Dental Student Australia 12

Support for Dental StudentsDecember 2014

DentalStudentAustraliainside issue 12Hello 2 School report 3–5 Success continues 6 News 6 Loupes 7 How to be smartphone savvy 8–9 Ageing smiles 10–11 Remote control 12

2 Hello from ADSA

Hello from ADSA and DPL

The ADSA 2014 Convention was absolutely marvellous as wewelcomed 300 dental and oral health students from aroundAustralia and New Zealand to the Gold Coast for a week ofepic activities and adventures

A big thank you goes to all the lecturers from GriffithUniversity who gave up their valuable time to share theirexpertise. I’m sure many of the delegates will long rememberthe fabulous parties. Friendships were formed, memoriesmade – and you’d be crazy to miss the ADSA Convention2015 in Cairns.

The committee has been working on two major initiatives – a mental health awareness campaign for all dental and oralhealth students for 2015 and a petition to stop the oversupplyof dentists and dental practitioners in Australia. Look out forthe petition in the next few weeks and get ready to share thiswith your family, friends and colleagues. We have also beenworking with some of our stakeholders – the RoyalAustralasian College of Dental Surgeons (RACDS), theAustralian Dental Association (ADA) and, hopefully, a newpartnership with the International College of Dentists (ICD).

The 2014 Committee has gone above and beyond to ensurewe provide the best possible information and services we canto our members. I would like to thank the ADSA committee –Peter Tran, Caroline Petroff, Cathleen Dong, James Tran,Lousie Hanrahan, Amy Cao and Jess Zachar – for all theirhard work and dedication this year. We have already achieveda lot, and their ongoing commitment to ADSA and the dentalcommunity should be applauded.

I would also like to wish our members all the best with theirupcoming exams and hope that you all have a relaxing breakand recuperate so you are fresh for another year. And tothose graduating – congratulations!

Audrey IrishPresident ADSAwww.adsa.org.au

Mi Fung Lee from Adelaide loves her new iPod Shuffle that shewon at Convention 2014

Hi again and welcome to our twelfth edition of Dental StudentAustralia! Since the last issue I have had a great time meeting many of you at different events and showing DPL’scommitment and support of your dental school activities. Afteryou completed your mid-year exams and enjoyed some timeoff, the school events started again in July.

Great ConventionOnce again DPL was a sponsor at ADSA Dental Conventionand we’re so pleased we could be involved. The event washeld at Griffith Uni’s Gold Coast campus and it was a fantasticopportunity to meet with dental students from all over thecountry. Thank you to everyone who attended Dr AnnaleneWeston’s interesting and entertaining lecture which had evenbigger attendance than last year.

We received so much positive feedback at the trade show and really enjoyed having the chance to chat with our studentmembers, including all the new ones who signed up. We ran a competition for our student members and bigcongratulations go to Mi Fung Lee from Adelaide Uni whowon a new iPod Shuffle. See below.

We are delighted that Cairns will be the location for ADSAConvention in 2015. See you all then.

Run up to YDCA couple of weeks after Convention, I attended MelbourneUni’s Mentor Night together with one of our Dento-LegalAdvisers (DLAs), David Evans. Then a quick trip to SydneyUni’s common room for a Pizza Lunch, before the rest ofAugust became really hectic as we geared up for the thirdannual Young Dentist Conference in Sydney.

It was a very special event and we’ve already locked in thedate for the next YDC – mark your calendar for 29 August2015. In September we held risk management lectures forboth UQ and Sydney Uni students, and attended the secondsemester Tradeshow at Griffith Uni.

In October, I returned to the Gold Coast for the Griffith UniFuture’s Evening and then soon after I was accompanied by Dr Mike Rutherford when we attended Adelaide Uni’sAcademic and Professional Development Program (AAPDP).Mike is one of the five Australian DLAs who work for DPL.

In the next issue I will tell you about my trip to visit graduatingclasses offering 18 months graduate membership at no costtogether with a memento of your time in that university class.For those of you who have sat your final exams, congratulationsfor making it through your dentistry course and best of luckfor your bright careers ahead.

AppreciationWe really appreciate the help and support from everyone who has contributed to our publication. We couldn’t havecompleted this issue of Dental Student Australia without you.

Best wishesKara StokesMarketing [email protected]

Kara Stokes

Hello from DPL

3School reports

AdelaideOur AAPDP lectures continued, giving us fantastic topics in whichto engage, including whitening, forensic dentistry and managingorthodontic patients. Our student affairs team also piloted our ownR U OK? day, aimed at helping share the stress that often comeswith intense studying. This included a discussion whiteboard,nibbles, anonymous question box/online form, and initiating anopen discussion about stress.

There was a return of last year’s new venture – our Sleep Out – thatsaw 200-plus students, with staff, sleeping outside under the starsto raise money for the university’s community outreach dental clinicthat provides free dental care to homeless and marginalisedmembers of the community. So far, we have raised more than$5,000. Our community aid team also delivered our annual Trivia forTimor night, filled with quiz questions, a live auction, performancesof dance and our choir, all to support our joint efforts with theRotary/Lions East Timor dental clinic.

Our inaugural grand dental ball had a classic Hollywood theme andother events included our final year farewell basement party, theinter-year sports events and a careers night from the Uni RuralHealth Alliance.

Hannah DolbyYear 3

Charles Sturt UniversityThe past few months have been super busy with our Roland BryantCup, the Halfway Ball for Year 3 and our annual dent revue that wasa major success this year with a full house! The night ended withhorror film ‘Frasaco’, the winning act of the night featuring our veryown Frasaco heads in stimulation clinic.

As the year is coming to an end, fifth years have had their last clinicsession ever and all other years are preparing for their end of yearfunctions.

CSU Student Dental Association has worked so hard this year toorganise these events. We can't wait to welcome our newcommittee for 2015.

Kim NguyenYear 3

Griffith UniversityIt has been an exciting few months at Griffith! We thoroughlyenjoyed hosting the ADSA convention this year; it was great tomeet other dental students from around the country and NewZealand. We are all looking forward to the convention in Cairns next year!

Earlier this semester, the third years celebrated their halfway ball at the Hilton Surfers Paradise, a great opportunity for everyone torelax and celebrate. Special thanks to Pat, Van, Janani and Lisa fororganising such a fun event, on top of all the uni work! We were proud to support the Cancer Council’s Relay for Life 2014and the dentistry team stayed up all night to raise much-neededfunds.

Sports activities have been on the forefront this semester withdentistry teams competing in the Halas cup, Dentistry Vs Med Vsinterdisciplinary soccer tournament and the annual GUDSA inter-dentistry basketball tournament.

Rhea AllsoppYear 3

DPL – Dental Student Australia 12

Griffith University

Griffith University

Adelaide Adelaide

Charles Sturt University

4

School report

School reports

La TrobeThe year may have gone fast, but it did not go uneventfully. Thanksto the hard work of all involved in BOHDS (Bendigo Oral Health andDentistry Society), there was always an event to look forward to –from pizza and laser tag (third year victorious) to a jungle-themedcocktail party.

Achievements have extended to charitable events with volunteeringat the special school of Bendigo, donating to blood drives andraising money for the Good Friday Appeal. The work of BOHDS hasnot gone unnoticed by the university and it was awarded Club of theYear 2014.

Finally, we would like to wish all the graduating dentistry and oralhealth students a fantastic, rewarding and enjoyable career, andcan’t wait to join you in the ‘real’ world.

Sarah Louise Mueller Year 3

James CookIt's been a great year for students and for the development ofJCUDSA. There has been a key focus on fundraising and charitywork within the dental school and we have been involved withmany organisations to raise awareness and funds to assist those in need.

JCU has its second lot of graduates entering the workforce andalready many have been successful in obtaining positions in theprivate and public sector Australia wide. It looks like it's going to be another positive outlook for the graduates.

The year seems to have flown by and it's been good to see theongoing development of JCU dentistry, with the expansion ofnumerous overseas placements and the securing of regional andrural teaching sites it seems that the JCU students will be excellingas student practitioners and potential leaders in the dental world.

Corbin BarryYear 5

MelbourneWe have made ripples in both the social and academic arenas,beginning with the DDS2’s cocktail soiree – an underground, classyaffair to celebrate their halfway milestone. Next, the MelbourneDental Students’ Society (MDSS) hosted its annual mentor night.

One of the biggest highlights for 2014 has been the inaugural inter-school sporting competition between the Bendigo Oral Health &Dentistry Society (BOHDS) and MDSS. The Dental Schools VictoriaSports Cup (DSV Sports Cup) is a joint venture to encouragecamaraderie and build strong friendships between the two schools.The day was a huge success and a big thank you must go toBOHDS for hosting and organising venues, awards and dinner. The friendly rivalry will continue and we look forward to defendingthe title in 2015!

To cap off the social calendar, the grand dental ball was held at theSea Life Melbourne Aquarium and it featured a live jazz band. Wealso saw the MDSS Committee hold its first ever annual generalmeeting. A big thank you to the exiting MDSS 2014 committee fordoing an outstanding job throughout the year and making eachevent flawless; thereby setting new standards for years to come.

Alejandra Hernadez Pulido Year 4

La Trobe

James Cook

Melbourne

Melbourne

Melbourne

Melbourne

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QueenslandReflecting on 2014, UQ dental students have enjoyed a plethora ofenticing social and academic events held by UQDSA over the pastyear. These include the spectacular Winter Wonderland 2014 dentalball, boat cruise, lunch-and-learn seminars, as well as numeroushappy hours with friends.

First years are experiencing their first taste of the end-of-yearmaelstrom, while second year students can be seen preparing toleave behind the lowly pre-clinic world. Further down the road, thirdand fourth years, past the halfway point and exhausted fromtreating patients all through the year, are looking towards a well-deserved break. Last, but not least, our fifth years – almost ready tosay goodbye – are gearing up to take their first steps into the greatunknown.

Excitement bubbles as the UQ Dental School prepares for its bigmove. Doors of the UQ Oral Health Centre will burst open inJanuary 2015, so it shouldn’t be long until students and patients –can finally say a very last farewell to good ol’ Turbot Street!

Cheryl X ChenYear 1

UWASince the last update, UDSS has organised great events, startingoff the second semester with the GV Black’s Cocktail Party atLlama Bar, where students dressed up in their cocktail best andtook some cheeky photos in the photo booth. Students also had a chance to dress up for NOBOTE, the nautical-themed pub crawlaround the city’s bars. And, more recently, the Back To the 90s quiznight saw some great outfits from Braveheart, Clueless and plentyof denim. Topics ranged from music, staff history and of course,dentistry, while challenges included chubby bunny and plasticinesculpting, with the fourth years winning the competition. UDSS alsohosted two social sports weekends of badminton and basketball.

Although the semester is finished and exams are already here, thatalso means this year’s dental ball is right around the corner!Students are definitely looking forward to the first official night offfrom classes, exams and patients at The Rising Sun dental ball –and the summer break!

Spencer LiYear 2

SydneyThe past few months have been scattered with social and sportingevents to keep students sane and let off some steam amidst thehectic academic schedule. Highlights include, among others, theWomen in Dentistry cocktail function in association with the ADA,and the quad-faculty rugby tournament against Medicine,Veterinary Science and Pharmacy.

The year was rounded out with SUDA’s night of nights, the annualcocktail ball at the Ivy Sunroom – a fantastic night where all fouryears of dentistry, three years of oral health students and alumnigathered to party in their best suits and dresses.

The second years enjoyed their halfway ball as did the fourth yearswith their graduation ball. Well done to the Class of 2014 and welook forward to an even more exciting year in 2015.

Darian KarunaikumarYear 2

Queensland

Queensland

UWA UWA

Sydney

Sydney

Sydney

Sydney

Success continues

NewsElectivesDid you know overseas elective cover is one of the benefits ofstudent membership with DPL? If your school offers an electiveplacement in one of the countries in which we serve members, thenwe’ve got you covered*. Please get in touch with us before your tripso we can help organise your dental indemnity well in advance. *subject to the terms and conditions of the policy and underwritingapproval

Get FestiveWe are running our third annual Get Festive competition over thesummer break where we ask our DPL Australia Facebook followersto post or share their most festive Christmas photos. Create some‘Kodak’ moments and tag DPL Australia in all of your fun, cute orcreative photos. If you want to win one of three Myer vouchers,please note the competition ends Friday 16 January 2015.

Keep in touch on FacebookNot yet our friend on Facebook? Find the DPL Australia page todayto see the latest news of upcoming events, topical articles, studentcompetitions and check out our recent photos. It’s a great way tostay connected and learn more about all that DPL has to offer.

Contact detailsWe know some of you move around a lot, so please rememberto keep us informed of any changes to your contact details. Tocontinue to receive this publication in the mail and other updatesfrom DPL it is important to provide us with your current postaladdress. Call us on 1800 444 542 or email us [email protected] to let us know.

About to graduate?Check out this website for all sorts of tips –www.theyoungdentist.com/au

Sponsored by DPL, this is a dedicated resource for young dentistsincluding articles, event dates, and information on working abroadand volunteering.

Want more graduate information?Never fear! After assisting ADSA with their first ever go-to-guidethey have continued to make it better year after year. Their 2014Graduation Booklet is available online at www.adsa.org.au

New website!The address remains the same but we are excited to bring you a brand new website in time for the new year. Take a look and letus know what you think – www.dentalprotection.org/au

The annual Young Dentist Conference(YDC) has sold out for the past twoyears, so expectations were high forthis year’s event

The speakers lined up for the event were Dr Serpil Djemal, Dr MarkO’Brien (Founder and Medical Director of Cognitive Institute),Tristan Miller (a high-profile Australian motivational speaker), and Dr David Sykes (a member of our advisory panel).

The presentations created a perfect blend of clinical and non-clinical topics, with Mark and Tristan describing how to managedifficult patient interactions and the importance of following yourpersonal passions, respectively.

An event not to be missedKara Stokes, DPL’s Brisbane based Marketing Coordinator,organised the conference with support from two of our EducationEvent Coordinators, Emily Liston and Tanya Goodall. No wonderthe conference was a sell-out yet again.

The speakers all did a fantastic job and although a lot of the clinicalcontent was expected to be on the dry side, the presenters weresurprisingly entertaining. Given that the programme is specificallydesigned for young dentists, the reunion aspect of the conferenceis certainly one of the many benefits. Not only were the catch-upsessions in the break a wonderful sight to see, but the NetworkingSocial that followed the all day conference was abuzz withexcitement. The acca daiquiris added some elegance to theevening playing jazz tunes on stage and they even appreciated thedrink of choice, the strawberry daquiris, thinking it was selected inhonour of them!

The feedback from delegates and sponsors has beenoverwhelmingly positive with many promising to come along againnext year. With YDC 2015 scheduled for 29 August 2015, theplanning has already started to produce another memorable event.

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Success continues News

7

DPL – Dental Student Australia 12N

Magnification Most companies would recommend youstarting at around 2-3x, as this level offersthe best depth of field for most clinicalwork. It is worth bearing in mind that thehigher the level of magnification, the smallerthe depth of field.

IlluminationLoupes are often sold with a light source, inorder to reduce eye strain. There are manythings to consider about the type of lightsource to choose:

• Any filters (some versions come with acomposite filter to avoid premature curing) • Strength of the light (the brighter thebetter) • Ease of focusing • Battery life

Try before you buyA good place to try them out is at a tradeshow or conference, so you can see what’son offer. If possible, try to purchase them infinal year or your first year out as manycompanies will offer discounts to recentgraduates. They may even increase thediscount if you make a group purchase.

Lily Duffy investigateswhy they are a star buyfor clinical excellence –as well as an investmentin your health

In my first year out in practice, I wasamazed by the number of dentists andspecialists using loupes. Many of themwere enthusiastic in promoting theirbenefits. As a result, I also decided to invest in my first pair of loupes.

Before purchase, I considered both thebenefits and potential drawbacks of thevarious products on the market and I amdelighted to share them with you in thisarticle.

InvestmentGood quality loupes are expensive, butthey should be viewed as an investment.The benefit to your posture and improvedquality of care is well worth the money.Some dental professionals worry they maybecome dependent on them for simpleprocedures. So long as cases are selectedappropriately, loupes have a real benefit inmodern dentistry. With developmentstowards more conservative approaches –and, increasingly, technique-sensitiveprocedures and materials – magnificationhelps to provide the highest standard ofcare.

Different designsThrough-the-lensThese loupes are custom-made to specificworking distance. This is the distance fromyour eyes to the patient’s mouth, and is theoptimum ergonomic position for working in.They are lighter by weight (as opticalsystem is attached to the frame) and have awider depth of field, which means they canfocus on an object at different levels, andare more tolerant when operating andmoving. These benefits tend to make thesesystems more expensive.

Flip-upThis design means they need not beremoved when talking to patients, as thelens can be moved up out of your eyeline.This also means they weigh more, due tothe framework, and also have a smallerdepth of field. Some types are adjustableand they also tend to be more affordable.

Right choiceIn my opinion, I made the right choice inpurchasing loupes early in my career, asthey have allowed me to adjust anddevelop my clinical techniques. I don’t usethem routinely for every check-up or filling,but they have become a valuable piece ofkit for more complex procedures and Iwould encourage every young dentist toinvest in loupes!

Optical benefits• Increased magnification (enlargementof an object)• Better resolution (ability to distinguishbetween two objects)• Improved clinical skills (errors andinadequacies become much more apparentunder magnification)

Ergonomic benefits• Effective in eliminating back strain• Encourages your optimum workingposition

Loupes – worth their weight in their gold!

Lily is in her second year practising in Yorkshire, England

Lily Duffy

8

How to be smartphone savvy

Binish Khatoon recentlyscooped the title of UK Young DentalCommunicator Award.Here, she considers theperils of mobile phonesfor dental professionals

Smartphones seemingly grow ever smarter.The latest models are not only used formaking calls and sending messages, but areused as mini computers to provide instantaccess to information anywhere, at any time.Smartphones today also have a wide rangeof associated functionality. Keyboardsincorporated into devices, such as theBlackBerry, resemble a laptop or desktopcomputer in myriad ways. With the addedfeature of touchscreen capabilities, it isunsurprising the number of smartphonesowned by students today has increased tosaturation point; it is not uncommon to ownseveral.

Technology has come a long way and todayit is smartphones and integrated devicesthat seem to be the dominant platform.While technological advances are makingour student and personal lives very exciting,there are pitfalls when they are used as aresource to support an undergraduatecourse.

Bright as a button Attractive appsThe most attractive feature of a smartphoneis its ability to download applications directlyonto the phone – instantly. In the field ofdental education, there are many appsavailable to students. But, are these appscreated with research that has also beenpeer reviewed? Or, are they just a way ofmaking money?

Is it valuable?Evidence-based dentistry uses currentscientific evidence to guide clinicians. Justlike information accessed on the internet –and in books and journals – mobileapplications should provide information thatis evidence based, founded on extendedknowledge and peer reviewed. Responsibledevelopers will ensure the information in theapp meets these criteria.

The risk of downloading an app to help you with your studies is that you may beaccessing information that fails to meet theseexpectations so don’t be misled by the blurbin the app store. Always find out where theapp comes from and the authority behind itscontent. Most apps come with developer’sinformation and detail the benefits the newdownloaded application can offer. If you havedoubts about the provenance and have tothink twice, ask a tutor and never be temptedto download it without checking – particularlyif there is a payment involved!

EvaluationMost apps are compatible with the operatingsystems of the majority of smartphones,whether Apple or android. When you comeacross an attractive app, take a moment to seethat it really has the features that you need.

For example, ‘1000 Dental Flashcards andQuiz’ is an app developed to help studentslearn 1,000 terms and concepts for the DentalAssisting National Board (DANB) certificationtest in the US. Potentially, it could be a quickrevision tool. The app consists of multiplechoice-style quiz questions, flashcards,interactive dictionary search and concentrateson modules, such as tooth development,dental charting and dental anatomy.

Although it promises to equip you with enoughknowledge to be prepared for the test, there islittle information on the background researchbehind this app. However, it does have a linkthat directs you to the developer’s website(Sagemilk, 2013). This is a website that createsapps and allows users to create apps as theywish. As there is no information available aboutthe supporting research behind the variousapps, you might reasonably wonder exactlywhat degree of informed knowledge goes intotheir creation.

The most attractive feature in app design,applied to dental, is the ability to creategraphics that resemble real life. One exampleof this is the application named ‘3D Tooth R’.The application claims to offer high-quality 3Dmodels of the teeth, including the pulp androot canal systems. It is available in manydifferent languages and provides anencyclopaedia, once downloaded. There is no evidence of the supporting research listedwithin the application. However, there is a linkthat leads to the developer’s website – apersonalised website of applications createdby a developer (AppAnnie, 2013).

Communicating anywhere,anytimeWe need to talkInstant messaging is a form of online textcommunication that offers the ability to ‘chat’with other users in real time. Communicatingwith fellow students and sharing information is all part of education. Apps such as‘WhatsApp’ can be used to discuss tasks thatinvolve this sharing of ideas and group work.

As most of us keep our phones in ourpockets (even in lectures!), keepingupdated and communicating on the go hasnever been easier. Checking the odd emailor sending a quick instant message to ourfriends seemingly may not have anynegative impact on our ability to learn.

But, such multitasking may well affecteducational outcomes; instant messagingwhile also concentrating on university workis not a good idea. Many students nowtake their laptops in the lecture hall to takenotes, but it is far too tempting to also sendinstant messages and check emails. If yourexam results are suffering as a result,consider resorting to pen and paperinstead.

Your documents areeverywhere!It’s good to shareFile-hosting services are a popular way ofstoring – and sharing – files too large toemail and that are too important toprecariously save only on a laptop. You canupload these documents to the site –Dropbox is free and a popular option – andaccess them not only via your computer,but other devices, too, once the storageprogramme software has been downloadedand installed.

So, what’s the problem?Although we no longer need to guard USBsticks with our lives, once files are droppedinto our Dropbox account, we need to beaware these files are scattered everywhere.The files are online in our Dropbox and ondifferent devices and also the devices ofother students and friends with whom weshare our Dropbox account. Not only canothers view your files, but they can edit,delete and add to them, too. As dentalstudents, you will sometimes haveconfidential information about patients. It is important to remember that the sameprinciples of patient confidentiality applywhen using file-hosting services. There aretimes when you need to share documentsfor advice or help from fellow students,especially during revision periods beforeexams. Always double check your files donot contain patient information that may beable to identify or link back to them. It isalso possible to password protect thedocument so only those trusted with thepassword can see the contents.

Got it taped?Sometimes during a lecture, we are facedwith the problem of a tutor who talks too fastfor us to take sufficiently comprehensivenotes. Recording lectures and going homewith everything the tutor has explained –without missing the important bits – can besatisfying. However, recently there havebeen cases where students are recordingthe lecture and sharing this on file-sharingsites.

How to besmartphonesavvy

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If you or anyone you know is sharing videosor voice notes, always inform the tutor. Itmay be unethical to record someone andshare that material on such a large platformwithout his or her knowledge. Updatingyour tutors about the latest gadgets or toolsyou prefer will ensure the tools are correctlyused and may enlighten some tutors of thebenefits – and risks – of any newtechnology.

Binish Khatoon is a PhD student at the Birmingham School of Dentistry (UK),undertaking research into mobile learning.She was the recipient of the 2014 BritishDental Editors Forum (BDEF) Young DentalCommunicator Award

Application

Dental Dictionary

Dental Geek RSSReader

iPanoramic

Anatomy TeethDissection

Istudent MCQ

Tooth Morphology

Dentistry Pro Consult

All things Dentistry

Research carried out

YesMosby’s DentalDictionary

None

None

None

Yes Created by a dentalstudent at King’s DentalInstitute

YesCreated by a dentalstudent at The school of Clinical Dentistry,Sheffield

YesCreated by GeorgiaRegents University

YesCanadian Dentist

Further information

Includes definitions ofwords that dentalhygienists and assistantsmay need

Can monitor sites withRSS feed and sendupdates such as dentalblogs, websites,podcasts, etc

The Marcilan websiteallows user to getsupport for the app andread upon anatomy,pathology and givesguided navigation

Zoom in and out ofteeth parts to analysestructure and textures

New version to try outcalled istudent MCQ prolite that includesunlimited bank ofquestions

High quality images toshow teeth morphology.Three areas covered:tooth development,distinguishing featuresand Morphology

Three categoriescovered: Restoration,panoramic imaging andprosthodonticsocclusion animations

Some videos may gobeyond undergraduatedentistry, but are stilluseful.

Purpose

Dictionary from Mosby’sDental Dictionary

Automatically sendsdental-related info tosmartphone and iPad

Patient’s teeth, bones andjaws can be seen throughpanoramic radiographsand app allows users toview different panoramicradiographs and use pinsto mark the different areas

Students can learneverything aboutanatomy teethdissection and each partcovered can be focusedon

Multiple choicequestions to help withexam preparations.Includes fun games

Targeted at students intheir early years oftraining. A touch-friendlyresource for informationon tooth morphology

Provides videos andexplanations for errors inpanoramic imaging

Dedicated app createdby a dentist who directsusers to his YouTubevideos, designed to helpwith undergraduatestudies.

Developer andavailability

Developer: Wang YunVersion: 2.0Available on: Apple,iTunes

Developer: Lanmark 360Version: 1.1 Available on: Apple,iTunes

Developer: WisamAl-RawiVersion: 1.2Available on: Apple,iTunes

Developer: JoseBarrientosVersion: 1.0Available on: Apple,iTunes

Developer: VedaantPatelVersion: 1.2Available on: Apple,iTunes

Developer: PrateekBiyaniVersion: 1.4Available on: Android,iOS, Google play

Developer: GeorgiaRegents UniversityVersion: 2.5Available on: iTunes,optimised for iPhone 5.

Developer: Ashley MarkVersion: 1.4Available on: Requires1.6 android and above,iOS

Ageing smiles

10

Teeth for lifeThe Adult Dental Health Survey 2009showed that, in the last 35 years, there hasbeen a 31% increase in the over-65demographic. It is estimated that, by 2028,total tooth loss will be largely eliminated inthose aged less than 65 years andsignificantly reduced in the populationunder the age of 75 years. Only adults aged85 years and over will have an appreciableproportion (20%) of their age group whowill be edentate.

Analysis of the data shows there will soonbe a cohort of 45-54 year olds with heavilyrestored teeth. This cohort will live a longtime and may retain their teeth until theydie

1. Dental professionals should prepare

for this inevitable change. For the ageingpatient – with a lightly restored, a heavilyrestored or a potentially failing dentition –prevention is vital.

CompromiseProviding high quality dental care can bechallenging for us all, even at the best oftimes. Compromises – due to age-associated ill health or infirmity – may be reasonably considered after carefuldiscussion with the patient, their family,their medical practitioner and/or carers.There is never an excuse for failing toaddress treatable dental pathology.However, a complex medical profile, illhealth or a lack of tolerance for lengthyappointments might mean sensible clinicalcompromises are appropriate.

This may include the monitoring of anasymptomatic periapical radiolucency in anoctogenarian (if clinically sound

1) which, in

a completely healthy young patient, thealternative approach involving two hours ofcomplex endodontics may be more easilytolerated. Subjective assumptions aboutthe tolerance levels of an elderly patientshould be made at your peril. Detailed, butopen-minded, discussion to cover alloptions is a must.

AggressiveAs the cohort of elderly patients grows,gingival recession is likely to be ever morefrequently seen and recorded. The exposedroot dentine and cement-enamel junction isoften irregular, less mineralised and morecomplex in shape to clean. This can lead tocaries in areas of the tooth relatively difficultto access and vulnerable to diseaseprogression. Coupled with xerostomia andreduced dexterity, excessive exposure tosugars can lead to aggressive progressionof caries. The associated lesion may bewide and/or deep. Root caries should,theoretically, be entirely preventable.

A robust regimen of dietary advice, salivasubstitutes, appropriate fluoride therapyand oral hygiene instruction may make thedifference between maintaining a healthynatural dentition tooth loss. Dietary adviceshould be sympathetic, but informative.Oral hygiene advice should include ademonstration of the use of broadinterproximal brushes in a mirror and dueconsideration should be given to the use ofprescription strength fluoride toothpaste (upto 5,000ppm).

Fluoride trays may be used for 20-30minutes per day along with an appropriatemedicament like Tooth Mousse (GCEurpore, Belgium) or a toothpastecontaining stannous fluoride (eg: Oral-BPro-Expert, Oral-B). Fluoride mouth rinsescan also be used on a daily basis (as225ppm as 0.05% sodium fluoride) butshould be used at a separate time of dayfrom brushing.

The population of olderpatients can expect tolive longer than everbefore and evidenceshows they are likely to retain their teeththroughout this extendedlifespan

In Australia and elsewhere, the total numberof people aged 65 years and older isgrowing as a direct result of the boom inthe number of babies born at the end of the Second World War.

Prolonging lifespanThe medical and dental profile of thispopulation is also changing. Advances inmedicine continue to play a major role inprolonging lifespan. As a consequence,there is an ever-increasing complexity ofpharmaceutical prescriptions being given to older patients to manage their diseases.Any medications taken may also have sideeffects, impacting on both systemic andoral health.

Ageing smiles

Richard Porter

Richard Porter, a consultant in restorativeand implant dentistry, considers the dentalchallenges of an ageing population andsuggests that the future is now

1Int Endod J. 1994 Mar;27(2):75-81. Retreatmentor radiographic monitoring in endodontics. Van Nieuwenhuysen JP, Aouar M, D’Hoore W

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Be prepared In addition to pre-existing restorative dentalwork and poly-pharmacy (associated with amedical illness and xerostomia) there maybe other inevitable changes in the profile ofageing patients. These include:• Recession of the periodontal attachmentand exposure of root dentine• Reduced dexterity• Reduced memory and challenges inaccessing dental care• Social circumstances that make accessto suitable dental care challenging• Reliance on others for oral hygienepractices and dietary input

Dry mouthThere is a very long list of xerogenic drugs; antihistamines, antidepressants,anticholinergics, anorexiants,antihypertensives, antipsychotics, diuretics,sedatives, anti-emetics, anxiolytics tomention but a few. Any one or acombination of these drugs may render a patient, previously dentally stable,susceptible to new primary disease,particularly if the apparent ‘newly drymouth’ is relieved with sugared drinks orsnacks. In addition, conditions such asdehydration or poor nutritional intake,diabetes mellitus, Sjögren’s syndrome,sarcoidosis, amyloidosis, systemic lupusand degenerative disease may also bestrongly associated, if not causative, ofxerostomia.

One size will not fit allDespite even the most robust ofpreventative regimens, some patients willstill require extractions and as such, manyof these patients will go on to requestdentures. Some will have pre-existingdentures that may ‘no longer fit’. There is a long list of potential clinical difficulties inproviding dentures for the elderly. Examplesof such problems may be a severelyresorbed ridge or flabby displaceable tissuein the denture-bearing area. These may becompounded by the patients’ previouspositive experience, largely brought aboutby the good ridge dimensions andfavourable anatomy present at the time.

Patients may expect a new set to feel astheir previous dentures did when they werefirst fitted. This is an unreasonableexpectation, as the denture foundation(anatomy) will have deteriorated overtimeand such expectations should be managedearly during the consultation process

2.

Currently, the McGill3and York

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consensuses state that edentulousmandibles should be restored with twoimplants providing overdenture support fora denture. Certainly, this expensivetreatment modality is not possible oraccessible or appropriate for all and it isimportant to remember that one size willnot fit all.

The future is nowAs a young clinician, you should be awareof the impending growth in the over-65patient demographic, their medicalcomplexity and dental needs. Futurehealthcare systems will need to bedesigned to accommodate the additionalneeds these patients may have.

This is not a valid excuse for providinginadequate care or a lack of knowledge,however, and young dentists would besensible to prepare for the challenges ofan ageing population.

Non-destructive approachNon-carious tooth surface loss (tooth wear)is an inevitable consequence of ageing. Itshould only be considered pathological if itis a threat to the survival of a tooth or if it isa concern to the patient. Adhesive dentistryhas revolutionised the treatment of mosttypes of dental pathology but it is, perhaps,in the management of tooth wear in whichthe most non-destructive approach hasreceived most attention and the evidence is so compelling.

In many wear cases, one can attachrenewable materials to the alreadydamaged remaining natural tooth tissue inan entirely incremental (or at least minimallydestructive) way. This approach doesn’t‘age’ the teeth, in contrast with moreconventional approaches that require theremoval of large amounts of healthy toothtissue. No amount of tooth wear canbiologically ‘age’ a tooth as quickly as anair rotor and diamond burr combination!

2J Prosthet Dent. 1972 Feb;27(2):120-32. The continuing reduction of the residual alveolar ridges in complete denture wearers: a mixed-longitudinal study covering 25 years. Tallgren A

3Eur J Prosthodont Restor Dent 2002;10: 95–96. The McGill consensus statement on overdentures: Mandibular 2 – implant overdentures as the first choicestandard of care for edentulous patients.Thomason JM

4Eur J Prosthodont Restor Dent 2009; 17: 164–165.The York consensus statement on implant-supported overdentures. British Society for the Study of Prosthetic Dentistry

Perfectly healthy unrestored teeth are nowunrestorable after six months followingradiation-induced xerostomia and a lackof oral health advice

Root caries at the cemento-enameljunction can be arrested or treated witheffective dental advice and treatment. Note plaque retention at gingival marginand suspicious lesion on lateral border of tongue adjacent to the two remainingteeth


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MirrorThe cultural spread of the students’backgrounds was vast, ranging fromAboriginal to Pacific Islanders, ironicallymirroring the broad spectrum of their oralhealth that illustrated the need to educateparents on their children’s oral healthneeds, too. After the dentist examined thekids, I sat with the children to teach themhow to brush their teeth with a model set ofteeth and a toothbrush. I was rewardedwith smiles full of gaps!

Immediate attentionI also visited the East End CommunityHouse that supports refugees, asylumseekers and Indigenous Australians withtheir dire state of oral health. This was aresidence set up by the Victorian StateGovernment to create a central point ofcommunication and allow the communityto foster a sense of ownership for thehouse. Local residents would come to thehouse every day to cook for others usingfresh vegetables and herbs from thebackyard community garden.

Programs and events are organised by thecommunity house to engage and educatelocal residents in essential life skills. Theteam set up a makeshift dental chair in aroom to allow the residents to have theirteeth checked. A significant finding with allthe patients was that their deteriorating oralhealth is in need of immediate attention.Chronic and aggressive periodontitis waswidespread, with smoking a serious issuein rural communities.

Jen Cheah recalls histravels to rural Victoria,helping the Royal FlyingDoctor Service and itsMobile Dental CareProgram

As a third-year dental student, there ismuch to learn in the world of dentistry –and an opportunity to help and supportdisadvantaged communities in remoteVictoria was a privilege.

So, when I volunteered for the Royal FlyingDoctor Service in their Mobile Dental CareProgram, I knew it would be full ofunexpected surprises and experiences.

Travelling with two dentists and a dentalassistant, I ventured off to the town ofMildura where the team was split into two –one group heading to the Mallee DistrictAboriginal Services (MDAS) to providedental examinations to indigenousAustralians, the other (with me) to thePrinces Court Residential Aged Care toeducate carers on the importance of oralhealth care.

Disaster struck, however, when we wereinformed that the residential facility hadbeen in lockdown due to a gastro outbreakso we headed to Mildura Primary School aday ahead of schedule to perform dentalscreenings of the students.

Remote control

We headed back to Mildura Primary Schoolto continue dental examinations and runinteractive sessions with the students.Many kids never knew to brush their teethtwice a day or why we brush our teeth, soto fill this gap in their knowledge was anaccomplishment.

The final day we travelled to Robinvale toprovide comprehensive examinations andtreatment to disadvantaged patients.Robinvale is in urgent need of dental carefor its residents and there is a high rate ofpreventable hospital admissions caused bydental conditions, a shortage of publicdental services and a population at risk ofdental diseases. When we arrived at theMurray Valley Aboriginal Co-operative(MVAC), the dental surgery room wasserved by neither electricity nor water. We had to use our intuition again to workaround the limitations.

InspirationThis experience with the Royal FlyingDoctor Service has given me inspiration tohelp make important changes, not only tothe community of Mildura and Robinvalebut to other remote communities that lackthe support from oral health services.Knowing that you’ve made a change to the lives of the less fortunate gives you afeeling like no other – and I’ll bevolunteering again when I graduate as adentist.

In the words of Mahatma Gandhi, ‘Be thechange that you wish to see in the world’.

Make the most of your membership. Register your email address at www.dentalprotection.org/australia

DPL Australia Pty LtdLevel 1/65 Park Road, Milton QLD 4064 Postal address: PO Box 1013, Milton BC QLD 2064Telephone 1800 444542 Facsimile (07) 3831 7255

Marketing CoordinatorKara Stokes [email protected]

Operations ManagerKen Parker [email protected]

Editor [email protected]© Dental Protection Limited December 2014

DPL Australia Pty Ltd (‘DPLA’) ABN 24 092 695 933, CAR No. 326134 is a CorporateAuthorised Representative of MDA National Insurance Pty Ltd ABN 56 058 271 417, AFS Licence No. 238073. DPLA Members have access to the Dental Indemnity Policyunderwritten by MDA National Insurance Pty Ltd

DPLA is a wholly owned subsidiary of the Medical Protection Society Limited (MPS)(registered in England No.36142) at 33 Cavendish Square, London, W1G 0PS. ‘DPLmember’ and ‘DPLA member’ means a non-indemnity dental member of MPS served by DPLA. The benefits of MPS membership are discretionary and set out in itsMemorandum and Articles of Association. Neither DPLA nor MPS are insurancecompanies

Anna (dentist) and me showing Grade 4 students in Mildura, how tooth brushing creates a great smile

Dental Student Australia 12

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