How do you preserve the stately charms of a bygone era while rejuvenating the look and feel of a modern practice? That was the challenge that Levitch Design Australia (LDA) faced in the revamp of Alcaston Dental Care.
 
By Danny Chan
 
Nestled within a heritage-listed property on 2 Collins Street, one of Melbourne CBD’s main arteries, the clinic is surrounded by 1930s architecture that holds historical significance to the State of Victoria. Dr Gitika Sanghvi, Owner and Principal Dentist of Alcaston Dental Care, wanted to preserve the period character within her own practice design while refreshing the staid interiors.
 
The dentist started working at ADC in 2014 when she bought into the practice as an associate. Having bought the rest of the practice in 2018, Dr Sanghvi felt a physical facelift was overdue last year. She picked LDA, a healthcare fitout specialist, based on good word of mouth and positive vibes following initial face meetings.
 
“We needed a revamp as the practice hadn’t really been renovated much in the past. I wanted to keep the warm, welcoming feel of our practice as well as highlight the period and art deco features. Many of our patients have been coming to this practice for a very long time, so it was important for the practice to still have the same welcoming feel as before.”
 
“I was a little worried that after the refurbishment, the practice might feel too clinical and impersonal.  In terms of clinical workflow, I really wanted the steri to be a self-contained space. I also wanted to future proof the clinic so that I had options to add more tech in the long term.” 
 
In summary, the goal was to create a space where the old meets the new in a tasteful and welcoming environment – without compromising on practical function, patient comfort or that sense of familiarity.
 
Looking at the interiors, it’s not hard to appreciate how Levitch Design Australia has seamlessly integrated all these elements. The revamped 100-sqm space is an exquisitely presented clinic in which millennial hipsters and art deco lovers can happily co-exist.
 
The warmth and familiarity of the beloved family practice is lovingly preserved, along with tasteful reminders of the building’s rich tradition and heritage. The contemporary feel is brought out by the minimalist decor, bright airy spaces and snazzy equipment – such as the slim flip-out overhead screens inside the surgeries. The elemental balance of tradition and modernity is evident throughout the clinic.
 
In one of the surgeries, an old fireplace has been closed up and repurposed into an elegant mantelpiece that blends flawlessly with the bespoke cabinetry. Its classical look offers a unique twist to a room geared and wired for clinical expedience. Over at the waiting room, a large format photograph of gleaming skyscrapers is juxtaposed with old-glam furnishings – blue velvety chairs with gold-coloured legs and gold-framed glass displays.
 
With the help of an Instagram picture, Dr Sanghvi had showed the Levitch designers a particular shade of blue that she wanted for the cabinets. What resulted from that input is probably the most prominent facet of the entire design.
 
Indeed, one of the first things you’ll notice are these dark navy blue cabinets with shiny rounded gold handles. Paired with glossy white counter tops, the fetching hues and quaint design of the cabinets evoke a timeless quality without that chintzy look. They effectively break the monotony of the white walls and furnishings with subdued yet posh elegance.
 
The overall environment is cosy and tranquil owing to a blend of natural light and warm down-lights. Thanks to character-filled cabinets and a grand reception counter that harks back to a glitzier time, the clinic possesses a somewhat offbeat personality that works a treat for jaded eyes.
 
“We are just really happy with the complete outcome. Personally, I am in love with the colours and lighting that we have in our practice,” Dr Sanghvi gushes. “The lighting features have added something different and the handles on our cabinets are amazing. (LDA) really stuck to the period of the building and made sure that everything tied in.”
 
In terms of patient and operator comfort, the dentist reports equally positive feedback:
 
“Our patients love the space and always comment on how beautiful and relaxing it feels. Our staff love the amount of storage we’ve managed to fit into the practice, and the size of our sterilisation room now. Brooke is super happy with her new desk at reception and how much space she has to work in now.”
 
The general practitioner has full praise for the Levitch team that made the transformation possible while highlighting several key personnel: Interior Designer Kay; Project Manager Carl; Project Consultant Ben; Project Manager Michael; and even the tradespeople who were “really lovely and accommodating to our requests”.
 
“Everyone tried their best to make sure that we were functional as soon as possible. They were good about completing details before and after business hours so not as to disturb us and our patients,” Dr Sanghvi enthuses.
 
“Speed and turnaround was good – they did as much as they could to fit into our timeline. Cost wise, it ended up costing as much as I thought it would.”
 
Reiterating the importance of maintaining a familiar atmosphere to which the clinic’s loyal patients would feel belonged, the dentist is pleased with the way the designers kept her clued in throughout the process – updating her with images and colour samples so that there were no surprises. The same level of efficiency and work ethic, she attests, was also evident throughout the construction process. The grateful dentist takes the opportunity to individually acknowledge the Levitch team members:
 
“Thank you to Ben, Carl, Kay, Michael and the team at Levitch.”

Passionate about identifying and treating the root causes of dental problems that often extend beyond the oral cavity, Dr Joseph Da Cruz has the ideal cone-beam unit for the job.
 
By Danny Chan
 
From addressing headaches and migraines to TMJ pain to obstructive sleep apnoea, the dentist developed his own methodology and Mandibular Advancement Device (MAD) to treat a multitude of health problems – some of which are cases that he says have commonly been misdiagnosed or areas where dentists have trouble understanding the full extent of.  
 
He is Founder and Principal Dentist of Wholistic Dentistry, a Queanbeyan practice which philosophy is predicated on the view that “the current perception of the dental field, viewed both by medical physicians and the broader community, is narrow and does not reflect the true capacity that dentistry can offer patients.”
 
Dr Da Cruz believes that dentists have much to offer in the diagnosis and treatment of fundamental structural issues in the human body that affect the nervous system and the rest of the body. He is currently involved in non-invasive dental treatment, focusing on interrelated conditions of malocclusion, TMD and sleep disordered breathing using functional appliance therapy. His work is facilitated through use of the Splint, Orthopaedic, Myofunctional dental Appliance (SOMA).
 
Based on occusion signalling as well as growth and development patterns, the appliance was created to correct issues pertaining to translation of the lower jaw. Central to the clinician’s treatment philosophy is the need to calm the nervous system and relax muscles. SOMA as well as the integrated, single-phase treatment approach – developed in collaboration with Dr John Diamond – is unique to Dr Da Cruz’s work.
 
As someone who frequently operates outside the purview of general dentistry, the holistic dentist adopts cutting edge technology to help stay ahead of the curve. The tech savvy dentist owns a fully equipped in-house lab powered by Sirona Cerec McX5, in addition to the KaVo Key Laser 3, Seiler Revelation Dental Microscope, MyRay cone-beam flatbed unit and ICAT cone-bean x-ray that he has been using for over 13 years.
 
The latest addition to his diagnostic toolbox is the Green 21, Vatech’s top-end cone-beam innovation that he purchased in 2018. Dr Da Cruz says the unit’s top-notch image clarity and large FOV makes it one of few CBCTs out there that can rise to his exacting diagnostic demands.
 
“You need a large FOV that allows you to see more of the neck, which is important in my field. The issue is not necessary the airway or sleep apnoea but it could be a neck issue, TMJ or a big tongue so it helps to see all of it in crisp detail.”  
 
The Green 21 offers a wide range of selectable FOV that helps to limit patient radiation exposure, and allows users to capture only the region of interest. Users can select between 21x19, 17x15, 17x11, 12x9, and 8x8 fields of view. The large 21x19 FOV is designed for complete diagnostic imaging, covering the airway as well as ENT regions.
 
For his type of work, Dr Da Cruz says the image quality of a cone-beam machine is non-negotiable. One of the reasons he picked the Vatech x-ray unit has to do with the Korean company’s superior optical sensors, which is constructed from in-house components – all the way from CMOS design to viewer software. The Green 21 utilizes a proprietary 49.5 um high-resolution x-ray sensor, which makes it one of the finest pixel and highest resolution CBCTs available on the market today.
 
Dr Da Cruz relates how in just one year of using the Green 21, the machine already helped with the early detection of a patient’s tumour. “From the clear image, I could detect that she had bone loss which led to further investigation and discovering the tumour.”
 
“It’s so gratifying to know that you’ve made a difference to someone’s life, especially in this case because she went on to have twins,” he beams, “plus this was a peculiar jaw problem with potential for misdiagnosis.”  
 
Besides top-notch sensors, the dentist attributes Green 21’s high resolution images to the ease with which patients are positioned with minimal movement during capture – thanks to a sturdy and patient-friendly chin-holder – and 64-bit image processing capability. The latter feature greatly improves anti-aliasing and scaling with far more accurate rendition, as compared to 32-bit images. Having invested in six new computers that can support this advanced imaging feature, Dr Da Cruz says the financial outlay was well worth the returns: “It literally pays for itself.”
 
One of the key features of the multi-modality CBCT is its ability to automatically generate up to six images – Panorama, PA Ceph, Lateral Ceph, SMV Ceph, and Waters' View Ceph – in one scan. With a few simple clicks, the system can capture images for craniofacial, maxillofacial, and orthodontic treatment planning.
 
“Not only does the (Green 21) help you to formulate treatment plans more accurately, it practically sets up the conversation with your patient.”
 
“When patients cannot visualise the treatment plan, you need to do it for them. The quality of the images therefore becomes an integral facet of this conversation.”
 
It also helps to have an in-house unit when attending to overseas or interstate patients that simply do not have the time to shuttle between the practice and an imaging centre. The convenience factor is a major plus for Wholistic Dentistry’s visiting implant surgeon, who can access the x-rays on the spot and make decisions on the fly.
 
The Green 21’s volumetric analysis and measurement tools are indispensible for documentation and making accurate comparisons over time, whether for showing patients or teaching other dentists. A powerful tool for airway volume analysis, the Green 21 features the 2-click airway region selection; automatic airway volume measurement; as well as simultaneous analysis for both TMJ. 
 
“The type of research and clinical work that I do is rather new. Proper case documentation is very important for establishing the feasibility and success rates of my treatments, some of which are presented as case studies in my lectures.”
 
“The Green 21 is essential for advancing evidence-based dentistry in my practice as a remarkable teaching and communication tool.”
 
Dr Da Cruz’s success dealing with complex cases – some of which were referred to him after having received little or no help elsewhere – has attracted interest from the orthodontic and broader dental communities in Australia, India, China and the US, where he recently held a two-day speaking seminar with progressive orthodontist Dr Barry Raphael in New Jersey.
 
“Beyond surgical treatments, dentists can provide treatment for conditions previously thought unconnected to dentistry – as my work in the last 43 years would testify. I’ve been treating my practice like a research lab over the years accumulating a string of success stories showing positive results from repeatable treatment modalities.”
 
Happy with his purchase decision and Vatech’s customer support, he adds:
 
“Whether to investigate the airway, neck, jaw or teeth, I want the best quality x-ray machine that provides long-term comparative metrics for my work now and into the future.”
 
“The Green 21 has been – and will be – that machine for me.”