Download Registration under Specialist SOP

Notes for Contributors
The NZAO Newsletter welcomes original articles, personal comment and news items. Text should preferably be e-mailed to the Editor at
[email protected] as an attachment in rich formatted text (RFT). Illustrations and photographs should also be e-mailed as
attachments in jpeg format. Illustrations and photographs may alternatively be sent on diskette provided the resolution is at least 150
dpi. The Editor reserves the right of refusal, the right to edit articles so they conform to the style of the Newsletter and the right to cut to
meet space restrictions. Galley proofs will be sent by prior arrangement only. Special thanks to Karen Brook, Paul Crowther, Mark
Beresford, Kirsty McDonald, Phillip Murfitt, Randal McAlister, Judith Hey, Janice Somerville and Peter Fowler for their contributions to
this issue as well as to our advertisers. Next issue close off date 20 August 2004.
PRESIDENTIAL NOTES June 2004
Registration of Orthodontic Auxiliaries
I expect by now you will have read more than you every really wanted to read on this subject. My
“Letters to members” of May 12 and June 14 (previously emailed) are reproduced below. To
ensure that your staff can be registered as an Orthodontic Auxiliaries under the grandparent
provision the completed forms must be with the Dental Council by July 9.
Queries can be directed to me or directly to Janet Eden [email protected] .
Radiography Training Programme
Those who attended the pilot Radiation Training Course organised by Peter Fowler late last year
have received their exemptions from the MRTB and can legally take intra and extra oral
radiographs. Judith Hey is now organising this same course in Auckland, August 26 and 27. We
will be applying to the Dental Council for this course to be approved as a prescribed qualification
for registration on the additional Scope of Practice for Extra Oral Radiography in Orthodontic
Auxiliary Practice.
Remember, after September 19 only staff who are registered Orthodontic Auxiliaries with the
additional Scope of Practice for Extra Oral Radiography in Orthodontic Auxiliary Practice will be
legally able to take radiographs.
We are hoping to run another South Island course later this year.
Peter Fowler’s detailed report on the pilot course features in this issue of the Newsletter.
The Survey
Paul Crowther has worked hard to provide Part 2 of the Survey report and this is also published in
this Newsletter. As you will see comments are many and varied, frequently positive, mostly very
constructive with only a few that are just plain negative. The committee will be incorporating
constructive suggestions into the strategic plan at its face-to-face meeting in Auckland on August
2.
Marketing
Derek Barwood is working on putting together a comprehensive pack to be given to each new
graduate involved in the new-graduate program. This kit will include an invitation to join the NZAO
as an Associate member, sample of NZAO brochures and posters, articles on the need for postgraduate training, case selection for orthodontics in general practice, guidance on when to refer
and articles on why extractions can be necessary.
Conference and Continuing Education
Dunedin, 13 - 16 October 2004
The Conference will open with Welcome Drinks, at the Art Gallery at 5pm on Wednesday October
13.
You should all have received registration brochures by now and the online registration is running
well. For general conference queries contact Pat at Dunedin Conference Management Services
[email protected]. Specific queries about the Staff program can be directed to Peter Fowler at
[email protected] and queries about the orthodontists program should go to Janice Sommerville
at [email protected] .
Membership of APOS
We have received notification from Dr Mitani (President APOS) that the ASO and the NZAO will be
offered membership of the APOS. We look forward to receiving more details soon.
HDC Advisors
The Health and Disability Commissioner has asked for advisors from our Association. I would like
to thank Drs Trevor Webster, Wayne Dalley, Richard Clarke for agreeing to have their names put
to the Commissioner.
DCNZ Disciplinary Tribunal Advisors
Drs Janice Sommerville, Bob Stallworthy, Peter Dallimore have kindly agreed to nomination as
advisors to the DCNZ Disciplinary Tribunal.
Oceania WFO Representative
In September 2004 Robert Max will compete his second and final term as Oceania representative
on the WFO . The NZAO (and the ASO) have nominated Dr Ian Watson (Immediate Past
President ASO) as Robert’s replacement. Ian has worked incredibly hard building bridges in the
Asia and Pacific Region. He was largely responsible for securing the successful bid for Sydney to
host the 7th WFO Congress in 2010 and has worked tirelessly to have both New Zealand and
Australia accepted as members of the APOS. A decision on this position will be made by the WFO
in September.
Membership
At the May NZAO Committee meeting Dr Pei Ti Lin was granted Provisional Membership. Pei Ti
graduated form the Melbourne postgraduate program. She has joined Heather Keall in practice in
West Harbour in Auckland and is also working at Greenlane Hospital.
Dr Andrew Marriott (Nelson) also became a Full member of the NZAO.
Communication
Feedback on my emails sent to all members to coincide firstly with the DCNZ Newsletter on
Orthodontic Auxiliaries and secondly with the arrival of registration packs for registration of
Orthodontic Auxiliaries was very positive and illustrated the benefits of all members being on email
(and checking it regularly).
Next Meeting
The next meeting of the NZAO Committee will be a Teleconference meeting on Wednesday June
30 with an all day meeting scheduled for Monday August 2 in Auckland.
Karen Brook
May 12, 2004
To all NZAO Members:
In the next day or two you will all receive the DCNZ Newsletter. It is vital that you READ IT
CAREFULLY. It will contain all the information you need to decide whether you will need to register
any or all of your staff as Orthodontic Auxiliaries and information on providing names and address
of staff you will want to register. The NZAO Committee has been working closely with the Dental
Council to achieve the best possible outcome for Section 11 Workers in Orthodontics, under the
HPCA Act.
REGISTRATION OF ORTHODONTIC AUXILIARIES
Section 11 workers in Orthodontics will now be known as Orthodontic Auxiliaries. Only those who
carry out tasks on the Restricted List will need to be registered. Unbelievable as it may seem the
MOH has not yet released the Restricted List and has recently called for submissions on a
discussion document (available from the secretary ([email protected]). The DCNZ
Newsletter gives a broad outline of the proposed restricted list. The taking of radiographs will most
certainly be on the final Restricted List.
Registration prior to September 17 ,2004.
Orthodontic Auxiliaries will be registered under the Dental Hygiene Board, which will also register
Hygienists and Dental Auxiliaries. It is expected that any Section 11 worker in Orthodontics who
applies for registration as an Orthodontic Auxiliary prior to September 17, 2004 will be granted
registration so long as their employer will vouch for their competency and experience. AFTER
September 18 anyone wanting to register as an Orthodontic Auxiliary will need to have completed
an approved Orthodontic Auxiliary Training Course irrespective of their previous training or
experience.
Fees
The fees incurred in registering an Orthodontic Auxiliary are significant. There will be a one off
Registration Fee of $150 - $300 and the initial fee for an Annual Practicing Certificate (APC) will be
$1150. It is hoped that this fee will come down in the future as the initial high cost reflects the
significant costs involved in establishing a totally new Board.
CPD/Competency
Under the HPCA Act all registered health practitioners (and this includes orthodontic auxiliaries)
will need to demonstrate competency to qualify for an APC. The NZAO has been asked to develop
a course for training orthodontic auxiliaries and a CPD/Competency program as required under the
Act. Andrew Marriot has had a keen interest in Auxiliary training and has joined Mark Beresford
(Chair), Tony Lund and Winifred on that Sub-Committee. Their proposed Orthodontic Auxiliary
Training Program will be presented to DCNZ for ratification on June 2.
Should you wish to discuss any aspects of Orthodontic Auxiliary registration please contact either
Mark Beresford ([email protected] ) or myself [email protected] If you
wish to find out more about the proposed training program please contact Andrew Marriott at
[email protected] .
Radiography Training Program
Registration as an Orthodontic Auxiliary will not automatically make it legal for an auxiliary to take
radiographs. It appears they will need to have completed a recognized course and taking
radiographs will then be added to their Scope of Practice. One pilot course has been completed
and we are waiting for final approval of this course from the MRTB. A course is planned for
Auckland once this approval is received. Only 15 can attend each course as it involves significant
one- on one instruction and we realise the demand for the course will be considerable. If you wish
to discus this further please contact Peter Fowler [email protected] .
Other Issues Relating to HPCA Implementation
With September 18 looming there has been a flurry of discussion documents arriving from the
DCNZ with tight deadlines for return submissions. Whilst the HPCA legislation itself defines the
broad skeleton of how we will practice under the Act is the individual professions that have to “put
skin on the bones” and make the requirements of the Act workable – and a workable system has to
be in place by September 18.
Scopes of Practice (SOP)
The HPCA Sub-Committee (Wayne Dalley(Chair), Judith Hey, Mike Courtney) has been working
on this. They provided a submission defining specialist orthodontists scopes of practice. However
after requesting and receiving numerous submissions the DCNZ have decided to gazette the
specialist definitions decided in 2001/2 with a review in 12 – 18 months.
Just this week the DCNZ have provided a second discussion document requesting detailed SOP’s
despite the fact that at the it was stated clearly at the Select Committee stage that SOP were not to
be a “laundry list” of tasks!!
Wayne, Judith and Mike will now work on detailed SOP with a deadline of August 6th and please
contact Wayne Dalley [email protected] if you would like to discuss this area further.
Registration under Specialist SOP
We received a discussion document in late March requesting a pathway for registration of
overseas trained specialists in NZ. The Equivalence and Mentoring Sub-Committee of Phil Sanford
(Chair), Andrew Quick and Mark Savage produced excellent submission document which is
available from the Secretary or from Phil Sanford [email protected] .
Competency/CPD
Dexter Bambery, Chair of the DCNZ’s HPCA Act Implementation Working Party, has invited the
NZAO to develop a Competency/CPD program to fulfill the HPCA requirements in this area.
The complexity of this task resulted in combining the membership of two sub-committees into a
new, very broad based sub-committee. Phil Sanford is chairing this committee supported by
Andrew Quick, Mark Savage, Wayne Dalley, Judith Hey and Mike Courtney
Dental Therapists
You all received this discussion document from the DCNZ and Winifred emailed all NZAO
members urging you to put in your own individual submission. The Committee has also drafted an
NZAO submission (available from [email protected] )
On behalf of all NZAO members I would like to thank to all those who have worked so hard at such
short notice to provide submission documents which we can only hope may be taken into account
in the implementation of this complex piece of legislation. Please feel free to contact any NZAO
Committee or sub-committee members to discuss issues relating to the HPCA implementation.
Regards
Karen Brook
President
[email protected]
REGISTRATION OF ORTHODONTIC AUXILIARIES – Update 14 June, 2004, from Karen Brook
Registration packs, for registration of staff as Orthodontic Auxiliaries, were sent out last week by
the Dental Council. If you have not received a registration packs for your staff, please contact
Janet Eden at DCNZ [email protected] as soon as possible.
To ensure that your staff can be registered as an Orthodontic Auxiliary under the grandparent
provision the completed forms must be with the Dental Council by July 9 (only 4 weeks away).
The registration pack contains 5 documents:
1. Appendix 1. The Scope of Practice for Dental Hygiene Practice, Dental Auxiliary Practice
and Orthodontic Auxiliary Practice.
2. A general guide to the registration process – please read this VERY carefully.
3. A guide specifically for Employers
4. The Application Form (6 pages)
5. Information and application form for Professional Indemnity Cover.
It is a lot to read!!! To follow is a summary of various salient features of each document to help you
and your staff complete the required documentation quickly and correctly.
1.APPENDIX 1. THE SCOPE OF PRACTICE FOR DENTAL HYGIENE PRACTICE, DENTAL
AUXILIARY PRACTICE AND ORTHODONTIC AUXILIARY PRACTICE.
Confusion has arisen between concept of a Scope of Practice and the issue of the Restricted List.
A. The restricted List:
The HPCA legislation provided for the Minister of Health to create a list of activities which could
only be carried out by registered practitioners (the Restricted List). If a task is not on this list then
anyone can do it – no evidence of any training or any need to maintain any competency is
required.
Unfortunately and almost unbelievably the Ministry of Health still has not provided the definitive
Restricted List although the Minister of Health Annette King has reiterated many times that there
will be one.
The problem for us is that our auxiliary staff WILL ONLY NEED TO BE REGISTERED IF THE
TASKS THEY PERFORM ARE ON THIS LIST.
So where does that leave us?
There is a “provisional list” and it seems that this will become part of the definitive list. Two items
on that list that effect us are:
“Carrying out any invasive activity ie where there MAY be bleeding”
“Taking radiographs”
The best advice I can give is that any staff who takes radiographs or carries out any activity on a
patient WHERE BLEEDING MAY OCCUR will need to be registered as an Orthodontic Auxiliary.
There is of course an understandable disquiet that the need for registration of a staff member is
determined only on the say so of a “provisional restricted list” – I agree that this is far from
satisfactory but there seems no way around the impasse.
Individual orthodontists may choose make a stand and not apply for registration of staff until the
restricted list is finalised. However the Dental Hygiene Board has given notice that it cannot
guarantee that applications received after July 9 will be processed in time to grant registration
before September 18. If you delay sending in your staff registrations until the final restricted list is
gazetted then it is unlikely that the registration will be processed by September 18 and your staff
will loose the opportunity for automatic registration as an Orthodontic Auxiliary under the
“grandparent “ provision.
After September 19, 2004 the prescribed qualification for registration as an orthodontic auxiliary
will be an accredited qualification in orthodontic auxiliary practice. So regardless of previous
experience any staff wishing to register as an orthodontic auxiliary after September 19 will have to
go back and complete an approved course in orthodontic auxiliary practice before they can be
registered (NZAO is developing such a course but the first of the training modules will not be
available until early 2005.)
B. Scopes of Practice
All registered Health Practitioners will be registered in a Scope of Practice – this is basically a
description of the tasks they have been trained to do and the tasks that they will be required to
maintain competency.
By definition a Scope of Practice will include all tasks that are on the restricted list but also many
other tasks that are not. Hence the Orthodontic Auxiliary Scope of Practice includes restricted
activities such as placing separators, taking impressions, fitting bands (which could all cause
bleeding in some patients but also activities such as providing oral hygiene instruction and taking
clinical photos which are not restricted activities.
i. Clinical Staff who take extra-oral radiographs
Staff who take radiographs will need to register under an additional separate scope of practice . At
this time only an registered Orthodontic Auxiliary can apply for the additional Scope of Practice for
Extra Oral Radiography in Orthodontic Auxiliary Practice and only these staff will be legally able to
take radiographs after September 18.
To gain registration with this SOP your staff must provide a MRTB Exemption Certificate in ExtraOral Radiography and they must provide the name and address of the person who holds the x-ray
licence for the machine they will be using. Exemption certificates have been granted to those who
completed the pilot radiation-training course in Christchurch last year. A second Radiation Training
course will run in Auckland on August 26 and 27. In the next day or two you will be receiving
details about this course from Judith Hay.
After September 18 the Medical Radiation Technologists Board will no longer administer the
granting of exemption certificates. The Dental Council will take over this role and the NZAO will be
applying to the new Dental Council to have this Radiation Training Course approved as a
prescribed qualification for registration on the additional Scope of Practice for Extra Oral
Radiography in Orthodontic Auxiliary Practice.
ii. Non-Clinical Staff who take Radiographs
In some practices reception or dental assisting staff take radiographs. At this time there is no
category for them to be registered in as currently a staff must first be registered as an Orthodontic
Auxiliary before applying for the additional Scope of Practice for Extra Oral Radiography in
Orthodontic Auxiliary Practice. The Dental Council realises this is a problem area and is looking at
way of creating a registration category of “Dental Auxiliary with Scope of Practice limited to
Radiography”. I am in discussion with the DCNZ on this issue and need an idea of how many staff
fall into this category.
PLEASE CAN YOU EMAIL ASAP WITH DETAILS OF YOUR STAFF WHO WOULD FALL INTO
THIS CATEGORY.
Janet Eden has asked that these staff do not complete registration documents at this time.
2. A GENERAL GUIDE TO THE REGISTRATION PROCESS – POINTS TO NOTE
i. Fees: One –off non-refundable registration application fee of $350.
$775 Annual Practicing Certificate (APC) fee. Refundable if application not approved.
ii. Certified Copies of Documentary Evidence of Dental Qualifications
Staff will need to provide “Certified true copy of original document sighted” for all requested
certificates.
Those who cannot locate their original School Dental Nursing qualification need to apply to the
contact listed. She will provide a form and for $6 the appropriate transcript will be forwarded. This
process however takes at least 4 WEEKS!!!
THEREFORE STAFF SHOULD PHOTOCOPY THEIR TRANSCRIPT REQUEST FORM AND
ATTACH IT WITH THEIR APPLICATION TO THE COUNCIL. AS SOON AS TRANSCRIPTS ARE
RECEIVED THEY CAN BE FORWARDED SEPARATELY TO THE DCNZ.
iii. Hepatitis Status
All applicants for registration are required to provide an original, typed and signed Hepatitis B &
C status report including Hepatitis B surface antigen and antibody and Hepatitis C antibody.
This report should be less than 12 months old and from a New Zealand registered IANZ
laboratory. This is apparently a standard requirement for all new applicants for any type of
registration. If you have any concerns regarding this pleases contact Janet Eden.
3. A GUIDE SPECIFICALLY FOR EMPLOYERS
As employers we must provide a statutory declaration, on letterhead witnessed by a solicitor, JP
etc. A draft of the letter is provided in the DCNZ document but I have attached copies of sample
declaration, approved by DCNZ, one for a staff who will register as an Orthodontic Auxiliary and
also register with a Scope of Practice for Extra Oral Radiography in Orthodontic Auxiliary Practice.
4. THE APPLICATION FORM (6 PAGES)
Passport photo required
Application Form and certificates must be taken to Solicitor, JP etc to be witnessed.
If a staff member is applying for a Scope of Practice for Extra Oral Radiography in Orthodontic
Auxiliary Practice but is taking the August course to gain an exemption certificate please indicate
that on the application form and forward the Exemption certificate as soon as it is granted.
5. INFORMATION AND APPLICATION FORM FOR PROFESSIONAL INDEMNITY COVER
As a registered health practitioner orthodontic auxiliaries will need to have Professional Indemnity
Cover, which is their “malpractice/negligence” protection when claims and complaints are made
against them. Full information and an application form for cover with Dental Protection LTD (MPS)
have been provided with the registration pack.
SUMMARY
My staff found the large amount of paperwork that arrived with the registration pack
overwhelming. To get them started and to prevent repeat trips to the Justice of the Peace I
formulated this “get started” list which your staff may also find helpful.
REGISTRATION AS AN ORTHODONTIC AUXILIARY – WHAT YOU NEED TO GET STARTED.
1. Registration pack from DCNZ
2. Passport photo
3. Copy of relevant Certificates eg SDN training – If certificate issued in different name eg
maiden name, then certificates showing why name changed eg marriage certificate is also
required. All these copies of documents will need to be certified as true copies by a lawyer
or JP.
4. Copy of Passport – JP can certify it when all the other documents get certified. Remember
to take the originals of all the documents to the solicitor or JP.
5. Hepatitis Status: All applicants for registration are required to provide an original, typed and
signed Hepatitis B & C status report including Hepatitis B surface antigen and antibody and
Hepatitis C antibody. This report should be less than 12 months old and from a New
Zealand registered IANZ laboratory. Arrange through your GP and attach results to
application.
6. Fill out the registration form (6 pages)
Copy of request for Transcript of School Dental Nurse Training if applicable.
Evidence of attendance at August Radiation Training Course, if relevant.
7.
Fill out the application for MPS membership (malpractice insurance)
Please contact Janet Eden [email protected] or me if you have any queries.
Karen Brook
President
[email protected]
EDITORIAL
What direction should this newsletter take? This must be determined by the membership, and the
recent survey serves as our best guide. The short answer responses were reported in the March
issue, and the current edition contains comprehensive, full-text individual answers to more openended questions. In both cases, the responses to questions on the newsletter were obviously of
interest to me as Editor. It is clear that the change to electronic publication has suited the majority
(76%), but definitely not all, of the membership. A lack of internet access for some members is just
one of the issues, which also include matters relating more to preference in reading habits rather
than the sheer ability to view the edition.
These matters of preference were anticipated when the change was instituted – it comes as no
surprise that members often wish to have a copy to read while away from their computer, and
many people also prefer to avoid reading from a screen. It has therefore been my intention to
make it as easy as possible to print a hard copy from the website. Unfortunately some
shortcomings in communication between me and the website providers have meant that the
convenience of printing such a copy has varied from issue to issue. I will try to streamline the
process, and will continue mailing hard copies to those who lack internet access.
As an aside, I have received an isolated report of email notification failing to reach a member when
a new issue was being announced. If any other members have not received email notification
would you please let me know so that I can investigate possible quirks in my setup for group emailing.
Some have mentioned a preference to keep hard copies of back issues for reference. The website
currently retains issues of the newsletter as far back as June 2001. This is an example of the
convenience offered by a web-based resource, and it is intended to retain this comprehensive
archive. Depending on the future preference of members, the option of a fully e-mailed newsletter
may be explored, an arrangement under which back-issues of the newsletter could still be
available on the website. Whether publication is by email or website, the lack of formal printing
arrangements allows the size of each issue to vary without difficulty, as demonstrated by the large
size of the current edition due to some long items.
With regard to content, there is an overwhelming majority (93%) in favour of retaining the current
emphasis, which has strong news content. I consider that within certain editorial boundaries, such
a regular and accessible forum must be available to members and the Committee. This in no way
precludes the publication of scientific articles, which are always welcome, but I believe that it would
be inappropriate to restrict news-style copy in an effort to change the newsletter into a scientific
journal. Three quarters of survey respondents are satisfied with the current scientific content.
If members have material to offer, or have practice-based research material to report, I would be
delighted to hear from them. I cannot give an assurance that all material will be accepted. On
previous occasions I have sought the guidance of the committee regarding selection of copy.
I was alarmed (as many other members will be) by one member’s suggestion in the survey that
editors could retain the position for FIVE years! In my hands the loss of readership would be
terminal.
Peter Dysart
NZAO Survey Report
Part II - Respondents Comments
By Paul Crowther
Explanation
Rather than a summary of collated comments, this is complete report of all the comments on all the
topics covered in the 2003 NZAO Survey of members. Some of the comments extend beyond the
topics specified. Some editing for brevity was done in a very few instances but I have tried to retain
the accuracy and tone of the comments. Virtually no comments have been omitted. Several
comments are duplicated but this is representative of the frequency of the views expressed.
Comments about the NZAO Newsletter
I haven't seen it for a long time.
It is expanding into a very worthwhile publication and I presume it will continue to improve with
time.
Its a newsletter not a research journal.
Well done.
An excellent production.
The world does not need another glossy orthodontic journal. It should remain a news letter.
We don't need another scientific journal. Well done, Mr Editor.
The newsletter is a critical line of communication and is doing that job well.
I enjoy and applaud the efforts of the editor and contributors and feel this inter association link is
very important.
Any newsletter is only as good as the contributors, anyone who complains should have to write an
article. Editors do a great job. A change of editor and style is good every five or so years.
Needs a ‘PR makeover’ - to be an academic journal for publication purposes to increase credibility
and the quality of articles. Maybe change the title – Journal of NZAO? Get rid of the school
newsletter image.
Very simple with desktop publishing to create a more “polished” format.
I think last editor’s idea of combining with Australian Journal and add as a supplement (electronic
or otherwise) is inevitable/preferable.
Comments regarding Newsletter Format
Electronic is the way to go.
Must be able to be printed out with one button push. Otherwise post it.
Electronic - time consuming opening.
I like being emailed of its ‘posting’.
Perhaps it could be broken into shorter updated versions.
The newsletter should pass across members’ desks without them having to actively seek info at a
website.
The newsletter probably wont come through e-mail due to size limits.
Prefer a hard copy - check e-mail infrequently.
I preferred the hard copy for archiving.
Is good / prefer to be in hard copy.
Suggested Newsletter Content
Post-grad students research could be interesting in the newsletter.
What works in my practice. Reminiscences by the older practitioners. New products (good for
advertising revenue).
New products/developments.
An increase in articles on useful clinical tips, reviews of new technology etc. would be useful.
Comments about Communication
Could be better - minutes etc., what are the arguments supporting positions.
Could be a bit better.
Always room for improvement.
Excellent currently.
Presidents notes are excellent
Concise summaries of current issues should be in the newsletter.
Communication is the key to success. Chat room, minutes (timely - not three months later).
Discussion, discussion, discussion.
A phone call to any committee member should be the best way to communicate.
Some recent issues have been publicised too late. Too many surprises at the AGM. (This
respondent continued into a lengthy and more general comment regarding the NZAO. Continues,
abridged)
NZAO needs to evaluate its structure. It has the structure of the Ekatahuna Kindergarten
Committee; well meaning individuals skilled in their profession but lacking in skill in most other
areas that require expertise. The committee is hard working and have genuine intentions. The fact
is that we are a $50 million dollar industry and need 1. an executive officer a la Janet Eden, even if
part time. 2. advocates and lobbyists 3. to be more proactive in promoting our organisation. The
toll on members of the executive in the last year has been visible. Also, we have to wonder of the
‘real’ costs of having an ‘amateur’ president/secretary in both monetary terms (loss to individual
practices), mental and physical well-being, and sad to say (in certain areas) lack of management
ability to orthodontists in N.Z. in dealing with crucial issues. Executive officer should be say parttime 20 hours per week, could work from home, would suit a lawyer, accountant, manager who is
1. semi-retired 2. has children and doesn't want to work full time 3. only wants to work part-time
from home. The temptation in the present situation is to employ secretarial staff. This is not where
help is needed. Times have changed and we must too, so we can provide an excellent
representation for our members.
Comments about the Website
Computers not a priority in my life.
Hate all websites, browsing, dont have time. Prefer written material.
Rarely if ever use it. Too time consuming.
Too slow, too difficult,whats on it that I need?
I’ve got better things to do than scan the internet.
Our own practice survey revealed that only eight had used the NZAO website - who is using it?
Information not marketing.
Needs to be updated frequently, more interactive - links - study groups, electronic newsletters.
Should be for orthodontists, set up a separate info site for the public.
Require a balance, but what percentage really require access to all information? - use links.
All the marketing topics should be on the website.
Potential to have brochure material and handouts which could be downloaded.
Brochures should be available on website.
I like the design, seems quite accessible.
Well presented. Needs some minor tweaking.
The website is a huge step forward. Youngsters use it a lot. It should be used more for ‘branding’.
Needs to be a strong proactive voice for orthodontists/public giving quality information and
stressing our specialist status. No apologists please.
An orthodontists in the news section for public.
Type of Information for Members wanted on the Website
Practice management
Conference info - ortho/non ortho
Tips and techniques
Calendar of Events
Transfer guidelines and formula
Links to overseas orthos for patient transfer
Evidence on hot issues with refs.
Membership list and practice locations and types
Photo of members
Members home contact details
Forums
Problem cases and successes
NZAO minutes
Ortho problems chat room
Queries for help
Topics of interest
Pamphlet info
Type of Information for the Public wanted on the Website
Q+A
Reference/resource material
Branding of NZAO
Marketing committee pulications
Exo vs Non exo debate
Any interesting new stuff of benefit
News updates and rapid response to issues
General ortho treatment info (10)
Ortho care and first aid
Problems assoc. with alternative ortho
Links to scientific evidence
Comments about Marketing
Philosophically I am against such groups.
Why bother? - who needs more patients?
How effective are pamphlets? (value for money?)
Doing a good job - a balance of proactive and informative.
All marketing topics should eventually go on the website.
I do endorse improving our (NZAO) identity.
We need to brand and market orthodontists more heavily ((like pharmacists) - ‘the doctor for your
smile’ type of thing.
If appropriate can give a very positive view of our profession - can show that the benefits for kids
are worth the costs of treatment.
Very happy for collective marketing using the NZAO logo.
Promote orthodontics and orthodontists as a group rather than individuals.
Encourage magazines to research articles themselves.
Concentrate on only one or two areas per year. e.g. Early vs late treatment.
Encourage the positives of orthodontics rather than us vs them.
‘Marketing’ comes from within the practice, not from advertising to the masses in a glossy
magazine.
Let the public know about our efforts to educate ourselves and raise standards - esp. that we selffund our training and continuing education.
Needs to be coordinated and planned to achieve - increased NZAO brand and quality awareness,
specialist status orthodontists, info for patients makes life easier for everyone.
How about local t.v., national radio, local newspapers - interviews with articulate and educated
orthodontists.
Marketing topics desired for pamphlets
Most popular with 40+ votes
Braces
Removable Appliances
Why extract
Why jaw surgery
Retention
What happens after ortho treatment
Oral hygiene with braces
Next most popular topics 20-39 votes
Quad helix
RME
Twin block
Pre treatment records
Elastics
Headgear
Wisdom teeth
Pericisions
Thumb and digit sucking
Several said that all topics should be on the website.
Comments about Conferences, Courses and Education
Comments regarding quality of overseas speakers.
Sarver very good, Behrents average.
Most American speakers are outstandingly bad value for money - recycle old material. Australian
speakers are generally good value.
To many lectures merely trade promotions disguised as science.
Its very difficult to please everyone and cover all interests.
Lack of statistical evidence.
Prefer Australian or European speakers - less well known are better value.
Comments regarding sponsorship of speakers
Company sponsorship of speakers should be strictly rotational - a stated policy.
OK as long as the commercial relationship is acknowledged - keeps costs down to hear world
class speakers.
Provided association is clear.
Be selective.
Unrealistic not to have it - would be too expensive for everyone.
Sponsorship is OK - even academics have a vested interest, to present their research to further
their career.
Is facing the reality, we get a good deal and the speakers are usually very good.
Good as long as they acknowledge their association with the commercial relationship.
That’s life, most good speakers are affiliated.
The relationship must be very clear.
As long as there is a balance. No pushing one technique in favour of all others.
We all know they’re pets, that’s OK.
Only with conditions.
As appropriate.
Where worthwhile.
If the supply companies don’t feel it is worthwhile I’m sure they’ll inform the NZAO.
Really a matter of catching the up and coming together with overviews from older more
experienced speakers.
Balance can be a problem. Commercial relationship must be public.
Is the reality of business.
Useful to find out how to use different products.
Only if the speaker has a recognised reputation.
No problem as long as the speaker acknowledges the commercial relationship.
Commercial reality. Allows speaker quality at reasonable cost.
As long as there is balance.
NO.
The association should be very clearly explained.
No. Have never heard one that was worthwhile.
Reality of modern life. Most members are reasonably intelligent and should have their ‘bullshit
spam detectors’ activated.
Comments about one day clinical meetings
No clinical meetings - unless they can be non- proprietary.
One day meetings should be mostly clinical provided there is more academic emphasis on the
annual conference.
Other comments
Symposium is best value - they should happen at least every 2 years.
I think that NZAO should expand its role in education/training of Section 11 workers.
Venues - Waitangi - Autumn
- Queenstown - Spring
Content - plenty of good science not too much anecdotal stuff.
At the moment this Radiographic training course is too site specific. The qualification is not
transferable, therefore is of limited use.
We need speakers who can back up their assertions with evidence. Recent speakers have paid lip
service to scientific evidence and rely on charisma and speaking reputations to negate the fact that
they expand and treat to profiles instead of to a stable lower arch.
A must for all practising orthodontists.
The ERDG meetings provide better value than the traditional NZAO meetings.
We should be making more use of overseas speakers while they’re here - e.g. breakfast meetings
and interactive type settings.
Should also have business related topics covered at conferences.
My concern is the cost for getting staff training- distance learning is my preference (comment by a
recent grad.)
Upgrading computer software. Radiography.
Distance teaching for education only - not for a formal qualification.
We have a good balance of academic and clinical, but annual conference needs more academic
input. We can go overseas for clinical/company affiliated speakers.
One in four conferences at resort locations. Combine conferences with events if want overseas
participants. e.g. Bledisloe Cup. Food and Wine festivals. Make it attractive as possible for people
to attend.
Wake up to modern teaching and computer-based training. Need to be proactive in providing
training for staff. This is a national quality issue.
Comments about NZDA membership
This is essential - we must be part of it to influence it.
Has to be all or nothing.
Up to us to use our representation to improve NZDA representation of orthodontists in general.
I don't see a lot of benefit from belonging to the NZDA. Very poor value for money.
We are probably (just) better off staying in NZDA at present, to assist and influence.
NZDA back general dentists before orthodontists i.e. members are not treated equally.
They will always under estimate our requirements.
Being a member of NZAO should give automatic membership of NZDA (cost an issue for young
graduates).
Unenforceable anyway!
NZDA committees have not adequately represented the interests of orthodontists esp. at a higher
level.
NZDA membership should not be a requirement of NZAO membership. Its time to be autonomous
and relinquish the umbilical connection.
With new specialists registration an anachronism for NZDA membership as overseas trained
orthodontists with no registrable BDS equivalent can be registered as orthodontists but cannot join
NZDA.
Membership with NZDA will probably have to continue due to requirement to collect CDE points as
a prerequisite to maintain Council registration.
We still have to be dentists and legislation affecting dentists affects us as well.
Orthodontists are dentists first and our colleagues need to know this (2 comments the same).
Why alienate our sub-profession from the bulk of general practitioners? What do we gain from
separation, why lose what goodwill we do have?
NZDA membership is unnecessary given the fact that we are no longer general dentists.
We are considered elitist by dentists - not belonging to NZDA would alienate us further - at both
local and national level.
A few years ago I argued that we are all dentists and it was essential we remained in contact. But
lately I perceive even more than before an ‘anti-specialist sentiment’ among the NZDA hierarchy.
I feel NZDA have an appalling attitude to orthodontists/specialists in general.
NZDA is primarily for dentists not specialists. NZAO is strong enough to do without them but there
should be some communication - an orthodontist should be able to attend exec/board meetings.
NZDA has no interest in our cause. We should breakaway as soon as possible.
Comments about NZAO finances
Suggestions on use of money;
Send the money to me.
They’ve been squabbling about that for years!
Why not support post grad. students?
Reimburse committee better.
Marketing.
There is a need for a financial reserve for conferences but the association should not be in the
business of accumulating funds. Return to members, subsidise speakers, publicity material etc.
Should continue to accumulate (finances).
Use similar to Australian Foundation - need more $ to build up a base.
Back-up finance to ensure high quality speakers at conferences (subsidise if necessary).
Further helping the development of the Discipline of Orthodontics at the University of Otago.
Establish an interest free loan fund for NZ orthodontic graduate students no matter where they may
be training.
Running training courses for GPs.
Reduce conference costs by subsidising speakers.
Subsidise overseas conferences, library - CD ROM/ DVD. Regional speakers or clinical days.
NZAO should be run as a non profit organisation.
Employ an Executive Officer to take the load off the Executive and Committee.
Use for funding graduate research or part funding of practice based research. Use interest only establish $500 000 on deposit (learn from the Australians).
Should spend funds for help when presenting submissions to Govt. etc.
Developing the website and publicity material, subsidising worthwhile causes, assisting post grads.
Ortho. research esp. via Otago University.
Funding research.
Better support for the committee, better support of ERDG.
Give it to the graduate students - course funding in return for staying in NZ.
Bringing highly skilled clinicians to NZ for education purposes.
Aiding young professionals with huge student loans - e.g. conference subsidies.
Marketing pamphlets.
More public info. on website.
Buy subscriptions to online journals for members.
That surplus is a disgrace in a society this size. Financial assistance to graduate students.
Subsidise costs of clinical meetings.
Spend on continuing education (apart from conferences); self testing programmes, evidence based
product evaluation, literature reviews.
Leave 50% on term deposit for ‘backup’. Other 50% into better interest-earning investment areas.
A post-grad. fee scholarship for the best student (2 comments).
Upgrade ortho.dept. facilities - it should have the latest in facilities.
Keep capital - use interest for subsidies/scholarships and the ortho.dept.
Trading trust for profit exercise eventually leading to a ‘foundation’ type organisation.
Continuing education/courses with overseas speakers, or self testing courses marked/set by paid
staff who feedback to NZAO.
Subs too low - please raise to fund continuing ed./executive meetings.
Pay an honorarium to committee members esp. Pres./Sec./Treas.
Supplement student fees if students stay in NZ.
Trying to run a budget service is naive. More money, more power, more influence = better service,
scholarships, academic and lobbying. More money the better. Set up a charitable arm of NZAO.
1. Take advantage of charitable status re tax
2. Get money from suppliers and tax deductible contributions from dentists that most of us are
doing pro-bono work for.
3. To do charitable work/conferences and leave other money for more important things such as
executive officer.
There is a need to separate business from the charity/education/benevolent aspect.
A couple of additional comments
Grad. students should have to pay their way at conferences as we had to.
Orthodontic supply companies could pay for grad. students attendance at conferences.
Comments about the Competency Assessment Programme
Reasons for not doing the CAP
It’s window dressing.
Poorly designed - sole emphasis stability - no consideration for aesthetics, quality of result.
Assumes one philosophical approach for all practitioners, rather than accepting diversity. Needs
reconsideration urgently. Drs Sarver, Damon, Bagden etc. would not pass in current form. Is
encouraging hypocrisy as many using Damon type systems.
Too academic.
Close to retirement.
It only tests the practice at one point in time.
Time, family, priorities, time!
I disagree with important aspects of the assessment philosophy.
What about academics?
Finding the time to do it and getting organised for the programme.
I have significant problems with the very prescriptive nature of the assessment criteria for
treatment planning. Telling people how far they can move their lower incisors doesn’t assess
practice competency.
Who examines the examiners? I see no long-term justification for it - things change very quickly
these days - what works today could be wrong tomorrow.
Time and work pressure means other issues seem more important.
I’m generally moving further away from proactive to reactive in regards to all forms of compliance
and bureaucracy.
Comments on problems with the CAP
No problems.
Not Macintosh readable disc.
I support the scheme but I don’t think it really tests for competency, only gives an idea of who may
be really incompetent.
Comments on completing the programme
Good programme.
Good - helpful.
Collective discussion of the clinical cases and MCQs by orthodontists who have completed the
programme - perhaps at conferences (i.e. one per year) Also discussion on the programme itself.
Excellent - covers all the normal aspects of a practice relative to today's requirements. Beneficial
for staff.
Other comments
It doesn’t mean much unless we all have to do it.
It must continue to be evidence -based.
Is the CAP a meaningful accreditation and does it serve it’s initial purposes? Lack of external
regulation/control.
The Australian Board should also be promoted more for New Zealanders.
A new patient recently commented that another practice in town has done an assessment
programme that ranks their skills as higher than the rest of the practices in town. This is exactly
what I thought the CAP was not for and I was disgusted to hear other practitioners using it as a
marketing tool. Please do something to prevent this.
Comments regarding Mentoring
Mentoring Topics Suggested;
Practice/business management (18)
Diagnosis and treatment planning (7)
Treatment issues (4)
Case reviews (4)
Legal/regulatory issues(3)
Time management (3)
Orientation to NZ practice (3)
Products/materials (3)
Orth Surg
ACC
Employment
Treatment modalities
Informed consent
Buy/Sell practice
Ethics
Literature
Practical ortho/clinical
Codes of practice
Controversies
Life balance
Preparing for retirement
Branch practices
Communication
Retention
Orthodontics
Suggestions as to how a mentoring programme might be controlled/structured.
Points system for courses etc. like a VT scheme. Part of NZAO.
Appoint senior member of NZAO to oversee.
Self assessment programme.
It should be combined with the competency assessment programme.
One senior mentor in NI, one in SI, one study group each island each year.
Credit points.
A requirement of Provisional membership. Then completion of CAP for Full membership.
It will need to be via a committee. Mentors will need a course on mentoring.
Logbook - electronically on website - similar to FRACDS.
Too hard to control.
Being mentored for two years could be part of scope of practice.
This should be a function of DCNZ not NZAO.
Can’t and shouldn’t be controlled.
I do not think it should be mandatory.
More of an informal buddy system.
Publish names of those in mentoring programme in NZAO newsletter.
Subcommittee.
NZAO.
Self assessment cross referenced to assessment by the mentor.
Finances from NZAO and paid mentoring panel.
Informally.
Difficult.
Through accreditation committee.
Discuss with present study group members.
Not necessarily structured - more an advisory service which can develop/evolve as required.
Informal quarterly sessions and joint annual sessions at the annual NZAO conference.
Informal study groups and social activities help.
Mentoring should be compulsory for 2-3 years then voluntary membership of study group.
Mandatory for new graduates. Those going overseas should be excused. Subsidised
conference/course fees would apply.
Should be informal on a when needed basis.
Mentor could be responsible for a report to NZAO at the end of the period of provisional
membership.
General comments on mentoring
First step finding appropriate mentors.
Mentors will need to be far enough away to be independent from and not competing with the new
graduate.
Should be mandatory but light-handed. Compatibility important.
Very useful early in career for advice. Study group is great but not enough early on
Very important.
Mentoring is an excellent idea but compatibility will be the problem and the orthodontist must
choose the mentor.
Risk of personality clashes.
Aims should be spelt out. Duration, more than one mentor, exemptions clearly stated.
Mentors need to be of an excellent standard, may be chosen from a group by the candidate.
All NZAO specialists should be available as mentors.
Benefits the specialty, benefits the individual.
New grads. may need assistance with financial and/or personal skills.
What are the aims/objectives? Sounds like b.s to me.
NZAO members should always assist colleagues.
In a small country it would be difficult to match orthodontists for style of practice and education.
What evidence do we have that graduates want to be mentored?
Are there similar programmes elsewhere?
Compatibility important. Change possible if not compatible.
If mandatory have to think of new grad/new to NZ - give time to settle into practice.
I started by myself and learnt the hard way on a lot of issues - would have benefited from working
in a good practice. Perhaps the ‘mentoring’ concept would help address that. I could definitely
have benefited from some practice management/admin. advice.
Each graduating student could be designated a practising orthodontist who they could contact with
any queries.
I greatly appreciated the help/advice of my mentors. It is a very personal relationship and would not
work if compulsory or forced upon a person.
The letter from NZAO to DCNZ regarding 2 years registration after graduation was an
embarassment. Poorly written with outdated views. Much better to organise a voluntary mentoring
scheme that would be of benefit to new orthodontists.
In my experience many older members are 1. Overly patriarchal 2. Lack respect from younger
members.
Can’t and shouldn’t be controlled.
A 1960’s “we know best sonny” concept thought up by over the hill “1960s” generation. Look to the
future!!! And look to other professions.
MY EXPERIENCE OF THE AMERICAN ASSOCIATION OF ORTHODONTISTS 104th ANNUAL
SESSION ORLANDO, MAY 2004
By Mark Beresford
I knew I would hate it – the 12 hour flight to L.A. going cattle-class was as bad as ever – the pens
have not improved over the years apart from the provision of individual “TV screens”. Fortunately,
my 2 children (8 and 10 years) slept most of the way (I ate most of my son’s special kids meal as it
was better than mine) but my wife and I barely slept. You probably know this, but just before the
lights go out, the cattle crew pass out little bags containing bottles of water and snacks to carry you
through the night – and so that passengers don’t bug them while they relax in their own quarters.
On our approach to L.A., we had to deviate because NASA was launching a rocket from Southern
California carrying a geophysical experiment – something to do with Einstein’s theory of the
bending of light. As we were taxiing to the terminal, we passed a mass of fire appliances and
police cars surrounding an aircraft – there was no press around so we assumed it was just an
exercise. But this is a country at war.
The process of going through immigration, baggage collection and customs was the usual drag.
They don’t really want us to enter their country. It took us 2 ½ hours to leave the aircraft, be
processed, walk to another terminal (10 minutes) and check in our luggage for the internal flight
which was still 3 hours away. It was a huge relief to find that the United Airlines flight L.A. to
Orlando was on a smaller aircraft with almost as much individual passenger room as business
class on Air New Zealand. A very interesting and comfortable flight across the States in the middle
of the day.
We arrived at our hotel, the Sheraton World Resort, at about 11 pm, just before room service
closed! Our room was quite big but was shabby. It was dark, old fashioned and slightly grubby,
badly in need of an upgrade by a bulldozer. No hint of this on the AAO registration form, not even
by price. It was in a superb position in relation to the theme parks but so were the 10 – 15 other
hotels in the immediate vicinity.
Talking of theme parks – we did them all! Plus some other things – a trip to Cape Kennedy (Cape
Canaveral, NASA etc) was a highlight for everyone, including a 3 hour bus trip throughout the vast
site looking at everything we had only previously seen on TV. The guide on our bus gave us a
very intimate description of how the toilets work on the space station and the laser aiming practice
that the astronauts do before the real thing. Everything you really want to know but were too
embarrassed to ask. Cape Kennedy is also a wild life reserve and we saw more ‘gators, bald
eagles, turtles and other wild life there than on a 1 hour trip on an airboat over swamp lands near
Orlando. Sea World was superb while Universal Studios was the best of the actual theme parks
for both children and adults. The Terminator and Shrek 4-D shows were inventive and amusing.
While I was at the conference, the kids went on a water slide at Blizzard Beach which descended
120 feet - you reach a top speed of 60 miles per hour and come out of it with high blood pressure
and a colossal wedgie. As part of the conference, there were 2 showings of the Cirque Du Soleil
which is permanently stationed at one of the theme parks. Like the show in Auckland a few years
ago, it was astounding at times and always quirky and entertaining. Don’t miss it if you go to
Orlando.
Epcot was surprisingly interesting and a relief from the usual theme park activities. A standout was
the 360 degree movie in the Canadian exhibit. By this stage (actually it was only after 2 days), we
were heartedly sick of American food and we were looking out for something “ethnic” and finally
chose to eat at the Moroccan exhibit. Complete with belly dancer. The evening closed at 9 pm
with an “Illuminations Show” of laser lights and massive fireworks. However, there was a Florida
thunderstorm (which lasted an hour!) at the same time. The theme park was flooded everywhere
to ankle depth but the illuminations were made much more spectacular by the storm. Disney
appeared to have a deal with G-d.
Otherwise, the weather in Orlando was beautifully warm, not humid and no wind. Our return to NZ
nearly didn’t happen. On the last night we discovered that United Airlines had cancelled our return
flight to L.A. because they said we hadn’t flown into Orlando – “Hello! We’re here! Just down the
road from you!” Easily fixed: 4 hours later (at 2.00 am), plus $NZ250 in phone bills and $1700 in
airfares for American Airlines (and a call to the insurance company) and we could make our
connection.
Orlando is definitely a great place to visit and now that we have done all the theme parks, never
again!
Oh yes. The scientific programme? Most of it is in the JCO.
Editor’s note – Mark’s report on the scientific programme actually follows below.
AAO 104th Annual Session, Orlando, May, 2004
Report on Scientific Programme
By Mark Beresford
This was held at the Orange County Convention Centre which is vast - even with all the
orthodontists and trade in the building, it seemed empty. And this was just the west side – across
the road was the east side, just as big.
The Opening Ceremony started with an a cappella choir of 9 singers, singing patriotic American
songs. Imagine! The Canadian WFO representative sitting next to me didn’t clap either.
One of the first lectures I went to was by L’Tanya Bailey who spoke of surgical treatment of Class
III patients at UNC. They had placed much more emphasis on maxillary procedures with 2/3rds of
their surgical corrections being 2-jaw and about 1/3rd maxilla only coming forward. They now do
very few mandibular reductions. However it seems that they had problems controlling the ramal
inclination as they appeared to have had too many cases of the ramus being tipped back leading to
prompt relapse. Are their treatments being dictated by problems with the surgical procedure rather
than diagnosis?
Kokich & Kokich were ….. Kokich & Kokich. Some of the illustrations seemed to be a bit old?
Nevertheless, it is good stuff although every time I have positioned a diminutive upper lateral
slightly mesial of centre (as they recommend), the dentist has asked for the tooth to be centred
properly.
Tablet computers, as demonstrated by Ralph Maijer, might be the laptops of the future and are
particularly interesting to someone like me who cannot type. See his article in a recent JCO.
The JV Mershon Memorial lecture (1 ½ hours!) was given by Lionel Sadowsky – this was a general
chat about common orthodontic problems given in a low key, common sense manner. His practice
would have achieved accreditation in New Zealand as he summed up by saying that the lower
inter-canine dimension should be maintained, take care with advancing lower incisors (ie avoid)
and stick to the original arch form.
The use of the chin cap in Skeletal III therapy is not my thing but Hideo Mitani was actually very
interesting on this topic. He showed several good results, for example the child who started the
chin cap at 5 years, 12 – 14 hours per day. After the Class III / Skeletal III problem has been
corrected, this has to be retained with the chin cap being worn say, every second day, with a lower
force . . . but for up to a total of 11 years! The face looked good but the patient was probably a
pervert. Mitani said that the chin cap gives significant changes initially which tend to relapse and
therefore have to be retained until growth has ceased. The recovery growth after treatment
depends on any growth time remaining and genetic predisposition. So my prejudice was right.
Lysle Johnston was his usual urbane iconoclastic self. He spoke about the CO-CR difference and
the effect that orthodontic treatment may have. He gave the results of a longitudinal study of
treatment of Class II Division 1 patients, seen up to two years post treatment. His final number
was 11 patients (the rest died of TMD). Most patients had no change in condylar position pre-post
treatment and for those with a large change, there was no TMD. There was no systematic long
term change. He said that condylar position is not related to dysfunction. “Faces grow, dentitions
adapt, articulators rust”.
An interesting lecture was given by James Mah on applications of 3D technology in orthodontics.
The imaging machine that he spoke most about was the New Tom Plus which Dr David Hatcher
will be speaking about at the Dunedin conference. Depending upon the machine, patient etc., the
radiation dose varies from 5 -–17 times that of a panoramic radiograph. However, the scan has
much more information than orthodontists achieve with an OPG, lateral skull and PA skull. The
radiation risk, according to US Standards, ranges from “negligible” to “minimal” for the patient.
The University of Southern California now does these scans routinely for their orthodontic patients.
No doubt David Hatcher will elaborate on the value of these scans. James Mah showed a 3D
image of a lower third molar and a segment of the IDN immediately adjacent. The image could be
rotated to give any view desired to show the exact relationship of the nerve and the root. With
views like these, radiographic interpretation may become a dying art.
Three consecutive lectures were given by speakers from Turkey, USA and South Korea on the use
of various types of implants for anchorage. The principal use was for the closure of openbites with
intrusion of usually maxillary but some times mandibular molars. Excellent results were shown
which have proved to be very stable two years post treatment. Other uses were for deep
overbites or over-erupted teeth (when opposing teeth have been lost) and for anchorage.
Maybe I missed it but there did not seem to be much about functional orthodontics – a passing
phase?
The trades exhibition had plenty on computerisation and the AAO had its own “exhibit” on the
electronic office. Personally, I think the NZAO and oral surgeons should get together and buy a
New Tom Plus and set it up somewhere in Auckland (probably Remuera Rd) so that we can all
share it. I will bring this up at the next AGM. Maybe.
DISCIPLINE OF ORTHODONTICS - Graduate Profiles
The following are brief profiles of the current final year graduate orthodontic students in the
Discipline of Orthodontics, University of Otago. Each profile is followed by a summary or abstract
of the research study the student is carrying out as part of their course.
Kirsty McDonald
I graduated with a BDS from Otago in 1999 and then moved north to Hawkes Bay, attracted by the
hot weather, fine wine, and excellent life-style! The first year after graduation I spent as a housesurgeon in the Napier hospital and moved out into private practice the following year. The next two
years were spent working between private practice in Havelock North and Napier. At the end of my
time as a house-surgeon I met Craig who introduced me to every surf-break in the region claiming
they made great “picnic spots”! At the end of 2002 we moved back to Dunedin where Craig started
his specialist medical training in Obstetrics and Gynaecology and I started Orthodontics. We
returned to Hawkes Bay at the start of this year to be married in our favourite vineyard. I am
currently in the final year of the Masters of Dental Surgery (Orthodontics).
My research project is a retrospective study to identify and quantify the factors that influence
orthodontic treatment time, and continues on from Karen Brook’s research presented at the 2001
Queenstown conference. The sample consisted of 366 adolescents (220 females and 146 males)
aged from 10 to 20-years, who were treated by a single orthodontist (Karen Brook), had undergone
a complete course of orthodontic treatment and were treated in a single stage with fixed
appliances. Data were collected from consecutively completed, meticulous treatment records on 34
variables that were arranged into 4 categories: sociodemographic characteristics, malocclusion
characteristics, treatment method and patient cooperation. Average treatment time was 23.5
months with nine variables found to explain 38% of the variation in orthodontic treatment time. Of
these nine, five were pre-treatment characteristics: gender, upper crowding of greater than or
equal to 3 mm, Class II molar cases, extractions or delayed extractions. The remaining four
variables to significantly increase treatment duration, three of which were associated with patient
cooperation, were: poor oral hygiene, poor elastic wear, bracket breakages and brackets rebonded for repositioning. Of all the variables analysed, immediate extractions and delayed
extractions increased orthodontic treatment duration the most. Two flow-charts have been
constructed for the clinician’s use. The first has been designed to enable the orthodontist to predict
treatment time from the information available at the outset of treatment. The second explains as
much as possible of the variation in treatment time, due to clinical and patient factors that can not
be accounted for prior to treatment, but could however be used as strong motivators to encourage
patient cooperation and therefore reduce treatment time.
Phillip Murfitt
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Graduated BDS from the University of Otago in 1996.
Since graduating has worked in Dunedin Hospital and then has modelled his career on
Andrew Marriott by working at Warren Trotter’s practice in Ely, Cambridgeshire for four
years and then returning to New Zealand to undertake the Master’s course in Orthodontics.
He does not however intend to move to Nelson following graduating at the end of this year.
Whilst in England he met and married his English rose, Naomi.
He has a dog called Fudge (also English), a cat called Harry, and a half share in a horse
called Ben (The rear half according to his wife!!!).
Presently in the final year of the MDS in Orthodontics.
Research Project
My research project was a prospective randomised clinical trial to investigate the bracket failure
rate of brackets etched and primed with a self etching primer.
There were 39 participants in the study, whose teeth were etched using a split mouth design so
that each patient acted as their own control.
The self etching primer used was Transbond™ Plus Self Etching Primer (3M Unitek, Monrovia,
Calif), while the control etch and primer used was 37% Phosphoric acid (3M Scotchbond™
Etchant) and Transbond™ MIP primer (3M Unitek, Monrovia, Calif).
Each participant was the followed for a 12 month period. If a bracket failed during this period, the
amount of adhesive remaining on the tooth was recorded using the Adhesive Remnant Index. The
date of failure and the reason for failure were also recorded.
The last of the participants have recently finished their 12 month observation period and the data is
currently being analysed.
I intend to present my findings from this study at the annual conference in Dunedin later this year.
CALENDAR OF EVENTS
The list below includes NZAO events and also those of other Associations and Societies that have
officially notified NZAO of conferences and meetings. For a far more comprehensive database of
international orthodontic events visit the WFO website at www.wfo.org
2004
8-13
Aug
Xth International Symposium on Dentofacial Development and Function.
Bahia, Brazil.
13-14 Aug
NZ Orthodontic Study Group Meeting, Rotorua (see details in General
Notices).
14-16 Oct
NZAO Conference, Dunedin.
15-19 Oct
Royal Australasian College of Dental Surgeons 17th Convocation. Alice
Springs, NT, Australia.
19 November
ASO Western Australia Branch Annual Clinical Day, Fremantle
4-6 December
3rd Asian Implant Orthodontics Conference, Taiwan.
E-mail: [email protected]
2005
23-26 February
Richard McLaughlin and William Arnett course on “Facial and Dental
Planning for Orthodontists and Oral Surgeons”, Sydney
31 March – 2 April
5th Asian-Pacific Orthodontic Conference, Beijing. (See invitation in
General Notices)
8 April
Robert Little One Day Course, Wellington
5-6 August
NZAO ERDG Symposium, Tauranga
10-14 September
6th International Orthodontic Congress, Paris.
E-mail: [email protected]
GENERAL NOTICES
NZ Orthodontic Study Group
The Rydges Rotorua Hotel conference room has been booked as the venue for Friday 13th August
and Saturday 14th August.
We have been given a special room rate for the conference attendees of $115 + GST for a
standard room or $135 +GST for a Spa Deluxe room. Delegates need to book the rooms
themselves at least 35 days prior to the conference and inform the hotel that they are with the
Orthodontic Study Group to get these rates. The deluxe rooms are 50% bigger and with a better
view as well as the spa - well worth the extra $20 per night.
Details for booking the accomodation are:
Phone 07 349 0099
Fax
07 349 0900
e-mail [email protected]
Web www.rydges.com
Please let me know if you plan to attend
Andrew Lush.
The 5th Asian-Pacific Orthodontic Conference
The following invitation was received by Karen Brook – please contact the editor if you require
details.
The 5th APOC will be held in Beijing, China on March 31st-April 2nd, 2005. It is a grand meeting
for the orthodontists in Asian-Pacific region. Orthodontists in our region are encouraged to
exchange individual valuable experience in the clinic, education and research. We cordially invite
orthodontists in your country to participate in the Conference. We hope you can organize the
students, the
staffs, and the orthodontists in your country to come to Beijing.
I send the Conference Announcement, Registration Form and Abstract Form by attachment of the
e-mail. And the Conference Announcements with
Registration Forms and Abstract Forms are sent by airmail to NZAO. The documents will arrive at
you soon.
We are looking forward to seeing you in Beijing.
Thanks for your support for the Conference.
Best regards.
Yours sincerely;
Minkui Fu, DDS, MS
Co-organize Chairman
5th APOC
President Emeritus
Chinese Orthodontic Society
Professor
Peking University
School of Stomatology
NZAO BROCHURES
Members are reminded that further stocks of both NZAO brochures (“Your Questions Answered”
and “What You Need to Know”) are available for order from Derek Barwood. An electronic order
form will soon be posted on the website.
WEBSITE REPORT
By Randal McAlister
Password/Login
The new password and login are the ones created by yourself. They grant access to the members
page as well as access to membership details.
Please note the old password login will cease to work on 1/8/04 and access to the website
will only be granted with the new password/login. By now most members will have their new
password/login. If not there are details below to make the change.
To change your password/ login
If you haven’t changed your password login go to the members’ page
The opening page states "Please sign in below for access to our Members Area. If you are a
Member of the New Zealand Association of Orthodontists and do not have a password please click
here to request one"
Click there to get a password.
You will receive an email notifying you that your password has been changed. Please keep this in
a folder in case you forget your password.
If you forget your password
Email me. I have the authority to retrieve your information. I will then email the information to you.
Find an Orthodontist
There are two databases 1) The NZAO members database managed by the secretary and 2) The
website database.
The data on the website (that "Find a Orthodontist" uses) is accessed via the members page using
your password/login. Use your (new) password / login to change your details via the button
"Change your membership details" on the members page.
This will then change your details only on the "Find a Orthodontist". To change your details with
the association please contact the secretary Winifred Harding [email protected]
NZAO Conference
Details for the NZAO conference, Dunedin are posted on the website. The brochure and
registration details are accessed via buttons on the conference page. This page is accessed via
the NZAO conference button on the home page. You can either register online or by downloading
the PDF registration form and posting it.
RETENTION OF HEALTH INFORMATION
(aka what to do with all those damn records!!)
By Judith Hey
From time to time discussion arises over “what do you do “ with study models & records of
previously treated orthodontic patients. As anyone who has been in practice for any time will attest
the volume of paperwork/Xrays/photos & study models that one accumulates is in itself an issue
that needs to be managed.
Various solutions have been suggested:
- buy the house next door & store them all there (really expensive)
- store them in the shed at the bottom of the garden (significant other may not appreciate this)
- store the written files on disc & the models as holograms (for the technophile)
- photocopy the study models & put this in the paper file (at least it reduces the volume)
- give them to the patient (either all the records or at least the study models) etc…
However when considering what to do there are our “legal” obligations as well as that which is
considered prudent in light of a rising tide of complaints & litigation that we are increasingly being
faced with.
Our legal responsibilities are covered by “The Health (Retention of Health) Regulations 1996”
which states;
…unless the context otherwise requires, “minimum retention period”, in relation to health
information that relates to an identifiable individual, means a period of 10 years beginning on the
day after the date shown in the health information as the most recent date on which a provider
provided health services or disability services, or both, to that individual.
The regulations then go on to stipulate …”this regulation does not prevent a provider from
transferring health information that relates to an identifiable individual to:
a)
Another provider; or
b)
The individual to whom the information related; or
c)
If that individual is dead, the personal representative of that individual.”
Therefore it is quite appropriate to give patients their “before & after’ study models at the
completion of treatment & leave it up to them to look after them – much in the same manner as
individuals are now given Xrays by the large private Radiology Groups for personal care.
There is also nothing in the regulations that requires any health information to be retained in any
particular form – therefore photocopying/ photographing the study models & putting this into the
patient file is also legally acceptable.
While the above paragraphs outline what our “legal” obligations are there are some
circumstances/cases where prudence will dictate that records should be held longer than 10
years.
Speaker Profile for NZAO Dunedin Conference
Dr Fredrik Bergstrand
Dr Fredrik Bergstrand, DDS completed his orthodontic training at the Eastman Institute Stockholm
in 1986. Since that time, he has been part time in private practice, and since 2000 has been 3M
Unitek’s Global Professional Service Manager. Dr. Bergstrand has held positions as Assistant
Professor at both the Pedodontic and Orthodontic Departments at the Karolinska Institute 19771983 and Dep. Chief of Department at the Eastman Institute 1984-1992. In addition, he is a visiting
Professor at the University of Southern California, Department of Orthodontics in Los Angeles. He
has lectured extensively throughout the world on orthodontic techniques, procedures and materials
and has published numerous Articles and Abstracts.
At our conference, Dr Bergstrand will be giving two lectures to the orthodontists and also two
lectures to the staff. His first lecture on the orthodontist’s program is titled ‘New technologies and
beyond’, capturing what’s new and what is in the pipeline. This will be a review from a short and
long term perspective. His second lecture will be on the ‘Incidence and prevention of White spot
lesions”, a more in depth version of a similar lecture he is giving to the staff. His second lecture to
the staff is titled
‘Bonding – state of the art’, a review of current bonding techniques.
Editor’s Note
Profiles of the other major speakers at the Dunedin Conference appeared in the last issue
Radiographic Exemption Certificates for NZAO Orthodontic Staff
By Peter Fowler
Late last year the NZAO undertook a two-day radiographic course for orthodontic assistants. The
course aims were to enhance the education, training and experience of assistants in all aspects of
radiographic imaging relevant to orthodontic practice in New Zealand. The two-day course covered
radiographic imaging currently undertaken in orthodontic practices both of in terms of generic and
individual practice requirements. Those who successfully completed the written examination at the
completion of the course and then applied to the Medical Radiation Technologists Board for
exemption to hold a radiographic licence were recently (this week) successful in being granted an
exemption certificate.
The certificate exempts the holder to practise diagnostic radiography under the supervision of a
registered dentist who holds a licence under the Radiation Protection Act 1965. The exemption is
site specific (ie. Practice location) and allows the holder to perform “bite-wing and periapical
radiographs also orthopantomograms, lateral and PA cephalograms and anterior occlusal
radiographs”. For those patients under the age of five years prior approval of the registered dentist
is required. There is also a requirement that the certificate holder’s work is closely monitored by the
licensee and that the certificate holder receives continuing education regularly and that this is
documented. The certificate is valid so long as the holder’s employment and supervision remain
substantially the same .
The implications of being successful in receiving exemption certificates from the MRT board are far
reaching, although in saying this, the MRT Board itself will no longer be issuing exemptions
certificates as from September 2004. This role will be taken over by the Dental Council of NZ who
will in addition to issuing registration for “Orthodontic Auxiliary Practice”, will also being issuing
“additional scopes of practice to take radiographs” for those who hold an exemption issued by the
MRT Board current as at 18th September or those who “pass in the DCNZ Dental Hygiene
Examination (intra and extra oral radiography)”.
The course instructors were Dr Martin Lee, Director of School Dental Services, Canterbury District
Health Board and Course Convenor for School Dental Therapist Radiographic Training Courses,
Mr Alastair Stockdill, Director of Radiographic Supplies Ltd and Former National Radiation
Laboratory Scientific Advisor, Mr Peter Cartwright, Scientific Advisor from the National Radiation
Laboratory, Dr Randal McAlister, Orthodontist and holds a Diploma in Dental Radiography
(University of London) whose material was presented on the day by Dr Peter Fowler, Orthodontist,
Oral Health Centre, Canterbury District Health Board.
The course was held at the Oral Health Centre, Christchurch on Thursday/Friday 6th/7th of
November 2003. The course curriculum is set out below.
DAY 1
9.00-9.15
Introduction
Meet other assistants and instructors
Information on venue/course objectives
Time Table and Course contents
9.15-9.30
Legislation
The Radiation Protection Act, Medical Radiation
Technologists Regulations, Code of Practice for Dental
Radiography
9.30-10.30
Electromagnetic
An introduction to the production and radiation behaviour
of x-rays.
10.45-11.15 ALARA
The guiding principle of radiation safety
11.45-12.30 Orthodontic
Radiographic views commonly used in orthodontics
radiographs
12.30-1.30
Lunch
1.30-4.00
Radiation Safety
NRL Presentation on radiation safety and hygiene
DAY 2
9.00-11.30
Film Processing
11.30-12.30
Quality Assurance
12.30-1.30
13.30-2.15
2.15-4.30
4.30
Lunch
Written Examination
Practical Radiography Demonstrations
Course closure
Film processing and chemistry, digital and processing
systems
Issues relating to patient/film positioning, exposure
settings and processing systems. Cross infection control
All those who participated in the course (13 in total) successfully passed. The course was
intensive and the lecture from the NRL was very technical for most participants. Quite a few felt
quite stressed prior to taking the examination on the second day. Before attending the course,
each staff member had to complete a pre course questionnaire to ensure that information given on
the course could be tailored to allow for “ site specific” instruction. Following the completion of the
course there was a 6-page exemption application form to complete as well as a $100 fee for the
processing of the application.
Due to the nature of this course (the first one like this to be assessed by the MRT Board) it took
considerable time for the “wheels” to turn and after numerous delays, frustrating correspondence
and numerous phone calls/ emails, eventually the MRT Board issued the required exemptions.
Now that the process has finally been approved it paves the way for several more courses to be
run, the next located in Auckland (see Judith Hey [email protected] for details)
The NZAO acknowledges and greatly appreciates the efforts of Alastair Stockdill and Martin Lee in
formulating, preparing and presenting this course.
Sharing a “lighter” moment during the day course
Proud course participants who successfully completed two day course including the
examination!
Pre-Course Practice Questionnaire
NZAO Radiography for Auxiliaries
Pre-course Practice information questionnaire
Practice:_____________________ Participant/s _________________________________
Administrative
1
Name those persons in your practice who hold a license issued under the Radiation
Protection Act.
_______________________________________________________
2
Have you seen and read a copy of the following:
( a ) Radiation Protection Act
( b ) Radiation Protection Regulations
( c ) NRL Code of Safe Practice (Dental) C7
( d ) Operator manual for your x-ray machine
( e ) Any other related publications (list)
Y/N
Y/N
Y/N
Y/N
Y/N
X-ray machine/s
1
What is the Make and model of the Panoramic (OPG) machine that you use.
2
__________________________________________
Does it have a cephalostat attached.
Y/N
3
When was a preventative maintenance check last carried out? ____/___/___
4
Do you use any other x-ray machines
Y/N
If yes, list:
___________________________________________ Films taken: Ceph
p.a.
Occlusal
X-ray film and cassettes (for digital, see below)
1
What brand and type of intensifying screens do you have in the cassettes?
Y
Y
Y
written
Pan _______________________
2
Ceph ____________________
What brand and type of film do you use?
Pan _______________________
Ceph ____________________
X-ray film processing/Digital
Do you use: Manual processing
Automatic processing
Digital
Y
Y
Y
Go to appropriate sections below
Manual processing
1
What is the volume of the developer and fixer tanks?
_________ litres
2
What brand and type of chemicals do you use?
__________
3
What is the dilution rate for these chemicals?
_____:____
4
Do you have a time/temperature chart for these chemicals?
Y/N
5
What is the process time for panoramic film at a temperature of 22 degrees C? ____
6
How long do you leave the film in the fixer? _______
7
How long do you wash the film? _______
8
Do you replenish the developer and fixer? Y/N If Y, with what volume at what period?
______ml/_______
9
After what period are the developer and fixer tanks emptied and refilled? _______wks
Automatic film processing
1
What is the make and model of the processor. ________________________
2
What brand of chemicals do you use? ______________
3
What is the developer temperature? _________degrees____
4
What is the dry-to-dry time? _________
5
Do you have automatic replenishment? Y/N If N, do you manually replenish? Y/N
6
After what period do you empty and refill the tanks in the machine? ________
7
When did the machine last have a preventative maintenance? _____/______/____
8
Do you have any quality assurance program? Y/N
Digital
1
What is the make and model of the system? _________________________
2
Does it acquire the image by direct digital? Y , or scanned plate? Y
3
Do you have any quality assurance program? Y/N
Operator and patient protection
1
Do you use any form of operator protection? Y/N If yes, state.
_______________________________
2
Do you use any form of patient protection? Y/N If yes, state.
_________________________________
3
Do you use radiation monitoring films from NRL? Y/N