Surgery Setup Academy (SSA) found all the missing pieces to Dr Luke Heazlewood’s start-up puzzle.
 
By Danny Chan
 
“Crossing the river by feeling the stones” is a famous saying by former Chinese leader Deng Xiaoping that illustrates the process of doing something that is unfamiliar or unclear. It aptly describes the set up process that many dentists, taking the plunge to set up their first surgery, have to go through.
 
For Dr Luke Heazlewood, Principal Dentist/Founder at Battery Hill Dental, the proverbial ‘stones’ represented unchartered territories in surgery fit out, finance and equipment selection.
 
“I have never had to fit out or finance a shop before. Those were the grey areas that I needed to wade through,” says the young dentist, relating the difficulties he faced during the initial stages of establishing the community-centred suburban clinic in the Sunshine Coast Region in Queensland.
 
That was before Luke came across Surgery Setup Academy (SSA) – that turned out to be a gem of a discovery, attributed both to his online research and contacts he made throughout the years.
 
Organised by Henry Schein Halas, SSA offers a holistic platform that helps dentists answer all their start-up queries. It covers the entire spectrum of topics throughout each development phase – equipping dentists with the knowledge and contacts to better plan, design, build, equip, finance, market, run and maintain a successful surgery.
 
Luke began attending the SSA events “to gather some more information and find out about the things that (he) wasn’t familiar with”. Available as evening lectures or all-day events, SSA seminars are held 2-3 times a year in all Australian states.
 
“It was a great place to start piecing together the different parts of the start up puzzle. Additionally, it led to some great connections that became very helpful in the whole process.”
 
At first brush, SSA may look like it offers no more than informational sessions when in fact, the real benefits extend well beyond the classroom.
 
SSA brings together dental partners belonging to Henry Schein Halas’ diverse ecosystem. As one of Australia’s leading suppliers of dental equipment, instruments and consumables, HSH boasts an extensive network of specialist firms – each one potentially offering unique expertise and assistance towards your practice set up.
 
The fields represented are exhaustive: Property Lease, Equipment Supply, Legal Advice, Dental Consumables, IT Integration, Software, Technical Installation, Fit Out & Construction, Sterilisation Workflow, Project Management and Business Development, etc.
 
Through SSA, Luke found resourceful HSH personnel that connected him to other field experts, many of whom eventually formed the set-up team behind Battery Hill Dental.
 
Outlining the initial challenges he encountered, Luke recounts: “There were several main considerations and challenges after I figured out what and where I wanted to set up. Firstly, finding a good space in the desired location was essential. This took time; actually, everything takes longer then you assume.”
 
“Secondly, it was extremely important to me to find the right team to work with. This included people for finance, surgery design, legal, and equipment, etc. This took some time as well, but it was truly worth the effort when we found the right people. The next steps became easier to navigate, problems easier to solve, and the process more enjoyable.”
 
Luke readily attributes the speedy, efficient and cost-effective set-up to the team that was assembled through his connections at SSA. One such HSH-recommended contact was Mark McKibbin, from McKibbin Design, a firm that specialises in healthcare, medical and dental practice fitouts.
 
“Mark was easy to work with and he took the time to understand what we wanted to create. He did a great job, and saved us a lot of money. Compared to other quotes we received, McKibbin Design ended up saving us $100-$150k on surgery fit out alone.”
 
Luke credits the pleasant set-up experience to Emma Addy, Equipment Specialist at HSH, who acted as his main point of contact.
 
“She was excellent. Emma knew her product range very well, and her experience of setting up a lot of surgeries really showed. She helped us think through a lot of things, not just equipment, which helped make the whole set up process go as smoothly as possible.”
 
“HSH also provided us with the majority of our equipment and consumables. Emma was a great help with this. She was never pushy which made the process simple; an underrated ability for your first ever set-up. Additionally, HSH had a lot of connections outside of their domain if we ever needed them.”
 
In terms of equipment selection, Luke listed ‘patient comfort’ as the main priority, followed by speed and reliability, saying:
 
“We ended up choosing the Planmeca itouch (dental unit). I wasn't familiar with Planmeca products initially, so was hesitant but it has been incredible. I really enjoyed working with it and other Planmeca products like digital sensors and OPG, which are quick and reliable.”
 
“In terms of suction unit and compressor as well as the steri room equipment, we opted for equipment that are durable and future-proof – allowing for surgery expansion down the road. We've been extremely happy thus far with our choices.”
 
Luke found the one-stop shopping experience at HSH equally satisfying:
 
“As we bought the majority of our equipment from HSH, this gave us access to good discounts on equipment and consumables. In relation to costs, and to our surprise, they were the most cost effective out of the three major companies we were looking at for the particular equipment that we wanted.”
 
“HSH’s service and delivery was excellent. We never had a problem with timing. The team was efficient with install, and there were no delays with equipment (large, small, or consumables).”
 
Asked whether he would recommend the Surgery Setup Academy to others, Luke replies without hesitation:
 
“Absolutely; particularly if you are setting up for the first time, or the first time in a while. It is a great place to learn things you may not have thought about, connect with others who are considering setting up, and start building the right team and connections to make building your practice as simple as possible.”
 
The results of Battery Hill Dental’s successful set-up are best expressed through the feedback Luke gets from his customers:
 
“Every single day, we get great feedback from patients. They love it. A frequent compliment is how comfortable they feel in our surgery – how it feels less clinical and more like a home.”
 
Grateful to the HSH team for their contributions and recommendations – courtesy of the incredible work they do at SSA – Luke says:
 
“The HSH team was exceptional. No company is ever perfect. For a company as large as HSH to work as effectively as they have, we couldn’t have been more pleased.”
 
Just as Henry Schein Halas and SSA provided an ecosystem that helped to meet his set-up needs, Luke has created a space for young dentists across Australia to come together and connect with peers who are on the same journey – through interaction and learning opportunities with some of Australia's best dentists and specialists.
 
Besides upskilling young dentists with new skills and techniques, the Young Dental Conference (YDC, cometoydc.com) also helps members of Australia’s young dental community to overcome their emotional and mental struggles through dialogue and sharing of ideas.
 
“There's a lot more mental illness in the industry than we would care to see. If we can be a part of making life easier in such a foundational time for younger dentists, then we've succeeded with YDC.”
 
Even as SSA provided Luke a knowledge-based and networking platform for practice set-ups, YDC gave him an avenue for peer exchange in a like-minded community:
 
“YDC helped guide me on setting up a practice, refining thoughts on what I truly wanted to achieve through it for the community I found myself in.”
 
“Particularly through connecting with numerous specialists over the years, YDC offers a great resource to learn from the best. We are truly blessed with some incredible specialists and dentists in Australia.”
 
 

Peter Mac’s Dental Oncology team shares how dental professionals can help to enhance the quality of life and survival of cancer patients

By Danny Chan

According to Cancer Council Australia, around 134,000 new cases of cancer will be diagnosed in Australia this year. That number is set to reach 150,000 by 2020. If not already, it is likely that you will soon be seeing some of these patients at your dental practice.

A patient’s health and quality of life may be significantly compromised by oral complications arising from cancer treatments, including head and neck radiation or chemotherapy. Conversely, pre-existing oral diseases can also affect cancer treatment.

This brings to the fore questions on the readiness of the dental profession in caring for a steadily increasing number of cancer patients: Are you or your staff sufficiently equipped to deal with the potential side effects? Are you prepared to counsel, guide or educate patients at different stages of their treatment cycles? What is your role in patient management related to – and beyond – the oral cavity?

If these questions do not sound to you as pertinent as they should, the dental oncology team at Peter McCallum Centre believes, and rightly so, that more awareness campaigns and educational programs on the importance of dental health in oncology are necessary.

“Yes, there is a need for greater awareness on the subject within the dental profession. As a community, all dental professionals will see more and more cancer patients and survivors in practice,” notes Margaret Randles-Guzzardi, Dental Hygienist at Dental Oncology Clinic, Peter MacCallum Cancer Centre. 

Equipping Australian dentists to handle cancer patients

Peter Mac is one of the world’s leading cancer research, education and treatment facilities and Australia’s only public hospital solely dedicated to caring for people affected by cancer.
 
The Centre’s Dental Oncology team comprises a General dentist, an Oral Surgeon, a Prosthodontist, an Oral Medicine Specialist, two Dental Hygienists, and nursing and administrative support staff. The team focuses on the prevention and management of oral complications associated with cancer and cancer treatments.
 
The clinic’s functions are divided into 3 core areas: 1) Education; 2) Oral examination and dental care; and 3) Research. The educational component is further divided into different target groups: Patients; Dental Professionals; as well as Medical and Allied Health personnel.

Concurring with her colleague on the need for greater awareness within the dental profession, Dr Sophie Beaumont, adds: “At risk of over generalising, I would say that Australian Dentists are not usually well equipped to deal – or are familiar – with cancer types and complications.”

Areas for improvement range from Patient Education to Patient Management, Pre- to Post-Treatment.

There is relevant information online – including from leading cancer centres Lifehouse Sydney and MD Anderson (USA) – but Margaret says the field would benefit from a “comprehensive set of recommendations and strategies that are the same in each institution.”

Equipping dental professionals with the right educational tools paves the way for informed patient management. Dentists may be required to treat and advise cancer patients on a range of oral conditions before, during and after cancer treatment.  

“It needs to be understood that oral side-effects from treatments such as radiotherapy and bone modifying agents are for life,” Margaret qualifies, “These side-effects impact on quality of life and self-esteem. They don’t cease when the all clear is given or the cancer is in remission.”

Multi-faceted roles and responsibilities

Clients are referred internally by the hospital’s staff. Dr Beaumont says it may be more effective for patients to be referred prior to radiation therapy in order to allow more time for pre-treatment and healing – however, this is not always possible.  

Patients are brought in 6 weeks following completion of cancer treatment, and subsequently, every 2 months for a further 6 months – typically or until ready to return to their general dentist.

At Peter Mac, the dental oncology team performs a variety of tasks that most general dentists do not, including:

• Mapping tooth loss risk: Predicting up to five years whether teeth will stay and recommending prosthetics for those that may be lost or require removal.
• Dealing with cases of osteonecrosis (in the jaw): This can result from therapy, especially some sulphur-based drugs used in treatments – “some patients have bone erosion so significant that teeth literally fall out.”
• Handling the client’s self-esteem: “Many struggle with self-image after losing dentition so the service is vital. It is also vitally important for their ongoing nutrition.”

Advocating patient education as an integral part of pre-treatment evaluation, Margaret says that it should encompass discussion of potential oral complications. She stresses on the need for patient education and oral cancer screening at every dental visit.

“Australian dentists need to understand their role in terms of prevention and early detection – they go hand in hand. From organising regular oral cancer screenings to recommending high fluoride toothpaste to providing restorations that are functional and easy to clean, the dentist plays a unique role in the preventive process.”

“The oral side-effects of many cancer treatments can affect the patient for life. As dental professionals, we need to understand how these treatments can be detrimental for teeth.”

To provide an avenue for Australian Dentists to learn more about treating cancer patients, Margaret reveals that the Centre intends to run an education program in the future. How dentists would respond to such a program, given that many suffer for being time-poor and overloaded with work and business commitments, remains to be seen.

Indeed, playing an active role in cancer treatment may seem like a chore to many dentists, Shae Beaton, the Clinic’s other Dental Hygienist, readily acknowledges, before issuing a gentle warning about measuring it in monetary terms:

“Finances should not be the consideration. A simple cancer screening should be part of every dental examination. The dental professional has an obligation to do this as the medical profession generally are not familiar with the oral cavity. That said, providing ongoing empathetic care will attract patients and lead to referrals from cancer centres that indirectly will build their practices.”

“Practice building is also about having a rewarding experience,” Dr Beaumont reminds, “like being able to positively influence the outcome for a cancer patient.”

Building bridges and team effort

Dental oncology occupies an uncharacteristic area of dentistry that spills into the medical domain. Focusing on the dental and oral manifestations of chemotherapy, radiation therapy and/or head and neck surgery, dental oncologists find themselves in a unique position somewhere in the middle of the dental-medical divide.

Operating within a multi-disciplinary dental specialist clinic means that the team works in close association with all of the oncology streams, including: Head and neck, haematology, breast, lung, and skin.

 “At Peter Mac, we believe that it takes an entire village, including dental and medical professionals working alongside one another, to care for people affected by cancer,” Shae comments. 

From their vantage viewpoint, the team sees the Australian dental and medical fields converging in positive ways.

“There are well established communication lines and mutual respect on both sides. Oncologists regularly discuss patients with dental staff and vice versa,” Margaret confirms.

Dr Beaumont adds: “You will find excellent team work and no real hierarchy at the Centre – there’s always good communication and respect for what we do.”

That same open-style communication and professionalism extends to the dental community with which the team regular works and liaises – including all referring specialists, community dental clinics and private dentists.
 
“Whether for resources or support, we want to make our department the go-to for dental and medical professionals,” the Oral Surgeon concludes.

“We work together as a team for the best patient outcomes, reduced morbidity and improved quality of life.”

​

By Danny Chan
 
Almost 3 times more dental amalgam waste has been collected in 2017 compared to the previous year, according to data compiled by EPA-licensed mercury distilling company CMA Ecocycle. The figure is based on the total weight of dental amalgam the company collected in each of the last 3 years. Australasia’s main mercury recycler, CMA Ecocycle processes the bulk – up to 95% – of the region’s mercury waste.
 
The sharp increase suggests industry-wide efforts to educate dental practitioners on the proper disposal of amalgam waste is paying off, says Ian Crawford, Dental Specialist at CMA Ecocycle.
 
“These figures show an improved commitment and willingness by Australian dentists to do their fair share. They demonstrate the success of industry and state-sponsored awareness campaigns, all of which help to drive home the message that, indeed, dentists play an important role in the protection of our environment by acting responsibly with their amalgam waste.”
 
Citing data accuracy within 1% margin of error, Ian reveals latest figures showing 2736 kg of dental amalgam was collected with 944 kg of mercury recovered for recycling in 2017. This represents a huge jump over 2016/2015 figures: 955 kg collected and 320kg recovered; 1500 kg collected and 500 kg recovered, respectively.   
 
Ian Crawford is no stranger to the dental-related environmental cause, having been the leading spokesperson for the Dentists for Cleaner Water (DFCW) project. Launched 2008 in Victoria, the $1 million program was aimed at promoting the installation and use of amalgam separators in private sector dental practices in an effort to eliminate mercury from the state’s sewerage systems. DFCW was jointly organized by the Victorian Branch of the Australian Dental Association (ADAVB) and metropolitan water retailers, in partnership with the Environment Protection Authority (EPA) Victoria.
 
Although the state-wide initiative concluded in 2011, Ian says, Victorian dentists continue to respond postively even as similar awareness campaigns have rolled out throughout the country. 
 
“Perhaps due to the success of DFCW, we have seen a healthy take up rate in Victoria. We have been busy promoting the cause in other states, hoping that we can encourage an equally robust participation.”
 
While the recent uptake is encouraging and heading in a positive direction, Ian warns against complacency:
 
“There is still a long way to go before we can confidently say that the majority of Australian dentists have done right by the environment, making sure that we live in a safer environment – now and for generations to come.”
 
“By responsibly disposing off their amalgam waste, Australian dentists are also safeguarding the health of staff members who currently may be improperly handling the mercury waste.”
 
The responsible disposal method entails the installation of amalgam separator units and updating suction systems – costing between $600 - $8000, depending on the number of chairs/ surgeries in your set-up. Next is the “collect-and-recycle” phase where the clinic has to arrange the regular collection and recycling of the separator collected amalgam waste.
 
“It is not an easy task convincing dentists to invest and make a commitment, simply because for many, this is not seen as a priority. It would require a concerted effort by all parties concerned – playing their part as members of the dental family, if you like – to make widespread adoption of proper amalgam disposal methods a reality.”
 
Meanwhile, the well-documented dangers of mercury exposure and poisoning continue to attract international attention. Closer to home, the Australian parliament has been deliberating over the decision to ratify the Minamata Convention, a multilateral environmental agreement that addresses the adverse effects of mercury. It is named after an infamous incident that occurred in a Japanese town – where thousands of people were poisoned by mercury in the mid-20th century.
 
Ian believes such discussions will spur policy makers to call for more practical action – with possible trickle down effects on the dental community:
 
“Whether it be the installation of amalgam separators and/or amalgam recycling, the dental market will gradually address the subject of harmful mercury in the environment. If the Minamata situation is ratified in Federal Parliament, we certainly won’t be hearing the last of it.”