ADAVB President's Comments
June 2018 Hide Comments

Signing off

The Dental Board of Australia (DBA) has proposed changes to the Scope of Practice Registration standards for oral health therapists (OHTs), dental hygienists (DHs) and dental therapists (DTs), including the removal of structured professional relationships with dentists. 
Along with ADA President Dr Hugo Sachs and the other state branch Presidents, I co-signed a letter to federal, state and territory health ministers outlining my concerns about the proposed changes late last year. 
OHTs, DHs and DTs have varying qualifications and educations. Some have two-year diplomas while others have three-year Bachelor degrees. Their courses do not have the same rigorous science courses in subjects such as anatomy, biochemistry, physiology, pharmacology, pathology and microbiology as in dentistry. These subjects give dentists the necessary background to manage patients with polypharmacy and complex medical conditions. 
In addition, an OHT, DH and DT cannot do complex dentistry such as the diagnosis and treatment planning of adults with dental or orofacial pain, endodontics, crown and bridge, surgical extractions, periodontal surgery and implant placement and restoration. These treatment modalities can only be done be a dentist. 
Approximately 20 years ago, Australian dental prosthetists (DP) were given independent practice to make dentures and mouthguards. The rationale for this independent practice was to reduce the costs to patients. This did not occur. DT and DH in some states of the USA such as Minnesota and Colorado were granted independent practice to treat patients in remote areas and reduce fees. Likewise, the fees were not reduced. This is because all dental professionals have the same fixed costs of running a dental surgery such as dental chairs, x-ray units and other equipment, staff, infection control requirements and dental materials and supplies. 
It is very important to educate our patients and members of the public that there are some treatment modalities that can only be undertaken by a dentist. Dentists must continue to be the leaders in oral health in Australia. 
It has truly been an honour being the President of the ADAVB over the last 12 months. This year would not have been possible without the assistance of many people in so many different ways. 
It was very daunting knowing that the ADAVB CEO of 26 years, Garry Pearson, would retire 12 days into my term. Thankfully, Matt Hopcraft has been the perfect replacement – transitioning seamlessly. Matt has instituted a number of wonderful initiatives in his first year as CEO and will continue to lead the ADAVB management from strength to strength. 
It has been a pleasure going into the ADAVB office every week and catching up with the staff. The ADAVB is really lucky to have such committed and friendly people working there. The ADAVB councillors are really supportive and are always there for help and advice. A special thanks to the ADAVB Executive, Drs Andrew Gikas, Kevin Morris, Gitika Sanghvi and Angelo Pacella for all you have done over the last 12 months. 
Running a private practice is not easy with the added responsibilities of the ADAVB. I am very grateful to my staff who moved patients for meetings and media engagements, sometimes at short notice. 
Many thanks to my friends, family and especially my very supportive husband, Gary, who have helped with school pick-ups and play dates for my son Benjamin. 
ADAVB will be in very capable hands under the leadership of the incoming President Dr Kevin Morris. I wish Kevin all the best for a very exciting and fulfilling year. 
Dr Susan Wise

As all our members are aware, we have a two-year service agreement with ADAVB, which is due for renewal in mid-2019. Many of our services (excluding regional study groups) are covered by our expanded agreement with ADAVB. 
In line with that, we have restructured our branch, and our ‘office’ has effectively ‘relocated’ to the ADAVB office in Yarra Street, Melbourne. This means that the membership now has access to the benefits of the resources and infrastructure that is normally available to members of a much larger branch. One of my concerns is that members who live in a regional or remote location should not be disadvantaged in terms of member services purely because of their location. The restructure of the agreement is aligned with a more collaborative vision at a national level, which includes reducing the duplication and replication of services across the country. Your Council is pleased and excited about the opportunities this new restructure affords. Hopefully, this will translate to a more effective and better delivery of services to members. 
The benefits of the service agreement provide us with the best of both worlds: our own sovereignty, and the support and access to services that, in the past, only a big branch would have. Thus, members have the benefits of the services provided by a large branch as well a robust local council. All the councillors have expressed their willingness to be available to answer members’ queries. I encourage you to contact any councillors if you would like to ask any questions or provide feedback to the ADATas Council. 
Your Council has been focusing on a thorough governance review, which is almost complete. It will include realignment of our strategic plan with other states as well as ADA. 
For some time, I have been aware of what I feel is a ‘gap’ in our dental community – both professionally and personally. I feel that we do not treat our ageing population in the manner they deserve. 
I recently attended the induction dinner for the International College of Dentists and I was particularly moved by the address of a keynote speaker, Graham, in which he shared his journey of 30 years working as a volunteer dentist in the Congo. Graham shared a paragraph from Paul Theroux’s book Dark Star Safari, and I would like to share that paragraph with you: 
‘The old are not as frail as you think, they are insulted to be regarded as feeble. They are full of ideas, hidden powers, even sexual energy. Don’t be fooled by the thin hair and battered features and the scepticism. The older traveller knows it best; in our hearts we are youthful and we are insulted to be treated as old men and burdens, for we have come to know that the years have made us more powerful and certainly streetwise. Years are not an affliction – old age in strength.’ 
When I graduated as a dentist in 1977, we were handed a document called The Dentist’s Creed1, which I still have. I recently read it and was quite amazed at how much of it is still relevant: 
‘As I enter this noble profession I recall the long journey man has undertaken through the ages in his never-ending quest for a happy and painless existence. My predecessor was indeed none other than the pre-historic healer who used a beast’s bone or a wooden prong to prise out a painful tooth. Thus, I see myself placed at the frontier of the endeavours engaged upon by many before my time. 
‘That primitive dental practitioner was no doubt invested with a very special authority and probably performed [the] therapeutic task in an aura of magic and superstition. Today my standing in the community is not as awesome but my function is no less ameliorative than that of our ancient ancestors. As they did, I shall always be willing and eager to provide succour in the hour of need. 
‘The dental elements are fundamental to some of man’s keenest pleasures – the use of his mouth for the taking of sustenance, for speech and sensual enjoyment and for cosmetic appearance. His ready susceptibility to discomfort and suffering in this vital bodily area is very intense and personal and gives the dental physician the opportunity of establishing a special relationship with his patient. So it is that the [person] in the chair becomes not merely a subject for clinical diagnosis and considered treatment but also a particular being with his[/her] own vanities, idiosyncrasies and very human needs. 
‘I value most highly my membership of community of healers and restorers whose duties carry the discipline and fulfilment of a self-imposed responsibility. The principles of brotherhood of those who practise our specialised form of medical care ensure that I shall not lack the understanding and support of my fellows. All of us are in a true sense the seekers after the touchstone – the elusive criterion of perfection. 
‘May I never in the pursuance of this goal fall prey to the temptation of commercialising my profession. May I always set for myself the highest standards and so prove myself deserving of my patients' infinite trust. May I always regard every patient as worthy of a reverence which transcends individuality and becomes indeed a reverence for life itself in all its diversity.’ 
With my term as ADATas President ending, I would like to thank the members of the branch for their confidence in me, and to express my gratitude to the councillors for their hard work and support. I would also like to thank the ADAVB personnel who have actively supported me during my term in office. I have worked closely with several significant people at ADAVB and I am most appreciative of the efforts of all of them – particularly, Lisa Legge, Caroline Kaur, Garry Pearson, Susan Wise, Matt Hopcraft, Maria Omizzolo, Sonia Georgiades and Cathy Workman. 
Your Council is constantly striving to improve and to streamline services in accordance with the needs of our Tassie members, and in that vein, we welcome and appreciate any constructive feedback that might contribute to the smooth running of our services. 
Dr Errol Kilov 
ADATas 2017/18 President 
1Ernst van Heerden, Commissioned by Mer-National Laboratories, The Dentist’s Creed. May 1977.

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