A devotion to dental

DHAA Life Member Joan James fondly recalls her dental hygiene journey – from the early days of the industry in Australia to some of the more disappointing decisions being made by the authorities

My dental hygiene journey started in small-town USA. My father was a dentist in Nebraska, and I assisted him after school and during school vacations. However, I was not aware of the profession of dental hygiene until I went to the University of Nebraska in 1970 (majoring in interior design) and found part time work assisting in the student health centre dental clinic. The dentists in the clinic encouraged me to apply to the four year bachelor’s degree program in dental hygiene. I was accepted into the program after doing a year of prerequisite study (after two years in my original program) while working full-time in the health clinic as a nurse’s aide.

All dental hygiene subjects and clinical practice were delivered at the University of Nebraska Dental School. In the clinic we wore white (nursestyle) caps and white pant uniforms, no masks, gloves or eye protection. Infection control has come a long way since then!

Upon graduation in 1975, I was employed by a dentist in Billings, Montana but soon returned to Nebraska to practice. I moved to Brisbane in July 1977 with my future husband, an Australian, whom I had met while he was teaching orthodontics at the University of Nebraska Dental School.

Dental hygiene practice was not legally allowed in Queensland in 1977 – the Dental Act allowed only dentists to practice intra-orally. I found employment as a dental assistant and was fortunate enough to work chairside with a periodontist (and a good friend), which kept me up-to-date with current trends in preventive dentistry. During that time, South Australia offered a dental hygiene course and, along with SA, other states were starting to allow the practice of dental hygiene.

In 1987 the Queensland Dental Act was changed to allow qualified dental hygienists to 'list' with the Dental Board of Queensland to practice dental hygiene. Overseas-trained hygienists were required to sit a proficiency exam. The written exam was delivered in Brisbane in the early years, but the clinical exam was given in Adelaide at the Gilles Plains Dental Clinic. The Adelaide exam component was challenging and extremely unpleasant— as experienced by many other overseas-trained hygienists.

“At the end of my professional life, I was an advisor with Dental Protection Limited, an indemnity insurance provider. That was very rewarding work in that esteemed organisation, and I would have relished it had I been 10 years younger!”

Upon completion of that exam, I felt fortunate to be able to return to the familiar periodontal practice, employed as a dental hygienist. I practiced there for 21 years, leaving private clinical practice in 2011. During that time, I was occasionally involved in the clinical assessment of students in the Academic Upgrade Program at the University of Queensland (UQ) School of Dentistry. The program (subsidised by Queensland Health, available from 1998-2005) provided school dental therapists with dental hygiene skills to add to their scope of practice. From 2009-2013, I was a part-time clinical supervisor and lecturer in the University of Queensland Bachelor of Oral Health (BOH) program. And for a short time, at the end of my professional life, I was an advisor with Dental Protection Limited, an indemnity insurance provider. That was very rewarding work in that esteemed organisation, and I would have relished it had I been 10 years younger!

Presenters and DHAA Committee – Uluru 2005

Joan James presenting Len Bray with award for his services – Uluru 2005

L-to-R: Anna Pattison and husband Gordon, Robyn Watson & Joan James – 2006

I was one of the foundation members of the Dental Hygienist's Association of Australia (Queensland Branch) and the inaugural president from 1991-1992. I eventually represented Queensland on the DHAA Inc. National Council and then served as national president from 2005-2006. During that time, one of the most rewarding activities was leading a team that organised the 2005 National Symposium at Uluru—'Oral Histories: Pacific Perspectives of Indigenous Oral Health'. We enjoyed a wide-ranging program around that theme, including international presenters, and a very memorable social program. It was always a pleasure to work with other dental hygienists on professional committees and some of my dearest friends today are those I met through the association.

One very challenging (yet rewarding) CPD activity that several of us organised at national level was a road trip around Australia with Anna Pattison. Anna was the 'guru' of periodontal instrumentation at the time. We booked the venues and all that was required for her clinical workshops, then accompanied her to Sydney, Adelaide, Perth, and Brisbane. Also during my time on the National Council, the first DHAA online database was developed, thanks to the invaluable expertise of Len Bray. Len was the husband of DHAA member Deb Bray, who served as DHAA secretary for some years.

During my professional life, I enjoyed attending several International Symposia of Dental Hygiene (ISDH) in Sydney, Madrid, Glasgow, Toronto, and Brisbane. I was also honoured to be a member of three Australian Dental Council accreditation teams, and it has been very pleasing to see the growth of the profession in Australia over the years since 1977. However, more recently it has been disappointing to see programs terminated. Why aren’t programs valued for the preventive oral health skills of the hygienist and OH—skills that can greatly benefit individuals and communities? For example, with an ageing population that is rapidly growing, hygienists and OHTs are perfectly placed to deliver invaluable preventive and screening oral health services in under-serviced residential aged care centres. I’m hopeful the DHAA can lobby the relevant government and regulatory bodies for recognition and integration of those services in the near future. I am now fully retired and enjoy golf at least twice a week. I was a member of the golf club Women’s Committee for six years and served as President from 2019-2020. I am active in a local group of St. Vincent de Paul and continue involvement in a book club established over 30 years ago. I enjoy singing in church choir and with larger groups from time to time. I travel back to the USA every year (notwithstanding pandemics) to keep in touch with my American family. However, I feel very privileged to live in Australia and to have had a very satisfying career in dental hygiene here.