Oral Hygiene September 2013

oralhygiene September 2013

Infection

OUT OF CONTROL DENTAL ECONOMICS

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TAX SAVERS you may be missing RAISING ENGAGEMENT to see success

Release your INNER ‘INTREPRENEUR’ www.oralhealthgroup.com

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The New Philips Sonicare FlexCare Platinum More innovation. Less plaque between teeth.

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1 Than a manual toothbrush. M. Ward, K. Argosino, W. Jenkins, J. Milleman, M. Nelson, S. Souza. Comparison of gingivitis and plaque reduction over time by Philips Sonicare FlexCare Platinum and a manual toothbrush. Data on file, 2013.

2 Defenbaugh J, Liu T, Souza S, Ward M, Jenkins W, Colgan P. Comparison of Plaque Removal by Sonicare FlexCare Platinum and Oral-B Professional Care 5000 with Smart Guide. Data on file, 2013.

Single use study.

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oralhygiene CONTENTS

FEATURES Tax-Saving Ideas You May Be Missing

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David Chong Yen, CFP, CA

Dental Economics 101: Principles of Targeted, Scientific, Strategic Marketing

11

Susan M. Badanjak, RDH, ADA, MDH Student

Infection “Out of Control”

20

Leslie Sanderson, RDH

Raising Engagement to See Success

24

Dorothy Garlough, RDH, MPA

How to Release the ‘Intrepreneur’ Within!

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8

Kathleen Bokrossy, RDHU

DEPARTMENTS Editorial News AboutFace John Lennon Tooth HPV Study

New Products Dental Marketplace

Editorial Board Members Lisa Philp | Jennifer de St. Georges Annick Ducharme | Beth Thompson

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20 Cover image & top of page: thinkstockphotos.com

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EDITORIAL

The Social Network – Can We Get That Channel?

Pinterest. Instagram. Facebook. Twitter.

Youtube. MySpace. Digg. Technorati. Bing.

Google. Flickr. Zoocasa.

If you said any one of these words not too many years ago people would have thought you’d taken leave of your senses.

Now, most people know some, if not all, of these social media names and the services they perform. We’ll discuss hashtags, URLs and widgets another time.

Why is social media important, frankly critical, to you and your practice? Social networks are incredibly powerful; they shape your life and your friends’ lives and affect almost everything we think and do. What is a network?

“A group of interconnected or intercommunicating things, points or people. A group of people who exchange information, contacts and experience for professional or social purposes.” 1 In the book Connected: “How your friends’ friends’ friends affect everything you feel, think and do,” the authors offer four rules for life in the network: Rule 1. Humans shape and reshape their networks all the time. “The primary example of this is homophily, the conscious or unconscious tendency to associate with people who resemble us.”

Rule 2. Our network shapes us. “Whether your friends and other social contacts are friends with one another is crucial to your experience of life.”

Rule 3. Our friends affect us. “Diners sitting next to heavy eaters eat more food.”

Rule 4. Our friends’ friends’ friends affect us. “It turns out that people do not

copy only their friends. They also copy their friends’ friends, and their friends’ friends’ friends.” 2 LinkedIn, once considered a repository for electronic business cards, is now considered a star among social networks. Introduced in 2003, LinkedIn launched as a social network for ‘professional’ relationships. The site now has more than 50 million users. Eighty percent of companies surveyed are using or planning to use LinkedIn to find employees but one of the best features of LinkedIn are the ‘groups’ that offer a way to communicate with other members to answer questions and solve problems. LinkedIn is a ‘dashboard’ to your professional world, a place where you can stay informed about your profession, make new contacts and find the people and knowledge you need to achieve your goals. It provides a chance to control your professional identity.

Now that I’ve impressed you with the virtues of LinkedIn, let me welcome you to the Oral Health group and the Oral Hygiene group. Both of these sites are places you can meet, chat, share, ask questions and find solutions. Visit us at LinkedIn.com and search under groups for Oral Health Journal and Oral Hygiene Magazine.

I look forward to seeing you there!

Catherine Wilson Editor

REFERENCES 1. Oxford Canadian Dictionary (second edition).

2. Connected, Nicholas Christakis, MD, PhD and James H. Fowler, PhD.

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NEWS BRIEFS

www.kissonline.com/

KISS Member Teams Up With Not-for-Profit KISS front man, Paul Stanley, has been a spokesperson for the Canadian-based AboutFace organization since 2000. In this role, Stanley has met and spoken with parents and children about his own personal experience with the birth defect known as Microtia, a deformity of the outer ear, and the additional loss of hearing in his right ear. Stanley is the narrator of the AboutFace educational program, Facing Differences, which teaches children aged seven to 12 how to understand and embrace those with physical differences. With his participation, KISS presented AboutFace with a generous $10,000 donation.

AboutFace is a charitable organization dedicated to helping individuals with facial differences. Founded in 1985, AboutFace is the only organization that provides emotional, peer and social support, resources and educational programs to individuals with facial disfigurements and their families. www.aboutface.ca

American Scientists Attempt To Clone John Lennon From Tooth John Lennon’s tooth is going under the microscope in a US lab with scientists considering ways to extract the genetic code from the fragile specimen owned by Canadian dentist-tooth collector, Dr. Michael Zuk. The dentist attracted attention from skeptics for purchasing the rotten molar for over $30,000 US at a UK auction in 2011. Dr. Zuk

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September 2013

A BUSINESS INFORMATION GROUP PUBLICATION Account Manager: Editorial Director: Tony Burgaretta / 416-510-6852 Catherine Wilson tburgaretta@oralhealthgroup.com 416-510-6785 cwilson@oralhealthgroup.com Classified Advertising: Editorial Assistant: Karen Shaw / 416-510-6770 Jillian Cecchini kshaw@oralhealthgroup.com 416-442-5600, ext. 3207 jcecchini@oralhealthgroup.com Dental Group Assistant: Kahaliah Richards Art Direction: 416-510-6777 Andrea M. Smith krichards@oralhealthgroup.com Production Manager: Associate Publisher: Phyllis Wright Hasina Ahmed / 416-510-6765 Circulation: hahmed@oralhealthgroup.com Cindi Holder Senior Publisher: Advertising Services: Melissa Summerfield Karen Samuels 416-510-6781 416-510-5190 msummerfield@oralhealthgroup.com karens@bizinfogroup.ca Vice President/Canadian Publishing: Consumer Ad Sales: Alex Papanou Barb Lebo President/Business Information Group: 905-709-2272 Bruce Creighton barblebo@rogers.com

is standing firm with his conviction that the investment could be one of the best decisions of his life. Zuk says in the press release “to potentially say I had a small part in bringing back one of Rock’s greatest stars would be mind blowing”.

The exact details of the scientific research is being kept confidential, but if sequencing is possible, the dentist has approved tests to be conducted to gain insight into Lennon’s genes for a UK documentary on celebrity genetics. www.JohnLennontooth.com

HPV Infection Linked To Poor Oral Health, Say Cancer Prevention Researchers Researchers from the University of Texas Health Sciences Center in Houston analyzed data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES), which was carried out by the National Center for Health Statistics of the Centers for Disease Control and Prevention (CDC).

Some 3,439 participants were included in the data, aged between 30 and 69 years. The oral health data included the following four measures: self-rating of overall oral health, presence of gum disease, use of mouthwash to treat dental problems (within past 7 days of survey) and the number of teeth lost. Factors that may influence HPV infection were also analyzed, including age, gender, marital status, marijuana use, cigarette smoking and oral sex habits.

The findings showed that the participants who reported bad oral health had a 56% higher risk of developing oral HPV infection compared with those who had good oral health.

For more information on the study, visit http:// www.medicalnewstoday.com/articles/265083.php

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A Splash of Brilliance

It all started with one sonic toothbrush. A lot has changed since then, but one thing’s stayed the same — from Sonicare to Zoom, we never stop seeking out ways to make your patients smile.

philipsoralhealthcare.com (800) 278-8282

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FINANCE David Chong Yen, CPA, CA, CFP

Of DCY Professional Corporation Chartered Accountants is a tax specialist and has been advising dentists for decades.Additional information can be obtained by e-mail at david@dcy.ca.

Please visit our web­­site at www.dcy.ca.

This article is intended to present tax saving and planning ideas, and is not intended to replace professional advice.

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I

Tax-Saving Ideas You May Be Missing

t is never too early in the year to start looking ahead to next April and consider ways to reduce your tax bill next year. The following lists some simple ideas, which may be helpful for you and your family in planning your financial future.

Many dental hygienists work in several dental practices as an employee and may have not fully investigated the advantages in changing their status to self-employed, or even to an employee of their own corporation. The Ontario government recently changed the rules to allow dental hygienists to practice through their own dental hygiene professional corporation (DHPC), provided that only the hygienist owns shares in the DHPC. While normally, a DHPC only really makes sense if you earn at least $80,000 annually, a company can allow you to “smooth” your income over several years to your tax advantage.

For example, if you earn $60,000 during 2014 as an employee, you could pay up to $12,000 tax. But assume you plan to take the 2015 year off (to start a family, travel, etc.) and won’t have any income during that year.

You could set up a DHPC with a year-end for tax purposes of June 30, 2015. The first $30,000 earned during 2014 would be taxed in that year, with total tax of only approximately $2,800. The income earned during the second half of 2014 would be earned in your new DHPC’s fiscal year, running from July 1, 2014 to June 30, 2015 and could be paid out to you in 2015 as a $30,000 salary from your DHPC, on which you would again pay only approximately $2,800 of tax. Instead of reporting $60,000 as 2014 income, you report $30,000 in 2014 and $30,000 in

2015, so the total tax for the two years would be $5,600 — at least $6,400 less than what you would pay if the income had to be declared all in one year. If you expect that your income over the next few years will be “lumpy” with some high-earning years and some years with little or no income, consider incorporation as a way to reduce your total tax bill. This should only be done with professional advice, if you only work for one dentist, the “personal services business” rules may reduce the tax benefits from adopting this strategy.

Some costs can only be expensed for tax purposes by self-employed persons — not by employees. For example, costs to travel to and from home cannot be claimed for income tax purposes by an employee, but if you are a self-employed person with many clients, you can claim the cost of travelling to those clients. The easiest way to claim travel costs from your DHPC is to pay yourself 54 cents per business kilometre for the first 5,000 km travelled in a calendar year. This rate applies for 2013 and is reviewed annually. This can be expensed in your DHPC or in your self-employment statement on your personal tax return, and if you have a DHPC, the same amount can be extracted from your DHPC tax-free. You should keep a logbook during the year, recording the date, distance, and purpose of all business-related trips, to make life easier when the Canada Revenue Agency (CRA) audits you.

As a self-employed person, you may have more opportunity to deduct other expenses as well. For example, some training courses do not meet the CRA’s tests for qualifying tuition costs, and therefore as an employee

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FINANCE you cannot claim them for a credit against income tax. If your employer reimburses you for the cost of the course, you will not be out-of-pocket. But if your employer is not willing to reimburse you for the cost, and the course is not qualifying tuition, you cannot claim the course on your personal tax return, unless you are self-employed (and can claim it as a training cost associated with carrying on a business) or work through your own DHPC (and can deduct it in the DHPC’s financial statements as a training cost). Similarly, an employee cannot deduct the cost of a telephone used for work purposes; if the employer does not reimburse those costs, the employee is out-of-pocket.

However, a self-employed person or a person whose business is operated through a DHPC has greater opportunities to deduct business-related outlays such as cell phone cost, business-related meals and entertainment, subscriptions to professional journals and office supplies.

Many newly graduated workers do not realize that outlays made during their student years can benefit them during their early working years. For example, tuition expenses incurred during your years in school may not have been reported on your tax returns for those years, since you did not have any income and hence did not need any tax credits or deductions during those years. However, your unused tuition expenses may be carried forward and claimed against income once you start working. If you did not report your tuition outlays during your student years, consider re-filing the tax returns for those years in order to ensure these amounts are duly reported, so that you can use these outlays against the income you are earning now. Likewise, charitable donations you made during your student years can be carried forward for up to seven years. If you have donations made in past years, which you did not claim, you can claim them now that you are earning income. Recently, the federal government introduced a one-time enhanced credit for first-time donors, so it is advisable to save up small donations over

several years so that you can eventually report one large donation amount on which you can claim the enhanced credit.

You may also have decided to defer saving for your retirement through a Registered Retirement Savings Plan (RRSP). But, an RRSP can also be a useful tool for saving for the down payment toward your first home, through the first-time Home Buyers’ Plan.

This program is designed to allow first-time homebuyers to invest their RRSP savings in their own home. You can use up to $25,000 of RRSP savings to help pay for your first home; your spouse or common-law partner can invest up to the same amount. Therefore, if you have each saved $25,000 as a down payment on your first home, you should consider putting those funds into an RRSP. You will each be able to deduct $25,000 from your income, resulting in a significant tax saving. The funds must remain inside the RRSP for at least 90 days before they can be withdrawn under the Home Buyers’ Plan. Once the funds are withdrawn, they can be put toward the cost of your new home, reducing your mortgage and future interest costs. For each of you, this $25,000 must be repaid to your RRSP over 15 years in even amounts, beginning the second year after the year of withdrawal. If you cannot make the repayment in a given year, the CRA will add 1/15 of the total amount to your taxable income for that year, and you will pay additional income tax that year at the rate applied to your tax bracket. This program has proven very popular with Canadians, so the rules have been relaxed somewhat, to allow a person to use the plan if neither they nor their spouse or partner owned a house at any time within the five years before buying a new house.

There are ways in which your total tax burden can be reduced with careful forward planning. The time to think about these ideas is not on April 29, rushing to file by the April 30 deadline, but instead, to begin planning months, or even a year or more, in advance. These efforts, and good professional advice along the way, can end up being a powerful investment. n

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ORAL HYGIENE

Dental Economics 101

Principles of Targeted, Scientific, Strategic Marketing Abstract

The dentist’s economics index scores continue to fall; all symptoms of a sluggish economy, altered dental service consumerism, fierce competition in an overcrowded industry and lack of business astuteness. With the playing field level, effective marketing becomes critical in these dire circumstances.

Market share is stolen like bases and not walked by bad pitches in a tied business game. In this new dental park, the sport is played with precise targeting skills, scientific positioning and game-plan strategy. This literature digest identifies dental economic tactics designed to generate revenue, while the less accomplished dental market players sit on the sidelines. The potential winners are the patients identified in this document, as they have the most to gain, if such dental economics are applied.

Introduction

According to Levin1 the 2008-2010 recession brought about a 30% decline in new patients, as patients have changed their dental care buying practices. Dentists are now businessmen and the patients are now consumers.1 With the opening of 15 new dental schools in the US, higher student loan debt, and decreases in the insurance industry’s reimbursements, dentists both young and old will work 8-10 years longer than they did in the past.1 As public perception of dentistry has changed from oral healthcare provider to dental entrepreneur, dentists will have to

manage their practices with business acumen to remain profitable and competitive.

In times of economic downturn most business owners, including the owners of dental practices, are reluctant to spend. However according to Tullman, 2 difficult financial times are precisely the moment when they need to spend. A survey of 600 US companies, from the 1981-1982 recession era, showed just how important advertising dollars in times of economic blight are. 2 During this timeframe, those companies that increased their advertising, increased their revenue by 275%; those who decreased their advertising saw revenue gains of only 19%. 2 It is imperative to invest in or upgrade to evidence-based assessment, diagnostic, preventive and restorative dental equipment and materials. 3 Many of the technological innovations are prevention-oriented and this information should be relayed to actual and potential patients. 3 Although this body of work hones in on two age brackets, the focus of the dental practice should be on overall health, promoting longevity of life and teeth, and span all generations.

Target Market – Baby Boomers & Beyond

Susan M. Badanjak, RDH, ADH, MDH Student

Published (peer reviewed), bilingual, registered, Canadian Board and American Board certified, Dental Hygienist, with 26 years of experience in the healthcare field, including 11 years as a Specialty Pharmaceutical Sales Representative in nine different therapeutic fields of medicine and 12 years of clinical experience in 6 therapeutic fields of dentistry.

Breathomic and genomic (dental caries) Educator and Consultant. Currently pursuing a MSc. Dental Hygiene at Forsyth School of Dental Hygiene —MCPHS University, Boston, MA.

A recent analysis by the American Dental Association (ADA) shows that dental spending has been stagnant since 2008.4 The ADA’s Health Policy Resources Center (HPRC) brief shows that 41% of adults visited their dentist in 2003; in 2010 that number

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ORAL HYGIENE

dropped to 37%. 5 However, there is a rise in dental expenditures by Baby Boomers (those born between 1946 and 1964) and the elderly. 5 As Baby Boomers make up approximately 26% of the US population and those 65 and older about 14%, it is believed that these population segments could provide the monetary boost the dental economy needs.6 The Impact of Birth-Cohort Screening for Hepatitis C Virus (HCV) Compared with Current Risk-Based Screening on Lifetime Incidence of and Mortality from Advanced Liver Disease (AdvLD) in the United States (US), recommends an aged-based screening for people born between 1946 and 1970, for HCV.7 It is estimated that about 1.6 million Americans, aged 40-64, are hepatitis C seropositive and unaware of their condition.7 Poor oral health among patients with HCV has been well documented and hepatitis C infection is the strongest predictor of patients reporting poor oral health. 8 They have significantly more caries, gingivitis, periodontitis, and missing teeth. 8 Patients experience significantly higher incidence of caries due to inadequate saliva production. 8 Oral sicca symptoms9 and HCV-induced diabetes10 also impact periodontal health; periodontitis has been reported in more than 35% of HCV positive and chronic liver diseased patients. 8 Dental problems delay treatment of hepatitis C. 8 Management of the oral environment is of paramount importance in HCV-infected patients.

In Nova Scotia, Canada, an observational, cross-sectional survey of adults, aged 45-64 and 65 and older, living independently in rural and urban settings, compared the oral health status of these two groups.11 The survey results show that being 65 years of age or older is a predictor of increased tooth decay, missing teeth, filled teeth, presence of decayed and/or filled roots, and presence of gingival attachment loss that is ≥4 mm.11 However, being 65 years and older is not a significant predictor of presence of untreated coronal caries.11 The authors conclude that a decrease in edentulism and a higher risk for root caries with increasing age, foretells there will be a need for more complex dental care as populations age.11

12

In 2008, data by Helmick et al12 suggested rheumatoid arthritis (RA) was becoming a disease of older adults, as the average age of individuals with RA increased from 63. 3 years in 1965 to 66. 8 years in 1995. The disease can occur at any age in adulthood; however, the average age of onset is in the fifthdecade of life.13 It increases progressively with age, with maximal incidence in the 65-74 age group and declines in those 75 years and older.14 Unfortunately, data from the last decade show an increase in incidence after four decades of decline.13 Another study revealed the actual overall health status of Baby Boomers compared to their parents.15 Thought to be the healthiest and most active generation, Boomers are actually in worse, overall health than their parents.15 They have higher levels of hypertension, diabetes, dyslipidemia, and disability than their parents.15 Perhaps a surefire way for a dental practice to increase revenue is by bridging the gap between oral and systemic health. Targeted, scientific, strategic marketing aimed at these demographics, may make all the difference for both oral healthcare providers and their patients.

Scientific Evidence – The Oral Systemic Link

An oral systemic link exists between a number of diseases, which affect whole body systems and include the following systems, among others: cardiovascular, endocrinological, metabolic, pulmonary, and immunological.16 As the incidence of disease increases with age, the target patient population will likely experience at least one of these ailments.17 Furthermore, many diseases manifest in the oral cavity first; those exclusive to the mouth, can also go undiagnosed if dental visits are infrequent, leading to more advanced disease states. Examples include hepatitis C-induced lichen planus, 8 oro-pharyngeal cancer,18 Sjögren’s syndrome oral sicca, 8 and metabolic or systemic disorders detected through breath.19

Cardiovascular Link Level-A evidence, from the American Heart

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ORAL HYGIENE Association, states that periodontal disease is independently associated with arterial disease. 20 Although periodontitis does not cause atherosclerotic cardiovascular disease, the data support an association between the two, independent of confounding risk factors. 20 Periodontal therapy decreases not only systemic inflammation, which is a major risk factor for cardiovascular disease, but also reduces the risk of major adverse cardiovascular events (MACE) such as acute coronary syndrome, myocardial infarction, transient ischemic attacks (mini stroke), and cerebrovascular accidents (stroke).16 According to Gude et al16 studies have shown that Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis have evident associations with future stroke, increased risk of myocardial infarcts, and acute coronary syndrome. The INVEST trial demonstrated that periodontal pathogen load has a positive linear association with hypertension; hypertension is the primary cause of strokes. 21 It would be remiss not to discuss chronic kidney disease (CKD), as a bi-directional relationship exists between CKD and periodontal disease; both are mediated by hypertension and duration of diabetes.16 Shultis et al 22 have shown that periodontitis is also a risk factor for overt nephropathy and end-stage renal disease (ESRD).

Endocrinological/Metabolic Link Considerable evidence demonstrates that diabetes increases the risk of periodontal disease and in turn, periodontitis promotes insulin resistance, which deranges glycemic control.16 Periodontal therapy has been correlated with decreased glycosylated hemoglobin A1c (HbA1c) values.16 Those diabetics with higher HbA1c have severe perio­dontitis, deeper gingival pocket depth, and more gingival attachment loss.16 Saliva is also altered in diabetic patients; the pH level is disrupted and its buffering capacity lowered, resulting in dry mouth, increased risk for caries and susceptibility to oral candidiasis.16 Taylor 23 states that treating periodontal infection in people with diabetes is an important component of their overall diabetes management.

Patients with osteoporosis, whether acquired through bone metabolism disorders or iatrogenic origins, tend to have greater clinical attachment loss and interproximal gingival recession, characterized by a cupped appearance.16 Osteopenic patients will suffer the same fate,16 without dietary modification and supplementation, geared towards including more calcium and vitamin D. 24,25 Weight-bearing exercise, especially on a sunny day, is also part of bone metabolism management.13,24,25

Respiratory Link Bacteria-laden biofilm in the oral cavity is pathogenic and bronchoaspiration of these pathogens may cause aspiration pneumonia.16,26 The elderly are more susceptible to lung infections due to impaired deglutition and cough reflex, as a result of declining neuromotor functionality, specific to these reflexes. 26 Furthermore, age-related malfunctioning of the esophageal sphincter may trigger gastroesophageal reflux, a condition where gastric acid and the stomach contents backwash into the mouth. 26 Normally, regurgitation activates the gag and cough reflex, and the epiglottis lid drops thereby, closing the airway passage to the lungs. 27 Swallowing is obviously not possible during a reflux event. However, because of impaired reflexes, the usually co-ordinated neurological action is poorly orchestrated, or outright absent, causing aspiration. 26,27 Finally, patients with chronic obstructive pulmonary disease (COPD) have a significantly higher prevalence of chronic periodontitis, an association that appears to be independent of known risk factors for periodontal disease.16

Immunological Link The common ground between periodontitis and host immune response is the absence or presence of an inflammatory cascade.16 Some patients have a decreased immunologic response and are therefore, more vulnerable to infections.16 Examples include patients with diabetes or drug-induced immunosuppression. 28 Others have an overzealous immune response, resulting in inflammation-induced destruction.16 Patients

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ORAL HYGIENE

Strategy Implementation – Customer Centric

According to Ries and Trout, 35 strategic marketing is about finding a hole and then filling it.

The market niche discussed in this paper is that of Baby Boomers and geriatric patients; success in any business requires catering to the market. 3 Dentistry as a whole is customer-centric and is not about the oral care provider; it’s all about the patient. 3 As such, a dental practitioner must be able to convey his competency and knowledge to his client, by making the discussion about his client, hence the targeted market and scientific strategy outlined previously. Bray36 states dentistry is a service and the dental consumer expects it to be exceptional. Truth be told, personality trumps skill. 36

With so many dental practices to choose from, patients opt for extraordinary service in lieu of extraordinary clinical care. 36 This modified, anonymous poem from Stilson’s37 web site sums up this key message nicely:

I see that you’ve spent quite a big wad of dough, To tell me the things that you think I should know.

How your practice is so big, so fine and so strong, And how your history’s so rich, so solid and so long.

So you started your practice in 1992?

How tremendously interesting that is to you.

You built up this thing with the sweat of your life.

I’ll run home like mad and tell that to my wife.

Your equipment is modern and, oh, so complete!

Your “rep” is so flawless, your employees so neat.

Your motto is “Quality” with a capital Q. Damn I’m getting tired of hearing about you.

So tell me quick and tell me true, Or else my friend, to hell with you!

Less about your practice and how it came to be, And a little bit more about what you can do for ME! Stilson 37 discusses research on the relationship between consumer complaints and loyalty. He writes that only 9% of people who

Table 1. Stilson’s Help Them Whine Strategiesa • I n patient correspondence, make it clear that you want to hear from them if they are not 100% satisfied. Promise to resolve any problem quickly.

•A fter any dental procedure, remind the patient that you want to know if s/he has any problems or concerns.

•A dd a complaint box in your reception/waiting area and supply complaint cards. Leave a place for them to sign their name and encourage them to do so ... but don’t make it mandatory.

•H ang an attractively framed Statement of Satisfaction Policy in the reception/waiting area that reiterates your desire to know about any problems or complaints the patient may have. Encourage patients to share their complaints. Explain that you’re always looking to improve the practice and by voicing their concerns, patients are actually helping you.

• F ollow-up by phone with patients occasionally, to ask if there’s anything you could do to make the experience better.

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with hepa­t itis B virus (HBV) and HCV-infection exhibit this acute severe periodontal disease, early on post-infection. 29 Then there are those individuals who have underlying, autoimmune connective tissue disease, such as RA or ankylosing spondylitis. 30 Patients with RA are at an increased risk for periodontitis, clinical attachment loss and tooth loss. 31,32 Periodontal disease has also been implicated in cardiovascular disease, respiratory disease and diabetes all of which can be complications of RA. 33 Ortiz et al 34 showed periodontal treatment reduces the severity of RA, irrespective of the medications used to treat RA.

*

a Adapted from Stilson G. Marketing tips for dentists. Web site. http://marketingtipsfordentists.com. Updated April 25, 2013.

Accessed April 25, 2013.37

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Table 2. Free Assessment Marketing Tactics •O ral cancer risk assessment &/or screening •D ental caries risk assessment and genetic caries predisposition assessment •P eriodontal disease risk assessment •O ral mucosal lesion(s) assessment and identification •B reath assessment with quantifiable, differential diagnosis of hydrogen sulfide; methyl mercaptan; dimethyl sulfide •B lood pressure assessment •B lood glucose testing

are dissatisfied, but do not complain, will remain loyal. 37 If people do complain, but the problem remains unresolved to their satisfaction, only 19% will remain loyal. 37 Loyalty jumps to 54% when a complaint is resolved to their entire satisfaction and by expeditiously resolving the problem, loyalty soars to 84%. 37 Stilson’s 37 suggestions to keep patients’ complaints flowing are listed (Table 1).

Advertising comes in many forms, but the most effective seem to be word-of-mouth, direct mail, and social media. 37 A 2012 survey of US dental practices determined that 52% of dentists use social media. 38 Of those who use social media, 91% use it as a marketing tool. 38 Do not presume that the targeted generations are not tech-savvy; quite the opposite is true. 39 Advertising and promotional material must be specific to the target market and when free services are offered, the offer should be time-bound. 37 Freebies are excellent at enticing prospective patients to an office and they are effective repeat sales drivers. 37 Listed are some examples of feasible, inexpensive, free services that could be offered to prospective patients (Table 2).

Collaborating with and referring to other healthcare providers in the community is another way to generate leads. 37 Creating alliances with physicians, nurses, pharmacists, and managers of retirement communities and assisted-living facilities is time well spent. 37 Providing a business card is common practice, but asking for one, receiving it, and following up with a phone call, is exercising marketing prowess. 37

Discussion Business sense is not innate to all people. As

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the dental world becomes more of a corporate world, dental practitioners will undoubtedly need sales and marketing training.

Knowledge of current medical epidemiological trends and their impact on oral health would interlink two health disciplines, to better treat one system – the whole human body.

The information presented is also relevant, pertinent, and timely for hygienists, as the profession moves through a modernization process, which will allow for private, dental hygiene practices. Hygienists will have to compete for their piece of the pie; recognizing and harvesting the lowest hanging fruit, makes quick work of cutting out a slice. n

REFERENCES 1. Levin RP. Eight permanent game-changers for today’s dentist. Dental Economics.

Web site. http://www.dentaleconomics. com/articles/print/volume-102/issue-10/ practice/eight-permanent-game-changers-for-todays-dentist.html.

Published Octo­ber 1, 2012. Accessed April 25, 2013.

2. Tullman HA. Saving your way to success: why you can’t do it. Inc.com Web site. http://www.inc.com/howard-tullman/saving-your-way-to-success-why-you-cantdo-it.html. Published January 3, 2013.

Accessed April 22, 2013.

3. Chavez R, Sayre N. Healthcare Marketing. In: Buchbinder SB, Shanks NH, ed.

Introduction to health care management.

2nd ed. Burlington, MA: Jones and Bartlett Learning; 2012:95-111.

4.

A DA analysis shows national dental spending flat since 2008. Dentistry IQ Editors. Web site. http://www.dentistryiq.

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ORAL HYGIENE com/articles/2013/04/ada-analysis-showsnational-dental-spending-flat-since-2008. html. Published April 2013. Accessed April 22, 2013.

5. Wall T, Nasseh K, Vujicic, M. Per-patient dental expenditure rising, driven by Baby Boomers. ADA Health Policies Resources Center. Web site. http://www.ada.org/ sections/professionalResources/pdfs/ HPRCBrief_0313_2.pdf.

Published March 2013. Accessed April 25, 2013.

6. The older population in the United States: 2011. United States Census Bureau. Web site: http://www.census.gov/population/ age/ data/2011.html. Updated November 28, 2011. Accessed April 22, 2013.

7. McGarry LJ, Pawar VS, Panchmatia HR, et al. Economic model of a birth cohort screening program for hepatitis C virus.

Hepatology. 2012; 55 (5):1344-1355. doi: 10.1002/hep.25510.

8. Nagao Y, Sata M. Dental problems delaying the initiation of interferon therapy for HCV-infected patients. Virol J. 2010; 7:192422 X-7-192. doi: 10.1186/1743-422X-7-192.

9. Nawito Z, Amin A, El-Fadl SA, Abu El Einen K. Sicca complex among Egyptian patients with chronic hepatitis C virus infection. Clin Rheumatol. 2011;30(10): 1299-1304.

10. Ko HM, Hernandez-Prera JC, Zhu H, et al. Morphologic features of extrahepatic manifestations of hepatitis C virus infection. Clin Dev Immunol. 2012; 2012: 740138. doi:10.1155/2012/740138.

11. McNally ME, Matthews DC, Clovis JB, Brillant M, Filiaggi MJ. The oral health of ageing baby boomers: a comparison of adults aged 45-64 and those 65 years and older. Gerodontology. 2012. doi:10.1111/ ger.12022. In press.

12. Helmick CG, Felson DT, Lawrence RC et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part 1. Arthritis Rheum.

2008;58(1):15-25. doi:10.1002/art.23177.

13. Tobon GJ, Youinou P, Saraux, A. The environment, geo-epidemiology, and autoimmune disease: rheumatoid arthritis. J Autoimmun. 2010;35:10-14. doi:10.1016/j. jaut.2009.12.009 14.

Myasoedova E, Crowson CS, Kremers

HM, Therneau TM, Gabriel SE. Is the incidence of rheumatoid arthritis rising? : Results from Olmstead County, Minnesota, 1955-2007. Arthritis Rheum. 2010; 62(6): 1576-1582. doi: 10.1002/art.27425.

15. K ing DE, Matheson E, Chirina S, Shankar A, Broman-Fulks J. The status of Baby Boomer’s health in the United States: the healthiest generation? JAMA Intern Med. 2013; 173(5): 385-386. doi: 10.1001/ jamainternmed.2013.2006.

16.

Gude D, Koduganti RR, Prasanna SJ, Pothini LR. Mouth: a portal to the body.

Dent Res J (Isfahan). 2012;9(6):659-664.

17. Martin LG, Freedman VA, Schoeni RF, Andreski PM. Health and functioning among baby boomers approaching 60. J Gerontol Psychol Sci Soc Sci. 2009; 64(3): 369-377.

18. Rethmen MP et al. Evidence-based clini-

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cal recommendations regarding screening for oral squamous cell carcinomas. Tex Dent J. 2012;129(5):491-507 19. Badanjak SM. Halitosis in the absence of oral causes: recent research on the etiology of non oral origins of halitosis. Can J Dent Hygiene. 2012;46(4):231-237.

20. L ockhart PB, Bolger AF, Papapanou PN et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association? A scientific statement from the American Heart Association. Circulation. 2012; 125(20): 2520-2544.

21. Desvarieux M, Demmer RT, Jacobs DR Jr, Rundek T, Boden-Albala B, Sacco RL et al. Periodontal bacteria and hypertension: the oral infections and vascular disease epidemiology study (INVEST). J Hypertens. 2010;28:1413-1421.

22. Shultis WA, Weil EJ, Looker HC, Curtis JM, Shlossman M, Genco RJ et al. Effect of periodontitis on overt nephropathy and end-stage renal disease in type 2 diabetes.

Diabetes Care. 2007;30:306-311.

23. Taylor GW. Treat gum disease to improve diabetes. Surgical Restorative Resource.

Web site. http://www.surgicalrestorative. com/articles/2013/03/treat-gum-diseaseto-improve-diabetes-dr-george-w-taylorto-talk.html. Published March 6, 2013.

Accessed April 25, 2013.

24. Hagen KB, Byfuglien MG, Falzon L, Olsen SU, Smedslund G. Dietary interventions for rheumatoid arthritis. Cochrane Database of Syst Rev. 2009;(1):CD006400. doi:10.1002/14651858.

25.

Haque UJ, Bartlett SJ. Relationships among vitamin D, disease activity, pain and disability in rheumatoid arthritis.

Clin Exp Rheumatol. 2010;28(5):745-747.

26. Gomes-Filho IS, Passos JS, Seixas da Cruz S. Respiratory disease and the role of oral bacteria. Journal of Oral Microbiology.

2010;2:5811. doi:10.3402/jom.v2i0.5811.

27. Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. AM J Gastroenterol. 2013;108(3): 308-328. doi: 10.1038/ ajg.2012.444 28. Smith HS, Smith AR, Seidner P. Painful

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Rheumatoid Arthritis. Pain Physician.

2011;14: E427-E458.

29.

Jayavelu P, Sambandan T. Prevalence of hepatitis C and hepatitis B virus in­fection(s) in patients with oral lichen planus. J Pharm Bioallied Sci. 2012;4 (suppl 2): S397-S405. doi:10.4103/0975-7406. 100302.

30. K iltz U, van der Heijde D. Health-related quality of life in patients with rheumatoid arthritis and in patients with ankylosing spondylitis. Clin Exp Rheumatol. 2009; 27(4 suppl 55):S108-S111.

31. Ziebolz D, Pabel SO, Lange K, KrohnGrimberghe B, Hornecker E, Mausberg RF. Clinical periodontal and microbiologic parameters in patients with rheumatoid arthritis. J Periodontol. 2011; 82(10): 1424-1432. doi:10.1902/jop.2011.100481.

32. Mercado FB, Marshall RI, Bartold PM. Inter-relationships between rheumatoid arthritis and periodontal disease. J Clin Periodontol. 2003; 30(9): 761-772. doi: 10.1034/ j.1600-051X.2003.00371.x 33. Detert J, Pischon N, Burmester GR, Buttgereit F. The association between rheumatoid arthritis and periodontal disease.

Arthritis Res Ther. 2010; 12(5): 218. doi: 10.1186/ ar3106.

34. Ortiz P, Bissada NF, Palomo L et al. Perio­ dontal therapy reduces the severity of active rheumatoid arthritis in patients treated with or without tumor necrosis factor inhibitors. J Periodontol. 2009; 80(4): 535540. doi: 10.1902/jop. 2009. 080447.

35. R ies A, Trout J. Positioning: The Battle for Your Mind. 3rd ed. Whitby, ON: McGraw-Hill Ryerson; 2000.

36. Bray R. Extraordinary service: a dental necessity. J Mass Dent Soc. 2012;61(2):22-24.

37.

Stilson G. Marketing tips for dentists.

Web site. http://marketingtipsfordentists. com. Updated April 25, 2013. Accessed April 25, 2013.

38. Henry RK, Molnar A, Henry JC. A survey of US dental practices’ use of social media.

J Contemp Dent Pract. 2012; 13(2): 137-141.

39. Dowd C. Gadgets Every Boomer Needs.

Fox Business. Web site. http://www.foxbusiness.com/personal-finance/2012/06/21/ gadgets­-every-boomer-needs/. Published June 21, 2012. Accessed April 25, 2013.

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Speaker and consultant on instrument sterilization and infection prevention for Dental professionals.

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Infection “Out of” Control T

he news that broke on March 28th this year of a Tulsa, Oklahoma, based Oral Surgeon who treated patients with unsanitary and unsafe practices is as shocking to dental professionals as it is to the patients they treated. How frightening it must be to receive a letter recommending that you be screened for HIV, HCV and HBV because the dental office you attended had out of control sterilization practices. In fact, over 7000 people received that exact letter and while we may never know for sure how many contracted any diseases, the Associated Press reports that there is a least one suspected case of HCV transmission to a patient.

Allegations include that the dentist was using instruments that were rusted and pitted, using single vials of medications on multiple patients and allowing unlicensed individuals to perform procedures that would require licensure. The office also did not wrap their instruments, biologically monitor their sterilizer or have a written infection control protocol.

Sadly there are more and more of these stories making the headlines and becoming national news. Every night our patients are watching the healthcare reporters bring the latest story of the current outbreak, deadly virus, or an account of yet another breach somewhere in infection control. Patients judge the sterilization, cleanliness and safety of your office by what they see, hear and smell. Many will ask questions but the majority will anx-

iously wonder in silence if that is in fact a sterile instrument, if that saliva ejector is new or if that cup with water you want them to rinse with was left behind from the last person you saw in this room. Many healthcare watchdogs and news agencies, including CNN, have even posted check lists of things to look for and questions to ask on their next visit to your office.1 Would your office be able to answer those questions or pass the test?

The Office Environment • I s the office tidy, clean and free from clutter?

• A re cloth and carpeting avoided in treatment and sterilization areas?

• Is the sterilization area organized, clean and uncluttered?

• A re there sharps containers visible?

The Dentist, Hygienist and Dental Assistant (DHCP)

• Does the DHCP wear a mask and eye protection?

• Does the DHCP wash hands or apply alcohol based hand sanitizer prior to gloving before treatment?

• Were the gloves dispensed from a box and not off an unsterilized counter?

• A re gloves removed when leaving the room and discarded?

The Infection Control Process • A re all clinical surfaces cleaned and disinfected between patients?

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ORAL HYGIENE • Do high touch areas have barriers?

• A re the instruments packaged and unwrapped in view?

• A re all single use items discarded after use?

• A re all instruments that are damaged, rusty or in poor condition discarded?

• A re the handpieces sterilized after every use?

• Is the sterilizer monitored by regular spore testing?

• A re the water lines treated to maintain the water quality?

• Will the office allow you to see the sterilization area?

• Does the office have a written infection control plan that is reviewed regularly?

Whether you take a reactive or proactive approach to these questions, consider that these inquiries can provide an excellent opportunity for you to discuss the effective infection prevention measures you have implemented to ensure their safety and yours. It is also essential that your entire team portrays the same information and enthusiasm as mixed messages can increase the doubt your patients may feel. That is not as easy to do as it sounds, especially since most of us have an all hands on deck approach to sterilization.

By this I mean that no one person is responsible for the entire process of instrument sterilization. For example, the hygienist may place their instruments in the washer or ultrasonic, but someone else will empty it, an-

other person may wrap them, someone else will place them in the sterilizer and yet another person will remove them from the sterilizer and place them in storage. I have spent many hours observing in sterilization areas, watching teams run through their typical sterilization procedures and the more people involved, the more chance there is that the procedure will vary.

To make sure we are all consistent, the CDC asks dental practices to develop a written infection prevention and control program to prevent or reduce the risk of disease transmission to patients as well as DHCPs from work related injuries and illnesses. An infection control co-ordinator is appointed and given the responsibility for overseeing the program. To be an effective infection control coordinator, you need to be competent in infection control practices and understand the basic elements of an infection control program. The responsibilities of the infection control coordinator include: • Evaluation and recording of the infection control protocols • Training of team members • Ensuring the appropriate disinfectants and sterilants are used • Monitoring effectiveness, implementation and currency within local regulations.

Training The first step is proper training for all dental healthcare providers. The infection control

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It is important that all DHCPs know their personal immunization status and ensure that it is up-to-date coordinator can conduct the infection control and safety training for all team members to ensure that everyone is aware of the correct procedures and products used to accomplish the task. This is vital to ensure that the same protocols are followed and also that they are done in the correct way to protect employees from infectious agents. This training should include techniques to prevent contact with these infectious agents, instrument processing protocols, and personal protective equipment (PPE) that is available for use. The training must be site-specific and include information on the office’s exposure control plan.

Immunizations & Exposure Management Immunizations are an essential part of prevention and infection control programs for DHCP, and a comprehensive immunization policy should be implemented. Immunizations substantially reduce the number of DHCPs susceptible to these diseases and the potential for disease transmission to other DHCPs and patients. It is important that all DHCPs know their personal immunization status and ensure that it is up-to-date. All DHCPs should be adequately immunized against the following diseases:2,3 • Hepatitis B • Influenza • Measles • Diptheria • Mumps • Pertussis • Rubella • Tetanus • Varicella • Polio We are at risk for exposure to, and possible infection from, infectious organisms. Bloodborne pathogens, such as HBV, HCV and HIV, can be transmitted through occupational exposure to blood, saliva and other body fluids. Significant exposures must be handled in a prompt and organized fashion; therefore, an exposure management protocol is an important component of an in-office Infection Prevention and Control Manual. Immunizations are an essential part of prevention and infection control

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programs for DHCPs, and a comprehensive immunization policy should be implemented.

Personal protective equipment Developing a policy for PPE ensures consistent protection of DHCP’s vulnerable tissues from exposure to potentially infectious material. This also protects patients, by preventing the DHCW from becoming a vector for the transmission of micro-organisms from patient to patient. The infection control coordinator can help employees have adequate protection by providing instructions on placement and disposal of paper gowns, gloves, eyewear, single-use face shields, and surgical masks. For reusable items, the infection control coordinator can train employees on proper decontamination techniques.

Hand hygiene Hand hygiene is the single most important measure for preventing the transmission of micro-organisms.4 The infection control coordinator should evaluate whether hand hygiene procedures are followed. Employees must wash hands before donning gloves and every time hands are visibly soiled (including with powder from gloves) or contaminated with body fluids. Effective hand washing includes vigorously rubbing together all surfaces of lathered hands for at least 20 seconds, followed by rinsing under a stream of water.

If the hands are not visibly soiled, an alcoholbased hand rub may be used.

Environmental surface disinfection The infection-control coordinator should make sure that environmental surfaces such as dental carts, countertops, dental chairs, and X-ray equipment are disinfected correctly using appropriate products. Non-critical items should be cleaned after use and then disinfected with an appropriate low-level dis-

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ORAL HYGIENE infectant (e.g., 0.5% accelerated hydrogen peroxide, 3% hydrogen peroxide, 60 to 95% alcohols, iodophors, phenolics and quaternary ammonium compounds). 5 There are many choices in products to use and must be applied with a complete understanding of the directions, time required to achieve the actual disinfection or the safety profile. Criteria for choice in disinfection products should include; cleaning efficiency, germicidal activity, personal health and safety and the environment. Cleaning and disinfection of some noncritical items may be difficult or could damage surfaces, in which case the placement of a barrier is recommended.

The sterilization area Sterilization is a complex process requiring specialized equipment, adequate space, qualified staff and regular monitoring for quality assurance. Correct sorting, cleaning, drying, packaging, sterilizer loading procedures and sterilization methods should be followed to ensure that all instruments are adequately processed and safe for reuse on patients. The infection control coordinator is responsible for overseeing this process as well as making sure that the sterilization area is designed to facilitate quality control and ensure safety.

(Figure 1) The instrument processing area should have clear separation of clean and dirty areas with separate sections for: • receiving, cleaning and decontamination • preparation and packaging • sterilization • storage When using sterilizers, ultrasonic tanks, instrument washers, or other cleaning devices, it is important to follow the manufacturers’ instructions. Sterilizers should be properly maintained, serviced, and operated.

The infection-control coordinator can inspect instrument bags, cassettes, or wraps to ensure sterility and reprocess any bags or cassettes that are compromised by punctures, tears, or contamination. The infection-control coordinator must verify that sterilization monitoring is performed. This includes: mechanical monitoring or the recording of each cycle, chemical monitoring; an external indicator that is used to demonstrate that an item has been exposed to a sterilization process

and biological monitoring or commonly known as spore testing. Biological indicators, also known as spore tests, are the most accepted method for monitoring the sterilization process.1 The infection control coordinator is responsible for documenting the results of these tests, reviewing any failed tests, and maintaining the results in a log.

Conclusion Every day you practice Standard Precautions by cleaning, disinfecting and sterilizing to protect patients and yourself in the dental office. But you are only as effective as the weakest person on your team. Changing regulations, new technology, and information overload can make infection control stressful enough, now add in patients asking questions and wanting to be reassured. For that dentist in Tulsa, poor infection control is not only life threatening, it is also career ending. Appointing an infection control coordinator and evaluating your infection control protocols is a systemic way to ensure procedures are useful, feasible, ethical, and accurate and take the stress out of instrument cleaning and sterilization so that the dental team can focus on caring for patients. n

REFERENCES 1. CNN Health, 5 Things to Do at the Dental Office. www.cnn.com/2013/03/29/health/ dentist-5-things by Dr. Mark Burhenne, April 2013.

2. Molinari JA, Harte JA; Cottone’s Practical Infection Control in Dentistry 3rd Edition. Lippincott Williams & Williams 2010, 95-99.

3. RCDSO, Guidelines for Infection Prevention and Control, November 2009, 15 16 4. Molinari JA, Harte JA; Cottone’s Practical Infection Control in Dentistry 3rd Edition. Lippincott Williams & Williams 2010, 125-133.

5. RCDSO, Guidelines for Infection Prevention and Control, November 2009, 30 6. William A. Rutala, Ph.D., David J. Weber, M.D., M.P.H, et al; Centers for Disease Control and Prevention. Guidelines for infection control in dental health-care settings — 2008, 73.

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Raising Engagement to See Success

Dorothy Garlough, RDH, MPA

Graduated from Western Kentucky University in 1975 and has been a practicing dental hygienist continuously since that time. She now focuses on bringing her entrepreneurial and technical knowhow to business settings, helping improve workplace climate through leveraging creativity and fostering healthy team attitudes. Her insights into how to raise innovation within the work environment has led companies to breakthroughs and the implementation of new products, services and processes. www.innovation advancements.com

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E

verywhere we turn today, we hear the word innovation. It is in the media, advertisements, business profiles and even prominent within our dental practices. What exactly is innovation? We think that it is a new idea, but it is actually more. Innovation is defined as a new idea, product or process that adds value. The rapidly changing economic environment is propelling the prominence of innovation. Within the corporate and private business communities (including dentistry) it is no longer considered optional but essential.

Dentistry is a leader in technological innovations; neuromuscular analysis and treatment, digital impressions and x-rays, 3D printing, adaptive motion endo technology and lasers are just a few of the advances that have taken dentistry to a whole new level.

Some dentists are junkies, obtaining the newest and latest technological advancements without ever masterfully learning to utilize the tools. Often the level of investment is substantial, with the offices never getting a ROI (return on investment). There would seem to be a ‘disconnect’ in revolutionary technical innovation and the process for engagement to make use of it. This is a clear example where innovation should not be pigeonholed only with technology.

Business leaders recognize they need innovative processes to engage staff and raise the level of excellence within the business. They target a new training process every three to five years to maintain levels of commitment to the company. This commitment not only results in more satisfied employees but also a higher functioning company. Statistically, everything improves when we are truly present in the day. According to a recent Gallup Poll, with higher than average engagement, profit-

ability increases by 27% and customer loyalty is up by 50%. Staff and doctors are happier and this translates into better care for the patients. Engagement is a three way win!1 Research has shown that the carrot and the stick method of raising engagement has little value. 2 Threatening people to perform in a work environment went out the window with the passage of the Industrial Revolution. A staff member being told by the doctor that she had better buckleup or else, will have an eroding effect on not just the recipient of the stick but also upon the entire office. Such caustic behavior is like a virus, it spreads and unless it is attended to, it will incubate and eventually erupt into a full blown infection.

This can lead to disease within the entire office, perpetrating fear, detachment and disengagement.

Even rewarding people with high bonuses, although positive in the short term, will in the long term not hold value. Evidence has been shown by researcher, Allfie Kohn that extrinsic rewards can actually transform an interesting task into a drudge and send performance, creativity and even upstanding behavior toppling like dominoes. Bonus systems within the dental practice rarely work in the long run. Although reaching the monetary goal is stimulating at the beginning, it can become tiresome if the goal is unattainable over the long haul. Although being paid a fair wage has been shown to be imperative for commitment, putting a monetary bonus in place can actually cause stress and reduce interest. Apparently, we cannot buy engagement.

So, how should dental offices approach engagement today? Perhaps we could follow the corporate worlds’ model in training people to ‘think differently.’ They are involving their teams in the innovative process. Creativity

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training is proving to be invaluable, not only coming up with new ideas, arriving at breakthrough thinking but also producing both collaboration and autonomy within the workplace. Giving staff the tools to access their creative brains is empowering, unleashing talent that they didn’t even know they have. It also builds autonomy…the self governing and independence that gives the individual the capacity to make decisions and act on them.

Apparently, being listened to, valued and involved in making a difference has the effect of motivation upon us all.1 Picture a staff meeting where there are certain staff members who are naturally more vociferous and confident to express their views. Maybe the office is guilty of divisive sub grouping, where there is an ‘in’ crowd and an ‘out’ crowd. The predominate ‘in crowd’ tends to monopolize the conversation.

The quieter staff members appear to have no input, ideas or insights. Without a doubt, this is far from the truth. It is likelier that those not voicing their ideas have more to offer than the ‘in’ group. Their listening skills may be better honed and they practice more thoughtful, broad and inclusive thought patterns. They tend to be better at analyzing and incubating workable solutions. We need to empower everyone on the staff for positive advancement. This recognition will enable everyone to be involved in their work in a significant way. Empowerment is the result and engagement is the gain.

There are five criteria for developing innovative processes within the dental office: 1. C reating a culture of innovation — The modus operandi within the office needs to support creativity. The leader of the team has to lead innovation and promote it in thought, word and action. Funding for training in not only the use of technology but creative processes is imperative to tapping into the office’s greatest resource — its people. The right tools and resources need to be established. Surveys, brainstorming and mind mapping will reveal what is needed and what benefits can be gained.

2. Begin with the goal in mind — What is it that you wish to achieve? How will you measure engagement? What does success look like? Are you wanting ‘buy in’ to a new technological tool, are you wanting to

achieve breakthrough of a dysfunctional situation? Provide a feedback loop so that you and the team know what progress is being made.

3. Involve the entire team — Often the best ideas come from the bottom up. Build collaboration into the process and ensure that everyone is offering input and being heard. Sometimes one-on-one meetings are initially necessary to break barriers and enlist active engagement.

4. Try things in a small way and get a quick win. Offering evidence of a win is encouraging to employees that they are on the right path. This promotes more of the same. Mark the occasion in a special way; an outing, an inspirational speaker or even a donation to a common cause.

5.

C elebrate both failures and successes.

Failure is part of the learning process and in many institutions is recognized. Corporate firms today have ‘failure parties’ where failures are brought forward joyfully as a means to an end. Edison said after 10,000 tries to make the first incandescent bulb that “I have not failed. I’ve just found 10000 ways that won’t work.1 With all of the amazing innovative equipment in our dental practices, it is crucial that we keep abreast of innovative processes. The human factor is the hardest factor to measure and engage yet is the most essential. When you ensure that your innovative engagement processes are in alignment with your office strategy, and meet the criteria for developing them, the entire dental team becomes engaged.

Dentistry is a people industry and we need to become innovative in enlisting our people. We will then see what great success looks like! n

REFERENCES 1. http://www.cornerstoneondemand.com/ sites/default/files/whitepaper/csod-wp_ empowerment_oct10.pdf.

2. Drive - ISBN: 978-1-59448-480-3, Daniel Pink, Riverhead books, 2009.

3. Innovation Management: http://www.innovationmanagement.se/2013/03/04/iscreativity-the-new-business-edge/.

4. http://www.businessweek.com /stories/ 2006-07-09/how-failure-breeds-success.

September 2013

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ORAL HYGIENE

How to Release the ‘Intrepeneur’ Within!

I Kathleen Bokrossy, RDH

Business Director at rdhu and RDH Portfolio Manager. rdhu, The Unique Dental Hygiene Professional Development Centre, offers experiential and on-line learning to dental hygienists across the country and RDH Portfolio Manager, is an on-line tool designed to help the dental hygienist build and create their Professional Portfolio with ease. Kathleen is committed to helping dental hygienists flourish within their practice, both independent and within a dental setting. She can be contacted at kathleen@rdhu.ca

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t’s a common scenario. You attend a continuing education course, a lecture or product demonstration at a conference. The information shared is exciting, it offers the opportunity to truly change how the practice operates and/or the level of care the client will experience. You can’t wait to share this practice-changing news with the team. Unfortunately, when you explain what you think is the greatest idea ever; you are not greeted with the same enthusiasm. With their arms crossed and their resolve to resist change solidly in place, the great idea dies a quick death.

Each objection they raise fills you with doubt about being able to follow through and implement the changes in order to reap the benefits. You get drawn back into the daily routine and all the opportunity is quickly forgotten. You and the practice slide back into the “rut” wondering why things aren’t improving and you’re not reaching your practice goals. Well at least until the next course or lecture comes along when you repeat the entire cycle again. How did Einstein define insanity? “Repeating the same actions over and over and expecting things to change.”

If this isn’t a problem for you, then congratulations! If you can introduce a new idea to your office, get the team excited and implement all the changes required, then you naturally exhibit the skills of an ‘intrepeneur.’

What is an ‘intrepeneur’? One of the most valuable assets to any dental practice! An intrepeneur doesn’t ‘own’ the practice but looks at how the practice runs and continues to introduce positive change, like it’s their own. Whether change is through better client experience, which leads to greater client retention and attracts new clients into the practice, or efforts to reduce costs and increase revenue, an intrepeneur is an essential member of any dental team.

The biggest difference between an entrepreneur and an ‘intrepreneur’ is who needs to

be “sold” on the game-changing idea. Any change carries with it both risk and reward.

Where an entrepreneur in most cases risks their own time and money to move an idea forward, an intrepreneur risks the resources of their employer, in most cases, the dentist.

Presenting both the risks and the rewards in a manner that the team can understand is often the biggest barrier to change. The good news? Through some subtle changes in how you make your “pitch” to the team, you can dramatically increase your chance of success.

Follow these simple steps to ‘Release the Intrepeneur Within’ and drive positive change to your practice today!

1. A ctions speak louder than words!

Focus on what matters

Show an active interest in the productivity of the practice. Not all dentists will share their revenue numbers with you, and you don’t need to know everything, but you should have an idea of what revenue your operatory generates as well as your supply costs. This change in focus made a huge difference for me. When I started paying attention to what I was billing and the cost for each day, I began to understand where I was having a significant impact on overall profitability. When I saw opportunities for improvement and pointed them out to the dentist, he/she saw that my focus was aligned with his/hers.

Showing your commitment to the practice consistently over time will build your credibility, so when you do bring forward ideas, the dentist will know your intentions and commitment is to implement positive change to the practice.

Warning: I believe positive client experience is THE most important aspect of any dental practice. Be sure your efforts to manage costs and improve efficiency does not negatively impact how the client is treated nor their overall perception.

September 2013 www.oralhealthgroup.com

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13-09-05 2:15 PM

Look for different ways that you can contribute to your team meetings by suggesting systems/processes that help increase productivity. There are so many resources available today that offer great ideas that have been successfully implemented by other practices.

Resources such as; on-line education, continuing education courses or from the technical sales representatives that call on your office, there is no shortage of ideas that can be implemented.

Warning: The trick is to separate the good ideas from the great ones! Introducing the flavor of the month will hurt instead of help your credibility. It is important to do your homework to determine which ideas will deliver a measurable benefit instead of just being a distraction from what’s already working.

3. Prepare a Benefits summary that you can share with the team.

If you would like to implement new technology, a product, a program or a system into your practice, you need to present your ‘case’ to the dentist AND the team. By outlining the benefits as well as the risks into a single consistent summary, you can quickly address initial concerns and illustrate how the new idea will improve practice productivity. It helps to engage the entire team when you get ‘buy in’ and

ORAL HYGIENE

2. Do your Homework

there is an understanding of the total benefit available through the change. Since different members of the team are affected in different ways, it is important that the total impact of the new idea is understood by all.

It also demonstrates to the team that you are truly committed to the idea and will put forth the sustained effort necessary to see it through to the end.

Prepare a document that you can share that has the following elements!

Current State You need to understand and explain what the current situation is, related to the new idea, so that you can prepare a document that will show where you would like to be. By identifying current inefficiencies or costs associated with the current method, it becomes possible to determine the net change of the idea you plan to implement.

Benefits of the new process Create a list of the benefits that this new product, system or program can bring to your practice, and your clients.

Risks Most people don’t like to talk about risk, but it is important to bring these risks forward and discuss them with the team. Risks that aren’t exposed at the beginning appear to be bigger than they actually are and can sometimes highjack the idea during the implementation.

OPERATORY MANAGEMENT PROGRAM Current Situation # of hygiene operatories Frequency of replacing instruments Annual Budget for instruments Usuage of Instruments Number of instruments Overall Clinician experiencing

3 It's been over 3 years Nil All 3 ops are full-time 5 sets of 6 for each op.; 15 sets of 6 90 instruments Fatigue, slipping during instrumentation, clients are complaining about hygienists being heavy handed

Sharpening Frequency

2 times a day (app 10 min) (X 3 hygienists at $40 per hour) Cost to practice: $39.60 per day; $39.60 X 5 days = $198/week $792/month

Cost

Proposing the OIM Program 3 operatories receiving new instruments every 4 months

5 sets of 6 instruments per op 90 instruments every 4 mos

Benefits

Gentle care, efficient tx, effective tx, less fatigued RDH; more enjoyable appt for client and RDH’s no more having to deal with waste and disposal of instruments or long sharpening time, quick sharpening only required; save time on ordering and organizing instruments

Cost

$99 per op $297/month $495/month

Savings

September 2013

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ORAL HYGIENE

Proposed Costs There are two types of costs that need to be identified. The initial implementation cost as well as the ongoing operating cost. Initial costs are the up-front costs and effort required to get the new process in place. The operating costs reflect the specific time, effort and expense required to maintain the new process.

Summary: Profitability and the Bottom Line

By comparing current costs to the proposed costs plus all the other benefits identified, it becomes possible to put together a single document that outlines the reasons (both fiscal and non-fiscal) to proceed.

For your reference, please find a few examples of how you can present your ‘case’: 1. Crest Oral B Program has a great program (www.healthypracticenow.ca) that is designed to help make the dental hygiene department more productive, it puts systems in place, recommendations for treatment, it empowers your clients and it involves the entire team.

On presenting this to your team: a) Show examples of a few current ‘recare’ clients: How often they come in for treatment, the average revenue for each, what kind of treatment they receive, how long their appointments are and the self-care given to them. b) Show the same few ‘recare’ clients and apply the program to those clients and show the difference in the treatment received, the length of appointments, the frequency of the appointments, how the responsibility shifts to the clients, the team involvement. c) C ompare the revenue from the current situation to one of being on the program. d) Show how the program works (visit the website and do the Practice Assessment together). e) Offer to bring in a sales rep if you need help to ‘close’ the deal, making sure that the dentist is present at the demo.

2. Operatory Instrument Management Program (OIM Program) offered by D-Sharp, illustrates the potential savings associated with an instrument maintenance program versus what most offices do to maintain their instruments. By plugging in your current situation, it is possible to use this format to evaluate whether moving to a man-

28

aged program would deliver a significant benefit to your practice. a) Show the current situation of your instruments: How often your instruments get replaced, the cost of new instruments that you have purchased in the past, the organization of the instruments, purchasing of the instruments and the time spent, the sharpening situation, how much time it takes to sharpen, when do the instruments get sharpened, and if you can – the cost of the dental hygienist being paid for sharpening time. b) If you have a dental hygienist in your practice that you hear is “heavy handed”, note that. Most times than not, it is the instruments in the hands of the dental hygienist rather than the dental hygienist him/herself. Many clients try to switch dental hygienists or simply leave the practice. Show the cost of losing a client (ex $10,000 over a lifetime of a client). c) Show the benefits of being on the program for the client, the dental hygienist and the practice. d) Show the cost of the instruments per month by being on the program, and the time saved by not having to organize ordering, sifting through instruments to find the sharp ones, disposal of the instruments.

3. A n electronic periodontal probing method a) Show the current situation: The time in the chair to probe, if an assistant is required and the cost associated with that. b) Show how this new technology will help you, the response of the client, the ease of use, the time saved. c) C ompare the cost of the device to what it is currently costing you.

By being prepared, recognizing your current situation and knowing your facts, you will feel confident in presenting your case to your employer and your team. By releasing the ‘intrepeneur within’, your practice will reap the rewards, your ‘job’ and professional satisfaction will soar, and you will become a valuable asset any office would be lucky to get.

Warning: If after consistently demonstrating your commitment to improve practice productivity, you do your homework and present well thought out strategies to improve the practice but you STILL can’t break in and help make a difference, you may not be in the practice that is best suited for you.

But that’s for a different article!!

Good luck! n

September 2013 www.oralhealthgroup.com

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Get an educational kit for your outreach activities!

Established with a founding gift from Dr. Esther Wilkins, the Esther Wilkins Education Program provides dental hygiene professionals and students with community education kits to promote good oral health practices among children, parents and caregivers.

Kit materials subject to change. Shipping and handling charges may apply.

Now, you can help continue the great work started by Dr. Wilkins as a member of the Esther Wilkins Legacy League!

The Esther Wilkins Legacy League unites dental hygienists in their mission to prevent dental disease and serves as the driving force for ongoing oral health promotion efforts conducted by program volunteers.

Members are eligible for special recognition throughout the year, a ToothFairy pin, prize drawings for

速

loupes and other prizes!

To volunteer or join the Esther Wilkins Legacy League, visit www.CanadasToothFairy.org Scan here to go to our website and register!

Program Sponsors

100% of your contribution goes directly smile-saving programs thanks to these generous Corporate Underwriters:

OHYSept13 p29 Nat Childrens AD.indd 29

13-09-05 2:16 PM

PRODUCT PROFILE

BLUEPHASE Bluephase Style is a compact high-performance LED curing light launched by Ivoclar Vivadent. Due to its ergonomic, well-balanced and lightweight design, hands and arms of practitioners are less strained. Ivoclar Vivadent now offers the light with two new colour elements: blue and pink. The new shortened light probe head increases its usability, as even the difficultto-reach mouth region can be comfortably light-cured.

This means that patients, especially children, are no longer required to open their mouth for an excessively long time.

With its large diameter of 10mm, Bluephase Style can lightcure even extensive cavities, thus rendering multiple curing cycles with MOD restorations superfluous.

www.ivoclarvivadent.com

TRU-ALIGN Exclusively distributed

by Clinical Research Dental, TRU-ALIGN laser-collimation system lowers dental x-ray radiation exposure as much as 60%.

A typical round cone emits a large beam of radiation that makes it easy to aim at the desired area but it also emits a lot of excess scatter radiation that is absorbed by the patient, instead of the x-ray sensor. TRU-ALIGN easily retrofits to any round cone, transforming the beam to a smaller, rectangular collimator to reduce x-radiation.

www.clinicalresearchdental.com

MEDICOM Inspired by the fusions of flavour seen across the food industry, Medicom is pleased to introduce three new blends of exclusive flavours to the DentiCare and Duraflor Halo fluoride line. CinnaMint, MelonMint and CitrusMint combine refreshing mint with delicious extracts to create new, exciting combinations. These new flavours are now dye-free across the Denticare fluoride line.

http://www.medicom.com/en/products/30/denticare-fluorides

GUMCHUCKS® GumChucks® is the first and only flossing system of its kind.

Resembling miniature Nun Chucks, they feature disposable tips that are equipped with a ¾ inch piece of dental floss. GumChucks can be used in the recommended and effective C shape – something flossers can’t do. Kids think it’s a toy, but parents and dentists know it’s a great tool for teaching and improving Oral Health.

www.GumChucks.com CROSSTEX/SPSMEDICAL STEAMPLUS™ Effective sterilization is a key component of infection control protocol, and Class 5 integrators can help health professionals ensure the efficacy of the sterilization process. Crosstex International STEAMPlus Class 5 integrators are used with steam sterilization cycles to provide a distinct pass or fail result, which allows for the release of all nonimpant loads before the results of the spore test are received. Moving-front technology provides an immediate readout integrator for use in gravity, prevacuum, and flash cycles. STEAMPlus™ Class 5 integrators promote patient safety by helping to detect sterilizer failures.

www.crosstex.com

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Send new product press releases to cwilson@oralhealthgroup.com September 2013 www.oralhealthgroup.com

OHYSept13 p30-31 Products.indd 30

13-09-06 11:22 AM

PRODUCT PROFILE

NEW GOOGLES® Kerr TotalCare, the Leader in Dental Infection Prevention, is proud to introduce the next generation in Personal Protective Equipment (PPE) with NEW Googles®. NEW Googles® feature an improved lens attachment system, which makes changing out the lenses significantly easier.

New Googles® also feature a larger, more rounded frame allowing for greater area protection and user comfort and provide a lightweight design with distortion-free optical grade, fog free lenses.

www.KerrTotalCare.com/googles P R O F E S S I O N A L

P R O P H Y L A X I S

P A S T E

ENAMEL PRO Swirl-mint flavors for lustrous smiles! ®

SPORICIDIN® Sporicidin® Brand products have been used in hospitals and dental offices for infection control for over 30 years.

The product line consists of disinfection solution, towelettes and wipes, enzymatic cleaners, antimicrobial soap, and a cold sterilant. The disinfectant wipes fight cross-contamination anywhere in the office. Pre-saturated, it contains a combination of surfactants, which clean and remove the soil and biofilm where bacteria live. The Sporicidin® chemistry is EPA and FDA approved.

www.sporicidin.com

Enamel Pro® prophy paste line offers the most comprehensive mint selection in the market.

The fresh clean feeling that mint flavors provide your patients is a functional benefit.

• Strengthen their smiles Enamel Pro® delivers 31% more fluoride uptake1 • Enamel Pro creates increased luster2,3

NATURAL EXTENSIONS® Benco Dental customers can now purchase natural extensions® Earloop Masks in bright fuchsia and a donation will be made to the Keep A Breast Foundation™ with each box sold. The masks are fluid-resistant and latexfree, with a white facial soft tissue inner layer and an adjustable noseband.

www.benco.com/kab

• The colorful swirl design, aroma and flavors appeal to patients and professionals • Gluten-free

3+1 FREE! Buy any three boxes of Enamel Pro Prophy Paste, get one box FREE!* Order through your authorized dealer.

ADVERTISER PAGE Colgate-Palmolive Canada. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Crosstex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 GSK – GlaxoSmithKline. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IBC Kerr TotalCare. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 National Children’s Oral Health Foundation . . . . . . . . . . . . . . . . . . . . . . . . . 29 Philips Oral Healthcare. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IFC, 7 Premier Dental Products. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Quantum Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Sci Can. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 VOCO Canada. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OBC

Y E A R S

Premier® Dental Products Company 888-670-6100 • www.premusa.com * Offer valid through 9/30/13. / 1-3 Data on file.

www.oralhealthgroup.com

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DENTAL MARKETPLACE

DENTAL MARKETPLACE

Contact: Karen Shaw • tel: 416-510-6770 • fax: 416-510-5140 • e-mail: kshaw@oralhealthgroup.com Toll free: CDA 1-800-268-7742, ext 6770 • Toll free: USA 1-800-387-0273, ext. 6770

PROFESSIONAL SERVICES

Alglobe • • • • • •

Construction Company

20 years construction experience Dental office construction and design + cabinet making.

Provide turn key operation to dental office.

Reliable construction timing, Good following up service after construction.

Call: Stanley New dental location and lease negotiation.

Tel: (416) 321-3313 Save time, save money. www.alglobe.com

ONTER CONSTRUCTION • Specialized in dental office design & construction.

• In-house architect and interior designer.

• We are qualified code consultants to review all drawings and make your building permit application easy.

• Own millwork facilities for best quality of custom built cabinets and time control of your project.

Tel: (905) 793-2344

www.onterconstruction.com

CAREERS ST. CATHARINES, ON Experienced office administrator/ reception needed full-time for our St. Catharines office.

Please send your resume wassim@fortismed.ca

Looking To Get Paid What You Are Worth?

Be Fully Supported, Continue Your Education, Work With A Skilled TEAM, While Earning Performance Bonuses & Incentives…

Is This YOUR New “Dental Home”? www.DentalDreamTeam.ca/assistant

PRACTICES & OFFICES INGLESIDE, ON

(located about 20 minutes from Cornwall and 1 hr. from Ottawa/Montreal) 1200 square foot space available for sale or lease. Terms are flexible. Great demand for dentist in the community.

Privy to other opportunities in community if current location deemed unsuitable.

Please call Bryan (Pharmacy Owner) at 613-537-2477 or email me at inglesidepharmacy@hotmail.com for more information.

BARRIE, ON

Modern, spacious 6 op, all equipped, well established practice for sale. 780k collections. 3 day DDS, 3&1/2 day hygiene. no weekends or evenings. Asking for 650k, owner relocating overseas.

E-mail: paulsmith1347@gmail.com

MAPLE, ON

Specialist Retiring.

Unit available in Busy Maple Plaza.

Leasehold improvements completed.

Call for details: Anna (416) 993-8097 Email: annalorefice@rogers.com

MILTON, ON

Dental Office space for lease, new plaza in Milton, 1500 – 2000 square ft second floor unit facing road. Tenants include Sherwin William Paints, Restaurant, Osmow Sheverma. Nutritionist, Medical office with Physio and Pharmacy, Beauty Salon, Halton Catholic adult learning center.

Contact: sunnydhaliwal@gtmortgages.com

ARE YOU A DENTAL ASSOCIATE LOOKING FOR A FULL SCHEDULE?

Newly Renovated, State of The Art Equipment, 10 Operatories, Skilled TEAM, Performance Bonuses & Incentives…

Is This YOUR New “Dental Home”? www.DentalDreamTeam.ca/Dentist

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September 2013

OHYSept13 p32-34 Classifieds.indd 32

ST. CATHARINES, ON Lake Street Dental in St Catharines is looking for an experienced dental assistant for one to two days a week.

Please send your resume as soon as possible to: info@lakestreetdental.ca

ASSOCIATESHIPS VICTORIA, BC Dental Associate Wanted

2 to 3 days a week starting in November for established Royal Oak practice with an Active Recall Program. Minimum 2 years experience required, preferably trained on Cerec Machine.

Email: Shane@RoyalOakDentalClinic.com

CAMBRIDGE, ON Seeking a friendly, motivated full-time associate for a modern dental facility.

Email resume to: cambridgedentalop@gmail.com

EAST OTTAWA, ON

Full time associate dentist needed for state of the art practice in a growing bedroom community in East Ottawa, ON. New graduates welcome. Opportunities to buy in.

E-mail: lisa-hawkins@hotmail.com

TORONTO, ON

FINCH/DUFFERIN MEDICAL BUILDING with 50 doctors looking for dentist, periodontist, endodontist and dental lab.

Please send your resume to: 2chdrive@gmail.com

FULL TIME ASSOCIATE WANTED — NORTHERN ONTARIO (TIMMINS AREA) Bright, busy, modern well established practice. Superior Compensation Package $20K-$25K per month range. Cheerful, professional & efficient staff. Vibrant and active community in pristine setting. Graduates and Experienced Dentists welcome.

Please e-mail resumes to firstline_dental@hotmail.ca

OAKVILLE, ON

Associate required for busy general practice. 2 days a week, no evenings or weekends.

Email: reception@oakvilledental.ca

MISSISSAUGA, ON

Mississauga Dental Practice looking for Part-time Associate. Experience preferred.

Please send CV to Skymark2@winningsmiletor.com

TORONTO, ON YONGE & FINCH

Part time experienced associate required for a fabulous,friendly & family dental clinic.

Fluent in Mandarin must be an asset.

Appreciate if you email your resume to smile@northyorkdentalclinic.com

IMMEDIATE PARTNERSHIP OPPORTUNITY IN SMALL TOWN

Par tner needed for growing small town practice. Amazing opportunity with immediate ownership to further develop an existing office with large new patient flow and no competition. Must be dynamic, have leadership skills and enjoy all aspects of dentistry.

Reply to: partnerpriority@outlook.com

OSHAWA, ON

Progressive growing practice in Oshawa is looking for an associate dentist. To start beginning of September for Tuesdays, Thursdays and every other Saturday.

Please forward resume to dentaloshawa@yahoo.ca

OTTAWA ON F/T ASSOCIATE REQUIRED

Seeking highly motivated and experienced individual to work in established family practice. Candidate must be knowledgeable in most aspects of dentistry and dedicated to patient care.

Please email resume to: ottawadentalgroup@gmail.com

www.oralhealthgroup.com

13-09-03 8:55 AM

BARRIE, ON

Looking for orthodontist in Barrie.

Busy neighborhood.

Start date December 2013.

Please forward your résumé to dental_manager@ hotmail.com RED DEER, AB F/T Associate needed for busy general practice in Red Deer, Alberta. No weekends & evenings. New grads are welcome to apply.

Please send resume to carolfuis@gmail.com

TORONTO AND GTA, ON Endodontist seeks full time or part time associationship.

Email: fzsl@yahoo.com Phone: 416-875-0582.

ORILLIA, ON

Part time associate required 1-2 days per week for busy general family practice.

Please forward resume to dental_2010@live.ca

TORONTO, ON

Dentist required for downtown Toronto office. Having your own patients is a plus.

E-mail: tooth32@295.ca with your resume.

TORONTO, ON

Part- time: Orthodontist, Periodontist and General Dentists are needed for a rapidly expanding family practice in Toronto.

Please fax your resumes to (416)-538-8422, or email to davidkourosh@hotmail.com.

SASKATOON, SK Associate required for modern, very busy practice with strong new patient flow.

Great opportunity in a University setting.

E-mail: associatedentist@ymail.com Fax CV: 888-880-4024.

VERNON, BC

SASKATOON, SK

Full and part time associate opportunities in very busy modern family practice.

Fax CV to 866-764-1860 or call Bob in confidence at 306-260-6919.

OAKVILLE, ON

Experienced dental associate opportunity required for a well-established & prestigious family practice in Oakville.

We offer the latest technology and all aspects of dentistry. Flexible schedule including some evening and Saturday hours. Seeking a positive, energetic individual with excellent clinical and communication skills who is eager to join our progressively growing team.

Please email oakvillesmiles@hotmail.com

ASSOCIATES FOR HAMILTON & WATERLOO, ON

Associates required, for TWO VERY busy and modern practices with VERY strong new patient flow.

E-mail: associatedentist@ymail.com Fax CV: 888-880-4024

BURLINGTON, ON

Endodontist needed for Burlington Dental Practice 2 – 3 days per month to start.

Email CV to excellenceinpractise@gmail.com

RICHMOND HILL, ON

Part-time leading to full time position available for the self-motivated, caring individual who can perform all aspects of dentistry.

Please fax resume to 905-770-5130 or e-mail: info@eltekdental.com

TORONTO, ON Busy, growing Toronto dental office looking for the following providers to join its team: • Endodontist • Periodontist • Orthodontist Please contact Janice at 416-248-0045 or e-mail: kiplingdixondentist@gmail.com

Cornerstone Dental Group is seeking a full time associate to take over an existing associate position in Vernon BC. The successful applicant will be an enthusiastic, energetic individual, have more than 2 years experience in all areas of general dentistry and have an appetite for continuing education. Our newer, well equipped office is fully computerized (paperless/digital radiographs) and has a Cerec machine, microscope and 2 soft tissue lasers. We have a committed staff and a large, loyal patient base.

For more information call 250-260-0281 or email dr.rex@shaw.ca

www.oralhealthgroup.com

OHYSept13 p32-34 Classifieds.indd 33

DENTAL MARKETPLACE

ASSOCIATESHIPS PETERBOROUGH ASSOCIATE

4 – 5 days available for General Dental Associate for Two different high-tech offices. Potential Partnership for a right person. Above average remuneration.

Please send your CV to dental.associate.east@gmail.com

VICTORIA, BC

Career opportunity of a Lifetime. Seeking F/T associate, for one of B.C.’s highest grossing practices in the Westhore area of Victoria. Would assume a full practice load with huge potential for further growth. Experience is required, Cerec experience an asset. Must possess strong patient interaction and treatment presentation skills.

Please call 1(250) 474-5308 or email dawn@westshoredental.com

EDMONTON, AB A full time associate dentist required to take over an existing full patient load from the current associate who is leaving. This truly is a very unique opportunity for a new associate to be immediately busy from day one.

The office is bright, modern and very well equipped and is continually updating the core systems to better position the office for the future. If your primary focus is the needs and well being of the patients, and if you are willing and able to work with others in a larger group practice environment then this clinic is right for you. A positive attitude, a sense of humor and some flexibility in scheduling will lead to a very successful and rewarding position for the right individual.

Email: qdental@shaw.ca 780-965-3787.

CAMBRIDGE, ON

A Board-Certified Pedodontist is needed by Coronation Dental Specialty Group. Coronation is a multidisciplinary specialist practice with OMFS, Perio, & Endo in a collaborative environment.

Coronation has 5 offices, is opening 2 more in late 2013, and enjoys excellent relationships with a large and loyal referral base. The Pedodontist is not expected to work from all the offices. N2O available, GA by an MD anesthesiologist. Competitive remuneration.

Contact Mitzi Bryant: mbryant@cdsg.ca, 519-629-3220 (w), 519-629-3225 (f)

September 2013

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TISDALE, SK

GRANDE PRAIRIE, AB

Associateship or buy in opportunity in busy dental practice in Northeast Saskatchewan. Tisdale Dental Group is looking for an associate or buy in partner in Tisdale, Sask. Moving into new Tisdale Health Plex Complex in near future.

For further information and details contact Tisdale Health Plex Dental Group 306-873-4255, 4247, 4204 fax or email tdhc.connie@sasktel.net

A full time associate/colleague needed for our well established, busy family practice, with travel to our satelite clinic in High Prairie, AB. Our practice offers all aspects of family dentistry including implants.

If you are trustworthy, friendly and committed to excellence please contact Christa or Dr. Roy at: 780-539-6883 or email resume to drroy04@telus.net

BROCKVILLE, ON

ASSOCIATES WANTED FOR NOVA SCOTIA AND ONTARIO

Dentist – Associate position available for the Brockville Area.

Position available 2-3 days a week.

8:30am – 4:30pm Email: info@georgestdental.ca

Looking for an associate (part/full time) to join our group of multidisciplinary practices which are focused on the highest quality of patient care and using the latest technology available. We are looking for a self-motivated, high-energy, clinically strong candidate who is interested in learning and continuing education. This is a great opportunity for the right candidate to grow with our expanding group and to work in a great environment. Buy-in opportunities are also available for the long-term associates.

If you are interested, please email your CV in confidence to edmontondentalcareer@gmail.com

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September 2013

OHYSept13 p32-34 Classifieds.indd 34

OTTAWA, ON

Full and Part time associates required for multiple busy practices. We offer all aspects of dentistry and a terrific team to work with. Mentorship opportunity available.

Please send resume to claudia@maritimedentalgroup.ca

EDMONTON, AB

WHITEHORSE, YUKON Come enjoy the beauty of the great north in the beautiful city of Whitehorse, Yukon. Have the best of both worlds.

Hiking, fishing, biking, sking are all waiting for you to enjoy!! Busy 8 operatory practice looking for a full time general dentist.

Please fax resume to Pine Dental Clinic at 867-668-5121 or email us at pinedental@northwestel.net

ASSOCIATE WANTED to work between two busy dental offices in west end Ottawa.

Once a caring, ethical, good-conversationalist associate is hired, one of the two dentists plans to retire, leaving behind almost 5,000 active patients. Both offices feature modern facilities, friendly patient bases and efficient, hard-working staff.

Phone: (613) 224-7885 E-mail: ottawadentist@live.ca

LLOYDMINSTER, ALBERTA (Population 32,000 – 2hrs drive from Edmonton or Saskatoon).

Direct flights available from Lloydminster to Calgary

Full time position available for a quality-conscious, motivated associate wishing to practice in a modern, well-established family oriented practice with well established clientele.

Monday to Friday daytime hours. Excellent team and patient-oriented, energetic staff. Adherence to recent ADA regulatory standards and dedication to patient care is our first priority. New grads welcome. If interested in joining our welcoming community, please contact: Mimi McMaster at 780-871-4550 or e-mail: mimimcmaster@shaw.ca

www.oralhealthgroup.com

13-09-03 8:56 AM

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