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April Newsletter Contents:

Blog Post: April 2021

CPD Junkie Blog Like everything good in life, there must be a balance. It is not something you find, but something you create.” Jen Truong

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Expert Q&A – April 2021

Expert Q&A with: Dr. Melissa Chew I think it is important to get good mentorship. Mentorship is invaluable, especially post-graduation. ” Dr. Melissa Chew Bio: Dr.

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Speaker Spotlight – April 2021

Speaker Spotlight with: Dr. Mehdi Rahimi I always approached research with a “Can do” attitude and believed that “Persistence is the keyto success.” Although you

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The CPD Junkie Newsletter Archive

April Newsletter

CPD Junkie Blog

Like everything good in life, there must be a balance. It is not something you find, but something you create.”

Jen Truong

Work-Life Balance– 

Can we Really Have it all?

Do you constantly worry about upcoming deadlines or work? Do you find yourself always talking about what you ‘have to get done’ and only half listening to your friend’s weekend escapades? Well, you’re not alone. It is estimated that 19% of Australian workers spend more than 45 hours a week at work (ABS Labour Force Survey, 2021). In fact, on average, studies suggest that full time employees spend about 4.6 hours working for free per week (Browne, 2019).  

So why the imbalance? It is thought that work can provide purpose, can encourage a sense of community, boost productivity and good habits, and more importantly, provide the financial basis for living. As we all know, overhead costs are not free. Although work may provide many desirable rewards, there is a misconception that ‘more is better’, which can result in people working long hours for diminishing or even worse returns.
 

But why is work- life balance necessary? It can

  • Prevent early burnout and reduce stress– by keeping your work and life separate, you can try to leave the stress at work and retreat home for some necessary rest and relaxation;
  • Promote a healthy mind and body– the mind and body are inseparable, having a healthy mind and body can lead to higher energy levels and emotional stability;
  • Increase productivity– it is about the quality of time spent not the quantity. Studies found that people work more overtime hours are less productive (Shumizu et al., 2004). Remember a fatigued mind is an unproductive mind; and
  • Make you more well-rounded– it is okay to have a life outside of your job. In fact, it is encouraged. You are, above all else, a human. Try to use those outside interests to connect with others and pursue hobbies outside of the mouth.

So how do we manage to pursue your passion while still having a life at the same time?

Here are a few ways to start:

Stop and take care of yourself – burnout is not the solution

Spend some time to re-evaluate your values and prioritise interests that matter to you. Ensure you take breaks, get some daily exercise and incorporate good habits. Patients can tell when you are stressed, so instead of rushing through that last filling, use the extra time to go over treatment plans, type your notes or enjoy a quick stroll in the sun.

Live in the present

Although easier said than done, try to focus on the now. Deadlines and tomorrow’s woes will happen whether you worry about them or not. Best to direct your energy towards the task at hand and leave the worrying for tomorrow.

Set Boundaries

Establish a routine that encompasses both work and outside activities. It is okay to say “No” when situations arise outside those hours, most appointments can be rescheduled, anyways.

Practice Time management and Make a Plan

Try to restructure and organise your schedule more efficiently. Manage your time, so you can continue doing activities outside the clinic. Work smarter (remember those “SMART” goals you wrote down at the beginning of the year? Well, it may be time to revisit them), so you don’t have to break your back while working harder. Make a schedule, pencil in those date nights and make sure you follow through. Happy spouse = happy house.

Ask for help

If you find yourself overwhelmed, try to reach out to someone. Developing a healthy work-life balance can be difficult, but help is available, even when you think you do not need it. Learn how to manage stress effectively and let go of the little things, your staff will thank you for it.

Dentistry can be demanding, but it does not have to consume your every thought. Like everything good in life, there must be a balance. It is not something you find, but something you create. We work to live rather than live to work. Try to smile and enjoy those moments when you’re not thinking about how crooked those teeth are, although difficult, it can happen.


Expert Q&A with: Dr. Melissa Chew

I think it is important to get good mentorship. Mentorship is invaluable, especially post-graduation. ”

Dr. Melissa Chew

Bio:

Dr. Melissa Chew studied Bachelors of Dental Science at the University of Melbourne, graduating in 2013.

She fervently believes that education plays a major role both in empowering clientele with oral health knowledge as well as in one’s own continuing professional development.

Melissa’s area of expertise as a 7 year long practicing dentist in Lilydale resides in cosmetic and restorative dentistry.

Aside from the technicalities, Dr Chew possesses an innate ability to connect with patients at a personal level, building long standing relationships whilst assuaging apprehensions to put their minds at ease.

Besides work, she is quite fond of escape rooms and travel.

How do you find working in community clinic vs. private and how was our transition?

Both community and private clinics have their advantages and disadvantages. As a new grad, I found community clinic to be a place where I could improve my clinical skills after graduation. I was able to enhance my techniques, increase my efficiency and develop the fundamental ‘bread and butter’ of dentistry without having the pressure to meet business demands because you are on salary. I was also fortunate enough to work with great staff and make life-long friends. Alternatively, I found that working in the public sector also had its limitations. Depending on your particular interest, you will not be able to see a lot of prosthodontic and complex multi-disciplinary cases. You will spend most of your time doing restorative work, emergency care and cleanings.

On the other hand, in private practice, there is the additional pressure of meeting targets, time management, keeping your books filled and patient retention. Communication became the biggest obstacle. In community clinic, I found that I did not have to sell my treatment plan and building rapport was not as necessary. While in private, I could not sell the treatment plans without building rapport. Dental work can be costly and patients can be very reluctant about treatment expenses, so it is imperative that you convey the information well and provide patients with appropriate options. The transition from public to private was initially difficult; however, rewarding. There are genuinely positive aspects to both, but ultimately, I felt I had more potential to grow as a clinician in private practice.

 

Being a few years out, what advice would you recommend to new grads?

I think it is important to get good mentorship. A mentor can be anyone who imparts knowledge like a friend, relative, peer, teacher or someone you merely meet in passing. Someone who is willing to simply listen, make suggestions/ give advice, is supportive and understands what it means to be a new grad. Look for positions that offer mentorships specifically in your field of interest. Do not be afraid to leave a company if they are not willing to teach you and facilitate your learning, particularly early on. Mentorship is invaluable, especially post-graduation. 

If you are struggling with something, ask for help (online or in person), take CPD courses, watch videos, etc. Be proactive and use the resources that are available out there, e.g. dental forums, Facebook, Instagram, podcasts. We are fortunate to have the information at our fingertips.

Speaker Spotlight with: Dr. Mehdi Rahimi

I always approached research with a “Can do” attitude and believed that “Persistence is the key
to success.”
Although you can fail, you can learn a lot from that failure, which motivated me to go forward”

Dr. Mehdi Rahimi

“The most important thing is to inform the patient and deliver the news in a non-inflammatory way. Often, clinicians struggle with telling their patients of the misadventure and when they do, they stumble explaining it.”

Dr. Mehdi Rahimi

Bio: 

Dr. Mehdi Rahimi (Principal Endodontist)
BSc, BDS Distinction (NZ)
DClinDent (Melb), FICD, FPFA, MRACDS
Adjunct Associate Professor (CSU)
President of the Australian Society of Endodontology (ASE NSW)
Guest Lecturer (Melb & Syd)
ADA NSW Councillor

Dr. Rahimi is an Adjunct Associate Professor at Charles Sturt University (Orange). Mehdi graduated with a Bachelor in Dental Surgery with distinction from the University of Otago (New Zealand) in 2002 and received his Doctorate of Clinical Dentistry (Endo) degree from the University of Melbourne in 2008. He has been actively involved in Endodontic teaching at various continued education levels, both nationally and internationally. Mehdi is a guest lecturer at Sydney and Melbourne Universities, and a CPD mentor and Councillor for the Australian Dental Association NSW. Mehdi has obtained a number of publications in the field of forensic dentistry and Endodontics (resin based obturation material and fractured instruments). In 2000, he was awarded the Sir Allan Wilkinson award for the most worthwhile research in Medicine and Dentistry from the University of Otago, in 2001 he was awarded the International Association for Dental Research Young Researchers Award and in 2002, Mehdi received the Pierre Fauchard Academy Award of Merit.

Mehdi is the current President of the Australian Society of Endodontology (NSW branch), the immediate past-president of the Australian Asian Association of Dentists, a fellow of the International College of Dentists (FICD), a fellow of the Pierre Fauchard Academy, a member of the Australian Dental Association (NSW) Education & Research Committee, a member of the Royal Australian College of Dental Surgeons in Endodontics, and a member of the Australian and New Zealand Academy of Endodontists.

You have published some articles on forensic dentistry. Tell us more about that and what you think all dentists should know.

My background, before dentistry, was in research, and I continued to pursue dental research during dental school through summer studentships. I was fortunate enough to start a project with a world-renowned researcher who had an interest in forensics and bite marks at a molecular level, precisely what bite marks left behind – bacteria.

Having had experience from my previous degree in genotypic analysis, I looked at the bacteria to determine what constituted the dominant strain in a bite mark. This can then be used to determine the perpetrator’s identification, so if it is speculated that the perpetrator is a male, e.g., the stepdad of the child, you can swab his teeth and the bite mark and compare the dominant strains. This is particularly important in the first 12 hours, where you can recover enough bacteria to determine the dominant strain and then match it to the possible perpetrator.

After I left, this research went further, and another colleague of mine looked into the dominant strain between twins and found this to be an objective method that can be used at the crime scene after rape or child abuse. Before, they compared the imprint bitemarks left on the skin, which can be subjective and difficult to match.

Once I got into post-grad training, I found research to be more rewarding. I genuinely enjoy having a project where you might do something repetitive whilst searching for an answer.  Unfortunately, I did not have enough time to take on a PhD type research, but I continue doing a little research with students. One of the research projects I supervised the Sydney University students through is about to be published in the Australian endodontic journal in May.

 

If a file fractures, what is one thing you wish you had known as a new graduate or something you advise to all dental professionals when this happens.

I think the most crucial thing when these things happen is communication and management. Try to think about it in three parts: 

  1. Did you inform the patient of the possible complications of treatment, and did you mention how it will be managed? If so,
  2. Did you do so in a non-inflammatory way, and
  3. Will a fractured instrument change the treatment outcome?  

From the literature, we know that if most of the chemo-mechanical disinfection was completed before a file fracture, the patient would likely heal. It makes no difference whether the fractured file is left or not. It’s all about the communication beforehand, which many people tend to skip or do in a hurry because of the urgency of the situation: getting the patient out of pain.  Often, clinicians forget that it is not until the second or third visit when the full instrumentation occurs, so I always recommend giving the patient the information before they leave so that they can read about it before the next visit. That’s how you make sure they are fully informed!

Being on the Dental Council, I have seen a lot of people dig their own holes. We find that complaints arise when patients are unaware of a file fracture because the dentist fails to inform them. Dentists refrain from telling the patient; they assume no one will find out, or they do not fully disclose the situation as soon as it happens. The most important thing is to inform the patient and deliver the news in a non-inflammatory way. Often, clinicians struggle with telling their patients of the misadventure and when they do, they stumble explaining it. What most clinicians often forget is that these file fractures do not impart a significant impact on the overall treatment outcome. An instrument fracture is a part of treatment and is something that we must accept as a misadventure rather than medical negligence. Many of us will say, “Oh, I feel terrible, I feel so bad. I’ll pay for the treatment,” and that’s when things start to go wrong; clinicians begin to take responsibility for an unfortunate mishap wrongfully. What happens if the case goes pear-shaped and turns into a root fracture and eventual tooth loss? These are the cases where the patient never leaves the dentist alone. They keep blaming the dentist, and before you know it, no one is happy.

 

How do you overcome ‘hot pulp?’

“Hot pulp” commonly occurs in lower molars, specifically in the 6-7 area and less commonly in the upper region. This could be due to the lower region’s complexity, so whenever you are giving a block, you might be aiming a little lower than you should because you got the anatomy wrong. Also, the tooth is probably located in an inflamed area, meaning there are more tetrodotoxin (TTX) sensitive channels present and the c- fibres are highly resistant to local anaesthetic, meaning you likely require more anaesthetic.

So, I recommend having a good plan, remembering your anatomy, giving the block higher up, similar to a Gow Gates version of the block, together with a higher volume, doing supplementary infiltrations and giving more time for the local anaesthetic to work before the commencement of treatment. Older patients might have more dense structures, so it might take longer to get to those cells and anaesthetize the region entirely. My first block is an ordinary block with a lignocaine. Then I give a Gow Gates, higher up, aspirate, and deposit Scandonest and although this may be seemingly insignificant, what I have done is mixed the drugs. When you look at the pharmacology, when you combine drugs, they become more effective, especially in the local anaesthetic delivery. Anxiety can also play a role, particularly in a patient who has not slept and is inflamed. Sometimes you need more time to get them comfortable and into a relaxed state. Nitrous oxide can also be effective in accomplishing this. It gives you a state of euphoria, especially in patients that have been under stress, and when patients feel less stressed, they are less likely to feel pain.

 

You have accomplished a lot during your career. How did you get into research, and how did you overcome all the challenges that involved?

As I mentioned, I have a background in research. My graduate-entry was in gene therapy, and I had an honours degree in the field of pharmacology and physiology. When I entered dentistry, I had time to do further research and spent my summers doing projects.

I always approached research with a “Can do” attitude and believed that “Persistence is the key to success.”

Although you can fail, you can learn a lot from that failure, which motivated me to go forward. Not every paper or article is going to be revolutionary. If your research is not successful and does not yield results, it can be used as a methodology paper to discuss the shortcomings. Research can pose a lot of challenges, but you can still learn a lot from it. At the end of the day, I think it is not about making a difference; it is about understanding what research entails, especially if you are doing a doctorate, like a Master’s. What you are trying to achieve is an overall understanding and, quite possibly, make a difference, albeit small, to the scientific field. It can be challenging and has its downsides but understanding the purpose and the process is the important part. If it were not for research, the COVID vaccine would not exist, and they would not be able to improve on it from vaccine to vaccine. There had to be some research or some science to do this. Some people go, “I’ll never do another research project again”, but they still look up and respect the researchers that get a lot of articles published and make a contribution. In the way we practice, the equipment we use and the technology behind it, this all stemmed from research. For example, Nickel-titanium or the more flexible files would not exist. We would still be limited to manual filing and would be having the same sort of procedural problems as we used to have 20-30 years ago if we did not have research.

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