The Bulletin - Issue 59 Jun / Jul 2021 by eroomcreative.com

Issue 59 June-July 2021

The official newsletter of the Dental Hygienists Association of Australia Ltd AFTER THE AWARD

WHAT ARE YOU

REALLY

RENEW MEMBE YOUR RSHIP TODAY

WORTH?

The new Oral Health Workforce Survey from DHAA and ADOHTA holds the answers

Oral Health Literacy

One of two projects on the DHAA agenda for Federal funding

The DHAA Aged Care Chapter An ambitious challenge for the oral health profession

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

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03 3

Continually charting the waters of change

Contents 04 The aged care difference An ambitious challenge for the oral health profession.

“You can’t control the wind, but you can adjust your sail.” Cora L V Scott (1840-1923) In 2021 the DHAA celebrates a 30-year milestone as a National Association. In 1991 representatives from all DHAA state and territory branches came together and resolved to form a new overarching national body. The last 30 years has seen the wind of change blow through the oral health profession many times; and so the association and our members have adjusted our sail, grown and evolved. We are now facing change once again. As 1 July approaches, we are closing in on securing the inclusion of dental hygienists and oral health therapist in the Health Professional and Support Services Award. As with any big change, there are questions and concerns about how we will be affected; both as individuals and as a profession. Many of our members are already feeling the effect of incoming award levels and rates on current wage negotiations. One thing that I hear a lot is that members don’t feel confident in their salary negotiations. It's uncomfortable, can be intimidating, and they don’t know how to approach these kinds of discussions. While I’m certainly no expert, here are my tips for overcoming the awkwardness to negotiate like a pro: • It’s not personal – it’s business and should be treated as such. Approach any discussions with the professionalism and respect you give to your patients on a daily basis. • Do your homework - get to know the award and how it applies to you. Find out the market rates for salary. Make notes to take with you into any meetings. • Back yourself – you have so much knowledge and experience, don’t be afraid to let it shine! Again, take notes into the meeting if you feel self-conscious talking about yourself in this way. • Get expert help - reach out and use the services available to you at dhaa.info Tennis champion Arthur Ashe (1943-1993) once said “One important key to success is self-confidence. An important key to self-confidence is preparation.” So, get prepared, get confident and get ready to be successful in navigating this change! Cheryl Dey DHAA National President

07 From the top

Highlighting the year’s challenges and opportunities.

08 Oral cancer screening

How Victorians are getting supported in early detection.

10 Symposium countdown

What you can expect at this year’s national event.

12 Heading back to school

Choosing a career path in education can be rewarding.

14 Ask DHAA...

Your questions answered and knowledge shared.

COVER STORY

18 What are you really worth?

A new Oral Health Workforce Report holds the answer.

20 Taking the challenge

Two projects on the DHAA agenda for Federal funding.

26 Custom-made changes Explaining the changes to custom-made guidelines.

28 Become your own hero Cast your self in your own movie and plot your path.

32 State of the Nation

Your quarterly round-up of what's happening near you.

Key Contacts CEO Bill Suen CONTACT

PRESIDENT Cheryl Day CONTACT

MEMBERSHIP OFFICER Christina Zerk CONTACT

BULLETIN EDITOR Robyn Russell CONTACT

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

Aged care: Together we will make a difference Introducing the DHAA Aged Care Chapter – an ambitious challenge for the oral health profession in our country By Bill Suen

THE DHAA HAS taken on an enormous challenge to improve the oral health of older Australians. The Board has set an ambitious strategic goal of getting half of Australian residential aged care facilities to be serviced by a dental hygienist or oral health therapist by 2026, and 80% by 2031. To achieve these targets, an aged care chapter has been established within

the Association to develop a national approach to the practice of oral health care for older Australians. It promotes and seeks recognition for improving and supporting oral health in aged care and the provision of value-added, professional oral health services. Members of the DHAA Aged Care Chapter will demonstrate competence in oral health care to older patients. Up-to-date and relevant professional knowledge will be provided through the Chapter’s education program that covers a range of critical competences including: • Physiological changes in the oral cavity and associated systems with ageing • Behavioural changes and mental health of older people • Chronic diseases associated with

ageing and the impact and association to oral health • Pharmacological updates for older people • Speech and nutrition for older people • Denture and implant maintenance and assessment • Commonwealth and State health services for older people and their referral pathways • Informed consent, privacy and relevant legislative requirements in aged care In recognition that many DHAA members are clinicians – and therefore may have limited business skills – the DHAA will help Aged Care Chapter members to establish viable

From the Big chair When the going gets tough, quitting is not an option, says Bulletin Editor Robyn Russell

“ The chapter and education program will commence in July 2021, and DHAA members are urged to join the Aged Care Chapter when renewing their DHAA membership for 2021-2022” operations or gain employment in aged care through a range of resources, workshops, marketing and business development support. Ongoing CPD for aged care will also be provided to ensure that chapter members are kept up to date with any clinical and system developments within the Australian aged care setting. The chapter and education program will commence in July 2021, and DHAA members are urged to join the Aged Care Chapter when renewing their DHAA membership for 2021-2022. Registering for the aged care education program will equip you with the necessary knowledge and skills in dealing with the Australian aged care sector and understanding the special

needs of older patients. The education program has the generous support of many passionate and prominent leaders within the sector. These include Associate Professors Janet Wallace, Dr Mark Wotherspoon, Sarah Griffiths, Neuropsychiatrist Dr Samantha Loi, Speech Pathologist Jenni-Lee Rees, Dietitian Chris Hughes, Pharmacist Jodie Cotte. They have been working tirelessly with our hygienists and oral health therapists team Ali Taylor, Karen Smart, Shida Taheri, Lisa Bryan, Linda van Adrighem and supported by many others behind the scenes in putting the education program together. Further information is available on the DHAA website. n

Sitting in the surgeon’s office last week and listening to the recommendations for surgery on my shoulder; I was forced to consider four weeks in a sling, and eight weeks off. My mind was racing. What? No driving? No patients? No way! 'Is this injury a result of your work?' A role that relies heavily on working in a confined space for long periods of time, performing repetitive tasks where precision and accuracy are paramount. Very possibly. I’m sure I don’t have to tell you about the concomitant pain that this job can evoke for both our bodies and minds. But would you consider another profession, or your role within this profession? Again, no way!! The people, the challenges, the relationships, the health, the colleagues, the reasons to stay are infinite. While we may be able to find countless reasons to either continue or to leave our dental career, the one thing that we do not have is the luxury of time. The time to learn more, the time to do more, the time to be more, or the time to challenge ourselves. Our profession is about to navigate through some changes and possible challenges. Now is the time for us to embrace this change and move forward. As Eleanor Roosevelt once said: “Do one thing every day that scares you”. DHAA Bulletin Editor bulletin@dhaa.info

MAKING A PROPER SPLASH The DHAA hosted the first live CPD event for some time. Christina Zerk reports

SATURDAY 15 MAY was an exciting day for Queensland members as it signaled the return to face-to-face events. 'Make a Splash' was our first full day event since social distancing restrictions came into effect. After a year of cancellations and uncertainty this was a welcome break from all the Zoom meetings and online catch-ups. Hosted at the QT Hotel - Gold Coast those staying overnight before the event got to wake up to sunrise over the water or a lovely mountain view before joining us in the Sunrise room which is true to its name. It was wonderful seeing attendees greet each other in person and the whole room was buzzing. The CPD program was packed with exciting topics and started off with Amelia Seselja presenting on sustainability in dental. We all know how much plastic is used in dental and aim to reduce it but Amelia’s presentation went deeper touching on other forms of sustainability like social sustainability. How can we reduce the overall burden, the need for more complex dental procedures which require more instruments and more potential waste? Her second talk took a further look at how we can achieve social sustainability through oral health promotion. Colgate have been a massive advocate of oral health promotion for many years and attendees got an early peek at the relaunched Bright Smiles, Bright Futures oral health promotion kits that are tailored to educated children on better oral health. Shipping delays meant kits weren’t available to take home, but all attendees can head online to claim a kit and start promoting better oral health in their community.

Make a Splash was a very popular opportunity to meet up again with friends and colleagues

Tabitha Acret presented on Motivating Your Patient, which tied in wonderfully to Amelia’s presentation. Tabitha took us back to our university (or TAFE) days where oral health education and oral health instruction was a key component of every appointment. Her presentation focused on the importance of OHI and how knowing how to care for their teeth is crucial not only to maintaining healthy dentition, but also to the longevity of high-end dental work. A fun activity with Lego™ taught us that the delivery of oral health instruction is extremely important as we all scrambled to make a helicopter out of bricks having watched a video earlier that day.

Shida Taheri was our third presenter, and she took us on the journey of starting her own mobile dentistry business right before a global pandemic. She talked about what drove her to start mobile work and how she used the downtime brought on by lockdowns to increase her business and social media skills. The highlight was Shida taking us through everything that she did. Starting with what instruments and equipment she uses, her dental software, how she moves her equipment from room to room and of course the crucial sterilisation and infection control considerations. Phil from NSK then took the floor, not as a sales representative but as a fellow dental professional, to inspire us all as a part of the group of practitioners who make up a larger dental team. Dr Carol Tran then presented an update on DHAA advocacy and how we can keep the ball rolling on current campaigns to make changes to oral health. Colgate, NSK and SingleUse were all in attendance and had a range of products to show and scientific updates to go along with their range. We even got to take home some of the new fluoride varnish materials mentioned last month in the Colgate Fluoride Varnish webinar. Our final speaker for the day was Dr Meng-Wong Taing a pharmacist who finished the day off with some heavier CPD content focusing on antithrombotic medications. The venue was set up so attendees could sit enjoying the open space and mingle; and while the CPD content was fantastic, the highlight that everyone kept commenting on, was how lovely it was to be face-to-face again and enjoying each other’s company. n

FROM THE TOP

2021 continues to be a year of challenges and opportunity The DHAA are working on a number of fronts to ensure that our members are protected and supported at all costs

and leaders who generously offer their time and expertise from both within and outside our Association. The program is looking impressive, and you can be part of it and together we will make our goal a reality. (See story on page 18). 2021 also sees the return of our renowned National Symposium in Melbourne during Spring Carnival. Registrations for this highly sought-after event have been coming in

Bill Suen DHAA CEO

rapidly over the past few weeks and I would encourage you to register for the early bird discount rate as soon as possible before

TIME FLIES AND it is the month of June

we reach capacity. Many of us cannot wait

again, and we are getting close to the

to catch up for another quality educational

halfway mark of 2021! This is of significance

and networking event to learn and explore

to our profession as this is the last month

new practice and opportunities June is also membership renewal time.

before the Health Professional and Support Services award becomes enforceable for

Your DHAA membership and professional

dental hygienists and oral health therapists.

indemnity insurance are due for renewal.

There has been an increasing number of

For those who may think the renewal

members seeking advice on the new award

comes early this year. This is mostly likely

rates and some are being asked by their

due to the fact that we deferred last year’s

employers to change their employment

renewal by five months due to COVID, and

contracts. I wish to assure members that the

it may be just over half a year since you

Award merely sets the minimum rates, terms

renewed your membership last. DHAA

and conditions to protect employees, and

“The DHAA continue to keep in touch with the Commonwealth Department of Health on the provider number project”

has been working hard and we are able to

pressured or need clarifications of their

we expect some progress to be made

on hand to be able to capitalise on these

employment rights and entitlements.

soon. With the Federal election expected

while they are available. Your membership

within the next 12 months, the DHAA has

renewal is therefore the most important

together to publish the 2020-2021 Oral

stepped up our advocacy effort for oral

factor for the success the DHAA and the

Health Workforce Report, this report

health funding, particularly in aged care

immediate future of our profession.

contains current actual market rates of

and oral health literacy. In addition, we

pay for the profession. We are making this

have launched our Aged Care Chapter

membership to your colleagues, and

report public to enhance the transparency

and its education program to prepare

also transfer your professional indemnity

of market remuneration for our profession.

and support our members to service the

insurance to DHAA if you have not already

This should be a very useful reference in

residential aged care sector. The DHAA

done so. You do not need to wait for July as

the recruitment and performance review

Board should be congratulated for rising

you will be able to get immediate insurance

processes. (See story on page 16).

to confront the challenge head-on by

coverage until next renewal without any

setting an ambitious goal to have every

extra charges.

that any existing employment contracts and agreements will not be affected, provided that they are above the minimal standards set by the Award. Members are urged to seek professional advice through the DHAA Industrial Relations advice line if they feel

DHAA and ADOHTA have also worked

2021 is a year of opportunities for

plan and deliver many useful and relevant projects for members. We are most thankful to the many volunteers that help make these things happen. There are so many great opportunities ahead of us and we need every bit of help and resources

You can also help by promoting DHAA

Together we can support each other

our profession. The DHAA continues to

second residential aged care home visited

keep in touch with the Commonwealth

regularly by our members within five years.

to ensure we all enjoy a professionally

Department of Health on the provider

The program has been developed with the

satisfying and financially rewarding career

number project. While the process is slow,

support of many highly regarded experts

in oral health. n

Oral cancer screening and prevention Dental Health Services Victoria are supporting oral health professionals to detect oral cancer earlier

ral cancer continues to rise in Victoria with more than 16 people diagnosed with the disease in an average week. It is now the eighth most common cancer in men, and the fourteenth most common in women. Oral cancer includes cancers of the oral cavity and oropharynx. Around three in four cases of oral cancer are linked to modifiable risk factors, notably tobacco use and alcohol consumption. The COVID-19 pandemic saw alcohol retail sales remain elevated between the first and second lockdowns in Victoria. The pandemic is also impacting oral cancer screening and detection. Reduced access to dental and other primary healthcare services and patients deferring appointments saw head and neck cancer diagnoses, including oral cancers, drop 41 per cent last year in Victoria. Late diagnosis of oral cancer can lead to ineffective treatment and significantly worse prognosis. A strong socioeconomic gradient exists, with Aboriginal and Torres Strait Islander people and low- income earners at higher risk of these types of cancers. A further risk factor for cancer of the oropharynx is human papillomavirus (HPV). Routine oral examinations are an opportunity to identify early external signs, including neck lumps. In response, Dental Health Services Victoria (DHSV) has launched an online training resource to help Victorian oral health professionals across public and

private practice to identify people most at risk and detect oral cancer earlier. The Oral Cancer Learning Hub aims to enhance oral health professionals’ knowledge, confidence and skills in oral cancer prevention and detection. The practical, evidence-based resource supports practitioners to recognise potentially malignant lesions and refer for specialist opinion and diagnosis. It also arms oral health professionals with the information they need to have potentially life-changing conversations with patients about their individual risk. DHSV CEO Susan McKee highlights the valuable part that oral health professionals play: ”Oral health professionals are integral to the prevention and early detection of oral cancer,“ she explains. ”There’s been a steady increase in cases of oral cancer over the last 15 years. The Oral Cancer Learning Hub will enhance the skills of oral health professionals in Victoria to identify people most at risk and have essential conversations that can save lives.” Professor Michael McCullough from the University of Melbourne Dental School points out how easily screening can be incorporated into treatment: ”Oral cancer examination and risk assessment takes only a short time and is an integral part of routine care,” he says.

”Refer your patient if you suspect oral cancer or signs and symptoms persist for two weeks, even if you’re unsure. Early detection can save a person’s life.” The learning hub includes information about risk factors and prevention, a visual ‘atlas’ of suspicious lesions, examination resources, clinical case studies, referral guidance and a CPD quiz. Content was developed in partnership with experts at Dental Health Services Victoria, the University of Melbourne Dental School, the Australian Dental Association (Victorian Branch), La Trobe University Department of Dentistry and the Department of Health. The hub was produced with funding from the Department of Health in response to the increase in oral cancer in Victoria. Evaluation from the program’s 2019 training pilot with Victorian oral health professionals indicated a need for accessible oral cancer educational resources. Find out more about the Victorian Oral Cancer Screening & Prevention Program. n DISCOVER MORE... Visit the Victorian Oral Cancer Screening & Prevention Program website.

Symposium Countdown The DHAA Symposium 2021 in Melbourne is getting closer. Here's what to expect

he DHAA National Symposium is back, refreshed and packed with great education and social activities that guarantee a satisfying and rewarding experience in 2021. It will be run at the Melbourne Cup weekend right at the peak of the Melbourne Spring Carnival so attendees may also take the opportunity to experience the internationally renowned festivity that stops the nation annually.

Laneways to better oral health Our enhanced education program kicks off on Friday 29 October with our Symposium open and some exciting speakers. First up we have Dr Raahib Dudhia presenting on cone beam CT in dentistry followed by the DHAA Awards before we head off into our multi stream program with presentations to suit dental hygienists, oral health therapists, education and even some business skills. The four concurrent streams will provide choices for everyone to meet attendees’ personal CPD needs. Keynote speaker, comedy hypnotist and mind hacking expert Matt Hale, will be presenting about increasing productivity and improving your life. He joins us again on Friday evening with his hypnotism routine at our Gala Dinner! Saturday we are underway looking at our environmental footprint in dentistry before diving into some deeper topics. Dr Sharrone Zaks will be talking to us about treating survivors of sexual assault and trauma. Again the pick and choose multistream sessions will be a test for attendees in deciding their preferred session to attend.

For those keen to pick up new skills or refine existing ones, your need to get in early and choose from a range of workshops available on Thursday 28 October. There's a wide range of disciplines on offer. These include workshops covering hall crown technique, ergonomics and periodontal instrumentation, motivational interviewing, clear aligners and a local anaesthetics workshop focusing on performing a predictable IAN block. Our full program features three days of exciting CPD with something for everyone. 2021 is a year of opportunities for our profession in many areas including independent practice, aged care, research and education, rural and remote, and many new and emerging practice models. Besides the usual clinical sessions the Melbourne Symposium offers sessions specially designed for educators, early career practitioners, students and prospective business owners/practitioners. Out trade exhibition is one of the most popular trade events for dental and oral health companies. The trade exhibition will be up and running from Thursday evening at the Welcome Reception, with a range of products and updates in the trade hall to keep you busy during breaks. See the latest innovations and newest products with lots of samples and prizes to be won, and maybe score yourself a Symposium discount! The contributed poster section is usually the hidden treasure of the National Symposium. Practitioners and researchers will display their most recent work and practice experience that define future practice and trigger innovation at the grass root level. Come along to explore and find your treasure yourself.

DHAA SYMPOSIUM 2021: FEATURED SPEAKER

Dr Michael Mandikos

DR MANDIKOS is a celebrated prosthodontist with over 20 years of specialist private practice experience. He owns and operates a very successful and well-regarded practice – Brisbane Prosthodontics – that operates under the mantra of ‘we don’t just fill teeth; we restore the function and the aesthetics of your smile.’ Dr Mandikos is also heavily invested in dental

Fun, fun and more fun – all for a good cause

education and has established a purpose-built training facility

To get everyone into the festive mood, the welcome reception on Thursday evening will be a great occasion for all to dress up and show off your Spring Carnival flair. Find out who will win the best dressed title on the night. The Friday night Gala Dinner at the Crown Aviary is themed Op Shop Glam. Your participation will support a worthwhile charity which will definitely add more joy to a wonderful fun evening of dining, entertainment and dancing. For the highly energised, the night can continue downstairs at the Crown Entertainment Complex.

in Brisbane. The Australian Dental Centre of Excellence has a

A bit extra to support our members Another new feature for our National Symposium this year is the DHAA members’ market place. The 2021 DHAA Symposium stand will allow members to promote their personal enterprise to other members and symposium participants. The extension of the DHAA space will allow members to promote their products, display products or services, and even sell them. This opportunity is free of charge to DHAA members who have registered for the 2021 National Symposium. Members who want to be part of the DHAA members’ marketplace should email ceo@dhaa.info to request an application form. n

dental simulation laboratory, lecture theatre and a live-patient treatment dental chair. An impressive set-up, which operates solely to provide excellent educational opportunities for the dental profession. Dr Mandikos graduated from the University of Queensland. With a Bachelor of Dental Science and then went on the complete a Doctor of Clinical Dentistry (Dental Pros). He has been a visiting specialist prosthodontist at

“ Dr Mandikos is also heavily invested in dental education and has established a purpose-built training facility in Brisbane”

the University of Queensland for many years. He also holds the titles of Visiting Specialist at the University of Queensland Dental School, Honourary Associate at the University of Sydney Faculty of Dentistry, and was formerly a visiting specialist consultant to the Royal Australian Airforce. He is nationally and internationally renowned for his expertise in Prosthodontics and he serves as a reviewer for four international dental journals. Dr Mandikos is regularly invited to present lecture programs and clinical technique workshops at meetings across Australia and overseas.

GET YOURSELF REGISTERED EARLY Early bird rate is available until 31 July so register now and save!

We are very fortunate to have a featured speaker of Michael’s stature attend this year's DHAA Symposium to impart his very extensive knowledge.

CAREER DEVELOPMENT

Heading back to school Choosing a career path in education can be rewarding role in familiar surroundings By Melanie Hayes

WHEN HYGIENISTS AND OHTs start to consider alternate career paths, one of the first options they consider is teaching. This makes sense, given we all graduated from a higher education program and were exposed to academics, many of whom inspired us to be the clinicians we are today! Teaching can be a great opportunity to use your expertise and ‘give back’ to the next generation in the profession. Recent research has identified that one of the biggest barriers to dental practitioners embarking on an academic career is the lack of a clear career pathway (Hayes & Ingram, 2021). This is a challenge for the profession; there is

no ‘one size fits all’ approach given there are a variety of roles and opportunities for those interested in teaching. Casual work as a clinical educator or supervisor can nicely complement clinical work, and often requires sufficient experience, and a willingness to undertake some training and education on teaching in higher education (such as a Graduate Certificate). fixed-term or permanent work as a lecturer or professor has the same requirements, and often an additional commitment to engage in higher levels of education, such as a Masters or PhD. In previous editions of this column, the importance of networking and

adaptability have already been emphasised as important strategies for career change. These are also important when considering if teaching is the right career avenue for you. A great first step can be getting back in touch with your Alma Mater or with the lecturers that taught you. Ask questions about how they started their teaching roles, and find out about what skills and qualifications are needed, as this does tend to differ by institution. You might consider embarking on some further studies, or perhaps even observing, shadowing or volunteering to see if teaching is something that is the right fit for you.

Lecturer Denise Higgins with third-year oral health student Meshal using virtual reality technology

What’s the most interesting/exciting part of your role? My passion is in simulation-based education which I can apply to several courses in the degree. I can design simulation to be standardized and fair for all learners with various degrees of complexity. Simulation gives me the opportunity to utilise my creative side and apply it to academia. What was the scariest/most challenging part of choosing an alternate career path? It was difficult to leave a secure job that I loved and had been in for over 10 years. I found it challenging to make the decision about my career in two different jobs that I loved. I continue to feel challenged everyday when I confront new and different tasks.

Were there people along the way who helped you get the career you wanted? Sometime the path we take in life is A teacher’s tale determined by us or influenced by other people. I have been extremely fortunate to For this edition, I spoke with Dr Denise Higgins, an oral heath meet people in my life who had a significant therapist who currently works as a Lecturer for the Bachelor of Oral influence on what I do and the decisions I Health Therapy at the University of Newcastle. made. The significant people in my life have seen potential in me and encouraged me to set Tell us about your current role: higher career goals, push myself and achieve more. My My role includes curriculum design, delivering educational career fortune has been continuous over the years, as I content including lectures, tutorials and workshops, continue to meet generous, intelligent people who share simulation coordination and education, student their knowledge and expertise with me. Obtaining my engagement, teaching, research and designing fit-forPhD was one such significant event that would not have purpose dental and oral health simulation equipment. been achievable without the continuous, unconditional support of my supervisors. What education or experience did you need for this role? Do you have any advice for DH or OHT who are looking Initially, I needed to be an experience registered oral health for a change from clinical practice? therapist with honours and an interest in academia. As Yes, I have three pieces of advice: 1 Listen to your compassionate inner voice – it is often the years in my role progressed, I was required to gain my giving you good information PhD, a qualification in tertiary teaching and continuous 2 Find your people – surround yourself with like-minded, education in researching skills. Due to my special interest kind and uplifting people who will support you and in simulation-based education, I also completed a encourage you to be a better version of yourself, and qualification in clinical simulation which has been valuable. 3 Set an educational goal to support your career – it is never too late to learn something new which will What are the day-to-day activities in your role? contribute to a progressive career My days involve answering emails and actioning attached items, developing and evaluating course content, References: Hayes MJ, Ingram K. Australian dental designing educational sessions based on the learning practitioner perspectives on academic careers. outcomes, delivering sessions including presentations J Dent Educ. 2021;85:341–348. https://doi.org/10.1002/ and simulation, and ensuring that assessment designs are jdd.12459 fair, robust and marked on time.

AskDHAA... Dear DHAA... I would like to book in for the Symposium in Melbourne but I will have a newborn baby who will be breastfeeding more than likely, is it possible to bring the baby along? Emilia, NSW

Dear DHAA... I am a current member and want to transfer my PI insurance from another provider to DHAA. Should I wait until the existing insurance expires in July and I can renew my DHAA membership and add my PI insurance at the same time? Charlotte, Vic

This shouldn’t be a problem. While we won’t have a creche, we will have a room available for feeding and nappy changes for nursing mums and their babies. Dear DHAA... I am starting a new job next week at a general dental clinic in rural Victoria. What should be my award wage as an experienced oral health therapist? Visy, Vic

The incoming Award will commence on 1 July 2021. Please note that the award only lists MINIMUM wage rate and working conditions. It is not the benchmark. We know that the vast majority of our peers receive well above what the award stipulates, and it is not enforced until 1 July 2021. Award rate setting is based on responsibility and not years of experience - however, we do expect practitioners with more experience and skills usually

undertake jobs with more complex responsibilities. All employment contracts signed before 1 July 2021 will carry through, provided the agreed terms and wages are above the award minimum. Please refer to the Health Professionals and Support Services Award 2020 – visit the link here. Section 17 outlines the pay rates of all levels of health professionals covered by the award. Schedule A.2 provides definitions all levels of health professionals in this award. These sections should assist you to determine your MINIMUM wage from 1 July 2021. In addition DHAA and ADOHTA will publish our 2020-2021 Oral health Workforce Report which will contain market wage information to guide

members and employers in determining the appropriate remuneration levels. Dear DHAA... I renewed my DHAA membership not so long ago, why am I renewing again so soon? Sam, Qld

June each year is the annual renewal time for DHAA membership and Professional Indemnity Insurance. Due to COVID-19, DHAA Board provided relief for members in the form of a discount of 30% of membership fee and the option of deferred renewal from June 2020 to 30 November 2020. The deferred renewal was for the period 1 July 2020 to 30 June 2021. This is why it is now time to renew for the new membership period 1 July 2021 to 30 June 2022.

DHAA membership and PI insurance renewals are now available for all members. If you add PI insurance to your membership in June, you will be covered immediately for the same price, and there is no need to wait until July. Adding insurance when renewing your membership is simple. Simply go to your members profile and click renew now. Make sure the PI insurance option is checked and proceed to check out and submit payment online. Dear DHAA... I signed up for the free student membership in March last year. I tried to register for a free DHAA member webinar this morning, but the system told me that I am not a member. Can you help? James, ACT

Thank you for your query. You need to be a DHAA member to access any free webinars and workshops.

RASHID SADYKOV / UNSPLASH

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

You might have just set up an account to access the DHAA website, but this is not joining student membership, not as yet from what I can see. Please access your account by typing in your email address as username, and log in if you remember your password, if not, simply click forget password and it will email you a link to reset your password. To join, visit the DHAA website, under Membership click ‘Join Now’ and follow the prompt to select student membership and complete the registration process. Once you have done it you will receive an order confirmation email, and you can than access all membership benefits. You will then be able to go to DHAA member portal to register for any free webinars as a member. Dear DHAA... Could you please advise me if my insurance with the DHAA covers me for mobile services provided as long as I’m working within my scope of practice? Sonja, NSW

Thank you for your query. Your DHAA BMS PI insurance is not site specific. It covers your professional indemnity for practicing anywhere within Australia within your scope. Please note that PI insurance does not cover any business-related matters. Please check with your lawyer and/or accountant for any additional insurance

requirements if you are providing your mobile service as a self-employed sole trader or a company. You may wish to contact dhaa@bmsgroup.com to check if they may assist you for any additional businessrelated insurance.

Credit where credit is due THE RECENT VOLUNTEER week highlighted the wonderfully generous people that give their time and effort to planning advocacy and local CPD events for all of our members. Each state committee is led by a dedicated state chair, a deputy and a local committee supporting them in their role. Our volunteers for 2021 are as follows: • NSW: Chair - Steven Chu; Deputy Chair - Jody Inyoue • QLD: Chair - Jen Turnbull; Deputy Chair - Lizzy Horsfall

Dear DHAA... I have had issues at work with bullying and harassment which I would like to seek some advice and support. Elizabeth, WA

We're sorry to hear you're subject to bullying and harassment. There are two aspects of your request: 1. Your right and possible course of actions in accordance with various workplace legislations. If you are seeking that advice, please go to the DHAA member portal and submit an IR advice request. It is important that you complete all sections of the form as it provides important information from a legal perspective. It will then go to our industrial relations lawyer for follow up. 2. Personal peer support through the process of addressing the bullying and harassment at the workplace. We can assign an experienced local oral health professional to support you while you are addressing the issues at the workplace. Both can occur concurrently. If a peer support person is needed, please give permission for us to provide your details to the peer support volunteer. n

• VIC: Chair - Desiree Bolado (also Employment Officer); Deputy Chair - Aimee Mills • SA: Chair - Sue Tosh; Deputy Chair - Sally Hinora • WA: Chair - Carmen Jones; Deputy Chair - Rhonda Kremmer • TAS: Chair - Michael Charlton-Fitgerald Our national webinars and symposium also have dedicated teams. Our national webinar planning is done by our CPD committee which is headed up by National CPD Chair Jacquie Biggar who has been a dedicated volunteer with DHAA for almost 10 years. National symposiums are organised by separate committees with a chair and a team of volunteers. Our 2020/21 Melbourne Symposium is headed up by Ron Knevel and Deb Hume-Brown. And our 2022 Symposium planning is already underway with Michelle Kuss taking the reins. No events would go ahead without the time and effort that all of our volunteers have put into creating them. Special Interest Groups (SIG) work within their interest areas on advocacy education and planning. Each have a chair leading a team of experienced and passionate volunteers who work together to achieve better oral health for that subset of the population. These are led by the following people: • Oral Health Promotion & Public Health Committee: Ian Epondulan • Aged Care: Lynda Van Adrighem • Rural and Remote: Lyn Carman • Special Needs & Vulnerable Persons: Margie Steffens OAM The Bulletin team – led by editor Robyn Russell – are a wonderful team of writers who all put pen to paper to get stories out to our members every quarter. And last but not least is a very special group of unnamed caring, compassionate and experienced clinicians that make up our peer support group. These anonymous individuals provide a confidential shoulder to lean on for any members dealing with stressful work related concern. We thank you all for being the unsung hero's behind the scenes. The DHAA and all of our members would like to thank you for all the time and effort you give in working towards better oral health for all and supporting our members to do the same.

Introducing the Oral-B iO An electric toothbrush featuring an all-new linear magnetic drive system

ral health care professionals play an important role in empowering their patients to make decisions that fit their individual needs. Patient empowerment is defined by The World Health Organisation 'a process through which people gain greater control over decisions and actions affecting their health' (WHO, 1998). With more health knowledge, patients are better equipped to participate in managing their own health (Jørgensen CR et al. 2017). This is particularly true of oral health. Oral health care professionals have a pivotal role to support their patients in understanding the information that is out there. Especially in relation to home care products, oral health care professionals have a responsibility to try out and embrace new technologies, supporting patients in improving their oral health and enabling patients to track their progress of health improvement. Acknowledging the patient’s preferences, adapting information and ad-

vice to the patient’s style is essential for compliance and sustainable behavioural change. In addition to respectful communication and patient empowerment, technology is another tool to achieve behavioural change management. Electric toothbrushes: oscillating-rotating or sonic, with or without smart sensors, continue to grow in popularity. Clinically it has been shown that they effectively disrupt the dental biofilm. The Cochrane collaboration states that rotation oscillation brushes demonstrated a statistically significant reduction in plaque and gingivitis at both time points (Yaacob M et al. 2014). Electric toothbrushes also reduce gingival bleeding better compared to manual toothbrushes. Compared with manual toothbrushes, powered toothbrushes are more effective than manual brushes in reducing plaque and gingivitis in the long and short term (Yaacob M et al. 2014). Technology embedded in electric toothbrushes has already been used

to motivate people to brush longer and to become more effective. Smart phone applications allow users to track their technique, frequency and duration, increasing brushing effectiveness. Apps can also motivate children to brush their teeth longer through music and games. In 2021, Oral-B introduces a new electric toothbrush, the Oral-B iO. The Oral-B iO combines the clinically proven oscillating-rotating technique, unique to Oral-B, with a new linear magnetic drive system. This revolutionary technology is frictionless and quiet, leading to a brush that is preferred by many patients (... or their partners). With the gears of the older brush technology replaced with a magnetic mechanism, energy is directed straight from the drive to the bristles to remove the dental biofilm. The focussed power also creates additional micro-vibrations in the bristles. The intelligent oscillating-rotating iO brush has a novel smart pressure-sensor that indicates the correct brushing

pressure. A green light indicates correct, effective, and safe pressure, measured as between 0.8 and 2.5 Newtons. A red light indicates excess pressure on the brushing head, and a white light indicates not enough pressure. This visual feedback is integrated in the handle of the brush and emphasised in the new Oral-B smart phone application. This positive reinforcement mechanism guides patients to apply safe and effective pressure to the brush head, improving dental biofilm removal, helping patients to brush effectively without harming the gingiva. This is a major benefit for patients who are scared to brush along their gums, apply insufficient pressure, or brush too hard. The brush grabs attention via the personalised display, which provides traditional feedback about completing the required brushing time (2 minutes) and offers visual incentives such as smileys or stars. The improved Oral-B app and the

tracker technology in the Bluetooth enabled brush, allows patients to track more accurately where the brush is. In addition to the smart sensor, using the app provides additional immediate brushing guidance, leading the user around the mouth, reinforcing a surface by surface, sextant by sextant approach, leading to an increase in a patient’s awareness about brushing efficacy. The history tracking in the app can easily be integrated in the planning and tracking of the oral hygiene care. The iO toothbrush, in combination with the tracker application, is another opportunity to achieve improved oral health outcomes. Oral health care professionals continue to embrace new technologies, including phone applications, to support behavioural changes in their patient. People are getting more familiar to track steps, workouts, diet, water intake etc. It is time we consider using tracking applications or gamification to support patients in achieving better oral health.

References WHO Health promotion glossary. Geneva: World Health Organization; 1998 Jørgensen CR, Thomsen TG, Ross L, et al. What facilitates “patient empowerment” in cancer patients during follow-up: a qualitative systematic review of the literature. Qual Health Res. 2017;28:292-304 Yaacob M, Worthington HV, Deacon SA, Deery C, Walmsley AD, Robinson PG, Glenny AM. Powered versus manual toothbrushing for oral health. Cochrane Database of Systematic Reviews. 2014(6).

18 AFTER THE AWARD

WHAT ARE YOU

REALLY WORTH?

The new Oral Health Workforce Report from DHAA and ADOHTA holds the answers By Robyn Russell

he first day of July signifies the start of a new financial year. In 2021, the date also carries a great significance for the dental workforce. While the DHAA has been working tirelessly for many years to oppose the introduction of an award for its members, the power of the union movement eventually pushed MA000027 over the line. Putting aside personal bias and disappointment with the end result, accepting the possible long-term effects on the remuneration possibilities for our profession has proven difficult. The argument from the union-led push focused on the premise of creating equitable wage and entitlement conditions. While this may seem like an admirable endeavour on their part, the cynical view suggests that promoting union membership may have led this push. The award outlines hourly rates in accordance with prescribed levels of practitioner qualifications. These hourly rates seem somewhat low when compared the market rates the profession has experienced. The DHAA has responded positively with solutions to assist members during the wage negotiation process. They have teamed up with ADOHTA and created the Oral Health Workforce Survey. The impetus for this survey was to provide the profession with up-to-date and real data on the current demographics of the workforce and their rates of remuneration. This data will provide support for DHAA members during wage negotiations by providing benchmarked wage information. The dataset will be made available to all members of the dental profession, in an attempt to provide transparency for all. The workforce survey was overseen by Associate Professor Carol Tran and Nicole Stormon with the assistance of DHAA CEO Bill Suen. Over 600 dental hygienists (DH), dental therapists (DT), and oral health therapists (OHT)

contributed through a cross-sectional anonymous survey. The survey was delivered via SurveyMonkey – an online platform – and participants were given an 11-week window to respond. The survey results will be published very soon, but the DHAA are releasing this snapshot through the The Bulletin prior to the delivery of the full dataset. Currently within Australia, there are almost 5,000 registered DH, DT and OHTs, and the survey response from 600 of these practitioners demonstrates a response rate greater than 12%. The valuable data this survey illustrates includes the characteristics of each participant, including the age, gender, state and years of practice. The The data contained in the report will provide support for DHAA members during wage negotiations

survey also reports on current trends in employment type. Interestingly, when grouped as a collective (DH, OHT, DT), over half of the respondents were employed on a part-time basis. This is a phenomenon that we have all witnessed anecdotally, and one may prophesize that it has occurred due to the fact that most of the profession are female. Further reporting included the number of participants working in a private general practice and receiving compulsory entitlements as superannuation, and paid overtime. Data was gathered on additional employment benefits such as salary sacrifice, additional paid leave entitlements, reimbursement of personal expenses and above mandatory superannuation benefits from both principle and secondary places of employment.

Data was gathered from the respondents on the amount of hours worked each week – both pre-COVID and post. As expected, the data shows some movement during this time of uncertainty. The hourly wage rate was of most interest for the profession, and was also reported both pre and post COVID. Median hourly and annual earnings were recorded and compared to the Australian Bureau of Statistics data for other occupations with a skill level 1. The current remuneration for OHTs, DHs, and DTs as a collective being higher than that of the average skill level 1 employee. This important data will provide a benchmark for the dental community to work together when negotiating wage entitlements moving through the unprecedented time of award conditions. For the most part, those who employ DHs, DTs and OHTs see the true value in the potential of such a team member. Those that do not value the skill that these team members bring will possibly see the award as an opportunity to reduce the remuneration rate of these employees. The individual DH, DT and OHT must decide what they will do if faced with this situation. The DHAA strongly encourages all members of the dental workforce to become familiar with the information with the Oral Workforce Survey as it will prove to be a valuable resource and guide to fair wage determination. Our profession continues to push forward through these uncertain times of wage confidence. The commitment to excellence in all facets of clinical, communicative, and professionalism remains unwavering. The only way to determine your real worth to yourself and to your profession is through constant learning and re-evaluation. Those that we ultimately serve; our patients, will be the victors of such endeavours. n

DHAA submission for oral health challenges in 2021 With the federal election expected in the next 12 months, the DHAA has taken the opportunity to advocate for funding allocations on a couple of oral health projects. The following has been submitted to the respective federal ministers, reaffirming our commitment to aged care and oral health literacy

he Australian Federal Government has stated that chronic conditions are a continuing challenge, and it has been reported that 36% of chronic conditions in Australia are due to modifiable risk factors 1. One modifiable risk factor, which is also an individual public health concern2, is oral health3. Both chronic diseases and oral health have higher rates within priority populations groups. Poor oral health is associated with cardiovascular diseases, diabetes, chronic respiratory conditions, stroke,

oral cancers, rheumatoid arthritis, chronic kidney disease, cognitive impairment and adverse pregnancy outcomes4 5. Higher rates of poor oral health are identified among priority population groups as highlighted in the National Oral Health Plan 20152024 while these same groups are at higher risk of developing many chronic diseases6 7 Priority populations groups are also at a higher risk of multi-morbidity. This occurs when an individual has two or more chronic diseases and is of great concern as it makes treatment complex and even

more costly 8. It is estimated that 20% of Australians currently experience multimorbidity 9. Poor oral health and chronic disease contribute to the economic burden placed on the Australian healthcare system with varying degrees of these chronic diseases and oral health issues present throughout all age groups10. It is estimated that by implementing 20 cost-effective interventions over the lifetime of the Australian population born in 2003, $4.6 billion would have been spent on interventions, averting $11 billion in healthcare costs11. Arguably oral health prevention measures would be an effective intervention that could avert growing healthcare costs. In 2017-18 one in four Australians reported that the cost of dental treatment prevented them from seeking treatment while it is estimated during this same time 72,000 hospitalisations due to oral pain may have been avoided with preventive dental treatment12. Preventive oral health strategies have the potential to lessen avoidable hospitalisations, minimise the effect of poor oral health on chronic diseases and improve the quality of life of priority populations in Australia. While prevention efforts in oral health have been made more needs to be done. CHALLENGE ONE

Residential aged care facilities Research on barriers for accessing oral health care in residential aged care services in Australia revealed that while most health care providers understand and accept responsibility to provide good oral care, it receives low priority because of other competing demands for the limited time and resources available13 14 15. • Literature reviews also confirm

multiple barriers arising from the current accreditation and funding model of the Australian residential aged care sector. Some key barriers include: • Lack of legal or contractual protocols and guidelines on oral health care in residential aged care facilities (RACFs) • Dental professionals’ preference to work in well equipped practices and challenges in transportation of RACF residents to these facilities, particularly in rural and remote areas • Affordability of high cost of dental services • Little focus on holistic and collaborative approach on oral health The Australian Aged Care Quality and Safety Commission’s current Accreditation Standards 2.15 requires that “care recipients’ oral and dental health is maintained”. There is no further elaboration on mechanisms to maintain the care, measurement and evaluation of the service provided or outcome achieved. It is up to the providers to determine the type and level of care delivered. In practice, competing demands for very limited time and resources often lead to oral care being regarded as low priority and ignored.

“ Preventive oral health strategies have the potential to lessen avoidable hospitalisations, minimise the effect of poor oral health on chronic diseases and improve the quality of life of priority populations in Australia.”

Considerations to rectify current situation There is a pressing need to improve oral health among RACF residents. Additional resources assigned to this purpose are desperately needed and the following aspects must be considered to ensure efficient and effective use of resources to deliver the optimal outcome:

1: Paradigm shift Historically, dentistry adopts a treatment dominated, invasive and high-tech approach to care that is often expensive. The cost

has always been a major barrier for consumers and governments. While incorporation of dental services into the universal health coverage would allow dental services to be integrated to overall health care services and improve access, the scheme is likely to be complex and takes time to develop. A preventative, maintenance and minimal intervention approach is needed immediately to reduce the burden on the clinical paradigm that has shown to be ineffective within the current system16. Recent research has shown the success of an approach that provides RACF residents with preventative oral care, improvement in oral health literacy of residents, staff and carers, and provision of a referral pathway for timely medical care and complex dental treatment17 18.

2: Restore balance of priorities on oral care There is an urgent need to rectify the inequality of oral care in RACFs that has arisen from ongoing neglect due to other more recognised priorities within the system. This can be achieved by clear guidelines and more prescriptive directions for service providers, and appropriate incentives directly linked to provision of oral care. Recognising current barriers, it is important that additional funding for oral care at RACFs should be provided directly to dental practitioners to prevent the allocated resources being redirected to other priorities. Prescriptive oral health service requirements and outcome measurements should be mandated in RACF accreditation assessment checklists to ensure all RACFs plan and deliver the required services to their residents.

3: Oral care services to be delivered on site A preventative and maintenance oral health service is best delivered on site, as it does not require a dental chair or expensive equipment. Removing the need of transportation of residents to dental practices will improve access to services, reduce cost and administration efforts from RACFs. The on site preventative and maintenance service can be used to provide screening, early detection and intervention of oral diseases, leading to appropriate and timely referral to medical and dental services.

DHAA recommendations In order to address the existing problems that have been identified, the DHAA recommends that: • Prescriptive assessment guidelines be developed for Standard 2.15 of the Australian Aged Care Quality and Safety Commission’s Accreditation to mandate the delivery and measurement of oral care services for residents in RACFs. • Specific funding be provided directly to dental practitioners enabling on site preventative and maintenance oral care to residents dwelling in RACFs.

1 C rosland P, Ananthapavan J, Davison J, Lambert M, Carter R. The economic cost of preventable disease in Australia: a systematic review of estimates and methods. Australian and New Zealand Journal of Public Health. 2019;43(5):484-95. 2 Peres M, Macpherson, L., Weyant, R., Daly, B., Venturelli, R., Mathur,M., Listl, S., Celeste, R., GuarnizoHerreño, C., Kearns, C., Benzian, H., Allison, P., & Watt, R. Oral diseases: a global public health challenge. The Lancet. 2019;394(10194): 249-60.

“ The onsite preventative and maintenance service can be used to provide screening, early detection and intervention of oral diseases, leading to appropriate and timely referral to medical and dental services”

3 Borgnakke WS. Does Treatment of Periodontal Disease Influence Systemic Disease? Dent Clin North Am. 2015;59(4):885-917. 4C ardoso EM, Reis C, ManzanaresCéspedes MC. Chronic periodontitis, inflammatory cytokines, and interrelationship with other chronic diseases. Postgraduate Medicine. 2018;130(1):98-104. 5 Nazir MA. Prevalence of periodontal disease, its association with systemic diseases and prevention. Int J Health Sci (Qassim). 2017;11(2):72-80.

DHAA members are AHPRA registered dental practitioners with training and expertise in screening, early detection and intervention of oral diseases. They are available to provide RACFs onsite preventative and maintenance oral care services. They are well placed to liaise with staff, other health professionals and carers to improve the health and wellbeing of residents through a holistic and collaborative approach that is desperately needed. DHAA is keen to work with stakeholders and the Australian Government in shifting paradigms and

6 Health AIo, Welfare. Australia’s health 2014. Canberra: AIHW; 2014 7 Governments CoA. Australia’s National Oral Health Plan 20152024. South Australia: COAG; 2015. 8 Sheehan OC, Leff B, Ritchie CS, Garrigues SK, Li L, Saliba D, et al. A systematic literature review of the assessment of treatment burden experienced by patients and their caregivers. BMC Geriatrics. 2019;19(1):262. 9 Health AIo, Welfare. Chronic conditions and multimorbidity. Canberra: AIHW; 2020. 10 H ealth AIo, Welfare. Burden of

disease. Canberra: AIHW; 2020. 11 V os T CR, Barendregt J, Mihalopoulos C, Veerman JL, Magnus A, Cobiac L, Bertram MY, & Wallace AL. . Assessing Cost-Effectiveness in Prevention (ACE–Prevention): Final Report. University of Queensland, Brisbane and Deakin University, Melbourne. 2010 12 H ealth AIo, Welfare. Oral health and dental care in Australia. Canberra: AIHW; 2020 13 H earn L, Slack-Smith L, Oral health care in residential aged care services: barriers to engaging

as already described. Culturally and linguistically diverse (CALD) population groups are identified as a priority group in Australia and research has established that language proficiency is a barrier for this population group to access dental care20. According to the most recent census 21% of Australians do not report English as their primary language and 2.8% identified as Aboriginal or Torres Strait Islander 21. Furthermore, recent research has identified the average reading level of Australian is at a year 6 level 22. This necessitates the need for health information to be accessible and easy to understand. Studies show that when information is not understood it leads to no information or inaccurate information being transmitted and this is higher in priority population groups 23.

innovating to address the longstanding neglect of oral care for residents of RACFs. CHALLENGE TWO

Oral health literacy Research demonstrates that low oral health literacy is associated with poorer oral health outcomes19. This establishes the need to increase oral health literacy among priority populations groups and those living with chronic diseases as this has the potential to improve both their oral health and their general health

health-care providers, Australian Journal of Primary Health, 2015 (21) 148–156 14 H opcraft M, Morgan M, Satur J, Wright F, Dental service provision in Victorian residential aged care facilities. Australian Dental Journal , 2008 239–245. 15 Webb B, Whittle T, Schwarz E, Provision of dental care in aged care facilities, NSW, Australia – Part 1 as perceived by the Directors of Nursing (care providers). Gerodontology, 2013 (30) 226–231 16 W att R, Daly B, Allison P et al,

DHAA recommendations

Why invest in oral health prevention?

The Department of Health states one of their objectives is to increase focus on health promotion and prevention. In accordance with this the DHAA proposes the following recommendations for oral health prevention in the public sector: • Develop a multi-lingual website with oral health information and instruction. The languages would align with commonly spoken languages in Australia and include pictorial resources for Aboriginal and Torres Straight Islander people groups. Feedback would be sought on the readability from priority population groups in addition to a feedback form on the website as unidirectional communication has been proven to increase the efficacy of communication. • Award a grant for oral health professionals to develop health promotion activities among CALD population groups.

• Decrease the economic impact of poor oral health and its effect on chronic diseases • Increase prevention among priority groups who are at higher risk of poor oral health and chronic diseases • Increase oral health resources for the general Australian population

Feedback on readability should be sought from vulnerable populations so that the transmission of information is no longer uni-directional, and the efficacy of communication can be evaluated to enhance the readability of future communications. n

Ending the neglect of global oral health: time for radical action, The Lancet, 2019 (394) 261-272 17 Wallace J, Mohammadi J, Wallace L, Taylor J, Senior Smiles: preliminary results for a new model of oral health care utilizing the dental hygienist in residential aged care facilities, International Journal of Dental Hygiene, 2015, 1-5 18 H opcraft M, Morgan M, Satur J, Wright F, Utilising dental hygienists to undertake dental examinations and referrals in residential aged care facilities, Community Dental

and Oral Epidemiology, 2011 (39) 378-384 19 B askaradoss JK. Relationship between oral health literacy and oral health status. BMC Oral Health. 2018;18(1):172 20 H oang H, Feike S, Lynden T, Barnett T, Crocombe L. Oral health needs of older migrants with culturally and linguistically diverse backgrounds in developed countries: A systematic review. Australasian Journal on Ageing. 2020;39(3):193-208. 21 S tatistics ABo. Census reveals a fast changing, culturally diverse

nation. ACT; 2017 June 17. 22 F erguson C, Merga M, Winn S. Communications in the time of a pandemic: the readability of documents for public consumption. Australian and New Zealand Journal of Public Health.n/a(n/a). 23 F erguson C, Merga M, Winn S. Communications in the time of a pandemic: the readability of documents for public consumption. Australian and New Zealand Journal of Public Health. n/a (n/a).

PROMOTION 24

Quality Quality over over quantity quantity

Moira Crawford speaks to Professor Robert Hill and asks how less fluoride Moira Crawford speaks to Professor Robert Hill and asks how less fluoride can actually be more can actually be more

luoride has long been seen as the ‘magic in dental protection. luoridebullet’ has long been seen as the Since its effect in reducing tooth decay has ‘magic bullet’ in dental protection. Since been recognised, patients its effect in reducing toothhave decaywidely has been advised to use a toothpaste been recognised, patients containing have widely fluoride on a daily basis. It has alsocontaining generally been advised to use a toothpaste been accepted thatbasis. the higher the generally level of fluoride on a daily It has also fluoride, the more the the toothpaste been accepted thateffective the higher level of at remineralising enamel, so fluoride, the moredamaged effective tooth the toothpaste while most regular toothpastes fluoride at remineralising damaged toothcontain enamel, so at around parts per millioncontain (ppm), fluoride while most1,450 regular toothpastes prescription toothpastes contain fluoride in at around 1,450 parts per can million (ppm), concentrations of up to 5,000ppm. prescription toothpastes can contain fluoride in Fluoride treatments varnishes are applied concentrations of up and to 5,000ppm. toFluoride the teeth of children at varnishes risk of caries, in treatments and are and applied several regions fluoride at hasrisk been addedand to the to the teeth of children of caries, in water tofluoride improvehas thebeen dental health severalsupply regions added to of the local people. water supply to improve the dental health of There’s no doubt that the introduction of local people. fluoride a beneficial effect on theofrates of There’shas no had doubt that the introduction decay, especially children deprived fluoride has had aamong beneficial effectfrom on the rates of backgrounds, butamong it may be time to reassess the decay, especially children from deprived levels of fluoride that are given. Too much fluoride, backgrounds, but it may be time to reassess the caused by that fluoride treatment or children levels ofeither fluoride are given. Too much fluoride, ingesting toothpaste, cantreatment cause fluorosis. In some caused either by fluoride or children parts of the world there a strong anti-fluoride ingesting toothpaste, caniscause fluorosis. In some lobby,ofinthe theworld UK scientists now arguing parts there is aare strong anti-fluoride that concentrations of fluoride alone lobby,high in the UK scientists are now arguing are actually not the best strategy. that high concentrations of fluoride alone Professor Robert Hill, best research director at the are actually not the strategy. Dental Institute andHill, head of dental physical Professor Robert research director at the sciencesInstitute at Queen London, Dental andMary headUniversity of dentalof physical has beenatresearching thisUniversity area for some years, sciences Queen Mary of London, and is convinced that this applying ever higher has been researching area for some years, concentrations ofthat fluoride to theever teeth does and is convinced applying higher not have the benefit that has previously been concentrations of fluoride to the teeth does believed. increasing amount been of fluoride not have ‘Simply the benefit that hasthe previously within the‘Simply toothpaste is frankly crude solution, ’ believed. increasing the aamount of fluoride he argues. of theisadditional soluble fluoride within the ‘Much toothpaste frankly a crude solution, ’ just goes to‘Much waste.of’ the additional soluble fluoride he argues. Professor and’ his team have been working just goes toHill waste. onProfessor bioactiveHill glasses, initially developed for bone and his team have been working grafting, and glasses, have developed a toothpaste on bioactive initially developed for bone that contains a bioactive glassathat delivers a grafting, and have developed toothpaste combination calcium, phosphate and fluoride that contains of a bioactive glass that delivers a ions to promote effectivephosphate remineralisation combination of calcium, and fluoride of tooth enamel effective through the production of ions to promote remineralisation fluorapatite, the fluoride of natural of tooth enamel throughanalogue the production of tooth mineral. fluorideofinnatural Biomin F is fluorapatite, theBecause fluoridethe analogue incorporated thethe structure glass,Fitis tooth mineral.within Because fluorideofinthe Biomin is delivered gradually as the glass dissolves, andit incorporated within the structure of the glass, therefore a lower concentration (approximately is delivered gradually as the glass dissolves, and therefore a lower concentration (approximately

equivalent to 500ppm) is required, yet is actually more effective. equivalent to 500ppm) is required, yet is actually more effective. The problem with fluoride toothpaste Professor Hill’s experiments have demonstrated The problem with fluoride toothpaste

that whenHill’s conventional fluoride Professor experiments have toothpaste demonstrated containing a soluble fluoride suchtoothpaste as sodium that when conventional fluoride fluoride or sodium monofluorophosphate is containing a soluble fluoride such as sodium used, there is an immediate ‘high’ of fluoride fluoride or sodium monofluorophosphate is in the mouth, but this drops rapidly as the in used, there is anthat immediate ‘high’ of fluoride toothpaste washed away by salivary flow, the mouth, is but that this drops rapidly as theso that after around only away 100 minutes theflow, amount toothpaste is washed by salivary so of fluoride that remains is below therapeutic that after around only 100 minutes the amount levels (Figure 1).remains Even at ishigh concentrations, of fluoride that below therapeutic the fluoride rapidly away, so the effect levels (Figureis1). Even washed at high concentrations, is only shortisterm. Fluoride varnish, is only the fluoride rapidly washed away,too, so the effect effective for aterm. few days. is only short Fluoride varnish, too, is only A further is that high concentrations effective fordrawback a few days. ofAfluoride calcium fluoride known as furtherform drawback is that high(also concentrations fluorite) instead fluorapatite, what is of fluoride form of calcium fluoridewhich (also is known as required for effective remineralisation. largeis fluorite) instead of fluorapatite, which isInwhat quantities canremineralisation. form a whitish crust on the required forfluorite effective In large tooth surface, which was previously thought quantities fluorite can form a whitish crust onto the act as surface, a reservoir of fluoride, but Professor Hill’to s tooth which was previously thought act as a reservoir of fluoride, but Professor Hill’s

Figure 1: Soluble fluoride drops rapidly below therapeutic levels Figure 1: Soluble fluoride drops rapidly below therapeutic levels

research has shown that this is not the case. ‘It is completely andthis does notthe release research hasinsoluble, shown that is not case.fluoride ‘It is at all,’ he explains. By contrast, thenot fluoride completely insoluble, and does releasecontained fluoride within glass structure of Biomin F is released at all,’ hethe explains. By contrast, the fluoride contained slowly around 12 hours and is therefore used within over the glass structure of Biomin F is released more effectively. ‘ A s it dissolves, the glass structure slowly over around 12 hours and is therefore used in Biomin F provides slow release for the more effectively. ‘As itadissolves, the vehicle glass structure fluoride, andaphosphate together, in Biomincalcium F provides slow release vehicle enabling for the itfluoride, to formcalcium fluorapatite, which is more stableenabling and and phosphate together, resistant acid conditions, ’ he it to formtofluorapatite, which is says. more stable and resistant to acid conditions,’ he says. How fluoride works in Biomin F Biomin F has been developed to address three How fluoride works in Biomin F

key problems in dental health: to hypersensitivity, Biomin F has been developed address three caries and dental erosion, caused by loss of key problems in dental health: hypersensitivity, tooth or demineralisation. Under normal caries enamel and dental erosion, caused by loss of conditions, theorhydroxyapatite mineral in normal tooth tooth enamel demineralisation. Under enamel is inthe dynamic equilibrium with the conditions, hydroxyapatite mineral in tooth calcium, hydroxyl ions saliva, enamel isphosphate in dynamicand equilibrium with in the but under acidic conditions, such ions as following calcium, phosphate and hydroxyl in saliva,an acidic drink,acidic this equilibrium is shifted, the pH in but under conditions, such as following an the mouth demineralisation acidic drink,falls thisand equilibrium is shifted,can theoccur. pH in Asmouth the bioactive in Biomin F gradually the falls andglass demineralisation can occur. dissolves, releasingglass phosphate, calcium and As the bioactive in Biomin F gradually fluoride these phosphate, work in concert withand the saliva dissolves,ions, releasing calcium to restore thethese equilibrium. more clever, at fluoride ions, work inEven concert with the saliva atolower pHthe theequilibrium. glass dissolves that the restore Evenfaster, moresoclever, at effect in more a lowerkicks pH the glassrapidly. dissolves faster, so that the Professor summarises: effect kicks Hill in more rapidly. ‘This smart response means thatHill if the user consumes an acidic drink, Professor summarises: ‘This smart response Biomin F dissolves faster to protect teeth means that if the user consumes anthe acidic drink, against dissolution. Biomin Facid dissolves faster’ to protect the teeth Prior toacid thedissolution. launch of Biomin F, bioactive glasses against ’ had already introduced the dental Prior to thebeen launch of Biomininto F, bioactive glasses arena. Thesebeen conventional bioactive had already introduced into theglasses dental(eg, Novamin) form hydroxyapatite material in the arena. These conventional bioactive glasses (eg, mouth, butform this hydroxyapatite is less stable and less resistant Novamin) material in the to acid than fluorapatite. The difference Biomin mouth, but this is less stable and less with resistant to Facid is that has been within the thanfluoride fluorapatite. The incorporated difference with Biomin structure of the glass itself and, to aid and speed F is that fluoride has been incorporated within the remineralisation, the phosphate been structure of the glass itself and, tocontent aid andhas speed significantly increased. remineralisation, the phosphate content has been significantly increased. Rigorous testing Professor labs at Queen Mary University RigorousHill’s testing

Figure 2: How Biomin works Figure 2: How Biomin works

of LondonHill’s use labs state-of-the-art equipment for Professor at Queen Mary University analysis anduse have tested and timed the action of London state-of-the-art equipment for of Biomin F both bufferand solution, analysis and haveintested timedcontaining the action no calciumF or phosphate and in artificial of Biomin both in bufferions, solution, containing saliva (AS). The effects were impressive. In buffer, no calcium or phosphate ions, and in artificial the glass to fluorapatite in around six saliva (AS).converts The effects were impressive. In buffer, hours, butconverts in artificial saliva this starts occurring the glass to fluorapatite in around six in hours, but in artificial saliva this starts occurring in

Figure 3a: Scanning electron micrograph image showing tubule occlusion before brushing with Figure Biomin3a: F Scanning electron micrograph image showing tubule occlusion before brushing with Biomin F

Figure 3b: Scanning electron micrograph image showing tubule occlusion after brushing with Figure Biomin3b: F Scanning electron micrograph image showing tubule occlusion after brushing with Biomin F

Figure 5a: Scanning electron micrograph image showing tubule occlusion before acid challenge Figure 5a: Scanning electron micrograph image showing tubule occlusion before acid challenge

Figure 5b: Scanning electron micrograph image showing tubule occlusion after acid challenge Figure 5b: Scanning electron micrograph image showing tubule occlusion after acid challenge

under an hour after brushing, as shown by X-ray diffraction. under an hour after brushing, as shown by X-ray The structure of hydroxyapatite and fluorapatite diffraction. is The verystructure similar, and cannot be distinguished of hydroxyapatite and fluorapatite using techniques but, according to is veryconventional similar, and cannot be distinguished Professor Hill, Queentechniques Mary has abut, dedicated probe using conventional according to for its NMR spectrometer, the teamprobe to Professor Hill, Queen Maryallowing has a dedicated measure fluorine and study how it converts for its NMR spectrometer, allowing the teamto to fluorapatite – important because of its increased measure fluorine and study how it converts to stability and–acid resistance. Here too was fluorapatite important because of itsitincreased possibleand to see that the fluoride converted stability acid resistance. Hereistoo it was to fluorapatite in around hours in and to possible to see that thesixfluoride is buffer converted under 45 minutes in AS. F continues fluorapatite in around sixBiomin hours in buffer andto remineralise toothin enamel for approximately under 45 minutes AS. Biomin F continues to12 hours but some effects are still continuing at 24 remineralise tooth enamel for approximately 12 hours but aftersome brushing. hours effects are still continuing at 24 In order the glass to dissolve slowly where hours afterfor brushing. it’sInneeded, has to slowly stay onwhere the order forthe thetoothpaste glass to dissolve teeth. The polymer used in Biomin F increases it’s needed, the toothpaste has to stay on the the viscosity the toothpaste, but alsoFchemically teeth. Theofpolymer used in Biomin increases the bonds to both the calcium in tooth enamel viscosity of the toothpaste, butthe also chemically and thetocalcium in calcium the Biomin F, sotooth that enamel it sticks bonds both the in the

to the tooth surface and remains in place to release the fluoride, and phosphate to the tooth surface calcium and remains in place to ions for several hours (Figure 2). As the glass particle release the fluoride, calcium and phosphate ions size is very small, these particles are ableparticle to for several hours (Figure 2). As the glass enteris the tubules and work to occlude size verydentinal small, these particles are able to these the (Figures 3a and 3b). Fluorapatite enter dentinal tubules and work toforms occlude preferentially rich walls of the these (Figureson 3athe andapatite 3b). Fluorapatite forms peritubular dentine within the tubules (Figure preferentially on the apatite rich walls of the 4) gradually occluding them, an still(Figure visible 4) peritubular dentine within theeffect tubules after acid challenge and 5b). Professor gradually occluding (Figures them, an5aeffect still visible Hill and research (Figures team believe that after acidhischallenge 5a and 5b).fluorapatite Professor crystals favour growing the existing Hill and probably his research team believeon that fluorapatite apatite-rich walls favour of the dentinal which crystals probably growingtubules, on the existing have a higher mineral content. apatite-rich walls of the dentinal tubules, which As the fluorapatite have a higher mineraloccludes content.the dentinal tubules, reduces the flow of fluid through As the itfluorapatite occludes the dentinal them, known as hydraulic which tubules, it reduces the flowconductance, of fluid through is the cause sensitivity. in the Queen them, knownofas hydraulicStudies conductance, which Mary have shown that the fluorapatite is the labs cause of sensitivity. Studies in the Queen formed byhave the dissolution thefluorapatite glass in Mary labs shown thatofthe Biomin F is more resistant to acid challenge formed by the dissolution of the glass in than hydroxycarbonated from Biomin F is more resistantapatite to acidformed challenge

and the calcium in the Biomin F, so that it sticks

than hydroxycarbonated apatite formed from

Figure 4: Schematic image of tubule occlusion. Fluorapatite forms preferentially on the apatiteFigure 4: Schematic image ofdentine tubule occlusion. rich walls of the peritubular within the Fluorapatite forms preferentially on the apatitetubule rich walls of the peritubular dentine within the tubule

soluble fluoride in conventional toothpastes, and so the tubules occluded toothpastes, more soluble fluorideremain in conventional and completely. The hydraulic conductance so the tubules remain occluded more shows acompletely. greater percentage reduction as well as faster The hydraulic conductance shows remineralisation rates than other toothpastes a greater percentage reduction as well as faster tested, says Professor (Figure remineralisation ratesHill than other6).toothpastes tested, says Professor Hill (Figure 6). Professor Hill and his research team’s work in developing Biomin F has shownteam’s clearlywork that itinis Professor Hill and his research not quantity of fluoride that improves its efficacy, developing Biomin F has shown clearly that it is but quality – of thefluoride way that it isimproves delivered. not quantity that its efficacy, Incorporating the structure of but quality – thefluoride way thatwithin it is delivered. the bioactive glass, combining with phosphate Incorporating fluoride within itthe structure of and calcium ions to enable quicker production of the bioactive glass, combining it with phosphate stable, acid-resistant fluorapatite, and adhering and calcium ions to enable quicker production of the product to the teeth so that it and can dissolve stable, acid-resistant fluorapatite, adhering slowly wheretoit the canteeth deposit fluorapatite most the product so that it can dissolve effectively, is the keydeposit to its effectiveness. slowly where it can fluorapatite most Biomin F isis athe smart using new effectively, key toothpaste, to its effectiveness. technology to deliver efficient remineralisation at Biomin F is a smart toothpaste, using new levels of fluoride far lower than conventional technology to deliver efficient remineralisation at toothpastes. It seems that inthan thisconventional case, less fluoride levels of fluoride far lower really can be Itmore! toothpastes. seems that in this case, less fluoride really can be more!

Custom-made changes There have been regulatory changes to the guidelines for custom-made medical devices that are used in dentistry. So, what does this mean for DHAA members? By Bill Suen

Personalised medical devices

s part of the Commonwealth Department of changes came into force on 25 February 2021, the TGA offers Health, the Therapeutics Good Administration a transition period that extends to 1 November 2024 for (TGA) is responsible for regulating the supply, compliance. However, affected practitioners or organisations import, export, manufacturing and advertising of must notify the TGA by 25 August 2021 to access transition therapeutic goods. The TGA keeps at the Australian Register arrangements. of Therapeutic Goods (ARTG) that contains a list of therapies Under the TGA, medical devices are classified according to the goods that can be supplied lawfully in Australia. level of harm they may pose to users or patients. (See table 2). Therapeutic goods cover medicines, biologicals and a wide The recording, reporting, quality control and compliance variety of medical devices that include many instruments, requirements vary with the different classifications. implants, prosthetics and appliances commonly used in The Global Medical Device Nomenclature (GMDN) is an dentistry. international system used to identify and classify medical Under the previous medical devices’ regulatory framework, devices. The TGA use the GMDN system as one of the criteria custom-made medical devices were exempt from the to distinguish one kind of medical device from another. requirements to be included in the ARTG. A new regulatory 25 February 2021 framework came into force on Regulatory amendments commence 25 February 2021. (See table 1). The impact of these Custom-made medical devices Custom-made medical devices (new definition) changes is that the majority of Exempt from inclusion in the ARTG Exempt from inclusion in the ARTG the devices currently supplied under the custom-made Patient-matched medical devices medical device exemption will Must be included in the ARTG no longer be eligible for supply this way. Most dental devices Devices produced using a Medical Device manufactured and supplied Production System (MDPS) to patients via dental labs and clinics are now included in the Adaptable medical devices Adaptable medical devices category of patient matched Must be included in the ARTG Must be included in the ARTG medical devices. While the TABLE 1

All medical devices entered on the Australian Register of Therapeutic Goods (ARTG) will have an associated GMDN code. Given the complexity of the new regulatory framework and the possible widespread impact on dentistry, seven peak industry groups representing the dental and oral health sector, including DHAA, were invited to participate in a workshop convened by the Therapeutic Goods Administration (TGA) on 1 April 2021 to discuss concerns arising for the sector from the implementation of the new regulatory framework for personalised medical devices. Key points discussed at the workshop included: nT he level of understanding across the dental and oral health sector about the Australian regulatory framework for medical devices and requirements associated with the previous exemption for custom-made medical devices. nT he definition of a medical device and how this relates to dental products. nT he regulatory obligations for suppliers and manufacturers of patient-matched medical devices under the new regulatory framework. nE nsuring consumer safety while balancing regulatory burden. Medical device classification

Level of potential harm

n Class I

n Lowest

n Class Is, Class Im

n Low

n Class IIa

n Low to moderate

n Class IIb

n Moderate to high

n Class III, AIMD

n High

“ The impact of these changes is that the majority of the devices currently supplied under the custom-made medical device exemption will no longer be eligible for supply this way.”

TABLE 2

The working group will continue to work closely with the TGA over the coming months, providing input, advice and feedback on approaches to managing the concerns raised by the sector. The TGA, in conjunction with the working committee have proposed a scope of works for consultation and includes the following action items:nR eviewing various dental devices to reduce the number of GMDN codes by broadening the definition to include similar devices in each code. nR eviewing the devices and associated GMDN codes to classify them in the lowest possible class level within the system, or to exclude them where possible within the new framework. For example, whitening trays and mouthguards are deemed not for therapeutic use, while others are regarded as ‘raw materials’, not medical devices, and as such are all excluded from the regulatory framework. nC larifying the compliance assessment requirements for the classes of devices, and negotiating ways to meet the requirements. nP reparing dental guidelines with practical examples to advice the dental sector. From the information on hand so far, the following points should be noted by DHAA members: nS upply of whitening trays and mouthguards (when not used for therapeutic purposes) are not regulated under the current TGA regulatory framework. nT he entities (and the persons in charge) that manufacture and/or supply the dental devices covered by the framework is responsible to ensure the devices are included in the ARTG and all compliance requirements met. nN otification of devices for transition extension must be submitted to the TGA by 25 August 2021. nF ull compliance of the regulatory framework by 1 November 2024. nT GA Dental Devices Guidelines will be released in the coming weeks. An information session will be provided via ZOOM once the dental guidelines are launched, to offer an opportunity for DHAA members to seek clarifications with TGA. The details will be emailed to all members in due course. DHAA will continue to update members on any further developments. n

Download the Australian Government Department of Health guidelines here

Become the hero of your story

Cast yourself in your own movie screenplay and plot your own hero's journey By Lyn Carmen

29 “We must let go of the life we have planned, so as to accept the one that is waiting for us.”

PHOTO: HELLO I'M NIK / UNSPLASH

1 Joseph Campbell, The Hero with a Thousand Faces (1949) Pg 23

Joseph Campbell

CONSIDER ALL THE MOVIES and stories you know of epic adventure - where your heart is swayed and your mind is challenged as you are carried along with a character whose story begins with a mostly average existence to dizzying heights of bravery, courage and everything in between. Think of Luke in Star Wars, Neo in The Matrix and Dorothy in The Wizard of Oz - there are many more movies, from Middle Earth to the Marvel Universe. These stories all follow the same mythological sequence – they are identical; they all contain within them the same characters, who have the same attributes, strengths, and weaknesses; they have the same dark moments, they all get stuck in the middle or a dark place; they save themselves physically and only realise in the end, triumphantly, it was always the mind that mattered. “A hero ventures forth from the world of common day into a region of supernatural wonder: fabulous forces are there encountered, and a decisive victory is won: the hero comes back from this mysterious adventure with the power to bestow boons on his fellow man.” 1 How many times have you been deeply touched by a character’s experience and think about how many times we are influenced by these stories throughout our lives? Essentially, the hero’s journey is a quest. A search Recognising the for answers, for clarity, and desire to create stages of the meaningful circumstances. Ultimately, the hero’s Hero’s Journey. journey is about transformation; and we can all be the heroes of our own story, no matter where we find ourselves today. When you are willing and courageous enough to venture out, explore new territory and face the unknown, you are on your way to becoming your own hero. It’s not about how strong you are, how well you can do ‘it’, or how many resources you have; It's about navigating your current condition, to face the unknown territory and view your life as a heroic journey. Depending on your circumstances, you may be thinking of yourself as anything from: 'Yes I am a hero – the creator of my story’; all the way to ‘I am an un-named helpless extra in the story, waiting to be rescued by a real hero’.

There is no right or wrong. Whatever stage you're at in your own journey, just remember that most heroes start out with an average existence in the ordinary world. In fact it’s likely that you have felt both extremes and nearly every stage in between. You may have also realised that staying in the role of the ‘extra’ is a story that serves no-one and nothing. To become the hero of your story, there are three things you must accept as true: 1. You are the hero of your own story. 2. You have the power to change your narrative. 3. You will fail - in fact, you must fail - but you must also refuse to give up. Do what it takes to accept these truths. Write them down; put them on your mirror; say it often. It is what a hero would do, after all. 😉 A strong mindset is the compass for your journey, and simply follow and recognise where you are on the map. Look at the Hero's Journey wheel. What part are you up to? Be completely honest about where you are right now and where you need to go next - you have the compass, now follow the map. Identify where you are on the (simplified) Hero’s Journey: Part 1: The Call to Adventure - A hesitant step towards something new. Part 2: The Trials and Initiation - Finding guides and mentors to navigate the path through. Part 3: The Test and Transformation - Realisation of growth and capability. Part 4: The Heroic Return - Acceptance, mastery and a new normal. In each part there are tests; there is doubt; and there is commitment to progress and, of course, there is refusal to return to the old normal. A true hero isn’t made from their successes but from their refusal to give in to their failures. Remind yourself of the three accepted truths, identify what part of your story you are writing and aim to progress to victory. Be the hero of your story! The simplified Hero’s Journey is based on Joseph Campbell’s monomyth from his book, ‘The Hero with A Thousand Faces’.

Employment placement done right

here are three basic elements needed to motivate people and enhance their wellbeing – a sense of competence, a sense of autonomy and a sense of relatedness. If these exist in any job, workplace satisfaction and productivity are all likely to improve. Meeting your needs for a role which ticks many of your boxes, can be a challenge to say the least. Helping individuals and workplaces meet their employment needs is a purpose of mine and I would love to share how we can match those needs. Who here reading this, has ever questioned if they are in the right place? I wonder, who has questioned; if it’s the right profession, the right job, the right practice? I know I have at various times throughout my career spanning over three decades as a dental hygienist. For me, work has been spent focusing on ‘people stuff’. I am grateful to have, I believe, great technical skills thanks to wonderful teachers and mentors and yet it’s the people who make my world turn. Having worked in some terrific places with fabulous mentors and wonderful people who attended as patients... I’ve often thought we could do this better! Work could be better for all of us, more inclusive, more about the people, more real! Which is what prompted me to purchase my own practice, not once but twice. When workplaces are driven by the dollars alone and people feel undervalued, underutilised (minimal use of their skill set), burnt out and chasing their tail, with no sense of belonging… making those dollars becomes harder, more stressful and impact our relationships outside of work. When the conversation shifts from purely economics and includes purpose and belonging then, I believe, our workplaces become more equitable, more prosperous and better for the communities we serve. I wonder if you agree. A large part of our adult life is spent ‘at work’, in some cases it may be over 100,000 hours - 2000 hours per year! Work is a large part of our existence,

our identity, our financial independence, and ultimately, our overall wellbeing. The impact a pandemic has had on our thinking has been profound. For many of us we are questioning our happiness at our place of work, what gets us up out of bed in the morning ready to give our best; what makes us feel valued and part of a team, inspired and energised to use our hands, minds and hearts to contribute to the communities and create a ‘happy’ workplace. Lync Squad was born out a need for an innovative approach to matching employment requirements for individuals and workplaces and supporting them here. A specific oral health care squad, matching needs – for all roles in the team. • For urgent temps who can be on call to support for unplanned absences. • Short or long-term placements – for temporary holiday, or leave cover or to increase capacity. • Permanent placements for ‘forever’ team members. • When specific oral health knowledge is required for other businesses.

Pro Membership: For employers Finding the right players and managing the team can be one of the biggest and most expensive headaches ongoing – and it does not have to be this way! Being a Lync Squad member introduces employers to people who are a match for their workplace. Access to specific step by step guides to elevate practices and processes working towards a harmonious and productive ideal day, every day. A network of people and specific team workshops and resources are constantly being designed and available to access. Understanding your needs and culture helps us to connect you with people who are a specific match for who you need and when. Register with a yearly membership and a one-off fee for placement.

Player Membership: For individuals Finding the ideal workplace, a specific match for what you are seeking can be tough, feeling unappreciated and knowing you have so much more to give, can affect your every waking moment – and it does not have to be this way. Understanding your specific needs and values helps us to connect you with employers who are offering what you seek and support you to be the best you can be. If there are gaps in how to achieve your best with confidence and clarity Lync Squad membership will provide you with a community of professionals, who support each other and contribute to expanding our professional and individual value. With a large network of mentors and providers, specific training can be provided in areas to build your skill set. Access to all this with a yearly membership. Student Membership also available.

Together let’s build an oral health profession utilising our passions, strengths and expertise, attract people into and one we are all proud to thrive in. Lyn Carman Owner and founder of Lync Squad

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

STATE NATION ACT

NSW

ACT contacts: Director Amy McDermott directoract@dhaa.info

NSW contacts: Director Warrick Edwards directornsw@dhaa.info

Staff Bill Suen bill.suen@dhaa.info

Chair Steven Chu chairnsw@dhaa.info

n Following the booked out May GC workshops at the National Canberra Arboretum at Molonglo Valley, the ACT Committee is busy planning the next get together later in the year. CEO Bill Suen attended the ACT Allied Health Professional Associations Forum on 16 March. The Chief Allied Officer Dr Helen Matthes led a panel to brief the ACT Allied Health sector on various health service planning and allied health projects. You may view the recording of the forum here: There will be an ACT members only briefing session to be run virtually in June/July to provide a forum for updates and feedback on ACT specific matters. The details will be emailed to ACT members in due course. ACT members are encouraged to attend and be more engaged in the planning of events and also providing input on the advocacy front for both the Association and our profession.

Deputy Chair Jody Inouye contactnsw@dhaa.info

n The Hunter Valley full day event was again fully booked early, and the NSW Chair Steven Chu expressed his apology to colleagues who missed out due to the capacity of the venue. Feedback from attendees was excellent, particularly the quality of the highly regarded presenters including Professors Ian Myers, Deborah Cockrell, Dr Alexander Holden and Tabitha Acret. The next event will be a join DHAA & ADOHTA full-day event at the Rydges World Square, Sydney following the theme ‘professional pride’. Evidencebased presentations will be delivered by gurus such as Professor Laurie Walsh on enamel defects, lifestyles and oral health. Rochelle McPherson will deliver content on orofacial myofunctional therapy . Dr Lizzy Hua on the linkage between

periodontal diseases and systemic conditions, and Karyn Gardner on risk management and infection control. Attendees will also hear from Andrew Terry on appropriate use of respectful language and appropriate approaches for health practitioners working with the LGBTIQA+ community. Early registration to the event is highly recommended to secure a place - click here.

NT NT Contact: Staff Bill Suen bill.suen@dhaa.info

n NT members attended a special NT members only virtual meeting on 22 February to discuss CPD needs, and advocacy work locally. Arrangements had been made for DHAA members to access ADA NT CPD programs, with the first event on Socket Grafting held at the Darwin Sailing Club. The next ADA NT event available to DHAA members is a full-day on Sports Dentistry event on Saturday 19 June at Hilton Hotel Esplanade Darwin. The topics include dental trauma management and prevention, mouthguard, diet

and lifestyle impact on oral health. Event registration here. With the Darwin Convention Centre being confirmed as the venue for the 2022 DHAA Symposium. Work has already begun with the help of NT member Leonie Brown as the local representative at the symposium organising committee. Other NT members are encouraged to be involved. If you are interested or requiring more information about the Darwin symposium, please email ceo@dhaa.info

Qld Qld Contacts: Director Carol Tran. directorqld@dhaa.info Chair Jen Turnbull chairqld@dhaa.info Deputy Chair Lizzy Horsfall contactqld@dhaa.info

n The Queensland committee was kept busy with the planning of the fullday event at the QT Hotel, Surfers Paradise on 15 May. The six hours of CPD include pharmacology, mobile dentistry, motivational interviewing, sustainable dental practice and the relaunch of the Bright Smiles

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

Desiree Bolado and Christina Zerk hosted the DHAA stand at ADX

Tas Tas Contact Director: Alyson McKinlay directortas@dhaa.info Chair: Michael Charlton-Fitzgerald chairtas@dhaa.info

“ The committee also raised the disparity that exists in Queensland in that dentists are exempt from needing to apply for a radiation licence ”

- Bright Futures program. We will provide a report on this event in the next Bulletin. Members of the Queensland committee reached out to the CQU and Griffiths University to present to oral health and hygiene students over recent months. It is an important role for state committees to connect with students to promote DHAA membership. A journalist from the Queensland Courier Mail contacted us for advice in preparation of an article on

dental costs in Queensland. Jen Turnbull, Carol Tran and Bill Suen had provided advice to the journalist and we are looking forward the publishing of the article and will alert members of it accordingly. The committee also raised the disparity that existed in Queensland in which dentists are exempt from needing to apply for a radiation licence. The exemption does not apply to dental hygienists, dental therapist and oral health therapists. The matter has been brought to the attention of the CEO who is in the process of addressing it through the appropriate channels. The Queensland committee is keen to hear from members outside of the local CBD that would like to jump into their next committee meeting in July to see what it is all about, for details please email contactqld@dhaa.info.

n Following on from the January TAS membersonly Zoom meeting, Michael Charlton Fitzgerald and CEO Bill Suen have been liaising with TAS ADA and Pharmaceutical Society to organise a joint event for dental practitioners and pharmacists on Monday 21 June at the Rydges Hobart. This event is the result of a huge effort involving executives from all three associations; and

“T his event is the result of a huge effort involving executives from all three associations; and recognition of the need for collaboration”

recognition of the need for collaboration. Not only would this improve efficiency due to very limited local resources, but also the importance of trans- professional communication to improve patient care. As this is a joint event that covers members of multiple groups, places may be limited, so please register early to secure your place here.

SA SA Contacts Director Cheryl Dey president@dhaa.info Chair Sue Tosh chairsa@dhaa.info Chair Sally Hinora contactsa@dhaa.info

n SA members enjoyed a great day of CPD and wine tasting at Clare Valley on Saturday 20 March. The day started with coffee and Dr Paul Sambrook’s insightful and high-tech presentation on the changes using technology in the planning surgical procedures, followed by a session from BMS on the ins and outs of record keeping to maximise protection of practitioners in the case of a claim being lodged.

A lecture on pain management, bleeding control using various medications followed after lunch. Before heading to the wine tasting room, an evidence-based session on self-care and awareness was delivered by Sabine Tosh, drawing on both eastern and western science to strike a balance in life. The wine tasting afterwards provided a relaxing completion of a day of effective learning and enjoyable socialising. The SA Committee never stop working and the next event on the drawing board is a dinner meeting in June at the Lion Hotel in North Adelaide with specialist periodontist Dr Paul McHugh. We will also have Sue Aldenhoven presenting on the past 30 years of dental hygiene in South Australia- an event not to be missed. Register here.

“ The SA Committee never stop working and the next event on the drawing board is a dinner meeting in June at the Lion Hotel in North Adelaide with specialist periodontist Dr Paul McHugh. ”

The full-day CPD and wine tasting event at Clare Valley was a roaring success

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

Vic Vic Contacts Director Ron Knevel. directorvic@dhaa.info Chair Desiree Bolado chairvic@dhaa.info Deputy Chair Aimee Mills contactvic@dhaa.info

n After multiple cancellations in 2020 due to COVID-19, the joint DHAAADOHTA event is now confirmed for Saturday 17 July. This will be a day of networking, handson workshop and trade display at the Holmesglen Dental Simulation Centre, Chadstone. While the event provides valuable CPD on the Hall Technique and advanced periodontal instrumentation, the value of networking has equal significance. All attendees are invited to join us for lunch, even if only attending a half day workshop, to mingle with colleagues and check out the latest products and services at the trade exhibition. It is a great opportunity to reconnect with peers while updating your skills at the well-equipped dental simulation centre. Register here. Victorian chair Desiree Bolado, CEO Bill Suen and staff Christina Zerk attended the Melbourne

“ While the event provides valuable CPD on the Hall Technique and advanced periodontal instrumentation, the value of networking has equal significance” ADX in May. This was an excellent opportunity to mingle with colleagues, students and industry partners. They managed to sign up new members and promote DHAA services to many companies in the dental industry, with follow up on symposium sponsorships and other opportunities for our members. Work has also begun, in collaboration with ADOHTA, to prepare for the next round of Victorian public sector enterprise bargaining agreement (EBA) negotiation, with meetings being held with the industrial relations representatives of both DHAA, ADOHTA and the local union. This is a complex and slow process, and we will keep Victorian members up to date with any developments. If members working in the Victorian public sector wish to provide information and discuss their individual issues relates to the EBA, please email ceo@dhaa.info .

WA WA Contacts Director: Aileen Lewis. directorwa@dhaa.info Chair: Carmen Jones chairwa@dhaa.info Deputy Chair: Rhonda Kremmer contactwa@dhaa.info

n The WA World Oral Health Day celebration at the Pagoda Resort & Spa in Como, was another successful fullhouse event. Laura Drummond made a fascinating presentation on “Remineralisation, the Building Blocks of the Future.” It focused on the treatment of the risk factors of caries. It included many new preventative measures in primary and secondary demineralisation, which definitely struck a chord with the audience. Laura has been invited to speak again at “Down South

“ The deputy premier has asked his policy adviser to meet with DHAA representatives on his behalf to discuss the matters of early intervention dentistry planning/policy in three key areas”

Escape”, which is our full-day CPD event scheduled for February 2022. Other great news in WA is that Deputy Chair Rhonda Kremmer and long-term committee member Wendy Wright have successfully made contact with WA Deputy Premier Roger Cook MLA, who is also the minister for health, medical research, state development, jobs, trade and science. The deputy premier has asked his policy adviser, Ms Ruth O`Toole to meet with Wendy and Rhonda on his behalf to discuss the matters of early intervention dentistry planning/policy in three key areas: 1) 0-4 yr olds 2) Aged care access to essential preventative oral hygiene / treatment and, 3) The provider number advocacy issue for OHTs, dental hygienists and dental therapists so we can effectively service and care for our community, especially those most vulnerable. Further details will be provided as we progress along this very important trajectory. The next WA event will be a joint event with ADOHTA at ADA House on the 23 June 2021 in Perth. Please mark this in your diary – click here – and further information will be released shortly. n

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Run-Off Cover Locum Cover • One off cost for permanent • retirement Protect yourself at no cost • You're covered to work as a during Maternity Locum • •  PO rotect yourself at no cost • You're covered to work as a • Claims arising from lost or • Policy specifically design ne off cost for permanent during Maternity Locum retirement leaked documents for Dental Hygienists & O • One off cost for permanent Health Specialists retirement • $100,000 Limit Public Relations Legal Advice

• We can cover the refund of Refund Of Fees fees to a complainant (where appropriate) Refund Of Fees • W e can cover the refund of Up to $10,000 fees to a complainant • W e can cover the refund of (where appropriate) fees to a complainant • Up to $10,000 (where appropriate) p to $10,000 • U

• We can cover up to $50,000 Public Relations to preserve and restore your reputation Public Relations • We can cover up to $50,000 to preserve and restore your • W e can cover up to $50,000 reputation to preserve and restore your reputation

Overseas Work

Run-Off Cover

• Access to specialist legal Legal Advice advice at the time of a claim

Legal Advice

• Access to specialist legal advice at the time of a claim • Access to specialist legal advice at the time of a claim

Locum Cover

This policy is offered exclusively to DHAA members, for any further questions or dwde Cover (except • Protect yourself at no cost • You're covered to work advice, contact BMS on 1800 940 762 or dhaa@bmsgroup.com during Maternity Locum This policy is offered exclusively to DHAA members, for any further questions or ding work in Canada • One off cost for permanent advice, contact BMS on 1800 940 762 or dhaa@bmsgroup.com This policy is offered exclusively to DHAA members, for any further questions or retirement This page contains general information, does not take into account your individual objectives, advice, contact BMS on 1800 940 762 or dhaa@bmsgroup.com financial situation or needs. For full details of the terms, conditions and limitations of the

covers, refer to the specific policy wordings and/or Product Disclosure Statements available from BMS Risk Solutions Pty Ltd on request. BMS Risk Solutions Pty Ltd (ABN 45 161 187 980, This page contains general information, does not take into account your individual objectives, AFSL 461594) arranges the insurance and is not the insurer. financial situation or needs. For full details of the terms, conditions and limitations of the covers, refer to the specific policy wordings and/or Product Disclosure Statements available This page contains general information, does not take into account your individual objectives, from BMS Risk Solutions Pty Ltd on request. BMS Risk Solutions Pty Ltd (ABN 45 161 187 980, financial situation or needs. For full details of the terms, conditions and limitations of the

Develop Empower Support www.dhaa.info

STRIVING FOR EXCELLENCE

The Bulletin - Issue 59 Jun / Jul 2021

Articles inside

Oral cancer screening and prevention

Aged Care: Together we will make a difference

Symposium countdown