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MAY 2019

Inside this issue ORAL HYGIENE

8 16

Gut Healthy Chairside Conversations Uche Odiatu, DMD; Mahsa Bakhshandeh, RDH

How YouTube Has Made Me a Better Hygienist Irene Iancu, BSc, RDH, CTDP

Biofilm Conquered: Gylcine Power to the Rescue Nancy Miller, RDH, BA

10% Carbamide Peroxide: A Gateway to Oral and Overall Health Susan Woodley, DH, RDH

DEPARTMENTS 5 6

THE SOCIAL MEDIA INFLUENCE

Jillian Cecchini

NEWS

Expansion of Dental Services to Low Income Seniors HPV-Oral Cancer Link

34 DENTAL MARKETPLACE

MAY 2019

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EDITORIAL

The Social Media Influence

Jillian Cecchini Managing Editor

MAY 2019

The influence of social media in modern society is no secret. It's safe to say that most of us are consumed by it. But is this necessarily a bad thing when it comes to our professional lives? Or are these platforms providing us the opportunity to learn and connect with our peers? By now, we are all aware that social media is not just a trend. It has had a tremendous impact on our culture, in business, and on the world-at-large. That being said, I am fully aware that social media can have a negative impact when it comes to our mental well-being. But in this moment, I want to discuss the benefits of social media as a marketing and learning tool within our industry. Without a doubt, social media has become a highly successful business opportunity for many people within multiple industries. Social media marketing in dentistry is often overlooked, but it should be a staple part of the overall strategy. A well-optimized website for the practice and a social media plan on multiple platforms can help build relationships with existing and future patients. It's also proven beneficial for brand awareness. When you think of a particular brand, you can most likely associate that particular brand with a face. This is referred to as a type of influencer marketing. Influencer marketing is described as a form of marketing in which focus is placed on influential people, rather than the target market as a whole on social media. Whether an influencer’s target audience is small or large, an influencer can reach consumers (via their social networks and blogs) that the brand may not be able to.

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Though influencer marketing has officially reached the world of dental, it is not an entirely new concept for the industry. Key opinion leaders (KOLs) have been around for as long as we can remember. They are described as experts whose opinions are valued in a specific industry or area of knowledge, and are listened to by a broader audience. Most companies have KOLs who represent their brand and provide educational or promotional lectures and articles, to help deliver expert knowledge and drive growth within the industry. Unlike influencers, their main communication channel is not social media – though we are seeing a shift to more of an online presence. Compared to KOLs, influencers have an unspecified following. Their followers have a shared interest in the influencer’s lifestyle and personality. People follow them because their content matches their own opinions and likes. On the other hand, KOLs speak to a particular demographic. Their audience values their opinion due to their expertise and experience in the industry. Influencers and KOLs may be different but the main goal is still successfully accomplished. Knowledge is being delivered. Information is being retained. Engagement is at an all-time high. They are providing information that is essential to our professional growth and success. And yes, we are learning this from social media platforms. Even though I’m a millennial, I will leave you with one piece of advice when it comes to social media. In a world of algorithms, #hashtags, and followers, be sure to remember the true importance of human connection.

May 2017

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NEWS

Expansion of Dental Services To Low-Income Seniors A Strong Improvement For Oral Care In Ontario Say Dental Hygienists The Canadian Dental Hygienists Association (CDHA) is applauding a move by the Ontario government to expand dental care for lowincome seniors in the province. The investment of $90 million will see new services provided as early as summer 2019. “We have been advocating on this initiative for years and are very pleased that Premier Ford and Minister Fedeli have now made initial steps to improve access to oral care,” said Ondina Love, chief executive officer of CDHA. “Preventive oral care is often out of reach for low-income seniors without dental benefits. This funding may take pressure off the acute care system by providing access to dental treatments for oral health concerns before they progress to more serious conditions or diseases.” In 2018, CDHA wrote to Premier Ford recommending that

public dental programs for children be expanded to include lowincome seniors. As Love explains, “Every 9 minutes in Ontario someone goes to a hospital emergency room, and every three minutes to a doctor’s office due to dental problems. We are glad to see the Government of Ontario committing to provide oral health care to seniors through mobile services, in public health units, community health centres, and Aboriginal Health Access Centres.” Dental hygienists know that bringing oral health care services directly to the people who need support is an important step in improving both oral and overall health. They look forward to the implementation of this new program in the coming months. For more information, please visit www.dentalhygienecanada.ca.

HPV-Oral Cancer Link Spotlights Health Disparities Among Men An emerging new type of oral cancer in men has increased over the last 15 years. The culprit is human papillomavirus (HPV), and key social factors are contributing to its growth. April was Oral Cancer Awareness Month, and with the ongoing rise in cases of throat cancer linked to HPV, many medical and dental professionals encouraged the public to take measures in an effort to help prevent this form of cancer. The prevalence of oral HPV in men in the U.S is estimated to be more than 11 million—much higher than previously believed. In the case

oralhygiene

of HPV-related throat cancer – which actually surpasses the annual incidence rate for cervical cancer — men outpace women by 4-1. HPV is believed to be the cause of 70 percent of throat cancer in the United States. Approximately 11,000 people, or 4.8 percent who contract the disease, will die from it this year. These cancers are more likely for some racial and ethnic groups, and are also impacted by socioeconomic status. To view the full study, please visit www.amerihealthcaritas.com.

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A NEWCOM Media Inc. Publication

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

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OFFICE: Located at 5353 Dundas Street West, Suite 400 Toronto ON M9B 6H8 Telephone 416-614-5831, Fax 416-614-8861. Oral Hygiene serves dental hygienists across Canada. The editorial environment speaks to hygienists as professionals, helping them build and develop clinical skills, master new products and technologies and increase their productivity and effectiveness as key members of the dental team. Articles focus on topics of interest to the hygienist, including education, communication, prevention and treatment modalities. Please address all submissions to: The Editor, Oral Hygiene, 5353 Dundas Street West, Suite 400 Toronto ON M9B 6H8

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MAY 2019

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ORAL HYGIENE

GUT HEALTHY CHAIRSIDE CONVERSATIONS

Uche Odiatu, DMD Dr. Uche Odiatu is a Toronto area dentist and a professional member of the American College of Sports Medicine. He lectures throughout North America on total patient health.

ant to add some variety to your chairside conversations? Would you like to share cutting edge scientific findings with your patients? Would you like to be seen as a person of influence with a broad knowledge of nutrition and healthy living strategies? “Some patients still see us hygienists as teeth cleaners and aren’t aware of the scope of our education, which includes an intense nutrition component,” says Mahsa. Caution: this article contains foundational strategies to support oral health and total patient health. “All disease begins in the gut” – Hippocrates 300BC How did the first physician who the Hippocratic Oath is named after have such insight into what has only been recently scientifically uncovered? He didn’t have a microscope or access to the National Institute of Health’s groundbreaking initial Human Microbiome Project findings but he proclaimed, “Let food be your medicine and medicine be your food”.

Mahsa Bakhshandeh, RDH Mahsa graduated from Durham College and has been in private practice for nine years. She enjoys travelling and exploring the world, its many cultures, and their variety of wonderful cuisines.

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KEY GUT PLAYERS Mind your guts. Not the outer abdominals but the gut flora on the inside of your belly. You see we live in harmony with over 100 trillion single celled bacteria. Eighty per cent of them live in your digestive tract1 and a recent groundbreaking article in Scientific American reported their influence on our health is shaking the very foundation of

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medicine and nutrition. 2 The bacteria in your gut play an important role in immune system modulation. Three quarters of the cellular constituents of your whole immune system are located in this area. 3 If you want to build the strongest foundation for your immune system, you need to do these things to keep your gut flora in good shape: a) eat 25 to 30 grams of fiber each day (the average North American consumes half that amount). Justin Sonnenburg, PhD and Assistant Professor in the Department of Microbiology and Immunology at the Stanford University School of Medicine reports that fiber is the gut bacteria’s number one choice of nutrition on which all other interactions depend. “The human microbiome is only recently thought to influence health as powerful as your genes.” – SK Mazemanian, PhD, Professor of Microbiology, California Institute of Technology What is the number one influence on the human microbiome? “The food we eat dictates what bacteria grow in our body. And our human microbiome is predominantly (99 per cent) made up beneficial bacteria,”4 says gastroenterologist Robynne Chutkann. What does this have to do with dental patients? Why should we talk food and gut health in its relationship to oral health and overall health? Because the gut flora, our microbiome or our gut garden, play a major role in our immune system health, nutrient absorption, energy levels, and our emotional well-being. MAY 2019

“Our gut microbiome guides our immune system, metabolism & even our mood and behaviour.” – J. Sonnenburg, PhD, Microbiologist Stanford University School of Medicine5 Now you know why food is so important. Our single celled passengers have an intimate relationship with them. Their very survival depends on a regular supply of healthy food. And which health care industry professionals are in charge of the eating apparatus? Is it the chiropodist? Is it the optometrist? The cardiologist? The physiotherapist? No. It is the dental professional - the dental hygienist, the dentist and the dental assistant. We are the care givers of the teeth, the jaw, the muscles of mastication. If people want to be able to break down food, digest it, and absorb it (6000 of our enzymes have bacterial origin)6 , they need optimal masticatory function. Eating, digesting and absorption of nutrients MAY 2019

is one of the most intimate things we do with our environment.

MIC DROP Questions from patients are a good opportunity to share our total health knowledge about the bodymouth connection. Our answers can go beyond the usual: apples and cheese are healthy snacks and be sure to avoid juice and pop. What else can I do between hygiene visits to keep my gums healthy? In the days following a dental hygiene appointment – especially if it is a patient that has not been in for regular hygiene, their soft tissues may feel tender for 24 hours or more after the appointment. For adequate healing, their immune systems need to be in optimal health. We sometimes receive calls from patients asking, “Why were my gums tender after the last cleaning?” We can respond by saying that the healing depends on the

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ability of your immune system to do its job in the healing and repair process. An impeccable diet provides you with the building blocks for healing. Did you know that only five per cent of the population eats the recommended 25g of fiber daily? 7 Our gut flora needs a regular intake of fiber – this is a keystone foundational relationship. This is where our gut bacteria produces short chain fatty acids. Bob Hutkins, PhD, and Food Scientist at the University of Nebraska, claims these are some of the body’s most powerful anti-inflammatory agents. Ian Chapple stated most of the destruction of periodontal structures were from the host and dental professionals need to include host factors when they are creating their treatment plans. 8 Ninety-seven per cent of the population does not eat the recommended amount of fiber. Without this keystone, there will be a poor supply of SCFA’s and nutrients for the gut flora. And the body cannot put

May 2017

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Regular exercise makes your gut bacteria more diverse in their make-up. This adds to the stability and potency, and most of all, keeps pathogens in balance.

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out the fires of inflammation burning in the bodies of our patients. Rollercoaster elevations in blood sugar from poor eating habits promote post-meal dysmetabolism, which support inflammation and disease.9 Scientists now report that chronic inflammation is a major player in most modern degenerative diseases. Isn’t a once-a-year hygiene visit enough? Sixty per cent of the population reports not getting sufficient sleep to feel rested each night. This raises the red flag that “poor sleepers are poor healers”.10 Seventy per cent of the adult population don’t eat a single piece of fruit each day.7 Red flag: less phytonutrients, fiber and antioxidants to help douse the flames of inflammation. Only five per cent of the population exercises regularly.11 Red flag waving: 95 per cent of patients don’t enjoy the anti-inflammatory benefits of exercise. Anyone who doesn’t have healthy lifestyle habits need to think about increasing their hygiene frequency to lower their inflammatory burden.

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I am at a loss. My gums seem to bleed and be tender no matter what I do? Dental hygienists scale, root plane, debride, floss. All these procedures need our patients to have a highfunctioning immune system to recover and heal after our treatments. Seventy per cent of our immune system is located in our GI tract. Our gut flora influences our immune cells. They do this through the TREG cells. This communication can only work well if the gut bacteria are stable and diverse in variety. This communication is facilitated if they haven’t been recently decimated by a recent course of antibiotics. Antibiotics have shown to disrupt a third of a person’s good bacteria and it can take up to a year to bounce back.12 My mouth has become drier over the last year. Should I be worried? Epidemiologist Tim Spector, PhD, who studied 15,000 twins over ten years, said there are many reasons for the human body deteriorating. A number of aging theories exist. He listed the loss of muscle, changing social circumstances but also MAY 2019

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Without adequate sleep, opportunistic gut bacteria can get the upper hand and cause disruption. affirmed the loss of dental integrity and lower amounts of saliva.6 This epidemiologist reported that all other factors accounted for, nutrition and diet stood out as the major factor in influencing the microbiome and its impact on senior’s health. How many times have you heard from patients as they sit down slowly in the chair, “Getting old is not for sissies” or “The golden years aren’t so golden.” By focusing on the importance of maintaining all their teeth and acknowledging the side effects of medicines that cause dry mouth, we can be their health champion. We can encourage them to preserve arch integrity and replace missing teeth, stay hydrated and help them choose OTC products to keep their mouths moist.

SUMMARY TIPS: 1. Eat free range hormone free meat Eating hormone free, free range, antibiotic free meat used to be a very expensive food choice. Gastroenterologist Emaran Mayer, MD, reports that it is rather now seen as a good investment in our overall health, and in particular, our gut health. Antibiotics are fed to aniMAY 2019

mals, as animal growth enhancers have the ability to disrupt our delicate gut flora. 2. Exercise Regularly Regular exercise makes your gut bacteria more diverse in their make-up. This adds to the stability and potency, and most of all, keeps pathogens in balance.13 3. Manage Stress Unmanaged stress also decreases diversity in your gut flora, and therefore, hampers fabrication of the cellular constituents of your immune system. Poorly managed stress or life events that not only rock us emotionally, can thin the mucus lining of our patients stomachs and bring pathogenic bacteria in closer proximity to the general circulation.14 4. Limit Sanitizing and Being Hyper-Clean at Home Limit your use of hand sanitizers outside the operatory. Robynne Chutkan, MD, author of The Microbiome Solution, wrote that part of developing a balanced gut flora means having them less disrupted by our patient’s extreme sanitization practices at home.

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5. Eat More Fruits and Vegetables There is irrefutable scientific evidence that food and its macro and micronutrients can ramp up or dial down inflammation in the body. Vegetables and fruits are loaded with phytonutrients, antioxidants, polyphenols and most of all fiber, which our gut flora need to make SCFA’s – one of the body’s most important anti-inflammatory agents. Health Canada’s brand-new Food Guide makes it perfectly clear – half the plate ought to be fruit and vegetables to enjoy optimal health.16 6. Get A Good Sleep When you’re awake, your body’s repair/recover/rebuild system is running on standby mode. It is only while you’re sleeping that your body launches its powerful offense, where close to 95 per cent of resources are poured into regeneration mode. Without adequate sleep, opportunistic gut bacteria can get the upper hand and cause disruption.15 We encourage patients to reevaluate their sleep habits to ensure they are getting adequate quality and quantity for optimal GI function. 7. Take A Good Probiotic Probiotics are good bacteria and can be found in cheese, yogurt, ke-

May 2017

oralhygiene

fir, sauerkraut, miso soup and assorted vegetables. If consumed regularly they will support optimal gut health and the fortification of an empowered immune system. How about probiotic supplements? Great question. Everyone seems to be interested in this popular supplement. There’s sound scientific evidence for the value of probiotics helping prevent antibiotic associated diarrhea. It is a developing science and many different companies are vying for top of mind in the consumer. Is it for everyday use? In a placebo controlled, double-blind, random assigned study in the Journal of Strength and Conditioning Research (January 2017),17 it looked at 30 hard-driving athletes and showed that probiotic supplementation would help rebuild the first line defense or humoral immune system that gets beaten up from intense training in the winter

months. The athletes who took the probiotic had less respiratory illnesses. The authors went on to say the findings could make a case for the consumption by immunocompromised populations (the very young and the very old) who tend to get sick each winter. There are different formulations and numerous brands available in high-end health food stores, grocery stores and pharmacies. We prefer room temperature stable varieties with multiple strains that are easy to swallow.

Patients enjoy

SUMMARY STATEMENT

on oral health.

and welcome their dental professionals emphasizing total health along with focused attention

Patients enjoy and welcome their dental professionals emphasizing total health, along with focused attention on oral health. Talking nutrition that is relevant to oral health and overall health is within our scope of practice, and lastly, our patients are hungry for it.

References 1. Bermon S et al. “The microbiota: an exercise immunology perspective. Exercise Immunology Review 2015. 2. Scientific American 2015 Special report. Pp S1-S15 3. Campbell SC & Wisniewski P “Exercise is a novel promoter of intestinal health and microbial diversity” October 2016 American College of Sports Medicine Journal. 4. Chutkan R. MD., The Microbiome Solution 5. Sonnenburg J & Sonnenburg E., The Good Gut © 2015 Penguin Books 6. Spector T. Diet Myth: the Real Science Behind What we Eat © 2015 Weidenfeld and Nicolson 7. Greger M MD., How Not to Die © 2015 Flatiron Books 8. Chapple L., Potential Mechanisms Underpinning the nutritional modulation of periodontal inflammation” JADA 2009; 140(2): 178-184 9. O’Keefe J, Bell D., Postprandial hyperglycemia/hyperlipidemia is a cardiovascular risk factor. Am Journal Cardiology 2007;100(5):899-904 10. O’Brien M MD., The Healing Power of Sleep © 2009 Biomed General 11. Chek P., Can Fit Pro Annual Personal Trainer Summit. Toronto August 2018 12. Mayer E., The Mind Gut Connection. © 2016 Harper Collins 13. Clarke SF et al. “Exercise associated dietary extremes impact on gut microbial diversity.” Gut 2014 14. Enders G., Gut: the Inside Story of Our Body’s Most Underrated Organ © 2016 (audio) Brilliance Audio 15. Stevenson S., Sleep Smarter © 2016 Rodale 16. Canada Food Guide. https:/food-guide.canada.ca 17. Michalickova DM et al “Lactobacillus Helveticus Lafti L10 Supplementation Modulates Mucosal.

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MAY 2019

+oin the best Be part of Canada's leading network of dental practices learn more at careers.dentalcorp.ca

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ORAL HYGIENE

HOW YOUTUBE HAS MADE ME A BETTER HYGIENIST

Irene Iancu, BSc, RDH, CTDP Irene Iancu has worked in various specialties including Paedo, Perio, General Practice and Orthodontics. Her goal in her current holistic practice is prevention and maintaining an optimal mind, mouth and body. Irene connects the systemic effects of oral conditions to her clients, while making a change for overall health and wellness. As a Peer and Quality Assurance Mentor contracted by the CDHO, a Clinical and Theoretical Dental Hygiene instructor at Oxford College, and a practicing dental hygienist in Toronto; Irene shares her passion for education with us today in the hopes we can change the lives of our clients and their loved ones.

oralhygiene

ome people look to YouTube for educational videos and others look for entertainment. When you think of YouTube, what is your first instinct? Have you ever thought that YouTube could make you a better clinician? I write articles from a place of experience and I connect with the written word on an emotional level. This piece comes your way because I realized that entertainment and education combined have made me a better clinician, speaker and educator. Some of you may know me from my podcast Tooth or Dare. I’m very fortunate to have a rockstar cohost, Whitney Rose, whom this article is inspired by. Whitney is a registered dental hygienist based in Chicago with a YouTube channel called Teeth Talk Girl. Her main goal is to educate and entertain. She creates videos about the profession of dental hygiene, all while discussing things like the difference between plaque and tartar, flossing tricks for permanent retainers, water flossing, and videos about the day in the life of a dental hygienist. Her videos get tens of thousands of views. Some even hundreds of thousands of views! And who watches these videos you may ask? We do – RDH’s, assistants, therapists, dentists and the general public.

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It’s no surprise that Whitney is well-liked. Knowing her in her “human form” (as Whitney calls it), I better understand how my podcast partner-in-crime is changing the face of dental hygiene and how we educate our clients. I virtually sit down with Whitney aka Teeth Talk Girl, trying to keep our friendship aside and really discuss what inspires her to do these videos. Every week she creates awesome content, which is educational, along with entertaining concepts that inspire us all to bring fun back into discussing topics such as “how to hold your floss” and “what’s the best mouthwash?”. This year, the Canadian Dental Hygienist’s Association and the American Dental Hygienist’s Association joined forces to celebrate dental hygienists and raise awareness for oral health to the public. It’s only fitting that with this new “Put On Your Purple” collaboration from North to South, we highlight the importance of growth and compassion to the profession of dental hygiene. This year, Whitney is one of the winners of the 3rd Annual Heart to Hands Award. This award was presented to her solely due to her contributions to dental hygiene and for uplifting oral health related community activities and extraordinary encounters. Aside from her popuMAY 2019

Whitney is a registered dental hygienist based in Chicago with a YouTube channel called Teeth Talk Girl. Her main goal is to educate and entertain. lar YouTube channel, Whitney goes above and beyond in her community, educating children about oral health, all while wearing a tooth fairy costume. I asked Whitney a few questions for you, the readers, to get to know her better. What inspired you to start this channel? I was inspired to start my YouTube channel because I was waiting for my dental hygiene license to arrive in the mail and I couldn’t wait to start my career as a dental hygienist, especially the patient education part. In the interim, I started making dental hygiene education YouTube videos. I have a background in film and acting, and somehow, MAY 2019

I've found a way to combine my two passions (teeth and videos)! What kind of feedback have you received from RDH’s out there? I’ve had nothing but positive feedback from my viewers! I'm overwhelmed by how positive the response has been. The dental hygiene community is lovely. I've really felt the amazing support and how we all raise each other up. It's absolutely comforting. Has your channel helped you treat clients differently? I definitely hope it has helped me to treat my clients differently. It definitely makes me think about things differently, especially when patients ask the same questions over and over. It’s made me realize that

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there are multiple ways to explain things, which is extremely important. I'm also constantly thinking of video ideas during appointments, in which I feel makes me more attentive to my clients. Do you think your YouTube channel has made you a better clinician? Absolutely! Of course, experience is the number one thing that has made me a better clinician. But coming in at a close second is all of the research I do for my videos. It's like I'm constantly taking personal CE courses without getting any credit! Do your clients see your videos? This is a great question! The first year that I started creating my vid-

May 2017

oralhygiene

My bosses were extremely supportive and they now actually promote my videos to our patients, even when I don't. eos, I didn't even tell my bosses that it was happening. I was very nervous! But then once I wanted to start making videos in the office, I obviously had to bring it up. My bosses were extremely supportive and they now actually promote my videos to our patients, even when I don't. I'm still a little shy about it, believe it or not! A Note From The Editor: I’ve had the pleasure of working with Irene for a couple of years now and I can’t express my gratitude for her support of our publications.

oralhygiene

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She’s an extremely vital resource and her vast knowledge of the profession, and her strong desire to educate, is inspiring to witness. I had the opportunity to meet Whitney this year at the Chicago Midwinter Meeting where we recorded a podcast together (coming soon!) She is a vibrant and intelligent woman whose personality is infectious. Be sure to check out Whitney’s YouTube Channel, Teeth Talk Girl, and subscribe to Irene and Whitney’s podcast, Tooth or Dare. I guarantee you won’t be disappointed! MAY 2019

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*With twice-daily brushing. Always read and follow the label. 1. GlaxoSmithKline Consumer Healthcare. Data on File 207211. 2017. 2. GlaxoSmithKline Consumer Healthcare. Data on File 205710. 2017. 3. GlaxoSmithKline. Consumer Healthcare. Data on File 205697. 2017. 4. Seong J et al. J Dent Res. 2017. 96(Spec Iss A): 1544. 5. Parkinson, CR et al. Am J Dent. 2015. 28:190-6. 6. GlaxoSmithKline Consumer Healthcare. Data on File 205201. 2017. 7. GlaxoSmithKline Consumer Healthcare. GSK Data on File 207212. 2017. 8. Hall P et al. J Dent Res. 2017. 96(Spec Iss A):1541. 9. GlaxoSmithKline Consumer Healthcare. Long-Term Study to Investigate the Effect of Changes in Dentinal Hypersensitivity on Oral Health Parameters. Adapted from RH01897, GSK Data On File. May, 2015. 10. Khan S et al. J Dent Res. 2017. 96(Spec Iss A):1543. Trademarks are owned by or licensed to the GSK group of companies. ©2019 GSK group of companies or its licensor.

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rom a very young age, Meghan had her eyes set on a career in oral health care. Described as an “exemplary professional” and a “natural optimist with a can-do attitude” by colleagues, Meghan is a determined Dental Hygienist with a clear passion for her profession. Just two years into her career, Meghan developed and implemented the Periodontal Program in the dental office in which she was employed. She further challenged herself to learn the duties of the administrative team and take on significant management responsibilities, including recruiting, hiring and training team members, as well as overseeing infection control at two office locations. In addition to her clinical practice, Meghan works as a Practice Management Coach, assisting other oral health professionals in providing their patients with the highest standards of care. When describing the most rewarding aspect of being a Dental

2018 Leaders in Practice presented by dentalcorp

Hygienist, Meghan states, “I love being able to make a difference in patients’ lives and motivating others to value dental hygiene treatment.” For Meghan, “There is nothing more fulfilling than seeing a patient through active therapy, having them return for their re-evaluation, and seeing the difference in their oral health.” Meghan believes passion and excellence in patient care go hand-inhand. “We need to deliver excellent care to achieve excellent results. Dentistry is an ever-changing field, so as a Dental Hygienist, my passion for my profession and excellence in patient care fuel my desire to constantly learn, adapt and grow.”

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MAY 2019

oxic biofilm is enemy number one when it comes to dental diseases. It lurks in a patient’s mouth above and below the gum line. It clings to natural teeth, restorative work, gingival tissue and the tongue, implants and orthodontic appliances. It is very challenging to remove or debride all of the biofilm from the oral cavity. But with a repurposed technology in air polishing, we have a fighting chance as clinicians to thwart it’s destructive path. What we used to consider to be planktonic bacteria floating in crevicular fluid has become a much more complex entity know as biofilm. Bacteria colonize and replicate within their safe environment of a community, held together by a sticky protein matrix known as glycocalyx. The bacteria communicate within this “biome” for their replication and survival. As this biofilm matures and spreads, it can lead to inflammatory processes that manifest as periodontal or caries diseases. Due to the challenging anatomy of teeth and roots, this becomes very difficult to remove with traditional instruments as in the past. Traditional air polishing as done in the past was a cosmetic procedure

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concentrating on removing stain above the gum line. The powder most often used was Sodium Bicarbonate and most clinicians experienced difficulty in using the devices due to discomfort for the patient, messiness and grittiness of the powder, and lack of control of the particle and bacteria laden aerosol. I like to joke that it was like a day at the beach: water washing over you, gritty sand getting in every part of your body and tasting like saltwater! Today a paradigm shift is occurring within air polishing as we now use it to “pressure wash” the patient’s mouth for more complete and quicker removal of the biofilm. This is now considered to be therapeutic, not cosmetic as in the past.1 The secret is in the smaller particle size and type of powder used today and in the devices designed to accommodate this powder efficiently with the proper air pressure. Traditional sodium bicarbonate or aluminum trihydroxide particles are 75-microns and up in size, whereas the newer entrants on the market, glycine or erythritol powders, are 14-25 microns. I compare this size difference to getting sprayed with kosher salt (larger particle) or cornstarch (smaller par-

May 2017

oralhygiene

As a clinician, I debride the soft deposits/biofilm/

Figure 1

loosely adherent stain from all oral surfaces I can access with glycine powder Airflow therapy first.

Figure 2 EMS-Hu-Friedy Handy Premium

ticle). Larger particles would sting and be more aggressive at removing or harming oral structures. Smaller particles can be used on any surface supra or subgingivally, as they are very gentle to structures. Glycine is a nonessential amino acid and is naturally sweet flavored and 25 microns in size. Erythritol is a natural plant sugar and is 14 microns in size. Either powder can be used successfully subgingivally without harming any natural or restorative oral structures. Glycine may have some therapeutic properties as it has been shown to interfere with cytokines produced by the inflammatory process. This cytokine byproduct interferes with collagen production. 2 Erythritol, though a smaller particle, is harder

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and is somewhat more effective at removing stain without harming any of the tooth structures. 3 There are several units that can accept this smaller size particle successfully. Acteon has a portable handheld unit called the Air and Go (Fig. 1) that has interchangeable powder chambers that will accept both large or small size particles. They also have a perio nozzle that is designed to go subgingivally but is made of inflexible metal. Coltene has a tabletop combo unit with an air polisher that will accept the smaller particle but their perio nozzle is also metal. I am most familiar with the EMSHu-Friedy units. Their table top unit has removable chambers so switching powders becomes very easy.

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Their handheld Handy 3.0 Premium (Fig. 2) has both the standard handpiece that can be used around all oral structures supra and subgingivally, as well as a perio handpiece that accepts a disposable flexible nozzle that can be inserted into a sulcus up to 10mm. The handheld unit is very portable and is a good starting point for a lot of practices. I consider it another tool in my toolbox that can be shared when the implant or ortho patient comes in. If the device is not intended for smaller particle use it should not be used as it could clog the device and invalidate the warranty. For those who utilize the Dentsply Prophyjet, this is especially true, since the air pressure in that unit is set higher to impel the bigger size particle recMAY 2019

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ommended for use in that device. Thus, PSI is too aggressive for tender tissues and restorative materials even if glycine could be used. While biofilm gets disrupted with any manipulation within the pocket and on the tooth surface with hand or power inserts, research is showing that the most efficient way to disrupt the biofilm is via what is called Air Flow Therapy, or Guided Biofilm Therapy.4 As a clinician, I debride the soft deposits/ biofilm/loosely adherent stain from all oral surfaces I can access with glycine powder Airflow therapy first. This saves me time, approximately five to ten minutes, as I then follow with my ultrasonic scaler and am not wasting effort scaling soft deposits or invisible biofilm. Research backs up my claim of time savings. 5,6 Any remaining stain is usually mixed in with calculus and as Airflow does not remove hard deposits I need to scale that off anyhow. I suggest that clinicians utilize disclosing solution when learning how to effectively use Airflow Therapy. Disclose half the mouth so the biofilm is visible and practice removing it thoroughly. Then, do the other half of the mouth and disclose to see what you left. This will soon have you more rapidly and efficiently using the device. I use both a stationary saliva ejector resting in the posterior vestibule to gather up excess water, and a HVE suction device in my non-dominant hand (Fig. 3). I follow the Airflow handpiece around the mouth to suction up the aerosol created by the pro-

Figure 3

cedure. This is definitely not a “day at the beach” as very little aerosol/ powder gets outside the mouth. Utilizing Airflow Therapy in your practice will not only save you time that can be spent on other procedures or patient education, it will benefit the patient’s overall health. Research shows GBT removes biofilm more completely and in less time.5,6 Being the practice that offers cutting edge technology is a benefit to patients via value added services, as well as being a marketing tool. The ability to safely and effectively remove biofilm from root surfaces, gingivae, implants, restorative material and orthodontic appliances is definitely a benefit to any practice. Today’s Guided Biofilm Therapy using Airflow Therapy is definitely not your grandmother’s air polishing as in the past!

Utilizing Airflow Therapy in your practice will not only save you time that can be spent on other procedures or patient education, it will benefit the patient’s overall health.

References 1. A Paradigm Shift in Mechanical Biofilm Management. Bastendorf KD et al, Quintessence International 2013 July/August; 44(7): 475-477

4. Graumann S, Sensat M, Stoltenberg J Air Polishing: A Review of Current Literature. J Dental Hygiene 2013; 87:173-180

2. Potential Immune Modularity Role of Glycine in Oral Gingival Inflammation. Schaumann, Teresa et al. Clin Dev Immunol. 2013; 2013: 808367.

5. Wennstrom JL, et al. Subgingival debridement of periodontal pockets by air polishing in comparison with ultrasonic instrumentation during maintenance therapy. J Clin Periodontol 2011; 38: 820-827

3. Davis, K. Erythritol Powder: Its broad implications for oral health. RDHMag 2018 Aug; p 26

MAY 2019

6. Moene R et al. Subgingival plaque removal using a new air polishing device. J Periodontol 2010; 81: 79-88

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Susan Woodley, DH, RDH, Practice Consultant at Dentalcorp Susan Woodley is a Registered Dental Hygienist and Practice Consultant at dentalcorp. Throughout her career in dental hygiene, Susan has worked across general, orthodontic and pediatric practices. In her previous role as Manager of Professional Education for Philips Oral Healthcare North America, she provided continuing education courses to dental professionals as well as educational programs to dental, dental hygiene and dental assisting students across Western Canada. Susan is a published author and former parttime professor of dental hygiene and dental assisting programs. She and her husband now reside in Kelowna BC. MAY 2019

any dental hygienists, including myself, say they entered this profession to assist clients in developing and maintaining healthy beautiful smiles. It is widely accepted that whitening gels play a significant role in developing those beautiful smiles. According to research from EKWA Marketing (2018) Trends in Teeth Whitening: $11 billion is spent yearly on products or procedures for whitening teeth; $0.9 billion is spent globally on teeth whitening strips every year; 89% of Orthodontists received teeth whitening requests; 99.7% of people believe that an attractive smile is an important social asset; and individuals are 58% more likely to get a job after whitening their teeth.1 These statistics are testament to the importance our clients place on a whiter smile.

THE WHITENING CONVERSATION Despite these statistics, dental professionals often find the whitening conversation uncomfortable. Perhaps they fear coming across like a

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sales person, or believe if the client doesn’t mention it, they must not be interested. In any case, we dental professionals are in the best position to have these whitening conversations with clients as we are equipped with the necessary evidenced-based information. Our clients are looking for our expertise to help guide their oral health decisions and teeth whitening should be no exception. Having a Smile Evaluation form for all new clients to complete prior to their appointment can be a great conversation starter. This becomes the pathway to learn more about your clients’ wants, which can also translate into an important relationship building opportunity. When clients understand we care about their wants as well as their needs, a trust bond is formed. Additionally, having a Smile Evaluation form specific to recare appointments can be valuable in determining the wants for those we may not have had the opportunity to learn from. It also captures any changes, be it wants or needs, since their last visit.

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Performing a baseline shade assessment is the next step in a comprehensive treatment plan. Ideally, involving the client in this process and having them identify their shade first, allows you a better understanding of how to proceed with your professional recommendations and provide realistic expectations for your client. Managing clientsâ&#x20AC;&#x2122; expectations is a vital component to the conversation. Not everyoneâ&#x20AC;&#x2122;s teeth whiten at the same rate and, in some cases, teeth within the same mouth donâ&#x20AC;&#x2122;t whiten at the same time. Some individual teeth may require more time on task. The use of professional custom trays allows tailoring to those needs when or if this situation presents. The client can simply add whitening gel to the specific wells for teeth requiring more time.Â

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Dental professionals may be surprised to learn that research demonstrates the value of whitening gels in adjunctive therapy for caries risk and soft tissue management.Â Hydrogen peroxide (HP) was first reported for intraoral use in 1913 to decrease plaque formation 2 and has long been the treatment of choice for acute necrotising ulcerative gingivitis 3 and pericoronitis.4Â While initially identified for its therapeutic value, it was later discovered that it had a beneficial side effect of whitening teeth. Over time, whitening became the leader of the story because it received more attention from our clients. 10% carbamide peroxide (CP) is the most thoroughly researched CP formulation and is widely preferred over HP for therapeutic use. Composed of 6.5% urea and 3.5% peroxide, 10% CP is active up to 10 hours in the mouth, while hydrogen peroxide is only active for 30 to 60 minutes. 5 It further removes plaque, kills bacteria and elevates the mouthâ&#x20AC;&#x2122;s pH which results in fewer caries and acts as a tissue healing agent.Â Careful consideration, however, should be taken before whitening gels are introduced in the presence of active caries. CP therapy is recommended for use in the prevention of carious lesions/white spot lesions as well as improving gingival health. Clients that can benefit from this adjunctive therapy include those with special needs where oral healthcare can present manual dexterity challenges; elderly clients; clients with xerostomia; clients undergoing orthodontic treatment; as well as clients who have demonstrated difficulty in maintaining an acceptable level of oral hygiene. Â One method to consider for caries and soft tissue control is a customized, non-scalloped, noâ&#x20AC;&#x201C;reservoir tray, which extends 1 to 2 mm onto the gingival tissue. It should not extend into undercuts to the path of insertion, nor encroach on frenum attachments.6Â Having an extensive background in Orthodontics myself revealed the challenges of home care efficacy

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MAY 2019

Dry Mouth Relief

Figure 3. A nonscalloped tray with no reservoir, trimmed to cover soft tissue 1 millimeter beyond gingival margins.

Figure 1. A fractured tooth and root caries in an elderly patient with arthritis and poor manual dexterity. Figure 2. The patient depicted in Figure 1 has maintained a low level of plaque using a bleaching tray and 10 percent carbamide peroxide gel. The patient also uses the tray as a temporary removable partial denture to hide missing and broken teeth.

and the far-reaching effects that can occur. Extensive white spot lesions and/or multiple carious lesions at the end of treatment too often result. Providing a therapeutic solution for both hard and soft tissue affords a practical option to deal with the problems of oral hygiene during orthodontic treatment. Invisalign trays can also be used for therapeutic healing (hard and soft tissue) as well as whitening teeth. With traditional orthodontics, the use of thermoplastic trays works well. In this technique, the single clear soft tray is heated, softened in warm water that has been initially brought to a boil, then applied to the arch and directly contoured to the teeth by finger pressure. The patient then occludes into the softened tray and applies suction to form-fit the tray to the teeth. After the tray has cooled, the tray handle is then removed, and the tray trimmed to fit. 8 9

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parnellpharm.com BLEACHING PRODEDURE (2) The thicker tray seems to work better over the orthodontic brackets by covering more teeth and shrinking less when heated. (3) The path of insertion of the tray should be from the facial. Try in the tray with the patient before heating to ensure a proper path of insertion and full patient understanding of relaxing their lips. (4) After the softened tray is seated correctly, quickly apply finger pressure on the facial and lingual of the tray to adapt to the gingival areas, starting from the midline and proceeding distally.

MAY 2019

BLEACHING PRODEDURE (5) Instruct the patient to close onto their back teeth, and create suction with their lips. (6) When the tray has completely cooled in the mouth, disengage it from any brackets or wire extensions. (7) Remove the custom-fitted tray that has been made directly in the mouth over the orthodontic brackets.

BLEACHING PRODEDURE (8) Scissors may be used to both shorten any extended flanges, as well as remove the handle from the anterior portion. (9) Once trimmed, the patient will have a smooth comfortable tray for applying the 10% carbamide peroxide that covers the anterior brackets, which also protects the cheeks and provides a comfortable MI occlusion. (10) A thick 10% carbamide peroxide is applied sparlingly in the groove area formed by the brackets.

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Recommending evidence-based products like 10% carbamide peroxide can have a dual effect – both supporting your client’s whitening wants and needs and fulfilling your professional obligations.

A CP professional product that checks all the boxes is one that contains 10% CP, amorphous calcium phosphate and potassium nitrate (5% KN03) for sensitivity management. It protects hard tissue, helps heal soft tissue while managing sensitivity, provides lustre to the teeth and has the added bonus of a whiter smile. As previously mentioned, the multipurpose of hydrogen peroxide extends to soft tissue healing. The known mechanism of antimicrobial action is the release of oxygen, and pathogenic effects that are seen in gram-positive as well as gram-negative organisms.10Another mechanism of antimicrobial action is the effect hydrogen peroxide has on the debridement of bacterial cell walls. The presence of oxygen makes it difficult (if not impossible) for anaerobic bacteria to survive. Long-term bleaching studies involving recare visits have shown that CP application can be continued indefinitely to suppress plaque formation and control caries in patients who have difficulty maintaining acceptable levels of oral hygiene.11

AN EVIDENCE-BASED SOLUTION Knowing that research supports the use of professional whitening gels in adjunctive therapy for caries risk and soft tissue management, we can set aside faulty beliefs that a healthy mouth is necessary before teeth can be whitened. With that mindset, many of our clients would never be candidates for professional whitening and, as a result, prompt them to seek OTC methods or other online solutions lacking research to support their safety and efficacy. As we have seen, whitening gels have tremendous potential to improve oral health with an added bonus of whiter teeth. Recommending evidence-based products like 10% carbamide peroxide can have a dual effect – both supporting your client’s whitening wants and needs and fulfilling your professional obligations. Perhaps your next whitening conversation just became a little easier!

References 1. https://www.oralhealthgroup.com/blogs/trends-teeth-whitening/ 2. Gold SI. Early origins of hydrogen peroxide used in oral hygiene. J Periodontal. 1983;54:247. [PubMed] 3. Farrell GW, McNichols WA. Efficacy of various medicaments in the treatment of Vincent's Stomatitis. JAMA. 1937;108:630–3. 4. Mandel ID. Antimicrobial mouth rinses. J Am Dent Assoc. 1994;125:25–105. [PubMed] 5. Haywood (2007); https://www.dentaleconomics.com/articles/print/volume-100/ issue-1/features/bleaching-and-caries-control-in-the-elderly.html 6. (Haywood 2006, 2007); https://www.dentaleconomics.com/articles/print /volume-100/issue-1/features/bleaching-and-caries-control-in-the-elderly.html 7. https://jada.ada.org/article/S0002-8177(14)64739-5/pdf 8. http://www.vanhaywood.com/uploads/articlespage/2010%20Orthodontic%20 Caries%20Control%20and%20Bleaching.pdf 9. www.vanhaywood.com/uploads/articlespage/2010%20Orthodontic%20 Caries%20Control%20and%20Bleaching.pdf 10. Marshall MV, Cancoro LP, Fischman SL. Hydrogen Peroxide. A Review of its uses in dentistry. J. Periodontol. 1995; 66:786-96. 11. https://jada.ada.org/article/S0002-8177(14)64739-5/fulltext

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FULL-TIME DENTAL HYGIENIST POSITION GREAT SLAVE DENTAL CLINIC 5014 48TH STREET (BOX 2615), YELLOWKNIFE, NT Great Slave Dental Clinic is a busy patient centered Clinic located in the downtown core of Yellowknife. Compensation Package: Hourly Rate: $50 Group Insurance Extended Healthcare Benefits Relocation Airfare to Yellowknife C.E. Course in Edmonton after 1 year Hygienist Office Hours: Monday to Thursday: 9-00AM to 6-00PM; Fridays 8-00AM to 5-00PM Please email or fax resumes to: Dr Roger Armstrong: drrogerarmstrong@gsdental.ca Fax: 867-873-5032 Office

LIBERTY VILLAGE – TORONTO, ON P/T dental hygienist Saturdays. May lead to more days in the week. Located at Downtown King West/liberty village modern offices. Has the best reputation in the neighborhood. E-mail: karl@archdental.ca

EQ U I P M E N T MISSISSAUGA, ON For Sale: Belmont Voyager II dental chair unit, Belmont X-Calibur V dental chair unit, Philips Zoom whitening unit, Sirona Heliodent Plus intra-oral x-ray, Schick digital x-ray sensors sizes #1 and #2, AirStar AS50M compressor, RamVac Bulldog QT vacuum, SolmeteX amalgam separator. Please email: canine_2000@yahoo.com

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CALGARY, AB A well-established dental practice in Calgary is looking to hire an Associate Dentist to join their team of stellar dental professionals who strive to provide the very best care to their patients! About the practice: Full service family practice that provides children’s dentistry, cosmetic dentistry, Invisalign, implants, sedation, along with other forms of traditional general dentistry such as endodontics and extractions. The successful candidate will have a passion for building strong patient relationships and contributing to their ongoing oral health. As an Associate at the practice, you will have the opportunity to work alongside a strong team of dental professionals, learn from the principal dentist, and have access to online continuing education. Requirements: • 2 to 3 years of experience with a broad range of service and skill set including: root canals, extractions, pedo, restorative dentistry and Invisalign • Graduate from an accredited DDS/DMD Program or completion of the NDEB Equivalency Exam • Certified with NDEB • Licensed and in good standing with provincial regulatory body • Valid CPR Certification E-mail: careers@dentalcorp.ca

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MAY 2019

ASSO C I AT ES H I P S GREAT LAKES DENTAL CARE MISSISSAUGA, OAKVILLE, MILTON Associate opportunities for pt/ft. Opportunity for mentorship to learn and grow. e-mail: jungzilla@hotmail.com

BRAMPTON, ON Experienced general dental associate needed ASAP. Must be proficient in root canals, extractions. 2 days/week – Wednesday and Thursday – 10am to 7pm. E-mail: nk490@nyu.edu

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

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

EDMONTON, AB

ROCKWOOD, ON

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

ORTHODONTIC ASSOCIATE WANTED We are a growing office looking for a part-time Orthodontic Associate. Be busy right from start! Flexible days and hours. Busy, well established dental practice looking for a dedicated professional to start immediately. Applicant must obtain a current Certificate of Orthodontics and be in good standing with the provincial licensing of Ontario. Experienced candidates preferred but new graduates welcome. Please e-mail resumes to rwdentist05@gmail.com

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

ORILLIA, ON

CALGARY, AB

Looking for a part time associate.

An Orthodontic Practice located in Calgary, Alberta is looking for a fulltime Orthodontist. Join a team of dental professionals who have 35 years of combined experience specializing in Orthodontics. As an Orthodontist at this practice, you will have the opportunity to work alongside a strong team of dental professionals and will have access to online continuing education.

Please send resumes to dental_2010@live.ca

SCARBOROUGH, ON Busy dental office in Scarborough looking for an associate dentist 2-3 days per week(alternate Saturdays Sept-June). Must have 2+ years experience and be proficient with molar endos and extractions. E-mail: christine@smilesonbrimley.com

E-mail: careers@dentalcorp.ca

DUNCAN, BC

WHITEHORSE, YT

A well-established dental practice in Duncan, British Columbia is looking to hire an Associate Dentist to join their team of stellar dental professionals who strive to provide the very best care to their patients!

A well-established dental practice in Whitehorse, Yukon Territory is looking to hire an Associate Dentist to join their team of stellar dental professionals who strive to provide the very best care to their patients!

The successful candidate will have a passion for building strong patient relationships and contributing to their ongoing oral health. As an Associate at the practice, you will have the opportunity to work alongside a strong team of dental professionals, learn from the principal dentist, and have access to online continuing education.

Requirements:

• Graduate from an accredited DDS/DMD Program or Completion of the NDEB Equivalency Exam

• Certified with NDEB

• Licensed and in good standing with provincial regulatory body

• Valid CPR Certification

E-mail: careers@dentalcorp.ca MAY 2019

www.oralhealthgroup.com

E-mail: careers@dentalcorp.ca

oralhygiene

ASSO C I AT ES H I P S SE CALGARY, AB

ESTEVAN, SK

A well-established Dental Practice located in SE Calgary is looking for a part-time Oral Surgeon to join their team.

(2 hours south of Regina; 15 minutes from US Border)

Full Time Associate Dentist Language: English Education: Graduate degree in Dentistry, NDEB certificate of Canada. Dental School: Graduate of Canadian or American Dental Institutions preferred. Remuneration: Starting Salary $130,000 per year; moving to Commission. 40Hrs/Week. **Benefits Include Extended Medical and Dental Insurance, Performance bonus, Moving Bonus & Housing.

Scotsburn Dental Centre is currently seeking a full-time Associate Dentist to join their team. This position is ideal for the experienced dentist, as well as the new graduate, who is wanting to grow. This 9-chair practice works 5 days a week, with a healthy hygiene program overseen by 3 full-time hygienists; seeing more than 20 new patients a month. The highly trained and experienced support team includes a Treatment Coordinator, Hygiene Coordinator and Dental Therapist. This modern & digital practice utilizes Dentrix software (including charting), along with Recall Max for patient communications. A Practice Coordinator oversees the practice management operations of the office to ensure maximum efficiency and production. Management is assisting the new associate in their transition to Estevan by providing housing if necessary; along with a moving allowance. Remuneration for services provided will initially be in the form of a Salary; graduating to a commission once the associate has stabilized a busy schedule. Scotsburn Dental Centre is thriving, and we are very excited to have a long-term, positive and motivated dentist to join our team. Enjoy a wonderful patient demographic that has been loyal to this practice that was established in 1972; and sold to Dr. Wempe in 1997.

www.scotsburndental.com Contact Darlene Giese, Practice Coordinator | P: 780-953-1713 | E: dentaledge@shaw.ca

PICKERING, ON

VAUGHAN, ON

Associate or Specialist with own patient base required for 2-3 days per week and alternating Saturdays for our dental practice located in Pickering. Please email Michelle@durhamdental.ca

Part-time Orthodontist required for busy Family Dental office in a great location in Vaughan; assistant with ortho experience provided. Fully digital, high-tech office. Email resume to: toothconnectiondental@gmail.com

DOWNTOWN VANCOUVER, BC FULL TIME ORTHODONTIST OPPORTUNITY Work in a state-of-the-art clinic and join an industry leading team. E-mail: careers@dentalcorp.ca

MIDTOWN TORONTO, ON

VANCOUVER, BC Full Time /Part time dental associate needed. Excellent long term opportunity. Please email resume to: smiledoctors1@hotmail.com

CALGARY & AIRDIRE, AB

Part-Time Orthodontist for a wellestablished practice in Midtown Toronto. Looking for a Specialist to join the practice on Fridays. E-mail: careers@dentalcorp.ca

Full time dentist needed in established practice in NE Calgary & Airdrie locations. Full time position available. Excellent long term opportunity. Please submit resume to: smiledoctors1@hotmail.com

TORONTO, ON

THORNHILL, ON

Associate Specialists needed for busy speciality practice. Endodontist needed for 4 days a week permanent position. Oral surgeon needed 1 day per week. Cost share arrangement available for own patient base too. Can start today. Andyc@coradixgta.com

Thornhill dental practice is looking for a Periodontist to work once a month. Please send resumes to: info@coultersmilldental.com

oralhygiene

LOOKING FOR A PERIODONTIST

www.oralhealthgroup.com

This is a great opportunity for someone looking to pick up 2-3 shifts a week for a few hours each shift. This is a very busy practice that is open 7 days a week, so there may be potential opportunity for those seeking more hours. E-mail: careers@dentalcorp.ca

MIDTOWN TORONTO, ON A well-established practice in Midtown Toronto is looking for a Pediatric Dentist to join their dynamic team! E-mail: careers@dentalcorp.ca

NW CALGARY, AB Full-time dentist wanted for busy NW Calgary dental clinic. Successful candidate will take over full patient load from current associate who is leaving to pursue specialization. Excellent interpersonal skills and motivation required! Come and join the best family oriented, friendliest and most flexible dental clinic in Calgary! 2 years experience is preferred but will consider a new grad. Please email in confidence to dent430@outlook.com

CALGARY, AB Well established and progressive NW Calgary practice is seeking a motivated and ambitious dental associate. Full clinical freedom. Excellent support staff and facilities. Patients with a high dental IQ attend this practice, which is mainly non- assignment. Exceptional opportunity for the right candidate. Please email resumes to dev@roicorp.com

NORTH YORK â&#x20AC;&#x201C; TORONTO, ON A growing practice in North York is seeking a part time associate to join the team. Must be proficient and interested in all aspects of dentistry including surgeries, cosmetic dentistry, pediatric dentistry and molar endos. A dedicated individual who is looking to serve the public and learn and grow as a practitioner would be a great fit. Email: ysdental309@gmail.com MAY 2019

ASSO C I AT ES H I P S

NW CALGARY

WEST KELOWNA, BC ASSOCIATE DENTIST NEEDED FT position in a busy, progressive, fun and expanding family practice in beautiful, West Kelowna, BC. Digital x-rays, iTero, CBCT Scanner, electric handpieces and excellent long term staff in a modern, 20 year established, group practice. All dental operatories and staff room have beautiful views overlooking Okanagan Lake and Valley in the center of West Kelowna. Our goal is to work as a team to offer the best dental care to our patients in a supportive and positive environment. We value continuing education and a healthy work/life balance in a four seasons playground. • Graduate from an accredited DDS/DMD Program • Completion of the NDEB Equivalency Exam • Licensed and in good standing with provincial licensing Visit www.carringtondental.ca. Please send resume to Dr. Gary Powell at dentalteam360@gmail.com

ASSOCIATE REQUIRED A well-established dental practice in NW Calgary is seeking an associate for their amazing team of dental professionals who strive to provide the very best service & care for their patients! As an associate with our practice, you will have the opportunity to work together with a strong team, learn from the Principal Dentist and grow a strong community-based practice. The successful candidate will have a passion for cultivating strong patient relationships and contributing to their ongoing oral health. Requirements: • Minimum 2 to 3 years of North American experience with a broad range of service and skill set including: root canals, extractions, pedo, and restorative dentistry. • Excellence in both spoken and written English. • Exemplary soft communications skills are a must. Please forward your CV and a letter of intent to judy@involutioninc.ca in confidence.

PARKSVILLE, BC

LETHBRIDGE, AB FULL TIME PERIODONTIST A specialized Periodontal practice in Lethbridge, Alberta is looking to hire a Peridontist to join their practice on a full-time basis. This is a great opportunity to join a busy and well-established practice that has been serving the community of Lethbridge for the past 15+ years. It is their goal to continue to build partnerships with dentists across Southern Alberta to provide specialized care to each and every patient. Requirements: • Graduate from an accredited DDS/DMD Program or Completion of the NDEB Equivalency Exam

A well-established dental practice in Parksville, British Columbia is looking to hire an Associate Dentist to join their team of stellar dental professionals who strive to provide the very best care to their patients! The successful candidate will have a passion for building strong patient relationships and contributing to their ongoing oral health. As an Associate at the practice, you will have the opportunity to work alongside a strong team of dental professionals, learn from the principal dentist, and have access to online continuing education. Requirements:

• Certified with NDEB

• Graduate from an accredited DDS/DMD Program or Completion of the NDEB Equivalency Exam

• Licensed and in good standing with provincial regulatory body

• Certified with NDEB

• Valid CPR Certification

• Licensed and in good standing with provincial regulatory body

• Interest in progressing into a partner role E-mail: careers@dentalcorp.ca MAY 2019

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

www.oralhealthgroup.com

oralhygiene

ASSOC I AT ES HI P S

AD INDEX

NORTH VANCOUVER, BC

3M Oral Care . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

A well-established dental practice in North Vancouver, British Columbia is looking to hire an Associate Dentist to join their team of great dental professionals who strive to provide the very best care to their patients!

AMD Medicom . . . . . . . . . . . . . . . . . . . . . 22, IBC

Ivoclar Vivadent . . . . . . . . . . . . . . . . . . . . . . . .IFC

Clinical Research Dental . . . . . . . . . . . . . . . . . . 33 dentalCorp . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 GSK – GlaxoSmithKline. . . . . . . . . . . . . . . . . . . 19

McCaughey Consumer Products . . . . . . . . . . . 31 NSK America . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Philips Oral Healthcare . . . . . . . . . . . . . . . . . . . . 4 Premier Dental Products Company . . . . . . . . . 26 Sable Dental Industries . . . . . . . . . . . . . . . . . . . 30

Requirements:

SciCan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

• Graduate from an accredited DDS/DMD Program or Completion of the NDEB Equivalency Exam

Sunstar America . . . . . . . . . . . . . . . . . . . . . . . . 12 VOCO Canada . . . . . . . . . . . . . . . . . . . . . . . OBC

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

WINNIPEG, MB

KINGSTON, ON

Part-time Oral Surgeon opportunity available in Winnipeg, Manitoba. Join a clinic that performs the full scope of oral and maxillofacial surgeries, including the extraction of teeth and wisdom teeth, bone grafting, jaw reconstruction, and the treatment of disorders of the mouth and jaws. The oral and maxillofacial surgery specialists at the clinic are committed to helping their patients achieve good oral health. E-mail: careers@dentalcorp.ca

We are seeking a motivated, full time associate for our busy clinic. We are a quickly growing General and Specialty Dental Practice with a strong support team. Three month guaranteed monthly salary. Email: associatedentistcfd@gmail.com

SPRUCE GROVE, AB Very busy dental practice in Spruce Grove is seeking part time / full time dental associate. Please send your resume to smiledoctors1@hotmail.com

TORONTO, ON Toronto dental office looking for an experienced associate to join our office for Wednesdays and Fridays. Please email resumes to careers@sabharwaldentalgroup.com

oralhygiene

1.5 HR NE OF CALGARY, AB Visiting Orthodontist required for a busy general practice. 1.5 hours North East of Calgary. 1-2 days per month to start with great potential to grow. Open to negotiation for the right person. Contact us at orthodonticreferrals@gmail.com

OTTAWA IS CALLING YOU! Highly reputable, multi-location dental organization privately operated is looking for a full-time Associate. All our facilities are equipped with the latest technology and are paperless. We look forward to meeting you. Email: mladani@7dental.com

www.oralhealthgroup.com

BELLEVILLE , ON Busy non-corporate family practice with sole owner and over 7200 active recall patients seeks a full time associate. Work schedule can accommodate up to 5 days per week. Owner works 4 days per week. No weekends required. Remuneration 45% of billings. Strong communication skills an absolute must. Clinical experience an asset. Newly renovated clinic with great staff and work environment. Immediate start available if suitable. Email: toothdoc911@gmail.com

VAUGHAN, ON We are looking for a part-time associate for one-two days per week in a friendly family dental practice. Please send resumes to vsd.resources1@gmail.com

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

SUDBURY, ON PT Locum/Associate required for busy and established dental office in Sudbury. Excellent support team in place and high new patient flow. Position available immediately. Kindly send your resume to Claudia@smile-express.ca MAY 2019

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