Dr Helen Voronina walks the talk when it comes to ethical and sustainable dentistry

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Dr Helen Voronina
Dr Helen Voronina sees three main issues as problematic in dentistry: the tendency to prioritise treatement of preventable diseases over prevention, the generation of too much waste, and the unethical use of animals in medical research. Photography: Eamon Gallagher

Dr Helen Voronina’s successful dental and implant practice is at the ethical and sustainable forefront of Australian dentistry. By Frank Leggett

Ethical and sustainable are much more than just buzzwords in today’s business environment. Consumers are now well informed about business practices and actively make choices based on personal criteria. Likewise, many business owners are embracing more sustainable practices, not just to attract consumers but because it aligns with their own values and beliefs.

Fortunately, it’s possible to run a dental surgery with the highest levels of professionalism, treatment and service while embracing ethical and sustainable practices. The level of sustainability can range from a simple effort to minimise waste to completely reworking the day-to-day procedures in order to be as sustainable—and ethical—as possible.

Dr Helen Voronina owns and runs Dr Helen’s Dental & Implant Studio in Melbourne’s East Prahran. Ethical business practices are a passion of Dr Voronina and the business is run to the highest standards of sustainability.

Starting out

After graduating from the University of Melbourne in 2003, Dr Voronina worked in a number of regional practices. Her interest in the surgical side of dentistry grew so she took a position in a surgery with a predominant emphasis on oral rehabilitation with implants. However, her goal since graduation was to buy and run her own business.

“I bought an existing practice in 2008,” says Dr Voronina. “It was the most amazing little business. It opened in the 1920s and has been operating as a dental surgery for nearly 100 years in the same location. I have one patient who started coming here when he was four years old. He’s in his 90s now.”

Today, Dr Helen’s Dental & Implant Studio is a single practitioner practice with a practice manager and two staff members. Dr Voronina’s mindful approach to general and implant dentistry has seen the business go from strength to strength.

Common sense dentistry

“I don’t call it ethical dentistry,” says Dr Voronina. “I call it commonsense dentistry. There are three main issues I see as problematic in our profession. Firstly, there’s a tendency to prioritise treatment of preventable diseases over prevention itself. Secondly, minimising waste is a huge issue. Finally, we need to address the ethical issues in dentistry and medicine relating to the use of animals.”

At Dr Voronina’s surgery, amalgam retention suction is routinely used and the recycling and minimisation of waste is standard practice. She stays on top of the latest research and embraces cruelty-free products. Whenever available, non-animal derived graft materials and medications are used. She also supports and promotes a plant-based lifestyle for its ethical, health and environmental benefits. 

“The first principle in dentistry is ‘do no harm’,” says Dr Voronina. “As an implantologist, I see patients with the most severe dental conditions and every time I work with these people, I’m reminded of the fact that the harm has already been done. In an affluent country like Australia, we’re faced with an epidemic of preventable diseases, many of which are dietary-related that need not exist.

The first principle in dentistry is ‘do no harm’. As an implantologist, I see patients with the most severe dental conditions and every time I work with these people, I’m reminded of the fact that the harm has already been done.

Dr Helen Voronina, owner, Dr Helen’s Dental & Implant Studio

“After extensive surgical rehabilitations, I take care and time to counsel my patients on their overall health. For example, inflammation is one of the underlying factors in periodontal disease and saturated fat is known for being associated with inflammation. Studies have also found that high-dietary saturated fat intake is associated with greater numbers of periodontal disease events. So a diet of animal fat and protein that leads to high cholesterol and coronary heart disease may also contribute to periodontitis.”

Health counselling

Dr Voronina would also like to see more caution around promoting the consumption of dairy products by dentists. Common wisdom suggests three serves of dairy a day—a glass of milk, a slice of cheese and a tub of yoghurt. 

“Dairy-specific effects have been noted by researchers, and some of those include altered age of sexual maturity, fibroids, osteoporosis, as well as oestrogen and IGF-1 related breast cancers and prostate cancers,” she says. “Essentially, we’re recommending that patients drink milk for its calcium content but ignoring the disease-causing factors of the food. Why recommend dairy if we can get calcium from very healthy sources such as kale and broccoli?”

Dr Voronina is passionate about counselling her patients on overall health and dentistry. She is committed to giving patients access to lifestyle changing information and not—as she says—just putting “bandaids on bullet wounds”. While the response from patients is mixed, it’s also overwhelmingly positive.

“I spoke to one diabetic patient about his teeth and the role of sugar in his diet,” she says. “He undertook further research and changed to a whole food plant-based diet. He’s lost weight and his endocrinologist has taken him off his diabetes and hypertension medications. His cholesterol levels have normalised and his eyesight has improved. To some this is a miracle; to me this is evidence-based, responsible medicine. When we have evidence that works, I believe dentists are ethically compelled to be more proactive and counsel patients on their nutrition.”

Reduce, reuse, recycle

Minimising waste and keeping dangerous products and chemicals out of our environment is a concern of many dental practices. While amalgam retention is commonplace and easy to retrofit, it is possible to go much further in reducing waste. 

“I’m certainly no expert on this but we’re constantly introducing changes and implementing new practices,” says Dr Voronina. “Dental surgeries tend to use a lot of barrier plastics but it doesn’t have to be that way. Surface disinfectants do just as good a job and for general examinations, there are autoclaveable and reusable stainless steel cassettes that will help reduce the amount of waste going to landfill.

Dr Voronina’s practice is practically paperless by using email and online resources. Instead of washing instruments under a running tap, they are soaked in a specialised basket. Single-use items are used as minimally as possible. As Dr Voronina says, “Disposables might be convenient but at what cost to the future of our planet and generations to come?” To keep the staff healthy and their morale up, lunch is cooked in-house rather than everyone running out to buy takeaway food.

Impact on staff

So how does ethical, sustainable business practices affect staff? Do staff members accept the fact that things are done differently and embrace the change? Does it have a positive impact on them?

“No question about it,” says Neil MacGuffie, practice manager at Dr Helen’s Dental & Implant Studio. “I find that interactions between staff are more meaningful than previous experiences. When you get a group of people together who share a passion, the conversations are very rewarding. There is a great sense of camaraderie between our staff members.

A lot of business owners simply can’t be bothered to adopt a new environmentally friendly way of doing business. But dentists are educated people so I say to them, ‘Open your eyes, look at the bigger picture and look at the condition of the planet’.

Dr Helen Voronina, owner, Dr Helen’s Dental & Implant Studio

“And it’s not just staff that benefit; it’s our patients, too. Working in a highly considerate environment translates to a greater level of consideration and understanding. I found that I quickly became attuned to patients’ needs and expectations, and to any apprehension they might be experiencing.”

Animal products

Animal welfare is one area where Dr Voronina is very passionate. While she sees the consumption of animal protein as unacceptable for health reasons, she believes the use of animals for medical research is ethically indefensible. 

“We take it as a given that animals have to be sacrificed for the good of medicine but when we look closer, many animal models are hardly relevant in humans,” she says. “Animals have different metabolisms that are not easily translatable to human medicine. Additionally, many animal studies give false positives and false negatives.

“We might feel powerless as practitioners in changing ingrained practices overnight but we have to redefine how we think about the ethical treatment of animals in medical experiments. With the technology that’s now available, more effort could be directed towards relevant and scientifically sound non-animal models in the future.”

While it may be easy to say there are no downsides to an ethical practice, that is simply not true. We are creatures of habit and implementing change is never easy. There can be resistance and a desire for things to stay the same. However, once the change is made, it quickly becomes the new norm.

“By implementing small changes over a period of time, we’ve encountered little resistance,” says MacGuffie. “When those changes result in positive, tangible outcomes, the adoption of those practices quickly become habitual. In my personal life, I try to reduce my environmental footprint and make ethical choices. To work alongside professionals with shared values and principles is fantastic. I doubt I could work for an employer whose ethics didn’t align with mine.”

Big picture thinking

The spread of ethical and sustainable dental practices is slowly increasing. They may not be the norm yet but as consumers demand more of their health professionals, it’s a given that things will keep changing.

“A lot of business owners simply can’t be bothered to adopt a new environmentally friendly way of doing business,” says Dr Voronina. “But dentists are educated people so I say to them, ‘Open your eyes, look at the bigger picture and look at the condition of the planet’. I read a study that shows how humans respond very quickly to fast moving threats. However, we don’t tend to perceive a slow coming threat, such as environmental change, so we tend to disregard it.

“Not only are we in a profession that’s regarded as caring and compassionate but we’re also in a leadership position where we can implement changes. Look at the research, look at what the scientists are telling us—the planet is in a very volatile state and it’s desperate. The economy, politics, society and humankind will all collapse if we haven’t sustained the environment.

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