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SEPTEMBER 2019

Inside this issue ORAL HYGIENE

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Strategies to Increase the Profile of Dental Hygienists in the Community Natalie Muccioli Emery, RDH, BHA

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Integrating Preventive Oral Healthcare into the Medical Management of Diabetes: Early Findings from a Toronto Pilot Study Julie DiNardo, RDH, Kate Marten, RDH; Dr. David Engelberg; Dr. Elena Pankratieva; Shakira Wynter BHS/RPN; Geena Sakellaris, RN

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10 Strategies for Handling Parents of Your Pediatric Patients Brenda McNulty, Chief of Pediatrics and Orthodontics, Jameson

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I’m All In Irene Iancu, BSc, RDH, CTDP

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JUST A SPOONFUL OF…STRESS? Jillian Cecchini

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NEWS High Doses of Vitamin D During Pregnancy Found to Help Child's Dental Health After Career-Ending Work Injuries, Dental Hygienist Turns to Researching the Problem

34 DENTAL MARKETPLACE

SEPTEMBER 2019

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EDITORIAL

Just A Spoonful Of… Stress?

Jillian Cecchini Managing Editor

SEPTEMBER 2019

A recent study from the Oral Health Foundation caught my attention. According to the study, evidence suggests that office workers are the most likely to eat sugary food and drinks as a result of stress – rather than those out of work. As a result, the Oral Health Foundation is calling for ‘stress-free working environments’ to end these sugar binges. Does a stress-free working environment even exist? I work for a very successful company. I’m an editor for a great publication, have amazing co-workers, and a brand-new office that provides a beautiful and creative space to work every day. With that being said – stress still happens. I’ve written multiple editorials on stress in the workplace and how to do your best to manage the inevitable. But is a stressful workplace at fault for my sugar cravings? It’s no secret that sugar can wreak havoc on your body if you’re indulging in a little too much of the good stuff. The harmful effects it can have on your physical, mental, and oral health are well-studied, and the fact is that when you eat more sugar, the more you crave it. Full disclosure: I jumped on the bandwagon for a fad diet that eliminated all sugar and carbs. It proved very successful for many months and I was pleasantly pleased with the results. A lot of people questioned why I was on the diet in the first place. I’ll be honest, it had nothing to do with my weight or appearance. It had everything to do with my health. The research I did, though many people will have different opinions, led me to believe that cutting out sugar and carbs would overall change how I felt. And it did. I

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found myself with a lot more energy and a lot less bloated. I was sleeping better, my moods were consistent, and my cravings to constantly snack were pretty much nonexistent. But I fell off this summer. Hard. I’m back to eating carbs and sugar (in moderation) but I must admit that I prefer the way I felt before. August was a particularly busy for the Oral Health Group as we were producing an additional 13th issue of Oral Health (coming soon)! This was alongside our September issues of Oral Health, Oral Hygiene and Oral Health Office. With multiple deadlines looming and the workload constantly piling up, I found myself full of cravings. And in this office, all I had to do was walk over to the kitchen to see what was waiting for me on the island. Samosas? Yep. Butter tarts? Sure. A bowl of jelly beans? Fine. What happened to my will power to pass and pick up a healthy snack instead? For many years, ‘comfort eating’ has been seen as an excuse to consume unhealthy sugars and fats. When under stress, our bodies release a hormone called Cortisol, which increases our appetites. Sugar can weaken your body’s ability to respond to stress, which can trigger anxiety and the ability to deal with the cause. This explains everything. But now, how do we promote a healthy work environment? Maybe it’s time to gather as an office and come up with different ways to promote a healthier environment. Consult with your team and brainstorm ideas of how to incorporate a healthy lifestyle in the office. And after you do that, be sure to email your tips over to me because I currently need them more than ever.

May 2017

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NEWS

High Doses Of Vitamin D During Pregnancy Found To Help Child’s Dental Health Upping vitamin D intake during pregnancy can significantly help the health of the child's teeth long after birth, according to a new study. Danish researchers started their work in 2009, when more than 300 women were given high doses of vitamin D once they reached 24 weeks of pregnancy. More than 300 other women were given placebo pills. All the women were told to continue with the normal amounts of vitamin D they had already been taking. Once the children born to those women turned six, they underwent comprehensive dental exams to determine how the treatment had affected their tooth health. The researchers found that chil-

dren whose mothers had taken the extra doses of vitamin D were 50 per cent less likely than the others to have issues such as discolouration and enamel breakdown. Based on those findings, the researchers recommend that pregnant women use vitamin D supplements to boost their child’s dental health. Health Canada’s recommendation is that pregnant women, like all people between the ages of nine and 70, should take at least 600 IU of vitamin D per day and should not take more than 4,000 IU daily. Find the full story: https://www. ctvnews.ca/health/high-doses-ofvitamin-d-during-pregnancy-foundto-help-child-s-dental-health-1. 4536992

A NEWCOM Media Inc. Publication

Managing Editor: Jillian Cecchini 416-510-5125 jillian@newcom.ca

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Chairman and Founder: Jim Glionna President: Joe Glionna Vice President, Publishing: Melissa Summerfield Director of Circulation: Pat Glionna

After Career-Ending Work Injuries, Dental Hygienist Turns To Researching The Problem A P.E.I. dental hygienist who had to stop practicing because of repetitive strain injuries is now researching just how common the problem is and coming up with strategies to prevent it. Marilyn Harris practiced for eight years but had to stop in 2015 because of carpal tunnel syndrome and tendonitis, which four surgeries couldn’t fix. “I’m not pointing fingers at any organization or any business, but I think as a whole we all could do more,” said Harris. Harris and her research partner received survey responses from more than 600 members of the Canadian Dental Hygienists Association. Eighty-three per cent said they have experienced some form of

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an injury, and over 60 per cent of those have been practicing for fewer than 10 years. She also arranged for graduate students from Dalhousie’s occupational therapy program to assess the first year dental hygiene students as they did their clinical work. “They took pictures and made notes and they actually came back and did a session where they taught the class, the dental hygiene students, different things they can do to improve their workspace, or their own postures, or to self-assess for those ergonomic issues,” said Harris. Find the full story: https://www.cbc. ca/news/canada/prince-edwardisland/pei-dental-hygienist-rsi-1. 5225963

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OFFICE: Located at 5353 Dundas Street West, Suite 400 Toronto ON M9B 6H8 Telephone 416-614-5831, Fax 416-614-8861. 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, 5353 Dundas Street West, Suite 400 Toronto ON M9B 6H8

Subscription rates: Canada $25.00/1 year; $47.00/2 years; USA $46.95/1 year; Foreign $46.95/1 year; Single copies Canada & USA $10.00, Foreign $18.00. GST/ HST #103862405RT0001.Printed in Canada. All rights reserved. The contents of this publication may not be reproduced either in part or in full without the written consent of the copyright owner. From time to time we make our subscription list available to select companies and organizations whose product or service may interest you. If you do not wish your contact information to be made available, please contact us via one of the following methods: Phone: 416-614-5831; Fax: 416-614-8861; E-mail: mary@newcom.ca; Mail to: Privacy Officer, 5353 Dundas Street West, Suite 400 Toronto ON M9B 6H8 Canada Post product agreement No. 40063170. Oral Hygiene is published quarterly by Newcom Media Inc., a leading Canadian magazine publishing company. ISSN 0827-1305 (PRINT) ISSN 1923-3450 (ONLINE)

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ORAL HYGIENE

STRATEGIES TO INCREASE THE PROFILE OF DENTAL HYGIENISTS IN THE COMMUNITY Natalie Muccioli Emery, RDH, BHA Natalie Muccioli Emery is a dental hygiene educator at Oxford College, she is dedicated to addressing oral health inequalities and issues surrounding access to oral health care. She received her bachelor’s degree in Health Administration, Health Services Management from Ryerson University and has worked in private dental practice for 12 years. She serves on the Board of Directors for the Gift from the Heart project. Natalie hopes for a future where dental hygienists will be valued members of interdisciplinary health care teams helping to improve overall health outcomes.

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s a profession, dental hygiene is at a tipping point. We are balancing on a scale. On one end, the occupational model of practice, and on the other end, the professional practice model. The past 30 years have been a period of sustained growth for the professional model of practice. Dental hygiene professional practice has been augmented through the capacity to formulate a dental hygiene diagnosis, authorization to prescribe some medications, and the ability to open an independent practice in many jurisdictions. As significant as these high points are, there is still work to be done. Public perception of dental hygienists is generally positive.1 However, many continue to view the role of the dental hygienist as an auxiliary to the dentist, rather than

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as a collaborative partner of the oral health care team.1 Such a perception is a problem. Health inequalities place enormous strain on the healthcare system; and in many instances, poor oral health contributes to diminished overall health outcomes.2 There are well established connections of overall health to oral health, with linkages to diabetes, respiratory disease, and emerging research in negative cardiovascular outcomes.3 Due to economic barriers, not all members of the public can access a private dental practice.4 The solution is apparent. Dental hygienists who are qualified, educated professionals in oral health care and disease prevention may provide health promotion, as well as primary and secondary preventive measures at the community level before oral health problems present in hospital SEPTEMBER 2019


emergency rooms; often ending in an antibiotic or narcotic prescription, persisting pain or extraction.2, 5 So, why are more dental hygienists not reaching patients at the community level? Where are the opportunities? A scroll through any employment search engine will yield hundreds of opportunities for dental hygienists; many for an occasional Saturday, an evening here, a morning there, all in private dental practice, without a single opportunity in a community healthcare setting. In order for oral health inequalities to be addressed, the healthcare provider qualified to meet the unmet needs of the community must physically be in the community and not in a private practice. As someone who has worked in dental hygiene education for twelve SEPTEMBER 2019

So, why are more dental hygienists not reaching patients at the community level? Where are the opportunities? A scroll through any employment search engine will yield hundreds of opportunities for dental hygienists.

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years and has studied health care policy and administration, I see an untapped opportunity for new graduates, along with unrealized benefits for members of the community. I have often asked why more dental hygienists are not pursuing opportunities beyond private clinical practice? I believe the answer is twofold. Firstly, many new graduates believe the only valid employment opportunity post-graduation is private dental practice. Secondly, opportunities for dental hygienists in the community health care setting are very limited. Thus, I propose two potential avenues for exploration for a solution. An examination of how dental hygiene educators influence student career aspirations and an encouragement of decisionmakers to consider the inclusion of

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HOW DENTAL HYGIENE EDUCATORS CAN HELP INFLUENCE THE FUTURE OF DENTAL HYGIENE Instead of Saying…

Consider This Instead…

“ You can’t diagnose any conditions”

“ Ensure your diagnosis is a dental hygiene diagnosis”

“ I have to check with the dentist”

“ Let’s have a dentist consult/collaborate on this treatment plan”

“ These teeth have suspicious areas”

“ These teeth have signs and symptoms which are consistent with dental caries, however the definitive diagnosis must be made by a dentist”

Dental hygiene educators can be the catalyst for much needed solutions by directing new graduates to opportunities where the people who need them most can access them.

dental hygienists on interdisciplinary healthcare teams. Research emphasizes the fundamental role of college faculty in shaping the attitudes and aspirations of the student.6 Just as students are often asked to self-reflect, I encourage my colleagues in dental hygiene education to do the same. How often do we refer to post-graduate careers only in a private practice context? Alternatively, how often do we refer to roles of the dental hygienist, researcher, educator, and administrator as a footnote to clinical practice? In clinical education, do we say “check” with a dentist or “collaborate” or “consult” with a dentist? Our lexicon cannot change reality; however, language can indeed modify the lens in which reality is viewed.7 As educators, we must be mindful that our language does not impart a limited worldview on the student. Exposing students to potential roles in a community capacity is a starting point. However, it is perhaps futile if those roles do not exist. As dental hygienists, we can

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advocate for increased recognition of the dental hygienist as a valued and crucial member of the health care team. Professional associations offer excellent advocacy resources to assist members motivated to start an advocacy project. Also, dental hygienists may participate in community health initiatives through application to Board of Directors’ postings; thus, bringing the voice of a dental hygienist to the decisionmaking table. Finally, dental hygienists can have their voices heard through voting. Supporting political candidates who value oral health care and are willing to put pressure on policy makers and stakeholders for an increased presence of dental hygienists in the community will increase public awareness of their role in healthcare. Change can be tough and often the fallback is to stick with what we know. However, the dire state of oral health care in our communities is too critical to ignore. Dental hygiene educators can be the catalyst for much needed solutions by directing new graduates to opporSEPTEMBER 2019


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HOW DECISION-MAKERS CAN HELP IMPROVE ORAL AND OVERALL HEALTH OUTCOMES FOR THE COMMUNITY Consider dental hygienists as members of an interdisciplinary health care team such as: • A seat for dental hygienists on the Board of Directors of Community Health Care Centres • Employment opportunities for dental hygienists in long term care facilities • Dental hygienists as part of interdisciplinary health care teams such as, medical offices, diabetes programs, and cardiovascular programs. Especially, where there are established linkages between oral and overall health.

An increased presence of dental hygienists in the community is win-win for the profession and society.

tunities where the people who need them most can access them. Decision-makers can also help by ensuring there is a place for the dental hygienist to serve all constituents, not just those who hold private dental insurance. An increased presence of dental hygienists in the community is a win-win for the profession and society.

This article is dedicated to Paul Sharma, Director of Chronic Disease and Injury Prevention at Region of Peel, for giving me a chance in dental hygiene education many years ago. Thank you.

References: 1. Turner J. Oral Health for Total Health: The Integral Role of the Dental Hygienist. Oral Health [Internet]. 2019 [cited 12 August 2019];. Available from: https://www. oralhealthgroup.com/features/oral-health-for-total-health-the-integral-role-of-thedental-hygienist/ 2. Farmer J, Peressini S, Lawrence H. Exploring the role of the dental hygienist in reducing oral health disparities in Canada: A qualitative study. International Journal of Dental Hygiene. 2017;16(2):e1-e9. 3. 3. Gao L, Xu T, Huang G, Jiang S, Gu Y, Chen F. Oral microbiomes: more and more importance in oral cavity and whole body. Protein & Cell. 2018;9(5):488-500. 4. Bedos C, Loignon C, Landry A, Allison P, Richard L. How health professionals perceive and experience treating people on social assistance: a qualitative study among dentists in Montreal, Canada. BMC Health Services Research. 2013;13(1). 5. Hasan S. Prescription from ER doctor: expand public dental programs. The Star [Internet]. 2017 [cited 12 August 2019];. Available from: https://www.thestar.com/ opinion/commentary/2017/02/21/prescription-from-er-doctor-expand-publicdental-programs.html 6. Komarraju M, Musulkin S, Bhattacharya G. Role of Student–Faculty Interactions in Developing College Students’ Academic Self-Concept, Motivation, and Achievement. Journal of College Student Development. 2010;51(3):332-342. 7. Schafer J. Words Have Power [Internet]. Psychology Today. 2010 [cited 12 August 2019]. Available from: https://www.psychologytoday.com/us/blog/lettheir-words-do-the-talking/201011/words-have-power

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ORAL HYGIENE Julie DiNardo, RDHi, Kate Marten, RDHii, Dr. David Engelbergiii Dr. Elena Pankratieva,iv Shakira Wynter BHS/RPN,v Geena Sakellaris, RNvi i.

Julie Di Nardo, RDH, founder of the Gleam Smile Centre, Hamilton, Ontario. ii.

Kate Marten, RDH, founder of LifeSmiles Dental Hygiene, Whitby, Ontario

iii.

Dr. David Engelberg, DMD, MD, CCFP, FCFP, family physician, MCI The Doctor’s Office, Royal Bank Plaza Clinic, Toronto, Ontario iv.

Dr. Elena Pankratieva, family physician, MCI The Doctor’s Office, Royal Bank Plaza Clinic, Toronto, Ontario v. Shakira Wynter, BHS/RPN, Clinic Manager, MCI The Doctor’s Office, Royal Bank Plaza Clinic, Toronto, Ontario vi. Geena Sakellaris, RN, Regional Clinic Manager, MCI The Doctor’s Office, Toronto, Ontario

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INTEGRATING PREVENTIVE ORAL HEALTHCARE INTO THE MEDICAL MANAGEMENT OF DIABETES: EARLY FINDINGS FROM A TORONTO PILOT STUDY he integration of services is a route increasingly taken by healthcare organizations to improve outcomes and access, and to reduce costs. A new American study has shown, for example, a greater level of integration in medical services and a focus on patient outcomes can reduce costs significantly. Starting in early 2019, new preventive oral healthcare services have been offered in a Toronto group medical practice to adult patients with Type 2 diabetes. To our knowledge, this is the first integration of oral hygiene services into the management of a chronic disease in med-

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ical practice. This article outlines the reasons for starting this new oral healthcare service, how it has developed, the response by the patients, and the experience of the medical team.

WHY INTEGRATE ORAL HEALTHCARE INTO THE MANAGEMENT OF DIABETES? In late 2018, a breakthrough study was published in The Lancet to show that improved periodontal health significantly improved glycemic control (HbA1C) in adults with moderate to severe periodontal disease and SEPTEMBER 2019


Figure 1 Levels of glycated hemoglobin (HbA1C) in high risk adults with Type 2 diabetes over 12 months comparing periodontal scaling and root planing (red) versus super-gingival dental cleanings every 3 months (blue). Source: D’Aiuto F et al. 2018. Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single centre, investigator masked, randomized trial. Lancet Diabetes Endocrinology, published online October 24.

Figure 2 Ontario’s Diabetes Disease Management Program, 2009

with Type 2 diabetes. HbA1C levels dropped by 10% when study participants received periodontal scaling and root planing (SRP) every 3 months for a year, compared to those with a super-gingival dental cleaning at the same intervals (Figure 1). Systemic inflammation also improved, as measured by levels of C-reactive protein. This study culminates years of similar studies, including the Cochrane Review, which have reported better oral health can be consequential to the management of diabetes. The study’s results are also confirmed by American health insurers which have shown from their claims experience, that better oral health means lower medical claims by diabetics and others with multiple chronic diseases. For example, Aetna estimates that lowered oral inflammation could reduce medical premiums by 17% primarily by reducing hospitalization and use of the Emergency Room of very sick individuals such as adults with diabetes. This is an extraordinary level of healthcare cost savings, SEPTEMBER 2019

well beyond what has been achieved integrating medical services. From a medical perspective, moreover, it is also important to understand that poor oral health is bidirectional with diabetes. Diabetics have three times the level of caries and periodontal disease. Indeed, periodontal disease has been called the sixth complication of diabetes, along with heart disease, nerve damage, vision problems, kidney disease and peripheral arterial disease. While poor oral health has not historically been a concern of the medical team, this concern needs to change, particularly in an aging community with limited access to the dentist and more co-morbidities which bring on poor oral health. In the case of diabetes, this condition most often appears after age 60, a time of life when the majority of Canadians lose their dental insurance, have fixed incomes, and reduce their use of professional dental care. With these older Canadians, a referral to a dentist by the physician can be frustrated by poor compliance – the patient

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rarely goes to the dentist. Witness a recent analysis which found that fewer than 1 in 10 American adults with both diabetes and periodontal disease, actually received periodontal care. So, there are good reasons to improve the access and adherence of diabetics to oral health services with new models of delivery in the medical practice. If the medical team is to manage diabetes in its aging caseload, services to improve oral health are a valuable part of the patient’s visit to the doctor’s office.

THE CURRENT MODEL OF MANAGING ADULT DIABETES For several years, the Ontario Ministry of Health has reimbursed physicians for a series of regular medical services for diabetics (Figure 2). Every 3 to 6 months, physicians test glycemic control, blood pressure, body mass index and the self-management behavior of their diabetic patients. Annually, other tests and

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In short, both the medical team and the patient are engaged in a wellestablished flow of medical procedures which excludes oral health. So far, the mouth is not considered to be part of the body when it comes to managing diabetes. Figure 3 Poster for the medical examination room

evaluations are conducted including: lipid control, a risk assessment of microvascular and macrovascular complications from diabetes including nephropathy, retinopathy, peripheral neuropathy, erective dysfunction and cardiovascular disease. Immunization against influenza and pneumonia are also provided. This program has governed how the physician and the medical practice handles the diabetic patient. Visits are scheduled accordingly in the Electronic Medical Record (EMR) and the resources assigned to perform these services regularly. Notably, because the Ontario program excludes evaluating and treating poor oral health, the activity to manage oral inflammation in adults with diabetes as described in this article is a leading and innovative approach. Likewise, diabetic patients follow this Ministry of Health program without mentioning they have sore gums, their teeth regularly bleed when they are brushed, or that they have loose teeth. These complaints are reserved for the dentist if the patient has one, or are simply accepted as being part of getting old. In very few cases, does the patient

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consider these conditions to be important to their diabetes. In short, both the medical team and the patient are engaged in a well-established flow of medical procedures which excludes oral health. So far, the mouth is not considered to be part of the body when it comes to managing diabetes. The current model of managing both diabetes and oral health is also based on “free” services. The patients rarely pay for anything when visiting the doctor, and they can resist paying for dental services which are not covered by their dental plan. Because the proposed preventive oral health service in this pilot project was paid for by the patient out of pocket, the authors were concerned this would minimize patient acceptance.

THE TORONTO PILOT STUDY’S MEDICAL PRACTICE AND THE INTEGRATION TEAM This project is taking place in a group family medical practice in downtown Toronto. This medical practice primarily serves office workers in the financial services industry; most have

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a dentist, make regular dental visits, have a dental insurance plan and have incomes at or above the Canadian average. In other words, the caseload is younger and more insured for dental services than most Canadian diabetics. The integration team involves two family physicians, the clinic’s coordinator and two independent hygienists. The coordinator of 11 affiliated medical practices is also an active member of this small team. One medical examination room is assigned for this oral health service. The limited equipment used in this service (a small compressor for air, a backrest for the examination room chair and disposables) is set up quickly in this examination room and when not in use, is stored at the back of the clinic. Sterilization of instruments takes place in the medical practice. Lastly, posters and patient brochures are displayed (Figure 3) and a short questionnaire to record patient feedback is used during the consultation with the patient. The hygienist records all aspects of the patient visit in the EMR. Patient visits are also scheduled via the EMR. All hygiene activity follows a manual of procedures which in turn is based on rules and regulations set by the College of Dental Hygienists of Ontario (CDHO). The preventive oral health service is offered one day a week to diabetic patients served by the two participating physicians.

INNOVATING A NEW ORAL HEALTH SERVICE IN DIABETES CARE This pilot study has introduced several new procedures to serve these diabetic patients. • A new pathway for the patient which fits into the normal patient flow and recall patterns in this medical practice. • A new procedure which combines debridement of the periodontium with a high-strength, long-lasting, SEPTEMBER 2019


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In this first 6 months, it has become clear that the diabetic patients respond very favorably to the consultation and to this new service.

broad spectrum, topical antiseptic (Prevora). This medication has shown remarkable efficacy and safety over many years and many patients in reducing oral inflammation and treating periodontal disease even amongst those patients unresponsive to SRP; moreover, it simultaneously protects against root caries which is also a key component of poor oral health in diabetics and older patients. If the patient requires a full mouth SRP, he/she is referred to an outside dental professional as there are time and space limits to conducting this service in a medical setting. • An outreach education program to the diabetic patient which involves telephoning patients on behalf of the physician to schedule a consultation on oral health in the medical practice. This approach alleviates complexity and work for the physician and the clinic coordinator, and accelerates adoption by the patients. • A revenue-sharing model to reward all parties from the benefits of better oral health. For the pilot study, the price per treatment has been set at $120. This revenue is shared by the medical clinic, the hygiene team and the supplier of Prevora. The critical step on the patient pathway is the consultation with the hygienist in a medical examination room. This takes up to 20 minutes, involves an education of the patient on the role of better oral health in managing their chronic condition and an assessment of risk factors for poor oral health. Much of this information is new to the patients and they are very receptive to it. Patients also complete a short questionnaire about their oral health status, about what they know about their oral health, and what they think of this new service. The risk assessment by the hygienist is recorded in the EMR for future reference by the medical team and the hygienist. At the end of the consultation, the hygienist makes a recommendation for treatment or future re-examina-

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tion, whichever is appropriate. The treatment appointments are scheduled if possible to coincide with the regular medical visits. In the first year, there are 4 treatment visits and thereafter, two per year or as indicated by the hygienist’s clinical judgement.

FAVOURABLE RESPONSE BY PATIENTS In this first 6 months, it has become clear that the diabetic patients respond very favorably to the consultation and to this new service. It is also clear that this service fits readily into the setting of a busy group family medical practice and is a valued part of the medical care. The service has proven, moreover, to be economically viable for the patient, the medical practice and hygiene team. Clinical outcomes regarding oral inflammation and diabetes markers will be evaluated in 2020 when sufficient data is available. These are the most important interim observations of this study: • When reached by phone by the hygienist as part of the medical team, the vast majority of patients agree to a consultation on their oral health. They also attend this consultation; there are few cancellations. • For every 10 consultations with these diabetic patients, 4 have good oral health and 6 are candidates for more preventive oral healthcare due to oral inflammation and periodontal disease. • Amongst the patients needing more preventive oral healthcare, almost all agree to enter the preventive treatment plan. • The price of the treatment plan is accepted by the patient. • The patient survey data show that 2 of 3 diabetics are not aware that the health of their gums and their diabetes are inter-related. • A significant majority rate this service as being very important and most also indicate they will be using this new service in the next year (Figure 4). SEPTEMBER 2019


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Perhaps the most important finding so far is that independent hygienists can join the medical team; there is confidence, trust and a professional working relationship between all healthcare professionals involved in this new service.

References 1 2 3

4

5 6 7

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https://www.nejm.org/doi/full/ 10.1056/NEJMsa1813621 https://www.ncbi.nlm.nih.gov/ pubmed/30472992 https://www.cochranelibrary.com/ cdsr/doi/10.1002/14651858. CD004714.pub3/full Avalere Health, 2016. Evaluation of cost savings associated with periodontal disease treatment. Unpublished, available upon request. https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC5285600/ https://www.nature.com/articles/ bdjteam20157 Loe H, 1993. Periodontal disease – the sixth complication of diabetes mellitus. Diabetes Care, v.116, Supplement 1, January, 329-334 Avalere Health, 2016. Evaluation of cost savings associated with periodontal disease treatment. Unpublished, available upon request DiNardo J. 2018. Preventing poor oral health in older clients with multiple chronic conditions: the experience of the Gleam Smile Centre. Canadian Dental Hygienists Association, Oh Canada! Summer issue, 22-25.

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RESPONSE BY THE MEDICAL TEAM Perhaps the most important finding so far is that independent hygienists can join the medical team; there is confidence, trust and a professional working relationship between all healthcare professionals involved in this new service. This is the necessary foundation for taking next steps.

THE NEXT STEPS

This project will continue to enroll the diabetic patients of more family physicians in this practice given the teamwork and favorable acceptance to date. Treatment and outcomes will be recorded in the EMR so that patterns in oral health, glycemic control and blood pressure will become evident over the next 12 months. In addition, the team is considering expanding the selection criteria for this service to include patients with

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co-morbidities which are also linked to poor oral health. Cardiovascular disease, cerebrovascular disease, respiratory disease and mild cognitive impairment are good candidates for an adjunctive preventive oral health service delivered when the patient visits the physician.

CONCLUSION

A pilot study of integrating preventive oral health services with the medical management of adult diabetes is underway in a Toronto group family medical practice. After six months, the hygiene team has become part of the medical team and the patients are very receptive to this new service. The pilot study will continue with more physicians and more patients, and is expected to generate data on changes to oral health, glycemic control and blood pressure in 2020.

SEPTEMBER 2019


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ORAL HYGIENE

10 STRATEGIES FOR HANDLING PARENTS OF YOUR PEDIATRIC PATIENTS ediatric patients in the dental office create an interesting environment that can be both exciting and chaotic. Often times, the parents can be far more dramatic than the patients themselves. Parents are trusting your office with their most prized possession. It is imperative for teams to connect both with the parents as well as with the patients. A successful practice with pediatric patients takes into consideration the parent perspective on a daily basis.

Brenda McNulty, Jameson Advisor, Jameson Management With experience in dentistry that spans over 20 years, Brenda brings a depth of both clinical and business knowledge that encompasses the unique scenarios found not only in general practices, but those of orthodontic and pediatric practices as well. As a Jameson advisor, Brenda coaches’ dentists and dental team members nationwide, helping them improve the systems of their business, increase their productivity and profitability and do it all while having FUN. Brenda has been a speaker for multiple study clubs and dental society meetings sharing information on impactful topics like the utilization of technology, development of teamwork, enhancing case acceptance and customer service. For more information on Brenda, the Jameson team and Jameson’s services, visit www.jmsn.com.

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Strategy #1 – Clear expectations of the office should be communicated and agreed upon before procedures are initiated. Some providers feel strongly that parents do not belong in the treatment rooms while others appreciate the parent’s presence. You get to decide what works best for your office. Parents need to know these expectations prior to scheduling with your office. Know the benefits and disadvantages for both stances and be able to verbalize these to your potential new patients. Strategy #2 – Be sensitive to the emotional state of the parents when discussing treatment. Parents often believe that they have failed when they hear that their child have dental disease. Validate the positives and accentuate their decision to seek dental care. Provide education without judgement. It is imperative that you provide the parents with the tools necessary to appropriately care for their children’s teeth from this point forward. Strategy #3 – Make it an experience for both the parents and the child. Allow the parents to enjoy some luxuries such as a coffee bar

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or massage chairs while they wait for their precious youngster. Have comfortable chairs in the reception area and harder chairs in the treatment rooms as a technique to discourage parents from accompanying their child into the clinical area. Strategy #4 – Demonstrate true concern for the patients overall dental health. As the dentist you must receive the parents trust, like and confidence before they will eagerly accept your recommended treatment. Explain the benefits of the procedures and the projected outcome from both completing and not completing the treatment prior to discussing any financial liabilities for the parents. Parents who are educated about the procedures are far more likely to accept the treatment regardless of the costs associated with those services. Strategy #5 – Be worth the ticket to the dental show. Create value for your services by explaining each action. Utilize a tell-show-do approach while generating a fun factor whenever appropriate. Their child’s dental visit will cost them more than a ticket to Disneyland. Help your team understand that from the moSEPTEMBER 2019


ment they enter the door they are on stage. Parents see all and hear all. Hire “Tiggers” for your office and let the “Eyores” remain at home. Team members who exhibit a true passion for their patients and their profession build relationships. Dental skills can be taught so hiring for attitude and personality may pay off in the long run. Strategy #6 – Help your parents schedule successfully for their child. Have the school schedules available for your parents to review when reserving time with your office. Make note of important school obligations such as state testing and inform the parents when they are attempting to reserve time with the doctor during these crucial attendance periods. SEPTEMBER 2019

Strategy #7 – A parent may have a need to have someone other than themselves bring the child to their dental appointments. Be prepared for nannies, grandparents, aunts, uncles, siblings, or friends that may bring your patients to the appointments. Don’t assume that a written policy on this topic is read by the parents. Verbally ask who will be attending the appointment with the child and complete the necessary paperwork with the parent. Be proactive and provide the necessary paperwork to the parent in advance of the appointment to eliminate frustrations.

Parents see all and hear all. Hire “Tiggers” for your office and let the “Eyores” remain at home.

Strategy #8 – Under promise and over deliver. In any care utilizing this strategy with your patients can

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May 2017

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prove to be successful. A parent that is trusting you with their childâ&#x20AC;&#x2122;s dental care will feel taken advantage of if the services abruptly change during treatment. Explain all the possible situations that could occur and do not minimize their concerns. Validate all possible scenarios with the parent prior to initiating treatment.

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Strategy #9 â&#x20AC;&#x201C; Understand that they have the right to refuse service. If you feel that the relationship between the doctor and the parent is not conducive of the proper dental care of the patient you can follow the steps outlined by your local dental association for releasing that patient. Strategy #10 â&#x20AC;&#x201C; Constantly show

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A practice that initiates proactive communication strategies will be far more successful in creating an environment where both the patient and the parent is comfortable. appreciation to your team, your patients, and their parents. Happy parents make for a more relaxed environment for the patient. A practice that initiates proactive communication strategies will be far more successful in creating an environment where both the patient and the parent are comfortable. Take every opportunity to create value for your services by turning their childâ&#x20AC;&#x2122;s visit into a positive experience. Provide the necessary support for your parents to make educated decisions. When your office is fun, exciting, and appreciative your parents will see the value of your services. A little empathy and compassion goes a long way with parents. Utilize these strategies with the parents of your pediatric patients and watch your practice succeed.

SEPTEMBER 2019


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ORAL HYGIENE

I’M ALL IN Irene Iancu, BSc, RDH, CDTP Irene Iancu has worked in various specialties including Paedo, Perio, General Practice and Orthodontics. Her goal in her current holistic practice is preventing and maintaining an optimal mind, mouth and body. Irene connects the systemic effects of oral conditions to her clients, while making a change for overall health and wellness. As a Peer and Quality Assurance Mentor contacted by the CDHO, a Clinical and Theoretical Dental Hygiene instructor at Oxford College, and a practicing dental hygienist in Toronto, Irene shares her passion for education with us today in the hopes we can change the lives of our clients and their loved ones. Irene can be contacted at Irene@toothlifestudios.ca, www. toothlifestudio.ca, IG: @ToothLife.Irene, @Toothlife, @Toothordare.podcast.

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ave you ever asked for a raise and been declined? What about benefits, new equipment, fancy scrubs or lab coats? I’m guilty. We all have needs and wants. Practice owners have moments of splurge when the cash in pouring in, and the next moment could be a drought. The conversation around money always rears its ugly head in matters of business, and until July of this year, I thought I knew a decent amount about the business of dentistry. Rookie move – I was wrong! I attended a conference hosted by Dental Economics (Endeavor Business Media and the organizers of RDH Under One Roof). As an emerging practice proprietor, so extremely new that the link on my lease has yet to fully dry, I arrived armed with a list of questions focused on being a first-time practice owner. My calculated list slowly

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turned into two pages, as the first day opened my eyes to what it’s really like to own a dental practice as a first-timer. For every one of my questions answered, three follow-up questions appeared at the bottom of my list. I found this experience to be profound and I’m eager to share my takeaways with you in this article. My first realization is that no two businesses are the same. What works for one may not mirror for another, and that is absolutely okay. Each presenter brought his or her own insights and experiences that led me to make some game changing decisions about life, passions, and what my 15-year plan is. Retirement seemed like an odd thing to think about so early in the game, but as the first few minutes into the event elapsed, it was clear that using your endgame vision as a strategy to plan your career was an essential reality to face early on. Dr. Roger Levin, who was the first SEPTEMBER 2019


He shifted into customer service and encouraged us to think bigger and model our teams to handle patients just as the Ritz Carlton and Disney do with their clientele.

speaker to take the stage, opened with the question that I feared the most. “How many of you own your own practice? How many of you own two, or are on your third, fourth, fifth, sixth or seventh practice?” Fair question. He was getting to know the audience. But then again, we were just getting to know each other, too. Considering my office only had one side of its drywall completed ironically that same morning, and only one main water line, my hand stayed down but my eyes definitely shifted. As the practice numbers increased, the number of hands SEPTEMBER 2019

decreased – as you could imagine. When I looked around the room at the mass of people, team members, and practice owners, I immediately concluded. These are the people I want to be surround by. These are now my people. Even folks with five to seven practices to their names were there, sitting among the newbies such as myself, openly showing their hands, sharing their bluffs, and playing at the same table with the same (yet higher stack) of chips. Dr. Levin gave advice on the metrics that practices need to be cogni-

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zant of. He also offered insights, such as having ‘targets for every department within your practice’. For example, staff pay should be about 25% of gross earnings and that a practice needs 800-1000 patients to keep a registered dental hygienist busy full-time. He shifted into customer service and encouraged us to think bigger and model our teams to handle patients just as the Ritz Carlton and Disney do with their clientele. This extremely condensed version of his lecture was a great introduction to the services he provides as a consul-

May 2017

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tant, and merely skimmed the surface of the ‘8 most important actions that every dental practice should immediately implement. It was a great way to start off my first day. Dianne Watterson, RDH, MBA, spent a good portion of her time talking about the dental hygiene department and the benefits of boosted efficiency by utilizing a designated hygiene assistant. Not only anecdotally but as it reflects on the daily billings. This is something that I have experienced first-hand as a gigantic benefit in practice, from complex orthodontic cases all the way to recall visits and initial records. This operating model is something every practice should consider if you’re working on increasing hygiene efficiency and productivity. With short lectures, it’s often difficult to get all the questions answered, which made the lunch session an extremely valuable piece of the day.

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The moderated panel primarily focused on digital marketing, and having a consistent online presence. The session was moderated by Dr. Chris Salierno, with panelists Dr. Josh Austin and Graig Presti. Takeaways from this doubles-match were executed perfectly to hit all online skill levels. In order of importance, they encouraged us all to look into adding your own photos and details. Ensuring that all platforms have consistency and accuracy help beat the algorithms, which then help to rank you higher on Google without paying a cent to third-party agencies or providers. For local communities, direct mailers are still of value, however, they need to be repeated for consistency and exposure. If you’re using direct mail marketing, don’t be discouraged if the first set doesn’t flood the front gates. Give it some time and keep it consistent. The post-lunch session was led by SEPTEMBER 2019


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Vin explained that DSO’s make decisions based on business, metrics, and numbers. Dentists often make decisions based on experience, passion, fear, and sometimes pressure.

Vin Cardillo, MBA, who knew a thing or two about the business side of dentistry. A former DSO practice investor, and “private equity guy”, you could see it in his eyes that he knew his stuff about the ever-growing DSO business model. Among the group of delegates, not one person was associated with a DSO, however, we all wanted one question answered: “How do they do it?” Vin explained that DSO’s make decisions based on business, metrics, and numbers. Dentists often make decisions based on experience, passion, fear, and sometimes pressure. Modeling office roles based on a DSO model is a great idea for anyone, regardless of size or number of locations. Having a structured reporting system is key. For example, always knowing who is responsible for specific decision making – “something as simple as having one designated person responsible for vacation approvals, budget distribution for equipment, and IT”. Having clearly defined positions, job descriptions, and employee manuals, reduces the guessing game behind the operation of a business. The DSO model clearly has an advantage and an advantage is a good thing to have when you’re in a tight spot. In my years of practice, I can say that only a few practices have had these structured systems in place, and unfortunately, not all at once. Vin gave us all a great deal to think about and reiterated the importance of staying on our toes. To conclude my first day, we were in for a treat as Norfolk Virginia was a quaint little seaside town, with a

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stunning waterfront – making the sunset cruise a beautiful way to reflect on the day. Vendors, speakers, and delegates walked together and boarded a three-story ship to set sail towards the sunset. This was the perfect opportunity to chat with the experts, explain my personal situation, and hopefully get some free advice over a Negroni. New friendships were formed and I was able to get to know people on a more personal level. Often, we talk mainly about the business highlights but this mini getaway opened us up mentally, which helped open up to some of their business failures. In my opinion, this is the best way to learn. Day two was short and bittersweet, as the realities kick in of practice ownership, growth and the unknown future of dentistry. Dr. Josh Austin took the stage as the last mainstage speaker of the conference, and brought his A-game on the topic of Google/Yelp reviews and creating your practice philosophy. He shared some inspired ‘howto’ tips on getting Google/Yelp reviews to stick and rank, then closed his set with the importance of handling negative feedback with fines delivered in his own uniquely branded style. Dr. Austin encouraged us to isolate all little compliments we get every single day. “Don’t brush them off as ordinary patient/clinician banter”. Make it official and have a patient take that compliment and post it to your Google business page. Ask for location check-ins on your business platforms, like Facebook and Yelp, and turn those compliSEPTEMBER 2019


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As an employee, you may not be privy to the financial inner workings of your department or practice, which is not your fault. However, understanding a sliver of these principals might assist in navigating conversations differently in your negotiations for your wants and needs.

ments into reviews to help your practice rank higher. Add a little topspin to that review and have your patient upload a photo. The photo doesn’t have to be a curated selfie. It could simply be a photo of your reception room, a cool indoor fig tree, or even a tennis ball collection. Photos will ultimately give you a little bit more credibility online and help those reviews to be ranked as more relevant to potential and existing clients. This conference was never about how to ask for a raise, getting health insurance, or even new equipment. Though, as the hours elapsed, it helped us to get a better understanding of how it all works behind the scenes, which gave me ideas on how to successfully offer solutions that could alleviate some fiscal constraints. As an employee, you may not be privy to the financial inner workings of your department or practice, which is not your fault. However, understanding a sliver of these principals might assist in navigating conversations differently in your negotiations for your wants and needs. Molar of the story: across the board, every speaker echoed the importance of having a solid team moral. Work on the team, keep working on the team, and grow together – not apart. I liked Dr. Austin’s parallels

between the elite culinary world and dentistry. “Get creative but always maintain the level of service as a 3 Michelin Star establishment”. This includes superior customer service, strength as a team, and a led by a true trailblazing visionary. This is something in dentistry that we should all attempt to accomplish if we want those consistent 4.7 to 5-star reviews. The climb can take decades but it is possible for the strong willed and the driven. Staying at the top is another hurdle. The atmosphere created by the exceptional organizational team that brought Principals of Practice Management together was that of an open learning and sharing environment, led by an all-star team with decades of success and failure stories, which made this experience more than just another course. Approachable speakers, experts and involved vendors provided useful insights and realistic takeaways that can be implemented the moment you got home. I encourage you all to consider an extended conference for your future practice management CE. You’ll find that with just a few more hours, your knowledge on the business of dentistry will be more valuable, and the friendships you make will serve as lifelong benefits.

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REGINA, SK

Modern and nicely equipped dental clinic with a well established and growing patient base is seeking a full-time hygienist. All experience levels welcome. Competitive wages and benefits to be discussed at interview. Moving assistance for successful out of area applicants available. Contact: admin@oriondentalgroup.ca

We are looking to hire hygienists to join our busy and well-established practices in Ontario, Saskatchewan, Alberta, and Manitoba. What you will benefit from: • Excellent remuneration • Mentorship and access to a large network of dental professionals • Work life balance with evenings/ weekends off • Additional perks for the right candidate New grads welcome! If interested please send your resume and cover letter: info@enspireopportunities.com

Busy dental clinic with a growing patient base has an immediate opening for a permanent, full-time RDH. All experience levels welcome. The ideal candidate would be well organized, an effective communicator and a team player. Competitive wages and benefits to be discussed at interview. Moving assistance for successful out of area applicants available Contact: officemanager@courtsidedental.ca

SCARBOROUGH & MARKHAM, ON FULL-TIME/ PART TIME REGISTERED DENTAL HYGIENIST REQUIRED Full time registered Dental Hygienist for a busy well established Dental office in Scarborough and Markham. Candidate should be energetic, confident and strong communication skills. Fax: 416-443-9090

FLIN FLON, MB FULL TIME DENTAL HYGIENIST A busy family practice, located in Flin Flon MB, looking for a full time Registered Dental Hygienist. Please send your resume to vfdentalc@gmail.com

MEDICINE HAT, AB River Dental in Medicine Hat is looking to hire Dental Hygienists to join their team! Both part time and full-time hours are available. This is a wonderful opportunity for new graduates looking to start their career in a wellestablished practice, and of course, those with experience are also encouraged to apply! E-mail: careers@dentalcorp.ca

P RACT I C ES & OFFI C ES NOBLETON, ON

CAREERS LOCUM NEEDED Ominica Dental Group is seeking a full time locum dentist to cover a maternity leave beginning Oct 1, 2019. We are a busy, family dentistry practice located in downtown Moose Jaw, SK. Office hours are 8am-4pm, Monday to Friday. Expected length of term is 6 months, with possible extension. Please email Nicole at nip105@mail.usask.ca for more information.

REDUCED PRICE: $400K.

PETERBOROUGH, ON

IN AND AROUND TORONTO, ON

ATTENTION SPECIALIST DENTISTS!

Turn key operation for anyone looking to own their first practice in a residential growing community. Modern, newly built practice of 4 years in the township of King. Spacious, 4 operatories, pan room, consult room and team area. A must see!! E-mail: info@dentalacquisitions.ca

A very large patient friendly space available for rent in Peterborough !! All lease holds included !! Many options available !! Ideal for a periodontist, endodontist or a prosthodontist. Please connect with Dr. Vipin Grover at 705 740 5239 or email me at vipingrover@yahoo.com

Full-Time/Part-Time Anesthesiologist wanted to join our team. We are looking for candidates on a part-time and full-time basis for up to 15 days/month in a private dental office setting. Pediatric experience is an asset. Excellent compensation provided. Please email your CV to hr@appletreedentalforkids.com

SARNIA, ON

GEORGIAN BAY, ON

Turnkey dental office, 4 ops, 1270 sq. ft. Minimal start up cost, location only.

Office for sale, Georgian Bay, gross fees, $1.1 million, appraised value $1.35 million, active patients in excess of 1,700, real estate available too, owner will remain as associate for a short period of time.

Emailaddressformee@yahoo.ca 416-346-1965

DOWNTOWN VANCOUVER, BC

DENTAL PRACTICE OPPORTUNITY–FOR SALE Established 30 plus years practice in a strata-titled professional building in the heart of DT Vancouver. Please reply to: Oral Hygiene – Box 61 – karen@newcom.ca

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oralhygiene

If interested please forward summary CV to practicesale@minnaar.ca

ASSO C I AT ES H I P S WATERLOO,ON SEEKING FULL OR PART TIME ASSOCIATE Well established 27 year old Busy Family Dentistry Office looking for an Associate. Days and hours can be decided. High Tech office with a wide range of services. General Dentistry to Surgeries, Cosmetic and Orthodontic. New Graduates welcome. Please Contact Via email at drka@drkashraf.com

www.oralhealthgroup.com

SEPTEMBER 2019


ASSO C I AT ES H I P S HIGHLY PRODUCTIVE DENTAL OFFICES WITH BUY IN POTENTIAL, SEEKING FULL TIME GENERAL DENTISTS AND ORTHODONTISTS TO WORK IN MAJOR CITIES OF ALBERTA. Each practice has multiple associates along with a Senior Dentist catering to all aspects of dentistry including cosmetic dentistry, Invisalign, implants, IV sedation, endodontics and surgeries and orthodontics. Mentorship provided and expect to be busy from First Day. The successful candidate will have a passion for building strong patient relationships and be a Team Player. Please email resume to calgarysmiles2018@gmail.com

TORONTO, ON

OKOTOKS, AB A well-established general dental practice in Okotoks, Alberta is looking to hire an Associate dentist. Join a great team of dental professionals who strive to provide the best to their patients! The successful candidate will have a passion for building strong patient relationships and contributing to their ongoing oral health. As an Associate at the practice, you will have the opportunity to work alongside a strong team of dental professionals, learn from the Principal dentist, and have access to online continuing education. What’s in it for you: • Ongoing learning and development • Access to a network of dental professionals • Competitive Compensation Requirements: • Up to 3-5 years of general dentistry experience

Associateship Specialty in Orthodontics leading to partnership available in a prestigious, successful office located on the Yonge line in Toronto.

• Experience in pediatrics is an asset • Certification and experience with Invisalign an asset • Graduate from an accredited DDS/DMD Program or Completion of the NDEB Equivalency Exam • Certified with NDEB • Licensed and in good standing with provincial regulatory body

Please submit application to: glondos@icloud.com

• Valid CPR Certification E-mail: careers@dentalcorp.ca

LABRADOR CITY, NL

SOUTH CALGARY, AB

Enthusiastic dentist required for a family dental practice, in Labrador City, Newfoundland, friendly staff to assist you. For further information, please contact Rehan at 709 944 4294 or e-mail rmalik@crrstv.net

Deer Valley Dental Care has been providing exceptional dental care to the community of south Calgary for over 30 years. We are excited to continue adding to our team and are in search for a full time Associate Dentist. Join a great team of dental professionals who strive to provide the best to our patients!

GTA & SURROUNDING AREAS, ON

As an Associate at the practice, you will have the opportunity to work alongside a strong team of dental professionals, learn from the principal dentist, and have access to online continuing education.

Associate opportunities available across the GTA and surrounding areas including Scarborough, Mississauga, Brantford, Hamilton, Barrie, Dundas, Brampton, Etobicoke, Oakville, Waterloo, and Owen Sound. E-mail: yourdentaldream@gmail.com

What’s in it for you: • Ongoing learning and development • Access to a network of leading dental professionals

EDMONTON, AB Full time associate required for busy dental group servicing Edmonton and surrounding community. Long term associateships preferred. Please email resume to omar@infinitydental.ca

TORONTO & WESTERN GTA, ON ASSOCIATE DENTIST OPPORTUNITY

Looking for two enthusiastic part time associates. Positions in Toronto and Western GTA. If interested, please forward your resume to: chaggerdental@gmail.com SEPTEMBER 2019

• Competitive compensation Requirements: • Graduate from an accredited DDS/DMD Program or completion of the NDEB Equivalency Exam • New graduates are encouraged to apply! Will also consider those with experience • Certified with NDEB • Licensed and in good standing with the provincial regulatory body • Valid CPR Certification E-mail: careers@dentalcorp.ca

www.oralhealthgroup.com

oralhygiene

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ASSO C I AT ES H I P S OTTAWA, ON

CALGARY, AB A well-established dental practice in Calgary is currently looking to hire an Associate Dentist. Join a great team of dental professionals who strive to provide the very best to their patients! As an Associate at the practice, you will have the opportunity to work alongside a strong team of dental professionals, learn from the principal dentist and have access to online continuing education. What’s in it for you: • Ongoing learning and development • Access to a network of leading dental professionals • Competitive compensation Requirements: • Graduate from an accredited DDS/DMD Program or completion of the NDEB Equivalency Exam

Join our large customer-oriented multi-disciplinary group dental centre and build your practice through referral and extraordinary new patient flow. Let us help you rapidly advance a career to be proud of. Located in a centrally-located major retail plaza, we offer extended hours and supply superb support staff, state-of-the-art equipment, and committed colleagues. Whether you’re just starting out, already have years of quality experience, or somewhere in between, if you want to love where you work, please contact us today!

• Minimum 8-10 years of general dentistry experience required

business@adcottawa.com

• Must be confident in all general dental procedures including RCTs, crowns and dentures

NEWMARKET/BRADFORD AREA, ON

• Invisalign trained and certified • Certified with NDEB • Licensed and in good standing with the provincial regulatory body • Valid CPR Certification E-mail: careers@dentalcorp.ca

SALT SPRING ISLAND, BC

ONE HOUR EAST OF TORONTO, ON

Gorgeous waterfront location on desirable Salt Spring Island seeks full-time associate. Modern, paperless office with digital x-rays, CBCT, incorporating the full range of dentistry with a wonderful support team. Come enjoy a relaxed lifestyle with easy accessibility to both Vancouver and Vancouver Island. Exceptional amenities include schools, hospital, wellness and aquatic centers. Experience preferred. Email resume to: saltspringdental@telus.net

FULL TIME ASSOCIATE OPPORTUNITY IN BUSY OFFICE

COLD LAKE, AB

We have an opportunity for an associate in our office. We are a group of team oriented, busy offices that are easily accessible from Hwy 401. Full service dental practices with great autonomy for the associate while being mentored by knowledgeable practice owner. Attractive compensation and support. Please contact 289-251-0799 for more information.

SCARBOROUGH, ON

Cold Lake Dental Centre is seeking a dedicated Associate Dentist for a full-time position to provide comprehensive dentistry. An opportunity exists to transition into ownership. Send cover letter and resume to naqvident@hotmail.com

Scarborough Part time associate wanted Thursday and Saturday, eventually could be full time. New grads welcome. Experience an asset. Must have great communication skills and team player. Email resume to: dentalresumes0101@gmail.com

STRATFORD, ON

HIRING ASSOCIATE DENTISTS

Hiring P/T Associate Dentist Eventually Seeking F/T Opportunity. Comprehensive Dental Practice with 85+ All 5-Star Google Reviews. Beautifully Equipped & High Production Office. E-mail resume to: info@mcadental.com

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ASSOCIATE DENTIST OPPORTUNITY WITH A LEADING PRACTICE.

oralhygiene

FOR MULTIPLE PRACTICES IN OTTAWA-GATINEAU REGION

Do You Want to Take Over an Existing Patient Base and Earn More Income? E-mail resume to: info@mcadental.com

www.oralhealthgroup.com

Full time or part-time positions. Depending on availability. Some Evenings & some Saturdays required. Good with children. Nitrous License is preferred. summerhilldental@hotmail.com

CAMPBELLFORD , ON (2 hours east of Toronto near Peterborough)

Full time dental associate needed in very busy dental office. Unlimited potential. Hospital privileges available. Can easily make $600K in billings if capable. Must be able to work independently. Will mentor in complicated cases. Please send your resume to sidhumehboob@hotmail.com

PETERBOROUGH AREA, ON Full-time or Part-Time Associates in busy Peterborough area Group offices providing family, cosmetic, preventative & restorative dentistry for 13 years in Peterborough. Our office is a fun-loving, fast-paced environment that creates a friendly and welcoming atmosphere for not only our patient but also for our doctors and our staff. We work hard to be leaders in the dental industry. Our offices are constantly growing; we operate a busy office with high levels of traffic. We are looking for doctor who is passionate, outgoing, able multi-task in a fast-paced atmosphere, and is eager to become part of a team of leaders in the dental industry. Email to ChemongFD@outlook.com SEPTEMBER 2019


ASSO C I AT ES H I P S RED DEER, AB A well-established practice in Red Deer, Alberta is looking to hire a full-time Associate dentist. Join a great team of dental professionals who strive to provide the best to their patients! The successful candidate will have a passion for building strong patient relationships and contributing to their ongoing oral health. As an Associate at the practice, you will have the opportunity to work alongside a strong team of dental professionals, learn from the Principal dentist, and have access to online continuing education. What’s in it for you: • Ongoing learning and development • Access to a network of dental professionals • Competitive Compensation Requirements: • New grad or up to 1 – 2 years of experience. Great mentorship opportunity available! • Graduate from an accredited DDS/DMD Program or Completion of the NDEB Equivalency Exam • Certified with NDEB • Licensed and in good standing with provincial regulatory body • Valid CPR Certification • Strong communication skills

Opportunities for experienced associates and specialists across Canada — Contact careers@dentalcorp.ca or learn more at careers.dentalcorp.ca

E-mail: careers@dentalcorp.ca

ANTIGONISH AND PORT HAWKESBURY, NS Antigonish & Port Hawkesbury is currently looking to hire an Associate dentist who has a passion for working with children to join our well-established family practice. The successful candidate will have a passion for building strong patient relationships and contributing to their ongoing oral health. As an Associate at the practice, you will have the opportunity to work alongside a strong team of dental professionals, learn from the Principal dentist and have access to online continuing education. New grads welcome! What’s in it for you: • Ongoing learning and development • Access to a network of dental professionals • Competitive compensation E-mail: careers@dentalcorp.ca

OSHAWA, ON Growing family practice in Oshawa is seeking part time associate to join our team on Tuesdays and alternating Fridays. The right person will be caring, honest, self motivated and fluent in English both spoken and written. Please email resumes to dentaloshawa@yahoo.ca SEPTEMBER 2019

NORTH BAY, ON FULL TIME ASSOCIATE DENTIST – 35 TO 40 HOURS – MONDAY TO FRIDAY Our Dawson Dental practice located right by the water is currently looking to hire an experienced Associate Dentist to join our well-established practice. The successful candidate will have a passion for building strong patient relationships and contributing to their ongoing oral health. As an associate at the practice you will have the opportunity to work alongside a strong team of dental professionals within our 13 Operatories, learn from the principal dentist and have access to online continuing education. Our practice is equipped with Itero Scanning machines & Gold standard in infection control. Over 7200 active patients, booked approximately 3 months in advance.

What you will benefit from: • 75% off continuing education courses through our preferred partner • Mentorship Growth opportunities • Remarkable holiday parties • Extended Health Benefits Requirements: • Graduate from an accredited DDS/DMD Program or completion of the NDEB Equivalency Exam • Certified with NDEB • Licensed and in good standing with the provincial regulatory body • Valid CPR Certification • Sedation credentials would be beneficial • French speaking an asset

E-mail: careers@dentalcorp.ca

www.oralhealthgroup.com

oralhygiene

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ASSO C I AT ES H I P S PARIS, ON

MISSISSAUGA, ON

FULL TIME ASSOCIATE REQUIRED

ASSOCIATE NEEDED IN BUSY MISSISSAUGA PRACTICE Our busy dental office is looking for an enthusiastic, caring and proficient general dentist starting immediately. We are a well-established and highly recognized dental practice in Mississauga since 1975. Modern and digital practice offering full scope dentistry. Close relationships in the community, looking for a long-term, part-time associate dentist – possible hours of Tuesday evening, Wednesday and alt. Saturday but are flexible – hours will expand with the right candidate. Please email resume to: smiledentists10@gmail.com

BURLINGTON, ON A growing dental office in Burlington is looking for a part time associate, 2-3 days a week, to join our team. If your idea of dentistry is a position in a friendly community, working with a great team and the latest equipment, we have the position for you. Our established patient base and a healthy new patient flow provides a busy environment. The successful candidate will have a passion for building strong patient relationships and contributing to their ongoing oral health. Remuneration is paid on production. E-mail: alison@lakesidefamilydental.ca

DRYDEN, ON FULL-TIME ASSOCIATE FOR DRYDEN/ONTARIO Offering 50% earnings and a fully furnished apartment. Full-time associate dentist position is available immediately for a hardworking, positive and clinically skilled general practitioner. We operate an established, successful and busy dental practice with more than 6000 active patients. Full schedule from day one and a fully trained dental team. Prefer Canadian experience but not a must. Enjoy exceptional outdoor living in Northwestern Ontario. Contact us at vivadental@hotmail.com

SOUTHERN NIAGARA REGION, ON PART-TIME ASSOCIATE NEEDED

Privately owned clinic, in Paris, Ontario requires experienced Full Time Associate. Three years or more experience in Root Canals, Extractions, and Cosmetic Dentistry. We currently operate with one Dentist, one Manager/Administration, an Assistant and 2 Dental Hygienists. We are in a rapidly expanding community, an easy two minutes access off the 403. Great patient base and patient flow, benefit of dedicated experienced Team and continual practice growth. Please send a cover letter with your application telling us why you would be our ideal Associate. Email to: shammick@gmail.com

SHELBURNE, ON Incredible opportunity for a General Dentist to join a private practice in Shelburne, Ontario with state of the art technology. We are growing and would love to have a passionate, caring and experienced Dentist with excellent communication skills to join our professional team. The ideal candidate has worked with patients of all ages and is committed to the highest quality of patient care. Great location with excellent patient base. Minimum of one year of private practice experience required. E-mail: shelbournedentalassociates@gmail.com

MEDICINE HAT, AB River Dental in Medicine Hat is looking for an Associate Dentist to join their team! Excellent mentorship is available for new graduates who are looking to start their career; however, those with experience are encouraged to apply as well! There is an opportunity to receive relocation assistance for those not local to Medicine Hat or surrounding areas. E-mail: careers@dentalcorp.ca

WHITEHORSE, YT Full time associate required. We enjoy a modern clinic and our excellent team is focussed on patient centered care. Come and join us and experience a northern lifestyle second to none. Tel: 867-633-4401 Fax: 867-633-4402 E-mail: office@murrayadental.ca

We are a well-established and progressive dental office practicing in the Southern Niagara Region. We are seeking a part-time associate to join our growing practice.

Looking for a part time associate.

Qualified candidates can email their resumé to niagaradentist@hotmail.com

Please send resumes to dental_2010@live.ca

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oralhygiene

ORILLIA, ON

www.oralhealthgroup.com

SOUTH-EAST OTTAWA, ON Busy practice located in the south-east Ottawa area (about 25 minutes from the airport) looking for a full time associate (no evenings or weekends). We are looking for an individual who is compassionate, outgoing and a team player. Send resumes/cover letters to admin@brightdentalcentre.com

SCARBOROUGH & MARKHAM, ON LOOKING FOR ASSOCIATES AND HYGIENIST Experienced associates required to work in supportive and progressive practice in Scarborough & Markham locations on weekdays and Saturdays. Candidates should enjoy every aspect of dentistry. E-mail: rose-2010@live.ca Fax: 416-443-9090

IN AND AROUND TORONTO, ON Pediatric Dentist wanted for established and growing pediatric dental clinics, in and around Toronto. If you are a recent graduate or established doctor we want to hear from you! Excellent compensation provided. Please email CV to hr@appletreedentalforkids.com

BOWMANVILLE, ON Established busy practice in Bowmanville looking for an associate. Great team, modern office, large patient base and patient flow. Ideal candidate is experienced, outgoing, thrives independently or with a team. Email: Bowmanvilledentist@gmail.com

PICKERING, ON Looking for a part -time associate for family oriented practice. Wednesdays and Saturdays to begin. Please e-mail your resume to: osowski.iwona@gmail.com or call 905-683-5448. SEPTEMBER 2019


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Oral Hygiene September 2019  

Oral Hygiene September 2019