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Strength to Strength in Numbers

5/10/2022

 
The 25th Anniversary of Dental Innovations proves that the purchasing network for independent dentists is alive and well in our highly corporatized industry.

By Danny Chan

In 1997, while serving as senior regional manager for NAB, Merv Saultry was approached to research the dental industry. What he found was shocking.

Suppliers were charging dentists vastly different prices for the same product – even if they were located on the same street or in neighbouring townships.

Seeing how individual dental practices were easily exploited for lack of buying power in a largely opaque supply market, Merv decided to leverage his financial knowhow and set up a dental buyer’s network.

The concept was straightforward: Draw on the collective strengths of individual dentists to amass greater negotiating and buying power. That seed idea has since grown into Australia's largest commercial network for dentists.

As Dental Innovations marks its 25th Anniversary this year, it brings to bear a salient point – what Merv had discovered in 1997 is still as relevant today.

United we stand

In a marketplace increasingly dominated by large corporates and health fund providers, the economic imperative for dentists to unite is still as pertinent – though more profoundly felt than ever.

“The Dental Industry has changed significantly over the last 25 years and continues to do so,” says Berris Saultry, Director of Dental Innovations.

“However the value proposition of the independent dentist who owns and operates his or her own practice still remains unchanged.”

The same dichotomy can be said of the company. Although Merv stepped down as the CEO in 2011 to let his sons Tim and Berris run the organisation, nothing has changed fundamentally.

They remain a family business dedicated to improving the bottom-line of their members. They continue to help practice owners systemise their business while leveraging the power of the collective to enhance individual prosperity.

What has changed is the scale and delivery of the business. From a modest outfit in 1997, DI has grown into a bona-fide network boasting more than 750 independent dental practices across Australia and New Zealand.  Since its inception, DI has saved its members millions of dollars.  

Savings (both time and financial) are accrued from a range of membership benefits: Stock Management and Inventory Control systems including exclusive discount pricing with ten suppliers on more than 60,000 products; reductions in credit card merchant fees; practice insurance premiums; equipment discounts and access to complimentary marketing content resources.

The company has also created various avenues for members to connect and exchange ideas and best practices with other dentists. These include a private online forum, networking events and webinars.

These well-received programs have been developed in keeping with the rapid change of pace as well as increased pressure on dentists.

“Dentists are up against multi-nationals. Venture capital is flooding in. Health funds are attempting to control the industry,” Tim adds. 

“It’s an increasingly hostile environment. What most dentists want to do is dentistry but they end up having to cope with the immense pressures of running a business.”

Membership has its privileges

The message is clear. Only by banding together can dentists ever hope of generating enough critical mass to make themselves stand out in the crowded marketplace or heard above the media-saturated cacophony.

That said, there are those who join Dental Innovations with simpler goals.

Dr Sam Rogers, who has been with DI right from the start, said he was looking to form a peer group – preferably one with “very efficient buying power that the Australian Dentist Association wasn’t involved in.”
​
While complimentary of DI’s peer group support, exclusive deals and customer service, the owner of Northbridge Dental Clinic believes his biggest membership gains were the friendships he had cultivated within DI’s collegial framework.
 
“It’s the feeling of not being in it alone,” he summarises, identifying one of those ‘invaluable intangibles’ rarely associated with the price of a membership.
 
Echoing the sentiment, fellow Foundation Member Dr Andrew Prideaux said he also joined DI because he saw the value of grouping with like-minded dentists.
 
Dr Prideaux joined as part of a group practice in 1998, but found bigger membership yields since moving into his own private practice in 2000.
 
The Director of Mosman Fine Dental says he benefited the most from DI’s networking information, online portal and benchmarking services.   
 
Dr Prideaux singles out the peer-to-peer chat forum as the go-to conduit for sourcing timely information – everything from bang-for-buck consumables to buying a car. He also appreciates the online ordering portal and the quarterly reports on practice expenditure and other timely data.
 
The network’s industry-benchmarking data, he attests, outperforms even commercially available third party alternatives.   

“As a practice owner, you are always looking for that happy medium between the clinical and operational aspects of dentistry,” he avers, “DI helps to fill part of that knowledge gap – the stuff they don’t teach you in university.”

Mission Possible
One of the “missions" described on the Dental Innovations website is to “take on the big boys” through helping dentists gain leveraged access to the best suppliers and providing peer-to-peer support.

How does the company stack up against the competition? By ‘competition’ we mean big corporate health funds and practice aggregators with deep pockets.
​
“They may have deep pockets,” Tim Saultry admits, “but not the personalized service and relationships which independent dentists can leverage. 
 
He cites the example of Dental Innovation’s 25-year relationship with Dentsply Sirona which has been supporting the DI Network concept since 1997.
 
“Corporates that are accountable to investor returns so often miss the importance of relationships. This problem is exacerbated by a high staff turnover where their personnel seldom stay long enough to cultivate strong relationships,” he adds.
 
“Unlike most other industries, a dentist remains a dentist for their working life. That’s why they look to industry service providers with whom they can partner for the long haul.” 
 
Unlike bureaucratic corporate structures, Berris Saultry believes the DI community thrives on having a proactive support network.
 
“We saw this community spirit in action during the recent pandemic lockdown,” he says. “Our members were helping each other navigate through that crisis.
 
“I think that member dental practices will continue to grow as they differentiate themselves from corporate groups in the market.
 
“Being part of DI will allow those practices to achieve the same economies of scale as corporates but still maintain their independence.”
 
“Our mission is the same as it was in the beginning,” Tim interjects, “empowering and supporting dentists, allowing them to be proactive within their own industry.”

Rinse of the future

5/3/2022

 
Perio Plus | The River Tree | Danny Chan
Dr Tihana Divnic-Resnik | The River Tree | Danny ChanDr Tihana Divnic-Resnik
Can a natural antibacterial agent extracted from bitter oranges be the modern equivalent of Chlorhexidine for oral rinses? Danny Chan gets the details from chemical plaque control expert, Dr Tihana Divnic-Resnik.

Citrox® is an exciting organic antibacterial agent that could be used in a whole new generation of mouthwashes.

​While its strong antimicrobial and anti-inflammatory properties have been likened to those of Chlorhexidine (CHX) – currently one of the most widely used antiseptics for plaque control – Citrox® has demonstrated some benefits that could make it a formidable weapon in the battle against oral plaque.

Although yet early days, initial test results have so far been positive.

“We believe that Citrox® is proving itself as an important ingredient in efficient mouth wash solutions and together with cyclodextrins, will play a crucial role in the future of oral healthcare,” attests Dr Tihana Divnic-Resnik.

Dr Divnic-Resnik is a university-based researcher studying the potential uses of Citrox® as part of a broad exploration into different avenues of chemical plaque control. She is also involved in the research of Curaden’s CURAPROX Perio Plus+, an oral antiseptic range that combines Chlorhexidine with Citrox®.

Dr Tihana Divnic-Resnik is a Senior Lecturer at the University of Sydney. For 10 years, she served as lecturer in Periodontics and Oral Medicine at the University of Belgrade, Serbia, where she also practised as a specialist of Periodontology and Oral Medicine.

She currently practices at the Department for Periodontics at Sydney Dental Hospital. Dr Divnic-Resnik holds a master’s degree and PhD in Periodontology.

Part of your research involves debunking myths surrounding the use of chemical plaque control in dental clinical practice. Why do you think these misconceptions exist in the first place and how do you go about unravelling them?

There are many myths related to chemical plaque control, as its use extends to ancient civilisations that used mouth washes in the prevention and therapy of numerous oral diseases, including gingivitis and periodontitis.

The global market is loaded with new products. Under pressure to sell, manufacturers are sometimes presenting their products in the best light creating misconceptions that the product may be more effective than it really is, neglecting potential adverse effects.

However, from the aspect of prevention, it is important to emphasise that chemical plaque control should not be used routinely and that oral antiseptics should be used as adjunct to mechanical plaque control.

Plaque control with a toothbrush and an interdental brush/floss is of paramount importance and first choice in regular hygiene maintenance. Adjunctive use of oral antiseptics may further reduce colonisation of bacteria and alleviate gingival inflammation.

As dental professionals, we should be up to date with most recent evidence and choose products that are tested and proved to be effective and safe for our patients.

Chlorhexidine is one of the most widely used antiseptics for plaque control, but you also highlight its negative side effect of discolouration. Should dentists continue to recommend rinses containing Cchlorhexidine?

Chlorhexidine (CHX) is a well-documented and effective antiseptic used for primary and secondary prevention of gingivitis and periodontitis as an adjunct to mechanical plaque control. Commonly, it is used as antibacterial mouth rinse at various concentrations twice a day for up to four weeks.

Although CHX exhibits broad antimicrobial spectrum and has outstanding substantivity, its major drawback is its ability to stain teeth and aesthetic restorative materials.  

In the recent few years, due to widespread use of CHX not only in dentistry but also in medicine, concern has been raised in relation to increased number of cases of allergy to CHX as well as enhanced microbial tolerance. Such undesirable reactions have resulted in calls for modified clinical practice and exploration of alternative substances for oral care.

Until new approaches have been developed, CHX remains a viable choice in practice – provided that dentists and patients are aware of its potential adverse effects.

What can you tell us about Citrox® and its potential uses as an ingredient in the formulation of antiseptic mouthwashes, gel and toothpaste?

In the last few years, phytopharmaceuticals have been recognised to have an outstanding role in new drug delivery. Citrox® is a soluble formulation that contains natural bioflavonoid complex, derived from the Citrus aurantius (bitter orange), and organic acids.

Studies have shown its strong antimicrobial, anti-inflammatory, and anti-oxidative potential. Citrox® has broad antimicrobial spectrum and is very effective against bacteria, viruses, and fungi. Its mechanisms of action on cellular level are very similar to CHX.

In addition, Citrox® can attenuate microbial pathogenicity by targeting their enzymes and virulence factors, thus reducing their potential to cause disease. This property is of importance in combating CHX resistant microorganisms that have developed tolerance against certain antibiotics.

Used in combination with CHX in PerioPlus+, Citrox® demonstrated synergistic activity, which may enable using lower concentrations of CHX in oral health products and subsequently a reduction of its adverse effects.

We believe that Citrox® is proving itself as an important ingredient in efficient mouth wash solutions and together with cyclodextrins, will play a crucial role in the future of oral healthcare.

Based on your study on tooth staining caused by commercial mouthwashes, do you think Citrox® can help to counter the issue? If so, how?

Reducing concentration of CHX and supplementing it with another potential antiseptic such as Citrox®, may result in reduced side effects, whilst maintaining antimicrobial properties. Our in vitro study tested discoloration potential of PerioPlus+ mouthwashes on direct aesthetic restorative materials such as composite resins and glass ionomer cements.

In our tests, PerioPlus+ mouthwashes caused less staining in specimens of the tested aesthetic materials, as compared to similar concentrations of CHX. While the initial results look promising, these are still early days, and further studies are necessary to elucidate the role of Citrox® in reduction or prevention of staining.

Does your research on Perio Plus show it as a step in the right direction when it comes to designing the “rinse” of the future?

Positive results of in vitro studies demonstrated the potential of PerioPlus+ to overcome some of the drawbacks of CHX.

However clinical studies are necessary to confirm in vitro results and to further explore various indications for its clinical use.  

Currently, we are designing clinical studies with our colleagues from Europe, and the University of Sydney will be one of the first centres to test PerioPlus+ mouth washes in the clinical settings.

We also aim to continue exploring various natural ingredients that might set standards for the future oral healthcare products.

References

Hooper SJ, Lewis MA, Wilson MJ, Williams DW. Antimicrobial activity of Citrox bioflavonoid preparations against oral microorganisms. Br Dent J. 2011 Jan 8;210(1):E22. doi: 10.1038/sj.bdj.2010.1224. PMID: 21217705

Jeyakumar J, Sculean A, Eick S. Anti-biofilm Activity of Oral Health-care Products Containing Chlorhexidine Digluconate and Citrox. Oral Health Prev Dent. 2020 Oct 27;18(1):981-990. doi: 10.3290/j.ohpd.a45437. PMID: 33215489
​
Malic S et al. Antimicrobial activity of novel mouthrinses against planktonic cells and biofilms of pathogenic microorganisms. Microbiology Discovery  2013 Microbiology Discovery. Doi:10.7243/2052-6180-1-11.

    The
    ​Dental Blog Writer

    Danny Chan | Dental Blog Writer

    Danny Chan

    Danny is founder of The River Tree, a Multimedia Company based in Melbourne that provides Quality Content & Digital Marketing Services to Dental Professionals across Australia and New Zealand.

    ​Danny Chan is also the Managing Editor of Dental Resource Asia, a digital news and information platform for dental teams across the APAC region.

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