Just For Canadian Dentists 2013-11 November December by Just For Canadian Dentists

november/ december 2013

life + leisure

ice climb in

Alberta explore the

Big Island win

a visa gift card or $1,000 in CE gift certificates! page 37

+ escape to

BAHAMAS Speed Week + a DENTIST fights poverty at home + abroad + the ultimate GIFT GUIDE + the hybrid practice sale

Publications Mail Agreement #41073506

inside: Continuing dental Education Calendar

where will you meet? edmonton / sacramento / galapagos / dublin / lincoln >>

F I N A L LY, A N I N J E C T A B L E H Y B R I D R E ST T ORA AT I V E F O R A L L I N D I C AT I O N S

Just for C

de nti sts life + leisure

november/december 2013

contents

November/December 2013

NEW SHADES!

Publisher Linh T. Huynh

Editor Barb Sligl

B1, B2, C2 & D2

Art Direction BSS Creative

Contributing Editor Janet Gyenes Editorial Assistant Adam Flint

• Indicated in classes I, II, III, IV & V

Contributors Timothy A. Brown Michael DeFreitas Dr. Holly Fong Janet Gyenes Darryl Leniuk Manfred Purtzki Dr. Kelly Silverthorn Roberta Staley Cover photo Darryl Leniuk

• Physical properties rival hybrids • Stackable & sculptable; stays put • Self-polishing “leveling-effect”

Shofu Dental full page IFC ad

• High radiopacity, beyond enamel

Senior Account Executive Monique Nguyen

BEAUTIFIL Flow Plus is the next step in the evolution of restorative materials, combining the delivery of a flowable and the strength, durability, and aesthetics equal to or better than leading hybrid composites.

Production Manager Ninh Hoang

Circulation Fulfillment Shereen Hoang CE Development Adam Flint Sales, Classifieds and Advertising In Print Circulation Office 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada Phone: 604-681-1811 Fax: 604-681-0456 Email: info@AdvertisingInPrint.com

Visit www.shofu.com or call 800.827.4638

SNBFP-0512

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Shofu Dental Corporation • San Marcos, CA

clockwise from top left: Darryl Leniuk; B. Sligl; Darryl Leniuk

Scan here for more information on Giomer Technology & watch the Acid Neutralization video.

Account Executives Lily Yu Wing-Yee Kwong

Just For Canadian Dentists is published 6 times a year by Jamieson-Quinn Holdings Ltd. dba In Print Publications and distributed to Canadian dentists. Publication of advertisements and any opinions expressed do not constitute endorsement or assumption of liability for any claims made. The contents of this magazine are protected by copyright. None of the contents of the magazine may be reproduced without the written permission of In Print Publications. In Print Publications 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada

FEATURES

15 climbing Canmore Via shimmering sheets of ice 28 go big in Hawaii Where the Big Island offers it all COLUMNS

DEPARTMENTS

8 photo prescription

5 November/December mix 19 CE calendar 37 sudoku 38 small talk

Shooting on the move

12 motoring Bahamas Speed Week

14 pay it forward Pediatric dental surgeon Dr. Geoff Smith’s poverty-fighting work at home and abroad

26 the wealthy dentist

The hybrid sale

34 the thirsty dentist

www.justforcanadiandentists.com

Printed in Canada.

want to reach us? check out our website!

Essential bar tools, part 2—the booze

with Dr. Michael Zuk

cover photo

Winter rush: Learning how to ice climb in Canmore, Alberta. Story on page 15.

35 the hungry dentist

The slow braise

36 practice management

Become a bestseller

November/December 2013 Just For Canadian dentists

from the editor

what/when/where > November/December

clockwise from top

and-very-with-it guides, you’ll scramble to the top, pretty much guaranteed. Those guides’ patient encouragement may not help win you any races, but this kind of exertion is one surefire way to partake in wonderful winter (page 5). Most of us, though, will opt for the winter getaway plan. That is, Hawaii. This year, make it the Big Island. And make it the Kohala Coast (page 28). It’s a resort paradise carved out of lava rock, and it’s an easy home base for exploration from north to south, Hawi to South Point, cowboy country to coffee plantation. One dentist who’s making the most of his travels is Dr. Geoff Smith—from remote Newfoundland and Labrador to Nyahururu in Kenya. It’s travel with a purpose (page 14). Another dentist on the move is the

stay

here! winter

Providing Dental C.E. Since 1996

rush rather rock-star-like Dr. Michael Zuk, who recently embarked on a UK tour of beloved Beatle, John Lennon. He also bought Lennon’s tooth and plans to use the precious DNA within to potentially clone the genius musician (see page 38). Strange or savvy? What do you think? And how are you making a mark in the world of dentistry or beyond? We love hearing how dentists are making a difference, at home and abroad. Let us know if you have a story to share, big or small, abroad or at home. And if you’re looking for something interesting and inspired to give to those who made your list this holiday, check out our gift guide (page 7). Bonus: while you’re out during the holiday rush, practice those photography skills by shooting on the move (page 8). Mad mall dash, anyone? Don’t forget to enter our two contests (page 37), and tell us what you’re up to this winter—warm-weather destination or cold-temperature adventure. We want to hear from you; let us know where in the world you’re travelling, photographing, volunteering, working…stay in touch through justforcanadiandentists.com. Enjoy!

hot + cold

feedback@InPrintPublications.com

Just For Canadian dentists November/December 2013

B Sligl

mbrace the ice. It’s chilly, yes but it’s also striking beauty-wise. Just think of the crystalline forms found in the curtains of ice that are frozen waterfalls. In winter, ice climbing such slick routes only makes the scenery—and your foothold (or, rather, crampon-hold)—that much better. Just outside Canmore in Alberta, the winter onslaught means a spike in adrenaline-seeking ice climbers and a chance to discover an entirely different perspective. Waterfalls are now slick climbing walls. Game on. And, if you’re a beginner, then the rush only promises to be that much richer (see page 15). If you want a more controlled environment, there’s the man-made climbing tower at Big White near Kelowna, BC. Under the patient tutelage of young-

Beauty on the Big Island: the lounge-worthy seaside pool, wind-swept beach and lemonricotta pancakes at the Four Seasons Resort Hualālai at Historic Ka‘ūpūlehu on the Kohala Coast, Hawaii. Story on page 28.

B. Sligl

winter rush

mix

BIG ISLAND bliss

On this guest ranch on the quiet northeastern side of Hawaii’s Big Island, there’s a private pool, historic house, chicken coop, horse riding, ancient heiau and an artist enclave in the nearby town of Hawi…think bliss. >>

November/December 2013 Just For Canadian dentists

mix

BIG ISLAND

November/December

ice ice baby

gift guide holiday

just do it!

hot list

bliss

make like a paniolo at puakea ranch Paniolo is the Hawaiian word for cowboy, stemming from “espanola,” used to describe the original Spanish vaquero who came to the island in the late 1800s. On Puakea Ranch, listed on the State Historic Register, you’ll be following in the footsteps (or horse trails) of four generations of paniolos and plantation workers who once lived here. There are four gorgeously restored ranch houses on this country estate in North Kohala. Our pick: Yoshi’s House with its wraparound deck or lanai (with killer ocean views) and a stunning pool (think lava-rock beauty overlooking ranchland and sea and maybe even Maui; see page 5). There’s also Cowboy House, a former bunkhouse, Miles Away and James Cottage. Each property oozes character with local art and Hawaiiana. And to get in full-on paniolo mode, there’s horseback hotel / riding, of course (see one of the resident equestrian mustbeauties on page 33). Best stay thing about this hideaway: it feels remote but is still only minutes from Hapuna Beach (listed as one of the top beaches in the world) and has wi-fi (that is, if you’ll use it…maybe just to post envy-inducing Instagram images). —B. Sligl puakearanch.com See page 28 for more on the Big Island.

give

Get a little something for everyone on your list

Written + produced by Janet Gyenes

3 the road-tripper The sojourner will enjoy ticking off the days until the next stateside adventure, inspired by beautifully rendered landmarks in the Travel America calendar. $26, Rifle Paper Co.; riflepaperco.com 4 the dandy Even if he can’t race up the Long Island coast in Jay Gatsby style, these sterling silver Roadster cufflinks will transport him to the seaside during a delightful daydream. $605, Tiffany & Co.; tiffany.ca

tackle a tower…of ice ”You’re doing great, keep going.” Arms shaking, knees wobbly, breath winded… I’m not feeling so great, but I keep going. I’m climbing a massive 60-foot tower of ice under the calm reassurances of Aussie guide Joe. After another few minutes or so (time seems irrelevant when you’re clinging to slick icefall with just milli-

sport fix

metres of ice-axe leverage), I make it to the top to ring the bell suspended there. It’s a serious adrenaline rush and I feel chuffed … even knowing afterward that Joe’s record is a mere 19 seconds. Gulp. Here, at Big White Ski Resort, just over 50 km southeast of Kelowna in the Okanagan, it’s easy to feel chuffed. That morning, I skied through fresh powder amidst fantastical

snowghosts. Whether slopeside amidst the surreal snowscape or atop that man-made ice tower, the never-ending views of the Monashee Mountains just add to my winter rush. Now, if I can shave some seconds (or, rather, minutes!) off my climb here, maybe I can head out there… —B.S. GO Big White Ski Resort; bigwhite.com

Caught the ice-climbing bug? Go beyond the tower and head into the wild (winter’s frozen landscape offers myriad climbing routes) on a multi-day ice climbing course. See story on page 15.

Just For Canadian dentists November/December 2013

cufflinks photo: © Tiffany & Co.; fishing rod photo: www.RH.com / RH, Restoration Hardware

5 the BIBLIOPHILE Acknowledge her love for the written word. The crystallized layers of these agate book ends are as intricate as a well-woven story. From $16.99 ea., HomeSense; homesense.ca

b. Sligl

historic hideaway

hot

1 + 2 the ANGLER He can tote the retractable Pocket Fishing Pole to watering holes worldwide, and the Ultimate Fishing Tool has everything for tackling the one that didn’t get away. $45, Pocket Fishing Pole. $24, Ultimate Fishing Tool, Restoration Hardware; rh.com

getaway

mix

November/December

6 the ENTERTAINER A must-have for every host? Toothpicks infused with essential oils (Lemon No. 11) or spirits (Single-Malt No. 16). $19.99/4 pack, Old Faithful Shop; oldfaithfulshop.com

2013 editor’s pick 6

7 the modernist These jewel-like glass Vitriini boxes from Finland’s Iittala are sparkling in their simplicity. From $39, Quasi Modo Modern Furniture; quasimodomodern.com 8 the mix master No bartender will balk at a bottle of artisanal spirits, such as London Dry Gin, a smooth sipper handcrafted at Vancouver’s Long Table Distillery. $49.99, BC Liquor Stores; bcliquorstores.com

9 the GOURMET Chefs and foodies alike will appreciate the bright and fruity flavours of Sicily (by way of Brooklyn) encapsulated in Frankies 457 organic extra-virgin olive oil. $29, Old Faithful Shop; oldfaithfulshop.com 10 the anglophile This trio of Tom Dixon candles recreate the essences of England. Think crocuses intermingled with the Thames, Indian weddings redolent of roses, and tea time with strawberry scones. $84 ea., GR Shop Canada; grshop.com

savour Sicily!

p h o t o p r e s c r i p t i o n m i c h a e l d e f r e i ta s Michael DeFreitas is an award-winning photographer who’s been published in a wide variety of travel publications. With his initials, MD, he’s been nicknamed “doc,” making his photography prescriptions apropos.

Buses, planes and trains offer an interesting photographic platform

Shooting on the move Killing time en route on a bus, plane or train? Look through the window and, with the help of a lens hood and polarizing filter, take some shots. top The Grenadine Islands and Caribbean are even more dramatic from the air. above left Sit at the front of the bus and use your anonymity and perch to shoot scenes just outside the front windshield, like this image in Egypt. above right Another through-the-windshield shot from a bus in Egypt.

Just For Canadian dentists November/December 2013

Impression-taking has never been easier

Send your photos and questions to our photography guru at feedback@ inprintpublications.com and your shot may be featured in a future issue!

n a recent trip to Egypt I was on a tour bus headed for one of the country’s many ruins. I grabbed an aisle seat near the front of the bus in case something photo-worthy popped up and checked with our guide that I could sneak up front periodically to shoot. Then I just watched and waited. The large windshield was like a giant portal into daily Egyptian life. Soon after presetting my camera controls, I noticed a colourful local Egyptian bus up ahead. I moved up to the windshield as we drew closer. The back of the bus was open and one of the male passengers looked directly at me as I snapped away. I captured his intent stare framed by the colorful bus. A bit further down the road, I shot an old Arab man sitting on his grassladen donkey. A moving vehicle is like a blind. You can shoot out, but your subjects usually don’t realize that you’re there. Removing yourself from the scene lets you capture more natural-looking images than if you were on foot and your subject was aware of you. Shooting from any moving vehicle has its challenges, but you can improve your odds with a few easy techniques. Blurred images caused by bouncing around and engine vibrations are the biggest problem when shooting from a moving vehicle. Use a fast shutter speed to neutralize most vibrations and camera shake. I typically set my camera controls to shutter priority mode and select a shutter speed of 1/500 to 1/800 of a second, depending on the vehicle’s speed and vibration. Glass windows also produce blue colour casts and reflections. (Needless to say, it’s always best to shoot through an open window where possible). The tint on most vehicle windows typically adds a blue or “cold” hue/cast to your images by blocking out the warmer colours (reds and oranges). Set your camera’s white balance control to “cloudy” to add some warmth and reduce the blue cast. Reflections are a bit trickier to eliminate, but you can reduce their effect by getting your lens as close to the window as possible.

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shooting on the move

3Shape TRIOS

photo prescription [continued]

PRO TIPS for shooting on the move > Go for the window seat. > Check flight, bus or train routes and time of day before picking a

seat. Try to get a window seat on the side away from the sun. Avoid shooting into the sun.

> Always pack a few wet wipes to clean window glass, especially on planes where people tend to rest their head against the windows.

> If you can’t get close to the window use a polarizing filter to help reduce glare and reflections off the glass.

> Wrap a dark-coloured shirt or scarf around the end of the lens when

you press it to the window (it will help with reflections and vibrations).

> Light and bright clothing reflect more off windows. Try to wear darker colours.

> Make sure to turn off your flash.

Ready to take it to the next level?

gear up Lens hoods are a great way to stop stray light or glare from hitting the front element of your lens. They also help to protect the front element and reduce distracting reflections when shooting through glass. They typically come in metal, hard plastic or rubber. Rubber hoods are best for shooting through glass in a moving vehicle because they tend to absorb some of the vibration and make a neater fit when pressed against the glass. Most camera manufacturers offer plastic and rubber lens hoods ($6 – $35). Some camera stores like Henry’s offer less-expensive housebrand rubber hoods.

Just For Canadian dentists November/December 2013

Use a lens hood when shooting through any window and position the hood against or a few millimetres away from the glass to prevent stray light from hitting the window in front of the lens. This will reduce most reflections. But remember to increase your shutter speed when doing this. Your body does a pretty good job of absorbing vibrations, but when your lens or camera touches any surface of a moving vehicle, it vibrates and shakes at the same frequency as that surface, producing blurred images. On a recent Caribbean trip I snapped some shots as we flew over the beautiful Grenadine Islands. I pressed my lens hood against the window to reduce reflections and increased my shutter speed to 1/1000 of a second to compensate for the plane’s engine vibration passing from the window to my camera. When shooting from a moving vehicle, I get the best results when using a medium telephoto lens (70 – 150 mm range). Eliminating reflections is more difficult with wide-angles lenses (16 – 35 mm range), and long telephoto lenses (150 – 400 mm) tend to magnify vibrations and shake. Travellers spend a lot of time on buses, trains, boats, cars and planes. Use that time and these techniques to take some dynamite images.

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November/December 2013 Just For Canadian dentists

motoring

D r . k e l ly s i l v e r t h o r n

Dr. Kelly Silverthorn is Just For Canadian Dentists’ automotive writer. He tries to keep one convertible and/or one track-day car in the family fleet.

it’s better in the Bahamas

Hot cars + hot weather make a great mix in Nassau during the Bahamas Speed Week Revival

from 1954 to 1966. Sixty or more top sports car teams from Europe and the Americas would come together in a festive season-ending week of racing. Key Nassau ingredients were large cash prizes, brilliant sunshine and legendary parties. Winners included a who’s who of post-war racing greats: de Portago, Moss, Gurney, A.J. Foyt, Penske and Donahue. The list of winning makes is equally illustrious: Ferrari, Maserati, Scarab, Aston Martin, Lotus, Chaparral and Lola. Bahamian political winds of the mid60s are said to have doomed the original Bahamas Speed Week. A then-new government of populist leanings did not sit easily

alongside catering to an international jet with timed runs from Arawak Cay up the set. Nevertheless, it’s the same left-of-centre bluffs to this historic military installation. The parties in government that now largely unfastest hillclimb times of the day, by some derwrites international organizers re-estabmargin in fact, are the cadre of modern 125-cc lishing a racing event that attracts high-value, Shifter Karts present. (Further history lesson: shoulder-season visitors. Stirling Moss was a the First Annual World Karting Championship marquee driver attraction back in the day… was held in Nassau in 1959!) Fastest “car” on and contemporaneously too. Now knighted, the hill is a late-model limited-edition ACR the 83-year-young Sir Stirling still races his Viper—Dodge’s answer to showroom-legal beautiful red 1956 OSCA (see photo). race-ready cars, from Porsche and Ferrari. The modern Bahamas Speed Week Saturday’s fastest classic car is a multi-million(Revival) is centred at Arawak Cay, less than a dollar 1957 Ferrari 500 TRC. mile from the downtown Nassau cruise ship Sunday is the Arawak Cay Sprints, esterminus. Between these two sentially competitive timed laps of a 1.6-mile landmarks is the official circuit on closed public roads around Arawak host hotel, the British Cay, including two inter-island bridges. The Racing legend spectator experience is enhanced by a Sir Stirling Moss in capable public address system anchored his bright-red OSCA, by a professional radio host, bleachers just one of the sweet at the best vantage points, pedestrian rides seen at Bahamas bridges and a VIP tent option. Ed Hugo Speed Week. For more in the ACR Viper triumphed again among go to bahamasspeedthe modern cars with a one-minute-andweek.com. 29-seconds lap. Simon Arscott in the 1966 Aston Martin DB5 was fastest of the classics at one minute and 35 seconds. The more “in the moment” readers will already be thinking…Friday, Saturday, Sunday do not a “Revival Week” make. Indeed, the original Speed Week boasted wheelto-wheel racing every day for eight days. Contemporary Speed Week features social events for participants on the Wednesday and Thursday. 2012 was just the second edition of the Revival, and subsequent versions will hopefully trend to filling out the week with more competition. Old Nassau’s Colonial, established in 1898. Unlike many backstreets mimic some of the great townsuch vintage hotels, the Colonial is in fine based special stages in Targa Newfoundland, fettle. so there is clearly promise for more Bahamian Public portions of Speed Week begin racing formats. Friday evening with a robust street party celIt would take a cold heart indeed not to ebrating the competition cars. The Bahamian cheer for the future success of the Bahamas locals appear quite adept at such events. Speed Week Revival. I fully credit this young Perhaps they are just tuning up for the worldevent in drawing on the resources available to renowned Junkanoo Festival (spans Boxing re-establishing the Bahamas as an important day to New Year’s). After the street party, the stop on the international racing calendar. It’s many downtown restaurants will vie for your got great history, tropical scenery, warm tropiattention. My picks for eateries here: Van cal climate and a government that’s now fully Brugel’s, Café Matisse, Athena Cafe, Luciano’s on side. And the Bahamas should definitely and the Brussels Bistro. stick with its late November date to attract us Saturday is the Fort Charlotte Hillclimb, sunshine-starved Canadians.

Just For Canadian dentists November/December 2013

Open Road HONDA full-pg ad

Kelly Silverthorn

s November a month you long to head south? Me too. This is when daylight hours in Canada are painfully short. The skies are an oppressive grey but not yet generating enough snow cover for winter play. And Christmas is too far off to act as a mental-refuge buffer. So when I learned of the Bahamas Speed Week Revival, scheduled for November’s final week, I rejoiced that my month was saved. The Bahamian sun— mingled with the sights, sounds and smells of classic racing cars—would surely provide November’s remedy. My wife even expressed genuine enthusiasm. To execute a “Revival,” one must reference an original. The Bahamas Speed Week ran

pay i t f o r w a r d

ttrraavveel l aatt h o m e

r o b e r ta s ta l e y

As the temperature dips, a frozen landscape comes to life and offers a new adrenaline rush… ice climbing. Strap on some crampons, wield a pick and go where only winter will let you

Roberta Staley is an award-winning magazine editor and writer with experience reporting from the developing world and conflict and post-conflict zones. Staley, who specializes in medical and science reporting, is a graduate student at Simon Fraser University and magazine instructor at Douglas College.

pediatric dental aid

he tears on the face of the young boy’s father were ones of gratitude rather than distress. They were also a clear — if unintended — indictment of the omnipresent poverty in native communities in Newfoundland and Labrador. “His kid hadn’t slept in a year due to his cavities,” says Dr. Geoff Smith, the province’s preeminent pediatric dental surgeon. The aboriginal youngster’s rampant mouth rot was relieved thanks to Operation Tooth, a program that Smith started in 2008 to chip away at the 600-strong list of pediatric dental patients—mainly Inuit

Dr. Geoff Smith, Newfoundland’s preeminent pediatric dental surgeon, shares his expertise in Kenya.

and Indian—who were waiting to fly to St. John’s for treatment at Janeway Children’s Hospital. Smith created a self-contained practice, filling several suitcases with dental paraphernalia, and set out several times a year to such far-flung Newfoundland and Labrador communities as Gander and Happy Valley-Goose Bay. Smith continues to spend up to eight weeks on the road travelling to rural communities to provide emergency treatment. “The thought of leaving a kid in pain — I can’t do that,”

says Smith, who won a Distinguished Service Award in 2012 from the Canadian Dental Association and is currently a member of the group’s Committee on Clinical and Scientific Affairs. Smith says that the poor dental hygiene has long-lasting, deleterious effects on children. “They can’t eat properly and can’t sleep properly because their teeth hurt, so they don’t do well in school,” says Smith. “You fix their teeth and their weight increases in six months to where they should be.” Dental decay, Smith adds, is largely “a disease of poverty. Eighty per cent of the cavities are found in the lowest 20 per cent of the socioeconomic scale. Those numbers go way up in native communities,” due in large part to high-sugar diets, says Smith, who has been president of the Newfoundland and Labrador Dental Association and chief of dentistry for Eastern Health. In the past, one of the factors influencing poor dental health was a dearth of dentists in the rural areas of Newfoundland and Labrador. To combat this, Smith helped establish a bursary program whereby dental students from across Canada receive a $25,000 bursary through the Department of Health and Community Services Dental Bursary Program, up to a maximum of $150,000 over three years. In exchange for each bursary received, recipients must commit to one year of service in a rural or in-need area of the province. As a result, Newfoundland and Labrador now has the best pediatric dentistry care in Canada, says Smith, who was the only pediatric dentist in the province for a quarter century. Several years ago, Smith extended his outreach to include pediatric dentistry abroad. In 2011, he became a visiting instructor at the University of Haiti Dental School, based in the capital city of Port-auPrince. In addition to arranging the export

Just For Canadian dentists November/December 2013

of used dental equipment such as chairs and drills to the school, Smith lectures and gives continuing education courses on such procedures as fitting stainless steel crowns onto children’s cracked and rotting teeth—“the bread and butter of pediatric dentistry.” Thanks to Smith’s twice-annual Haiti visits, the dental school overcame its “fear of treating children” and incorporated pediatric dental care into its programming. “It’s one of the most gratifying things I have ever had happen down there,” Smith says. Interestingly, although the need for kids’ dentistry in Haiti is dire, tooth decay rates are lower than in Canada’s native communities, he says. Smith has shifted his focus to another, similarly destitute part of the world. In 2012, he took his wife and daughter to Kenya. While the latter two went on safari, Smith drove three hours north of the capital of Nairobi to a town called Nyahururu. Here, a church-run dental clinic, staffed by a solitary dental therapist named Ben Mburu, was trying to tackle an endemic of fluorosis, caused by excess fluoride in the town’s well water. Smith’s first set of patients included three girls with “horribly disfigured” teeth. Smith rebuilt the choppers with composite crowns, and the teenagers walked out smiling. Smith found that, similar to Haitian practitioners, Mburu was uncomfortable working with children. So Smith schooled him in pediatric dentistry with the help of videos, showing him the art of freezing a youngster’s mouth to prevent pain. Mburu was a quick learner, absorbing Smith’s lessons and becoming proficient at gaining the trust of his young charges. By the time Smith left, Mburu was affixing stainless steel crowns in cavity-strewn mouths. “You just have to know how to talk to a kid,” says Smith. Smith, 61, isn’t too sure how many more years he will practice dentistry—five, perhaps 10 more? But those years will be spent doing something he loves, helping bring good health through dental care to youngsters around the world struggling in Third World conditions. “The challenge,” Smith says, “is poverty and access to care.”

courtesy of Dr. geoff smith

From Newfoundland to Kenya, this dentist is fighting poverty in the dentist’s chair

icecapades story + photography by darryl leniuk

November/December 2013 Just For Canadian dentists

travel at home

harp shards of ice bounce off my face like broken glass on a crashtest dummy. Each swing of my ice axes sends frozen debris flying: a fist-sized chunk ricochets off my forehead; another fragment finds its way down my neck, under three layers of clothing, and melts against my belly. I’m 20 metres up a frozen waterfall called The Junkyard, just outside Canmore, Alberta, in the heart of the Canadian Rockies. At the base of the icy

monster from Middle Earth; the sharp spikes protruded from my feet like talons. But it’s this awkward equipment that makes the sport possible. With its roots in 19th-century mountaineering, ice climbing has evolved considerably since the days of chopping steps to climb a frozen slope. In the 1930s, Laurent Grivel designed front-pointing crampons. Then in 1966, Yvon Chouinard, founder of the Patagonia clothing line, developed the first ‘reverse curve’ ice picks, which enabled climbers to get purchase on vertical ice. When I finally reach the top of the 30-metre rope, I turn around for the first time. I’m frightened at how high I’ve come and at not being able to see Holeczi over

“How was that!” says the lanky, bearded guide. “Felt pretty good,” I reply. “How do your hands feel?” I don’t notice them until he asks. But then I realize they’re both hot and cold and tingly. And they hurt like hell. “Hah! You’ve got the screaming barfies!” he says. When warm blood returns to your hands after gripping ice tools in cold weather, he explains, the effect is pain so bad you want to vomit. It’s a common side effect of ice climbing and will go away he assures me. After a few tips on footwork, he sends me back up, but this time with only one axe. Now I’m forced to totally support myself on

previous page Guide Steve Holeczi hanging out on a route near Lake Louise. this page, from left Holeczi starting a route at The Junkyard, near Canmore. > Crampons make climbing vertical ice possible.

clockwise from top left Guide Steve Holeczi climbing a frozen waterfall at Grotto Canyon near Canmore. > Tools of the trade: lightweight, reverse-curve ice axes make ice climbing possible. > Holeczi climbing a route near Lake Louise. Unlike rock climbing, belayers always stand off to one side to avoid being hit by falling ice. > The modern ice axe.

60-degree slope, Steve Holeczi, my guide from Yamnuska Mountaineering School, controls the rope that I’m harnessed into and shouts encouragement. But I don’t want to go any higher. My forearms burn from death-gripping the two ice axes I use to pull myself up and my calves wobble uncontrollably as I struggle to secure my crampons in the icy slope. I try to remember Holeczi’s coaching: crampons need full contact with the ice to be effective; ice axes need to be solid, like an axe in a block of wood; and body position is everything. This was the beginning of Yamnuska’s introductory two-day ice climbing course. Wearing crampons made me feel like a clawed

the cauliflower-shaped slope. I call out and am reassured when I hear his reply. I lean back and take in the view: across the ice-covered Bow Valley, the snowy peaks of the western Rockies glisten in the waning afternoon light. Looking closely, I can see tiny white threads dangling off these mountains. More frozen waterfalls. In all, there are over 1,000 ice-climbing routes within a two-hour drive of Canmore, making this town of 12,000 one of the best places in the world for the sport. Each winter Canmore plays host to an ice climbing festival and is the scene of a vibrant iceclimbing culture. I repel to the base of the falls, and Holeczi is waiting for me with a high-five.

Just For Canadian dentists November/December 2013

my feet when I swing my axe. I tremble at first, not trusting the fang-like protrusions coming out of my boots. But I don’t slip; my feet are rock-solid. I try other movements with my crampons to give my ankles a rest and shift my weight side-to-side. I swing the axe fluidly, and feel the hold it’s meant to provide. It goes much smoother, and I’m up in half the time. Being a beginner rock climber, I had thought of ice climbing as a more extreme version of a sport I was not very good at to begin with, and that I would be woefully underskilled to have a go at it. But almost anyone can climb ice. My biggest concern was the ice itself. Unlike rock, ice melts, cracks, breaks November/December 2013 Just For Canadian dentists

travel at home edmonton / sacramento / galapagos / dublin / lincoln … | c a l e n d a r and is otherwise a whole lot less stable than granite. When I asked Holeczi about accidents, he explained that the sport has a very good safety record. “The equipment is at the point that it far exceeds what we’ll put onto it.” He told me that the ice screws used for securing ropes can hold 1,000 kg or more. Even so, there are a handful of fatalities involving ice climbing each year. Most involve avalanches. Since the best ice routes tend to form in narrow canyons and gulleys, which are also prime avalanche territory, an understanding of the backcountry is important. “The danger is in how you interpret the environment,” said Holeczi. Using a qualified local guide is one of the best ways to minimize the risk. Marc Ledwedge, a public safety warden at Banff National Park, has seen several accidents involving ice climbing in the 20 years he has worked for the park. “Many beginning ice climbers are not aware of the avalanche hazard,” said Ledwedge. “It’s not uncommon to see people on ice routes when they shouldn’t be.” He’s also seen many leg and ankle injuries caused by ice climbing. The gripping nature of crampons can make them dangerous in a fall. And, for this reason, learning to fall is not taught in

Check www.ContinuingEducation.net for updates to our 2014 schedule

ice-climbing courses. You just don’t fall. The next day a fierce arctic storm descends on the Rockies. The outside air temperature is -24C, and dipping to -40C with the wind chill. From the vantage point of the Coffee Mine Cafe, in downtown Canmore, Holeczi and I watch swirling snow and blustery winds pelt those foolhardy enough to venture outside. The local radio station reports all schools are closed. Holeczi has heard it may clear this afternoon. We wait a while and then decide to make a go for it. We drive to Grotto Canyon, another iceclimbing route just outside town. I blindly follow Holeczi through a forest of blowing snow. I’m soon breaking fresh tracks on a frozen creek in a steep-walled canyon. It’s bitterly cold but at least I’m sheltered from the wind. I pass a snow-dusted granite wall with bolts marking a summer rockclimbing route. Holeczi stops and shows me an ochre-coloured native painting. Then I notice icicles hanging off his moustache like a hoary mountaineer of old. We continue up the canyon to the Grotto waterfall we’ve come for. It covers the end of the chasm in a giant jacket of ice. Like enormous steps, the falls are vertical for seven or eight

metres, level to a ledge and then another sheer pitch. It will be my first time climbing vertical ice. The surface is wet, and I get good purchase from my crampons. Despite the cold, I move upward, slowly but methodically. I probe for good placement with my picks and stand up on my feet. I feel exhilarated; climbing ice is as exciting as skiing, less work than snowshoeing and easier than rock climbing. The clouds part and the Grotto falls shimmer in the winter sunlight. I glance across and see my shadow, axes swinging, crampons kicking, ice chunks flying. Awesome.

Continuing Dental Education Cruises

An in ter n ation a l guide to continuing dental Education

winte r 2013 + beyond

go Canmore is a 90-minute drive west of Calgary. do The ice-climbing season in the Rockies runs from November through March. Yamnuska Mountaineering offers two-day introductory courses in ice climbing starting at $265 including equipment. For more info visit yamnuska.com or call 1-866-678-4164. more Check out Tourism Canmore at tourismcanmore. com or call 1-866-226-6673, or get the goods on other ways to get a winter rush across the province at Travel Alberta’s website travelalberta.com.

1 5

Ask about our guest travels free program and about planning a cruise meeting for your organization

Contactus@continuingeducation.NET • www.ContinuingEducation.NET

Just For Canadian dentists November/December 2013

food photo: B. Sligl; Edmonton Economic Development Corporation (4)

December 22, 2013 Road Map to Planning, Grafting and Restoring Complex Implant Cases 9 AGD PACE Credits 9 ADA CERP Credits 7-Night Eastern Caribbean from Florida February 16, 2014 Simplified and Successful Endodontics for Dental Practitioners 9 AGD PACE Credits 9 ADA CERP Credit 7-Night Eastern Caribbean from Florida March 15, 2014 Comprehensive Dentistry: The Pursuit of Excellence 14 AGD PACE Credits 7-Night Western Caribbean from Florida April 29, 2014 The Pediatric Dental Course You Wished You’d Had in Dental School 14 AGD PACE Credits 12-Night D-Day Anniversary European Cruise Rome to Copenhagen July 5, 2014 Treatment Planning and Sequencing 14 AGD PACE Credits 7-Night Alaska from Seattle August 8, 2014 Oral Dermatology and Oral Pathology 14 AGD PACE Credits 7-Night Alaska from Seattle August 15, 2014 Treatment Planning in the 21st Century 9 AGD PACE Credits 9 ADA CERP Credits 7-Night Alaska from Seattle October 4, 2014 Oral Dermatology and Oral Pathology 14 AGD PACE Credits 7-Night Canada and New England Montreal to Boston October 19, 2014 Predictable Treatment Planning: From the Seemingly Simple to the Worn Dentition...and Everything in Between 14 AGD PACE Credits 7-Night Western Caribbean from Florida

Elegant + edgy Edmonton. The central-Alberta winter doesn’t stop this city from offering a surprising mix of haute + hip on the prairies—year-round. (CE events in Edmonton are highlighted in blue.)

1-800-422-0711 (727-526-1571) • www.ContinuingEducation.NET

Edmonton

if you go

Florida Seller of Travel Reg. #14337

t’s time to reassess the rather flat capital of Alberta… because it’s flat no longer—in terms of style that is. There’s a rather artsy and funky vibe going on here these days; Edmonton offers a somewhat surprising foodie and fashionista fix. First, think chic cuisine with a definite French flare. Local Franco-Albertan Giselle Courteau (who can trace her lineage back to 18th-century France!), recently opened the must-go Duchess Bake Shop 1 , touted as the best patisserie in Canada. Really. Here, patrons lounge in Louis XV sofas and chairs while sampling florentines, macarons, brioche Pétin croissants, pains aux raisins and au chocolat… Then, on the other end of the food spectrum, there’s Tres Carnales Taqueria. It’s boho beach fare from three amigos bringing serious sustainable style to Edmonton’s dining scene (everything except the seafood is sourced within 200km). Sated with fab food, it’s time for another dose of big-city sophistication—in fashion. Edmonton is

donning some of the quintessential blue that evokes all things pomp and posh; Tiffany is opening a storefront in the West Edmonton Mall…so get ready to channel Audrey Hepburn in the Albertan prairies. On the other side of the winding North Saskatchewan river, there’s groovy Whyte Avenue 2 , where traditional window shopping has hipster appeal at “it” shoe emporium Gravity Pope, which started right here… Who knew? And Edmonton-raised designer, Cassandra Hobbins, was a finalist in last season’s hot reality-TV show, Fashion Star. Seems Edmonton has plenty of style to uncover. Here’s what else to discover in Edmonton this winter… Get some visual inspiration at the Art Gallery of Alberta—inside 3 and out 4 . The structure itself is a mix of curvilinear and angular shapes with a 190-metre steel ribbon that mimics the winding North Saskatchewan River and Aurora Borealis. Head to that river. Edmonton’s river valley network of trails, paths and parks is beloved and well-used by locals.

The icy North Saskatchewan River and snow-kissed trees are a winter oasis in the midst of the city. Visit the pyramids. Seriously. Edmonton boasts four of its own pyramids, albeit the glass variety filled with exotic plants. Feel humid heat and heady tropical scents while snow drifts pile up just outside the Muttart Conservatory 5 . Go back out to the river. This time strap on some nordic skis. That network of paths and parks means groomed cross-country ski trails in the winter. There’s even a Wednesday Night Social Ski with the Edmonton Nordic Ski Club. Kick back at a local pub. Back on Whyte, after some serious shoe shopping, hang with the university crowd over a pint at the Black Dog. And make it a local Big Rock brew. Try the Big Rock Gopher Lager on tap at Black Dog—it’s one of the brewery’s newer additions to its lineup of mostly ales. Yum! —B. Sligl For more, go to edmonton.com/for-visitors.aspx.

November/December 2013 Just For Canadian dentists

contact

website

A Hands-On Review Of Local Anesthesia

University of Detroit Mercy

313-494-6694

udmercy.edu

IV Sedation Training For Dentists

Conscious Sedation Consulting

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sedationconsulting.com

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dentistry.ualberta.ca

calendar

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Nov 09-12

Victoria British Columbia

Current Concepts In Dentistry Prosthodontic Success: From Concept To Delivery Medical Emergencies In Dental Practice Office Oral & Maxillofacial Surgery A Critical Look At Dental Adhesives, Composites & Light Curing

University of Victoria

250-472-4747

uvcs.uvic.ca

Nov 10

Ottawa Ontario

Alpha Omega Dental Fraternity Ottawa Chapter Launch & CE Brunch

Alpha Omega Dental Society

301-738-6400

ao.org

Jan 10-22 2014

Vancouver British Columbia

Science & Treatment Planning

Pacific Implant Institute

604-868-9700

pacificimplantinstitute.com

Maui Hawaii

34th Annual Hawaiian Dental Forum

Dental Seminars & Symposia, LLC

952-922-1707 See Ad Page 21

dentsem.com

Detroit Michigan

Jan 17Feb 16 2014

Sacramento California

Feb 20-23 2014

Edmonton Alberta

Through 2013

Western Canada

FOCUS Dental Education Series: Part II

F.O.C.U.S.

Dec 07

Montreal Quebec

Modern Concepts In Restorative Dentistry (Special Guest: Dr. Elliot Mechanic)

International Dental Institute

877-463-1281

idi.org

Feb 01-08 2014

Dec 21Jan 05 2014

Hong Kong to Singapore Cruise

Building Blocks Of Aesthetic Restoration

Mindware Educational Seminars

888-574-8288

mindwareseminars.com

Feb 08-15 2014

Kauai Hawaii

34th Annual Hawaiian Dental Forum

Dental Seminars & Symposia, LLC

952-922-1707 See Ad Page 21

dentsem.com

Jan 10 2014

Lincoln Nebraska

Weeth Lecture 2014

University of Nebraska Medical Center

402-472-7993

unmc.edu

Feb 15-20 2014

Big Sky Montana

Alpha Omega Dental Fraternity Toronto Chapter Western Ski Seminar

Alpha Omega Dental Society

301-738-6400

aotoronto.org

Jan 23Feb 02 2014

East Africa Safari

Current Concepts In Prosthodontics Addiction, Methadone And The Dental Office, How To Survive Your Next Medical Emergency Combining Art & Science

kennedyseminars. com

Mar 06-08 2014

Vancouver British Columbia

Pacific Dental Conference

BC Dental Association

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pdconf.com

Kennedy Seminars

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Mar 15-22 2014

Caribbean Cruise

Comprehensive Dentistry

Sea Courses Cruises

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seacourses.com

Mar 15-30 2014

Bangkok, Chiang Mai, Krabi

Thailand Adventure & Learn: Dr. Jeffery Coil, Dr. Chris Wyatt, Dr. Charles Shuler

University of British Columbia

604-822-6156 See Ad Page 24

dentistry.ubc.ca

Apr 03-05 2014

Calgary Alberta

Rocky Mountain Rhapsody

CE Solutions

604-575-4570

conedgroup.com

Jun 29Jul 7 2014

Galapagos Islands Cruise

Dental Challenges In Isolated Communities

Professional Education Society

877-737-7005 See Ad Page 40

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Alaskan Cruise

Alaska For Treatment Planning

Sea Courses Cruises

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Jul 05-12 2014

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Sep 10-20 2014

Dublin and Belfast Ireland

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Oct 19-26 2014

Western Caribbean Cruise

Predictable Treatment Planning: From The Seemingly Simple To The Worn Dentition... And Everything In Between

Continuing Education, Inc./University at Sea

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continuingeducation.net

514-398-4314

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Nov 08-15 2014

Tahiti Cruise

Dentistry At Sea / Comprehensive Dentiry

Professional Education Society

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Dec 27 2014-Jan 3 2015

Eastern Caribbean Cruise

Dentistry At Sea / Dental Healthcare Delivery

Professional Education Society

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Local Anesthetic Course

University of Alberta

new CE to Just For Canadian Dentists be placed

Feb 07-22 2014

Southern Caribbean Cruise

Mar 08-15 2014

Turks and Caicos

Problem Solvers For Restorative Dentistry (Available Mar 07-14 or Mar 08-15)

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Montreal Quebec

A Critical Assessment of Dental Materials: Composites, Adhesives and Light Curing

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Las Vegas Nevada

2013 Fall Conference - Contemporary Concepts In Periradicular Surgery: Diagnosis And Treatment

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Cutting Edge Endodontics: Advances In Instrumentation And Irrigation

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Apr 12 2014

Walla Walla Washington

To Biopsy Or Not To Biopsy: Interactive Soft Tissue Oral Pathology For The Dental Practitioner

University of Washington

206-543-5448

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Oct 04-11 2014

New England Cruise

Oral Dermatology & Oral Pathology

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Jan 10-11 2014

New York New York

Sinus Lift Surgery - The Lateral Approach: A Clinical Workshop

Columbia University College of Dental Medicine

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Feb 10-14 2014

Hawaii Hawaii

21St International Symposium In Oral And Maxillofacial Surgery

University of California San Francisco

415-476-1323

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Apr 25-27 2014

Vancouver British Columbia

Inhalation And Oral Sedation

University of British Columbia

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8 Sessions To Implant Therapy (Introduction: Mondays; Intermediate: Thursdays; Or Advanced: Fridays)

Renaissance Dental Implant Institute (RDII) and Dentsply Implants

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Nov 14-17

San Diego California

Advanced Hard And Soft Tissue Grafting Program With Cadavers Hands-On

California Implant Institute

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Nov 15-16

Montreal Quebec

All-on-4 Continuum (Modules I & II of IV)

McGill University

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Feb 03-07 2014

Kea Lani Hawaii

All-Ceramic Restorations In 2014: Clinical Steps; From Enamel To Zirconia. How To Optimize And Benefit From Current Adhesive Materials, Techniques For All Bonding Substrates; What Are These Drugs Our Dental Patients Are Taking?

University of British Columbia

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Mar 07-08 2014

Montreal Quebec

Atraumatic Tooth Extraction and Extraction Socket Management With Dr. Ralf Schuler

McGill University

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Jul 11-13 2014

Vancouver British Columbia

Surgical Operations & Wound Healing

Pacific Implant Institute

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Nov 21-23 2014

Vancouver British Columbia

Advanced Soft Tissue Surgery

Pacific Implant Institute

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Aug 01-04 2014

San Francisco California

Controversies And Innovations In Implants And Esthetics

Interdisciplinary Dental Education Academy

650-578-9495

ideausa.net

Nov 29Dec 01

Edmonton Alberta

Clinical Orthodontic Procedures Module – Clinical

University of Alberta

780-492-4474

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Ongoing

Podcast and Online Based

Medical Emergencies

DentalEdu

239-593-2178

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Jan 16 2014

Edmonton Alberta

Clinical Orthodontic Procedures Module – Theory

University of Alberta

780-492-4474

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Nov 22

Toronto Ontario

Medical Emergencies In The Dental Office And CPR Certification

Sleep for Dentistry

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India Tour

Gummy Smiles & Lingual Orthodontics; And Esthetic Implant Placement

Mindware Educational Seminars

888-574-8288

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Feb 13-15 2014

Vancouver British Columbia

Jan 19-30 2014

10 Things To Revitalize Your Practice, Medical Emergencies In Dentistry

University of British Columbia

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Carlsbad California

Bridging The Orthodontic Gap: Carlsbad

Henry Schein Dental Specialties Group

760-448-8717

hsdsg.com

Through 2013

Western Canada

Feb 2014 07-08

FOCUS Dental Education Series: Part I

F.O.C.U.S.

604-922-3465

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American Academy of Pediatric Dentistry

Dental Occlusion – It Can Make or Break You

Edmonton and District Dental Association

Management Of Pediatric Sedation Emergencies: A Simulation Course

aapd.org

Edmonton Alberta

Los Angeles California

312-337-2169

Dec 06

780-642-8270

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Mar 01-02 2014

Feb 19-20 2014

Chicago Illinois

AES 59th Scientific Meeting - Occlusion: The Bigger Picture And Beyond

American Equilibration Society

Seattle Washington

Law/Lewis Lectureship In Pediatric Dentistry

University of Washington

206-543-5448

uwcde.com

847-965-2888

Mar 07 2014

Ongoing

Podcast and Online Based

Understanding And Assessing Risk In The Treatment Of Periodontal Disease

DentalEdu

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Apr 29May 11 2014

Grand Europe Cruise

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Jan 17 2014

New York New York

Practical Infection Control For The Dental Office

Columbia University College of Dental Medicine

212-305-6881

columbia.edu

Apr 29May 11 2014

Italy to Denmark Cruise

D-Day 70th Anniversary Cruise Conference

Continuing Education, Inc./University at Sea

800-422-0711 See Ad Page 18

continuingeducation.net

Mar 15-22 2014

Western Caribbean Cruise

Comprehensive Dentistry And The Dental Team: The Pursuit of Excellence

Continuing Education, Inc./University at Sea

800-422-0711 See Ad Page 18

continuingeducation.net

Dec 05

Minneapolis Minnesota

Clinical Grand Rounds For The Dental Team: Lasers In Periodontal Therapy

University of Minnesota

800-685-1418

dentalce.umn.edu

May 02-04 2014

Pittsburgh Pennsylvania

University of Pittsburgh

412-648-8370

pitt.edu

SDTA Annual Professional Development

Saskatchewan Dental Therapists Association

Dec 06

Contemporary Periodontics

Saskatoon Saskatchewan

Dec 13-14

Oklahoma City Oklahoma

Root Coverage Technique

Tulsa Periodontal Institute

877-888-7017

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306-672-3699

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Pacific Dental Conference March 6-8, 2014

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Meet up with your colleagues from across the country! Three days of varied and contemporary continuing education sessions are offered, covering topics relating to clinical excellence, practice excellence and personal development Over 130 speakers and 150 open sessions and hands-on courses to choose from, as well as the Live Dentistry Stage in the spacious Exhibit Hall Two day tradeshow with over 300 exhibiting companies Registration and program information at...

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calendar

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Periodontics

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Medical Issues

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Just For Canadian dentists November/December 2013

Featured Speakers

John Kois

Aesthetics & Occlusion

Gary Glassman

John Cranham - Occlusion/TMD Brahm Miller - Prosthodontics Theresa Gonzales - Forensics Brian Chanpong - Anaesthesia

Endodontics

Derek Mahony Orthodontics

Sergio Kuttler - Endodontics Ross Nash - Aesthetics Rob Roda - Endodontics Elliot Mechanic - Orthodontics

Ray Padilla

Trauma Dentistry

Sonia Leziy - Periodontics Bart Johnson - Pharmacology Greg Psaltis - Pediatrics John Flucke - Technology

November/December 2013 Just For Canadian dentists

Hygienists Assistants

Radiology/ Imaging

Prosthodontics

Practice Management, Technology and Planning

Pharmacology

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website

800-356-0026

nova.edu

Ongoing

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Florida Board Of Pharmacy Misfills Course

Nova Southeastern University

Ongoing

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Advances In Xylitol

DentalEdu.Tv

239-593-2178

dentaledu.tv

Apr 03 2014

St. Paul Minnesota

Dental Pharmacology

University of Minnesota

800-685-1418

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Jan 22 2014

Winnipeg Manitoba

What Your Practice Is Worth Today And Why

ROI Corporation

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Jan 23-26 2014

Cabo San Lucas Mexico

Complete Dental Practice Rejuvenation Bring Your Entire Staff For A Complete Office Rejuvenation Experience

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Feb 15-22 2014

Sandals Whitehouse Jamaica

The Ultimate Opportunity To Optimize Your Practice

ROI Corporation

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Mar 05 2014

Vancouver British Columbia

What Your Practice Is Worth Today And Why

ROI Corporation

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Mar 28-29 2014

Montreal Quebec

Transition Planning In Dentistry

International Dental Institute

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roicorp.com

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May 28Jun 04 2014

Alaskan Cruise

The Ultimate Opportunity To Optimize Your Practice

ROI Corporation

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Jul 05-12 2014

Alaskan Cruise

Dental Treatment Planning And Sequencing

Continuing Education, Inc./University at Sea

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Jan 17 2014

St. Petersburg Florida

All-Ceramic Restorations In 2014: Clinical Steps

West Coast District Dental Association

813-654-2500

wcdental.org

Feb 20 2014

Perrysburg Ohio

Clinical And Laboratory Management Of Provisional Restorations

Harbor Light Oral & Maxillofacial Surgeons

419-517-2135

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Oct 11-24 2014

Multiple Cities India

Contemporary Fixed Prosthodontics

Kennedy Seminars

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Dec 16-17

Lincoln Nebraska

Radiology For Dental Auxiliary

University of Nebraska Medical Center

402-472-7993

unmc.edu

Sep 20-27 2014

Mediterranean Cruise

Dental Imaging

Continuing Education, Inc./University at Sea

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Nov 16

St. Paul Minnesota

Winter Dental Assistants’ Seminar

University of Minnesota

800-685-1418

dentalce.umn.edu

Nov 23

Stoney Creek Ontario

How To Integrate The Laser Into Dental Hygiene Practice

rdhu

855-295-7348

rdhu.ca

For feedback, requests or to have your course featured please email ce@inprintpublications.com

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Both parties get what they want—always a good thing!

A win-win for practice seller and buyer

n a typical practice transition the vendor and purchaser are at odds as to how the sale should be structured. The selling dentist wants a tax-free share sale by getting access to the capital gains exemption, and the purchaser wants an asset purchase so that the cost base of the assets is equal to the purchase price. Many baby-boomer practices were established from scratch or with a small investment in goodwill and equipment. This means that in a typical share deal the purchaser assumes assets at a lowtax cost yielding minimal future amortization write-offs. Basically, the purchaser is forced to pay for the practice with after tax dollars. The share versus asset purchase dilemma often causes the deal to collapse unless the vendor is prepared to accept a share sale discount.

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One way to bridge the gap between purchaser and vendor is the hybrid sale. Both parties get what they want: The purchaser receives the full-cost base of assets and the vendor can sell his shares tax-free. Here’s an outline of how such a hybrid transaction can be implemented: 1. Dr. S and Mrs. S are shareholders of Dentalco. The practice assets are valued at $1.6 million. They both “crystallize” their capital gains exemption of $800,000 each by exchanging their shares in Dentalco for $1.6 million of preferred shares. A special election is filed with the Canada Revenue Agency in order to effect the crystallization. 2. The purchaser buys the preferred shares

of Dentalco from Dr. S and Mrs. S for $1.6 million. 3. The purchaser acquires 100% of the assets from Dentalco for cash and a $1.6 million note payable. 4. Dentalco then redeems the $1.6 million of preferred shares held by the purchaser for a note payable of $1.6 million owing to the purchaser. This note payable of $1.6 million is offset against the note payable to Dentalco for the purchase of the assets. As a result the two notes payable are cancelled out. 5. Dentalco can either invest the after tax proceeds or pay it out to Dr. S and Mrs. S. in the form of tax-free capital dividends.

TOP RIGHT HAND PAGE

Al Heaps & Associates Inc. LOCAL KNOWLEDGE — INTERNATIONAL EXPOSURE

stating any capital gains realized by a minor will be subject to the top marginal tax bracket. Instead of getting the benefit of the exemption, the minor will receive a hefty tax bill. Therefore the crystallization of the capital gains outlined in Step 1 must be avoided. The changes in the law does not affect the minor’s ability to claim the capital gains exemption when selling the shares to an unrelated party.

And, based on that, here’s what you need to think about and discuss: 1. The shareholders benefit from the capital gains exemption as long as the following conditions are met: a. The shares must be held for 24 months prior to sale; b. At the time of the sale, 90% of the assets in Dentalco must be used in the “active” business. Surplus cash, portfolio investments are considered “inactive”; c. For the 24-month period prior to the sale, the value of the inactive assets cannot exceed the value of the active dental assets (equipment, goodwill, accounts receivable, working capital cash, etc.). 2. The purchaser receives full asset value, and is entitled to the amortization of $1.6 million of assets. 3. Many dental corporations are owned by family trusts with minor children as beneficiaries. CRA tightened the income splitting rules, effective March 11, 2011,

You will appreciate the rather complex series of transactions involved in setting up the hybrid sale. The hybrid may be the perfect solution to bridge the gap between the seller and the buyer and can prevent the deal from collapsing. Your professional advisor can help you select the appropriate tax strategies and advise you as well on CRA’s changing views regarding these types of structures. Selling or purchasing a dental practice is the biggest business decision you likely will ever make. It’s mandatory that you consult with a pro with experience and a thorough understanding of the tax, financial, and business aspects of dental practice transitions.

Practice Sales and Valuation Specialists

solution from September/October 2013 contest

Manfred Purtzki is the principal of Purtzki & Associates Chartered Accountants. You can reach him at manfred@purtzki.com.

t h e w e a lt h y d e n t i s t [ c o n t i n u e d ]

solution from page 37

t h e w e a lt h y d e n t i s t m a n f r e d p u r t z k i

sudoku 2 harder solution 2 5 8 6 9 1 3 4 7 4 3 7 8 5 2 1 9 6 1 6 9 3 7 4 5 8 2 5 7 6 9 3 8 4 2 1 3 8 2 4 1 6 7 5 9 9 1 4 7 2 5 8 6 3 7 2 1 5 4 9 6 3 8 8 4 3 2 6 7 9 1 5 6 9 5 1 8 3 2 7 4

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sudoku 1 easier solution 2 6 7 5 9 8 3 1 4 8 1 5 2 3 4 6 7 9 3 9 4 7 1 6 8 5 2 5 2 8 1 4 7 9 6 3 6 7 9 3 2 5 4 8 1 1 4 3 8 6 9 5 2 7 9 8 2 4 5 1 7 3 6 7 3 6 9 8 2 1 4 5 4 5 1 6 7 3 2 9 8

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1-888-759-4287

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Al Heaps 604-644-6297

George Osterbauer 416-312-6166

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November/December 2013 Just For Canadian dentists

travel the world

go big on Hawaiiâ&#x20AC;&#x2122;s

kohala

coast

story

+ photography Barb Sligl

Just For Canadian dentists November/December 2013

November/December 2013 Just For Canadian dentists

travel the world he Big Island is, yes, big. In terms of size (the rest of the Hawaiian islands would all fit within its mass) and diversity (it has all but two of the world’s climate zones). That range—from sugar-like beach to snow-topped mountain and churning volcanic crater—is what makes the Big Island a big must. And that range extends to all parts of island living. You can nosh on exquisite farm-to-fork fare at a highend resort or pick up a still-warm malasada served in a paper bag from a hole-in-the-wall bakery. You can succumb to an open-air lomi lomi massage at a world-renowned spa or take a spin in a Jeep to a very-off-the-beatenpath green-sand beach. You can watch the sun go down alongside hula dancing seaside or jump off cliffs while locals fish where ancient Hawaiians once did. Star gaze or surf, golf or hike, beach it or crater it… So, where to start? First, set up base on the Kohala Coast. This once barren, lavaencrusted landscape on the island’s west side has been transformed into a resort oasis, making for some sweet and surreal hideaways tucked amidst the piles of black rock. From here, it’s an easy day’s outing north, south and east—to lush and quiet North Kohala, the remote cliffs and still-roiling chasms of Kua, vibrant Kona and rainy and rich Hilo and Hamakua Coast. That is, if you can tear yourself away from your west-side idyll… Here are our picks on the Kohala Coast and beyond.

STAY If anything, you may have too many choices on this Gold Coast. Carved out of one of the island’s past lava flows, this string of resorts on the northwest coast began when Laurance S. Rockefeller spied the perfect crescent of Kaunaoa Beach from the air IF YOU GO The and said “Every Kohala Coast is also great beach known as the Gold deserves a great hotel.” Coast…for good reason. He went on Think golden weather + to build the luxe properties: Mauna Kea kohalacoastresorts. Beach Hotel in com 1965…and the rest is history. Today the resort retains an exclusive elegance and the beach is listed among the top-10 US beaches by Condé Nast Traveler. {maunakeabeachhotel.com} A short trek along rocky shoreline, past ancient ruins and modern mansions, brings 30

travel the world you to the perhaps-even-more-jaw-dropping overly commercialized extravaganzas that Hapuna Beach. The largest white-sand beach can verge on cheesy, the traditional luau is still a window on historic Hawaiian culture, on the island, it’s home to the Mauna Kea’s and if you’ve never been to one, the sunset sister property, the Hapuna Beach Prince luau at Waikoloa Beach Marriott Resort & Spa Hotel {HapunaBeachPrinceHotel.com. But here, it’s is as good a place as any—or better with its all about the beach, beloved by locals and backdrop of an Anaeho‘omalu Bay sunset. visitors alike and a primo sunset-viewing spot {WaikoloaBeachMarriott.com} and morning barefoot-jogging circuit. On the opposite end of the Kohala Coast, in the south (and only 15 minutes from the RELAX There might be nothing city centre and airport of Kona), is the Four better than simply setting yourself up seaside Seasons Resort Hualalai, where the seaside back at the Four Seasons’ central, adult-only suites feel more like hales (Hawaiian homes) pool. You can see the waves crashing onto than a hotel. After a recent multi-million-dolthe beach (and a lollygagging turtle or two), lar refurb, this resort is all about pampering— yet you’re sand-free on a plush lounge chair from the sushi bar to the spa. The beach is no under an umbrella awaiting Evian water Hapuna but the seaside pools spritzes and little amuseand King’s Pond, stocked with previous page Beach bouche style treats. The lounging at the Four tropical fish and a spotted service is such that you’ll be Seasons Resort eagle ray you can snorkel with, offered sunglasses cleanHualālai at Historic more than make up for it. ing… Plan on wiling away Ka‘ūpūlehu, opposite {fourseasons.com/hualalai} an entire day from your page, clockwise from There’s an even more poolside-perch. top left The entrance homey hale vibe at the Lava The same might be said to the Four Seasons, Lava Beach Club Cottages, all along the Kohala Coast, amidst lava rock and which mesh old-school but at those Lava Lava Beach an endemic wiliwili tree. Hawaiiana cool and stylish Club cottages, the cushy > Watching sunset swank. Each cottage boasts at Hapuna Beach, chairs on your private porch local art, a ukulele (go ahead consistently listed as are made for sunset viewing one of the world’s best and strum for the beach club while sipping a Mai Tai. It’s strips of sand. > The crowd), punee (Hawaiian your own bungalow…on a seaside pool at the Four day bed), take-home pareo beach! Anaeho’omalu Bay’s Seasons. > One of the or sarong (thank you very sunsets are legendary, and Fairmont Orchid’s local much) and a private, lava-wallmade even more so with the “beach boys.” > Graffiti, enclosed outdoor shower. You Beach Club’s sundown hula Big Island style, using won’t want to leave. {lavalavaand live-music show right on shells and coral along beachclub.com} the sand. The atmosphere the main highway along is so cheery, with a humthe Kohala Coast. > ming crowd scattered about PLAY Want to hang Classic cocktail, the the sand (the Beach Club’s Mai Tai at Merriman’s, with a bonafide “beach boy”? the godfather of farmversion of a patio), that the Do the Hawaiian Outrigger to-fork cuisine on the temptation is to get up off Canoe Paddling Adventure Big Island. > Makena your personal porch and join at The Fairmont Orchid. You’ll Beach, another beach the convivial vibe. Almost… meet champion Hui Holokai consistently on the Of course, to relax is Ambassadors (The Fairmont’s world’s best beaches somewhat synonymous water experts), who’ll teach short list. > Sunset from with a spa. Each resort has you the basics of this quintesAnaeho’omalu Bay at its own version of lomi lomi sential Hawaii sport. You’ll the Lava Lava Beach and wrap this, zen that. Club. > Outdoor shower ply the crystalline waters to Mix it up by heading to yet at a Lava Lava Beach in-the-know snorkel spots and another Kohala Coast resort, Club cottage. > Fresh maybe learn some local lingo the Mauna Lani Spa. A day local flowers at the along the way, brah. {Fairmont. Mauna Lani Spa. spa retreat, it’s been ranked com/Orchid} one of the world’s best spas There’s also SUP (stand-up by Travel + Leisure magazine. Here culture and paddleboarding), surfing, tennis, golf, biking chic mix with thatched open-air hales, natural (you’ll be sharing the road with Ironman lava saunas, a meditation pavilion and watsu trainees), snorkelling (unbelievable), diving, pool. Aloha! {MaunaLani.com} windsurfing, kite-surfing (which you can also simply content yourself to watch from your Lava Lava Beach Club perch)…take your pick. After burning calories (in the most fun way possible), load up again at a luau. While some of these celebrations have become

Just For Canadian dentists November/December 2013

EXPLORE The north end of the Kohala Coast is king’s country. Stand below Pu`ukohola Heiau and make like legendary King Kamehameha. This temple is a

travel the world reminder of Hawaii’s rich Polynesian past, and that tie seems even stronger knowing that Kamehameha was born just north of this sacred spot. Come early morning and you might spot sharks still swimming over an ancient submerged temple that was dedicated to the shark gods. {nps.gov/puhe} Kamehameha the Great looms large all along the Kohala Coast and beyond. Mamalahoa Trail or the King’s Highway (part of the Alu Kahakai this page, from top National Historic left Demo of cultural Trail) cuts right traditions at the through lava rock Pu`ukohola Heiau and manicured National Historic Site resort- and golfson the Kohala Coast. capes past scores > The King’s Trail of petroglyphs. cuts a path through the lava rock, and {nps.gov/alka} was once used to From just transport supplies about anywhere from north to south. on the Kohala > Must-try fish tacos Coast you’ll catch at Kohala Burger glimpses of the and Taco. twin volcanoes of Mauna Kea and Mauna Loa looming in the distance. Don’t be a stranger. Arrange a guided hike with Hawaii Forest & Trail to venture closer, or skirt Mauna Kea and go north on the Kohala Waterfalls Adventure to see a different Hawaiian countryside (think old sugar plantations, taro terraces, waterfalls, pools, wet-and-wild valleys) and the charming town of Hawi. {Hawaii-Forest.com} Or head south to a still-churning volcano (see right).

MORe BIG ISLAND BLISS upcountry chic Overlooking the west-coast sprawl of Kona, in the thick of the legendary Kona Coffee Belt, is a bit of unexpected paradise. Holualoa Inn is set on the slopes of Mount Hualalai, part coffee estate and part luxe B&B / boutique resort. You could spend all day just soaking up the high-above-it-all jungle vibe, meandering through tropical gardens redolent with torch ginger, papaya, avocado, macadamia-nut trees (crack ‘em and eat fresh on site!) 5 and some 5,100 coffee trees. There are 30 lush acres here, including pasture land… so poolside you might hear a moo or two. Inside, the inn is a Polynesian retreat full of gorgeous artifacts and treasures (it was once a private estate), and just past the driveway is historic Holualoa Village’s shops, galleries and farm-to-fork eateries. holualoainn.com 1

volcanic wonder What might be the most mind-bending thing about the Big Island is the fact that it is literally churning. At the southern tip of the island is a fireworks show courtesy of Pele, the Hawaiian Goddess of Fire, at Hawaii Volcanoes National Park. Surreal. Where else can you walk across a crusted-over lava lake? Get eruption updates and trail info at nps.gov/havo. 2

3 malasadas On the northeastern end of the island, stop in the cute town of Honoka’a (once a thriving sugar plantation) for this local classic and sweet treat. As they say at Tex Drive In, “ono Kine grindz” (good local grub). texdriveinhawaii.com

SAVOUR The Big Island is becoming known for big-name cuisine. Merriman’s Market Café has the renowned 4 kona brewing After a day of surf locally sourced fare of famed Chef Peter and sun, it’s time for some suds at Kona Brewing Co. Try the nutty, almost-toffeeMerriman, one of the founders of Hawaii like winter seasonal Koko Brown, regional cuisine. It also has a tasty take on the brewed with toasted coconut. Or go for Mai Tai. When in Hawaii… {merrimanshawaii. a beer flight (along with some fish tacos), com} And then there’s ‘ULU Ocean Grill at to taste the wide range of island-inspired the Four Seasons, the Kohala Coast’s go-to concoctions, from Big Wave Golden Ale eatery. Order makai, from the ocean, for local to Pipeline Porter. konabrewingco.com seafood like the Kona White Abalone with 6 extreme green Ever seen a green coconut and kaffir lime. The goal is “R.S.A.— sand beach? The Big Island has one of Regional, Seasonal and Artisanal” cuisine the world’s two. Half the discovery is the trek beyond South Point (the southernfrom more than 160 farmers and fishermen most part of the US) along moonscapeon the Big Island; 75% of the menu features like coast (hike or brave with a 4WD local, sustainable dining. {uluoceangrill.com} Jeep) to the remote remains of Of course, you can’t beat a fish taco this ancient cinder cone. in Hawaii. On the Kohala Coast, greensandbeachhawaii.com the unassuming Kohala Burger The Big Island 7 ranch it Go north and Taco won’t disappoint. is Hawaii’s most to paniolo—that’s {kohalaburgerandtaco} Hawaiian for cowdiverse with all but Whether the goal is to boy—paradise at two of the world’s stay, play, relax, explore or Puakea Ranch in North climate zones. Kohala. It’s also an savour, your choice is big— Discover more at equestrian’s dream. See Big Island big. gohawaii.com/ big-island.

page 5. puakearanch.com

travel the world

beyond on the BIG ISLAND

2 5

4 6

the thirsty dentist janet gyenes Janet Gyenes is a magazine writer and editor who likes to dally in spirits, especially when discovering something like corenwyn jenever (a gin-like Dutch spirit)—straight or in cocktails like the “bramble.” Have a boozy idea or question? Send it to feedback@inprintpublications.com

essential bar spirits

Outfit your home bar with the key spirits that make up classic cocktails and mixed drinks

hen I started bartending, no one muddled anything,” says Ryan Boyd of Vancouver’s Metropolitan Bartending School. “The Mojito really changed everything. Once people started squishing up that mint, it opened up a whole universe.” Boyd, a bartender for almost 20 years now and who has trained other budding bartenders worldwide, is explaining how Mojitos ushered in the “bar chef” trend

Part 2:

the booze OR how to stock your bar

Winter fix: white cranberry martini. about a decade ago. Today, a number of bartenders have taken the “chef” aspect to intoxicating new heights by barrel-aging spirits, creating infusions with herbs and spices and crafting their own

{learn} 34

bitters and tinctures, but that’s what makes average person likely can’t tell the difference them pros (and why you’ll never really be from brand to brand, especially with vodka, able to recreate that “classic” cocktail you adding that most industry people drink taste in your favourite haunt). Ketel One, not Grey Goose, and not just Unless you aspire to get because of price point. into mixology as a radical Rums and tequilas career change or serious are slightly different. The seasonal sipping past-time, leave such sugarcane and agave labour-intensive ventures spirits, respectively, come Need a winter fix? to the experts. Instead, in a range of colours Ryan Boyd recommends notbuild your home bar with from clear to amber and too-sweet white cranberry the booze basics, and as almost black. In general, martinis. Hosting a crowd? your stock expands, so “white rums are the least Avoid endless shaking and will your cocktail reperrum-y flavoured; dark pouring: mix up a pitcher. toire. rums tend to be overly 1 cup white There are the dependsyrupy, too sweet. Most of cranberry juice able spirits—vodka, gin, the rum companies put rum and tequila—ideal all their effort into their 4 ounces vodka for making the triedamber rums,” says Boyd, 2 ounces Cointreau and-true, if slightly whose current go-to rum Fill a cocktail shaker with ice. yawn-inducing is Cruzan Single Barrel, Add cranberry juice, vodka, cocktails. You an amber rum that gets and Cointreau. Shake to know the usual its colour, like reposado combine well. Strain into two suspects: vodka tequila, from barrel-aging. and soda, gin These spirits can sink large martini glasses. Garnish and tonic, or sing depending on with whole cranberries. rum and Coke. how you use them. If spirit stock Add a splash you’re making a Mojito of juice, a or Margarita for instance, ryan’s basic booze dash of soda it’s likely summer and you recommendations or squeeze of don’t want an overt spirit Vodka > Ketel One lime to these flavour. So don’t break out booze basics and your best bottles of aged Gin > Tanqueray No. Ten or you’ve got your rum or tequila, only to Hendrick’s Screwdriver, Gin mask their nuances with Rum > Bacardi 8 or Cruzan Rickey, Greyhound, those refreshing juices Single Barrel Cuba Libre… and herbs—the ingreWhile the quality dients you want to taste Tequila > Don Julio of the spirit can make on a sweltering day. Save Whiskey > good quality a difference in a cockthe high-end for sipping Canadian rye or bourbon tail, there’s no need to neat or on the rocks, and get lured by big-name opt for a good-quality unCointreau > brands, says Boyd. “It aged spirit instead. Cosmopolitans, Margaritas doesn’t mean they’re the And that’s another Sweet vermouth best or that you can’t rule for the home barSimple syrup find equivalents at lower tender. Consider the price points.” He says the season—and embrace it.

Get schooled! Learn how to craft cocktails from the pros at Metropolitan

Bartending School with one-day courses aimed at amateurs. metropolitanbartending.com

Just For Canadian dentists November/December 2013

thirsty cont.

You wouldn’t order a piña colada at a finedining establishment in the dead of winter, would you? So don’t serve such drinks during the cooler months. Something like Blueberry tea (a soothing sipper composed of one ounce each Amaretto and Grand Marnier, topped with hot Orange Pekoe tea), which Boyd has resurrected as one of his favourite post-repast libations, would be much more suitable. When it comes to gin’s juniper berryforward flavour, there’s plenty of variation from brand to brand. Boyd says Tanqueray No. Ten is a high-quality choice that’s a solid standby, but adds, “if you want to be experimental with gin, go with Hendrick’s. Because not only is it interesting, it’s available everywhere.” What sets Hendrick’s apart from most other gins, in particular, are two ingredients: rose petal and cucumber. “Muddle some cucumber slices in the glass, add gin and soda ….” It’s a simple standout. Choosing whisky (or whiskey) can get pretty complicated, but you can’t go wrong by covering the bases with a goodquality bottle of each bourbon, rye and scotch. The longer the age, typically, the better the quality, and unless you’re a purist, don’t stress too much about swapping bourbon for Scotch in a pinch. That’s how new cocktails are concocted, after all. Rounding out your home bar with a couple of liqueurs can expand your cocktail range monumentally. “About 25 per cent of the drink recipes in the world will have Triple Sec in them,” says Boyd, who implores you to replace this bottombasement orange-flavoured liqueur with Cointreau, its top-shelf orange peelinfused equivalent. “If you want to make Manhattans and Rob Roys and all those Mad Men drinks, you need sweet vermouth,” he adds. (Plus the aforementioned whiskey.) Dry vermouth is handy if you must make a classic Martini, but it’s perfectly acceptable to skip it altogether, just like most bartenders do. Add some simple syrup to your bar basics (buy it or make it yourself: boil equal parts sugar and water together, let cool and store in a jar in the fridge) and you’ll be able to impress even the most finicky guests with legions of libations. Just don’t forget the garnish.

Have a can’t-miss cocktail? Share it with us! feedback@inprintpublcations.com

the hungry dentist Dr. Holly Fong is a practising speech-language pathologist with three young children who’s always trying, adapting and creating dishes.

easy does it

Braising in the oven keeps your hands free for other stuff

ometimes on busy weekends, it’s hard to make an “easy” dinner that’s special. So when I saw lamb shanks on sale at the butchers, I knew I had dinner made. If braised in the oven, lamb shanks will cook for about 2 hours, unattended. And they’re the perfect dish when three children are demanding help with various projects. As the aromas develop and waft across the house, everyone’s appetites are whetted and homework seems to be completed sooner than later. Braising shanks in a little liquid over low even heat will yield fork-tender meat and a ridiculously tasty sauce. Instead of the usual tomato based sauce (especially if pasta is a standby), I used dry white wine, anchovies, lemons, parsley, garlic and lots of onions, to create a mellow rich sauce. The onions melt and add body to the sauce without the

need for flour or cream. An added lemon gremolata at the end accentuates the taste of the shanks with a last-minute hit of flavour. Serve the lamb on a bed of sautéed garlicky baby spinach with rice and steamed baby carrots and green beans for a comforting meal. Because the dish has some delicate lemony herbal flavours, it’s easy to overpower with a Shiraz. Go with 2009 d’Arry’s Original, an Australian-Shirazand-Grenache-blend from old vines. It opens with a nose of berry with a slight floral hint and, on the palate, has a velvety mouth feel with tastes of berries and plums followed by a long finish of spice with a touch of chocolate. Overall, this nuanced wine pairs perfectly with the lamb.

Braised Lamb Shanks with Onions and Lemon Gremolata (serves 6) 6 large lamb shanks 2 Tablespoons canola oil 2 large onions, peeled and thinly sliced 6 cloves garlic, peeled and smashed with the back of a knife 4 anchovy fillets packed in oil, rinsed, dried and coarsely chopped 1 teaspoon slivered lemon zest juice of ½ lemon 1 teaspoon of fresh thyme leaves, chopped salt and fresh ground pepper to taste 1 ½ cups of dry white wine 1 ½ cups low salt chicken broth gremolata

1 large clove of garlic, finely minced or grated grated zest from 2 lemons ⅓ cup of chopped Italian parsley leaves ¼ teaspoon salt fresh ground pepper to taste

Preheat oven to 300F. Pat lamb shanks dry with a paper towel; season with about 2 teaspoons of salt. Heat the oil in a very large heavy bottomed flame-proof oven casserole or Dutch oven large enough to hold the shanks in a single layer without touching. When the oil is shimmering, add the lamb and brown well for about 4 – 5 minutes per side. Set aside. Reduce heat to medium and in same pot, add more oil if needed. Add onions, garlicand ¼teaspoon of salt. Sauté, stirring frequently until golden brown, about 6 – 7 minutes. Take care to not burn the vegetables. Stir in anchovies and white wine, scrapping off any brown bits into the wine. Increase the heat to medium-high and boil until the wine is reduced by half. Add lemon zest, juice, broth and thyme, stirring to mix. Bring to a boil. Turn off heat. Add the lamb in a single layer. Cover the pot with aluminum foil and crimp along the edges making a tight

Don’t overpower delicately flavoured lamb shanks; go with 2009 d’Arry’s Original, an Australian Shirazand-Grenache blend from old vines.

seal to minimize evaporation. Bake in the oven for about 2 hours until the meat is fork tender. Transfer the meat to a serving dish and cover with plasticwrap or foil to keep warm. With a wooden spoon or spatula, scrape down sides and bottom of the pan to release all the browned bits. Strain juices into a tall measuring cup, pushing down on the solids to extract all the juice. Place the solids in a small saucepan. While waiting for the fat to rise, make the lemon gremolata by combining all the ingredients in a small serving bowl. Skim off and discard the fat from the juices. Add the juices to the solids in the saucepan and heat to boiling. Remove from the heat and blend until smooth using a handheld blender. Pour sauce over the meat and scatter gremolata on top. Serve at once with extra gremolata on the side. Enjoy.

November/December 2013 Just For Canadian dentists

practice management timothy brown

diversion

2 contests

Who are today’s bestselling buyers and what do they want?

They are hands-on, full-time practitioners who are motivated by most of the same things that existed when my father started a dental consulting business almost 40 years ago I’ve been accumulating data from buyers since 1974 and the “bestselling” dental practices all have certain characteristics in common: • Owned by a solo practitioner. • Gross billings in the range of $750,000 to $1,250,000. • Normalized (purified) operating cash flow* equals 40% or more of gross. • Sixty or more hours per week of preventive scheduling booked three to six weeks in advance. • Not located in the highest rent districts, such as a major mall or retail/storefront (although exposure always helps). • Do not employ long-term associates who are not on a contract. • Not involved in complicated partnerships, such as when a partner wishes to sell and another does not (selling a share of a practice is a very difficult task for any broker!).

Conceptually i-Dentist™ is a great business plan if owning and managing multiple practices is the goal. However, for any individual-minded dentist (assuming he or she desires control over the style of practice, as an estimated 75% or more of Canadian dentists do), this style of dental chain will inevitably include a long-term power challenge. The practices that are more difficult to sell usually display the following characteristics: • Employ associates that have long tenure and may negatively influence patients and/or staff after sale. • Associate(s) is not on a proper, written agreement. • Associates threaten the new practice owner and the open market dictates that the practice will be more difficult to sell, period! • Any type of arrangement whereby space or overhead costs are shared

Just For Canadian dentists November/December 2013

•

These issues have surfaced many times in the course of my business. I’ve performed calculations to support the theory that “bestselling” practices sell for the highest amount when considering alternative practices. The owners of these practices are the happiest, most stress-free individuals. They take more holidays, enjoy the lowestoperating overhead and generally work longer in dentistry because of the rewarding work environment. The choice is yours. Everyone has different philosophies, but any dentist can practice like a “bestseller.”

sudoku

Solve Sudoku puzzle #2 to win a $100 Visa gift card, compliments of ROI Corporation and to be entered into a draw to win one of three $1,000 CE Gift Certificates to be used towards Profitable Practice’s Destination CE—in Jamaica or Alaska! Each Sudoku puzzle has a unique solution that can be reached logically without guessing. Fill in the grid so that every row, column and 3x3 square contains the digits 1 through 9. GOOD LUCK! LAST ISSUE’S WINNER: Dr. Weijia Dong of Calgary, AB

(VISA gift card, value $100)

sudoku 1 easier solution on page 27

The national team of associates I work with also recognizes that dentists who own practices exhibiting these characteristics experience less stress. And similar observations reveal why the group dental practice dynamic can fail. Having worked in the largest-ever Canadian retail dental chain (Tridont) in the 1980s, I can predict some of today’s burgeoning dental chains’ chance of survival.

•

with another professional complicate the transaction. Basically, human nature equals potential for future conflict. Long-term staff that’s highly paid and not on a proper, written employment agreement. Purchasers realize that existing staff is valuable, it’s retained in most of the practices sold. However, highly paid or long-term staff can intimidate young purchasers. An established staff is very important for patient retention, but buyers with big loans, household mortgages and/or dependants are going to try to reduce expenditures to maintain profitability. The fear is that reducing wages and/or increasing hours may result in losing important members of the team. Over-sized offices or high-rent locations. During slow times high rents remain the same. Rent should be typically 3 – 7% of gross; if it’s higher, a buyer will be wary of that long-term risk. Practices that are over-capitalized (extravagant leaseholds and equipment) are difficult to sell because the facility is designed to accommodate more than one dentist or suit personal tastes. Yes, purchasers appreciate large, ultra-modern offices with hightech equipment, but they also don’t necessarily want to start off with the accompanying debt.

sudoku 2 harder solution in next issue

*Normalizedcashflowdoes not include“discretionary” expenses, spousal or familywages, or debts. Debt is not part of operatingoverhead, it is acapital cost of acquisition andgenerallywill beeliminatedover time.

7 8 1 5 6 1 9 7 4

6 2

2 8 2 6 1

3 4 6 8

5 1

4 6

5 2

4 9 2 3 1

1 4 5 2

Puzzle by websudoku.com

1 7 5 4 2

2 9 7 7

3 6 8

TROLLBYTES = SENSOR HOLDERS TROLLBAGS = PROTECTIVE SLEEVES FOR SENSOR OR SENSOR + HOLDER TROLLFOIL = FRAMED ARTICULATING FOIL - RED OR BLUE FOIL TROLLMOUNTS = POCKET X-RAY MOUNTS

www.TROLLDENTAL.com/ca

se r vi c e

Enter for a chance to to enter! win one of four prizes: 1 one of three $1,000 gift certificates to a Profitable Practice Destination CE seminar in Jamaica or Alaska, and 2 a VISA gift card.

become a bestseller he large majority of today’s buyers are not i-Dentists™. Rather than being in dentistry solely for investment purposes, owning and managing multiple practices, they are hands-on, full-time practitioners who are motivated by most of the same things that existed when my father Roy Brown started a dental consulting business almost 40 years ago. Today’s buyers want these basics: • To “be their own boss.” • Have control over their income. • Maintain complete authority over business and treatment decisions.

a t y ou r

Timothy A. Brown specializes in dental practice appraisals, brokerage, consulting, locum placements, associateships and practice financing across Canada. You can reach Timothy at timothy@roicorp.com.

feeling lucky?

Trol@shaw.ca

! e r e h d a r u yo Call 604-681-1811 now.

Use this space to deliver your message to 14,500 dentists across Canada.

CE Gift Certificate

Contest entry form (no sudoku necessary!) Name: __________________________________________________________ Address: ________________________________________________________ City, Province, Postal Code: _________________________________________

________________________________________________________________ E-mail: _________________________________________________________ Tel: ____________________________ Fax: ____________________________ CE gift certificate Contest Rules:

1. Contest entries will be entered into a random draw. 2. Send entry form to Just For Canadian Dentists, 200 – 896 Cambie Street, Vancouver, BC, V6B 2P6 or by fax to 604-681-0456. Entries must be received by December 15, 2013. 3. Prize 1 of 3 $1,000 CE Gift Certificates to be applied to the Dentist’s choice of Profitable Practice’s Destination CE seminar in Jamaica (valued at $2,312) or Alaska (valued at $4,699). Winner will be contacted by December 31, 2013. 4. Contest can be changed and/or cancelled without prior notice. 5. All entries become property of In Print Publications and ROI Corporation.

Sudoku 3 7

6 4 7 8 9

5 2 4 7 3

Puzzle by websudoku.com

Contest entry form (solve + send in sudoku!) Name: __________________________________________________________ Address: ________________________________________________________ City, Province, Postal Code: _________________________________________

E-mail: _________________________________________________________ Tel: ____________________________ Fax: ____________________________ sudoku Contest Rules:

1. Entry form must be accompanied with solved puzzle. Only correctly solved puzzles entered into random draw. 2. Send puzzle + entry form to Just For Canadian Dentists, 200 – 896 Cambie St., Vancouver, BC, V6B 2P6 or fax 604-681-0456. Entries must be received by December 15, 2013. 3. Prize: $100 Visa Gift Card compliments of ROI Corporation PLUS a chance to win 1 of 3 $1,000 CE Gift Certificates to be applied to dentist’s choice of Profitable Practice’s Destination CE in Jamaica (valued at $2,312) or Alaska (valued at $4,699). Winner will be contacted by Dec. 31, 2013. 4. Contest can be changed and/or cancelled without prior notice. 5. All entries become property of In Print Publications and ROI Corporation.

November/December 2013 Just For Canadian dentists

Dr. Michael Zuk is a madman. A marketing madman, that is. Channelling some of that Don Draper mojo, he gets a rush from coming up with a winning marketing plan. He’s currently on a mission to clone John Lennon. Really. His last big splurge was winning an auction for the deceased Beatle’s tooth (and the DNA within) that has drawn the attention of major networks, newspapers and Rolling Stone magazine. It’s all part of this dentist’s rock-star vibe, whether following Lennon’s trail around Liverpool or donning some seriously rockin’ shoes. Next up: Elvis’s crown. Rock on. My name: Michael Zuk I live and practise in: Red Deer, Alberta My training: DDS— general ortho and oral rehab (Spear)

The best souvenir I’ve brought back from a trip: Rock star shoes— from Leeds, UK from

Dream vacation: River cruise—Europe

My favourite room at home: Study

The word that best describes me: Creative

If I could travel at any time, I’d go to: Los Angeles for a weekend

My car: Tundra

I’m inspired by: Bruce Lee

Favourite book: Dr. Ruthless Management Michael Zuk’s rockstar impression; on TV Favourite film: after buying John Lennon’s Terminator tooth; on his “UK tour,” visiting Lennon’s childhood Must-see TV show: home; Strawberry Fields; Breaking Bad / 60 and his DNA pendant MINUTES with a bit of that tooth. top left

My last purchase: Diamond ring for my wife My last splurge: Celebrity teeth My most-frequented store: Nordstrom My closet has too many: Shoes My fridge is always stocked with: Guinness My medicine cabinet is always stocked with: ASA My guilty pleasure is: Chocolate Favourite exercise/sports activity: Weights Favourite sport to watch: MMA Celebrity crush: Raquel I’d want this with me if stranded on a desert island: Big knife My secret to relaxing and relieving tension: Marketing development A talent I wish I had: Speaking

Favourite music: Come Together— The Beatles

Why I was drawn to dentistry: Interest in anatomy, art and science

My first job: Janitor

My last trip: Liverpool The most exotic place I’ve travelled: Capri, Italy

A favourite place that I keep returning to: Manzanillo, Mexico

The gadget or gear I could not do without: iPhone

My scariest moment: A missing child My fondest memory: John Lennon’s tooth auction win A big challenge I’ve faced: Pulling a practice out of financial trouble One thing I’d change about myself: Personality

It takes guts to say it’s the best,

My biggest ego boost: Publicity My biggest ego blow: Never mind

but since we make the guts …

I’m happiest when: Giving birth to a new marketing plan My greatest fear: Premature death My motto is: Only Live Once

we can.

A cause close to my heart: Advocate against irresponsible cosmetic dental treatment

What makes NSK handpieces the best? We engineer and manufacture every part in-house – we don’t just assemble parts made by someone else. And, since we control the quality going into all of our handpieces, we can trust them to deliver the reliability you need. Like the Ti-Max Z95L. It’s the most durable of the high-performance electric attachments on the market. Crafted from solid titanium, it’s extremely light in use. Plus, it’s amazingly silent with virtually no vibration – lending superior comfort to operator and patient.

If I wasn’t a dentist I’d be: Marketing Madman What else should we know about you? I work as a marketing consultant for 1-800-VENEERS, High Speed Braces.org and KillerToothache.com. You may have seen me on CBC Marketplace as a dental consultant investigating dentist pricing, and I was recently elected to be on the board for the Alberta Dental Association and College. Off call? Assorted stuff behind the scenes with John Lennon’s tooth… and we may even be taking Elvis Presley’s crown on tour in the UK to raise awareness for mouth cancer.

100

Something I haven’t done yet that’s on my must-do list: Clone movie script

of all handpiece components are manufactured in house.

Try it FREE for a week!

Call your dealer or visit www.nskdental.us/Canada today.

NSK instruments are available from: photos courtesy of Dr. Michael zuk

s m a l l ta l k

dentists share their picks, pans, pleasures and fears

Smallest head & slimmest neck in electric attachments.* *Global handpiece market as of 11/2011

Just For Canadian dentists November/December 2013 1800 Global Parkway • Hoffman Estates, IL 60192 USA • Tel. (888) 675-1675 • www.nskdental.us/Canada

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