August 2023 Newsletter

Message from the President

Welcome to the August edition of the Dental Council of NSW’s (the Council) Newsletter, and my first as President.

I am honoured to be representing the profession in this capacity. I also recognise the important role we play, as dental practitioners, in patient health and wellbeing. 

On behalf of all registered dental practitioners, I take this opportunity to thank Clinical Associate Professor F. Shane Fryer OAM for his dedicated and diligent leadership of the Council over recent years. Very big shoes to fill indeed.

As you will be aware, the Council’s principal role is to protect the health and safety of the public. We do this by managing complaints about the conduct, performance and health of registered dental practitioners and students in NSW. The Council will take regulatory action only where it is necessary to protect the public or where it is in the public interest to do so.  I must stress that it is not a punitive process.

We, as health professionals, strive to do the very best we can for our patients and their families. Regardless of our good intentions, on occasion concerns may arise about the treatment we have delivered or in relation to our communication, interactions and behaviour.

We need to acknowledge that people have the right to complain.  Having been a dentist and oral surgeon for a number of years, I can appreciate how it feels when a complaint is made about you. Regardless of whether you did anything wrong, receiving a complaint and being contacted by a regulatory body can be stressful.  However, as registered dental practitioners, we have a professional obligation to work cooperatively with a regulator whenever a complaint is made about us.

The Council aims to ensure that its processes are fair and transparent. Practitioners are provided the opportunity to respond to a complaint and to provide as much information/documentation as they can, to assist the Council in managing the matter and finalising its decision. 

If you are the subject of a complaint, we strongly recommend that you make contact with your professional indemnifier and/or your professional association. These bodies are familiar with the complaints process and can offer you guidance and support throughout the process, including when providing responses or further information to the Council.

I can however assure you that it is not all doom and gloom! 

In the past the Council has received feedback from practitioners, following their involvement in the regulatory process, advising how the experience has helped them grow as a practitioner and how it has assisted with identifying areas of their practice that could be improved.  

I remind you that all registered dental practitioners have a professional obligation to abide by the Dental Board of Australia’s Code of Conduct. This shared Code applies to 12 of the 15 National Boards. Areas such as record keeping and consent processes are detailed in the Code and at the time of renewal of registration, we are all required to confirm that we have read and understood the Code. This may prompt you to refresh your memory as the end of the year approaches.

I am pleased to let you know that the Council continues to see a decline in the number of complaints received each year. I am hopeful that this will continue into the future.

Conjoint Professor Deborah Cockrell AM
President

NSW Health Professional Councils and Health Professional Councils Authority joint Aboriginal Cultural Safety Strategy 2023-24

In June 2023, the NSW Health Professional Councils and the Health Professional Councils Authority (HPCA) launched its joint Aboriginal Cultural Safety Strategy.  The joint Strategy aims to improve the experiences of Aboriginal people who interact with the NSW healthcare and regulatory system.

Our Strategy aligns with existing state and national initiatives to improve health outcomes for Aboriginal people.

The Councils, HPCA and regulatory system exist for the benefit and protection of the NSW community and we acknowledge that Aboriginal people have, and continue to suffer, disproportionate levels of disadvantage, including in health outcomes.

Our Strategy aims to strengthen cultural safety within the NSW regulatory system through increased participation of Aboriginal people and collaboration with stakeholders.

To read more about the Strategy and its launch, visit the HPCA website.

Recent media regarding complaints about sexual misconduct/boundary violations in the healthcare system

You may have seen recent media regarding sexual misconduct/boundary violations in the healthcare system and the action taken against health practitioners by regulatory bodies.

Each year, the Council receives a small number of complaints that relate to boundary violations. From a complaints perspective, boundary violations may encompass inappropriate sexual contact; inappropriate relationship (sexual or non-sexual); inappropriate sexual comments, or inappropriate use of social media.

Noting that the Council’s principal role is the protection of the public, complaints regarding boundary violations are taken very seriously.  The Health Care Complaints Commission (HCCC), which is an independent body, consults with the Council on each complaint.  A determination regarding how the complaint is to be managed is made on the individual circumstances and the information that has been received by the HCCC and the Council.

Complaints may result in no action being taken.  More serious complaints may lead to suspension/cancellation of registration or conditions being placed on registration.

We would like to take this opportunity to remind all dental practitioners of their obligations and responsibilities relating to professional boundaries, noting that these are integral to a good practitioner-patient relationship and they promote good care for patients and protect both parties.

The Dental Board of Australia’s Code of Conduct states that good practice requires you to:

a.    recognise the inherent power imbalance in the patient-practitioner relationship and maintain professional boundaries

b.    be clear about the professional boundaries that must exist in professional relationships for objectivity in care, and avoid conflicts of interest, as well as under or over-involvement

c.    never use your position to establish or pursue a sexual, exploitative or otherwise inappropriate relationship with anybody under your care; this includes those close to the patient, such as their carer, guardian, spouse, or the parent/carer/guardian of a child patient

d.    recognise that sexual and other personal relationships with people who have previously been your patients are usually inappropriate, depending on the extent of the professional relationship and the vulnerability of a previous patient, and

e.    not express personal beliefs to patients in ways that exploit their vulnerability, or that are likely to cause them distress.

While the above focuses on the practitioner-patient relationship, it is important to note that complaints raising concerns about professional boundaries are also received from staff in dental practice settings. In a joint position statement, released in June 2021, the Board reiterated that there is no place for sexism, sexual harassment or gendered violence in healthcare. This position statement also reinforces the professional, respectful behaviour expected of registered dental practitioners.

All dental practitioners need to be aware of and consistently comply with the Board’s codes and guidelines relating to professional boundaries, conduct and respectful professional behaviour.

Perceptions and attitudes of dental practitioners towards impacts of COVID-19 pandemic on clinical dentistry – by Dr Xiaoyan Zhou, The University of Sydney*

*In 2020, The University of Sydney was awarded a Dental Council of NSW Education and Research Grant for this research/project.

As of 19 July 2023, the World Health Organisation (WHO) has reported that the COVID-19 pandemic has resulted in over 768 million cases worldwide, with almost 6 million confirmed deaths. This ranks the pandemic as the fifth deadliest epidemic in history.

During this challenging time, all healthcare providers, including dental practitioners, have been significantly impacted. Dental professionals are regularly exposed to dental aerosols and potentially infectious body fluids, making them particularly vulnerable. In response to these challenges, researchers from the University of Sydney (Dr Xiaoyan Zhou, Dr Shanika Nanayakkara, Dr Jinlong Gao and Dr Alex Holden) conducted a survey from 2020 to 2021 to investigate the perceptions and attitudes of dental practitioners towards the impacts of COVID-19 on their professional practice, career decisions, and patient care.

A total of 252 dental practitioners registered in New South Wales (NSW) participated in the survey. After excluding responses with missing data, 206 responses were included in the analysis. The survey revealed that the majority of participants perceived dentistry as having a higher risk of infection compared to other health professions. In response to the pandemic, most dental practices adhered to guidelines from professional associations and implemented various safety measures, such as providing hand sanitisers, practising social distancing, and conducting risk screenings, to ensure the safe delivery of oral health care.

Concerns regarding patients’ accessibility to dental care were raised by over 80% of dental practitioners, despite the introduction of tele-dentistry as an alternative. Interestingly, almost half of the participants did not recognise tele-dentistry as an effective substitute. The COVID-19 pandemic has also had negative impacts on dental practitioners’ professional careers, including safety, working hours, and income. As a result, some practitioners contemplated changing their practice environment, transitioning to other sectors, or even leaving their careers in dentistry. However, the majority expressed a willingness to remain in their current practice environment and continue their dental careers.

These observations demonstrate the systematic disruption faced by dental practices in Australia due to the COVID-19 pandemic. It highlights the importance of providing timely educational training and support to dental practitioners to minimise the negative impacts and optimise dental care. The findings from this study have been published in BMC Oral Health (Zhou, X., Gao, J., Holden, A.C. and Nanayakkara, S., 2022. Perceptions and attitudes of dental practitioners towards impacts of Covid 19 pandemic on clinical dentistry: a cross-sectional study. BMC Oral Health, 22(1), pp.1-9.).

If you are interested in learning more about this study, please contact Dr Xiaoyan Zhou, Sydney Dental School, the University of Sydney at xiaoyan.zhou@sydney.edu.au.

Call for applications - Council education and research grants

End-of-year round opens on 1 September 2023.

The Council protects the public by managing complaints about conduct, performance and health matters concerning registered dental practitioners practising in NSW and health and conduct matters related to registered students training in NSW.

Under section 41S of the Health Practitioner Regulation National Law (NSW) the Council may establish an Education and Research Account to provide funding for research and education purposes relating to the health, performance and conduct of registered dental practitioners and students.

The Council’s Education and Research Program provides Grants to applicants to undertake approved research/education projects – up to $10,000 per application. Grants are available to applicants who are registered dental practitioners (all divisions) whose principal place of practice is in NSW, or registered students (all divisions) training in NSW. Grants may be awarded to individuals, groups or institutions.

Examples of the types of projects the Council may support include:

• Identification of areas of need in the Council’s regulatory programs. For example, deficiencies in educational programs that lead to registration, identification of risk factors associated with complaints, or the assessment of outcomes relating to health, performance or conduct pathways
• Development and evaluation of Continuing Professional Development courses or training that will support the Council’s regulatory activities. For example, professional ethics, regulatory processes, or training for members of the Council, Tribunals or Panels
• Preparation, coordination and conduct of conferences to convey outcomes of research relevant to the Council’s regulatory work.

The Research and Education Grants Guidelines provide further information about the application process.  To apply, please use the Research and Education Grants Application Form.

The Council calls for applications twice a year.  Applications for the mid-year round of funding open on 1 March and close on 1 May, and the end of year round of funding opens on 1 September and closes on 1 November.

For more information, please visit the Council’s website.

Health and wellbeing support service for dental practitioners

The Dental Board of Australia has funded a nationwide health and wellbeing support service for dental practitioners.

Dental Practitioner Support is the first national 24/7 telephone and online service for all dental practitioners. The service also offers support to dental students, educators, employers, Australian Dental Council exam candidates and concerned family members.

An experienced team of counsellors will provide confidential and immediate support, advice and referral on a wide range of health and wellbeing related issues. The service runs independently of the Board.  Anyone calling the service does not have to give their name.

Access Dental Practitioner Support:

• 1800 377 700
• dpsupport.org.au

If you are experiencing difficulties, the Council strongly recommends you access this free and anonymous service.