Expert Breakfast Report for 12 September 2018: Assoc Prof Jonathan Broadbent, Dept of Oral Sciences

Born and raised in Dunedin with a home-based education up to tertiary level, Jonathan Broadbent is now an Associate Professor in the Dental School.

There are a lot of opportunities in Dentistry, for a more varied pathway than you might think.

Home-based schooling

Prof Broadbent is a Dunedinite whose schooling, after just 10 weeks at “real” school, was virtually entirely home-based. This followed ’some nasty things that happened to some kids, perpetrated by one of the teachers at my school’ - some events that prompted his parents to withdraw all four of their children and home school them. Home schooling continued for Jonathan until he reached the age of 17 years, when he started university. In this environment he was ‘a bit bored’ and felt socially isolated. He had not been involved in sports in his youth, his parents had his attention concentrated on study and on music (cello and piano).

As a child his interest in ‘bugs’ and science made him decide he wanted to be an entomologist, but as time went on he could see no work for himself in zoology. One day during a routine dental visit at the age of 15 his dentist asked him what he wanted to do as a career. “I just looked at what you did. People walking with a problem, then you fix them, then they give you money.” A profession in which you help people and by doing so, make some money, and have your own business and not being answerable to people, appealed. The response from his dentist was, “Well, if you get into Dental School, I’ll give you a job when you graduate.” - And, as Jonathan was able to confirm years later, wrote this down in his notes.

At university he had to work particularly hard during the first year, having done very limited chemistry and no physics at home, while he felt his biology was ‘a bit out of date’. Other parts of the course, like English, he found much more straightforward. In the event, exams went quite well, and he obtained higher marks in the subjects he had been most anxious about than those that came more easily.

Horoscopes are unreliable

In 2nd year Dentistry at that time, ten 2,000 word assignments were set, each carrying 1% of the final paper grade for Oral Biology - over half the class did not do these assignments, only two students doing all of them. However, they were marked very rigorously and returned with plenty of feedback. This enabled Jonathan to learn how to write scientifically. After his first effort (in which he had not realised he needed citations) was very critically received, he learnt from the criticism and by the third assignment was getting plaudits for the quality. At the end of second year, he undertook a studentship into anaphylaxis medical emergencies in Dental Practice, stemming from a remark question his father - who worked at Dunedin Hospital - had asked about the frequency of anaphylaxis in dentistry. He wrote a proposal complete with full literature review and including a research protocol - largely as a result of what he had learnt doing the assignments.

This started a train of events that lead him to undertaking a PhD while working as a Research Fellow. “It seemed like an offer that was too good to be true - I still think it was too good to be true!” He had not planned to stay on in Dental School, and in fact had applied for and been offered a job as a maxillo-facial House Surgeon, but the Research Assistant Fellow offer prompted him to turn that job down. “That evening I looked in the newspaper at the horoscopes, and read “Avoid making career decisions today, you’ll make a bad decision.” Which simply goes to show that horoscopes are unreliable.

Keeping in touch with dental practice

However, working as a Research Fellow and doing a PhD meant he was missing out on real dentistry. As his PhD was in the field of dental health in health and equality in Public Health, he felt open to the criticism that he had not done much dentistry himself (particularly in a public health context). He partly countered this by doing voluntary work in the remoter islands of Fiji and in Papua New Guinea - while attempting to avoiding so-called ‘voluntourism’, which tends to leave the inhabitants without any long-term benefit. He also worked 4 nights per week in private practice, so for about six years he was working 5 days, 4 nights a week and every second week-end ‘on call’ - but then he got married, so that workload stopped.

Prof Broadbent looks back on the Ten Assignments as being a key point in determining his future, along with the hard work he put into his first year at University.

Be yourself at interviews - be aware that technical ability is important, AND answer the question that is asked

Currently Jonathan, who has been on the University staff for nearly 15 years, works in the field of Dental Public Health, oversees the 3 BDS second year papers as Year Chair, The Dentist and the Patient 1, Biomedical Sciences 1, and the Dentist and the Community 1 and co-ordinates the latter Dentist and the Community 1 and 3 papers (in 2nd and 4th year, respectively). His involvement in research involves work with the Dunedin Multidisciplinary Study. He holds a Health Research Council Project research grant of just over one1.2 million dollars over a five year period, which is used for staff salaries including a Research Assistant, part of his own salary, and the research activity itself with the associated overhead expenses.

Fluoridation and IQ

In answer to a question regarding water fluoridation and IQ, Prof Broadbent agreed that in high concentration fluoride can be neurotoxic - as can are many things in high enough concentration. He gave drinking a cup of tea as an example. Given that fluoridation of drinking water gives 0.7 ppm, the fluoride concentration in a cup of tea is between 2 and 15 may be many times greater - but you would likely reach the a toxic dose of caffeine before you would reach the toxic dose of one for fluoride.

In studies of areas around Dunedin with fluoride in the drinking water or no fluoride, no differences were detectable in IQ, though the prevalence of dental caries was greater observed in areas without fluoridated water when fluoride was not present. In some studies abroad, the fluoride levels - due to naturally occurring fluoride in the ground - have been much higher, so much so that the highly debilitating condition skeletal fluorosis is seen. In such circumstances, IQ could might be affected by these very high fluoride levels. A study in Sweden involving tens of thousands of subjects produced similar findings to the Dunedin ones - no detectable effect on IQ due to fluoridation levels in the prescribed range.

Other issues touched on included:

  • Maintaining a healthy work-life balance through exercise, music, reading, and family.
  • Booklets on Self-Care for Dentists prepared by the New Zealand Dental Association (available free in PDF form at https://www.dcnz.org.nz/resources-and-publications). - [And if you download it, take a look at the acknowledgements! - Ed]
  • The need for someone teaching a technical subject to also practice that subject regularly.
  • Large changes in Dentistry - Corporates owning dental practices, oversight of dental practitioners by accountants, etc.
  • Why dentistry is expensive for the patient.
  • The stresses of practising dentistry.
  • The enjoyable aspects - patient interaction, the pleasure of work well done, knowing what the day holds, etc.
  • Why the Public Health scheme in New Zealand does not include dentistry.
  • Anaphylaxis in Dentistry and changes in the Code of Practice.
  • ‘The Murder House’
  • Poor attendance rate by patients at annual check-ups.
  • Be yourself at interviews - and be aware that technical ability is important, AND answer the question that is asked!

Posted: Friday September 14, 2018