Oraqix® is not for injection or use with standard dental syringes. Oraqix® (lidocaine and prilocaine periodontal gel) 2.5%/2.5%.Indications and Usage: Oraqix® is indicated for topical application in periodontal pockets for moderate pain during scalingand/or root planing. Safety and effectiveness in pediatric patients under 18 have not been studied. ProductCharacteristics: A subgingival locally applied anesthetic gel consisting of a eutectic mixture of lidocaine and prilocainein a new thermosetting system, Oraqix® dispenses as a liquid, then sets as a gel in the periodontal pocket.Contraindications: Oraqix® is contraindicated in patients with a known history of hypersensitivity to local anesthetics ofthe amide type or to any other component of the product; and/or in patients with congenital oridiopathic methemoglobinemia. Adverse Reactions: The most common adverse reactions inclinical studies were application site reactions 15%, headaches 2%, and taste perversion 2%.
NEEDLE-FREE: PERIODONTAL DEBRIDEMENT ANESTHETIC GEL • Oraqix® – the needle-free, site-specific (periodontalpockets) anesthesia. Fast acting Oraqix® has a 30 second onset of action of local anesthetic effect – assessedby probing of pocket depths – with a duration of approximately 20 minutes (individual overall range 14 to 27minutes).1 Oraqix® dispenses as a liquid, then sets as a gel, in the periodontal pocket. Showing its efficacy,Oraqix® demonstrated less pain than placebo treated patients.1 Oraqix® provides a needle-free, blunt-tippedapplication that can be conveniently administered by a Registered Dental Hygienist.
Non Injectable Local Anesthesia (NILA) for Periodontal Debridement
Work Life Wellness
CDHA 50th Anniversary Celebrations Continue
Business of Dental Hygiene:
Oral Care At Home? There’s An App For That!
Manitoba RDH Support & Study Group Tackles Access to Care
Talking Ethics: Show Vs. Tell
Oh Canada! Volume 1 Issue 42
Message From The President & Executive Director.
4 MessagefromthePresident
6 MessagefromtheExecutiveDirector
Dental Hygiene Focus
8 TreatingtheMedicallyCompromisedClient• Caring For The Client With
Multiple Sclerosis• Dental Desensitizing From
A-Z• Treating Clients With Autism
Spectrum Disorders
Oh Canada! is the official oral health e-magazine of the Canadian Dental Hygienists Association (CDHA). CDHA exists so that its members are able to provide quality preventive, and therapeutic oral health care as well as health promotion for all members of the Canadian public. Published quarterly (winter, spring, summer and fall), Oh Canada! provides a forum for the communication of association news, clinically relevant dental hygiene and oral health information and product information. This is not a peer-reviewed publication. Opinions expressed are those of the individual authors and do not necessarily represent the views of CDHA. Subscription rate is included in the annual CDHA membership fee.
EditorAngie D’Aoust, Director of Marketing & Communications
Art Direction and Production:Michael Roy, Manager of Web & Creative Services Daniel Bianchi, Graphic Designer
Articles and other submissions (including photos and video) are welcome. Submissions of 150-800 words should be sent via e-mail with text in MS word format to [email protected]. The editor reserves the right to edit submissions for length and clarity. Information for contributors.
AdvertisementPublication of advertisements in this magazine in no way constitutes CDHA’s endorsement of the product/service or company. CDHA reserves the right to reject any submission if the advertisement, organization, product or service is not compatible with CDHA’s mission, vision or values. CDHA does not accept responsibility for the accuracy of statements by advertisers.
For advertising information, please contact: Peter Greenhough, Keith Communications Inc. 905-278-6700 ext.18 or 1-800-661-5004 ext.18 [email protected]
Nous sommes bien en l’an 2013 et je me demande : combien d’entre nous ont pris des résolutions pour la Nouvelle Année ? Il arrive souvent qu’à ce moment-ci, les objectifs usuels de mise en forme, de meilleure alimentation et de perte de poids s’affaiblissent ou sont abandonnés. Cela m’incite à me demander pourquoi certaines résolutions échouent alors que d’autres réussissent.
Il importe d’explorer et de reconnaître certaines des principales raisons d’échec des résolutions. Trop souvent, leurs objectifs sont trop grands, trop irréalistes et souvent ingérables. Parfois, nous suivons des routines redondantes et négligeons de mettre en place les soutiens nécessaires. Cela confirme presque que nous pouvons demeurer dans la voie du changement.
Par ailleurs, les résolutions qui se réalisent sont ordinairement les plus petites et les mieux définies. La réussite des résolutions suit souvent des étapes de progression. Le recours au soutien de la famille et des amis procure encouragement et détermination pour demeurer fidèle à la résolution.
Je me demande combien d’hygiénistes dentaires du Canada ont établi des résolutions professionnelles pour cette année. J’entends souvent des collègues dire que la profession change, mais j’aimerais voir si elle évolue plus rapidement. Sachant cela, je vous mets au défit, en tant qu’hygiénistes dentaires en exercice, de prendre comme résolution de la Nouvelle Année 2013 d’aider à accroître le profil public de notre profession dans toute la population canadienne. Cela est possible par le biais de nos clientèles, de nos collectivités, de nos collègues des services de soins de santé et même de nos dirigeants élus.
Au début, ce défi peut paraître accablant, mais en réalité, il ne l’est pas. Cette résolution commencera par de petits pas. La plupart d’entre nous établissons déjà le lien avec la clientèle – et ce lien fera d’excellents progrès chez les clients et clientes qui reconnaissent la contribution que nous apportons à leur état de santé.
Message ThePresident
We are well into 2013 and I wonder how many of us made New Year resolutions? Often by this time, the usual goals of getting fit, eating better, and losing weight are faltering or have fallen by the wayside. It leads me to question why some resolutions fail while others succeed.
It is important to explore and recognize some of the main reasons resolutions fail. Too often those goals are too big, too unrealistic and are often unmanageable. Sometimes we do the "same old, same old" routines and fail to put the necessary supports in place. This almost ensures we cannot stay on the path to change.
On the other hand, resolutions that are successful are usually those that are smaller and well defined. Successful resolutions often grow in incremental steps. Using family and friends for support provides the encouragement and determination to stay committed to the resolution.
I wonder how many of Canada's dental hygienists set professional resolutions for this year. I often hear from colleagues that the profession is certainly changing but they would like to see it change faster. With that knowledge, I challenge you as practising dental hygienists to take on a 2013 New Year's resolution by helping to increase the public profile of our profession to all Canadians. It can be done through your clients, your community, your healthcare colleagues and even your elected officials.
This challenge may initially seem overwhelming, but in reality it is not. This resolution will start with small steps. Connecting with clients is something that most of us do already—and excellent progress is being made with clients recognizing the contribution we make to their overall health.
Another way to approach this resolution may be to volunteer for a community health fair. This is a terrific way to profile our profession. It gives people the opportunity to ask questions they
From
Dental Hygiene Resolution For 2013 by Sandy Lawlor, RDH, BA(Psych), BSW • [email protected]
Oh Canada! Volume 1 Issue 4 5
La participation bénévole à une foire communautaire sur la santé peut être une autre façon d’aborder cette résolution. C’est d’ailleurs une excellente façon d'accroître le profil de la profession. Cela donne aux gens l’occasion de poser des questions qu’elles hésitent souvent de poser dans le cadre traditionnel du cabinet. Ils n’y voient aucune pression pour découvrir que la santé bucco-dentaire occupe une place importante parmi les soins de santé. Cela leur permet aussi de trouver des produits de soins de santé buccaux.
La participation à une activité interprofessionnelle est une autre façon d’accroître le profil de votre profession. La présentation à une autre profession de la santé ou la participation bénévole à un comité de soins de santé peut accroître grandement le profil de la profession d’hygiène dentaire. Les soins de santé évoluent définitivement vers un modèle d’approche de collaboration interprofessionnelle, mouvement auquel l’hygiène dentaire a besoin de participer. Il est donc important de livrer le message disant que la prévention en est la clé et qu’une bonne santé buccale peut aider à épargner de précieux dollars en matière de soins de santé.
La communication avec la direction élue est une façon excellente et efficace d’améliorer le profil de l’hygiène dentaire. Cela doit être une routine annuelle. Les politiciens ont la capacité de modifier et de soutenir la législation qui agit sur notre façon d’exercer à titre d’hygiénistes dentaires. Il est essentiel que ces dirigeants entendent notre voix et sachent comment nous complétons le tableau des soins de santé. Une lettre à notre membre du Parlement fédéral et à notre membre de l’Assemblée législative et membre du Parlement provincial est un objectif facile. Un appel téléphonique pour prendre rendez-vous avec votre dirigeant élu et lui livrer personnellement votre message sur la profession d’hygiène dentaire sera encore plus impressionnant. Nous oublions souvent que les politiciens ont besoin d’entendre la contribution que leurs concitoyennes et concitoyens apportent à la collectivité et les améliorations qu’il faut apporter à la population. Après plusieurs visites aux politiciens pendant ma carrière, je peux attester de ce qu’est une expérience autonomisante.
À l’approche de la Semaine nationale d’hygiène dentaire (7–1t avril), je mets au défi, chacune et chacun d’entre vous, de prendre votre résolution d’hygiène dentaire pour 2013 en choisissant une de ces voies pour accroître le profil publique de notre grande profession. L’ACHD, votre association professionnelle, est une de vos plus importantes sources d’information et de soutien. N’hésitez pas à communiquer avec le personnel de l’ACHD pour conseils et assistance.
Comme l’an 2013 est en route, il et temps de prendre une résolution en hygiène dentaire. Partagez vos efforts avec l’ACHD et moi-même à pré[email protected]. Nous aimerions entendre votre histoire. Ensemble, nous pouvons toutes faire une différence professionnelle.
are often hesitant to ask in the traditional office setting. It is a pressure free way for them to find out about oral health being a bigger part of the healthcare picture. It also allows them to find out about oral healthcare products.
Participating in an interprofessional activity is another way to raise the profile of our profession. Doing a presentation to another health profession or volunteering to be a part of a healthcare panel is a great way to profile the dental hygiene profession. Healthcare is definitely moving to an interprofessional collaborative approach model, and dental hygiene needs to be a part of this movement. It is important that we deliver the message that prevention is key and that good oral health can help to save valuable healthcare dollars.
An excellent and effective way to enhance dental hygiene’s professional profile is to communicate with our elected officials. This should be an annual routine. Politicians have the ability to change and craft the legislation that impacts how we practise as dental hygienists. It is critical these officials hear our voice and know what we bring to the complete healthcare picture. A letter to your federal Member of Parliament and to your Member of the Legislative Assembly/Member of Provincial Parliament is an easy goal. Even more impressive, is calling and setting an appointment with your elected official to deliver your message about the dental hygiene profession personally. We often forget that politicians need to hear what their constituents contribute to the community and what changes are needed to improve things for the public. Having made several visits to politicians over my career, I can attest to what an empowering experience it is.
With National Dental Hygienists WeekTM (April 7-13) approaching soon, I challenge each and every one of you to make your 2013 dental hygiene resolution by selecting one of these ways to raise the public profile of our great profession. The CDHA, as your professional association, is one of your greatest sources of information and support. Do not hesitate to contact the CDHA staff for guidance and assistance.
As 2013 is underway, it is time to take on this dental hygiene resolution. Share your efforts with CDHA or myself at [email protected]. We would love to hear your stories. Together we can all make a professional difference.
CDHA is governed by a board of directors who set the goals, referred to as “Ends”, of the association. CDHA staff are then tasked with developing a strategic plan to achieve the goals set by the board. My previous three articles in Oh Canada! focused on Public Awareness, Advocacy and Knowledge. In this issue I am going to present highlights on another End, “Workplace Wellbeing”, with the goal, Members have resources for safeguarding their wellbeing in the workplace.
Wellbeing is a hugely significant aspect of our work and careers. There is substantial research to support the fact that wellbeing is a major factor in quality, performance, productivity and therefore overall business effectiveness. When a person's wellbeing is reduced, so typically does his or her performance
and effectiveness. Wellbeing is also closely linked to work related stress.
Wellbeing at work is very closely linked to wellbeing and health in your life outside of work. When wellbeing is eroded, people can fall ill, both physically and mentally.
Since wellbeing plays such a significant part in your life, it’s important for CDHA to play a key role in increasing your knowledge and awareness of workplace wellbeing. We have done this in a number of ways, including instituting a regular column in this magazine focused on workplace wellness and the 2012 release of our 2011 Job Market and Employment Survey (which we repeat this year).
CDHA’s New Year resolution is to bring even more great savings to you! We're sprucing up the old and bringing in the new … Member Benefits!
Start the New Year right! Take Advantage of these remarkable offerings… all for you… all from CDHA…
• Dress for success with CDHA’s new discount uniforms• Free e-CPS — a $246 value• Read more for less at the CDHA eBookstore• Total fitness for half price through GoodLife• Revamped car rental discounts• Amazing hotel discounts• Dental coverage, office overhead and new grad perks from SunLife• Save more for later through CDHA’s exceptional Group Savings and Retirement Plan• TD home and auto insurance — a member favourite• FedEx and save in the New Year• And so many more… professional development, tools of the trade…
For our full array of member benefits, old and new, visit www.cdha.ca/Advantage. Our member benefits ... your CDHAdvantage!
Oh Canada! Volume 1 Issue 4 7
Another commitment we have made to members is ready access to CDHA staff members with the knowledge to answer your questions. We have dental hygienists on staff, policy experts and technology experts to answer your questions. What kinds of questions are you and your colleagues asking?
Here is a sampling of the types of calls we receive at the national office:
➤ Membership payments ➤ Assistance with online courses/webinars ➤ UIN and CDHAnet calls ➤ Employment and work conditions including restrictive
work covenants, independent contractor/employee differences, pay rates, contracts
➤ Working abroad as a dental hygienist and foreign trained dentists wishing to work in Canada as dental hygienists
➤ Job searching from frustrated dental hygienists ➤ Information on permits and permissions and insurance
required to start a mobile dental hygiene practice ➤ Requests about marketing and promotion of independent
dental hygiene practice ➤ Insurance requirements for starting a mouthguard
business
It appears that the CDHA is well recognized by the public as an oral health resource as we receive calls about dental products and concerns. These topics can range from whitening products to amalgam restorations.
Many callers are referred to the regulatory authorities for specific details of quality assurance requirements.
Another strategic objective is to develop corporate partnerships and affinity programs to enhance members’ personal and professional wellness. CDHA has a number of affinity programs that are enjoyed by members. These include:
➤ Goodlife Fitness ➤ Home and Auto Insurance – preferred rates through TD
Insurance Meloche Monnex ➤ Disability, Life, Health, Accidental death benefits – from
Sun Life ➤ CDHA MasterCard – BMO ➤ Discount on Scaler – Hu-Friedy ➤ Voice, data, and smart phone packages – Rogers ➤ DVD Quarterly of Dental Hygiene – discounted rates ➤ International Journal of Dental Hygiene of the IFDH –
50% discount ➤ New programs launched this past year include: ➤ Discounts on uniforms – through Utility Garments Inc. ➤ Car rental discounts – through Enterprise and National ➤ Exclusive hotel discounts worldwide ➤ Dental care and office overhead expense – new addition
to our Sun Life program ➤ Merchant credit card processing (independent
practitioners) – First Data ➤ eBookstore discounts – through Login Canada ➤ Savings on courier services through FedEx
Though these services are not a core service for national professional associations, we know members appreciate the significant savings these value added benefits can offer. For more details on CDHA’s special discount programs, check out the CDHAdvantage ad below.
Canadian dental hygienists are commonly affected by work related injuries, pain and discomfort. Twenty-four percent of respondents to the CDHA 2011 Job Market & Employment Survey reported having an occupational injury or medical issue related to their work as a dental hygienist. Issues and injuries to the shoulder, back and neck are most prevalent. Posture, repetition and force exertion are common risk factors for neuromusculoskeletal (NMSK) in the dental hygiene profession. In conjunction with the Canadian Memorial Chiropractic College (CMCC), CDHA has provided a three-part webinar series, including a chairside resource guide, to review common injuries in dental hygienists, discuss work related and personal risk factors, as well as offer ergonomic modifications, exercises and other solutions in order to minimize occupational risks.
As you can see, there are many actions CDHA has taken to provide resources to safeguard member’s workplace wellbeing — from an experienced voice on the end of the phone, to educational webinars, articles, and resources as well as comprehensive affinity program offerings. Your wellbeing is important to us.
Oh Canada! Volume 1 Issue 48
Focus:Treating the Medically Compromised Client
DentalHygiene
Caring For The Client With Multiple Sclerosis by Donna Kawahara, DipDH, BDSc(DH), MHST • [email protected]
What is Multiple Sclerosis?Multiple sclerosis (MS) is a neurological condition. It affects both sensory and motor nerve transmission due to damage of the myelin sheath around the axons within the brain and spinal cord.1 Individuals with MS have varying symptoms and needs. Understanding what these needs are, will assist the clinician in providing optimal care and support for the client living with MS. Some people have mild forms of the disease, while others have severe, disabling forms that render their bodies incapacitated. MS affects women three times more often than men, typically affecting young and middle aged adults. Canada, being part of the northern hemisphere, has one of the highest rates of MS in the world.123 Symptoms include dizziness, balance problems, bladder and bowel dysfunction, depression, cognitive impairment, difficulty with speaking, swallowing and walking, fatigue, dry mouth, and many other symptoms.2 Currently, there is no cure for MS and the treatment focuses on maintaining
quality of life and preventing further disability.1
Barriers to Daily Home Oral CareIndividuals with MS often have problems with manual dexterity, making it difficult for them to brush their own teeth.3 For those individuals, it is important that the caregiver is properly trained and capable of adequately providing daily oral hygiene care, including toothbrushing and flossing. Approximately 25 percent of individuals with MS are not
able to independently provide their own oral or denture care, and almost one third find the need to change from using their dominant hand to their non dominant hand as a result of the disease.1 The lack of dexterity, motor skills, and muscle weakness create barriers for independent oral care.
Barriers to Professional Oral CareWith the increasing severity of MS comes increasing barriers to accessing professional oral healthcare. MS is often accompanied with problems in gait, creating the need for walking aids or wheelchairs. Barriers may include stairs and small operatories that restrict wheelchair access. When the disease prohibits the individual’s ability to weight bear, she/he is unable to transfer from the wheelchair to the dental chair without assistance. This means the staff must either be capable of treating the client in the wheelchair or be able to transfer the individual to the dental chair by some means. In specialized dental clinics, a mechanical lift device is the best option, as it is the safest method of transfer for both the client and the staff. However, this type of equipment is costly and is not likely to be found in a general dental practice. Some wheelchairs have a reclining feature, making it easier for the clinician to treat the client within the comfort of her/his own wheelchair. Clinicians need to be aware that in advanced stages, the client may not be able to verbalize the need for professional oral care due to the inability to effectively communicate, and as a result, these needs may go unmet.
Risk Factors for Oral HealthGingivitis, candidiasis, glossitis, ulcers, gingival hyperplasia, chelitis, and xerostoma are a few of the oral conditions that may be present for those living with MS primarily due to the medications required to treat the condition.4 Because chronic pain is felt by 20–50% of individuals with MS, it presents difficulties for clinicians to diagnose and interpret pain from dental infection or disease.1 Chronic pain can present as
“Sponsored by TotalCare, the makers of CaviCide1 and CaviWipes1 the new 1 minute, low-alcohol disinfectant”
Oh Canada! Volume 1 Issue 4 9
Focus:TreatingtheMedicallyCompromisedClient
paraesthesia, burning, throbbing or shooting pain, or typically non painful touch that becomes painful for those with MS. Trigeminal neuralgia has been noted in up to a third of those with MS, with other facial muscle and temporomandibular joint pain in up to 40 percent.1 In addition, if the facial muscles are involved in the disease, it may become difficult for the client to wear or have dentures fabricated that fits properly and remains in place.5
Dysphagia, or difficulty swallowing, also becomes a risk, which creates a choking hazard. In addition, when MS becomes severe and dysphagia is present, the client may require tube feeding, instead of feeding by mouth. This increases the amount of calculus present within the oral cavity, creating a greater need for professional dental hygiene therapy.
ConclusionOral health impacts the quality of life of those living with MS, especially those that require the use of mouth activated devices for everyday living.1 It is important that care be accessible for these clients because MS is a condition that affects the entire
body. Practices that specialize in care for those with special needs and mobile oral health professionals need to take the lead in providing treatment for these individuals, ensuring that the needs of the client are met while still remaining sensitive to their condition, maintaining the client’s comfort and dignity.
References1. Lewis D, Fiske J, Dougall A. Access to special care dentistry,
part 7. Special care dentistry services: seamless care for people in their middle years – part 1. BrDent J. 2008;205:305–17.
2. Multiple Sclerosis Society of Canada. [cited 2012 December 11]; Available from URL: http://mssociety.ca/en/information/default.htm
3. Chalas R. Assessment of oral hygiene of patients with multiple sclerosis. Acta Stomatol Croat. 2008;42(4):335–41.
4. Danesh-Sani SA, Rahimdoost A, Soltani M, Ghiyasi M, Haghdoost N, Sabzali-Zanjankhah S. Clinical assessment of orofacial manifestations in 500 patients with multiple sclerosis. J Oral Maxillofac Surg. Epub 2012 Jun 27.doi: 10.1016/j.joms.2012.05.008.
5. Baird WO, McGrother C, Abrams KR, Dugmore C, Jackson RJ. Verifiable CPD paper: Factors that influence the dental attendance pattern and maintenance of oral health for people with multiple sclerosis. Br Dent J. 2007 Jan 13;202(1):E4; discussion 40-1.
Dental Desensitizing From A-Z by Kayla Ragosin-Miller, RDH, PID • [email protected]
Autism, down syndrome, fetal alcohol syndrome, ADHD, epilepsy, dysfunction of sensory integration are just a few diagnoses which are considered under the developmental delay spectrum. Often, behavioural issues follow children with these diagnoses, as they don’t typically respond well to traditional discipline due to issues with cognitive delay and lack of speech. This creates a barrier for oral health practitioners to treat children
with special needs, thereby making oral care one of the greatest unmet healthcare needs for this population. Special Smiles Dental Desensitizing, an oral health program, was created especially to fill this niche and to teach independence and acceptance to treatment in the dental office.
Common concerns that link parents of children with challenges include: promoting acceptance in the community, receiving appropriate care and preventing sedation for simple procedures like dental hygiene appointments. Smells, sounds, and foreign objects in a dental office instill fear for many individuals. Adding an element of the unknown to a child with special needs creates negative behaviours in an attempt to avoid unfamiliar situations. How do we teach these children to comply with what is expected of them in the oral healthcare setting? With the use of visual boards, breaking down the steps required during an appointment, frequent visits, and a positive reward system in place, the apprehension associated with an unpredictable visit to an oral health provider diminishes. Instead of negative behaviour, we get compliance equating to results.
Sponsor
Oh Canada! Volume 1 Issue 410
In 2008, I accepted a position as the dental hygienist at BC Children’s Hospital Dental Clinic; I observed first hand how many children on the autism spectrum required sedation for basic dental treatment. That is when I took on the challenge of developing the pilot project for Special Smiles Dental Desensitizing Program. I spent time taking methods from various intervention programs used by children with autism and amalgamated the necessary information to develop a dental program. Programs included: applied behavioral analysis (ABA), relationship development integration (RDI), behavioural analysis (BI) and social integration (SI). With the creation of this program, I am now pleased to report we’ve established independence and progress with the children visiting the dental clinic.
Visual boards, personal social stories and sensory armamentaria are personalized for each child’s dental visit. Communication with the children’s professional team such as speech therapists, behavioural consultants and school aids is essential to the success of a child’s dental desensitizing program. By working on the same goals in the same way outside of the dental office, a sense of predictability is instilled and children feel in control of
what is about to happen. The numerous letters I receive from the parents expressing thanks for this program doesn’t come close to the appreciation in the form of hugs and “high fives” I receive from my young clients when they are proud of themselves for completing a task independently.
Life is stressful, emotionally and financially, for families dealing with children of special needs. Often, oral health and preventive dental care are low priorities for these families, as the thought of visiting an oral healthcare provider becomes traumatic. Providing this desensitizing service is a way of giving back to a group in our community who really need it. Dental residents and dental hygiene students learn hands on how the techniques and strategies in the dental desensitizing program work through a mentoring program at BC Children’s Hospital. In the past few years, I have taken this program on the road, speaking at various conventions to spread the knowledge on how to treat clientele with special needs, to improve results in the dental chair. Integration for those with special needs in the community and society is what it’s all about, in our world as oral health professionals.
Treating Clients With Autism Spectrum Disorders by Nadine Russell, RDH • [email protected]
The prevalence of autism spectrum disorders (ASD) is increasing with each passing year. As dental professionals, it seems imperative that we learn more about ASDs and how to adapt our skills to better serve this population.
Dental hygienists are frontline, primary oral healthcare providers. Our clients, their families and our colleagues look to us for preventive oral healthcare treatment and solutions. So ask yourself, what is your level of preparedness when presented with a client with autism spectrum disorder?
The Centers for Disease Control and Prevention report an alarming statistical prevalence rate in ASDs of approximately 1 in 88. So, are you prepared?!
Working with an individual with ASD usually requires adaptation to the dental hygiene appointment, but accommodations can be made. The more you know about ASDs, the better you will be able to effectively assess your client’s needs and plan for a successful dental hygiene care appointment.
ASD is a neurological dysfunction that results in a lifelong developmental disability. Individuals with ASD demonstrate impairments in communication, social functioning and behaviour. It is important to remember that it is a “spectrum” disorder meaning that individuals can present with symptoms ranging from mild to severe.
Many individuals on the spectrum have sensory sensitivities of sight, hearing, touch, smell, and/or taste, significantly impacting the dental hygiene appointment. Typically, social interactions are impaired; many people on the spectrum may appear to have an aloof manner, they are unable to read facial expressions, and/or have poor eye contact. Communication deficits can include impaired language skills and the lack of understanding or the use of non verbal gestures.
Communication with parents or caregivers is recommended prior to the initial appointment. This allows the RDH to discuss medical history, review medications taken, and determine if there are any comorbid conditions present. It also provides
Nadine Russell working with young non verbal client named Sean and his grandmother, Yvonne.
an opportunity to discuss if there are any anticipated sensory, communications and behavioural issues and enables the provider to be aware of any intellectual/cognitive deficits. At this time, you can also assess if consultation with other health professionals is required prior to the appointment.
Clients on the spectrum will have greater success if they know what to expect. Prior to the initial appointment, have the client become familiar with your office. This can happen with use of a social story or books explaining oral healthcare. Photos of staff members allow the person to get to know who he/she will meet at the dental hygiene appointment. Arrange a tour to introduce staff, allowing the client to become familiar with the office and operatory. Explain sounds and smells, show armamentarium, and explain what will happen during the oral care appointment. Offering consistency and predictability will help ensure a more successful dental hygiene appointment. Subsequent oral hygiene visits should be booked with the same provider to ensure that consistency and predictability is maintained.
Choose an appointment time during “off-peak” hours and allow additional time for the appointment. Give your client time to become familiar with the surroundings and feel more comfortable with you. Some may want something to comfort or distract them (blanket, toy, music, videos). Explain each step; show what you will use allowing them to touch, see and/or smell before you initiate. Then, while reinforcing positive behaviour, work at the individual’s pace and comfort level. With every future visit, your new client will become more familiar with you and what to expect of the care you offer, ensuring greater success with every visit. If the individual’s behaviour puts anyone at risk for injury, perhaps referral to an alternate care setting may be a more appropriate choice for your client (i.e., practice specializing in anaesthesia).
Review oral hygiene instructions with the client and caregiver giving both verbal and written instructions. Provide suggestions on appropriate positioning techniques if the caregiver is providing the daily oral homecare routine. Collaboration with other health professionals that your client may be working with may be advantageous. For example, consultation with an occupational therapist can help incorporate adaptive techniques or aids should there be any fine and/or gross motor skill deficits. Reinforcement of required homecare routines can also be strengthened with ABA programming used by behavioural therapists and alternative communication resources used by speech-language pathologists. Parents can also ask for oral hygiene routines to be added in a child’s individual education plan (IEP) that can be reinforced at school.
I hope that I have stimulated sufficient interest to encourage you to seek out more comprehensive information and to learn more about ASDs. Helping clients with ASD improve their oral health can greatly impact the quality of their overall health and, in turn, the quality of their lives. Please feel free to contact me should you have any questions or need guidance on strategies.
Articles/Resource GuidesWaldman HB, Perlman SP, Wong A. Providing dental care for the patient with autism.
Autism Speaks Autism Treatment Network / Autism Intervention Research Network on Physical Health. Treating children With Autism Spectrum Disorders: A Tool Kit for Dental Professionals. 2011. Resource manual.
The Dr. Samuel D. Harris National Museum of Dentistry. Healthy Smiles for Autism, Oral Hygiene Tips for Children with Autism Spectrum Disorder. 2010. Resource manual.
Websites:
➤ National Institute of Dental and Craniofacial Research: www.nidcrnih.gov
➤ Autism Speaks Canada: www.autismspeaks.ca
➤ Centers for Disease Control & Prevention www.cdc.gov
CaviCide1 and CaviWipes1 are the ONLY low-alcohol surface disinfectants that kill TB and ALL other labeled pathogens in 1 minute.
The low-alcohol formula is compatible with most of your dental surfaces, arming you with the confidence that you can clean plus disinfect quickly and easily.
The world of apps... we check email, track flights and order pizza using them. Why can’t we use them for better oral healthcare?
Well, that’s exactly what we did at White Summit Dental Hygiene.
The app we made, Brush & Boogie, was well received on an international basis. The developer we worked with commented that it was one of the more successful apps their company had done. Initial downloads were high, over a thousand times, and the re-use of the app was also very high.
We decided to develop the app for a number of reasons—to create buzz for our new practice, to have clients have a re-care reminder, and to have a fun, functional timer that also teaches good brushing habits.
We didn’t put a huge promotional campaign together for the app. It was promoted in our newsletter, recommended to patients with an iPhone, and we also added a banner for it on our website. We did a small mailing campaign in which we featured the app. We felt this would be an eye catcher that would draw people to investigate our practice.
For development, we contracted the work to a local app developer called Association. Working closely with Association we were able to give the app more accuracy for time spent in each area to brush, and even choose the time to brush at intervals of 2,3 and 4 minutes. We found the two things that led to our success—having a very
specific idea of what we wanted the app to do and also a very specific budget. We communicated our needs up front to ensure there were no surprises during the development on either side.
Selecting the music for the app was a challenge. With a limited budget, a new business does not have the money to pay the royalties for “Disco Inferno” by the Bee Gees (which was my first choice), so we had to find a royalty free piece of music to license instead.
With more and more people turning to iPhones and other smartphones, I am glad that we took the opportunity to make an app. It will be useful for many years to come, especially as the use of apps increases daily.
Although the main intent was to raise awareness and promote our dental hygiene clinic, the side benefit was that users, around the world, have been exposed to dental hygienists in another light.
At the time this app was created, it was the first app created by a dental hygienist, as far as we know. I feel, the more we promote our profession locally, and globally, the more the public will learn about the role an RDH provides in their primary care, and about our profession in general.
Check out our App! whitesummit.ca/iphone
Check out all the details and updates on our 50th anniversary activities at www.cdha.ca/50
A 50th anniversary commemorative print edition of Oh Canada! magazine with greetings from CDHA past presidents and other great memories.
Our 2013 national conference in Toronto, October 3-5, will feature a Memory Lane exhibit, a 50th anniversary birthday party, complete with cake, as well as a 50th Golden Gala dinner atop the CN tower.
$50,000 fundraising goal for CIBC Run For The Cure in September. Cross Canada clinic participation in Gift From The Heart, February 2014.
Production of a die struck gold polish 50th anniversary commemorative pin that will be presented to all 25+ year members.
An anniversary gift draw — For 50 weeks, we’re randomly selecting the
name of one CDHA member to be awarded a new crystal gem RDH pin.
Member submitted Professional Identity statement contest - The winning submission
will be announced at the national conference in Toronto in October.
Super Smiles — Submit your best smile of a dental hygienist, a client, or something historical. Win a CDHA prize pack and see your photo in “50 Faces of Dental Hygiene” video and poster. Also, we will use your entries as our Facebook cover photos throughout 2013. Watch for entry details.
A Facebook ad campaign with the message, CDHA dental hygienists have been safeguarding your oral health for 50 years. Celebrate! This ad has appeared on more than 65,000 Facebook accounts.
Dental hygienists have been safeguarding overall health through better oral health care for more than a century. Join us in 2013, as we celebrate 100 years of the dental hygiene profession and 50 years of CDHA.
You’ve already noticed our 50th anniversary logo everywhere from our email signature blocks to our website. Watch for it on all 2013 CDHA publications, decals and pins, National Dental Hygienists Week™ materials and more.
Visit www.cdha.ca/50
we arecelebrating!
1963 - 2013
If you have celebration ideas or would like to share what you’re doing locally, email Angie D’Aoust, director of marketing and communications at [email protected]
Facebook challenge! 9,000 fans by the end of the year. This goal was decided by YOU, our CDHA member. If you aren’t a fan of facebook.com/thecdha become one today!
150,000 registered dental hygienists in the United States are also celebrating in 2013. ADHA welcomes the world in commemorating the 100th anniversary of the dental hygiene profession.The historic celebration will take place on June 19–25, 2013 in downtown Boston, Massachusetts, at the Hynes Convention Center. ADHA has created a specialized program for international colleagues to commemorate this centennial milestone.
Check out the program and registration details at www.adha.org/annual-session
Oh Canada! Volume 1 Issue 416
Dental Hygienists
Home&AwayVolunteering In Chemanius by Katharine Chatten, RDH • [email protected]
I’ve been working in the dental field for more than 33 years now, and during the past several years, I’ve been fortunate enough to be associated with The Dental Mission Project. This non profit society, founded by Dr. Doug Nielsen and his wife, Susan, aims to provide free dental care to people in need. For this, teams of dental professionals and students require portable dental equipment and supplies to bring to various, often remote, locations. In the past, there have been teams sent to Nicaragua, Guatemala, Mexico, the Philippines, Vietnam, India and Bhutan. Recently, we’ve been focusing on providing dental care locally, here in Canada, to areas such as the Mount Pleasant area in Vancouver, Penelakut Island and, this past summer, in Chemainus.
We receive a tremendous amount of support from Rotary Club, to which Dr. Nielsen belongs. Bob Blacker, a fellow Rotarian and strong advocate of First Nations’ rights, combined efforts with Dr. Nielsen to offer services to marginalized areas of Vancouver and Vancouver Island.
In Chemainus, we worked out of the H’ulh-etun Health Society, that offers services to the Penelakut, Halalt, Lyackson, and Malahat First Nations. For this trip, we were accompanied by two UBC dental hygiene students; Sayena Faraji, a 3rd year student and Kim Nguyen, a 2nd year student. As a mentor, it was very rewarding to see the eagerness and excitement that these two young ladies brought to the team. During our two and a half days
in Chemainus, our team of dental and dental hygiene students treated approximately 70 people. This particular health unit had a fully equipped operatory that Sayena, Kim, and I were able to use. We wanted to offer total client care: soft tissue screening, oral cancer screening, dental exam, scaling, polishing and fluoride treatment, as well as dental education.
In working with this group of people, I gained a much better understanding of the challenges they have had to endure and overcome. One day after our clinical day was over; one of the Elders came to talk to us about his experiences as well as those of his family and friends, in the residential schools where dental work was performed without any anaesthetic and, in most cases, with no explanation of what was being done or why. Fear and anxieties are often passed down from one generation to the next. Trust in these services did not exist and, to this day, accessing care can come at a high emotional cost.
This talk helped our understanding of, and appreciation for, the difficulties faced by the First Nations people and highlighted the need to treat our clients with dignity and respect. We made sure that our communication with the client was specifically tailored and we prioritized relieving anxiety and keeping the client well informed. Both Sayena and Kim became very aware of this fact and quickly adapted to make it a caring environment for everyone. We had a wide range of ages come to the clinic,
from ages 9 to 60. There is so much that can also be done in dental education in schools and community centres. Even speaking to parents groups is an asset to the First Nations people. All the people of the First Nations groups we dealt with, both as clients and employees of the
H’ulh-etun Health Society, made us feel very welcome and appreciated. It was a rewarding and educational experience for us all. Community work broadens the scope of dental hygiene, allowing one to grow as a well rounded health professional.
I always feel I gain so much more on these trips than I give. It has been a very rewarding way to expand on an already exceptional
career. I recollect my first volunteer trip to Guatemala; I was very nervous about the whole experience. I am now so glad that I stepped out of my comfort zone then and embraced the world of volunteerism. I have found it to be very positive part of my life.
Two University of Alberta dental hygiene grads, Amanda Schesnuk, class of 2010, and Kelsey Yaremko, class of 2008, recently travelled to India making a pit stop along the way at Kathmandu. The grads were asked to give a periodontal probing and hand instrumentation presentation and a hands-on demonstration to the second year dental hygiene students in Nepal. What they discovered along the way was eye opening.
“I was surprised to learn that their program was quite established,” said Amanda. “Their language is English, and they use the same textbooks as the U of A dental hygiene program.”
They discovered that the structure of their program was very similar, too, in that there is a one-year all sciences requirement to get in, six options, and that the students are required to wear a uniform.
There are some differences too, such as availability of hand instruments, and the terminology they use. “They call simulation heads, ‘phantom heads’ and they attend school six days a week,” said Kelsey.
Kelsey observed that access to dental care and facilities varies a lot from one country to another. In India, there is no dental hygiene program, yet in Nepal, dental hygiene is in high demand.
The commissioner of the program in Nepal talked about the work they do in outreach programs in rural Nepal. There is a lot of potential to leverage the existing program and to set up in other locations—he sees it operating more like a dental therapy program.
Amanda and Kelsey are both actively involved in the Kindness in Action missions. Kindness in Action (KIA) was brought to fruition in 1993 by a 1990 DDS grad—Dr. Amil Shapka. The local dental charity provides free dental care in areas around the world for those who have limited or no access to dental care.
For the last decade, KIA has made 15 missions per year to Central and South America to help fill needs beyond dentistry. Those involved have helped build schools, set up clinics, and developed and nurtured programs.
Amanda and Kelsey were in Cambodia for two weeks in January 2013. It will be their third mission with KIA.
“It’s not for everyone,” says Amanda. “But it is close to my heart because I love travelling, and feel it is important to provide access to dental care to those who otherwise wouldn’t have it.”
Oh Canada! Volume 1 Issue 418
Embracing Smiles Across The Miles by Sabrina Ponikvar Cooper, RDH • [email protected]
Twelve years ago, when I chose to be a dental hygienist, I knew that I would also do something else outside the four walls of a dental office. That “something” was to provide dental care some day to children in impoverished areas who could not receive regular treatment. In doing some research, I discovered an organization called Global Dental Relief whose vision and focus was similar to mine. This organization gives children in Guatemala, Kenya, Nepal, Vietnam and northern India the chance to have a healthy smile with the help of dental and non dental volunteers.
I did not know what to expect on arrival at the small community in San Martin Jilotepeque, Guatemala, but was filled with emotion as I saw the many smiling children waiting in line to see us. The clinic was set up in a building with mobile dental
units using generators for power, and had all the supplies and instruments we needed. Being in a situation different from my everyday routine took some time to adapt, but once there was a flow the surroundings did not matter. Our focus was helping as many children as we could and it was exhilarating to look around and see that this was being achieved. The days were long as dental hygienists and dentists completed many exams, sealants, dental cleanings, extractions and restorations, but it was very gratifying. Seeing the smiling mothers and children peeking through the doors and windows of the clinic as they lined up awaiting treatment, made me feel more appreciated than I would have done on a normal day at the office. Our team saw close to six hundred children in the five days we were there.
Our helpful team leaders Kim and Kerri made our time in the clinic run smoothly and kept everything well organized. The community and people of San Martin were very welcoming and helped make our stay a safe and enjoyable one. My dreams came true, and having my husband eagerly join me as a non dental volunteer made my experience even more special. Working in a different environment with people ranging from age twelve to eighty, allowed me to learn so much and I took away many life lessons. Many everlasting friendships developed, the people and the culture of Guatemala have touched my life forever. The experience we had with Global Dental Relief was definitely a positive one; and just knowing the good that was accomplished has us looking forward to volunteering with them again in the future. Please go to globaldentalrelief.org and find out more on how you can help children around the world get the dental care they deserve.
>>>> Dental Hygienists Home & Away
EasyThread TM Floss
Is your current Threader Floss a ball of FRUSTRATION?
Then take new tangle-freeG•U•M® EasyThread™ Floss for a spin!
• Innovative operatory container easily dispenses floss without hunting for individual strands, eliminating tangles and waste.
• G∙U∙M® EasyThreadTM Floss fibers are designed to fill interproximal spaces to maximize biofilm and food debris removal around crowns, bridges, implants, orthodontics, and fixed retainers.
• Dual-ended threader tips allow you to maximize cleaning with one strand. If one tip wears out, just use the other and keep flossing.
G•U•M® EasyThread™ Floss is available in 2 formats:• Hygienic Operatory Dispenser • Convenient Patient Trial Size
EasyThread TM Floss
Is your current Threader Floss a ball of FRUSTRATION?
Then take new tangle-freeG•U•M® EasyThread™ Floss for a spin!
• Innovative operatory container easily dispenses floss without hunting for individual strands, eliminating tangles and waste.
• G∙U∙M® EasyThreadTM Floss fibers are designed to fill interproximal spaces to maximize biofilm and food debris removal around crowns, bridges, implants, orthodontics, and fixed retainers.
• Dual-ended threader tips allow you to maximize cleaning with one strand. If one tip wears out, just use the other and keep flossing.
G•U•M® EasyThread™ Floss is available in 2 formats:• Hygienic Operatory Dispenser • Convenient Patient Trial Size
Oh Canada! Volume 1 Issue 420
TalkingEthicsTalking Ethics: Show Versus Tell by Cindy Isaak-Ploegman, RDH, BA, MEd • [email protected]
An article in a recent golfing magazine discussed how the game of golf teaches players life skills: cheating does not pay, how to follow the rules, self discipline, and managing life’s hardships,triple-bogeys in this instance. (Miller, 2012). I am sure the same claim could be made for a variety of other sports. It makes me wonder, however, if teaching ethical behavior is that simple? Merely through participation, do learners absorb all these other values? This raises the question of how professionals learn ethical behaviour.
Is ethical behaviour taught to students through formal instruction or absorbed from instructors that role model professional behaviour. In a study of dental hygienists, 63% responded that their ethical principles were influenced by role models as opposed to formal ethical instruction. (Gaston, Brown, & Waring, 1990). Examples may be role modelling the virtues of lifelong learning as individuals or as a study group by keeping up with literature, (Daaleman, Kinghorn, Newton, & Meador, 2011), or avoiding prejudicial comments that lead to stereotyping. (Kopelman, 1999). It is sobering to realize that as dental hygienists in private practice, research or education we are all role modelling how to engage in ethical dental hygiene practice to others, students and colleagues alike.
Professionals look to good role models, but they also wish to be unique, to create their own niche in their profession, and to make individual decisions in complex situations rather than blindly follow another’s example. For this reason, there is value in isolating ethical content and allowing students to discuss hypothetical scenarios, since it provides students with opportunities to vocalize their own values and beliefs and to discover that peers may not share the same opinions. (Jenson, 2005). It also provides instructors with the opportunity to highlight the CDHA Code of Ethics that guides decision making by licencing bodies when managing complaints from the public and other professionals. It prepares students for board exam content related to ethics, even though the result may not be an ethical graduate. (Jenson, 2005). Unfortunately, teaching professionals to avoid certain behaviours does not serve to inspire them to be what they ought to be. (Kopelman, 1999). From this perspective it seems role modelling is a more powerful vehicle since the implication is that a student’s role model is someone the student wishes to emulate.
Historically, role modelling was a formal mode of dental education in apprenticeships. In the early 1900s young men, aged 10–12 years, sons of English country gentlemen, were apprenticed for a fee, for 5–7 years. (Bishop, Gibbons, & Gelbier, 2002). Social control was exercised over the apprentice’s personal life since he was mandated to exclude behaviours inconsistent with Christian values such as fornication, card playing, drinking ale excessively, attending playhouses (Bishop, Gibbons, & Gelbier, 2002), lying, conniving, tale bearing and quarrelling. He was to maintain integrity, be frugal, industrious, and was given instructions on dealing with the opposite sex in courtship and marriage. (Barnard, 1740). These moral requirements extended throughout the professional’s lifetime. (Bishop, Gibbons, & Gelbier, 2002). To modern professionals, these rules of conduct paint a controlling environment that would seem an intrusive mode of moral education. Today, serving students as a mentor has increased in popularity in dental education. It is advocated and encouraged as being beneficial for both mentors and mentees, and is a forum to address students’ concerns and to provide advice. (Stenfors-Hayes, Lindgren, & Tranaeus, 2011).
Oh Canada! Volume 1 Issue 4 21
The following quotation encapsulates the philosophy of role modelling,
Each of us has the duty to take a personal interest in a student or several young budding dentists and become a one-on-one mentor and role model to each, so that the right way of life in the profession is indelibly imprinted in these fertile minds and hands of the future. Do not just tell them the way to success, show them!”
(Maitland, 2006, p. 309).
This quotation suggests that the “right way of life in the profession” is clear to all alumni and graduates alike, but we know from clinical practice that ethical choices of behaviour may not be clearly obvious. One suggestion to address this challenge, is to use popular mass media to relay ethical content. (Spike, 2008). The argument is that due to the unique method of exploring the ethical dilemma from all angles via the characters portrayed on television shows such as Scrubs, students are provided with a more thorough exposure to the repercussions of ethical choices made during treatment, or when communicating with their clients or third party sponsors. (Spike, 2008). The exhortation to medical students seems to be to watch more TV to become more ethically aware. (Spike, 2008).
We know that the formation of ethical professionals is the result of a process that develops over time. (Daaleman, Kinghorn, Newton, & Meador, 2011). Finding someone, whether it be a fictitious TV character or a real life mentor, to inspire us to be better professionals is as rewarding as a hole in one.
References:1. Barnard J.(1852). A present for an apprentice; or, a sure guide
to gain both esteem and estate: With rules for his conduct to his master and in the world. London: The Haberdashers Company, Charles and Edwin Layton. (Original work published 1740).
2. Bishop MGH., Gibbons D, & Gelbier S. (2002). Ethics—the early division of oral health care responsibilities by act of parliament. British Dental Journal, 192(1), 51–53.
3. Bishop MGH, Gibbons D, & Gelbier S. (2002). Ethics; ‘in consideration of the love he bears.’ Apprenticeship in the nineteenth century, and the development of professional ethics in dentistry. Part 1. The practical reality. British Dental Journal, 193(5), 261–66.
4. Bishop MGH, Gibbons D, & Gelbier S. (2002). Ethics; ‘in consideration of the love he bears.’ Apprenticeship in the nineteenth century, and the development of professional ethics in dentistry. Part 2. Hippocrates’ long shadow. British Dental Journal, 193(6), 321–25.
5. Daaleman TP, Kinghorn WA, Newton WP, & Meador KG. (2011). Rethinking professionalism in medical education through formation. Family Medicine, 43(5), 325–29.
6. Gaston MA, Brown DM, & Waring MB. (1990). Survey of ethical issues in dental hygiene. Journal of Dental Hygiene, 64(5), 217–24.
7. Jenson LE. (2005). Why our ethics curricula do work. Journal of Dental Education, 69(2), 225-8; discussion 229–31.
8. Kopelman LM. (1999). Values and virtues: How should they be taught? Academic Medicine : Journal of the Association of American Medical Colleges, 74(12), 1307–310.
9. Maitland RI. (2006). Disturbing trends in dental education. Journal of Esthetic and
10. Restorative Dentistry, 18(6), 307–09.
11. Miller J. (2012). 7 Lessons for a lifetime. Golf Magazine, 54(10), 63.
12. Spike J. (2008). Television viewing and ethical reasoning: Why watching scrubs does a better job than most bioethics classes. The American Journal of Bioethics : AJOB, 8(12), 11–13. doi: 10.1080/15265160802495630
13. Stenfors-Hayes T, Lindgren LE, & Tranaeus S. (2011). Perspectives on being a mentor for undergraduate dental students. European Journal of Dental Education : Official Journal of the Association for Dental Education in Europe, 15(3), 153–58. doi: 10.1111/j.1600-0579.2010.00649.x
Oh Canada! Volume 1 Issue 422
CDHA Code of Ethics: Ethical Distress, Ethical Dilemma, Ethical Violation; Using The Guidelines For Ethical Decision Making by Marcia Rushka, DipDH, RDH, and Laura Macdonald, DipDH, BScD(DH), MEd. • [email protected] • [email protected]
Dental hygienists are guided by a Code of Ethics.1 This paper uses a scenario to clarify the meaning of ethical distress, ethical dilemma, and ethical violation.
Scenario:Mrs. Donnelly, a 73 year old woman with dental anxiety, has not had dental hygiene care for more than fifteen years. She makes an appointment with Samantha, a dental hygienist. Mrs. Donnelly states: “My gums bleed, but I am so anxious about any treatment. I saw your advertisement about ‘being in good hands at this practice’ and it is why I came here!” The assessment reveals chronic periodontal disease with a 7 mm pocket depth (Class II furcation) on the distal surface of tooth #16. Samantha explains her findings and treatment options to Mrs. Donnelly. Both agree the best care would be debridement with local anaesthetic beginning with sextant 1.
Samantha arranges her instrument cassette on the bracket table; the curettes are new. While debriding the furcation of tooth #16, a loud “snap” is heard. “What was that?” asks Mrs. Donnelly. Samantha’s inner thoughts are racing: “Did the instrument tip break...how can that be? It was a new instrument...what do I do...? Mrs. Donnelly is already so nervous.” Samantha sees the tip of her instrument is missing.
What should Samantha do?Samantha must do what is right for the client. She knows the risks of leaving the instrument tip behind, yet fears disclosing the incident to Mrs. Donnelly (accountability). She wants to do her no harm (beneficence). Samantha’s concerns lie with Mrs. Donnelly’s anxiety level. If Samantha chooses to resolve the issue by removing the tip without informing Mrs. Donnelly, she believes she satisfies beneficence. Samantha’s decision is confounded by her emotions. She is frustrated by her decision to just remove the tip without Mrs. Donnelly’s knowledge. Samantha erred on thinking she was upholding the office acclamation: “You are in good hands” but knows Mrs Donnelly also has the right to know about the incident. Mrs Donnelly is not stressed by the incident, the tip was removed, and no harm resulted for the client. Yet, Samantha remains troubled by her decision. This exemplifies an ethical distress. Ethical distress is experienced when emotions like fear and anxiety pose a threat to the dental hygienist wanting to act “right” or “stand firm” on an ethical principle.
Samantha chooses to not to tell Mrs. Donnelly about the broken tip, but does follow protocol to remove it. Her decision making involved a tug and pull between being honest (integrity)
and acting only for the good of her client (beneficence). She concluded if she could remove the tip without Mrs. Donnelly knowing, then there was no need to tell her and potentially add to her anxiety. Samantha chose to shrug off the “snap sound” as a routine noise sometimes heard during debridement. The discourse experienced by Samantha in choosing what to do is an example of an ethical dilemma.
An ethical dilemma “... arises when there are equally compelling reasons for and against two or more possible courses of action: choosing one course of action means that something is relinquished or let go.”(CDHA Code of Ethics, 2012) If Samantha successfully retrieves the tip without Mrs. Donnelly’s awareness, then Mrs. Donnelly will not be caused undue stress. Samantha thinks of this as abiding by the ethical principle of beneficence. If she is honest with her, disclosing the fact that an instrument tip did break in her pocket, Samantha is abiding by the ethical principle of integrity, but possibly at the expense of Mrs Donnelly’s dental anxiety. Samantha’s internal struggle results in various pathways of doing “what is right” for her client.
What if Samantha chooses to avoid causing undue anxiety to Mrs. Donnelly (beneficence) and leaves the tip in the pocket of tooth #16? She does not document the instrument breakage in the computer/chart (accountability), and thinks if a problem arises, she’ll take measures to resolve the problem at that time. This action results in the breech of fundamental practice protocol (accountability). It exemplifies an ethical violation. An ethical violation arises when there is a failure to act or respond to an event which results in fundamental practice standards being disregarded. If Samantha chooses to leave the instrument tip in the periodontal pocket without Mrs. Donnelly’s knowledge and without documentation of the event, she not only violates ethical principles, but practice standards as well.
The five ethical principles: beneficence, autonomy, integrity, accountability and confidentiality guide our thoughts, decisions, and actions as health professionals. Becoming knowledgeable on identifying the type of ethical challenge faced, the dental hygienist is able to seek resolution of the challenge by using the guidelines for ethical decision making found in Appendix B of the CDHA Code of Ethics. This step by step process engages ethical reasoning and leads the dental hygienist to do what is right for the client.
References1. Canadian Dental Hygienist Association, 2012, Code of Ethics
retrieved November 9, 2012 from (www.cdha.ca/pdfs/Profession/Resources/CDHA_Code_of_Ethics_public.pdf)
>>>> Talking Ethics
As a dental hygienist, you look after clients to try to ensure optimal oral health and you educate clients about the importance of protecting their teeth and gums.
Now’s the time to look after yourself to ensure your financial health and protect your financial future!
As a member of the Canadian Dental Hygienists Association, you receive very competitive rates on the following insurance products:
• Long Term Disability • Accidental Death and Dismemberment
• Critical Illness • Office Overhead Expense
• Term Life • Dental
• Extended Health Care
The CDHA Insurance Program is underwritten by Sun Life Assurance Company of Canada, a member of the Sun Life Financial group of companies.
Life, and your teeth! are brighter… under the sun
You take care of other people every day. Take care of yourself today!
Learn how to protect yourself and your family –
visit www.cdha.ca/SunLife or
call toll-free 1-800-669-7921 Monday to Friday,
8:30 a.m. – 5:00 p.m. EST.
ATTENTION recent grads!!
If you’re a recent graduate or about to graduate, visit the website to learn more about a special offer available to you – www.cdha.ca/SunLife
As a member of the Canadian Dental Hygienists Association, you receive very competitive rates on the following
• Long Term Disability • Accidental Death and Dismemberment
If you’re a recent graduate or about to graduate, visit the website to learn www.cdha.ca/SunLife
AA-00223 CDHA_OCanadaAd_CJDHNov_v1.indd 1 12-10-15 9:00 AM
Oh Canada! Volume 1 Issue 424
ProductSpotlights
Product NameDentsply RDH Freedom™ Cordless Prophy System
Product CategoryPractice Equipment & Resources
Product OverviewFinally, a hygiene handpiece that offers cord-free accessibility plus enhanced infection control.
Product Features & Benefits1. Lightweight and balanced cordless handpiece
2. Autoclavable outer sheath for infection control
3. Wireless foot pedal
4. Specialized DPA
5. Portable to take into various clinical settingswww.dentsply.ca • 800-263-1437
Product NameSensitive Pro-ReliefTM/MC Mouthwash
Product CategoryMouthwash & Whitening
Product OverviewGive your patients a unique mouthwash that protects them from sensitivity with every rinse±. Colgate* Sensitive Pro-ReliefTM/MC Mouthwash with Pro-ArginTM/MC is clinically proven to provide effective & lasting sensitivity relief±.
Product Features & Benefits1. Prevents pain by coating the channels that lead to sensitive tooth nerves1
2. Superior at reducing dentin hypersensitivity2
3. Contains 225 ppm fluoride to help prevent cavities
4. Alcohol-free with soft mint flavor
www.colgateprofessional.ca
1. Boneta et al. Data on File; Colgate-Palmolive, November 2009. 2. Vs. a 2.4% Potassium Nitrate rinse. Data on File; Colgate-Palmolive, January 2010. ±When used according to instructions.
Oh Canada! Volume 1 Issue 4 25
Product NameG•U•M® PerioBalance™
Product CategoryHealth Product
Product OverviewG•U•M® PerioBalance™ is an advanced, clinically researched natural health product containing innovative probiotic Lactobacillus reuteri Prodentis. G•U•M® PerioBalance™ helps restore the balance of the oral microflora by supplying “good” bacteria to inhibit growth of “bad’ disease causing-bacteria in the mouth to improve oral health of gum tissue and teeth.
Product Features & Benefits1. Clinically proven to reduce moderate to severe plaque by 42% in 28 days.1,2,3
2. Clinically shown to inhibit growth of oral pathogens.4
3. Promotes healthy teeth and gums.
4. Fights bad breath.
5. Tasty mint-flavoured lozenge1. Plaque Index 2-3 on a scale from 0, for no plaque, to 3, for abundance of soft matter within gingival pocket and tooth surface2. Krasse P et al. Decreased gum bleeding and reduced gingivitis by probiotic Lactobacillus reuteri. Swed Dent J 2006; 30: 55-60.3. Data on _le. Note 28 day results from uncontrolled extension of the 14-day clinical study as referenced in footnote 4. Vivekananda MR, Vandana KL, Bhat KG. Effect of the probiotic Lactobacillus reuteri (Prodentis) in the management of periodontal disease – A preliminary randomized clinical trial. Journal of Oral Microbiology 2010, 2: 5344
www.gumbrand.ca/periobalance/
Product NameSeal-Tight® SPECTRUM
Product CategoryDisposables and Infection Prevention
Product OverviewThe patented technology behind Seal-Tight Spectrum is what sets it apart from all the other air/water syringe tips available today, making it the recommended choice for your dental operatory. Seal-Tight turns the traditional approach to tip installation on its head, with a unique interlock system, through the exclusive Seal-Tight Adapter, that eliminates wear-and-tear at the insertion point of your air/water syringe and ensures a fresh seal with every new tip. The combination of superior materials and superior engineering has yielded the best syringe tip for dry air, on demand, every time.
Product Features & Benefits1. Disposable - Provides maximum infection protection
2. Dry Air On-Demand. - The yellow rubber seal acts like an O-ring, ensuring dry air every time
3. Rapid & secure tip replacement - Only syringe tip with a unique technology designed for quick and sealed tip replacement
4. Flexible - Can be bent to a 90º angle without affecting water flow
5. Multiple Colors – available in eight assorted colors!To learn more or Try Seal-Tight Spectrum for FREE visit TrySealTight.com.
Oh Canada! Volume 1 Issue 426
Product NameSensodyne Repair & Protect
Product CategoryGeneral Oral Care
Product OverviewSensodyne® Repair & Protect is the first fluoride toothpaste to harness NovaMin®, a patented calcium and phosphate delivery technology that helps repair exposed dentin by creating a hydroxyapatite-like layer over and within dentin tubules.
Product Features & Benefits
1. Contains NovaMin, a patented calcium phosphate delivery technology.
2. Proven to build a robust hydroxyapatite-like layer over exposed dentin and within dentin tubules.
3. Proven to build a hydroxyapatite-like layer that is up to 50% harder than dentin.Alcohol-free with soft mint flavor.
4. Proven to build a layer that is resistant to daily mechanical and chemical challenges.
5. Delivers clinically proven relief from the pain of dentin hypersensitivitywww.repairandprotect.ca
>>>> Product Spotlights
®/MD
®/MD
®/MD
®/MDHEALTHY GUMS. HEALTHY LIFE.
Si l v e r B r o n
z e
Elite
Gold
CDHA Partners’ Circle
®/MD
®/MD
®/MD
®/MDHEALTHY GUMS. HEALTHY LIFE.
CDHA PArtners’ CirCle
The CDHA Partners’ Circle comprises dental industry firms dedicated to the advancement of the dental hygiene profession. Members of the CDHA Partners’ Circle recognize the important role dental hygienists play in the overall oral health team. We are extremely proud to announce the members of the CDHA Partners’ Circle for 2013.
YOUR PARTNER IN ORAL HEALTH
Colgate Palmolive Canada Inc. *TM Reg’d/M.D.
www.colgateprofessional.ca
† Vs. pumice fl uoride-free prophylaxis paste, regular fl uoride toothpaste and regular toothbrush.‡ When used according to Instructions for Use. For free samples or to order, call 1-800-2COLGATE
TOOTHPASTEDESENSITIZING PASTE
APPLY IN OFFICE RECOMMEND FOR EVERYDAY USE
Superior Sensitivity Relief† that’s Instant and Lasting‡
• Instantly forms a protective layer on exposed dentin surfaces• Instantly occludes dentin tubules• Provides lasting protection with a calcium-rich, acid-resistant layer
Colgate* Sensitive Pro-Relief TM/MC with Pro-ArginTM/MC Technology:
The ONLY clinically proven Treatment Program that provides...
®/MD
®/MD
®/MD
®/MDHEALTHY GUMS. HEALTHY LIFE.
Si l v e r B r o n
z e
Elite
Gold
CDHA Partners’ Circle
®/MD
®/MD
®/MD
®/MDHEALTHY GUMS. HEALTHY LIFE.
CDHA PArtners’ CirCle
The CDHA Partners’ Circle comprises dental industry firms dedicated to the advancement of the dental hygiene profession. Members of the CDHA Partners’ Circle recognize the important role dental hygienists play in the overall oral health team. We are extremely proud to announce the members of the CDHA Partners’ Circle for 2013.
Oh Canada! Volume 1 Issue 428
FEATURE
Non Injectable Local Anesthesia (NILA) for Periodontal Debridement: A Review and Discussion for Subgingival Application by Dani Botbyl, RDH • [email protected] (Part 1 of a 2 part series)
to have an up to date understanding of non injectable local anesthetics (NILA) for maximum effectiveness and safety. This article, presented as a two part continuum, will examine the classifications, formulations, maximum recommended dosage (MRD) and dosage control of NILA. It will also explore considerations specific to subgingival application.
Classifications and FormulationsIn dentistry, local anesthesia is classified as either ester type or amide type compounds. Today, all injectable anesthetics, available in cartridge form, are amides.³ Those not for injection, are available in amides or esters and depending on the manufacturer and application methods that include traditional mucosal delivery (non subgingival) or subgingival delivery. (See figure 2).
EstersFor intraoral use, benzocaine and tetracaine are the most common compounds found within the ester classification. Products can be purchased in various formulations including gels, liquids, sprays, creams, ointments
and patches. Familiar brand names include Hurricane, Cetacaine, Ultracare and Topex. Practitioners should consult each manufacturer to determine if traditional supragingival “topical” applications or non injectable subgingival applications are available. (See figure 3).
Benzocaine has effective concentrations in dentistry at 6–20%. A 2% concentration is recommended for topical applications of tetracaine. Tetracaine is the most potent, not for injection, dental anesthesia; excessive doses and too frequent administration should be avoided. Tetracaine is typically used in combination with other drugs; some products include combinations of two or more drugs as this can provide a much more useful range of anesthesia to any of the individual drugs acting alone.³
Figure 1
Figure 3
IntroductionOral health professionals have long used local anesthetic in conjunction with non surgical periodontal debridement with an objective to achieve maximum clinical outcomes while providing optimal patient comfort. For decades, clinicians have been using either injectable or topical anesthesia when pain control
is needed for scaling and root planing procedures. The use of “topicals” in this instance has been especially alluring as the needle free anesthesia without the classic numbing effects of injectable anesthesia is extremely desirable for the clinician and the patient.1,2 However, the traditional topical application of local anesthetics often fails to provide the effect needed to carry out debridement procedures comfortably. To improve clinical effectiveness, manufacturers have recently expanded the delivery methods of local anesthetics beyond traditional topical and injectable applications. Clinicians now have options to choose products that allow for the placement of local anesthesia drugs directly into periodontal pockets. In these instances, a blunt tipped canula, not a needle, is indicated as the “non injectable” local anesthetic is placed in a sulcus or pocket to be systemically absorbed. (See Figure 1). With the abundance of product choices now available, it is important for practitioners
Figure 2
Local Anesthesia in Dentistry today
LocalAnesthesia
Amide
Non-Injectable
Non-Injectable
Delivery:Mucosa, not subgingival
Injectable
Delivery:Subgingival
Delivery:Mucosa, not subgingival
Delivery: Subgingival
Ester
Oh Canada! Volume 1 Issue 4 29
FEATURE
Cetacaine (Cetylite Industries Inc.) and Hurricane (Beutlich Pharmceuticals LLC) are available as a traditional topical local anesthetic and for subgingival placement. Cetacaine is an example of a combination ester type and contains 14% benzocaine, 2% tetracaine and 2% butamben. According to the product insert, Cetacaine is “a topical anesthetic indicated for the production of anesthesia of all accessible mucous membrane except the eyes.” Although the product is not specifically indicated for application in periodontal pockets during periodontal debridement, with the Cetacaine liquid kit, the manufacturer provides armamentarium and instructions for subgingival delivery and indicates that the maximum dose when using the syringe provided is 0.4 ml per office visit.4 Recently, from the makers of Hurricane, HurriPak has become available in Canada. Hurripak is a liquid containing 20% benzocaine; it comes in a jar and is packaged with disposable syringes and plastic tips that allow placement of the liquid into the periodontal pocket. The maximum recommended dose of HurriPak is 3 ml.5
AmidesFor those preferring amide type compounds, lidocaine or lidocaine and prilocaine, eutectic mixtures are available. Effective concentrations in dentistry are 2–5%. As with the esters, the purpose of the combination of drugs is to enhance clinical effectiveness. Amide products for intraoral use can be purchased in ointments, sprays, gels, liquids and liquid gel—liquid at room temperature, gel at body temperature. (See figure 4.)
For practitioners wanting an amide packaged with armamentarium for subgingival application, choice is more limited than within the ester classification. Available in Canada since 2010, and specialized for subgingival application is Oraqix (DENTSPLY Pharmaceutical), a thermosetting liquid gel containing 2.5% prilocaine and 2.5% lidocaine that is packaged
in a 1.8 g cartridge. In addition to providing excellent tissue anesthesia and occasional pulpal anesthesia, this system has wide margins of safety, a known maximum safe dose and easily quantified volumes dispensed due to its packaging in cartridge form.³ According to the product monograph MRD of Oraqix is 5 cartridges.9 With the exception of Oraqix, all NILA products used intraorally— including those that are packaged with armamentarium for subgingival application—carry indications for general use on all accessible mucous membrane. Oraqix is indicated specifically for application in periodontal pockets for moderate pain during scaling and/or root planing9 and has received Health Canada approval for this indication.
Adverse EffectsAdverse effects may result from hypersensitivity or allergy. Esters are associated with a higher incidence of allergic reactions but allergies to amides have been described as virtually unknown.7 More often, adverse effects are dose related, caused by excessive dosage or rapid absorption of the drug. Products void of an exact indication for use in periodontal pockets may require greater deliberation to ensure maximum effectiveness and safe practice.
The next article in this series will cover adverse effects in more detail as it examines maximum recommended dosage (MRD), dosage control and considerations specific to the subgingival application of NILA.
References1. Milgrom P, Coldwell SE, Getz T et al. Four dimensions of fear
of dental injections. J Am Dent Assoc. 1997;128:756–66.
2. Crawford S, Niessen L, Wong S, Dowling E. Quantification of patient fears regarding dental injections and patient perceptions of a local non-injectable anesthetic gel. Compend Contin Educ Dent.. 2005;26 (2 Suppl 1):11–14.
3. Bassett KB, DiMarco AC, Naughton DK. Local anesthesia for dental professionals. Pearson. New Jersey. 2010.
4. Product monograph for Cetacaine liquid. revised 7/09.
5. Beutlich Pharmaceuticals HurriPak Drug Facts.. Waukegan, Illinois. Date of publication unknown. Source: www.beutlich.com/documents/hurripak/hurripak_drug_facts
6. Malamed SF. Handbook of Local Anesthesia. 5th Edition. Mosby, St. Louis, 2004.
7. Yagiela JA. Safely easing the pain for your patients. Dimensions. 2005;3(5);20-22.
Product mongraph PART I: Health Professional InformationSUMMARY PRODUCT INFORMATIONRoute of Administration
Dosage Form / Strength
All Non-medicinal Ingredients
Topical Periodontal Administration
DO NOT INJECT
Gel / Lidocaine 25 mg/mL; Prilocaine 25 mg/mL
Hydrochloric Acid, NF, Ph Eur
Poloxamer 188, purified
Poloxamer 407, purified
Purified Water, USP, Ph Eur
INDICATIONS AND CLINICAL USEAdultsORAQIX® (Lidocaine and Prilocaine Periodontal Gel) is indicated for topical application in periodontal pockets for moderate pain during scaling and/or root planing.ORAQIX® should NOT be injected.Geriatrics (> 65 years of age): There are limited data available on the use of ORAQIX® in the elderly. Greater sensitivity of some older individuals cannot be ruled out. Caution is advised in dose selection for the elderly (see WARNINGS and PRECAUTIONS, Special Populations, Geriatrics).Pediatrics (< 18 years of age): ORAQIX® is not recommended to be used in children (see WARNINGS and PRECAUTIONS, Special Populations, Pediatrics).CONTRAINDICATIONSORAQIX® (Lidocaine and Prilocaine Periodontal Gel) is contraindicated:• in patients with a known history of hypersensitivity to local
anesthetics of the amide type or to any other component of the product;
• in patients with congenital or idiopathic methemoglobinemia
WARNINGS AND PRECAUTIONS
ORAQIX® (Lidocaine and Prilocaine Periodontal Gel) must not be injected. ORAQIX® (Lidocaine and Prilocaine Periodontal Gel) should not be used with standard dental syringes.
GeneralAllergy: Allergic and anaphylactic reactions associated with lidocaine or prilocaine can occur. These reactions may be characterized by urticaria, angioedema, bronchospasm, and shock. If these reactions occur they should be managed according to standard clinical practice.Methemoglobinemia: Prilocaine can cause elevated methemoglobin levels particularly in conjunction with methemoglobin inducing agents. Methemoglobinemia has also been associated with amino- or nitro-derivatives of benzene e.g. aniline, dapsone and lidocaine although reports on the link between lidocaine treatment and methemoglobinemia are limited. Methemoglobinemia is well documented in relation to prilocaine and lidocaine combination treatment and correlated with exposure to prilocaine and the plasma levels of its metabolite o-toluidine.Patients with glucose-6-phosphate dehydrogenase deficiency or congenital or idiopathic methemoglobinemia are more susceptible to drug-induced methemoglobinemia. ORAQIX® (Lidocaine and Prilocaine Periodontal Gel) should not be used in those patients with congenital or idiopathic methemoglobinemia. Patients taking drugs associated with drug-induced methemoglobinemia are also at greater risk for developing methemoglobinemia. Treatment with ORAQIX® should be avoided in patients with any of the above conditions or with a previous history of problems in connection with prilocaine treatment (see DRUG INTERACTIONS, Methemoglobinemia). The development of methemoglobinemia is generally dose-related. Levels of methemoglobin observed after application of the ORAQIX® in clinical trials did not exceed normal values (i.e. <2% of the individual patient’s total hemoglobin). The individual maximum level of methemoglobin in blood ranged from 0.8% to 1.7% following administration of the maximum dose of 8.5 g ORAQIX® (see OVERDOSAGE, Methemoglobinemia). CardiovascularORAQIX® (Lidocaine and Prilocaine Periodontal Gel ) should be used with caution in patients with severe impairment of impulse initiation and conduction in the heart (e.g. grade II and III AV block, pronounced bradycardia) since these subjects may be particularly sensitive to local anesthetics and potential cardiac depression (see also DRUG INTERACTIONS – Antiarrhythmics)
Ear/Nose/ThroatORAQIX® should not be used in clinical situations where it can penetrate or migrate into the middle ear. Tests on laboratory animals (guinea pigs) have shown that a cream formulation containing lidocaine and prilocaine has an ototoxic effect. When the same animals were exposed to the cream formulation in the external auditory canal, no abnormalities were observed. Minor structural damage to the tympanic membrane in guinea pigs was observed when a lidocaine-prilocaine cream formulation was applied directly to the membrane. Care should be taken to avoid excess ORAQIX® from spreading to the oropharyngeal mucosa.Special PopulationsPregnant Women: ORAQIX® should be used during pregnancy only if the benefits outweigh the risks. There are no adequate and well-controlled studies to evaluate ORAQIX® during pregnancy. Animal reproduction studies are not always predictive of human response. Lidocaine and prilocaine cross the placental barrier and may be absorbed by the fetal tissues. It is reasonable to assume that lidocaine and prilocaine have been used in a large number of pregnant women and women of child-bearing age. No specific disturbances to the reproductive process have so far been reported, e.g., an increased incidence of malformations or other directly or indirectly harmful effects on the fetus. However, care should be given during early pregnancy when maximum organogenesis takes place. Nursing Women: Lidocaine and, possibly, prilocaine are excreted in breast milk, but in such small quantities that there is generally no risk to the infant being affected at therapeutic dose levels due to low systemic absorption. Pediatrics (<18 years of age)Safety and effectiveness in pediatric patients have not been studied. Very young children are more susceptible to methemoglobinemia associated with prilocaine treatment and this is related to the development of the enzyme methemoglobin reductase which converts methemoglobin back to hemoglobin. Methemoglobin reductase reaches adult levels at between 3 and 6 months. Geriatrics (> 65 years of age): Of the total number of subjects in clinical studies of ORAQIX®, 7% were aged 65 and over, while 1% were aged 75 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects. Other reported clinical experience has not identified differences in responses between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.ADVERSE REACTIONSAdverse Drug Reaction OverviewThe clinical safety database included 559 subjects, 391 of whom were exposed to ORAQIX® (Lidocaine and Prilocaine Periodontal Gel) and 168 to placebo gel. In a crossover study, 170 patients exposed to ORAQIX® also received an injection of 2% lidocaine with epinephrine. The most frequent adverse reactions in clinical trials were local reactions in the oral cavity. The frequency and type of reactions were similar for ORAQIX® and placebo-treatment patients.The treatment-emergent adverse events observed in three placebo-controlled parallel studies (B1 – B3) are summarized in Table 1. Table 1: Treatment-Emergent Adverse Events for ORAQIX® in placebo controlled parallel studies (B1 – B3) ( 1% and more frequent than placebo)
Adverse EventORAQIX®
n = 169(case, %)
Placebon = 168(case, %)
Application Site Reaction 25 (15) 20 (12)
Headache 4 (2) 3 (2)
Taste Perversion 4 (2) 1 (1)
Accident and/or Injury 2 (1) 2 (1)
Application Site Edema 2 (1) 1 (1)
Respiratory Infection 2 (1) 0 (0)
Allergic Reactions: In rare cases, local anesthetics have been associated with allergic reactions and in the most severe instances, anaphylactic shock (see WARNINGS AND PRECAUTIONS, Sensitivity, Allergy) Allergic reactions were not reported during clinical studies with ORAQIX®. Very rare cases of anaphylactic or anaphylactoid reactions associated with the use of ORAQIX® have been reported.For more details on adverse events reported during clinical trials, see ADVERSE REACTIONS in the Supplemental Product Information.To report a suspected adverse reaction, please contact DENTSPLY Canada Inc. by:Toll-Free Number: (800) 263-1437Fax: (905) 851-9809By regular mail: DENTSPLY Canada Inc.: 161 Vinyl Court, Woodbridge, ON L4L 4A3
DOSAGE AND ADMINISTRATIONDosing ConsiderationsORAQIX® is for TOPICAL USE ONLY. DO NOT INJECT. ORAQIX® should not be used with standard dental anesthetic syringes. Only use this product with the ORAQIX® Dispenser, which is available from DENTSPLY Canada.Conditions where dosing may require adjustment:• In patients who are administered other local anesthetics or
amide type local anesthetics (see DRUG INTERACTIONS).• In elderly patients or those with impaired elimination, dose
selection should be cautious, usually starting at the low end of the dosing range to avoid toxicity due to increased blood levels of lidocaine and prilocaine.
Recommended Dose Typically, one cartridge (1.7 g) or less of ORAQIX® (Lidocaine and Prilocaine Periodontal Gel) will be sufficient for one quadrant of the dentition. The maximum recommended dose of ORAQIX® at one treatment session is five cartridges, i.e. 8.5 g gel containing 212.5 mg lidocaine base and 212.5 mg prilocaine base.If additional local anesthesia is needed in combination with ORAQIX®, please refer to the product monograph of each adjunctive anesthetic. Because the systemic toxic effects of local anesthetics are additive, it is not recommended to give any further local anesthetics during the same treatment session, if the amount of ORAQIX® administered corresponds to the maximum recommended dose of five cartridges.The use of ORAQIX® in children and adolescents has not been assessed and therefore its use is not recommended in patients less than 18 years old.AdministrationApply ORAQIX® on the gingival margin around the selected teeth using the blunt-tipped applicator included in the package, then fill the periodontal pockets with ORAQIX® using the blunt-tipped applicator until the gel becomes visible at the gingival margin. Wait for 30 seconds before starting treatment. A longer waiting time does not enhance the anesthesia. Anesthetic effect, as assessed by probing of pocket depths, has a duration of approximately 20 minutes (individual overall range 14 - 27 minutes). If the anesthesia starts to wear off, ORAQIX® may be re-applied if needed. At room temperature ORAQIX® stays liquid; it turns into an elastic gel at body temperature. If it becomes excessively viscous in the cartridge, the cartridge should be placed in a refrigerator until it becomes a liquid again. When in the liquid state, the air bubble visible in the cartridge will move if the cartridge is tilted.Instructions for application of ORAQIX® using the ORAQIX® Dispenser are provided in the package insert supplied with the ORAQIX® Dispenser.OVERDOSAGEFor management of a suspected drug overdose, contact your regional Poison Control Centre.STORAGE AND STABILITYORAQIX® (Lidocaine and Prilocaine Periodontal Gel) is a liquid at room temperature and transforms to an elastic gel at body temperature in the periodontal pockets. Store at room temperature 15° - 30°C. SPECIAL HANDLING INSTRUCTIONSDO NOT FREEZE. Some components of ORAQIX® (Lidocaine and Prilocaine Periodontal Gel) may precipitate if cartridges are frozen. Cartridges should not be used if they contain a precipitate.Do not use dental cartridge warmers with ORAQIX®. The heat will cause the product to gel.DOSAGE FORMS, COMPOSITION AND PACKAGINGORAQIX® (Lidocaine and Prilocaine Periodontal Gel) is a microemulsion in which the oil phase is a eutectic mixture of lidocaine and prilocaine base in a ratio of 1:1 by weight. This eutectic mixture has a melting point below room temperature, therefore both local anesthetics exist as liquid oils rather than as crystals. ORAQIX® contains poloxamer excipients, which show reversible temperature-dependent gelation. Together with the lidocaine-prilocaine 1:1 mixture, the poloxamers form a low-viscosity fluid system at room temperature and an elastic gel in the periodontal pocket. ORAQIX® is administered into periodontal pockets, by means of the supplied special applicator. Gelation occurs at body temperature, followed by release of the local anesthetics, lidocaine and prilocaine.ORAQIX® is supplied in single-use glass dental cartridges that provide 1.7 g gel (42.5 mg of lidocaine and 42.5 mg of prilocaine). Each gram of ORAQIX® contains 25 mg lidocaine base and 25 mg prilocaine base. The gel also contains poloxamer 188 purified, poloxamer 407 purified, hydrochloric acid, and purified water. The pH of ORAQIX® is 7.5-8.0.Individually blister-packaged cartridges of ORAQIX® are distributed in a carton of 20. Each individual blister package also contains a sterile blunt-tipped applicator. The applicator has a blunt-tip end for ORAQIX® application and a sharp-tip end for piercing the rubber top of the ORAQIX® cartridge. Each blunt-tipped applicator is for single use only. Any unused periodontal gel should be discarded.
Product Monograph is available on request: DENTSPLY Canada Inc.: 161 Vinyl Court, Woodbridge, ON L4L 4A3
Oh Canada! Volume 1 Issue 4 31
Student Scene
Wednesday, November 7, 2012, Niagara Falls, Ontario
It was a day filled with excitement, education and wonderful participation as all of the staff and students of the Niagara College dental programs, including dental hygiene, dental assisting and dental office administration enjoyed the first “Niagara College Student Professional Development Day”. The Americana Resort and Conference Centre graciously hosted our event, with 220 attendees, in Niagara Falls, Ontario.
Staff and students eagerly listened to presentations from the Canadian Dental Hygienists Association, Ontario Dental Assistants Association and Niagara Region Public Health. Our fabulous keynote speaker was Dr. Peter Fritz. Niagara College utilized some of our key industry partners to provide a round robin session for the staff and students. Our generous partners included: Henry Schein, Dentsply, Hu-friedy, 3M, Supermax, Oral Science, PDT, Orascoptic, Synca, Glaxo Smith Kline, LED Dental- Velscope, rdhu and Niagara Region Public Health.
The Niagara College Student Professional Development Day provided a unique learning experience for everyone in attendance. The amount of knowledge and experience gathered from numerous professionals was simply inspiring. Students were given the opportunity to meet peers from every dental program at Niagara College as well as dental professionals in various roles throughout Ontario. Students were treated and spoken to as professionals, and this helped shape a prestigious learning experience.
Above all, the part of the event which impacted me most greatly was the presentation by keynote speaker Dr. Peter Fritz. His presentation included real life experiences, information and advice that any dental practitioner would deem priceless, and his informative and courteous style of speaking stole the spotlight. Not only did Dr. Fritz`s presentation provide valuable information to the audience but his passionate quotes, thoughts and beliefs on how dentistry needs to function were simply inspiring.
The guest speakers touched on almost all elements of the dental profession. One element best taught by the specialists themselves is that of dental supply companies and their products. It is important to be well educated about the instruments, products, and other technologies that dental industry companies provide. With so many dental companies represented, learning about the latest technologies and products was made easy through the round robin style of learning. Technology for oral health professionals is being revolutionized daily and continues to advance. In just ten minutes with vendors, students picked up important information, resources, and product samples. I was particularly impressed by some of the new instruments for dental hygienists that I had no idea existed. The resources and lessons presented in this unique and effective round robin will definitely help me with my future career.
This event was the first of its kind for Niagara College, and I believe that everyone in attendance was impressed. Continuation of this event for future students will serve to provide insightful experiences, allow them to take elements of the real world back into their classrooms and clinical settings, apply their new found knowledge, and enhance their post secondary dental profession career. This event will become an essential tool and a potential part of dental programs within Niagara College, and perhaps, will serve as a model for other post secondary institutions in Canada.
Niagara College Student Professional Development Day Harman Gill, dental hygiene student, Niagara College
Oh Canada! Volume 1 Issue 432
MemberMomentsCongratulations!
➤ Sonya Wallace-DiFranco, owner of CitiPlace Dental & Hygiene was named as a finalist for New Business of the Year by Ottawa Chamber of Commerce.
➤ Shelly Sorensen was elected to the Board of Directors for the Public Health Association of British Columbia.
➤ Elizabeth Mahadeo published a new book: Teddy Gets a Filling. Available on Amazon.com
➤ Jo-Anne Jones was selected by the dental editors of PennWell publications as author of the most important article published in 2012 for the dental profession. Jo-Anne’s’ article, “Sex and oral cancer: What is the connection?” appeared in the April 6 issue of RDH eVillage FOCUS e-newsletter. Her article shares some of the latest statistics regarding a possible connection between the human papillomavirus (HPV) and oral cancer. Read the article.
I’d also like to acknowledge the Canadian Dental Hygienists Association and LED Dental (VELscope) for all they have done to elevate awareness of oral cancer at the national level.– Jo-Anne Jones.
CDHA congratulates the following members for various achievements and honours:
If you know of any deserving CDHA members who should be recognized, please submit details to Angie D’Aoust at [email protected]
THE COLOR RESIN YOU WANT, THE QUALITY YOU DESERVE.Resin 8 Colors from Hu-Friedy
With Hu-Friedy Resin 8 Colors, you can have the best of both worlds— the color resin you want, with the Hu-Friedy efficiency and quality you deserve. Hu-Friedy’s Resin 8 Colors are ergonomic, lightweight and offer a color-coding system based on specific areas of the mouth. Plus, each scaler and curette features Hu-Friedy’s proprietary EverEdge® technology, which keeps the working ends sharper longer.
CDHA is pleased to welcome and profile new member, Courtney Donaldson, RDH, of Perth, Ontario.
Education:Durham College—Level II Dental Assistant Certificate, 2006
CNIH—Diploma in Dental Hygiene, 2009
Employer name and location:Dr. Cripps of West Carleton Dental Centre Carp, Ontario.
Why did you decide to go into dental hygiene?I always had an interest in health sciences. It was either going to be nursing or dental hygiene. After some research, I decided dental hygiene would better suit my lifestyle. After completing the dental assisting program and working in the dental atmosphere, I confimed my decision.
Describe your average work day:An average work day begins half an hour before my first scheduled appointment, tailoring treatment plans and prepping for the day. I have a lot of variety in my day working in a general practice. I can participate in all aspects of the dental office, from front desk to adult/child cleanings, periodontal, sealants and impressions. I’m allowed 60 minutes per adult client which gives ample time to explain treatment plans, and get to know my client.
Greatest professional challenge?My greatest professional challenge so far is building my independent practice. There is a lot of decision making, time, money, dedication and planning involved. It can be a challenge, but rewarding at the same time.
FeaturedNewMemberNew member, Courtney Donaldson, RDH Perth, Ontario • [email protected]
Greatest professional joy?My greatest professional joy is in knowing that I made the correct career choice. I am happy with my decisions and all the people I’ve met along the way. I get joy out of helping people achieve optimum oral health and in sharing dental knowledge.
What truly inspires you?My dad, also a business owner, has always inspired me. Without him I would not be where I am today. My ever evolving career inspires me, knowing that dental hygiene is always changing, and the continued learning involved keeps me researching and learning each day.
Outside of work, loves to: I enjoy spending time with my family, including my little girl, Brooke. I also like to keep active through exercise and jogging.
Favourite quote:“Never tell yourself you can’t, anything is possible and only you can make your dreams come true! Never give up….”
What do you hope to gain from your CDHA membership?I am happy to be a member of the CDHA. I hope to take part in continuing education courses, chat with other independent dental hygienists and attend CDHA 2013 National Conference in Toronto this October.
Oh Canada! Volume 1 Issue 434
PassagesDianne M. Gallagher January 12, 2013
Dianne passed away in Victoria losing a courageous battle with cancer after giving selflessly to her profession for more than 40 years. She was active in dental hygiene education and a strong advocate for the advancement of our profession throughout her career. She held positions on many boards and committees at the local, provincial, national and international levels. She was a past president, Distinguished Service Award recipient and Life Member of CDHA.
Dianne Gallagher made a difference. Through her vision and willingness to share her knowledge, she led the profession to a better place. Dianne will always be remembered as a mentor, colleague and friend. She helped establish the dental hygiene program at Camosun College, pioneered national dental hygiene certification, the scope of practice and competencies, was a warrior for self regulation, and a leader on so many levels for the profession.
A devoted teacher and colleague, Dianne's commitment and dedication to teaching, to learning, to her students and to the development of her profession were an inspiration to everyone who knew her. Her dedication has inspired many dental hygienists across Canada. She has led by example, and through her vision, has challenged dental hygienists to make their personal and professional futures better. She has been a role model to thousands, and has mentored and nurtured the role models of the future.
A mentor to multitudes of students and colleagues and a dear friend to so many, Dianne always brought a joyous passion to everything that she shared freely with others in her work. Her spirit and will to live was always remarkable, and she truly believed that everyone can learn how to dance (and floss)! May her presence in our lives guide us to be good and kind, and strong and courageous.
Dr. Sandra J. Cobban January 11, 2013
Sandy was ever an optimist, a dedicated, focused individual and a fighter. She was diagnosed and treated for cancer in 2004, only to have it return in 2007 during the time she was completing her PhD. Her quest to obtain her PhD while fighting cancer was a demonstration of Sandy’s passion for her studies and the pursuit of higher knowledge. She once said that her oncologist told her that people who have something they are working towards or something that they are continuing to work on, do much better than those who don’t. There’s truth in this because on March 22, 2012, Sandy successfully defended her PhD dissertation and on
June 13, 2012, Sandy proudly walked across the Jubilee Auditorium stage to receive her PhD from the Faculty of Nursing, the first the first non nurse in Canada to achieve that honour.
Sandy is considered a national and international leader and visionary in the dental hygiene profession and was well known for her many years involvement, as an associate professor at the University of Alberta School of Dentistry, and as a researcher, contributor, reviewer and editor of professional journals, including the Canadian Journal of Dental Hygiene. She presented her work in the United States, Australia, Wales, Denmark, The Netherlands, and Korea.
Sandy was a mentor to many who knew her. The past few years of her journey were full of ups and downs, but no matter what, she never gave up on her goal of getting her PhD, contributing to the profession with presentations, publications and committee work as well as living her life to its fullest.
Our heartfelt condolences are extended to both families. Donations in memory of Dianne or Sandy may be directed to the Canadian Foundation of Dental Hygiene Research and Education (CFDHRE) www.cfdhre.ca/makedonation.asp Please include a message in the instruction box to stipulate it is a memorial donation and specify for which individual.
It is with great sadness that CDHA recognizes the recent passing of two long time and committed CDHA members. Their passing is a huge loss to the dental hygiene community.
Oh Canada! Volume 1 Issue 4 35
Research&Resources
PDQ-EvidencePretty Darn Quick (PDQ) Evidence is a new database that provides quick access to high quality health system and public health evidence. It includes systematic reviews and overviews of systematic reviews, primary studies included in those, and structured summaries. The connections between the documents make PDQ-Evidence very easy and quick to search.
For example, each systematic review is linked to all of the studies included in the review—to overviews and policy briefs that include the review and to other systematic reviews that include any of the same studies. There are over 14,000 records in PDQ-Evidence, and include more than 1500 systematic reviews that fulfil basic quality criteria. These numbers are increasing weekly.
Try it out! www.pdq-evidence.org
Sports Mouthguards - Putting a Larger Bite into Injury Prevention Dental hygienists are united in supporting the use of sports mouthguards. CDHA has initiated an advocacy and awareness campaign to promote the recommendations in our recently launched position statement. We encourage your involvement at the community level to promote the use of sports mouthguards. Check out the new CDHA resources available to support these efforts at www.cdha.ca/mouthguards
Downloads:
➤ Quick Q & A on sports mouthguards ➤ Répondez aux questions sur le
protège-dents sportif ➤ Full sports mouthguard information sheet ➤ Protège-dents sportif – Q&R ➤ Sports mouthguard use and care tip
sheet – Do and Don’t ➤ L’usage et le soin du protège-dents
sportif ➤ CDHA position statement on sports
mouthguards ➤ Status of mouthguard policies for
Canadian sporting organizations ➤ politique du protège-dents sportif - des
organisations sportives ➤ Sample sports mouthguard policy for
athletic associations ➤ Protège-dents sportif – exemple
énoncé de prince d’une politique organisationnelle
Introducing Sensodyne® Repair & ProtectPowered by NovaMin®
Think beyond pain relief and recommend Sensodyne Repair & Protect
Sensodyne Repair & Protect is the first fluoride toothpaste to harness patented NovaMin® calcium and phosphate technology to do more than treat the pain of dentin hypersensitivity.
• Repairs exposed dentin*: Builds a robust hydroxyapatite-like layer over exposed dentin and within dentin tubules.1–5
• Protects patients from the pain of future sensitivity*: The hydroxyapatite-like layer is up to 50% harder than the underlying dentin6 and resistant to daily mechanical and chemical challenges.1,6–8
* With twice-daily brushing.
1. Burwell A, et al. J Clin Dent. 2010;21(Spec Iss):66–71. 2. LaTorre G, et al. J Clin Dent. 2010;21(3):72–76. 3. West NX, et al. J Clin Dent. 2011;22(Spec Iss):82–89. 4. Earl J, et al. J Clin Dent. 2011;22(Spec Iss):62–67. 5. Efflant SE, et al. J Mater Sci Mater Med. 2002;26(6):557–565. 6. Parkinson C, et al. J Clin Dent. 2011;22 (Spec Iss):74–81. 7. Earl J, et al. J Clin Dent. 2011;22(Spec Iss):68–73. 8. Wang Z, et al. J Dent. 2010;38:400−410.
TM/® or licensee GlaxoSmithKline Consumer Healthcare Inc. Mississauga, Ontario L5N 6L4
Pin presentation honours New Brunswick membersAnne Supak, NBDHA president
On the occasion of the annual general meeting of the NBCDH on November 3, 2012, the CDHA in collaboration with the president of the NBDHA presented several New Brunswick dental hygiene “pioneers” with an RDH lapel pin and long stemmed rose in recognition of their exceptional contributions and dedication to the dental hygiene profession in the province over the last twenty years.
From Left to right: Mary Peltier / Sharon Milroy / France Bourque / Trudy McAvity / Anne Comeau / Diane Theriault / Christine Robb (absent)
For more information, please visit: www.daldh50.ca
April 26-27, 2013
• Class Reunions• Celebratory Dinner• Continuing Education Courses• Live at 5 Pub Night
Early Bird Registration DeadlineMarch 1, 2013
HALIFAX, NOVA SCOTIA | CANADA | +1.902.494.1674 | DENTISTRY.DAL.CA
Celebrating 50 Years of Graduates!
Dalhousie 50th Anniversary Celebration
My fellow Dalhousie alumni,
In 1963, Marlene Arron, Evelyn (McArthur) Dowman, Laura (Smith) Mailman and Patricia
(Walters) Sampson became Dalhousie University’s inaugural Diploma in Dental Hygiene
graduates from the School of Dental Hygiene.
Since then, more than 1,400 alumni have graduated from this wonderful program. 2013
represents the 50th anniversary of the first graduating class from the School of Dental
Hygiene, and I would like to invite you to celebrate this special milestone with us.
Between April 26 and 27 this year, we will be welcoming our alumni, students, friends, and
current/former faculty and staff to join us for a fun filled weekend in Halifax. This event,
which we have dubbed “DH50,” will feature a “Live at 5” pub night on the Friday evening,
along with a full day of continuing education courses geared toward dental hygienists on the
Saturday, followed by a closing dinner to celebrate all 50 years of our graduates.
We are also encouraging each class to consider getting together for a class reunion, that will
surely be a major highlight of the weekend.
Whether you would like to participate in the CE courses, or just our social and reunion
events, please join us for what will surely be the biggest weekend in the history of the School
of Dental Hygiene. Register online at www.daldh50.ca or by calling 902-494-1674. Anyone
who wishes to donate $50 to help lower student ticket prices will be entered into a draw for a
great prize!
We hope to see you there, and look forward to celebrating with you.
Sincerely,
Prof. Heather Doucette (DipDH’94)
Chair, DH50
ProvincialPost
Oh Canada! Volume 1 Issue 438
FEATURE
Manitoba RDH Support and Study Group Tackles Access to Care by Mickey Emmons Wener RDH, BS(DH), MEd • [email protected]
Impetus and Vision Following decades of dedicated effort, Manitoba achieved its own dental hygiene legislation in 2008. This achievement was ultimately realized by the Manitoba Dental Hygienists Association (MDHA) with support from the Canadian Dental Hygienists Association (CDHA), a political strategist, and a three pronged plan directed towards the Minister of Health, supporters, and dental hygienists themselves. Success was realized and we can now govern ourselves. (see table 1 below)
This legislation significantly opened up the public’s access to care, particularly for underserved populations.
One question remained however. Were dental hygienists ready to tackle new opportunities outside of their traditional private dental practice positions? The College of Dental Hygienists of Manitoba (CDHM) sensed that they were, but believed dental hygienists
could benefit from accurate information regarding the legislation, professional support and a network of others with similar goals. So, in 2010, the CDHM-MDHA Access to Care Support and Study Group was initiated. It was facilitated by Mickey Wener in her position as extended practice program coordinator at CDHM with valuable project assistance from Andrea Fruehm.
The Program Key features of a successful study group were incorporated during the planning phase: a common goal and explicit objectives, use of adult learning principles, a safe collegial learning environment, a small group, agreed upon rules and structure, effective facilitation, regular attendance, scheduled dates, a specific focus for each session, guest experts and time for socialization.1-7 Joint sponsorship with the MDHA allowed for inclusion of business related topics which fell outside of the CDHM’s role.
RegulatoRy RequiRemeNts foR DeNtal HygieNe PRactice iN maNitoBa
Prior to the Dental Hygienists act under the Dental Hygienist act (2008)
Manitoba Dental Association licensure CDHM Registration
No National Dental Hygiene Board Exam (NDHBE) NDHBE for all registrants after initial year
No minimum practice hours 600 practice hours in 3 year period for “practising” registration
Only professional development requirement is annual CPR for those administering local anaesthesia
Annual CPR for practising registrants; self directed continuing competency program (2010)
Onsite supervision by a dentist requiredBy-law allowed RDHs to work in long term care facilities with a dentist’s indirect supervision (2004)Dental hygiene owned practice not allowed
RDH services except for scaling, debridement and local anaesthesia provided independently in any setting. Extended Practice designation allows RDHs with 3000 career hours to provide the above exceptions independently in specified facilities and programs :• Specified facilities: dentist’s office; long term care, hospital,
psychiatric• Specified programs: federal, provincial or municipal
government; University of Manitoba• Additional settings can request approval from the Minister
of Health• Dental hygiene owned practice to serve the specified
facilities and programs allowed
No malpractice insurance $3,000,000 malpractice insurance
One MDA Board representative every 2 years (RDH alternates with an RDA)
Registrar/Executive Director, Council and committees govern the CDHM
Table 1
Oh Canada! Volume 1 Issue 4 39
FEATURE
At Session #1, participants identified their goals and discussed the study group’s purpose, established ground rules and identified possible topics. Potential alternative practice settings were highlighted. To protect sensitive information being shared by RDHs contemplating businesses, a confidentiality agreement was signed; permission to publish was also provided. Using a scale of 1–10 to measure goal motivation, participants’ mean scores were 6.6 for ready; 5.8 for confident, and 3.1 for prepared.
Eleven sessions were held from June 2010 to November 2012, with participation varying from 12 to 16 RDHs who had 3–30 years of experience, predominately in traditional private practices. Each three hour evening session began with an informal time and
participant provided snacks. Discussion was a key component; each session ended with the group collaboratively deciding on the “next step”. Communication and supportive resources were provided via email.
Session #2 – Understanding the Legislation; Identifying Opportunities, Barriers and Unanswered Questions
Session #3 – Understanding the Health Care System and Potential Opportunities (Federal, Provincial, First Nations/Inuit)
Session #4 – Outline for a Business Plan: Women’s Enterprise Centre
Session #5 – Building a Business: Asper School of Business, University of Manitoba. At Session #5, the group decided to focus on the LTC population, an accessible niche market
Session #7 – The Needs and Challenges of Dependent Adults; Caregiver Interview Reports; Guest Panel Questions
Session #8 – Understanding the LTC Environment; Guest Panel
Session #9 – MDHA CE Speaker: Complex Medical Histories and Medical Emergencies; From LTC to the ICU
Session #10 – Caregiver Training: Resources, Presentation and Discussion
Session #11 – Wrap up Dinner, Discussion and Formal Feedback
Emerging Themes ➤ Confusion, and thus inaction, partially stems from
complex legislation that is difficult to interpret, specifically the lack of clarity around accessing all public clients.
➤ Motivated RDHs were keen to branch out, but were not familiar with the intricacies of how facilities and programs operate, and with whom to initiate contact.
➤ Launching a business is daunting and requires a financial and marketing plan, significant preparation, time, and confidence. MDHA and CDHA were valuable sources of information regarding billing codes and insurance coverage.
➤ The public is unaware of the RDH’s role beyond dental practices; however, once informed, the public is interested in our services.
➤ Safe first steps for reaching LTC clients: working with clients who are family caregivers, providing home care for existing private practice clients, shadowing an experienced provider, an existing part time position. Collaborating with each other and other health professionals has the potential to open up interesting opportunities.
➤ Important gaps: 1. all RDHs need help understanding the legislation
and 2. new legislation should address access without
restrictions and scope of practice to support complete independence.
alternative Practice setting options in manitobaLong term care (LTC) home
Hospital
Mental health facility
First Nations community
Government or municipal community health clinic, group home or home care program
Homebound clients with collaborative dentist
School based programs
Mouth guard clinics
Any setting or program approved by the Minister of Health
Participant goals centred around independence and reaching out
To see what opportunities there are for dental hygienists to work ‘outside the box’...
... my specific interest is dental hygiene in a hospital setting.
To start my own mobile dental hygiene business.
Oh Canada! Volume 1 Issue 440
FEATURE
Key Outcomes ➤ RDHs interested in access to care practice opportunities
were identified and supported. A cohesive group of like minded RDHs resulted. Efforts are underway to establish an ongoing, self directed study group.
➤ The overwhelming majority of participants valued the study group, in particular, the group discussions and support, knowledge gained, networking and the resources. The discussions created connections and a comfortable environment to share fears and trial practice experiences.
➤ Key start up issues: ability to start small, knowing who to contact, getting “feet wet” safely, and needing to consider time/money/family obligations.
➤ Significant individual “reality checking” occurred as a result of participating. At the last session, when asked how confident they were that they would achieve their goal—on a scale of 1-10 with 1 low and 10 high— scores ranged from 1–9, with a mean of 5.5, slightly lower than the 5.8 start up confidence. In the end, as one of the business speakers said, “If you want something, you have to go for it”. (see table 2)
➤ Some participants are “holding tight”, keeping their eyes open for opportunity. Five participants are currently working in LTC; several others see homebound clients in collaboration with their employing dentist. Collaboration with one of the guest speakers resulted in a LTC pilot project to employ an RDH oral health coordinator to assess residents’ oral health, make referrals, develop daily mouth care plans and train/coach caregivers.
➤ There was overwhelming appreciation expressed for the opportunity to participate.
References1. Akhund S, Kadir MM. Do community medicine residency
trainees learn through journal club? An experience from a developing country. BMC Med Educ. 2006 Aug. 22;6:43.
2. Lee AG, Boldt HC, Golnik KC, Arnold AC, Oetting TA, Beaver HA, Olson RJ, Carter K. Using the Journal Club to teach and assess competence in practice-based learning and improvement: a literature review and recommendation for implementation. Surv Ophthalmol. 2005 Nov-Dec;50(6):542-48.
3. Hartzell JD, Veerappan GR, Posley K, Shumway NM and Durning SJ. Resident run journal club: A model based on the adult learning theory. Med Teach. 2009 Apr;31(4):e156–61.
4. Deenadayalan Y, Grimmer-Somers K, Prior M, Kumar S. How to run an effective journal club: a systematic review. J Eval Clin Pract. 2008 Oct;14(5):898–911.
5. Price DW, Felix KG. Journal clubs and case conferences: from academic tradition to communities of practice. J Contin Educ Health Prof. 2008 Summer;28(3):123–30.
6. Cave MT, Clandinin DJ. Revisiting the journal club. Med Teach. 2007 May;29(4):365–70.
7. College of Registered Dental Hygienists of Alberta. A Study Club Example Gums R Us Dental Hygiene Study Club: Still Thriving. In Touch [newsletter online]. 2009 January. [cited 2010 June 13] Available from: www.crdha.ca/Portals/0/Newletters/2009/InTouch_Jan09%20Final.pdf
Without this group, I don’t think I would have had the confidence to jump in and start my business.
Manitoba support & study group... cont’d
feeDBack at WRaP-uP sessioN mean score (N = 11) 1 = Poor; 10 = excellent
Ability for group to choose topics and direction 9.0
Ability to openly express yourself and discuss the topic at hand 9.0
Depth of discussion and information provided 8.5
Effectiveness in helping you to meet your personal goals 6.7
Networking with other like-minded RDHs 8.7
Planning and facilitation of the sessions 9.8
Overall effectiveness 8.6
Use of CDHM & MDHA resources 8.8
Table 2
Oh Canada! Volume 1 Issue 4 41
1963 - 2013
Celebrating 50 years of CDHA & 100 years of the dental hygiene profession worldwide
COME CELEBRATE WITH US! vISIT CdHA.CA/2013COnfEREnCE
Oh Canada! Volume 1 Issue 442
Cat (round back out – convex) and Cow (round back in – concave)
Gentle pendulum swing of arm forward (flexion) and back (extension)
Gentle pendulum swing of arm out to side (abduction) and across body (adduction)
Shoulder shrug up down
Close – open fist
Cat Cow
WARM-UP
• Is important to minimize risk of injury
• Is best done at the beginning of the work day
• Is a dynamic mid range movement
• Is performed 4-5 times per movement
• Should always be done on both sides.
4x
repeat
4x
repeat
4x
repeat
4x
repeat
4x
repeat
WorkLifeWellnessCheck out a new guide to health and wellness now available for dental hygienists, and jointly produced by the Canadian Memorial Chiropractic College and the Canadian Dental Hygienists Association. A stretching and warm up resource
guide was developed as collateral material for the third webinar in the series, NMSK fitness care routine. This two page guide will help you remember the stretches and warm up exercises you can use, so your job doesn’t become a pain in the neck!
Oh Canada! Volume 1 Issue 4 43
STRETCHES
• Are important to minimize the risk of injury
• Should always start in neutral position and ensure proper alignment throughout the stretch
• Are slow and controlled movements to end range
• Are held for 30 seconds at end range
• Should feel like a gentle stretch, not extreme or painful – don’t overdo it
• Should always be done on both sides
• Can be done during scheduled breaks, micro-rest breaks and unplanned breaks
• Start every stretch in neutral position.
Consult with your primary healthcare provider prior to beginning any new exercise. Use these exercises at your own risk. Neither the CDHA or CMCC have any liability for injury that may occur as a result of practicing these warm ups and stretches.
Produced by Canadian Memorial Chiropractic College and the Canadian Dental Hygienists Association
Wrist flexors: straight elbow with palm up
Finger press Seated flexion with twist: bend forward and twist to side
Wrist extensors: straight elbow with palm down
Low back side bend: arms behind head and bend at waist
Wrist and hand lower back
30s
hold
30s
hold
30s
hold
30s
hold
30s
hold
Neutral standing Arm across chest
Chest stretch: clasp hands behind back
Neutral sitting Chest stretch: clasp hands behind back and raise arms
Neutral position - seated and standing shoulder and chest
30s
hold
30s
hold
30s
hold
B A
Chin Tuck: pull chin in toward chest and tilt head downwards
Neck side bend Neck upper back stretch (levator scapula muscle): tilt head down and to side
Neck Rotation: turn head to look over one shoulder
Neck side bend: with hand resting on head
Neck upper back stretch: tilt head down and to side with opposite hand hold
Neck
30s
hold
30s
hold
30s
hold
30s
hold
30s
hold
30s
hold
BB AA
Leg cross: bend forward
Front hip flexors: slight knee bend
Front hip flexors:deepest kneebend towards floor, raise arm overhead
Hamstring stretch: don’t lock knee on raised leg
Front hip flexors: more knee bend towards floor
Hips and legs
30s
hold
30s
hold
30s
hold
30s
hold
30s
hold
AB I
B
I
A
Beginner
Intermediate
Advanced
legend
Oh Canada! Volume 1 Issue 444
ContinuingEducationThe annual CDHA Educators’ workshop was held on November 16, 2012, in Ottawa, Ontario. Participants included dental hygiene educators from seven different provinces— British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec, and New Brunswick.
The workshop included presentations by:
➤ Doris Lavoie, BSc, MSc, MSW, CAE, executive director of the National Dental Hygiene Certification Board, who spoke about how the national dental hygiene certification exam is developed.
➤ Laura MacDonald, RDH, DipDH, BScD(DH), Med, who provided instruction, led discussion and facilitated group activities about the entry-to-practice competencies and standards for Canadian dental hygienists.- The afternoon included two panel presentations featuring discussions on:
How to encourage ethical thinking and behaviour Panelists:
➤ Sandy Lapointe, RDH, MA ➤ Kathleen Feres Patry, RDH, Cert. Ad.Ed ➤ Laura MacDonald, RDH, DipDH, BScD(DH), MEd ➤ Fran Richardson, RDH, BScD, MEd, MTS
articulation agreements Panelists:
➤ Sharon Compton, RDH, DipDH, BSc, MA (Ed), PhD ➤ Linda Jamieson, RDH, BA, MHS ➤ Nancy Rose, RDH, BSc
The day concluded with presentations honouring recipients of:
➤ CDHA Oral Health Promotion Award sponsored by Crest Oral-B. Dental hygiene school category Cambrian College, North Bay, ON. Received by Nancy Rose, instructor
➤ CDHA Excellence in Teaching Award sponsored by Dentsply Laura Mac Donald, RDH, DipDH, BScD(DH), Med
➤ CDHA Distinguished Service Award Linda Jamieson, RDH, BA, MHS
➤ CDHA Life Membership Award Lynda McKeown, RDH, HBA, MA
Plan now to attend the 2013 Educators’ Workshop being held on October 3 in conjunction with the CDHA National Conference in Toronto, ON.
Ethics Panel Participants, from left: Fran Richardson, Sandy Lapointe, Kathleen Feres-Patry, Victoria Leck
Sandy Lawlor, CDHA president awarding life membership to Lynda McKeown
Delegates hard at work!
Oh Canada! Volume 1 Issue 4 45
CDHA, in partnership with Hu-Friedy, is pleased to announce member dental hygienists who were awarded Hu-Friedy CDHA Nevi scholarships that amount to $10,000. Both Hu-Friedy and CDHA believe that education involves lifelong learning. This program was instituted to support Canadian dental hygienists continuing their education in a bachelor or master’s program through monetary awards. The recipients were selected on the basis of their academic record, the recommendations of their references and their accompanying essay. A panel of educational experts assessed thirty-seven applications and selected the award recipients.
Salima Thawer, RDH Spruce Grove, AB
Salima earned her diploma in dental hygiene and her bachelor of science in dental hygiene at the University of Alberta, graduating in 2005. Salima is dedicated to serving her community and has volunteered on several boards in the fields of education, health, social welfare and with her faith community. Salima also has volunteer
experience with CDAC, as the CDHA student representative to the dental hygiene education programs committee. Salima’s leadership potential is being developed as she completes her master’s in Public Health at the University of Alberta. Salima plans to inspire other dental hygiene students to explore public health as a career option in her role as instructor at the University of Alberta dental hygiene program, and to contribute to public health and dental hygiene education in countries where oral health is not a priority.
Salima was awarded a scholarship of $4,000 towards her MPH degree.
Shannon Waldron, RDH Maple Ridge, BC
Shannon graduated from George Brown College in Toronto in 1999 with a certificate in dental assisting and in 2001 with a diploma in dental hygiene. She continued her studies at the University of British Columbia, earning her BDSc(DH) in 2010. Shannon then enrolled in the master of craniofacial science program at
the University of British Columbia, and is conducting research on the faculty development needs of competency based dental hygiene programs. Her research explores what is necessary to provide an optimal learning experience for students.
Shannon has volunteered in many capacities, in her faith community and in support groups such as divorce care and Le Leche League. Shannon’s ability to juggle studies, employment, volunteer activities and family emphasize her dedication to the profession. Shannon’s goal is to gain the credentials and expertise required to be an effective instructor at a dental hygiene program.
Shannon was awarded $4,000 to support her master’s studies.
Elizabeth Cavin, RDH Nanaimo, BC
Elizabeth Cavin graduated from Vancouver Community College with a diploma in dental hygiene in June, 1987. She has been president of the Upper Island Dental Hygiene Society and frequently presents
to new immigrants through the Central Vancouver Island Multicultural Society. As part of her studies, she completed a four week immersion program with the First Nations people of the Cowichan area.
Elizabeth chose to return to the University of British Columbia’sdental hygiene degree completion program, and is concurrently earning her diploma as a provincial instructor at Vancouver Community College. Elizabeth’s vision is “to affect change that will promote oral health and access to dental hygiene services for everyone in our society. It is only through self development that dental hygienists will be seen as an integral part of healthcare. Only then can our profession lead the way to a healthier future for all.”
Elizabeth received $2,000 to support her BSc education.
Hu-Friedy CDHA Nevi Scholarship Program
Oh Canada! Volume 1 Issue 446
InterprofessionalCollaboration
Dental Hygienists: Partners In Interprofessional Collaboration For Seamless Care by Kamini Kaura, RDH, BSc • [email protected]
“The eyes are the window to the soul” is familiar to some, but to dental hygienists, the mouth is a window to overall health.1 Recent studies have shown a strong correlation between oral and systemic conditions, indicative of the need for increased collaboration between the medical and dental professions. Interprofessional collaboration between medical and oral health professionals is emerging as a critical component to effective patient centred care.2
The World Health Organization (WHO) and Canadian Interprofessional Health Collaborative (CIHC) define patient centred care as a healthcare approach that engages the patient as a member of the healthcare team when making care decisions, thus ensuring that the patient is at the centre and that the patient’s needs are the first priority.3,4 A scientific study in
2009 discussed the way dental hygienists perceived their role in interdisciplinary collaboration, concluding the necessity of communication, and leadership for effective participation.2 Dental hygienists are not only providing treatment for oral conditions but are constantly on the frontlines of early diagnosis of cases of diabetes, fungal or viral infections and in some cases, severe forms of cancer.2,3
Many conditions affecting the body, including diabetes, rheumatoid arthritis and heart disease, can be linked to gum disease. Gum disease in pregnant woman can be related to premature birth, tooth decay in adults related to possible transmissible infection in children, and similarly viral or fungal infections related to individuals with weakened immune systems.2,3. These correlations place dental hygienists in a great
“Being part of a collaborative team, dental hygienists need to take on more leadership roles, expanding their primary interaction with dentists to increasing communication with other medical professionals, thus providing seamless care to patients.”
Oh Canada! Volume 1 Issue 4 47
position, with a role requiring initiation of communication within the dental team and providing an intervention of “seamless care”.5,6
Regardless of being on the frontlines of public health and no matter how much experience you may have, there is always a first time for everything. Speaking from my own experience, the ability to detect something not “within normal limits” in a patient is not the hard part, it’s communicating with them that the situation may be more serious than it seems or even that there is a concern. This is the first step to ensure the patient is at the centre of our seamless care. The second step is to communicate with the dentist and other oralcare professionals, but how exactly this should be done is not something taught in a class room setting. In a case where I found a suspicious oral lesion on the mucosa of a patient, I paired my knowledge base then with the expertise of the dentist I was working with, and referred the patient to an oral surgeon; the patient was subsequently diagnosed with cancer. All documents from oncologists, radiologists and the oral surgeon were sent back to our office so that further treatment could be amended to ensure appropriate oral care of this patient. This team of health collaborators consisted of an oncologist, a radiologist, an oral surgeon, a dentist and dental hygienist, all working together to provide this patient with the best treatment possible.
Dental hygienists spend the most time with patients of all the dental team members, making our role in interprofessional care even more critical.4 However, the approach we need to take to
achieve this level of care needs to be taught in a practical setting with other health professionals. One such practical program is provided by George Brown College in Ontario, and involves both dental hygiene and nursing students where each educates the other on techniques such as bedside oral care and blood pressure initiatives, both commonly used on an interprofessional level.7 Being part of a collaborative team, dental hygienists need to take on more leadership roles, expanding their primary interaction with dentists to increasing communication with other medical professionals, thus providing seamless care to patients.
References1. Guinn S. Your mouth is a window to your body’s health. Live
Well. October 2011. www.columbian.com/news/2011/oct/17/mouth-your-body-oral-health/
2. Swanson Jaecks KM,.Current Perceptions of the Role of Dental Hygienists in Interdisciplinary Collaboration.. Journal of Dental Hygiene. 2009. www.ingentaconnect.com/content/adha/jdh/2009/00000083/00000002/art00007
3. Canadian Interprofessional Health Collaboration. What is Interprofessional Education? 2009. www.cihc.ca/files/CIHC_Factsheets_IPE_Feb09.pdf
4. World Health Organization. A framework for Action for Interprofessional Education and Collaborative Care. Geneva: 2010. World Health Organization Press.
5. College of Dental Hygienists of Ontario. CDHO Dental Hygiene Standards of Practice. CDHO. Toronto. January 2012.www.cdho.org/reference/english/standardsofpractice.pdf
6. Clovis J, Andrews C, Ryding H, McFetridge-Durdle J, Mann K. Dentistry and Dental Hygiene: Partners in interprofessional education to promote collaborative patient-centred care. Health Canada, April 2007. , http://seamlesscare.dal.ca/pdf/pmp_dentistry-dentalhygiene.pdfS
7. George Brown College. Interprofessional Education. Ontario. www.georgebrown.ca/ipe/presentations.aspx
We’d Love To Hear From You!
We are always looking for authors to submit interesting and informative material to publish in our magazine. Articles are welcome from members, dental industry partners, interprofessional partners, and others. Each issue includes a special FOCUS section on a specific subject, feature articles on a variety of topics as well as regular columns: Dental Hygiene at Home and Away, Work-Life Wellness, Student Scene, Talking Ethics, The Lighter Side, The Business of Dental Hygiene, Interprofessional Collaboration, Member Moments and Provincial Post.
Topics to be featured in this year’s FOCUS section include:
➤ Spring: The Challenge of Continuing Competencies & Portfolios – Deadline April 1
➤ Summer: Preparing for the Silver Tsunami - Working with Senior Populations – Deadline June 15
➤ Fall: Use of Lasers in Dental Hygiene – Deadline September 15
➤ Winter: All Things Perio - Deadline December 15Please review our author guidelines and contact director of marketing and communications, Angie D’Aoust at [email protected] if you are interested in submitting.
Oral Health Canada! eMagazine
Oh Canada! Volume 1 Issue 448
FEATURE
Polished Teeth and Sparkling Gowns: My Experience with Miss Universe Canada by Kylee Jean Apers, RDH BDSc(DH) • [email protected]
A sudden lull in my life prompted me to examine my current hobbies, or lack thereof. Yes, I was working full time, and yes, I had just completed the degree program for dental hygienists at the University of British Columbia. But on finishing my fourth year, I found I had more free time than usual. From high school, I had embraced my pre-requisites for dental hygiene program, and was the youngest dental hygiene graduate in my class. School had always been my priority, but for the time being, I was done.
Modelling was something that had been my childhood fantasy. I remember, as a child, going through my mother’s old belongings and looking at her modelling photos. Whether she was posing
with racquetball equipment in a stylish skirt and top or being crowned Miss Todd Mountain (now called Sun Peaks Mountain in Kamloops, BC) these photos always fascinated me.
There are two mantras that have become very pronounced in my life. The first is “The only limitations you have, are the ones you impose on yourself”. With this in mind I started freelance modelling and coordinated photo shoots. I built a diverse portfolio, and within a year I had signed with Allan International Models of Kelowna, BC.
It was then that I discovered my second mantra, “You never know what doors will open when you start to work towards something.” I was participating in a model and talent search with an agency when I met a scout for the Miss Universe Canada pageant. After discussing my recent graduation and interest in modelling, she suggested I submit an application for the pageant. Having no experience in pageantry, I was reluctant at first. However, as much as it was daunting, it was just as much exciting. Armed with my own determination and the support from family and friends, I began the process of applying and training.
ANNOUNCING … Your chance to shine!CDHA Dental Hygiene Recognition Program 2013
Visit cdha.ca/DHRP for YOUR chance to shine!
Made possible through the contributions of CDHA and its corporatepartners, the CDHA Dental Hygiene Recognition Program (DHRP) isdesigned to recognize the efforts and accomplishments of CDHAmembers including practising dental hygienists and dental hygiene students.Submissions in a variety of categories are now being accepted. Deadline is May 31.
®/MD
®/MD
®/MD
®/MDHEALTHY GUMS. HEALTHY LIFE.®/MD
Oh Canada! Volume 1 Issue 4 49
FEATURE
Once a month, for six months, I attended training for the pageant in Vancouver, BC. Training consisted of etiquette, poise, pubic speaking, and routines that we would have to perform during the pageant. At home, I became very busy finding sponsorship and also raising awareness and funds for the S.O.S. Children’s Villages (to which Miss Universe Canada is affiliated) and managed to raise $1,000 for the foundation.
The pageant itself consisted of two shows: a preliminary competition in which all the delegates participated, and the final show where the top twenty are announced and compete for the crown, Miss Universe Canada. There was also an interview portion that helps make up the total scores. Each delegate is required to have a three minute question/interview session with all sixteen judges. Questions ranged from the candidate’s goals and aspirations, to which woman in history the candidate would become if she had the opportunity. The winner then went on to compete for the title of Miss Universe. Time moved too quickly, and it was soon time to travel to Toronto.
My time in Toronto was a whirlwind of early mornings, late nights, and days filled with rehearsals and choreography. Roommate pairings were hand selected by the director, and my roommate, Marta, and I could not have been better matched. We were shuffled to appearances around the city, bused to
restaurants that hosted us and provided us with delicious meals, and each day practised the routines we would have to do on stage. We were also able to visit a local elementary school and spend the morning speaking to the students. Although the nine days in Toronto were somewhat stressful, I tried to keep in perspective what an amazing opportunity it was to be there in the midst of it all.
Looking back on the event there are so many reasons for me to be grateful. I loved getting to know the other delegates; they were such a high calibre of women—so goal orientated, strong, and diverse. There was no cattiness, just support and encouragement. It was amazing to be a part of the experience with them. Second, the backing I received from my local community was phenomenal. People I didn’t know were so supportive and I am grateful for their kind words. And finally, my name was announced in a four way tie for Miss Congeniality. Being recognized as a positive and encouraging role model, is something I will appreciate and cherish forever.
Photo credit: Allumski Photography
Oh Canada! Volume 1 Issue 450
AssociationinActionBetter Oral Health in Canada’s North: Inuit Oral Health Survey www.hc-sc.gc.ca/fniah-spnia/pubs/promotion/_oral-bucco/index-eng.php
The new Inuit Oral Health Survey (IOHS) shows unacceptably high rates of oral disease in Canada’s Inuit populations living in the North. The results of the survey indicate that in the Inuit population, tooth decay, a chronic disease which is preventable, is two to three times worse than that of other Canadians.
Key survey findings: ➤ High rate of oral disease that is two to three times that of the rest of Canada. ➤ 30% of Inuit reported ongoing pain in their mouths and stayed away from certain types of food due to mouth problems. ➤ 20 times the number of extractions, that are mostly preventable, performed in Inuit adolescents compared to non Inuit adolescents. ➤ 50% of Inuit made a visit to an oral health professional within the last year, in comparison to 74% of non Inuit peoples. ➤ 1 out of 5 Inuit (in the 40 year olds and up category) have no teeth.
iNuit - NoN iNuit comPaRisoNs
age group % with dental cariesmean count of teeth -
How can CDHA contribute to better oral health in the North?The results of the Inuit Oral Health Survey demonstrate an urgent need for changes to oral healthcare in Canada’s North. CDHA embraces a culture that places oral healthcare for all Canadians at the core of its values. Therefore, we are taking action in several areas to facilitate changes in the North.
In November 2012, CDHA placed an ad in the Hill Times calling for changes to dental hygiene legislation in the North. The Hill Times is a publication that reaches 11,500 elected officials and bureaucrats.
Now we are conducting a survey for CDHA members who work in Canada’s North (Northwest Territories, Nunavut, and Yukon). We want to obtain your views about potential changes in the North. Then, we will carry forward a collective message to key decision makers in Northern Canada about the role dental hygienists play in access to care. To ensure your voice is heard, please respond to the survey by March 29.
Help us protect the overall health and well being of Northern Canadians. Northern Canadians deserve access to quality oral healthcare.
Oh Canada! Volume 1 Issue 4 51
How does dental hygiene legislation in the North differ from dental hygiene legislation in the rest of Canada?
NoRtH/soutH comPaRisoN
NoRtHeRN DH legislatioN imPact iN tHe NoRtHsNaPsHot of tHe soutH
(the rest of canada)
No legislation allowing dental hygienists to practice independently.
Decreased choice and access to care for the public.
Dental hygienists can practise independently from a dentist in all provinces except for Prince Edward Island and Quebec.
No mandatory professional liability for dental hygienists.
Decreased protection of the public and dental hygienists in the instance of malpractice.
Dental hygienists are required to have professional liability insurance in all provinces.
No mandatory continuing competencies for dental hygienists.
Compromises the quality of dental hygiene services. There is no mechanism to ensure that dental hygienists are up to date on cutting edge research.
All provinces have mandatory continuing competencies or a quality assurance program.
Dental hygienists cannot administer nitrous oxide, sedate or prescribe antibi-otics (with additional education).
Limited options for clients who experience pain or anxiety.
Dental hygienists in Alberta can administer nitrous oxide and conscious sedation, which helps clients with anxiety and pain with treatment.
No mandatory clinical examination for graduates of non accredited dental hy-giene programs.
The quality of dental hygiene services may be in question.
Graduates of non accredited dental hygiene programs must pass a clinical examination in the provinces of Alberta, British Columbia, New Brunswick, Newfoundland & Labrador, Nova Scotia, Ontario, and Saskatchewan. Graduates of non accredited dental hygiene programs cannot practise in Manitoba or Quebec.
Are You Investing In The Right RRSP?CDHA’s Group RRSP, TFSA Savings and Retirement Program can help you to minimize your tax liability and secure your financial future. Unlike individual RRSPs, you can take advantage of the many unique features of this exceptional group plan.
FEATURES• Personal or Spousal
accounts• Spouses could join as
members• Registered and Non-
Registered accounts• Tax free savings account• No annual, front-end, or
back-end fees• No fees for switching
between funds• Full Portability at any time• And more!
Join Today! Click Anywhere On This Ad To Learn More
Oh Canada! Volume 1 Issue 452
ProfilingTheCDHABoardOfDirectorsWatch for more profiles in upcoming issues
Sophia Baltzis, Dental HygienistDirector from Quebec
Place of work:I am currently working in private practice in my hometown Laval. I have been working with the same dentist and dental team since 2002 when I graduated from John Abbott College.
Education:I graduated from the dental hygiene program at John Abbott College in 2002 and also completed a certificate in dental hygiene at Université de Montreal.
Greatest professional highlight:There is no greater satisfaction than having clients walk into my operatory and saying “I have been looking forward to this cleaning for the past few days! I love seeing you!”
Greatest joy:My younger clients are always the most pleasant! Children are always great to treat because they are very curious to learn, always asking questions!
Greatest challenge:Every client I see can be challenging. Throughout my ten years in the field, I have learned to listen and hear exactly what my client is telling me. I strive to make every client as comfortable as it is possible. It is not easy to deal with a new client who is afraid of any member of the dental team and who refuses treatment because of a previous experience. It takes a lot of patience but with good communication skills the client always leaves happy!
Outside work, loves to:I love spending time with my family and my friends. I have a fabulous nephew and a niece who get the best of me! I enjoy spending time outdoors, hiking and biking in the mountains of Tremblant. I enjoy travelling and try to visit the beautiful city of Paris as often as I can!
Favourite inspirational quote:People will hate you, rate you, shake you, and break you. But how strong you stand is what makes you – Unknown.
Final words:I truly believe that happiness comes from within. It is up to each person to figure out what they want from life- professionally, personally- and figure out a way to get to it!
Oh Canada! Volume 1 Issue 4 53
France Bourque, RDHDirector from New Brunswick
Place of work:Elmwood Dental Centre (private practice)
Education: ➤ Diploma in Health Sciences from
Université de Moncton ➤ Diploma in Dental Hygiene from Cégep
de Trois-Rivières
Greatest professional highlight:Opening my own dental hygiene and consultation business, Protected Smile/Sourire Protégé.
Greatest joy:My 10 year old son, Nicholas Charles.
Greatest challenge:To try to fit all the things I have to do in the 24 hours that I have.
Outside work, loves to:An outdoor enthusiast all year round from hiking on a mountain to snowshoeing. I enjoy summertime at the family cottage boating, clam digging and roasting marshmallows in the fire pit surrounded by my brothers and sisters in law playing on the fiddle, guitar and singing. I enjoy
winter time at the family camp, snowmobiling and sledding with the kids. For downtime I love watching movies, doing puzzles and cross stitch.
Most likely to:Run for election one day!
Favourite inspirational quote:“A life spent making mistakes is not only honorable, but more useful than a life spent doing nothing”.
Final words:It is not only my passion for the dental hygiene profession that has brought me this far in my career. I have to thank my teachers, my peers and most of all my family and friends who have always been so supportive of my dreams and ambitions. All my life I’ve lived to prove this French motto: C’est dans les petits pots qu’on retrouve les meilleurs onguent! So never let anybody tell you that you can’t do the impossible…only you can! I’m so proud to be a dental hygienist and being part of the growth of our profession. I’m just starting to live my dream, what about you?
➤ Popcorn is a dental hygienist’s worst enemy.
➤ Who gets hit on more, waitresses or dental hygienists?
➤ Do all dental hygienists have sketchers’ shape ups?
➤ Is there a factory somewhere that produces amazing looking dental hygienists? #JustSaying.
➤ Dental hygienists brighten the world one smile at a time.
➤ I wonder if dental hygienists take a class on small talk, because they’re very good at it.
➤ I think that a group of musically inclined dental hygienists should get together and start a band called “Incisor Sisters.”
➤ Have you ever considered how your face must look at the dentist’s office under that big light? I respect dental hygienists a lot more now.
➤ The first thing you notice is the teeth and gingival status of those on TV, movies, magazines.
TheLighterSideTwitter comments & questions about dental hygiene & dental hygienists
Oh Canada! Volume 1 Issue 454
DiscountSavings
Exclusive
Simon Chang
Eco Friendly
Designer UniformsDesigner Uniforms
Discount
Savings
Exclusive
Simon Chang
Eco Friendly
A thousand reasons to smile!The random draw winner of the recent DVD Quarterly Subscribe & Win
contest is CDHA member, Denise Ikert of Rosetown, SK. Denise takes
home a $1,000 cash prize courtesy of the DVD Quarterly of Dental Hygiene.
Congratulations Denise and enjoy your subscription!
Oh Canada! Volume 1 Issue 4 55
Online event Ongoing
On demand webinar
Professional Liability Insurance: your best preventive strategy
Free to members
Online
eventComing
SoonOn demand
webinarDietary interventions in a dental setting
$25
Online event April 10 Live webinar
Professional Whitening Solutions: Fact vs. Fiction
$10 (proceeds to www.CFDHRE.ca)
Online event Ongoing
On demand webinar
Let’s get physical! NMSK fitness care routine
$25
Online event Ongoing
On demand webinar
Don’t be a victim of NMSK disorders!
$25
Online
event OngoingOn demand
webinar
What is neuro-musculoskeletal disorder? Am I at risk?
$25
Online event Ongoing
On demand webinar
Getting the most out of your e-CPS
Free to members
Conference Event
October 3-5
Toronto Airport Marriott
CDHA 50th Anniversary National Conference
Online registration opens April
Events listed may be subject to change. Keep checking www.cdha.ca/calendar for any updates.
Plan ahead and participate in the events posted.CDHA Community Calendar
National Dental Hygienists WeekTM Is Coming Soon!
Check CDHA.CA/NDHW for newly added downloads including:
» New Top 10 Oral Health Tips » New Colouring Contest » New Trivia Quiz » New Publicity Tips » New Celebration Ideas
96 Centrepointe Drive - Ottawa, Ontario - K2G 6B1
2013 celebrates 100 years of the profession of dental hygiene and 50 years of CDHA dental hygienists.
