consisting of stage N1, N2, N3) and stage R (REM sleep) comprising 18-20% of average sleep. How are sleep apnea and oral health linked? Systemic inflammation which causes vascular morbidities from OSA is one of the mechanisms linked to periodontal disease. Research suggests that patients with sleep apnea have increased systemic markers of inflammation and increased levels of circulating cytokines. This inflammatory response (which is then readily available) might potentiate disease in individuals who already have inflammatory disease (periodontal disease). Additionally, symptoms of OSA include chronic and loud snoring and partial obstruction. During sleep, mouth breathing causes decreased saliva production. OSA patients often complain of dry mouth and this further acts as a risk factor for periodontal disease. Furthermore, treatments to treat OSA; the CPAP (Continuous Positive Airway Pressure) and MAS (Mandibular Advancement Splint) are both associated with xerostomia. CPAP forces high pressure air (through a facial mask) into the oral cavity, while MAS leads to disruption in lip seal, hereby promoting air through the mouth. OSA can be managed both surgically and non-surgically and the clinician should focus on contributing risk factors, such as history, upper airway imaging and physical examination when formulating a treatment modality for a patient. Patients suspected of SDB should be assessed through the following process:

“Dental practitioners need to be familiar with basic sleep disorders and understand the basic theory of how sleep affects oral health”

Clinical tools

Physical Examination

The increase in current obesity trends would cause the workload of sleep clinics to increase; therefore, predictors of SDB are required to allow both recognition and prioritisation of SDB within populations. Tools available to evaluate SDB include both Subjective Tools (which can be used in dental clinics) and Objective Tools. Subjective tools include the Epsworth Sleepiness Scale (ESS), the Karolinska Sleepiness Scale and the STOP-Bang Questionnaire. Objective tools are those such as the Multiple Sleep Latency Test and Multiple Wakefulness Test. Following presentation of sleep history, clinicians should utilise these clinical tools, such as the STOP-Bang Questionnaire and ESS to determine the need for further evaluation, such as polysomnography(PSG)

Clinical tools should be used in conjunction with physical examination when determining the need for PSG. Physical examination for OSA should be targeted to Body Mass Index (BMI), presence of anatomical factors such as retrognathia, or palatal abnormalities, nasal passages, neck circumference, placement of hyoid bone and oropharyngeal area (macroglossia). The classic four risk factors associated with SDB post adenotonsillectomy in children are; n enlarged nasal inferior turbinates n retro placement of mandible n nasal septum deviation n Mellampati score three or four.

Mellampati score has been considered the most important exam predictor of both presence and persistence of SDB post surgery with 98.2% children having incomplete symptoms controlled. Incidence of OSA peaks between the ages 2-8 years when adenotonsillar hypertrophy is prominent, therefore physical examination for children should include adenotonsillar assessment. Enlarged tonsils, adenoids and obesity are among the largest risk factors associated with SDB in children, with 37-66% prevalence of SDB reported in Obese children. Therefore, physical examination highlighting thick neck circumference, retrognathic jaw, high BMI, macroglossia should be investigated further through the use of PSG or at home sleep study.

Treatments Treatment for SDB varies according to age, for example, Tonsilloadenoidectomy often has been first line of treatment to treat SDB in children, while adult treatments include behavioral modifications, oral appliance therapy, surgical therapy, CPAP/ BPAP and topical/oral agents. Obesity is a major factor of OSA, so a weight loss program should be considered when modulating a treatment plan for OSA. Oral appliance therapy customised for a patients’ mouth can help in treatment of mild to moderate OSA, while CPAP and Bilevel Positive Airway Pressure (BPAP) help treat severe OSA and in some CSA cases. Dental practitioners need to be familiar with basic sleep

disorders and understand the basic theory of how sleep affects oral health. Sleep patterns differ across different ages and practitioners can identify risk factors associated with different age groups and how it affects craniofacial development. n References: • Arnold J, Sunilkumar M, Krishna V, Yoganand SP, Kumar MS, Shanmugapriyan D. Obstructive Sleep Apnea. Journal of pharmacy & bioallied sciences. 2017;9(Suppl 1):S26. • Bauer EE, Lee R, Campbell YN. Preoperative Screening for Sleep-Disordered Breathing in Children: A Systematic Literature Review. AORN Journal. 2016;104(6):541-53. • Bodenner KA, Jambhekar SK, Com G, Ward WL. Assessment and Treatment of Obstructive Sleep-Disordered Breathing. Clinical Pediatrics. tobacco: A meta‐analysis. Journal of Oral Rehabilitation. 2018;45(11):890-902. • Caples SM, Gami AS, Somers VK. Obstructive sleep apnea. Annals of internal medicine. 2005;142(3):187. • Cowan DC, Allardice G, Macfarlane D, Ramsay D, Ambler H, Banham S, et al. Predicting sleep disordered breathing in outpatients with suspected OSA. BMJ open. 2014;4(4):e004519. • Gozal D, Kheirandish-Gozal L. New approaches to the diagnosis of sleepdisordered breathing in children. Sleep Medicine. 2010;11(7):708-13. • Ioachimescu OCMDP, Collop NAMD. Sleep-Disordered Breathing. Neurologic Clinics. 2012;30(4):1095-136. • Jordan ASD, McSharry DGMB, Malhotra AP. Adult obstructive sleep apnoea. Lancet, The. 2014;383(9918):736-47. • Kim JH, Guilleminault C. The nasomaxillary complex, the mandible, and sleepdisordered breathing. Sleep and Breathing. 2011;15(2):185-93. • Mannarino MR, Di Filippo F, Pirro M. Obstructive sleep apnea syndrome. European Journal of Internal Medicine. 2012;23(7):586-93.

Happy in your job? What else is there besides clinical practice? The first of a regular series exploring the diversity of career opportunities for our profession. By Melanie Hayes

n todayâ€™s society, we no longer have jobs for life. Individuals will transition through multiple careers and need to adapt to such changes. However, traditional dental education only prepares graduates for one career option: clinical practice. Data from the Australian Institute of Health and Welfare tells us that most hygienists and oral health therapists (OHTâ€™s) are working as clinicians (97%), with the small remainder working in areas such as teaching and research. However, chatter on social media suggests that dental hygienists and oral health therapists are interested in career alternatives to clinical practice, but are unsure on what paths are available to them. Research has confirmed that hygienists do not see any opportunities for professional growth within the

profession (Hartley, 2015), and therefore the transition away from clinical practice is daunting. Dental hygienists are trained and educated to be clinicians, however after a few years of practice many seek opportunities to diversify their careers but donâ€™t know where to seek information. In fact, more than 70% of hygienists who graduated from dental hygiene school before 2010 said they do not feel like there is room for career growth (Hartley, 2015). Further, many suffer from occupational related musculoskeletal disorders, which essentially forces them to look for alternatives to clinical practice and transition to other work (Leggat, Kedjarune & Smith, 2007). However, there are avenues for postgraduate training and indeed a plethora of career opportunities in education, research,

industry, consulting, management and administration (Darby, 2004). Further education and career development would also contribute to advancing the professional credibility and reputation of dental hygienists (Darby, 2004).

The future plan This regular Bulletin feature aims to provide a brief overview on career development issues relevant to the dental hygiene and oral health therapy professions. Each article will include a case study exploring a member of our profession who has pursued an alternate career, to increase awareness of the opportunities for hygienists and OHTs. To get the ball rolling I recently spoke to Amelia Seselja, an oral health therapist, who after working as an oral health promotion consultant for the Australian

“This regular Bulletin feature aims to provide a brief overview on career development issues relevant to the dental hygiene and oral health therapy professions” Dental Association, moved away from the dental industry to embark on a role as a health service and facility planner. Tell us about your current role as a Health Service and Facility Planner. My role involves planning the future health facilities in Australia. The role requires a background of clinical knowledge, understanding patient centred care and service driven facilities, and how to then apply that to the health services in Australia. Most of the Health Services and Facility Planners have a clinical background, such as nursing or physiotherapy, with postgraduate study such as an MBA (Master of Business Administration). We all bring our own experiences and expertise. It quite different from a clinical and dental environment as the role is very much in the construction industry. We work with a diverse range of professionals such as architects, builders and health professionals. We also work with a variety of clients such as government, in areas such as hospital development. Project timeframes are quite extensive. What are your day-to-day activities ? It really varies depending on the type of project we are working on and the stage it is at. I might be developing a business case which involves a lot of research, such as conducting a literature review, data modelling or writing a brief on how a health service would work. I think this is what I love most about the role, it is so varied. I learn so much about other health services (other than dental) and I am challenged every day.

What education or experience did you need for this role? A clinical background and business skills were essential for the role. Experience in project and program management and data analysis skills are really key in this role. My MBA really helped with this, however an MPH (Master of Public Health) or other postgraduate degree would also be useful. This role can also be highly stressful at times, so I think the ability to work under pressure is also key (which I think working as an Oral Health Therapist really prepared me). What was the scariest or most challenging part of choosing an alternate career path? I really went from a profession where I was well connected and confident in my subject matter, to taking a giant leap into a position and industry where I was not well connected and was not the content expert. I really didn’t even know whether I would enjoy the role. Also, Health Service and Facility planning is a niche role, there is no specific course you can do at university and each facility will have different needs for that specific population, so it was a bit scary not to know what this career might look like in 10-20 years’ time. When you decide to move into a position outside of the dental industry, did you find it difficult not being a part of your discipline anymore? Yes, it’s quite daunting! That’s essentially what I have done, I have got out of my discipline. When someone asks

what industry I work in, I don’t work in oral health, I essentially work in the construction industry – and that’s weird! Were there people who helped you get the career you wanted? Definitely! I have always surrounded myself with good mentors and tried to ask questions from those who were working in interesting non-clinical roles. When someone changes careers, I ask them why they decided to make the change, or if someone is in an interesting job then I ask them how they got there, what were their stepping stones and experience they needed. Do you have any advice for hygienists or OHTs who are looking for a change from clinical practice? You have to understand it doesn’t happen overnight, but it’s creating little stepping stones to where you want to go. If you want to move out of clinical practice and into another area, look up job descriptions to see what skills and experiences are needed and then make a plan to get there. I would also speak to others and hear about the advantages and disadvantages of their jobs. Invest in yourself and extra education because it opens other doors. n

ABOUT THE AUTHOR Dr Melanie Hayes is a dental hygienist who has enjoyed a diverse career in clinical practice, teaching, research and management. She has a Master of Education majoring in career development, and is now working in an interdisciplinary role at the University of Sydney

Strive to be better Our regular series aimed to explore and encourage self development focuses on being better versions of ourselves Story by Lyn Carman

am constantly reminded of the responsibility I have to be the best version of me I can be. It is a choice for us to think, feel and act the way we do at any given time. You may recall my article in the previous edition, “Are you living above the line or below the line”, it is all about cause and effect. Let us consider this for a minute; how much of our day-to-day interactions with others are based on a perception of what was said, what was meant, how it was interpreted and how we respond? Take a look at this picture for a minute, what do you see?

How did you go? Did you see the two different images? If you haven’t seen this image before perhaps one image jumped out at you instantly. Did you need to take the time to understand what you were looking at, pause, step back and change your perspective of what you saw initially? It is all a matter of perception and how it was communicated to you. Perception acts as a filter through which we view all things as it is communicated to us. As people tend to perceive things differently, different people may interpret the same message quite differently. In the book 7 habits of highly effective people, Stephen Covey says: “Most people do not listen with the intent to understand; they listen with the intent to reply.” Being that communication is the most important skill in life, how do we learn to communicate? We spend a lot of time in our life learning how to speak, read and write, though when are we taught how to listen? What training do we have to listen deeply to really understand what another person is conveying to us? If you are like most people, we like to get our point across and wish to be understood. In doing so we may

inadvertently dismiss the other person. When the other person speaks, we are often listening to ourselves preparing our responses in our brain while they are talking and this means we are not fully and deeply listening. This may make us miss the meaning entirely. We then apply our terms of reference to what is being said, how we perceive it to be. I wonder if you can relate to this, I know I can and have done it myself. You are telling a story about something that happened in your day, sharing an experience and the person you are talking to finishes your sentence for you. They decide prematurely what you mean before you finish communicating, based on their story in their own mind. It may be the same ending or it may be a completely different tangent! These are some examples of when we don’t listen with the intent to understand. When you listen do you; 1 Hear them, make a judgement and either agree or disagree? 2 Give advice and find solutions? 3 Decide on their motives and behaviours based on your own experiences? 4 Ask questions based on your own frame of reference, perception?

“Being that communication is the most important skill in life, how do we learn to communicate?”

Most of us think we listen well, though we don’t. The consequences of not listening can be costly. When people don’t feel heard; it could create conflict, they can become irritated, confused and hurt. At the core of conflict there is always a breakdown in communication and the parties’ inability to understand each other. It could be said a conflict is often a dialogue of the deaf. When someone is listening to us deeply and sincerely, we are able to express ourselves, we lower our defences and we take down our masks. There is no better feeling than the feeling of being heard and understood, even if it means you don’t get your way or that the other person agrees with you. It is great to feel like someone put themselves in your shoes for a moment. This is a kindness we can extend to each other that is not only healthy and beneficial to both parties. It challenges you to be more flexible, more attentive and therefore better at making more complex decisions. It is the foundation for effective participative and collaborative relationships. In the pursuit of being the best version of ourselves, the starting principles could be: Don’t listen to reply, listen to understand. n

ABOUT THE AUTHOR Lyn Carman is a clinical dental hygienist and a personal, team and leadership coach.

A full state-by-state run-down of Association happenings around the country

STATE NATION ACT

I WOULD LIKE to take the opportunity to thank Madellyn Kennedy for her time and energy over the last two years as ACT Chair. I may have big shoes to fill but Madellyn is still on the CPD committee and is helping me every step of the way. I would also like to thank Sandra Lawry for her time on the CPD committee and for being involved with the Association in different roles over the years. Sandra has stepped down to focus on welcoming her grandson, Louis, into the world in September.

“We are still looking for a volunteer to take on the role of ACT Director. I feel so comfortable already and am only a few weeks into my tenure [as Chair], so please consider volunteering.” Jo Petrie will be joining the CPD committee and has volunteered to manage events on the Eventbrite website for the ACT. This will be a great help to me. So ‘Welcome Jo’ – I’m sure you will enjoy being an active part of the Association again. We are still looking for a volunteer to take on the role of ACT Director. I can say from personal experience that if you apply for, and win, this position the support

for a “newcomer” is great. I feel so comfortable already and am only a few weeks into my tenure, so please consider volunteering. If you wish to nominate somebody then please send an email to myself at chairact@dhaa. info, Cheryl Dey (DHAA President) at president@ dhaa.info or Tabitha Acret (DHAA Vice-President) at vice-president@dhaa.info. Unfortunately the original speaker that we had linedup for this week’s World Oral Health Day Dinner Meeting on the 20 March at the Duxton O’Connor had to cancel. We were extremely grateful to have Prof Matthew Cook (MB BS PhD FRACP FRCPA FFSc (RCPA)) offer to speak to us about immunology. There is still time to reserve your place so head over to the DHAA website and support this global event. The organisation of our Full Day Event on 11 October is traveling well and it will be sponsored by TePe. More details to follow when they have been confirmed. Enjoy the last few weeks of the Summer. It will be nice to see the beautiful Autumn display that Canberra creates. Susan Melrose ACT State Chair

Victoria

“In response to the feedback we have received from our members we have Hands-On Workshops on 1 June at La Trobe Bendigo campus.”

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

WE’RE GEARING UP for a big 2019 on the Victorian Committee. In social news, we say goodbye to committee member Lauren Hogan who will very, very soon be jetting off for her 12-month U.K. adventure and hopefully will rejoin us on her return. We have welcomed Hillary Ho in Lauren’s place. Hillary works in both specialist paedriatric and general practice as an OHT and is also a clinical educator at the University of Melbourne. She will be the event coordinator for our half-day event at Kooyong on 16 November. In other news, Desi Bolado, our communications officer, got engaged last year, which she plans to celebrate in March. Aimee Mills, our event organiser extraordinaire and allround right-hand woman will welcome baby number two in June. I am also very pleased to announce that I am expecting my third baby in August. Obviously there’s something in the air! Jade Wright has also rejoined our committee to be the event lead for our handson conference at Bendigo La Trobe on 1 June. In event news, there are three dates to lock into your diaries. This week

we have our World Oral Health Dinner at the Kent Hotel on 20 March, at which the captivating Dr Jeffrey Kesternberg will be presenting. In response to the feedback we have received from our members we have Hands-On Workshops on 1 June at La Trobe Bendigo campus. You can choose from three hands-on streams; EMS Airflow, Hu Friedy Instrumentation/Advanced Medical Emergency Training; or Hall Technique. Organising and coordinating these ‘hands on’ workshops has been an enormous task and we hope you appreciate the efforts our volunteers have gone to make this happen. We have been very fortunate to secure some great sponsorship in order to keep this event affordable but are limited in terms of registration places. Please support our CPD events by attending. To conclude the year, our annual half-day event will be held at Kooyong on 16 November. If there is anything that you as a DHAA member would like to see happen this year or next, please get in touch. We look forward to seeing you all there at our wonderful CPD opportunities

for professional growth! Our Victorian committee attended Roisin McGrath’s accredited Mental Health Training Day Workshop on 2 March. There will be a follow up day next month. Is mental health an area of interest for our members? If so, get in touch. More feedback to come. In conclusion, we were sad to say goodbye to our CEO,

Dr Melanie Hayes, who was a wonderful support and mentor to our committee (particularly as she was based in Melbourne) but do look forward to welcoming Bill Suen in her place. He has big boots to fill but comes with a wealth of experience to help lead our Association into a new era. Sarah Laing Victoria State Chair

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

Queensland

“In response to your feedback we will be providing more hands-on, more perio, more multidisciplinary, and more online CPD”

WE HOPE YOUR 2019 is going well and you’re enjoying an inspiring and insightful year. We’d like to extend a warm welcome our new CEO, Bill Suen and say a sad farewell to Dr Melanie Hayes. Our Queensland committee has been working hard on planning a fun CPD program for the 2019/2020 calendar. Throughout 2018 we engaged members in surveys asking what they wanted from their DHAA CPD. In response to your feedback we will be providing more hands-on, more perio, more multidisciplinary, and more online CPD. It all starts this week with our World Oral Health Day Dinner on 20 March. There is still time to reserve your place so head over to the DHAA website and support this global event. On 13 April join us at Sea World on the Gold Coast for a fullday event investigating an individual’s dental needs over the course of their life. Watch this space for some Hu-Friedy workshops and of course the ISDH will be in Brisbane from 15-17 August. So many opportunities to network and learn, grab a few friends and register for some of our great events. Aneta Zielinski Queensland State Chair

Northern Territory

“Our first-ever overseas event was in Bali and we have another one planned for November this year.”

2019 IS OFF to a great start in the Northern Territory with so many great events planned. If you have never been to the NT before then our fullday CPD event in June is not to be missed. Temperatures are perfect during the dry season in the NT and you can have a lovely winter escape, come and enjoy the sunshine, swim in some waterfalls and obviously also grab some great CPD. To learn more about NT CPD events keep an eye on the DHAA website. I would like to take this time to acknowledge the hard work and effort that Leonie Brown put in as previous Director and Chair and thank her for her valuable contribution. She has now gone on to have a break from volunteering and we are lucky to have Meg Ageninto come on board to help. We would love more help and if you feel you can help in any way please contact the DHAA. Our first-ever overseas event was in Bali and we have another one planned for November this year. I hope to see you at this or another of our 2019 events! Tabitha Acret NT Director and National Vice-President DHAA Ltd

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Western Australia

“Some of the children will also have intra-oral photographs taken and these will be used to develop an application for smart phones that provides dental screening using photos.”

FIRSTLY I WOULD like to wish Dr Melanie Hayes (past DHAA CEO) all the best in her future endeavours and in her new career. Mel has been an inspiration to many in the DHAA and I for one have shared two years of her excellent leadership and professionalism. She will be very much missed and we look forward to hearing about her successes in the near future. The DHAA WA Committee is working on bringing members valuable CPD events every year and 2019 is no exception. We look forward to seeing that our members at these events and especially at this week’s World Oral Health Day Dinner meeting on 20 March. This will be an Australia-wide event with all states holding a dinner/ event on the same night. Don’t delay - register today! The BOH 3rd Year student presentation in November, was very successful for recruiting new members. 29 students took up the membership with BMS indemnity insurance. A 100% enrollment has been achieved for 2019 new grads. On 15 February, Vice-Chair Andrea Tangiia presented the DHAA Graduating Student Award to “Most

Improved Student” to two recipients, Chanel Chu and Ciara Millers. A huge congratulations to both and we wish them every success in their new career. WA are fortunate to have DHAA members involved with a research project with Mohamed Estai of UWA “Teledentistry” which is being funded by the CSIRO. Research involves dental screening children in some schools in the metropolitan area and the regional areas of Bunbury, Busselton, Harvey, Brunswick Junction and Kojonup. Some of the children will also have intra-oral photographs taken and these will be used to develop an application for smart phones that provides dental screening using photos. Yvonne Markovic, Jocelyn Ho, Chelsea Bain, Christine Power and myself were chosen to participate in the research. Rhonda Kremmer has been appointed as WA Communications Officer for 2019 and I thank Bonnie Boudreau for her many years of contribution to the role. We also congratulate Fiona Lim and her husband on the arrival of their baby boy Lawrence in November, a brother for Verity.

I encourage all members to share any exciting news to share, whether births, marriages or other achievements - they do not need to be dental orientated. Send your story to contactwa@dhaa.info Eventbrite has all WA CPD events including; “Prevention is Better than Cure” Full-day CPD on the 5 April; Hands-On Workshop GC Fissure Sealants on 9 November; and still to be finalised for the 4 October combined Australian Society of Periodontology and DHAA Periodontal HandsOn Workshop. It is important to register as soon as possible for all events for catering numbers and we are very fortunate to have a number of sponsors supporting these events. The Committee work very hard to provide a variety of speakers and topics. Organising events is time consuming and if registrations are low we have to cancel. Please regularly check the DHAA website for updates and also check your spam and junk folders to make sure that your email hasn’t discarded any of our important updates! Aileen Lewis WA State Chair

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

Tasmania

“2019 is already looking like a busy year with March having two CPD events planned and in the diary”

HELLO TO ALL of our Tassie members! March has been busy with the GC Surface Protection Hands on Workshop in Hobart. This week we have two World Oral Health Day events. Northern Tasmania will be having a study group dinner in Ulverstone organised by Rachelle Johnson. Hobart will be having a lecture/dinner with Colleen O’Callaghan one of our members presenting case studies about her Mouth Matters business. there’s stil time to register for both. We have had a vacant chair position for a year now so I would like to ask our members to consider giving back to your profession, and expanding your skillset at the same time, by volunteering for a position with the DHAA. We have great national support and excellent learning opportunities so please give it some serious thought. Don’t forget we have a great website with resources and CPD events. I am looking forward to seeing members during the upcoming CPD events both locally and nationally. Keep safe when travelling and keep smiling. Alyson McKinlay Tasmania Director

New South Wales

“W ith presenters such as Professor Axel Spahr and Dr Peter King our Hunter Valley event on 6 April is set to be one of the finest yet.”

THE NSW COMMITTEE is looking forward to a busy year of professional development and volunteering. Firstly, I would like to wish Nicole Hocking all the best as she steps down from the committee to have her first baby in March. I also extend a warm welcome to Leena Najeeb who has joined the NSW team. Leena is really interested in professional development and helping organise events. We are very excited to have her on board. Another new committee member is Dr Melanie Hayes, as she has relocated to Sydney, we are lucky enough to have her back in a voluntary role. DHAA NSW is celebrating World Oral Health Day this week on 20 March with a dinner meeting at the Radisson Blu hotel, register quickly as tickets are limited. With presenters such as Professor Axel Spahr and Dr Peter King our Hunter Valley event on 6 April is set to be one of the finest yet. Great CPD, complimentary wine tasting and cheese post conference, it’d be rude not to! I hope to see you at one of our CPD events very soon. Jacquie Biggar NSW State Chair

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

South Australia

“The DHAA SA Committee have been working busily to plan some fabulous events for the rest of this year.”

WHERE DID THOSE couple of months go, can you believe it is already mid-March? This month Ian Epondulan and I had the privilege of attending the National Oral Health Promotion Clearinghouse on the Use of Fluorides in Australia. This two-day workshop was a fantastic opportunity to hear from leaders in research and stakeholders from various areas discuss the current Australian guidelines around the safe and effective use of fluorides in our profession and the wider community. The conclusions drawn from discussions over these days will be compiled and made available by ARCPOH in the months to come. Read the full report on page 9. We have a fabulous band of volunteers involved with the DHAA SA and similarly to the rest of Australia at this time of year, the DHAA SA Committee have been working busily to plan some fabulous events for the rest of this year. Our final event for 2018 was our Christmas Brunch, held at The Highway in early December. This event was well attended, and we were fortunate to have Robert Uliveri presenting on the restorative management of

children within the dental setting. This event was used as an opportunity to collect donations of toys and books for The Smith Family’s Christmas Appeal. I would like to take this opportunity to thank all who attended for their enormous generosity in donations. Our first events for this year were held on 16 February, with GC Hands-On Workshops in surface protection and fibre reinforced composite splints. These events had a fantastic turn out, with tickets for both selling out well before the event date. We trust attendees found the sessions informative and interesting and scope building. For World Oral Health Day 2019 we are hosting a supper celebration and CPD event this week at the striking Ellington in Hackney. You can still register if you’re quick by following this link – it’s an international event so come and support your industry – but don’t delay! Our speaker for the evening will be speech pathologist Victoria Pantazis, presenting on oral motor and speech development and disorders. This promises to be a fun and fascinating evening,

and the theme of “Say Ahh: Think Mouth, Think Health” is a timely reminder of our vital role as oral health practitioners in overall health. The next event on our calendar for the year is our Destination Victor Harbor event to be held on the beautiful Fleurieu Peninsula on 25 May. Joining us for this day will be A/Prof John Kaidonis discussing the oral ecosystem in health and disease, and A/Prof Cathy Snelling presenting on imaging technologies and their impact on clinical practice. Held in Victor Harbor, this event will provide the perfect excuse for a weekend away, and I hope that you will be able to join us! I would also like to take this opportunity to remind our wonderful members that I love hearing from you. If you have any suggestions or ideas that you would like to see us incorporate into our events or other areas of the DHAA SA, please email me at chairsa@dhaa.info . I hope 2019 proves to be a wonderful year for you, and I can’t wait to see you at an event this year! Lyn Carman South Australia State Chair

DHAA Year Planner - 2019

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

MONTH

DATE

EVENT

LOCATION

20 Mar ’19

DHAA ACT World Oral Health Day Dinner Meeting

The Duxton, O’Connor

20 Mar ’19

DHAA Vic World Oral Health Day Dinner

Kent Hotel, Carlton North

20 Mar ’19

DHAA Qld World Oral Health Day Dinner

Clovely Estate, Brisbane

20 Mar ’19

DHAA WA World Oral Health Day Dinner

The Pagoda Resort and Spa, Como

20 Mar ’19

DHAA SA World Oral Health Day Supper

The Ellington Hotel

20 Mar ’19

DHAA NT World Oral Health Day Study Club

Darwin Sailing Club, Fannie Bay

20 Mar ’19

DHAA NSW World Oral Health Day Dinner

The Radisson Blue Hotel

23 Mar ’19

DHAA NT Hand on surface protection workshop

Venue TBA

5 Apr ’19

DHAA WA 'Prevention is better than cure' Full Day

Burwood On Swan

6 Apr ’19

DHAA NSW Hunter Valley Full Day

Oaks Cypress Lakes Resort, Pokolbin

13 Apr ’19

DHAA Qld Sea World Full Day

Sea World Resort Conference Centre, Main Beach

MAY

25 May ’19

DHAA SA Destination Victor Harbour

Whalers Inn, Victor Harbor

JUN

1 Jun ’19

DHAA Vic EMS or Hu Friedy Hands-On Workshop

La Trobe Bendigo campus

21 Jun ’19

DHAA SA Mid-Year Dinner

Adelaide Oval, North Adelaide

22 Jun ’19

DHAA NT- Darwin Full Day

Sky City Darwin, Darwin City

2019

MAR

APR

22 Jun ’19

DHAA NSW Sydney Full Day

Luna Park

AUG

15-18 Aug ’19

International Symposium on Dental Hygiene

Brisbane Convention Centre

OCT

4 Oct ’19

DHAA WA Save the Date

Venue TBA

9 Oct ’19

DHAA WA GC Hands-On Workshop

Ambrose Function Centre

11 Oct ’19

DHAA ACT Full CPD day event

Venue TBA

18 Oct ’19

DHAA SA Full-Day CPD

Adelaide Entertainment Centre

26 Oct ’19

DHAA NT Alice Springs Half Day

Doubletree by Hilton Hotel, Alice Springs

26 Oct ’19

DHAA NSW Half Day

Newcastle

29 Nov ’19

DHAA ACT Dinner Meeting

Venue TBA

12 Nov ’19

DHAA NSW Sydney Dinner Meeting

Sydney

16 Nov ’19

DHAA SA Hu-Friedy Hands-On Workshop

Venue TBA

16 Nov ’19

DHAA Vic Annual Half-Day Event

Kooyong

30 Nov ’19

Bali Full Day CPD

The Westin Nusa Dua, Kawasan Pariwisata

1 Dec ’19

DHAA SA Christmas Brunch

Stamford Grand Hotel, Glenelg

8 Dec ’19

DHAA WA Save the Date

Venue TBA

October ’20

DHAA National Symposium

Melbourne

June ’21

DHAA National Symposium

Darwin

NOV

DEC 2020

OCT 2021

JUN

Key to the state colours n ACT

nN SW

n NT

n Qld

nS A

n Tas

n Vic

nW A

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Published on Mar 16, 2019

The Bulletin - Issue 50 Mar / Jun 2019

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