Bite magazine is a business and current affairs magazine for the dental industry. Content is of interest to dentists, hygienists, assistants, practice managers and anyone with an interest in the dental health industry
MARCH 2013, $5.95 INC. GST PRINT POST APPROVED NO: 255003/07512 Professor Hanny Calache and the team at Dental Health Services Victoria are having real success with their technique for treating childhood caries The white fight What’s the safe amount of peroxide for at-home teeth whitening? Grand design What you’ll face when you choose to build your own practice, page 24 Show me the money Making the right choice for professional financing arrangements, see page 28 Stop the stupidity! Why are state governments letting local councils cease water fluoridation? Tools of the trade Dentists review their favourite endo files, loupes, intraoral cameras and more SPECIAL REPORT Chairs and dental units product guide, page 35 Crowning achievement
Transcript
March 2013, $5.95 INc. GST
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Professor Hanny Calache and the team at Dental Health Services Victoria are having real success with their technique for treating childhood caries
The white fightWhat’s the safe amount
of peroxide for at-home teeth whitening?
Grand design What you’ll face when
you choose to build your own practice, page 24
Show me the moneyMaking the right
choice for professional financing arrangements,
see page 28
Stop the stupidity! Why are state governments letting local councils cease water fluoridation?
Tools of the trade Dentists review their favourite endo files, loupes, intraoral cameras and more
THE REVELATION3 MODES FOR 3 NEEDSSOPROCARE meets the needs of prophylaxis by performing a complete and rapid assessment of the patient’s oral health.
• ‘‘ PERIO’’ mode: Highlights the old and new dental plaque and gingival inflammations, even at the early stage.• ‘‘ CARIO’’ mode: Detects enamo-dentinal caries, from the stage 1 (code ICDAS II), in a simple way.• ‘‘ DAYLIGHT’’ mode: Macro vision makes visible the imperceptible and allows watching
the stability of micro lesions and their evolution.
COVER STORY YOUR BUSINESS YOUR TOOLS YOUR LIFECONTENTS
03
Contents
2421
3533
COVER STORYIn line for the crown A new technique championed by Professor Hanny Calache and Dental Health Services Victoria is tackling the problem of childhood decay
March 2013
16
custom content8,163 - CAB Audited as at September, 2012
Editorial Director Rob Johnson
Sub-editor Kerryn Ramsey
Creative Director Tim Donnellan
Contributors Amanda Lohan, Will Longfield, Susanna Nelson, A.M. Walsh
Commercial Director Mark Brown
For all editorial or advertisingenquiries:Phone (02) 9660 6995 Fax (02) 9518 5600
Bite magazine is published 11 times a year by Engage Media, Suite 4.17, 55 Miller Street, Pyrmont NSW 2009. ABN 50 115 977 421. Views expressed in Bite magazine are not necessarily those of the publisher, editor or Engage Media. Printed by Bright Print Group
NEwS & EVENTS4. Stop the stupidity!The fluoride fight begins again; Tasmanians get more money for dentistry; and more
YOuR wORld10. White fightThe debate over what is a safe level of peroxide in at-home tooth whitening kits continues, with battle lines drawn between the profession and the industry
YOuR buSiNESS 21. Indemnity politicsWith insurance companies modifying indemnity policies regarding imported medical devices, there is another hidden cost of cheap imports
24. Grand designChoosing to build your own practice doesn’t have to be a painful operation. Get yourself a second opinion about the best techniques in dental surgery design
28. Show me the moneyHow do you make the right choice for your personal and professional financing arrangements? YOuR TOOlS 8. New products The best new gear and gadgets from suppliers you can trust
33. Tools of the tradeSuper smooth endo files, super clear loupes, a super sharp intraoral camera and more are in the spotlight this month
35. Chairs and dental units product guide Everything you need to know about chairs and dental units YOuR lifE50. Bowled overYou always remember your first 300 game, according to Dr Dinesh Singham of Absolutely Dental @ Kirwan Plaza, Townsville, QLD
THE REVELATION3 MODES FOR 3 NEEDSSOPROCARE meets the needs of prophylaxis by performing a complete and rapid assessment of the patient’s oral health.
• ‘‘ PERIO’’ mode: Highlights the old and new dental plaque and gingival inflammations, even at the early stage.• ‘‘ CARIO’’ mode: Detects enamo-dentinal caries, from the stage 1 (code ICDAS II), in a simple way.• ‘‘ DAYLIGHT’’ mode: Macro vision makes visible the imperceptible and allows watching
the stability of micro lesions and their evolution.
COVER STORY YOUR BUSINESS YOUR TOOLS YOUR LIFENEWS & EVENTS
04
The Australian Dental Association (ADA) has announced it is outraged and dismayed at govern-ments’ lack of leadership
to support the well-established sci-entific evidence that proves fluorida-tion of water supplies is safe. “The Queensland and now other state governments’ decision to permit ill-informed local councils to choose to stop fluoridation of water sup-plies represent a failure to protect the public’s oral health. These Local Councils seem to be responding to fringe groups’ falsely based scare mongering and are not considering the scientifically well-established benefits of fluoridation,” ADA federal president Dr Karin Alexander says.
“World Health Authorities, the Aus-tralian Institute of Health and Welfare, the Australian Dental Association and the Australian Medical Association, to name a few, all recognise the sig-nificant benefits that occur in dental health when fluoridation of water supplies occurs. Despite this, the state governments’ capitulation to the irrational fears of a minority and failure to educate the public will only provide a temporary false sense of reassurance. The public’s health and the public purse will ultimately have to pay for this decision, when levels of dental disease and dental decay starts to massively increase.”
The Australian Research Centre for Population Oral Health at the Uni-versity of Adelaide has just released significant research that serves as a major addition to the scientific consensus that drinking fluoridated water is beneficial to all Australians’ dental health.
This new research shows the beneficial effects on adult populations. The release of the article, ‘Effects of Fluoridated Drinking Water on Dental Caries in Australian Adults’, in the
Journal of Dental Research, shows that Australian adults with a greater than 75 per cent lifetime exposure to water fluoridation have significantly reduced caries experience when compared with those with a less than 25 per cent lifetime exposure. This reduction has occurred in adult Australians born in both the pre- and post-fluoridation generation. The significance of this is that the introduction of water fluorida-tion to a community will benefit all residents, not only those who grow up drinking fluoridated water.
“We have a federal govern-ment wanting to deliver a plan that provides dental care to under 18-year-olds, commencing in 2014. Any benefit the scheme will have on childrens’ teeth will be seriously undermined by withdrawal of water fluoridation,” says Dr Alexander.
“If the Australian government wants this new scheme to have a positive impact and if state govern-ments want their public sector dental sector to be effective, then they must step in to ensure water fluoridation is maintained where it is in place and implemented where possible in the rest of the country.”
Back to the age of decayIf you thought the battle for fluoridation had finally been won, think again—oral health experts are back to explaining why it works as councils try to ban it
Buying smiles
You know it’s an election year when the government starts throwing extra money around for public dentistry, despite having limited funds up until recently. This week, the Federal Health Minister, Tanya Pliber-sek, visited Devonport last month to announce Tasmania will receive an extra $12 mil-lion from the Federal Govern-ment to reduce public dental waiting lists. Plibersek said the money will allow an extra 12,000 patients to get free or low-cost dental care over the next two-and-a-half years.
She says it is on top of a $70 million national children’s den-tal scheme which starts next year. “From January next year, 89,000 Tasmanian children will find it as easy to go to the den-tist as it now is to go to a GP,” she said. “They’ll be able to go to their dentist for that basic prevention, fluoride, all of the stuff that keeps teeth healthy instead of waiting until they’ve got a problem.”
While the Tasmanian branch of the Australian Dental As-sociation welcomed the news, president Wayne Ottaway told local newspaper The Mercury that the program needed to focus on prevention of dental disease in children.
Ottaway said that the asso-ciation should be consulted on the details to ensure reporting and administration was simple and the mistakes associated with the now-axed Chronic Disease Dental Scheme were not repeated.
From July next year, another $40 million will be delivered to Tasmania which Ms Plibersek said would give an extra 12,000 pensioners, sole parents and other concession-card hold-ers access to free or low-cost dental care. There are 14,000 adults on Tasmania’s dental waiting list.
A large body of research suggests fluoridation is both safe and effec-tive, but councils still fight it.
NEWS & EVENTS
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Aesthetics/Translucency
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Veneer
Thin Veneer
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Leucite glass ceramic
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Ivoclar Vivadent
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3 units (anterior / premolar)
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SCDL(material from
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Inlay bridge / Maryland
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Full arch possible
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Up to 6 units
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SCDL (material from
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High translucent zirconia
1200 MPa
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COVER STORY YOUR BUSINESS YOUR TOOLS YOUR LIFENEWS & EVENTS
06
Mouth rinse bolsters plaque fight
New research published in the Janu-ary/February 2013 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry (AGD), indicates that the use of a germ-killing mouth rinse in addi-tion to regular toothbrushing can sig-nificantly reduce plaque and gingivitis, more so than brushing alone.
“It’s simple—mouth rinses can reach nearly 100 per cent of the mouth’s surfaces, while brushing focuses on the teeth, which make up only 25 per cent of the mouth,” says Christine A. Charles, RDH, BS, lead author of the study and director of Scientific and Professional Affairs, Global Consumer Healthcare Research and Develop-ment, Johnson & Johnson Consumer and Personal Products Worldwide. “Even with regular brushing and floss-ing, bacteria often are left behind.”
The study found that using a germ-killing mouth rinse twice a day, in addition to regular brushing, can significantly reduce the occurrence of plaque, as well as gingivitis—the beginning stage of gum disease.
The six-month study included 139 adults with mild to moderate plaque and gingivitis who were separated into two groups. Members of the first group brushed their teeth and rinsed with a germ-killing mouth rinse twice daily; members of the second group brushed their teeth and rinsed with a placebo mouth rinse twice daily.
Healthy smiles for Victorian childrenBeating the federal government to the punch, last month the Victorian coalition government announced it has delivered on its election pledge to establish an innovative new program to promote better oral health among children and pregnant women.
Minister for Children & Early Childhood Development Wendy Lovell officially launched the Healthy Families, Healthy Smiles program at the Royal Dental Hospital, saying: “The Victorian coalition government is delivering on its $11.17 million election commitment to strengthen public dental services.
“As part of this commitment, we delivered $2 million for the Healthy Families, Healthy Smiles program, which aims to improve the oral health of Victorian children aged 0-3 years and pregnant women.”
Healthy Families, Healthy Smiles is a partnership between the Victorian Department of Health and Dental Health Services Victoria. Lovell said the program would boost the skills of health professionals to be better able to promote oral health, including healthy eating and drinking.
Dietary guidelines lack bite, says ADAThe National Health and Medical Re-search Council (NHMRC) has released updated dietary guidelines, including new infant feeding guidelines, which reflect stronger evidence that Austra-lians should eat more fruit and veg-etables, wholegrain cereals and core reduced fat dairy foods, while limiting their consumption of energy-rich nutrient-poor ‘junk’ foods. But while the guidelines have been welcomed by the Australian Dental Association (ADA), the organisation has warned that they don’t go far enough when it comes to limiting consumption of soft drinks to ‘low-kilojoule’ ones.
The revised guidelines (which were last revised in 2003) are based on Systematic Literature Reviews which looked at around 55,000 pieces of peer reviewed published scientific re-search. “While the Guidelines suggest
that the consumption of sugar-sweet-ened drinks (soft drinks) is associated with increased risk of weight gain in adults in children, the ADA warns that this only tells half the story,” chair of the ADA’s Oral Health Committee, Dr Peter Alldritt, said. “Whether or not a soft drink has ‘low sugar’ it still has the same amount of acidity, and therefore still increases the risk of dental caries. Australians should limit their consump-tion of soft drinks, whether or not they are high or ‘low’ in sugar.”
Ancient diet better for teethResearchers from the University of Ad-elaide revealed in the journal Nature Genetics that declining oral health aligns with major changes in the way humans lived and ate, with the start of farming in the Neolithic age and the industrial revolution being key turning points. The researchers concluded that modern food has decreased the amount of good bacteria in the human mouth, allowing bad bacteria to take over, which results in tooth decay and gum disease. That means the hu-man mouth is in “a permanent state of disease”, Professor Alan Cooper, director of the University of Adelaide Centre for Ancient DNA (ACAD), told newspapers. A team led by Prof Cooper’s centre studied teeth from prehistoric northern European human skeletons and found oral bacteria in modern man are much less diverse than historic populations.
Mouth rinses can reach nearly 100 per cent of the mouth’s surfaces.
NEWS & EVENTS
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NEWS & EVENTS COVER STORY YOuR buSiNESS YOuR LiFEYOuR TOOLS
New products
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New-release products from here and around the world
MAP System—MTA Placement with Swiss precision
DENTSPLY Australia is pleased to announce the release of the MAP System from DENTSPLY Maille-fer. The MAP System is used for placement of root canal repair material such as ProRoot MTA. It is used in clinical procedures such as pulp-capping, root perforation repair, root end fillings, perfora-tion at the furcation or retro-obturation in order for these to be performed in a simple and accurate way. With both Intro and Surgical Kits available, plus a wide range of specialised needles (includ-ing NiTi needles), the MAP System allows ProRoot MTA placement with Swiss precision.
For further information, please contact your local DENTSPLY sales specialist or our Client Services team on 1300 55 29 29 (Aust) or 0800 DENTSPLY (33 68 77) (NZ).
Keep an eye on your patient serviceYour dental practice doesn’t always offer perfect service. Sad-ly, patients that do have a negative experience at your prac-tice are unlikely to confront you with it. They are much more likely to simply tell others about it, write a negative review online and/or to just not come back.
Dental Patient Surveys is a new service launched by Prime Practice and Dentist Job Search to help you keep an eye on the patient service weaknesses of your practice and improve the patient experience. Visit the website at www.dentalpa-tientsurveys.com to arrange a free trial today.
Sdi launches Riva Bond Lc Stress Free Bonding = No SensitivitySDI Limited has announced the launch of Riva Bond LC, a 9th generation of adhesives that dramatically reduces the polymerisation stress caused by composites shrinking.Riva Bond LC is a universal light cured adhesive for direct restorations. Until now, dentists have had no choice but to place a composite that they know will shrink and not be able to do anything about it. “It is remarkably rewarding to see the launch of Riva Bond LC. There is no other adhesive that can achieve high bond strengths and significantly reduced stress at the restorative interface like Riva Bond LC,” said Joshua Cheetham, director of Research & Development.
YOuR TOOLS
NEWS & EVENTS COVER STORY YOUR TOOLS YOUR LIFE
010
YOUR WORLD
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In the middle ages, dentists and barbers were one profession, dedicated to the improve-ment of personal appearance. Customers could get a shave, then their teeth whitened by being filed with a metal ap-
paratus and then doused with nitric acid. As the current debate over teeth whitening shows, the definition of what is cosmetic and what is therapeutic medicine—and how far a person will go to improve their smile—is still as current as ever.
In May last year, following complaints of injuries by consumers, the Australian Competition and Consumer Commis-sion (ACCC) investigated the safety requirements for teeth whitening prod-ucts. They then ruled that any products that contained six per cent or more of hydrogen peroxide and 18 per cent or more of carbamide peroxide be re-moved from the shelves. Whitening kits with these levels are now only available to dentists for use in clinics.
The major stakeholders in this debate are dental professionals and the suppliers of dental products. While all agree with the ruling regarding kits that contain more than the six per cent/18 per cent levels of the chemi-cals, there is a fundamental disagree-
ment about what constitutes accept-able over-the-counter product.
The Australian Dentists Association (ADA), representing the dental profes-sion, current listings of the chemicals don’t go far enough, prompting them to lobby for a change to the Uniform
Scheduling of Medicines and Poisons (SUSMP). The primary concern of the ADA’s submission was to procure a scheduling outcome “that protects the public from injury associated with inappropriate use of some teeth whiteners.” They proposed that teeth
whitening products containing above three per cent hydrogen peroxide and nine per cent carbamide peroxide be included in Schedule 4 of the Thera-peutic Goods Act, defining them as ‘medicines’ and not ‘cosmetics’, and that whitening kits containing these
White fightThe debate over what is a safe level of peroxide in at-home tooth whitening kits continues, with battle lines drawn between the profession and the industry. A.M. Walsh reports.
Australian Dental Assocation
“By virtue of Dental Board of Australia (DBA) regulation, the provision and use of teeth whitening products by untrained personnel upon third parties falls within ‘the practice of dentistry’.”
Quote
YOUR WORLD
levels be accessible to consumers for at-home use only after receiv-ing a dentist’s approval. This would restrict over-the-counter sales of more whitening kits.
The crux of ADA’s argument is, be-cause of the inherent risks associated with using hydrogen and carbamide peroxides on the soft tissue of the mouth and throat, whitening teeth is something best performed under the supervision of a dentist. The ADA considers teeth whitening, using higher concentrations of chemicals that cause irreversible outcomes, to be dentistry. In their submission, the ADA quoted: “By virtue of Dental Board of Australia (DBA) regulation, the provision and use of teeth whitening products by
untrained personnel upon third parties falls within ‘the practice of dentistry’.” The submission also states there’s dan-ger in over-using the chemicals, which can make teeth brittle, translucent and sensitive, with “many consumers bleaching their teeth into oblivion”.
Professor Ian Meyers, vice chair-man of the ADA’s Dental Instruments, Materials and Equipment Commit-tee, stresses that the submission is all about public safety. “Research shows that higher amounts of peroxide are dangerous and can cause injury,” he says. “The public need to be aware of the risks involved and the best way to do that is to be under the guid-ance of a professional.
‘These are dangerous chemicals and not suitable for unsupervised use at home,” continues Prof Meyers. “I want to stress that the ADA is not about protecting services, but entirely con-cerned with public health safety.”
However, suppliers of dental prod-ucts are keen to keep the existing
listings of hydrogen peroxide and carbamide peroxide based on exist-ing scientific evidence. Troy Williams, CEO of the Australian Dental Industry Association (ADIA), says, “The Na-tional Drugs and Poisons Schedule Committee (NDPSC) established and subsequently confirmed the current scheduling classifications. As part of these reviews, the NDPSC compre-hensively reviewed the toxicology and safety of hydrogen peroxide. At the end of the day it was a factual determina-tion and there was simply insufficient clinical evidence tendered to support any other outcome.”
Professor Meyers agrees there has been no specific research conducted regarding the lower amounts of hydro-gen peroxide and carbamide peroxide in question, but says, “the effect on individuals can vary greatly and it’s difficult to assess its effect, making it all the more important that consumers are first seen by a dentist before they use the kits at home.”
“The effect (of teeth whitening) on individuals can vary greatly and it’s difficult to assess its effect, making it all the more important that consumers are first seen by a dentist before they use the kits at home,” says Prof Ian Meyers
12
The Advisory Committees on Medi-cines Scheduling (ACMS) and ACCS, however, did not find this argument compelling enough to warrant chang-ing the listing, deciding instead to add a new Appendix C clarifying the use of levels above six per cent/18 per cent.
Science aside, economics are also central to this issue. Dental suppliers are concerned that over-regulation of teeth whitening would increase the financial burden on domestic suppliers who would then fold. This would in turn lead to an increase in the purchase by consumers of OTC hydrogen peroxide (available in supermarkets at three to six per cent solutions) and internet-supplied products that are beyond the control of regulation, and therefore would put consumers even more at risk.
Higher levels of peroxide may increase tooth sensitivity, but it’s also proven that more concentrated perox-ide gives faster results. A quick search on the internet reveals that the banned whitening kits from last year are eas-ily ordered from overseas—in fact, whitening gels containing carbamide
peroxide up to 44 per cent are also available. Most dentists use solutions containing between 20-40 per cent of the chemical.
There’s no question that both the ADA and Australian Dental Industry Associa-tion (ADIA) are concerned for public safety, but perhaps the debate needs to be shifted from the what and who, to the how. It costs up to $500 to have an in-
chair treatment performed by a dentist, a procedure usually completed in about one hour; over-the-counter products cost from as little as $30 for recommended use over a two-to-four week period. If unregulated products offer the efficacy of the first procedure with the cost of the second, it seems this is where the real problem lies regarding dangerous levels of teeth-whitening chemicals.
YOUR WORLD
Higher levels of peroxide may increase tooth sensitivity, but it’s also proven that more concentrated peroxide gives faster results.
Today’s economic conditions and constant
changes in government programs are
having a big impact on dentists. But how
much of an impact is it really having?
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DAY 5: Theory
Target Audience
Broad Course Outline
Dentists with little or no orthodontic experience who wish to use SCDL’s treatment planning to deliver high-end, minimally invasive aesthetic dentistry
Additional Information
Pre-Course module must be successfully completed
Dentist must bring a suitable patient for treatment on Day 2
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Option to attend Day 5 is available (fees apply)
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Treatment planning is provided by SCDL’s expert panel headed by Dr Ray McLendon (orthodontist)
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To register or for more information call 02 9362 1177 or visit www.scdl-education.com.au
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Invisalign Education Courses 2013
2 Day Course 5 Day CoursePre-Course: On-line module
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DAY 2: Clinical
Pre-Course: On-line module
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DAY 4: Clinical (in your practice)
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Target Audience
Broad Course Outline
Dentists with little or no orthodontic experience who wish to use SCDL’s treatment planning to deliver high-end, minimally invasive aesthetic dentistry
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Pre-Course module must be successfully completed
Dentist must bring a suitable patient for treatment on Day 2
Once completed, dentist is responsible for own treatment planning
Option to attend Day 5 is available (fees apply)
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Pre-Course module must be successfully completed
Dentist must bring a suitable patient for treatment on Day 2
Treatment planning is provided by SCDL’s expert panel headed by Dr Ray McLendon (orthodontist)
CPD Points 33
Free DPO Invisalign website for 12mths
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Location 16 Courses around Australia and NZ from February through to December, 2013
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To register or for more information call 02 9362 1177 or visit www.scdl-education.com.au
Dentists with prior orthodontic experience and dentists who wish to manage their own orthodontic treatment planning to deliver high-end, minimally invasive aesthetic dentistry
2 Day a
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ourses
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A choice of thought-provoking, hands-on, state-of-the-art education courses which teach general dentists how to easily and rapidly integrate
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An absolute must for dentists wishing to upskill for the 21st century.
NEWS & EVENTS YOUR BUSINESS YOUR TOOLS YOUR LIFECOVER STORY
Pho
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A new technique championed by Professor Hanny Calache and Dental Health Services Victoria is tackling the problem of childhood decay. By Susanna Nelson
ates of hospitalisation for childhood tooth decay in Australia are high, particularly in disadvan-taged, indigenous and rural and remote com-munities—in fact, dental decay is one of the most common chronic diseases for children under the age
of six. The condition causes concern and expense for patients and their carers and has a number of implica-tions for development and health, including pain, ab-scesses and infection which in turn can cause reduced general health and poor sleep. In the longer term, it is thought that children can develop social and even academic problems from the stigma and discomfort of poor dental health.
Data from Dental Health Services Victoria (DHSV) revealed that, in 2009, 47 per cent of children aged under six attending public dental clinics had tooth decay. In the under-nine age group dental conditions are the second most common cause of hospital admis-sions after asthma. Yet the condition is, of course, highly preventable with the help of public health edu-cation about the formation of good early dental habits. It is also increasingly easy to treat—without the need for drastic and costly intervention.
A team in Victoria is investigating a method of treat-
ment that will not only alleviate the distress of young children needing care for tooth decay in primary teeth, but relieve the strain of unnecessary admissions on the hospital system. Dental health ranks particularly highly in Ambulatory Care Sensitive Condition admissions data—that is, the markers of hospital admissions that could have been avoided through more effective pri-mary care. Such unnecessary admissions are currently estimated to cost $9 million annually in Victoria alone.
Public health paediatric dentist, Prof Hanny Calache, director of Clinical Leadership Education and Research at Dental Health Services Victoria, is leading a study into the applicability of a drill- and needle-free dental technique that, in combination with good preventive health care, will substantially reduce the prevalence of the avoidable hospital admissions for childhood dental conditions and the unnecessary anxiety and discomfort tooth decay causes in young patients.
The Hall Technique is a method of treating early tooth decay in primary molars that involves no tooth cutting or preparation or local anaesthesia and is quick and inexpensive to perform. It was developed in Scotland, where there are high rates of untreated dental caries in primary teeth, and was subject to a five-year clinical trial in the UK. Results showed that the technique had similar outcomes to conventional treatments, where decay is removed under local anaesthetic, and that the method was well received by patients. Thus far, the technique has never been
In line for thecrown
COVER STORY
Public health paediatric dentist, Prof Hanny Calache, director of Clinical Leadership Education and Research at Dental Health Services Victoria.
18
clinically trialled in Australia and has never been investigated in preschool-aged children.
The method is unique because decayed tooth tissue on the primary molar is not removed by the dentist, but sealed under a pre-formed stain-less steel crown, which isolates the tooth from surrounding healthy teeth and prevents further decay by starving the dental decay-causing bacteria of the necessary oxygen and simple carbohydrates necessary for the bacte-rial proliferation that promotes the deterioration of the tooth.
“The crown is cemented in with glass ionomer cement for the life of the primary tooth,” says Prof Calache. “You ask the child to bite it into place to ensure that it fits properly. The procedure is the same as fitting a conventional crown. The difference is that you don’t remove the decay or any part of the tooth and there is therefore no need for local anaesthetic.”
In young children, the teeth are far enough apart that the crown can fit without any additional cutting of the tooth to make way for it, but where this isn’t the case, rubber orthodontic separators can be used prior to the procedure. The crown must fit the tooth well and must close over the tooth completely.
The technique can only be used
where there is a definite band of den-tine between the decay and the nerve. The tooth must not be in the advanced stages of decay. “It’s important to select cases for treatment appropri-ately, because the method will only be successful where the nerve is not affected,” says Prof Calache.
The technique promises to allevi-ate the suffering and anxiety many young children feel in the dentist’s chair, and in more serious cases, in hospital. “Children don’t want to sit for very long in the chair through drilling and removal of parts of the tooth, and very young children don’t like needles or the numb feeling and discomfort of a conventional treat-ment,” says Prof Calache. “It’s a very simple procedure—a lot quicker and more comfortable, with less anxiety for the patient.”
The method is also far less costly
than hospital treatment under general anaesthetic, and easier to manage from the perspectives of both patient and practitioner. Evidence from overseas also indicates that having the child take an active and painless role in the procedure, while sitting in the dentist’s chair, may also have the
positive psychological effect that is important to promoting good future self-esteem and prevention.
Prof Calache’s research seeks to dispel any concerns in the dental community about the method. The main issue that critics have with the technique is that the decay is not re-moved from the tooth before the crown is placed on it. This qualm is unwar-ranted, says Prof Calache: “There is a lot of literature in dentistry regarding techniques where we seal dental decay rather than remove it.”
“The second concern is that, if you
COVER STORY
“Children don’t want to sit for very long in the chair through drilling and removal of parts of the tooth, and very young children don’t like needles.”
Quote Professor Hanny Calache, Dental Health Services Victoria
Above: Cassie with Dr John Brownbill, one of Plenty Valley Community Health Centre’s dentists. Right: Mohamed is very happy with his stainless-steel crown.
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COVER STORY
don’t cut back the tooth before placing the crown on the tooth, you are opening up the bite by about two millimetres or so,” he says. “As far as this is concerned, all evidence demonstrates that within 30 days, this resolves itself and the bite returns to normal.
“The important thing is not to do, for example, 10 pro-cedures at once,” continues Prof Calache. “This technique is not suited to general anaesthetic, where the aim is to do everything at once. The procedure should be conducted in the dental chair, and you’d do one on each side of the mouth at a time rather than have two crowns opposing each other, so that you don’t open the bite too much.”
Prof Calache hopes that, in the long term, guidelines, standards and training will be developed to encour-age the positive reception and use of the technique among Australian dentists and that, in conjunc-
tion with good public preventive health education, this will coincide with a reduction in poor dental health outcomes for young children.
“This method generally hasn’t been used in Australia before, so this pilot study will allow us to test whether, in the Australian environment, this method would be ac-cepted by the dentists and dental therapists who apply it, as well as children and their parents; and to present evidence on the longer-term outcomes for the teeth treated using this method.
“What we would like to do with a bigger study is to conduct it across the state and then look at making a comparison between a group receiving this study and a group receiving conventional treatment.”
Prof Calache is a strong public health advocate and is ada-mant that good community preventive health is part of the battle to reduce the rates of poor dental health in children. Fluoridated water has played a major part, though it too is only part of the solution, along with good dental hygiene and food choices.
“It’s a long way to saying this is the solution, but hope-fully we will be able to provide the evidence for best prac-tice for dentists to use the method with confidence as part of the solution.”
The crown is placed—within 30 days, the bite will be nor-mal and the child will be smiling.
NEWS & EVENTS COVER STORY YOUR TOOLS YOUR LIFEYOUR BUSINESS
Some Australian dentists, concerned about the ris-ing cost of home-grown dental products, have turned to alternative online and international channels for more af-fordable options. With
changes to medical indemnity insurance, however, the costs of such products may prove far greater than they seem.
Since the first half of 2012, insurance companies have wised up to the increas-ing prevalence of imported dental product falling outside the requirements of the Therapeutic Goods Act (Cth) 1989. As with illegal music and movie downloads, the system has been slow to catch up
those skilled in exploiting the system—however, medical indemnity insurers are determined to make up for lost time.
The result, according to Troy Williams, CEO of the Australian Dental Industry As-sociation, has been a “natural alignment of a dental professional’s statutory and professional obligations”. In other words, insurance companies across the board have modified their medical indemnity policies—excluding protection in instances where imported Therapeutic Goods have been unlawfully employed.
With the requirement to disclose all product changes, it’s something you may have noticed creep through in corre-spondence from your insurance provider. It’s usually a slight modification to policy
wording, introducing the definition of approved Therapeutic Goods to an exist-ing clause. The change may have been barely detectable, but it could amount to a whole lot—particularly if you have already imported and used goods falling outside the regulations.
Since 1989, the Therapeutic Goods Act has dictated minimum standards for dental product and Therapeutic Goods available in Australia. Administer-ing this Act is the Therapeutic Goods Administration (or TGA), an Australian government body forming part of the Department of Health and Ageing. The TGA undertakes a range of assessment and monitoring activities to ensure Therapeutic Goods are of an accept-
Indemnity politicsWith insurance companies modifying indemnity policies regarding imported medical devices, there is another hidden cost of cheap imports. Amanda Lohan explains
Dentists need to know who their customers are and how they search for
local services.
21
Insurance companies have modified their medical indemnity policies—
excluding protection in instances where imported Therapeutic Goods
have been unlawfully imported.
22
able standard, inspecting and auditing production facilities around the world to ensure ongoing compliance and quality.
The TGA requires that Therapeutic Goods be entered on the Australian Reg-ister of Therapeutic Goods (ARTG) before they are able to legally be supplied in Australia. This database, established un-der the Therapeutic Goods Act, provides a fully searchable list of approved product. While there is no ‘naughty’ list to speak of, the ARTG ‘nice’ list names every single ap-proved Therapeutic Good in Australia.
Williams says that the Australian Dental Industry Association provides one source of businesses committed to supplying quality, compliant dental product. Dentists can also conduct their own individual research, using the TGA’s website to determine whether a product has been declared safe (and lawful) for distribution in Australia.
Collectively, insurance providers have noted the unlawful importation of goods as an increasingly risky omission in their policies, and they’ve been quick to pass the buck to their clients. “If a dentist wants to use product that is sourced outside the regulatory framework admin-istered by the TGA, it’s only natural that insurers would be concerned,” says Wil-liams, highlighting the basis of the driving force behind the change.
It is a change that has seen product
costs for dentists and end users grow, as manufacturers strive to meet the stringent requirements of the TGA. While Williams acknowledges the elevated cost of compli-ant product, he also says that this can largely be attributed to statutory compli-ance costs for the manufacturers and sup-pliers; costs which include thousands of dollars’ worth of application and evaluation fees payable to the TGA (over and above the costs directly associated with maintain-ing an acceptable degree of quality).
While these costs in some cases have become significant, Williams explains how the alternative could prove much worse. “Although it is possible to al-leviate the impact of this by ignoring reputable Australian suppliers, perhaps by purchasing online, the risks are very significant,” he says.
The risks and related costs Williams speaks of include management of cus-toms and quarantine restrictions, as well as civil and criminal penalties associated with the direct importation and use of non-compliant dental products. With, arguably, the world’s strictest quarantine restrictions, Australia’s borders have proved impen-etrable for many, and individuals looking to exploit the system may find it far more trouble than it’s worth.
Then again, while these costs have applied since the legislation came into place, it is the lack of insurance protection
that could expose dentists to the biggest financial risk of all. Medical indemnity insurance policies typically cover civil liability in the case of negligent errors, acts or omissions resulting in harm. In the absence of such protection, civil pen-alties and personal liabilities could prove financially devastating.
It is not just the direct financial costs, however, that render ‘cheap’ imports an increasingly risky option. Since the TGA’s main goal is to promote the safety, quality and reliability of Therapeutic Goods, it stands to reason that the risk of harm re-sulting from the use of unapproved goods would be far greater than that for approved goods (not to mention the clear case for negligence attaching to their use).
The message is clear: Those who choose to operate outside the legislative framework will find they no longer have the protection of their insurance. The buck stops here.
YOUR BUSINESS
What in this room is on the TGA’s ‘approved’ list?
What is a Therapeutic Good and are we covered?For the purposes of dental procedures, the definition of ‘Therapeutic Goods’ includes products associated with the following activities: Preventing, diagnosing, curing or alleviating a disease, ailment, defect or injury Influencing inhibiting or modifying a physiological process Testing the susceptibility of persons to a disease or ailment Note: Some products, even though they may technically meet the definition of a Therapeutic Good, are declared not to be Therapeutic Goods under section 7 of the Therapeutic Goods Act 1989. To check whether a Therapeutic Good is approved for supply in Australia, go to www.ebs.tga.gov.au, and search by product name, licence, active ingredients, ‘sponsor’ (supplier), or manufacturer.
NEWS & EVENTS COVER STORY YOUR TOOLS YOUR LIFEYOUR bUSINESS
24
Grand designChoosing to build your own practice doesn’t have to be a painful operation. Get yourself a second opinion about the best techniques in surgery design. By Kerryn Ramsey
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common mistake when designing a dental practice is to take on the whole kit and caboodle yourself—from finding the location to choosing the interior colour palette. While it’s tempting to project manage a build, an all-in-one package deal can save money and minimise stress. “A professional fit-out
can make the surgery more functional and make the patients more relaxed,” says Henry Schein Halas’s Andreas Schulz.
As national sales manager of of Henry Schein’s EQ division, Schulz points out that setting up a new practice is a long-term venture that must take future extensions into account. “You don’t want to have the extra cost of ripping out walls, slicing concrete, reworking the electricals and moving the plumbing in five or 10 years’ time,” he says.
Whether undertaking a new build or a refurbishment, there’s an abundance of council requirements and unforeseen circum-stances that can overwhelm even the most renovation-savvy den-tist. Despite that, “you’d be surprised how many try and end up having trouble,” says Nathan Reid, national marketing manager of Medifit Design & Construct. “They are fantastic dentists but there’s a whole other level of knowledge that’s needed.”
A dental design service, such as Medifit or Henry Schein Halas design guidance, initially provides a feasibility study, captur-ing the needs and desires of a practice. Starting from scratch, a dentist should have a clear idea of the size of the surgery, the location and, as Schulz has mentioned, future plans.
Reid says, “We work with the dentist to make sure the potential premises will support that vision for their practice. Regardless of styles, it’s really about the type of dentistry they want to provide and whether the demographic around that area will support the type of practice they are going to build.”
He suggests that a good way to start is to fit out two surgeries
in the first stage, then add another two or three later on as the surgery’s patient base expands. “That gives the owner the option of not getting in too deep before they commit to these things,” he says. A dental design service starts the process by finding the ideal premises and negotiating a lease, which could include a rent-free period during the construction time or landlord contributions towards the fit-out.
Schulz explains that fitting out a shell is often the most flexible and cost-effective option but there’s no reason to dismiss other opportunities. He admits, however, there can be unpleasant sur-prises when converting an old building or residential home into
a surgery. It might have to be re-stumped or internal walls might need to be moved to create disability access in hallways and cor-ridors. Heritage issues can also exist in older inner-city areas and may increase the cost of construction.
Legislative bodies in all states are now cracking down on dis-ability access and energy efficiency requirements. “That can be problematic when renovating an older practice,” says Reid, whose Medifit firm has been designing and building dental prac-tices throughout Australia for 11 years now.
Despite the potential risks, he has a similar conviction to Schulz when it comes to refiguring an old dwelling. “Sometimes
“You don’t want to have the extra cost of ripping out walls, slicing concrete, reworking the electricals and moving the plumbing in five or 10 years’ time.”
Andreas Schulz, Henry Schein Halas
Quote
YOUR bUSINESS
A professional fit-out makes a surgery work better, and is more relaxing for pa-tients, says Andreas Schulz of Henry Schein Halas.
26
it works out better in the long run,” he says. Also, in most states, a dentist requries a building licence to be able to conduct fit-out works and the drawings need to comply with the National Con-struction Codes and Australia Standards.
“This effectively prohibits a dentist in building and project man-aging their own fit-out,” says Reid.
A surgery build can take from six to 12 months, comprising of interior design, council approvals, issuing of building permits and construction which comprises of supply and installation of all cabinetry, electrical, plumbing, plasterboard walls and ceilings, internal structural wall supports, flooring, painting and loose furniture. Dental design firms provide initial floorplans and ren-ders in the early stages to get the ball rolling. “Once our clients can see 3D renders of the space, they begin to visualise and get excited about the possibilities,” says Reid.
Experienced designers are worth their weight in gold when it comes to ergonomics, traffic flow and getting the right amount of workable space to operate efficiently. “You don’t want staff tripping over themselves, and you need to leave enough room for right- and left-handed chairs,” says Schulz. “Many dentists say they can fit out a practice but they come unstuck when it comes to actually operating in the surgery.”
A dental chair is undoubtedly the centrepiece of the room but there are various aspects to consider. “It’s important to find the right set-up when it comes to placing the bench, getting the perfect distance between the bench and the headrest, and positioning the chair so it looks symmetrical,” says Schulz who’s
Your business
From 3D renders (below left), clients start to see how the final result will look (see above, left and right), and they get excited about the possibilities, says Nathan Reid of Medifit.
designed more than 250 practices from Germany to Australia. His design maxim—“space, function, design, hygiene, cleanli-ness and well feeling”—can be treated as a handy to-do list when putting together a new practice.
Benchtop functionality is key when designing a surgery. “It’s terrible if you open four or five drawers and still don’t find the cor-rect instrument. It doesn’t give patients much confidence,” says Schulz. Illumination also comes into play, with a light intensity around the operation field being between 24,000 and 37,000 lux. When configuring all the lighting and body-protected electrical areas, particularly with the OPG and X-ray unit, there are extra precautions and requirements that need to be followed, so it’s essential to get advice from a specialist.
As well as designing the layout and positioning the equipment, Medifit and the Henry Schein Halas team also work with the den-tist when putting together the interior design. Reid, for example, supplies a finishes board with samples of materials, colours and textures, in unison with 3D visualisation. The next stage of design is the detailed documentation, with all trades given implicit direc-tion on how to build the fit-out. For dentists who wish to refurbish an existing practice, they can complete the work in stages, ensuring the integrity of their cash flow is maintained. “Parts of the practice are hoarded off, and the dentist can also work after hours and on weekends to minimise any disruption to the daily operation of the practice,” says Reid.
When it comes to factoring in all the costs of setting up a prac-tice, it’s easy to agree with Reid—“it’s not something to be taken lightly. For a lot of people, it’s the biggest professional choice they’ll make and it needs to be respected,” he says. “We, and others operating in the area, take the stress out of it for dentists. We help them get on with operating their business.”
From greenfield sites and ground-ups to redesigns of exisiting surgeries, Medifit creates original dental practices that are state of the art in both form and function. Since 2002, Medifit has consistently delivered excellent results for dentists and specialists throughout Australia.
Working within clients’ timeframes and budgets, our design and construction team is unrivalled in producing the finest outcomes. It’s been the backbone of our success and the standard our competitors aspire to.
To experience the Medifit difference, contact us today for a no obligation consultation.
Your patients won’t be the only ones smiling.
SITE ASSESSMENT SPACE PLANNING INTERIOR DESIGN & FITOUT ARCHITECTURAL DESIGN BUILDING CONSTRUCTION & RENOVATION CORPORATE BRANDING
NEWS & EVENTS COVER STORY YOUR TOOLS YOUR LIFEYOUR bUSINESS
28
How do you make the right choice for your personal and professional financing arrangements? Will Longfield asked the experts
Choosing a loan to fund a new practice pur-chase or fancy fit-out is frequently stress-ful. Thankfully, most dentists only have to do it a few times in their careers but it can still be a daunting process.
There are three elements of a dental practice that frequently require financing: practice purchasing, equipment leasing, and overdraft for day-to-day needs.
Each has different loan options to accommodate the differ-ing levels of cash flow required. Often, a specialised dental financing company will come up with a finance agreement that incorporates all three of these considerations, which can save dentists a lot of time and headaches.
Stafford Hamilton is the NSW state manager of Investec Australia, a leading specialist banking company. Hamilton says Investec’s approach involves thinking outside of the square and meeting challenges in unconventional ways.
“The two most common courses of action for dentists involve either buying existing practices or setting up a new practice from scratch, which we call ‘squatting’,” Hamilton says.
He says that considering the variables is no easy task but
integration of the day-to-day operations of your dental practice into the long-term financial strategy of the business that drives it is a critical element of your continued success.
Country dentist Dr Richard Wise moved to Tamworth in NSW in 1995. He began his career as an employee at a small practice and after a few years, he organised to buy out one of his employers. By 2007, he had his share of the group practice and, with the aid of a financing arrangement with Medfin, is now the proud proprietor of his own clinic called Happy Smiles.
Dr Wise says he achieved his goal of establishing his own practice “through a combination of financing and a lot of effort”.
Show me the money
“The two most common courses of action for dentists involve either buying existing practices or setting up a new practice from scratch.”
QuoteStafford Hamilton, NSW state manager, Investec Australia
YOUR bUSINESS
30
“The bank will always ask for a busi-ness plan to see if you have the potential to pay things off,” he says. “When Hap-py Smiles got started, I had a very direct vision of what I wanted to achieve.”
Dr Wise has now expanded and in May last year, he bought a brand new building and moved into a seven-chair facility that he designed himself.
“I’ve done it step by step,” says Dr Wise. “Buying a share of an established practice is the cheapest way of doing anything, especially if you’re new to the industry. Once I got that going, moving out to set up on my own was relatively affordable.”
Experience should be the key for any choice you make that affects the financial status of your business, finance expert Hamilton says. “People come to us because we know dentistry. We know what they want before they know what they want. Most dentists only do this once or twice in their lives; we do it every day of the week.
“Banks look at a loan and say either ‘Yes, you need this money’, or ‘no, you don’t’,” says Hamilton.
“We are aware of what’s required for a practice to be successful and we know
when to take a risk on young dentists.“It can be a low-risk profession, so
in most instances that allows us to take calculated risks and take more of a chance on the individual than most other banks,” he says.
Although practice purchase financing is something Dr Scott Petrie of Optima Dental Clinic in Gladstone, Queensland,
hasn’t considered in a few years, when it was an issue, he knew how he preferred his interactions with lenders. “I wanted it to be brief, simple, and with someone I liked,” he explains.
“It was usually all sorted in one phone call; that was mainly the bit I was happy about,” the Queensland dentist says.
Dr Petrie says that ‘‘a good relation-ship with the lender on a personal level’’
is the key to a workable finance solution for your practice.”
While flexibility was important for Dr Wise and a good relationship was key for Dr Petrie, Hamilton says an understand-ing of the industry is also important.
“If you find yourself talking to a finan-cial institution and you feel like you have to explain to them what your business is all about, they can’t help you,” he says. “How can they help you if they don’t un-derstand a dental practice or the needs and requirements of one?”
Having been a frequent equipment leaser in his earlier years, Dr Petrie is featured on Medfin’s testimonial page. By leasing equipment, Medfin saved Dr Petrie money by reducing maintenance downtime and spreading the repayments to suit his budget.
However, he says he liked them so much mainly because of his close friendship with his local Medfin repre-sentative, Ian, which he developed early on in his life as a dentist.
“In the end,” says Dr Petrie, “if the person knows you and trusts you, you’re going to have an easier time getting ap-proved for financing and you can carry that through your whole career.”
When applying for loans, you have to take a lot of variables into consideration: how will the finance impact the cash flow of the business, will it work for the client, is it tax deductible, or perhaps there are other things in your portfolio that you should be paying off first.
“A good practice purchase loan is all-inclusive and must include design
considerations of your business,” says Hamilton. “Too many dentists and too many lending institutions have a one-track mind when selecting a finance agreement. Interest rates become the be all and end all, instead of the practical requirements of your dental practice.
“And really, what’s the point on getting a great rate if cash flow is going to kill your business?”
Your business
You’ve got enough on your mind with patients to have to get your head around finances, which is why personal relationships with your financier are so important.
“A good practice purchase loan is all-inclu-sive and must include design considerations of your business.”
QuoteStafford Hamilton, NSW State Manager, Investec Australia
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NEWS & EVENTS COVER STORY YOUR bUSiNESS YOUR LiFEYOUR TOOLS
33
Tools of the tradeSuper smooth endo files, super clear loupes, a super sharp intraoral camera and more are in the spotlight this month
Heine loupes with LED microlightDr Bradley Xue, The Smile Team, Balwyn North, VIC
Having used loupes alone for many years, I first tried Heine loupes with a light at a trade show about 12 months ago. While magnification is great for dentistry, it is the attached light source that makes the big difference in allowing all areas of the mouth to be seen clearly and easily. The loupes with the LED light has exceeded my expectations.
What’s good about itIt’s a very reliable piece of equipment that feels well made. The light is specifically designed to fit onto the frame of the loupes. It’s very lightweight and the battery life is excellent. It lasts about 17 hours which means you get a full day’s use without the need to recharge.
There are often periods of time when I only use the loupes for selective procedures and then the battery only needs to be recharged every two or three weeks.
The loupes are great for general restorative fillings, bridge work and endodontic treatment. What may have been tricky and awkward areas of the mouth in the past can now be treated with greater confidence and less stress.
When looking at a few different areas quite quickly, the loupes with a light are a much more practical option than an operating microscope.
Upon purchase, a customer representative fits them to suit your eye. You can also adjust them yourself which is handy and pretty easy to do.
What’s not so goodIt’s priced a little bit towards the upper end of the market but taking into account what it allows in delivering predictable quality treatment results, I think it’s great value for money.
Where did you get itI purchased it at a trade show directly from Heine.
X-Smart Plus WaveOne kitby Dr Ines Nurboja, Ryde Family Dentist, West Ryde, NSW
In the past, I had always used hand-files as I was working for someone that wasn’t keen on buying any new equipment. I took over the practice at the beginning of the year and updated pretty much everything. I had never used the rotary systems before so I went and did a few courses and tried a few different systems. I worked on extracted teeth when I was testing them.
What’s good about itA lot of the other rotary files that I tried on extracted teeth tended to grab the tooth and spin it. This nearly turned me off rotary endo. The WaveOne system has reciprocating files that work smoothly and quickly. It allows you to open and shape the canals nicely. I’ve started using it on patients and the results have been really great.
The teeth are much easier to obturate and the files are simple to use. With every other system, you go through at least three files but this system only requires one file. For most canals I use the primary red file, though there’s a choice of three different sizes.
The results have been wonderful. They look like the sort of endos that were being done by my specialist.
What’s not so goodThe files are strictly one use only. Once you autoclave them, they no longer fit in the handpiece. It means that the cost increases a little bit—they’re about $30 a file—but it’s completely worth it.
Where did you get itDentsply.
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NEWS & EVENTS COVER STORY YOUR bUSiNESS YOUR LiFEYOUR TOOLS
34
Tools of the trade (continued from page 33)
Leaf gaugeby Dr Barry Johnson, Carlton Dental, Carlton, VIC
The Leaf gauge is something I don’t use frequently but it’s a very good diagnostic tool for people who have temporomandibular joint problems.
What’s good about itEssentially a Leaf gauge is like the pages of a book. Each plastic leaf is quite thin—about 50 of them add up to 3mm. It is placed between the patients’ front teeth to hold their mouth open. By resting their lower teeth against it, the joint is gently guided into position. I then take out one leaf at a time until the teeth start coming together. I keep their teeth from meeting for five minutes and the joint gradually goes back into its relaxed state.
If they can hold their teeth open in this way for five minutes without pain, you can get a good idea of what in their bite is causing an interference. Quite often the jaw just slides forwards or sideways a few microns and in some people that can be critical and cause muscular tension.
When people have a lot of muscle tension, I find this a very useful diagnostic tool. On many occasions I can just adjust those contacts and it saves me from having to make an occlusal splint. I must admit the adjustment is time consuming, needs great attention to detail and all occlusal stops must be left.
What’s not so goodIt’s a bit fiddly when cold sterilising. You need to separate all the leaves before soaking it in a solution and then ensure it’s completely dry before using it again.
Where did you get itThe Australian Society of Occlusal Studies.
Sopro 717 digital cameraby Dr Stephen Carapetis, GP Dental Partners, Warradale, SA
I purchased this intraoral camera from Dental Concepts about 18 months ago. They installed it and gave demonstrations and instructions on its use in my surgery. I take photos during every new patient examination and haven’t had the slightest bit of trouble with the camera in that time.
What’s good about itI love it because I can do an examination and use the camera as I talk to my DA. The patient can see everything on a big screen attached to the ceiling above the chair. It really helps to highlight problem areas and gets patients concerned about their teeth. You can explain to a patient that they have a crack in a filling and it needs to be replaced and they can look at you with a glazed eye. However, as soon as you put the camera in their mouth and they can see what’s happening, they’re motivated to see the problem fixed.
It’s quite small and fits easily into the mouth. The lens can be varied to take macro shots that magnify the image.
I’ve used other intraoral cameras in the past but this one is brilliant. The quality of the pictures are fantastic and all the images are automatically stored in the patient’s file.
What’s not so goodThis is a great piece of equipment but it would be a real improvement if the camera could be made cordless. At present, a cord runs along my bench to the back of my computer. It’s not a big problem but the more cords you can get out of the way, the better.
Where did you get itDental Concepts.
YOUR TOOLS NEWS & EVENTS COVER STORY YOUR bUSiNESS YOUR LiFEpROdUCT gUidE
Chairs and dental units product guide
Bite magazine’s guide to the best chairs and dental units on the market today.
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NEWS & EVENTS COVER STORY YOuR buSiNESS YOuR LiFE
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Chairs and dental units product guide
When dentistry becomes a pain, it might be time to change your chairA simple change in patient chair has done wonders to help extend the working life of a popular Brisbane dentist.
Dr Brenda O’Sullivan was struggling with back pain after years of working with equipment which simply
wasn’t suited to her short stature.“Basically it got to the stage where,
despite physio treatment and attention to good posture, it was impossible for me to always work in good positions. This placed strain on my muscles and joints and over a period of time created numerous back issues.”
When Dr O’Sullivan moved into her new premises “Clarence Dental Cen-tre”, located at Indooroopilly Junction, it provided the perfect opportunity to review her ergonomic set up.
After much research she decided that the A-dec 500 patient chair and delivery system would be the “best fit”. Dr O’Sullivan also purchased the new A-dec LED operating light and a second A-dec 500 chair and light. The equipment was supplied by local A-dec equipment specialist, Mark Slater of RJ Dental in Brisbane.
“My posture improved straight away while working with the new equipment. The thin backrest and headrest means that I can sit or stand much closer to the patient. I need to have the patient chair quite low and so the lack of bulk on the backrest means I can get my knees under the chair so that I’m prac-tically cradling the patient’s head on my lap. It means I don’t need to extend my arms and shoulders so far forwards when working,” Dr O’Sullivan said.
“My patients love the chair too. The headrest adjusts in three dimensions, so I can alter it to accommodate those with long necks or who can’t extend their neck back very far.
“I like the fact that the instrument tray and DA suction console have ar-ticulated arms and can be pulled close to me. Being a small practice there
are times when my DA needs to leave the room, say to attend to the front desk. She is now able to move the suction tip within very easy reach while she’s gone. The design is such that I can manipulate the delivery system to customise where I would like the in-strument tray for each patient whether
they may be petite or large in stature.Finally I love the LED overhead light.
It can illuminate a wide field and so doesn’t need to be constantly reposi-tioned. It doesn’t emit any heat either which for someone who hates feeling hot while working is a very welcome change,” Dr O’Sullivan said.
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“My posture improved straight away while working with the new equipment”— Dr Brenda
O’Sullivan (right) pictured with Mark Slater of RJ Dental, Brisbane.
Comfort for you, too.The difference is in the details.The A-dec 500 chair is engineered for better dentistry. The pressure-mapped upholstery comforts the patient, while the thin graceful backrest optimizes ergonomics and brings you in close. Lasting innovation. True comfort. For you and your patient.
Visit a-dec.com/thedifference to find out how every detail behind an A-dec solution furthers the health of your practice.
and appealing design: this excellent dental unit offers high-level performance for dentists performing conservative dentistry, endodontics and implant surgery. An all-round hygiene system with automatic devices ensures maximum tranquillity for both personnel and patient. Last but not least, patients treated by dentists who have, by choosing the A Class, chosen the best, will appreciate the intrinsic versatility of the design and its superlative comfort.
Quality in the DNA of the DesignSometimes quality is invisible, yet perceived as soon as the day’s work begins. It becomes tangible in every single aspect that contributes to the enhanced effectiveness of work. A Class is the highest expression of Anthos quality. It features only the best, longest-lasting materials, specifically selected as a function of their precise purpose. Exclusive and, above all, practical design ensures enhancement and improvement of the treatment process. Innovative yet thoroughly tested digital electronics ensure cutting-edge performance. A Class is, quite simply, pure class.
The Dynamics of ComfortFeedom means boundless comfort. Dentists who choose A Class will enjoy more space and outstanding ergonomic versatility. Long-reach pantograph arms and ease of handling transform a compact dental unit into a treatment centre perfect for dentist and assistant alike.
Comfort and WellbeingComfort can transform and energize the daily sequence of dental surgery tasks. Many of the features on the A Class have been specifically designed to alleviate the physical
and mental strain dentists are often subject to on account of the nature of their work and workplace.Comfort and Operating logicCreating all the right functions and developing devices that synergically aid the dentist makes for a more natural workflow. Constant, maximised efficiency also becomes possible when operating light and foot control functions respond exactly to the dentist’s needs as treatment is carried out.
Maximum ProtectionNothing left out and nothing left to chance. This is the guiding philosophy of the all-round hygiene concept. While dentist and patient both need to rely on total safety, it should not come at the cost of distracting the medical personnel: their focus must be on actual treatment. Each active hygiene device works according to user-established criteria to ensure high levels of safety. Intrinsic to the design, the passive hygiene concept minimises any risk of contamination.
Call Anthos today on 1300 881 617 to find out more.
Choosing A Class means choosing the best and compromising on nothing.A complete integrated treatment centre in every sense, it adapts to different ways of working with ease.
The Anthos Classe
A9 Dental unit
NEW CLASSE AMULTIERGONOMY, MULTIFUNCTION AND A LOT MORE…
Anthos outlets in all capital cities: 1300 881 617E m a i l : i n f o @ a n t h o s . c o m . a u w w w . a n t h o s . c o m . a u
Bring together quality and aesthetics, practicality and design.
Ensure lifetime service and reliability.
New Classe A: the crossover concept by Anthos adds a new dimension
to your professional development and offers the latest in technological progress.
NEW CLASSE A: VERSATILITY AND FREEDOM OF MOVEMENT.
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Melbourne April
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Chairs and dental units product guide
S irona’s Centre of Innovation in Bensheim, Germany houses over 270 scientists developing state of the art dental equipment as well as improving and refining our products in the market. Knowing that
your dental chair is the centre of your working day, we at Sirona are dedicated to offering both you and your patients the best possible ergonomics and integrated workflow.
Intuitive Sitting PositionA relaxed treatment position is important to you, not only from an ergonomic point of view, but it also positively affects your workflow. Sirona offers you a variety of working stools. HUGO’s sophisticated design delivers optimum freedom of movement and outstanding comfort. The high-tech HUGO stool is a key element in the Sirona Ergonomics Program. HUGO enables you to maintain a healthy posture throughout the treatment process. The thermo upholstery provides you the feel-good factor and ensures increased comfort during prolonged treatment sessions.
The Sirona C+ wireless foot switch allows you to operate most of the chair functions hands free by using a curser on the foot control instead of touching buttons on the console. This is not only an ergonomic advantage but also reduces the risk of cross contamination.
Comfortable Patient Positioning Whilst it is important to maximise the dentist’s sitting position to allow the best possible access and to avoid any muscle strains and back pain, we at Sirona also want to maximise patient comfort to allow your patient to fully relax and stay in the optimal treatment position. The Sirona research and development team has worked on a number of patient chair features such as lumbar support and massage function, helping your patients to stay relaxed and comfortable.
All Sirona chairs have the ErgoMotion system, which ensures that the patient’s spine is not compressed or over-extended. The patient’s head always remains in the same position, eliminating the need to readjust the headrest. The special thermo upholstery prevents the build-up of heat in the area of the seat cushion and backrest. This creates a pleasant cooling effect and, in combination with the massage function, ensures that the patient remains relaxed.
Optimum VisibilityThe triple-jointed mounting of the Sirona LED operating light ensures optimum visibility of the treatment area. The LEDview can be operated via a no-touch sensor or via the
EasyTouch user interface. The LED operating light ensures optimum illumination and sets the benchmark for visibility, flexibility and design.
Perfect IntegrationBy providing you with an intuitive operation of our treatment centres we thrive to optimize your workflow. The Sirona chairs are characterized by user-friendly interfaces that allow you to program the unit to your individual needs, with clearly structured menus and no unnecessary control buttons.
Optimising your workflow means providing you with all the devices you need for a successful working day. Additional gadgets take up time of your staff, they require separate power, foot switches and extra room. Have everything you need at your hands with Sirona dental chairs. Our integrated clinical funtions include an endodontic and implantology program. The endodontic treatment function includes a graphical user interface indicating the root canal file. Just select your preferred endo file system from the library and the treatment centre controls the torque and speed settings automatically for you. The implantology program with included implant motor allows you to tailor your preferred mode of working. The speed, torque and quality of saline solution of the integrated NaCl pump can be adjusted to your needs.
Sirona can be contacted by phone on 1300 747 662 or via email at [email protected].
Sirona Treatment Centres – Ergonomics and WorkflowEasy Workflow, Perfect Results, Patient Experience – with this goal, Sirona continuously develops its ergonomics and integration program.
Sirona chairs are characterized by user-friendly interfaces
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Chairs and dental units product guide
Nothing but the bestDentists generally want the best equipment so they can offer the best care. They deserve the best financier to help them do that.
Purchasing Purchas-ing capital equip-ment for your prac-tice is an emotional
decision. Not as emotional as, say, buying a new car, but according to Investec’s Staf-ford Hamilton, it’s frequently accompanied by plenty of stress. “Dentists want the latest and best equipment,” he says. “That’s because they want to look after their patients, and the equipment will help them do that. It’s natural to be concerned that the amount of money needed to finance the equipment will be considerable. So they may want to purchase new equipment but it feels out of reach.”
That’s why there’s value in talking to a specialist medical and dental finance provider like Investec. “We help them chunk a big number down to a small number,” Hamilton explains. “So it may be a case of billing a couple of extra dollars to each pa-tient. Then it becomes very affordable.”
The specialists at Investec can do this because they have decades of experience in financing capital equip-ment purchases for dentists. It’s what the bank was established to do four decades ago.
For example, Hamilton says, at the start of the process you may find yourself talking to the bank about what equipment you want, and what you want to achieve with it. “An important distinction is the difference between revenue generating equipment and efficiency generating equipment,” Hamilton explains. “There is some equipment that will add revenue, and the process of financing that is obvious and clear but it’s not always so clear
with efficiency generating equipment. The classic example is when a dentist goes from one chair to two chairs. He or she will say I can still only work on one patient at a time, which is true, but they can increase patient output and yield because while one patient is being prepped in one chair the dentist can be busy finishing the patient in the other chair.
“Often we find clients have started to consider the efficiencies, but haven’t done the numbers on how it will work. That’s where we can help, by looking at how many patients you’ll see and ap-plying that exercise to the finance.”
Although other financial institutions lend to the profession, it isn’t always easy for them to change systems and products to suit particular individuals. “But we’re looking at the individual and structuring something around
them that makes sense for their circumstances,” says Investec’s Andre Karney. “Underlying the whole model is our specialisation in lending to this market. We’ve been able to design a product suite and a credit process that recognises their qualification as an asset.
“Dentists are a unique group. That allows us to treat them very differently.. We have flexibility and tailor our service to meet their needs,”
That flexibility doesn’t end at financing new equipment—“We have people who are looking at upgrading and they say what happens to the old agreement. The answer to that is we’ll simply bolt on the new agreement to it,” Hamilton explains. “It’s not a hassle. I think, in their mind, they think ‘I’ve got to take care of the old agreement first’, but we can just give you a new one so they’re working together and finishing at the same time. So it’s not a lot of
trouble to do.”In the end, Hamilton says, through
collaboration Investec can almost always come up with a well thought through option for any financial ques-tions you have; “We are here to work with our clients and help their practice grow,” he says.
The information contained in this article ("Infor-mation") is general in nature and has been pro-vided in good faith, without taking into account your personal circumstances. You will need to read the relevant disclosure documents. While all reasonable care has been taken to ensure that the information is accurate and opinions fair and reasonable, no warranties in this regard are provided. All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. We reserve the right to cease offering any product at any time without notice. We are not providing tax advice and we recom-mend that you obtain independent financial, legal and tax advice before making any decisions.
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Chairs and dental units product guide
Today Dentec works with a select range of interna-tional suppliers to provide a diverse range of dental units and operative equipment to Australian and New Zealand dental and medical practices.
Dentec’s quality equipment range is supported by a well-established network of qualified distributors and fully trained service technicians across the Australasian region. In-house technicians are qualified, fully trained and equipped to service your every need, backed by the renowned Dentec commitment to excellent customer service with a focus on innovative solutions.
Dentec Chair/Unit range includes: ■ Hekadental – Made in Denmark ■ Ancar – Made in Spain ■ Marus – Made in America ■ DentalEz – Made in America ■ DCI – Made in America
Dentec offers a comprehensive range of quality products to service the needs of dental and medical practitioners: ■ Dental Chairs and Units■ Plant Room Equipment■ Surgical Chairs and Treatment Tables■ Sterilisers / Autoclaves■ Components and Accessories■ Washer Disinfectors■ Handpieces■ X-ray Equipment■ Operating Lights ■ Ultrasonic Baths
For more information call Dentec on 1800 243 234 email [email protected] or visit www.dentecaus.com.au.
Dentec has serviced the unique needs of dental professionals for over 20 years.
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Cattani compressors – supporting Australian dentists for over 20 years.From single surgery practices to multiple surgery practices, Cattani has the range, quality and service support that dentsits can rely on.
Cattani compressors are oil free dry air systems, designed especially for the dental application and
have been in the Australian market for over 20 years, during which time they have earned a reputation for reliability, longevity and performance. A large range, from the single surgery unit, up to systems for hundreds of surgeries, ensures a unit suited to your practice
Cattani compressors are also avail-able in acoustic hood, which covers the compressor head unit only and reduces noise levels by approximately 8 dB(A), and acoustic cover, which covers the
entire unit and reduces noise levels by up to 20 dB(A).
As with any oil-free compressor, one of the key determiners of reliability and longevity is the operating temperature, and for this reason Cattani strongly recommends that consideration be given to the environment into which the compressor is installed. To assist you with the planning and design of your clinic’s plant Cattani have developed a website that offers practical advice, as well as examples of common issues and solutions – www.plantroom.com.au
The Cattani Tech Team is also avail-able to assist with any aspect of the
design or construction of your plant-area, be it giving recommendation to designers or tradespeople, or assisting in planning a ventilation or temperature control system.
Thanks to their reliability and longev-ity, all Cattani compressors are covered by a 5-year warranty*.
Feel free to give the Cattani Tech Team a call to discuss your clinic’s cur-rent or future requirements.
*The Cattani Warranty Statement can be accessed and downloaded at www.cattani.com.au/support.php by select-ing ‘Warranty Information’ and then clicking on ‘Warranty Statement’.
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Thanks to their reliability and longevity, all Cattani compressors are covered by a 5-year warranty*
...because we’re the specialists
Absolutely nothing. Now that’s something.
Oil-Free CompressorsSuction Systems Amalgam Retention Systems
It’s quite the art form, nothing. It requires advanced technology, innovative thinking, and of course, that extra something. Like the optional bacterial filter that removes particles down to 0.01 micron. Nothingness needs an internal tank coating to preserve its absolute perfection. Nothingness demands Cattani.
With Cattani oil-free air compressors, you can enjoy the benefits of absolutely nothing. Promise.
Speak to your Cattani supplier for further information. www.dentalcompressor.com.au
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The Victor V300
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Chairs and dental units product guide
The Victor 300he Victor dental unit is an Italian project that blends outstanding de-sign and excellent ergo-nomics with cutting-edge
instruments and technology, designed at an affordable price. The V300 offers a solid working base and ensures pa-tient comfort and working convenience for the dentist.
Making the differenceThe Victor V300 is reliable and pro-duced in compliance with industrial standards that have led of EC, ISO 9001, and ISO 13485 certification. Leading the market in an all featured chair at an economical price. Italian design with state of the art technology and features.
Simple, Smart, ReliableWith the victor V300 you’re ready to face the day with complete peace of mind, the dental unit provides instru-ments and technology specially de-signed for those performing conserva-tive and prosthetic dentistry at the very highest levels. The dentist’s module is configured to hold up to 5 instrument features ( features 2x FO high speed lines):■ 3-way syringes■ 1st Fibre optic midwest high
speed air line■ 2nd Fibre optic midwest high
speed air line■ NeXt brushless LED slow speed
electric micro motor■ Piezoelectric scaler■ Intra-oral camera *optionalThe NeXt brushless micro motor is
cutting edge of instrument design and comes as a standard item on the Victor V 300. An outstanding Italian made example of precision micromechanics. The NeXt micro motor is silent, ultra light, vibration free and can be disin-fected using specific products. The brushless design makes it maintenance free as there is no need to replace brushes.
The Victor V300 features highly reliable tried and tested devices that prevent the risk of cross-contamination on the dental unit. Designed to provide passive defence against contamination the Victor V300 makes cleaning task simple, fast and easy, The silicone tray and handpiece support mats on the dental module can be autoclaved. The cup and bowl fill unit is removable for fast and easy cleaning.
The operating light handles can be cold-disinfected and features a 3-axis adjustment and combines a light inten-sity of up tp 26,000 Lux with a colour temperature of 4100K
A Durr filter is incorporated in the suction system can easily be removed to make cleaning task easier.
The Victor V300 features an inbuilt 1.8 solid water bottle to provide an independent water feed to your instru-ments with a bypass switch for main water supply.
The Victor V300 wide patient backrest provides optimal support and the three joint articulated headrest adapts per-fectly to fit adults and children alike.
The right armrest swivels forward, thus creating more room in the work area and making access to the main seat easier. The over the patient delivery
systems on the dentist’s module ensures there is no irritating tug on the wrist. Thanks to the excellent overall reach of lever and tubing.
Chair ProgramsIn addition to 2 pre-set positions there are 4 additional ones that can be programmed as desired. The chair movement can be controlled from both the dentist, the assistant’s side as well as via the foot control. The Victor V300 powerful hydraulic system is smooth and silent, providing levels of comfort and ergonomics among the highest on the market.
The chair’s multi-function foot control makes it possible to activate/deactivate instrument and operate the chip air, chip water functions as well as the chair movements and overhead light switch-ing (on/off)
MultimediaWith the Victor 300 it has endless pos-sibilities; it has the ability to incorporate a multimedia system including intra-oral cameras and LCD screens to add value to the ergonomics of the dental unit
Victor V300 Is Simple, Reliable Ergo-nomically designed. Making a differ-ence, breaking the rules with price.
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Fimet NEO with IDIS (Integrated Digital Imaging System)Diagnostic imaging available for anyone
A compact solution for diagnostic imagingThe IDIS is a compact solu-tion that includes everything required for video and x-ray imaging: a video camera, a digital x-ray sensor and a tablet computer. Diag-nostic imaging no longer requires an expensive, dedicated imaging system. Now imaging is as easy as using any other instrument. You can also do away with a separate computer and store the imagining and patient data on the tablet. The tablet comes with 64 Gb of memory, enough for storing roughly 20,000 pictures. In other words, if the device was used for tak-ing 10 pictures every day, the tablet could be used for storing up to a decade’s worth of patient history. If needed, files can also be stored on a USB memory stick for moving to another computer. The operation systems of tablet is Windows 8, which is compatible with most digital sensors and video cameras.
Ergonomic DesignIntegrated to the instrument bridge, the IDIS is close to the patient and close at hand, allowing for ergonom-ic working conditions. The tablet is mounted with a ball joint, allowing for an optimal viewing angle. The display pivoting supports both horizontal and vertical use, allowing for efficient use of
the entire display surface.
Easy and clear user interfaceThe user interface is very clear, and you can learn to use the program in no time. With the tablet’s touch screen, you can select video or x-ray imaging or view pre-vious images. Images can be sorted by time or patient, or a certain patient’s dental images can be picked for viewing. Managing customer or teeth specific pictures is extremely convenient. Im-
age contrast and brightness can also be adjusted.
Convenient Digital X-ray ImagingWith diagnostic x-ray im-ages, you can ensure the right treatment and make the follow-up easier. Using digital x-rays in patient work is fast and easy. It’s also an inexpensive way to ensure the quality of patient work.A sensitive digital sensor is used for intraoral x-ray imagining. This reduces radiation exposure, making
imaging safe for both patient and the user. Visual information from videoVideo allows for going in areas that might be dif-ficult to examine with other means. You can also easily present the patient with live video of the procedure progress. Still images of the video can be saved for later viewing. They make it easier to plan procedures as well as follow-up on results of earlier procedures.
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Compact and elegant design,outstanding health, safety and productivity features.
www.empiredental.com.au1800 81 3877
Serving the Australian Dental Profession for over 20 years
Preview product video and brochure download
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Bowled overYou always remember your first 300 game, according to Dr Dinesh Singham of Absolutely Dental @ Kirwan Plaza, Townsville, QLD
It feels pretty cool when you bowl a perfect game of 300 in a ten-pin bowling competition. As you
approach the final frames, the pressure is on and the heartbeat increases. People in the alley soon get onto the fact that you are going for a 300 game. It gets quiet and you can sense everyone watching you bowl.
“The first one I threw was in a competition at the Surfers Paradise Tenpin Bowling Centre, which was also the first 300 game thrown there. The owner took a couple of photos of me with some meter-maids and put it on the wall. It could still be there. I haven’t been back since.
“When I was at university, I worked part-time in a bowling alley on Fridays and Saturdays. I thought I would give it a go, had a bit of coach-ing and really enjoyed it. There’s a definite art and sporting element to the game but there’s also the recreational side where you go for a laugh and a few beers with friends.
“If you just want to muck about with your mates, bowling doesn’t require any fitness at all. However, during a competition, you can be bowling up to 30 games in a weekend and that takes quite a bit of upper-body strength.
“Every year there’s a national competition and I represented Queensland in 2006, 2007 and 2008. It’s a pretty tough competition against the best in Australia and our team came fourth.
“I don’t bowl in serious competitions anymore. I’m just part of a league that meets every Wednesday. Our team is called The One and even though we haven’t been doing so well this season, it’s still a lot of fun.
“It’s a great sport for all ages and all levels of skill. Anyone can bowl in a league and be com-petitive. I throw about a 200 average and if I play someone with a 130 average, they’ll get a 60-70 pin handicap. If we both throw our averages, we are going to end up having a real battle.
“Dentists make good bowlers as it involves a fair bit of hand-eye coordination and that’s something we tend to have. It also gets you out of the surgery and away from golf. There’s just something very satisfying about sending the ball down and knock-ing over all the pins.
YOUR LIFE
All finance products are issued by Investec Bank (Australia) Limited ABN 55 071 292 594, AFSL 234975, Australian Credit Licence No. 234975 (Investec Bank). All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. Information contained in this document is general in nature and does not take into account your personal financial or investment needs or circumstances. We reserve the right to cease offering these products at any time without notice. You should obtain independent financial, tax and legal advice, as appropriate.Qantas Frequent Flyer points are earned in accordance with the Investec/Qantas Terms and Conditions available at www.investec.com.au/card. Points are earned on eligible purchases only. You must be a member of the Qantas Frequent Flyer program in order to earn and redeem points. Qantas Frequent Flyer points and membership are subject to the Qantas Frequent Flyer program Terms and Conditions. Full details are available at www.qantas.com/frequentflyer. Investec Bank recommends that you seek independent tax advice in respect of the tax consequences (including fringe benefits tax, and goods and services tax and income tax) arising from the use of this product or from participating in the Qantas Frequent Flyer program or from using any of the rewards or other available program facilities. Insurance products are offered by Experien Insurance Services (Representative No. 320626) , the preferred supplier of insurance products to Investec Bank.
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O u t o f t h e O rd i n a r y™
It takes a specialist bank to create a credit card for specialists
Investec has come up with a card specially designed for the dental profession. It’s quite clever: for instance, buy a car or equipment on your Investec card and you can earn Qantas Frequent Flyer points on that eligible purchase and then roll it over into a lease with Investec. You can also pay off your new and existing equipment or fit-out contracts with your card to earn even more points. Then all you have to do is start planning your next holiday.
Take a look at investec.com.au/medical or call one of our financial specialists on 1300 131 141 to find out how we can help.
The smoothest procedure you’ll ever performBuy a car or equipment with your card and take a holiday sooner
