Town & country
Leaving her roots in Perth WA, Annie Johnson crossed the country to Sydney for her studies – and the beginnings of committee work – before continuing her journey into remote and rural NSW, and a career addressing the needs of a country-based patient base at White Leaf Dental in the New England region.
What was it like to move across the country to study, and how do you think USyd has informed your career on graduation?
It was a big move, but I'm very happy I did it. I don't know much about dentistry at UWA so I can't comment on the differences – but studying at the University of Sydney gave me a great insight into working in two different public hospitals and their respective patient bases.
I also got the chance to have a placement in Broken Hill, one of the most remote towns in Australia. This was a big confirmation that I wanted to work in rural/regional after graduation.
USyd has a very strong theoretical base, especially in areas like oral pathology and medicine, which interested me a lot more than it might have if it was taught differently. This teaching also gave me a really strong base to draw from working rurally where there is limited access to specialists and working with an aging community with increased comorbidities.
What did you learn from your role as president of the dental students' association, at the time?
Being involved in Sydney University Dental Association (SUDA) was a great addition to my studying experience. SUDA taught me that forming connections and being part of the dental community is one of the best ways to move forward (and stay sane) in this career.
I've had a year off from active committee/ volunteer work since then, but I am still involved in the Recent Grad Committee at ADA NSW. Moving forward I am hoping to become more active in my role in the RGC and ADA as a whole.
Has your career start in regional NSW fit in with your expectations? What have been some highlights or challenges for you?
One year down working in regional NSW and it has been an adjustment after four years in the big city. However, working in a small town has been fantastic because of the strong sense of community. Very quickly I have had the chance to meet, and treat, many families with multiple generations coming through the practice.
It has been challenging to dive into the deep end of working after studying through COVID, but it has definitely caught me up on anything I might have missed at university.
Working between two clinics has been a welcome challenge, as our smaller clinic in Walcha serves a community of about 3,000 people, who are mainly farmers. This has shown me a completely different side to dentistry as a lot of our patients haven't had access to dental for many years before we opened, and there has been less focus on oral health education. As someone who has grown up predominantly in major cities, I've had a bit of a cultural shock but have learnt a lot from our patients there and love working in Walcha especially.
Does rural-based dentistry offer some particular experiences or benefits for recent graduates?
Rural dentistry has taught me a lot in a very short period. After primarily studying through COVID, the amount of practical experience I've gained in the last year has been fantastic, and almost overwhelming.
Working in a small and remote town has meant that for 95% of patients that walk through the door, often after travelling for hours, treatment has to be done on the day. It has forced me to upskill quickly, think on my feet and pull from all the knowledge I gained in university. I have been lucky to have a great mentor and amazing team that have been very supportive and guided me through this. We also have a visiting endodontist and an implant specialist that come up to the practice periodically who have been invaluable in my learning straight out of uni.
While not true for every rural dental clinic, we also see a large number of NSW Health voucher patients in our clinic. This gives a great balance of private and public patients and serves a big role in reducing public dental waitlists.
How does social media and internet-based tech fit in with your work?
Social media and online CPD has been my lifesaver this past year. Going to Sydney for CPD isn't always feasible as it means flights, accommodation, course fees and usually taking time off work midweek.
I spend far too much time on Instagram anyway, so having accounts like Dr Amanda Phoon Nguyen's oral medicine page and the Endoprep account/app has been great to add some education in. It helps me brush up on things from studying, and also typically answers any questions I have about complex cases and patients.
What have you seen to be the main challenges in the realm of oral health, in your work with remote and rural populations?
One of the biggest challenges I have seen is with the public waitlist; while the hospital dentists try to get through as much as they can, it is often years before patients see treatment, especially comprehensive treatment. I have had patients come through that haven't had teeth for 10+ years, and they have been waiting on the list for dentures since their teeth were removed.
There is also substantially less oral health education and priority in some cases. A lot of people in the region live on properties, where they are on tank water without additional fluoride which compounds the issue. Prior to opening the White Leaf clinic in Walcha, patients had to drive an hour just for check-up and cleans, and the same again for any other treatment they might need. This made it unrealistic for many people to keep up with dental treatment.
With an aging population and the diffculty getting dental treatment in the area, there is an increased need for denture work, both private and public. Very few clinics in the area do dentures as there is no full-service lab closer than Sydney, and so the wait times become longer and longer.
What would you personally like to see happen in the dental profession, and/or that you might like to be a part of?
I am currently studying for the RACDS primary exams and thinking about specialising in the future. Whether or not I specialise, I think long term I will stay regionally.
Something I have always been passionate about throughout uni and continuing now is bridging the gap between being a student and being a clinician – and I'd love to be more involved with the mentoring process. I think lately there has been a big push in CPD aimed at new graduates which is great, and I'd love to see more of that happening. Getting more industry involvement in the university experience would be great to see as well, so it can start early in new dentists' careers.
