Posted on 7th July 2020
After finishing her dentistry degree in Queensland, Barbara worked rurally (for Government and then in private rural practice). “When I moved back to the city, I taught restorative at the university for a short period of time and then when I got my FRACDS, I was eventually accepted into a Master’s course in oral surgery, which was quite difficult in those days – I was the first woman in Queensland and one of the first two women in Australia.
“I made a couple of attempts with both an honours degree and a fellowship and a few people were accepted over the top of me who hadn’t even made it through dentistry in the minimum time. I was then told, at about halfway through my final third year, that full membership of the specialist society now required a four–year training program and UQ couldn’t give me an extra year because they had two postgrad students coming up behind me. So, I went to England and worked as a registrar in a head and neck unit for 12 months and that convinced me that I needed to do medicine. I came back and did medicine at the same time as practising and doing my specialist fellowship.”
The oral and maxillofacial surgeon is clearly passionate about what she does but admits she nearly did prosthodontics. “I was very good at laboratory work but then I realised as a prosthodontist you don’t necessarily do your own lab work. At that stage we also believed that removable pros was a dying profession because people would be keeping their teeth,” she laughs.
“Surgery was my next love; I really enjoyed surgery. In fact, when I was a freshman just coming into dentistry, as a joke, we were taken into the lecture theatre and were played a movie of a particularly gory procedure (a maxillary osteotomy) and while everyone else seemed to think it pretty gross, I thought: ‘Wow – I’d like to do that.’”
On top of her practice work, Barbara is the chair of Operation Interface (an NGO affiliated with the International Association of Oral and Maxillofacial Surgeons). “We set up an OMS training program in Cambodia for Cambodian dentists,” she explains. “The problem we were facing was that we were inviting Pacific Island students over into our post–grad training program and they inevitably would struggle because they didn’t have English as a first language. Then they would finish the program and skip their visa. They would go underground because they could do better working as, for example, a wardsman in a regional hospital, rather than going home and being a specialist. It was not only counterproductive and a waste of resources for the training program but also caused a terrible brain–drain in the home countries.
“We decided we would trial training ‘in country’,” she adds. “We committed to that and got it off the ground in 2012. We have graduated our first five maxillofacial surgeons and there are another four in the program. We’re taking on two more next year, so eventually we’ll have two in every year of the four-year training program.”
Barbara tries to go to Cambodia twice a year to oversee the program. Between that and her work as a lecturer, Barbara finds herself travelling somewhere between once a fortnight to once a month (unsurprisingly, she’s a gold frequent flyer member with Qantas and platinum member with Virgin). However, she says she loves her work.
“I enjoy everything about my work; I just wish I wasn’t quite so busy because I’m getting older and I would like a bit more free–time,” she says. “I really enjoy talking to people; I enjoy helping people. I love reconstructive surgery because transforming someone whose appearance has been concerning to them for a long time is almost instantaneous with current digital surgery planning.”
Dr Woodhouse will be presenting Oral Surgery: Learn Practical Skills to Enhance Your Clinical Techniques on August 21 at ADA House.
“It is a back–to–basics thing,” she explains. “We start with looking at instrumentation and what is appropriate instrumentation and what is going to make the job easier by using that.
“I spend a lot of time on assessment, which I think brings out a collective groan in a lot of people, but proper assessment of the patient and the x-ray is the difference between saying ‘yes I can do this’ or warning the patient that it is going to be difficult,” she says. “It builds the patient’s confidence in the practitioner if they know what to expect. It also builds the practitioner’s confidence if things are going as they expected, rather than deteriorating because they didn’t assess properly and maybe decide to refer. Assessment is hugely important.
“I talk about the various techniques of extracting teeth and we have some videos that demonstrate that. I also talk about taking biopsies because a lot of our attendees are rural practitioners and from my own experience I know that trying to convince a patient from a rural area to go to the city for a quick snip can be like asking them to go to the moon. It’s important that the dentist is able to identify things which are abnormal and then biopsy it.”
Oro–antral communication is also discussed, as well as management of pain control. According to Barbara, many dentists lack confidence around oral surgery procedures, so she hopes this course helps increase that confidence. “I don’t think you get enough experience of oral surgery procedures in dental school,” she says. “In Queensland, we have a system where the students go and do placement for three or four months in a dental clinic. However, the dentists themselves are not confident with surgical extractions and so they are very reluctant to let students try to extract in case it turns into a breakage, which then has to be surgically removed.”