Oral Hygiene February 2018

oralhygiene FEBRUARY 2018

www.oralhealthgroup.com

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oralhygiene CONTENTS

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HEALTH A Healthy Mouth – A Healthier Heartt The Surprising Link Between Your Teeth,, Real Food, and Life-Changing Natural Health h

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Lorraine Gambacourt, RDH Women’s Coronary Heart Disease

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The signs and symptoms that may save a life

Sheri B. Doniger, DDS

LEADERSHIP MANAGEMENT The Song of Leadership Katherine Eitel Belt

LEGAL Infection Control Lawsuits:

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Getting Sued for Nervous Shock

Michael Carabash, B.A., LL.B., J.D., M.B.A., C.D.P.M.

COMMUNICATION The Magic of Effective Communication… Lois Banta

DEPARTMENTS Editorial

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Parting is Such Sweet Sorrow

News

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Dental Hygienists Promote Early Detection of Oral Cancer Colgate Advances the Future of Oral Care

Dental Marketplace

35 February 2018

www.oralhealthgroup.com

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EDITORIAL

Parting is Such Sweet Sorrow They say a lady always know when it’s time to leave and so it is with mixed emotions I tell you that I am retiring from the dental group and Newcom Media as of March 29th, 2018. I’ve only worked for two publishing companies (many, many owners) since 1986, a feat unto itself in the rapidly shrinking print media world. A few things have remained consistent throughout: my love of magazines, my insistence on editorial integrity and my tremendous luck in working with and for fantastic colleagues. I’ve worked with and for Melissa Summerfield for more than two decades, the last 18 years on the dental group. In fact, the reason I came to be on Oral Health is because I’d worked with Mel at another company and knew exactly what kind of publisher she would be (for the record, that meant she respected both editorial and advertising content and didn’t allow either to be confused). I couldn’t have been more proud than when she was named vice-president of publishing for Newcom. While her new position means she has a vastly expanded portfolio, I know the dental group remains her baby and she will never leave it unattended. I also know I leave the dental group in superb shape and in superb hands. I know you’ll support Jillian Cecchini in her new role as managing editor as you’ve supported me all these years.

The dental group has a perfect blend of incredible veterans and is now infused with fresh, new blood…something every successful magazine needs. I’d be remiss not to mention the past and present members of Oral Health’s editorial board, each of whom have been a joy and an honour to work with. Too many names to mention here but I will treasure my relationships with the late Dr. Jim Kerr, as well as Dr. Randy Lang and Dr. Jordan Soll, to name just a few, each of whom made me a better dental magazine editor. If I have any regrets it would be that I won’t have more time to spend working with and for our current, and hopefully longtime owners, Newcom Media and its president, Joe Glionna. There have been unimaginable advances in dentistry and dental hygiene, many of which we’ve covered in our pages, especially in our 100th anniversary issue of Oral Health (2011) and our celebration of Canada’s 150th anniversary (July 2017). The influx of women in dentistry is notable. And from 1913 when Alfred C. Fones opened the Fones Clinic For Dental Hygienists in Bridgeport, Connecticut, to 1919, when the Royal College of Dental Surgeons established a one-year dental nursing course and enrolled 17 women, to today when the pace of change is staggering, you’ve come a long way, baby. Continued health and success to you.

Catherine Wilson Editor

February 2018 www.oralhealthgroup.com

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NEWS BRIEFS

oralhygiene A NEWCOM Media Inc. Publication

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Dental Hygienists Promote Early Detection of Oral Cancer

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World Cancer Day (February 4) is a perfect time for dental hygienists across Canada to remind the public of the importance of regular oral cancer screenings, not only during dental appointments, but also now at home. The Canadian Cancer Society projected in 2017 that 4,700 Canadians would be diagnosed with oral cavity cancer, and that 1,250 Canadians would die. In hopes of improving the long-term outcomes for people diagnosed with oral cancer, the Canadian Dental Hygienists Association (CDHA) has partnered with the Oral Cancer Foundation and the American Dental Hygienists Association on a “Check Your MouthTM” initiative to help individuals identify the early signs and symptoms of oral cavity cancers. The Check Your MouthTM campaign features an interactive website (www.checkyourmouth.org) that offers easy-to-use tools and tips for a quick visual and tactile examination of the oral cavity. Individuals can learn to self-discover the early symptoms of disease and then seek further evaluation from a dental professional if necessary. By raising public awareness of oral cancer and its early signs and symptoms, dental hygienists are helping to meet the global challenge of saving lives. www.cdha.ca.

Colgate Advances the Future of Oral Care Colgate® has introduced its first app-enabled electronic toothbrush exclusively on Apple.com and select Apple stores. With the launch of the new Colgate® Smart Electronic Toothbrush E1 with Artificial Intelligence, Colgate® is taking a leap forward by providing users with real-time feedback about their brushing so they can take better care of their oral health. And, building on its rich history of understanding and anticipating the future of oral health and consumer needs, Colgate® and the new Colgate Smart Electronic Toothbrush uses Apple ResearchKit – with the user’s permission – to crowdsource toothbrushing data to get even smarter about oral care for better and faster future innovation. www.colgate.com/connect.

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Editorial Director: Catherine Wilson 416-510-6785 catherine@newcom.ca

Associate Publisher: Hasina Ahmed 416-510-6765 hasina@newcom.ca

Managing Editor: Jillian Cecchini 416-442-5600, ext. 3207 jillian@newcom.ca

Senior Sales Manager: Tony Burgaretta 416-510-6852 tonyb@newcom.ca

Circulation: Mary Garufi 416-614-5831 mary@newcom.ca

Account Manager: Holly Power 416-510-6846 holly@newcom.ca

Advertising Services: Karen Samuels 416-510-5190 karens@newcom.ca

Classified Advertising: Karen Shaw 416-510-6770 karen@newcom.ca

Production Manager: Phyllis Wright

Art Direction: Carolyn Brimer

MEDIA INC.

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

OFFICE: Located at 80 Valleybrook Drive, Toronto ON M3B 2S9. Telephone 416-442-5600, 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.

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, 451 Attwell Drive, Etobicoke, ON M9W 5C4. Canada Post product agreement No. 40063170. Oral Hygiene is published quarterly by Newcom Business Media Inc., a leading Canadian magazine publishing company. ISSN 0827-1305 (PRINT) ISSN 1923-3450 (ONLINE)

February 2018 www.oralhealthgroup.com

DEBUNKING POWERBRUSH MYTHS MYTH

At-home sonic powerbrushes can achieve the results of professional in-office ultrasonic scaling devices

REALITY • ALL powerbrushes can be considered SONIC but SONIC does not equal ULTRASONIC • NO at-home powerbrushes can achieve professional scaling results

SONIC SCALE

Oral-B® GENIUS™

How “sonic” are leading powerbrushes?1 10 GHz

ULTRA SONIC

Professional in-office cleaning devices: Ultrasonic Scalers: – Cavitron – Cavimed

458 Hz 20 KHz

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AUDIBLE SONIC

Sonicare DiamondClean

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At-home cleaning devices: Powerbrushes: – Oral-B GENIUS – Sonicare DiamondClean

SONIC: Having a frequency within the audibility range of the human ear*

MYTH

Sonic powerbrushes create fluid movement to clean “beyond the bristles” for superior removal of plaque biofilm

REALITY ALL powerbrushes require bristle contact to effectively clean teeth High frequency movements of both oscillating-rotating and side-to-side powerbrush mechanisms create a dynamic fluid force resulting in a unique brushing experience

Oral-B® Pro CrossAction Oscillating/Rotating Pulsating Action

ORAL-B® GENIUS™ vs. Sonicare Facts In a head-to-head comparison, Oral-B® GENIUS™ CrossAction is superior vs. Sonicare DiamondClean (p<0.001)2,3

Sonicare DiamondClean Side-to-side Action

28 PERCENT

36 PERCENT

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INCREASE IN WHOLE MOUTH PLAQUE REMOVAL2

INCREASE IN BLEEDING SITE REDUCTION2

INCREASE IN APPROXIMAL PLAQUE REDUCTION3

PERCENT

Oral-B Oscillating-Rotating-Pulsating Power Toothbrush accepted by the ADA.4 *Merriam-Webster online dictionary. Available at: https://www.merriam-webster.com/dictionary/sonic References: 1. Data on file at P&G Canada. 2. Ccahuana-Vasquez RA. An Eight-Week Clinical Evaluation of an Oscillating-Rotating Power Toothbrush with a Brush Head Utilizing Angled Bristles Compared with a Sonic Toothbrush in the Reduction of Gingivitis and Plaque. J Clin Dent 2015;26:80–85. 3. Klukowska M, Grender J M, Conde E et al. A six-week clinical evaluation of the plaque and gingivitis efficacy of an oscillating-rotating power toothbrush with a novel brush head utilizing angled CrissCross bristles versus a sonic toothbrush. J Clin Dent 2014;25(2):6-12. 4 . Oral Health. Product Spotlight. Oral-B Power Toothbrushes to Receive ADA Seal of Acceptance. Cited: January 2018. Available at: https://www.oralhealthgroup.com/products/oral-b-power-toothbrushes-receive-ada-seal-acceptance/ © 2017 P&G ORAL-22366

HEALTH

A HEALTHY MOUTH – A HEALTHIER HEART Lorraine Gambacourt, RDH has been a practicing Dental Hygienist for 32 years, currently at Parkway Dentistry. She is a Speaker, and also a Clinical Coach with OraVital® Inc. Lorraine invites anyone to reach out to her with questions or more information about the topics discussed here. She is passionate about helping to implement protocols that promote health and reduce oral-systemic risk. lgambacourt@OraVital. com Brantford, Ontario

The Surprising Link Between Your Teeth, Real Food, and Life-Changing Natural Health

I

t is said that awareness is the key to change. Awareness however, is simply not enough. We must take the new knowledge learned and actually do something with it! This requires effort, change, boldness, and a willingness to take consistent, persistent action in areas you may not have considered or applied before. February is considered Heart Health Month nationwide. According to the latest statistics, cardiovascular disease (previously listed as second) is now the leading cause of death in Canada, as well as globally.1 This highly preventable disease is not only posing a strain on our health care system, but is decreasing the length and quality of lives of those we care about. As dental health professionals we make a significant difference in the lives of those who put their trust in us. We are also exposed to numerous individuals on a daily basis who are at risk for a cardiovascular (CV) event. What if we could be even more impactful in our efforts? Although our clients’ response to our recommendations may be out of our control, the skills we acquire, the knowledge we share, the treatment we recommend, and how we empower our clients is in our control.

BREAKTHROUGH RESEARCH

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Earlier research suggested merely an association between periodontal disease and systemic disease, including heart health. 2 A new ground-breaking, peer-reviewed study published in the prestigious Postgraduate Medical Journal (Bale BF, Doneen AL, Vigerust

DJ) is the first to identify periodontal disease due to certain high-risk oral bacteria as a contributory, root cause of cardiovascular disease (CVD). 3 In addition, a 2016 meta-analysis found those with periodontitis were more than twice as likely to suffer heart attacks, compared to people with healthy gums.4 However, with a causal relationship now existing between periodontal disease and CVD, it is recognized that optimal treatment and management can not only decrease the risk, but could be potentially lifesaving, by helping to prevent heart attacks and strokes. 5 “This latest research totally changes the game, and should be a landmark paper that changes medicine and dentistry forever. When you have a condition that causes something, it demands that it be assessed and managed properly. This will also change the definition of periodontal disease. No longer can you define periodontal disease by clinical signs alone. The pathogens drive the risk with the arteries so the dentist has to objectively find out what pathogens are present and what that burden is. That demands DNA testing. You have to know the pathogens.” Dr. Bradley Bale, MD. Co-Author of the book, Beat The Heart Attack Gene and Co-founder of the BaleDoneen Method®. Dr. Bale has been a family practice based physician for over 25 years, and was alarmed with the number of his patients who were hav-

February 2018 www.oralhealthgroup.com

HEALTH ing heart attacks and strokes, despite the standard of care. His focus became to keep the arteries healthy enough to prevent heart attack or stroke. Arterial disease is driven by inflammation. While there are a myriad of conditions that can cause inflammation in the arteries, one of the most prevalent is periodontal disease caused by high risk pathogens. Although he helped his patients to manage modifiable risk factors such as weight, nicotine, stress, diet, sleep quality, cholesterol, etc. he discovered that 99% of the time the cause of unresolved inflammation in the arteries was coming from the mouth. Dr. Bale and his partner Amy Doneen, DNP developed the BaleDoneen Method® for the prevention of heart attack, stroke and diabetes. When a client harbours high and moderate risk pathogens such as Aa, Pg, Td, Tf, Fn, and Pm, they are at an increased risk of arterial disease, even in the absence of bleeding. Having additional risk factors increases the potential for deteriorating oral health, systemic disease, and the chance of a CV incident. When bleeding is present however, as I have heard Dr. Bale state, “it’s like the dam broke!”

“If there is blood in the sink, there is an open door for bacteria to spray throughout the body and cause inflammation as they do in the mouth- we need to close the door and kill the bugs” Dr. Charles Whitney, MD. – A nationally recognized educator in dentistry, writing and speaking to dental professionals about the impact they can have on a patient’s overall health. Harmful bacteria can get out of balance from years of neglectful attention or poor technique in cleaning the mouth, teeth, and gums thoroughly as well as infrequent dental hygiene visits. Consider that at least 75% of our clients have bleeding on a daily basis, allowing harmful bacteria a direct pathway into the blood stream. Oral bacteremia has been well established as a very significant contributor to many systemic diseases including heart disease, stroke, diabetes, rheumatoid arthritis, Alzheimer’s, as well as a myriad of other diseases. Think about the number of your clients who spit blood in the sink 24/7, 7 days a week, 365 days a year for decades, thus increasing inflammation in the arteries and oral-systemic health risk. It is comparable to having an open wound that is constantly infected. Our clients must accept that bleeding is not normal, healthy, or hereditary! As hygienists we know and can appreciate

February 2018 www.oralhealthgroup.com

9

HEALTH

As hygienists we know and can appreciate that changing daily habits can be challenging. This doesn’t mean that we give up, or stop trying to inspire change. that changing daily habits can be challenging. This doesn’t mean that we give up, or stop trying to inspire change. Something has to shift. Something has to motivate a person to change. Often that motivation stems from a fear of loss and connecting on an emotional level. An example is showing your clients mobility in anterior teeth to motivate them to wear their NightGuard. It works! Building relationships and earning trust is the first step. Then as you use the right assessment tools, and effective communications skills you will inspire lasting change that will that will help your client not only improve, but sustain better oral health and decreased oralsystemic health risk. Consider these suggestions to engage with your client. It will increase their awareness, understanding and force them to take ownership of their disease. 1.

2.

3.

4.

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Educate on the oral-systemic connection and the impact that high risk oral pathogens play in overall health. Share the latest breakthrough research. Reference other studies such as Miklossy, linking oral spirochetes to Alzheimer’s Disease6 Use the Papillary Bleeding score to assess bleeding, co-diagnosing with your client BEFORE you pick up a scaler. (Soft-Picks work well) Give them the mirror - ask if they were aware that they had that level of infection. Discuss disease transmission via kissing and sharing utensils. Knowing that they pass harmful pathogens to their loved ones may prompt them to take better care of their own oral health.

5. 6.

7.

8.

Use analogies to aid in understanding: EG: Wound analogy/Biofilm analogy Use a two-tone disclosing solution to identify undisturbed biofilm, then provide individualized coaching. This is ESSENTIAL! I understand we have much to do in an hour, but even disclosing one or two sextants, and taking intraoral camera photos will be a powerful visual and inspire your clients to take their home care, and brushing of the gums seriously. Many of my clients experiencing this for the first time ask me why no one has shown them this before. Introduce the right interdental cleaning tools, and demonstrate that firm pressure is necessary to disrupt biofilm well. Floss is not going to keep gums healthy! Give “tough love”! I have shifted my focus from offending to informing about the serious implications of oral infection.

At Parkway Dentistry, an integral part of our assessment and treatment is the recommendation of Biofilm DNA testing to screen for high risk oral pathogens. OraVital® Inc. is a company based in Toronto that providzes this type of testing and makes it available to dental and medical offices. Once we know what the pathogens and burden is, the client is placed on a periodontal therapy program that includes an antibiotic rinse, to ensure that healing takes place, the bleeding stops, and the high risk pathogens are decreased to healthy levels. The client needs to know however, that this is not a magic bullet, and that they must be vigilant in their daily efforts. We must also be diligent in our efforts to educate, support and coach towards

February 2018 www.oralhealthgroup.com

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HEALTH

The time is now for the integration of medicine and dentistry. Therefore, as a call to action, I invite all of you to play a part in this important mission. more effective techniques and tools. Our maintenance protocol may include three month periodontal maintenance, a daily antibacterial rinse, xylitol, and/or oral probiotics. We often do a brief nutritional assessment to help the client set small goals towards better nutritive choices.

BRIDGING THE GAP BETWEEN ORAL AND OVERALL HEALTH Many contributing causes of heart disease are routinely evaluated by physicians. While I would assume and hope that physicians/ medical providers are developing a better understanding of the connection between oral and overall health, is this concept being given the attention it deserves? In the past year, I was impressed that a few of my clients told me that their cardiologist recommended they visit their dentist/hygienist. Yet, if this link was well understood, I would expect that dental offices would be bombarded with calls or letters from medical providers to assess their mutual patients’ oral health.

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“Periodontal Disease is a medical problem with a dental solution, so we have to drive collaboration between medicine and dentistry in order to keep the arteries well.” Dr. Bradley Bale, MD So how can we inspire medical health providers to play a more integral part in the overall health of our mutual clients/patients? Do they understand fully, that by addressing oral inflammation/infection and working more collaboratively with their patients’ dental health providers, that they can help reduce inflammation in the arteries, and reduce the risk of heart attacks and strokes? There is much work to be done in this area. At our office, Parkway Dentistry, we have begun to take steps. We send a letter to inform physicians of HBP readings, and/or our mutual patient’s periodontal health, inviting them to partner with us in their care. We have also sent letters to all physicians in the area, informing them that we offer DNA testing and a treatment protocol to decrease high risk

February 2018 www.oralhealthgroup.com

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HEALTH

oral pathogens. Taking steps in this direction is a great way to provide added value and help your office/clinic stand out from the average. There must be an understanding of the critical role of oral health and arterial wellness, and its relationship to prevention of heart attacks and strokes. The time is now for the integration of medicine and dentistry. Therefore, as a call to action, I invite all of you to play a

part in this important mission. Do your due diligence; continue to implement best practices; raise your level of commitment. With knowledge comes great responsibility â&#x20AC;&#x201C; once you understand something, you canâ&#x20AC;&#x2122;t ignore it. Letâ&#x20AC;&#x2122;s work together to help bridge this gap and change the direction of our profession from disease management, to one of prevention, overall wellness, management of health.

1 https://www.ctvnews.ca/health/coronary-heart-disease-leading-cause-of-death-in-canada-around-theworld-1.3590219 2 The link between periodontal disease and cardiovascular disease: How far we have come in last two decades? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100856 3 Bale BF, Doneen AL, Vigerust DJ High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis Postgraduate Medical Journal 2017; 93:215-220. http://pmj.bmj.com/content/93/1098/215 4 Association between Myocardial Infarction and Periodontitis: A Meta-Analysis of Case-Control Studies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5095113 4 https://www.baledoneen.com/blog/landmark-bale-doneen-study-discovers-new-treatable-cause-ofheart-disease/ 6 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3171359

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February 2018 www.oralhealthgroup.com

15

LEADERSHIP MANAGEMENT

THE SONG OF

LEADERSHIP Katherine Eitel Belt

is an international speaker, author, and communications coach in the US, Canada, and the UK. She is the creator of The Lioness Principle and founder of LionSpeak, a revolutionary training company helping dental and discretionary healthcare professionals access and harness intuitive leadership and phenomenal, un-scripted communication skills. www.LionSpeak.net

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L

essons in leadership show up in unlikely places. As the mother of two rough and tumble boys, one of life’s greatest gifts was unexpectedly having to raise my niece, Carrie, from the age of five. While I’ve cheered at baseball games, marveled at snowboarding feats, and watched with one eye open at the motocross competitions of my boys, Carrie brought the pleasure of classical cello recitals and junior orchestra competitions. Her love for music introduced our family to a new kind of competition… one where individual achievement is acknowledged but never sounds as triumphant as when all the individuals play in harmony together. As a teenager, Carrie joined a small community orchestra funded solely by parents and fundraising efforts. The first day of rehearsals, a soft-spoken, petite conductor, Miss Lee, announced that they would be competing in a county-wide youth competition. As I looked around at 80 giggling, halflistening teenagers from all walks of life, they seemed an unlikely group to win any award, let alone a first-place orchestra award. Miss Lee definitely had her work cut out for her. A hush fell over the noisy room as she went on to say, “I have one crystal-clear objective: helping you become a first-place orchestra. We have four months to prepare, and it will not be easy. Some of you will not make it because you aren’t willing to do what it takes. I will be meeting with each of you individually to find out your level of commitment. Think hard on it. The competition is stiff. Last year, the winning orchestra went on to win at the national level. We will be competing with

larger, school-funded orchestras who enjoy daily school rehearsals, instrument loans, summer orchestra camps, and beautiful coordinated uniforms. This orchestra will have to furnish their own clothes, buy and maintain their own instruments, have weekly Saturday morning rehearsals, learn their music and practice on their own. You will work very, very hard, but I promise you this: those of you who commit to this effort will never forget the music we will make together.” It took Miss Lee nearly the entire first rehearsal to get the group seated, instruments ready, and sheet music distributed. From the collective moaning, we parents assumed it was a difficult selection. I certainly could not have recognized Holland’s Opus or Beethoven’s 5th from the sounds they produced before dismissal that day. For months before the orchestra competition, tutors worked with individual groups of instruments, but when the groups came together, one conductor had to lead them all. This leader was the conduit through which all individual effort melded into one beautiful piece of music. It was up to her to bring out the best in every player… in every child. She had to share her vision. She had to ask for their undying commitment to do what it would take to win the event. She had to speak frankly with those who did not. She had to coach them through their struggles. She asked for each to be a leader to their co-musicians. She had to make sure everyone was playing from the same sheet of music. That year at the competition, there were many incredible orchestras and flamboyant

February 2018 www.oralhealthgroup.com

LEADERSHIP MANAGEMENT conductors. Miss Lee’s style? She was calm, confident, no-nonsense, and expectant. Minutes before they were to go on stage, Miss Lee spoke privately to the group. “Four months ago, I shared with you my vision. You have exceeded my expectations. Regardless of the score we garner tonight from the judges, you have accomplished that vision. You have met the challenge. You are a first-place orchestra in every way that matters. I hope you will never forget the time we’ve spent together and the music we will make tonight.” Those kids would have done anything for Miss Lee and would have followed her anywhere she led. In just a matter of a few months, she had artfully and skillfully gained their trust and respect, brought out their pride and passion for a vision she made crystal clear, taught them to support and count on one another, and inspired them to reach for heights of which most would have thought them incapable of reaching… including themselves. What does this story have to do with running an efficient, profitable business or dental clinic? A lot, I think. I’m not saying that professional dental teams are like orchestras. What I am saying is that people are people, and that the keys to motivating them, uniting them, and getting them to perform at their highest potential are pretty much the same whether they’re playing in an 80-piece orchestra or working on a team that treats and cares for patients. As a communications coach, I have seen leaders on both sides of the effectiveness scale. I’ve had the privilege to work with some extraordinary leaders and have person-

ally experienced what the hand of leadership genius can do. Are these leaders and people, like Miss Lee, born with these skills or can they be taught and learned? I believe they can be taught. In my studies of great leaders and in my experience of observing and coaching many in North America and Europe, I’ve come to believe that the best leaders are aware of and play to their natural strengths, and they commit to learning and mastering the rest. The best dental teams are comprised of great personal leaders in every position and they are guided by strong, capable leaders at the helm. If you’d like to up your personal leadership game, here are six common traits which Miss Lee and other extraordinary leaders like her have mastered: CURIOSITY: It’s been said that if you only have meaningful conversations with people who already and always agree with you, you’ll limit yourself to a very small sliver of humanity and grossly inhibit your ability to explore and leverage new and creative ideas. Great leaders are genuinely curious about other points of view, different perspectives, and new ideas. They ask thoughtful, exploratory, and important questions of their colleagues, clients, advisors, and co-workers in an effort to expand their viewpoints and access rich possibilities. They also encourage team members to speak up and contribute opposing viewpoints. They are humble and know that they do not know it all. They know they are always evolving and expanding their base of knowledge.

February 2018 www.oralhealthgroup.com

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LEADERSHIP MANAGEMENT

18

FAIRNESS AND CONSISTENCY: People appreciate straight talk from leaders so hold your team members accountable, set the bar high, and give employees support to reach for that standard. Honest, immediate, and specific feedback is invaluable to team members, but don’t expect perfection. It’s an impossible standard. Do expect measurable improvement. Former Dallas Cowboy football coach, Bill Parcels, says about leaders, “You have to be honest with people. You have to tell them the truth about their performance, you have to tell them face-to-face, and you have to tell them over and over again. And then, you let them know you believe in them 100%.” Learning accountability and communication tools like Managing by Agreement allows us to treat everyone we lead in a consistent, less emotional, and non-judgmental fashion. Fairness is a huge asset for becoming a great leader. It builds trust. But, trust is easily eroded if your words do not match your actions consistently or you have a double standard when it comes to dealing with your employees, teammates, or even suppliers. It goes without saying that employees and team members are watching not only our example and measuring our choices, but they’re also taking stock of how we treat others. Great leaders walk their talk. Never expect from an employee or co-worker what you don’t expect from yourself. Professionalism, honesty, and commitment are traits we must demonstrate if we are to receive them from our teams. At the end of the day, character is the core competency of leadership. HIGH E.Q.: The third characteristic for great leadership is understanding how to connect with people in a meaningful way. This doesn’t necessarily mean spending more time with them. It means knowing how to make the time you do spend with them feel rich and relational. It means listening and responding in a way that your folks feel heard and understood. Having a high emotional in-

telligence allows you to show up in your converonversations focused, present, resent, and approachable while still being effective ve and efficient with yourr time. Similar to being curious, nt when being truly present ngs or we attend meetings rsations have crucial conversations sten and and learning to listen ion with a exchange information otional inhigh degree of emotional telligence allows uss to become highly effective leaders. aders. ENCOURAGING: G: Make sure your employees know now you believe in them. Many y of the football players that Bill Parcels coached say they remember one line that he often said to them, “I believe in you more re than you believe in you.” People ple can do more than they think they ey can, and people want to work for and with great leaders who are thoughtful and encouraging. There is a big difference between giving praise and giving encouragement. When you are specific about the exact thing you want to encourage, that behavior tends to increase. Additionally, highlighting how that behavior enhanced or benefited the team or the goals as well as simply saying thank you and expressing your gratitude increases the likelihood of a repeat performance. CLEAR AND DECISIVE: Great leaders know that their job as a communicator is to create clarity and inspiration every time they speak. People are repelled by confusion and drawn like a magnet to clarity, especially when they are personally inspired to act. Leaders must have a crystal clear vision. If you cannot clearly articulate your vision to

February 2018 www.oralhealthgroup.com

Lastly, a key characteristic PASSIONATE: L to great leadership leadershi is passion. It’s almost impossible to resist following someone who is enthusiastic and genuinely excited about the vision, mission, and strategies of a team. Other leadership shortcomings and missteps will often be forgiven quickly if a leader gets this final trait really, truly right.

LEADERSHIP MANAGEMENT

others, they will follow f their own path. Once you’re clear, you must m ask each individual for their commitme commitment to accomplishing the about their role, what dream. Be specific speci commitment will mean, and ancomm ticipated rewards. Don’t expect ticip them to care about the business the same way you do, but do expect them to be dedicated to, and excited vision. In the movie, “Miraabout, the vi cle”, the coach of the Olympic hockey team for the best players… said, “I’m not looking lo the right players.” I’m looking for th great leaders do enterIn addition, while wh tain and carefully consider other viewpoints and opinions, they the know at some point they must make a dec decision. Teams generally understand this, and an furthermore, expect it. anything, teams want leaders who More than anythi decision after they feel their concan make a decisi heard and considered. They tributions were h leaders who are willing to adalso appreciate le decisions turn out to be a mismit that some dec take and accept the th responsibility for it.

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So, I know what you’re wondering… did Miss Lee and her fledgling orchestra win the competition? No, but they did get a respectable honorable mention out of a dozen much larger and more experienced groups. She, the kids, and their parents were thrilled. It was a true testament to the power of great personal leadership. You can do the same with your band of brothers in the dental office. And, if you do, you’ll serve your patients better while driving up your own levels of personal satisfaction at work.

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HEALTH

WOMEN’S CORONARY HEART DISEASE

The signs and symptoms that may save a life

W

e are all familiar with the signs and symptoms of gripping chest pain, radiating to the jaw and arm for males, but do we know the difference for women’s heart attacks? Recently, many articles and television programs have been highlighting the very different signs for women in the throes of a heart attack. As dental professionals, we need to be aware of these signs, as well as alert the patient of risks of ignoring them. Coronary heart disease (also referred to as stable angina, coronary artery disease or ischemic heart disease) is the most prevalent cause of death in the United States, accounting for one in every five deaths. In Canada, heart disease is also the second leading cause of death, causing more than 48,000 lives in 2012. With an incidence of over one million cases a year, approximately forty two percent of afflicted patients die within a year. The statistics for women under the age of fifty are more staggering. Women are twice as likely to die as men if they experience a heart attack. According to the American Heart Association, “Coronary heart disease is the leading cause of death in American women”. One in five women have some form of cardiovascular disease. This includes: coronary heart disease, angina pectoris, stroke, high blood pressure, congestive heart failure and congenital cardiovascular defects. With one in every five women having some form of heart disease, the likelihood of one being in your care at any given time is high. One of the more pertinent statistics from the AHA states: “In 63% of women who died

suddenly of coronary heart disease, there were no previous symptoms of this disease”. Angina pectoris is more common in women than men. Over 6.4 million women suffer from angina and/or coronary artery disease. Many women have heart attacks that go unnoticed. Over 400,000 women have stable angina (pain or discomfort in the chest or adjacent areas due to insufficient blood flow though the coronary arteries), many with no pain. Furthermore, within six years of the first heart attack episode (a recognized myocardial infarction), 35% of women will have another heart attack, 14% will develop angina, 11% will have a stroke and 6% will experience sudden cardiac death. These are alarming statistics. Thirty eight percent of women with recognized myocardial infarctions die within a year. Myocardial infarction occurs when there is a blockage to one or more of the coronary arteries. This blockage usually occurs due to atherosclerotic plaques that build up on the arterial walls, constricting the blood flow through the lumens. These plaques can also cause blockage and subsequent rupture of the arterial walls due to arterial pressure and weakness. Blood clots or thrombosis will also occlude the less than patent arteries. If this blockage occurs, there is usually a pain incident associated with the event. Women tend to have their initial heart attacks at an older age than men. They are protected by estrogen through menopause. Estrogen keeps cholesterol in check: the good HDL cholesterol up and the bad LDL cholesterol and triglycerides down. After meno-

Sheri B. Doniger, DDS is a leading dental clinician, author, international educator, and consultant who currently practices dentistry in Lincolnwood, IL. Dr. Doniger is an avid researcher, frequently contributing to an array of dental publications on a variety of topics. She is a member of the IZUN Oral Healthcare Scientific Advisory Team. Please free to contact Dr. Doniger at www.donigerdental. com.

February 2018 www.oralhealthgroup.com

21

HEALTH

Table 1

22

pause, estrogen that was produced by the ovaries ceases, although some is produced from fat cells. This is not enough to afford cardiac protection. This dramatic drop may lead to the susceptibility of heart disease. Risk factors for both sexes include: heredity (family member having a heart attack under the age of 55), acquired or inherited high cholesterol, acquired, inherited or untreated hypertension, obesity, diabetes, and an inactive, unhealthy lifestyle (smoking, eating high fat foods). For females, the individual risk factors can be increased, sometimes seven-fold. An additional risk factor for women is aging, especially the post-menopause years. Ninety percent of women have more than one risk factor for stroke or heart disease. Triggers for heart attacks for both sexes include: arterial blockage, stress, exercise, and heavy meals. Where male triggers appear to be physical, female’s triggers appear to be emotional. Some studies have shown that men have physical exertion (as snow shoveling) prior to heart attacks while women experience emotional stress. As stated, many women do not experience the crushing chest pain normally associated with a myocardial infarction or heart attack. Women’s symptoms can include the expected symptoms of angina, diaphoresis and shortness of breath. As with their male counterparts, the chest pain or pressure may be centrally located and can last a few minutes. Non-chest pains occur more frequently in women. Women were more likely to present with neck, jaw or back pain. The pain could also radiate down both arms, starting from the back, with a deep throbbing or aching in the arms. The discomfort may only be mild. Nausea or flu-like symptoms are common. Non-chest pain symptoms such as musculoskeletal or neurologic pain can also occur. Many women who are familiar with the traditionally recognized symptoms of angina tend to dismiss these symptoms. Some women may have no pain at all. (See Table 1) Additional signs of clammy sweating, dizziness, lower extremity edema, anxiety, general malaise, heartburn, vomiting and nausea not relieved by antacids may also present themselves. Chronic breathlessness or waking up short of breath at night can be another symptom. Women will experience extreme fatigue,

WOMEN’S HEART ATTACK SYMPTOMS Dizzy Cold sweat Extreme fatigue Heartburn Indigestion Nausea General discomfort in neck spreading from chest Tightness in jaw spreading from chest Choking or burning in throat Dull ache in back spreading from chest Vomiting Shortness of breath

with or without activity. The mere act of moving from one area of the house to the other or putting on clothes may be too strenuous. The failure to recognize women’s heart attack symptoms could be the cause of higher death rates and pursuant disability due to heart attacks. Women tend to have their first myocardial infarction at an older age (usually over 60). They may have concurrent conditions such as diabetes, arthritis and osteoporosis. Aches and pains are common and these crucial symptoms may be overlooked or dismissed. Many of these symptoms can be misdiagnosed: nausea for indigestion or gastritis, fatigue from activity for chronic fatigue syndrome. Women do tend to downplay many of the symptoms, as well. Women tend to wait longer to call for emergency assistance. Women are also usually ten years older than men when their first coronary attack occurs. The sudden onset of weakness, body aches, a feeling of general “un-well being”, coupled with back or neck discomfort and nausea are usually attributed to the flu. Women also tend to wait longer to seek treatment, but when they do, historically, they receive less prompt treatment (the average waiting time in the emergency room is longer than men). Certain patients, be it female or male, do tend to “forget” they were told they have a problem or on a new medication. Even though

February 2018 www.oralhealthgroup.com

HEALTH the front desk may have questioned the patient on their health history, it is incumbent for all team members to ask if there have been any changes. Additionally, they do not feel some of these symptoms are issues a dentist needs to know. We need to stress to our patients, even though they don’t think it is related, after all, the teeth are connected to the rest of the body. We have much to offer in the dental office for our patients. Monitoring of blood pressure and questioning our patients concerning their diet and exercise can assist them in the long and short run. The oral-systemic link is highly important here. Proper oral hygiene will reduce oral bacteria and inflammatory sites. Stressing the need for routine preventive maintenance to monitor any gingivitis or periodontal concerns should be part of the treatment plan. Possibly discussing adjunct

therapies, such as mouth rinses to decrease plaque and inflammation, may be beneficial to her gingival health. We can discuss the risk factors that are reversible and offer alternatives. Recommending smoking cessation will not only help their cardiac health but their oral health as well. Evaluating diet diaries to assess both cariogenicity and “heart-smart” content of the food consumed will also be a dual assist in the patient’s overall health. Increasing fruits and vegetables, consuming lean meats, poultry and fish high in omega-3 fatty acids, checking food labels for hidden sodium and fat content are all nutritional suggestions that could be made. Recommending a consultation with the physician if the blood pressure is consistently elevated over 140 systolic or 90 diastolic (stage 1 hypertension classification). Discussing exercise of any form as a means to

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HEALTH “work off” stress and “work out” the body is a dual contribution for decreasing stress and weight. Walking is an excellent example of exercise that can be performed at any age and ability level. One very important thing is to remind patients to take their prescribed medications in the dosage dispensed. Many times, patients take it upon themselves to stop or alter prescription drugs. We need to discuss with them to do as their physician requested until a change is required. Furthermore, a large number of the medications given to cardiac patients do cause xerostomia. Discussing the side effects of dry mouth will lead to a conversation about proper hydration, the importance of keeping up personal oral hygiene and preventive visits. Coronary artery disease is no longer a male dominated arena. Women have overtaken the mortality statistic. Lifestyle alterations (low fat and low sodium diet, smoking cessa-

tion, increase aerobic exercise), in addition to proper and timely health care will increase the chances of a long and healthy life. With proper counseling, and education, women will be more aware of the signs and symptoms to alert of a cardiac event. For ourselves and for our patients, we all need to be aware of the distinctively different signs and symptoms of women’s coronary disease. Dedicated to my mom, Bernice R. Doniger, who died of heart failure, July 31, 2001.

Recommended References: www.americanheart.org https://americanheartsaver.com/ https://cwhhc.ottawaheart.ca/ http://www.cwhn.ca/en/womenandhearthealth https://www.goredforwomen.org/about-heartdisease/facts_about_heart_disease_in_womensub-category/statistics-at-a-glance/

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February 2018 www.oralhealthgroup.com

25

LEGAL

Michael Carabash,

B.A., LL.B., J.D., M.B.A., C.D.P.M.

Michael Carabash is a dental lawyer with his own law firm, DMC LLP. His websites are www.DentistLawyers. ca, www.dentistlegal forms.com, and www.DentalPlace.ca. He can be reached at 647-680-9530 or michael@dentist lawyers.ca.

26

INFECTION CONTROL LAWSUITS: GETTING SUED FOR NERVOUS SHOCK I

t is one of your worst nightmares. Public health officials get a complaint from one of your patients. They storm into your office and shut you down for having inadequate infection control practices. Bad as that may sound, it gets worse. They then send a letter to ALL of your patients, notifying them of the shut down and advising them to get treated or tested for Hepatitis B and C and HIV. And when the media finds out and publishes stories of your angry patients,1 well… that my dentist friends, is a practice killer. And that’s irrespective of the real extent to which diseases can be transmitted through improper cleaning of re-usable dental instruments and equipment (which is apparently very low). Next comes the class action lawsuit. That lawsuit will allege, among other things, that the owners and dentist operators at your practice were negligent in failing to properly follow infection prevention and control protocols, failing to properly train and supervise staff, and failing to warn patients about exposure to communicable diseases in a timely fashion. 2 Now, even if such allegations are proven, the issue then turns to whether the plaintiffs suffered compensable damages. And here’s where things get interesting. What if the patients didn’t test positive for any infectious diseases after they were told to get checked and did so? Absent real physiological or significant financial harm, plaintiffs will claim damages based on nervous shock, which is also known as psychological harm. In other words, they will ask a court to compensate

them for the psychological trauma of being told of the possibility of infection and the uncertainty as to their condition – despite the tests all coming back negative. So to what extent will a Canadian court award damages or approve class action settlements for nervous shock and psychological harm in these circumstances? Let’s find out…

SUING FOR NERVOUS SHOCK

Healey v. Lakeridge Health Corp.3 is one of the leading cases in Ontario on suing for nervous shock in the situation described above. That case involved 2 patients with active tuberculosis who attended an Oshawa hospital in 2003 and 2004. The hospital notified 4,402 patients who came in contact with those infected patients. Despite no cases of tuberculosis being diagnosed, a class action was started by uninfected patients. They asked for $7,500 a piece for nervous shock and psychological harm as a result of being told that they may have been exposed to, and that they should be tested for, tuberculosis. The Ontario Court of Appeal reaffirmed the lower court’s decision and dismissed the class action. The Court reviewed the jurisprudence on recovering damages for nervous shock in negligence cases where there was no physical injury and found that claimants “are required to show that they suffer from a recognizable psychiatric illness”.4 This was a high threshold. The injury claimed must be of sufficient

February 2018 www.oralhealthgroup.com

LEGAL gravity and duration to qualify for compensation. Such injury must rise above the ordinary annoyances, anxieties and fears that people living in society routinely accept. Minor and transient upsets do not constitute personal injury and do not amount to damage. 5 The Court noted that there were strong policy reasons for imposing such a high threshold on recovering for nervous shock. The Court wrote: “It seems to me quite appropriate for the law to decline monetary compensation for the distress and upset caused by the unfortunate but inevitable stresses of life in a civilized society and to decline to open the door to recovery for all manner of psychological insult or injury. Given the frequency with which everyday experiences cause transient distress, the multi-factorial causes of psychological upset, and the highly subjective nature of an individual's reaction to such stresses and strains, such claims involve serious questions of evidentiary rigour.”6 Turning to the facts of that particular case, the Court found that the evidence fell short of meeting this threshold and dismissed the class action. More recently, however, in Saadati v. Moorehead,7 the Supreme Court of Canada examined the law on recovering damages for nervous shock in negligence cases and removed the requirement that there be a recognizable or recognized psychiatric illness. The Supreme Court reiterated that claimants must show that the disturbance they suffer is serious and prolonged and rises above the ordinary annoyances, anxieties and fears that come with living in civil society. While expert evidence will assist in determining whether a mental injury has been established,

it is not necessary to show that their condition carries a certain classificatory label. In other words, a judge “should be directed to the level of harm that the claimant’s particular symptoms represent, not whether a label could be attached to them”.

CLASS ACTION SETTLEMENTS By way of background, class actions are designed to streamline the litigation process by allowing an identifiable class of plaintiffs to join together in one lawsuit because they share common issues. Since class actions litigation can be prolonged and prohibitively expensive, the parties tend to settle early on in the process – particularly after a court has ruled that a lawsuit can be certified and proceed as a class action. Importantly, class action settlements must be approved by the court. While these early settlements don’t necessarily speak to the merits of the claims alleged or damages, they do give some insight into the size of settlements that have been awarded. What follows is a review of some Canadian class action settlements that have centred around nervous shock from alleged inadequate infection control practices: In Anderson v. Wilson, 8 an Ontario class action settlement, class members who were notified of possible exposure to Hepatitis B at five medical laboratories that provided ECG testing and who tested negative received $1,000 each.

February 2018 www.oralhealthgroup.com

27

LEGAL

In Rose v. Pettle,9 an Ontario class action settlement, class members who had been notified of exposure to serious skin diseases because of the use of unsterilized acupuncture needles and who tested negative for Hepatitis and HIV received $560 each. In Rideout v. Health Labrador Corp.,10 a Newfoundland class action settlement, class members who were patients of a gynecological clinic that used improperly sterilized equipment and who tested negative for infection received $450 each and their spouses $100 each. In Fakhri v. Alfalfa's Canada Inc.,11 a B.C. class action settlement, customers of a grocery store who were notified of exposure to Hepatitis A and encouraged to be inoculated with Immune Serum Globin and who did not contract the disease received compensatory cash payments ranging from $150 to $300. In Vezina v. Loblaw Cos.,12 an Ontario class action settlement, the customers of the defendant grocery store who were notified and encouraged to be vaccinated because of exposure to Hepatitis A received a compensatory payment of $150.

1

2

3 4 5 6 7 8 9 10 11 12 13

28

In Farkas v. Sunnybrook & Women's College Health Sciences Centre,13 an Ontario class action settlement, class members who were notified that biopsy equipment used during their respective procedures might not have been properly disinfected to prevent any transmission of diseases, including HIV, Hepatitis B and Hepatitis C received at least $943.85 (depending on the number of claimants) and each spousal class member received approximately $100.

CONCLUSION Yes, there is a high legal threshold for recovering damages for nervous shock. And yes, there have been relatively low payouts approved in class action settlements in these circumstances. But that doesn’t change the fact that dentists must be ever vigilant in their infection control practices so that public health doesn’t end up sending those letters to patients, advising them to get tested for infectious diseases. The reputation harm (particularly once the media and social media get wind of it) can be fatal for a dental practice and the practitioners. In a forthcoming article, I will discuss infection control lawsuits that involved the spread of diseases to patients.

For example, one parent wrote the following in an online Google review for Guelph Dental Associates (site accessed: September 20 2017): “Would give no stars if possible. My daughter is was a patient here. We had no problem paying a much higher rate for a paediatric dentist, feeling like it would give her a safe and secure experience. Now we get a letter from public health saying that patients of this clinic should be tested for Hepatitis and HIV, as they weren't properly sterilizing equipment. 17 health code infractions. Closed by order of public health. When and if they reopen, please DO NOT TAKE YOUR CHILD TO THIS DENTIST. Google it, lots of media coverage of the closure.” See for example, Katelyn Lowe et al. v. Dr. Meikle Dentistry Professional Corporation c.o.b. Guelph Dental Associates et al., Statement of Claim, paragraph 18. [2011] O.J. No. 231. Ibid., at para. 60. Ibid, at paras 62-64. Ibid., at para. 65. 2017 S.C.C. 28. [January 2, 2002)] MacKinnon J. (Ont. S.C.J). [2006] O.J. No. 1612 (Ont. S.C.J.). [2007] N.J. No. 292 (N.L. T.D.). [2005] B.C.J. No. 1723 (B.C. S.C.). [2006] O.J. No. 2509 (Ont. S.C.J.). [2009] O.J. No. 3533 (Ont. S.C.J.).

February 2018 www.oralhealthgroup.com

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April 26-28, 2018 Metro Toronto Convention Centre — South Building

Featured Keynote Speakers Rick Hansen — Man In Motion Champion for Accessibility and Inclusion

Jim Carroll — Futurist Trends and Innovation Expert

Rick Hansen is currently CEO of the Rick Hansen Foundation and a passionate advocate for people with disabilities in Canada and around the world. As well as being a celebrated Paralympic athlete, he is best known for the Man In Motion World Tour, his epic two-year wheelchair tour around the globe.

Jim Carroll is widely acknowledged as one of the world’s leading global futurists on trends and innovation. Possessing a massive global blue-chip client list, he helps to transform growth-oriented organizations into high-velocity innovation heroes. He was named by Businessweek magazine as a leading source for innovation and creativity insight, while his observations are frequently covered in Fortune magazine.

Some ASM18 Headlining Speakers Include:

Trisha Osuna, RDH, BSDH, FAADH

Karen Davis, RDH

Bob Gray

What is It? Do I Use it? Today's Dental Products and Treatment Options

Think Outside the Mouth: Treatment-planning for Non-Surgical Periodontal Treatment

Kick-Start Your Own Brain Potential

Debra Engelhardt-Nash, AABFA

Jean Barbeau, PhD

Barbara Steinberg, DDS

Attracting and Retaiing Patients — A Team Event

Sterilization Centre: Management and Instrument-reprocessing Protocol

Optimal Aging for Women: Living to 100!

Register online at asm.oda.ca. Register by March 12 and save! The Preliminary Guide is available online. Like us on

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@ONDentalAssn

COMMUNICATION

THE MAGIC OF EFFECTIVE COMMUNICATION… Lois Banta “I’m sorry… we have not received your claim.” “Why did I get a statement? I have already paid your office my co-payment!” Ah, the wonderful effects of non-communication. Nothing is more frustrating for a dental office than a patient or insurance company who misunderstands what we are trying to communicate to them. The most important aspect of dentistry today is not what you say to patients and insurance companies, but how you say it. How many times have you called the insurance company to track a past due claim only to be told you have to re-submit it? I can almost hear your silent screams now! There is a definite connection between making the phone call and getting the results from the insurance company the first time. One of the most effective tools in communicating with insurance companies and getting speedy payments isn’t necessarily the content of the claim, but in talking to the insurance customer service representative. You catch so many more flies with honey…make a friend at the insurance company! Yes, that’s right; I said make a friend at the insurance company. You have to be prepared to plead your case while at the same time getting results now. My suggestion is to call the insurance company with this conversation in mind….”Hello, this is Lois from Dr. Smith’s office. I’m calling to check status on an outstanding dental claim”. Never say past due claim…it puts the insurance rep on the defense. Always write down today’s date, the insurance rep’s full name, and any

notes pertaining to the conversation. Some insurance companies train their staff to respond to your first phone call by telling you they have not received the claim. What I suggest as a response to that is to ask the rep to put you on hold and check the pending or inprocessing claims. This gives the insurance rep the opportunity to put you on hold and now tell you…”Oh, there it is, I don’t know why this wasn’t processed yet!” If they still insist they have not received the claim, ask for the FAX number and resubmit the claim by FAX, not “snail mail”, or re-send it by electronic claims if that is how it was originally sent. Communication with your patients can be equally frustrating if you assume they know the financial policies of your practice. The first thing every dental office needs is to have a financial policy. The second thing is to put it in writing. Always, and with no exceptions, explain all treatment recommendations to your patients before dental treatment is performed. There are many ways of discussing financial arrangements with patients because there are many types of treatment consultations. 1) If the patient is in your office for an emergency and there is time to do the permanent treatment that day, the financial coordinator should come back to the treatment room to answer any questions the patient may have regarding fees and insurance so that the patient can make an informed decision. The doctor and clinical team member

is CEO, President and Founder of Banta Consulting, Inc., a company that specializes in all aspects of dental practice management. Lois has over 40 years of dental experience and consults and speaks nationally and internationally. www.bantaconsulting. com

February 2018 www.oralhealthgroup.com

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COMMUNICATION

The important thing to remember in the “art of communication” is to speak to patients and/or insurance companies the way you would want them to speak to you. must leave the room at this time to allow for privacy. Discussing financial arrangements chair side allows for proper communication to take place regarding patient’s financial responsibility. 2) If the patient has a continuing care appointment with the hygienist, and dental treatment was recommended that is not too involved, the financial coordinator can make financial arrangements at the front desk if it is a private enough area. All financial arrangements should be made before the patient comes in for the next treatment appointment to avoid negative surprises. 3) If there is major treatment to do there should be a formal consultation privately for the patient and the financially responsible party (if different from the patient). In all cases, a written plan for treatment and estimate of financial responsibility should be available for every patient. All patients have a right to know what they are agreeing to… It’s called truth in lending. The importance of communication also comes into play for patients paying their “estimated portion” after insurance payment at the end of their dental appointment. You give patients the potential bad news before they get it on their statement. To avoid any repercussions from getting a statement after insurance pays and the patient has already paid their “estimated portion”, I tell the patient “If insurance pays less than we estimate, we will send you a final statement and it will be highlighted in orange at the bottom of your statement with the phrase…We have received final payment from your insurance”. This absolutely prevents an angry phone call from the patient because they just got a statement with a balance due after insurance has paid

32

and the patient has already paid their previous in-office payment. Give your patients the potential bad news before they get the “bad news” and you have just diffused a potential angry situation! It works like a charm. Another effective communication technique I use with patients is when we change the payment rules in the office. I find this the most difficult transition for patients because they were used to “making payments”. First of all, you should never have to be the “bank” for your patients. This is where we have become our own worst enemies. In order to change the rules effectively you need to be excited about the change. The conversation should go like this…” Mr. Jones, today’s visit was $700. We estimate insurance will pay approximately $350…therefore; we estimate you portion to be $350. Will you be taking care of that by cash, check or credit card today?” The patient usually responds by saying, “Just send me a statement like you usually do.” This is where the magic conversation must happen. You say “Actually, we are so excited, the accountant was just in our office recently and we are now prepared to handle your payment in office today…so…which would you prefer… cash, check or credit card?” If the patient still objects, give him/ her a courtesy statement with an envelope, and a stamp in instruct them to send you the estimated in the next 5 days. Say that you will follow-up with a phone call if for any reason a payment is not received. The important thing to remember in the “art of communication” is to speak to patients and/or insurance companies the way you would want them to speak to you. Remember the Golden Rule…”Do unto others as you would have them do unto you!”

February 2018 www.oralhealthgroup.com

SHE KNOWS THAT STRAWBERRIES HAVE A HIGH ANTIOXIDANT CAPACITY. WHAT ELSE WOULD SHE WANT TO KNOW? Young people today are staying informed to stay healthy.1 But do they know that healthy foods including fruit, juices and sports drinks are highly acidic and can put their enamel at risk?2-5 Exercise your influence as their trusted dental professional. Help educate every young patient about the effects of acid erosion. Because the investment in their enamel should start today.

For your acid erosion candidate. 1. GSK data on file, 2013. 2. Lussi A. Erosive tooth wear – a multifactorial condition. In: Lussi A, editor. Dental Erosion – from Diagnosis to Therapy. Karger, Basel, 2006. 3. Lussi A. Eur J Oral Sci. 1996;104:191–198. 4. Hara AT, et al. Caries Research. 2009;43:57–63. 5. Lussi A, et al. Caries Research. 2004;38(suppl 1):34–44.

TM/® or licensed GlaxoSmithKline Consumer Healthcare Inc. Mississauga, Ontario L5N 6L4 ©2017 The GSK group of companies. All rights reserved.

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HYGIENISTS

EQUIPMENT

THOMPSON, MB

EDSON, AB

Full-Time Registered Dental Hygienist required for a busy, well established dental office in Thompson, Manitoba. Candidate should be energetic, confident, possess strong communication skills. Permanent position available. Competitive wages/Great Income Potential. Email resume to: thompsondent@gmail.com or call 204-939-0083.

Busy family oriented general dental practice is looking for a full time dental hygienist. Ideal small town location, a stone’s throw from the Rocky Mountains for those who love the outdoors and all it has to offer. No evenings or weekends. Please send resume to ydcreception@shaw.ca

TORONTO, ON Family practice needs competent, caring long term hygienist to join team for 2.5 days + Sat. Hygienist should be comfortable with instrumentation, Perio charting & tx planning, active therapy. Min 3 yrs experience. Italian language an asset. E-mail: dent.teambuilding@gmail.com

NORTH MANITOBA HYGIENISTS NEEDED Dental office in north Manitoba is looking for two full time dental hygienists. Accommodation is available. Come and join our friendly team you can make 75k to 100k guaranteed per year. To apply email to Chris.p1933@ yahoo.com

www.oralhealthgroup.com

DENTAL MARKETPLACE

Contact: Karen Shaw • tel: 416-510-6770 • cell: 437-991-7187 • fax: 416-510-5140 • e-mail: karen@newcom.ca Toll free: CDA 1-800-268-7742, ext 6770 • Toll free: USA 1-800-387-0273, ext. 6770

CAREERS VANCOUVER AREA, BC Training & Implementation Specialist Share your knowledge of dental practices! Become an independent, part-time Training Specialist promoting the optimal use of ABELDent, Canada’s unparalleled practice management software. Details: www.abeldent.com/careers

CEREC OMNICAM - $51,000 Sirona CEREC AC Omnicam is powder free scanning. This unit is being sold by owner, was a second unit which was only used for minimal number(~30) of scans. The Omnicam is serviced by Patterson Dental and is on CEREC CLUB membership. It has the most updated software and even the Invisilign acquisition software for full mouth scans. The acquisition prism is in pristine, excellent condition. Unit was manufactured in Germany. Downtown Toronto pick up. Dentistryinto@gmail.com

Contact: Karen Shaw Tel: 416-510-6770, Fax: 416-510-5140 Cell: 437-991-7187 E-mail: karen@newcom.ca Toll free: CDA 1-800-268-7742, ext 6770 Toll free: USA 1-800-387-0273, ext. 6770

YOUR ADVISOR IS IN

February 2018

35

DENTAL MARKETPLACE

PRACTICES & OFFICES

BRANT COUNTY, ON

ENDODONTIC PRACTICE Well established endodontic practice for sale in southwestern Ontario. Flexible transition. Excellent opportunity. Email: endosale@outlook.com

TORONTO, ON (6085 YONGE ST.) FINISHED DENTAL SPACE AVAILABLE Very busy plaza second floor. Finished and 800 sq.ft. with two operation rooms, cheap rent, floor plan available upon request. Call 647-209-6292.

DENTAL PRACTICE (AND BUILDING) FOR SALE Modern, updated 3-op practice. 1500+ active patients. Gross revenue $650K+. Presently operating at 4d/wk, no evenings, weekends, or Fridays. Year-over-year increase in revenue at $50-100K and 240+ NPs annually with extremely low attrition. Owner wishing to associate 2d/wk and will sign contract. Formal appraisal of practice and building available with signed confidentiality agreement. Share sale, including real estate. Serious inquiries only may email BrantDentalOffice@gmail.com

PROFESSIONAL SERVICES

600C Magnetic Drive Toronto, ON M3J 2C4 Phone: 416-855-7606 www.cancongroup.ca

We are CANCON GROUP INC, a turnkey contracting company specializing in Dental and Medical office construction and renovation. We will walk you through the entire process of building your dream practice. From location selection – to design – to construction – and beyond. Our goal is to provide superior workmanship at competitive rates, coupled with expert project management by our President – who owned, operated, and managed numerous dental practices over a seventeen year career in clinical dentistry. We pride ourselves on consistently exceeding our clients’ expectations by completing each project in a timely fashion with exceptional tradesmen. Please contact us for a no obligation consultation at:

jordan@cancongroup.ca or 416-277-2426 (Cell)

STRATFORD MEDICAL CENTER STRATFORD, ONTARIO Opportunity in new 33,000 s.f. medical building. 90% Leased, last space – up to 3000 sf at main entrance. Very busy new facility, including 12 family physicians and various specialists. Generous Leasehold Allowance and competitive Rent. Contact jeffbibbings@rogers.com for information.

DOWNTOWN TORONTO Well established dental practice for sale in busy high traffic area in downtown Toronto. 3 fully equipped ops. Retiring DDS is willing to stay up to one year. Call or text 647 928 0113.

ASSOCIATESHIPS

CALGARY, AB ASSOCIATE REQUIRED Do you feel under-utilized and capable of more? Are you a go-getter with strong work ethic? Do you already have amazing communication and soft skills with the ability to consult, educate, empower and motivate people to make healthy dental decisions for themselves, but maybe the rest of your team isn’t quite there yet and cannot hit it home after you walk out of the room? If so, we have an amazing opportunity for you as a F/T Dentist in Northwest Calgary. We look at dentistry as a service industry like a fine hotel or restaurant with transparency and consistency. We can help you reach your maximum potential if you are willing to be coached and have the ability to park your ego at the door so we can all learn and grow together on a level playing field. You must be great with kids as well as being fairly broad based with the ability to recognize and diagnose from multiple dental disciplines as we do not refer much away. Please send your CV in confidence to judy@involutioninc.ca We look forward to meeting you!

www.oralhealthgroup.com 36

February 2018

www.oralhealthgroup.com

VAUGHAN, ON Orthodontist/Pediatric Dentist Opportunities. P/T and F/T available for a motivated individual. Buyin opportunity. Excellent colleagual collaboration. Digitally integrated. laser, GA onsite, modern facility. Experience preferred. Send CV: dr.gep@woodbridgekids.com www.woodbridgekids.com

EDMONTON, AB FULL TIME Associate required for a busy General practice. Large established patient base, great staff in place. Office hours from 8am â&#x20AC;&#x201C; 5pm NO Saturdays or evenings. Excellent long term opportunity. Please email resume to: smiledoctors1@hotmail.com

LABRADOR CITY, NL 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

THE PAS, MB Awesome opportunity for full/part time associate or locum. Principal wanting to take some much needed time off. Come and practice stress free dentistry in a state of the art, modern clinic. Be as busy as you want to be. License, travel, accommodations and even a car for you to travel around in all provided! Just show up and start working! Contact dentris2012@yahoo.ca or (204) 978-1158 for more details.

LLOYDMINSTER, AB Modern and nicely equipped clinic with a well established and growing patient base seeking a full-time, long-term, experienced Associate. Paid on PRODUCTION! Contact: admin@oriondentalgroup.ca

WATERLOO, ON Full-time associate is required for a very busy office in Waterloo. Successful candidate will only be needed to do one evening per week and no weekends. E-mail: saeedj20@hotmail.com

TORONTO, ON General dentist required for Saturdays possibly leading to more days in busy, large group practice. Portuguese, Spanish or Italian fluency beneficial but not mandatory. Please send resume to: den183gs@allstream.net

www.oralhealthgroup.com

DOWNTOWN TORONTO

DENTAL MARKETPLACE

ASSOCIATESHIPS

OWEN SOUND, ON

ASSOCIATE REQUIRED

Our busy modern paperless downtown practice is rapidly growing. We are looking for a part time associate dentist with excellent communication skills to join our team. Good earning potential and mentorship provided. Please email your CV to: sunnygill_dds@hotmail.com

FULL TIME TRANSITION OPPORTUNITY IN THE GTA Looking for a highly motivated individual to take over for a retiring Dentist with a fully booked case load. Interviews will be held on January 17th and February 20th. Preference will be given to candidates with surgical experience. Must be willing to work in a fast paced large practice. Incentive program available for highly productive individuals. Email in confidence to book an interview in person or by phone. annburkeVP@gmail.com

SOUTH NIAGARA, ON

Seeking a part time Associate to join established, very busy dental clinic (4 Dentist) in Owen Sound, Ontario. This is an excellent opportunity for a dentist seeking 2 to 3 days a week and enjoy a wonderful lifestyle in the Georgian Bay area whilst practicing dentistry at its best. The position will be available January 2018. Please e mail your resume to guychouinard@hotmail.com or phone at 519-376-4244

OTTAWA, ON EXPERIENCED DENTIST WANTED Established dental office in Westboro Neighborhood is looking for an associate dentist for 3.5 days per week. The ideal candidate is personable and able to work in a fast-paced environment. This is a tremendous opportunity for a dentist who would like to start with an established clientele in a thriving neighborhood. Please contact: westborodentaloffice@gmail.com

PART-TIME ASSOCIATE NEEDED

LONDON, ON

We are a well-established and busy dental practice in the Southern Niagara Region seeking a part-time associate to join or growing practice. Future buy-in opportunity will be offered to the right candidate. Please email resume to: niagaradentist@hotmail.com

WANTED ASSOCIATE DENTIST for immediate placement at a busy established family dental office for 4-5 days a week. Great opportunity to join our team and practice with CAD/CAM, Digital xrays and CBCT, Cerec, nitrous oxide sedation and paperless systems. We offer lots of opportunity for mentorship with our group of dental professionals. Experience of 2-4 years will be an asset, but new graduates can apply. Please send your resumes and applications to lavinawilma@gmail.com or call 6477869619 / 6479380342.

SHERWOOD PARK, AB Full Time Dental Associate required for a busy family practice in Sherwood Park. We have been serving the community for over 40 years. Experience is an asset. Email: jill_sherwood@shaw.ca

EDMONTON, AB Well established West Edmonton practice is seeking a Full-Time Associate to join our lively & upbeat dental team. This is a unique opportunity for a motivated dentist who wishes to be busy from the start! The office boasts modern technology, a strong hygiene department & a high new patient flow. Must be proficient in all aspects of general dentistry. This position will prove to be rewarding for individuals with a positive attitude, great communication skills and the drive to succeed. Please email your resume to: abcd.dentist@gmail.com

February 2018

37

DENTAL MARKETPLACE

ASSOCIATESHIPS

BURLINGTON, ON EXCITING OPPORTUNITY FOR EXPERIENCED DENTIST!!! Established Burlington practice looking for the right ‘fit’ with a part-time to full-time associate. Must have 3 years experience. If you are DRIVEN, PASSIONATE ABOUT DENTISTRY and interested in growing and establishing a consistent patient load, we would love to hear from you! Please respond to 1stdentalteam@gmail.com

OTTAWA, ON Our busy and well established Ottawa based practices are currently looking for full and part time Rockstar Dentists. Excellent potential! Please email in confidence to amyfudge16@gmail.com

KITCHENER/CAMBRIDGE, ON

THOMPSON, MB

We are looking for a part-time associate dentist for one to two days per week for a family dental practice. Email resumes to kwdentist66@gmail.com

ASSOCIATE – NEEDED IMMEDIATELY!!

ALBERTA Full time pediatric dentistry associate at a Pediatric/Orthodontic Practice in Alberta, Canada. The practice has the following features: Central location, Great population/specialist ratio, on site GA/Sedation theatre, 3D imaging, Expected minimum of 200 new patients a month, Possibility of buying the pediatric side of the practice, expansion potential, income potential is over 600k. Please call (780)716-4469 or email: saleh1997@hotmail.com

WELLAND, ON

CAMBRIDGE, ON Associate position available for 3-4 weekdays to take over an established associate patient base. Wide range of comprehensive treatment is possible. Send resume to cambridgeassoc@yahoo.com

NORTH OSHAWA, ON Modern and growing North Oshawa office is seeking a Dental Associate to join our fabulous team. The desired candidate will be motivated and patient-care oriented. Must be skilled and comfortable in all aspects of general dentistry. Please forward your resume in confidence to: OshawaDDSassociate@gmail.com

SHERWOOD PARK, AB FULL TIME Associate required for a busy General practice. In Airdrie and Calgary. Large established patient base, great staff in place. Excellent long term opportunity. Please email resume to: smiledoctors1@hotmail.com

38

February 2018

Full-time, energetic, detail oriented associate needed immediately for established, busy family practice with high income potential per month. Enjoy a fully booked schedule and ability to reach your goals as a dental professional. Experience preferred. Excellent opportunity. New grads welcome. Living accommodations provided. E-mail cv: thompsondent@gmail.com P: 204-939-0083.

ELMVALE, ON

AIRDRIE, AB Outgoing and friendly dentist needed to join our growing dental practice. Part time/ Full time position available. Please email resume to: smiledoctors1@hotmail.com

FULL TIME ASSOCIATE NEEDED We are currently seeking a full time experienced associate for our well established, progressive, family oriented dental practice. We are currently expanding our team as our practice is growing. We are looking for a caring, compassionate and passionate team player who provides quality dental care for all patients. Please submit your resume and a cover letter to recruiting@tmfd.ca

REGINA, SK Seeking motivated and dynamic Associate for long-term, full-time position in a growing, modern and well-appointed clinic. Paid on PRODUCTION! New grads welcome, mentoring available. Contact: admin@courtsidedental.ca

OTTAWA, ON OR GATINEAU, PQ Full-time Dental Associates Great opportunity to join established dental practice with CAD/CAM, Digital xrays, Cerec and paperless systems. We offer lots of opportunity for mentorship and community support within our group of dental professionals. Contact sarmstrong@mcadental.com

(25 MINS. NORTH OF BARRIE) Associate opportunity to join our dental family. Looking for a part-time Associate to join our dental family in a progressive, well-established and growing practice. Must be friendly and a team player with good communication skills. Please send resume to linda.sfd@outlook.com

ST. CATHARINES, ON PART TIME DENTAL ASSOCIATE wanted immediately for a large, modern dental practice in St. Catharines. Applicant must have 3 plus years of experience. Apply in confidence to info@lakestreetdental.ca

AD INDEX AMD Medicom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 Ansell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 CDLI – Canadian Dental Laser Institute . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 Clinical Research Dental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 Crest Oral-B, P&G . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IFC, 7, 20, 23, 25 GSK – GlaxoSmithKline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33, IBC ODA – Ontario Dental Association . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 Philips Oral Healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 Premier Dental Products Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34 Sable Industries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 SciCan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 Shofu Dental Corporation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24 VOCO Canada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OBC www.oralhealthgroup.com

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GlaxoSmithKline Consumer Healthcare Inc. Mississauga, Ontario L5N 6L4 ©2017 GSK group of companies or its licensor. All rights reserved.

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PLUS DE RÉDUCTION PLUS DE RÉDUCTION DES ZONES DE LA PLAQUE SUR LES DE SAIGNEMENT2 SURFACES PROXIMALES3

La brosse à dents électrique Oral-B à pulsation oscillo-rotative acceptée par l’ADA4 * Dictionnaire en ligne Larousse. Disponible à l’adresse : http://www.larousse.fr/dictionnaires/francais/sonique Références : 1. Données internes de P&G Canada. 2. Ccahuana-Vasquez RA. Une évaluation clinique de huit semaines d’une brosse à dents électrique à oscillations et rotations utilisée avec une brossette à soies inclinées *Merriam-Webster online dictionary. Available at: https://www.merriam-webster.com/dictionary/sonic comparée à une brosse à dents sonique contre la plaque dentaire et la gingivite. J Clin Dent 2015;26:80–85. 3. Klukowska M, Grender J M, Conde E et al. A six-week clinical evaluation of the plaque and gingivitis efficacy of an oscillating-rotating power with a novel brush head utilizing CrissCross bristles versus aofsonic toothbrush. J Clin Dent 2014;25(2):6-12. References: 1. Data on fitoothbrush le at P&G Canada. 2. Ccahuana-Vasquez RA.angled An Eight-Week Clinical Evaluation an Oscillating-Rotating Power Toothbrush with a Brush Head Utilizing Angled Bristles Compared with a Sonic Toothbrush in the Reduction of Gingivitis and Plaque. J Clin Dent 2015;26:80–85. 3. Klukowska M, Grender J M, Conde E et al. A six-week clinical evaluation of the plaque and gingivitis efficacy of an oscillating-rotating power toothbrush with a novel brush head utilizing angled CrissCross bristles versus a sonic toothbrush. J Clin Dent 2014;25(2):6-12. 4 . Santé buccodentaire. Produit vedette. Les brosses à dents électriques Oral-B reçoivent le sceau d’acceptation de l’ADA. © P&G, 2017 à l’adresse ORAL-22366 Disponible : https://www.oralhealthgroup.com/products/oral-b-power-toothbrushes-receive-ada-seal-acceptance/ (Janvier 2018) © P&G, 2018

ORAL-22366

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hygiénistes dentaires

Partager, apprendre et s’améliorer ensemble.

Créateurs de sourires. Bâtisseurs de confiance.

FAITES LA DÉCOUVERTE DU DENTIFRICE DU FUTUR

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Si vous êtes comme moi, vous aimez essayer et juger des nouveautés par vous-même. Ainsi, lorsque j’ai appris que Crest Pro-Santé offrait une nouvelle formule, j’ai voulu la mettre à l’épreuve. J’ai premièrement remarqué son goût. J’adore son arôme de menthe fraîche. Puis, sa texture douce, presque crémeuse, mousse agréablement bien. Elle procure une sensation douce et une mousse agréable en bouche. En somme, elle offre une expérience de brossage remarquable. Crest a bien visé dans le mille! Je suis enthousiaste de découvrir un dentifrice au fluorure stanneux qui soit aussi agréable à utiliser. Je peux maintenant recommander un dentifrice qui tient compte des changements d’habitudes alimentaires de mes clients et de l’augmentation continue des risques associés aux acides alimentaires. Cette nouvelle formule est pour moi facile à recommander et elle sera facile à apprécier par mes clients.

Jennifer Turner, hygiéniste dentaire agréée, B. Sc. Conseillère en formation, dentalcorp

JOIGNEZ-VOUS AU MOUVEMENT CREST® PRO-SANTÉ ! Visitez le Dentalcare.ca aujourd’hui pour recevoir votre programme COMPASS GRATUIT (un échantillon de 70 mL et le Guide d’étude sur le perfectionnement professionnel). • Sans micro-perles • Ne cause pas de desquamation

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© P&G, 2017 ORAL-22272

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HEALTH the front desk may have questioned the patient on their health history, it is incumbent for all team members to ask if there have been any changes. Additionally, they do not feel some of these symptoms are issues a dentist needs to know. We need to stress to our patients, even though they don’t think it is related, after all, the teeth are connected to the rest of the body. We have much to offer in the dental office for our patients. Monitoring of blood pressure and questioning our patients concerning their diet and exercise can assist them in the long and short run. The oral-systemic link is highly important here. Proper oral hygiene will reduce oral bacteria and inflammatory sites. Stressing the need for routine preventive maintenance to monitor any gingivitis or periodontal concerns should be part of the treatment plan. Possibly discussing adjunct

therapies, such as mouth rinses to decrease plaque and inflammation, may be beneficial to her gingival health. We can discuss the risk factors that are reversible and offer alternatives. Recommending smoking cessation will not only help their cardiac health but their oral health as well. Evaluating diet diaries to assess both cariogenicity and “heart-smart” content of the food consumed will also be a dual assist in the patient’s overall health. Increasing fruits and vegetables, consuming lean meats, poultry and fish high in omega-3 fatty acids, checking food labels for hidden sodium and fat content are all nutritional suggestions that could be made. Recommending a consultation with the physician if the blood pressure is consistently elevated over 140 systolic or 90 diastolic (stage 1 hypertension classification). Discussing exercise of any form as a means to

pH – Échelle d’acidité

NOS HABITUDES ALIMENTAIRES CHANGENT. COMMENT VOUS PROTÉGEZ-VOUS DE L’ÉROSION CAUSÉE PAR L’ACIDE?

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L’ÉMAIL COMMENCE À S’AFFAIBLIR À UN pH DE 4,0.

February 2018 www.oralhealthgroup.com

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HEALTH “work off” stress and “work out” the body is a dual contribution for decreasing stress and weight. Walking is an excellent example of exercise that can be performed at any age and ability level. One very important thing is to remind patients to take their prescribed medications in the dosage dispensed. Many times, patients take it upon themselves to stop or alter prescription drugs. We need to discuss with them to do as their physician requested until a change is required. Furthermore, a large number of the medications given to cardiac patients do cause xerostomia. Discussing the side effects of dry mouth will lead to a conversation about proper hydration, the importance of keeping up personal oral hygiene and preventive visits. Coronary artery disease is no longer a male dominated arena. Women have overtaken the mortality statistic. Lifestyle alterations (low fat and low sodium diet, smoking cessa-

tion, increase aerobic exercise), in addition to proper and timely health care will increase the chances of a long and healthy life. With proper counseling, and education, women will be more aware of the signs and symptoms to alert of a cardiac event. For ourselves and for our patients, we all need to be aware of the distinctively different signs and symptoms of women’s coronary disease. Dedicated to my mom, Bernice R. Doniger, who died of heart failure, July 31, 2001.

Recommended References: www.americanheart.org https://americanheartsaver.com/ https://cwhhc.ottawaheart.ca/ http://www.cwhn.ca/en/womenandhearthealth https://www.goredforwomen.org/about-heartdisease/facts_about_heart_disease_in_womensub-category/statistics-at-a-glance/

ARMEZ VOS DENTS DE LA PROTECTION DE L’AVENIR Les dentifrices ne contiennent pas tous le même fluorure. Contrairement à n’importe quel fluorure de sodium, le fluorure stanneux exclusif de Crest Pro-Santé protège les dents contre l’érosion alimentaire causée par l’acide à des pH bas. Offrez à vos dents une meilleure armure.

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© P&G, 2018 ORAL-22274

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February 2018 www.oralhealthgroup.com

25

ELLE SAIT QUE LES FRAISES COMPORTENT D’EXCELLENTES PROPRIÉTÉS ANTIOXYDANTES. QUE DEVRAIT-ELLE SAVOIR DE PLUS? De nos jours, les jeunes se tiennent au courant pour vivre sainement1. Mais savent-ils que les aliments sains, comme les fruits, le jus et les boissons pour sportifs, sont très acides et qu’ils peuvent mettre leur émail à risque2-5? Usez de votre influence en tant que professionnel dentaire de confiance. Informez chaque jeune patient des effets de l’érosion par acide. Ils doivent investir dans leur émail dès aujourd’hui.

Pour vos patients prédisposés à l’érosion par acide. 1. Données internes de GSK, 2013. 2. Lussi A. Erosive tooth wear – a multifactorial condition. Dans : Lussi A, directeur. Dental Erosion – from Diagnosis to Therapy. Karger, Basel, 2006. 3. Lussi A. Eur J Oral Sci. 1996;104:191-198. 4. Hara AT et al. Caries Research. 2009;43:57-63. 5. Lussi A, et al. Caries Research. 2004;38(suppl. 1):34-44.

MC/® ou sous licence GlaxoSmithKline Soins de santé aux consommateurs Inc. Mississauga, Ontario L5N 6L4 ©2017 Le groupe d’entreprises GSK. Tous droits réservés.

Contrôle la plaque, prévient la gingivite et procure un soulagement de la sensibilité? À votre santé!

Lorsque vous recommandez Sensodyne® Protection complète à vos patients, vous serez rassuré de savoir que vous les aidez à soulager l’hypersensibilité dentinaire, et que vous recommandez un produit procurant d’autres bienfaits pour la santé des gencives, comme l’élimination de la plaque et la réduction de la gingivite.

GlaxoSmithKline Soins de santé aux consommateurs Inc. Mississauga, Ontario L5N 6L4 ©2017 Le groupe d’entreprises GSK ou son concédant. Tous droits réservés.

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