Oral Hygiene May 2016

oralhygiene May 2016

Community Water Fluoridation: Tackling the Irrational Fears

www.oralhealthgroup.com

PURE and SIMPLE

Eye Wash Stations in the Dental Office

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oralhygiene CONTENTS

ORAL HYGIENE Pure and Simple: DUWL Solutions

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16

Leann Keefer, RDH, MSM

The Eyes Have It: Eye Wash Stations in the Dental Office

10

Lauren McFarlane, BA, CHSC

Community Water Fluoridation: Tackling the Irrational Fears

20

Pasquale Duronio, DDS

The Power of O.R.A.N.G.E

34

Judy Kay Mausolf

COMMUNICATION Is Your Next Great Patient Staring You in the Face?

16

Marketing 101: The Art of the Referral Larry M. Guzzardo

PATIENT MANAGEMENT Charm Offensive

30

20

Lisa Philp, RDH

TECHNOLOGY The Importance of your Dental Software

32

Feda Bashbishi

Editorial Professional Pride and the Power of Purple

News SIROWORLD 2016 Your Dentist Wants You To Butt Out

New Products Dental Marketplace Editorial Board Members Lisa Philp | Kathleen Bokrosssy Debra Englehardt-Nash

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DEPARTMENTS

May 2016 

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www.oralhealthgroup.com

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One in four has it.

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Many don’t know it.

2

They also may not know the oral health consequences.* They’re waiting for your guidance.

Dry Mouth is an oral health concern that affects people on multiple medications the most.3 Yet some people aren’t aware that it’s a problem.2 Talk to your patients about Dry Mouth and how Biotene can help provide relief.† ®

www.biotene.ca

GlaxoSmithKline Consumer Healthcare Inc., Mississauga, Ontario L5N 6L4 © 2016 GSK group of companies or its licensor. All rights reserved. * Dry mouth can disrupt the oral health environment and lead to halitosis, demineralization, and increased caries.4,5 † Mouthwash, Gel and Spray. ‡ As measured in a 28-day clinical study.6 1. GSK data on file. Biotène dry mouth growth opportunity (with Canadian U&A data). July 16, 2014. 2. Dawes C. How much saliva is enough for avoidance of xerostomia? Caries Res. 2004;38:236–240. 3. Sreebny LM, Schwartz SS. A reference guide to drugs and dry mouth, 2nd edition. Gerodontology. 1997;14:33–47. 4. Turner MD, Ship JA. Dry mouth and its effects on the oral health of elderly people. J Am Dent Assoc. 2007;138:15S–20S. 5. Fox PC. J Clin Dent. 2006;17(Spec Iss):27–28. 6. GSK data on file 2014, RH01986.

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EDITORIAL

Professional Pride and the Power of Purple Can we talk about your aura? If it’s purple, it means you are highly intuitive, benevolent and a seeker. In chakra colors (chakras are circular vortexes of energy lying across seven different points on our spinal column) purple is the color of the crown chakra. The crown chakra is associated with the pituitary gland, nervous system, and the brain and head region with its element of light. Purple combines the stability of blue and the energy of red. Purple (or violet) is affiliated with the planet Uranus as well as the moon. Its zodiac signs are Aquarius and Cancer and its associated with the numbers seven and 12 (no, I don’t know how a color has a favorite number, it just does)! Know how there’s a ribbon for every cause/ disease/charity? The purple ribbon symbolizes pancreatic and leiomyosarcoma. Colors by culture? In Western culture, purple signifies royalty and wealth; in Far Eastern culture purple symbolizes wealth, privilege and spirituality; purple means nobility, comfort and sorrow in Indian culture and in the Middle East, wealth, virtue and royalty. The color purple relates to the imagination and spirituality and allows us to get in touch with our deepest thoughts, or so I’m told. In color psychology, purple represents the future and dreams. Purple equals power. It has a richness and quality that demands respect. Purple is ambitious and confident – it is the leader type. The color purple is also synonymous with dental hygiene and has been the official color of dental professionals since 1897, when lilac was first chosen for the emblem of the

National Association of Dental Faculties. As part of the recent National Dental Hygienists Week, the Canadian Dental Hygienists Association repeated its highly successful ‘Put Your Purple On’ campaign, designed to encourage its members to display their professional pride. But is it limiting the profession to be represented by a single color when dental hygiene is experiencing an explosion of opportunities, a virtual rainbow of possibilities? Healthcare reforms in North America and Europe are redefining who does what and when and part of healthcare reform is the independence of the dental hygienist. It is important to recognize this new position and status for dental hygiene, says Ross Perry, as well as its accompanying responsibilities and opportunities. Perry is President of CHX Technologies (Toronto), a specialty pharmaceutical company developing the world’s first treatment for the bacterial infections causing dental decay. “[Hygiene] has to market itself, run the business, convey a more compelling brand and a range of services that scream value and necessity,” he says. And, perhaps most importantly, “it serves a different, more discerning and knowledgeable community.” Perry says some dental hygienists ‘get’ their new status and opportunities and are keen to offer a ‘rainbow’ of clinical diagnostic and therapeutic services to predict and prevent poor oral health for their patients. They are the early adopters and innovators who are developing the new model of hygiene for others to follow. Purple or rainbow? Color yourselves compassionate, purposeful and inspirational!

Catherine Wilson

Editor

May 2016

5

www.oralhealthgroup.com

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NEWS BRIEFS

SIROWORLD 2016 Dentsply Sirona, The Dental Solutions Company™, confirms list of Periodontic/Hygiene specialists speaking during new breakout track at SIROWORLD in Orlando, Florida. Hosted at the Rosen Shingle Creek Resort from August 11th-13th, SIROWORLD is a threeday educational festival where thousands of dental professionals are expected to gather to gain invaluable training and education. Network with peers and visit the 95,000 square-foot trade show floor, all while earning 18+ Continuing Education (CE) credits. This year, Dentsply Sirona introduced a new track: Periodontics/Hygiene. Speakers presenting at SIROWORLD include: • Heidi Arndt, RDH, founder and CEO of Enhanced Hygiene Session topic: “Hygiene Business Rule #1: Know Your Numbers” Session topic: “Grand Slam Hygiene Exam” • K risty Menage Bernie, RDH, BS, RYT, Co-founder and director of Educational Designs Session topic: “Paradigm Shifts in Periodontal Therapy: Implementing Evolving Protocols” Session topic: “Paradigm Shifts in Caries Management: Implementation of CAMBRA” • Patti Digrangi, RDH, BS Session topic: “Connecting the Dots: Coding to Care and the New 2017 Gingivitis Code” Session topic: DiGangi’s second breakout topic will be announced as the information becomes available. • Maria Goldie, RDH, MS Session topic: “Risk Assessment and Supportive Therapy for Implants” Session topic: “Oral Cancer and HPV: What’s Sex Got to do With It?”

To register now or to receive more information on SIROWORLD, visit www.siroworld.com.

Your Dentist Wants You to Butt Out It was estimated by the Canadian Cancer Society that 4,400 people in Canada were diagnosed with oral cancer last year. Chances are it was a dentist who first noticed the subtle changes in their patient’s mouth that led to a diagnosis. Oral cancer can be successfully treated if caught at an early stage and your dentist plays a role in its detection and prevention. In light of the Ontario government’s recent moves to further strengthen its smoking law and it’s Smoke-Free Ontario Strategy, Ontario’s dentist used Oral Health Month (April) to reinforce the message that tobacco use can lead to a high risk of developing oral

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May 2016

A NEWCOM BUSINESS MEDIA PUBLICATION Senior Sales Manager: Tony Burgaretta 416-510-6852 Editorial Director: tonyb@newcom.ca Catherine Wilson Classified Advertising: 416-510-6785 Karen Shaw catherine@newcom.ca 416-510-6770 karen@newcom.ca Assistant Editor: Jillian Cecchini Dental Group Assistant: 416-442-5600, ext. 3207 Kahaliah Richards jillian@newcom.ca 416-510-6777 kahaliah@newcom.ca Art Direction: Associate Publisher: Carolyn Brimer Hasina Ahmed Production Manager: 416-510-6765 Phyllis Wright hasina@newcom.ca Circulation: Managing Director: Mary Garufi Melissa Summerfield 416-614-5831 416-510-6781 mary@newcom.ca melissa@newcom Advertising Services: Vice-President: Joe Glionna Karen Samuels 416-510-5190 President: karens@newcom.ca Jim Glionna

cancer and other dental diseases. Deciding to stop smoking is the best decision you can make for your health, and your dentist can help improve your chances of success. The experts in oral health care, dentists can easily spot the damage tobacco does to the mouth and teeth – smokers tend to suffer from bad breath, stained teeth and dry mouth. People who smoke are also three times more likely to have severe periodontitis (gum disease) than non-smokers. Oral diseases associated with smoking are more obvious to the eye than other conditions and allows dentists to easily identify patients who use tobacco – and start the conversation about quitting. OFFICES Located at 80 Valleybrook Drive, Toronto ON M3B 2S9. Telephone 416-4425600, Fax 416-510-5140. Oral Hygiene serves dental hygienists across Canada. The editorial environment speaks to hygienists as professionals, helping them build and develop clinical skills, master new products and technologies and increase their productivity and effectiveness as key members of the dental team. Articles focus on topics of interest to the hygienist, including education, communication, prevention and treatment modalities. Please address all submissions to: The Editor, Oral Hygiene, 80 Valleybrook Drive, Toronto, ON M3B 2S9. Oral Hygiene (ISSN 0827-1305) will be published four times in 2016, 80 Valleybrook Drive, Toronto ON M3B 2S7.

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: 416614-8861; 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)

www.oralhealthgroup.com

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ORAL HYGIENE

Pure and Simple: DUWL Solutions Leann Keefer, RDH, MSM

In her role as Director of Education for Crosstex International, Ms. Keefer works to advance Crosstex’s thought leadership among influential dental care professionals. She proactively identifies trends in the fields of oral care and infection prevention, developing and implementing the corporation’s longterm strategies relating to education and professional relations.

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roviding clean, safe dental water is critical to implementing and maintaining effective infection control protocols. Exposure to poor water quality can pose a health risk for people and confl icts with universally accepted infection prevention protocols. Noted most recently, in 2011 was the fatal case of an 82-year-old otherwise healthy woman who developed Legionnaire’s disease after a dental visit.1 The goal of effective dental unit waterline (DUWL) treatment is to reduce the number of microorganisms present in the water, thereby helping to break the chain of infection. Dental unit waterline contamination was fi rst reported in 1963. 2 Challenges of basic equipment design and tubing contribute to the development of biofi lm in DUWL. Research has shown microbial counts can reach <200,000 CFU/mL within five days after installation of new dental unit waterlines. 3 Many water samples exhibit colony counts ranging from 1,000 to 10,000 colony forming units per milliliter (CFU/mL), with concentrations greater than 1,000,000 CFU/mL also having been reported.4 The Guidelines for Canadian Drinking Water Quality are established by the FederalProvincial-Territorial Committee on Drinking Water (CDW) and published by Health Canada. The standard established by the US Environmental Protection Agency (EPA) and other agencies for potable water is 500 CFU/mL of non-coliform bacteria; in Canada, while not a health-based standard, the recommendation for 500 CFU/mL is recognized.

Protocol recommendations for treatment of dental unit waterlines provided by the Alberta Dental Association and College and published in the 2010 document, Infection Prevention and Control Standards and Risk management for Dentistry: Dental Unit Waterlines • All waterlines must be purged at the beginning of each workday by flushing the lines thoroughly with water for a minimum of two minutes. • Waterlines must be purged for a minimum of twenty seconds after patient care. • Manufacturer’s instructions of the dental units and dental equipment must be followed for daily and weekly maintenance whenever closed water systems or other special water delivery systems are utilized. • Suction lines must be aspirated with water or disinfectant solution between patients to reduce likelihood of infectious material backflow. • Suction lines must be cleaned once a week with an enzymatic cleaner. While flushing of dental unit water lines has been recognized as a strategy for reducing planktonic (free-floating) microbial levels in dental water systems, yet the protocol has not been shown to affect the biofi lm accumulated on the DUWL tubing. 5 Recommendations regarding the efficacy of flushing have changed over the years; in 2003, the CDC Guidelines for Infection Control in Dental

May 2016 www.oralhealthgroup.com

• • • • •

Self-contained water systems Point-of-use fi lters Chemical treatment protocols Municipal water treatment systems Slow-release cartridge devices

REFERENCES: 1.

Ricci ML, Fontana S, Pinci F, et al. Pneumonia associated wit a dental unit waterline. Lancet 2012;379 (9816):684. April 2012 Blake GC. The incidence and control of bacterial infection of dental units and ultrasonic scalers. Br Med J. 1963; 115: 413-416 Barbeau J, Tanguay R, Faucher E, et al. Multiparametric analysis of waterline contamination in dental units. Appl Environ Microbiol 1996; 62: 3954–9. Molinari JA, Nelson P. The Need for compliance in Waterline Maintenance. The Dental Advisor 2016; Number 24 Porteous NB. Dental Unit waterline Contamination: Causes, Concerns, and Control, Updated 1st Edition; Release date November 2012, Review date October 2015; 9-10

2.

3.

4. 5.

Remaining vigilant to compliance with treatment protocols, including monitoring when required, is critical to achieving and providing safe, clean dental unit water during treatment.

ORAL HEALTH GROUP

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With four leading publications and a dynamic website, Oral Health Group delivers complete, comprehensive coverage of the dental profession in Canada. Our publications serve all members of the dental team: dentists, hygienists, dental lab owners and technicians, dental students and members of the dental industry. Proud to be serving the Canadian dental profession for over 100 years, Oral Health is the voice of Canadian dentistry! MARCH 2016

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ORAL HYGIENE

Health-Care Setting were amended and no longer supports flushing at the beginning of each day as there was no reliable scientific evidence to show that flushing affects biofi lm in the waterlines. However, flushing of all devices connected to the waterlines for 20-30 seconds between patients remains a protocol recommendation. The following treatment options are available for closed water systems to address the biofi lm with its resident microorganisms and optimize dental unit water quality:

16-02-25 12:05 PM

www.oralhealthgroup.com May 2016 www.oralhealthgroup.com

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ORAL HYGIENE

The Eyes Have It: EYE WASH STATIONS IN THE DENTAL OFFICE Lauren McFarlane, BA, CHSC

President of Dental Practice Safety A trainer, coach, visionary and consultant who is a leader in the field of Occupational Health and Safety (OHS). Lauren is a certified Consultant and Board Member (Toronto chapter) with the Canadian Society of Safety Engineering (CSSE) and has earned a long list of OHS certifications and training. The creation of the Dental Practice Safety Club demonstrates another benchmark achievement for Ms. McFarlane and another first within the safety and dental communities.

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hy would a dental practice require an eye wash station? Is it required by law? And if so, what type of equipment is needed? Although the Royal College of Dental Surgeons of Ontario recommends the installation of eye wash stations in dental offices (Infection Prevention and Control in the Dental Offi ce, 2010), there is still some confusion about whether they are actually required. This guideline, along with provincial legislation and product safety data sheets, detail why every dental practice is required to install an accessible eye wash station(s). What key features are required to ensure the station is safe and effective is found in the American National Standards Institute (ANSI) standard Z358.1-2014 (“Emergency Eyewash and Shower Equipment”) as well as manufacturer instructions. Provincial safety legislation is enacted to assure that workers are provided with safe and healthy workplaces. These laws authorize the adoption of complementary safety standards and regulations to fulfi ll the mandate of improving worker safety. With requirements and guidelines coming from what seems like every direction, it becomes clear that every dental practice requires an eyewash station(s).

Why Have an Eye Wash Station? The legal requirement for eye wash stations is found in most provincial and federal health and safety legislations. For instance, Ontario’s Occupational Health and Safety Act, Industrial Regulation 851, states: “Where a worker is exposed to a potential hazard of injury to the eye due to contact

with a biological or chemical substance, an eyewash fountain shall be provided.” Further, the “General Duty Clause” for employers to exercise due diligence and “take every precaution reasonable in the circumstances for the protection of a worker” applies anywhere that an occupational risk of eye injury could be said to exist. Do dental offices fall into this category? It’s clear that they do. While provincial safety regulations do not specifically mention dental offices, dental practices use a variety of chemicals and corrosive materials, putting both personnel and patients at risk of suffering eye injuries. Substances such as bleach, hydrogen peroxide, phosphoric acid, formocreosol, methyl methacrylate, varnish and more, are potentially hazardous to the eyes. Accidental chemical exposures can occur even with safety precautions and with the use of personal protective equipment. The fi rst 10-15 seconds after exposure to a hazardous or corrosive substance are critical. Eyewash stations provide on-the-spot decontamination. While you hope you will never need to use one, having an eyewash station installed could save a person’s vision. That’s why the Royal College of Dental Surgeons of Ontario advises: “The conjunctival mucosa of OHCWs [oral health care workers] should be protected from spatter and debris created during dental procedures by wearing appropriate eyewear or face shields… It is also recommended that an eye-wash station should be available in the dental office for both OHCWs and patients to aid in managing contact with any bodily fluid or dental chemical/solvent.”

May 2016 www.oralhealthgroup.com

ORAL HYGIENE

Left: Bradley’s swing activated emergency eyewash unit (model # S19274C) Below: Safety Data Sheets (SDSs)

Proper Use of Eye Wash Stations The biggest error people make when using eye washes is not flushing long enough. Holding the eyes open while streams of water flood them is uncomfortable, even when the eye has not been injured, and even five minutes can seem like a long time. However, many chemicals require flushing times of 15 minutes or more (up to an hour for penetrating corrosives) to ensure further damage to the eye is minimized. It is also important not to leave the victim unattended as they may need assistance in maintaining the bent-over pose while flushing the eyes. Safety Data Sheets (SDSs) must be easily accessible, so that appropriate fi rst aid can be quickly given. The fi rst priority is to flush the eye immediately. Once the person is set up at the eye wash station, the SDS should be consulted to determine recommended flushing time. Follow-up medical attention, of course, is essential.

Specifications for Eye Wash Stations As yet, there is no specific provincial or Canadian standard for the design and placement of eye wash stations nor are there plans to develop a Canadian standard. This is because in Canada, we follow the American National Standards Institute (ANSI) standard Z358.12014 (“Emergency Eyewash and Shower Equipment). The ANSI standard is used as the authoritative, comprehensive and current guideline. Let’s look at some of the key requirements specified in the ANSI standard.

Location The eyewash stations(s) must be located in areas that are easily accessible (no doors or other barriers to access) within ten seconds (roughly 55 feet). Imagine a person blinded by burning chemicals, stumbling towards the station. That person must not be at risk of colliding with someone’s desk or tripping over steps. The station should be identified with a highly visible sign that contains an easy-to-recognize symbol that does not require workers to have English reading skills to understand it.

May 2016 www.oralhealthgroup.com

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ORAL HYGIENE

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Water Delivery The unit should be designed so that it: • activates within one second or less • flushes both eyes simultaneously • provides hands-free operation (so the hands can be used to hold the eyes open) • delivers a minimum of 15 minutes of copious flushing • has protective covers on the nozzles (to prevent contamination) that are selfremoving when flow is started • delivers tepid water (16 – 38º C, see discussion below) • delivers adequate volume of water (at least 1.5 litres/minute; or 11.4 litres/ minute for a combination eye/face wash station). However, the water force must not be so strong that it could drive contaminants into the optic system or otherwise injure the eye.

Maintenance and Other Considerations The ANSI standard also covers: • shut-off valves: If shut-off valves are installed, there must be a device in place to secure them against accidental/unauthorized shut-off. • waste disposal: Flushing fluid may be contaminated and so proper disposal provisions must be in place. • proper maintenance and weekly testing: Carelessly maintained equipment may fail to perform properly when required or even contaminate the user’s eyes. Weekly testing ensures equipment is operating correctly and also helps clear the supply lines of sediment and bacteria build-up that is caused from stagnant water. It’s best to assign one person to perform weekly testing and to keep a signed, dated record of inspection.

Why Tepid Water? Water that is too hot (over 38º C) is harmful to the eyes and can actually enhance the action of harmful chemicals on the tissue. Cold water, previously deemed acceptable, is not ideal either. It can cause hypothermia, and because it is much more uncomfortable than tepid water, leads to inadequate flushing times. In fact, ANSI further defi nes tepid water as “a fl ushing temperature conducive to promoting a minimum 15 minute irrigation period.” When longer rinsing times—up to 60 minutes—are required, tepid water can make the difference between the treatment being tolerable for the required length of time, or not. Obviously, it’s essential that users not have to waste time adjusting the water temperature or risk injury to the eye due to temperature extremes such as scalding. Tepid water can be delivered to eye wash stations by different means, the most common being thermostatic mixing valves or water tempering valves. These valves effectively blend hot and cold water to provide a comfortable flushing fluid within the temperature range recommended by ANSI.

What About Eyewash Bottles? Eyewash bottles and other personal eyewash units are useful to allow quick flushing of small particles or contaminants, or to immediately rinse the eye before going to the eyewash station. However, as the above guidelines should make clear, they is no substitute for a full eyewash station. Bottles cannot provide the full 15 minutes (or more) of flushing that may be required, and it is difficult (or impossible, depending on the product) to flush both eyes at once.

Bio Med Wash with ph-balanced, tissue culture grade water acts as an intermediate step until the eyewash station can be reached or for quick flushing of small particles or contaminants.

May 2016 www.oralhealthgroup.com

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ORAL HYGIENE

GENERAL GUIDELINES FOR EYE FLUSHING Although eyewash stations are required to provide at least 15 minutes of flushing time, the Canadian Centre for Occupational Health and Safety (CCOHS) points out that some references

recommend a minimum of 20 minutes of flushing if the contaminant is not known. When known, the Safety Data Sheet should always be consulted, but in general CCOHS recommends:

Material

Minimum Flushing Time

Mildly irritating chemicals

5 minutes

Moderate-to-severe irritants

20 minutes

Non-penetrating corrosives (most acids)

20 minutes

Penetrating corrosives (most alkalies, hydrofluoric acid, phenol)

60 minutes

(Source: Canadian Centre for Occupational Health and Safety, OSH Answers Fact Sheet: Emergency Showers and Eyewash Stations)

Training Safety equipment, of course, can only do its job if people know how to use it. All workers require instruction in the proper use of eyewash stations before any emergencies occur. Instructions should be made available to all workers and posted beside the eyewash station. Contact lens removal should be included in the training, as immediate removal of contact lenses is important to prevent chemicals trapped under the lens from causing injury. The instructional process should include a “hands on” drill with workers demonstrating correct use. WHMIS training is the other important component in eye safety. Staff must be familiar with the various hazardous substances used in the practice and their safe handling, as well as the location of the SDSs and how to quickly fi nd the First Aid instructions on the sheet. IT ONLY TAKES a few seconds to permanently injure an eye. Considering the range of hazardous chemicals used in today’s dental

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practices, and the potential for particles to be projected at high speed during dental procedures, eye wash stations should be considered standard equipment for every practice— and there is little doubt that provincial safety inspectors will draw the same conclusion. Installing proper eye wash equipment protects everyone involved: staff, patients, and the dentists/practice owners themselves.

RESOURCES The Canadian Centre for Occupational Health and Safety’s OSH Answers Fact Sheet: Emergency Showers and Eyewash Stations can be read/downloaded here: https://www.ccohs.ca/oshanswers/safety_haz/ emer_showers.html The full ANSI standard may be purchased online here: http://webstore.ansi.org/RecordDetail.aspx? sku=ANSI%2fISEA+Z358.1-2014

May 2016 www.oralhealthgroup.com

COMMUNICATION

Is your next great patient staring you in the face? MARKETING 101: The Art of the Referral Larry M. Guzzardo

who has co-authored two books, “Powerful Practice” and “Getting Things Done” conducts in-office practice management consultations exclusively for dentists to enhance trust, create organization, increase profits, and the development of patient relationships that last. Larry has presented numerous workshops including, “Winning Patient Acceptance,” “Business Communication Systems,” and “The Leadership Challenge.”

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onsider the type of patient you would like in your practice. Stop spending time putting out fi res that consume valuable time and energy, with problem patients. Spend more time with your preferred patients and their friends. Birds of a feather really do flock together. Patient surveys show that the majority of patients fi nd out about dental practices from other friends who are already patients. This has consistently been the method of choice for patients to identify and locate a new dentist. Traditionally, all professional relationships have been developed through personal contact. Your practice will not be any different. Just ask other professionals such as your CPA or attorney. They know, all too well, the power of a well-placed referral Yes, it is true, advertising works. It’s just that it works with the wrong group of individuals. Anyone can create large volume if you give away dentistry at a discount or accept every patient who calls. It is far more rewarding to build a practice of patients who seek you out because they are looking for the unique dentistry you are trained to provide. Far, far more rewarding to have them curious about the problems you can solve for them, because their friend raved about you and your staff. If you would like to build a practice upon the referrals of your most preferred-type patients, well then, just ask them to refer their friends. Take these action steps to get started: • Get comfortable with the idea yourself. • Discuss the idea with the staff at your next staff meeting. • Make a list of the characteristics of your most preferred-type patient. Get agreement

on what you are looking for • Practice with the staff ways you can ask for a referral that will be comfortable for them. Help them to create an outline of what they would like to say without making them remember a script. • Review the schedule each day and decide what patient you would like to ask for a referral. • Ask every staff member to select a patient. • Track how many patients are asked. • Document the date and who asked. • Track what patient referred the most new patients. • Set a good example. Do not be surprised when the staff follows suit after watching the doctor take the lead asking for referrals. Look for opportunities to ask for a referral, such as after the patient has complimented the practice. Be proactive. Create opportunities that lead to compliments. During a post-treatment evaluation of the patient’s progress, ask them if you have been able to meet with their expectations. “Ms. Jones, I have to admit, we really enjoy having you here in our practice as a patient. Have we lived up to your expectations?” “Gosh Doctor, you and your staff have been fantastic. I could not be more pleased!” “Ms. Jones, we’re glad you feel that way. We work hard to create a rewarding experience for all our patients. Matter of fact, if you have any friends who are looking to have any dentistry done, and want to tell them about us, we would be happy to take just as good care of them as we have of you.” Let patients know they are special in your practice and a referral from them would be considered a compliment. Patients like to be

May 2016 www.oralhealthgroup.com

COMMUNICATION acknowledged and given permission to refer. For all they know, you have all the patients you can handle. Patients rarely make a referral based on a logical point of view, more often than not; their decision to refer will be based purely on emotion.

• The patient feels competent. • We show genuine concern for them. • They decide on what makes them feel better. (Not you or us.) • Accepting treatment has some excitement built into it. • We are sincere in our dealings with them.

What evokes or influences emotion: • The fi rst impression of your office. • Your personal appearance and the appearance of the office: • The history your client brings; IE: stereotypes, expectations, past experiences • Snap judgments or biases by patients about certain procedures or services without consideration of all the evidence. • Reliance on irrelevant information.

Your objective should be to create an experience that so overwhelms your patients with its positive side that small problems are insignificant. You cannot expect a patient to say anything about your practice if you simply meet their basic expectations to be greeted by name, seen on time, treated with courtesy, compliant with OSHA regulations, provide a pain-free experience, office to be clean and, up-to-date equipment and furniture.

Patients will feel positive about you when they experience gratitude, acceptance, happiness, relief or excitement. Emotions such as anger, disappointment, sadness, disgust, hurt, frustration, fear, and confusion have the patient feel negative about you. When patients feel good about themselves because of the experience they had with you or with your office, they tell others. The ensuing reputation that develops keeps your name where it should be. Social pressure has a stronger influence on people than mass media.

Getting past basic expectations

Positive emotions are around when... • We help the patient “fit in,” belong, satisfy long burning desires. • We tap onto core values held by the patient. • We present a solution to a problem. • We surprise them with something extra. • The procedure makes the patient feel important.

Are all relationships with the patient and each staff member healthy? Friendliness alone is not excellent service. All staff must be: • well trained in their jobs • confident • communicative • reliable • courteous • credible • energetic • knowledgeable • attentive and caring • an attitude of “I can do it for you now.”  What systems are in place to provide responsiveness (availability)?  What is your ability to solve a patient’s problem or help them get what they desire?  Can you create value for the fee paid? Can you help the patient understand what they are paying for and what makes the procedure so expensive?  Can patients get answers to questions?

May 2016 www.oralhealthgroup.com

17

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COMMUNICATION

Develop a referral base 1.

Create a list of patients, specialists, and other professionals who currently refer to the practice now. 2. Create a list of specialists and other professionals who do not currently refer to the practice but know you or about you and can talk to others. Identify what these individuals should know about you. Create a strategy to keep them upto-date. 3. Consider what information should be available for patients to help build your reputation. 4. Identify patients who are always into new things, the innovators, ask about what they are trying or would like to try. Then have samples available for them to use and give to others. 5. Focus on those who have referred before. 6. When you take up a suggestion from someone, tell everyone else, for example mail an announcement letter. 7. Ask vendors if there are ways you can get their information to patients. Also, get them to help you with names or contacts. 8. Provide service to someone influential even one of your best referral sources, specialist or member of their staff. Make the offer even if they never take you up on it. Let well-known people like your pastor, rabbi, or preacher know, that as a favor to them, you would donate your services to someone in need if they asked you. To pay back this favor, this “well-known” person will quietly promote you on their own. 9. Find out what group (professional or social) your best patients belong to – offer to make a presentation at their next meeting or help them with a donation. 10. Always follow-up quickly with good referrals sources after their last interaction or appointment with you. Send something about what was discussed, like an article or brochure, or even a short thank-you note.

11. Be prepared to discuss what is going on in dentistry. Provide a comparison of procedures or products. 12. Be seen as a leader among your peers. Present problem cases to your study club for input. 13. Network with companies or organizations through current patients. Offer to help those new to the area, speak to the Human Resource Manager, provide emergency services to select groups (become the Doctor of record). 14. Every patient should be given a Post Treatment Evaluation. 15. Select patients every day to be given a “TLC Call” after difficult treatment. 16. Make an attempt to learn why a patient has left the practice. 17. Talk with personal trainers, spa owners, dieticians, and healthcare educators. They always want to know how their ideas work. Find out what they promote and see how it relates to what you do. You can also provide them with information they can give to others. Become a resource for them, a person to learn from.

It is not enough for you to be good at what you do. You must also be good at promoting what you do. There is no amount of money to be spent that can influence a potential patient, in the same way, as a testimonial from a satisfied patient with first hand experience of what you really can do.

May 2016 www.oralhealthgroup.com

19

ORAL HYGIENE

Community Water Fluoridation:

TACKLING THE IRRATIONAL FEARS BY PASQUALE DURONIO, DDS AND STEVEN K. BAUM, PHD

Dr. Pasquale Duronio

is a general dentist practicing in Lion’s Head, Ontario.

Dr. Steven Baum

is a clinical psychologist practicing in Albuquerque, New Mexico and is the editor of the Journal for the Study of Antisemitism (www.jsantisemitism. org). The authors report no conflicts of interest nor have they received any financial support from any source.

20

Abstract: Over the past several decades, a political movement has evolved whose agenda is to end community water fluoridation. Despite decades of data demonstrating safe and effective reductions in dental caries, anti-fluoridation activists continue their efforts globally. Under the banner of concerned citizens, the activists lead with emotionally charged fears (e.g fluoride causes cancer, fluoride is used in rat poison), back their claims with questionable science and follow up with endorsements from like-minded professionals, including some dentists. Not fully understanding the nuances of research, legislators are urged to err on the side of safety and, when faced with organized public pressure, do so. We examine the psychology of anti-fluoride activism and the role social media and the Internet plays in misinforming the public. A call is made for organized dentistry to increase its online presence and advocacy. Key Terms: Public opinion, public health, community water fl uoridation, superstitions, poison.

Introduction: Despite the widespread endorsement of mainstream scientific, professional and educational organizations, dentistry and public health advocates may be losing the battle of community water fluoridation (CFW). Fluoridated water and fluoridated salt have been welcomed in Asia and Africa’s rural and remote communities devoid of health and dental providers. Yet while several nations support fluoridation, Germany, Switzerland, Finland, Sweden, Holland, Japan and Israel have reversed their decision to fluoridate their water supplies. Notably, some communities in Canada have also chosen to cease community water fluoridation. Reversing community water fluoridation is not based on any scientific evidence, but is politically motivated. When pollsters recently asked Americans, “Do you believe the government adds fluoride to our water supply, not only for dental health reasons, but for other more sinister reasons?” 74% said no,

but 9% said yes and 17% were unsure. The same poll revealed that 20% believe that vaccines cause autism(1). Devoid of support from mainstream dentistry and allied sciences, the anti-fluoridationists join fellow anti-science advocates such as the anti-vaccination movement in the use of social media campaigns to win public opinion.

A Brief History of Fluoridation: In 1945, Brantford, Ontario became the fi rst city in Canada to fluoridate their water supply. Brantford was paired with Sarnia, Ontario as part of an 11-year fluoridation case study. With a 35% reduction in caries and 63% decline in severity, Brantford community water fluoridation was hailed as a success(2). However, fluoridation had its opponents from the beginning. There was significant research conducted to determine if the claims of harm from CWF were true. A pivotal study in the history of water borne fluoride by Le-

May 2016 www.oralhealthgroup.com

ORAL HYGIENE one et al (3) and a study by Phipps and Burt(4) found that the only significant clinical effects from naturally fluoridated water at high levels was fluorosis, a cosmetic problem. They compared towns with 8ppm fluoride to .4 ppm in the Leone study and 3.5 ppm to .7 ppm in the Phipps study. It should be noted that these were concentrations of fluoride that were found naturally in the water supplies studied. A review by the World Health Organization in 1958 concluded that at 1ppm CWF posed no threat to human health(5). A number of studies have shown that CWF mainly helps children in lower socio-economic families(6,7,8). Israeli epidemiological studies found that children living in fluoridated areas had considerably less dental caries than those receiving un-fluoridated water(9) though within 15 years anti-fluoridation campaigners managed to have fluoridation stopped in that country. The 2007 Fluoride Expert Panel recommendations to Health Canada included re-setting the optimum level of fluoride to .7 mg/L (ppm) in recognition of other sources of fluoride in the Canadian diet(10). They found no evidence of increased cancers, fractures, or toxicities of any kind. While CWF is still supported, there is growing concern regarding political influences of the anti-fluoridation movement(11).

Relative Toxicity Hijacked: The Oxford English Dictionary defi nes toxic as “of or caused by poison; poisonous” and poison is defi ned as “a substance that can destroy life or harm health”. However, in scientific reality these defi nitions are useless without some reference to the amount of the substance in question. Members of the scientific community know that the measure of relative toxicity is the LD50 or LC 50 of a substance. LD50 is the amount of a material, ingested all at once, which causes the death of 50% of a group of test animals (12). This is not general knowledge for the population at large. The general population may not understand that almost all substances can be toxic. Water toxicity is well known as well as the relative toxicity of most common substances. The LD50 of water is 90 g/kg in rats. Simply stated, if a population of humans drank 8 litres of water all at once, 50% would die. By comparison, the LD50 of botulinium toxin used in cosmetic treatments is .000001 mg/kg, making it one of the most toxic substances known to man. Table 1. compares the LD50 of some common substances to show their relative toxicity. There is little correlation between the relative toxicity of substances and the alarm they provoke. The best example is botulinium – a substance widely used in cosmetic procedures

Table 1. Comparisons of LD50’s Substance

LD50

Source

water

90 g/kg in rats

MSDS, ScienceLab.com

table salt

3,000 mg/kg in rats

MSDS, Fisher Scientific

aspirin

200 mg/kg in rats

MSDS, Cayman Chemical Company

ibuprofen

636 mg/kg in rats

MSDS, Perrigo Pharmaceuticals Company

formaldehyde

800 mg/kg in rats

MSDS, United Agri Products Canada Inc.

botulinium toxin

.000001 mg/kg in rats

MSDS, MiProLab Inc.

fluorosilicic acid*

200 mg/kg in rats

MSDS, The Mosaic Company *used in water fluoridation - .7 ppm fluoride = .7 mg/kg

May 2016 www.oralhealthgroup.com

21

ORAL HYGIENE

22

with which the public and scientific community seem to be quite comfortable. Fluoride is a naturally occurring substance in the environment. It can be found in vegetables, fruits, and tea. Most natural water sources contain fluoride, sometimes in very significant concentrations. The anti-fluoride movement has made many claims about the toxicity of fluoride, including implicating it in cancer. They often quote reputable sources but, more often than not, the sources are taken out of context. The authors will introduce two main examples to illustrate how, at 1 ppm, this non-toxic substance has been converted into a toxic one in many people’s minds. A national anti-fluoridation organization Fluoride Action Network (http://fluoridealert.org) includes on its website the National Research Council’s review re: EPA fluoride study(13) as proof of the link between fluoride and bone fracture. They (a) do not acknowledge that the EPA’s work was concerned with excessive levels of naturally occurring fluoride in some U.S. domestic water supplies, (b) do not acknowledge that the review was a guide for states in removing that excess fluoride from water supplies and (c) do not acknowledge the NRC’s stand supporting optimal water fluoridation. The Fluoride Action Network website refers to research by Li Y et al(14) and claims that this works demonstrates that fluoride may be associated with higher cardiovascular risk. They fail to point out that the Li et al study was an investigation into whether injecting patients who had coronary artery plaques with fluoride would result in better resolution of these plaques on PET scans. This study had nothing to do with the effect of fluoride on cardiovascular disease. They investigated the use of fluoride as a diagnostic tool. Claims that fluoride can cause cancer in humans have never been supported by good science. A very defi nitive case control study was conducted by Gelberg et al(15) and they found

no association between fluoride intake and osteosarcoma. Despite the lack of any proof, the fear of cancer is a predominant theme in the anti-fluoridation efforts.

The Psychology of the Anti-fluoridationists: An anti-fluoridation narrative has emerged that is so compelling that a search on Google returns nearly half a million items. The narrative goes something like this: Nefarious elites, ie. organized dentistry, have colluded with public health officials and the government in an effort to advance an agenda that controls and undermines the people. By slow contamination of a community’s water supply, death by fluoride becomes a perfect crime. Known for its carcinogenic properties and effectiveness as a rat killer, increased levels of fluoride in the drinking water will disable and impair the population via blurred eyesight, cancer, coma and death. Increases of fluoride in the water supply elude detection similar to slow release medication. Anti-fluoride activists assert that CWF is medical treatment that they never consented to. They claim that due process was eclipsed and multiple illnesses have been caused. They claim that the same arguments do not apply to chlorination of water supplies. However, like chlorine, fluoride does not treat any disease. It is added to the water supply to prevent the world’s most prevalent infectious disease, dental caries. Once established, fluoride can-

May 2016 www.oralhealthgroup.com

H E T T L H L I A N G F S O YOUR PATIENTS MAY TAKE TO BED

THEIR DENTURES SHOULDN’T BE ONE OF THEM. 1-5

Though your patients may take comfort in keeping their dentures in at night, the consequences can be severe, from increased odour to fungal infections to increased caries.1–5 Guiding your patients through the best nighttime routine could be one of the most important conversations you have with them. That means removal and gentle, antibacterial cleaning with Polident®.6 1. Jeganathan S, Payne JA, Thean HP. Denture stomatitis in an elderly edentulous Asian population. J Oral Rehabil. 1997;24(6): 468–472. 2. Emami E, de Grandmont P, Rompré PH, et al. Favoring trauma as an etiological factor in denture stomatitis. J Dent Res.2008;87(5):440–444. 3. Barbeau J, Seguin J, Goulet JP, et al. Reassessing the presence of Candida albicans in denture-related stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(1):51–59. 4. Arendorf TM, Walker DM. Oral candida populations in health and disease. Br Dent J. 1979;147(10):267–272. 5. Compagnoni Ma, Souza RF, Marra J, et al. Relationship between Candida and nocturnal denture wear: quantitative study. J Oral Rehabil. 2007;34(8):600–605. 6. GSK data on file, 2011. (Polident CSS)

®

TM/ or licensed GlaxoSmithKline Consumer Healthcare Inc. Mississauga, Ontario L5N 6L4

©2016 The GSK group of companies. All rights reserved.

ORAL HYGIENE

With water being such a vital resource, the notion of it being poisoned has always struck a sensitive chord in human history.

24

not treat caries. A similar situation occurs with dysentery – once established it cannot be cured with chlorinated water. With water being such a vital resource, the notion of it being poisoned has always struck a sensitive chord in human history. Well poisoning fantasies pervaded Middle Ages beliefs. Conspiratorial rumours of those responsible often reached tipping points, especially during the bubonic plague. Church, state and social ostracism joined forces, pointing fi ngers at the Jews. In response, Jewish houses and synagogues were torched and individuals were burned. This fear of water poisoning cannot be ignored. For instance, the anti-fluoridation proponents do not rail against fluoride in toothpaste. Nations that use fluoridated salts are not met with the same fears as those that fluoridate their water. This is in spite of the fact that they believe that fluoride causes many serious ill effects. It would seem illogical for any lobby group that fi nds a substance to be a health hazard to not call for policy makers to discontinue its use throughout the environment. In fact the anti-fluoride lobby claims that CWF is no longer necessary because fluoridated toothpaste provides all the necessary decay prevention that society needs. It seems that the problem is the addition of fluoride to the water supply that inspires fear, not fluoride itself. A recent investigation into pseudoscience found that pseudoscience belief is inherently more interesting and emotionally appealing. “Science...by bowing to the demands of evidence tends to become hard to swallow for laypeople and even scientists themselves... Pseudosciences, on the other hand, by tuning in on comfortable intuitive representations of the world, have an edge in terms of popular acceptance...an intuitive allure”(16). Illogical

beliefs, resentment, pseudoscientific data and Internet empowerment have permitted the anti-scientific alienated members of society to voice their illogical beliefs in harmony with like-minded true believers. Conspiracy theories lie at the base of antiscience activism. More than left or right politics, conspiracy beliefs explained why someone accepted scientific fact or not(17). Conspiracy theories foster a distrust of science but many people are not aware that they are persuaded by them(18). Many anti-fluoridation activists believe that CWF is part of a conspiracy. But this begs two questions. Why would dentists promote CWF when it decreases the demand for their services and hence could reduce their income? How could over 50 worldwide organizations that support CWF be coordinated and motivated to join in this conspiracy? Furthermore, they do not explain how, since the late 1940’s not a single person has leaked any details of this apparent conspiracy.

Marketing the Bias:

Mertz and Allukian(19) made the point that the Internet and social media serve as the main sources of information on CWF for the general public. Measured between June of 2011 and 2012, anti-fluoridation website traffic exceeded the traffic of pro-CWF sites by 5-60 fold. Anti-CWF pages emerged 88-100% of the time when terms fluoride or fluoridation were entered into Facebook, 64% on Twitter and 99% on YouTube. Three key terms were repeated: poison, cancer, useless. Given that Facebook and Twitter reach billions of users, the authors concluded that thousands are misinformed daily. Legitimacy of much of the anti-fluoridationist claims is also strengthened by the use of “research” published in online, impressive sounding journals. When one checks some of

May 2016 www.oralhealthgroup.com

ORAL HYGIENE these “studies” for citations they are either not cited in any other research papers or the citations are in articles critical of the original “paper”. When one checks some of these journals on eigenFactor.org they are not even listed, let alone rated in importance. Open access journals charge the researcher a fee to publish their work. Unfortunately there are no standards of quality for these types of journals(20, 21).

Conclusions:

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It is known that changing opinions is much more difficult when others that are like-minded are around or when politics is involved. However, when one is not threatened and feels safe, he or she is more open to change. National Public Radio social science correspondent Shankar Vedantam, author of The Hidden Brain (Spiegel & Grau, 2010) offers his relationship with his daughter as a metaphor for change(22). From a recent interview on speaking to parents who are resisting their children’s measles vaccine he says, “The way to go is actually to build trust. You know..... when my child has a nightmare, I don’t come to her in the middle of the night and say, look, you’re a moron for believing there’s a monster under your bed. I acknowledge that the fear might be real, even if there is no monster under the bed. So we know for sure that the parents who aren’t vaccinating their kids are afraid. So the place to start is to acknowledge that the fear is real and to deal with it.” With fluoridation the fear for some is also real. The disasters of man-made substances like Thalidomide, PCB’s, DDT and others have made many people suspect of all chemicals. Therefore the supporters of CWF must remind the public and policy makers that the science of naturally occurring substances is very different from that of man-made ones. We have evolved with naturally occurring substances for thousands of years. We know what their effects are and at what doses because we can simply look at actual human subjects constantly exposed to fluoride, arsenic, formaldehyde, botulinium etc.

www.oralhealthgroup.com

ORAL HYGIENE The dental profession must always be prepared to fund and publish high-quality studies to investigate legitimate concerns about fluoridation safety. They should train allied professionals in counter-arguments and greatly expand their influence on the Internet. The public will increasingly receive most of their “scientific” information from the Internet. The dental profession should become extremely effective in capturing the online audience in order to spread scientific fact. The utilization of very skilled advertising and public relations fi rms that are expert in the use of the Internet and the media is necessary to defend CWF. Their goal should be achieving top ranking on Internet searches when a member of the public enters the word “fluoride” or “fluoridation”. These pages should not only point out the benefits of CWF but they must discredit the pseudoscientific claims made by the anti-CWF activists. The dental profession as a whole should become more politically savvy, taking strides to increase their influence with policy makers, politicians and public health officials. The profession must be prepared to discredit, in political hearings, the pseudo-science of the anti-fluoride spokespersons. All their arguments against fluoridation can be easily found on their websites and good scientific evidence must be collected to discredit each fallacious claim as it appears and in advance of any public hearing. The presentation of this science must be made understandable to the lay public. The supporters of CWF may need to constantly remind policy makers of sociologist turned senator Daniel Patrick Moynihan’s quip, “Everyone is entitled to their own opinion, but not their own facts”.

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Acknowledgements: The authors wish to thank Vincent Duronio, PhD, Professor, University of British Columbia Medical School and Director, Experimental Medicine Graduate Program for the review and fi nal editing of this paper.

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ORAL HYGIENE

REFERENCES:

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1. Public Policy Polling. National conspiracy theories. www.publicpolicypolling.com/ pdf/2011/PPP_Release_National_ConspiracyTheories_040213.pdf 2. Rabb-Waytowich D. Water fluoridation in Canada: past and present. www.cda-adc. ca/jcda/vol-75/issue-6/451.html. 3. Leone NC, Shimkin MB, Arnold FA, Stevenson CA, Zimmerman ER, Geiser PA. Medical aspects of excessive fluoride in a water supply. Public Health Rep. 1954; 69: 925-36. 4. Phipps KR, Burt BA. Water borne fluoride and cortical bone mass: a comparison of two communities. J Dent Res. 1990; 69(6):1256-60. 5. World Health Organization. Fluoride and oral health: First report of the expert committee on water fluoridation. Technical report series No. 146, 1958. 6. Carmichael CL, Rugg-Gunn AJ, Ferrel RS. The relationship between fluoridation, social class and caries experience in 5 year old children in Newcastle and Northumberland in 1987. British Dent J. 1989;167(1):36-38. 7. Evan DJ, Rugg-Gunn AJ, Tabari ED, Butler T. The effect of fluoridation and social class on caries experience in 5 year old Newcastle children in 1994 compared with results over the previous 18 years. Comm Dent Health. 1996; 13(1):5-10. 8. Riley JC, Lennon MA, Ellwood RD. The effect of water fluoridation and social inequalities on dental caries in 5 year old children. Int J Epidem. 1999; 28(2):300305. 9. Kelman AM. Fluoridation - the Israeli experience. Comm Dent Health. 1996; 13 Suppl 2:42-6. 10. Health Canada. Findings and recommendations of the fluoride expert panel 2007. http://www.hc-sc.gc.ca/ewh-semt/pubs/ water-eau/2008-fluoride-fluorure/indexeng.php 11. Quinonez CR, Locker D. Public opinions on community water fluoridation. Can J Public Health. 2009; 100(2):96-100.

12. Canadian Center for Occupational Health and Safety. What is a LD50 and LC 50? http://www.ccohs.ca/oshanswers/chemicals/ld50.html 13. National Research Council, Committee on Fluoride in Drinking Water. Fluoride in drinking water: A scientific review of EPAâ&#x20AC;&#x2122;s standards. 2006. http://www.nap. edu /openbook.php?rec ord _ id=11571&pages=R1 14. Li Y, Berenji GR, Shaba WF, Tafti B, Yevdayev E, Dadparvar S. Association of vascular fluoride uptake with vascular calcification and coronary artery disease. Nucl Med Commun. 2012; 33(1):14-20. 15. Gelberg KH, Fitzgerald EF, Hwang SA, Dubrow R. Fluoride exposure and childhood osteosarcoma: a case control study. Am J Public Health. 1995; 85(12):16781683. 16. Boudry M, Blanke S, Pigliucci M. What makes weird beliefs thrive? The epidemiology of pseudoscience. Philosophical Psychology. 2014. http://philpapers.org/ archive/BOUWMW.pdf L 17. Lewandowsky S, Gignac GE, Oberauer K. The role of conspiracist ideation and world views in predicting rejection of science. PLOS One. 2013. http://journals. plos.org/plosone/article?id=10.1371/journal.pone.0075637 18. Wood MJ, Douglas KM, Sutton RM. Dead and alive: Beliefs in contradictory conspiratory theories. Social Psych & Personality Sc. 2012; 3(6):767-773. 19. Mertz A, Allukian M. Community water fluoridation on the Internet and social media. J Mass Dent Soc. 2014; 63(2):32-6. 20. Enserink M. As open access explodes, how to tell the good from the bad and the ugly. Science. 2012; 338(6110):1018. 21. Rabesanratana T. The seer of science publishing. Science. 2013; 349(6154):66-7. 22. Vadantam S. The psychology behind why some kids go unvaccinated. 2015. www.npr.org/2015/02/04/383724467/thepsychology-behind-why-some-kids-gounvaccinated

May 2016 www.oralhealthgroup.com

PRACTICE MANAGEMENT

Charm Offensive Lisa Philp, RDH

is the President of Transitions Group North America, a full service coaching company for dentistry. She graduated from East Tennessee State University as a Registered Dental Hygienist in 1987. Her career began with clinical hygiene in United States and Canada to the creation of a periodontal disease management program in which she coached thousands of dental professionals. She is currently a leader, author, and coach and highly sought after North American speaker.

30

D

ental demographics are changing almost faster than we can keep up: The Baby Boomers are retiring, the Affordable Care Act is scrambling the marketplace and the archaic system of employer-provided benefits is looking more long in the tooth than ever. As such, smart dentists are reconfiguring their practices around a choicebased, consumerist mentality. Think of it from a customer-relations standpoint: To an unprecedented degree, dentists (and their staffs) must now be expert communicators, mastering both the verbal and nonverbal skills that will improve interaction with patients — and keep them coming back. Patient trust, of which good communication is the foundation stone, is repaid in loyalty, respect and more frequent case acceptance. Intriguingly, studies show that interpersonal communication is received just 10 percent through words and 30 percent tone of voice. The balance, a startling 60 percent, comes through body language. That means making a good fi rst impression with a new or prospective patient is more critical than ever. Those same studies have shown that people make snap judgments of others — not always well-founded ones, admittedly, as we all know – within three to four minutes of meeting them. So tone of voice and body language are joined here by our clothes, our personal hygiene, our overall appearance. It’s therefore incumbent upon you to make your practice’s “image policy” clear: uniforms, hair, makeup, jewelry, shoes, visible tattoos or piercings. The particulars are of course up to you, but they need to be consistent with the

type of culture you want to present and the kinds of patients you want to retain —and it’s never bad to err on the conservative side. That all-important body language, meanwhile, starts with good eye contact and openness. Does your practice have tall, bunkerstyle desks in the reception area? They’re good for employee privacy but can be daunting to patients. Be sure your front-office crew stands up to greet arriving patients. Likewise, don’t be too casual with your interactions; even offhand conversations about treatments should occur in a consult room, not the reception area or hallways. As for the operatory, eye-to-eye communication is by defi nition a little trickier when a patient is lying prone in the dental chair. So whenever you’re discussing overall oral health, charting or looking at photos or radiographs —and especially when you’re presenting a treatment plan — have the patient sit up. It’ll establish more equal footing and keep the patient from feeling (literally) talked down to. Even your posture matters: Like Mom always said, stand up straight, and keep your shoulders back and arms open (not crossed) — a position that says you’re open to calm, informative dialogue. Finally, you’re a dentist. So smile! Frequently. Dentistry, now more than ever, is a people business — and people increasingly have the option to take their business elsewhere. We live in a customer-centric world, after all, and even the most subtle communication cues can make all the difference between a practice that’s flailing and one that’s sailing.

May 2016 www.oralhealthgroup.com

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PRACTICE MANAGEMENT

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TECHNOLOGY

The Importance of Your Dental Software Feda Bashbishi

is the CEO and co-founder of iKlyk Inc., a Canadian Cloud-based dental software provider dedicated to raising the bar of quality in dental practice management software, patient privacy, and data security. Feda Bashbishi holds an MBA from Wilfrid Laurier University as well as a Master of Science in Software Development from San Jose State University in California. Prior to establishing iKlyk, for years, Feda has worked on enterprise level cloud-based applications.

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owadays, dentists are forced to balance between providing the best patient care and staying profitable and efficient. Recent changes in the dental industry and patient expectations have created a competitive market and introduced new challenges dentists never had to deal with in the past. Let’s face it. What was acceptable ten years ago is no longer tolerated by patients. Long gone are the days when patients accepted average level of service. Long gone are the days when dentists were booked weeks in advance. Our market research indicated that not only patients demand excellent dental care, they demand a modern and efficient dental office, more eye contact, hassle free environment, zero wait time, automatic email reminder, web access to their billing information, and reasonable prices. The huge increase in new dental offices has ignited stiff competition among dentists. According to the Canadian Dental Association (CDA), the number of new dental offices in Ontario alone is more than 300 per year. Dentists are forced to become creative in ways to retain patients and acquire new ones. Some offer low prices and special promotions, some offer late and weekend hours. Those tactics could support a dentist for a bit but they are not the permanent solution. The solution to a satisfied customer and at the same time maintaining profitability is the dental practice management software, we will call it the software going forward. One of the most important features in a good software is its ease of use. If you are still

using a desktop software that was built in 1990s most likely your software is hard to navigate through, sluggish, requires updates once in a while, requires daily or weekly data back-up, and requires constant expensive maintenance. Your staff will spend more time babysitting the software rather than building relationships with your patients. Another must have feature in your software is the ability to have access to your data on any device whether it is a PC, MAC, tablet, or cell phone. This way you are always connected with your staff regardless of your location. Your software should provide you the ability to track your fi nances and costs through a built-in dashboard and reporting tool. It is extremely risky to operate on intuition, use dashboards to track key performance indicators in your business for better business decisions. Your dashboard should be able to provide a comprehensive view of your business with the ability to drill down for more thorough details. Find out how many appointments you completed, how much was the wait time, how many referrals, how much are your receivables etc.? To minimize embezzlement, fi nd out if your software keeps an audit of all transactions that happen in your office: when a transaction was made and by whom. Your software should also be able to support your business growth. The trend nowadays in the dental industry is Dental Practice Management Companies (DPMCs) or corporate dentistry. The software should allow you to add as many new locations as your business demands with all locations sharing the same

May 2016 www.oralhealthgroup.com

TECHNOLOGY patient data and being managed under one account. Imagine having the same practice management software running on all of your locations. How effective and efficient will your staff and business become? How easy is it for your patients to choose among your locations? How much time and money can you save on application setup, maintenance, and training? Our survey of dentists and patients lead us to believe that a dental software that is missing those features could mean the difference between success and failure. The software should provide dentists the competitive advantage they really need to survive. It is time for dentists to demand more from their software providers. It is time for software providers to really understand the new reality in the dental industry. Software providers need to invest time and money to design a software that helps dentists stay profitable and not just patch up the existing fossil.

REFERENCES 1. Population to Dentist Ratios Canadian Provinces 1997-2013 Trend. Canadian Dental Association. [Online] https://www. cda-adc.ca/en/services/fact_sheets/dentist_pop_ratios.asp. 2. Ontario Patients: Information Wanted and Contact Preferences. Abate, Rose. 9, November 2015, Ontario Dentist, Vol. 92, pp. 14-15.

www.oralhealthgroup.com

ORAL HYGIENE Judy Kay Mausolf

is a dental practice management coach, speaker and author with expertise in helping others become happier and more successful! She is Past President of National Speakers Association (Minnesota Chapter), Director of Sponsoring Partners for the Speaking Consulting Network, and a member of the National Speakers Association and Academy of Dental Management Consultants.

34

THE POWER OF

O.R.A.N.G.E.! M y husband Steve, teases me about living in an orange bubble. Those of you who know me know that the color orange plays a big part in my life and how I brand myself. In fact, I often receive orange gifts from friends and colleagues...which BTW I love!

Radiate O.R.A.N.G.E.! So what is the Power of O.R.A.N.G.E.? Well different colors generate different energy and emotion. The color orange creates feelings of happiness and positive energy! I surround myself with orange to inspire happiness and positive energy. A happy and positive attitude is one of my core values that defi nes how I choose to live my life. Because I am an acronym addict I felt the need to come up with one for O.R.A.N.G.E! Are you ready? Optimistic Radiant Attitudes Nurture Great Energy! O.R.A.N.G.E. simply is about radiating positive energy to attract more great energy in your life. In other words if you radiate an optimistic attitude you will nurture great energy in your environment. So why should we care about radiating a positive attitude? Well, you may have heard our attitude determines our altitude in life! Our attitude affects our altitude by creating positive or negative energy in the environment around us. This energy we create can

generate either our success or our failure based on the Law of Attraction. The Law of Attraction is like seeks like based on the frequency of energy emitted. All energy has different vibration frequencies. Positive energy seeks other positive energy with the same frequency and negative energy seeks other negative energy with the same frequency. I would like you to think about a day when your world seemed friendlier. Maybe the birds sang louder, the sun shined brighter, and people even let you merge into traffic. We have all had one of those days when we think wow, if everyday could be like today, it would be awesome. Maybe they can be. I wonder what your role was in that day. I wonder what mood you were in when it started. I wonder what you wearing, how it made you feel, and were you smiling? When we feel good about ourselves, we radiate positive energy! The energy we put out there always resonates back to us. We do create our environment whether it is positive or negative! Not only does attitude affect our environment it also affects our health. Bad attitudes are harmful to our health. Consistent negative thoughts, words, or actions, such as anger, gossip, or complaining, whether we are the giver, or the receiver, or even just in the vicinity, change the electricity in our brain, which changes the energy in our body. The

May 2016 www.oralhealthgroup.com

NOT IN MY HOUSE. You can’t see them but they’re there. The invisibles: bacteria, viruses, and other potentially patient-harming pathogens. But not in your house. TM

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ORAL HYGIENE

I choose to smile and impact others in a positive manner regardless of what is happening. I don’t ever want to give my power to be happy over to another person or a situation.

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organs that need that energy are no longer nourished and they get disease and sometimes they die. Our attitude is everything in creating a happy and healthy environment. I am often asked how I stay so happy and positive. I will share with you that it is not only because I meet nice people. I meet some of the same people that you meet who are not always so lovely! It’s also not because my life is perfect or that everything is easy. I have had many difficult times and things don’t necessarily go my way. Instead it’s a choice I make every day! It’s a choice to be happy and positive regardless of what may come my way. I choose to smile and impact others in a positive manner regardless of what is happening. I don’t ever want to give my power to be happy over to another person or a situation. I created two orange rubber bracelet bands as a reminder that I have a choice to be positive and happy! One reads “Smile & Shine” and the other reads “TA-DAH!”! I wear them every day. They are available on my website at www.PracticeSolutionsInc.net. Smile energy is extremely powerful and wide spreading. A smile instantly creates positive energy in the environment and uplifts the mindsets of the giver, the receiver, and everyone in the vicinity. Sometimes life can seem difficult. Here is the biggest secret about staying happy and positive in difficult times. It does not take any super powers or anything special. It is simply a clear understanding of the power of focus. “Our focus creates our attitude.” If you fo-

cus on the positive you will have a positive attitude. If you focus on the negative you will have a negative attitude. Find a reason to be happy and feel good everyday and you will be. It is simple but not easy to do. Focus on the positive. Focus on what is good and right regardless of how simple, normal or mundane it may seem. See the value even in the little things in life. The hard part is that our human nature to emphasize the negatives and downplay the positives. We are drawn to the negative! Just look at the news and the shows that get coverage in the newspaper, magazines and TV! Drama and negativity draw the biggest following. There are very few shows that highlight the positive. Negative is what sells! The sad truth is it is not in our nature to focus on the positive! However, we can change that by developing S.P.F.! A Super Positive Focus! I told you I was an acronym addict! It is important to focus on what is already in our life and our world and appreciate it. It becomes much easier to do this if we embrace these simple facts: • Life is uncertain • Life is unexpected • No one owes us anything • Life can change in a moment Once we embrace these facts we will learn to appreciate what we have and what is regardless of what has happened and what isn’t. Regardless of how difficult a situation may get you can always fi nd something positive to focus on. Even if the only positive is the les-

May 2016 www.oralhealthgroup.com

She knows that 30 minutes of yoga boosts short-term memory. 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 ©2016 The GSK group of companies. All rights reserved.

ORAL HYGIENE

38

son learned. Look for three potential positives in any situation or any person. When you fi nd yourself sliding to the negative ask yourself the following questions: • What are three potential positives? • What lessons can I learn from this? • What changes can I make to make it more positive? Practice giving thanks and praise daily for what is already in your life. The more grateful we feel the happier we feel and the happier we feel the more we have to give thanks and praise. It is a very fulfi lling cycle of positive circulation. Words that label have tremendous impact on our attitude. We have to be careful on how we label the relationships, events and outcomes we have in life. If we label something as bad it becomes our belief and we manifest feelings and emotions that support the label of bad. I fi nd using the word interesting instead of bad, stressful or difficult takes away the negative power. Our beliefs of positive and negative are based on our past experiences. If we do something and we have what we believe to be a negative outcome we will label it as negative. Yet we may have an entirely different outcome if we attempted to do it again. For example, I went on a hot air balloon ride over

Napa Valley for my 50th birthday (just a few short years ago). It was serene and wonderful. I am even afraid of heights and I would do it again in a heartbeat. I would label it as a very positive experience. However the following day the winds came up unexpectedly and the balloons had a difficult time landing. I may have labeled it as negative had I gone on that day…and most likely would never consider going again. The great news is we can change our belief from negative to positive when we add new experiences that are positive. Truthfully, how can we label something as good or bad if we don’t know the end? None of us have a crystal ball. So how do we really know if something is good or bad? There have been many things in my life that at the time seemed interesting that actually turned out generating a very positive outcome. Haven’t we all thought or said this is going to be bad at one time or another and yet it turned out to be one the best things to happen to us. The bottom line is that a positive attitude is really just a skill set that we can learn to develop. Choose to be O.R.A.N.G.E and radiate an Optimistic Radiant Attitude to Nurture Great Energy in your life!

May 2016 www.oralhealthgroup.com

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PRODUCT PROFILE

CREST SENSI-STOP™ STRIPS Crest Sensi-Stop™ Strips are a thin, flexible strips that contain an active ingredient used by dental professionals. Unlike toothpaste, Crest Sensi-Stop™ Strips are applied directly to sensitive areas, providing targeted delivery of the key ingredient that allows for longer contact time on the surface of the tooth. Applied directly to sensitive areas for ten minutes, the strips give the special ingredient targeted contact time against sensitivity pain for immediate relief and up to onemonth of protection. www.crest.com/en-us/products/ crest-sensi-stop-strips CREST PRO-HEALTH® [HD] You’ve always taken the best care possible for your mouth. Now, you can upgrade to the new Crest HD daily two-step system. Isolated ingredients deliver superior results with a Purifying Cleanser and Perfecting Gel. Step 1 strips plaque away, and Step 2 polishes and whitens for an experience that lets you feel the difference from the first use. This product will also provide rapid gum health improvement for patients struggling with gingivitis, with the added benefit of noticeable whitening. Crest ProHealth [HD] is a system designed to leverage the incremental chemistry of stannous fluoride and hydrogen peroxide. Step 1 is necessary for health benefits, including cavity protection, while Step 2 is necessary for visible whitening benefits. http://crest.com/en-us/products/crestpro-health-hd-toothpaste

CLEARCORRECT™ ClearCorrect™ aligners are made from Zendura® plastic which has been specially formulated for ClearCorrect by Bay Materials. It is a polyurethane resin that has been crafted and tested to make it a superior plastic for clear aligners: it leads the class in stress retention, crack and impact resistance, clarity, and stain resistance. Similar to braces, if aligners change too abruptly between steps, they can cause unnecessary discomfort. ClearCorrect™ aligners employ a unique system, which balances patient comfort and treatment time. Generally, no individual tooth will be moved more than 0.3 mm per step, with a recommended two-week wear time for each aligner to allow for complete adjustment. https://support.clearcorrect.com

PF2™ MOUTHGUARD Like every other mouthguard Keystone has to offer, the PF2 is designed for use with any sport, especially contact sports such as football, hockey, boxing, MMA, lacrosse, and field hockey. The major difference that separates PF2 from the traditional custom-fit Pro-Form is that it’s a boil-and-bite that fits like a custom guard. In this, it allows for better communication and oxygen intake, both crucial to athletes of all sports. The dual-laminated guard protects teeth at the maximum, and fits to any mouth size. No other guard on the market can be boiled to fit your mouth in less than one minute and offer protection like a professionally fit custom mouthguard. The PF2™ is available individually in solid black or white. http://dental.keystoneindustries.com/product/ pf2-boil-bite-mouthguard/

GENGIGEL® Gengigel is a topical hyaluronic acid gel sweetened with Xylitol and indicated to relieve pain and reduce gingival inflammation associated with oral lesions, dry mouth, dentures, implant uncover, scaling and the majority of minor oral wounds. During inflammation and periodontal disease, tissue requirement for hyaluronic acid increased by 200%, demonstrating its central role in regulating cell turnover and optimizing tissue regeneration. It is perfectly suited for children three years and older, contains no Benzocaine and has no contraindications. www.oralscience.com

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May 2016 www.oralhealthgroup.com

We have an idea that doesn’t involve blue paper. Introducing SALUS™, the world’s first paperless, rack and sleeve, hygiene sterility maintenance container. Consider the time, cost and environmental pressure of using hundreds of sheets of blue paper. We came up with something better. The SALUS Container enables you to effortlessly reprocess multiple instruments at a time. It’s the faster, safer, cost-effective way to optimize your practice.

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P R O F E S S I O N A L

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Three minty flavors, one lustrous smile! Premier® Dental’s Enamel Pro® prophy paste offers the most comprehensive mint selection in the market; original Mint, subtle VanillaMint and new fruity RaspberryMint - three great refreshing finishes! Additional flavors include strawberry, O F E S S I O N and A L Pgrape. R O P H Each Y L A Xis I S gluten-free P A S T E cinnamon,P Rbubblegum and available in multiple grits.

ENAMEL PRO

Every cup of Enamel Pro® prophy paste creates a lustrous® enamel surface. This is a result of Amorphous Calcium Phosphate (ACP) filling in surface enamel crevices and defects, leaving your patients with an intense polish and shine.† Available through your authorized dealer.

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Enamel Therapy

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DENTAL MARKETPLACE

ASSOCIATESHIPS

PETERBOROUGH, ON Large busy practice is looking for a Part-time associate dentist to work Saturdays and some evenings to start. This rewarding position is suited to an experienced dentist who enjoys a busy environment and is a team player. Candidate should be competent in all aspects of general dentistry and be comfortable working with children. We provide an environment of learning and professional growth and seek a candidate who would like to grow with our practice. E-mail: cadilac@bellnet.ca

THOMPSON, MB

Westwood dental clinic in Thompson, MB team looking for experienced dentist full time or part time. Decent income plus accommodation . E-mail: westwooddental@hotmail.com

WHITBY, ON Part time associate position for friendly office in Whitby. Experience a must. Great staff and relaxed environment. Please send resume to dentaljobs1801@gmail.com

NEWMARKET, ON

Seeking Part-time associate for Monday and Wednesdays for our busy practice in Newmarket. Please email resume to: drcroppooffice@rogers.com

SOUTHWESTERN ONTARIO Chaudhry Corporation is looking for dental associates for multiple practices in their southwestern Ontario offices. Part time and full time available depending on location. Please send resume to heatherconsorti@hotmail.com or you can call Heather at 519-732-0920

SASKATOON, SK DOWNTOWN DENTAL requires a fulltime or part-time Associate for our well established clinic in downtown Saskatoon. This is an excellent opportunity to work in a newly renovated, modern dental office with an established patient base and a great staff. The current position involves no weekends or evenings.The ideal start date would be fall 2016 – January 2017. Check us out at www.downtowndentalsaskatoon.ca Contact donna@downtowndentalsaskatoon.ca or 306-664-3555.

ORILLIA, ON

Part time associate required 1-2 days per week for busy general family practice. Please forward resume to dental_2010@live.ca

KITCHENER, ON

Full-time associateship available in a busy, well established office. Above average New Patient flow, with eight existing operatories. Please email resume to doktorj@sympatico.ca

GRANDE CACHE, AB Full time associate required for Grande Cache Dental Care, located in the beautiful Rocky Mountains of Alberta. The successful applicant will be fully booked from day one. Must be comfortable with all aspects of general dentistry with special emphasis on diagnostics, restorative, oral surgery and endodontics. Strong communication skills are essential. No weekends or evenings required. High gross/net office – associate can expect above average remuneration. Experience preferred, new grads are welcome to apply! Please email to: grande.cache.dental.care@gmail.com

www.oralhealthgroup.com

44

May 2016

OHY May classifieds 44-48.indd 44

SCARBOROUGH, ON

Associate required to work on Wednesdays and possibly on Saturdays for a family practice providing all aspects of dentistry. Candidate must have caring attitude. E-mail: doffice2000@gmail.com

NEWMARKET, ON

Looking for general dentists and specialists for my busy and growing Newmarket practice. If you want to work in a friendly and relaxed environment, please contact me with resume and availability at eastriverdental@gmail.com

MULTIDISCIPLINARY DENTAL CLINIC IN BURLINGTON REQUIRES: Oral & Maxillofacial Surgeon 1 – 2 days per month to start. Orthodontist P/T This is an excellent opportunity in a well established, dynamic, privately owned practice, maintaining Type A facility permit, with 9 ops, 5 hygienists & 2 f/t dentists. Please email CV to guelphlinedental.andrea@gmail.com

FORT MCMURRAY, AB Fantastic opportunity in a busy mall practice. If you want exceptional Income with freedom and time off come join us. Contact Dr Jones at 1-780-740-7251

GRANDE PRAIRIE, AB

Full time associate dentist required for busy family practice. Looking for highly motivated associate. Our practice includes the latest in technology (IOC camera, digital x-rays, paperless etc.). Large existing patient base. Current associate moving, team in place to help. Please send resume to pmdcgp@telus.net 780-538-2992.

LONDON, ON AREA Position available for a dentist in the London, ON area. The successful candidate must have a thorough knowledge of RCDSO guidelines and the ability to create detailed treatment plan and comprehensive communication skills. Attention to the patient’s oral health and involvement with the hygiene team is of the utmost importance. Please email your resume with cover letter to dovedental@ody.ca.

www.oralhealthgroup.com

16-04-29 1:00 PM

SEEKING FULL TIME GENERAL DENTISTS AND AN ORTHODONTIST – AB and SK

OKOTOKS, AB F/T ASSOCIATE REQUIRED

Large group practice(s) seeking self motivated dentists who enjoy above average remuneration. Positions available in great established locations in Calgary, Medicine Hat, Regina and surrounding communities that are all within driving distance to airports. Progressive and established clinics with strong patient base and excellent support structure. Shifts available for minimum 4 days on, 4 days off allow the right individual an opportunity to enjoy life and be very productive. Remuneration to be greater of guaranteed income, or percent collections. Experience with kids, surgery, endo and sedation an asset. Mentorship and buy-in opportunities available to right candidates. Email resume in confidence to: airdriedentist@yahoo.ca

Busy family practice seeking F/T associate to start immediately (5 day work week – no weekends). We have a busy and well recognized practice of over 20 years. We are a highly organized and dedicated team. Our practice environment is friendly and focuses on patient care and comfort. Brand new, state of the art facility. We are located in Okotoks (15 minutes south of Calgary). Non-assignment office. Endo, Implant and Sedation are assets. Please fax CV to Sherry @ (403) 995-9578 or email manager@okotoksfamilydental.com

STONY PLAIN, AB

EDMONTON, AB

ENDODONTIST AND PERIODONTIST WANTED Our progressive, paperless & high tech clinic is looking for an Endodontist and Periodontist. You will have an eager team to maintain your schedule, referrals & keep you linked to a 50 km radius of Parkland County. We are 20 minutes from Edmonton. The ideal candidate will be a dentist who focuses on clinical excellence and poses a patient rapport that is caring and informative. Position is available for September 2016. Will assist with relocation. Please email your CV to dentalspecialist8g@gmail.com VICTORIA, BC PAEDIATRIC DENTIST

Great opportunity of mentorship & partnership. Beautiful new office. We offer IV, GA, nitrous & conscious sedation. Ideal opportunity for someone seeking a balanced lifestyle. Email: vpdc@outlook.com

DENTAL MARKETPLACE

ASSOCIATESHIPS

Great opportunity for a motivated associate with some experience. $80,000-$100,000 per month, in a beautiful office with new equipment and a great team. Current associate is moving to another province. Potential of earning up to 45% and longterm buy-in for the right candidate. Experience is an asset but not required. Please email: EdmontonDentalCareer@gmail.com

Bilingual Dental Associate – Full Time – 3-5 Days per week Dr. Nicole Brien – Children’s Dentistry Moncton, NB www.childrensdentistrynb.ca

A MONCTON DENTIST – SPECIALIZED FOR CHILDREN’S HEALTH

OTTAWA, ON Associate required for west-end family practice in Ottawa. E-mail: toothdocs36@gmail.com

CAMPBELL RIVER, BC F/T associate required to take over existing patient base in well established family practice. Fully digital office, steps from the water, with great long term staff. Ideal candidate is comfortable with all aspects of general dentistry, is passionate and energetic, and has a strong focus on patient-centered care. Email: drwags95@gmail.com

SOUTHWESTERN ONTARIO We are a family dental office looking for a periodontist available to work once or twice a month. Please reply to: a.dascalu.ca@gmail.com

www.oralhealthgroup.com

OHY May classifieds 44-48.indd 45

Having been a trusted children’s dentist in Moncton for a number of years, we are set up to offer on-site hospital procedures so children can receive the most advanced care in an atmosphere they already know and are comfortable in. Our staff are friendly and our dental experts will work together to ensure that a child’s experience with us is positive, fun and educational. In our modern office, we offer a variety of amenities and age-appropriate sedation techniques for the more nervous children. Dr. Nicole Brien – Children’s Dentistry is seeking a General Dentist to join our fastgrowing well-established pediatric practice as a full time associate. The ideal candidate will provide services to children and medically compromised adults from all over New Brunswick. Mentoring with our Pediatric Dentist and with potential for future opportunities to work in an OR setting. The successful candidate must have excellent communication skills and warm personality and sense of humor a plus. New graduates welcome to apply. Possible prospect of buying into the practice. Benefits include: Hours: Mon – Thurs 8:00 am – 4:00 pm & Fri 8:00 am – 12:00 pm Remuneration – 45% pending

Please forward resume or direct inquiries to Kathy Kirkby 902-489-5514 or email kathy@healthqueststaffing.com May 2016

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Dentin hypersensitivity protection, in a daily mouthwash Sensodyne® mouthwash contains 3% potassium nitrate and 0.009% fluoride with a clinically proven ingredient to provide ongoing protection from the pain of dentin hypersensitivity, with twice-daily rinsing*1–4

* When used twice daily, after brushing. 1. Gillam DG, et al. J Clin Periodontol. 1996;23:993–997. 2. Morris A, et al. Efficacy of a potassium nitrate mouthrinse for relieving dentinal hypersensitivity, IADR/AADR/CADR 87th General Session and Exhibition, April 1–4 2009. 3. Pereira R, et al. J Periodontol. 2001;72(12);1720–1725. 4. GSK Data on File (Study RH01751). A clinical study investigating the efficacy of a mouthwash in providing long term relief from dentinal hypersensitivity. Prepared March 2014. GCSAE/CHSENO/0256/13. GlaxoSmithKline Consumer Healthcare Inc. Mississauga, Ontario L5N 6L4 ©2016 The GSK group of companies or its licensor. All rights reserved.

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La bouche sèche est un problème de santé buccodentaire qui affecte surtout les personnes prenant plusieurs médicaments3. Pourtant, certaines personnes qui souffrent de bouche sèche ne savent pas qu’il s’agit d’un problème courant2. Parlez à vos patients de la bouche sèche et du soulagement que Biotène peut aider à procurer†. ®

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GlaxoSmithKline Soins de santé aux consommateurs Inc. Mississauga, Ontario L5N 6L4 © 2016 Le groupe d’entreprises GSK ou son concédant. Tous droits réservés. * La bouche sèche peut perturber l’environnement de santé buccodentaire et causer la mauvaise haleine, la déminéralisation et l’augmentation de la carie4,5. † Rince-bouche, gel et vaporisateur. ‡ Tel que mesuré dans le cadre d’une étude clinique de 28 jours6. 1. Données internes de GSK. Occasion de croissance de Biotène pour la bouche sèche (incluant les données U&A canadiennes). 16 juillet 2014. 2. Dawes C. How much saliva is enough for avoidance of xerostomia? Caries Res. 2004;38:236-240. 3. Sreebny LM, Schwartz SS. A reference guide to drugs and dry mouth, 2e édition. Gerodontology. 1997;14:33–47. 4. Turner MD, Ship JA. Dry mouth and its effects on the oral health of elderly people. J Am Dent Assoc. 2007;138:15S–20S. 5. Fox PC. J Clin Dent. 2006;17 (numéro spécial):27-28. 6. Données internes de GSK 2014, RH01986.

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EXCLUSIVITÉ WÉBINAIRES

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Oui, la forme joue un rôle PARTIE I - Les embouts courbés en parodontie ADAPTATION AU NIVEAU DES FURCATIONS Mettez en oeuvre une meilleure technique de débridement ultrasonique immédiatement! Les embouts ultrasoniques courbés peuvent améliorer les résultats cliniques car ils offrent un meilleur accès auprès des furcations, des concavités et des surfaces radiculaires courbées. Ce module en ligne va guider le clinicien au travers des principes de sélection et d’adaptation des embouts courbés gauche et droite dans les furcations.

Oui, la forme joue un rôle PARTIE II Les embouts courbés en parodontie DÉBRIDEMENT AU NIVEAU DES SEXTANTS POSTÉRIEURS Mettez en oeuvre une meilleure technique de débridement ultrasonique immédiatement! Les embouts ultrasoniques courbés sont préférables en parodontie que les instruments ultrasoniques rectilignes ou l’instrumentation manuelle. Ces embouts peuvent améliorer les résultats cliniques car ils offrent un meilleur accès au niveau des furcations, des concavités et des surfaces radiculaires courbées. S’appuyant sur les principes énoncés dans la PARTIE I, ce module va guider le clinicien au travers des principes plus poussés d’adaptation des embouts gauche et droite au niveau des dents postérieures.

Oui, la forme joue un rôle PARTIE III - Les embouts courbés en parodontie DÉBRIDEMENT D’UNE BOUCHE COMPLÈTE Dans ce dernier wébinaire, nous reverrons les principes d’instrumentation ultrasonique avec les embouts courbés employés au niveau des dents antérieures. Les concepts abordés dans les deux wébinaires précédents, soit l’emploi des embouts courbés au niveau des furcations et au niveau des sextants postérieurs, seront intégrés dans la séquence de débridement d’une bouche complète avec ces petits bijoux à découvrir en parodontie. De plus, des suggestions en matière de position client-opérateur seront aussi discutées.

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Vos patients peuvent trouver réconfortant de garder leur prothèse pendant la nuit, mais les conséquences peuvent être graves et englobent la mauvaise haleine, les infections fongiques et les caries plus nombreuses1-5. Guider vos patients à adopter de bonnes habitudes avant de se coucher pourrait être la plus importante conversation que vous aurez avec eux. Ces habitudes consistent dans le retrait de la prothèse et un nettoyage doux et antibactérien grâce à Polident®6. 1. Jeganathan S, Payne JA, Thean HP. Denture stomatitis in an elderly edentulous Asian population. J Oral Rehabil. 1997;24(6): 468–472. 2. Emami E, de Grandmont P, Rompré PH, et al. Favoring trauma as an etiological factor in denture stomatitis. J Dent Res. 2008;87(5):440–444. 3. Barbeau J, Seguin J, Goulet JP, et al. Reassessing the presence of Candida albicans in denture-related stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(1):51–59. 4. Arendorf TM, Walker DM. Oral candida populations in health and disease. Br Dent J. 1979;147(10):267–272. 5. Compagnoni Ma, Souza RF, Marra J, et al. Relationship between Candida and nocturnal denture wear: quantitative study. J Oral Rehabil. 2007;34(8):600–605. 6. Données internes de GSK, 2011. (Polident CSS)

®

MC/ ou sous licence GlaxoSmithKline Soins de santé aux consommateurs Inc. Mississauga, Ontario L5N 6L4

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©2016 Le groupe d´entreprises GSK. Tous droits réservés.

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Elle sait que 30 minutes de yoga stimulent sa mémoire à court terme. 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 ou 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. Puisqu’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, rédacteur. 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.

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MC/® ou sous licence, GlaxoSmithKline Soins de santé aux consommateurs Inc., Mississauga, Ontario L5N 6L4 ©2016 Le groupe d’entreprises GSK. Tous droits réservés.

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nouveau

De la protection contre l’hypersensibilité dentinaire dans un rince-bouche quotidien Le rince-bouche Sensodyne® contient 3 % de nitrate de potassium et 0,009 % de fluorure, avec un ingrédient éprouvé en clinique pour fournir une protection continue contre la douleur causée par l’hypersensibilité dentinaire, avec un rinçage 2 fois par jour*1–4

* Lorsqu’il est utilisé 2 fois par jour, après le brossage. 1. Gillam DG, et al. J Clin Periodontol. 1996;23:993–997. 2. Morris A, et al. Efficacy of a potassium nitrate mouthrinse for relieving dentinal hypersensitivity, 87e séance générale et exposition des AIRD/AADR/ACRD, du 1er au 4 avril 2009. 3. Pereira R, et al. J Periodontol. 2001;72(12):1720-1725. 4. Données internes de GSK (étude RH01751). A clinical study investigating the efficacy of a mouthwash in providing long term relief from dentinal hypersensitivity. Préparé en mars 2014. GCSAE/CHSENO/0256/13. GlaxoSmithKline Soins de santé aux consommateurs Inc. Mississauga, Ontario L5N 6L4 ©2016 Le groupe d’entreprises GSK ou son concédant. Tous droits réservés

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