Alumni winner speech — Dr Kia Pajouhesh

Media item: recorded alumni award speech

Speaker: Dr Kia Pajouhesh

This page records the media item. The recording is the property of its publisher and is not reproduced here, and no remarks are quoted.

What follows is general information on dental education in Australia — how someone becomes a dentist, how a dentist becomes a specialist, and what keeps registration current afterwards. It is worth understanding, because it is the substance behind every title on a practice website.

Becoming a dentist

Two routes, both leading to the same registration.

The undergraduate route. A five-year Bachelor of Dental Science or Bachelor of Oral Health, entered from secondary school, typically with an admissions test and interview.

The graduate-entry route. A prior bachelor's degree, then a Doctor of Dental Medicine or Doctor of Dental Surgery, usually four years. Australian dental schools have progressively moved towards this model.

Either way, the programme must be accredited by the Australian Dental Council, and the clinical years are spent treating patients under supervision in university and public clinics. Graduates then apply to the Dental Board of Australia for general registration, which must be in place before they treat anyone independently. The general practice they enter is described at General Dentistry.

Overseas-qualified dentists are assessed by the Australian Dental Council, usually through written and practical examinations, unless their qualification is covered by a recognition arrangement. This is a demanding process, and an overseas-trained dentist on the register has met the Australian standard.

The other registered professions

Often confused, so worth setting out:

• Oral health therapists hold a dual qualification in dental hygiene and dental therapy, and work within a defined scope. What is the difference between a dental therapist and a dental hygienist? separates them.
• Dental hygienists focus on periodontal care and prevention — see Dental Cleans and Hygienists, What do dental hygienists do? and Dental hygienist vs dentist.
• Dental therapists primarily treat children and adolescents — see Children's Dentistry.
• Dental prosthetists are registered to make and fit dentures and mouthguards directly for the public — see Dentures and Sport Mouthguards.

All four are registered by the Dental Board. Dental technicians, dental assistants and practice managers are not registered — technicians make appliances to a dentist's prescription and do not treat patients. The on-site laboratory is described at Smile Solutions Laboratory.

Becoming a specialist

This is where most public misunderstanding sits.

Specialist registration requires an accredited postgraduate specialist programme, typically three years of full-time study at Masters or Doctorate level, usually undertaken after some years in general practice, and frequently supported by fellowship examinations of the Royal Australasian College of Dental Surgeons. When do you need to see a dental specialist? covers it from the patient's side, and Specialist Care lists the divisions practised here.

Australia recognises thirteen dental specialties, including endodontics, orthodontics, periodontics, prosthodontics, paediatric dentistry, oral and maxillofacial surgery, oral medicine, oral surgery, oral and maxillofacial pathology, dento-maxillofacial radiology, special needs dentistry, forensic odontology and public health dentistry. Why the distinction changes the treatment is set out in Endodontist vs dentist for root canal, Orthodontic treatment: dentist vs specialist orthodontist and Should my child see a specialist paediatric dentist?.

Oral and maxillofacial surgery is the longest pathway in dentistry — it commonly requires both dental and medical degrees plus surgical training, and can run well beyond a decade after school. What does oral and maxillofacial surgery involve? describes the work.

Crucially: a weekend course does not make a specialist. ‘Cosmetic dentist', ‘implantologist' and ‘sleep dentist' are not specialties, and a practitioner may not use a specialist title without specialist registration in that field. The register at ahpra.gov.au shows exactly which, if any, a practitioner holds. The pages for those three areas are Cosmetic Dentistry under Specialist Care, Dental Implants — with Who should I see for dental and teeth implants? — and Sleep Dentistry.

What happens after graduation

Registration is not permanent by default. To renew each year, a practitioner must declare compliance with the Board's registration standards:

• Continuing professional development. The Dental Board sets a minimum CPD requirement over a three-year cycle, with a required proportion clinical or scientific. Practitioners keep a CPD portfolio and can be audited.
• Recency of practice, so registration cannot be maintained on paper by someone who has not practised.
• Professional indemnity insurance, which must be in place for the whole scope of practice.
• Criminal history disclosure.
• English language skills, where applicable.

Practitioners must also practise within their own scope, which is a personal judgement backed by a professional obligation: competence is what you can actually do, not what your degree permits in principle.

Early career, and why it is hard

Worth saying, because it is invisible from the waiting room.

A new graduate is a fully registered dentist on day one, legally able to do everything a dentist of thirty years' experience can. The gap between legal scope and practical competence is the central risk of early-career dentistry, and it is managed through mentoring, graduate programmes, supervised placements and — most importantly — a willingness to refer. The practice's own arrangements are at Graduate Program, Dental Internship and Careers.

Public sector and rural practice remains the fastest way to accumulate broad experience, which is why many practitioners begin there.

What a patient can take from this

• Check the register. Registration type, specialty and any conditions are public and free at ahpra.gov.au — Finding a dentist online in Australia explains how.
• A long list of course certificates is not specialist registration. Ask which is which.
• Experience in the specific procedure matters more than years in the profession generally. ‘How many of these do you do?' is a reasonable question — see What makes a truly great dentist? and 5 questions you've always wanted to ask a dentist.
• A practitioner who says ‘this should be referred' is demonstrating good training, not a limitation. What happens when multiple specialists need to collaborate describes the referral working properly.

Related pages: Dentists & Registered Specialists, Specialist Care, Our Team, Graduate Program, Dental Internship, and the full Our Media archive.

Common questions

Can a dentist go straight from graduating into specialist training?

No. The Dental Board of Australia's requirements for specialist registration include that applicants have "completed a minimum of two years general dental practice" — achievable outside Australia, subject to the Board's assessment — and have "met all other requirements for general registration as a dentist." So the postgraduate programme sits on top of a general degree plus at least two years of ordinary practice. That is why a person holding specialist registration in, say, endodontics has also spent years doing general dentistry, and why the shortest realistic pathway is still close to a decade from starting university.

What are the thirteen specialties actually called?

The Board's own list, approved by the Australian Health Workforce Ministerial Council, reads: 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. The wording matters because the titles are protected, and because the list is revised: the current version took effect 1 October 2017, the Board having noted at the time that the revision made "minor technical changes to the specialities of oral medicine, oral pathology and forensic odontology" to align the titles with international usage. An older name still in circulation is not evidence of anything except an out-of-date page.

Does the register tell me whether someone is good at the procedure I need?

No, and it is important to be clear about the limit. The Board describes the register as giving the public "up-to-date information about a dental practitioner's registration status", and says it "also includes details of the specialty or specialties for dentists who hold specialist registration." That is a check on entitlement: is this person registered, in what division, with any specialty, and are there conditions or undertakings recorded against them.

What it cannot tell you is skill, how often they do a particular procedure, or what their patients thought. Those you get by asking. The register does also show endorsements — the Board maintains a separate registration standard for endorsement for conscious sedation — so if sedation is part of what is proposed, that is a specific thing you can look up rather than take on trust. See Sleep Dentistry.

How does it work for someone who trained overseas as a specialist rather than as a dentist?

There are three routes. A qualification the Board has already approved supports a direct application. A qualification it has not approved goes through the Board's qualification equivalence pathway, which is available for twelve of the thirteen specialties.

Oral and maxillofacial surgery is the exception on both counts. The Board requires an applicant to "first apply for an assessment of your qualification with the Royal Australasian College of Dental Surgeons", and states plainly that it is "a specialty recognised by both the Dental Board of Australia and the Medical Board of Australia" and that "you must hold qualifications in both medicine and dentistry." Separately, under the Trans-Tasman Mutual Recognition Act, a practitioner registered as a dental specialist in New Zealand and holding a current annual practising certificate is entitled to registration here where the specialty exists in Australia.

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. See also Our Location and Contact Us.

Every practitioner's registration and any specialist entry can be verified free on the AHPRA public register at ahpra.gov.au.

This page records a media item. No remarks are quoted, and the material above is general information rather than a summary of the speech. Course structures, CPD requirements and accreditation arrangements change; the Dental Board of Australia, the Australian Dental Council and the individual universities are authoritative.

Smile Solutions trades under ABN 28 193 514 103.