ADC2025 speaker spotlight: A/Prof. Ramesh Balasubramaniam OAM

An oral medicine specialist with expertise in temporomandibular disorders, orofacial pain and dental sleep medicine, Associate Professor Ramesh Balasubramaniam OAM is the discipline lead in Oral Medicine at the University of Western Australia Dental School and is actively involved in teaching and research. Ramesh has numerous peer-reviewed publications to his credit, in addition to co-authoring several chapters, and co-editing and co-authoring three books, notably Contemporary Oral Medicine. In addition, he has lectured around the world, and serves as a reviewer for several peer-reviewed journals. He also has public appointments at the Oral Health Centre of Western Australia and the Perth Children’s Hospital.

What kind of subject matter will you be covering at ADC2025? How did you choose it and how will you be presenting it?

I’m involved in a pre-Congress, hands-on workshop, along with two other colleagues, on how to carry out what is known as the brief diagnostic criteria for temporomandibular disorder (TMD), so you can very quickly come up with a working diagnosis and also implement a preliminary treatment plan which does not require an elaborate history examination-taking process. I will also be giving a lecture on occlusal splints for temporomandibular disorders and sleep bruxism on the Friday, which will be a lecture, similar to the one I gave at the last ADA Congress in Perth, in 2009, and that was very well received. I vividly remember there was only standing room in that one, particularly!

I’ll be convening a symposium on dental sleep medicine titled Controversies in Dental Sleep and I will also give a small talk on the relationship between sleep bruxism and obstructive sleep apnoea. In addition, there will be orthodontists speaking on tongue ties and migraine expansion, and there will be a topic on oral appliances. Then the last lecture, which is on the Saturday afternoon, will be titled Predict and Prevent Post-Implant Therapy Pain – an interesting topic, essentially going beyond the biological aspects of how we assess patients, to figure out which cases are likely to develop post-implant pain, even weeks and months later after that initial inflammatory response should have healed. If the patient now presents with a persistent pain, I’m going to discuss in this particular lecture is how to predict who these patients might be, how to diagnose them and essentially how to match them, which is quite a challenging and interesting area.

Your career has taken you into the educational but also the innovation/invention spheres. Tell us about that?

I’ve got five values that essentially define what’s important to me, that govern how I run my practices and how I treat my patients and my colleagues: excellence, dedication, empathy, integrity, and innovation. Now, over the years, I’m always constantly thinking, perhaps overthinking: how can I make this better? How could this be simpler? In the last couple of decades, I’ve had various attempts at apps, telehealth, and perhaps the most recent invention/innovation is this oral healthcare product called Periogold gel. It is made out of botanical ingredients, namely micro-encapsulated curcumin, aloe vera, and elderberry, the purpose of which is to act as an anti-inflammatory, antioxidant, and antibacterial for oral inflammatory conditions, gingivitis, periodontitis, and more.

What are you most looking forward to at ADC2025? Or what is the most important part of it for you?

I’ve been to almost every Australian Dental Congress over the past 15 or 20 years. I always look forward to catching up with friends, dental school buddies, classmates, colleagues and some of my referrers. Interestingly, I get referrals from a wide demographic of dentists of various ages, and it’s nice to reconnect and meet new referrers: for example, overseas-trained dentists who have now qualified in Australia. Most importantly, I like seeing the dental community come together. In healthcare, some groups are very cohesive; others, not so much. I think being part of the Australian Dental Association is critical: taking part, showing up and supporting. Only those who’ve ever organised conferences would truly appreciate the time, effort and cost. It’s always nice, when we Perth practitioners so often fly to Sydney, Melbourne, etc, to have the dental community come and support us likewise. Rather than say, “What’s the ADA doing for you?”, for us I think, we ask, “What are we doing for the ADA, and what are we doing for each other?”

What do you think (or hope) the future holds for Australian dentistry more generally?

I think the future of Australian dentistry is bright. I recognise the challenges: third parties, for want of a better word, sticking their tentacles into dentistry.

I also recognise the financial pressures that young dentists now face. One of my concerns is the cost of studying dentistry. If you want to do dentistry, go into a post-graduate dental program after you’ve completed undergraduate degree which has already chipped away at your study aid, and then you go on and do dentistry which can cost $400,000 at some universities… then you work a couple of years and perhaps you fall in love with an aspect of dentistry and decide to specialise, whether it be endodontics, oral medicine, orthodontics.

What is unfortunate is over the last few years, I’ve had excellent candidates pull out after accepting a position, citing as a reason the cost. Completing a training program in oral medicine, for example, at UWA now, that’s over $150,000 in fees over the three years, not including the loss of income from having to study full-time. If you’re fortunate, you will do Saturday private practice, low-income type job, otherwise, and of course there’s the cost of living. Students are getting more mature these days than 20 years ago, so many are married with young families and have responsibilities and mortgages.

What would be your best advice for students or recent graduates?

Three things. I think it’s important to stay humble: when you first graduate it feels like you know a lot, but if you feel that you don’t know a lot, that’s not a bad thing. If you stay humble, you know your limitations, you know what you need to learn and you’re going to go out there and learn. If you ever feel, ‘Wow, I’ve learned everything’, that’s a red flag. Not many days go by where I don’t learn. This is the Information Age, and if you blink, you’ll be missing out on a barrage of information since the knowledge cycle is going at such a rapid pace.

Secondly, while you’re a student and when you graduate, you should find an excellent mentor. It will be priceless. A great mentor is able to support you, be patient, understand the steps required and hopefully has strong values that can essentially make a mark on your own dental career, to pave the way in which you conduct yourself as a professional.

Thirdly? Don’t forget to have fun. One thing that has recently happened in society is individuals in various vocational careers tend to change jobs, jump practices,and move very rapidly. Now, I’m not here to say whether that’s good or bad, but I will suggest that dentistry is a marathon, and it’s so important that you enjoy your dentistry. If there’s a particular part of dentistry that you simply don’t enjoy, I remind you there’s something called oral pathology: you can get paid looking under a microscope. There’s oral radiology: you can get paid sitting in a dark room by yourself looking at a computer screen. There’s research. There’s an academic opportunity, you can get into hospital dentistry, there are parts out there for every individual to find what really resonates with you. The first few years are always going to be a bit tough, but if you can find that aspect of dentistry that really appeals to you – general dentistry, family dentistry, aesthetic dentistry, whatever it is – then you do it well. Choose that one thing, focus on it and do it very well.