Billion Healthy Mouths Club

Dr. Mark Wotherspoon from Australia: “Portable dentistry is both practical and in demand.”

Meet Dr. Mark Wotherspoon, an experienced promoter of portable and aged care dentistry, and creator of a hygienic dental appliance product range.

Inspired by patients that could no longer visit his dental office due to frailty or illness, Dr. Mark Wotherspoon started to provide portable dental care – offering treatment in the comfort of the patient’s home. Learn his full story. 

Why did you decide to study dentistry?

I really wanted to be a professional golf player, but I found out quite early that I wasn’t a great golfer (laughs). As a teenager, I had a part-time job working in a bar collecting glasses and washing dishes. One of the barmen was studying dentistry, and when work was a bit slow he’d be studying and I’d look over his shoulder at these fascinating textbooks. And the rest is history.

How was dentistry perceived back then? Was it seen as an important profession? 

Yes, a very important one. In fact, at the university I went to, dentistry students and medical students studied together in the first year. And although it’s already a very well-respected profession, we would certainly like people to better understand the connection between oral health and their general health. 

“We would like people to better understand the connection between oral health and their general health.”

What were your first steps after graduating from dental school?

I’d been living in a very happy home, but when I graduated from dental school all I wanted to do was move as far away as possible. I applied for a job as a government dentist in the very remote Kimberley region of Western Australia. I was based at a small hospital in Wyndham, but every 6-8 weeks we would charter a light aircraft, pack up our portable equipment and fly out to isolated indigenous communities to set up short-stay dental clinics. I enjoyed that time very much. I was only 22, my dental nurse was 16 and the pilot was 19 – you can imagine it was quite an adventure. 

What was the state of oral health within Aboriginal communities? 

It was quite good, more gum problems than decay-type problems. Most of the work I was doing was extracting teeth. If somebody was in pain, they’d come in and I’d take the tooth out, there was no comprehensive dental treatment. 

Were there any important moments from those days that have had an impact on your whole career? 

It taught me that checklists and systems are very important, I had to be super organised. If you left something behind, you couldn’t just turn around and get it out of the cupboard. As I was the only dentist within 800km of these towns, I felt an enormous responsibility towards the people who were relying on me to look after them. It instilled in me a great sense of responsibility towards my patients and my small team. It also proved to me that a portable surgery was both practical and in demand.

Welcome to the Billion Healthy Mouths Club

Proper routines in prevention are the future of dentistry – that’s why we at Curaden launched the Billion Healthy Mouths Club – a community of dental professionals committed to the importance of prevention and a holistic approach to dentistry. Dr. Mark Wotherspoon is one of those dental professionals who shares these values, and we proudly present his experience and thoughts with other like-minded people from the field. Keep reading our Gently magazine to discover more interviews with forward-thinking professionals from around the world.

Your CV also includes a period of military service in the Army Dental Corps. What was your role in the army?

Military service in Australia is not compulsory, you volunteer for it. I joined the Australian Regular Army as a Dental Officer. Although I was only there for a few years, it was a wonderful experience and it had a profound effect on me. I learned to work within a large organisation and I became fitter and stronger, which is very important in our profession to reduce back and neck problems.

In the end, I was treating a lot of very fit, young, healthy people, and providing a lot more preventive services than restorative services. I did enjoy my time in the military because I went from working on my own in a very isolated place to working in a larger clinic with more experienced dentists, hygienists and nurses. I was like a sponge and picked up many tips and tricks.

Nowadays you run a few professional activities simultaneously. How is your work week divided into the different activities now?

I spend one day a week going out with my portable dental clinic, Dentist To Your Door, going to aged care facilities and providing care for people in hospitals and in their homes. I still work as a general dentist three or four days a week, and I spend one or two hours a day working on my other business, the Dr Mark’s HyGenie range of products. I need to be kept busy and I enjoy a busy lifestyle.

Tell us more about Dentist To Your Door. When did you start this service and what was your motivation? 

There were two reasons. One was personal and the other one was professional. My mother had a lifetime of health problems and I realised how much work went into looking after somebody with health issues. Any sort of assistance that we can give to such families is invaluable. I saw the value in being able to go out and help.

From a professional point of view, some of my long-term patients who would see me regularly, would one day just stop coming. They’d say, ‘’Look, we want to come, but it’s just too difficult.’’ It had simply become too hard or even impossible for them to attend the surgery due to ill health, frailty or both. I felt helpless and frustrated that I couldn’t do more for them. The situation was quite sad and often had significant consequences on both their oral and general health.

“Some of my long-term patients would one day just stop coming. It was too hard for them to attend the surgery, and I wanted to do more.”

So you decided to find a way to help them in a non-conventional way?

I discovered that there’s so many options for lightweight, portable dental equipment, available globally and in Australia, which can fit in the boot of the car. All that needed to be done was to develop some systems for working outside of the fixed surgery, and add some practical guidelines around time, logistics and fees to make the service practical and viable. Now this allows me to treat patients while they’re laying in their own bed or seated in their favourite chair, with their family member or staff member present.

Do you go alone or do you work as a dental team? 

I work alone. I wanted to develop a service that was financially accessible and to do that, and
keep costs down it is best to work solo.

What’s the general situation regarding the oral health of the elderly in Australia? Many dentists from various parts of the world say that, in general, seniors and their dental health do not get enough attention. Can you relate to that?

Very much so. In Australia, there was an investigation into the state of aged care nursing homes. One of the results that came out was that a lot more needed to be done for oral health. We have 250,000 people in nursing homes in Australia and we don’t have many dental professionals going in to provide services.

However, the issue isn’t so much a person’s age, as age is simply a number; the issue is the individual’s ability to self-care. It’s everything from cognition, communication, diet, transport, personal hygiene and more. The patients I serve with Dentist To Your Door range from 25 to 95+ years in age.

How do you motivate the elderly to take care of their oral health?

Great question. The first thing to know about this group of patients is that they’re proud and will do almost anything to hang onto their independence. They say, ‘’Oh, I’ve just cleaned my teeth.’’ But when you look in their mouths, you can tell that the brushing is not done properly and that the dentures are not cleaned properly.

So, I carry an intraoral camera with me. I put the camera in their mouth and take an oral photograph of what I see. I display the photo on the screen of my laptop, we look at it together and I say, ‘’Well, this is not up to your own standard. You need assistance, let me help you,’’ and normally they agree to be helped.

“I want a hygienist to be part of the staff at senior homes to make sure that everybody’s getting their mouths cleaned correctly on a daily basis.”

How do you approach patients with dementia? 

If the person suffers from dementia, then I show the photo to a family member and I demonstrate how to work with the correct toothbrushes, toothpaste and cleaning products, how to take the dentures out and how to clean them. While I’m doing this demonstration, I ask the family member to make a video using
their smartphone, of me demonstrating how to clean the patient’s mouth properly. They can then share this video with other family members or staff. This also means that even if that patient moves to a different facility, the person continues to receive the correct care.

Do you also train caregivers or employees at the senior homes on how to provide dental care? 

I’m going to start giving lectures and hands-on workshops utilising mannequins in the local technical colleges where they train nurses aged care workers. If we can improve daily cleaning and maintain regular visits from a dentist or a hygienist, that’s going to make a big difference.

I would really love to see dental hygienists as part of the staff in every facility. At the moment, you have physiotherapists, speech therapists, dieticians, even podiatrists, optometrists, but I want a hygienist to be part of the staff at the facilities to make sure that everybody’s getting their mouths cleaned correctly on a daily basis.

You have your own product range, Dr Mark’s HyGenie®. Why did you decide to focus on removable dental appliances?

It comes down to my personal and professional experiences. Watching my dad have trouble cleaning my mum’s dentures was one factor. In addition, I have three children and they all had to wear a mouthguard to protect their teeth when doing sports. We need to understand that a dirty sports mouthguard collects mould, and this is related to lung infections and asthma. It’s very important to have your mouthguard cleaned and then stored dry.

From a professional perspective, you only have to be in the dental profession five minutes to know that the home care of dentures, orthodontic aligners, splints and sleep appliances is well below standard. Oral hygiene instruction for the home care of these appliances needs to be taken far more seriously and I am not sure we always spend enough time educating our patients as to the reason “why” dental-appliance hygiene is so important, and then showing the “how” with regards to home care products that are easy to use and give a great result.

“We don’t always spend enough time educating our patients as to the reason ‘why’ dental-appliance hygiene is so important, and then showing the ‘how’ with regards to home care products that are easy to use and give a great result.”

Did you develop the products on your own, or did you collaborate with anybody else?

Our team consulted many dental professional experts, scientists and engineers, along with a number of consumer groups to design and test all six products.

Let’s talk about your profession more generally. You are an experienced dentist. When you compare today’s dentistry with the field during your university studies, how much has it changed? And what do you hope will come next?

Dentistry today is so much better! Digital technology, material science developments and the possible clinical results are truly breathtaking. The challenge is to keep the service affordable so most can enjoy these advances. We need to have a strong public service, so that people who can’t afford it can be looked after as well.

In terms of future, a lot more oral health content needs to be included in all medical and paramedical training. Tele-dentistry will be an important tool to facilitate this integration.

And what about the patients, do they care about their teeth more than they did in the past? 

Some people take their oral health seriously and others don’t care at all. I think just as many people care now as they did back then, and just as many people don’t. I wish I could say that people took the health of their mouths more seriously, but I think four out of five people care about their mouths, one in five just don’t. That’s why it’s important to keep educating the public about the relationship between oral health and general health.

How do you work on your continuing education? 

I love to go to conferences. There’s also so much content online – webinars are a wonderful tool. I can listen to an expert in Japan, an expert in Germany and an expert in the USA, all in the same day. We owe it to our patients to stay up to date with the latest science, techniques and products as they deserve and expect this from us.

What are the golden rules of your professional career?

Respect your patient’s opinions, time and money. Respect your staff and display good manners, fairness and decency, and of course, respect yourself.

“I believe we owe it to our patients to stay up to date with the latest trends because they expect it from us.”

What about your future plans? 

2022 promises to be an exciting year and I have already accepted a number of invitations to present and teach Portable Dentistry and Aged Care Dentistry. As I mentioned, I have also taken up a teaching role in a local technical college that trains aged care staff. I am a big fan of the iTOP philosophy and hope to continue my training, and along with my colleague Dr Tihana Divnic-Resnik, are in the development phase of an iTOP module tailored specifically towards aged care and seniors.

How do you keep your work-life balance? What are your favourite ways to relax?

Years ago, I was advised that “Nobody lays on their deathbed wishing they had spent more time at work”. I enjoy spending time with my family and friends and I’m still playing golf badly (laughs). In Australia we barbecue and picnic a lot, and now that Covid pandemic restrictions have lifted we will be heading to the beach.

Dr. Mark Wotherspoon is an accomplished dental practitioner, presenter and educator with 30 years of experience, based in Wagga Wagga, Australia. Mark has held government service appointments as a Dental Officer in Western Australia and in the Army Dental Corps. He is the founder of Dentist To Your Door, specialising in portable dental services, and of Dr Mark’s HyGenie, a range of dental-hygiene products for removal dental appliances.