Australia’s leading dental magazine

APRIL 2015 $5.95 INC. GST

While you were sleepingHow to recognise sleep disordered breathing, page 16

Another dimensionThe printing technology that is revolutionising the dental industry, page 24

Collaborate and listenThe benefits of aligning with various specialists, page 20

Special forces

ANNUAL REPORTBite’s guide to the best

radiography and digital imaging products on the

market today, page 37

Dr Mark Gryst has devoted his 34-year career to Special Needs dentistry. He explains how the demands are set to

expand in many ways, page 28

CONTENTS

ChairsDelivery SystemsLightsMonitor MountsCabinetsHandpiecesMaintenanceSterilisationImaging

For more information Email: a-dec@a-dec.com.au Phone: 1800 225 010 Visit: www.a-dec.com.au

© 2013 A-dec Inc. All rights reserved. AA781_INK1992-12

Pantone : 130 CC : 0 M : 30 J : 100 N : 0

THE REVELATION3 MODES FOR 3 NEEDSSOPROCARE meets the needs of prophylaxis by performing a complete and rapid assessment of the patient’s oral health.

• ‘‘ PERIO’’ mode: Highlights the old and new dental plaque and gingival inflammations, even at the early stage.• ‘‘ CARIO’’ mode: Detects enamo-dentinal caries, from the stage 1 (code ICDAS II), in a simple way.• ‘‘ DAYLIGHT’’ mode: Macro vision makes visible the imperceptible and allows watching

the stability of micro lesions and their evolution.

www.soprocare.com

1992-12_AA_A-Dec_SorproCare Ad_The Bite_1C_PP.indd 1 14/02/13 5:12 PM

COVER STORY YOUR BUSINESS YOUR TOOLS YOUR LIFECONTENTS

ContentsNEWS & EVENTSWrigley Company Foundation Grants 4This year’s Community Service Grants applications open; dental journalism winners announced, and much more …

YOUR WORLDSpot the sleep disorder 16Dentists have an important role to play in recognising sleep disordered breathing and, as a result, offering sufferers the greatest possible chance of treatment and recovery

YOUR BUSINESSPerfect match 20How to develop relationships with various specialists to add value to your practice

3D dentistry 243D printing makes it possible to manufacture crowns, bridges and other orthodontic appliances on demand

Making teamwork work 34Team harmony is essential for business success but a high-performing team requires regular management

YOUR TOOLSNew products 12All the latest gear for your practice

Product guide 37Bite magazine’s guide to the best radiography and digital imaging equipment

Tools of the trade 47Reviewed by your peers

YOUR LIFESaddle up 50Many years ago, Dr Chris Hardwicke of Corinna Dental Group decided to ride a horse. His life was never the same again

April 2015

custom content

9,459 - CAB Audited as at September 2014

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

Bite magazine is published 11 times a year by Engage Media, Suite 4.17, 55 Miller Street, Pyrmont NSW 2009. ABN 50 115 977 421. Views expressed in Bite magazine are not necessarily those of the publisher, editor or Engage Media. Printed by Webstar.

Editorial Director Rob Johnson

Sub-editor Kerryn Ramsey

Editor Nicole Hogan

Art Director Lucy Glover

Commercial Director Mark Brown

Sales Director Andrew Gray

Digital Director Ann Gordon

2 0

16

3424

COVER STORYAt the heart of the matter

With our ageing population, Dr Mark Gryst explains why the demands for Special Needs dentistry are

about to expand in a whole range of ways

28

ChairsDelivery SystemsLightsMonitor MountsCabinetsHandpiecesMaintenanceSterilisationImaging

For more information Email: a-dec@a-dec.com.au Phone: 1800 225 010 Visit: www.a-dec.com.au

© 2013 A-dec Inc. All rights reserved. AA781_INK1992-12

Pantone : 130 CC : 0 M : 30 J : 100 N : 0

THE REVELATION3 MODES FOR 3 NEEDSSOPROCARE meets the needs of prophylaxis by performing a complete and rapid assessment of the patient’s oral health.

• ‘‘ PERIO’’ mode: Highlights the old and new dental plaque and gingival inflammations, even at the early stage.• ‘‘ CARIO’’ mode: Detects enamo-dentinal caries, from the stage 1 (code ICDAS II), in a simple way.• ‘‘ DAYLIGHT’’ mode: Macro vision makes visible the imperceptible and allows watching

the stability of micro lesions and their evolution.

www.soprocare.com

1992-12_AA_A-Dec_SorproCare Ad_The Bite_1C_PP.indd 1 14/02/13 5:12 PM

COVER STORY YOUR BUSINESS YOUR TOOLS YOUR LIFENEWS & EVENTS

4 Bite magazine

Now in its fifth year, the Wrigley Company Foundation, in partnership with the Australian Dental

Association Foundation (ADAF), has announce that the applications for its Community Service Grants to help improve access to dental care to some of Australia’s most marginalised groups is now open.

Introduced in collaboration with the Australian Dental Association in 2011, the Community Service Grants continue to make a difference to high-risk groups such as elderly, disabled, homeless, Indigenous and children’s groups.

This year, the Wrigley Company Foundation, in partnership with the ADAF, will provide more than $US82,000 in funds via 13 grants:• 8 x $US6000 Community Service

Grant for registered licensed dental professionals

• 4 x $US6000 Community Service Grant for currently enrolled dentistry students

• 1 x $US10,000 for ‘Principles in Action’ Community Service Grant to support large scale projects. Applications close on 26 June.

For enquiries and donations, contact enquiries@adaf.org.au.

The Australian Dental Association (ADA) has announced the winners of its Excellence in Dental Journalism 2014 Awards.

The awards are for dental journalism published in Australia through public print, television or radio in the two years prior to 31 December 2014. Two separate awards are granted: one for electronic media and another for print media. Each award includes a cash prize of $5000.

Neil Keene and Jane Hansen are joint recipients for the print media category of the awards for their series of articles that formed part of the Daily Telegraph’s ‘Stop the Rot’ campaign over August-September 2013. The campaign called for fluoridation of water to become a State Government issue, taking it out of the hands of Local Councils. Geraldine McKenna and Ruben Meerman’s ‘Water Fluoridation’ story, which aired on ABC-TV’s Catalyst on 8 August 2013, won the Award

for the electronic media category. This story considered the science supporting water fluoridation in light of the Queensland Campbell Newman Government’s decision to return Local Councils with the power to add fluoride to their water supplies.

ADA president Dr Rick Olive AM RFD presented the awards at the recent 36th Australian Dental Congress in Brisbane. “These awards are the dental profession’s opportunity to recognise the media’s exceptional reporting about dental issues,” he said. “There is an increasing awareness of the link between good dental health and good general health.

“While dental decay and gum disease are the most common adverse health conditions in Australia, most dental disease is preventable. We encourage the media to continue to do its part in raising community awareness about the importance of dental health.

“These specific winning entries for these awards provided a much needed public focus on the scientifically proven dental health benefits that fluoridation of public water supplies to the community.

“While the ADA regularly campaigns on a variety of issues and holds its annual Dental Health Week in August, we hope that the media continues to raise dental issues with the community and this in turn encourages policy makers and our elected representatives to make a greater investment in everyone’s dental health,” said Dr Olive. For more information about the ADC and the winning Award entries, visit www.adc2015.com.

Wrigley Company Foundation grant applications open

ADA’s dental journalism awards announced

NEWS & EVENTS

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COVER STORY YOUR BUSINESS YOUR TOOLS YOUR LIFENEWS & EVENTS

6 Bite magazine

Hair and teeth are ectodermal appendages that share common developmental mechanisms, although the major structural components making up hair and teeth are very distinct. A new study, however, by the National Institutes of Health—National Institute of Neurological Disorders and Stroke has found a link between hair disorders and susceptibility to dental caries.

The hair shaft is essentially made of keratin filaments that are highly cross-linked. Tooth enamel matrix is primarily composed of enamel proteins (amelogenin, ameloblastin) that are degraded and replaced by minerals during enamel maturation. Fully mineralised enamel contains a small fraction of cross-linked organic material that has not been fully characterised. In this study, researchers assessed the presence and functionality of a specific set of hair keratins in this organic fraction of enamel.

Transcriptomic analysis was performed on the enamel organ from conditional knockout mice lacking the transcription factor distal-less homeobox 3 (DLX3), previously shown to regulate hair keratin expression in the hair follicle. Immunolocalisation of hair keratins was performed on mouse enamel organ and mature human enamel. Utilising data from genetic and intra-oral examination, the researchers tested the association of polymorphisms in hair keratins with dental caries susceptibility. Functional impact of hair keratin mutations on the

structural and mechanical properties of tooth enamel was assessed on extracted teeth using transmission and scanning electron microscopy, micro-computed tomography and micro-hardness testing.

The researchers found that several hair-specific epithelial keratins are expressed in murine enamel organ and are significantly down-regulated in the absence of DLX3. Several of these epithelial hair keratins are produced by ameloblasts in mouse and are constituents of the organic material present in mature human enamel. We further determined that polymorphisms in hair keratins, associated with hair disorders, are also associated with increased susceptibility to caries. Functional analyses revealed that mutations in hair keratins result in altered enamel structure and reduced enamel micro-hardness. At the conclusion of the study, the researchers’ findings determined that epithelial hair keratins are crucial components of tooth enamel and mutations in these keratins increase the risk for dental defects and caries. To learn more, visit www.aadr.org.

On 20 March, dentists across the country supported the National Day of Action by delivering free dental treatments to many Australians in urgent need of dental care.

Held in conjunction with World Oral Health Day, the initiative is coordinated by the National Dental Foundation and supported by the dental community who donate their time, surgeries and equipment on the day. Now in its eighth year, the initiative will deliver volunteered dental services to Australians who are in need of dental treatment, but have not been able to access it due to their personal circumstances. All treatments are delivered free of charge.

Led by Dr David Digges, chair

of the National Dental Foundation, the initiative was spawned following a life changing trip to East Timor. After seeing the traumatic dental issues that were being faced by the underprivileged on his travels, Dr Digges decided to look into the issues prevalent in his own backyard and found that there were many Australians in need of support and urgent dental health care.

“Over the past eight years, we have delivered millions of dollars in free dental care to some of those most in need in Australian society. Working closely with a number of charities, we have been able to change the lives of thousands of Australians,” said Dr Digges. “This year we have decided to take this

one step further and assemble as many dental professionals and patients as we can at multiple sites around Australia, with the aim of delivering more treatments on one day than we ever have before.”

The National Day of Action is a collaborative effort, and relies on generous support of partners including the Commonwealth and NSW Governments, the Australian Dental Association, the Australian Dental Industry Association and many charitable organisations. A proud supporter, Colgate, also endeavours to provide patients with the tools to maintain dental health and hygiene post-treatment by supplying take home care packs to enable them to stay on top of their oral health.

National Day of Action

Hair disorders suggest dental caries

NEWS & EVENTS

For more information contact Steve Douglas 1-300-362-761or email steve@quickstraightteeth.com.au

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1,2

A scientist, a colonel and a bus tripWhile NovaMin® – a bioactive glass technology used in

dentistry was patented in 2002, the inspiration for it came

decades before, in 1967.3

Professor Larry Hench, a scientist researching the

resistant properties of glass to nuclear radiation, boarded

a bus headed for an army materials conference in New York.

On the bus he struck up a conversation about his work

with a fellow passenger, Colonel Klinker, who had just

returned from a tour of duty in Vietnam as a supply offi cer

with the Army Medical Corps.

The question that changed everythingAccording to Hench, Colonel Klinker didn’t appear overly interested – but he did ask a question that would change

Hench’s life. Klinker had seen hundreds of limbs amputated

in Vietnam. In many cases this was because the patients’

bodies had rejected the metals or plastics being used to mend

their bones. So he asked, “If you can make a material that

can survive exposure to high energy radiation, can you make

a material that will survive exposure to the human body?”3

Backing a hunch and Hench The US Army backed Hench’s hunch on how to do it.3

Two years later in 1969, the same year as the Apollo 11

moon landing, another historic event took place. Hench

answered Klinker’s question with a “yes”.

He had developed a bioactive glass, which he called

Bioglass. A major step forward, Bioglass is a biocompatible

material that mimics bone tissue and assists in bone

repair and regeneration.4,5 Bioglass continues to be

used successfully in medicine today.5

The dental ‘ahh-ha’ momentMuch later, in 1996, dental school professors from the University of Maryland, Gary Hack who specialised in tooth sensitivity and Len Litkowski who had been working with Bioglass got together. They came up with the notion that bioactive glass technology could be adapted to be used as a treatment for dentine sensitivity.

They then worked with researcher, David Greenspan, to invent the oral care application for Bioglass, which they called NovaMin.

The re-adaptation of the technology took them fi ve years of intense research and development.

Builds an enamel-like layer of protectionThey found that the elements that make up Bioglass (calcium, sodium, silica and phosphorus) had little use in oral health on their own.

However, activated by saliva with the brushing of teeth, this compound forms a layer that has a similar composition to hydroxyapatite – the tough mineral layer that makes up human enamel and dentine.6–8

GSK recognised the signifi cance of this. It was one of the biggest things to ever happen in sensitivity toothpastes. So they acquired NovaMin and incorporated this advanced calcium and phosphate technology into the formula of their premium sensitivity toothpaste, Sensodyne® Repair & Protect.

Powered by NovaMin to protect sensitive teeth With regular brushing, Sensodyne Repair & Protect buildsa hydroxyapatite-layer over and within dentine tubules6–11 that’s 49% stronger than dentine.1 This has literally given you a way to help stop food and beverages getting on your patients’ nerves.2,12,13

So there you have it It’s the story of how a scientist, a colonel, two dental professors and a researcher worked to develop technology that can help shield your patients with sensitivity issues from pain. All you need to do now is let your patients know about it so they can enjoy the food and drinks they love again.

* Compared with fl uoride toothpastes containing either arginine/calcium carbonate, casein stabilised amorphous calcium phosphate (CPP-ACP), or potassium nitrate.1,2 Based on tubule occlusion scores.1,2

References: 1. Parkinson CR, Willson RJ. J Clin Dent 2011;22(3):74–81. 2. Salian S et al. J Clin Dent 2010;21(3):82–87. 3. Hench LL. J Mater Sci Mater Med 2006;17(11):967–978. 4. Krishnan V, Lakshmi T. J Adv Pharm Technol Res 2013;4(2):78–83. 5. Kaur G et al. J Biomed Mater Res A 2013;102(1):254–274. 6. Earl JS et al. J Clin Dent 2011;22(3):62–67. 7. Earl JS et al. J Clin Dent 2011;22(3):68–73. 8. Effl andt SE et al. J Mater Sci Mater Med 2002;13(6):557–565. 9. Burwell A et al. J Clin Dent 2010;21(3):66–71. 10. LaTorre G and Greenspan DC. J Clin Dent 2010;21(3):72–76. 11. West NX et al. J Clin Dent 2011;22(3):82–89. 12. Du Min Q et al. Am J Dent 2008;21(4):2104. 13. Pradeep AR and Sharma A. J Periodontol 2010;81(8):1167–1173.For the relief of sensitive teeth. Sensodyne® contains NovaMin®. Sensodyne®, NovaMin® and the rings device are registered trade marks of the GlaxoSmithKline Group of Companies. GlaxoSmithKline Consumer Healthcare, 82 Hughes Avenue, Ermington NSW 2115. Auckland, New Zealand. GSK1532/UC 03/15. TAPS PP5453. CHANZ/CHSENO/0091/14 June 2014.

*

1,2

A scientist, a colonel and a bus tripWhile NovaMin® – a bioactive glass technology used in

dentistry was patented in 2002, the inspiration for it came

decades before, in 1967.3

Professor Larry Hench, a scientist researching the

resistant properties of glass to nuclear radiation, boarded

a bus headed for an army materials conference in New York.

On the bus he struck up a conversation about his work

with a fellow passenger, Colonel Klinker, who had just

returned from a tour of duty in Vietnam as a supply offi cer

with the Army Medical Corps.

The question that changed everythingAccording to Hench, Colonel Klinker didn’t appear overly interested – but he did ask a question that would change

Hench’s life. Klinker had seen hundreds of limbs amputated

in Vietnam. In many cases this was because the patients’

bodies had rejected the metals or plastics being used to mend

their bones. So he asked, “If you can make a material that

can survive exposure to high energy radiation, can you make

a material that will survive exposure to the human body?”3

Backing a hunch and Hench The US Army backed Hench’s hunch on how to do it.3

Two years later in 1969, the same year as the Apollo 11

moon landing, another historic event took place. Hench

answered Klinker’s question with a “yes”.

He had developed a bioactive glass, which he called

Bioglass. A major step forward, Bioglass is a biocompatible

material that mimics bone tissue and assists in bone

repair and regeneration.4,5 Bioglass continues to be

used successfully in medicine today.5

The dental ‘ahh-ha’ momentMuch later, in 1996, dental school professors from the University of Maryland, Gary Hack who specialised in tooth sensitivity and Len Litkowski who had been working with Bioglass got together. They came up with the notion that bioactive glass technology could be adapted to be used as a treatment for dentine sensitivity.

They then worked with researcher, David Greenspan, to invent the oral care application for Bioglass, which they called NovaMin.

The re-adaptation of the technology took them fi ve years of intense research and development.

Builds an enamel-like layer of protectionThey found that the elements that make up Bioglass (calcium, sodium, silica and phosphorus) had little use in oral health on their own.

However, activated by saliva with the brushing of teeth, this compound forms a layer that has a similar composition to hydroxyapatite – the tough mineral layer that makes up human enamel and dentine.6–8

GSK recognised the signifi cance of this. It was one of the biggest things to ever happen in sensitivity toothpastes. So they acquired NovaMin and incorporated this advanced calcium and phosphate technology into the formula of their premium sensitivity toothpaste, Sensodyne® Repair & Protect.

Powered by NovaMin to protect sensitive teeth With regular brushing, Sensodyne Repair & Protect buildsa hydroxyapatite-layer over and within dentine tubules6–11 that’s 49% stronger than dentine.1 This has literally given you a way to help stop food and beverages getting on your patients’ nerves.2,12,13

So there you have it It’s the story of how a scientist, a colonel, two dental professors and a researcher worked to develop technology that can help shield your patients with sensitivity issues from pain. All you need to do now is let your patients know about it so they can enjoy the food and drinks they love again.

* Compared with fl uoride toothpastes containing either arginine/calcium carbonate, casein stabilised amorphous calcium phosphate (CPP-ACP), or potassium nitrate.1,2 Based on tubule occlusion scores.1,2

References: 1. Parkinson CR, Willson RJ. J Clin Dent 2011;22(3):74–81. 2. Salian S et al. J Clin Dent 2010;21(3):82–87. 3. Hench LL. J Mater Sci Mater Med 2006;17(11):967–978. 4. Krishnan V, Lakshmi T. J Adv Pharm Technol Res 2013;4(2):78–83. 5. Kaur G et al. J Biomed Mater Res A 2013;102(1):254–274. 6. Earl JS et al. J Clin Dent 2011;22(3):62–67. 7. Earl JS et al. J Clin Dent 2011;22(3):68–73. 8. Effl andt SE et al. J Mater Sci Mater Med 2002;13(6):557–565. 9. Burwell A et al. J Clin Dent 2010;21(3):66–71. 10. LaTorre G and Greenspan DC. J Clin Dent 2010;21(3):72–76. 11. West NX et al. J Clin Dent 2011;22(3):82–89. 12. Du Min Q et al. Am J Dent 2008;21(4):2104. 13. Pradeep AR and Sharma A. J Periodontol 2010;81(8):1167–1173.For the relief of sensitive teeth. Sensodyne® contains NovaMin®. Sensodyne®, NovaMin® and the rings device are registered trade marks of the GlaxoSmithKline Group of Companies. GlaxoSmithKline Consumer Healthcare, 82 Hughes Avenue, Ermington NSW 2115. Auckland, New Zealand. GSK1532/UC 03/15. TAPS PP5453. CHANZ/CHSENO/0091/14 June 2014.

YOUR TOOLS YOUR LIFENEWS & EVENTS

10 Bite magazine

Good Indigenous dental health figuresThe number of teeth affected by decay is about one third more in Aboriginal children compared with non-Aboriginal children in Victoria, according to a report by Dental Health Services Victoria (DHSV).

The data was collected by DHSV based on patients visiting public dental clinics in 2013-14. DHSV chief executive officer Dr Deborah Cole said that while the dental health gap between Aboriginal and non-Aboriginal Victorians still existed, great progress has been made.

“We have worked very hard to reverse the trend and the figures are looking positive,” she said. “Ten years ago, our data showed that Aboriginal children had almost twice the number of teeth affected by decay compared with non-Aboriginal children.

“That difference is now 30 per cent, meaning that although Aboriginal children still have higher levels of oral disease, the gap between Aboriginal and non-Aboriginal children is closing. Part of that reason for that is improving access to dental care.”

The Royal Dental Hospital of Melbourne has seen a steady increase in its Aboriginal and Torres Strait Islander patients, thanks to its efforts to bring better care to the community. One of them is introducing an Aboriginal liaison officer in 2007 to greet and support patients and their families receiving care.

“We had only 50 Aboriginal patients visiting the hospital in 2007-08, and in 2013-14, we treated more than 1100 patients, and this story is reflected in public dental clinics across the State,” Dr Cole said.

“Our Aboriginal liaison officer provides support to our Aboriginal patients and also liaises with agencies to make sure they can access the services in the best way possible.”

DHSV’s unique Indigenous Dental Assistant Traineeship program has also been hugely successful so far, with two of its graduates being the first Indigenous students to be accepted in La Trobe University’s dentistry program.

“We want to create a culturally inclusive team that can meet the needs of the Aboriginal and Torres Strait Islander peoples,” Dr Cole said. “More and more Aboriginal Victorians are accessing care in our public dental clinics and we want to make sure we can provide dental access to even more in the community.”

NEWS & EVENTS

•Compact,quiet,andaffordable,thenewCS7200istheidealsolution

forroutineX-rayexamsatthechairside.

•Versatile,automated,idealformultipleusers,theCS7600

istheintelligentsystemyou’vebeenwaitingfor.

NEW CS 7200CS 7600

Whetheryou’reasolepractitionerorworkwithmultipledoctors,ourdigitalimagingplatesystemsarethesmartchoiceforyourpractice:

HAPPILY MARRIED

©CarestreamHealth,Inc.2015.

LET’S REDEFINE EXPERTISE

Discover more at carestreamdental.com

Both digital and film benefits, together at last.

DigitalefficiencyFilmergonomy

• Compact,quiet,andaffordable,thenewCS7200istheidealsolution

forroutineX-rayexamsatthechairside.

• Versatile,automated,idealformultipleusers,theCS7600

istheintelligentsystemyou’vebeenwaitingfor.

NEW CS 7200 CS 7600

Whetheryou’reasolepractitionerorworkwithmultipledoctors,ourdigitalimagingplatesystemsarethesmartchoiceforyourpractice:

HAPPILY MARRIED

©CarestreamHealth,Inc.2015.

LET’S REDEFINE EXPERTISE

Discover more at carestreamdental.com

Both digital and film benefits, together at last.

Digitalefficiency Filmergonomy

•Compact,quiet,andaffordable,thenewCS7200istheidealsolution

forroutineX-rayexamsatthechairside.

•Versatile,automated,idealformultipleusers,theCS7600

istheintelligentsystemyou’vebeenwaitingfor.

NEW CS 7200CS 7600

Whetheryou’reasolepractitionerorworkwithmultipledoctors,ourdigitalimagingplatesystemsarethesmartchoiceforyourpractice:

HAPPILY MARRIED

©CarestreamHealth,Inc.2015.

LET’S REDEFINE EXPERTISE

Discover more at carestreamdental.com

Both digital and film benefits, together at last.

DigitalefficiencyFilmergonomy

NEWS & EVENTS COVER STORY YOUR BUSINESS YOUR LIFE

12 Bite magazine

NEW PRODUCTS

New products

Unlike a typical wedge, The A+Wedge is coated with an astringent allowing the clinician to control gingival bleeding. Many dentists experience interproximal bleeding

during composite restorative procedures and generally use a wedge and an astringent separately. The A+Wedge

combines the two, simplifying the restorative procedure.In addition to adapting naturally and mimicking interproximal anatomy,

the A+Wedge is coated with aluminum sulfate that provides an astringent effect. This all-new anatomical wedge improves clarity of the restoration area while adapting naturally to the contours of the teeth. The A+Wedge is the first and only plastic wedge coated with an astringent.

The wedges are designed to prevent back-out and are long enough for proper matrix ring placement. They come in various sizes and can be purchased individually or as a component in Garrison’s sectional matrix kits.

For more information on the A+Wedge™, call 1800 790 349 or visit www.garrisondental.com.

The A+Wedge™

Imaging plate system launch

Carestream Dental recently launched the CS 7200 imaging plate system, an ultra-compact system that delivers leading image quality. The slim design and the quiet scanning of the unit are ideal for chairside use and the system features a familiar film-like

workflow, which paves the way for practices looking to transition to digital in a cost-effective manner. www.carestream.com.au

Leading mouthwash brand Listerine® is calling on Australians to take its 21 Day Challenge after research has shown that 70 per cent of

Australian households fail to complete a three-step oral care routine[1].

Completing this three-step oral care routine consisting of brushing, flossing and ADA approved mouthwash twice daily helps kill bad breath germs and reduces plaque which can lead to oral diseases such as tooth decay.

Research has shown that brushing and flossing alone will not remove all plaque within the mouth[2]. The addition of a fluoride mouthwash can help strengthen teeth, control plaque and kill germs that cause bad breath.

It is believed that it takes just 21 days to form a new habit and with this in mind, the Listerine® 21 Day Challenge aims to encourage consumers to form a healthy habit and jump-start a healthier mouth in just three weeks. From Day 1 and beyond, consumers will start to experience the benefits of a healthier mouth.

To mark the challenge, the brand has released two snazzy new designs for the bottle available at leading grocery and pharmacy outlets, and dental clinics.

RRP: Listerine Total Care Mouth Wash, 500ml, $9.45.Stockist enquiries: 1800 029 979.Visit: www.listerine.com.au.

Creating habits

1. Aztec Panel Data, MAT Dec 2014. 2. NC Sharma et al, JADA April 2004; Vol. 135:496-504, *In lab test

Helping you put a smile on your patient’s face…

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NEWS & EVENTS COVER STORY YOUR BUSINESS YOUR LIFE

14 Bite magazine

NEW PRODUCTS

New products

Tongue Buddy – a soft tongue cleaner

CareDent’s Tongue Buddy™ helps remove dental plaque, food debris and bacteria from the surface of the tongue, helping fight against bad breath.

Ergonomically designed with two rows of soft arches that are both comfortable and gentle on the tongue, Tongue Buddy has a gracefully designed handle with moulded contours which minimise sensitivity and the gagging reflex, allowing easy access to the back areas of the tongue.

Tongue Buddy comes in a new elegantly designed sleeve, and is available in two striking colours—green and blue. For more information or to request a free sample, please contact CareDent on 02 9987 4891.

iQ Digital Treatment Planning System

Quick Straight Teeth (QST) Australia has launched iQuantify and iQualify, a new Digital Treatment Planning System for dentists. This is included free as part of the QST short-term

ortho system. It provides the dentist the opportunity to discuss and demonstrate the correct short-term orthodontic treatment required for an individual patient, including detailed before-and-after scenarios.

iQuantify is the first stage of the process which scans the arch and provides a digital evaluation of the space requirements and the IPR quotient required for each individual patient.

iQualify allows the digital movement of teeth into their new positions and generates a three-dimensional image of how the patient can expect their smile to look post-treatment. This provides significant reassurance for a dentists and is a vital part of the consent process.

For more information on Quick Straight Teeth and its 2015 short-terms, email info@quickstraightteeth.com.au or call 1300 362 761.

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16 Bite magazine16 Bite magazine

Dentists have an important role to play in recognising sleep disordered breathing and, as a result, offering sufferers the greatest possible chance of treatment and recovery. Chris Sheedy reports

Spot the sleep disorder

That boy at the back of your child’s classroom, the one that is overweight and is known for being naughty, who rarely participates positively in group activities,

who is constantly yawning and always has bags under his eyes—he must be from a bad family, right? Don’t be too quick to pass judgement, experts say.

“That is actually the classic sleep apnoea patient,” says Dr Zoran Becvarovski, director of St George ENT (ear, nose and throat) and Sutherland Children’s ENT. “The downside of sleep apnoea is that your IQ may drop by up to 20 points, depending on the severity. The child may stop breathing 40 to 50 times an hour every hour during sleep, causing the brain and body to be starved of oxygen, resulting in difficulty concentrating at school.

“And it’s not just about concentration and IQ. It’s about problems with all their schooling, with physical development, with speech and with communication. There is a five-fold increased risk of attention deficit hyperactivity disorder (ADHD). All of these issues are increased

in children that have obstructive sleep apnoea, depending on its severity.”

There are many issues related to the group of ailments known as ‘sleep disordered breathing’. They include restless leg syndrome, narcolepsy and obstruction. Specialists say dentists should be familiar with physical signs as many of those symptoms are related to the nose, mouth and throat.

Dr Derek Mahony, a specialist orthodontist whose business Full Face Orthodontics has four practices

across Sydney, says dentists trained to look at the teeth and the oral cavity are becoming more aware of the importance of looking a little further, into the oropharynx.

“The dentist is probably the best person to look for initial signs of obstructive sleep apnoea (OSA),” Dr Mahony says. “Signs can include the fact that there is no room behind the tongue. If that is the case then that is where they are going to get breathing obstruction. Another tell-tale sign includes a very red and enlarged uvula. That is something a dentist can pick up in seconds.”

Of course, these are also symptoms of a classic snorer. But they are all signs that can and should be further explored to ensure those with OSA are recognised and referred onwards. This is especially important in children—a group in which 95 per cent of OSA sufferers may never be diagnosed.

If an adult has obstructive sleep apnoea and for whatever reason they can’t cope with the positive air pressure of a continuous positive airway pressure (CPAP) mask worn nightly in bed, one treatment is to conduct surgery

known as a ‘bi-max advancement’, Dr Mahony explains. This involves the upper and lower jaw being operated on and brought forward, opening up the airway.

“That is a big surgery,” he says. “With an adult you cannot move the jaws non-surgically, but with a child who has the same problem—because they are growing—you can use orthodontic appliances to widen their palate and bring their jaw forward. That prevents the apnoea from occurring.”

Thanks to the fact that OSA risk worsens

Bite magazine 17

Spot the sleep disorder

Dr Zoran Becvarovski, St George ENT and Sutherland Children’s ENT

“The child may stop breathing 40 to 50 times an hour every hour during sleep, causing the brain to starved of oxygen, resulting in difficulty concentrating at school.”

Quote

although some may be referred on by the ear, nose and throat specialist for this.

“In terms of treatment, there is medical and surgical therapy,” Dr Becvarovski says. “If somebody has sleep apnoea they will most likely need surgical therapy. However, there are some medical

with age and obesity (although children with the condition may be underweight, Dr Becvarovski says, because they burn calories at night as they struggle to breathe), and Australia is officially one of the most obese countries in the world, dentists are likely to be confronted with an increasing number of patients expressing symptoms. So, how can a dentist help?

“In my courses, I teach every dentist to do three things with every patient before they even look into the patient’s mouth,” Dr Mahony says. “The first is to measure their oxygen saturation. People who have OSA may have a reduction in their oxygen saturation. Next, take the patient’s blood pressure. OSA goes hand in hand with hypertension. Finally, give them a questionnaire. The world standard is the Epworth Sleepiness Scale, a series of questions around when and why they might become tired in an average day.”

A dentist might also measure the circumference of a patient’s neck. Statistics show, Dr Mahony says, that neck sizes of 15 inches (38 centimetres) or greater in women and 17 inches (43 centimetres) or greater in men are signs of OSA risk.

If a patient is found to be at potential risk of OSA, they should be referred to an ear, nose and throat specialist, Dr Becvarovski says. “And for children, give their parents a sleep diary they can fill out and take to the specialist,” he says. “It is a seven-day diary, filled out just after midnight for 15 minutes each night, looking at issues such as snoring,

mouth opening, pauses in breathing, restlessness, sweating, gagging, making unusual breathing noises, waking and sleeping in unusual positions.”

The specialist can then examine the child and determine a treatment plan. Not all children need a sleep study,

YOUR WORLD

18 Bite magazine

Dr Zoran Becvarovski

“Little Johnny who was considered lazy and naughty sees his IQ improved by 20 points and suddenly he’s a different person, thanks to a simple diagnosis.”

Quote therapies that can be initiated to begin with. There are simple things like dust mite covers on the mattresses and the pillows; if there is allergy in the nose it will block off the breathing. There are also steroid nasal sprays which are commonly used. If surgery is necessary, the most common operation is a tonsillectomy and adenoidectomy. That has a cure rate of over 90 per cent. A cure represents a very good result for the patient, especially for a child. Suddenly little Johnny at the back of the class, who was tired and was considered lazy and naughty, sees his IQ improved by 20 points and he’s a different person, thanks to a simple diagnosis.”

Symptoms of sleep apnoeaDr Zoran Becvarovski has created this handy check-list that can be shared with parents of children who, upon physical examination, are judged to be at potential risk of obstructive sleep apnoea. For further information, see www.ent.com.au.

S noringL aboured breathing during sleepE xcessive sweatiness and/or restlessness during sleepE xcessive day time sleepiness and/or morning tiredness or headachesP auses in breathing and/or choking/gasping/snorting during sleep

A wakening due to bad dreams and/or sleep walkingP ositions (sleeping in unusual positions; eg. extended neck, sitting up)N asal obstruction and mouth breathingO verweight or underweightE nuresis (bedwetting)A ttention/learning/behavioural problems.

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by dental surgeries to a whole new level; it’s all about being able to offer clients a complete service for their particular ailments. After all, many dental matters are quite complex and may stem from underlying problems unrelated to what you just see inside a mouth, such as teeth grinding that is caused by sleep disordered breathing.

Dr Anthony Au of Dental Specialists Turramurra in Sydney likens himself to a ‘master builder’ in his surgery and admits that about 80 per cent of his clients would need outside care in conjunction with his treatment. “Because dental

Are you aware that more and more dentists are taking the next step in customer service by offering peripheral care for their clients? For example,

someone might visit a dentist for a tooth extraction, while being overseen by a psychologist to get over a phobia of going to the dentist. Or a person may suffer from facial pain so a dentist will refer them to a temporomandibular joint (TMJ) physiotherapist.

Collaboration between numerous specialties is raising the care provided

Your practice can’t offer every single service under the sun, so how do you develop and maintain effective relationships with various specialists that can add value to your practice? Natasha Shaw find out

20 Bite magazine

Perfect match

YOUR BUSINESS

Bite magazine 21

problems can be complex, I’m like the manager of a building project and have to get other contractors in to help,” he says. “A lot of the time a patient’s jaw problem is linked to their neck, spine and shoulders so often they need treatment further down and it’s not appropriate for me to go there. That’s when I might need to refer to a TMJ physiotherapist or musculoskeletal physician. For complex restorative cases, we will refer to a periodontist; root canals an endodontist; we also use orthodontists, and so on.”

As patients are often seeing two specialists at once, and sometimes

Collaboration between numerous specialties is raising the care provided by dental surgeries to a whole new level.

multiple, the coordination of their care can get tricky. “Coordinating between various specialists can be difficult. I often can’t start my treatment until someone else is finished, so if I’m not, or my staff are not, on top of it, then patients can be left by the wayside,” explains Dr Au. “Also, professionals who are technically skilful can be booked up quite far ahead. We have a database of who we have referred the patient to and our staff constantly check it to see how patients are going with other people.”

It takes two professionals to tangoDr Narinder Singh is an ear, nose and throat (ENT) surgeon who specialises in rhinology and snoring/OSA (obstructive sleep apnoea). He is the head of the ENT Department at Sydney’s Westmead Hospital and runs his own practice, Ear, Nose & Throat Sydney. About half of his referrals come from dentists, including general dental, cosmetic, orthodontic and maxillofacial practitioners.

“Building a trusted relationship with an experienced and proactive ENT colleague, with a special interest in the airway, is critical to the success of all dental practices, particularly those with paediatric and snoring/OSA patients,” says Dr Singh. “Undertaking interceptive maxillary and dental interventions without first addressing the nasal airway may result in poor outcomes and patient dissatisfaction. Most paediatric dental patients are referred to me for the

combination of blocked nose, mouth breathing and snoring (leading to underdevelopment of the maxilla), and malocclusion.”

Collaboration tends to work best when you are dealing with good

communicators and both parties are happy to work in a team approach. This way the patient is provided with added value because they are managed by specialists and get special overall care.

“For us, every patient referral involves close collaboration,” says Dr Singh. “We work with our dental colleagues to ensure a clear nasal airway prior to the majority of interceptive dental and maxillary interventions. Also, whenever a Mandibular Advancement Device is being considered for snoring/OSA, it is only created in the setting of a complete treatment plan.”

Similarly, psychologist Gemille Cribb of Equilibrium Psychology in Sydney’s CBD feels that close collaboration with a dentist over a person’s treatment is important. “We can work independently, if needed, but collaboration via phone call or email is preferred. The dentists find it helpful to know what to expect from a patient and the techniques that the patient has been taught to use during their dental procedure,” she says.

In the treatment of a person experiencing a phobia of going to the dentist, Cribb says it is very beneficial to collaborate with the dental practice so the patient can engage in graded exposure which will help them overcome their phobia.

“Graded exposure involves the patient exposing themselves to stimuli that cause anxiety. We construct a

Dr Anthony Au, Dental Specialists Turramurra, NSW

“Because dental problems can be complex, I’m like the manager of a building project and have to get other contractors in to help.”

Quote

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hierarchy and generally start with the stimulus that is the most tolerated, such as watching videos of dental work, being in the waiting room of the dental practice, looking at dental instruments, etc, and work up towards the stimulus that causes the most anxiety such as watching a needle being given, getting a needle, etc,” she explains. “Cooperation with the dental practice allows the patient to move more quickly through their phobia as they have better access to the stimuli and situations that are on their hierarchy.”

Building relationshipsEstablishing close working relationships with specialists can be a little like dating—you win some, you lose some— but in the end you hope to find lasting happiness.

From an endodontist to a periodontist or a musculoskeletal physician to a psychologist, just how and where do you meet them? Industry talks and workshops are a good start—Dr Singh met some of his dental colleagues while being the guest ENT speaker at dental airway/snoring/OSA courses and conferences around the country.

Dr Au has been working with many of his preferred specialists for 10 to

YOUR BUSINESS

22 Bite magazine

with them is to give them a call and ask, ‘Can you help?’ and see what they say. You could also take a case to them and ask, ‘Is this the type of work you do?’.

“These days a lot of specialists are also very active on Facebook,” adds Dr Au, “so some of the younger colleagues would refer patients to those specialists that parade their victories there. Their page might look impressive and so a dentist will decide to give them a go.”

And why not? If dating is heading online, why shouldn’t dentists take advantage of this forum too? Here’s to finding your perfect professional match!

15 years now and says he met them through a combination of word of mouth, recommendations from other people who used them and networking with other dentists. But what if you are just starting out?

“If somebody is a new dentist working at someone else’s practice and they need to refer, they would probably ask their boss for a name. The other way people meet specialists is during their undergrad training,” says Dr Au.

“There are specialists who come in to teach and the undergraduate might remember one or two of their teachers. The best way to begin a relationship

Industry talks and workshops are a great way to meet professional specialists.

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3D printing has attracted significant attention in recent times for good reason: the technology is transforming the speed, ease and cost at which

products can be manufactured. What’s more, 3D printing is accessible to almost everyone, from NASA scientists and car manufacturers to fashion designers and students of all ages.

The applications for the medical and dental professions are particularly exciting. Medical experts have created a jaw, a pelvis and several customised hip replacements from metal. Dentists are producing bridges and crowns in

3D printing makes it possible to manufacture crowns, bridges and other orthodontic appliances on demand. Charmaine Teoh takes a look at the printing technology that’s revolutionising the dental industry

dentistry

24 Bite magazine

Models being printed on an Objet PolyJet 3D printer from tdl Precision Orthodontics.

their practices. Such is the interest that the medical and dental market for 3D printers is set to grow by 365 per cent to $US867 million by 2025, according to the research firm, IDTechEx.

So, what is 3D printing? You start by uploading a 3D scan of the object or a computer aided design (CAD) file to the 3D printer. Instead of ink, the printer sprays out layer upon layer of a plastic or metal gel or powder in the shape of the object. In a number of hours, you’ll have a product that’s as good as anything manufactured using conventional processes.

Dental laboratories around the world are using 3D printers to print

a wide range of items, including digital impressions from intra-oral scanners to create orthodontic appliances, crowns, bridges and acrylic and cobalt chrome denture fabrications; sequential models for orthodontic aligners; pre-operative diagnostic models for surgical planning; titanium implant components; and surgical drill guides. The materials used in 3D printing are typically tough, acrylic-based plastics in a variety of colours and grades. Bio-compatible materials that are suitable for prolonged use in the mouth are also available.

In Australia, the use of 3D printing in the dental profession is beginning to gain traction. One of the earliest to adopt the technology is Victoria-based tdl Precision Orthodontics. The orthodontic dental laboratory offers Cloud 3TM rapid prototyping services and manufactures fixed, removable, functional, medical, thermoform and surgical appliances; digital study models; and sequential aligners.

“We bought our first 3D printer in 2009 on the back of seeing a YouTube video and being totally intrigued at how a machine could create a fully functioning, three-dimensional, shifting spanner with no assembly needed,”

3D

YOUR BUSINESS

3D printing. “For example, we can offer sequential aligners that are digitally produced using specific, intuitive software, which is complemented by high-resolution, cost-effective work models,” says Tass. “We can also fabricate retainers ready for insert on the de-band appointment, so the patient doesn’t have to make another appointment to have their retainer inserted. We have the de-band scan on file if the retainer needs to be repaired or replaced, so there’s no need for a new impression or even a surgery visit—the patient just has to call us.”

Tass estimates only five to 10 per cent of the Australian dental profession is currently using some form of 3D printing technology. This is mainly due to a lack of knowledge about 3D printing processes (including 3D

Sid Tass, Precision Orthodontics founder/managing director

“In 2009 we could print six dental models in 48 hours at a not-so-high resolution. Today we can print 44 dental models in 4.5 hours.”

Quote

dentistry

Bite magazine 25

says Sid Tass, founder and managing director of tdl Precision Orthodontics.

The lab now has the latest state-of-the-art 3D printer and is re-skilling technicians, who work in a plaster room pouring, trimming and numbering fragile wet models, to use the 3D printing technology. The current equipment can produce extremely accurate (16 microns) models in a few short hours with minimal human involvement.

“In 2009 we could print six dental models in 48 hours at a not-so-high resolution. Today we can print 44 dental models in 4.5 hours,” says Tass. “We’ve also experienced dramatic time savings because impressions from intra-oral scans are emailed instead of needing to be physically picked up from our clients.”

The time and production efficiencies enable tdl Precision Orthodontics to offer clients high-quality products in short timeframes, a major competitive advantage over labs that don’t utilise

intra-oral scanning and 3D manipulation software) and the size and high cost of printers. A top-of-the-range commercial printer, like the one used by tdl Precision Orthodontics, can weigh in at up to 450 kilograms. The price tag can range from $60,000 to $500,000 and upwards.

“However, as more people become aware of and understand how the technology works, it’s inevitable that they will all require access to this technology, especially with the interest in and momentum surrounding intra-oral scanners,” Tass says.

A new generation of smaller, more affordable printers may spur the take-up of 3D printing in the Australian dental industry. Printers such as Stratasys’ Objet30 OrthoDesk desktop printer are more compact and cost around

Sequential aligners with printed models from tdl Precision Orthodontics.

3D-printed dental wax-ups on ProJet 1200 from 3D Systems.

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one-third the price of high-end systems. The cost of delivery, installation and training for desktop systems starts from around $37,000 plus GST.

“When evaluating 3D printers, dentists should consider accuracy, surface finish, throughput, cost per print and post-processing (if any) of the printed parts,” says Matt Minio, managing director of Objective 3D, the largest distributor of Stratasys 3D printers in Australia and New Zealand. “Almost as important is a reliable supplier who can provide all your materials, maintenance and service needs, as well as ongoing technical support for your system.”

Minio assures novices that the 3D printing process is pain-free. “I liken it to preparing a detailed PowerPoint presentation,” he says. “The skill is in preparing the data you want to print. Producing the document is as easy as file printing. 3D printing is similar; once the 3D model has been scanned or prepared, the process of 3D printing is the easiest part.”

Before investing in 3D printing technology, Tass explains, dental

YOUR BUSINESS

practices should consider whether they have the space, staff and funds to install and maintain a 3D printer, as well as the ability to adjust workflows and hire or train technicians to operate the equipment.

“3D printers will soon be a standard piece of household equipment to

print food, consumable parts for toys, tools and equipment,” explains Tass. “In the dental industry, material scientists are racing to create printable materials to replace traditional biocompatible materials used to fabricate dental appliances. The future for 3D printing is bright.”

Henry Schein Halas will market and sell tthe 3D micro-SLA ProJet® 1200.

Updates in the different disciplines of dentistry and multi-disciplinarytreatment planning

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Updates in the different disciplines of dentistry and multi-disciplinarytreatment planning

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Updates in the different disciplines of dentistry and multi-disciplinarytreatment planning

INTRODUCTION TO COSMETIC INJECTING

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NEWS & EVENTS YOUR BUSINESS YOUR TOOLS YOUR LIFECOVER STORY

28 Bite magazine

At the heart of the matter

With our ageing population, Dr Mark Gryst explains why the demands for Special Needs dentistry are about to expand in a whole range of ways. John Burfitt reports

Bite magazine 29

There was a time, years ago in Adelaide, when Dr Mark Gryst was working in a public health clinic. Whenever the receptionist saw a person in a wheelchair

approaching the front doors, she would immediately call Dr Gryst and announce his next patient was on their way.

“Whether that person was a patient or not, there was just an assumption if they were in a wheelchair, I would be the one treating them,” Dr Gryst tells. “Whenever someone had a patient who had some kind of disability, their dentist would often palm them over to me. I got a reputation for that.”

Considering he has devoted his 34-year career to Special Needs dentistry, such an assumption is certainly understandable. It is even more so when Australian Dental Association (ADA) figures reveal Dr Gryst is one of the few registered and specifically qualified Special Needs dentists in the country. As of December 2014, there are 17 in Australia.

By definition, Special Needs dentistry covers patients with intellectual disabilities, physical, medical or psychiatric issues, behavioural problems and the frail and elderly. “Many dentists just didn’t know how to cope with people with disabilities and how to treat them as patients,” Dr Gryst explains.

“Even to this day, I get patients referred to me all the time. Some of the dentists are passing the buck, but others I assume just do not know what to do. Then there are others who simply do not want to spend the time learning new skills.”

At a time when the future health needs of Australia’s ageing population is under focus by the government, a significant proportion of the ADA’s 2015-16 Federal Pre-Budget submission was devoted to the dental needs of people over the age of 65.

The submission highlighted such issues as over 50 per cent of Australians over the age of 65 have gum disease P

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or periodontitis, over 20 per cent have complete tooth loss and those who have retained their teeth often have complex restorations which need maintenance. It also highlighted the fact that residents in aged care facilities are particularly at risk of poor oral health.

“Dentistry remains one of the poor cousins when it comes to the health of people with special needs and there is this perception that it is harder to get a patient to a dentist,” Dr Gryst says.

“Often, there is unintentional neglect. If there is something going on with their skin or eyes, then that can easily be spotted. But unless you are looking in someone’s mouth, you have no idea what the state of their oral health is.”

Dr Gryst, 61, currently divides his

time between his private practice in the Colgate Australian Clinical Dental Research Centre and the public sector at the Special Needs Unit at the Adelaide Dental Hospital.

He has been dealing with Special Needs since graduating from the University of Adelaide in 1981, and full-time since 1985. He completed his RACDS secondary exams in Special Needs in 2002, achieving his specialty registration in 2005.

One of his first jobs out of university was working in a residential facility for 700 people with intellectual disabilities.

“I was interested in the area, I enjoyed it and I found I had skills in those areas. I found I was good at it,” Dr Gryst says.

“I have always tended to be more compassionate in that way. I quickly realised that if I could offer a service to regular patients, then I thought why was I not offering it for an individual

with Special Needs? In this area—Special Needs—it tends to break down into those who enjoy working with the medically compromised and those who enjoy working with people with disabilities, the frail and the elderly. I am in the latter category.

“It might be very routine dentistry, but it might be on a patient who doesn’t want to be there, who is not compliant and who has a range of serious medical issues. That is what I find so fascinating and it is that variability that makes it so interesting.

Dr Gryst then adds, “You see things in Special Needs that you will never see anywhere else in dentistry.”

The most important lesson about treating patients with Special Needs he

learned from early on, Dr Gryst recalls, is one style of service does not fit all.

“You have to treat each person specifically for their condition, so a Down syndrome person is treated differently to a cerebral palsy person and differently again to someone who has had a stroke or has dementia,” he says. “I still get patients I am not sure how to treat, but you just get in and do your best.”

By adopting such an approach from early in his career, a reputation for being the dentist who could treat patients deemed ‘difficult cases’ quickly grew. To this day, he still often receives patients other dentists deem too hard to handle.

“I frequently get referred patients from other dentists who claim they were not able to treat this person who will need a general anaesthetic to treat,” he says. “When they come in, we are often able to treat the patient in the chair, without

Dr Mark Gryst, Special Needs dentist

“Many dentists just didn’t know how to cope with people with disabilities and how to treat them as patients.”

Quote

30 Bite magazine30 Bite magazine

general anaesthetic and without issues. And that is not about being arrogant; it is just that we have different skills.

“I occasionally have to quell that notion these patients are dangerous. A little empathy goes a long way towards understanding that, and in treating them successfully.”

While Dr Gryst has worked extensively in the care of people with Special Needs, it is the area of aged care that is of particular concern.

He fears the industry has not been set up well enough to cater to the growing demands of this sector into the future. “There are many dentists doing good work in nursing homes, but the problem is there is not enough of them,” Dr Gryst says. “The dental industry has not taken

up the role of taking care of them in a better way, and it’s getting all a bit too late.

As for recent reports of an oversupply of dentists in Australia, Dr Gryst responds, “I don’t think we have an oversupply in the Special Needs area. One of the things about Special Needs is this is not an area you can ask people to do. It is something people want to be doing and feel committed to.”

Among the range of oral health issues presented in the elderly, it is the rapid decay and deterioration of teeth that is of most concern, resulting from dry mouth or too often from a high sugar intake from sucking on sweets or drinking cordial every day.

“One of the biggest things these patients endure is boredom, and every

time they put sugar into their mouth, they are just adding to the decay,” he explains. “Then there are other patients who are losing their memory and forget to brush their teeth. As a result, their mouths tend to break down quickly.”

What Dr Gryst advocates for the future of aged dental care is better access to dental treatments in nursing homes through not only a committed team of dentists but also better trained general medical staff.

“Every nursing home should have a dental team attached to it, otherwise people are going to suffer,” he says. “I also think training the staff to better monitor what is being consumed to stop the deterioration of teeth that we are currently seeing is crucial.”

“A little empathy goes a long way,” says the Adelaide-based dentist, Dr Mark Gryst.

Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL No. 235249 Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321.Terms and conditions apply. See phcawards.com.au for details

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Young Leader

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Know someone in primary health care who deserves an award?

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2013 winners, left to right: John van Bockxmeer, Craig Maloney, Alison Gibson and Jodie Mackell representing MIA.

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Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL No. 235249 Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321.Terms and conditions apply. See phcawards.com.au for details

hestaawards.com.au

Young Leader

Team Excellence

Individual Distinction

Recognise a physiotherapist, dentist, GP, pharmacist, therapist or other primary health care professional for their outstanding contribution, by nominating them in one of three categories:

Know someone in primary health care who deserves an award?

Proudly presented by:

$30,000in prizes to be won!*

*Generously supported by:

NOMINATE NOW!

2013 winners, left to right: John van Bockxmeer, Craig Maloney, Alison Gibson and Jodie Mackell representing MIA.

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Momentum Full Page ad_Bite Magazine_HR.pdf 1 27/03/2015 11:59:14 AM

Dr Mark Gryst, Special Needs dentist

“The advice I give is for graduates to get a few years of general experience, then they are equipped to deal with Special Needs after that.”

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The other area of reform Dr Gryst would like to see is for health funds to support preventive care as much as restorative care. “There is just going to have to be funding for preventive care in nursing homes into the future,” he states.

The best hope for good change lies with the training of the new generation of dentists coming through the ranks at our universities. Dr Gryst, who works with final-year students at the University of Adelaide, believes on the job experience is the best way to recruit new professionals into the field.

As he has now entered his sixties, Dr Gryst says he feels he has commenced, “the final chapter” of his own career.

Creating a legacy of a dental profession well equipped to deal with people of Special Needs has now become one of his top priorities.

“We are a lot better now in how we handle Special Needs, but we still have a great deal of work to do, and I just don’t know if there is adequate exposure of people with disabilities to undergraduates,” he says.

“We used to run an all-day course at the end of fourth year and afterwards there were always students keen to consider that area. But if they are not exposed to it, they don’t know about it. They need to see it and experience it to understand it. We have in the past also had electives when students spent

time with dentists working in Special Needs.

“This is not a sexy area of dentistry and it is not always fun. The advice I give is for graduates to get a few years of general experience, then they are equipped to deal

with Special Needs after that.”It is not only the landscape of

treatment that is changing, but the attitude towards it as well.

“Until recently, the majority of work was done in the government area,” explains Dr Gryst. “Now it’s in private as well. This is such a big area for all of us to take care of.

“I recently had a phone call from a colleague who said he had a group of Down syndrome lads coming in. I responded to him: ‘I suppose you want me to take them.’ Instead, he said, ‘No, actually I want to know how to do it better than I am.’

“Hearing that kind of approach to Special Needs made me very happy.”

Momentum Full Page ad_Bite Magazine_HR.pdf 1 27/03/2015 11:59:14 AM

NEWS & EVENTS COVER STORY YOUR BUSINESS YOUR LIFEYOUR TOOLSYOUR BUSINESS

34 Bite magazine

YOUR BUSINESS

and consequently, the business will suffer commercially.”

But while the commercial benefits of having a tight team are clear, it doesn’t always translate into reality. For many practice owners, running the non-clinical aspects of their business can be a case of trial and error, particularly when first starting out. If the dentist is not trained in running a small business—including managing staff—it can impact negatively on the business.

Skills aside, according to Parkes a good practice manager or principal dentist should be immediately aware on a day-to-day basis of any dysfunction occurring in their business. Any problems with systems, stock ordering or patient bookings should be an obvious trigger, he says, and a sign that they need to talk to staff immediately to uncover if it was a one-off mistake or a deeper issue with staff attitude. If the problem stems from a fragmented team, further investigation is necessary.

Systems assessmentTo help create a professional and calm work environment, assess the processes and systems in place and check that team members clearly understand their role within the practice. A patient flow process, beginning when the patient arrives at the surgery, can be an effective

Good team cohesion, where staff are aligned and united, is necessary for optimal business performance. This is particularly so in a small

business where team members interact with customers. In dentistry, a tight-knit team that works well together achieves the best outcomes for both patients and the business’s bottom line.

“Patients can tell if the practice runs well from when they walk through the door and this is especially important in a business where the customer can be nervous,” says Pam McKean, director of AB Dental Employment Agency.

At its foundation, a cohesive team has good communication skills and aligned goals, and works together to make the best decisions and create a smooth patient experience.

“It’s important that everyone in the team has a common goal and shares the same values. This results in a good experience for the customer, and flows to repeat business and referrals—a good commercial outcome for the business,” says Geoff Parkes, director from the management consultancy firm, Dental Advantage Consulting Group (DACG). “Conversely, if there is a weak link in the chain, one negative experience is enough for a patient not to come back

Team harmony is essential for business success but a high-performing team requires regular management. Nicole Szollos shares advice from the experts

Bite magazine 35

A tight-knit team that works together achieves the best

outcome for both patients and the business’s bottom line.

Makingworkteamwork

tool as it ensures staff members know their responsibilities and provide a consistent level of service. McKean says implementing a patient flow process gives staff clear direction and creates a positive patient experience.

Setting expectations with staff is also important; when the business’s vision and strategy is understood and values are aligned, the team can work towards common goals. “Dentists need to be really clear of their expectations with their staff—everyone needs to be on the same page,” says Parkes. Importantly, the team concept applies to everyone—dentists included—and each individual must be accountable for their behaviour. A performance management strategy with regular staff performance reviews is one method to ensure open lines of communication between staff members and clear expectations are being set.

When cracks appearIf a team has become fragmented due to negative morale, it’s vital to understand the underlying cause. While there are many variables, some common issues include low staff satisfaction and feeling undervalued, mismatched culture fit among team members, lack of clear expectations set, or the behaviour of the dentist themselves. “The practice owner is a leader,” says Parkes, “and often teams break down without good leadership. You have to be really honest with yourself about what the cause of the trouble is, as it may be you.”

Solutions need to be practical and specific to the problem. If disengagement is being caused by dissatisfaction with salary, re-evaluate staff rewards and conduct pay reviews across the team. If the issue is isolated to one staff member, a performance management strategy introduces a formal structure to help resolve differences, bridge skills gaps or move

YOUR BUSINESS

Practical tips for a cohesive teamn Implement a thorough HR

process, including outlining clear role responsibilities and expected performance in the contract.

n Communicate well and be consistent with messages.

n Hold regular team meetings with outcomes consistent with the company values, vision and mission statement.

n Conduct regular performance reviews.

n Ensure staff feel valued and an important part of the team.

n Pay staff fairly and try to offer equal remuneration for staff at the same level doing the same role. If not, be prepared to explain why.

36 Bite magazine

them on. If employee disillusionment is being caused by misaligned expectations or values, a team-building day can provide a forum to communicate openly and help the team reach a united front.

Team strengtheningTo be most effective, a team-building day should focus on addressing and fixing problems as the primary goal, with the social element as secondary. Among its services, DACG helps practice owners run a Staff Harmony Day. The consultancy works directly with the practice owner to conduct an analysis of the business and identify where improvement is needed. The content of the Staff Harmony Day is then created against a commercial framework.

“Typically, an issue with staff is the trigger for a Staff Harmony Day, but once we get into the analysis, we often find an underlying problem that needs to be addressed,” says Parkes. “Sometimes it’s about the dentist’s behaviour or leadership style, and this can often be a bit of a surprise to them.”

Parkes’s advice to practice owners is to take a good look at the entire business, including their own position, and be authentic and honest, focused on running the best practice they can. He believes a shift in dentists’ thinking is required, since it is now harder to set up and operate a profitable practice and the market is more competitive. “Dentists can’t afford to get it wrong in their practice; there is a lot more pressure to get the business aspects right,” he says.

McKean agrees; “There is more customer focus in dentistry than 15 years ago due to more competition and the need to have a point of difference. If patients are anxious, it makes all the difference if there is that confidence among staff when they walk in.”

Geoff Parkes, Dental Advantage Consulting Group director

“Dentists need to be really clear of their expectations with their staff—everyone needs to be on the same page.”

Quote

Implementing a patient flow process gives staff clear direction and creates a positive patient experience.

NEWS & EVENTS COVER STORY YOUR BUSINESS YOUR LIFEPRODUCT GUIDE

Radiography and digital imaging

product guideBite magazine’s annual guide

to the best radiography and digital imaging

products for dentists

Bite magazine 37

NEWS & EVENTS COVER STORY YOUR BUSINESS YOUR LIFEPRODUCT GUIDE

ADVERTORIAL

PRODUCT GUIDE

Embracing the benefits of miniaturisation, easy networking and an innovative improved approach to infection control,

the new PSPIX® from ACTEON® Imaging is the latest innovation in phosphor plate scanners for the dental market. It combines contemporary design, revolutionary size and wide range of functions making this new phosphor plate scanner as easy to use as possible.

A surprising and futuristic designThe latest technology used in the new PSPIX has enabled the development of compact components to offer the smallest scanner on the market. The futuristic and elegant design brings a wave of freshness and innovation to the modern dental practice.

Pure simplicity for multi-surgery practicesThe new PSPIX is compatible with both MAC and PC and has the ability to be shared among up to 10 workstations, making it ideal for both small and large dental practices.

The Click & Scan! automatic management system further revolutionises ease of workflow by allowing the user to

Radiography and digital imaging product guide

The new PSPIX— the world’s smallest phosphor plate scanner

38 Bite magazine

select their workstation directly from the new PSPIX touch screen, for a more fluid procedure. The scanner’s status is also visible at a glance due to the colour back-lighting on the new PSPIX display.

Optimised for the individual userThis new scanner is small, affordable and well-suited for individual examination rooms or dental surgeries. A few seconds is all it takes for a high quality radiograph to be processed, to provide a clear and reliable diagnosis which allows more valuable time with patients.

Innovation in hygiene The new PSPIX is built from parts which

can be removed and cleaned in a thermal disinfecting cleaner, the latest standards in effective disinfection. What’s more, PSPIX is the only scanner that offers optional removable parts that can be sterilised in an autoclave, offering maximum protection.

With the new PSPIX, ACTEON Imaging can now offer every practitioner a scanner that fulfils their surgery’s needs.

For more information visit www.acteongroup.com.au or contact 1800 225 010 for the nearest A-dec dealer.

Optimised for the individual user

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practices

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wen eht ,t pec noc ” nacS & kcil C“ evi s ul cxe na gni r ut aeF •PSPIX is totally intuitive: make your selection on the large touchscreen, drop in your imaging plate and let the PSPIX do the rest…

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NEWS & EVENTS COVER STORY YOUR BUSINESS YOUR LIFEPRODUCT GUIDE

ADVERTORIAL

PRODUCT GUIDE

Anthos in Australia is proud to announce the release of the MYRAY HYPERION X5 Panoramic X-Ray.

The HYPERION X5 now makes it easier and simpler for every Australian practice to offer panoramic x-ray/OPG in their own practice. The clinical benefits and efficiency of in surgery panoramic imaging/OPG are widely understood and appreciated by the dental community. However, there are still a vast number of dental practices who have cited a lack of suitable installation areas within their practice, and concerns on initial capital costs, as main reasons for not having an OPG in their practice.

The MYRAY Hyperion X5, which was released at the IDS 2015 Cologne Dental Show—available from ANTHOS in Australia—addresses these concerns.

Firstly with regards to space, the MYRAY Hyperion X5 is the smallest wall-mounted panoramic imaging system in the world. All you need is a wall. There is zero foot print. It’s so light, that installation requirements are equivalent to those of an intraoral X-ray unit. This opens up greater installation possibilities in a practice.

The MYRAY Hyperion X5 has been designed with the focus on the 2D only Digital panoramic user requirements specifically in mind. This has allowed MYRAY the opportunity to offer all and more of the 2D panoramic imaging features required by dental practices, but at a price to shake up many dentists perceptions on the cost of a digital panoramic x-ray/OPG.

The Hyperion X5 is able to achieve these new benefits while surpassing the quality and features expected from a 2D Digital

Radiography and digital imaging product guide

ANTHOS in Australia and the new MYRAY X5 PANORAMIC X-RAY

40 Bite magazine

Panoramic X-Ray/OPG. Thanks to the automatic focusing, with parameters automatically set for the patient, Hyperion X5 avoids underexposed or overexposed images, thereby preserving the patient from useless radiation. Morphology Recognition Technology (MRT) spares the need to manually set the emission parameters.

Accurate diagnoses for different requirements, from adults to children, with all in all 15 diagnostic programs, including dentition with improved bitewing orthogonality, temporomandibular joints and maxillary sinuses. Additional features include a low dosage program, QuickPan, allowing for a reduction in exposure times and radiation dose, thereby safeguarding the patient’s health. The MultiPAN Function offers you the possibility of choosing the panoramic imaging best suited to highlight the clinical detail of relevance from a range of different views obtained through a single examination.

Hyperion X5 shares its own images with all the PC’s present in the practice thanks to the image management iRYS software, common to every MyRay device. It is possible to send images with a TWAIN protocol to compatible practice management software.

Hyperion X5 is an open system: the virtual console, available both for WINDOWS systems and as iPad APP, enables a remote

control of the machine and a visualisation of the images acquired on the tablet. Managing and archiving the images is practical and quick: because of that, Myray has conceived a powerful platform capable of interfacing with third party systems, thanks to the DICOM protocols and other communication methods.

Please consult ANTHOS in Australia on phone 1300 881 617 or email: info@anthos.com.au to find why, with the MYRAY Hyperion X5, it no longer makes sense to refer OPG’s out of your practice.

World’s smallest wall-mounted Panoramic X-Ray/OPG

MYRAY is a worldwide name in image-assisted diagnostics, a brand that has earned the trust of dental professionals and radiologists all over the world.

adVERTORiaL

Automatic determination of exposurefactors

HYPERION features innovative MorphologyRecognition Technology (MRT) which automaticallyidentifies patient size and all parameters required toensure correct X-ray exposure.With MRT there’s no need to program exposuretimes, kV or mA technical factors or even choosepatient size.

Ready, steady, go in less than 9 seconds

With HYPERION, reassuring eye contact with yourpatient is possible at all times.The face-to-face approach makes it comfortable forboth dentist and patient. A steady posture is achie-ved in no time at all. Then you’re ready to scan inless than 9 seconds.

Wide Diagnostic Spectrum

Acquire automatically selected standard andpaediatric panoramicprojections, frontal andlateral views of the maxil-lary sinuses, multi-anglelateral and posteroanteriorviews of the temporo-mandibular joint.

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032-033_Anthos_Apr12.indd 33 31/08/12 1:12 PM

NEWS & EVENTS COVER STORY YOUR BUSINESS YOUR LIFEPRODUCT GUIDE

ADVERTORIAL

PRODUCT GUIDE

Radiography and digital imaging product guide

42 Bite magazine

With a wide variety of digital sensors available on the market, each with their unique shape

and size, it can be difficult to find a positioning system that fits. Flow Dental who have supplied dental professionals for over 40 years in X-Ray film and accessories have developed a universal sensor holder called SensiblesTM. Flow’s unique ‘one-size fits-all’ solution offers the dental practice flexibility and unparalleled patient comfort not seen from alternative products.

The magic is in Flows patent-pending adjustable SensiblesTM bite blocks which incorporates a ratchet system, locks down the bite block on the sensor for a custom fit. In addition, the flexibility allows the user to place the sensor in either a vertical or horizontal position.

For bite wings the user simply adjusts the bite block to the approximate mid-line of the sensor. On completion of radiography, a quick release button is located at the back of the bite block for easy removal of the digital sensor. The two sizes of bite blocks available fit size 1, 2 and 0 sensors.

Flow have spared no expense in ensuring their SensiblesTM Universal Sensor Holder is of the highest quality. High quality stainless steel arms, and premium resins are used to ensure long lasting wear and tear from patients and the autoclave. Patients will also

benefit from the quality finish with no sharp edges to cut the mucosa.

Ease of useTo use, attach either an anterior, posterior or bite-wing alignment arm to the bite block with its corresponding aiming ring. Insert the digital senor inside the bite block and clamp down. The sensor should now be securely in place. For using the bite-wing x-rays adjust the bite-block to the centre.

CleaningCleaning the Sensible Universal Holder system is very easy. Disinfect, ultrasonically clean and steam sterilise. All the components except for the disposable barrier sleeves are fully autoclavable.

In summary• Perfect for Anterior, Posterior and

Bite-wing images• Adjusts easily; holds securely• Autoclavable and resuable• Durable and 100% laxex free

For more information contact Ark Health on 1800 422 227

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NEWS & EVENTS COVER STORY YOUR BUSINESS YOUR LIFEPRODUCT GUIDE

ADVERTORIAL

PRODUCT GUIDE

3D CBCT imaging technology has been a popular choice for a wide range of dental practices looking for enhanced

diagnostic information to improve treatment options.

While many 3D CBCT equipment users charge their patients direct (utilising private health insurance where available), some choose to use a teleradiology service to enable access to Medicare or send patience to imaging centres with CBCT equipment.

From 1 November 2014, Medicare changed the item numbers and placed restrictions on how they can be applied.

Many existing users have taken unfair advantage of the Medicare system and the Medical Services Advisory Committee were brought in to review the use of CBCT imaging.

Over-servicing and concerns of unnecessary radiation exposure were raised as some issues.

As a result, there have been significant changes, with Medicare item numbers amended and added restrictions to encourage the judicious use of CBCT.

The main changes are:• Co-claiming for more than one CBCT

per day (or CBCT plus a panoramic image) not permissible.

• CBCT scans can be requested ONLY by Medicare-eligible medical practitioners and specialist dentists: General dentists can no longer request CBCT services under Medicare.

• Services performed on hybrid units are excluded

• CBCT services can only be performed at practices that are DIAS-accredited (Diagnostic Imaging Accreditation Scheme).

It is important to note these changes will only impact on those accessing Medicare (using teleradiology services or referring to imaging centres).

What does this mean?For the general practice with existing CBCT equipment: If you access Medicare via a teleradiology service, you will no longer be able to. You will either have to have a specialist referrer, or charge your patient out-of-pocket or through private health insurance.

For the general practice who refers patience to imaging centres: You will no longer be able to refer.

For dental specialists:If you are using a teleradiology service to access Medicare, or referring to an imaging centre, check with your provider to see if the changes will affect your practice or their ability to provide.

For either general dental or specialist practices who rely on CBCT imaging:These restrictions are only applicable to those accessing Medicare. If you see CBCT imaging as vital to your practice, charging out-of-pocket or through private health insurers is still available as normal, but due to the restrictions, may need to be accessed in-house instead of through referrals.

For more information, visit:http://www.health.gov.au/internet/main/Publishing.nsf/Content/diagnosticimaging-aboutus.htm

Radiography and digital imaging product guide

A reminder about the Medicare CBCT changes introduced in November 2014

44 Bite magazine

Disclaimer: Whilst the information contained on this factsheet has been formulated with care, Australian Imaging does not accept any liability to any person for the information, or use of such information, which it contains. The information is provided for general purposes only and does not constitute legal advice.

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NEWS & EVENTS COVER STORY YOUR BUSINESS YOUR LIFEYOUR TOOLS

Galileos Comfort Plusby Dr Harry Marget, East Bentleigh Dental Group, VIC

This state-of-the-art cone beam machine has transformed how we operate our daily practice with its accurate 3D diagnostic tools. Having the ability to produce patient information quickly and simply completes the circle of accuracy and delivery that’s so often required today.

What’s good about itThe advantages of owning this machine are numerous. It has diagnostic capabilities that can be used for a wide variety of cases, including implants, every form of surgery and endodontic analysis.

The Galileos has the ability to rapidly create an image that can be fully manipulated. The user can look at both neurovascular and anatomical structures in all aspects.

It’s an invaluable tool for all types of operative dentistry where accurate diagnosis is essential. Pinpoint accuracy is possible in regard to the placement of implants and dental pins. When performing any kind of oral surgery, the Galileos becomes the operator’s friend.

To ascertain and develop a sleep apnoea practice without the use of such a tool would be virtually impossible. The delivery of appliances requires such accurate analysis of the jaw joints and the occlusal vertical dimension that this tool is an essential component.

What’s not so goodThere is quite a steep learning curve in the use of this machine. However, in recent weeks, all our operators have achieved a high level of proficiency and skill. They are now very comfortable using the Galileos and appreciate the fact that it’s literally downstairs and available at all times.

Where did you get itSirona (www.sirona.com.au).

Tools of the tradeAn extraction system that gets you out of trouble; helping patients with dentine sensitivity, and much more are under review this month …

Benex Extraction Systemby Dr Cameron Arnold, Smile Dental, Townsville, QLD

This is a great tool for extracting difficult roots, particularly in the anterior of the mouth.

What’s good about itIf a root breaks off during an extraction and it is impossible to reach with forceps, the Benex will get you out of trouble. It’s a great alternative to surgically removing the root.

A small lug is screwed into the root, a cable is attached to the lug and the other end of the cable is attached to the Benex. The tool is supported by the teeth on either side of the root on which you are working. Once everything is attached, a small handle is rotated to increase pressure and within 30 seconds, the root comes straight out.

The Benex works particularly well if you are extracting a root in order to immediately place an implant. In that situation, all the bone is preserved. I had a case recently where a mechanic was hit in the face by a spanner. It broke off his front tooth, leaving the root a centimetre down into the bone. I turned straight to the Benex and popped it out.

Any dentist who’s regularly putting in implants should really have one of these tools. It can get you out of a heap of trouble. Whenever I explain to a patient how the Benex will easily remove the root without any trauma, they are generally quite impressed. It’s a remarkable little tool.

What’s not so goodIt’s not applicable if the root is vertically fractured and like most things in dentistry, there’s a reasonably steep learning curve. It’s also quite expensive but if you’re doing a lot of implant work then it’s a fantastic tool to own.

Where did you get itDental Implant Dynamics (www.dentalimplantdynamics.com.au).

Bite magazine 47

YOUR TOOLS NEWS & EVENTS COVER STORY YOUR BUSINESS YOUR LIFE

Tools of the trade (continued from page 47)

The Wand STA—single tooth anaesthesia systemby Dr Jeffrey Tho, Bakery Hill Dental, Ballarat, VIC

I wasn’t really a believer when I first started using this system. However, the response from patients has been amazing. It’s a very common reaction for a patient to say, “Don’t you guys use needles anymore?”

What’s good about itThis system is a controlled way of giving anaesthesia without using a syringe. The hand-piece looks like a plastic pen with an unobtrusive needle at the end. It’s a lot less confronting for patients, particularly those who are needle phobic.

It’s also very light and easy to manoeuvre. It is more comfortable when administering anaesthetic as you don’t have to bend your whole arm.

A foot pedal controls the delivery and there are different rates at which you can administer the anaesthetic. The rate is set on the body of the unit but if the foot pedal is half pressed, it will administer the anaesthetic at the slowest pace. I do this for the first 10 seconds and patients rarely feel anything. When the foot pedal is fully pushed down, the system will administer at the set rate. The maximum rate is still slower than what a dentist would do with a traditional syringe.

Basically, the technique with the Wand STA is exactly the same as with a syringe. It simply administers at a slower rate and makes the whole process less confronting for the patient.

I mightn’t have been a believer at the beginning but I am now. I never use a normal syringe when numbing a patient.

What’s not so goodThe main disadvantage is that it does take more time. It’s also more expensive than just using a syringe. The other tricky thing is that a nurse has to change the cartridge so you don’t break infection control.

Where did you get itHenry Schein Halas (henryschein.com.au).

48 Bite magazine

Colgate Sensitive Pro-Relief Desensitising Polishing paste by Dr Ailin Teo, Ailin Teo Dental Surgery, Geelong, VIC

I have been using this professional paste since it was first released in early 2009. The pro-argin technology works by occluding exposed dentine tubules with a calcium-rich layer.

What’s good about itFor patients with dentine hypersensitivity, I use this paste prior to scaling and cleaning. After a routine application of topical anaesthetic on the gingiva, I place a thin layer of Pro-Relief paste on the exposed root surfaces, distributing it and rubbing it into the teeth with my fingers. I find this method to be less messy and more efficacious than spinning with a prophy cup, as this eliminates the splatter that often occurs when the cup/paste catches saliva.

Patients like it because it reduces their sensitivity and many remark on how ‘painless’ the clean was.

It is also useful for reducing post-op sensitivity in deep cavity preparations. I use a microbrush to apply a small amount of Pro-Relief paste onto the base of the cavity, rubbing it into the dentine with the microbrush, letting it sit for 10 to 20 seconds and then rinsing it off thoroughly. I then restore the tooth, usually placing a Vitrebond lining on the dentine prior to composite build-up.

I was concerned that it may interfere with the strength of the composite bond but this has not, to date, been an issue. Almost all patients experience no post-op sensitivity.

What’s not so goodFor patients with extremely sensitive teeth, local anaesthetic administration may still be required. This is especially true in cases of severe periodontal disease where deep scaling and root planing is required.

Where did you get itHenry Schein Halas (henryschein.com.au).

P: 02 8062 9800 | E: info@scdlab.com | W: scdlab.comBldg 6, 190 Bourke Road, Sydney Corporate Park, Alexandria NSW 2015

1. We know your needs. Established for dentists, by dentists.

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alloy, implant components, Invisalign® products, education. 3. The 10% discount applies to all eligible laboratory products invoiced from the

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NEWS & EVENTS COVER STORY YOUR BUSINESS YOUR TOOLS YOUR LIFE

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My interest in horses began 24 years ago. My three daughters were very young at the time and my wife thought that it would be a good idea for the girls to

learn to ride. I began to take them to riding lessons on Sunday mornings but, as a city slicker, I would just read the newspaper and have a coffee.

“One of the trainers said to me, ‘You should give this a go; you’ll enjoy it’, and before I knew it, it had taken over my life. It was a really good thing to do with my girls. We had fun, spent time together and were seriously competitive against each other.

“I acquired one horse, then two horses, then the numbers grew. Everything else followed—the property, the four-wheel-drive, the trailer, more horses. It just kept escalating.

“The girls were competing in the show ring while I was involved in both the show ring and as an eventer, competing in dressage, show jumping and cross-country. The commitment continued and I started my coaching accreditation. I am currently an NCAS (National Coaching Accreditation Scheme) level-two coach—teaching in all disciplines. From there I became a coach educator

training other coaches, a workplace assessor and national assessor. At present I am one of the five appointed national committee members responsible for equestrian coaching with Equestrian Australia. If I’m not coaching or riding, I’m often out there judging.

“I’m also heavily involved in breeding horses and have some cute youngsters on the ground. I have two beautiful dressage horses and a very talented show jumper in work. I also have a couple of old eventers that carried me safely for years. They are enjoying their retirement on my property now.

“One of my horses, Meeandah Zebedee, is currently being ridden by a young blind teenager. They have been working on their dressage and she has recently started show jumping. That’s incredibly brave! I’m very proud that my horse does such a good job for her and retains the training he received growing up with us. The rider is a definite candidate for the Paralympics.

“My involvement in the equestrian world is a huge commitment of time, energy and finances but it’s one of the greatest joys of my life. It’s a privilege to be able to work and relax with these animals. They have given me so much in return.

50 Bite magazine

Many years ago, Dr Chris Hardwicke of Corinna Dental Group in Woden, ACT, decided to ride a horse. His life was never the same again

Saddle up

YOUR LIFE

It’s a big decision. Huge. For most, it’s a once in a lifetime proposition.

We take this very seriously too.

So much so, that over the last 20 years we’ve developed a process for medical professionals looking to go out on their own.

But, we don’t just look at you, we look at the business as a whole. We act as your partners in ensuring that it is a viable and profitable opportunity. We assess everything – location, competition, client-base and growth potential.

Then, and only then, we tailor a loan to meet your needs.

Forgive the pun, but we have a lot of practice when it comes to buying a practice.

Visit us at boqspecialist.com.au or call 1300 131 141

Financial products and services described in this document are provided by BOQ Specialist Bank Limited ABN 55 071 292 594 (BOQ Specialist). BOQ Specialist is a wholly owned subsidiary of Bank of Queensland Limited ABN 32 009 656 740 (BOQ). BOQ and BOQ Specialist are both authorised deposit taking institutions in their own right. Neither BOQ nor BOQ Specialist guarantees or otherwise supports the obligations or performance of each other or of each other’s products. The issuer of these products is BOQ Specialist AFSL and Australian Credit Licence 234975. All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges and eligibility criteria apply.

Equipment and fit-out finance / Credit cards / Home loans / Commercial property finance / Car finance / Practice purchase loans SMSF lending and deposits / Transactional banking and overdrafts / Savings and deposits / Foreign exchange

You don’t buy a practice every week but we do

BOQS000006 10/14

CLINICALLY

PROVEN

BLOCKSchannels to the nerve

NUMBthe nerve

Most SensitiveToothpastes†

WHY DOES IT WORK BETTER?

† Potassium variants which numb the nerve. * When directly applied to each sensitive tooth with a fingertip for one minute.** Vs. Potassium and strontium based sensitive toothpastes. 1 Nathoo S et al J Clin Dent 2009; 20 (Spec Iss): 123-130 .

. . . . . . . . . . . . . . . . . Instant relief * . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . Superior lasting relief ** . . . . . . . . . . . .

. . Clinically proven Pro-Argin™ technology . .

. . . . Relieves the pain of sensitive teeth . . . .

Provides instant relief with directapplication and continued relief with

subsequent twice daily brushing1

Colgate® Sensitive Pro-Relief™ Toothpaste

Positive control: Toothpaste with 2%potassium ion

Negative control:Toothpaste with1450ppm fluorideonly

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CLINICALLY

PROVEN

BLOCKSchannels to the nerve

NUMBthe nerve

Most SensitiveToothpastes†

WHY DOES IT WORK BETTER?

† Potassium variants which numb the nerve. * When directly applied to each sensitive tooth with a fingertip for one minute.** Vs. Potassium and strontium based sensitive toothpastes. 1 Nathoo S et al J Clin Dent 2009; 20 (Spec Iss): 123-130 .

. . . . . . . . . . . . . . . . . Instant relief * . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . Superior lasting relief ** . . . . . . . . . . . .

. . Clinically proven Pro-Argin™ technology . .

. . . . Relieves the pain of sensitive teeth . . . .

Provides instant relief with directapplication and continued relief with

subsequent twice daily brushing1

Colgate® Sensitive Pro-Relief™ Toothpaste

Positive control: Toothpaste with 2%potassium ion

Negative control:Toothpaste with1450ppm fluorideonly

Air

bla

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CLINICALLY

PROVEN

BLOCKSchannels to the nerve

NUMBthe nerve

Most SensitiveToothpastes†

WHY DOES IT WORK BETTER?

† Potassium variants which numb the nerve. * When directly applied to each sensitive tooth with a fingertip for one minute.** Vs. Potassium and strontium based sensitive toothpastes. 1 Nathoo S et al J Clin Dent 2009; 20 (Spec Iss): 123-130 .

. . . . . . . . . . . . . . . . . Instant relief * . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . Superior lasting relief ** . . . . . . . . . . . .

. . Clinically proven Pro-Argin™ technology . .

. . . . Relieves the pain of sensitive teeth . . . .

Provides instant relief with directapplication and continued relief with

subsequent twice daily brushing1

Colgate® Sensitive Pro-Relief™ Toothpaste

Positive control: Toothpaste with 2%potassium ion

Negative control:Toothpaste with1450ppm fluorideonly

Air

bla

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