Oral Hygiene February 2013

oralhygiene February 2013

Practice essential PATIENT RETENTION Hygiene EXAM MANAGEMENT What HYGIENISTS contribute Eliminating, reducing the RISK OF DENTAL CARIES INFECTION CONTROL Q&A

CANADA’S

Toothfairy program Promoting childrens’ oral health care

www.oralhealthgroup.com

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oralhygiene CONTENTS

FEATURES Promoting children’s oral health in Canada and abroad

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Fern Ingber, Med

Practice essentialpatient retention

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Debra Engelhardt-Nash

Infection control Q&A Nancy Andrews, RDH, BS

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Eliminating and reducing the risk of dental caries

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What hygienists contribute

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Jenny de St. George

Hygiene exam management — Critical system for success

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Lisa Philp, RDH, CMC

DEPARTMENTS Editorial News Dental Marketplace

Editorial Board Members Lisa Philp | Jennifer de St. Georges Annick Ducharme | Beth Thompson

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12 On the Cover: Canada’s Toothfairy Program Promoting childrens’ oral health care.

Illustrations from thinkstockphotos.com compiled by Andrea Smith

February 2013

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www.oralhealthgroup.com

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EDITORIAL

Be Inspirational Who do you think you are and who are you, really?

What do others think of you? Would you be surprised, taken aback, dumbstruck to find out?

Perception and reality

Develop your personal brand…Let people get to know you, your core story of experiences and how they relate to your drive • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e B e

and vision.

Stand for something…position yourself as a strong thought leader. Women tend to distrust powerful women, and men may view women as weak or too collaborative and sensitive. Don’t be afraid to take a stand.

You don’t gain respect by telling people to respect you.

Before you can define who you are, you have to understand who you are.

transparent. passionate. one-faced. honest, no matter the consequence. responsible for your actions. a bit of a perfectionist. adaptable and compatible. Be compassionate. driven and ambitious. patient and forgiving. loyal to friends, loved ones and colleagues. impartial and fair. Be discreet and dependable. conscientious. Do what you say you’re going to do. dutiful, precise, persistent and meticulous. optimistic, enthusiastic, keen and fearless. encouraging and exuberant. Be humble and helpful. open to change; be expressive. attentive to others. Be polished and worldly. self-reliant and self-disciplined. exacting and respect schedules. detail-oriented and embrace order. sympathetic and empathetic and put people at ease. scrupulous and principled. exploratory and curious. Be decisive and confident. professional and self-monitoring. lenient and magnanimous. a good fit. free of clichés and buzzwords. a great listener and a better communicator. Be studious. convincing, conceptual and task-oriented. a problem-solver. an encourager. a builder. there for others. Be constant. unpretentious, be engaging, be empowering. genuine, be self-aware. able to leverage other’s strengths. efficient, be excuse-free. committed to continuous improvement. filled with integrity.

BS-free.

Talk is cheap and meaningless. Walk the walk.

As I said at the top, it’s all about percep-

Catherine Wilson Editor

tion and reality. Who do you think you are and who are you, really? n

February 2013

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www.oralhealthgroup.com

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NEWS BRIEFS

Germs Spread Fast at Work, Study Finds When someone comes to work sick, about half of the commonly touched surfaces in the office will become infected with the virus by lunchtime, according to a new study at the University of Arizona.

The study finds that more than half of commonly touched surfaces in an office — like doorknobs, copy machine buttons, the office refrigerator — can become infected with a virus when a single person in the office is ill.

Some of the likeliest germ hotspots include the coffee pot handle in the break room, telephones, desktops and tabletops.

“We really felt that the hand was quicker than the sneeze in the spread of disease,” said Charles Gerba, UA professor of soil, water and environmental science and co-principal investigator on the study.

Premier Dental Products Company, founded in 1913 by instrument maker Julius Charlestein, is celebrating its 100th anniversary. Premier established a Canadian presence in the 1980s, headed by the late Charlie Hunt. Today, the family-operated business is in its 4th generation serving dentists in over 75 countries, and is growing most rapidly in Canada. www.premusa.com

European Commission Tries Closing Door On Product Descriptors

In 2012, the IdentAlloy/IdentCeram Council fulfilled a record 18.6 million requests for the certificates used by restorative material manufacturers to verify the content of their products for labs, dentists, patients and insurers.

“Several factors are driving demand,” says Charles Yenkner, Executive Director for the Council. “Dentists continue to see the certificates as an easy way to underscore their professionalism. Labs and manufacturers use them to attest to their own commitment to quality and thereby gain competitive advantage over rivals not providing the verification.”

European consumers could be plunged further into the dark as foods and beverages stand to lose hundreds of commonly recognized descriptors. The outcome of a European Commission (EC) consultation could see an end to categorizing descriptors such as ‘digestif’, ‘cough drops’, ‘tonic water’ and ‘digestive biscuit’, under the controversial EU Nutrition and Health Claims Regulation (NHCR).

The Alliance for Natural Health International described the EC’s proposals on generic descriptors as “preposterous” and “absurd”.

Art Direction: Andrea M. Smith Production Manager: Phyllis Wright Circulation: Cindi Holder Advertising Services: Karen Samuels 416-510-5190 karens@bizinfogroup.ca Consumer Ad Sales: Barb Lebo 905-709-2272 barblebo@rogers.com

February 2013

Celebrating a Century of Success

Demand for Restorative Material Verification Hits New High

A BUSINESS INFORMATION GROUP PUBLICATION Classified Advertising: Editorial Director: Karen Shaw Catherine Wilson 416-510-6770 416-510-6785 kshaw@oralhealthgroup.com cwilson@oralhealthgroup.com

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“It’s very gratifying to see industry leaders and start-ups alike embracing a program of voluntary, self-regulation,” said Stuart Steinbock, VP of Whip Mix and President of the IdentAlloy/IdentCeram Council. “It’s helping improve both the quality and efficiency of dental healthcare, and at no cost to the labs and dentists receiving the certificates.” www.IdentAlloy.org

Dental Group Assistant: Kahaliah Richards 416-510-6777 krichards@oralhealthgroup.com Associate Publisher: Hasina Ahmed 416-510-6765 hahmed@oralhealthgroup.com Senior Publisher: Melissa Summerfield 416-510-6781 msummerfield@oralhealthgroup.com

Vice President/Canadian Publishing: Account Manager: Alex Papanou Tony Burgaretta 416-510-6852 President/Business Information Group: tburgaretta@oralhealthgroup.com Bruce Creighton

OFFICES Head Office: 80 Valleybrook Drive, Toronto ON M3B 2S9. Telephone 416-4425600, Fax 416-510-5140.

Oral Hygiene serves dental hygienists across Canada. The editorial environment speaks to hygienists as professionals, helping them build and develop clinical skills, master new products and technologies and increase their productivity and effectiveness as key members of the dental team. Articles focus on topics of interest to the hygienist, including education, communication, prevention and treatment modalities. Please address all submissions to: The Editor, Oral Hygiene, 80 Valleybrook Drive, Toronto, ON M3B 2S9.

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ORAL HYGIENE Fern Ingber, MEd

Founding President and CEO of the National Children’s Oral Health Foundation: America’s ToothFairy/Canada’s Toothfairy® (NCOHF).

NCOHF was established in 2006 in the U.S. by a group of concerned dental professionals to address the nation’s most common chronic childhood illness — pediatric dental disease.

NCOHF has delivered over $11 million in financial and product support to non-profit community oral health programs. Now extending services in Canada as Canada’s ToothFairy, National Children’s Oral Health Foundation is reaching children throughout North America.

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Promoting Children’s Oral Health in Canada and Abroad

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reated especially for dental hygienists, the Esther Wilkins International Education Program (EWIEP) is an innovative program from National Children’s Oral Health Foundation of Canada: Canada’s ToothFairy ® (NCOHF) supporting the outreach efforts of dental professionals in the fight against pediatric dental disease. Established with a founding gift from Dr. Esther Wilkins, a revered and internationally recognized icon in oral health, this program provides dental hygiene professionals and students with community education kits to promote good oral health practices among children, parents and caregivers.

Formed in the U.S. in 2006, as a collaborative effort of clinicians, academicians and corporate leaders, National Children’s Oral Health Foundation® (NCOHF) is dedicated to eliminating children’s preventable suffering from pediatric dental disease by providing programs and comprehensive resources to deliver community-based critical preventive, educational and treatment services.

Recognizing the mouth is the gateway to the body, NCOHF, also known as America’s ToothFairy ® in the U.S., supports the deliv-

ery of oral health education and care beginning at the prenatal level. Now extending services in Canada as Canada’s ToothFairy, National Children’s Oral Health Foundation is reaching children throughout North America.

With a growing Affiliate network of exemplary non-profit community programs, the Kids Club, professional and student service programs, NCOHF: America’s ToothFairy/ Canada’s ToothFairy is creating a powerful, united effort to eliminate tooth decay and protect the smiles of our most vulnerable children.

Chaired by Michele Darby, BSDH, MS, Maria Perno Goldie, RDH, MS, Anna Pattison, RDH, MS and Rebecca Wilder, RDH, MS, the Esther Wilkins International Education Program has attracted volunteers throughout the U.S., Canada and military bases throughout the world. In addition to the Cambrian College Dental Hygiene Program in Sudbury, Ontario, a majority of the dental hygiene schools in the U.S. are also participating in the program.

Every dental hygienist can embrace this smile-saving cause as members of the Esther

February 2013 www.oralhealthgroup.com

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ORAL HYGIENE A program volunteer teaches children about the decay process using the materials she received through the Esther Wilkins International Education Program

A boy learns about making healthy snack choices during a presentation by a program volunteer

Wilkins Legacy League. The Esther Wilkins Legacy League unites dental hygienists through a variety of special activities and social media in their common mission to prevent dental disease and honors their role as community oral health educators and prevention specialists. Esther Wilkins Legacy League members will serve as the driving force for ongoing oral health promotion efforts conducted by the Esther Wilkins International Education Program volunteers.

Aligning with this mission, Esther Wilkins International Education Program volunteers are supplied with NCOHF Community Education Kits that include basic nutrition information and prevention strategies appropriate for prenatal through young adult learning levels.

Dental hygienists and students are using their Community Education Kits at home and on mission trips abroad to promote good oral health habits for thousands of children around the globe. In addition to helping promote positive oral health behaviours for children and their families in Sudbury, Ontario, students in Cambrian College’s Dental Hygiene program helped children beyond Cana-

Dental hygiene students use the Community Education Kit to encourage good oral health behaviors for children in their community.

da’s borders on a trip to Vietnam.

The Vietnam mission was led by Nancy Rose, RDH, a dental hygienist with 23 years of experience and first-year Lead Clinical Professor for the Dental Hygiene program at Cambrian College and Cindy Wing, CDA, Coordinator of the Dental Assisting program. The two professors and 10 students travelled to the hill tribe villages near Sapa, Vietnam. The students used their Community Education Kits to provide oral health education for over 600 children ages 4-12.

Visiting five elementary schools and an orphanage on their journey, the professors and their students appreciated having engaging tools and lesson materials that encouraged participation from the children and reinforced good oral health behaviors. “We are so grateful for these educational materials from National Children’s Oral Health Foundation of Canada: Canada’s ToothFairy,” remarked Nancy. “The kits that we received through the Esther Wilkins International Education Program provided a variety of comprehensive resources for sharing important oral health messages with children and their families.”

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ORAL HYGIENE

I would absolutely recommend this program to volunteer dental hygienists as well as professors and students in dental hygiene programs in Canada who want to volunteer in their community or abroad Reinforcing the value and the growing need for programs supporting oral health education, Nancy went on to say, “National Children’s Oral Health Foundation of Canada: Canada’s ToothFairy and the Esther Wilkins International Education Program are important programs because they support oral health promotion initiatives that have significant impact in our communities.”

Through the Esther Wilkins International Education Program, volunteer dental hygiene professionals and students can take the lead in breaking the vicious cycle of pediatric dental disease by providing children and their caregivers with the knowledge they need to maintain beautiful, healthy smiles for a lifetime. Expressing her support, Nancy stated, “I would absolutely recommend this program to volunteer dental

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hygienists as well as professors and students in dental hygiene programs in Canada who want to volunteer in their community or abroad. I’m sure that every accredited dental hygiene school has community outreach activities in their curriculum and would definitely benefit by providing students with valuable resources like the Community Education Kit.” Volunteer dental hygienists and students are now reaching thousands of children with preventive strategies and education through this smile-saving program. However, without continued support from dental hygiene professionals, the number of children being helped will diminish, leaving countless children victim to childhood tooth decay and the pain and shame associated with oral disease.

Now, dental hygienists have an opportunity to join Dr. Wilkins and help support the great work of Nancy, her students and colleagues as members of the Esther Wilkins Legacy League! As a member of the Esther Wilkins Legacy League, your donation will go directly to providing valuable educational tools to promote prevention and good oral health behavior. Esther Wilkins Legacy League members will also be eligible for special drawings for Orascoptic® loupes and other prizes!

Make your difference and your Esther Wilkins Legacy League donation today at www.CanadasToothFairy.org! n Fern Ingber’s email address: fingber@ncohf.org

February 2013 www.oralhealthgroup.com

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1. Burwell A, et al. J Clin Dent. 2010;21(Spec Iss):66–71. 2. LaTorre G, et al. J Clin Dent. 2010;21(3):72–76. 3. West NX, et al. J Clin Dent. 2011;22(Spec Iss):82–89.

4. Earl J, et al. J Clin Dent. 2011;22(Spec Iss):62–67. 5. Efflant SE, et al. J Mater Sci Mater Med. 2002;26(6):557–565. 6. Parkinson C, et al. J Clin Dent. 2011;22 (Spec Iss):74–81. 7. Earl J, et al. J Clin Dent. 2011;22(Spec Iss):68–73. 8. Wang Z, et al. J Dent. 2010;38:400−410.

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ORAL HYGIENE Debra Engelhardt-Nash

Founding member of and served two terms as President of the National Academy of Dental Management Consultants, where she currently serves as member-at-large.

She is an active member of the American Dental Assistants Association.

Debra can be emailed at: rdnash@aol.com

Practice Essential-Patient Retention M

ost conversations about practice growth would have acquiring new patients right at the top of their list of things to do. For established practices, one of the vital keys to grow the practice is to keep hold of existing clients. What is the point of acquiring more new patients if the practice can’t hold onto existing ones?

Building and focusing on keeping your clients can be a significant way to grow your practice and save marketing dollars. According to Frederick Reichheld of Bain and Company: Studies have shown it is 6 to 7 times more expensive to acquire a new customer than it is to retain a current customer and As little as a 5% increase in customer retention can increase profits by 25 to 95%.

Why do Customers (patients) Leave?

According to work done at the American Society of Quality Control, the main reasons customers leave or stop doing business are: the following: 1% Die; 3% Move to another area; 5% Influenced by friends or contacts to go elsewhere; 9% Lured away by competition; 14% Don’t stay because they are disappointed with product or service; 68% Because of an attitude of indifference to them.

Further, research by RightNow Technolo-

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gies indicates that there is a marked difference between the reasons that companies think customers leave and what their customers actually think.

According to their study, 73% of customers leave a business (your practice) because of a lack of customer service, while most companies view that it is 21% of the reason they lose the client.

If these findings are true they have major implications for your practice. They suggest that loss of clients is not about how good your product or service is or how competitive your fees are in the industry but rather it’s more about how you treat your clients and how much you care about them.

These implications fall into areas that may need focus: • C ustomer service involves everyone on the team; • Your relationship strategies with patients may need refreshing; • Taking more time with patients during their visits.

Do you want to Improve the Retention of Your Clients?

Here are a few steps to get you started: Focus on relationship during the patient visit.

The bulk of the conversation is about the patient — who they are, what they are looking for and how the practice may meet their expectations in a highly personalized way. Office protocols can wait. Patients will be more likely to comfortably comply with practice

February 2013 www.oralhealthgroup.com

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ORAL HYGIENE thinkstockphotos.com

Building and focusing on keeping your clients can be a significant way to grow your practice and save marketing dollars systems when they feel listened to and cared about. Appeal to the human side of doing business with the patient, and your office standards will be more inviting.

Spend more time with patients during the Recare Visit. Many practices consider a large quantity of recare patients seen in a day a mark of success, and the less time required to treat returning patients a sign of efficiency.

But further review may reveal that these patients are not referring friends and family or moving forward with treatment needs that have been planned.

Introducing treatment possibilities during the recare visit should not happen occasionally but should occur consistently.

Give the patient something to talk about.

Find opportunities to update the patient by telling them about recent treatment techniques and technologies that have been incorporated into patient care. Describe how these will enhance their experience and the results of their treatment in the office. Have you recently incorporated Velscope Screenings, the Inman Aligner or Invisalign? Do you have a new dental lab that you are working with and excited about the results of their work? Let your patients know. They may pass the good news onto friends.

These steps may require Systems Review and Team Training. Be certain your team understands its critical role in gaining patient loyalty and treatment acceptance. Ensure you have enough time to do this properly by scheduling appropriate captive appointments

that allow the correct time to treat the patient exceptionally well.

The Recall Renewal Exam Patient familiarity can often lead to making inaccurate assumptions about patients’ interest in treatment. A history with certain patients may create bias in presenting treatment options, and prevent the dental team from discussing elective treatment options with the same zeal and conviction applied to new patients. Some offices review the hygiene patients’ charts for the day with a “been there, done that” attitude. The doctor and hygienist may be internalizing that they know these patients would not be interested in cosmetic treatment, or a review of an updated comprehensive treatment plan. They may even be afraid of offending long term patients if they emphasize outstanding treatment needs or introduce updated techniques and materials.

If patients are not informed of the treatment options now offered, they will never choose these procedures.

Time must be allowed to renew patients’ interest in recommended treatment and introduction to new treament possibilities. This is an important role of the dental hygienist. In fact it is a critical responsibility of every team member.

Professional dental associations recommend that patients’ radiographs are renewed every three to five years. This would also be a good time to renew the patients’ hygiene experience. At this visit, practice philosophy is

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ORAL HYGIENE

reviewed. Patients are reminded of new treatment modalities that have been incorporated into their care.

New baseline data is gathered and treatment plans are discussed utilizing visual aids.

The conversations may go something like this: “Mr. Benson, you have been a patient here since 1997 — can you believe it? Thank you for your loyalty. This is what we have done since then. It’s time to gather new baseline information, so today we are going to proceed as though you were new to the practice.

We are going to review where you are now and talk about how we are going to proceed with your future goals.”

Being excited about treatment possibilities transmits to patients. The dental team must convey its zeal for the practice. Praising the doctor and exhibiting enthusiasm for what the treatment plan can offer the patient in dental health and appearance translates to the patient. When the staff is genuinely excited about the office, and apparently proud of the doctor’s care, it captures the patient’s interest. Patients like to be surrounded by a team of professionals that exude confidence and show interest in their care. The enthusiasm of the team captivates the patient.

The Recall Renewal examination is an appropriate time to rejuvenate the relationship between the patient and the practice.

Recall Return Rate A healthy general practice maintains a minimum 80 percent recall return rate. This means that 80% of patients seen within the past two years are coming back for care. Reviewing the office recall return rate can determine the health of the hygiene department.

Calculate the number of available hygiene appointments throughtout the year. Since patients are seen at least twice a year, divide the available appointments by two for the approximate number of patients that can be seen. Example: Two hygienists seeing eight patients per day during a four day work week 50 weeks annually (200 days per year) equals 3,200 available hygiene appointments. If the of-

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fice has 2,000 active patients, the practice has an eighty percent recall return rate. But, if this number is too low, the office may strategize how to increase hygiene appointment availability. Some of the options may be adding hygiene time, developing an assisted hygiene protocol to increase appointment effectveness, or referring more treatment to a specialist.

It is important to ensure that the practice has the capacity to serve the majority of active patients of record in addtion to availabillity to serve new patients in a timely fashion.

This is where restorative care will be discovered and fill the doctor’s schedule.

Knowing the practice recall return rate is key in determining if the majority of patients are being utilized to fill the practice schedule, or if the practice is recycyling and relying on a smaller majority of patients to keep hygiene and doctor busy.

For patients who have fallen out of their recall cycle, they may be contacted innovatively through text or email reminders. Companies such as Smile Reminder, Sesame and Demand Force provide this service to dental practices. Patients are more likely to respond to these methods of contact due to its ease of communication.

The Results of Improving Your Retention

More business — listening learning and paying attention will get better response rates from your patients.

Increased patient loyalty — once you establish a stronger relationship with your clients, you can develop a partner like relationship.

At that stage, you’ll be able to meet and exceed their expectations. The deeper the realtionahip, the more they wlll appreciate your relationahip with them and the less likely they will be to move their records elsewhere.

They will also be more likely to refer.

Teams that are excited about the prospect of serving others seem to have many patients seek their help. Those who focus on enriching patient relations will assuredly find practice success. n

February 2013 www.oralhealthgroup.com

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INFECTION CONTROL

Infection Control: Q&A Q: A:

We are wondering which way to place sterilization bags into the auto clave... plastic side up or plastic side down? — Terri Mee Terri, your question is one that confuses many people! First, if you have racks and can stack the pouches on their sides (plastic touching paper, all facing the same direction) this is the best.

For those who lay the pouches down, the answer depends on the direction of steam flow in your sterilization chamber. If you have a gravity steam sterilizer the steam will rise inside the pouches. If the plastic side is up it traps the steam: condensation collects inside the pouch under the plastic and drips down on the instruments. So, for gravity steam sterilizers, place the paper up so the steam will escape and dry better.

If you have a vacuum sterilizer, the vacuum directs the steam downward to vent. For those models place the paper down, plastic up.

Q:

We are concerned about the environmental impact of plastic barriers. However, we are more concerned with patient safety. Our local dental hygiene program has recently discontinued use of all plastic barriers. We cannot find any definitive information on whether or not to use barriers, or just to use approved wipes.

Please help! — Jacqueline (IN)

A:

Jacqueline, your question about the environmental impact of surface barriers is a growing concern among

many members of the dental community. The worldwide issue of environmental protection should, in my opinion, be at the top of everyone’s list of challenges. At the same time, patient protection is a requirement of our role as clinicians, and many of us are confronting ways to better balance these two goals. Unfortunately information that helps us compare the overall environmental impact of using barriers vs. using chemical disinfectants is not readily available.

As you said, the other issue is reliable infection control. Research comparing surface disinfection vs. using new barriers for each patient shows that if both methods are used correctly, they provide similar reliability.

Therefore, each office must optimize factors such as time efficiency, patient preferences, cost of supplies, storage and waste management. Most offices use barriers on a few complex surfaces that take more time to clean and disinfect. Barriers improve time efficiency and are believed to reduce human error resulting from time and technique limitations. The barriers are visible and communicate asepsis to patients, which may be positively viewed by them, or in some cultures may be seen as wasteful use of plastic.

The bottom line is that there is no compelling science to support either barriers or disinfectants as superior: both are equally effective and neither is clearly more environmentally “green” than the other.

If recyclable barriers can be used and recycled from dental offices, barriers might offer a more sustainable option than chemicals.

Nancy Andrews, RDH, BS

Ms. Andrews graduated from, and was a clinical instructor in Dental Hygiene at the University of Southern California and teaches Oral Pathology, Preventive Dentistry and Infection Control at West Coast University Dept. of Dental Hygiene. She is a speaker, author and consultant, focusing on infectious diseases, clinical safety, instrument sharpening, ergonomics and preventive dentistry. Contact TotalCare online at TotalCareProtects. com or email questions to CE@TotalCare Protects.com

Continued on page 29

February 2013

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ORAL HYGIENE

Eliminating and Reducing the Risk of Dental Caries Editor’s Note:

As I prepared for this issue of Oral Hygiene, I scanned the internet to see how hygiene was being practiced around the world.

During my web travels, I came across a technique commonly used in Europe to combat caries by reducing bacteria in the oral cavity. While this technique is not standard practice in North America at this time, I did want to leave you with a thought-provoking concept that someday may become the standard of care here in Canada.

CW

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T

he oral cavity is filled with bacteria, some of which is beneficial to our health and some harmful. Bacteria infiltration can occur in natural dentition and surrounding and under restorations when bacteria adhere to hard-to-reach areas that are not easily accessible for cleaning (i.e., lesions, pits, or fissures on the surface of, or inside teeth).

These changes compromise the integrity of the tooth. Destructive bacteria (i.e., Streptococcus mutans, Streptococcus sobrinus, and Lactobacilli) are a pathologic factor for caries and disease pertaining to natural teeth or those treating restoratively, namely implants, crowns and bridges.

Caries is a widespread problem affecting individuals of all ages, including the young and elderly, as well as those classified as high risk caries patients (i.e. individuals with high plaque levels or a genetic predisposition).1 Patients with open dentin tubules, gingivitis, and xerostomia are also at an increased risk for caries.

Eighty percent of all cavities occur in hardto-reach areas of the mouth, and the presence of cavities and/or recurrent decay destroys teeth. While professional dental cleanings and the proper oral hygiene methods of brushing and flossing are extremely beneficial, they are rendered insufficient in these particular areas. 2 Over the years there have been many preventive measures taken to reduce or eliminate dental caries risk factors, all of which are associated with reducing the amount of

plaque in the oral cavity. One of the leading preventive measures—and arguably the most effective—has been the use of fluoride as an added ingredient in some toothpastes and table salts. The most successful usage of fluoride has been government mandated public water fluoridation programs, which began in 1945 as part of a clinical trial that proved its effectiveness. 3 Water fluoridation has been an effective way to reach and help provide cavity protection in individuals of all ages and socioeconomic statuses.4 Scientific research supports the usage of water fluoridation as a way to decrease caries prevalence in both adults and children. Another effective preventive measure has been re-mineralization of natural teeth by restoring healthy levels of calcium, phosphate, and fluoride.4 Another longstanding precautionary method — public oral health education — is the first line of defense in caries prevention. An additional component to oral health education is outlining the benefits of a healthy diet low in simple carbohydrates, sugars, and acid, 5 as well as incorporating functional foods into the diet, such as green tea, apples, and milk.

Further, chewing gum containing xylitol is also recommended. Chewing gum with xylitol increases saliva function and aids in washing away sugary substances and food debris before they can stick to teeth and turn into plaque. Research indicates that extended use Continued on page 20

February 2013 www.oralhealthgroup.com

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2013 AWA R D S

Distinction

OF

Gala

SATURDAY, APRIL 6, 2013 Honouring: • Rita Bauer • Dr. Barry Sessle • Dr. Bryan Tompson In support of the Access to Care Fund The Faculty of Dentistry at the University of Toronto makes dental care possible for 15,000 patients every year. Many of them have to postpone treatment so they can care for their families — they simply cannot afford to do both.

Your support can help us change all that.

To hear our students talk about how the Access to Care Fund has impacted them and their patients, go to:

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Miriam Stephan, Manager of Alumni Relations University of Toronto, Faculty of Dentistry 416·979·4775 Miriam.Stephan@dentistry.utoronto.ca

www.utoronto.ca/dentistry/alumni

OHY Feb2013 p17 UofT AD.indd 17

13-02-05 8:33 AM

ADVERTORIAL

Array of Crosstex Products Helping Clinicians Maintain Sterility Standards Most clinicians would agree that preventive dentistry should go beyond simply screening patients for disease, but should be an all-encompassing mindset of the entire dental team. One of many measures clinicians take to prevent the spread of diseases is to keep their office, including their dental instruments, clean and sterile. Crosstex International, a company dedicated to infection prevention in the dental office, has recently acquired SPSmedical Supply Corporation, forming a partnership that the companies say will result in more dental offices having the information, as well as the products, necessary to adhere to sterility protocols.

Chuck Hughes, VP, Infection Prevention and Consulting Services at Cantel Medical, says, “The Crosstex and SPSmedical product offering is unique in that they have pioneered sterility products while improving procedures. The Sure-Check sterilization pouch with builtin external and internal multi-variable indicators, the SteamPlus Class 5 chemical indicator for use with all steam sterilization cycles, the ConFirm and PassPort mail-in sterilizer monitoring systems, and the ConFirm 10 in-office biological monitoring system are all products that help the clinician ensure that their equipment and instruments meet CDC sterility standards.”

Sterility in the dental office is not a one-step process, advises Leann Keefer, RDH, MSM, General Manager and Director of Education at Crosstex. She explains that sterility assurance is a multistep practice and involves three different levels of monitoring. “The clinician must not only consider biological monitoring, but also physical and chemical monitoring,” Keefer says. “Clinicians must understand how these three processes work together to provide the highest level of sterility assurance. Sterility assurance is a mindset that begins with the whole process of treatment. One of my favorite phrases is, ‘You can’t see sterile.’ You must use appropriate procedures to increase sterility assurance.”

Hughes points out that according to the Centers for Disease Control and Prevention (CDC) Guidelines for Infection Control in Dental Health Care Settings (2003), it is recommended that biological indicator monitoring of sterilizers should occur at least weekly and with every load that contains an implant. Moreover, the CDC Guideline for Disinfection and Sterilization in Healthcare Facilities (2008) makes the same recommendation, but adds daily testing if a sterilizer is used frequently (ie, several loads per day).

It’s not just because of CDC guidelines that clinicians are concerned with sterility assurance, Hughes suggests; it is also important to the practice, as a business, that sterility is maintained. “When the dental team is able to provide the highest level of sterility assurance, patients not only take notice but are also put at ease. Patients benefit greatly by seeing clinicians properly use infection control products in compliance with infection prevention best practices. This builds trust,

CE

and patient trust ensures dental practice success,” Hughes explains.

Crosstex goes to great lengths to ensure that its products, which Keefer points out are US-made, offer the utmost in sterility assurance. But even the best products available, she suggests, must be accompanied by proper training. “Anyone can sell an infection control product. At Crosstex we are committed to making sure that we have educational resources available to our clinicians as they need them,” she says. Crosstex’s website, in particular, serves as a valuable resource to clinicians, offering a wealth of information regarding infection control and sterilization procedures. The company also has an 800 number, a clinical consultative service, and an educated sales team that is able to discuss the proper use of the company’s products.

“We also conduct webinars, write articles, and present programs at national, state, and local meetings on infection control, and Crosstex consults with a number of clinicians to make sure all of our information is up to date and accurate,” Keefer adds.

Keefer and Hughes both emphasize that infection control products are not just commodity products—they are science-based technological products that are constantly changing and improving.

“New technologies on the horizon will focus on faster sterilization processes and more complex instrument design,” Hughes suggests. “I see dentistry moving away from gravity steam sterilizers and moving towards dynamic air-removal sterilizers, which are more efficient and will provide more effective sterilization and a faster turn-around time.”

Adds Keefer: “Keeping procedures simple and efficient leads to better compliance and gives clinicians better results. At Crosstex, we aspire to continue moving toward a simpler, more effective solution that will benefit not only our clinicians, but their patients as well.”

T C B

Crosstex International 10 Ranick Rd Hauppauge, NY 11788 888-276-7783

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Originally published in Compendium Contin Educ Dent. 2013;34(1):72. Copyright © 2013 to AEGIS Publications, LLC. All rights reserved. Reprinted with permission from the publisher.

* **

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crosstex.com | 888.276.7783

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ORAL HYGIENE

Continued from page 16

of xylitol, or chewing gum containing xylitol decreases Streptococcus mutans counts in saliva while simultaneously fostering the remineralization of early carious lesions.6 Even with all of these simple and low cost caries preventive measures, some patients still require additional protection. This can be achieved through the use of dental sealants. Dental sealants are a minimally invasive alternative for preserving teeth that is suitable for almost every patient. Research demonstrates that sealants efficiently halt the carious disease process by preventing bacteria infiltration and are far more cost-effective than restorative care. 3 However, while sealants are extremely effective, they should not be used as the sole caries preventive method or as a replacement for proper oral hygiene routines. When used in combination with these methods, dental sealants provide steadfast caries protection and dramatically decrease the risk of cavities.

Cervitec Plus

Cervitec ® Plus is a chlorhexidine varnish system applied to areas of the tooth that are highly susceptible to caries. The varnish, which is a sealant, provides a protective coat to exposed, at-risk, and sensitive tooth surfaces and effectively seals teeth from bacteria infiltration. In addition to reducing bacterial activity on dentin surfaces, Cervitec® Plus protects exposed root surfaces and treats hypersensitive cervical margins. Moreover, this varnish system aids in decreasing the number of cariogenic germs in the oral cavity.7 Cervitec ® Plus differs from other varnishes and sealants on the market because it protects natural dentition and restorations through customized oral health management.

This results in treatment plans requiring individualized solutions pertaining to the concentration, delivery form, and application of the varnish.

Patients benefit from the pleasant taste, and because it is clear, the sealant provides optimal esthetics by blending seamlessly with natural dentition. The application is fast and painless, saving time for the patient and hygienist. Furthermore, the application process is easily integrated into a treatment procedure within the dental office routine. Dental

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hygienists can apply Cervitec ® Plus directly onto the patient’s teeth with a single brush applicator.

Cervitec ® Plus is unique because of the effective combination of one percent chlorhexidine and one percent thymol. These properties enable the varnish to firmly adhere to tooth surfaces, creating a shield barrier of long-lasting protection, enhanced adhesion, and increased moisture tolerance during application. Research has shown that the antimicrobial effect of chlorhexidine varnishes protects tooth surfaces that are susceptible to caries.

The composition of Cervitec ® Plus consists of ethanol, water, acrylate copolymer, vinyl acetate copolymer, chlorhexidine diacetate, and thymol. Cervitec ® Plus is available in multi dose or single dose tubes. The multi dose tubes allow the requisite amount of varnish to be dispensed hygienically, effectively preventing the risk of cross contamination, while single dose tubes are intended for one time use.

Sample Protocol The application steps vary slightly depending on whether the case requires a single dose of cervitec® plus or a multi dose, and on which tooth areas the varnish will be applied: proximal or interproximal.

First, the tooth surfaces must be thoroughly cleaned using etchant and then meticulously rinsed off with a water syringe. Next, the tooth surfaces are dried individually with cotton rolls and an air syringe. It is important that all surfaces are completely dry.

The varnish’s adhesive properties will diminish if mixed with moisture (i.e., water or saliva). Then selected teeth should be isolated by using cotton rolls.

In the instance of cases requiring a single dose of varnish, the tinfoil should first be removed from the single dose package, and the varnish applied onto the desired tooth areas using a single brush applicator. Once used, the single dose package and brush applicator are discarded.

For multi dose purposes, the tube should be held in a vertical position with the cap facing upwards and the opening held vertically down to press out three drops of varnish into a dappen dish. The tube then should be re-

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ORAL HYGIENE

Figure 1. The Cervitec® Plus sealant is applied with a dental wand onto the dentition near the gum line where the caries risk factor is greatest.

Figure 2. For multi dose purposes, three drops of varnish are dispersed into a dappen dish.

Figure 3. For a single dose, the sealant is applied with a single brush applicator that can be discarded after use in order to prevent contamination.

sealed by holding it in a vertical position. A thin coat of varnish can then be applied to the surfaces by using an applicator with dispensing tip, or suitable brush.

For application in interproximal areas, dental floss is coated with varnish and spread onto selected regions by flossing.

The varnish is allowed to dry until it hardens, and using an air syringe to disperse air over the sealed areas speeds this process. After 30 seconds, the cotton rolls are removed.

Finally, patients are informed not to rinse their mouth until the sealant has dried and to avoid food or beverage for one hour after application.

Conclusion After more than a century of attempted prevention, dental caries still remains a significant issue for the majority of Americans.

Considerable progress has been made over the years to rectify the problem, including the development of dental sealants. When used in conjunction with a proper daily hygiene routine and professional cleanings and examinations, sealants like Cervitec® are highly effective in preventing caries development.

However, despite the progress that has been made, there is still no effective standalone method for complete caries prevention. n

REFERENCES 1. I to A, Hayashi M, Hamasaki T, Ebisu S. How regular visits and preventive programs affect onset of adult caries. J Dent Res. 2012 Jul;91(7 Suppl):52S-58S. 2. M D Siegal, C L Farquhar, J M Bouchard.

Dental Sealants. Who needs them? Public Health Rep. 1997 Mar-Apr; 112(2):98-107.

3. Zero DT, Fontana M, Martínez-Mier EA, Ferreira-Zandoná A, Ando M, GonzálezCabezas C, Bayne S. The biology, prevention, diagnosis and treatment of dental caries: scientific advances in the United States. J AM Dent Assoc. 2009 Sep;140 Suppl 1:25S-34S. 4. Lussi A, Hellwig E, Klimek J. Fluoridesmode of action and recommendations for use. Schweiz Monatsschr Zahnmed. 2012; 122(11):1030-42.

5.

Gazzani G, Daglia M, Papetti A. Food components with anticaries activity. Curr Opin Biotechnol. 2012 Apr;23(2):153-9.3 6.

Toors FA. [Chewing gum and dental health. Literature review]. Rev Belge Med Dent (1984). 1992;47(3):67-92.

7. Z hang Q, van Palenstein Helderman WH, van’t Hof MA, Truin GJ. Chlorhexidine varnish for preventing dental caries in children, adolescents and young adults: a systematic review. Eur J Oral Sci. 2006 Dec; 114(6):449-55.

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ORAL HYGIENE Jenny de St. George

Has built a strong reputation for delivering her bottom-line and logical approach to solving complex management issues, in a highly motivating and humorous manner through her speaking, articles, take-home audio programs and implementation services. Jenny has spoken at virtually every leading dental meeting in the US, Canada and UK and has a very strong global following. www.jdsg.com or email: help@jdsg.com

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What Hygienists Contribute I come to dentistry from a non-clinical background. My perspective on dental practice management has, therefore been molded differently than if I had a clinical background.

I was drafted into dentistry. I left my Fleet Street, London newspaper job many years ago and moved to NYC to work for the J. Walter Thompson ad agency. After moving to San Francisco, I held three widely diverse jobs — personal assistant to an entrepreneur, a Collection Manager for the country’s oldest mortgage company and Assistant Return Manger for California’s largest privatelyowned clothing manufacturing company. I saw my future climbing the corporate ladder.

Marriage to my former husband, two weeks

after his graduation from a California dental school changed my destiny.

We spent nine long months setting up our new practice. As the final details fell into place, I began to consider a new job in the private sector. My husband however, said. ‘I need you here to answer the phone for the first two to three weeks, until I find someone who actually knows what they’re doing!’

Blessed with a husband who did not interfere, our practice became my management lab. We worked well as a team. I never interfered in the clinical area and he never questioned me about patient and management systems. We both waited until we got home. I made every mistake in the book: from sitting

Nine Essential Concepts for a Successful Incentive Bonus Program

A

well-designed program should not cost the Doctor a penny! The productive program is designed to promote the practice growth while protecting the practice financial stability, with built-in triggers to prevent bonus being paid when goals are not met.

Bonus incentives can add fun, enjoyment and financial rewards for each team members. A wellstructured incentive bonus plan can be extremely effective in maximizing the focus of the dental team while ensuring the financial success of the practice.

The program is a wonderful, proactive way of including the hygienist in the team. The Hygiene bonus is calculated separately, yet is integrated into the team’s program to foster total team support and enthusiasm. The hygienist’s ability to increase production is enhanced, as team solidarity is increased and maintained.

The JdSG Program, (designed by Christene Bern-

hardt, retired Director of Consulting for JdSG International Inc) has nine criteria to ensure the best return on investment for all the players: 1. The plan must be simple if it is to be motivating.

Complicated calculations that most participants do not understand lead to disinterest, distrust, and confusion.

2. The overhead percent budget for staff salaries must be protected. The plan will not succeed if staff overhead increases as a result of the bonus.

3. Production, collections, and staff salaries must be in proper relationship before bonus dollars can be paid. In other words, production and collections must be high enough that when the guaranteed salaries are paid, additional dollars will be available for bonuses without increasing the percent budgeted for staff overhead. The staff must be educated that the bonus is earned, not given.

4. The plan must be based on short term goals to

February 2013 www.oralhealthgroup.com

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dSG Inhe best

vating. cipants istrust,

salaries ceed if bonus. s must dollars nd cole guarwill be he perff must given. oals to

ORAL HYGIENE the telephone installation man as a new patient exam to asking a new denture patient, in front of everyone ‘how do you like your new dentures?’

For the first six years, I managed our practice 24/7. During social gatherings with other dentists, I heard local dentists complain about this management issue and that patient problem. I would offer a suggestion. Feedback later showed my input had solved their problem. I became curious about what philosophies and techniques the management courses were offering practices. I found their approaches very different from how I looked at things. The next thing I knew, my speaking career was born.

It became very clear to me after just eight weeks in the practice, that dentistry is a business with a health aspect. I quickly realized that, regardless of a business size, every business had three key parts; The customer, the staff who supplied the service/product and running the business. This realization eliminated the feeling of being overwhelmed and allowed me to take control. I feel hy-

gienists plays a strong role in all three management areas.

1. PATIENT MANAGEMENT A. Build Patient Relationships

Successful practices are built on patient referrals. A referred patient has bought before they even walk through the door. In marketing terms, we need to find new patients, keep them happy and send them back to the community to become practice ambassadors.

I am, still, after all the years in dentistry, confused by dentists who feel they cannot afford a hygienist in their practice. In my opinion, they cannot afford not to incorporate this service. We brought our first hygienist into our new practice after 90 days.

Their focus on patient education and quality of communication skills made it a necessity, not an option.

B. Patients and Money In my opinion, it is essential that hygienists

effectively maximize motivation. A monthly plan utilizing a rolling three month average maintains enthusiasm and is very effective in controlling staff overhead.

5. The bonus cannot be given in lieu of a good salary since it is not guaranteed. Periodic raises are necessary to keep wages competitive with the market place and, in a well designed plan, can be given without disturbing the budgeted overhead percentage.

6. The hygienists’ bonus should be calculated separately from clinical assistants and business administrators while still allowing them to feel part of the team. An effectively designed program will tie their incentive to the total practice goals and results to promote support of, and for, the total practice team.

7. The plan must be designed to reward teamwork and not the accomplishments of a single person or department. When designed around a total result, there is a benefit for all team members to offer support when and wherever it is needed.

8. Pull the team together, share the results, and celebrate when you succeed provides and sustains the motivation and teamwork you, the Doctor, desire.

Sharing the month-end results and calculating the bonus should be done in a group meeting, held at a pre-selected time shortly after month’s end. This meeting guarantees group awareness of the levels of productivity and collections which are needed to support the overhead for salaries.

9. Division of bonus dollars must be equal according to the amount of time each participant contributed towards the end results. Exceptionally high skill levels and longevity should be rewarded in salaries.

As the Employer, you can ensure the long-term success of an incentive program even when your practice growth seems to have been maximized and production plateaued. Adding an extra day of hygiene, hiring another assistant, or maximizing the facility are only a few options for increasing practice growth.

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be educated on how to handle patient’s questions about fees, payment and dental insurance. I look to hygienists to educate patients on the benefits of the patient’s financial investment in their oral health. As importantly, learn how to deflect specific questions about dental insurance limitations and fees back to the management team. The most casual remark in hygiene ‘Oh yes, most insurance coverage usually covers 50% of crowns’ has the potential of creating patient/practice misunderstanding and collection problems down the road.

C. Patients and Scheduling From a management perspective, a doctor’s new patient examination and the hygienist’s new patient prophy appointment should be scheduled on separate visits. It did not take me long to learn the five major shortcomings of scheduling these two appointments together.

1. T he chances of a hygiene opening being available immediately after scheduling the doctor’s new pateint exam are slim to none.

And, a new patient’s examination should be within seven days of the patient contacting the practice. I found scheduling these two providers on the same visit neither practical or good clinical service for doctor or patient.

2. Our hygienist was not happy on the day I scheduled a new patient, after seeing Doctor, with a full upper denture and lower partial. She cleaned the four lower anteriors in short order-hardly good use of her one hour appointment.

3. Not having a medical history on file, caused me to schedule a new patient with hygiene who needed antibiotics 24 hours prior to treatment. We had to send the patient home.

4. I learnt when doctor’s schedule ran behind, it caused hygiene to run behind.

5. We can’t have patients thinking of a hygienist as the ‘cleaning lady’! The New Patient Exam is the perfect time for the dentist to educate new patients to the importance of hygiene and the Continuing Care Program (Recall to readers who may not have or read my articles). If the patient has perio issues, needs more than

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one hygiene appointment, this is the time to set the hygiene stage.

D. Legal: Malpractice Prevention I am in total awe of the high standards hygienists maintain in handling their clinical notes. I feel, in part, this might be self preservation as they move from office to office.

Besides meeting legal standards, it is also a courtesy to future hygienists joining a practice. I acknowledge their diligence and attention to this most important part of patient management and legal recordkeeping-which in turn is practicing Malpractice Prevention.

2. TEAM MANAGEMENT This complex and far-reaching management section can be reduced to three simple functions 1. Hire for Retention 2. Manage for Harmony 3 Address issues promptly

A. Hiring I can not over-emphasize the important role a hygienist plays in helping a new employee learn about Doctor’s philosophical and clinical standards. Time constraints often prevent dentists discussing these important issues with the team. Hygienists, through their words, actions and attitude can offer both new and all employees insight to what makes the doctor ‘tick.’

B. Team Maintenance As many hygienists work part time in one or more practices, a fallout of this system is in many practices hygienists are not always embraced by staff as one of the team. There are always two sides to a story. In my opinion, however, the hygienist who reaches out in the following manner will enjoy respect and support from the practice 1. To be part of as many staff meetings as possible.

2. A ny hygienist (or employee) absent from a meeting receives the meeting agenda and minutes within 24 hours to ensure the team is up to speed with the practice needs and meeting designated outcomes.

Continued on page 28

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ORAL HYGIENE

Hygiene Exam Management Critical System for Success

T

he dental hygiene department directly im­ pacts patient loyalty and retention, perio­ dontal disease management, re visiting outstanding dentistry, treatment planning of new dentistry and increasing case acceptance.

Every practice differs in vision, personali­ ty, emphasis, and demographics, all have common negative “stressors” that prevent or block optimal performance. A common “stressor” that drives chaos if not properly managed, is hygiene exams. The need to jug­ gle a full day of restorative procedures with speed and skill while having multiple inter­ ruptions to “get up” and leave their restor­ ative patient to check a hygiene patient can be disruptive if not handled accordingly.

The chaos of a poorly managed hygiene exam system not only impacts the dentist but has impact on the entire team. For the dental hygienist, the chaos is the “wait time” for DDS exams that cause them to run behind when another patient is waiting in reception.

If hygiene exam management is not a prob­ lem for you then you are one of the lucky ones.

However, if you find the process frustrating then it is time to problem solve as a team by reviewing a day sheet of a hectic day in hygiene exams and read across the schedule to assess how many places one DDS was expected to be in the same place at the same time each hour.

Daily Preparation. RDH reviews their charts prior to the day and alerts the team at morning huddle who does or doesn’t need an exam for the assistant to help the DDS to pre­

Lisa Philp, RDH, CMC pare in the morning as opposed to winging it on the fly.

Stagger the start times of the hygiene/restorative appointments. Begin the hygiene department 10-15 minutes (one unit) later or earlier than the restorative department at the beginning of the day. This may prevent all ap­ pointments ending at same time and all need­ ing the DDS in the same time frame. This will also prevent a long line of patients wait­ ing at the 3-5 minute check out station.

Create a level of Urgency system for hygiene exams. Develop a respectful non-intru­ sive way to alerting the restorative department when ready for an exam based on level of ur­ gency. Level 1 — Green means ready anytime, Level 2 — Yellow means need you soon and Level 3 — Red means we are past the end of appointment time and need you NOW. Agree that the Periodontal Maintenance patients who honor their 3/4 month intervals only need an exam twice a year. Work to­ gether to agree and be comfortable that pro­ viding there are no new dental conditions and the oral health is maintained, checking the patient 3-4 times a year is not necessary.

Block out the hygiene schedule for the perio­dontal root planing procedures and 3/4 month maintenance patients. This allows for an evenly balanced day of procedures for the hygienist which prevents fatigue and burn out while scheduling day where not every hygiene patient needs an exam.

Don’t wait until the END of the appoint-

President of Transitions Consulting Group, a full service coaching company for dentistry.

She can be reached at transitionsonline.com

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ment to call the DDS. The RDH collects all assessment data (medical history, cancer screen, perio charting, patient concerns, xrays, photos, cavity check) in the first half of the appointment. Then communicate with the dentist and assistant that you are ready and can accept the DDS to pop in at any time during the remainder of appointment.

The RDH NEVER leaves the DDS alone to check the patient to guess what occurred during the appointment. The hygienist may feel tempted to leave the room to begin preparing their instruments for the next patient.

If the dentist goes it alone, it takes more time to figure out what occurred in the appointment which causes the need to RE-QUESTION. Patients get irritated being asked the same questions they’ve already answered with the RDH and the duplication makes them think there is a lack of shared communication between professionals.

Cruise Hygiene. When DDS gets up to check one RDH, check them all at same time before returning to Restorative patient. Especially with more than one RDH Complex treatment plans are rescheduled.

If the treatment plan is simple and involves one tooth or quadrant treatment, ask if the patient has any further questions and the DDS can exit the room for the hygienist to transfer them to the financial/treatment coordinator to explain insurance and financial arrangements.

When the patient needs more than a cursory hygiene exam due to complex needs or massive changes to oral health, reschedule them to come back for a comprehensive exam or separate consult to give the DDS time to work up the treatment plan.

The RDH prompts the Dr. out loud using a systematic format of the data. Prompting the Dr. is a concrete, routine way for a hygienist and a dentist to communicate clearly and out loud in front of the patient, involving them in the results of their exam. It allows the dentist to maintain uniqueness of diagnosis and treatment plans while receiving patient information in the same way and order every time.

The result is an establishment of a succinct dialogue between two dental professionals

26

which naturally causes the patient to be more secure in regard to the treatment they are receiving and demonstrates a high level of trust between both providers. The acronym to remember how to prompt is PMSHARD.

P

ersonal information. State the patient’s correct name so the DDS knows who is in the chair and they can use their name as part of their communication. Share something personal about their family, occupation or what they do for recreation. This eases the approach and builds immediate connection between the dentist and patient. e.g. Dr., Mrs. Smith just returned from a two-week vacation in Mexico.

M

edical history review. Provide a general medical health statement that encompasses a review of the patient overall wellness and medical concerns. Areas to cover may include information such as medications, systemic diseases, risk factors or hospitalization. e.g. Mrs. Smith has developed early onset diabetes and is currently managing with diet.

No other changes noted today.

S

oft tissue/hygiene status. Communicate a hygiene conclusion of health, disease or maintenance status. If the patient has active disease, state the case type by name, Gingivitis, Early, Moderate or Advanced periodontal disease. Be sure to emphasize the patient’s recommended interval of hygiene visits to reinforce the importance of their next visit.

(Practices that have not instituted a structured periodontal disease management program will struggle with this technique) e.g. “Mrs. Smith’s periodontal examination indicates she has signs of Early Periodontal Disease. I have recommended upon your confirmation that she return for half-mouth gum therapy. This would involve three one hour visits with the first two being 7-10 days apart and the third 4-6 weeks later to assess her healing. (Re-evaluation).”

H

ard tissue / restorative conditions. This is most effective when the dentist begins in the same quadrant each time and follows a

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13-02-05 8:45 AM

ORAL HYGIENE sequence. If the beginning point is the upper right, review each quadrant with speaking out loud anything suspicious that the dentist needs to check, see or evaluate. Examples of these conditions may be large fillings, discolored margins, fractures, crowding, missing teeth etc...

Once the dentist has assessed this area and told the hygienist what to document, they are then guided through other areas of the patient’s mouth. Try to keep things moving as quickly, but efficiently as possible while writing in the chart what was diagnosed.

“Dr. beginning in the upper right quadrant, could you please assess the missing tooth?

Dr. moving along to the upper front teeth, Mrs. Smith doesn’t like the color of teeth and was asking me about whitening.”

A

sk the DDS is there is anything else to document before bringing the exam to closure.

“Dr., is there anything else you would like me to note for Mrs. Smith.”

R

adiographs for next visit.

“Dr what photos or Radiographs would you like to have next visit.”

D

ismiss the doctor to help the dentist exit the room gracefully and allow them to return back to their restorative patient.

“Thank you Dr. Jones,” and give them a window to get up, say good bye and move on. **It is important for the hygienist to never say out loud in front of a patient that they didn’t see or find anything; this makes it uncomfortable for the dentist if they see something to be addressed and discredits the RDH. “Dr., please assess the upper left.” **The patient may request to know what the treatment options are, before you are finished and interrupt your exam process. This is a risky trap to fall into, so the best approach here is tell the patient that once the diagnostics have been reviewed in completion, you will discuss the treatment solutions or options.

If everything goes according to plan, not

only will the patient be impressed by the smooth transfer, they have heard about their oral health more than once. They will see you as a cohesive dental team and develop a trust that will encourage them to be more open to treatment solutions.

Managing the time spent in a hygiene exam, checking patients at the convenience in the schedule by sequencing the first half of appointment and identifying suspicious restorative conditions will reduce negative stress caused by disorganized exam sequence.

As long as you’re covering all of the ground that you need to during the exam by keeping the dentist active, removing professional jargon to keep the patients involved, then you will definitely be on the right track to a smooth flowing hygiene exam. n

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13-02-05 8:45 AM

ORAL HYGIENE

Big Easy® Ultralite™

Light Touch™

Continued from page 24

3. W hen hygiene suffers a No Show or Cancel Short Notice, the hygienist who offers to help in the clinical area or support to the management team becomes a star. To remain in the hygiene treatment room and use the opening as personal downtime does not win respect.

Big Easy®

C. Team Issues Any employee, young or old, experienced or new to dentistry, can have an ‘off’ day. Things just don’t seem go right. Maybe Doctor delivered more dentistry than scheduled, or took too many phone calls during the day. The schedule goes out of the window; staff stress builds and the staff complain. I know that is a tiny minority of hygienists who allow themselves to be pulled into such staff complaining. Short-term, it might build a sense of team unity. Long term it does not!

3. BUSINESS Originally from England, I came from a culture where the ‘boss’ did not share a company’s financial business figures with employees. Now, I believe the more staff are informed about the practice overhead, the more they want to help in decreasing cost and increasing production/bottom line.

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•

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•

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•

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SUMMARY When I first started speaking outside North America over 25 years ago, hygienists were employed by very few countries. I found, however, there was a black market in some countries for North American hygienists!

A doctor would pay for a hygienist to move to their country and practice for a year. An apartment was provided. Dentists felt so strongly about the benefits of providing their patients with a hygienist, they circumvented the Dental Practice Act. Everyone knew, no one spilled the beans. Today, more and more countries are opening hygiene schools. It bodes well for the future of the profession on a global basis.

I have always seen hygienists in a managerial role in a dental practice. This leads me to discuss Incentive and Bonus Programs. A good Incentive and Bonus Program (see sidebar) lifts a practice to new heights. A poorly designed plan can have the staff in revolt. To be effective, fair to all and deliver on its promise, a well thought-out Incentive program must involve the hygienists on two levels. The first plan is based on the hygiene department alone and the other plan has the hygienist as a member of the whole team in the practice plan as the hygienist’s involvement (outstanding or not) impacts every part of patients’ treatment and therefore the practice growth and financial stability. n

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13-02-05 9:35 AM

We use the same prophy angle hand piece (the motor) for the entire day of patients, wiping it down between patients with CaviWipes, is this Ok? — Virginia, IL

In the past, the practice of leaving slow speed handpiece motors on the cord connectors and wiping them with surface disinfectants between patients was accepted; only the prophy angle was removed and autoclaved or disposed of. The rationale for this was that the slow speed motors worked differently than the high speed handpieces; because they do not have air and water passing through them, they were thought to be “clean inside.” Also, the motor portion was considered less critical because it typically remains outside the mouth. The recommendations changed after research showed that slow speed motors can become contaminated internally and are potential vehicles for disease transmission. Current recommendations are to remove the slow speed motor and sterilize it between patients, and you should always consult your manufacturer’s instructions for cleaning and sterilization.

Many people think that sterilizing slow speed motor handpieces will be much more costly. However, equipment repair experts say that wiping the outside of slow speed motors with any surface disinfectant is likely to introduce disinfectant into the motor, and shorten the life of the mechanism more than correctly processing them through steriliza-

INFECTION CONTROL

Q: A:

Continued from page 15

tion cycles. So, while sterilizing them requires having more handpiece motors, they should last longer.

Q: A:

Will a surface disinfectant that kills M. tuberculosis also kill MRSA? Or does that need to be stated in the directions separately? — Sharon Kuttler, IA

Whenever a company states efficacy against a particular organism on the label, it has been tested specifically against that organism and is therefore more reliable than if the target organism is not listed on the label. Having said that, the concept that intermediate-level disinfectants have been tested against mycobacterium tuberculosis, a benchmark organism, implies strongly that the product should destroy other, less resistant pathogens. However, it is not guaranteed, unless it is stated on the label. The key factor that must not be forgotten here is contact time (the time a surface remains wet during disinfection, after pre-cleaning). Some pathogens actually require more contact time than TB, depending on the disinfectant. Vegetative bacteria, including MRSA, are generally considered to be within the group of organisms that intermediate-level disinfectants kill within the recommended contact time, but due to the resistant nature of MRSA and the importance of controlling this pathogen, I personally recommend using a product with this target organism specifically listed on the label. n

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DENTAL MARKETPLACE

DENTAL MARKETPLACE

Contact: Karen Shaw • tel: 416-510-6770 • fax: 416-510-5140 • e-mail: kshaw@oralhealthgroup.com Toll free: CDA 1-800-268-7742, ext 6770 • Toll free: USA 1-800-387-0273, ext. 6770

PROFESSIONAL SERVICES

Alglobe • • • • • •

Construction Company

Epicon Construction

20 years construction experience Dental office construction and design + cabinet making.

Provide turn key operation to dental office.

Reliable construction timing, Good following up service after construction.

Call: Stanley New dental location and lease negotiation.

Tel: (416) 321-3313 Save time, save money. www.alglobe.com

New practice fit-ups and practice renovations www.epiconconstruction.ca tel: 613-702-5333

ONTER CONSTRUCTION

PRACTICES & OFFICES

• Specialized in dental office design & construction.

• In-house architect and interior designer.

• We are qualified code consultants to review all drawings and make your building permit application easy.

• Own millwork facilities for best quality of custom built cabinets and time control of your project.

Tel: (905) 793-2344

MISSISSAUGA, ON

www.onterconstruction.com

PRACTICES & OFFICES OAKVILLE/BURLINGTON AREA, ON

Established general family practice with strong hygiene in a highly visible location centrally located with great parking. 1,600 active patients with four operatories.

Please email all inquiries to enhancedental88@gmail.com

SCARBOROUGH, ON

Dental practice for sale. Located close to large residential area on the main floor of a medical center with street exposure in Scarborough. 3 new dental operatories + 1 plumbed room ready to expand. 800 patients + lots of room for growth. Great opportunity for unique partnership to share the risk but make all clinical decisions. Selling price at fair market value.

Contact: scarborough.dental.clinic@gmail.com

MILTON, ON Practice for sale in Milton – Surrounded by new homes, 4 ops, 2 equipped, in store front medical center, totally digital.

E-mail: Miltondentaloffice2@yahoo.ca

OTTAWA, ON Owner retiring. Central, 27 year old practice selling below appraised value for quick sale. Cheap rent.

E-mail: P_T_Y_B@hotmail.com

TORONTO, ON PRIVATE SALE

Downtown dental practice focusing on implants and cosmetics in Dundas/ University area. Owner will stay on for mentorship or associate role, if agreeable.

Please reply to: dentaltrt@gmail.com

ETOBICOKE, ON

Dentist or specialist for cost sharing & possible associate,1 operatory available.

Call Lola at 416-740-7060.

To place your ad contact Karen Shaw at 416-510-6770 or kshaw@oralhealthgroup.com

LESS OFFICE RESPONSIBILITY — EXCEPTIONAL OPPORTUNITY We are a progressive office in mid-town Toronto that is able to accommodate your existing practice 2-4 days per week. All aspects of practice management looked after. This is an ideal opportunity for someone facing lease termination due to sale and demolition, or simply wants to practice without additional stress.

Our practice offers comprehensive care with a strong preventive model and on-site periodontist.

Dreaming of an easier 9-5? Consider joining our high profile practice that is quality centered.

Serious Inquiries Only: info@aestheticsindentistry.com

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February 2013

OHY Feb2013 p30-34 Classified.indd 30

For sale: Successful, family oriented, hygiene driven practice with motivated, loyal patients receiving complete dental care for 30+ years in a beautiful part of south-west Mississauga. Two operatories, private office, reception, lab, all in the basement of a private home located in mature tree-lined culde-sac. Separate entrance, ample and convenient parking. Owner will assist during transition period.

Interested persons are encouraged to contact gfz_111@hotmail.com

SOUTHERN ALBERTA

Well established general practice with 5 ops, over 1,700 active patients and a strong hygiene team in place. This successful practice operates out of a 1,900 sq. ft office with excellent lease terms, and is located within 1 hour of Calgary in a growing, family-oriented community.

For additional information, please contact Mike Devonshire at michaeld@thecatalystgroup.ca.

LEASE TAKE OVER — GUELPH, ONTARIO This is a rare opportunity to take over the lease of an un-built office space for 6 operatories. Drawings are ready to go. A Smart Centre retail plaza in a prime location with excellent traffic at all times of the day.

The 1,545 square foot unit is unfinished and ready for your personalized design and build. The net rent of $30.50 is fixed for the first 5 years and only goes up marginally to $33.00 before being fixed again for another 5 years.

Call Karen McAdam to inquire.

416-876-3569. www.oralhealthgroup.com

13-02-06 1:02 PM

CAREERS

You could be in this exciting medical field sooner than you think with Trillium College’s Inter-Oral Dental Assistant diploma.

Study in a fully equipped modern classroom with a low teacher/student ratio.

Our program is offered at 9 campuses across Ontario, and can be completed in as little as one year.

Call us today.

1.855.613.1456

trilliumcollege.ca

UBC FACULTY OF DENTISTRY GRADUATE PROGRAMS MSc AND PhD IN CRANIOFACIAL SCIENCE PROGRAMS These programs are research-oriented and do not include clinical training. The MSc degree normally requires two years full-time study and can also be taken part-time. The PhD degree requires a minimum of three years. Both offer research training in various oral and dental sciences.

• Combined PhD or MSc in Craniofacial Science/Diploma in Endodontics • Combined PhD or MSc in Craniofacial Science/Diploma in Orthodontics • Combined PhD or MSc in Craniofacial Science/Diploma in Pediatric Dentistry • Combined PhD or MSc in Craniofacial Science/Diploma in Periodontics • Combined PhD or MSc in Craniofacial Science/Diploma in Prosthodontics The above programs will offer a minimum three-year MSc degree or a minimum six-year PhD degree combined with a Diploma in their specialty. These programs will prepare the students for clinical practice and provide research experience. Applicants must hold a DMD or its equivalent.

FOR MORE INFORMATION VISIT WWW.DENTISTRY.UBC.CA OR CONTACT: MRS. VICKI KOULOURIS, MANAGER, vkoulouris@dentistry.ubc.ca; TEL: 604.822-4486/FAX: 604.822-3562 OR MS. JACKIE LEE, fodadms@interchange.ubc.ca/TEL: 604.822-8063 POSTGRADUATE PROGRAMS ORAL MEDICINE AND ORAL PATHOLOGY RESIDENCY PROGRAM This postgraduate residency training n Oral Medicine and Oral Pathology is offered in conjunction with University-affiliated teaching hospitals. It consists of a three or four-year hospital-based, stipended residency in one of three pathways: Oral Medicine, Oral Pathology, or both specialties combined.

GENERAL PRACTICE RESIDENCY PROGRAM In conjunction with three University-affiliated teaching hospitals the Faculty offers positions in a oneyear dental residency program beginning July 1 or June 15 for pediatric residency.

FOR MORE INFORMATION ON POSTGRADUATE PROGRAMS VISIT WWW.DENTISTRY.UBC.CA OR CONTACT: MS. DOROTHY STANFIELD, MANAGER, dstanf@interchange.ubc.ca TEL: (604) 822-0345/FAX: (604) 822-4532

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DENTAL MARKETPLACE

Dentists are Hiring!

www.oralhealthgroup.com

NORTH YORK, ON Seeking part time dental hygienist for busy North York dental clinic. Must be fluent in Italian or Portuguese, preferably both.

Please send resume to den183gs@allstream.net.

AJAX, ON New modern, high tech dental office opening in Ajax. Doctors, Hygienist, assistants and receptionist.

Please apply to dentistryinajax@gmail.com

VAUGHAN, ON

Locum needed for Oral surgery practice. Selective days each month through the year. All staff and equipment to be supplied. Please contact us for further information. 905-669-2616 or education@concordoralsurgery.ca

ASSOCIATESHIPS BURNABY, BC

Busy family practice in Burnaby seeking part time (2-3 days) associate. The candidate must speak fluent Korean, minimum 2 yrs work experience and must be great with children.

Please e-mail resume to: karlapark@hotmail.ca

KESWICK, ON

Associate needed to replace retiring dentist. Well established, busy family practice with strong patient base. Interested candidates please email resume to: dentistneeded@live.com

SOUTH WESTERN ONTARIO Full time associate required in Guelph, ON Please reply with resume to: dentalassociate123@gmail.com

VICTORIA, BC

Looking for Full Time Associate in Victoria, BC. Position available immediately. Established 6 chair practice in downtown Victoria, BC. Practice is located in a beautiful, newly renovated Heritage home. State of the art equipment, including Cerec, offered in practice. This position is also open to a buy in opportunity.

Please check out our website at www.dentistvictoria.com.

Contact Joanna at 250-385-6552.

KITCHENER/WATERLOO, ON A great FT or PT Associate position is available in a very busy family practice in KW area. Minimum 2 years experience required. The candidate must be proficient in molar RCT and surgical extractions.

Please email your resume to: susandellx2@yahoo.ca

February 2013

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DENTAL MARKETPLACE

ASSOCIATESHIPS BRAMPTON, ON

Busy Brampton dental office looking for an oral surgeon to come in once a month.

Must be friendly and have excellent customer service skills. Position is available asap, if interested please e-mail or contact us.

WELCOME@FCDO.COM 10725 Mclaughlin Road Suite #8 Brampton, ON L7A 3E5 Phone: 905-495-1155

ALBERTA — SUNDRE

Full time associate required for a busy small town practice near Calgary.We are a strong team based practice, providing a wide range of dental services such as implants, periosurgery, endodontics, E4Dmilled restorations and more. This is a great opportunity and experience for new grads.

Please submit your resume to: DrRichardKolen@hotmail.com or fax resume to 403-638-3604.

ASSOCIATES FOR HAMILTON & WATERLOO, ON

Associates required, for TWO VERY busy and modern practices with VERY strong new patient flow.

E-mail: associatedentist@ymail.com Fax CV: 888-880-4024

MISSISSAUGA, ON

Part-time Associate Dentist needed to join a family practice in Mississauga. We are seeking a compassionate and friendly dentist. A dentist who is proficient in all aspects of dentistry and who strives to deliver quality care to their patients. We have a strong dental team who create a great working atmosphere and for the right candidate this can be opened up to become a Full-time position.

Please email your resume to info@cityheightsdental.com

SASKATOON, SK ASSOCIATE REQUIRED

Full Time Associate required to work in a busy, well established clinic in Saskatoon. Ideal start date would be summer/fall 2013. Please visit our website at www.downtowndentalsaskatoon.ca to learn more about us.

Please contact Dr. Michael Hammer or Dr. Bryce Bahrey at 306-664-3555 or email: donna@downtowndentalsaskatoon.ca

GRANDE PRAIRIE, AB A full time associate dentist required to take over an existing full patient load from the current associate, you will be busy from day one. Office is bright, modern and very well equipped, computerized, digital, paperless. Opening July 1, 2013.

Please send resume to: pmdcgp@telus.net

NORTHERN BRITISH COLUMBIA

Full-time or part-time associate needed immediately for established, busy family practice in Burns Lake with high income potential. The clinic features high quality full time hygienists, dental assistants, Cerec and friendly, hard working staff.

Contact David: drdwy45@gmail.com or 435-767-8375.

OAKVILLE, ON

Full time associate wanted for a very busy well established family practice.

Experienced dentists with strong clinical and communication skills required. Our practice offers comprehensive care with a strong emphasis on periodontal health offering an on-site periodontist.

Please email resume to saraoakville@gmail.com

Dr. Steven Bongard and Associates at West End Dental Centre in Trenton, Ontario are looking for a caring, compassionate dentist with strong communication and clinical skills to join our busy, progressive practice. This full-time position is an excellent career opportunity for a dedicated dentist with excellent income potential and the potential for future partnership. We offer the knowledge and experience of our doctors along with the support of a friendly and well-trained staff. The office is located 1 hour east of Oshawa on the beautiful Bay of Quinte.

Please e-mail your CV to westenddental@bellnet.ca or fax 613-392-3783, Att’n: Diane Shalai, Practice Manager

February 2013

OHY Feb2013 p30-34 Classified.indd 32

Associates wanted for busy practices in the Toronto and surrounding areas.

Associates experienced with endo, surgery, perio, extractions and placing implants will be given preference.

Email: info@finetouchdental.com or phone Andy or Kevin 1-888-526-3535.

EAST GTA

Established, busy, growing dental office east GTA requires a P/T associate offering all aspects of dentistry.

Minimum 2 years experience. We offer state of the art digital equipment, please forward you resume to Oral Hygiene, Box 13 – e-mail: kshaw@oralhealthgroup.com

KINGSTON, ON

ASSOCIATE — TRENTON, ONTARIO

32

GTA — SENIOR FULL-TIME ASSOCIATE

Leading Dental Group looking for an associate for an established family practice.

Must have at least 5 years experience.

Contact Trish: at trishc_9@hotmail.com

THUNDER BAY, ON

Full Time Associate Needed Scott Family Dental seeks full time associate for their busy general practice, open since 1980. Our clinic includes 5 computerized operatories, digital intraoral as well as pan radiography, and an enthusiastic and efficient staff. An option to purchase the practice and building may be available to an interested individual.

Resumes may be faxed to (807) 345-8581. Any questions may be answered by calling Dr. Brian Scott at (807) 345-6331.

WILLIAMS LAKE, BRITISH COLUMBIA DENTAL ASSOCIATE POSITION

Full Time Dental Associate needed for large multidisciplinary family dental practice. Whether you’re someone who’s just starting off in your dental career or a seasoned provider we would welcome you to join our team.

We are a digital and paperless practice, newly renovated with the latest technology (including CBCT). Come and work in an office where you can experience a variety of dental cases, work with the latest technology and be supported by our highly trained and skilled team.

We have a very successful clinic that is a great place to practice dentistry!

This is an excellent environment to gain experience and earn a six figure income while enjoying a healthy lifestyle.

Position Available July 2013.

Call Perry @ 250-398-0532 Vitoratos@shaw.ca and visit us at www.cariboodentalclinic.com

www.oralhealthgroup.com

13-02-06 1:02 PM

KITCHENER/WATERLOO, ON

FT or PT Assoicate needed. Successful candidate must be proficient at most areas of dentistry. Good communication skills essential. No weekends.

Send resume to apex8526@yahoo.ca

DOVE DENTAL CENTRES

ORANGEVILLE, ON

JUST NORTH OF BRAMPTON Progressive well established family dental practice seeking a PT associate with FT potential. Large dental practice with 7 spacious treatment rooms, all digital x-rays and digital scanning for crown and bridge impressions, implants.

We currently have 3 specialists and an in-house Anaesthesiologist. Seeking associate with at least 1-2 years experience and must be fluent in English. Self motivated, caring, honest individual with good communication skills.

Full time associates needed for progressive, modern, multi-location group dental practice in London, Ontario and surrounding area. Interested candidates should forward resume and cover letter to: dovedental@ody.ca

Email resume to: Progressivedental16@hotmail.com

WEST COAST F/T ASSOCIATE POSITION Enjoy the West Coast Lifestyle and practice as a full time Associate in one of our locations across Vancouver Island. This position presents significant opportunity to practice F/T with access to all general dentistry treatment. The ideal candidate will have over three years experience and aspire to engage in CE and mentorship.

We do not limit our associates access to patients. Buy in opportunity available in future.

Interested applicants may contact via email at carmen@dogwooddental.com or call Carmen at 1-250-830-4590.

SUDBURY, ON

I have a very unique full time position available for an associate in a busy, well established practice located in Sudbury, just 3.5 hours north of Toronto. We are looking for a self-motivated, caring individual proficient in all aspects of dentistry. Full time, no weekends. The successful applicant would be the only dentist in the practice. He or she would have the ability to work on their own without all the headaches that come with owning your practice. The staff consists of a receptionist, an assistant, a floater, a full time hygienist and a part time hygienist.

Please e-mail: krista123@bellnet.ca

ASSOCIATE OPPORTUNITIES AVAILABLE!

Kingston, ON — Our well-established, progressive practice in historic Kingston, Ontario is looking for an enthusiastic, self-motivated and dedicated long-term Associate to work for two to four days per week. Associate must have a minimum two years’ experience and be comfortable performing a full range of services. If you are interested in this opportunity, please e-mail resume in confidence to hr@dentalcorp.ca and quote File # DD13.

We are always eager to meet new and experienced Associates looking for meaningful work. For more information please email info@dentalcorp.ca.

www.oralhealthgroup.com

OHY Feb2013 p30-34 Classified.indd 33

CALGARY, AB

DENTAL MARKETPLACE

MISSISSAUGA, ON

Established busy family practice seeking periodontist twice per month.

Please email mtcdental1@gmail.com

An immediate full time associate required for a busy northeast and northwest practice in Calgary. We are looking for a hard-working, selfmotivated, strong communication skills, and clinically strong individual who is willing to work on both evenings and weekends (Saturday and Sunday). Possible buy-in opportunities may also be available for longterm associates.

If you are interested please email your cover letter and resume to Mcdental@hotmail.ca

EDMONTON, AB Looking for an associate (part/full time) to join our group of multidisciplinary practices which are focused on the highest quality of patient care and using the latest technology available. We are looking for a self-motivated, high-energy, clinically strong candidate who is interested in learning and continuing education. This is a great opportunity for the right candidate to grow with our expanding group and to work in a great environment. Buy-in opportunities are also available for the long-term associates.

If you are interested, please email your CV in confidence to edmontondentalcareer@gmail.com

SW CALGARY, AB Associate required part time for busy, progressive, family, cosmetic practice located in SW Calgary with excellent New paient flow. We are expanding our dental clinic and are searching for an associate who believes in high quality dentistry and patient care. If you are looking for an excellent work environment and a great team who strives for the best in patient care we are the office for you. All aspects of dentistry are offered at our clinic, Implants, Sedation, Cerec-3D Crowns, digital x-rays, Orthodontics, Cosmetic dentistry and much more. Associate position is ideal for a candidate with 2 or more years experience. There is an opportunity for buy in for the right individual in the future, New grads are welcome to apply.

Must be willing to work some evenings and Saturdays.

Please email your resume in confidence to: Cherylplas@gmail.com

February 2013

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13-02-06 1:02 PM

DENTAL MARKETPLACE

LAKE SIMCOE, ON

Located on the southern shores of Lake Simcoe, our well established, multi chaired family practice dental offices are looking for an associate to join our team. A great opportunity for a selfmotivated individual to invest themselves long term.

Email resume to aabramowicz@liveddm.com

SCARBOROUGH AND NORTH RICHMOND HILL, ON

P/T ASSOCIATES Part time Chinese speaking associates wanted for family practices in Scarborough and North Richmond Hill.

Please email resume to: scrhdental@gmail.com

EAST OF GTA — ASSOCIATE Peterborough 1.5 hours from Toronto.

Digital X-rays, Paperless Chart.

Contact at Dr. Alex at alexrheedds@gmail.com or 905-706-7665.

EAST OTTAWA, ON

Full time associate dentist needed for state of the art practice in a growing bedroom community in East Ottawa, ON. New graduates welcome. Opportunities to buy in.

E-mail: lisa-hawkins@hotmail.com

LOWER FRASER VALLEY, BC Looking for a busy high production office?

Located in Lower Fraser Valley minutes from salmon fishing, Garrison office offers high tech with high touch. If you are a talented dentist with the desire to be busy & produce great dentistry this is the right team.

Forward resume to E: staceyhryciw@gmail.com

RED DEER, AB

Busy office located in central Red Deer.

F/T and P/T required. No evenings or weekends.

Please send resume to reddeerdental@hotmail.com Immediate start.

NORTH OF TORONTO

Dr. Parekh and Associates are looking for a caring, compassionate dentist with strong communication and clinical skills to join our busy, progressive practice. The office is located North of Toronto.

Contact Information: drparekhdentist@gmail.com

WINDSOR, ON

Experienced, friendly, compassionate associate dentist needed for a busy, family oriented practice situated in a new state of the art office setting.

Email resume to: sjasey47@hotmail.com or fax to (519) 972-7362.

TORONTO, ON

Busy practice downtown Toronto area looking for associate dentist 3-4 days a week.

E-mail resume to info@bcddental.com atten. Karolina.

KINGSTON, ON

Associate wanted for a practice in the Kingston area. Minimum 3 years experience required.

Please send your resume to resumes@dawsondental.ca or fax it to 1-877-482-4320

STOUFFVILLE, ON

Associate needed for new Stouffville practice. Part-time to start,one day a week and alternating Saturdays. Minimum 2 years experience.

Please email resume to: nomoredecay@gmail.com

UNIONVILLE, ON

Looking for a part-time associate.

Unionville office.

Please email resume to: ginavoutsas@rogers.com.

OTTAWA, ON

Full-Time Associate Needed. Outstanding opportunity for a dynamic, dedicated team-oriented individual to join a large, well-established group practice in Kanata, (Ottawa) Ontario.

Please submit CV by email: hazeldeandental@gmail.com

FORT ERIE, ON — REQUIRED IMMEDIATELY

Are you having enough fun at work?

With the core values of Health, Growth & JOY, Sierra is expanding and accepting applications for Pediatric Dentists & General Practitioners in Calgary, Alberta.

Why Calgary?

This beautiful city sees more days of sunshine than any other major Canadian city. Home to 1.3 million people, Calgary is diverse and community-minded.

It is also the mecca of business & financial growth with the strongest economy in the entire country.

Because you deserve to feel joy at work! Sierra believes in cultivating and sharing positive energy and strives for a joy-filled environment for all staff & patients. If you are clinically strong, high energy, and self-starting, we look forward to meeting you.

With over 12,000 active patients and a tremendously successful internal referral program we are excited to welcome the right doctor. Sierra also provides a unique practice ownership program. If you are passionate, clinically committed and seeking happiness in your work environment, send resume & cover letter to lavonne.keal@sierracentre.com

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February 2013

OHY Feb2013 p30-34 Classified.indd 34

OTTAWA/TORONTO/SASKATOON/HALIFAX Associates wanted both full and part-time in established practices.

Ottawa, Toronto, Saskatoon, Halifax locations.

Email: info@finetouchdental.com or phone Andy 888-526-3535.

BURLINGTON, ON

Why Sierra Dental?

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Full-time dental associate in Fort Erie required to take over previous associate position of 6 yrs. Well established busy family practice.

Please forward resume to forteriedentalgroup@bellnet.ca or fax to 905-871-3977.

11-11-20 8:38 PM

Burlington associate position available.One evening, no weekends in a busy, progressive and friendly family practice. Experience would be an asset.

Please reply in confidence to: assoc.wanted@gmail.com.

EQUIPMENT BROCKVILLE, ON FOR SALE Biolase MD hard and soft tissue laser for sale at $25,000.00.

E-mail: sam@sandhudental.ca.

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