The Bulletin - Issue 68 October / December 2023

Time flies when you're having fun

LAST MONTH, I had the pleasure of attending my local DHAA CPD event in Brisbane and provided an update on the work the DHAA has been undertaking on behalf of our members. The event was sold out and it was great to chat with attendees discussing issues affecting our profession. Listening to member's issues and discussing how DHAA may support you is very satisfying. Through these chats we are able to direct our strategic planning to serve our members.

The DHAA Board has undertaken a thorough analysis and developed a new DHAA strategic plan for the next three years. I am very pleased to present it to you in this edition of the Bulletin with further details available on the DHAA website

Our current advocacy effort is focused on seeking access to the Commonwealth chronic disease individual allied health services, more info can be found here

We hope that through this service item under Medicare, we will be able to provide oral health assessment and education to the public through collaboration with general medical practitioners. If successful, this will be the first small step to integrate oral health back into general health through the lens of the government and the broader medical fraternity. We have engaged a consulting firm to develop an advocacy campaign over the next three months. I will keep you all posted on its progress.

The bi-annual DHAA membership survey is another opportunity for members to inform the DHAA board of your individual needs and provide any suggestions that you might have. The last survey provided us with valuable information, I encourage you to participate in the survey regardless of your membership status. The survey should take 10-15 minutes, and we read all responses and incorporate that information into service improvement – member survey and non-member survey

The DHAA flagship event of the year, the 2023 National Symposium being held at the Adelaide Convention Centre between 21- 23 September is approaching fast. This is an excellent opportunity for everyone to connect with their peers across the country, update your clinical and professional knowledge as well as see a cross-section of new products and services on the market. I invite you to check out the comprehensive education program and social events here. This is the one event not to be missed and I look forward to seeing you there.

Northern Territory Director, Hellen Checker, recently resigned from her position role to focus on her family and community work. Her new work with trauma and improving mental health in Alice Springs is amazing. I would like to take this opportunity to thank Hellen for her service over the past two years. She has contributed significantly in the strategic review of the association and played a key role in connecting with NT members and stakeholders.

A/Professor Carol Tran DHAA President

Contents

04 It's on!

The DHAA National Symposium is upon us.

06 From the top

CEO Bill Suen announces the DHAA's latest strategic plan.

10 Share your story

Real-life stories to inspire and encourage the lives of others.

12 Career development

Advance your career through lifelong learning.

16 Get your CPD fix online

Improve your skills and knowledge from home.

COVER STORY

22 Don't get caught out

Discover how to treat a patient in an emergency.

28 Dealing with diabetes

Understand type 2 diabetes, its effects and management.

32 Accidental impact

How an injury could impact you as a dental hygienist.

34 Going green

How to make your practice more sustainable.

36 Leadership lessons

The power of influence in building others.

38 State of the Nation

A countrywide round-up and 2023 event calendar.

DHAA National Symposium 2023

IT'S ON!

EVERYTHING IS LOCKED and loaded for this year's DHAA National Symposium (21-23 September). A raft of industry-leading speakers, technical experts and exhibitors will be descending on the Adelaide Convention Centre to share their wisdom as well as demonstrate their wares.

With the infamous Gala Dinner on the Saturday night, this really is an event that you don't want to miss... unless you've already missed it. Register today!

Keynote speakers

The Numbers Game: How to Play

It Safely

With a host of top-notch speakers, exhibitors and fun events, this year's DHAA National Symposium promises to be the best ever

Register today!

DHAA National Symposium

21-23 September 2023

There's still time if you're quick... so what are you waiting for?

Go to the website

Dr Martin Webb

Dr Mark Hutton Sustainability: Angels, Ostriches, and Furphy

Dr Sarah Kelly Can we do zero waste dentistry?

Dr Trudy Lin Intersectional approaches to overcome health inequality

Keeping tabs on competencies

The Australian Dental Council (ADC) released the revised Professional competencies of the newly qualified dental practitioner (the Competencies) in 2022, which has come into effect from 1 July 2023.

The Competencies are an important resource for the ADC. These outcomesfocused statements are used in program accreditation to ensure students undertaking dental programs are prepared with the skills, knowledge and capabilities needed to practice safely upon graduation. For the overseas qualified dental practitioner assessment process, the Competencies are an important reference point for mapping and blueprinting examinations.

It is important to note that the Competencies have a broader application beyond the work of the ADC. The dental professions, regulators, consumers and employers all have use for the Competencies.

The most significant change is the consolidation of the Competencies for dentists, dental hygienists, oral health therapists, dental therapists and dental prosthetists into one comprehensive document. This change reinforces that professionalism, communication and leadership, and critical thinking are core skills for all dental practitioners. It also supports collaborative team practice by facilitating a better understanding of competencies across the different dental practitioner divisions.

The revised Competencies also have an increased focus on the provision of culturally safe care for Aboriginal and Torres Strait Islander peoples. These revisions are designed to support the inclusion of Domain 6: Cultural Safety into the ADC/Dental Council (New Zealand) Accreditation standards for dental practitioners (the Standards) in 2021. Updates to the Competencies supporting this Domain include aligning the definition of cultural safety for Aboriginal and Torres Strait Islander peoples with the definition agreed across the National Registration and Accreditation Scheme in June 2018. New statements have also been introduced into Domain 1 to ensure the definition of cultural safety is implemented. These statements outline what a practitioner must do to ensure culturally safe and respectful practice for Aboriginal and Torres Strait Islander peoples. Implementation of the revised Competencies will occur across the ADC’s program accreditation and dental practitioner assessment processes. For accredited dental practitioner programs, the ADC is working closely with dental education and training providers and assessors on the implications the revisions to the Competencies will have on the program accreditation process.

Several resources have been developed to support education providers in transitioning to the revised

Competencies. A webinar was held in late 2022 to provide an overview of the review process, what has changed in the revised Competencies and the plan for implementation. Guidance notes have also been prepared to support education providers with the implementation of the revised Competencies, which cover six focus areas: interprofessional collaborative practice, cultural safety, domestic and family violence, rural and remote populations, social responsibility and at-risk populations. The guidance notes introduce each of the focus areas, outline the revised domains within the Competencies and provide examples of ways providers can prepare students to be able to demonstrate the revised Competencies. The webinar and guidance notes can be accessed on the ADC website.

Planning for the implementation of the revised Competencies against the ADC’s written and practical examinations is underway. Further updates on this planning will be provided on the ADC website as more information is available.

Learn more about the revisions to the Competencies and download your copy today at www.adc.org.au  n

Since July 2023, all accreditation activities are assessed against the revised Professional competencies of the newly qualified dental practitioner. We take a look at what it means to new grads just starting out on their careers

Professional competencies of the newly qualified dental practitioner May 2022 (effective 2023)

Activating a process of support

The recently-released DHAA strategic plan is a demonstration of our commitment to promote the mental health and wellbeing of members

and amplify the wellbeing awareness across Victorian dental teams.

Bill Suen DHAA CEO

MOST OF US know that dental practitioners can experience high levels of depression, anxiety, burnout, psychological distress and suicidal ideation when compared with the general public and other health professionals. There is a need to improve the wellbeing and mental health of members of our profession. The recently released DHAA strategic plan has explicitly indicated our commitment to promote mental health and wellbeing of members, with a number of projects already in place to support this strategy.

In Victoria, we have successfully applied for a government grant to offer a certificate of workplace wellbeing course in collaboration with the ADA (Victorian Branch). The program consists of 10 hours of online live training workshops, focused on the six pillars of wellbeing: Positive Emotion, Engagement, Relationships, Meaning, Accomplishment and Health (PERMAH). Participants will develop and run a small wellbeing project of their choice in their dental practice (or maybe across several practices in their local area), and then showcase their projects. The ADAVB has already run this course earlier in the year and had received excellent feedback from participants. We are hoping that through this project we can enhance

With the support of DHAA Director, Dr Roisin McGrath, we are launching our National Mental Health First Aid Training for our members. This is a blended online course that includes a self paced eLearning component and an instructor-led component via video conferencing. The course teaches participants about the signs and symptoms of mental health literacy and provides practical skills needed to support someone experiencing a mental health problem, or in a mental health crisis until appropriate

services in times of stress over the phone. The volunteer may also provide advice on where to seek appropriate professional support. Since its inception we have supported members who are:

• A subject of a professional practice investigation either through the PI insurer and/or AHPRA.

• Affected by an occupational health and safety or industrial relations situation as an employee at the workplace.

• Seeking advice on practice matters that may lead to a PI insurance claim or AHPRA notification.

professional help is received or the crisis resolves. It informs participants of the types of help and supports available and how to help someone access the support they need.

The DHAA Peer Support Service (PSS) was launched in 2020 to support DHAA members (including graduates and students) on matters related to the many challenges and demands related to a dental practitioner in Australia. The service provides an experienced dental practitioner to act as a listening ear as well as advise on other support

We are most thankful for the volunteers who have offered their support to a small number of members who sought the service over the past few years. While the number of episodes is low, those who sought help found the service extremely valuable in addition to other professional services they have received. This is an excellent opportunity for members to give back to the profession and support our peers. We are now seeking expressions of interest from members who wish to be part of this caring volunteering community. Initial training is provided for new volunteers and there is no obligation to take on any cases unless the volunteer feels comfortable with it.

I invite you to take part in any of the above initiatives and be part of our strategy to promote positive mental health and wellbeing of our members. Please see details of these opportunities on pages 9, 13 and 15.

“The DHAA Peer Support Service was launched to support DHAA members (including graduates and students) on matters related to the many challenges and demands related to a dental practitioner in Australia”

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The DHAA Strategic Plan 2024-2026

2. Relationships & Advocacy: fostering collaborative relationships with key stakeholders

2.1. Advocating for oral health professionals to be recognised in the allied health sector as an integral part of the primary healthcare team

Vision

All people in Australia have equitable access to preventive-focused oral health care.

Mission

DHAA is the peak organisation for the advancement of the oral health profession in the delivery of healthcare.

Goals

DHAA’s approach to achieving its mission is to:

n Develop the capacity of our members as oral health professionals and broaden awareness of their integral role in the primary healthcare team.

n Empower our members as oral health professionals with expertise in preventive models of care.

n Support our members to help them become better healthcare professionals and meet the needs of diverse patient populations.

Pillars

DHAA will achieve its mission by:

1. Focus on Prevention: promoting preventive models of care as primary healthcare providers

1.1. Capacity building through education and support

1.2. Advocating for evidence-based preventive models of care

1.3. Supporting research translation that empowers preventive models of care

2.2. Maintaining and improving communication and collaboration with key stakeholders

2.3. Building and maintaining relationships with all levels of government and health policymakers

2.4. Supporting members by shaping professional standards, policies and codes via proactive involvement in regulatory and professional bodies, relevant panels and committees

3. Member Support: providing services and support

3.1. Conducting satisfaction surveys to inform quality improvements to member services

3.2. Maintaining and enhancing the Professional Indemnity insurance program

3.3. Expanding the Advisory Panel to provide a range of expert advice and support to members

3.4. Prioritising the development of programs that support rural and regional members

3.5. Informing and supporting members regarding registration and provider number requirements

3.6. Developing frameworks and guidelines to support relevant practice areas

3.7. Developing strategies to promote mental health and wellbeing of members

4. Promotion & Recognition: advancing the profile and role of oral health professionals and of the association

4.1. Refreshing the DHAA brand

4.2. Progressing towards a new peak association to represent all dental hygienists, dental therapists and oral health therapists with a united voice, through proactive leadership of TOPA initiative.

4.3. Developing a marketing strategy

5. Building Capacity: providing education and sharing knowledge to empower members

5.1. Designing and delivering DHAA programs that develop new skills and build capacity

5.2. Implementing a leadership mentoring program

5.3. Maintaining the national symposium as the flagship CPD event

5.4. Coordinating and promoting annual events calendar

6. Sustainable Association: ensuring best-practice governance, growth and management of the association

6.1. Reviewing the role of and support for state committees

6.2. Developing and implementing a comprehensive communications strategy

6.3. Enhancing member engagement

6.4. Maintaining contemporary governance

6.5. Ensuring ongoing financial management

Approved by DHAA Board, 22 July 2023

The DHAA strategic plan is a regularly updated document that demonstrates our focus on objectives and action plans that will keep the Association relevant

THE DHAA ABORIGINAL and Torres Strait Islander - Dental Hygiene and Oral Health Therapy Student Study Grant provides support to indigenous students in their undergraduate study, leading to a career as a registered dental hygienist or oral health therapist in Australia. This annual grant provides a cash payment of $5000, entry to the DHAA student leadership program, and a mentor for the recipient. Congratulations to our 2023 recipient, Caitlin Steedman of the Central Queensland University. Below is her reflection on the receipt of the grant.

"MY NAME IS Caitlin (Caiti) Steedman, and I am a proud Gunggari woman. My love of oral health began through working as a dental assistant for four years prior to starting a Bachelor of Oral Health course. I loved helping people through their oral health journeys and building relationships with each patient who walked through the door. I decided I wanted to become an oral health therapist so I could pursue my passion for helping others and hope to be able to improve their lives through prevention and education.

"I grew up going home to the country in Mitchell, to the Saunders family reunions to celebrate and learn about our culture and pay respect to my elders and ancestors. I love living in Central Queensland but hope to broaden my horizons by working and volunteering in rural areas in the hope of caring for and educating people in these regions who struggle to access the basic resources and facilities we all have the right to.

"I am currently in my second year of the BOH course at CQU Rockhampton. The course has a smaller intake of students, so the learning environment is perfect for rapid learning and improvement as we get a lot of one-on-one time with the supervisors. The course is very full-on, and this grant will allow me to continue with my studies full-time without the stress of working. My favourite part of the course at the moment is treating patients. I love when they leave with a smile and feel well taken care of. This lets me know I have done my job. I am very motivated and have loved studying oral health thus far and cannot wait to begin my career in the dental industry.

"I am so honoured to receive this grant from DHAA as I share the same beliefs that our ever-growing profession needs to be promoted and supported in every possible way so that we can help our communities to the best of our ability." n

Certificate in Creating Wellbeing in Workplaces

The DHAA and the Australian Dental Association Victorian Branch (ADAVB) are partnering with global leaders in the wellbeing sector the Wellbeing Lab to run a Certificate in Creating Wellbeing in Workplaces for dental team members across Victoria.

The program consists of 10 hours of online live training workshops, focused on the six pillars of wellbeing: Positive Emotion, Engagement, Relationships, Meaning, Accomplishment and Health (PERMAH). Participants will develop and run a small wellbeing project of their choice in their dental practice (or maybe across several practices in their local area), and then showcase their projects.

The online training will run after hours in October 2023, and the projects and showcases will be held in November 2023. The cost of the program is $2000 per participant. Participants will be required to pay $150 and DHAA will fund the remaining cost for the training with a grant from the Victorian Government.

New dates:

• 4 & 11 October (Wed)

6-9pm Live Class

• 28 October (Sat)

8:30am-12:30pm Live Class

• 1 & 15 November (Wed)

6-7pm Community of practice call

• 25 November (Sat)

8:30 - 10am Final Showcase

At the time of publishing, there are only eight places available. If you are interested, please register ASAP

“I hope to broaden my horizons by working and volunteering in rural areas in the hope of caring for and educating people”

Anaphylaxis Saturday

YESTERDAY I LOST a day of my life, but it could easily have been the day that I lost my life.

I left the house bright and early, to attend a ‘continuing education’ day with an interesting line-up of topics and speakers. Usually, I go to these events as a necessity of my profession, but this one I was looking forward to.

Arriving comfortably on time, I enjoyed the first session. Morning tea was served and appeared to go seamlessly. I was second in line for coffee, nice, but the food line was long. I looked around for the usual “special diet” table, but there was none. I did, however, notice there was dairy/gluten-free food labelled on the main table. I had filled in the dietary requirement form letting the venue know I have a nut allergy, so I assumed that because there was no nutfree option, all the food was nut free. Having collected a few samples of food, I returned to my seat and ate from my plate. A few minutes later I realised the inside of my mouth felt tingly and weird, and was starting to swell. The person next to me was eating the slice that I had eaten and as I looked at hers, I saw what looked like a sultana but suspiciously looked ‘not’ a sultana. I asked her what it was and she tried it and announced that it was a walnut.

A walnut. My worst fear has just been realised. Alarm bells go off in my head. Have I just eaten the most toxic food given my allergies? By now, some panic sets in, my head is spinning, and I’m stressed. I tell myself to relax and get accurate information, so I approach a staff member from the centre to ask, and he comes back with the news that it was indeed a walnut. My world implodes!

Now I know that I am not imagining the tingling in my mouth and my throat has started to feel wrong too. At this point, breathing is still okay. I now must make a life-saving decision that only I can

make, but I am also in a state of losing the ability to apply logic. I realise that I must administer a dose of adrenaline using the EpiPen in my handbag and never use it unless I call an ambulance.

Stepping outside I use the EpiPen and dial triple-0. Suddenly I find I cannot talk clearly. I started shaking uncontrollably and I cannot even think clearly, but thankfully I have two lovely colleagues with me. One takes over the phone call and the centre manager is now aware of the problem, as does the conference coordinator. All have the best intentions and are trying to help. At this point of the reaction, it is hard to know if part of my involuntary responses is due to the adrenaline or an escalation towards anaphylaxis.

I explain the situation and find myself

trying to calm them down! I try to let them know it will be okay, but in that same moment, feeling like an idiot for making a rooky mistake of assuming that ‘all’ of the food was fine.

I try to regain my composure to calm everyone down, telling them I will be fine; that it will all be okay; that I will be observed at the hospital and eventually released to go home. I downplay the seriousness of the incident.

Sadly, I’ve been through this before. It’s not my first brush with possible death from anaphylaxis. From an outsider’s perspective, I probably looked fine - just that I had an unfortunate incident and missed out on CPD points. But I spent money on a day I did not get to enjoy and my jeans were damaged from the bleeding from the EpiPen. Not huge in the scheme of things.

On the inside the story is very different. I could have died. This was not ‘just an incident,’ it was life-threatening due to the nature of my exposure. The only reason it was not worse is that I knew how to respond.

I realised that I downplayed the incident to make others feel better. I didn’t want to be a ‘bother’ but this was serious and it was traumatic. I still shake when I think about it, and when I am don't, I burst into tears randomly. I am exhausted both physically and emotionally. I should not have to face the prospect of death because of the negligence or carelessness of others.

I told my friend not to be mad on my behalf, but on reflection, I am glad she was. Today I am realising that I should have been mad too, rather than denying my feelings for the sake of others.

What do I want to happen?

I want others to understand the seriousness of food allergies and that it is not some form of lifestyle choice. For those of us with anaphylaxis, the allergy

“I realise that I must administer a dose of adrenaline using the EpiPen in my handbag and never use it unless I call an ambulance”

DHAA member Alaina Lendon recalls the dramatic events that unfolded after consuming an innocent morning tea snack

could end our life! Comparing a “food discomfort/preference” (e.g., Gluten intolerance) with anaphylaxis does not help those of us who could die from such an allergic response.

The utmost importance and priority must be placed on people with allergies. Their life is on the line when they eat from your catering and for which they have placed trust in you. BIG trust. My life is important and should not be put at risk from poor allergen management. Greater awareness of the trauma these incidents create. Yesterday I relived past trauma and experiences of nearly losing my life, my children losing their mother, my husband losing his best friend and my best friend losing me. Thankfully the physical danger has passed but today, the day after the event, I am still affected. I hope that tomorrow will be better but, as many will know, trauma is not something you can simply ‘switch off’. n

DHAA response:

The DHAA is grateful for Alaina’s reflection and understanding of this unfortunate but preventable situation. We have immediately undertaken a full review of the circumstance leading to this occurrence.

We have since implemented changes to ensure attendee’s food allergy is routinely checked and identified, and insist with venues and caterers that all food allergy requirements are appropriately plated, clearly identified and appropriately informed to attendees at all future DHAA events.

We also hope that this reflective piece will raise awareness of allergies and the need to take all possible measures to prevent their occurrence.

From student to practitioner

Graduate oral health therapist Roksy BoglariDavykoza reflects on her career journey so far

REFLECTING ON MY journey from student to practitioner, and my role in the DHAA, I am struck by how seamlessly the values and principles I embraced within the organisation have woven themselves into my professional path. The transition from being immersed in theoretical knowledge as a student to becoming a confident and capable practitioner was transformative. However, it was the parallel journey within the association that added a unique dimension to my growth.

The core values upheld by the DHAA, such as a commitment to excellence in patient care, continuous learning, and community engagement, have not only shaped my approach to dental therapy and hygiene but have also played a pivotal role in determining the course of my career. It is through the embodiment of these values that I have been able to find employment opportunities that align harmoniously with my personal and professional beliefs.

In both the public and private sectors, I find myself surrounded by teams that share a common dedication to the principles championed by the association. This alignment of values has created an environment of unparalleled support and camaraderie. In the public sector, where the focus is on delivering essential oral healthcare services to underserved communities, I am empowered by a shared commitment to making a meaningful impact. The collaborative spirit and shared sense of purpose within my team at

Merri Health are a testament to the strength of the values we hold dear.

Similarly, in the private sector, where innovation and patient-centred care thrive, I am fortunate to be part of the team at DSPA, which places a premium on expanding my professional skillset and patient education. The emphasis on staying at the forefront of advancements in dental hygiene mirrors the commitment to continuous learning, ensuring that I am equipped to provide the best care possible.

The emphasis on community engagement has also influenced my career choices. Through my involvement in various outreach programs, I have been able to extend my impact beyond the treatment room, just as the association extends its influence beyond its membership. This has further deepened my sense of purpose and connection to the broader community.

Reflecting on my journey, I am acutely aware of how the Association has not only provided a platform for professional development but has also guided me toward fulfilling and aligned career paths. The values I have internalised through my involvement with the DHAA have become a compass, directing me towards opportunities and environments where I can thrive and contribute meaningfully. As I continue to evolve as a practitioner and active member, I remain grateful for the serendipitous alignment of values that have made me feel fortunate and supported within the teams I am privileged to be a part of. n

Take the life-long way home

Advance your career through lifelong learning and use mandatory CPD as an opportunity to elevate your career

By Associate Professor Melanie Aley

In the ever-evolving field of oral health, staying up-to-date with the latest techniques, technologies, and industry trends is paramount to a successful and fulfilling career. We shouldn’t think about continuing education as just a requirement for our registration; it’s an opportunity for oral health professionals to expand their skill set, enhance patient care, and open doors to new professional avenues.

Lifelong learning through continuing professional development can enhance our careers in numerous ways. It can allow us to adapt to advances and elevate our patient care. Dental research and technology are rapidly advancing, with new approaches, tools and equipment introduced regularly. By engaging in continuous education, dental hygienists and oral health therapists can master these tools and technologies and ensure they are providing evidence-based treatments to achieve more efficient and effective patient care.

Ongoing education and professional development can also create opportunities for career growth. Many focused roles within oral health or non-clinical career pathways require additional training. Continuous learning can open doors to positions in research, education, practice management, and more.

There are many continuing professional development providers and sources where you might find relevant learning opportunities. Professional associations such as the DHAA and ADOHTA regularly host workshops, webinars, and conferences. These events provide insights into the latest advancements and best practices in the field, and source reputable, high-quality presenters who are experts in their field.

Numerous online platforms offer courses tailored to dental hygienists. These platforms allow flexibility in learning and provide access to a wide range of topics. You can join or start a local study group where dental practitioners can share insights, discuss case studies, and learn from one another’s experiences.

Attending industry conferences such as ADX provides opportunities to learn from experts, network with peers, and explore the latest products and technologies.

Embracing continuous education is not only a professional responsibility but a proactive choice that can propel dental hygienists and oral health therapists toward success. By investing in lifelong learning, oral health practitioners position themselves as knowledgeable, adaptable, and innovative professionals who contribute positively to patient care and the dental community as a whole.

Five tips to maximise lifelong learning

1. Set Goals

Define what you want to achieve through continuous education, whether it’s improving your existing knowledge or skills, mastering a new technique or gaining expertise in a specific area. The Dental Board of Australia has a reflective practice tool that you might find useful!

2. Plan Ahead

Review your career goals and identify the skills or knowledge you need to reach them. Then, seek out learning opportunities that align with those goals.

3. Diversify Learning Sources

Explore a mix of formats, from online

“Lifelong learning through continuing professional development can enhance our careers in numerous ways”

courses and webinars to handson workshops. This well-rounded approach ensures exposure to different instructors and teaching methods.

4. Take Notes and Reflect

During and after continuing professional development sessions, take notes and reflect on key takeaways. How is what you learned going to impact on your clinical practice or your career? Apply these insights to your practice and discuss them with peers and colleagues.

5. Network and Collaborate

Engage with fellow dental hygienists, oral health therapists and other dental professionals during workshops and conferences. Networking can lead to valuable connections and collaborative opportunities. n

Dr Melanie Aley (nee Hayes) is a dental hygienist who has enjoyed a diverse career in clinical practice, teaching, research and management. She has a Masters of Education majoring in Career Development, and after working in multidisciplinary roles, is now an Associate Professor and the Bachelor of Oral Health Program Director at the University of Sydney.

Opportunity to give back to our profession and help our peers

The DHAA Peer Support Service (PSS) provides support to DHAA members (including graduates and students) regarding the many challenges and demands related to being a dental practitioner in Australia.

The service is provided by DHAA volunteers who are experienced dental practitioners to act as a listening ear as well as advise on other support services in times of stress over the phone.

Volunteers must either be a registered dental practitioner with a minimum of five years clinical experience, or a retired dental practitioner that had practised for over 10 years prior.

All volunteers must complete the DHAA PSS online training and are expected to participate in volunteer briefings to cover the issues that callers are experiencing, as well as relevant skills updates. De-identified requests are sent to the volunteer pool and it is up to each individual to review the request and to accept them if appropriate. There is no obligation for any volunteer to take up any request unless the volunteer feels comfortable and is free to take care of that particular case.

The number of requests over the past two years had been low but the recipients of the service have found it extremely useful.

Further information about the service is available.

If you are interested to be a part of the PSS team, or requiring further information please email Bill Suen (ceo@dhaa.info) or phone 0412 831 669.

DHAA... Ask

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

Dear DHAA... Our dental clinic has a strong hygiene throughline and our dentists work closely with many hygienists and OHTs. Through some of our discussions to better support and provide specific and relevant professional development, we got to a point where we did not seem to have a clear understanding of each of their respective scopes of practice. I was wondering if someone could point me towards any documents that will help me/us best understand the scope for these different professionals?

Thank you for your email regarding scope of practice.

Please refer to the Dental Board’s scope of practice registration standard You may notice that the Dental Board doesn’t specify or list the items that one may or may not perform within each category of dental hygienists, dental therapists or oral health therapists.

The Dental Board expects that as a healthcare professional, practitioners should know their own scope of practice and do not practise beyond the range of their training, qualifications, experience and competence.

This is to ensure the safety of the public, so consumers can have confidence in the dental profession when seeking oral healthcare.

Each individual must determine their own scope based on their tertiary training as well as their own confidence that they are up to date. They must feel competent and confident to perform all tasks and not put the public at risk. There is no difference between a dentist determining what is within his/her scope and feeling safe to undertake certain tasks.

The Board has a reflective practice tool to help individuals know their own scope of practice and to support continuing professional development.

Dear DHAA... I can't seem to find an answer about health funds and provider numbers. Until I receive a provider number, does this mean I won't be legally allowed to treat patients?

Thank you for your query regarding provider numbers. The provider number and item codes arrangement is purely a commercial agreement between the provider, funding agency and the patient. Each funding agency will make its own

rules and decide what item code and under what terms and conditions they will pay to practitioners. It is up to providers and patients to agree to the terms if they wish to access the funding. It is also important to note that provider number arrangements have no bearing on the legality of practice or scope of practice. However, it is expected that providers can only legally provide services and make claims under their provider number for treatments that are within one’s scope.

The provider numbers are issued by Services Australia to allow DH, DT and OHT access to the Commonwealth funded CDBS. It is optional and not mandatory for DH, DT and OHTs to obtain Medicare provider numbers that provide access to the Child Dental Benefit Scheme (CDBS) funding. However, if you acquire it, you must use it in the CDBS.

Since 1 July 2022, various health funds decided to recognise the Medicare provider numbers for claiming their dental benefits (some are not recognising them). They set their own rules and each fund is different.

DHAA members have access to the provider number

information, training and resources via the DHAA member portal.

We will also update the information and email members as various health funds inform us of any progress in their approach to our provider numbers.

Dear DHAA... I just have a question about legitimate CPD courses, can I read some dental magazines and can this count towards my CPD log?

The registration standard on continuing professional development (the Standard) is very flexible in its approach to the types of continuing professional development (CPD) activities you may undertake and the number of hours you can spend on each activity to meet the Board’s requirements. The Board does not review or approve CPD courses or CPD course providers. You, as a registered health professional, need to make a professional judgment about the appropriateness of the CPD activities you undertake.

The Dental Board Guidelines on continuing professional development provide direction on the characteristics you should consider when choosing your CPD activities.

You should choose activities that demonstrate the following characteristics:

• Open disclosure about monetary or special interest the course provider may have with any company whose products are discussed in the course.

• The scientific basis of the activity is not distorted by commercial considerations. For example be aware of embedded advertising and direct commercial links.

• The learning objectives, independent learning activities and outcomes.

• Articles from peerreviewed journals and/or be written by a suitably qualified and experienced individual.

• Address contemporary clinical and professional issues, reflect accepted dental practice or are based on critical appraisal of scientific literature.

• The content of CPD activities must be evidencebased.

• Where relevant, select CPD activities where you can enquire, discuss and raise queries to ensure that you have understood the information.

• If the CPD activity includes an assessment or feedback activity this should be designed to go beyond the simple recall of facts and seek to demonstrate learning with an emphasis on integration and use of knowledge in professional practice, and

• An opportunity to provide feedback to the CPD provider from participants on the quality of the CPD activity.

So it is up to the practitioners to determine appropriate CPD activities and record them on the CPD log.

Dear DHAA... How would I go about getting an up-todate guide of award pay rates for dental hygienists?

Please refer to the Health Professionals and Support Services Award 2020

Section 17 outlines the pay rates of all levels of health professionals covered by the award.

Schedule A.2 provides definitions of all levels of health professionals in this award.

Please note the following important points of the award:

1. It only lists minimum wage rate and working conditions, not the benchmark. We know that the vast majority of our peers receive well above what the award stipulates.

2. Award rate setting is based on responsibility and not years of experience - however, we do expect that practitioners with more experience and skills usually undertake jobs with more complex responsibilities.

3. The actual pay rate should be based on the market rate, which is published as part of the Australian Oral Health Workforce Report in the University of Queensland Open Source e-space library.

Table 3.5 provides detailed information on the current market rate. n

If you have a question to ask then please email it to bulletin@dhaa.info

DHAA Mental First Aid Training

A blended online Mental Health First Aid training course that includes a self paced eLearning component and an instructor-led component via video conferencing.

The course teaches participants about the signs and symptoms of mental health literacy and provides practical skills needed to support someone experiencing a mental health problem, or in a mental health crisis until appropriate professional help is received or the crisis resolves. It informs participants the types of help and supports available and how to help someone access the support they need using a practical, evidence based action plan.

Training format:

• Self-paced eLearning modules that will take 5-7 hours to complete.

• Participants must allow for adequate time to complete the 5-7 hours eLearning component prior and notify the trainer prior by the due date prior to the first scheduled interactive Zoom session.

• Instructor-led video conferencing sessions - 2 x 2.5 hours

• Total CPD hours 12 scientific

COURSE FULLY BOOKED

Course sessions are now full, we are in the process of scheduling more courses- please look out for future release of further session details on the DHAA website.

Get your CPD fix online

Our regular update on some great courses to improve your skills and top up your CPD hours

Study at home, at times convenient to you and get your CPD account rolling. Subjects in this editions round-up include; a tax on sugary drinks; and the long-term effects of Covid; managing patients with Parkinson's to name a few.

Whatever your special interest, there's truly something for everyone.

Heavy breathing

Locally acquired respiratory diphtheria in Australia

Med J Aust 2023; 218 (10): 446-448. || doi: 10.5694/mja2.51938

• Published online: 5 June 2023

• CPD Hours 0.25 Scientific

Respiratory diphtheria is now rare in Australia, but locally acquired cases are increasing; the recommended frequency of adult booster doses may need to be re-evaluated if high-risk community settings emerge. Respiratory diphtheria often follows a complicated course, with delayed onset cardiac and neurological

involvement that requires patient counselling, close monitoring, and multidisciplinary supportive care.

Not so sweet

Modeled health economic and equity impact on dental caries and health outcomes from a 20% sugar sweetened beverages tax in Australia

Health Economics July 2023

• CPD Hours 0.5 non-scientific

Dental caries is the most prevalent oral disease across the life course. This study modeled the population health and economic impact of a 20% sugar sweetened beverages tax (SSB) for preventing dental caries compared to no intervention (societal and healthcare perspective).

A cost-effectiveness analysis according to quintiles of area-level socioeconomic disadvantage was performed for the 2020 Australian population (0–100 years old) using a

closed cohort Markov model.

A qualitative assessment of implementation considerations (e.g., acceptability, equity, sustainability) was undertaken. Health outcomes were modeled as decayed teeth prevented and disability-adjusted life years (DALYs) averted.

The 10-year and lifetime scenarios were modeled with probabilistic sensitivity analysis (Monte Carlo simulation, 2000 cycles).

The 10-year scenario from a societal perspective yielded costsavings of AUD$63.5M, healthcare cost-savings of AUD$42.2M, 510,977 decayed teeth averted and 98.1 DALYs averted.

The lifetime scenario resulted in societal cost savings of AUD$176.6M, healthcare cost-savings of AUD$122.5M, 1,309,211 decayed teeth averted and 254.9 DALYs averted. Modeling indicated 71.5% and 74.5% cost-effectiveness for the 10-year and lifetime scenarios, respectively.

A three-fold health benefit for the least advantaged was found compared to the most advantaged. A 20% SSB tax in Australia is costeffective and promotes health equity.

Carry on COVID

Profiling post-COVID-19 condition across different variants of SARSCoV-2: a prospective longitudinal study in unvaccinated wild-type, unvaccinated alpha-variant, and vaccinated delta-variant populations

The Lancet. May 16, 2023 DOI:https://doi. org/10.1016/S2589-7500(23)00056-0

• CPD hours scientific 0.5

Self-reported symptom studies rapidly increased understanding of SARSCoV-2 during the COVID-19 pandemic and enabled monitoring of long-term effects of COVID-19 outside hospital settings. Post-COVID-19 conditions present as heterogeneous profiles, which need characterisation to enable personalised patient care. This study aimed to describe post-COVID-19 condition profiles by viral variant and vaccination status.

Associated oral disease

An umbrella review of the evidence linking oral health and systemic non-communicable diseases

Nature Communications volume 13, Article number: 7614 (December 2022)

• CPD hours 0.25 scientific

Oral diseases are highly prevalent worldwide. Recent studies have been supporting a potential bidirectional association of oral diseases with systemic non-communicable diseases (NCDs).

Available evidence supports that people with NCDs have a greater prevalence of oral diseases particularly those with limited ability of oral self-care. Regarding the reverse relationship, the lines of evidence pointing out NCDs as putative risk factors for oral diseases have increased significantly but not with a consistent agreement.

This umbrella review of metaanalyses appraises the strength and validity of the evidence for the association between oral health and systemic health. An extensive search included systematic reviews that have provided meta-analytic estimates on the association of oral diseases with NCDs. The overall strength of evidence was found to be unfavourable and with methodological inconsistencies. Twenty-eight NCDs were strongly associated with oral diseases. Among those NCDs are five types of cancer, diabetes mellitus, >>

If there were a sugar tax...

“The 10-year scenario from a societal perspective yielded cost-savings of AUD$63.5M, healthcare cost-savings of AUD$42.2M, 510,977 decayed teeth averted and 98.1 DALYs averted”

cardiovascular diseases, depression, neurodegenerative conditions, rheumatic diseases, inflammatory bowel disease, gastric helicobacter pylori, obesity, and asthma. According to fail-safe number statistics, the evidence levels are unlikely to change in the future, indicating a fairly robust consistency.

Oral health affected workforce

Association of oral health with various work problems: a crosssectional study of Japanese workers

BMC Oral Health volume 23, Article number: 488 (July 2023)

• CPD Hours 0.25 scientific

Oral diseases affect quality of life and are known to decrease productivity. This paper examined the impact of oral health status on various types of work problems.

A total of 3,930 workers were included. Overall, a total of 6.2% of workers reported having at least one oral health-related work problem in the past year, whereas 21.8% of those with poor self-reported oral health reported work problems. Workers with poor self-reported oral health had 3.58

times higher odds of reporting work problems than those with excellent self-reported oral health.

Health before profit

Commercial determinants of human rights: for-profit health care and housing

Med J Aust 2023; 219 (1): 4-8. https:// doi.org/10.5694/mja2.51982

• CPD Hours 0.25 Non-Scientific

Health care is a multitrillion-dollar global industry. Ostensibly, for-profit health care does not undermine patient wellbeing. However, evidence suggests that commercial profits often come at the expense of patients.

Commercial determinants often undermine health and health equity. It is possible to redesign our systems so that health is prioritised over profiteering. Nine types of interventions that act at the systems level were identified, moving the focus from people to structures and organisations.

Parkinson's patience

Clinicians’ view on the management of oral health in Parkinson’s disease patients: a qualitative study

BDJ Open volume 9, Article number: 20 (May 2023)

• CPD 0.25 hours non-scientific

Due to numerous motor and nonmotor symptoms, dental treatment in patients with Parkinson’s Disease (PD) can be challenging. Knowledge regarding optimal management of oral health in PD patients is lacking. Dental care in PD patients requires;

1) adaptation of timing and length of treatments and consultations, and;

2) intensifying preventive measures. Managing oral health in PD patients is challenging, and interdisciplinary collaboration

bureaucratic burden and patients more effectively and, consequently, improve their oral health.

Your industry. Your association.

Actively supporting the continuing development of the oral health profession

Membership Includes:

Exclusive DHAA member discounts

Quarterly Bulletin

Local and national CPD events

Industrial Relations Advice

Peer Support Program

Business Support

International Connections Leadership Opportunities

Advocacy for the Profession

International Connections

The DHAA is the peak professional body representing dental hygienists and oral health therapists in Australia.

The mission of the association is to support the continuing development of the oral health professions and preventive models of care.

Through continued growth and development, the DHAA is able to provide high-quality member benefits, legal advice and CPD opportunities.

As well as the option of Professional Indemnity Insurance designed by specialists, tailored for DHAA members.

DHAA Aged Care Chapter

Our DHAA Aged Care Chapter is additional support and ongoing CPD for members working in or interested in working in the aged care sector.

Student Membership

DHAA student membership is free and gives you access to all the same member benefits as our full members.

If

New and Recent Gradaute Membership Join or Renew Today! Contact us: membership@dhaa.info

BOOK CLUB

Those of you who had the pleasure of attending the DHAA 2022 Symposium in Darwin (a reminder to get your tickets for Adelaide ASAP so you don't miss out on this years fun!) may recall hearing about this book. Associate Professor Matt Hopcraft and Roisin McGrath did a joint presentation which moved me to tears numerous times about their experiences with mental health related to their work. It goes without saying that we are a unique profession and for the twenty years I have been a part of it I know until this event I had not had the exposure to others’ perspectives on their experiences with feeling burnout.

Given we are about to get to the pointy end of the year I thought it was a great time to dust this one off and encourage those of you that might be feeling as if you might be feeling burnout or have someone in your practice showing signs, to pick this one up and see if this groundbreaking research can help.

Let’s start with who wrote it given we are making such bold claims as groundbreaking. Professor Gordon Parker is an academic psychiatrist specialising in mood disorders, with a particular interest in the optimal ways to model and account for heterogeneity in both their diagnosis and treatment. He is currently a Scientia Professor of Psychiatry at the University of New South Wales (UNSW) and has worked for over 50 years as a clinician and researcher, is the founder and executive director of the Black Dog Institute, head of the School of Psychiatry at UNSW, director of the Divisions of Psychiatry at Prince of Wales and

Prince Henry Hospitals, and editor-inchief of the Australian & New Zealand Journal of Psychiatry.

Professor Parker has devoted his research efforts to elucidating precise definitions and the clinical differentiation of mood disorders and related conditions, leading to the development of properly tailored management options and customised intervention models. In particular, he has applied these to the study of the clinical syndromes of burnout and melancholia (as distinct from depression), and bipolar disorder subtypes (as distinct from each other

and from personality and psychotic

With the help of co-authors Gabriela Tavella (research officer) and Kerrie Eyers (psychologist), Burnout was published in 2021. It is described as the first complete guide to burnout helping the reader identify if they have burnout along with strategies for recovery.

Even for those of us not feeling as if we are experiencing ‘burnout’ it is a great text to read to help us understand what others who may be experiencing burnout may be feeling given it goes to great lengths to explain what ‘burnout’ actually is versus how it is so often depicted. It also gives the reader a chance to understand the difference between burnout and depression.

It goes without saying the last few years have highlighted how the study of mental health has been neglected. This fascinating study, mentioned as the first of its kind, highlights how our modern world has our brains working harder than ever without the opportunity to recover. Given the unlikelihood of this change being slim, we must adapt to our new environment and the way in which the authors feel we can do this is with stronger mental agility.

Given this is the first book on the topic I expect further research, studies and even further editions of this book will follow but for now, for those who may need it, there is this first stepping stone to a better understanding of a condition we have all heard of but may not have taken all that seriously. n

Do you have a book, journal, or podcast that you think others would love to know about? Send it through to be reviewed; email the details to bulletin@dhaa.info

As part of an occasional series of book reviews, Danielle Gibbens carefully turns the pages of Burnout by Gordon Parker, Gabriella Tavella and Kerrie Eyers

Medical emergencies can happen at literally any time. You can't predict them but you can be prepared to manage them. The five medical situations that follow are soem of the more likelythat you may face in a dental practice.

We have detailed their clinical presentations and management principles. This is not designed to replace existing protocols and/or guidelines but to elaborate on the detection, assessment and management of these emergencies from a paramedic’s perspective (the author having attended many of these in dental settings).

Syncope

Syncope is defined as a sudden loss of consciousness, lasting seconds to minutes and normally with complete recovery 1. Syncope can be broadly classified into three groups: cardiac, reflex and orthostatic. Cardiac syncope results from abnormally slow, fast or irregular cardiac rhythms, along with pre-existing structural changes to the heart (e.g. cardiomyopathies, valvular heart disease).

Orthostatic syncope results from the inability of the sympathetic nervous system to maintain adequate blood pressure during positional changes. For example, when a person goes from lying down to standing up, greater pressure is required to pump blood against gravity, so the heart rate and force of contraction increase cardiac output and peripheral arteries and arterioles constrict to reduce vessel

Syncope is also called fainting or 'passing out'. It most often occurs when blood pressure is too low

Discover what to do if a patient has a medical emergency in your chair

diameter, thereby increasing pressure. In some individuals, this normal compensatory mechanism becomes inefficient, influenced by age, medications (e.g. beta-blockers) or blood volume depletion (e.g. dehydration)1.

Lastly, and possibly the most likely to be seen in dental practice, is the reflex syncope. These result from inappropriate reflex activity, with dilation of blood vessels and/or a reduction in heart rate in response to specific stimuli, often mediated by the vagus nerve (vasovagal syncope). Common triggers include pain, anxiety, intense emotions such as fear or exposure to trauma.

Just prior to loss of consciousness (sometimes referred to as pre-syncope), the individual will present with pale or ashen-coloured skin, profuse sweating, nausea, light-headedness, feelings of heat or chills and may experience visual disturbances (blurred vision or “seeing stars”).1 These symptoms are indicative of the sudden loss of blood flow to the brain and the body’s activation of the sympathetic nervous system in an attempt to compensate. Syncope of all types may be more likely if a person has reduced blood volume (from blood loss or dehydration) or already has their peripheral blood vessels dilated due to a hot environment.

Effective management of both syncope and pre-syncope involves positioning the person lying down with elevation of the legs where possible1. If the person is unconscious, positioning laterally in the recovery position may be necessary to maintain a clear airway, especially if vomiting occurs secondary to nausea. Vital signs should be recorded where possible including pulse rate, rhythm and strength and respiratory rate. Where equipment is available blood pressure, pulse oximetry and electrocardiography (ECG) should also be recorded. In the absence of equipment, the pulse rate, regularity and strength can be useful in terms of detecting abnormally fast, slow or irregular heart rhythms. Most people will recover spontaneously1. However, due to the large range of possible contributors to syncope, medical attention should be sought to establish a cause, especially if the patient demonstrates signs of cardiac syncope. Failure of the person to improve with positioning should prompt immediate medical care via ambulance response.

Anaphylaxis

Anaphylaxis is a life-threatening multisystem allergic reaction that can result from exposure to a number of antigenic substances. Common antigens

their

include foods (nuts, shellfish), insect bites and medications (e.g., penicillin). In healthcare settings, apart from medications, common antigens include iodine, chlorhexidine, latex and adhesive (e.g., tape). It is vital to check for known allergies to avoid inadvertent exposure, but as reactions often escalate with subsequent exposures, the first presentation of anaphylaxis may be to a substance that was not previously known to cause a reaction.

Clients suffering from anaphylaxis will commonly present with:

n Cutaneous signs – redness/erythema of the skin, swelling and/or urticaria (“hives”)2

n Respiratory symptoms – shortness of breath, bronchospasm, and wheeze2

n Upper airway symptoms – difficulty talking or swallowing due to laryngeal oedema, swelling of the lips and/or tongue, and stridor (high-pitched upper airway noise)2

n Cardiovascular symptoms – tachycardia, hypotension, lightheadedness, dizziness, syncope/fainting2

Cutaneous signs tend to be the most recognisable symptoms of anaphylaxis; however, anaphylaxis can also present in the absence of these signs. Sudden onset of hypotension, shortness of breath or upper airway swelling should be suspected to be anaphylaxis and treated as such.2 >>

Anaphylaxis is potentially lifethreatening and should be treated as an emergency

“A client with an altered conscious state should be positioned laterally in the recovery position to maintain

airway.”

Treatment should start with positioning1,2 Unless the client needs to be sitting up to relieve respiratory symptoms, they should be positioned supine, as there is a significant risk of collapse due to reduced blood pressure. A client with an altered conscious state should be positioned laterally in the recovery position to maintain their airway. Oxygen should be administered if available 2 and titrated to pulse oximetry levels of 94-98% if pulse oximetry is available 3 (otherwise oxygen at a flow rate of 1215 litres per minute).

Clients with anaphylaxis may also require intravenous corticosteroids, intravenous fluids to treat hypotension, and/or inhaled bronchodilators (e.g., salbutamol, ipratropium bromide) for persistent bronchospasm. Severe cases may also require ongoing intravenous adrenaline infusions. For these reasons, early activation of an ambulance response will enable these additional treatments and rapid transport to a hospital for definitive care.

Anxiety

Apart from being a potential trigger for syncope, anxiety can present difficulties when managing a client in many healthcare settings. Clients presenting with anxiety may be having an acute emotional response, or the anxiety may be part of a diagnosed or undiagnosed mental health condition. In either situation, the anxious client may present with increased awareness of pain and hyperventilation. Signs of anxiety most easily recognised include increased respiratory rate, increased muscle tone (e.g. white knuckles of the hands on the armrest of the chair), a rigid posture/lack of movement and a slow blink rate. A person with anxiety may actively engage in deep breathing as a means of regulating their anxiety.

Intramuscular adrenaline (epinephrine) should be administered as soon as possible. This will often be available in the form of an autoinjector such as EpiPen® and Anapen®. These devices are preloaded with an adrenaline dose appropriate for an adult (300-500 micrograms) or child (150 micrograms)2. Pharmacologically, adrenaline targets the symptoms of anaphylaxis, increasing cardiac output and constricting the peripheral circulation to increase blood pressure and reduce capillary leakage responsible for tissue swelling. Adrenaline also dilates the bronchioles in the lungs, reversing bronchospasm1. Intramuscular adrenaline doses can be repeated every five minutes, and often more than one dose is required.

Anxiety is best managed with information, psychological support and strategies to regulate the sympathetic nervous system. As fear is often a precursor to anxiety, a well-informed client is less likely to feel out of control and anxious. Likewise, conversation can be both calming and distracting, as is music or other audio-visual media (audiovisual distraction can be particularly effective with children). Deep and slow breathing can be used effectively to reduce anxiety. For example, box breathing (breathing in slowly, holding the breath in, breathing out slowly, and holding the breath out before inhaling again) can reduce a person’s heart rate and have a calming effect. Mindfulness techniques such as grounding offer simple interventions that may be effective in calming a client. For example, some grounding techniques work by asking the person to describe five things they see, four things they feel, three things they hear, two things they smell and one thing they taste (5-4-3-2-1 grounding technique)4. This may or may not be appropriate at the moment, especially if some of those “things” are triggers for the person’s anxiety. Another technique is to give the person a cold pack to hold – and ask them to focus on the shape, temperature, and feel of it.

“Anxiety is best managed with information, psychological support and strategies to regulate the sympathetic nervous system. ”

Clients presenting with anxiety may be having an acute emotional response

Choking / inhalation of foreign bodies

Upper airway obstruction is another potential emergency that may be encountered in dental practice, with fillings, dental burrs or crowns being the possible culprits. These objects, dependent on size, may either obstruct the upper airway or be aspirated into the lungs. In adults, the right main bronchus is larger and more vertical than the left. As a result, inhaled objects that are small enough to pass the vocal cords will most likely end up in the right bronchial tree, preserving left lung function.1

Upper airway obstruction will present with sudden difficulty in breathing. If the obstruction is complete, the person will demonstrate significant effort of breathing, but without air movement or appreciable noise of breathing. If the upper airway is partially blocked, breathing is normally noisy, often with high-pitched breathing sounds (stridor) and an urge to cough. In either case, the person will also present with signs of severe respiratory distress, such as increased effort of breathing, pale and/or cyanosed (blue) skin, elevated breathing rate and heart rate, and decreasing oxygen levels (if able to be measured).

The best immediate management is per established first aid guidelines.5 For a partial obstruction, the person should be encouraged to cough to remove the object. If the object is not able to be coughed up, urgent medical attention should be sought via ambulance. The person should be kept calm, and oxygen administered if available (titrated to SpO2 of 94-98%).3 For a complete obstruction with an ineffective cough, back blows should be used, ideally

with the person positioned to allow gravity to assist with the removal of the object (i.e., bent forward, or for a child, facing head down). If back blows are not effective, chest thrusts can be attempted – these are similar to CPR compressions, but performed in a sharp, abrupt manner.5 If at any point the obstruction is visible in the oral cavity, it can be removed manually or with the assistance of suction.

If back blow and chest thrusts are not effective, and in facilities where personnel are trained in the procedure, direct laryngoscopy can be performed, and the obstruction removed with Magill’s forceps +/- suction.1 As laryngoscopy can be performed by most paramedics, early activation of an ambulance response is important should the earlier first aid measure be ineffective.

Hypoglycaemia

Hypoglycaemia (low blood glucose) occurs when there is reduced intake of carbohydrates, increased metabolic use of glucose and/or increased action of insulin. Under normal conditions, insulin is released from the pancreas in response to rising blood glucose after meals, facilitating the uptake of glucose into all body tissues with the exception of the central nervous system.1 In the diabetic patient, insulin is either underproduced (type 1 diabetes) or the body develops resistance to insulin, making it less effective (type 2 diabetes).

Hypoglycaemic events are generally less common in non-diabetic patients as they have mechanisms to preserve their blood glucose levels. When blood >>

“If back blows are not effective [for choking], chest thrusts can be attempted – these are similar to CPR compressions, but performed in a sharp, abrupt manner”

Occasionally, individuals with diabetes will carry glucagon injection kits, but otherwise treatment will require the attendance of paramedics

glucose drops, the body responds by releasing glucagon from the pancreas. Glucagon stimulates the breakdown of glycogen into glucose within the liver, increasing glucose within the blood.1 Glycogen stores tend to be lacking in individuals who have liver disease or in people who have been fasting. Clients avoiding food intake prior to dental appointments may make them prone to hypoglycaemic events.

Hypoglycaemia presents with signs of sympathetic nervous system activation: tachycardia, dilated pupils and pale, cool, clammy skin.1,6 Due to the lack of glucose supply to the central nervous system, patients can present with a range of neurological symptoms including confusion, agitation, an altered level of consciousness, slurred speech, unsteady gait, seizure activity and/or complete loss of consciousness.1,6

Treatment of hypoglycaemia is dependent on the individual’s conscious state; more specifically, their ability to ingest glucose orally without risking airway compromise. If the person is able to safely ingest fluids, treatment should include offering the person drinks such as juice or soft drink with a high simple sugar content.1,6 Honey or glucose gel can also be used, as can lollies or other foods, but fluids or gels are often easier to consume for confused clients. Where an individual is not able to safely ingest glucose, treatment involves injection of intramuscular glucagon or an intravenous infusion of glucose where available.1 Occasionally, individuals with diabetes will carry glucagon injection kits, but otherwise treatment with glucagon or intravenous glucose will require the attendance of paramedics outside of a hospital or medical clinic. As the person’s conscious state can deteriorate, early recognition is important to be able to treat the condition with oral glucose as opposed to invasive treatments that may not be readily available. A drop in the person’s conscious state will also necessitate repositioning to maintain a clear airway, notwithstanding the need to manage aggressive behaviour and/or seizure activity. n

About the author: Dennis Walker is a lecturer and clinical placement coordinator for the undergraduate Paramedicine program at the University of Southern Queensland. He is also a registered paramedic, having worked within the Queensland Ambulance Service for 27 years in a range of roles including Critical Care Paramedic, Flight Paramedic, Isolated Practice Area Paramedic and Clinical Support Officer. Dennis is in the final months of completing his PhD in the area of prehospital medication safety.

References

1. Hockberger, R., Gausche-Hill, M., Wilcox, S. R., Walls, R., & Erickson, T. B. Rosen’s Emergency Medicine: Concepts and Clinical Practice (10th Ed). Elsevier; 2022.

2. Australian Society of Clinical Immunology and Allergy. Acute Management of Anaphylaxis. 2023. Accessed via https://www.allergy.org. au/images/ASCIA_HP_Guidelines_Acute_ Management_Anaphylaxis_2023.pdf

3. ANZCOR Guideline 9.2.10 – The Use of Oxygen in Emergencies. ANZCOR; accessed via https:// www.anzcor.org/home/new-guidelinepage-2/guideline-9-2-10-the-use-of-oxygenin-emergencies

4. Schuldt, W. Grounding Techniques. Therapist Aid; accessed via https://www.therapistaid. com/therapy-article/grounding-techniquesarticle

5. ANZCOR Basic Life Support Guideline 4 –Airway. ANZCOR; accessed via https://www. anzcor.org/home/basic-life-support/guideline4-airway

6. ANZCOR Guideline 9.2.9 – First Aid Management of a Diabetic Emergency. ANZCOR; accessed via https://www.anzcor.org/home/new-guidelinepage-2/guideline-9-2-9-first-aid-managementof-a-diabetic-emergency

“Treatment of hypoglycaemia is dependent on the individual’s conscious state; more specifically, their ability to ingest glucose”

Our Symposium theme is Synergy and Sustainability.

We will explore the many ways these concepts can be interpreted - such as working with vulnerable groups to support their needs & human rights, investigating new and emerging technologies, working towards sustainability in dental and other settings, and our social responsibilities as practitioners.

Keynote presentation

The Numbers Game - how to play it safely. An in-depth look at item numbers, audits and provider numbers.

Dr Martin Webb

Can we do zero waste dentistry?

Dr Sarah Kelly

Sustainability – angels, ostriches and Furphy

Dr Mark Hutton

Intersectional approaches to overcome health inequality

Dr Trudy Lin

The unexpected side effects of new anti-cancer drugs: they’re not what you’d think!

Geraldine Moses

Workshops

Royal Flying Doctor Service: Rural and remote oral health promotion workshop

Ergonomics & Wellness for Hygienists and Oral Health Therapists

Aged Care Workshop

Blood, blood, glorious blood

Social Events

Welcome Drinks in the Exhibition

Student & Recent Graduate Networking Event

Themed Gala Dinner

“Oops I wore it again!” - be sustainable and show off your favourite outfit by wearing it again .

South

‘Dr Trudy Lin appears by arrangement with Claxton Speakers International.’

Dealing with

Diabetes

Understanding type 2 diabetes, how it affects teeth and the importance of lifestyle factors on its management

by Michaela von Geijer, Doctor of Dental Surgery

Diabetes is a dramatically growing disease, affecting hundreds of millions worldwide at enormous societal costs.

Topical research proves a bi-directional link between periodontal disease and diabetes and that periodontal health benefits diabetes patients. As dental professionals, we can act from a holistic perspective and encourage positive lifestyle changes, influencing not just oral health but the overall well-being of our patients.   There are two types of diabetes – Type

1 diabetes mellitus (meaning there is no insulin production) and Type 2 diabetes mellitus (T2DM). A patient with T2DM has a production of insulin, at least at an early stage of the disease. The function of insulin is to assist the body’s cells in absorbing glucose from the bloodstream. In patients with diabetes, the cells cannot make proper use of the insulin, resulting in insulin resistance. This article covers only T2DM and how lifestyle changes can improve T2DM or reduce the risk for patients with pre-diabetes.

A rapidly growing disease

T2DM affects hundreds of millions around the globe. Figures show the most pronounced increase in men compared to women and in low- and middle-income countries (Kolb & Martin, 2017; NCD-RisC., 2016). Many are not diagnosed, and one-in-two people remain undiagnosed (IDF diabetes atlas, 2021). Approximately 10% of adults have diabetes, and a more than 50% increase in diabetes incidence is predicted by 2040 (IDF Diabetes Atlas Tenth edition, 2021). The societal costs of treating diabetes and its complications have increased massively during the last decades. Diabetes complications are often established long before the actual diagnosis of the disease. Figures tell us that up to 30% of patients have micro- or macro-complication before diagnosis (Gilles et al. 2008; Cieslik et al., 2022). Also in Australia, medication and treatment complication costs have increased enormously within the last 15 years. Clearly, treating the complications due to diabetes costs much more than patients not developing diabetes (Dinh et al., 2022).

We must address this global epidemy and reverse diabetes at its early stages by creating and improving healthy habits. Even small changes will have an impact on overall health. Dental professionals are experts on this; we have the tools to inspire patients to individualised lifestyle changes.

Diabetes and periodontal disease

At the dental office, we meet patients daily at risk of developing T2DM or with confirmed disease. Because clinical signs of diabetes may be found in the mouth, we should refer the patient to a physician for a blood sugar check if we suspect pre-diabetes or diabetes. Early detection and treatment are of uppermost importance to reduce the risk of complications, and starting medication will also increase the quality of life for the individual.

The two-way relationship between diabetes and periodontal disease is well established, not the least among dental professionals. Keeping the periodontal tissue healthy and treating periodontal disease is key for patients with diabetes since periodontitis is associated with increased HbA1c and diabetes complications. We know that periodontal treatment will improve HbA1c levels (Sanz et al., 2018).

The importance of lifestyle factors

Taking good care of the mouth every day is a lifestyle factor we should encourage; However, dental professionals are also in a position to improve other lifestyle changes. We are trained in motivation and communication techniques and practice these skills at every session. Many of us have an in-depth knowledge of a healthy diet, which we often share with patients. Encouraging positive lifestyle changes in our patients will

impact glycaemic levels for those with diabetes, thus decreasing the risk for complications and more medications. Even minor changes may result in a later onset or progression and hopefully fewer diabetes complications. Some lifestyle changes seem more critical than others, but every little step we can influence is beneficial – for the patient and society (Lau& Teoh, 2015).

Lifestyle factors play a vital role in managing type 2 diabetes. Since they could be enough to reverse the disease early, we may prevent or delay type 2 diabetes in many patients through our influence. Lifestyle changes that impact diabetes are, for example, a healthy diet, daily exercise, a healthy weight, healthy gums, less stress, and 7-8 hours of sleep. The genetic component (family history) and ageing will, of course, also impact the development of T2DM (Wu et al. 2014, IDF Diabetes Atlas Tenth edition, 2021).

Normal body weight

Being overweight is one of the strongest risk factors for DMT2. The way we live today, with plenty of energydense, unhealthy Western foods and a sedentary lifestyle, causes an increase in body weight (Wu et al. 2014). The more excess weight, the more cell resistance to the insulin hormone is created. Especially visceral obesity, fat surrounding internal organs, seems to increase the risk, >>

“We should refer the patient to a physician for a blood sugar check if we suspect prediabetes or diabetes”

rather than high body mass index (BMI) (Kolb & Martin, 2017). Reducing weight is one of the primary targets to reduce the risk of diabetes (Hamman et al. 2006).

Healthy eating

For many people living in developed countries today, over-eating and unhealthy food are a problem, and an unhealthy Western diet will increase the risk for TD2 (Jannasch et al., 2017).

We all understand and know the importance of a healthy diet for all patients, but especially for patients with the risk of developing diabetes or with a diabetes diagnosis. Implementing changes towards a healthy diet is very hard; no one wants to be on a diet for the rest of their lives. We know that habit formation takes time to implement (Lally et al. 2009). Therefore, we must encourage small changes in eating habits that will become a natural preference for healthier food.

Healthy eating for T2DM patients with overweight includes a reduction of energy intake with smaller portions of food and a healthier choice of food, such as carbohydrates with a low glycaemic index rich in fibres (brown rice, buckwheat, whole oats, pulses) and healthier fats. In addition, an increased daily amount of vegetables and fruits adds minerals and vitamins to the body. Sugar, salt and red meat intake should be reduced, and alcohol consumption should be moderate. Remember that special diabetic food is not always healthier (Diabetes UK, The British Diabetic Association). Moreover, soft drinks should be avoided; water is the perfect thirst quencher. The Mediterranean and Paleolithic diets are examples of healthy eating, including a high intake of vegetables, fruit, olive oil, and fish, which are shown to reduce the risk for future diabetes (Martin-Pelaez S. 2020; Esposito et al., 2014).

As healthcare providers, it’s important to discuss with our patients their eating habits, including the types and amounts of food they consume, in order

3 key takeaways

n Encourage all of your patients to adopt a healthier lifestyle.

n Be observant of diabetes symptoms in the oral cavity. If you suspect the patient’s sugar levels are high, referring them for glucose testing is recommended.

n It is important to ensure that patients with diabetes receive regular maintenance care.

to maintain a healthy weight and blood sugar level. Let’s share our expertise and advice on overall dietary patterns.

Physical activity

Physical inactivity is becoming a significant global health problem. Yet, performing any physical activity will enhance health, such as improving lipid profile, reducing blood pressure, and impacting overall well-being (Kanaley et al., 2022). The benefits of exercise can’t be overstated, especially for patients with pre-diabetes/diabetes. Daily exercise reduces glucose levels, improves insulin sensitivity, strengthens muscles and bones, and helps control body weight (Wu et al. 2014).

Among those who perform any

physical activity during leisure time, the incidence of T2DM is lower (Smith et al. 2016). Physical activity might reduce the development of T2DM by 30-50% (Bassuk&Manson, 2005; Wu et al. 2014). There are physical guidelines for suitable activities, mainly applicable to patients with diabetes (Smith et al. 2016; CDC 2023).

Since we nowadays have a more sedentary lifestyle, we would all benefit from very short activity breaks during the day but also planning for regular physical activities several times a week. All kinds of activity are of value (Kanaley et al., 2022).

Avoid tobacco use

Tobacco usage, especially smoking

The Mediterranean and Paleolithic diets are great examples of healthy eating

cigarettes, is a lifestyle factor most of us bring up with patients suffering from periodontitis. It’s important to discuss this issue with all patients, as it can negatively affect their overall health and have a significant impact on diabetes. According to the World Health Organisation, smoking is a modifiable risk factor in preventing disease (WHO, 2016). Furthermore, smokers will find diabetes harder to manage since smoking impacts insulin sensitivity and insulin production in the pancreas (Durlach et al. 2022; Maddatu et al., 2017). Smoking will increase the prevalence of macro- and microvascular complications in these patients (Sliwinska-Mosson&Milnerowicz, 2017).

It has been shown that smoking increases the risk of central obesity. In

Enough sleep

Studies show that lack of sleep, insomnia, irregular sleep, waking up too early and other sleep-related disorders are associated with an enhanced risk for T2DM since it increases insulin resistance (Anothaisintawee et al., 2016; Engeda et al. 2013).

Too little sleep will raise cortisol levels, and cortisol will counteract the effect of insulin, causing insulin resistance. Sleeping five to six hours per night increases the risk for T2DM but there are also studies showing that sleeping more than the standard svene to eight hours per night might increase the risk of developing T2DM (Chaput et al. 2007; Engeda et al., 2013).

Thus, sleep-related disorders will make diabetes harder to manage, while a good night’s rest benefits patients with diabetes and all individuals alike.

Healthy gums

on oral health as a modifiable risk factor is rarely included in the information for patients with diabetes (AIHW, 2022; fip, 2021; Diabetes Australia, 2023)

Conclusion

It is essential to understand the complexity of diabetes and the numerous risk factors involved, some of which can be affected by a change of behaviour. When diagnosed early, patients only receive recommendations on lifestyle changes. Following the advice and making lifestyle improvements can make glucose values drop and insulin resistance disappear. A healthy lifestyle is associated with a lower risk of mortality in patients with T2DM (Han et al. 2022).

addition, the accumulation of visceral fat is a well-known risk factor for insulin resistance (Maddatu et al. 2017). Cigarette smoking is linked to a 30% or 40% increased risk of developing T2DM. (CDC, 2022). In light of this, smoking cessation is a fundamental task for diabetes prevention and for managing periodontitis.

Less stress

There seems to be some evidence that high stress and anxiety levels are related to T2DM. They increase cortisol levels which might hinder the insulinproducing cells from working properly and affect the insulin resistance or sensitivity in the cells (Wong et al., 2019; Hackett&Steptoe, 2017).

There is a two-way relationship between diabetes and periodontitis. Periodontitis increases the risk of diabetes by 20–30% and severe periodontitis is associated with a higher risk of diabetic complications (Graziani EFP, 2018). Patients with periodontitis and diabetes have poorer glycemic control, and patients with diabetes are more likely to develop periodontitis (Sanz et al. 2018).

Periodontal treatment reduces glucose levels and improves HbA1c in patients with diabetes; the effect is equivalent to adding a second antidiabetic drug (Chapple et al. 2013). After 12 months, periodontal treatment still had a good effect on HbA1c levels (Simpson et al. 2022). Periodontal treatment is safe to perform and should be carried out in patients with diabetes, just as in all patients with unhealthy gums. To maintain results, the patient must also perform thorough plaque control, cleaning all sides of the tooth with a toothbrush and interdental cleaning. Despite the clear connection between diabetes and periodontitis, information

As dental professionals, we have the power to make a difference by sharing information and knowledge with our patients, medical staff, pharmacy, and other stakeholders. Every little lifestyle change benefits the patient. n

About the author: Doctor of Dental Surgery, Dr Michaela von Geijer is working part-time at a private dental office in Sweden and at TePe HQ in Malmö, Sweden. She has long clinical experience, with a particular interest in prevention and oral health. She has always placed a high value on working with a preventative focus.

Dr von Geijer has held temporary preclinical positions as amanuensis at the University of Lund, including basic research and assistance with education/training at the medical and dental schools.

She also has experience lecturing to professionals when employed by pharmaceutical companies as well as companies within the dental industry.

She has been employed by TePe and a lecturer at universities around the world since 2015.

“As dental professionals, we have the power to make a difference by sharing information and knowledge with our patients”

Accidental impact

How could an injury impact you as a practising dental hygienist?

As a dental hygienist, your ability to work impacts your earnings. So, what happens if you experience an injury and are unable to work? Would you be able to manage without an income for several months?

In this article, BMS, the partner insurance broker of DHAA, discusses what Personal Accident Insurance is and how it could help in the event of an injury.

What are the potential risks?

Let’s imagine you’re about to head off for work one morning.

As you walk down the stairway, you suddenly lose balance after missing a step. This causes you to fall and injure your knee and wrist. Your injuries mean you’ll need surgery and be off work for a couple of months. You’ll also have some regular medical expenses as part of your recovery.

How could this impact your financial well-being, career, or business as a dental hygienist?

You could face the following challenges:

• Loss of income

• Medical costs

• Stress

What is Personal Accident Insurance?

Personal Accident Insurance provides cover in the event of accidental death or permanent/temporary disability or injury.

Cover can typically provide financial assistance (loss of income) while you’re unable to work, but could also extend to provide cover for rehabilitation, corrective surgery, and medical expenses.

Personal Accident Insurance is different to Workers

Compensation as it generally provides cover even if the injury happened outside of work.

How do I decide if I need cover?

There are different types of policies that could provide cover should you become injured or ill. It can be confusing to decide whether you should consider additional cover and what is suitable for you.

“As a DHAA member, you have exclusive access to a range of insurance solutions, including Personal Accident Insurance offered by BMS”

Ask yourself these questions:

• Do I have the financial means to support myself for potentially several months if I became ill or injured?

• Do I run my own practice or work as a sole trader?

• Do I have employees?

• Do I work off-site often?

On the oppostite page is a high-level breakdown of Personal Accident Insurance and Workers Compensation to help you distinguish between each:

How can BMS help?

In the example on the right, your DHAA Professional Indemnity insurance policy would not cover you. In this circumstance, Personal Accident Insurance could step in to help cover medical expenses and lost income during recovery.

As a DHAA member, you have exclusive access to a range of insurance solutions, including Personal Accident Insurance offered by BMS.

For more information or to arrange a quote, speak to BMS on 1800 940 762 or email dhaa@bmsgroup.com

You can also submit an enquiry by using the connect with us form in your account, at dhaa.bmsgroup.com n

• Cover if you’re unable to work due to accidental injury, death, or permanent/ temporary disability. The cover is typically provided regardless of where the injury took place.

• Cover for staff in the event of injury or illness that has occurred due to their work. This includes payment of medical expenses, rehabilitation, and salary while staff are unable to work.

• Rules for Workers

Compensation insurance vary between States. Refer to the business.gov.au and the Fair Work Ombudsman websites for more information.

Personal Accident Insurance Workers Compensation

Going

How can we as dental professionals make our practice more sustainable?

According to the Australian Government’s Department of Industry, Science, Energy and Resources, Australia generated 67 million tonnes of waste in the year 2016-2017 (Australian Government 2020). Dental care, both at home and in the clinic can be seen to produce significant levels of single use waste. With global waste levels rising, what strategies can we as dental professionals implement to decrease the level of landfill associated with oral health care?

Sustainably and minimally packaged oral health products

Sustainably and minimally packaged oral health products have now increasingly become available across supermarkets, pharmacies and in dental practices. Materials commonly used in these products include, bamboo,  for example;  bamboo toothbrushes, and it is of note that companies like Colgate use sustainably grown bamboo. Cardboard is another example, you can opt for your patient take-home packs to be made from cardboard, which can be  recycled, rather than single use plastic bags.   It is also great to see so much innovation in the recyclable plastic space, in fact, the first fully recyclable toothpaste tube  has been launched by Colgate, and this technology will be shared with all dental companies worldwide.

Each of these materials and innovations,  help in reducing the

green

amount of single use waste that arises from at home dental hygiene practices. These products can be advocated and used within your workplace to empower patients to join the movement in helping to reduce waste.

Clinical Practice

Multiple use clinical equipment can be a fundamental strategy for your workplace to reduce the waste from single use products. Re-processable metal instruments, patient cups, digital x-ray films, and other clinical equipment that can be sterilised and reused ongoing should be strongly considered. Electronic patient records and communications can help to enable practices to aim for paperless operation. Careful organisation and treatment protocols involving all staff can significantly help in ensuring that the equipment set out for each patient is dispensed appropriately and only what is required for the appointment is used. This can help in reducing the changing of PPE by assistants during examinations and treatments also. Not only is our main goal to drive the message of dental disease prevention to our patients to empower them to improve their oral health but, less disease incidence can result in less materials and waste generated from clinical treatments.  A win-win for both patient and clinician!

Colgate’s Terracycle program

Another strategy you can implement is getting your workplace to participate in Colgate’s Terracycle program. The program is a voluntary, opt-in initiative developed through a partnership between Colgate and Terracycle. The

program is entirely free for dental clinics to participate in, providing shipping boxes and allowing anyone to drop off used oral health products of any brand that would otherwise be sent to landfill. Such products include toothpaste tubes and caps, manual toothbrushes, electric toothbrush heads, toothbrush and toothpaste tube plastic packaging and floss containers. Electric toothbrush handles and bases can also be recycled but through a separate program here. Once the recycled products are collected at the dental clinic, they can then be sent off to be recycled. Each unit received collects points which can be redeemed for a monetary donation to a not-for-profit organisation or school of your choice. At present there are over 6,000 participating locations across

Australia recycling close to 650,000 units of used oral care products and raising over $10,500. The recycled waste is then processed and used in making a range of products such as garden beds and benches for schools (just to name a couple!).

References:

Austalian Government, 2020 ‘Reducing waste’, Department of Industry, Science, Energy and Resources, viewed 21st October 2020, <https://www.energy.gov. au/households/reducing-waste>.

Terracycle, 2020 ‘Oral Care Recycling Program’, Terracycle, viewed 21st October 2020, <https://www.terracycle.com/enAU/brigades/oral-care-brigade-au>.

About the author: William ‘CJ’ Carlson-Jones is an Oral Health Therapist currently working as a lecturer with the University of Sydney teaching into their Bachelor of Oral Health program. Completing his Bachelor of Oral Health, Graduate Certificate in Oral Health Science, and Master of Business Administration CJ has strong aspirations to facilitate accessible, high quality dental care for all Australians. CJ has also commenced further studies undertaking a Doctor of Philosophy with the University of Queensland. His research will focus primarily on impact the transitional workforce from dental therapist to oral health therapist might have upon consumers, public dental services, tertiary institutions, and regional areas. He is the President of the Australian Dental Oral Health Therapists’ Association (ADOHTA) and is a strong advocate for a team approach to dental care. CJ continues to strive for high-level corporate governance through his membership with the Australian Institute of Company Directors (AICD). He is a founding representative on the Colgate Advocates for Oral Health: Editorial Community.

“Materials commonly used in these products include, bamboo toothbrushes, and it is of note that companies like Colgate use sustainably grown bamboo”

The power of influence in building others

Part three of a four-part series on core leadership skills fundamental for building your leadership muscle

By Lyn Carman

TO DATE, IN this series on leadership, we have covered two of the four core skills: Self awareness and communication. In this article, we discuss the third in the four core skills - Influence.

Ever heard the saying, “We have a responsibility to influence the people in our lives to be the best possible people they can be: Therefore encourage one another and build each other up”? It’s a cool idea that reminds us of how much impact we can have on each other’s lives.

To recap the definition of leadership I particularly like: To influence, inspire and help others become their best selves, building their skills and achieving goals along the way. Think about it – whether we’re leading a team at work, helping a friend, or just being there for our family, we’re all influencers in some way. It’s not about having a fancy title; it’s about making a positive difference.

In my work with dental professionals, I often hear – “I have nothing to offer, what do I have that is of value to others?” “I’m not a leader!”

Sometimes we might feel like we don’t have much to offer in terms of influence. Maybe we’re not the loudest in the room

or the ones in charge. But that’s not what influence is all about. It’s not about being the boss or having the most followers on social media.

This belief that we have nothing to influence others often stems from self-doubt, misconceptions, and limited awareness of our own abilities. By expanding our understanding of influence, celebrating small victories, and fostering selfconfidence, we can begin to see our ability to make a positive impact on those around us.

Leadership is not merely about holding a position of authority; it’s about creating a positive impact on those around us. At the core of effective leadership lies the fundamental skill of influence. As leaders, we have a responsibility to harness this skill to inspire and guide individuals toward becoming the best versions of themselves. So, let’s explore the essential role of influence in leadership and how it fits with the concept of building others up.

Influence is the ability to affect the thoughts, emotions, and actions of others. Whether you’re leading a team, mentoring a colleague, or guiding family members, the power to influence is a vital tool that can drive positive change. Through influence, we can inspire others to adopt new perspectives, embrace challenges, and work towards common goals. Remember, influence is not about manipulating or controlling others; it’s about inspiring and guiding them towards positive outcomes.

Great, so what are some impactful ways we can influence? – I’m sure you're already doing many on this list. Perhaps it’s a good time to become aware of those you might need to do more of or even reflect on the leadership in your workplace and how it impacts the team.

n Lead by example: Show through your actions the qualities you value and want to inspire in others.

n Effective communication: Engage in clear and meaningful conversations that foster understanding and connection.

n Empathy: Understand others’ perspectives and emotions to build trust and influence.

n Support and guidance: Offer assistance, advice, and mentorship to empower others.

n Share knowledge: Share your expertise and insights to empower and educate others.

n Acknowledge and appreciate: Recognise contributions and create a positive atmosphere of value.

n Provide feedback: Offer guidance for improvement in a helpful manner.

n Encourage creativity: Foster innovative thinking by valuing unique ideas.

n Set high standards: Strive for excellence and inspire others to do the same.

n Stay positive: Maintain an optimistic attitude that encourages resilience in others.

n Build relationships: Develop genuine connections based on trust and rapport.

n Respect differences: Embrace diversity and value differing opinions and backgrounds.

n Celebrate wins: Acknowledge achievements and boost morale through celebration.

n Promote collaboration: Encourage teamwork and cooperation for collective success.

n Lead with integrity: Uphold ethical principles to establish credibility and meaningful influence.

As oral health professionals, we all carry the responsibility to uplift and inspire those we lead. This responsibility is not just a task; it’s a privilege that comes with the potential to transform lives. When we encourage and build others up, we create an environment where people feel valued, supported, and motivated to excel. This is where the true essence of leadership shines – not in the authority we wield, but in the positive impact we make on individuals. A leader’s influence transcends short-term results; it contributes to the establishment of a culture of growth. When leaders consistently uplift their team members, it creates a ripple effect that reaches far beyond individual interactions. Team members learn to support one another, leading to a collaborative and harmonious environment where everyone’s strengths are acknowledged and nurtured. And even more than this, the ripples flow outward to our communities, to our patients and the experience they have when they choose us to care for them.

Influence is not just a tool in a leader’s toolbox; it’s the cornerstone of effective leadership. Our responsibility as leaders is not limited to achieving objectives or maintaining authority. It’s about recognising the potential within those we lead and guiding them to become the best possible versions of themselves. By embracing the power of influence and adhering to the principle of encouraging and building each other up, we can create a world where leadership is defined by the positive impact it leaves on individuals and the broader community.

Workplace harmony and culture are dependent on good leadership. Share this knowledge with your team and take action as a leader in your space – influence your team.

I look forward to sharing the final in this series next issue –part four; Learning Agility. n

“Leadership is not merely about holding a position of authority; it’s about creating a positive impact on those around us”

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

STATE NATION

ACT

ACT contacts:

Director Amy McDermott directoract@dhaa.info

Chair Kate Spain. chairact@dhaa.info

n ACT members gathered at the Southern Cross Yacht Club over dinner on 2 August to welcome the new periodontist in town, Dr Clarence Da Cruz. The event was sold out and Dr Da Cruz took the opportunity to answer questions from members on periodontal diseases as well as discuss the current periodontal classifications.

The next ACT event will be two Joint (DHAA-ADOHTA) hands-on workshops on Ergonomics & Edges, and Posterior Restoration at QT Hotel Canberra on Saturday 28 October. Options are available to register for one or both workshops.

REGISTER TODAY

Another popular ACT event is the end-of-year celebration that will be held on Saturday 25 November at the Crown Plaza, Canberra. The event will feature periodontist Dr Robert Fell and Oncology Radiologist

Dr Alison Salkeld.

REGISTER TODAY

Given that recent ACT events were all sold out in advance, it is highly recommended that you register for these events early to avoid disappointment.

NSW

NSW contacts: Director Warrick Edwards directornsw@dhaa.info

Chair Jinous Eighani-Roushani chairnsw@dhaa.info

n The NSW Smiling for Life full-day event on 22 July was held at the Pullman Hyde Park and was sold out well before the registration

deadline. The education program was packed with everything from birth through to elderly patient care and featured paediatric dentists Dr Kareen Mekertuchian and Dr Jad Clarke; periodontist Dr Ehsan Mellati; hygienist and dental surgeon Dr Laura Blackmore; special care dentist Dr Avanti Karve; and dental prosthetist Jenine Bradburn. The DHAA apologises to many who missed out on attending the day as we have exceeded the capacity of the venue.

The next NSW event will be a Joint event held by DHAA and ADOHTA for hands-on workshops

“ The next NSW event will be a Joint event held by DHAA and ADOHTA for hands-on workshops on Ergonomics & Edges, and Posterior Restoration ”

on Ergonomics & Edges, and Posterior Restoration at the Mercure Hotel, Chippendale on Saturday 21 October. Options are available to register for one or both workshops. Workshops are limited to 20 attendees so don›t miss out on registering your attendance. REGISTER TODAY

NSW members enjoyed a full day event at the Pullman Hyde Park in Sydney

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

NTNT Contact:

Staff Bill Suen bill.suen@dhaa.info

n NT bid farewell to Director Hellen Checker, who recently resigned from the role to focus on her family and local community services. All communications for service and support can be directed to CEO Bill Suen until we fill the vacant positions of NT chair and/or director. Please contact Bill if you wish to be involved in these leadership roles to represent and serve local NT members.

All NT members are invited to join the local WhatsApp group which was established to foster communication and networking. This chat group provides a forum for members to share ideas and for the DHAA to provide support to NT members. Once joined, members will receive notifications of all communications within the chat group. Individuals may then choose to initiate or participate in any discussions that they are interested in. It is absolutely fine if individuals wish to be a silent member of

group

the group and continue to be kept in the loop of all communications.

The chat group is hosted by DHAA NT member Leonie Brown. To join, simply click on the link.

Qld

Qld Contacts: Director Carol Tran. directorqld@dhaa.info

Chair Stacey Billinghurst chairqld@dhaa.info

Deputy Chair Karen Smart contactqld@dhaa.info

n The Collaborative Care full-day event in Brisbane on 5 August was another sold-out event at capacity, with a long waiting list and attendees turning up on the day hoping to fill last minute absentees’ places. The education program looked at collaborative care and learned from allied

health and oral health professionals to expand knowledge and improve patient care. A range of interesting topics such as special care dentistry, sexual behaviours and oral health, and periodontal diseases were covered by, Oral Health Therapists

Leah Hobbs and Stephen Moor; Sexual Health Nurse Linda Trewin; and Periodontist Dr Christopher Barker National President A/ Professor Carol Tran was in attendance and provided an update on DHAA activities to local members. The next QLD event is our Christmas Brunch in Brisbane on Saturday 2 December. Please mark this date in your diary and look out for an announcement with program details and registration links.

SA

SA Contacts:

Director Michelle Kuss michelle.kuss@dhaa.info

Chair Sue Tosh chairsa@dhaa.info

Deputy Chair Courtney Rutjens contactsa@dhaa.info

n The SA annual dinner was held at the elegant Martini Ristorante on 23 June featuring two of Adelaide's top periodontists, Dr Ranu Acharya and Dr Steve Soukoulis. The dinner was well attended at capacity and attendees were most impressed with the excellent presentations from Dr Acharya on periodontal referrals from dental hygienists and Dr Soukoulis discussing the very useful dental implant registry. There was plenty of networking on the night with many familiar faces.

The next SA event will be the annual SA Christmas Brunch at the Robin Hotel, Norwood on Sunday 3 December. This is a highly popular event that everyone talks about so please mark this date in your diary and look out for the announcement with program details and registration links.

JOIN

“ All NT members are invited to join the local WhatsApp

which was established to foster communication and networking”

“ The education program looked at collaborative care and learned from allied health and oral health professionals to expand knowledge and improve patient care”

Tas

TAS Contacts:

Chair Karen Lam chairtas@dhaa.info

Staff Bill Suen bill.suen@dhaa.info

n Our TAS Chair Karen Lam has been working hard behind the scenes with ADOHTA to bring to our members a joint fullday seminar in Launceston on Saturday 11 November at the Sebel Hotel. The full-day comprehensive education program will include expert presenters Dr Alex Du Bois on periodontics; Dr Ruthy Hernandez on cosmetic injectables; and Dr Ioan Jones will cover special care dentistry. This is a unique opportunity to network with peers from both DHAA and ADOHTA while gaining new clinical knowledge from the experts. Please mark this date in your diary and look

out for the announcement of program details and registration links as places will be filling up quickly.

Vic

Vic Contacts

Director Roisin McGrath directorvic@dhaa.info

Chair Cathryn Carboon chairvic@dhaa.info

Deputy Chair Sarah Laing contactvic@dhaa.info

n After increasing the capacity four times to its maximum, the Victorian Reconnect and Recharge full-day seminar was held

at the beautiful Treacy Centre in Parkville on 15 July. It was a perfect day of quality education held in a beautiful Victorian mansion surrounded by stunning gardens. The program included a great variety of topics from experts covering periodontal and peri-implant diseases, vaping, social media communication, paediatric dentistry, OHT business practice and an update on recent changes to the oral health professional environment. Attendees were treated with gifts, door prizes and finished off the day with nibbles and drinks. A big thank you to

“ The Reconnect and Recharge full-day seminar was held at the beautiful Treacy Centre in Parkville – a perfect day of quality education held in a beautiful Victorian mansion surrounded by stunning gardens”

Cathryn Carboon, Sarah Laing and the Victorian committee for organising such a memorable event, and our sincere apologies to those who missed out as we reached capacity fairly early.

“ TAS Chair Karen Lam has been working hard behind the scenes with ADOHTA to bring to our members a joint full-day seminar in Launceston ”

The stunning Treacy Centre in Parkville hosted a perfect day of quality education (this page)

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

CEO Bill Suen presented to Victorian oral health students at the Charles Sturt University Holmesglen Campus on 14 August. The joint DHAA - ADOHTA collaboration was a great success, with a total of 60 students joining as student members on the spot.

WA

WA Contacts

Director: Phoebe Thomas . directorwa@dhaa.info

Staff: Bill Suen bill.suen@dhaa.info

n The WA full-day event on 17 June at the picturesque Pagoda Resort and Spa

in the Historic Ballroom was a big hit with another full house. The array of expert presenters including Prosthodontists Dr. Graham Carmichael; Elouise Hawkins from the Child and Adolescent Health Services; Periodontist Dr. Melanie McAlpine; Oral Medicine Specialist Dr. Amanda Phoon Nguyen; and our own Aileen Lewis put together an education program that covered a wide spectrum of topics that blew everyone away with the level of expertise and knowledge that was shared. WA members were treated with an ergonomics and instrument sharpening hands-on workshop at the Mercure Perth in

July. This joint DHAAADOHTA event was well attended by members of both associations. We look forward to more collaborative opportunities for both associations.

A big thank you to WA Committee member Carmen Jones for representing DHAA at the WA State

The Victorian committee is now planning for our next event at the Kooyong Lawn Tennis Club on Saturday 2 December. Topics to be covered include the role of DHs/OHTs in head and neck cancers, Oral mucosal diseases, sleep disorders and orofacial myofunctional therapy. This is a very popular event that guarantees to deliver great education and enjoyable social networking for Victorian members. Early registration is highly recommended given the popularity of this event and the limited capacity of the venue.

The full-day event a the Pagoda Resort & Spa hosted a sell-out event in WA

“ A big thank you to WA Committee member Carmen Jones for representing DHAA at the WA State Oral Health Advisory Council on 21 July. ”

Sixty oral health students at Charles Sturt University Holmesglen Campus welcomed a presentation from DHAA CEO Bill Suen (above and below)

Oral Health Advisory Council on 21 July. Quarterly meetings are held for members to review oral health activities and advise the WA Government on oral health matters. We are grateful to Rhonda Kremmer who presented to third year Curtin University students on behalf of the DHAA. Together with the ADOHTA representative, Rhonda promoted DHAA membership and offered our support to graduating

students.

The next WA event has been scheduled for Sunday 12 November at the South Perth Royal Golf Club. Please mark this in your diary and keep an eye out for an announcement of program details in the coming weeks. This is guaranteed to be another unforgettable event as the WA Committee is working very hard to put together another great education and social event for the locals. n

Event Calendar

Get

SEPTEMBER 2023

n 21-23 September

National Symposium

Adelaide

OCTOBER 2023

n 11 October

Webinar

Online

CPD: 1 hour

n 21 October

Joint Hands-On Workshop with ADOHTA

New South Wales

n 26 October

Webinar

Online

CPD: 1 hour

n 28 October

Joint Hands-On Workshop with ADOHTA

Australian Capital Territory

NOVEMBER 2023

n 8 November

Webinar Online

CPD: 1 hour

n 12 November

Half Day

Western Australia

CPD: 2 hours

Key to the state colours

n 18 November

Joint ADOHTA

Full Day

Launceston, Tas

n 23 November Webinar

Online

CPD: 1 hour

n 25 November

Half Day

Australian Capital Territory

CPD: 3 hours

DECEMBER 2023

n 2 December

Christmas Brunch

Victoria

CPD: 4 hours

n 2 December

Christmas Brunch

Queensland

n 3 December

Christmas Brunch

South Australia

n 13 December

Webinar

Online

CPD: 1 hour