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Issue 46 March-April 2018

The official newsletter of the Dental Hygienists Association of Australia Ltd

Read our guide and make sure you’re prepared Look who’s coming to Cairns? Meet two of the speakers coming to Symposium

Volunteer for good Discover a great way to feel rewarded

STATE ROUND-UP Find out what’s happening in your local area


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The association’s future is in safe hands AS ORAL HEALTH STUDENTS begin or return to their studies for the year, I’m excited by the opportunities the DHAA have launched for our student members. Student membership has grown by over 50% in the last year – a significant fact for an association that holds the needs and support of it’s members, and the profession, close to it’s heart. How to improve our engagement with the futures of our profession has long-been on the collective minds of the DHAA Board. Now, with the full-time dedication and skills of our CEO Melanie Hayes and Membership Officer Amelia Munn, we are in a strong position to make significant changes that were previously out of reach for our volunteer committees. Tabitha Acret (our NT Director) has taken on the role of student liaison to complete the team. We have launched our Student Leadership Program in partnership with Colgate. One representative from each of the schools across the country will become the direct connection between students in their program and the association. This will enable a better understanding of the issues associated with students and new graduates. I’m personally looking forward to is meeting the students at our leadership training day. Our directors, chairs, special interest group leaders and up-and-coming leaders get together annually, where there is networking and collaborating and discussing the future direction of the association. To involve our student leaders will not only help them to develop their leadership skills but help build an association with the next generation at the forefront. Another partnership we have made recently, with the Australian Dental Health Foundation, will impact another small group of students. Up to five grants are offered to students of Aboriginal or Torres Strait Islander background, in either dental hygiene or oral health therapy. It is a long-term goal of the board to contribute to the health of the Indigenous community in a culturally appropriate manner. What better way than having health workers from their own community? As if that wasn’t enough, the board has also approved the roll-out of a pilot mentoring program. While it will be open to all members, I can see the real benefits to new graduates in particular, as it will give them access to the wisdom and life experience of our more mature members. To misquote Whitney Houston: ‘I believe the students are our future. Teach them well and let them lead the way’. Somewhere out there are all our future presidents and board members. Now that’s exciting! Kathryn Novak DHAA National President

Contents 04 News New data breach laws; DHAA Study Club; and nine benefits of membership.

08 Who’s coming to Cairns Meet two of the great speakers already lined-up for DHAA Symposium 2018.

12 COVER STORY CPD Audits Get ready for an audit with our handy guide.

14 Silver Fluoride Bullet Our role using fluoride in the treatment of dental caries.

16 Warming ageing hearts Managing the oral health care of dementia patients.

18 Volunteer for good It’s easy to do and the rewards are immeasurable

22 Ask DHAA Your questions answered.

24 Living the ortho life The role of the hygienist in the orthodontic practice.

28 Bridging the gender gap Is female domination of our industry a positive thing?

30 The power of possibility Choose your career path and make it happen.

33 Rant! Mind your language.

34 State of the Nation Your local state round-ups..

Key Contacts CEO Mel Hayes CONTACT




IT REP Josh Galpin


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





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New Data Breach Laws From 22 February 2018 businesses and individuals must adapt to new mandatory data breach notifications


fter many years of trying, and 15 years behind the USA; Australia has finally introduced mandatory data breach notifications within 30 days of becoming aware of a breach. The timing of this legislation could not have been better, with a 15% increase in incidents reported in the 2017 Australian Cyber Security Centre (ACSC) Threat Report. The risk of cyber compromise to Australian businesses assessed as “high”. On behalf of the DHAA the BMS Group have created an article that explores some of the key aspects of a data breach and some of the changes you should make in your business to prepare for the new law. DHAA members can read more about the implications and effects of the new mandatory data breach notifications here*. Will these changes affect you? Visit the DHAA website today for a review of risk resources and additional information on how to prepare for these new laws. n *Please note that you will need to log-in to read the content.

“ T  he timing of this legislation could not have been better, with a 15% increase in incidents reported in the 2017 Australian Cyber Security Centre (ACSC) Threat Report”


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7 Nine benefits of DHAA membership


Making the most of your professional community DHAA member, Hayley Watson, tells us why she initiated the Blue Mountains Dental Hygienist Study Group LATE LAST YEAR, Hayley Watson decided to get together a group of local, like-minded hygienists and oral-health therapists for a study club. “Having worked in the dentistry for many years, I was well aware of dentists and dental specialists forming study groups and wondered why I had never witnessed or heard of dental hygienists doing the same,” explains Hayley. “We have a vast knowledge and all come from differing backgrounds and work settings. It seemed silly not to be able share insight with each other. I felt it would be very beneficial for local dental hygienists and OHTs to network and hoped that such a group would boost our professional profiles.” Being a DHAA member Hayley contacted the association for support. As luck would have it, the DHAA had been developing resources for study clubs, and were looking for a club to pilot the materials – so the timing was perfect! Hayley and five of her colleagues met for the first time in November, using the DHAA guidelines to set up the club, which Hayley describes as “incredibly useful”. To date they have trialed study packs on molar-incisor hypomineralisation and silver diamine fluoride, and provided valuable feedback and ideas for future materials. “The study packs created by

the DHAA are current, informative and well composed, with very useful and relevant resources.” A study club has provided Hayley with an opportunity for CPD that was otherwise not easily available to her. “Not living in the city and having young children means that being able to gain local and free CPD is invaluable. We all meet when and where it is convenient for all of us and I think the others in the group would agree that we look forward to our next study club for both professional development and a social gathering.” Hayley has advice for others looking to start up a study club: “When starting the group I had planned to email all the local dental practices inviting their hygienists and OHTs to join us, but surprisingly word of mouth and forming a private Facebook group meant that we formed with minimal effort. I suggest starting the conversation with other hygiene professionals in your area to assess interest and then confirming a date and location of you first study club meeting. It’s as simple as that - the DHAA supply everything else you need!” If you are interested in starting a DHAA study group in your local area, you can access all the resources in the members area of the DHAA website. n

1. Expand your knowledge and advance your career Discounted CPD events regularly held around Australia, and a National Symposium held every year to help you meet your registration requirements. The DHAA website also provides links to professional development hours, and downloadable resources. 2. Improve your career opportunities Seek out career opportunities across the country on the jobs board. 3. Professional Indemnity Insurance The DHAA has partnered with BMS, a global insurance broker with dedicated teams in Melbourne & Ottawa specialising in Allied Health Association Insurance programs, to provide an affordable PI option for members. BMS provides coverage for more than 350,000 healthcare and regulated professionals through 50+ associations. 4. Member discounts From hotels to healthcare and car hire to computers you’ll save money on a wide range of household names through our member benefits program. 5. Professional representation The DHAA presents submissions to the Australian Senate, Fair Work Australia and other key stakeholders in matters affecting our profession and the oral health of the public. 6. Develop leadership skills Realise your professional potential and expand your horizons by volunteering for board or committee positions. 7. Build professional credibility Be part of an association and unite with more than 1,500 oral health practitioners across the country. 8. Free industrial relations advice DHAA members can access free legal advice through our Industrial Relations Advice Service. 9. Free drug advice line Members can access our online advisory service and receive advice from our consultant pharmacist.


Who’s coming to Cairns? The DHAA Symposium is hitting Cairns in October and plans are well-advanced to make this an event not to be missed Story by Leonie Brown


he response to our National Symposium in Cairns has been tremendous, with over 200 people already taking advantage of the Sunrise Discount. People have also embraced the new payment plan, being offered for the first time this year (see panel on p18). It’s such a great way to spread the cost of this must-attend, annual event for oral health professionals. As well as being a great source of education and information, DHAA Symposium is the perfect opportunity to spend time with colleagues, friends and family in an outstanding location, and earn a stack of CPD too!. Early Bird rates are now in place with some healthy savings for you to snap up, plus there is still time to take advantage of the payment plan system Visit the symposium website www.dhaasymposium2018. to find out more or email au

Look who’s talking The DHAA Sympoisum organising committee are working their socks off to lock-in some the world’s best speakers in the oral hygiene arena. The Bulletin caught up for a quick chat with a couple of them. SPEAKER #1

Professor Ann Spolarich Prof. Ann Eshenaur Spolarich (RDH, PhD, FSCDH) is an accomplished U.S. speaker and presenter and will be a ‘must-see’ event at DHAA Symposium 2018. Ann is an internationally recognised author and speaker on pharmacology and the care of medically complex patients. She has presented over 900 lectures and has over 100 professional publications.. Where did you study and where are you currently working? I was born and raised in Pennsylvania, just outside of Philadelphia in the US. I received my certificate in dental hygiene from the University of

Pennsylvania School of Dental Medicine; my bachelor degree in dental hygiene from Thomas Jefferson University in Philadelphia, and both my master of science degree in dental hygiene and a PhD in physiology from the University of Maryland in Baltimore. Currently I am Professor, Course Director of Clinical Medicine and Pharmacology, and Director of Research at the Arizona School of Dentistry and Oral Health, A.T. Still University, in Phoenix, Arizona.  In addition to this I practice part-time in the Special Needs Care Unit in our Advanced Care Clinic at the university.  I also serve as the Associate Director of the National Center for Dental Hygiene Research and Practice, based in the US. What topics will you be discussing at DHAA Symposium 2018? I will be discussing two great topics at symposium this year. The first will be a presentation about what science is saying about patient behavioural change as it pertains to health


promotion and oral health. Many attendees will be surprised by what methods have been shown to be effective, and more importantly, what methods are ineffective.   As dental hygienists, we struggle with finding the best approaches that help our patients adopt - and sustain long-term, positive actions to improve their overall and oral health.  This is a really fun and interesting topic.   Secondly, I will be presenting how to treat individuals with special needs – a topic that is very close to my heart.   I started out working in a hospital setting on a cancer ward for patients with blood cancers.  Throughout the course of my 36-year career, I have devoted myself to caring for some of the most medically complex patients that we see in dentistry.   My presentation will share some core concepts and competencies for dental professionals about caring for older adults, medically complex patients and those with intellectual and developmental disabilities.  

Prof. Ann Spolarich

There is so much to learn and I want to help everyone stay current with the ever-changing knowledge in this area. What do you want delegates to take away from your presentations? I am hoping to help bring the most up to date information to the delegates so that we can all improve the care that we provide to our patients every day. As a scientist and a clinician, I most enjoy helping my colleagues learn about how to incorporate best practices into their own care settings.   What first made you interested in these topics? Much of what I have learned over the years began with my initial work in the hospital setting.  It was here that I really began to appreciate the intricacies of caring for patients who were once only seen in that type of setting. Now, we are all treating

Mary Mowbray

complex patient populations - in every care setting, and regardless of the age of the individuals we see. While not everyone has had the opportunity to participate in research, it is important for all clinicians to be good consumers of the scientific literature. This means that it is critical that we all stay up-to-date with new knowledge as it evolves. It is not easy to practice with an evidence-based philosophy. I have been told that I am very good at translating complex science into real-world clinical applications that make sense for my fellow clinicians.  I have been so fortunate to have had many unique opportunities in academia and in practice that have brought these topics to life for me. I like to share my experiences with my colleagues.   

10 What excites or worries you about the future of dental? I love that dental hygienists and oral health therapists are now able to practice in so many different settings - bringing care to the underserved is a wonderful opportunity for all of us to improve the health of our communities. It is especially exciting to see a growing appreciation for working interprofessionally. Interprofessional collaboration is not a new topic - I did this 36 years ago in the hospital - but now, our students are being trained to work collaboratively and it is an excellent model for both clinicians and patients alike. That said, I worry that our educational models are not keeping pace with the growing demands of the curriculum. Too many oral hygienie professionals do not have the academic degrees and credentials that reflect the time that they spend in an academic program, nor have our programs expanded to accommodate the breadth of knowledge that we must all have to treat the ageing and medically complex population. We must expand our curriculum and elevate the entry level into practice so that we are educated and credentialed to the same levels of our colleagues in other health disciplines.  Only then will we be considered equal members of the healthcare team. Have you been to Cairns before? This will be my second visit to your beautiful country and my first visit to Cairns. I am so excited to come to be with all of you!   It has been a lifelong dream of mine to see the Great Barrier Reef.  My husband and I love water sports and snorkeling and plan to become dive certified so that we can scuba dive while we’re there.   We are planning to stay for two weeks, so I would love to hear all of your suggestions for “must do” activities. Most of all I am looking forward to making new friends while at the symposium.   Australians are so friendly and fun.  We can’t wait for October!


Mary Mowbray Mary Mowbray is a registered dental hygienist, innovator and educator in the area of oral health. She is widelyrespected among her peers, both in her home country, New Zealand, and overseas. Mary is also the Chief Executive of the Institute of Dental Hygiene (the institute is set up to ensure the professional development of dental hygiene in NZ. Where did you study and where are you currently working? My first career was as a paediatric nurse working in NICU at an Auckland Hospital. I then moved to the UK and completed a Diploma of Dental Health Education, followed by a Diploma of Dental Hygiene. I now own and work in my own dental hygiene clinic in Auckland, NZ. What topics will you be discussing at symposium? I will be covering three topics: ‘The ups and downs of owning your own hygiene clinic;” “Stress management for you and your patients ;“ “Issues with the tissues – peri-cementitis.” With more hygienists owning dental practices, what is your own experience and what do you want delegates to take away from this presentation? The opportunity to own my own practice arose when I was given the opportunity to rent out a space in the same building as a dentist. After discussing my options with the New Zealand Dental Council (NZDC), I jumped in at the deep end, and set up my clinic. There is definitely a growing interest being shown by hygienists with regard to owning their own practice. I intend to help them understand the pros, cons, ups, and downs, of working in as well as running their own business.   Why are you so passionate about this stress management? It became an issue when I had a highly

stressed patient, who I was treating for periodontitis, repeatedly complained she was suffering from a severe ache in the 26, 27 areas. When the periapical X-rays showed no periodontal or apical abscess she was referred to her GDP; he replaced both fillings. However, the pain continued, so he performed root canal treatment on both teeth. Still the pain continued, so both teeth were extracted. In the meantime, I was reading-up on myofunctional issues and suggested that the pain could be muscular. I worked my thumb up towards her TMJ; palpated the muscles, and ‘wow’ she sure felt the pain! It all started from there. With research showing the relationship between stress and periodontal disease, I hope to share with the delegates how we can help our patients manage anxiety, depression, loneliness, overworked and stressrelated habits.


How the payment plan works Attending symposium can be a sizeable financial commitment, especially if it’s not in your home town. For this reason the DHAA has the added a payment plan option to spread the cost of registration.

Tell us a little more about your final presentation on peri-cementitis – what can we expect? My interest in peri-cementitis started when I worked in a periodontal practice back in the late 1990s; I would see up to 100 implants a week. All too often I found ‘issues with the tissues’. I got frustrated by seeing red and oedemic gums, with suppuration oozing out after palpitation, and not knowing the cause. My investigative personality wanted to find out more and what I discovered astounded me; excess cement was often the problem. Both peri-implant mucositis and periimplantitis can be associated with excess cement left under the gingival margins after cementation of the final prosthesis. This type of tissue destruction, known as peri-cementitis and can be avoided with the correct attention to detail. If diagnosed and treated early, this

The Early Bird plan breaks down the registration fee into three instalments which will be deducted as per the following schedule: Instalment #1: Due 15 days after registration Instalment #2: Due 16 May, 2018 Instalment #3: Due 16 July, 2018

type of disease can be reversible when the infiltration is limited to the soft tissue. However, if left untreated, the bacteria associated with the cement can lead to a progressive, irreversible inflammatory response. This, in turn, can lead to bone loss, thus increasing the difficulty in treatment and the possibility of losing the dental implant. What excites or worries you about the future of dental? Where do I begin? So much research is studying issues of the mouth and connecting them to the body. This is expanding the role of the dental hygienist in educating our patients on complete body health. The oral manifestations of systemically compromised patients, gives us the opportunity to assess conditions like auto-immune diseases. As hygienists, we can pick-up signs and

The payment plan option will be available until the Early Bird registration deadline (Monday 16 July, 2018). Please note that there will be a charge of 4% of the registration fee. Should you have any questions about DHAA Symposium 2018 please email the symposium managers.

symptoms before the patient is aware. An ulcer is not just an ulcer if you don’t know what has caused it. One needs to eliminate trauma, viral, immune issue, blood disorder etc. What worries me? Hygienists who are not educating and working with their patient to the full extent of their scope; those who are performing ‘drive by scaling’; and think they can complete a hygiene appointment in thirty minutes. Dental hygiene is a worthy profession and we need to be proud of what we can achieve. What are you most looking forward to? It’s exciting to be among like-minded hygienists, with a thirst for knowledge. I look forward to chatting with my peers and gaining more knowledge that I can pass on to my patients. This displays to them my commitment to be at the forefront of my profession. n


It’s our individual responsibilty to document our completion of the required CPD hours, but would you be ready if you were selected by AHPRA for a CPD audit?



Each three-year CPD cycle covers three registration periods from 1 December to 30 November. The current CPD cycle runs from 1 December, 2016 and will end 30 November, 2019.

n an increasingly electronic world, many of us rely on emails and cloud storage to maintain records. This can make us relax a little when it comes to keeping our paperwork organised. If you were audited on your CPD by AHPRA tomorrow would you be prepared? The Australian Health Practitioner Regulation Agency (AHPRA) is the organisation responsible for the implementation of the National Registration and Accreditation Scheme across Australia. The Dental Board of Australia is established under the Health Practitioner Regulation National Law as in force in each state and territory (the National Law). The Board’s role is to regulate dental practitioners in Australia under the National Registration and Accreditation Scheme (the National Scheme). Anyone can search the status of a health practitioner’s registration and check it is current and if any sanctions have been made.

Ways to accrue your CPD Although conferences offer many opportunities for CPD, there are many other ways that you may not have considered to obtain affordable and informative CPD. You could access: ● Scientific journals and publications; ● Universities and other education providers whom provide seminars or public events; ● First aid and CPR training; ● Indemnity insurance companies: face-to-face and online risk management seminars; ● Researching medications/medical conditions for patient care.

What AHPRA require Every year when we renew our AHPRA registration we make a declaration that we have completed the mandatory minimum 60 hours of Continued Professional Development (CPD) over the three-year CPD cycle. AHPRA registration standards for Continuing Professional Development (as of 1 December 2015) states the following: To meet the registration standard, you must complete a minimum of 60 hours of CPD activities over a three-year CPD cycle. ● a minimum of 48 of the 60 hours (80 percent) must be spent on clinically or scientifically-based activities, and; ● a maximum of 12 of the 60 hours (20 percent) can be spent on non-scientific activities.

How DHAA can help with CPD As part of the DHAA commitment to it's members there are numersous support channels to assist you manage and maintain your CPD requirement, including; ● Each state/territory holds meetings for DHAA members, refer to the CPD calendar at the back of this Bulletin or visit the DHAA website. ● DHAA national and international symposiums. ● DHAA Study Club where you can study with friends. You can find out more here. ● Reciprocal rights to attend other association events at member costs. ● Online resources such as recorded webinars, online modules, and a repository of external web-based CPD resources. n

FAQs on CPD I read a lot of journal articles, does that count towards my CPD hours? Yes it does, however just stating “20 hours of reading” is not adequate evidence. If audited, all topics/ articles read need to be referenced and a printed list included with documentation.

Does working part-time mean that I have reduced CPD requirements? No, the declaration you make states you have completed the minimum mandatory requirements. Regardless of how many hours you work, it is important to meet the minimum requirements.

Do I need to keep hard copies of my CPD certificates? If you are audited you may have to provide original certified copies of your CPD certificates so, keep the originals in a safe location just in case.

If I’m on maternity leave do I still need to fulfil my CPD obligations? Yes, you still need to obtain 60 hours over the three year period.

How long should I keep a record of my CPD activity? 5 years

What should I do if I have not been keeping a record of my CPD? 1. Create a log book (either electronic or manual). The DHAA provides an online

log for members on the DHAA website in the My CPD section. Additional templates are available from the Dental Board website. 2. Collate and file all original certificates. 3. Calculate the hours you have completed in the current cycle and make a plan to complete the remaining hours by searching for meetings, conferences, and journals. 4. It can be useful to write a brief summary of what you have learnt, and/ or a reflection on how this will impact your practice. For further information on the audit process, please go to the Dental Board website.


The Silver Fluoride Bullet Could dental hygienists play a role in the treatment of dental caries Story by ?????


ental hygienists in collaboration with dentists have the potential to play a major role in the potential change in the philosophy of dentistry away from one of expensive extraction and filling teeth to cost-effectively arresting dental caries by using silver diamine fluoride (SDF), a treatment dating back to the early twentieth century. The philosophical change is from one of surgically removing dental caries either by drilling or extraction and replacing the lost tooth structure with either a restoration or a denture to conservatively treating the disease. It will be of particular use for residents of aged care facilities, young children, people with mental and physical disabilities, refugees, Indigenous Australians, and people in developing countries. Under the current surgical treatment philosophy, once teeth are restored, they are subject to the “repeat restoration cycle”, whereby teeth are restored and re-restored with more and more complex procedures as the existing restorations fail1. The SDF treatment by arresting dental caries will break this cycle resulting in less need for dental clinical care with a subsequent reduction in both costs and patient stress. Research shows that silver diamine fluoride (SDF) has greater dental caries arrest and prevention abilities than sodium fluoride varnish.2,3,4,5,6,7,8 In early studies, these abilities were thought to derive from the combined effects of silver salt-stimulated sclerotic or calcified dentin formation9, silver nitrate’s potent germicidal effect10, and in later studies by fluoride’s ability to reduce dental caries.11,12,13 A recent literature review of papers of multiple languages found that the possible mode of action of SDF for arresting caries may be attributed to its inhibition of mineral demineralisation, promotion of mineral remineralisation and protection of the collagen matrix from degradation14. SDF is easy to apply, affordable and able to improve access to care for public health purposes and has fewer adverse effects than interim therapeutic restorations15. The use of SDF turns the tooth black16 which indicates that the caries has been arrested17. The use of potassium iodide (KI) immediately after the SDF application, and the resultant production of the white

silver iodide reaction precipitate, may remove the blackness18 and have a more aesthetic result. It is theoretically possible that KI could reduce the bacterial inhibiting component of SDF by removing the silver from the tooth19, but it is also possible that KI’s antibacterial effect could more than compensate any negating of the antibacterial effect KI possibly has by removing the silver component of the SDF. By covering the SDF with a glass ionomer (GI) fissure sealant, the GI seals the SDF into the tooth so that high concentrations of fluoride ions (1.5%) penetrate to the base of the dental caries after two weeks20; thereby killing any bacteria in the dentinal tubules.

“ It will be of particular use for residents of aged care facilities, young children, people with mental and physical disabilities, refugees, Indigenous Australians, and people in developing countries” No research is apparent to refute or substantiate whether the use of KI nor whether covering the KI with GI fissure sealant influences SDF’s dental caries arrest properties. A randomised controlled trial on deciduous teeth is currently being undertaken in Hobart by the University of Tasmania, Oral Health Services Tasmania and Southern Dental Industries Ltd. A similar trial on adults is being investigated in collaboration with Bendigo Health. Silver fluoride has been called the silver bullet because it could solve our problems of treating dental caries19. More work needs to be done, but maybe it just could, and it’s possible preventive-minded dental hygienists could play a large role in its use. n A/Prof Len Crocombe / Dr Geoff Knight


References Elderton R. Clinical Studies Concerning Re-Restoration of Teeth. Advances in Dental Research. 1990, 4(1): 4-9. Lo ECM, Chu CH, Lin HC. A Community-based Caries Control Program for Pre-school Children Using Topical Fluorides: 18-month Result. J Dent Res 2001; 80(12):20712074. Zhi QH, Lo ECM, Lin HC. Randomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children. Journal of Dentistry. 2012; (40): 962-967. Chu CH, Lo EC, Lin HC. 2002. Effectiveness of SDF and sodium fluoride varnish in arresting dentin caries in Chinese preschool children. J Dent Res 81: 767-70. Chu CH, Lo EC. 2008. Promoting caries arrest in children with SDF: a review. Oral Health Prev Dent 6: 315-21. Llodra JC, Rodriguez A, Ferrer B, Menardia V, Ramos T, Morato M. Efficacy of SDF for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial. J Dent Res 2005; 84: 721-4. Walker D, Yee R. 2011. Arrest of caries technique (ACT): Appropriate technology for the clinician and for disadvantaged communities in Nepal; Retrieved online June 20, 2011 From:// downloads/Arrest_of_Caries_ Technique.pdf. Liu BY, Lo EC, Chu CH, Lin HC: Randomized trial on fluorides and sealants for fissure caries prevention. J Dent Res 2012, 91:753–758. Stebbins EA. What value has argenti nitras as a therapeutic agent in dentistry? Int Dent J 1891; 12:661-670. Miller WD. Preventive effect of silver nitrate. Dent Cosmos 1905; 47:901913. Marinho VC, Higgins JP, Logan S, Sheiham A. Fluoride varnishes for preventing dental caries in children

and adolescents. CochraneDatabase Syst 2002; Rev CD002279. Marinho VC, Higgins JP, Sheiham A, Logan S. Combinations of topical fluoride (toothpastes, mouthrinses, gels, varnishes) versus single topical fluoride for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2004b; CD002781. Marinho VC, Higgins JP, Sheiham A, Logan S. One topical fluoride (toothpastes, or mouthrinses, or gels, or varnishes) versus another for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2004a; CD002780. Zhao IS, Gao SS, Hiraishi N, Burrow MF, Duangthip D, Mei ML, Lo EC-M, Chu C-H. Mechanisms of silver diamine fluoride on arresting caries: a literature review. International Dental Journal. 2017; 1-10. Santos Junior VEd , de Vasconcelos FMN, de Souza PR, Ribeiro AGb Rosenblatt A. Adverse events on the use of interim therapeutic in schoolchildren: Silver diamine fluoride × interim therapeutic restorative – a pilot study. Rev Odonto Cienc 2012; 27(1):26-30. Wambier DS, Bosco VL. Use of cariostatic in pediatric dentistry: silver diamine fluoride. 3. Rev Odontopediatr 1995;4:35-41. Craig GC, Powell KR, Price CA. Clinical evaluation of a modified silver fluoride application technique designed to facilitate lesion assessment in outreach programs. BMC Oral Health 2013, 13:73. Obwegeser H, Von Wachter R. The treatment of hyperesthetic dentin with nascent silver iodide. Zahnarztl Welt 1954;9:429-430. Rosenblatt A, Stamford TCM, Niederman R. SDF: A caries ‘’silverfluoride bullet’’. J Dent Res 2009; 88: 116- 25. Knight GM, McIntyre JM, Mulyani. 2006. The effect of silver fluoride and potassium iodide on the bond strength of auto cure GIC to dentin. Aust Dent J 51: 42-5.


Warming Hearts in Aged Care When managing the oral health care of dementia patients, actions really do speak louder than words Story by Marcy Patsanza (Dental hygienist at Aged Care SA)


reating an elderly patient with short term memory loss can be a bit tricky when you have to introduce yourself or repeat yourself every five minutes. While trying to maintain good ergonomics, you soldier on with the treatment but nothing warms your heart quite like the moment a patient glances at you after the appointment, smiles and you watch her eyes light up as she gives you a cheerful “thank you”. A bit stunned by the response, you can’t help but wonder how she has remembered what has just been done for her. Only momnets ago she could barely remember your name or anything you had said! Perhaps it is true, that people may forget what was said, but they will remember how you made them feel. When words are so confused within their minds, our actions become the best tool to warm their hearts in return. As dental hygienists we are skilled in promoting better oral health practices, but what happens when we are faced with a target group whose condition means they fail to retain the detailed instructions we give them? The DHAA has acknowledged that there is an increase in the ageing population who are dentate. This means that there is a relative rise in the need for oral intervention for this target group.

While it is true that not every elderly person currently, or will, experience any form of dementia, the prevalence is unfortunately a high statistic impossible to ignore. In 2018, there are an estimated 425,416 Australians living with dementia, with around 250 people joining this group every day. Three in 10 people over the age of 85 years and one in 10 people over 65 years have dementia. According to a report by the Australian Institute of Health and Welfare, dementia is the single greatest cause of disability in Australians aged over 65 years old. (NATSEM, 2016) Dementia Australia describes dementia as a collection of symptoms caused by disorders affecting the brain. This may affect one’s behaviour, memory and ability to perform daily tasks. Dementia itself is not a specific disease but the most common types of dementia are Alzheimer’s disease, Parkinson’s disease, Vascular dementia, Fronto Temporal Lobar Degeneration (FTLD), Huntington’s disease and Alcohol related dementia (Korsakoff’s Syndrome). (, 2018) As oral health professionals, we need take a stand and make our actions speak louder than our words for the ageing population. To help us gain the skills required to deliver this heart-

warming service for this rapidly expanding group we must look to achieve the following goals: ● Aim to understand the needs of the patient group; ● Be aware of the presenting factors and effects; ● Be equipped to meet their needs; ● Become part of a network of professionals working in the field. Getting involved If you are keen to find out more, the DHAA SA will be offering an online course and a hands-on clinical component as part of the DHAA Aged Care Portfolio to get you equipped. The two hour online content is compiled by Alzheimer’s Association and must be completed prior attending the threehour hands-on workshop. Details for the workshop are on the opposite page. The online course – worth two hours of CPD – can be accessed on the DHAA website here . I look forward to growing with you in knowledge and skill in this rising need. Look out for interviews from experts in trade, research updates in the industry, future events and resources as well as personal experiences in upcoming Bulletin issues to assist you with your professional development journey. Please feel free to email the editor at and/or myself at for any suggestions or recommendations of oral health in aged care. Also remember the DHAA is representing you at a national level with the National Aged Care Alliance – the peak body for informing government and putting our case forward. Our representatives are Margie Steffens – Chair ( au); Lynda Van Adrighem (; and Rachel Bray (rbray85@ Let’s take a stand together in this heart warming experience because after all, actions speak louder than words. n


Hands-on clinical workshop Date 18-20 April, 2018 Session Times 9am–12pm or 1-4pm (3 hours CPD) Venue Fullarton Residential Care, 345 Fullarton Road, Fullarton SA 5063 Facilitator Archana Pradhan (University of Queensland) Cost (Lunch included): ● Members: $120pp ● Non-members: $250pp Contact email ● Lyn Carman, DHAA State Chair ● Margie Steffens DHAA Chair for Aged Care

DHAA Study Club We have a study club pack specifically on Oral Health and Dementia. Members can download and read it here.

References: (2018). Dementia Australia | What is dementia?. [online] Available at: https://www.dementia. [Accessed 24 Feb. 2018].; The National Centre for Social and Economic Modelling NATSEM (2016) Economic Cost of Dementia in Australia 2016-2056

VOLUNTEER FOR GOOD If you’re filled with the community spirit and want to direct it at something worthwhile then here’s the ideal way to stand up and be counted Story by Danielle Gibbens

“No act of kindness, no matter how small, is ever wasted.” – Aesop.


he DHAA encourage not only our members, but all oral health professionals, to get involved with community-based programs and volunteering at all levels. We are fortunate enough to be part of a community in which we are often willing to give our time and knowledge to one another. CPD events, study clubs and volunteering for the DHAA are all very worthy causes, but have you ever felt you wanted to do more? The Bulletin is planning a series of community-focused articles to highlight the ways in which you can volunteer outside of your practice and into the wider community, and in some cases the world. Volunteering is something that many of us consider, but all too often we never quite get there. As well as finding enough time, one of the more common hurdles is the lack of knowledge on how to start a program or where to find a program to join. The Bulletin plan on providing you with a guide that includes first-hand encounters from some of our members who have taken the leap into the volunteer world.

On the DHAA website you will find a volunteering section under the ‘Support’ tab in the main menu. This features five volunteer programs, all of which are supported by the DHAA, either directly or indirectly. These programs are predominantly in Australia, and include; volunteering for the DHAA, the Common

“Volunteering is something that many of us consider, but all too often we never quite get there” Ground facility in Adelaide – founded by Margie Steffens, the Brisbane Youth Service, and Carevan Sun Smiles, which has DHAA’s Cath Carboon as a director. The overseas volunteering program featured on the DHAA website is the Long Tan Clinic in Ba Ria, Vietnam – one that many of our members would have heard of. This clinic is sponsored by the DHAA, with 1% of all ticket sales from our symposium events going to the clinic every year. The volunteer program

is lead by Dr Colin Twelftree, Dental Coordinator for AVVRG. More than four times a-year, volunteer groups will go to Vietnam to spend a week at a clinic. The teams are lead by dentists but oral health professionals, such as hygienists and OHTs, will make up the numbers. If you want to find out more about any of these programs go to the DHAA website. If these programs aren’t what you’re looking for then there are hundreds of other options. The ADA have supported the set up the Australian Dental Health Foundation (the new name for the National Dental Foundation). In this program you can either ‘adopt a patient’ or you can organise a volunteer day from your own surgery. To find out more visit the ADHF website Our colleagues over at the ADA also have a list of current volunteer projects. Check it out at here – they may just have the right one for you! Have you already been volunteering and want to share your story? Then please contact The Bulletin at bulletin@ If you have a program that needs oral health professionals, or you know of someone, or a program, that should be featured, then drop us a line and we’ll follow it up.


One week in Sri Lanka Danielle’s Story I MUST ADMIT to being a bit of a volunteering junkie. For more than eight years I have held a number of voluntary positions within the DHAA. I have also volunteered through the National Dental Health Foundation; spending several Saturdays in our clinic providing dental care to those in need in our local community. I have also developed and implemented oral health educational programs in local mothers groups, kindergartens and primary schools. More recently I have turned my attention to overseas volunteering, and I am about to head off to the Long Tan Clinic, which I found out about through the DHAA. It’s long-been on my list of ‘things to do’ and this year I have made a conscious effort to set the time aside and make it happen. Many colleagues have gone previously and all have found the trip to be rewarding. My first-ever overseas volunteering trip was to Sri Lanka, last year. I was invited to travel with a dentist colleague of mine. We had discussed doing this trip together and when I got the email to say that: ‘She

was going, and would I like to come?’ – I jumped at the opportunity. This program is in its infancy, and is a collaboration of a local charity that has sought funding for AusAID and other similar Australian medical charities. My friend, who also has a passion for volunteering, had contacted AusAID

in regard to current volunteer groups looking for dentists. They had put her in touch with a Sri Lankan-born dentist practicing here in Australia who is currently the only Australian volunteer helping the charity in Sri Lanka. Between them they coordinated the trip and I was lucky enough to tag along!

“W  e had discussed doing this trip together and when I got the email to say that: ‘She was going, and would I like to come?’ – I jumped at the opportunity.”


In November 2017 I spent a week travelling around Northern Sri Lanka. On arrival in the capital of Sri Lanka it appears to be quite an affluent country; but as you travel to the rural areas and learn the history of the people, and the divisions caused by the civil war, it becomes more apparent why this country needs such a program. We were based in a very small town called Kilinochchi, which is predominantly Tamil, and soon got talking to our local guides and the local dentists. They discussed with us the post civil war hardships and the fact that many professionals had left these areas due to safety concerns. That was nearly ten years ago and they have still not returned. Our week was spent travelling to rural schools to screen primary school-aged children. We would set up our makeshift dental office in a spare room, or in a

classroom, that each school would make available on the day. My role was to triage the children. Those that didn’t need treatment from a dentist got a fluoride application and were sent on their way with a thumbs-up and a high five. Those children with oral

of hypo mineralised 6s which was very interesting to see in a particular age group of children. Being from rural areas, many of the children ate a lot of fruit and drank fruit juice. The tropical climate means that these natural treats are available in abundance. Sadly though, western

“ There was a general warmth and an appreciation from the whole community that we had taken the time to come and help them� conditions such as caries were sat down together to see the dentist. I had brought along a portable ultrasonic, so I did as much cleaning as I could, while the children queued. In four days we saw 441 children with a vast range of oral health issues, some needing serious dental work done under general anesthetic. There was a high prevalence

influence has infiltrated their culture and sweets and fizzy are available at the local corner store. My week in Sri Lanka was challenging in many ways. Not having the equipment or sterilisation procedures that we are accustomed to; the language barrier as very few people spoke English; and the general learning curve we encountered

21st International Symposium on Dental Hygiene Call for Oral Sessions & Poster Abstracts


he International Federation of Dental Hygienists (IFDH), in collaboration with the Dental Hygienists Association of Australia (DHAA), invites colleagues from the international community to submit proposals to be considered for the oral sessions and poster display at the 21st International Symposium on Dental Hygiene which will be held on August 15, 16 and 17, 2019 in Brisbane, Australia.

Oral sessions will be held within 45 minute, 60 minute and 90 minute time frames pertaining to the theme of the conference, LEAD: Leadership, Empowerment, Advances, and Diversity. Preference will be given to proposals that include two speakers (content expert and a dental hygienist who translates how that information can be used in practice) and incorporate significant time for questions and answers. Poster sessions are an opportunity to share original research, learn new concepts, network and exchange ideas, and stay current on relevant information. Research presented should pertain to the theme of the conference, LEAD: Leadership, Empowerment, Advances, and Diversity; be pertinent to published national research agendas; and, be significant to advancing the dental hygiene body of knowledge. All oral proposals and poster abstracts must follow the appropriate templates and be submitted through the relevant Submission Portal by 30 April 2018.

Dates and Deadlines Call for Oral Proposals & call for Poster Abstracts open 19 February 2018 Call for Oral Proposals & call for Poster Abstracts close 30 April 2018 Notifications to Authors 30 June 2018

For more information on the submission guidelines, selection criteria, and terms and conditions please visit the ISDH2019 website


Have you got a volunteer story to share? We’d love to hear from you. Please email as the program attempted to navigate these limitations. Having said that, this was also the most rewarding dental work of my career. Every child thanked us the best that they could, and they were always happy to see us. Each day, hoards of children would run up to us with their toothbrushes, to show us how good they had been at brushing. There was a general

warmth and an appreciation from the whole community that we had taken the time to come and help them. One local mobile dentist was so grateful when I told her that the portable ultrasonic I had brought with me was being donated to the program – she’d never had this kind of equipment at her disposal before. My trip to Sri Lanka has renewed me

as a hygienist; I now remember why I am so passionate about my chosen career, despite there being difficulties at times. Visiting a community that is fortunate in some ways, but less fortunate in so many others, and then witnessing their joy to see you, and their enthusiasm for you to help them, is a more rewarding experience than I can put into words. n


Ask DHAA... Your opportunity to ask the questions, check the rules and share your knowledge

Since the association became one national body we have restructured memberships to renew annually, in-line with the financial year, from 1 July. This works well for the many members that are adding the option of DHAA Professional Indemnity Insurance to their membership as both can be renewed together.

Dear DHAA... I never got around to doing the whitening add-on course which is no longer available. What can I do as my employer would like me to do in-house whitening?

When it comes to scope of practice always check back with the guidelines – did you learn it when you studied? Most courses in Australia currently give base theoretical knowledge on whitening to hygienists and OHTs so these criteria should be met. The criteria that most people are lacking is the ‘are you competent’? It is not something we do practically in our studies which can then be done in our compulsory CPD counting towards our clinical/ scientific quota. The DHAA has heard you and recognised this gap between the base theoretical knowledge and gaining competency practically for in-house whitening. There is now a ‘Whitening Roadshow’ touring the country to assist members in improving their in-house whitening skills. Head over to our CPD Events page of the DHAA website – – to find out if the roadshow is coming your way soon.

Dear DHAA... I want to be a member of the DHAA but already have insurance. Can I still be a member without taking up your insurance?

Of course! We want all our members to have a choice. The BMS insurance is not compulsory at all. While we believe it is currently the best value for money option on the market, you can still be a member without it. Simply opt-out when processing your membership online. Dear DHAA... Where do I go to find out more about the Cairns symposium?

Each year our symposium has a website dedicated to all

things symposium! You can find the link on our DHAA website or head straight to www.dhaasymposium2018. If you can’t find what you are looking for you can head to the Contact tab and shoot a message through to our symposium committee who will be able to help you. It’s that simple!

Dear DHAA... I’m not sure about some details for my upcoming CPD event. Can you help?

Dear DHAA... I don’t understand why I am being asked to renew my membership for only three months?

All the details to our events will be on the CPD Events page of our website – www.dhaa. info/events. If you can’t find the information you’re looking for on the page there will be a contact email on each specific event listing. Please note that although we are one national body, our events are still run individually by our state committees. To ensure that you get the best answer please ensure you direct your enquiry to the right committee for your event.

Previously your DHAA membership was renewed annually from the date that you joined.

Got something you want to ask? Send your email to


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Living the Ortho Life Discover what it’s like to be a dental hygienist in an orthodontic world Story by Kailey Paterson


ental hygienists and oral health therapists are pretty lucky when it comes to our ability to explore our careers in specialist practice. Not only are we able to work with a wide range of patients in general practice but we can develop a specific subset of skills in as an oral health practitioner in a specialist practice, enabling us to work with the procedures and patients we enjoy in a team approach to care.. Working in orthodontics is an exciting area of our profession. You see patients get a bit of a cosmetic transformation – not always the case as a hygienist (all the gore, none of the glory sorry to all you perio hygienists). There’s definitely an impressive energy when you remove someone’s braces after 18 months of treatment, and they see themselves in the mirror for the first time. It’s like they’ve taken a bite out of the moon! The role allows for genuine excitement on a daily basis. The vibe is buzzing when collecting an anxiously excited patient from the waiting room, because it’s a big deal for them. Sometimes there’s hugs or even a little scream of excitement you just don’t get that in all areas of hygiene. The ‘elephant in the room’ for the orthodontic dental hygienist is the more-complex hygiene needs of the patient, and a large part of the role is to keep them on the right track in terms of brushing and plaque control. Many studies show that brackets and wires contribute to plaque levels, which seems fairly obvious with there being more surface area to attract the plaque. We’ve seen big developments in products, such as Invisalign,

“Not only are we able to work with a wide range of patients in general practice, but we can develop a specific subset of skills in as an oral health practitioner in a specialist practice”




Working with hygienists in an orthodontic practice From the perspective of Orthodontist, Dr Sarah Lawrence

WORKING WITH oral health professionals is integral to the way I work in orthodontic practice and I would not have it any other way. When I first started out, we did all the work ourselves. As our practice grew, we made the decision to employ oral health professionals (OHPs) to help with the work load, and patient care. I have worked with OHPs for the past 10 years and we now employ five, of which three or four will work on a given day. This involves a combination or dental therapists, dental hygienists, and oral health therapists. The job is definitely different to that in a general dental practice and the skill set is specific to orthodontic care. As there is limited OHP training in most programs for orthodontics, there is a very steep learning curve for anyone coming to work in this specialist area. Many months of on-thejob training is required, which in our case entails shadowing an established OHP to

learn the multiple skill sets required. Working with an OHP involves delegating tasks in patient care, both from a physical perspective – i.e. tying in wires, scanning teeth etc – as well as with the education and management of patients. We work together to assist in patient care. Working with OHPs allows me to focus on the things that the doctor needs to do, such as decision-making at each appointment, placing braces and bending the wires etc. Jobs that are delegatable, such as tying and untying in wires, are carried out by the OHP. In most cases

“As there is limited oral health professional training in most programs for orthodontics, there is a very steep learning curve for anyone coming to work in this specialist area”

these responsibilties are dovetailed, with the orthodontist and OHP both present in the same appointment. We believe in training all of our OHPs to be the best that he, or she, can be. Regularly engaging them in training and education in all areas of orthodontics, including clinical and patient customer service. This training is carried out in our practice as well as at various conferences – both in Australia and overseas. Orthodontics (as is dentistry) is a rapidly changing speciality, especially in terms of digital technology, and we all need to keep learning and be constantly improving. Due to the large number of patients seen in a day at an orthodontic practice (80 – 110 on average), the job is very highpaced with speed and accuracy being aramount, as well as excellent customer service and good people skills. Oral Health Professionals really do make our working life easier.

27 that aim to make it easier to keep teeth clean. Anecdotally, we see the effects of removable orthodontic appliances in practice every day, but surprisingly studies don’t necessarily show this. A recent study 1 discussed the hygiene differences between aligners and braces after nine months of treatment. However, after 18 months the differences were no longer significant. Ultimately the aligners did not offer less PI/GI than braces. Both were self-ligating and elastic module brackets. These results are pretty surprising for anyone who works with orthodontic patients, but the researchers report this result is similar to other studies. Research is continuing into the types of plaque that accumulate to see if there’s a difference in the pathology of plaque accumulating around braces or aligners. Most orthodontic patients, whether they have braces or aligners, come through the experience unscathed. But, as in all areas of dentistry, compliance to oral health can be a challenge. One main concern is the demineralisation of the enamel which has been shown to occur with atleast one tooth in around 50% of cases2. Although, there doesn’t appear to be much research into demineralised lesions around attachments in aligner patients, it’s logical to consider these patients may well be affected too, based on information regarding plaque scores discussed in other studies 1. Fluoride and CPP-ACP (casein phosphopeptide amorphous calcium phosphate) for high-risk patients is pretty standard and the research supports this3, although it doesn’t generally make an enormous impact if the patient’s brushing is really bad. I always think back to my uni days when a litigation advice lecturer discussed white spot lesions as being one of the top reasons for litigation in orthodontics. So it’s really worthwhile to make notes and give the patient whatever they need to stay in the game. When I started working in orthodontics, I’d assumed thatI would mostly be working with moaning teenagers, but infact the teenagers are actually very like-able on the whole – when you get them out of their natural environment. The reality is that we get to see a whole range of age groups, our oldest patient was in her 80s! More adults are getting orthodontic treatment than ever before, and the diversity of treatment is growing. As oral health professionals, we understand that teeth are a huge part of a person’s self-esteem and it’s always rewarding to see you’ve contributed to someone regaining theirs. n References: 1 Which Orthodontic appliance is best for oral hygiene? A randomised clinical trial, Aditya Chhibber et al – Am J Orthod Dentofacial Orthop 2018;153:175-83; 2 Demineralised white spot lesions: An unmet challenge for orthodontists, Matthew J. Miller , Shira Bernstein, Stephanie L. Colaiacovo, Olivier Nicolay, George J. Cisneros – Department of Orthodontics, New York University College of Dentistry, New York, NY 3 Long-term remineralising effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on early caries lesions in vivo: a systematic review. Li J1, Xie X1, Wang Y2, Yin W3, Antoun JS4, Farella M4, Mei L5 – J Dent. 2014 Jul;42(7):769-77. doi: 10.1016/j.jdent.2014.03.015. Epub 2014 Apr 3

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Bridging the gender gap In a female-dominated industry are the cracks of equality beginning to show? Story by Amelia Roff


ntil recently the differences between male and female roles in our society were considered socially acceptable. However the desire for equality could actually be proving detrimental to our industry. The World Health Organisation has acknowledged that the average life expectancy for men is generally lower than women with women outliving men by six years (Baker et al.). This disparity has, at least in part, been attributed to ‘masculine’ behaviours such as; reduced use of health services compared to women; increased alcohol consumption; and risk taking behaviours associated with notions of masculinity. On the flip-side, intimate partner violence is responsible for more preventable ill-health and premature death in Victorian women under the age of 45 than any other of the well-known risk factors – according to a report conducted by the Victorian Department of Human Services, While it is true that the national average of men experiencing intimate partner violence is 6%, the percentage of women who have experienced intimate partner violence is much higher, at 17%. In recent weeks

with the #metoo campaign our society has had the spotlight shone on toxic masculinity. What place does this have in the DHAA Bulletin? Dental hygiene is a female-dominated profession. Though this is not inherently problematic, the notion of ‘feminine’ and ‘masculine’ workplace roles feeds into the culture of toxic masculinity. As such, it would serve to benefit the profession of dental hygiene and broader society if we made efforts to be more inclusive of all genders. By allowing the image of dental hygienists as a feminised profession to remain unchallenged, this creates barriers for men, and genderdiverse people, to enter the profession.. By allowing the image of dental hygienists as a feminised profession to remain unchallenged, creates barriers for men, and gender-diverse people, to enter the profession. Actively encouraging men to seek positions as dental hygienists means allowing men to be seen in a nurturing role. This is important because it challenges the idea of toxic masculinity. This idea forces men to

remain ‘tough’ and allows men to demonstrate the capacity to be caring. In a qualitative analysis of men’s experience as dental hygienists, male hygienists expressed that they had experienced difficulty in finding hygienist work, and were often told by patients that they were not expecting a male hygienist (Faust). These issues may seem small, but they act as a deterrent for those wanting to enter the workforce. The female domination of dental hygiene reinforces a gendered stereotype of dental hygienists. By perpetuating gendered roles in the workplace we unwittingly encourage damaging stereotypes that see women in ‘feminised’ roles and men in classically ‘masculine’ roles. It is this kind of compartmentalising that reinforces damaging gendered traits that socially enforce codes of behaviour and allow toxic masculinity to spread. People that transgress these codes of behaviour are often subject to discrimination.

the n i n me o w ive t s r u o l c p te in sup a o e r t c t rtan ortant to ssions ” o p s im also imp all profe i t i e s is il “Wh place, it ders acros work for all gen s space


While it is important to support women in the workplace, it is also important to create inclusive spaces for all genders across all professions. In order to be inclusive to all genders, real work has to be done to ensure that gendered workplace stereotypes are challenged. By creating a more genderdiverse workforce, these stereotypes are challenged. The undermining of these structured roles creates more choice for those seeking to enter the workforce and challenges long held conceptions about the expected behaviours of men and women. Gender diversity in the workforce benefits all people in the workforce. Being an affective ally in this instance can be as simple as challenging workmates on their hiring practices - asking why one candidate was chosen over another

and if this choice was impacted by any possible unconscious bias. This same thinking could also be used to assist any minority group in getting hired. Mentoring those struggling to get a job who are experiencing these kinds of discrimination – often new graduates – find their skill set diminishing, making it even more challenging to get into the workforce. It may be a useful tool to examine interactions with patients at a deeper level: if a patient has been unhappy with a provider, was this purely down to the service, or has there been some form of discrimination that has informed this patient’s behaviour? Being aware is half the battle. n

References ABS. “Personal Safety Survey, Australia: User Guide.” Canberra: Australian Bureau of Statistics, 2016. Date Accessed Baker, Peter, et al. «The Men’s Health Gap: Men Must Be Included in the Global Health Equity Agenda.” Perspectives. World Health Organisation 2014. Web. Date Accessed 15th Feb 2018. Faust, Charles. “A Qualitative Study of Males in the Dental Hygiene Profession.” Connelly, Mary Jane: ProQuest Dissertations Publishing, 1997. Date Accessed VicHealth. “The Health Costs of Violence: Measuring the Burden of Disease Caused by Intimate Partner Violence.” Victoria: State Goverment of Victoria, 2004. Date Accessed




“There are only two days in the year that nothing can be done. One is called ‘Yesterday’ and the other is called ‘Tomorrow’. Today is the right day to love, believe, do and mostly live.” – Dalai Lama XIV


ow can we replicate excellence and allow people to achieve outstanding results in human behaviour? How do we accelerate our results in our relationships, our career and our finances? How can we actively take charge of our emotional spiritual and financial destiny? Over a series of articles we will discuss different ways to do this and you can learn many different tools to take charge of the various aspects of your life. Think about how you learn to use your dvd player, your car, your PC, your mobile phone. If you are like me, you read the manual and learn how to get started, and then when something doesn’t run the way you want, you can go back to the manual and find out how to get it running again. There are many techniques we can use in the pursuit of taking charge of our worlds which are like an owner’s manual for your mind. How can you run your mind in the most effective way to produce the results that you want in your life? How do you take the results that you want to create in your life, in your relationships, your finances, your career, your spirituality your personal development? How do you take those

results and accelerate the process? Have you ever listened to somebody who had transformed virtually every aspect of their life, their finances and their career, and their relationships where they literally took charge of their spiritual emotional and financially destiny? Think about that! Have you been inspired and thought to yourself if this person can do it, then I can too? I am hoping many of you will be inspired by this and realise that you really do have the ability to shape and determine your own reality. You are like a sculptor, like Michelangelo. When Michelangelo looked at the raw block of stone which was to become the infamous statue of David, he saw the pure potentiality within it. If we were to look at our futures through a sculptor’s eyes, I expect that many of us would see them as a blob, or a piece of stone ready to be moulded and shaped into any shape you choose. Be the sculptor of your own destiny and shaper of your dreams. When there are no limiting beliefs of how hard or how this isn’t the way, or even how it needs to be, there is really no limit to human potentiality. I personally believe the nature of human kind is to do things better and quicker and faster, we are growth machines we are not designed to just stay in a steady state, or to not change. It is our natural states our natural way of being to look to change or to look for improvements or look for growth. What we thought was possible yesterday and what we thought we

You are the sculptor of your own destiny. All you need to do is decide what you want to be Story by Lyn Carman

were limited by yesterday, today we are starting to understand those limits were just limits in our own minds, that’s all they were, limiting beliefs. According to legend, experts said for years that the human body was simply not capable of a 4-minute mile.  It wasn’t just dangerous; it was impossible. On May 6, 1954, Roger Bannister broke the illusive four-minute barrier for running a mile. He ran the distance in 3min 59.4sec. As part of his relentless training, he visualised the achievement in order to create a sense of certainty in his mind and body. Barely seven weeks after Bannister’s accomplishment, someone else had beaten his time. Now, it’s almost routine with the current record standing at 3min 43.13sec. These days, even a strong highschooler can run a four-minute mile. This is an impressive indicator of the power of the mind, the power of possibility of what we are truly capability of. Not only have we had major developments in science and technology, we have had equal leaps forward in personal development, self-development and tapping into what we are really capable of in reaching our full potential. You can change what you think your reality is instantly and forever as you begin to change your focus. Remember, “what we focus on is what we get.” Each edition we will discover a pattern of thinking, we will challenge your thinking and discover steps and strategies to move you forward towards your ideal life, your career, your relationships, your finances. n


“If we were to look at our futures through a sculptor’s eyes, I expect that many of us would see them as a blob, or a piece of stone ready to be moulded and shaped into any shape you choose”



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Minding your language could make a difference


ince the DHAA Symposium in Adelaide I have been thinking a lot about the language that we use as dental professionals. We communicate with our patients on a daily basis, but once we graduate we don’t re-assess the language that we are using. I can say this, as I have worked with many dental professionals and we all use similar language and similar analogies to help us get the message across. My interest was piqued while listening to American speaker, Shirley Gutkowski, at the symposium. If you were there you would remember her – she sparked a lot of conversation at the event. The pearl that Shirley left me with was raised during open discussion. she suggested that when a dental professional restores a tooth they are fundamentally doing a partial amputation, and then using prosthetics to restore and regain the tooth structure. Talk about ‘mind blown’. Of course this is exactly what we do, but we don’t use this language - not at all. Sure, when we send someone off to the prosthetist they are getting a prosthetic, but do we ever look at a denture the same way we look at a prosthetic limb? Personally I have never thought of a restoration as a partial, or an extraction as an amputation, but fundamentally that is what they are. So what did I do with this pearl? I used it in my practice. If this had blown my mind then how would my patients react? My thinking was that it could be quite confronting. Can you imagine the scenario? ‘Sir, I am going to amputate your mesial buccal cusp due to an irreparable fracture’. We already have to deal with the fact that the dental practice is often perceived as a fearful place

to be, and carries the stigma of being scary – especially among older generations. The danger is that we have watered ourselves down too much to compensate for this illusion of us being ‘mean’? I recently used this new language with a patient returning after having a restoration. They were complaining that the tooth was still tender after a week of it being placed. I explained that part of the tooth had been removed to place the filling, as it was irreparable. So the dentist partially amputated the tooth and put a prosthetic or a ‘filling’ in your tooth. It was as if your foot had got gangrene and the doctors couldn’t save the toes, so they needed to be removed.


RANT! also not suggesting that we all rush out and completely change our dental language – especially not for every patient. However, I put this question to you. How many times have you heard a patient being told, or have told a patient, that their tooth is going to be ‘fixed’, when really it is being partially amputated and a prosthetic is being placed? How many times have you told a patient, or have heard a patient being told that while fixing their tooth that the ‘fix’ has had an unexpected complication? Followed by someone having to explain, to a confused patient, that the fix hasn’t worked. Yes, it is confronting to tell patients what we are really doing, but does this not make it easier for them to understand

“It was as if your foot had gangrene and the doctors couldn’t save the toes, so they needed to be removed.” The patient looked at me quizzically but said nothing, so I continued. If one had their toes removed one wouldn’t expect instant relief. Wounds would need time to heal and you would need to get used to your new circumstances. Similarly, the tooth needs to go through the same process. I reassured the patient that after a week it was a good sign that it was getting better, but that it still needed time to re-adjust. Surprisingly, the patient thanked me for explaining what had happened in such detail, as they hadn’t realised this, despite having had teeth fixed in the past. Yes, I do appreciate that this conversation may not have ended as well as it did. The patient had never heard this before, and having dental caries compared to gangrene could well be perceived as confronting. I am

the processes? If they understand the repercussions of their actions, and ours, does this not simplify their education on prevention? At the end of the day we are there to give patients accurate information, so that they can make informed decisions. The language we use on a daily basis can directly influence our patients. I encourage you to review your own language and assess whether the information you are providing, to your patient, accurately depicts the process or fully explains the situation. I think you may be pleasantly surprised – I know I was. n Rant! Is supplied by an independent contributor and is not an expression of the view of the Dental Hygienists Association of Australia.

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


“Shamus Breen from BMS will cover ways to reduce practice risk and key aspects of the professional indemnity insurance plan”

WE ARE ALREADY well into 2018 and we have a busy schedule ahead of us. But just to backtrack to last year – our last event for 2017 was the Christmas party at Kokomos. It was really nice to see so many DHAA members attend and I hope that everyone enjoyed themselves and it set the mood for the rest of your holiday celebrations. For those of you who are regular readers of the Bulletin, you may recall a lovely article written by Dahlia Kruyer early last year that provided a bit of the history behind the DHAA ACT Hygienist of the year award (if you missed it, it is in the March/April 2017 edition). At our Christmas

event I was humbled to be the receiptant of this award and honoured to be recognized along with other hygienists’ that I have admired and looked up to over the years. Our first event for this year is a half day on Saturday the 5th May: “Modern Concepts in Periodontal Therapy & Implant Maintenance with Dr Sal Shahidi presenting and a hands on workshop using AIRFLOW® and PIEZON® technologies. Early bird registrations for this event finish on the 16th March. Please note there are limited numbers for this day, which are filling fast. The “Risky Business” PD Day that was scheduled for March has now been

postponed until 23rd June. This day includes a presentation from Mr Shamus Breen from BMS and will cover ways to reduce practice risk and key aspects of the professional indemnity insurance plan. We also have an infection control update planned as well as some other very interesting topics. The second half of the year we are holding a joint PD day with NSW at Lake Crackenback, so all you skiers register now for this event on the 4th August. We will also be holding one of our very popular dinner meetings on the 4th October and our guest speaker will be Professor Jane Dahlstrom and she will be presenting

35 For all the latest info on DHAA events near you please visit

New South Wales

on oral pathology. Then to round out the year we will be having a Christmas event on the 1 December. So the annual calendar is set, speakers are lined up and all we need now is the great attendance by our ACT DHAA members. I’d like to thank the CPD committee for your support in organizing our events for this year and special congratulations to our Communications Officer, Michelle Bonney, who got married on the 10 February. I am excited about the program that we have for the next 12 months and really looking forward to seeing you all soon. Madellyn Kennedy ACT State Chair

THE NSW COMMITTEE has been hard at work organising the 2018 CPD events, which are set to be top notch! Coming up: Bondi Beach, Jindabyne, Taronga Zoo and more, covering the latest research and evidence based practice. Our strategic plan for the coming years is also well underway, the DHAA strives to provide quality CPD that our members want. Unfortunately our Byron Bay event was cancelled due to lack of registrations, a joint decision was made to save members money, and avoid fees and charges. I once again would like to apologies for any inconvenience this caused, however if Byron Bay is a desirable location for CPD please let us know in the member surveys we send out annually. NSW is making a conscious effort to give back to our community and to sponsor

charities that are close to our hearts. This year we are very proud to be accepted as official sponsors of the Love Your Sister Foundation. Our full day event at Taronga Zoo we will be making a huge effort raising money for cancer research. There will be a raffle, door prizes and donation boxes around with fun games and chances to win big prizes for your kind donations. It will be our biggest day of the year for CPD and we are looking forward to our top quality local and interstate presenters. Jacqueline Biggar NSW State Chair

Upcoming events in NSW: • Full Day event, Newcastle “Control the infection” • Breakfast, Bondi Beach “Risky Business” • Full Day event in the Snow, Jindabyne • Full Day event at Taronga Zoo (Sponsoring Love your Sister)

“O  ur strategic plan for the coming years is also well underway, the DHAA strives to provide quality CPD that members want ”



2017 FLEW BY in a flurry of activity in Victoria. In June we hosted a wonderful full day event at Dayleford, which included speakers such as our very own Dr Melanie Hayes and Roisin McGrath. Roisin also did us very proud when she travelled to the BSDHT Oral Health conference in Harrogate in November. Cathryn Carboon published her children’s book “Who is the Tooth Fairy’s Best Friend?” (which is available from the DHAA facebook page). And we welcomed two new honorary junior members, Aimee Mill’s daughter Evelyn and Sarah’s son Curtis. Yet to see if a career in Oral Health awaits! Nearing the end of the year we saw a committee reshuffle, with Melanie stepping from Victorian Director to National CEO and Ron Knevel accepting the role of Director in Victoria. We also welcomed two

student representatives from the BOH course at Melbourne University, Peta Morrissey and Simon Chiem. December brought with it our Kooyong Tennis Club half day event, where we welcomed a new speaker, Ear, Nose and Throat Surgeon, Mr Perry Burstin, who enlightened us regarding surgicial management of airway issues. Dr Suman Bellar also spoke regarding non-surgical periodontal management and together, their multidisciplinary approach was well received by attendees. 2018 has brought more changes, with Sarah Laing stepping up into the role of chair and Desi Balodo into that of Communications Officer. Anne Di Paolo will continue to assist as past chair. We also welcome a shiny new committee member, Lauren Hogan, who will be assisting with

“Victoria, has a lot of in-house talent and some shiny new blood, which during 2018 we plan to harness ”

event management and our in-house editor. Jess Goldsworthy manages our contact email and our February dinner meeting whilst Aimee Mills will look after our upcoming “Xmas in July” full day event. We are also hosting a “Risky Business” DHAA roadshow in May and planning another tennis fiesta at Kooyong in November. The way we see it, Victoria, has a lot of in-house talent and some shiny new blood, which during 2018 we plan to harness and really listen to the feedback from members to deliver events encompassing both a multidisciplinary and modern take on Oral Health. So hoping to catchup with you all over a wine or two at our dinner meeting February 28th and be updated on Pharmacology whilst we are at it! Sarah Laing Victoria State Chair

37 For all the latest info on DHAA events near you please visit


“We are looking for volunteers to help us deliver these CPD events to our members”

THE START OF 2018 has seen me take over the role of Queensland State Chair. I’d like to thank outgoing chair, Carlene Franklin, for her leadership over the last few years. She has left me big shoes to fill, but I’m looking forward to diving in and helping to deliver events and support for our members. In addition to the great CPD events listed below, we are looking for volunteers to help us deliver these CPD events to our members. This is a great opportunity to build experience with event management, meet other oral health professionals and contribute to the direction of our association in Queensland. If you would like to know more, please email me. Kelsey Pateman Queensland State Chair

Upcoming events in Qld: • Ultrasonics and Air Polishing, with Dr Carol Tran • Fundamentals and advanced periodontal instrumentation facilitated by Hu-Friedy • Risky Business Roadshow, covering indemnity insurance and strategies to reduce practice risk. • DHAA Symposium 2018 in Cairns. Further details can be found at

Northern Territory

“We are excited to have three interstate speakers with the day focused on prevention”

THE YEAR STARTED with a joint CPD event with the ADA NT. It was a great night learning about how the dental team and ENTs can work together. Thanks to those who came along and for those who couldn’t make it this time we hope to see you next time. Our next event will be the Full-Day CPD on June 30 in Darwin. We are excited to have three interstate speakers with the day focused on prevention. There is an infection control day in Alice Springs in September and then a second joint CPD event in October. We are working hard to provide quality CPD in the top end. If you have any suggestions for future events please let me know. Lastly, I would like to say a huge thank you to Leonie Brown. She has worked tirelessly as both the CPD chair and director for the NT and has to stepped down to focus on planning the National Symposium in Cairns this October. Thanks Leonie for everything you have done for the NT dental community, the work you continue to do nationally and your dedication to your profession and the DHAA. April Lunnie NT Chair



“We urge you to come along and support our upcoming events on the Apple Isle”

IT’S ALL SMILES on the Apple Isle as we bring in another new year! Since our last State of the Nation report, Tassie turned on the weather for our half day CPD event in Launceston at Hotel Grand Chancellor on Sat 3rd February! We were delighted to have our CEO Dr Melanie Hayes present on Dietary Analysis and Advice. Eye opening statistics reinforced our preventive role ensuring we use a risk assessment tool to help individualise advice and identify the other contributing factors patients may not disclose; most importantly we recognised Mel’s love hate relationship of chocolate! Associate Professor Catherine Snelling delivered an entertaining and engaging session on Interrogating your Radiographs. Catherine reinforced the importance of recording what we see to compare change over time, shared some practical tips and hints to perfect our technique recognising the ‘outlier patient’. Although we can’t diagnose, delegates can appreciate the importance clinically and legally of exposing high quality images. Dr Hayes presentation was the perfect lead up the

Delegates listen intently to Dr Melanie Hayes

post event festivities at Festivale in the Launceston City Park; Festivale has been an annual fixture on the summer event calendar for over 30 years, providing the opportunity for both locals and visitors to sample the wonderful produce, cool climate wines, beers, ciders and spirits Tasmania has to offer, whilst enjoying all the entertainment! Save the date in your diaries! Come along and support our next upcoming events; a great opportunity to visit family and friends if you’re an interstate delegate! Registrations are open for the ever popular Guided Biofilm Therapy Masterclass on 26th May and the Risky

Business Roadshow on 7th July! There will then be excitement in the air for the main event; the DHAA National Symposium, Talking Teeth by the Reef! I will be stepping down as Tasmanian Chair to focus on developing my clinical hygiene skills. Volunteering for the DHAA had provided great opportunities for networking and helping shape the future of our association. I encourage anyone who may be interested in volunteering to contact their local committees; thanks DHAA! We look forward to seeing you at our events in 2018! Rachelle Johnson Tasmania State Chair

What do DHAA members receive?  DISCOUNTED CPD  FREE JOBS BOARD  DISCOUNTED PROFESSIONAL INDEMNITY INSURANCE  FREE ADVOCACY  FREE INDUSTRIAL RELATIONS ADVICE  FREE DRUG INFORMATION ADVICE  DEVELOP LEADERSHIP SKILLS with board and committee positions  BUILD PROFFESIONAL CREDIBILITY There’s strength in numbers. Be part of an association and unite with more than 1,500 oral health practitioners across Australia and the world.  SHOPPING DISCOUNTS


South Australia

“Adelaide hosted the annual event in October and broke the record for the number of attendees at over 500 delegates!”

“Life is like riding a bicycle; to keep your balance you must keep moving” – Albert Einstein NOW WHEN IT comes to Symposium – Adelaide hosted the annual event in October and broke the record for the number of attendees at over 500 delegates! What an outstanding success. The speakers were varied, informative and engaging, the trade display keeps getting even better with the majority of our industry partners in attendance, and the socialising and ‘catching up’ was off the scale. Well done everyone involved in the organisation and to those who attended, making it such a success. In December we had our end of year Christmas Breakfast by the Beach at the Beachhouse, Glenelg with Dr Mel Hayes, DHAA CEO engaging and inspiring us with her presentation on “The future of Oral Health” I know those in attendance enjoyed the interactive discussions on some of our ‘big’ questions such as: Who makes the rules and why? Why is scope of practice such a big deal (or not)? Have we lost focus as a profession? What does the future hold? Where can my

career take me? Could we, should we, be more globally engaged? We welcome all of our newest graduates! Early February saw our New Graduate Supper, provided by the DHAA SA for all 2017 graduates of BOH and ADOH courses. An opportunity to meet with their DHAA committee and also our wonderful industry partners, with those in attendance not only enjoying some nibbles and

drinks, also receiving a gift of a complimentary scaler each, generously donated by Jill Tayler from OneDental. Also for those who attended on the night, upon renewal of their DHAA membership in June, an entry into a draw to receive full registration for our CPD full day event on Friday Sept 7th. Connecting and engaging with the others in the profession is a wonderful way to network, hear about opportunities and learn from others

41 For all the latest info on DHAA events near you please visit

experiences. 2018 is going to be a busy year of events with our intention to offer a wide and varied program of events to choose from, providing content our members have requested, such as “Early Orthodontic Intervention” in March. Aged Care – 2 hour online module + hands-on workshop in April, Prof Mark Bartold at our July Dinner, this will be huge! Sprout Cooking School – Diet, Genetics and Health, Infection Control, BMS “Risky Business” and more! We are incredibly privileged to have a career which offers life long learning and growth, so we can continue to be the best clinicians, educators, volunteers we can be, offering the best of ourselves professionally. It is however equally important to remember our personal development and being kind to ourselves, nurturing our minds and bodies so we can continue to enjoy life to its fullest. We have so much to look forward to this year as a National Association, with so many opportunities for Professional Development in our own state and beyond. Lyn Carman South Australia State Chair

Western Australia

“If you are interested in volunteering please express your interest to a committee member.”

WITH SO MANY exciting CPD events being organised for 2018, I am looking forward to representing WA for the DHAA for another year. Remember to get in early for all the CPD activities this year, as places are limited and are filling up. At our recent half-day seminar at Wembley’s Bendat Centre we had to turn delegates away! Thank you to those that attended the social event at The Windsor Hotel in January. This was a lovely night for getting to know our members “old and new’’, networking and enjoying a pleasant atmosphere. I would like to welcome two new committee members from networking that night Andrea Tangiia and Fiona Pham joining us with a fresh approach and insight. Andrea Tangiia will be accompanying me and WA director Sam Stuart to Melbourne for Leadership Training. If you are interested in volunteering and would like to attend in future please express your interest to a committee member. I had the pleasure of presenting the third year graduating OHT Emilija Cvetanoska with the award of $250 for “Most Improved Student” on Friday 9th February. Of the full 2017

cohort of 3rd year graduates, 26 of those have become DHAA members! WA currently has 183 members! On the 3 February 14 members attended Rokeby Dental who hosted Philips Zoom Whitening Hands on Course. A big thanks to dentist and owner John Watson and Associates for providing their surgery and knowledge. Thank you to attendees that visited from interstate, one member travelling just for the day from Melbourne! Our next CPD event is the EMS Guided Biofilm Therapy Workshop in April we look forward to seeing you there. For other future events head to the DHAA website. We have listened to members feedback for future events and CPD and are planning more hands on workshops for the future. If there are any particular ideas/courses that you would like to see, please email me. We are also requesting expressions of interest for more committee members to come on board for 2018/19. We will need new members for succession planning and new input for Perth’s Symposium in 2020! Please email me dirtectly. Aileen Lewis Western Australia State Chair


DHAA Year Planner - 2018/19

The CPD Events calendar is filling up. Full details at







DHAA QLD Ultrasonics and airpolishing

Parklands Tavern, Meridan Plains


DHAA SA Supper Meeting



DHAA NSW Newcastle Full Day

Hunter Valley, NSW


DHAA WA Guided Biofilm Therapy

Pagoda Resort & Spa, Como


DHAA SA Aged Care Workshop

Lourdes Valley Lodge, SA


DHAA ACT Modern concepts in periodontal therapy



DHAA SA What are you packing? Nutrition

Sprout Cooking School, Hilton SA


DHAA NSW 'Risky Business' Roadshow

The Blue Room, Bondi Beach


DHAA QLD Fundamentals of Instrumentation



DHAA TAS Guided Biofilm Therapy

Mantra Charles Hotel, Launceston


DHAA ACT ‘Risky Business’ Roadshow



DHAA NT It’s all about prevention

Mantra on the Esplanade, Darwin


DHAA SA Dinner Meeting

Adelaide Oval


DHAA TAS ‘Risky Business’ Roadshow

Wrest Point Casino


DHAA WA Full day

Pagoda Resort & Spa, Como


DHAA VIC Full day “Christmas in July”

Brooklands of Mornington


DHAA NSW CPD Ski Weekend

Novotel Lake Crackenback Resort & Spa, NSW


DHAA SA ‘Risky Business’ Roadshow

Barossa Valley


DHAA NSW ‘Love Your Sister’ Full Day

Taronga Zoo, Sydney, NSW


DHAA QLD Subgingival and advance debridement workshop



DHAA SA Full day CPD



DHAA NT ‘Risky Business’ Roadshow

Alice Springs


DHAA WA ‘Risky Business’ Roadshow

Pagoda Resort & Spa, Como



National Symposium 2018

Cairns Convention Centre



International Symposium on Dental Hygiene

Brisbane Convention Centre



JUN-18 JUL-18



Key to the state colours n ACT

nN  SW

n NT

n Qld

nS A

n Tas

n Vic

nW  A

Develop Empower Support


The Bulletin - Issue 46 March / April 2018  

The Official Journal of the Dental Hygienists Association of Australia Ltd

The Bulletin - Issue 46 March / April 2018  

The Official Journal of the Dental Hygienists Association of Australia Ltd