NOVEmbEr 2011, $5.95 INC. GST

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NorthernlightsTrevor Holcombe and Bruce Newman are reaching out to improve the dental health of Aboriginal children in the Northern Territory

SPECIAL REPORT:Intra-oral cameras and magnification,

starting on page 30

Location, location Designing a state-of-the-

art practice in the spot where the people are

Tools of the trade:The final impression

on Itero; the Zeon Discovery light;

NobelClinician software and much, much more

A watching briefFaced with problems in the public dental system, our elected leaders have established a taskforce

Dentist in a bagDr Clive Rogers has found a way to pack his surgery into a bag in his quest to treat special-needs patients around the country, page 26

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FIRST 50 CUSTOMERS to purchase a SoproLIFE caries detection aid will receive a FREE docking station of their choice!

FIRST 50 CUSTOMERS to purchase a Sopix size 2 sensor will receive 50% off the size 1 sensor!

Visit us at the AOS Conference Adelaide, 9 - 12 November 2011

EMAIL: product.management@a-dec.com.au

Bite 3

News & events05. DBA warns on adsThe Dental Board has fired a shot across the bows in the discussion of what dentists can advertise. ALSO THIS MONTH: Fees become an issue in the popular press; a British study suggests sugar-free gum may not be as good for teeth as we thought; sensitive toothpaste makers get sensitive; renew your rego; and much more

Queensland dentists Bruce Newman and Trevor Holcombe are taking their winning team effort to work with indigenous children in outback communities

20Remote control

Your business16. Death by committeeA national dental advisory

council set up recently may provide some solutions to the dental healthcare crisis but experts have

raised questions about its structure and effectiveness

26. The travelling dentist Dr Clive Rogers doesnt run a traditional practice

or have a surgery. Instead, he spends his time on the

road travelling to nursing homes, hospitals and

residential care facilities, providing dental work for those with special needs

36. Head for the hills Dr Anthony Naims practice

in the growing northwest suburbs of Sydney takes

all the negatives of being remote and turns

them to his advantage

Your tools14. New productsThe best new gear and gadgets from

suppliers you can trust

30. Intra-oral and magnification product guide

Bought to you by Investec Medical & Dental Finance, heres the latest, greatest products for magnification

and intra-oral imagery

39. Tools of the tradeThis month, seeing the

light, getting the bag, ditching the gag; and

much, much more

Your life42. Passions

Dr John Cropley from Nelson Bay in New South Wales on the great joys a

beautiful garden can bring to himself and his patients

Contents03

November 2011

16

Bite 3

Editorial Director Rob Johnson

Sub-editor Kerryn Ramsey

Contributors Sharon Aris, Nicole Azzopardi, Kerryn Ramsey, Lucy Robertson, Maureen Shelley, Gary Smith

Creative Director Tim Donnellan

Commercial Director Mark Brown

For all editorial or advertisingenquiries:Phone (02) 9660 6995 Fax (02) 9518 5600

info@bitemagazine.com.auSuite 4.08, The Cooperage 56 Bowman Street Pyrmont NSW 2009

Bite magazine is published 11 times a year by Engage Media, ABN 50 115 977 421. Views expressed in Bite magazine are not necessarily those of the publisher, editor or Engage Media.

Printed by Bright Print Group

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7,714 - CAB Audited as at May 23, 2011

GREAT IMAGING OFFERS!

SAVE up to $3,800!CARIES DETECTION AID

WITH BUILT-IN INTRA-ORAL CAMERA

Digital X-ray systemwiTH ACE TECHNOLOGY

OFFERS END31ST DECEMBER 2011

Offers not available in conjunction with any other offers.

SAVE up to $5,900!

FIRST 50 CUSTOMERS to purchase a SoproLIFE caries detection aid will receive a FREE docking station of their choice!

FIRST 50 CUSTOMERS to purchase a Sopix size 2 sensor will receive 50% off the size 1 sensor!

Visit us at the AOS Conference Adelaide, 9 - 12 November 2011

EMAIL: product.management@a-dec.com.au

Rsalli_ausdent.indd 1 2/11/11 2:01 PM

The Dental Board has put out a warning to dentists that they have to be careful about whatand howthey advertise

he Dental Board of Australia (DBA) has shot a warn-ing across the bow of any dental practice advertising services (such as whitening)

that make reference to a person improving their physical appearance. In a communi-qu released last month, a copy of which is available online, the DBA reinforced what it believed was not acceptable in advertis-ing. The Board said in the release, For many dental practitioners in a number of jurisdictions, both the legal framework and the standards expected by the Board are different to those previously in place before July 2010. As a result, for the first year of the National Scheme the Board (and all National Boards) has taken a largely edu-cative approach to matters related to advertising, by helping dental practi-tioners understand the law and the new requirements set down in the Boards Advertising Guidelines.

However the Board expects dental practitioners to ensure that their advertis-ing complies with the Boards guidelines.

The Board particularly highlights section 5(b) of the Guidelines which states that advertising of services must not encourage unnecessary use of health services; for example references to a person improving their physical appearance. The Board con-siders the use of such services and claims as unacceptable advertising.

The release also promised that next year the Board will adopt a more structured approach to addressing concerns about advertising, including an escalating series of warnings to the dental practitioner, initially reminding them of their obligations about advertising and ultimately, possible prosecution for non-compliance with the National Law and the Boards guidelines. If the Board deems that a dental practi-tioners failure to comply with a Boards request warrants it, matters related to ad-vertising can also be progressed through the conduct and performance pathways of the National Law.

You too can have teeth like this, but your dentist cant promise it.

DBA warns on ads

Bite 5

05

News bites

Cost complaints The cost of dental care has been in the news again following the release of the report by the Ipsos Social Research Unit, which showed that around 1.9 million people went without dental care in 2009 because they could not afford it. The early results of the detailed survey of 2700 Austra-lians also revealed cost as a major reason for about 3.5 million Aus-tralians having avoided the dentist for more than four years.

Even private health cover was not enough to ensure people obtained dental care, the study found. A quarter of Sydney residents in that situation still did not go to the dentist because of out-of-pocket expenses. The cost issues are impacting not just lower-income households, the reports director, Ryan Williams, said. They are affecting middle-income households and pushing into the higher brackets as well.

The head of oral pathology and oral medicine at the University of Sydney, Associate Professor Hans Zoellner, said the figures were even worse when considering those people who did not immedi-ately require dental care but who could not afford it if they did. The state government recognises half of people cant afford dental care but the public system cant cover the demand. Greens senator for Victoria, Dr Richard Di Natale, said the results were consistent with previous research on the issue. Making dental care a bigger priority for the federal government was a key condition of the agree-ment struck between the Greens and Labor after the last election, he said. It was a key campaign priority for us going into the last two elections.

R

salli_ausdent.indd 1 2/11/11 2:01 PM

Standing the test of time

Medifit will be celebrating an important milestone next year. The company has been offering a comprehensive one stop design, construction and fitout solution to the dental and allied healthcare

industries since 2002 and will be celebrating 10 successful years in early 2012.

Medifits mission has always been to make the process of establishing and operating a contemporary practice easier for busy dentists and their staff. From the outset, Medifit recognised the benefits of specialisation, building a significant knowledge base of the design, building and fitout requirements for efficient dental practices. Managed from their Perth head office, Medifit have completed more than 200 successful projects Australia wide in the last decade, ranging from fitouts to complete building constructions from the ground up.

While national building codes and disability access requirements have changed over time, certain aspects of practice design and construction have remained constant. Dentists have always wanted the best practice they can afford, in the shortest possible timeframe, with the least possible stress. Medifit has responded through the years with optimal space planning, aesthetically stunning designed environments and excellent service delivery throughout the entire process.

Lucas Dental in Adelaide was one of Medifits original ground up construction projects and was completed in early 2003. We contacted Tracey ONeil, the practice manager from Lucas Dental to see how the practice has stood the test of time.

How has the design held up after all this time?Its been fantastic. Everything has held up extremely well. After 8 years, the practice still looks state of the art. The only maintenance work we are even considering is repainting.

What are the best features?The windows, the use of natural light and the colours used throughout. The building looks great from the road and internally, the curved front office desk is a great eye catcher. The overall design is architecturally very pleasing and hasnt dated at all.

Have you grown into the design, or did it feel right from the very start?Right from the very start it just felt right and continues to do so.

Was it worth going to a professional dental design team?Definitely.

Would you recommend Medifit again?Yes, definitely. We have already done so and will continue to recommend Medifit. A lot of people have come through the practice over the years and been impressed by the design and quality of the workmanship. Our practice is a reflection of the high quality of service we provide to our patients, and our building still stands as a state of the art, iconic symbol of Adelaide, a great reflection of the quality of service and product provided by Medifit.

Medifit is currently planning their 10th birthday celebrations for early 2012. If you are a past or present client and would like to be involved, or even just get in touch, drop them a line at admin@medifit.com.au or call Sam Koranis on 1300 728 133.

06

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6 Bite

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Bite 9

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News bitesChewed upA new study in the British Dental Journal has caused a stir by questioning one of the basic bits of oral health we all receive regularly: that chewing sugar-free gum is good for your teeth. The study suggested there was an unrecognised risk of acidic flavouring in sugar-free candies and drinks which can erode tooth enamel. A team from the universities of Boston, Helsinki and Southern Nevada examined the role of sugar substitutes used in products to tackle tooth decay. They said a group of substitutes of sugar alcohols including xylitol and sorbitol can reduce the risk of cavities, but also increase mouth acidity which erodes dental enamel. This is especially true if they contain fruit flavourings.

Writing in the review, the researchers said: As the use of sorbitol and xylitol containing products increases, the public should be educated on the hidden risk of dental erosion due to acidic additives, as well as the adverse effects of gastric disturbance and osmotic diarrhoea.

Especially in sugar-free products, these adverse effects may be more insidious because the public has blind confidence that they are oral health friendly.

The university team concluded that further clinical trials were needed in the area.

TGA says instant isnt instantRecent newspaper reports revealed the Therapeutic Goods Administration (TGA) has asked both Colgate and GlaxoSmithKline to stop advertising those products that offer instant relief for sensitive teeth, on the grounds that they dont. Reports in Sydneys Daily Telegraph revealed both companies made complaints about each others advertising to the TGA. The complaints related to claims that the toothpastes Colgate Sensitive Pro-Relief and Sensodyne Rapid Relief give users instant relief from the discomfort of sensitive teeth. The regulator has found both companies claims are inaccurate.

The inaccurate claims centre around the idea of instant relief, which both companies qualified meant relief within 60 seconds. For example, countering a complaint from Colgate-Palmolive, GlaxoSmithKline argued that when it said instant about Sensodyne Rapid Relief on its website, it was clearly linked to a clarification that the product works in 60 seconds. Responding to GlaxoSmithKlines complaint, Colgate said that its toothpaste gave instant relief after it had been rubbed in to a tooth for 60 seconds. The panel also found that could not be said to be rapid when it took 60 seconds per sensitive tooth.

Each of the manufacturers has been asked to stop using the advertisements.

1637-55_AA_Agile News Bulletin FP_2A.indd 1 18/08/11 4:57 PM

10 Bite

10

News bites

Mushroom mouth rinse deliversIt sounds more than a little rustic, and not particularly appealing, but researchers from Italys University of Verona have found that using a mouth rinse made from shiitake mushrooms may reduce gingivitis. The full study is available online.

They did the study because an extract from mushrooms has been shown in laboratory experiments to control the growth of oral bacteria. Mushroom extracts also appear to kill oral bacteria and make it more difficult for the bacteria to stick to teeth.

The study involved 90 volunteers. All of them had their teeth professionally cleaned. For the following six days, they brushed regularly. Between days seven and 17 of the study, people did not brush, but rinsed twice a day with one of three mouth rinses, made from either water, shiitake mushrooms, or a commercial mouth rinse.

After a couple of weeks, people rinsing with the mushroom rinse had significantly less plaque than those in the water-based rinse group did. Also people in the mushroom rinse group had significantly less gum inflammation than people in the group using the

commercial mouth rinse or the water-based rinse group.The researchers did not find that the mushroom rinse

destroyed bacteria that commonly occur in dental plaque. The mushroom rinse, however, did slow the growth of some bacteria responsible for the progression of gum disease to periodontal disease.

A weapon in the fight against gingivitis.

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ALWAYS READ THE LABEL. Use only as directed. If symptoms persist, consult your healthcare professional. For the relief of sensitive teeth. Sensodyne Repair and Protect contains NovaMin. Sensodyne, the rings device and NovaMin are registered trade marks of the GlaxoSmithKline group of companies. References: 1. Burwell A et al. J Clin Dent 2010; 21(Spec Iss): 6671. 2. LaTorre G, Greenspan DC. J Clin Dent 2010; in press. 3. Efflant SE et al. J Mater Sci Mater Med 2002; 26(6):557565. 4. Clarke AE et al J Dent Res 2002; (spec Iss A): 2182 and 5. GSK Data on File. 6. Du MQ et al. Am J Dent 2008; 21(4): 210214. 7. Pradeep AR et al. J Periodontol 2010; 81(8): 11671173. 8. Salian S et al. J Clin Dent 2010; in press. 08/11 GSK0007/UC

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12 Bite

12

News bites

DBA reminds you time is running outDental practitioners with registration due to expire on Novem-ber 30, 2011 have just weeks left to renew online and on time. Around 17,900 dental practitioners across Australia are due to renew their registration by November 30the annual registra-tion renewal date for the profession under the National Registra-tion and Accreditation Scheme.

Dental Board of Australia chair Dr John Lockwood said all registered practitioners in the National Scheme were responsible for renewing their registration on time.

The job of the Boardwith the Australian Health Practitioner Regulation Agency (AHPRA)is to make this as simple and straightforward as possible, Dr Lockwood said.

The quickest and easiest way to renew registration is online.The Dental Board of Australia has reinstated a late registra-

tion renewal fee for 2011-12 registration. The late fee had been suspended for the first year of the National Scheme.

Dr Lockwood said the late fee applied to practitioners who submit an application to renew during the one month late period built into the National Law. The late fee is payable in addition to the annual renewal fee.

There are significant consequences for individual dental

practitioners who do not renew on time in the National Scheme. Under the National Law, practitioners who do not renew registration within one month of their registration expiry date must be removed from the National Registers.

Their registration will lapse and they will not be able to practise dentistry in Austra-lia until a new application is approved. Neither the Board nor AHPRA has any discretion about this under the National

Law. Dental practitioners who forget to renew their registra-tion by November 30 2011, or within the following one-month late period, can apply to AHPRA for a fast-track application for registration. These practitioners should note that they are not able to practise in their profession until their fast-track registra-tion application has been processed and approved. Fast-track applications incur a fee.

Get online to renew your registration now.

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ED-NOV 2011 BITE.indd 1 1/11/2011 4:30:44 PM

Give your patients some entertaining relief.

Find out how FOXTEL can entertain your customers and benefi t your business by calling 1300 734 856 today.

Having FOXTEL in your surgery can help your patients feel less stressed during their visit. Theres a huge range of quality entertainment, with something for all your patients on channels that include The LifeStyle Channel, Cartoon Network, MTV Hits and National Geographic Channel, not to mention a great selection of movies available. Having FOXTEL will not only help your patients feel more relaxed and comfortable during their visit, it will make you a more attractive option when theyre choosing their dentist.

FOXTEL is not available in some areas/all premises. Some channels not available in public viewing areas. FOXTEL marks are used under licence by FOXTEL Management Pty Limited. FOX0051

14 Bite

14New productsNew-release products from here and around the world

Kerr SonicFill Kerr SonicFill is the only easy-to-use, sonic-activated, bulk-fill composite system for posterior restorations that requires no additional capping layer. Proprietary sonic activation enables a rapid flow of composite into the cavity for effort-less placement and superior adaptation. Its fast, easy and effectivegreatly reducing procedure time. Now you can go from placement to a polished restoration in less than three minutes on cavities up to 5mm in depth.

SonicFill Advantages Effortless placement Superior adaptation Easy contouring without stickiness No need for 2mm incremental layering No final capping layer required 20-second full depth of cure.

The Tri Auto Mini The Tri Auto Mini from Morita has a refined, compact design with a very small body. The handpiece is very light-weight (only 100 grams) and is extremely easy to handle without any loss of tactile sensation, with the same feedback as manual filing. This unit of-fers automatic controls for speed, rotation direction and torque that sig-nificantly increase the ac-curacy and safety of root canal treatment. These controls also reduce the risk of file jamming and breakage. The head is only 9mm in diameter and makes it easy to access molar regions. The slim design allows for easy access to posterior teeth with the ability to view both the canal openings and the pulpal floor during instrumentation. The LCD display changes colour for quick and easy recognition of changes in torque, file tip location and display. The Tri Auto Mini handpiece can be con-nected to the Root ZX mini to add an apex locator function. Available exclusively through Ivoclar Vivadent, contact product manager Sarah Leverett for more details on sarah.leverett@ivoclarvivadent.com or call your territory manager for informa-tion or a demonstration.

Cavitron Focused Spray slimLINE 1000 (30 KHz)Dentsply Australia has released its latest innovation in ultrasonic scaling technology, the Cavitron Focused Spray slimLINE 1000 (30k) insert.

Dentsply has combined the features of its two best-selling inserts: the FSI SLI Straights thin tip and the FSI-1000s triple bend and bevelled edge to produce the new Focused Spray slimLINE 1000.

The benefits of this new insert include: Improved access to interproximal and subgingival areas Better adaptation around line angles Quick and effective removal of calculus FSI patented water delivery designed to enhance patient comfort and clinician visibility.

The FSI slimLINE 1000 is just the latest addition to Dentsply's plethora of products available to aid you in providing preventive care to your patients. Other inserts in the range include the SofTip, specifically designed to safely remove plaque biofilm, calculus and endotoxin from around titanium implants and abutments as well as the THINsert and its standard range of TFI and FSI inserts.

From November 7 December 23, Dentsply is offering you a FREE Cavitron Focused Spray slimLINE 1000 insert when you purchase any other three Cavitron 30K inserts. To take advantage of this exciting offer, please contact your local Dentsply sales specialist or client services on 1300 552 929 (Australia) or 0800 DENTSPLY (336 877) (New Zealand).

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References: 1. Better Health Victoria in consultation with ADA Victoria, www.adavb.net 2. Sreebny LM, et al. Oral Surg Oral Med Oral Pathol, 1989; 68: 419-427. 3. eMIMS August 2010. GlaxoSmithKline Consumer Healthcare. Australia: 82 Hughes Avenue, Ermington NSW 2115. Tollfree 1800 028 533. biotne is a registered trade mark of the GlaxoSmithKline group of companies. GSK0060/UC

GSK0060 BiteAd_297x210_v3_FA.indd 1 1/04/11 10:56 AM

16Your worldGovernment funding

he National Advisory Council on Dental Health was announced in Septem-ber by Federal Health Minister Nicola Roxon and Greens Senator, medical doctor Richard Di Natale, with the stated aim of looking at the mix and coverage of dental services and considering priorities for future reform. There are over half a million Austra-lians who cant afford dental care,

Senator Di Natale had said in a joint media release. Poor dental health is one of the biggest causes of preventable presenta-tions to the emergency room. Thats why the Greens have made dental health such a high priority and we look forward to the councils recommendations. But will these issues be addressed in a meaningful manner with actions, not just words?

As is common with advisory councils, members have signed confidentiality agreements regarding internal discussions of the group; however, the South Australian Dental Services Dr Martin Dooland spoke in general terms to Bite about the Council, headed by former senior public servant Mary Murnane and with the deputy chair position held by former director of the Australian Research Centre for Population Oral Health, Profes-sor John Spencer.

Dr Dooland, speaking after the council had held its first meeting, explained that the Councils work would likely be

revealed in the Federal budget, since the Federal Government had announced it would address dental health in the next budget. Dr Dooland says the council is well-placed to make a meaningful contribution and consider the range of advice and findings of various task forces and reports in recent times. A great advantage of the new council is that it includes not only experts from dentistry but also from public health and edu-cation. It is our job to bring the skills around the table, and they are considerable, to the best information available, Dr Dooland said.

But Association for the Promotion of Oral Health Chair, As-sociate Professor Hans Zoellner, says the Federal Government has lacked a genuine commitment to bringing dental funding in line with the rest of healthcare. What we would reasonably expect the Federal Council to do is make recommendations about dental Medicare because thats what the Federal Gov-ernment can do. But based on past experience that [a move towards Denticare] is not what were going to see happen.

Associate Professor Zoellner gives the example of the National Health & Hospitals Reform Commission recommen-dations, which advocated for a denticare system that did not have wide-based support from the profession. The model put forward was based on either health insurance provider or pub-lic healthcare delivery, but Zoellner stresses: Public services can only really employ about 10 per cent of the actual dentistry workforce, so no matter what you do... you cant get more

A national dental advisory council set up recently may provide some solutions to the dental healthcare crisis but experts have raised questions about its structure and effectiveness

Death by committee

16 Bite

Article Vivienne Reiner

dentists to treat patients in the public system. He says it is no wonder the denticare recommendations were not taken up by the Government, because the advice on which the recom-mendations were made was narrowly constructed and was not defensible in the public sphere.

Although task forces play an important role in sifting through current information to make relevant recommendations, theres always a risk that they can become a tool for obfus-cation, he says. But Associate Professor Zoellner, who is on the NSW Dental Health Taskforce set up by Healthy Lifestyles Minister Kevin Humphries on September 1, says the state governments have different motivations. I think the state governments are really looking for structural reform, he says.

I am hopeful that the task force will actually be able to make some sensible recommendations of practical things we can do in NSW to give better access with the resources we have.

Remote oral health services consultant Bruce Simmons believes the Federal Government is to be congratulated on the makeup of the new Councilwhich includes Dr Jenny May, who has headed the National Rural Health Alliance, which Dr Simmons is also involved withbut he says there is a need for greater consultation and transparency. Dr Simmons has observed first-hand the risks of task forces not being given the power to have significant effect, having served on the Austra-lian Health Ministers Advisory Council Steering Committee for National Planning for Oral Health, which in 2001 released the final report of oral health of Australians: National planning for oral health improvement, ahead of Healthy Mouths Healthy Lives: Australias National Oral Health Plan 20042013. The committee had provided a situational analysis in great detail but this nonetheless did not result in the necessary financial commitment from the Commonwealth.

Dr Simmons says the current health plans shortcomings include the fact that it lacks nationally consistent key perfor-mance indicators to measure improvements in the two main areas of concern, namely equity in access and improvements in oral health, especially for people most at risk (children and adolescents, older people, low income and socially disadvan-taged, people with special needs, Aboriginal and Torres Strait

Associate Professor Hans Zoellner believes State gov-

ernments are genuinely look-ing for structural reform

What we would reasonably expect the Federal Council to do is make recommendations about dental Medicare because thats what the Federal Government can do, but based on past experience, that is not what were going to see happen.Associate Professor Hans Zoellner, Chair of the Association for the Promotion of Oral Health

Bite 17

islanders, rural and remote dwellers). As well, Dr Simmons says: The National Advisory Committee on Oral Health, which prepared and subsequently monitored the plan, does not report publically so there has not been the opportunity for the public to assess and comment critically on its progress nor for governments to be accountable.

Dr Simmons welcomes the formation of the council to pro-vide up-to-date advice on a new national plan after the current plan expires in 2013, pointing out that the workforce has changed considerably in the past decade. But he questions whether the Government is open to dental reform, given

that the oral health policies announced at the last Federal elec-tion were meagre, with only the Greens revealing ambitions for substantial changes. The big question is, what is the Govern-ments commitment and do they have a vision of where they want to go, Dr Simmons says.

We do need a new National Oral Health Plan led by the Commonwealth with substantial new money but requiring the states and territories to at least maintain their commitment.

The new plan also needs to clearly address access to care and the related workforce size, mix and distribution issues that are major barriers to care in the areas of greatest need.

The council, if provided with funding and the right terms of reference, has the capacity to develop a new national plan and to report on progress but it needs commitment from the governments, most notably the Commonwealth, and the Plan needs to be much more specific with measurable national tar-gets and public reporting and accountability, he concludes.

Government funding

18 Bite

Sick of long waiting lists? The government has established a taskforce to investigate what to do about it!

We do need a new National Oral Health Plan led by the Commonwealth with substantial new moneyBruce Simmons, Remote Oral Health Services consultant

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Dr Bruce NewmanI still remember the day I had to fill in my university enrolment form, and I had no idea what I wanted to do. Flicking through the careers guide, I came across dentistry. Thats how I ended up at the Uni-versity of Queensland in Brisbane.

Being a part of the community and assisting with its health was important for me. I worked in the country in areas like Kingaroy, Caloundra and Nam-bour before landing at the QEII Hospital in Brisbane as principal dentist.

It was during this time I first met Trevor Hol-combe. It was in the mid-1990s. He had been working in the Kingston area for a long time as principal dental officer for the Logan-Beaudesert Health Service District. He later became director of the Oral Health for the area.

Trevor is very dedicated and has a great social conscience. He also has a forceful personality, and that is a good thing. We had been mates for a while, and also worked together on the union side on a few things, so we knew we worked well together. In

1999, we also both did a graduate certificate in clini-cal dentistry in paediatric dentistry.

By 2004, I was a bit bored and figured I still had quite a few more years before I retired, but I just needed a change of direction. Trevor told me there was a position going at Kingston as he planned to do the Masters of Dental Science in Paediatric Dentistry at the University of Queensland. So, I ap-plied and was accepted as the principal dentist at the Kingston Dental Centre. Working with each other since has been good as we complement each other.

In March 2009, we attended an ADA conference in Perth and there was a stand for the Northern Terri-tory Oral Health Services. Andrew McAuliffe, who we knew from his time with Oral Health in Queensland, had taken on the role of program director in Northern Territory. He said to us, When are you guys going to give me a week sometime? We nodded, said we would and walked on.

Queensland dentists Bruce Newman and Trevor Holcombe are taking their winning team effort to work with indigenous children in outback communities

Article John BurfittPhotography Richard Whitfield

Bruce Newman (left) and Trevor Holcombe have teamed up to work with indigenous kids.

controlRemote

20Your world Giving back

20 Bite

Bite 21

I so respect the staff up there as it is not an easy job coordinating all those patients and getting them into the hospital from the outlying communities, but they make it happen Dr Bruce Newman

Giving back

A few months later, the phone rang and it was Andrew. Hey, remember when you said yes to coming to the Northern Terri-tory? he said. Well, I am now calling that in.

He told us we were needed at Katherine Hospital for a week, and already had patients booked in. We were asked how many we could see in theatre, as they were all general anaesthetic patients, and then they arranged everything.

We flew up on the Saturday, drove down to Katherine on the Sunday and were in the theatre at the hospital from Monday to Friday with 37 patients. We then drove back on the Saturday and flew out on the Sunday. It was a big week.

All the patients were children, and the state of their health was poor, but it was much the same standards as in some areas I have dealt with around Kingston. It didnt faze Trevor or me as we are used to it. The main procedures were extractions, root decay, oral hygiene, restorations and we did as many crowns as we could.

I so respect the staff up there as it is not an easy job coordi-nating all those patients and getting them into the hospital from the outlying communities, but they make it happen.

The appreciation of the children is so genuine, but theres also the appreciation of their grandparents who bring them in. The children had to fast before their procedures, so the grandmoth-ers would also not have breakfast. It was the same with the afternoon sessions, when those women wouldnt have lunch either. I thought that was a terrific effort on their behalf to sup-port their kids and it was so touching to see that.

Last year, Trevor and I went to Darwin and in August this year, we returned to Katherine. This is important to both of us. We just feel like we need to do our bit and help out.

We will get the call again next year and they will let us know when and where they need us. I like doing this with Trevor, as we think alike in terms of our planning and we work alike in our procedures. We have very similar thought processes and we work together very well. He has great technical skills, and his great desire is to do the best for the patient every time. He in-spires me with his dedication and his great energy. He is a good man to work with.

Dr Trevor HolcombeI am not too sure really why I wanted to become a dentist, but at the time I was considering my options. I liked the thought of being able to help people who needed help. That idea led me to dentistry.

Bruce and I had similar backgrounds. My initial degree was at University of Queensland and Bruce was one year behind me. He decided to work in the public health sector and I did as well.

Bruce was working with rural dental service, and moving through different places in the country, while I have spent most of the past 20 years working in Kingston and the Logan area. I started in the school dental service and have spent years work-ing with kids. Later I became in charge of the oral health service for the district.

Bruce was at QEII Hospital, and first came down here to Kingston when he was training in his specialty area under the University of Queensland. That was about 2004.

The Masters was the specialty training. We had very few specialists within the area, and this is such a high-demand area

22 Bite

There is no perfect treatment for indigenous kids as you are

dealing with their entire family as well, says Trevor Holcombe.

The appreciation of the children is so genuine, but theres also the appreciation of their grandparents who bring them in. Dr Bruce Newman

BROUGHT TO YOU BY THE MAKERS OF PANADEINE EXTRA IN THE INTEREST OF THE QUALITY USE OF MEDICINES. Panadeine Extra contains paracetamol 500 mg and codeine phosphate 15 mg. Use: For the temporary relief from moderate to severe pain. Contraindications: Hypersensitivity to any ingredient in the product; children under 12 years. Dosage: Adults and children 12 years and over: 2 caplets every 46 hours orally with water; (maximum 8 caplets in 24 hours). Precautions: CNS, respiratory depression; high doses, prolonged use; renal, hepatic Impairment; poor CYP2D6 function; pregnancy, lactation. Adverse reactions: Dependence; Impairment of mental & physical abilities; nausea, vomiting, constipation; dizziness, drowsiness. Interactions: Anticoagulants; sedatives, tranquilisers; drugs affecting gastric emptying; chloramphenicol; hepatic enzyme inducers; CYP2D6 inhibitors. Please review full Product Information (PI) before recommending Panadeine Extra. The full PI is available from GlaxoSmithKline Consumer Healthcare on request (FREECALL 1800 028 533). Panadeine and the Panadeine Vibration are trade marks of the GlaxoSmithKline group of companies. GlaxoSmithKline Consumer Healthcare. 82 Hughes Avenue, Ermington, NSW 2115. 1800 028 533. GSK0164/BIT/UCReferences: 1. Hargreaves K, Abbott P. Aust Dent J 2005; 50(s2): S14S22. 2. Beaver WT. Am J Med 1984; 77(3A): 3853. 3. Oral and Dental Expert Group. Therapeutic Guidelines: Oral and Dental. Version 1. Melbourne: Therapeutic Guidelines Limited; 2007. 4. Macleod G, et al. Aust Dent J 2002; 47: 14751. 5. Comfort MB, et al. Aust Dent J 2002; 47: 327330. 6. Bentley K, et al. Curr Ther Res 1991; 49: 14754.

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Panadeine Extra is the strongest analgesic available without a prescription based on codeine content per doseSingle-agent analgesia may not be sufficient to achieve adequate pain relief.1Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs, like ibuprofen) can be used for the temporary relief of dental pain,2,3 however single-agent analgesic therapy may not always be sufficient to achieve adequate pain relief.1

A combination of analgesics that work in different ways like paracetamol and codeine may be beneficial.This is because a combination of analgesics that have two different modes of action can enable an increase in analgesia whilst minimising side effects.3,4 In some patients it may be appropriate to offer a fixed-dose paracetamol/codeine combination rather than an NSAID or NSAID/codeine combination for the management of stronger pain, particularly for patients in whom NSAIDs are contraindicated.3Strengthen your recommendation in dental pain relief with Panadeine ExtraPanadeine Extra has been specially formulated, by combining the strength of codeine phosphate (15 mg) with paracetamol (500 mg) per tablet to provide fast, effective temporary relief from strong pain. Panadeine Extra contains the highest OTC dose of codeine (15 mg of codeine phosphate), making it the strongest pain reliever available without a prescription.Paracetamol/codeine combinations have been clinically proven in post-operative dental pain46Several clinical studies have provided evidence of effective pain relief when paracetamol is combined with a low codeine dose.46

In a study of patients who had undergone surgical removal of impacted third molars, paracetamol + codeine phosphate (500 mg/15 mg tablet x 2) [e.g. Panadeine Extra] provided significant improvement in post-operative pain relief over paracetamol (500 mg tablet x 2) alone (p=0.03), with no significant difference in side effects over 12 hours.4...there is a significant improvement in postoperative pain relief following this combination [paracetamol 1000 mg plus codeine 30 mg]4

Another study (n=139) compared the efficacy of a single tablet of either paracetamol/codeine phosphate (300 mg/15 mg), paracetamol/codeine phosphate (300 mg/30 mg), floctafenine (400 mg) or placebo for the relief of pain following dental surgery.6 All three treatments were significantly superior to placebo (p=0.0001).6

A later study of 232 patients who underwent impacted third molar surgery, received either paracetamol + codeine phosphate (500 mg/8 mg x 2 tablets) taken every 46 hours or the NSAIDs etodolac (200 mg x 2 tablets taken every 68 hours) or diflunisal (250 mg x2 tablets taken every 812 hours).5 All three drugs were found to be effective in the control of post-operative pain.5So the next time a patient requires proven relief from dental pain46 consider recommending Panadeine Extra

GSK0164 Bite_297x210_FPC_v1a_FA.indd 1 21/06/11 5:07 PM

that we needed them and had the opportunity to train under the University of Queensland. We both enrolled and got accepted.

Bruce was a good fit and enjoyed working with paediatrics. Bruce is a man with a strong sense of social justice and he does want to make a difference. I think that is why we connect. He is very much there for the underdog and the patient. And he is very patient focused. He looks out for them and tries to do the best for the patientsthere is no shortcut with him.

In 2009, we went to the ADA conference in Perth and saw Andrew McAuliffe. I knew Andrew from when he was in charge of Queensland Oral Health Service before he went to the North-ern Territory. When he invited us to go to the Northern Territory, I said yes as it is always a good experience you are seeking in your career.

There is no perfect treatment for a lot of the indigenous kids, as you are not only dealing with the kids but the parents as well. And they often dont have a very good concept of the impor-tance of dental care, so we have to target both sides of it. It can be very complex treatment plans at times, but Bruce and I work well together and we have a very good team up there to work with. We manage the patients the best way we can.

I enjoy working with kids and I love helping them out, and in this area there is a high need. We try to do a lot of prevention programs and what we have really worked on is to decrease the decay rate. That first week in Katherine was great, but it was a busy time. At the end of the time, we had helped a range

of kids, and it was long hours, but the outcomes override everything. It is a good feeling at the end of the week when you know you have helped so many needy kids.

The main issues we see up there are really very similar to what we see in our area of Queensland, particularly in the case of high decay rates. It is because the organisation

up there is excellent and so professional that we are able to put so many kids through in the one week.

Everyone had one thing in minda good outcome for the kids, and everyone works towards that. It makes me always happy to go back up there again whenever they ask. Whenever they want us, Bruce and I will be back. We work together well, and that is what makes it enjoyable. It is a great team there and we both fit in easily with that group.

They can struggle to get services up, and the needs are high. If everyone made a little bit of time to help out, it would make things so much better. It would make a big difference to help the people who most need the help. Were always happy to go back.

Giving back

24 Bite

I enjoy working with kids and I love helping them out, and in this area there is a high need. We try to do a lot of prevention programs and what we have really worked on is to decrease the decay rate. Dr Trevor Holcombe

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26Your worldSpecial needs dentistry

ifteen years ago, Dr Clive Rogers ran a typical suburban dental practice in Perth. During this time, he spent a month in India where he provided dental care to Tibetan children in the Himalayan mountain villages. This Rotary-organised tour, driving from village to village in an ambulance, provided him with the skills to work outside a sur-gery. Everything he had to use was carried in bags and a few boxes.

On returning to his hometown of Perth, Dr Rogers received a request to visit an older past patient who was living in a nurs-ing home. The patients problem was fairly easy to resolve, but the nurse requested that he take a look at another long-time resident who was having trouble eating.

I took a look in this womans mouth and was horrified, says Dr Rogers. I had never seen anything like it. It was shocking to think there could be anyone in Australia with a mouth in that condition. During my time in India, I hadnt seen anything that came close to the ravaged and infected mouth of this elderly lady living in a nursing home.

According to Dr Rogers, it soon became obvious how the oral

health of nursing home residents deteriorated so badly. Once a person became cognitively impaired and were no longer control-ling their own diet, they were fed high-frequency sugary foods. On top of this, they were usually on a multitude of medications, which has the side-effect of reducing saliva flow and quality. Finally, their teeth werent being brushed because they couldnt do it and no-one was doing it for them.

The rapidity and severity of the breakdown, and the fact that there was no-one intervening, was hard for me to understand, he says. In 1998, Dr Rogers was booked in to attend a four-day course about special needs dentistry and advanced problems for people mainly in care facilities. It was headed up by the

Dr Clive Rogers doesnt run a traditional practice or have a surgery. Instead, he spends his time on the road travelling to nursing homes, hospitals and residential care facilities, providing dental work for those with special needs

The visiting dentist

26 Bite

Article Kerryn Ramsey

I took a look in this womans mouth and was horrified. I had never seen anything like it. It was shocking to think there could be anyone in Australia with a mouth in that condition.Dr Clive Rogers

late Associate Professor Jane Chalmers with input from Dr Liz Coates, Dr Mark Gryst, and Professor John Spencer.

I had been going out to nursing homes for two years, recalls Dr Rogers. In the first year, it was one session a fortnight and then became one session a week due to the number of patients. I was looking forward to this course but it was cancelled two weeks prior to its start date. I contacted the organisers and pleaded with them not to cancel.

As it turned out, I was the only dentist interested in doing the course. They agreed to run the course just for me and charged me half the price. Instead of running it as a lecture seminar, I spent one whole day with each of these eminent dentists. I began to get to grips with what was happening in our social system.

A year later, Dr Rogers was spending two days a week on the road and two days back at his surgery. He was consistently coming across teeth, mouths and gums in unbelievably bad condition. It was obvious that dental care and maintenance had fallen by the wayside for the elderly and people with disabilities.

In 2003, Associate Professor Chalmers came to Perth and gave a lecture to about 50 dentists. Dr Rogers was perplexed by her choice of visual aids. I asked her why she hadnt pulled out the really grim photos of mouths. She explained that when she

shows dentists the mouths that are truly horrific, they dont be-lieve it. They think it isnt happening in Australia and the photos are from some third-world country. Then they tend not to listen any longer. She understood that dentists needed to be eased into the truth.

As Dr Rogers points out, The poor oral health of our elderly in care facilities was simply slipping under the radar. It has changed in the past three years but theres still a lot of phobia and mis-conceptions about the mouth.

There have also been some quite radical changes about our understanding of what causes tooth decay and gum disease, but that hasnt filtered through to the public very well. The other aspect is that when someone is in either low- or high-care, car-ers were not acknowledging how challenging it is to brush or maintain another persons teeth.

Dr Rogers knew he had to begin training the carers in daily oral maintenance. He had been teaching at the dental school but as a demonstrator not a lecturer. So he decided to get a degree in education.

For two years I studied part-time for my graduate diploma in education [primary]. I did a bit of teaching in primary schools as part of my practical work. I was also running a two-hour

Dr Clive Rogers sur-gery. Turn to page 39 to see his review of

his travelling bag.

Bite 27

Dr Derek Mahony

Specialist Orthodontist

BDS(Syd) MScOrth(Lon) DOrthRCS(Edin)

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Prof Robin Hawthorn

Prosthodontist

B.D.S. (Hons) MDS FICD OAM

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University of Sydney

Professor Robert Mitchell

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BDS., MDS., FRACDS(OMS)., FADI

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carer training course on special needs dentistry that hadnt been as successful as I hoped. The problem was that because I was trying to impart a large amount of knowledge in a short amount of time, all I was doing was creating confusion. At this time, Dr Pat Shanahan, who had been something of a mentor to Dr Rogers, retired from the Univer-sity of Western Australia [UWA] where he taught special needs dentistry. Dr Rogers was asked to take over his role.

My main focus has always been to state the problems in oral health that exist in special needs groups, and the importance of carers and how they are trained to prevent the problems. In Aus-tralia the training of carers is through a system called Vocational Educational Training. I knew that if I was going to be training car-ers, I needed to get into that system. I completed a Certificate 4 in Training & Assessing and wrote a national unit of competency for the training of carers in oral health care, says Dr Rogers.

Even though I started by working with the elderly, age had become irrelevant. There are people who get dementia at 50 and people who have car accidents at 20 and major care problems. There are people who spend their whole lives needing some sort of care. So this course is not just for the elderly. It takes in all those under the umbrella of special needs.

In 2006, Dr Rogers set up the Clive Rogers Prize in Special Needs Dentistry, which he financed himself. It is awarded to the top fourth-year student in the Special Needs subject at the UWA. Dr Rogers understands that these top students put in the extra work and go that extra mile, and he wanted them to be acknowledged.

So now Dr Rogers, The Visiting Dentist, spends his time on the road treating patients in residential care facilities, training carers, and trying to raise awareness of what can be done to care for the oral health of people with special needs. When more complicated procedures require a visit to

a surgery, he has connections with several dentists in Perth. These practitioners are prepared to step outside the box and deal with patients that can be challenging.

My work can be quite confronting but also heartwarming, says Dr Rogers. I have seen some wonderful, beautiful people, but also seen a lot of ignorance, infection and pain. I have been privileged to meet absolutely amazing elderly and disabled men and women in our country.

A dentist once said to me that we dont get very much appreciation in our profession. Its a rare patient that will write you a card or letter or say thankyou for your help. When he was saying that, I couldnt help but smile to myself. I receive those kind of cards, letters and calls weekly.

Special needs dentistry

Bite 29

Dr Clive Rogers says special needs dentistry isnt just for the elderly.

Dr Derek Mahony

Specialist Orthodontist

BDS(Syd) MScOrth(Lon) DOrthRCS(Edin)

MDOrth RCPS(Glas) MOrth RCS(Eng)

MOrth RCS(Ed)/FCDS(HK) FRCD(Can)

IBO FICD FICCDE

Prof Robin Hawthorn

Prosthodontist

B.D.S. (Hons) MDS FICD OAM

Associate Professor

University of Sydney

Professor Robert Mitchell

Oral & Maxillofacial Surgeon

BDS., MDS., FRACDS(OMS)., FADI

Dr David Lowinger

ENT Surgeon

MB. BS FRACS

Mr. Ron Phelan

Neuro-Structural Therapist

RMT, NST, Dip TT, Dip. Eng.

AAMT, ANTA, BTFA, BSSCMD.

in the management of patients with Orofacial Pain & Temporomandibular Disorders

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30Intra-Oral and magnification product guide

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30 Bite

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As a healthcare professional, you are presented with many finance options for you and your practice so its important you have a thorough understanding of what is right for you. Poor financial decisions can

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Some of the factors to consider when making finance decisions include:

1. Current Cash Flow:All practices, especially in the first few years of business or during expansion, may experience limited or tight cash flow. To help compensate this, you may be able to consider obtaining a line of credit. The big catch in traditional bank Overdrafts lies in the fees you pay even when you arent using the facility. Most banks also require asset security for an Overdraft. As a specialist financier, Investec Medical and Dental Finances healthcare clientele benefit from a low cost alternative, without ongoing fees, and the benefit of both options unsecured or asset secured Overdraft facilities.

Make sure that you shop around to get that the best product to suit your needs.

2. Loan Structure:Financing your practice, equipment and fitout is not simply a matter of choosing the lowest rates. People tend to focus their attention on interest rates alone, but that is only one of the many factors affecting the overall cost of a deal. Different finance structures can affect the total cost of the transaction for your practice and personal assets. The final cost of the structure that you choose, will be governed by many factors including tax, how quickly you pay off the loan, interest rate, GST and other fees. It is important to realise that the final cost and interest rates may not correlate. Upon consideration of the loan structure, it is also important to consider the cost of each option, but remember cheaper isnt always better.

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comfortable with very high image quality, but features macro vision for larger close-ups. Both can be fully integrated into the A-dec delivery system.

SoproLIFEThe ultimate in intraoral devices is the revolutionary SOPROLIFE Light Induced Fluoresence Evaluator, which introduces the scientifically proven breakthrough of fluorescence-based caries detection, to see what was once invisible, even on some X-rays.

SOPROLIFE enables the dental practitioner to diagnose occlusal or interproximal caries and differentiate healthy tissue from infected tissue with outstanding accuracy, enabling the preservation of vital dentine and excavation of only the infected dentine.

SOPROLIFE is an indispensable aid for performing minimally invasive dentistry and is an especially powerful tool for case presentation and acceptance as the images can be clearly displayed on the patient monitor for discussion of treatment options.

Optimized ergonomics Advanced design and technologyThe Blue Revolution

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Bite 33

The SoproLIFE is the ultimate in intra-oral devices, combining caries detection functions with full still and video camera features.

The Sopro 617 intraoral camera is a popular choice because of its excellent optics, wide angle of view and superior ergonomics.

Technology is revolutionising the way we do things - the way we straighten teeth is no exception. Invisalign is taking things to the next level by integrating the latest intra-oral scanning

techniques into the Invisalign treatment process with the iTero digital scanner.

This ground-breaking technology provides an efficient alternative to messy PVS impressions.

The iTero intra-oral scanner delivers high tech dental records with superior

detail, unmatched onscreen visualisation and gives doctors

real time feedback for immediate adjustments. More

accurate records result in better fitting aligners

and better clinical outcomes for your patients.

For more information visit www.aligntechinstitute.com or call us on 1800 468 472 to find out how you can incorporate Invisalign into your practice.

ScIence In every SmIle

35Intra-Oral product guide

Advertorial

iTero and OrthoCAD iOC scanning systemsA successful outcome in Invisalign treatment or restorative dentistry starts with an accurate impression

Bite 35

One of the more recent and significant changes to the Invisalign process is the introduction of intra-

oral scanning techniques using the iTero and OrthoCAD iOC scanning systems. This new interoperability provides doctors with an alternative to the PVS impression and scanning technique for capturing accurate data required prior to Invisalign treatment.

Dr Ian Watson from Sensational Smiles in Adelaide is just one of many doctors who is making the most of this new technology to reduce chair time, improve productivity, deliver superior impression accuracy and ensure a more comfortable patient experience.

Ive been practicing for around 40 years now and believe this 3D scanning technique has the potential to deliver productivity improvements that are equivalent to the change high-speed drills brought to general practice back in the 1960s, said Dr Watson.

Creating an accurate PVS impression is no simple task and often requires the skills of a specially trained hygienist or treating doctor. I always felt responsible for the accuracy of the impressions I submitted especially for Invisalign treatments. A proper-fitting and comfortable aligner can make-or break the clinical outcomes and patient satisfaction. For this reason, I liked to take them myself and would reserve 30 minute appointments for each patient. This was ample time if we were able to capture the upper and lower arch plus bite records and photographs on the first try, but if they needed to be repeated the allocated time slot was cutting it a bit fine.

As soon as Dr Watsons practice received the iTero scanner, he made it a priority to train his dental nurses to capture accurate records on his behalf.

We dedicated a whole day to scanner training and within two weeks, my nurses were able to capturethe

records I needed in around 12 minutes. Not only is this a much more comfortable process for the patients, but my staff really enjoy undertaking the procedure and it also means I no longer have any impression appointment time on my books.

The scanner also allows the practice to commence Invisalign treatments quicker than ever before. The scanner allows me to submit images to

Invisalign and within 11 minutes I can start working on their treatment plan.

Dr Watson believes the iTero scanner has been cost neutral for his practice. Not only can we better manage my patient chair time, but the scanner also eliminates the need to take a set of alginate impressions to have plaster models made. At around $80 a pop, this cost has completely disappeared.

Technology is revolutionising the way we do things - the way we straighten teeth is no exception. Invisalign is taking things to the next level by integrating the latest intra-oral scanning

techniques into the Invisalign treatment process with the iTero digital scanner.

This ground-breaking technology provides an efficient alternative to messy PVS impressions.

The iTero intra-oral scanner delivers high tech dental records with superior

detail, unmatched onscreen visualisation and gives doctors

real time feedback for immediate adjustments. More

accurate records result in better fitting aligners

and better clinical outcomes for your patients.

For more information visit www.aligntechinstitute.com or call us on 1800 468 472 to find out how you can incorporate Invisalign into your practice.

ScIence In every SmIle

The productivity improvements resulting from the iTero scanner could be great.

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36Your businessDesign

r Anthony Naim is a busy man. A maxillofacial surgeon dual quali-fied in medicine and dentistry, he splits his time between Westmeads private and public hospitals, day surgeries at Castle Hill, and his role as a senior lecturer for Sydney Universitys Faculty of Dentistry. In May of this year, he added another feather to his cap when he opened a

new private practice in QCentral part of the Norwest Business Park in Bella Vista New South Wales.

Dr Naim is no stranger to working in regional areas hav-ing completed, like many of his peers, a number of years of medical training in areas such as Dubbo, Coffs Harbour, Port Macquarie and Murwillumbah.

The Norwest Hills area is growing and under serviced, says Dr Naim, citing the population growth observed during his 18 to 20 years of training at Westmead as the key driver behind the decision of where to locate his practice. I am a specialist however I think in an area such as this, which is growing, there is always going to be a need.

The Hills area is also infamous for a public transport in-

frastructure shortage that affects accessibility to services in other regions, and waiting lists for procedures at local public hospitals are notoriously long. With the new private practice, patients arent waiting as long to see me, says Dr Naim, The patients have absolutely loved the place, and theyve loved the location. Part of that is the pleasant nature of the rooms and the size of (the practice), but its also the parking availability. Indeed, the abundance of free parking for locals who are used to driving everywhere must be a major drawcard.

Apart from the proximity of the practice to Norwest Private Hospital (its literally across the road), the Business Park is also conveniently positioned close to the main arterial M2 and M7 motorways, providing convenient access not just to locals, but also for regions from as far as Campbelltown in Sydneys South all the way to the Blue Mountains.

Unending urban sprawl across the country has meant that suburban practices such as this are growing in popularity for areas desperate for more local services. The key to Dr Naims success has been to tap into that need and that growth.

Dr Naims advice to others who are thinking of setting up shop in non-traditional areas? Base your set-up on your vi-sion Im talking about a ten to fifteen year plan, not a five year plan; suitable for now but with potential for growth.

Dr Anthony Naims practice in the rapidly-growing northwest suburbs of Sydney takes all the negatives of being remote and turns them to his advantage

Head for the hills

36 Bite

Article Amanda Lohan

As a result of his dual qualification, Dr Naims practice is a bit different to a typical dental surgery, incorporating many aspects of the medical profession not typically found in dentistry.

The first thing you notice about the design of the practice, com-pleted with the assistance of healthcare design specialists, Perfect Practice, is that every one of the 110 square metres of available space has been maximised. The small admin room behind the main reception areas is remarkable for the fact that it is almost

empty. We were one of the first surgeries to go completely pa-perless, says Dr Naim. Anything and everything is scanned into the system, including radiology images, and the system provides secure backup for file recovery, It means we can easily expand without the need for additional storage space.

This paperless concept was borrowed from the hospitals where Dr Naim spends a large part of his time, and many other

hospital design features are apparent throughout the surgical areas. In fact, only the dental chair in the centre of the surgi-cal rooms distinguishes them from hospital operating theatres. All of the equipment is either ceiling or wall mounted to give complete access to the patient from all sides, the suction unit is tucked away in the cabinetry to keep the floor completely clear for hygiene purposes, and the overhead lamp is sensor driven to prevent cross-contamination. Impressively, the digital x-ray with sensor capability transmits images immediately to the monitor, giving Dr Naim instantaneous information about the patients oral cavity during surgery.

In addition to this state-of-the-art equipment, the sterilis-ing room was the subject of much of the initial investment. Dr Naim uses a cassette-driven system that expedites the sterilisation process and minimises the storage space required for instruments. The upfront investment in multiple instrument cassettes now allows Dr Naim to perform four or five opera-tions without the need to resterilise, and the autoclave is run on a digital barcoding system that can track an autoclave cycle to an individual patient. Its easy for the nursing staff. Its a better way to sterilise, says Naim.

Back out in the reception and waiting area, this sterile feel is traded for a softer touch that Dr Naim attributes to his wife,

The reception area in Dr Naims rooms at QCentral.

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We were one of the first surgeries to go completely paperless. It means we can easily expand without the need for additional storage space.Dr Anthony Naim

Nadine. Here, the surgical vinyl is replaced by modern tiles, and design features in the reception desk and wall recesses make for an aesthetically pleasing result. The large glass doors leading into the practice promote a sense of openness, and the main blue entry feature wall brings a subtle touch of calm to the otherwise stark white interior.

The consultation room sits just off the waiting area, and was a key inclusion in the original design, because it gives Dr Naim somewhere non-intimidating to discuss the surgical process with his patients. The frosted glass separating the room from the main waiting area offers some privacy, but also lets in some much-desired natural light.

The waiting area, although modest in size, is sufficient for its purpose and incudes a number of design features that Dr Naim says were incorporated to offset the nervousness that many patients feel in visiting the practice. The lowered ceiling has en-abled the inclusion of a beautiful overhead lighting feature, and an LED TV facing the seating area has been used not only as a distraction, but also to mask the acoustic problem of Dr Naims loud voice booming from the consult room. A small columnar barrier at the side of the reception desk offers confidentiality in the payment process and Practice Manager, Laurie Dyer, says that this design feature has been excellent for the patients be-cause it gives them somewhere to sit if she needs to take a call, people are always more patient if they are comfortable.

Design

38 Bite

Dr Naims surgery design was inspired by hospitals in its sleek-ness and practicality.

Since 2002, Medifit has completed over 200 dental design and construction projects throughout Australia. Were dental design and construction specialists, its all we do, and we make it our business to stay abreast of the latest technologies, equipment and compliance requirements.From renovations to complete ground up builds, well help you to get the most out of your available space and transform your practice to work the way you do. And well do it on time and on budget.For advice on making your practice work as hard as you do, contact us today for a no obligation consultation. Your patients wont be the only ones smiling.

1300 728 133 www.medifit.com.au

MakingDentistsSmile

MEDIFIT_Bite_HPV_Ad_June2011.indd 1 4/07/11 1:40 PM

Bite 39

Tools of the tradeThis month, seeing the light, getting the bag, ditching the gag; and much, much more

Bite 39

Carry-on bag (with wheels)by Dr Clive Rogers, The Visiting Dentist, Subiaco, WA

In 1996, I had the usual suburban practice and started visiting nursing homes to give dental check-ups to the residents. This work grew until it became the main focus of my practice. I dont have a surgery now. As I travel constantly, visiting different nursing homes and their residents, I need to carry everything with me. I manage to fit all my general set of instrumentsand everything else I may requireinto a standard-sized trolley bag with wheels. Its exactly like a bag that people take as carry-on luggage in aeroplanes.

Whats good about itIt has an extendable handle that I find very handy. On occasions, I need to take an ultrasonic scaler and a drill with me. I place both of these into camera bags and stack them on top of the trolley bag, attached to the elongated handle. It means I can just trolley all three bags along while carrying other things.

Virtually everything I carry inside my trolley bag is in boxes or plastic bags. All my individually bagged and sterilised instruments are stored in one box. I also pack an extra bag that I take when Im not sure what may be involved or what path a treatment might take. It took about a year of trial and error to work out exactly what my bag should contain, though Im slightly refining it all the time.

The bag has a few external pockets to keep things like protective glasses, pens and pencils, tape recorder and other sundry equipment close at hand.

My main requirement is that the interior is one large space. At one stage I thought separate compartments and pockets would be ideal but that stopped me from having the flexibility I needed.

Whats not so goodI wish the bags had bigger wheels and sturdier extendable handles.

Where did you get itThey are available at any bag store.

Iteroby Dr Arnaldo Avenia, Dental Options, Brisbane, QLD

When I purchased my Itero last year, I was the 10th customer in Australia. Its a digital imaging system that replaces the need to take a final impression after completing a crown preparation.

Whats good about itInstead of filling the patients mouth with impression material, fitting a tray and waiting five or six minutes for it to set, you simply take a series of shots. For a single crown, about 21 images are neededeight shots of the opposing arch, 10-12 shots of the arch where the tooth is prepared, and two shots of the teeth together in occlusion. These images are then emailed directly to Canada where a machine turns all that information into a three-dimensional model. My technician receives this perfectly machined model within five working days. The crown is a perfect fit and no adjustments are necessary because its so dimensionally accurate. Each digital image produced by the Itero records 100,000 reference points. It certainly beats what we do with impression materials. Its a real time saver and patientsparticularly those with a gagging problemare much happier not facing the impression material. There is no mess and less lab work afterwards. The technicians absolutely love it. The Itero is also a mobile unit and can be shifted between surgeries.

Whats not so goodAt the moment all information is sent to the one machine in Canada. However, a new dental surgery is being built in Wagga Wagga [NSW] and the Itero people are keen to have all model production for the Southern Hemisphere manufactured there.The head size of the camera unit is quite large and can be difficult to position in some cases.

Where did you get itItero.

39Your tools Reviews

Your tools Reviews

Zeon Discovery lightby Dr David Houston, John Street Dental, Redcliffe, QLD

I started using illumination with my loupes at the beginning of