Graduate Program

Enquiries: theteam@smilesolutions.com.au, or phone 13 13 96.

Places are offered as they arise. What follows is a straight account of what the first year out actually demands, because most of it is not taught and all of it matters.

Before you start: the registration obligations

On graduating from an ADC-accredited program you apply for general registration with the Dental Board of Australia. From that moment:

• Professional indemnity insurance is mandatory. Arrange it before you treat anyone.
• Continuing professional development applies from your first registration period, and is audited.
• You are personally accountable to AHPRA for every clinical decision, regardless of who employs you, who owns the practice, or who suggested the treatment. No employer instruction changes that.
• Mandatory notification obligations apply to you — and, importantly, so does the ability to seek help for your own health. The threshold for a health notification is substantial risk to the public, not having a condition. Practitioners who avoid care because they fear being reported are the problem those provisions were amended to address.
• Your registration, division and any conditions are public at ahpra.gov.au. So are everyone else's — including the general dentists and registered specialists you will be working alongside.

The standards themselves, and when each took effect

The obligations above are not general advice; they are written down, each in a registration standard with its own date of effect. The Board describes them as defining "the requirements that applicants, registrants or students need to meet to be registered". The ones that will apply to you from your first day:

Source: Dental Board of Australia, Registration Standards.

Read the scope of practice standard first. It requires dental practitioners to practise within the scope of their education, training and competence at all times — the Board treats it as fundamental enough that it applies the standard when assessing trans-Tasman applications and may impose conditions to keep a narrower overseas scope narrow here. In your first year it is the standard that answers the only question that really matters before you pick up a handpiece: am I the right person to be doing this, today?

The criminal history standard has a current version effective 15 July 2026, replacing the one that ran from 1 July 2015. The English language skills standard took effect 18 March 2025, and the Board notes changes to minimum test scores effective from 23 April 2026. If you memorised either at university, check whether you memorised a retired version.

Conscious sedation is an endorsement with its own standard, in effect since 27 October 2015, and its own published competencies. It is not something you drift into providing because a colleague does — see sleep dentistry for how it is actually delivered here, and note the separate anaesthetist and facility fees that come with it.

What the first year is actually like

Speed is the shock. University teaches you to do it correctly with unlimited time. Practice requires it correctly within an appointment. Speed comes from sequencing and preparation, not from rushing — and it comes in about eighteen months.

You will not be as fast as you expect, and that is normal.

The hardest skills are not technical:

• Telling someone the cost. Practise saying a number without apologising for it and without discounting reflexively — the published fee guide is the reference point, not your own discomfort.
• Telling someone they need nothing. "Watch and monitor" is a legitimate clinical decision, and it is harder to say than "we'll fill that."
• Saying "I don't know, I'd like to check" in front of a patient. It builds more confidence than guessing, and guessing is how harm happens.
• Managing an anxious patient, which is a larger share of the day than anyone expects.
• Managing your own posture, before it becomes an injury.

The clinical habits worth forming in year one

These are the ones that separate careers.

1. Take a proper medical history, every time, and update it. The list that changes management: anticoagulants (do not tell a patient to stop them — that is the prescriber's call), bisphosphonates and other antiresorptives, diabetes and its control, immunosuppression, previous head and neck radiotherapy, cardiac conditions requiring prophylaxis, allergies, pregnancy, and every medication that causes dry mouth, which is a great many.

2. Chart periodontally, properly, and record it. Gum disease is diagnosed by change over time. A first set of numbers is worth nothing except as the baseline for the second, and the cases that will not stabilise belong with the periodontists.

3. Examine the soft tissues, every time. Tongue, floor of mouth, cheeks, palate, tonsillar region, neck nodes. This is oral cancer screening, and it is the highest-stakes thirty seconds of the appointment. Any ulcer, white patch, red patch or lump unhealed at three weeks is investigated — not reviewed again.

4. Justify every radiograph. Because it will change a decision, not because it is due.

5. Use rubber dam. For endodontics it is the standard of care. For adhesive restorations it is the difference between bonding and hoping.

6. Do not over-treat. Early enamel demineralisation can remineralise. The pressure runs toward intervention — from production-based remuneration, from patient expectation, and from your own uncertainty. Resisting it is the whole job.

7. Consider cuspal coverage on root-filled posterior teeth, and the evidence behind it.

8. Write notes that would make sense to someone else in ten years — because that is exactly who reads them.

9. Consent as a conversation, not a form. Diagnosis, options including doing nothing, the material risks (the Rogers v Whitaker standard is what this patient would attach significance to), the cost with ASDS item numbers, and time to think. A signature on a form is evidence a conversation happened; it is not consent.

10. Refer before you are out of your depth, not after. Knowing the limit of your competence is a professional obligation. Failing to refer in time is a recognised source of harm — Record payout to patient for failure of GP's duty of care to refer to a specialist.

The mistakes that generate complaints

Worth knowing in advance, because they are predictable:

• Cost not discussed, or discussed incompletely. The single largest source of complaints in Australian dentistry. Itemise, in writing, before starting.
• A quote that omits the second half — the crown after the root canal, the abutment and crown after the implant, the retention after orthodontics, the anaesthetist and facility fees that come with treatment under sedation.
• Persisting past competence — the separated instrument, the perforation, the nerve injury.
• Failing to diagnose periodontitis, because nobody probed.
• Reviewing a persistent soft-tissue lesion instead of investigating it.
• Poor record-keeping, which turns a defensible case into an indefensible one.
• Not returning the call about a complication.

If you are thinking about specialising

Most graduates are, at least loosely. The structure is worth knowing early, because it changes what your first few years should look like.

The Dental Board recognises 13 dental specialties in Australia, approved by the Australian Health Workforce Ministerial Council: dento-maxillofacial radiology, endodontics, forensic odontology, oral and maxillofacial surgery, oral medicine, oral and maxillofacial pathology, oral surgery, orthodontics, paediatric dentistry, periodontics, prosthodontics, public health dentistry (community dentistry), and special needs dentistry. (Source: Dental Board of Australia, Specialist Registration.)

The gate is two years. The Board's specialist registration standard requires applicants to have completed a minimum of two years of general dental practice — which may be achieved by experience outside Australia, subject to assessment and approval by the Board — and to have met all other requirements for general registration as a dentist. Every applicant must hold general registration and be on the Register of practitioners under the division of dentists.

Which reframes the first two years. They are not a holding pattern before the real training; they are part of the requirement for it — and the breadth of general work you do in them is what you will draw on for the rest of your career, including as a specialist.

Three details that catch people out:

• Overseas qualifications run through the qualification equivalence pathway for twelve of the thirteen specialties. Oral and maxillofacial surgery is the exception: recognised by both the Dental Board and the Medical Board, it requires qualifications in both medicine and dentistry, and an overseas applicant must first be assessed by the Royal Australasian College of Dental Surgeons.
• New Zealand specialist registration transfers under the Trans-Tasman Mutual Recognition Act — but the Board assesses equivalence and may impose conditions, for instance where a scope of practice is narrower in New Zealand than in Australia.
• The two countries' lists are not identical. The Board and the Dental Council (New Zealand) have 11 specialties in common; dento-maxillofacial radiology and forensic odontology are recognised here but not there, and restorative dentistry is recognised there but not here.

Entry-level competencies for dental specialties have been developed by the Board in partnership with the Dental Council (New Zealand), in part to assist the assessment of overseas applications. They are published, and they are the clearest available statement of what a specialist is expected to be able to do.

The title rule, which is stricter than most graduates realise

Under the National Law, a person must not knowingly or recklessly take or use the title "dental specialist" or a specialist title for a recognised specialty unless registered in that specialty — and a person must not use any title, name, symbol, word or description that would induce a belief that they are, or are qualified as, a specialist. These are the "holding out" provisions, and they apply to how anyone describes you as well as how you describe yourself.

The penalties are not nominal. AHPRA's advertising guidelines state that for unlawful use of a protected title an individual may face a financial penalty of up to $60,000 per offence, imprisonment of up to three years per offence, or both, and a body corporate up to $120,000 per offence (in Western Australia, $30,000 and $60,000 respectively). Source: AHPRA, Guidelines for advertising a regulated health service.

In practice this is the rule behind a piece of advice you will get repeatedly: describe what you do, not what you are. "I have a particular interest in root canal treatment" is a statement about your practice. A coined title is a statement about your registration, and the register is the only thing entitled to make it.

Looking after yourself

Start here, not after the injury:

• Ergonomics from day one. Loupes, saddle stool, patient positioning, and standing up between appointments. Musculoskeletal injury is the most common occupational health problem in dentistry.
• Have your own GP. Self-diagnosis and self-prescribing are discouraged in the Board's code of conduct.
• Find peers. A study group breaks the isolation and improves your decisions at the same time — which is much of the argument for working where everything is under one roof.
• Understand your contract. Most Australian associates are independent contractors paid a percentage of what they generate — no sick leave, no annual leave, income tied to being in the chair. Read the restraint clause, and understand who owns the records.
• Support: confidential practitioner health services operate in every state and territory, independent of AHPRA and of employers. Lifeline 13 11 14. Beyond Blue 1300 22 4636.

How to apply

Email theteam@smilesolutions.com.au with your CV, your graduating institution and year, and your AHPRA registration number once you have it.

Tell us what you want more exposure to, and what you would rather refer. The second answer is the more useful one.

Common questions

The patient asks whether it will hurt. What can I honestly say, and does topical anaesthetic actually do anything?

Start with what you cannot say. AHPRA's advertising guidelines name "safe", "effective", "risk-free" and "pain-free" as words that minimise the complexity of risk when used without acknowledging possible adverse reactions or mixed evidence. That constrains how the practice advertises, and it is also a reasonable discipline for how you talk in the surgery. Describe what you will do to manage discomfort; do not promise an absence of it.

On topical anaesthetic specifically, the evidence is narrower than the habit. A systematic review and meta-analysis of randomised controlled trials in the International Journal of Oral and Maxillofacial Surgery concluded that "using topical anesthetics only relieves pain during needle puncture and in the maxilla". For pain caused by anaesthetic infiltration in the maxilla the pooled effect was a mean difference of −6.4 (95% CI −12.81 to 0.01) on a 0 to 100 scale — not statistically significant (P = 0.07) — and for needle puncture in the mandible the review found no statistically significant difference.

A related pooled analysis of onset time found −0.65 minutes (95% CI −1.38 to 0.09), again not significant, with faster onset in the subgroups for inferior alveolar nerve blocks and inflamed tissue — each resting on only two studies, so treat those as hypotheses rather than findings.

None of that is a reason to stop using topical. It is a reason not to oversell it, and a reason to put your effort into the things patients actually rate: telling them what is about to happen, going slowly, warming the cartridge, giving them a way to stop you, and not standing over them while they are lying down.

A large share of my day is anxious patients. What does the evidence say actually helps?

More than you might expect, and the best synthesis is recent. A systematic review and meta-analysis in the Journal of Anxiety Disorders (2024) screened 173 randomised controlled trials, pooled 67 of them across 14 analyses, and covered 6,038 participants completing follow-up. Mean age 34, about two-thirds female, average attrition only 3%, and 85% of included trials had registered protocols — an unusually solid base for this field.

On psychotherapies against untreated or waitlist controls, the primary analysis gave a standardised mean difference of −0.80 (95% CI −1.00 to −0.59), rated low certainty; excluding an outlier it fell to −0.48 (95% CI −0.72 to −0.24) at moderate certainty. For CBT specifically the primary pooled estimate was −0.59 (95% CI −1.09 to −0.10), low certainty, and −0.43 (95% CI −0.68 to −0.17) at moderate certainty once an outlier was removed.

Read those two numbers together rather than quoting the larger one. The pattern across the analyses is that the headline effects shrink and the certainty rises as outliers and waitlist comparisons are stripped out — which is what an honest effect looks like. Psychological approaches work, moderately, and the trials are heterogeneous.

What that means on a Tuesday afternoon: the effective ingredients are mostly not specialist referrals. Shorter early appointments, explicit stop signals, predictable sequencing, and treating the fear as a clinical finding to be recorded rather than a personality trait to be worked around. Refer on where the anxiety is genuinely phobic and the treatment need is substantial — and see dental anxiety for what is available here.

Can I use nitrous oxide, and what does the sedation endorsement actually gate?

Nitrous oxide and the conscious sedation endorsement are two different questions, and graduates routinely conflate them.

The Australian Dental Association's position is that "dentists are the only dental practitioner who can independently administer nitrous oxide", that "only dentists who have adequate training and experience should administer nitrous oxide", and that other dental practitioners who have undergone suitable training "may provide treatment utilising nitrous oxide sedation under a dentist's supervision" once relative analgesia has been established. It also directs that dentists administering it comply with the relevant professional standards and follow the ADA's own guidelines for administration.

That is a competence and supervision question, and it is governed day to day by the scope of practice standard: your education, training and competence, at all times. Holding a degree is not the same as being trained in this.

Separately, conscious sedation is an endorsement on registration with its own registration standard, in effect since 27 October 2015, and its own published competencies — that is the formal gate, and it is not obtained by working alongside someone who has it.

At the other end of the scale, the ADA's position on general anaesthesia is that dental treatment under GA "should only be undertaken when indicated" — an indication, not a convenience. On the practical side, note what that adds to the patient's bill: separate anaesthetist and facility fees, which belong in the quote from the outset.

How do I talk about fees without apologising for them?

By knowing the system well enough to explain it, because most fee discomfort is really uncertainty.

Three facts that help. First, there is no national dental fee schedule in Australia — a submission to a Parliament of Australia inquiry into out-of-pocket costs records this plainly, which is why fees differ between practices and why a patient comparing two quotes is doing something reasonable rather than something insulting. Second, cost is the dominant barrier: the same submission cites an AIHW survey finding that nearly a third of people aged 5 or older (32%) avoided or delayed visiting a dentist due to cost. Third, insurer-owned no-gap clinics and preferred providers cluster in major cities, so a patient's out-of-pocket position is partly geography.

What follows practically is a script rather than an apology. Quote the whole course of treatment, not the appointment in front of you. Use ASDS item numbers so the patient can check their own rebate and compare elsewhere. Name what is not included — the crown after the root canal, the abutment and crown after an implant, retention after orthodontics. Offer the staged version where staging is clinically acceptable, and say which part is urgent.

And know the rule that sits underneath it. Section 133 of the National Law prohibits advertising that offers a gift, discount or other inducement without stating the terms and conditions of the offer, and AHPRA specifically names quoting an instalment amount without the total cost as a potential breach. If you find yourself reaching for a discount to make a number easier to say, that is the moment to give more information instead.

Related pages: Join our Team, Dental Internship, Dentists & Registered Specialists, Our Team.

Practical details

Smile Solutions, Level 1, 220 Collins Street, Manchester Unity Building, Melbourne VIC 3000. Phone 13 13 96, or theteam@smilesolutions.com.au. Monday–Friday 8.00am–6.00pm, Saturday 8.30am–1.30pm, Sunday by appointment.

This page contains general information. Registration requirements are set by the Dental Board of Australia and change; confirm current requirements with the Board. This is not an offer of employment, and it is not employment, clinical or legal advice.

Smile Solutions trades under ABN 28 193 514 103.