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NOVEMBER 2019
Inside this issue ORAL HYGIENE
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Good Things Come To Those Who Hustle Irene Iancu, BSc, RDH, CDTP
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rdhu Celebrates 10 Years! Kathleen Bokrossy, RDH
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The ‘System’ Of A Dental Hygienist Sherry Priebe, RDH, BDSc, MSc
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Premature Birth: Helping Pregnant Patients Understand The Dangers Of Gum Disease Amanda Tavoularis
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DEPARTMENTS 5
ORAL HYGIENE PRESENTS: THE HYGIENIST HANDBOOK Jillian Cecchini, Managing Editor
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NEWS Dental Hygienists Call For Exemption On Treatment Of Spouses Canada’s Dental Hygienists Elect New President Global Wave Of Ransomware Attacks Hitting Canadian Health Care Facilities
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EDITORIAL
Oral Hygiene Presents: The Hygienist Handbook
Jillian Cecchini Managing Editor
NOVEMBER 2019
As you are all very aware, dental hygienists are educated health professionals who specialize in the promotion of oral health and the prevention of oral diseases. But in the grand scheme of things, you are so much more than that. You are a trusted resource provider. You’re an educator. You’re a professional. You’re more than just a clinician – you’re an advisor. This special Hygienist Handbook, included with the November issue of Oral Hygiene, is intended to be your go-to source for all things related to your dental hygiene career. Though the content published in the issue is non-clinical, the articles are based around very important aspects of your career. The content is intended to help guide and assist you, whether you are just starting out as a new hygienist, or simply just looking for information to enhance your career. In the Hygienist Handbook, we start from the beginning. We’ve recruited some of the industry’s top experts to help shed some light on what it takes to excel. From outlining the rules of your job search, to strategies to help land your dream job, to explaining everything you need to know about contracts and financial ‘tips, tricks and traps’, we’ve got you covered. It has always been Oral Hygiene’s mission to serve dental hygienists with content that is known for the same level of editorial excellence that Oral Health is known for. It is also our mission to en-
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sure that the editorial environment speaks to you, the dental hygienists throughout Canada, as professionals. With our clinical content, we intend to help you build and develop new clinical skills, master new products and technologies, and to also increase your productivity and effectiveness as key members of the dental team. With the Hygienist Handbook, we hope this informative special issue will help you grow, develop and maintain your dream job. As a dental hygienist, most of your time will be working with patients. Your role is solely based on providing a service to others. That being said, it’s essential to remember that your people skills are just as important as your clinical skills. You have the opportunity to educate your patients about the importance of their oral health but you also have the opportunity to build trusting relationships with each patient that sits in your chair. I hope that this special issue helps you be fully prepared for your future as a dental hygienist. I also hope that it helps you to reflect on what you’ve learned so far throughout your career so that you are able to continue to evolve into, and better understand, the most authentic versions of yourselves. One last thing: be sure to read all of the articles in the handbook thoroughly and take the quiz on our website to win an exciting mystery prize. I wish you the best of luck (on the quiz) and throughout your careers! O
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NEWS
Dental Hygienists Call For Exemption On Treatment Of Spouses In response to recent media coverage of an Ontario registered dental hygienist who lost his appeal to have his 5-year licence revocation for treating his wife overturned, the Canadian Dental Hygienists Association (CDHA) is strongly urging the government of Ontario to grant the same exemption for spousal treatment to dental hygienists as they have for dentists. Currently, the professional misconduct provisions of the Regulated Health Professions Act (RHPA) prohibit dental hygienists from providing
dental hygiene services to spouses. Yet, as self-regulated health professionals within the RHPA, dental hygienists are well educated in their ethical obligations regarding the treatment of ALL clients “It is time for government to prevent any further drastic sanctions and hardships for regulated dental hygienists”, states Ondina Love, CEO, CDHA. “The charge in this case brands the individual as a sexual abuser—an unfair characterization of this health care professional.”
Canada’s Dental Hygienists Elect New President The Canadian Dental Hygienists Association (CDHA) is pleased to announce the installation of its new president, Leanne Huvenaars, at its recent national conference in St. John’s, Newfoundland and Labrador. Leanne is from Saskatchewan and joins president-elect Tiffany Ludwicki (Newfoundland and Labrador), past president Tracy Bowser (Prince Edward Island), and directors Rae McFarlane (British Columbia), Alexandra Sheppard (Alberta), Kathy Yerex (Manitoba), Beth Ryerse (Ontario), Fran-
cine Trudeau (Quebec), Wendy Stewart (Nova Scotia), Anne Marie Caissie (New Brunswick), Lana Clow (Prince Edward Island), and Natasha Burian (North) on CDHA’s board of directors for 2019-2020. As president of CDHA, Leanne looks forward to connecting with dental hygienists across Canada and developing a stronger understanding of the challenges and opportunities facing the profession. For more information, visit: www.dentalhygienecanada.ca.
Global Wave Of Ransomware Attacks Hitting Canadian Health Care Facilities A Toronto dentist recently learned that his office’s computer network had been attacked with ransomware. Staff were locked out of digital files for at least a day and had to take notes on paper. The dentist said files on 19 out of the clinic's 22 computers became encrypted. A message left on the infected machines read "Ryuk," identifying the ransomware as the same strain that recently hit three Ontario hospitals and health-care facilities in Alabama and Australia. A recent survey of Canadian organizations found the
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vast majority (88 per cent) experienced a data breach over the last 12 months. It's unclear why Canadian firms are increasingly being targeted but B.C.-based cybersecurity expert Brett Callow has a theory. "It could simply be that the bad actors are broadening their horizons," he said. "They've had a lot of success in the U.S. and now they're trying their luck in other areas." Find the full story: https://www.cbc. ca/news/technology/more-ransomware-canada-1.5317871
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NOVEMBER 2019
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ORAL HYGIENE
GOOD THINGS COME TO THOSE WHO HUSTLE
Irene Iancu, BSc, RDH, CDTP Irene Iancu has worked in various specialties including Paedo, Perio, General Practice and Orthodontics. Her goal in her current holistic practice is preventing and maintaining an optimal mind, mouth and body. Irene connects the systemic effects of oral conditions to her clients, while making a change for overall health and wellness. As a Peer and Quality Assurance Mentor contacted by the CDHO, a Clinical and Theoretical Dental Hygiene instructor at Oxford College, and a practicing dental hygienist in Toronto, Irene shares her passion for education with us today in the hopes we can change the lives of our clients and their loved ones. Irene can be contacted at Irene@toothlifestudios.ca, www. toothlifestudio.ca, IG: @ToothLife.Irene, @Toothlife, @Toothordare.podcast.
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wning my own practice seemed unsurmountable in 2010 when I put together my first business plan. It took me three months to add the lines and numbers into various spreadsheets and when I realized that I didn’t have enough money, time or knowledge about business, I put the welldetailed, colour-coded binder in a storage bin that moved around the city of Toronto with me. As a dental hygienist of seven years at the time, I wasn’t sure if I could do it. I quickly gave up and went back to my weekly grind. At 27 years old I lived with my parents, worked seven days a week and dreamed that one day I could take back control of my dental hygiene practice. I knew back then that something needed to change in my career; my neck started hurting and there were days I laid in bed, staring at the ceiling, contemplating calling in sick to work for no good reason other than I didn’t want to go. Fast forward to October 2018. I’m now happily married and purchased our first modest home in Toronto. I dug up the very outdated binder and scheduled a meeting with my husband Chris, an accountant by training, now working for a large financial institution in tax, wealth and estate planning. I was enlisting
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the assistance of the person whom I’ve trusted my entire life with and now the future of my career. We had a choice to make: renovate our home or open a business. Over 30 days, we relentlessly created an updated version of my 21page business plan. The idea of opening my own practice and how it would operate in my mind was a well-thought out and planned business. Putting my thoughts down on paper was much more challenging than I expected. My business plan wasn’t merely for me but for the institutions I ultimately would approach to seek financing for this venture. With only six per cent of dental hygienists in Canada owning their own practice1, lending/borrowing would still require some convincing to the banks and private lenders. Ironically, when applying for funding from a bank, an independent dental hygienist is categorized in the same group of applicants as dentists, physicians and chiropractors. From my research, I realized that there were a few ways dental hygienists were compiling their business plans and outlining the dayto-day activities of their business. Some were purchasing practices with the equipment in place, some were starting from scratch and purchasing gently used equipment, and NOVEMBER 2019
I had a vision in mind: a state-ofthe-art facility with brand new equipment, space for educational events and a place I could amalgamate all of the aspects of my career in one location, all while providing a high-level of dental services to the patient/clients I had grown over the years. few were opening from scratch and building a brand-new office. Some generated other streams of revenue from chair rental agreements to other hygienists or room rental agreements to other allied health care professionals. Adjacent to mobile dental hygiene clinics, which were a very interesting concept but didn’t quite fit the model I was looking for, I reached out to multiple colleagues (so if you’re reading this – thank you for your insights). The collaborative efforts will help us grow and sharing your experiences is the greatest gift you could have given me. We’ve all had a different start, different planning stages and ultimately different business plans related to opening our own practices. NOVEMBER 2019
Michelle Worton, RDH from Blooming Smiles Dental Hygiene in Fort St. John, BC, said “I am a mother to two incredible young humans and they are my everything. Having a schedule that fit the needs of my family, with a mother that could take the TIME when needed. It injected me into my practice. A practice where my patients feel valued, where they are an extension of a Blooming Smiles family. A culture. A practice where we laugh, we cry, WE bloom.” Beautifully spoken words by a fellow #Perioslayer with a thriving practice, which has recently expanded. Jennifer Michelle Grzebien, RDH of Eternal Smiles Dental Hygiene Studio, said "I started out as a mobile practice in 2015 and have been
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working on growing and tweaking my practice ever since. I am not where I want to be yet but am slowly getting there one day at a time. I still have plans and I don’t think you are ever 100 per cent perfect from the start. Your practice is like an ever evolving being and it grows and changes as you grow, seeing what works and doesn’t, what feels right and what doesn’t quite sit well with you." I had a vision in mind: a state-ofthe-art facility with brand new equipment, space for educational events and a place I could amalgamate all of the aspects of my career in one location, all while providing a high-level of dental services to patient/clients I had grown over the years. Trying to find
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“I am a mother to two incredible young humans and they are my everything. Having a schedule that fit the needs of my family, with a mother that could take the TIME when needed. It injected me into my practice. A practice where my patients feel valued, where they are an extension of a Blooming Smiles family. A culture. A practice where we laugh, we cry, WE bloom” Michelle Worton, RDH Blooming Smiles Dental Hygiene, Fort St. John, BC.
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words to describe how social media, product reviews and dental hygiene services all fit into a practice was an odd thing to relay to the bank. Selling that concept to an institution would be an even greater challenge and I hadn’t heard of anyone doing that just yet. My executive summary was the first statement in my business plan. It’s like a 60 second elevator pitch to a financial institution stating what I do, what I’m looking to build and how much I’m asking to borrow. “An opportunity exists for an ambitious and experienced registered dental hygienists in Ontario to create their own thriving, successful independent practices. Irene Iancu is motivated to open a practice in her own neighbourhood to serve her devoted patient following and provide quality hygiene and education services in a modern setting. We are seeking a financing partner for the purchase of equipment and leasehold improvements for this independent dental hygiene practice, Toothlife Studios Inc., to be opened in East Toronto. Estimated financing required is $250,000.” This was followed by the opening balance sheet detailing working capital, inventory needs, equipment estimates, leasehold improvements and legal costs.
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Subsequently, a section titled “The Opportunity”, which was basically an educational 302-word section educating the financial institution about Independent Dental Hygiene practice. Using statements related to the “Who, What, Where, When, Why and How” dental hygienists are opening up clinics and operating. Still to this day, it is a very new concept to much of the world, despite us having the authority to do this for nearly a decade. The first person at the bank I spoke to was a huge disappointment. Chris and I went into this meeting together after prepping for three days to ensure I knew every word and item line so that we could defend my numbers. Despite sending her this document weeks prior, she didn’t read it, kept questioning my legal ability to open a practice, and then confusingly called me doctor multiple times. If this happens to you, please do not be discouraged. Eventually, we met with a great banker who got it. Not only did he read the overtly detailed document but he Googled me and pulled off some impressive facts that I was shocked he even knew. Not a pitch for the professional department at RBC by any means, but if you’re looking for someone I’ve had sucNOVEMBER 2019
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If you’re looking to open your own practice, start looking at numbers for an entire calendar year, if not more. cess with, that’s where I went.
UNDERSTANDING YOUR GROSS BILLINGS In my final months of private practice, I really started to pay attention to my gross billings daily and the comparisons to the same month, one-year prior to estimated growth percentages. This information would be very helpful not only for my business plan but for my operation of the practice. The reality was that I was working in an established practice operated by a dentist, which was different than a start-up clinic; however, I didn’t want to deviate from those metrics much. I wanted to adopt the “if you build it they will come” mentality but I knew that some efforts would be required to build up my patient base. What I didn’t want to do was discount my work and instead devote the capital to marketing and events. I documented my earnings and gross billings to better understand what the growth potential was for my practice, which was a direct comparison to the work I was already doing in a different practice setting. If you’re looking to open your own practice, start looking at numbers for an entire calendar year, if not more. As we know in dentistry, there are high and low times for billings. Had I only used the metrics from July to November, my business plan projections would NOVEMBER 2019
have been specific to this time of year and likely calculation errors would have presented when my plan was forwarded to the analysts who was involved in plan approvals. It’s essential to create your business plan, plug in your numbers, and over a year or two, keep defending those numbers in your plan. If it doesn’t make sense to you then the bank will tear that plan apart.
ACCOUNTING/LEGAL/ CORPORATE STRUCTURE CONSIDERATIONS There are a few ways to identify the business structure for a practice, which depends on a few variables. Is there a partnership involved? What’s your personal income tax situation and where are you planning on operating? These questions, along with dozens more, were proposed to me when I met with my accountant and lawyer, who both specialize in dental practice corporate structures. No two individuals and practices are alike so I can’t stress enough the importance of working with someone who has successfully set up these structures, specifically for dental professionals. With new practice builds, we knew that HST would be something we would like to recover, which is one of the largest that contributed to my corporate structure. Cost for a specialty accountant/ lawyer = $250-$400 per hour in the
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city of Toronto.
LOCATION, LOCATION, LOCATION! Commercial real estate is also very different than residential. I opted to work with a commercial agent who only deals with the listings related to businesses. She was instrumental in my negotiation of my space, assisted me in navigating tough conversations with my landlord, and ultimately through her experience and negotiation was able to secure me with four months of free rent, while fixturing tens of thousands of dollars of leasehold improvements. The lease agreements are very detailed and having them looked at by a lawyer is very important. My lawyer had closed dozens of dental deals. Yes, his fees were higher than most would expect but his experience was worth the capital. Signing a 10-year lease is a really big deal that shouldn’t be taken lightly and it’s interesting that commercial tenants have fewer rights than residential tenants – so be prepared for those documents. They can be brutal!
CONTRACTORS/SUPPLIERS What’s my greatest weakness? Control. I need it all. I can’t give any of it away and I have struggled with this my entire life (I’m working on it). I was faced with this reality early on and had a really challenging time getting out the words, “I can’t do
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“I started out as a mobile practice in 2015 and have been working on growing and tweaking my practice ever since. I am not where I want to be yet but am slowly getting there one day at a time. I still have plans and I don’t think you are ever 100 per cent perfect from the start. Your practice is like an ever evolving being and it grows and changes as you grow, seeing what works and doesn’t, what feels right and what doesn’t quite sit well with you.” Jennifer Michelle Grzebien, RDH Eternal Smiles Dental Hygiene Studio
this alone”. Despite my only child “I don’t need anyone” mentality, I knew that I needed a team. It’s funny how expectations and reality often don’t align. I had this vision that my father (a civil engineer and an architect) would design my office and together like the good old days flipping houses together, we would enlist the assistance of family and friends in putting up drywall and doing plumbing and electrical work. In the past, we’ve all hammered a nail in a wall but when it comes to building a practice, I’ve learned it’s best to leave it to the professionals. I interviewed three contractors for the job, all very well-known in the industry and all solely work on and build dental practices. Discount construction can serve to be helpful in some cases but in my situation, I was in a time constraint. With only four months of free rent, I knew that I needed someone who would be efficient. By hiring Tripar, the company who is building the space, I not only was given a contractor but also an expert in the dental field. Dave and Lee were instrumental in the selection of equipment, communication with the landlord, and they both involve me every step of the way. I highly recommend using a
company that has a proven track record for successful office buildouts. Yes, they too come at a higher price point per square foot but they definitely make up for it in efficiency, time management and project management. Dave and Lee, along with my suppliers at Patterson, have been in direct communication together to move the project along smoothly and efficiently, which is worth the extra injection. The stress is real, the tears are real, but the moments of accomplishment are the best part. Followed by the little celebrations. I’m sharing this story with you all in real time for those of you that may be considering practice ownership. I’ve been told building a practice is a lot like having a child. In the moment, you remember every painful thing but as time passes, you forget about the struggles and can focus on the good. I can’t defend or deny that, I don’t have children or a practice yet. But I can see how that might be true. To close out the first article in this series, I leave you with a statement that my tennis coach used to say to me: “Lots to think about, nothing to worry about, focus on your game and take it point by point. Hold on to the advantage for as long as you can.” O
References 1.
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https://files.cdha.ca/career/2017-executive-summary-EN.pdf
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Q&A Q&A with Michelle Worton, RDH Blooming Smiles Dental Hygiene Fort St. John, British Columbia Irene: When did you know you wanted to open your own practice? Michelle: In 2015, the entrepreneurial vision began. Why? I’ve always had a passion for health. For wellness. For connection. For beautiful SMILES. My beginning was a shift. A shift in how the delivery of healthcare services can be provided when we recognize the connection between overall wellness and oral health. But that was just the beginning. I am a mother to two incredible young humans and they are my everything. Having a schedule that fit the needs of my family, with a mother that could take the TIME when needed. I injected me into my practice. A practice where my patients feel valued, where they are an extension of a Blooming Smiles family. A culture. A practice where we laugh, we cry, WE bloom. Where our patients know they can leave their worries at the door. Now, it’s not easy. Nothing worth the hurdles and hustle ever is. I wanted to show my children that hard work, dedication and commitment are worth evNOVEMBER 2019
ery single effort. Some days are going to be challenging and those days are worth it. I wanted to show them that they can dream big. That they can accomplish anything they put their minds to. Today. I am grateful. I am fuelled. I chose. There’s always a beginning. I am forever grateful for this beginning. For both the personal and professional journey. The growth. The relationships formed. The connection with the communities. The Blooming Smiles Family. The culture I’ve created. Irene: How long did it take you from the inception of the idea to actually making the motions to open? Michelle: From inception of the idea to the initial satellite practice was four months. What started as a satellite practice has now, almost four years later, grown into an expanding storefront Dental Hygiene Clinic with a growing team of professionals. Irene: In the planning phase, what was the most challenging part for you?
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Michelle: The concept of independent dental hygiene practice in 2015 was completely foreign to our region. The educational component to the inner workings of dental hygiene practice and articulating my passion for this profession, as well as a delivery method of preventative services, posed to be quite a challenge. Ensuring that professional relationships were fostered within the dental community to allow for a smoother integration of independent dental hygiene practice. Irene: What is one thing looking back you wish you had done differently in the planning phase of your practice? Michelle: I can’t place one particular thing I would have done differently. I have learned throughout the process. And still continue to do so. I believe that you make decisions with the best of strategic planning methods, but through trial and error and adaptation phases evolve. O
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ORAL HYGIENE
TRANSFORMING
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RDHU CELEBRATES 10 YEARS!
Kathleen Bokrossy RDH is the president of ‘rdhu’, a professional development company, which provides team events, hands-on programs and online learning (Dental Hygiene Quarterly). Her vision is to help ‘Transform the Dental Hygiene Experience’ for dental hygienists, practices and clients.
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’ve been blessed to have an extraordinary support team of friends, family and colleagues who have helped me with every step of our mission, to help ‘Transform the Dental Hygiene Experience’, for the Clinician, the Client and the Practice. It is with this mission in mind that has led me on my quest to create a platform that helps get dental hygienists engaged, by reminding them of the importance of our profession and to love what they do. By continuing to learn, grow and implement change in our practice, it not only improves our client care; but also, keeps us engaged, allows us to give back while living a fulfilled and happy life! We can all feel ‘stuck’ from time to time, but if one is to truly live their life with intention and make every day matter, by making every appointment unique to that specific client, we can get off the hamster wheel and really make a difference. On Thursday, September 26th, we celebrated rdhu’s 10 Year Anniversary in the most beautiful venue ~ The Rock Gardens, at the Royal Botanical
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Gardens in Waterdown, Ontario. The love and support that was shown that evening absolutely blew me away. I am really thrilled to announce that we re-launched our ever-popular talk show, The RDH View on this night as well! We have two new cast members and are excited to take this show on-the-road. Thank you to our Corporate Partners who helped make this evening happen. Many of you came from quite a distance and we appreciate it so much. The dedication of the people who work for these companies goes above and beyond what is expected of them. It is in part because of their commitment and hard work that helps keep advancements happening in our profession; which in turn, helps us in our every day practice. So, to Bisco, Crest & Oral B, Oral Science, Germiphene, Synca, PDT, WinTerra, OraVital, 3M, Dentsply and Ivoclar Vivadent (who sponsored our photo booth #optragatefun). Thank you from myself, my team and all of our members for your commitment to our profession and for supporting rdhu along the way. We appreNOVEMBER 2019
Thank you from myself, my team and all of our members for your commitment to our profession and for supporting rdhu along the way. We appreciate you, your hard work, your commitment and all of your products and services that you provide us with. ciate you, your hard work, your commitment and all of your products and services that you provide us with. To all of the Associations and regulatory bodies that have worked with/or corresponded with rdhu, from coast-to-coast from the beginning, thank you. We appreciate working with you and your valuable input on what we can offer to help support dental hygienists to elevate the profession. To our presenters and Key Opinion Leaders who are constantly learning and sharing their wealth of knowledge and skills with our members. Thank you for the endless NOVEMBER 2019
hours that take you to research and put your programs together and for all the ‘extras’ you do! I am so fortunate to work with these beautiful intelligent and inspiring ladies. You know the saying, ‘You are the average of the five people you spend the most time with.” I am honoured to have you and many of our members in my circle. And a big thank you to our members who were able to share the evening with us at the RBG and also online via Facebook. If you missed the event, it is available on rdhu’s Facebook page. We are so fortunate to have an incredible community not only across the country, but
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To all of the Associations and regulatory bodies that have worked with/or corresponded with rdhu, from coast-to-coast from the beginning, thank you. We appreciate working with you and your valuable input on what we can offer to help support dental hygienists to elevate the profession. from around the globe. Together, we will continue to elevate our profession and make an impact on oral and overall health. Thank you for your continued support, whether it be through our Video-Based Learning through ‘Dental Hygiene Quarterly’, or attending a hands-on workshop at our boutique CE facility in Ontario or if you have invited us for an on-the-road event in your
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city or province. Thank you for continuing to look for ways to improve your practice, to keep you engaged no matter where you live and to continue to strive to provide optimal care. And to Oral Heath ~ Oral Hygiene publications, thank you for attending our special event, and for inviting me to be a frequent author of your esteemed publication. I NOVEMBER 2019
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Thank you for continuing to look for ways to improve your practice, to keep you engaged no matter where you live and to continue to strive to provide optimal care.
would love to encourage all of our readers/members to ‘Think Outside the Tray’ and about perhaps writing something for this publication. What interests you? Do the research and share your findings. There is so much more that we can do besides working in our ‘regular’ practice, whatever that may be. Step outside your comfort zone and go for it! The world is at your fin-
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gertips. We all have a unique ability and something special to share. I encourage you to discover what yours is and share it! Please always feel free to reach out to me, kathleen@rdhu.ca I would be happy to support you. O With much appreciation, Kathleen Bokrossy, RDH NOVEMBER 2019
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ORAL HYGIENE
THE ‘SYSTEM’ OF A DENTAL HYGIENIST
I Sherry Priebe RDH, BDSc, MSc Sherry impacts the lives of people globally with her dental hygiene life focus to “assist people to attain optimum oral health through research, education and clinical practice”. Sherry graduated with her Dip. DH (UofA), BDSc and MSc (UBC). She has published in the Vietnam J of Med and Pharm, the Can J of Dent Hyg, the Int’l J of Dent Hyg and the Dent Health J (UK). Sherry was awarded the ‘World Dental Hygiene Award in Research’ by SUNSTAR and the International Dental Hygiene Federation for her pioneering study in oral cancer and cultural risk factors in Vietnam. She mentors UBC students in further study by taking them annually to Vietnam to learn about risk factors and oral cancer victims.
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recently had coffee with one of my dental hygiene classmates from the University of Alberta. We reminisced about our days of learning about the profession of dental hygiene with memories of our favourite instructors, exams, radiography labs, petri dishes and dental hygiene clinics. We shared our unique individual amazing stories of our experiences during the Outreach Dental Practicum Rotation that was held in a mobile home, serving the remote villages around Slave Lake, Alberta. Our discussions included the joys of our dental hygiene careers and how the dental hygiene profession served us and our patients so well in Canada, or has it? People want to have healthy teeth but are often afraid to go to the dentist or dental hygienist for fear of pain during and after treatment, having enough finances to pay for the treatment, being scolded or belittled for not taking care of their teeth and finding time to do the prescribed dental treatment. For some reason, past pain during the dental hygiene appointment is often a person’s cause to not return to the dental office. This summer, I was at my friend’s daughter’s wedding reception where I sat at a round table with some of my acquaintances and some relatives of the bride. The lady who sat beside me is a friend and member of my mentorship group, as well as a life coach to
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many Fortune 500 personalities. She is an intelligent and thoughtprovoking individual whom I admire greatly. She directed the conversation around the table asking what people did for their careers and jobs. One lady said she was a librarian. My girlfriend said that she thought technology had a huge impact on her career and completely changed how and what she did as a librarian. She continued to ask others around the table what they did and again shared how amazing technology was in their professions. However, when she came to me, she said, "Oh Sherry, technology has not influenced you in your practice of dental hygiene at all". I was completely shocked at her comment and realized that she had no idea how impacted by technology I was. Obviously the practice of dental hygiene as a whole has not incorporated any of the amazing technology that is being introduced to make our patients’ lives more comfortable in our chairs. Since graduating with my Diploma in Dental Hygiene from the University of Alberta, I practiced my profession based on those days of understanding the biological and scientific facts and techniques of scaling and root planing. New scientifically evidenced based discoveries and new technology has been introduced to me about why and how to ‘clean’ my patient’s teeth. While attending dental conferences, I learn about new toothbrushes NOVEMBER 2019
that are recommended for my patients to use that are equipped with artificial intelligence and bluetooth to signal them if their plaque is effectively removed from their teeth. We have been introduced to Lasers, lights and numbers that are on indicators to identify decay and light fluoresced tissue regarding possible precancerous or cancerous tissue. Yet, my friend announced openly that she thought that technology has not affected the dental profession and specifically, the dental hygiene profession has not advanced in the way or how we ‘clean’ teeth. In fact, what she said was true, as she said we clean teeth in the same old way that has been done since the beginning of time! WOW! I realized then that she was right. We have not progressed at all in using technology for our paNOVEMBER 2019
tients’ oral health or our advantage. We have been trained in dental hygiene school to somewhat use the Cavitron as a mediocre ultrasonic cleaning device. However, most hygienists believe our hand scaler instruments are not and could never be discarded. Are hand scalers really the gold standard of dental hygiene? Is there a more technological and advanced way to remove the debris and hard and soft deposits on and around the teeth to improve our patients’ oral health? What are we missing? As dental hygienists, we diagnose periodontal issues while charting with our variegated probes and tell our patients that we will have to make four appointments for them so we can ‘deep clean and root plane their roots’ to get their disease under control. We work very hard to get
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their roots ‘glassy’ smooth as that is the goal, and the patient gets upset with us that it costs so much. They complain that their gums hurt while we curette their teeth and their teeth ache for weeks after with bleeding gums. Sound familiar? I realized there is a disconnect with what we say to our patients and what we do. We tell them to use an ultrasonic toothbrush to disrupt the bacteria in their sulcus but we use hand instruments to disrupt it while they are in our hygiene treatment chair. I decided I needed to do some research on hand scaling versus ultrasonic scaling and specifically the piezoelectric scaler. The dentist I work with bought piezoelectric ultrasonic systems for the hygiene treatment rooms. I used it and realized that the ultrasonic action and tips were uniquely
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activated. The action along with the water lavage improved the health of my patients’ gingival tissue. I began to investigate the variety of ultrasonic tips for more effective adaptation and fine sub- and supra- gingival removal of calculus and plaque. My method of ‘cleaning’ teeth has changed and the understanding of the biology behind what I do and why I do it. Healing occurs in the mucosal tissue with the removal of and disruption of the accumulation of bacteria and biofilm. I can do that much more effectively with the piezoelectric ultrasonic scaler with unique fine tips that are thinner resulting in patient’s comfort and preference than using a hand instrument for many more hours. Research has changed the way that not only private dental and dental hygiene offices look at the removal of bacteria and hard deposits around the teeth. Many periodontal offices have realized the proven scientific findings and use of piezoelectric ultrasonics in their offices as there is now proof of the biology of bacteria being disrupted by the higher activation of energy. Phagocytic cells in the gingival tissues are activated to destroy and remove bacteria and unhealthy tissue by the ultrasonic action of cavitation forming bubbles that break the bacterial cell walls. Greater energy dispersion and greater tactile sensitivity is possible with the piezoelectric ultrasonic scaler as the vibration is all directed to the instrument lateral edges. I have perfected my ‘system’ of the dental hygiene appointment. The word ‘system’, as defined by ‘Siri’ on my iPhone, is “a set of things working together as parts of a mechanism or an interconnecting network, a complex whole.” The scientific evidence that was known when I graduated provided the basis for how I performed my care and implementation of dental hygiene for my patients. I learned the anatomy and morphology of a tooth along with the surrounding NOVEMBER 2019
tissues in dental hygiene training through learning how to scale teeth. I am not saying to ‘throw away’ the teaching of scaling in dental hygiene schools, as it serves to learn the technique of scaling and as an understanding of the feel of the tooth and the difference between natural tooth and calculus. New evidence has changed the way we name and perform periodontal disease diagnosis treatment and prognosis; new techniques of oral cancer checks are always being improved; we call our patients differently now using terms such as clients; and we use various new improved hygiene polishing products to ‘clean’ teeth better. Hygienists using the piezoelectric ultrasonic scalers have much less fatigue in their arms and hands. Carpel tunnel syndrome is no longer the feared problem as the issue of severe and long hand scaling appointments is not necessary. Yet there is still controversy and hygienists have told me that they will never let go of using their hand scalers and that it is just not possible to do a good job with only a piezoelectric scaler regardless of varied tips. Yes, my dental hygiene scaling and root planing clinics have served an important knowledge of tooth anatomy. I have served my patients well using my hand scaling techniques in the hygiene profession over the years. However, I know now that with using the latest technologies and proven scientific findings, my preferred way to treat periodontal disease is with the piezoelectric ultrasonic scaler as the main tool of removal of hard deposits and disruption of bacterial colonies and biofilm in the sulcus. New technology works and why would I not use it for both my patient’s and my comfort? Has technology influenced our profession? I am proving it to my patients every clinic day that using technology to our benefit in and out of the office is winning the battle of periodontal disease! O
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There is still controversy and hygienists have told me that they will never let go of using their hand scalers and that it is just not possible to do a good job with only a piezoelectric scaler regardless of varied tips.
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ORAL HYGIENE
PREMATURE BIRTH: HELPING PREGNANT PATIENTS UNDERSTAND THE DANGERS OF GUM DISEASE
Amanda Tavoularis, Dr. Amanda Tavoularis has been committed to excellent dentistry for over 20 years. She studied at the University of Washington School of Dentistry and has gone on to complete over 200 hours of study at the prestigious Kois Center located in Seattle. She belongs to numerous dentistry networks include the American Dental Association and the Wellness Dentistry Network. With being a female dentist on the Dentably team, Dr. Amanda can provide her expertise for dental care for women as well as expecting mothers. She has a son of her own and is committed to providing the most accurate information possible for patients.
NOVEMBER 2019
eing pregnant is a wonderful time for women, and it’s packed with so much to do when preparing for their baby. Unfortunately, during this busy time, one of the things that sometimes gets less attention is dental health. This is really is troublesome, because dental issues like gum disease can lead to premature births. In fact, it’s been shown that upwards of 40% of women develop gum disease during their pregnancy; that’s truly staggering. It’s important that we as dentists and hygienists help women understand the dangers present to them and their child due to letting their oral health lapse during pregnancy. I’ve been a dentist for nearly 20 years, and routinely work with pregnant women to help keep their mouth healthy. I know many other dentists are as well, so I’ve put together my checklist on what I do to make sure oral health doesn’t fall by the wayside during pregnancy.
EXPLAINING THE DANGERS OF GUM DISEASE First off, it’s important to understand the dangers of gum disease and poor oral health. Many women
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are simply unaware of the danger it poses, and would be much more inclined to take it seriously if they’re educated on the risks. Make sure to explain how gum disease is a bacterial infection and when left untreated can spread to their uterus and placenta. This directly leads to a higher risk of premature birth and other health issues. Not all women know this, and knowledge is half the battle. Armed with this knowledge, they’ll see exactly where the dangers are in letting their oral health go.
ENCOURAGING REGULAR VISITS It’s also important to encourage regular dentist visits in your pregnant patients. Most women won’t even know they have any serious issues if they don’t go. With so much to do during pregnancy, it’s very easy just to put off going to the dentist for a few months. Help them understand that dental care is just as important as any other doctors visit during their pregnancy. Many women are also a bit hesitant to go to the dentist while pregnant, and worried about safety. It’s important to encourage women to
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Getting the knowledge out there about things such as gum disease and its role in premature births can help get more pregnant women to the dentist before anything happens.
go, and assure them that most procedures are perfectly safe to have done while pregnant. Simple things like teeth cleanings are always okay, and go a long way in preventing more dangerous issues. Even more complicated procedures are safe for pregnant women, so let them know not to put things off, the sooner they get the necessary work done the better. It’s also important to know that pregnant women are more susceptible to issues like gum disease due to their increased hormone levels. Even with good home care they are still potentially at risk. That’s why dental visits are so important, as they can help determine if this is the case and catch issues before they get worse.
HELP THEM ESTABLISH A HOME ROUTINE Good oral health starts at home, and you should really drive this home for your patients. The best
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way to prevent gum disease and other dental issues is simply to follow a good oral health care routine. Preventative care is really the best option here, and when done correctly is the best way to prevent gum disease. This includes the big three, brushing, flossing and mouthwash. Educate your patients on the importance of each one, and make sure that they understand the proper techniques for each. If you notice them lacking in a certain area, make sure to bring this up so they have all the information they need to correct any issues. Going back to the point above, let them know that even with proper care they still need to keep up with their appointments. You can also let them know the dangers of sugar and urge them to limit their intake. Sugar’s role in tooth decay is well known, but it never hurts to reiterate the facts to your patients, especially those who NOVEMBER 2019
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might be eating a less balanced diet due to pregnancy cravings.
ASSISTING IN TREATMENT AND QUESTIONS
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It’s also important to be ready to make treatment recommendations and assist in answering any questions. If a woman is diagnosed with issues they are likely to have a lot of questions about it and their treatment. Be prepared to answer questions about the treatment, as well as pregnancy specific items such as any anesthetics interaction with their unborn baby. This is very important as it’s essential to make sure the patient understands that the procedures are safe for both her and her child. Many women are a bit ambivalent about dental work during their pregnancy, and may choose to skip getting it done. Help them understand the dangers of doing this, and give them the knowledge that getting dental work done during your pregnancy is safe. Having a healthy mouth is very important to a healthy pregnancy, and few people recognize that. Getting the knowledge out there about things such as gum disease and its role in premature births can help get more pregnant women to the dentist before anything happens. It’s one big step towards having a healthy, happy pregnancy. O NOVEMBER 2019
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Dental Marketplace Contact: Karen Shaw | 416-510-6770 | 437-991-7187 | karen@newcom.ca C fax: 416-510-5140 | toll free CDA & USA: 1-888-639-2669
OPPORTUNITIES IN TH E DE NTI STRY PROFESSION
H YGI E N I STS HYGIENISTS WANTED
REGINA, SK
We are looking to hire hygienists to join our busy and well-established practices in Ontario, Saskatchewan, Alberta, and Manitoba. What you will benefit from: • Excellent remuneration • Mentorship and access to a large network of dental professionals • Work life balance with evenings/ weekends off • Additional perks for the right candidate New grads welcome! If interested please send your resume and cover letter: info@enspireopportunities.com
Busy dental clinic with a growing patient base has an immediate opening for a permanent, full-time RDH. All experience levels welcome. The ideal candidate would be well organized, an effective communicator and a team player. Competitive wages and benefits to be discussed at interview. Moving assistance for successful out of area applicants available Contact: officemanager@courtsidedental.ca
P RACTI CES & OFFI C ES LOWER MAINLAND AND/OR OKANAGAN VALLEY, BC General Dentist looking for practice in Lower mainland and/or Okanagan valley. Not a part of any corporate group, save on broker fee. Transition of principal owner of practice can be negotiated. Please email at vancouverdentist2113@gmail.com
DOWNTOWN TORONTO, ON Busy intersection, high exposure, dental clinic for sale or space for lease. Turn key. Call George @ 416 558 0847.
MULTIPLE LOCATIONS IN GTA Dentist owner of multiple profitable locations in GTA seeking sophisticated buyer and exit strategy and options. Reply to Oral Hygiene – Box 63 – karen@newcom.ca
WHITEHORSE, YT FULL TIME DENTAL HYGIENIST Busy 8 operatory practice looking for full time registered dental hygienist. 3 full time dentists and 2 full time hygienists. Health benefits. Office is very modern with all up to date equipment. Fully digital and computerised. Whitehorse is a beautiful community of 40,000. Hiking, fishing, skiing and mountain biking all out your back door. Please reply by email to: pinedental@northwestel.net
LLOYDMINSTER, AB Modern and nicely equipped dental clinic with a well established and growing patient base is seeking a full-time hygienist. All experience levels welcome. Competitive wages and benefits to be discussed at interview. Moving assistance for successful out of area applicants available. Contact: admin@oriondentalgroup.ca
CAREERS NORTH YORK – TORONTO, ON Busy North York office seeking Locum Dentist to relieve owner Dentist when on vacation several times a year. Please contact islingtondental@gmail.com
P RACT I C ES & O F F I C ES BRANDON, MB ORTHODONTIC PRACTICE Servicing a population of 180,000 with only one other practice in the Brandon, MB area. The practice has top of mind recognition and is located in a new office in a highly visible location. The experienced staff is known for friendliness. The practice runs itself and is literally a no-stress environment. This is a great opportunity for someone who wants an amazing income with plenty of time for their personal life. Financing available. They say you can’t have it all, but you can. E-mail: rob@wchrs.com
ASSO C I AT ES H I P S TORONTO, ON
FULL TIME/ PART TIME DENTIST Seeking experienced clinician for busy modern and well reputed TO GP offices. Equity available. Molar endo; treatment planning; excellence in chair side and long term associate position sought. Excellent in restorative and being a team player. Reply to Oral Hygiene – Box 62 – karen@newcom.ca
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MISSISSAUGA, ON Busy Mississauga Office is looking for patient-care oriented dentist with great communication and clinical skills. Minimum 2 years experience preferred. Must be available 2-3 days a week and 2 Saturdays a month. Evening hours required. Please send your resume to dentalresume30@gmail.com
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TORONTO, ON P/T associate needed for established, progressive, patient centered family practice. Strong hygiene department. Ideally, looking for conscientious DDS who is ultimately interested in buying the practice in the very, very near future. Must be a good fit. Please submit resumes to imajen@rogers.com NOVEMBER 2019
ASSO C I AT ES H I P S NEW HAMBURG, ON FULL TIME ASSOCIATE We are searching for a FT associate to join our extremely busy and growing practice. This is an exceptional opportunity for an ambitious and driven person with strong clinical and interpersonal skills. The ideal candidate should be open to providing all aspects of dentistry and be willing to learn through mentorship of the senior dentists, who are ready to slow down. Our progressive office provides current technology including Primescan, Cerec, 3D printer and CBCT scanner. We offer great support staff for you, along with no evening or weekend hours! We do require a minimum of one year of post graduate experience to consider your resume. Please forward your resume to: dentistsreply@yahoo.ca
FAMILY DENTISTRY & IMPLANTS
515 5th Street South, Lethbridge, Alberta Toll-Free: 1-800-552-8053 Office: 403-327-7227 Fax: 403-327-8816 Website: www.abledentalgroup.com
FULL TIME PERMANENT GENERAL DENTIST REQUIRED FOR POSITION IN MEDICINE HAT, AB – #10, 2020 Strachan Road S.E., Medicine Hat, Alberta, Canada THE SUCCESSFUL CANDIDATE MUST HAVE Alberta practice permit and one to four years of pre-dentistry university studies, and a university degree from a recognized dental program . BE SKILLED IN THE FOLLOWING: • ALL ASPECTS OF GENERAL DENTISTRY INCLUDING CLINICAL DIAGNOSIS TREATMENT PLANNING • MUST BE A TEAM PLAYER AS WE PRIDE OUR COMPANY’S SUCCESS ON TEAMWORK AND PROVIDING A TEAM ENVIRONMENT • COMFORTABLE WITH MOLAR ROOT CANALS, SURGICAL EXTRACTIONS, COMPLETE AND PARTIAL DENTURES, CROWNS. • PROFICIENT IN ENGLISH AND THE ABILITY TO COMMUNICATE WITH A MULTI-GENERATIONAL CLIENT BASE • DESIRE FOR CONTINUED GROWTH PERSONALLY AND PROFESSIONALLY JOB DUTIES: • Examine patients' teeth, gums and surrounding tissue to diagnose disease, injury and decay and plan appropriate treatment • Restore, extract and replace diseased and decayed teeth
KINGSTON, ON Progressive and modern clinic in beautiful Kingston is in need of a full time associate. Mon to Thurs 8-5, apply today! E-mail: dr.tabesh@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
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
• Perform oral surgery, periodontal surgery and other treatments • Clean teeth and instruct patients on oral hygiene • Design bridgework, fit dentures and provide appliances to correct abnormal positioning of the teeth and jaws, or write fabrication instructions or prescriptions for use by denturists and dental technicians • Supervise dental hygienists, dental assistants and other staff. SALARY RANGE: $125,000 to $135,000 annually
PLEASE CONTACT OUR OFFICE TO ARRANGE AN ON-SITE MEETING AND VIEWING
OSHAWA AND COURTICE, ON We are looking for a progressive licensed Periodontist in our Oshawa location on Mondays and our Courtice office on Tuesdays. This is a full schedule of existing patient care, including all aspects of periodontics. We are looking to start the transition in December, in preparing for the commitment in the new year. E-mail: ocdental@rogers.com
HIGHLY PRODUCTIVE DENTAL OFFICES WITH BUY IN POTENTIAL, SEEKING FULL TIME GENERAL DENTISTS AND ORTHODONTISTS TO WORK IN MAJOR CITIES OF ALBERTA. Each practice has multiple associates along with a Senior Dentist catering to all aspects of dentistry including cosmetic dentistry, Invisalign, implants, IV sedation, endodontics and surgeries and orthodontics. Mentorship provided and expect to be busy from First Day. The successful candidate will have a passion for building strong patient relationships and be a Team Player.
ANGELA MURRAY – OPERATIONS MANAGER angela@abledentgroup.com – tel: 403-327-7529 ext 261
OTTAWA, ON An associate is required for a full-time permanent position in multiple busy, modern state-of-the-art Ottawa group practices. We are committed to providing above and beyond standards of care possible through extensive continuing education. The ideal candidate is enthusiastic and caring with good communication skills and an interest in continual learning. Please email resume: maisiouti@gmail.com
TORONTO, ON Associateship Specialty in Orthodontics leading to partnership available in a prestigious, successful office located on the Yonge line in Toronto. Please submit application to: glondos@icloud.com
Please email resume to calgarysmiles2018@gmail.com
NOVEMBER 2019
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ASSO C I AT ES H I P S THORNHILL, ON
SASKATCHEWAN
(YONGE AND STEELES)
We are looking to hire an Associate Dentist to join our busy and well-established practice in Saskatchewan! What you will benefit from: • Excellent remuneration • Mentorship and access to a large network of dental professional • Work life balance with evenings/ weekends off • Additional perks for the right candidate New grads welcome! If interested please send your resume and cover letter: info@enspireopportunities.com
We are a busy office located in the heart of Thornhill (Yonge and Steeles). We are looking to hire an oral surgeon for placement of implants and complicated extractions. We are also looking for an orthodontist. We are also looking for a general dentist for Saturdays for scaling and exams. We will possibly increase your hours in the future. Please send your resume to our email address: info@worlddental.ca
AURORA AND BARRIE, ON Fast Growing Progressive Dental Practice seeking motivated and enthusiastic candidate to join us in one of our locations in Aurora and Barrie for a great mentorship opportunity.This is an exceptional opportunity for growth for the dentist with an entrepreneurial mind and drive to succeed. We invite you to contact us for further information on this lucrative opportunity. New Grads welcome! E-mail: kris@bigbaydental.ca
MIDTOWN TORONTO, ON Established practice in busy plaza, midtown Toronto looking for a PT associate. Great team, modern office, large patient base. Ideal candidate is experienced, outgoing, thrives independently or with a team. Email: pdcare496@gmail.com
EDMONTON, AB Full time associate required for busy dental group servicing Edmonton and surrounding community. Long term associateships preferred. Please email resume to omar@infinitydental.ca
WATERLOO, ON
PERIODONTIST NEEDED Specialty associateship in Periodontics in a well established, busy and high tech office. Please submit CV to: periowaterloo@gmail.com
CAMBRIDGE, ON A friendly dental office is looking for a friendly, gentle dentist for 3-4 days a week including some evening hours and alternating Saturday. The office is paperless with digital x-ray and pan. Please email your resume to kaylashiru@gmail.com
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oralhygiene
CAMBRIDGE, ON Part time orthodontist needed once a week in a busy established orthodontic practice within a pedodontic practice. There are going to be 4 ortho hygienists, a coordinator and an assistant dedicated to you. Enjoy a steady stream of new young patients transitioning from our pedo and general practices. Take over existing patients as well as start 10 new cases a month. E-mail: donna@countrydental.ca
BARRIE, ON
DOWNTOWN WINNIPEG, MB Full time associate dentist opportunity. Dental clinic located in down town Winnipeg MB looking for full time associate dentist with good skills in surgery, root canals. To apply email: maingate2019@yahoo.com
FULL TIME ASSOCIATE Unique opportunity for a self-motivated, caring individual who can work unsupervised and perform all aspects of dentistry. E-mail resume to: botony@rogers.com or fax 416-800-6184.
KANATA (OTTAWA), ON Our well established practice is looking for a full-time associate starting in January 2020. Hours are Monday-Wednesday 8-5 and Thursday 8-6:30. The clinic is a bright, modern, and clean facility in Kanata (Ottawa) near the high tech area. No Fridays or weekends. Please email your resume to kanatadentist65@gmail.com
NEWMARKET, ON We are looking for a part-time associate to join our large, established practice in the heart of Newmarket on Mondays and Wednesdays. Candidate must be outgoing and have a friendly positive attitude to join our family oriented practice.. Email resume to creeksidefamilydental@rogers.com
Inquire about the new monthly
DENTAL MARKETPLACE EBLAST! Contact Karen Shaw at tel: 416-510-6770 e-mail: karen@newcom.ca
AD INDEX AMD Medicom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IBC Clinical Research Dental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 Crest P&G . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4, 23 dentalCorp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15, 26 Ivoclar Vivadent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IFC ODA – Ontario Dental Association . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Philips Oral Healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 Premier Dental Products Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 Sable Dental Industries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31 SciCan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Sunstar America. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 VOCO Canada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OBC
www.oralhealthgroup.com
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