CAO BULLETIN - Fall 2011 by LS Graphics

Fall 2011

Bulletin

CANADIAN ASSOCIATION OF ORTHODONTISTS / ASSOCIATION CANADIENNE DES ORTHODONTISTES

Message from the President Message from the Outgoing President Committee Reports CFAO Graduate Student Posterboards - Part 1 of 2 Component Society Reports From the Editor

Message from the President

Canadian Association of Orthodontists Association canadienne des orthodontistes 2175 Sheppard Avenue East, Suite 310 Toronto, Ontario M2J 1W8 Telephone (416) 491-3186 / 1-877-CAO-8800 Fax (416) 491-1670 E-mail cao@taylorenterprises.com Website www.cao-aco.org AND www.canadabraces.ca

Dr. Ritchie Mah Unplugged Dr. Richie Mah [Email: ritchiemah@yahoo.ca]

I had an opportunity to catch up with incoming CAO President Ritchie Mah and ask him a few questions about life, love and the pursuit of happiness. Here’s an opportunity for the membership to get to know Ritchie on a whole new level. Ritchie, where were you born and where did you grow up?

2011/2012 Board of Directors

I was born in Red Deer, Alberta, but moved to Edmonton when I was nine years old, so Edmonton is home.

OFFICERS

I completed two years of basic science at the University of Alberta and then was admitted to dentistry, graduating in 1990. I completed my orthodontic training at the U of A in 1995.

President President Elect Past President 1st Vice President 2nd Vice President Secretary/Treasurer

Dr. Ritchie Mah Dr. Paul Major Dr. Howard Steiman Dr. Garry A. Solomon Dr. Helene Grubisa Dr. Michael W. Patrician

REGIONAL DIRECTORS British Columbia Alberta Saskatchewan Manitoba Ontario Quebec Atlantic

Dr. Rick Odegaard Dr. Phil Williamson Dr. Mike Ziglo Dr. Susan Tsang Dr. Sheila Smith Dr. Jean-Marc Retrouvey Dr. Dan A. Stuart

COMMITTEES Communications Nominations President CFAO CAO/AAO Liaison Insurance Planning & Priorities

Dr. Dan Pollit Dr. Howard Steiman Dr. Stephen Roth Dr. Garry Solomon Dr. Robert Cram Dr. Ritchie Mah

Membership

Dr. Paul Major

Policy & Procedures

Dr. Amanda Maplethorp

Sponsorship

Dr. Michael W. Patrician

World Federation of Orthodontics National Scientific Meeting Coordinator CDSA Liaison Canadian Orthodontic Educators Liaison COSA Liaison New & Younger Members Rep

Dr. Ritchie Mah Dr. Richard Marcus Dr. Ritchie Mah Dr. Gerry Solomon Dr. Bob Cram Dr. Susan Tsang

CAO Web Master Assistant Web Master Bulletin Editor Database/Directory Consultant Historian/Archivist CAO Helpline Task Force GST Advisor

Dr. Daniel Pollit Dr. Jules Lemay III Dr. James Posluns Dr. Stephen Roth Dr. Garry A. Solomon Dr. Howard Steiman Dr. Michael W. Patrician

Where did you go to school?

Tell us a bit about your practice. I began building my office in late 1995 and opened it in April, 1996. I started the practice from scratch, but also associated part-time in another office. My office, located in the Metrotown area of Burnaby, BC is a solo practice and encompasses all aspects of orthodontic practice, with a particular interest in adult orthognathics. You have a few dentists in the family. Give us a behind-the-scenes glimpse into a Mah family Christmas. I see my brother James, who is also an orthodontist, at various orthodontic conferences and functions. He is a full-time academic who frequently lectures internationally, so although I do see him often, it is for short periods of time as both our schedules are quite busy. We often discuss orthodontics, ranging from interesting individual cases to new research concepts in current graduate programs. It is not until Christmas when we return to Edmonton for a large family get-together that things slow down a bit and we get to catch up on personal endeavours. My wife, Lenore Louie, is also a practicing orthodontist, graduated from the University of Nevada, Las Vegas, and presently practices as an associate in BC. We have a 16 month old daughter, Aveline, who keeps us very busy. She just started part-time junior kindergarten and has more energy than the two of us combined! We currently live in Coquitlam, BC, which is another suburb of Vancouver with plans to move to Burnaby early in 2012. Continued…

Consider supporting the advertisers and service providers referred to in this Newsletter, recognizing that they have been supporters of the CAO. Advertisements are paid advertising and do not imply endorsement of or any liability whatsoever on the part of the CAO with respect to any product, service or statement. The authors, the Canadian Association of Orthodontists, and its representatives will not be held liable in any respect whatsoever for any statement or advice contained herein. Authors’ views expressed in any article are not necessarily those of the Canadian Association of Orthodontists.

Fall 2011 • CAO Bulletin

Where can we find you when you’re not straightening teeth or attending to CAO matters-at-hand? I’m into skiing, hiking, and spending time outdoors with family. I also enjoy working on my cars, riding my motorcycle, and shopping! What’s your vision for the upcoming year? I’d like to engage more of the new and younger members in shaping the future of our profession and of our association. Orthodontics is one of the greatest professions of which to be a part, but it is only through the dedication and energy of the newer orthodontists that it will continue as such. My goal is to ensure these new and younger members are aware of the CAO and its role in helping to maintain a strong profession. It is their involvement in the CAO and organized orthodontics that is critical to keep orthodontics moving forward by embracing new concepts and recognizing the changes within. How do you see the current state of the profession? We are fortunate to be orthodontists, but our role within the dental team needs to be reinforced if our specialty is to flourish. Several concerns regarding the direction our profession is heading have been brought to my attention. There are an increasing number of general dentists who offer orthodontic services and do not utilize orthodontists as a referral option. This trend is partly linked to the aggressive marketing by product manufacturers who offer their own courses and frequently use profit as the main motivation for general dentists to attempt orthodontic treatment. In many cases, the specialization and expertise of orthodontists is no longer offered to patients. This scenario undermines the orthodontists when patients are not made aware of their treatment options and do not receive the quality of care they deserve. Interestingly, there have also been concerns raised by various individuals, groups and regulatory bodies about the direction that some orthodontists have taken in taking their message di-

rectly to the public. Radio advertisements selling orthodontic services, offering reward points as a bonus for utilizing their office, and even offering a discount on any written competitors’ estimate are all modalities that have invaded our once serene profession. While those that have been in the profession for any length of time may be shocked that this type of marketing takes place, it is up to the new and younger members of the profession to decide whether direct marketing is the future of orthodontics. We are not alone. In speaking with periodontists and with prosthodontists, similar concerns are expressed regarding the under-utilization of specialists by general dentists. These specialities would also like to make the public more aware of their options directly rather than relying on general dentists to make those decisions on behalf of their patients. It seems that specialty differentiation will be a challenge for many specialists for the foreseeable future. Thanks Ritchie. The CAO continues to be in very capable hands. All the best this year, Ed.

Rapport du président

En tête-à-tête avec Ritchie Mah J’ai eu l’occasion de rencontrer Ritchie Mah, le nouveau président de l’ACO, et de m’entretenir avec lui sur la vie, l’amour et la poursuite du bonheur, histoire de vous le présenter sous un jour plus intime. Ritchie, où êtes-vous né et où avez-vous grandi? Je suis né à Red Deer, en Alberta, mais j’ai déménagé à Edmonton à l’âge de 9 ans. Je suis donc originaire d’Edmonton. Où avez-vous fait vos études? J’ai étudié deux ans en science fondamentale à l’Université de l’Alberta. J’ai ensuite été admis en médecine dentaire et obtenu mon diplôme en 1990. J’y ai aussi suivi ma formation en orthodontie, que j’ai terminée en 1995. Parlez-nous un peu de votre pratique.

Mah family pumpkin patch.

CAO Bulletin • Fall 2011

J’ai d’abord aménagé mon bureau; j’ai choisi son emplacement à la fin de 1995 et je l’ai ouvert en avril 1996. J’ai commencé ma pratique à partir de zéro, tout en travaillant à temps partiel dans un autre cabinet. Je travaille en solo dans mon bureau situé près du centre commercial Metrotown de Burnaby, en Colombie-Britannique. Ma pratique couvre tous les aspects de l’orthodontie, et j’ai un intérêt particulier pour les orthognathes adultes.

Il y a d’autres dentistes dans votre famille. Dites-nous comment se passe Noël chez les Mah. Je côtoie régulièrement mon frère James, qui est aussi orthodontiste, dans le cadre de ses diverses conférences et fonctions professionnelles. Il mène une carrière universitaire à temps plein et participe souvent à des conférences internationales; je le croise donc fréquemment, mais nos rencontres sont brèves, car nous avons tous les deux un horaire plutôt chargé. Nous parlons souvent d’orthodontie, des cas individuels intéressants aussi bien que des nouveaux concepts de recherche dans les programmes d’études supérieures. Ce n’est qu’à Noël, quand nous nous retrouvons tous à Edmonton pour notre grand rassemblement familial et que nos activités ralentissent un peu, que nous avons le temps d’évoquer nos projets personnels. Mon épouse, Lenore Louie, est elle aussi orthodontiste praticienne. Diplômée de la University of Nevada, à Las Vegas, elle est devenue associée en Colombie-Britannique. Nous avons une fille, Aveline, âgée de 16 mois, qui nous tient très occupés. Elle fréquente depuis peu une garderie à temps partiel et a plus d’énergie que nous deux ensemble! Nous vivons à Coquitlam, en banlieue de Vancouver, en Colombie-Britannique, mais prévoyons déménager à Burnaby au début de 2012. Où pouvons-nous vous trouver, quand vous n’êtes pas en train de redresser des dents ou d’assister aux réunions de l’ACO pour régler les affaires en cours? J’aime bien skier, faire de la randonnée pédestre et passer du temps en plein air avec ma famille. J’aime aussi bricoler sur mes voitures, conduire ma moto et magasiner! Quelle est votre vision de l’année à venir? J’aimerais amener un plus grand nombre de nos nouveaux membres à façonner l’avenir de notre profession et de notre association. Les orthodontistes exercent l’une des professions les plus valorisantes qui soient, mais seules la détermination et l’énergie des jeunes orthodontistes permettront que cela continue. Mon but est de faire en sorte que nos jeunes membres connaissent bien l’ACO et son rôle, et contribuent à assurer l’avenir de la profession. Leur engagement envers l’ACO et l’encadrement de la profession sont essentiels pour que l’orthodontie puisse continuer d’évoluer en s’ouvrant aux nouveaux concepts et aux changements qui en découlent. Comment voyez-vous l’état actuel de la profession? Nous sommes privilégiés d’être orthodontistes, mais nous devons affirmer notre rôle dans l’équipe des dentistes si nous voulons que notre spécialité demeure florissante. Plusieurs préoccupations au sujet de l’orientation que prend notre profession ont été portées à mon attention. Un nombre croissant de dentistes généralistes offrent des services orthodontiques à leurs patients sans leur parler de la possibilité de consulter un spécialiste. Cette tendance est en partie liée aux techniques de marketing trop entreprenantes utilisées par les fab-

Ritchie and Lenore in Halifax 2011

ricants de produits, qui offrent leurs propres cours et font souvent valoir le profit comme principale motivation pour inciter les dentistes généralistes à se lancer dans les traitements orthodontiques. Dans bien des cas, la spécialisation et l’expertise des orthodontistes ne sont plus offertes aux patients. Cela nuit aux orthodontistes, lorsque les patients ne sont pas informés des traitements qu’ils peuvent recevoir et sont privés des soins de qualité qu’ils méritent. Fait intéressant, des particuliers, des groupes et des organismes de réglementation ont aussi soulevé des préoccupations au sujet de l’orientation que certains orthodontistes ont adoptée en s’adressant directement au public. Les publicités à la radio dans lesquelles des cabinets vendent des services orthodontiques en offrant des points de récompense, voire des rabais sur les estimations écrites de leurs concurrents, font partie des procédés qui entachent l’honorabilité de notre profession. Bien que ceux qui sont dans la profession depuis un certain temps puissent être choqués par l’existence de ce type de marketing, c’est à ses nouveaux membres qu’il revient de décider s’il faut voir l’avenir de l’orthodontie dans le marketing direct. Nous ne sommes d’ailleurs pas les seuls à éprouver ce genre d’inquiétudes. En parlant avec des parodontistes et des prosthodontistes, j’ai constaté que la sous-utilisation des spécialistes par les dentistes généralistes les préoccupe autant que nous. Ces spécialistes aimeraient eux aussi informer le public directement des services qu’ils peuvent offrir plutôt que de dépendre des généralistes, qui prennent ces décisions pour leurs patients. Il semble que de nombreux spécialistes auront à se battre pour faire reconnaître leur expertise dans un avenir prévisible. Merci, Ritchie. L’ACO demeure en de très bonnes mains. Je vous souhaite beaucoup de succès cette année. — Ed.

Fall 2011 • CAO Bulletin

Message from the Outgoing President Dr. Howard Steiman [Email: straightsmile@sympatico.ca]

Time flies when you are having fun and this year sure flew by fast for me. I was so very pleased to receive so much great feedback from my incoming Spring Bulletin message that I have decided to share a few more humourous/interesting/ complexing/mind stirring thoughts in my outgoing Fall Bulletin message. Those hard core political junkies need not worry! There are lots of juicy CAO tidbits just a short read away… So, here we go (again)… 1. Is millionaire Bruce Wayne cheating the Gotham City municipal government on his property taxes? I mean, when stately Wayne Manor was last assessed, I bet he didn’t show the Property Inspector the Bat cave and all the upgrades to his house (like a Bat pole with the optional explosion propelled lift feature, private elevator for the Alfred the Butler, nuclear reactor, etc)? The pool in my backyard sure changed my property taxes. I can’t imagine how much more I would pay if I had a secret cave with the latest, high tech equipment and a car that shoots flames out its tailpipe? 2. In all those James Bond movies where the villain resides in a secret, gynormous, state of the art complex that must have taken years to build with hundreds/thousands of man hours and more construction materials than one could possibly imagine (like building a rocket launching silo out of a dormant volcano complete with monorail in “You only Live Twice”), how come nobody ever finds out about it until the absolute last minute when the world is about to be taken over? 3. If Mr. Keebler employs tiny little Elves working in small tree stumps, how do they make those large cookies in regular sized packages in volumes to feed the worldwide cookie craving population? 4. I am a tried and true exotic car fanatic, but I believe that the stand alone electric car has its place in our future automotive world. So far, nobody has been able to figure out

CAO Bulletin • Fall 2011

how our electric grid system will handle all those cars charging at the same time when everyone gets home from work. So, when everyone is plugged in and you get out of the shower, what’s going to happen when you turn on that hairdryer and the circuit blows across 4 provinces? Furthermore, what are we going to do with all those batteries 10 years from now when they all lose their recharging capabilities? Will the Energizer bunny be hunted down by trigger happy environmentalists? 5. I have the perfect idea for eliminating all those parent/patient phone calls where all they do is complain. Install one of those complex, multi level auto attendant phone systems. By the time the complainant gets directed to the appropriate area, they will have forgotten why they wanted to gripe at you, your receptionist, your hygienist or your assistant in the first place!! 6. Why do songwriters dream up so many songs about young people who are so madly in love that they can’t live another day without being together? Why can’t they write songs about people who have been married together for 15 years or longer? I bet the lyrics would be dramatically different…..don’t you think? I am a firm believer in loving life and laughing when you have the chance. However, there is a more serious side that maintained its presence during my presidency. Here are just a few of things that went on behind the scenes in the second half of my term: • The sacred CAO gospel was spread to all 7 Provincial areas. I attended AAO and WFO meetings on your behalf as well. • I have said over and over that our Past Presidents have a wealth of knowledge and expertise that seems to fall by the way side after they finish their line officer commitment. In an effort to keep those interested Past Presidents involved in the CAO, I created an “In the Loop” e-newsletter which was sent out roughly every 6-8 weeks. • The inaugural Past President’s Breakfast Business Meeting was held last September in Halifax. It was a wonderful success with great discussion! • In order to help streamline the CAO and make committee positions more easily transferable and transparent, Terms of Reference for each CAO committee are in the works. They essentially outline the duties, responsibilities and framework for each committee and its Chair to the CAO board. • Our Policies and Procedures manual is being trimmed down to reflect the true operations of the CAO. All other informa-

tive material will be moved to our website for any member to access. • New Component Society agreements with the CAO are being drafted. The existing ones are more than 10 years old and with the passing of new Canada Not for Profit Corporations Act, it is imperative that the relationship between our Component Societies and the CAO be updated properly and be in compliance. Furthermore, under the new Act, the CAO Board structure must be revised as it would not be compliant as it currently operates. A committee, chaired by our Parliamentarian (Dr. Amanda Maplethorp), has been struck to investigate this issue. There is a 3 year grace period before the required governance changes are in place. • A new Code of Ethics has been drafted which outlines the expectations and responsibilities of our Board members to the CAO proper. • The Board has decided against creating a CAO Facebook page, however, sponsoring a national “How Orthodontics Changed my Life” contest is moving closer and closer to becoming a reality. We are also looking for ways to increase the member registration and usage of BraceSpace (our website chat room). Please read on to learn about all the other things that the CAO Board is doing on your behalf. Provincial Directors, Treasurer, CDA/CDSA Liaison, Membership, CAO-AAO Liaison, New and Younger Members and Scientific Session reports (just to name a few) are just fingertips away for your reading pleasure! In closing, I am both happy and sad to become a Past President. It is certainly nice to get my life back, but at the same time, there is something to be said for having your finger on the

Which one is The Prez??

pulse of the Canadian orthodontic information highway. I have had an absolutely wonderful year which was topped off with a rocking fun evening at the President’s Gala in Halifax. Over the past year, I hope that I have put a smile on your face at the same time as making people realize that we are part of the most privileged specialty in dentistry. Preserving this privilege is paramount. As I step down, my friend and colleague, Dr. Ritchie Mah steps up to the plate. He is a brilliant, level headed, common sense person which is a huge upgrade from me. It gives me tremendous comfort to know that our organization is in great hands and I’m sure that Ritchie will raise the bar for the CAO to even greater heights. Best of luck Ritchie, but I know you won’t need it. I would like to thank Diane, Alison and all the great people at Taylor Enterprises, Ritchie, Paul, Garry, Mike P., Rick, Phil, Mike Z., Susan, Helene, J.M., Dan S., Amanda, Gerry Z., Bob, Gordie, Stephen, Gerry S., Dan P., Richard and Jim for all their hard work and efforts. Without all of you, the CAO would not be the well respected, progressive organization that it is. Respectfully Submitted in a high protein, low fat kinda way, Howard Steiman

Rapport du le président sortant Le temps passe vite quand on s’amuse, et c’est pourquoi je ne l’ai pas vu passer cette année. J’ai été si enchanté des nombreux commentaires que j’ai reçus à la suite de mon message à titre de nouveau président dans le Bulletin de l’AOC le printemps dernier, que j’ai décidé de vous faire part cet automne d’autres réflexions humoristiques, intéressantes, étonnantes ou inspirantes dans ma communication de président sortant. Cependant, les accrocs des intrigues politiques n’ont pas à s’inquiéter! Ils auront aussi des quantités de cancans savoureux à se mettre sous la dent dans le Bulletin de l’AOC. Voici (de nouveau) quelques-unes de mes réflexions… 1. Est-ce que le millionnaire Bruce Wayne trompe les autorités municipales de la cité de Gotham au sujet de ses taxes foncières? La dernière fois que son manoir a été évalué, je parie qu’il n’a pas montré à l’inspecteur foncier la Batcave et toutes les améliorations apportées à sa résidence (comme le Bat poteau avec système de levage optionnel à moteur à explosion, l’ascenseur à l’usage

Fall 2011 • CAO Bulletin

exclusif d’Alfred, le majordome, le réacteur nucléaire, etc.)! La piscine aménagée dans ma cour a sûrement fait grimper mon compte de taxes foncières. Je n’ose pas imaginer à combien il s’élèverait si j’avais une cave secrète contenant de la haute technologie dernier cri et une voiture dont les tuyaux d’échappement crachent des flammes! 2. Dans tous les films de James Bond où le méchant réside dans un mégacomplexe secret à la fine pointe de la technologie dont l’édification a dû prendre des années et des centaines, sinon des milliers d’heures de travail, de même qu’une quantité inimaginable de matériaux de construction (comme pour la fabrication du silo lanceroquettes avec monorail intégré logé dans un volcan dormant, dans On ne vit que deux fois), comment se fait-il qu’on ne découvre l’existence de ces installations qu’à la toute dernière minute, quand le méchant s’apprête à dominer le monde? 3. Si M. Keebler emploie de minuscules lutins qui travaillent dans des troncs d’arbres, comment font-ils pour produire ces gros biscuits emballés en paquets de format standard en quantité suffisante pour satisfaire les fringales de biscuits de la population mondiale? 4. Bien que je sois un maniaque fini des voitures de collection, je crois que la voiture électrique autonome a sa place dans l’industrie automobile de l’avenir. Jusqu’à présent, personne n’a cependant réussi à déterminer comment notre réseau électrique gérera la charge de toutes ces voitures à l’heure du retour à la maison. Si tout le monde est branché et que vous sortez de la douche, qu’arrivera-t-il si vous utilisez le séchoir à cheveux et que les circuits sautent dans quatre provinces? Et qu’allonsnous faire de toutes ces batteries dans 10 ans, quand elles auront perdu leur capacité de rechargement? Est-ce que des environnementalistes à la gâchette rapide vont se mettre à traquer le lapin Energizer?

5. J’ai une idée géniale pour éliminer les appels des parents et des patients qui passent leur temps à se plaindre. Il suffit d’installer un de ces systèmes téléphoniques complexes à multiples choix de réponse automatique : le temps de parcourir le dédale des options, ils auront oublié pourquoi ils voulaient vous importuner, vous ou votre réceptionniste, votre hygiéniste ou votre assistante! 6. Pourquoi les auteurs de chansons composent-ils toujours des romances sur des jeunes gens si follement amoureux qu’ils ne peuvent vivre un jour de plus l’un sans l’autre? Pourquoi n’écrivent-ils pas des chansons sur des gens mariés depuis 15 ans ou plus? Je parie que les paroles seraient totalement différentes… vous ne croyez pas? J’estime qu’il faut profiter de la vie et rire dès qu’on en a l’occasion. Cependant, j’ai aussi été sérieux durant ma présidence. Voici quelques-unes des activités qui se sont déroulées à l’arrière-scène dans la deuxième partie de mon mandat : • La bonne parole de l’ACO a été propagée dans l’ensemble de nos sept zones provinciales. Je vous ai aussi représenté lors des rencontres de l’AAO (Association américaine des orthodontistes) et de la WFO (Fédération mondiale des orthodontistes). • J’ai toujours dit et répété que les présidents de l’ACO acquièrent des connaissances et une expertise précieuses qui semblent se perdre une fois leur mandat terminé. Pour tenter d’intéresser les anciens présidents à demeurer actifs au sein de l’ACO, j’ai créé le bulletin électronique In the Loop, qui a été distribué à une fréquence approximative de 6 à 8 semaines. • Le premier petit-déjeuner-causerie des anciens présidents de l’ACO a eu lieu en septembre dernier à Halifax. L’événement a été un franc succès et a donné lieu à des discussions passionnantes!

The 2011/12 CAO Board at their first board meeting of the year in Halifax, NS.

CAO Bulletin • Fall 2011

• Afin de contribuer à simplifier l’ACO ainsi qu’à favoriser le transfert et la transparence des positions de ses comités, l’élaboration des attributions de chacun des comités de l’ACO est en cours. Ces attributions décrivent essentiellement les tâches, les responsabilités et le cadre d’intervention de chaque comité et de son président auprès du conseil d’administration de l’ACO. • Notre manuel de politiques et procédures sera prochainement élagué pour refléter les véritables activités de l’ACO. Tous les autres documents d’information seront affichés dans notre site Web pour que tous les membres de l’association puissent les consulter. • De nouveaux accords entre l’ACO et ses sociétés membres sont en cours d’élaboration. Les accords existants datent de plus de 10 ans et, avec l’adoption de la nouvelle Loi canadienne sur les organisations à but non lucratif, il est impératif que les relations entre l’ACO et ses sociétés membres soient actualisées de façon appropriée pour être conformes. De plus, en vertu de cette nouvelle loi, la structure du conseil d’administration de l’ACO doit être révisée, puisqu’il semblerait que son fonctionnement actuel n’est pas conforme. Un comité présidé par notre parlementaire (la docteure Amanda Maplethorp) a été formé pour étudier cette question. Nous bénéficions d’une période de grâce de trois ans pour mettre en application les changements de gouvernance nécessaires. • Un nouveau code de déontologie a été rédigé afin de décrire adéquatement les attentes et les responsabilités des membres du conseil d’administration de l’ACO. • Le conseil d’administration s’est prononcé contre la création d’une page Facebook de l’ACO, mais le projet de commanditer un concours national, nommé How Orthodontics Changed my Life (Comment l’orthodontie a changé ma vie), est en bonne voie de se réaliser. Nous cherchons aussi à augmenter les inscriptions des membres et la fréquentation de BraceSpace (notre site de clavardage). • Veuillez poursuivre votre lecture pour découvrir toutes les autres choses que le conseil d’administration de l’ACO fait pour ses membres. Les rapports des directeurs provinciaux et du trésorier, les bulletins de liaison de l’ADC et l’ACSD (l’Association dentaire canadienne et l’Association canadienne des spécialités dentaires), les rapports sur les inscriptions, les bulletins de liaison de la CAO et de l’AAO (l’Association canadienne et l’Association américaine des orthodontistes), ainsi que les rapports sur les nouveaux membres et l’Assemblée scientifique (pour n’en nommer que quelques-uns) sont à votre disposition d’un simple clic!

de retourner à mes activités habituelles, mais, en même temps, il y a des avantages à toucher du doigt l’évolution de l’orthodontie au Canada. J’ai passé une année absolument fabuleuse, qui a atteint son point culminant à l’occasion d’une soirée divertissante au gala du président à Halifax. Au cours de l’année écoulée, j’espère vous avoir fait sourire et avoir fait comprendre aux gens que nous faisons partie des spécialistes les plus privilégiés de la médecine dentaire. Il est primordial que nous conservions ce privilège. Alors que je viens de terminer mon mandat, mon ami et collègue, le docteur Ritchie Mah, entame le sien. C’est une personne brillante, équilibrée et pleine de bon sens, ce qui sera une nette amélioration par rapport à son prédécesseur! Cela me rassure énormément de savoir que notre association est en bonnes mains, et je suis certain que Ritchie rehaussera l’ACO encore de quelques crans. Je souhaite bonne chance à Ritchie, mais je sais qu’il n’en aura pas besoin. Je tiens à remercier Diane, Alison et le personnel exceptionnel de Taylor Enterprises, ainsi que Ritchie, Paul, Garry, Mike P., Rick, Phil, Mike Z., Susan, Helene, J.M., Dan S., Amanda, Gerry Z., Bob, Gordie, Stephen, Gerry S., Dan P., Richard et Jim, pour tous leurs efforts et leur excellent travail. Sans vous, l’ACO ne serait pas l’organisation respectée et progressiste qu’elle est actuellement. Respectueusement vôtre et soumis à un régime hyperprotéiné et faible en gras, Howard Steiman

CAO DATABASE… It’s Up to YOU! Just a reminder that whenever you have a change to your contact information, you can make that change instantly yourself. Just log on to your Personal Database Information and make the correct change. It will change the “Find An Ortho” and Membership Directory in real time! If you have any questions about the online database, contact the CAO office at: cao@taylorenterprises.com

En conclusion, cela me réjouit et m’attriste de devenir l’un des anciens présidents de l’Association. Je serai certes heureux

Fall 2011 • CAO Bulletin

Highlights of the 2011 Scientific Session

Banquet attendees enjoy the reception in the museum at Pier 21.

People danced up a storm to the Celtic Band at the Ceilidh.

Dr. William Wiltshire and friends at the Welcome Reception.

Drs. Marcus and Cram go over CAO Insurance at a luncheon.

Manitoba Students and Graduates gather.

W. Mitchell wows the crowd!

Heading over to the Banquet at Pier 21.

CAO Bulletin â&#x20AC;˘ Fall 2011

Dr. Gerry Zeit retiring from the Board.

Thanking Dr. Don Robertson for all of his contributions to the CAO.

Dr. Gordie Organ retiring from the Board.

Artist at work for the CFAO Auction.

Dr. Mike Salysyn discusses mouthguards.

The Plenary Session was impressive.

Round tables are always popular.

Coramarie Clark inspires!

Past Presidents at work

Fall 2011 â&#x20AC;˘ CAO Bulletin

Thank you to our 2011 Sponsors!

CAO Bulletin â&#x20AC;˘ Fall 2011

Highlights of the 2011 Scientific Session

Dr. Mike Patrician presents Dr. Stephen Roth a present for his work with the CFAO.

Passing the torch from Dr. Steiman to Dr. Mah.

Dr. Steiman enjoying his gift for his Presidential service.

Piped over to the Ceilidh at Murphy's on the Water.

King Orthodontics enjoying the Banquet.

Surrounded by the 80's at the Banquet.

The President Rocks Out!

Waiting for their lobsters at the ceilidh.

Dr. Marcus to Dr. Buzzatto: How do you eat this thing?

Fall 2011 â&#x20AC;˘ CAO Bulletin

Highlights of the 2011 Scientific Session

"Anyone want to go for a boat ride in Halifax Harbour?"

Welcome to the Show!

Dr. Earl Haltrechtâ&#x20AC;&#x2122;s team about to head over for some fun at the Ceilidh.

Drs. Iain Meldrum and Dan Stuart meet up at the Welcome Reception.

Trade Show Raffle Prize Winners Debbie Khedo Discover Orthodontics Brampton, ON Gift Basket

Marie-Josee Langlais Dr. Helene Huard Dieppe, NB Whitening Trays

Dr. Christa Oliver St. Johns, NL Evolution Chair

Mickey Dumesnil King Orthodontics Medicine Hat, AB Triumph Toothbrush Dr. Peter Konchak Saskatoon, SK $500 of Brackets

Dr. Keith King Medicine Hat, AB Travel Gift Certificate

Congratulations to all our winners and a special thank you to those companies that donated prizes!

CAO Bulletin â&#x20AC;˘ Fall 2011

Committee Reports Treasurer’s Report

HST Report

Dr. Michael Patrician Treasurer

[Email: drpatrician@bellnet.ca]

In 2010, the general operations of the CAO yielded net revenues of $14,881.65. The joint Scientific Session with the CAOMS in Whistler B.C. yielded net revenues of $14, 245.50. Joint meetings require significantly more staff time and revenues are routinely negatively affected. The combined net revenue for both the general operations and the scientific session for 2010 was $636.15. As of December 31, 2010 the total members’ equity was $549,743.88.

There have been no new communications with CRA in 2011. The status of the HST return mechanism is unchanged as of this date. \

CFAO Report Dr. Stephen Roth CFAO President [Email: stephenfroth@mac.com]

As of June 30, 2011, the general operations of the CAO are in line with projections. Total members’ equity is $792,854.74. In 2011, there has been an additional expenditure for the CDSA seed money amounting to $15,000.

DID YOU KNOW??? The CAO offers free listings on our Members Only website for available locum services! We are happy to list both locations available and doctors willing to serve in this capacity. This service is open to all members, and all you need to do is just send us an email at cao@taylorenterprises.com and we will list it in the Classified Section of the website. Just include your name and contact info where you can be reached…we’ll do the rest!

CAO Bulletin • Fall 2011

The CFAO held its annual Board of Directors meeting via conference call on June 22nd, 2011. The successful auction held at the Gala banquet in Whistler, BC explored a new source of funding for the organization. A second auction was held at the banquet in Halifax, NS. The CFAO greatly appreciates all of the many items donated by the members of the CAO. The CFAO will be offering an annual award for outstanding achievement in fourth year undergraduate orthodontics to each of the ten Canadian undergraduate programs. The CFAO president has conversed via e-mail with undergraduate educators for input as to how to structure the award. 2011 is the final year of the CRA mandated distribution quotient. The CFAO is required to distribute approximately seventy thousand dollars this year. At minimum, $6,500.00 is being offered to each of the six graduate orthodontic programs in Canada, with the remaining funds destined for a November webinar presentation and for the aforementioned undergraduate awards. The CFAO’s distribution will drop by approximately fifty percent in 2012. The CFAO is in the process of re-establishing its fundraising objectives. Although currently in a solid financial position, donations have slowly begun to decrease over time. The CFAO is looking to promote and to publicize in the future. Addresses were made by the CFAO President to the New and Younger

Committee Reports Members and to the golf tournament participants. E-mail blasts and conventional mailings to the membership as a means to increase awareness of the CFAO are currently being considered.

Insurance Report Dr. Robert Cram Chair, Insurance Committee [Email: drbob@reddeerortho.com] Some notes from the wonderful world of insurance. ESI has rebranded itself as Express Scripts Canada. Please do not sign the Dent 29 Form and instead sign the new CAO Standard Information Form and attach it to a Dent 29 Form where the parent completes the requested personal information. When dealing with aboriginal clients/patients, the CAO position remains unchanged: treat all patients consistently. Dr. Richard Marcus recently contributed to a discussion between Pacific Blue Cross and Dr. Tom Moonen on behalf of the BCSO. A Canadian graduate orthodontic clinic had not been completing the CAO Standard Information Form for more than ten years but only recently did one of the carriers ask about it. More than ten examples of how to properly complete the insurance form and the CAO guidelines were sent to the clinic. The ‘new’ CAO Standard Information Form has been posted on the CAO website. A licensing agreement must be signed before a release of the PDF file to the softwear designers once a new provider has been retained.

New and Younger Members Dr. Susan Tsang New and Younger Members Representative [Email: s_tsang2@hotmail.com] The CAO was present at the 2011 Graduate Orthodontic Residents Program (GORP) meeting at St. Louis University from July 28-31, 2011. The weekend was productive, answering Canadian residents’ many questions regarding membership. Organizers reported that this meeting

had the highest attendance to date. The NYM is looking forward to 2012 at the University of Michigan. Mr. Joe Banfied, a commercial real estate broker with Re/Max was the keynote speaker at the 2011 NYM luncheon at the CAO Annual Session in Halifax. Mr. Banfield addressed common questions about leases and lease negotiations. The NYM group is open to suggestion regarding topics of interest to be addressed at future CAO sessions. If you have ideas or know of speakers that you would like to hear, please contact Susan at drtsang@winnipegorthogroup.com at your convenience. The NYM has an online forum on the CAO website through BraceSpace, the ideal site for questions about practice, board exams, interesting cases, or anything else that comes to mind. Please visit the site and place a posting today. Feel free to contact your NYM representative or the CAO office for any reason.

CAO/AAO Report Dr. Garry Solomon CAO/AAO Liaison [Email: hellener@lks.net]

As is customary, a topical discussion ensued during the latest CAO-AAO Liaison meeting held during the AAO Annual Session in Chicago, May 15, 2011. The Consumer Awareness Campaign recently made use of coupons redeemable for free consultation services. Linda Gladden reported that there were 3,284 downloads for coupons by February 1, 2011. Coupons are an ineffective marketing modality. Voluntary reporting indicated that sixty three coupons were redeemed in February and thirty eight in March in comparison to a control group of ninety orthodontists who reported eighteen and twenty for the same time period. Most importantly no increase in new case starts was reported. According to Dr. Michael Rogers, President of the AAO, during the first two quarters of the advertising blitz eighty percent of orthodontic treatment with fixed mechanotherapy was performed by orthodontists, providing insight into the overall market penetration. By the fourth and fifth quarters of a three-to-five year campaign, market penetration attributed to

Fall 2011 • CAO Bulletin

Committee Reports advertising exposure was eighty-seven and eighty-one percent respectively. The market penetration for clear aligners for orthodontists was fifty-seven percent in the first quarter compared to sixty-four and sixty-five percent in the fourth and fifth quarters respectively. Professional regulations in Canada prohibit orthodontists from using coupons and from advertising any or all fees including a zero fee. In spite of these regulations, the AAO offers no redistribution of the advertising levy affecting all Canadian members. The current AAO Consumer Awareness Program has contracted with a new advertising agency Athorn, Clark and Partners of New York City. The $650.00 assessment is scheduled to continue over the next two years. This firm has been directed to increase the overall market share for orthodontists by aggressively expanding into the adult cohort while continuing to promote the message highlighting the additional education required for one to become an orthodontist to mothers of children and teens. While the marketing of the message will be adapted locally, social media will be an integral part of the delivery.

The “More Than a Smile” advertisements on CAO members’ websites and printed materials must be removed as the usage rights will expire within a short period of time. As of September 2011, $1.2 million of the $1.5 million AAOF Legacy Goal to fund the Craniofacial Growth Legacy Project has been raised. The AAO has confirmed it will contribute $5,000.00 to the Alberta Society of Orthodontist’s legal review initiative to contest the use of all logos in advertising. The CAO has agreed to contribute one-third of the funds contributed by ASO members, up to $3,000.00 in total. The AAO is seeking reciprocity recognition and portability of licensure between states in the US.

Canadian Orthodontic Educators Report Dr. Gerry Solomon Canadian Orthodontic Educators Liaison [Email: solomonstr8ner@rogers.com] The annual spring educators’ meeting was held in conjunction with the 3M Whistler meeting on April 7, 2011. The Canadian educators and the CCOE/CCGOPD are grateful to 3M Canada and to Mr. Silvano Brecevic for their consistent and generous support.

CFAO Donations (since April 2011) Dr. Stuart Hunter Dr. Walter Swiston Dr. David Way In Memorium Dr. Sarah Davidson CAO In honour of her webinar to the CAO membership

CAO Bulletin • Fall 2011

On October 21, 2010 Align entered into a memorandum of understanding to resolve the class action lawsuit filed against the company regarding its proficiency requirements. To date, the settlement agreement has not yet received court approval. If the settlement agreement receives approval, all class members will be reinstated to prescribe Invisalign treatment following completion of a free three hour on-line course. Certain class members will have the option to select a $500.00 remedy instead of the reinstatement benefit. Orthodontists who have had their Invisalign accounts deactivated or suspended as a result of the proficiency requirements program are included in the settlement. All Canadian graduate programs have re-introduced Invisalign as part of their clinical curriculum. There were twelve applications for the one Dental Specialist Assessment and Training Program (GAP) position available

Committee Reports \

at the University of Toronto. The successful completion of GAP training results in a certificate of completion enabling the candidate to register for the RCDC examination. No confirmation of equivalency is afforded through the program. The Canadian Council of Graduate Orthodontic Program Directors (CCGOPD) reiterated the challenges in terms of physical, human and financial resources that GAP training places on their respective programs potentially leading to compromise in their ability to deliver the consistent quality graduate education that is currently provided. The CCGOPD has written the dental regulatory authorities and CDAC voicing their recommendation for a three-year (36 months) standard for all Canadian graduate orthodontic programs. Confirmation of this consistent standard is still outstanding. The Canadian graduate orthodontic programs have agreed to move their 2011 acceptance dates to coincide with the U.S. Match program. ‘Decision Date’ will be on or around December 1, 2011. One resident from the University of Manitoba presented a Breakfast Round Table at the 2011 CAO Annual Scientific Session. The session was a ‘diagnostic challenge’ designed to seek diagnostic advice rather than to offer clinical tips, suggestions or wisdom. This novel endevaour was designed as a test case to measure and evaluate the acceptance of and interest in this form of Round Table presentation. The WFO is constructing a new website under the guidance of Amanda Maplethorp and Jean-Marc Retrouvey designed to connect orthodontic residency programs and orthodontic residents worldwide. The CCOE/CCGOPD suggested that the website contain links to all the national associations included in the WFO and to provide access to designated student areas within their respective websites.

COSA Report Dr. Robert Cram COSA Liaison [Email: drbob@reddeerortho.com] The Canadian Dental Specialities Board of Directors participated in a conference call July 17th, 2011 to review contacts with other national dental organizations. An offer was sent to CDRAF detailing involvement in the new dental specialty definition and explaining the dental specialty recognition process that is currently underway. A reply was received from CDRAF thanking the CDSA for its interest and for its offer to provide input in the form of written concerns. However, the CAO representatives expect direct face-to-face stakeholder involvement. A second, more strongly-worded reply has been sent to CDRAF and to the other national dental organizations speaking to this position. From the discussions between CDSA President Aaron Burry and CDA President Rob McGregor it appears as if the CDA expects to represent dental specialists at the national level since most dental specialists are now mandatory members of CDA through their provincial memberships. This apparent position brings into question exactly how specialists are to be ‘officially’ represented going forward with their national issues. Dr. Burry is scheduled to meet and to participate in further discussions with the CDA, since CDA had previously been supportive of CDSA becoming the ‘official’ voice of dental specialists.

A new subcommittee of educators within the AAO is being considered to compensate for the lack of activity among orthodontic educators at the American Dental Educators Association. This subcommittee of the COE is to include all orthodontic educators, including those who teach part-time. The initiative was to be passed by the House of Delegates at the AAO Annual Session in Chicago in May, 2011. Next year’s Educators meeting at the AAO Annual Scientific Session in Hawaii will be a workshop focusing on the standards of graduate orthodontic education and will address such issues as course length, case requirements and others.

Dr. Murray and Marjan Deller are always there to enjoy the Scientific Session.

Fall 2011 • CAO Bulletin

Committee Reports

WFO Report Dr. Amanda Maplethorp WFO Committee

RCDC Report Dr. Hugh Lamont Orthodontic Councillor, RCDC/RCDC Liaison

[Email: a_maple@shaw.ca] The annual WFO breakfast was held during the AAO Annual Session in Chicago in May of 2011. The meeting was well attended by presidents of numerous orthodontic organizations from around the world. A plethora of awards and plaques was distributed to organizers and participants from previous IOC meetings. A resident from London England is in the midst of creating an e-survey as part of a research project to assess the state of orthodontics world-wide. The survey is to be sent to every orthodontic president of each WFO affiliated country. A presentation was made by the organizers of the IOC meeting taking place in London, England September 27th to the 30th, 2015. The meeting will be held on the grounds of the upcoming Olympic games and not surprisingly, the facilities, the scientific program and the social programs promise to be amazing. A microphone was passed to each president in attendance, giving him or her opportunity for an introduction and to say a few words. The CAO Annual meeting was promoted through the promise of the world’s best lobster dinner, although it appears as if only our AAO counterparts accepted the offer. A large group photograph was taken to close out the meeting.

The National Dental Specialty Examinations (NDSE) are now an annual event. The greater numbers of candidates has necessitated a move to a larger venue. There were some ‘growing pains’ and logistical challenges associated with the new venue, but overall, the examinations proceeded without incident. Modifications are in process to enhance the candidates’ exam experience. The private examination cubicles and the audio-visual systems eliminate the need for external examiners entering and exiting the exam on a regular basis. On January 13, 2011, the written exam took place simultaneously in several locations across Canada and the United States. Future written exams will take place in Toronto only in March of any given year. Of the thirty-seven candidates, one failure was noted for an overall pass rate of ninety-seven percent. Candidates must pass the written examination to be eligible to register for the oral exam. The oral exam took place in Toronto, June 17 and 18, 2011. Thirty eight candidates were examined, with a resultant pass rate of eighty seven percent. The Association of Canadian Faculties of Dentistry (ACFD) is discontinuing their role in the Dental Specialty Core Knowledge Examination (DSCKE). Graduates of non-accredited dental specialty programs may initiate becoming licenced practitioners in Canada by passing the DSKE exam as a first step. The DSCKE assesses the candidate’s understanding of core dental science to determine eligibility to the Dental Specialty Assessment and Training Programs (DSATP) offered by select faculties of dentistry. The Royal College of Dentists and others are looking into options to determine which Canadian dental organization is best suited to fill the vacancy left by the ACFD.

Helpline Report Dr. Howard Steiman Helpline Liaison [Email: straightsmile@sympatico.ca]

See? Even Sammy, Frankie and Dean knew the CAO was in town!

CAO Bulletin • Fall 2011

All is quiet on the Western, Eastern and Central Helpline fronts. Unfortunately, the recent Alberta issue concerning a patient whose treatment went well beyond the projected time and a miscommunication surrounding the finan-

Committee Reports cials has reared its ugly head again. The Alberta Helpline representative is back on this case, but again, there is silence in response to communication. The file on this case may close permanently should the complainant not reply in the immediate future. CAO staff continue to take calls and e-mails from patients and parents across the country and Dr. Steiman will continue to act as interim representative until a permanent representative is appointed.

Communications Report Dr. Daniel Pollit, CAO Web Master [Email: dpollit@sympatico.ca] The AAO received approximately one hundred submissions to their Video Scholarship Contest in 2010, of which seven were from Canada. While considered a success, changes are forthcoming, including the use of YouTube to facilitate judging, the use of non-clinical personnel for final judgment and the inclusion of a wider pool of potential applicants. Since winners were years away from commencing their college or university education, awards were being held in trust until proof of enrolment could

be established, after which the award is paid directly to the institution to offset tuition. Should the recipient opt not to proceed to higher education, forfeiture of the award would be required. The Scholarship Contest was promoted by E-Bulletin, print, news releases and on the website. The future may include a downloadable PDF for in-office print and display. A Canadian Scholarship Program has the potential to be successful in creating website content to promote the benefit of orthodontic treatment. Anticipated costs associated with the program include the cost of the award itself, the cost of marketing and the potential cost associated with judging the entries. The potential pool of applicants is smaller than the United States so it may be in the CAOâ&#x20AC;&#x2122;s best interest to widen the parameters of eligibility to older patients and to those currently in treatment. Effective marketing of the program remains a challenge. An attractive campaign will need to be constructed encompassing in-office materials for distribution, the internet, email-blasts and the inclusion of information in the Bulletin; all designed to motivate practitioners to encourage patients to apply. The CAO has decided not to proceed with a Facebook page, deciding instead to continue to promote and develop the website.

Holiday Greetings! On behalf of everyone at the CAO office, we wish all of our readers a wonderful Holiday Season and a Healthy and Successful 2012! Kindly note that the CAO offices will be closed from 5:00 pm on December 23rd and will re-open on Monday, January 2nd, 2012 at 9:00 am.

Fall 2011 â&#x20AC;˘ CAO Bulletin

CFAO Graduate Student

Posterboards Abstracts from the 2011 CAO Annual Scientific Session – Part 1 of 2 part series

University of Manitoba CHANGE IN ORAL HEALTH-RELATED QUALITY OF LIFE AFTER ORTHODONTIC TREATMENT- PRELIMINARY DATA Authors: Sawan H, Lekic C, Asadoorian J, Wiltshire W. INTRODUCTION: Well-aligned teeth and a pleasing smile carry positive status at all social levels and ages. Protruding maxillary incisors have greater susceptibility to trauma, and increase the risk of inability to seal the lips and facilitate mouth breathing. Untreated malocclusions have physical, psychological, and social consequences on the quality of life of adolescents. AIM: To assess changes in oral health-related quality of life (OHRQoL) of children and their parents after overjet reduction by utilizing a before-and-after design. SUBJECTS AND METHODS: A sample of 60 patients between the ages of 8-18 years with increased dental overjet (≥ 6mm) was selected of which 30 were pre-treatment (Group 1) and 30 were post-treatment (Group 2) with dental overjet reduced to normal limits. The data collection instrument was the Child Oral Health Quality of Life (COHQoL) Questionnaire which consists of self-completion Parental-Caregiver Perception Questionnaires (P-CPQ) and Child Perception Questionnaires (CPQ). PRELIMINARY RESULTS: The prevalence, extent, and severity of quality of life impacts were calculated from responses of ten adolescents before treatment. Overall, half of the adolescents experienced functional and psychosocial impacts ‘Often’ or ‘Everyday ⁄ almost everyday’: 40% had oral symptoms, 50% experienced functional limitations, 30% reported impact on social well-being and 10% had an impact on their emotional well-being. The extent scores also indicate that the main impacts concerned functional limitations. CPQ severity scores ranged from 11 to 37, with a mean score of 23.75. The data collection is ongoing.

(*Presenter)

CAO Bulletin • Fall 2011

CONCLUSION: Orthodontic treatment impacts the quality of life of patients positively.

University of Montreal LONGITUDINAL EVALUATION OF SLEEP-RELATED BREATHING DISORDERS IN AN ORTHODONTIC POPULATION Authors: Manuela Hrit 1 2, Belinda Nicolau 2, Jack Turkewicz 1 Université de Montréal, Department of Orthodontics, Montreal 2 McGill University, Faculty of Dentistry, Montreal 1

OBJECTIVES: The aim of the present study is to investigate the evolution of sleep-disordered breathing (SDB) in children and adolescents having undergone orthodontic treatment in a university setting. MATERIALS AND METHODS: Questionnaires on sleep and day-time behavior have been administered to 168 subjects at two time points: at the screening session, when they were admitted for treatment at the University of Montreal, and four years later, when most of them were on retention, but some subjects were still in active treatment or growth follow-up. The mean age of the subjects at the time of the first evaluation was 13 years. Data analysis involved (i) exploratory data analysis to identify the main patterns; (ii) Bivariate analysis using χ2 tests to examine the association between nominal/ordinal variables; (iii) Multivariate analysis using linear logistic regressions for continuous and binary outcomes. In all these statistical models, potential confounding factors have been controlled for. RESULTS: The results of the present study show that most of the subjects that initially didn’t present symptoms of SDB remained symptom-free following the orthodontic treatment, whereas those that at the base-line investigation presented symptoms of SDB continued to manifest them after the orthodontic treatment. 12% of the subjects developed symptoms of SDB during the present study, but none of the orthodontic treatments investigated (non-extraction vs. two-

CFAO Graduate Student Posterboards premolar or four-premolar extractions) was statistically significant associated with them. CONCLUSIONS: Orthodontic treatment involving teeth extraction has been incriminated as being responsible for development of sleep apnea. The present study shows that SDB in an orthodontic population is mostly constant before and after the orthodontic treatment, and that the new cases developed are not related to any kind of orthodontic treatment.

University of Western Ontario IN VITRO COMPARISON OF TWO SELF-ETCHING PRIMERS USING AN INDIRECT BONDING METHOD Author:

,lower lip retrusion, and increase in overjet. Mandibular second molar extraction resulted in the largest increase in overbite, flattening of the occlusal plane, and distal crown tipping of the first molar. Non-extraction treatment was successful but changes were to a lesser degree than in the other groups. Mandibular third molars erupted successfully in the majority of second molar extraction cases. CONCLUSIONS: From this study we may conclude that all three treatments can achieve a satisfactory outcome if patients are selected appropriately. Mandibular second molar extraction in the camouflage of skeletal Class III malocclusion can be successful for patients who present with mild to moderate crowding in the lower arch, minimal overbite, steep occlusal plane angulation, mesially tipped mandibular posterior teeth and well-positioned mandibular third molars.

Stefanuto Alison

INTRODUCTION: This study was a comparison of treatment effects in the orthodontic camouflage of skeletal Class III malocclusions. METHODS: Subjects were divided into three groups based on treatment modality: extraction of mandibular second molars (n=24), extraction of premolars (n=33), and non-extraction treatment (n=44). A retrospective analysis of lateral cephalometric radiographs revealed significant differences among the groups for changes in dental and soft tissue measures from pre-treatment to post-treatment.

University of Toronto IMPACT OF ORTHODONTIC MINI-SCREW ANGULATION RELATIVE TO DIRECTION OF FORCE APPLICATION ON STABILITY, MOVEMENT, AND THE PERI-IMPLANT INTERFACE Author: Dr. Michael P. O’Toole, Master’s of Science Degree, Department of Graduate Orthodontics, Faculty of Dentistry, University of Toronto

RESULTS: In mandibular premolar extraction treatment, the largest changes were seen in lower incisor retroclination

The purpose of this study was to determine the impact of insertion angle of orthodontic mini screws on the stability and resistance to movement of the mini screw, and on the peri-implant interface. Three orthodontic mini screws were placed in

Taking in the Posterboards

The Educators take a break during their meeting.

Fall 2011 • CAO Bulletin

CFAO Graduate Student Posterboards each tibia of six New Zealand white rabbits bilaterally (N=36), with randomized angulation (65° away, 65° toward, or 90° to the direction of applied force). After two weeks, two orthodontic mini screws within each tibia were loaded with a 200g Nitinol closed-coil spring for up to 14 days. No statistically significant differences were found among the variably angulated loaded and unloaded orthodontic mini screws in the amount of movement or change in angulation demonstrated over the experimental period. Micro CT analysis revealed no clinically significant differences in the amount of cortical boneto-implant contact. Mini screw placement angulation seems to have minimal impact on stability and migration of orthodontic mini screws over time.

University of Toronto THE MECHANICAL AFECTS OF FLAMING NICKELTITANIUM ORTHODONTIC ARCHWIRES Author:

MacLeod M.

BACKGROUND: The practice of flaming the end of superelastic nickel-titanium orthodontic archwires is commonly employed by clinicians in order to enable the placement of a permanent bend in the wire. OBJECTIVE: This study was conducted to assess the mechanical effects of archwire flaming and to determine whether these effects are isolated to the region of wire immersed in the flame.

METHODOLOGY: Two sizes of pre-formed austenitic nickeltitanium archwires (0.014” and 0.019” x 0.025” in dimensions) were tested (n=10 per group). Using a ceramic heat shield, the 5mm-long terminal end of all experimental wires was heated for five seconds using a diffusion-type butane lighter (max temp 1657 °C). Changes in Knoop micro-hardness values along a midline transect were used to determine the heataffected zone for both wire gauges. Cantilever bending was then performed, using an Instron® testing machine, to assess the mechanical properties of heated wires both within and outside of the heat-affected zone. RESULTS: The heat-affected zone for the 0.014” wires extended 1mm past that of the 0.019” x 0.025” wires, terminating at distances of approximately 7mm and 6mm from the flamed tip respectively. The 5mm-wide flamed zone for each wire size was characterized by a lower force threshold to reach the super-elastic plateau, a flatter super-elastic plateau and an increased tendency for plastic deformation compared to controls. CONCLUSIONS: The heat-affected zone of austenitic nickeltitanium wires extended no more than 1-2mm past the flame boundary for the wire gauges tested. Flamed areas of wire displayed a lower force threshold to reach the super-elastic plateau and a slight flattening of the super-elastic plateau. These results do not indicate a need to alter current clinical practice, due to the limited ability of austenitic wires to conduct heat past the boundary of the flame.

Thanks to GAC for their support of the CFAO Posterboards

CAO Bulletin • Fall 2011

Component Society Reports British Columbia Dr. Rick Odegaard [Email: dr.odegaard@shawcable.com] The Annual General Meeting of the BC Society of Orthodontists was held at the UBC Golf Club on June 10, 2011. President Dr. Howard Steiman represented the CAO both on and off the golf course. Dr. Steiman presented a thoroughly entertaining outline of the values and the activities of the CAO. The slate of BCSO officers for 2011-12 is President Ryan Bulat, Vice President Alexa Herbertson, and Secretary-Treasurer Gina Ball. A task force has been struck by the BCSO chaired by Dr. Lun Wang to develop a protocol for engaging new and younger orthodontists through guidance and mentorship. Three key objectives of the committee are the maintenance of contact with new registrants, the creation of a code in the areas of promotion and advertising and the revival of a structured mentorship program. The Spring for Kids program, a non-profit fundraiser in support of craniofacial and cleft palate research, was successful in winning the on-line Pepsi Refresh program. The $100,000.00 prize will fund treatment for financially compromised patients through BC Childrenâ&#x20AC;&#x2122;s and UBC Hospital.

DID YOU KNOW??? You can list your practice in our classifieds!

Thanks and congratulations to Dr. Angie Loo for a fantastic job generating such strong support in promoting the program. The PCSO Annual Scientific Session was held in Vancouver September 22nd to 25th, 2011.

Alberta Dr. Phil Williamson [Email: drphil@telusplanet.net] The Alberta Society of Orthodontists (ASO) Annual General Meeting was held March 4th and 5th, 2011 at the Rimrock Resort in Banff. Dr. John Graham presented on a variety of topics including TADs and 3D CBCT. Dr. Howard Steiman attended the meeting and updated the membership on the current state of the CAO. The current executive of the ASO includes Immediate Past President Michael Bleau, President Cory Liss, Vice President Warren Cohen and Secretary/Treasurer Ivan Hucal. The ASO has formed a committee chaired by Dr. Barry Hoffman to review the recent ADA&C draft of the CBCT guidelines. The original document has been revised and a position paper has been drafted providing recommendations.The ADA&C is expected to meet again and to produce a final document early in 2012. The demand for CAO / AAO logo in member advertising has encouraged the ASO to retain a lawyer to provide an initial opinion on the ADA&C position. President Cory Liss expects more information in the near future. The CAO has contributed $3,000.00 to the ASO toward these initial legal costs.

Whether you are looking to expand and need an associate, or if you are getting ready to sell your practice, the CAO can help! Listings on our Members Only website are free, but for a 50% reduction on the regular ad rates, you can also publish your ad in the CAO Bulletin.

The ASO is moving its website to the CAO-hosted website and has created a unified email address for all member correspondence. Electronic surveys are now in use to improve membership communication.

Let the CAO help you fill your practice needs! You can remain anonymous and have the CAO office field all file enquiries. Contact the CAO office at cao@taylorenterprises.com for more information.

The next ASO Annual Meeting will be held at the Rimrock Resort on March 9-10, 2012. Dr. Lisa Alvetro, courtesy of 3M Unitek, will speak on Class II correction with the Forsus appliance. It is anticipated that an additional speaker will be added for a half-day in the near future.

Fall 2011 â&#x20AC;˘ CAO Bulletin

Component Society Reports Saskatchewan

Ontario

Dr. Mike Ziglo

Dr. Helene Grubisa

[Email: mikeziglo@hotmail.com]

[Email: drgrubisa@sympatico.ca]

The summer has been a quiet one in Saskatchewan. The annual meeting of Saskatchewan orthodontists featuring Dr. Bob Fry, was held in October in Saskatoon. There are no outstanding issues to report at this time.

Manitoba Dr. Susan Tsang [Email: s_tsang2@hotmail.com]

The Manitoba Orthodontic Society (MOS) held its annual general meeting on April 21, 2011 featuring president Dr. Howard Steiman, who brought greetings from the CAO and gave a presentation to the membership highlighting recent association activities. The MOS by-laws were approved. The next step in the process is to sign the AAO affiliation agreement.

The moratorium on the purchase of cone beam CT units in Ontario has been suspended as of July 1st, 2011. Following a two-day University of Toronto continuing education course and following successful completion of a written examination, dentists may purchase small field CBCT units. All users must follow the regulations to the letter, including a written report on all volumes obtained, be it by the dentist or through referral to an oral and maxillofacial radiologist. Ontario has been fine tuning the goals of the public awareness campaign and the most effective delivery medium. The 2010 campaign encompassed on-line and digital media, making use of the AAO materials to direct traffic to the recently revamped OAO website. The OAO Executive is finalizing the exact message to be conveyed to the public in coming years campaigns, and which media company is in the best position to successfully deliver this message.

Dr. Conny Athansopulous and Dr. Roger Moir will continue as the President and Treasurer of the MOS, respectively. Congratulations to Dr. Babette Cohen, incoming president of the Midwestern Society of Orthodontists. The University of Manitoba is searching to fill a full-time academic position. The newest graduate orthodontic residents are Drs. Richard Halpern, Jonelle Crichton, and Mireya Senye. Recent guest lecturers are Dr. Vittoria Cacciafesta (lingual orthodontics) and Dr. Wick Alexander. The U of M’s inaugural graduate pediatric program is up and running and has accepted its first three residents as of July 2011. Dr. Frank Hechter received this year’s Faculty of Dentistry’s Alumni of Distinction Award at the annual awards dinner held September 20, 2011.

MSO President Dr. Babette Cohen of Winnipeg, Manitoba invites you as a CAO colleague to bring your team “On Board” for this unique CE program featuring: Ms. Rosemary Bray, Dr. Katie Graber, Dr. Lee Graber, Dr. Vincent Kokich, Sr., Ms. Marylee Maendler and Dr. Anoop Sondhi. Call Special Event Cruises at 800-422-0711 or go to www.msortho.org for more information!

CAO Bulletin • Fall 2011

Component Society Reports There is a new ‘points’ program to regulate continuing education in compliance with the Ontario Health Professions Act Legislation designed to promote continuing competence and practice improvement among the members of the profession. This program, commencing December 14, 2011, dictates a ninety-point requirement per every three- year reporting cycle. There are four elements to the new quality assurance program; (1) Continuing Education, (2) Practice Enhancement Tool, (3) Practice Enhancement Consultant, (4) Annual declaration. The RCDSO is presenting ‘Lunch and Learn Webinars’ worth one CE point each if the member completes a post-webinar on-line assessment form.

Quebec Dr. Jean-Marc Retrouvey [Email: jmretrouvey@videotron.ca] On May 30th 2011, Dr Manon Paquet gave a full-day presentation on three-dimensional radiology to the orthodontists of . Her presentation highlighted the numerous advantages of this technology over conventional two-dimensional radiography and provided a better understanding of overall patient exposure with the “cone beam” technology. Dr Howard Steiman presented a humorous, entertaining and informative speech on the role of the CAO. Initially scheduled to present for 10 minutes, Dr. Steiman stayed on stage for 45 minutes, actively participating in a discussion about media advertising and website design. Assistance was offered to the CAO representative for input regarding the future website of the AOQ. The AAO special contribution for marketing our profession was discussed at length at the general assembly. In Quebec the contribution has not been well received; French speaking orthodontists benefit little from the program overall. The AOQ Executive elected to create an informative public website about orthodontists and committed forty thousand dollars to the project. A web-design committee was formed under the guidance of Dr Jules Lemay, and held its first general meeting with the design company on September 13th 2011. The committee’s main objective is to create an inclusive and educational website to act as a portal for all the websites of certified orthodontists in Quebec (members of the AOQ). Dr. Steiman encouraged all orthodontists from Quebec to attend the CAO Annual Session in Halifax, stressing the ease of

location and local hospitality. On October 14th, 2011 Dr. Debra Morrison et al. spoke on sleep apnea followed by the third annual Gala of the Association des Orthodontistes du Québec. Last year’s event was an amazing party and raised over one hundred thousand dollars on behalf of the children hospitals. The 2011 gala was again a resounding success with record attendance and raised an amazing $142,000 for the three foundations it supports. Just amazing!

Rapport de la province de Québec Le 30 mai 2011, la docteure Manon Paquet, a présenté une journée complète de formation en imagerie tridimensionnelle aux membres de l’association des Orthodontistes du Québec. Sa présentation soulignait les multiples avantages de cette technologie en comparaison avec l’imagerie bidimensionnelle conventionnelle. Dr Paquet nous a expliqué aussi de façon détaillée les différentes quantités d expositions subie par les patients avec la technologie « cone beam ». Durant l’assemblée générale, le Dr Howard Steiman,, président de la CAO nous a présenté dans un cadre humoristique le rôle de l’association canadienne des orthodontistes. Cette présentation, d’une durée de dix minutes, s’étira sur plus de 45 minutes. En effet, Dr Steiman participa activement à la discussion sur la publicité corporative et l’importance de l’internet. Dr Steiman a également offert l’assistance du CAO dans le design du site internet de l’AOQ. La contribution spéciale de l’AAO pour le marketing de la profession fut longuement discutée. Au Québec, cette contribution a été assez mal perçue car les orthodontistes francophones en retirent très peu de bénéfices. L’assemblée a donc décidé de former un comité sous la gouverne du docteur Jules Lemay pour la création d’un site d’information sur l’orthodontiste certifié plutôt que sur l’orthodontie elle-même. Dr Steiman a encouragé tous les orthodontistes du Québec à assister à la session annuelle de l’AOC qui s’est déroulée à Halifax, en soulignant la facilité d’accès et l’hospitalité de la région. Dr Debra Morrison et al. a discouru sur l’apnée du sommeil lors de la conférence du 14 octobre 2011. Cette allocution a été suivie par le 3ème Gala annuel de l’association des orthodontistes du Québec qui a eu lieu à l’hôtel Crown Plaza. Rappelons que le Gala de 2010 avait remporté un vif succès et avait permis d’amasser plus de cent mille dollars au profit des hôpitaux pour enfants de Montréal. Le gala 2011 a dépassé toutes les attentes en récoltant $142,000. Un success retentissant!

Fall 2011 • CAO Bulletin

Component Society Reports Atlantic Report Dr. Dan Stuart [Email: danstuart96@hotmail.com] The Atlantic Orthodontist’s Association held its latest Annual General Meeting in Wallace, Nova Scotia at the world-class Fox Harb’r Resort June 24th and 25th, 2011. Dr. Howard Steiman, CAO President honoured the Association with his attendance, where he tore up the golf course, followed by tearing up the dance floor. Doctors and spouses enjoyed a golf tournament, cooking lessons, a kitchen party with the Maritime band Pogey and continuing education with Dr. Wick Alexander.

Recently, the Storm Valley Metal Detectors Club has been given permission to search the four farms near Storeville. On the first day, a major discovery was made on each farm. From the clues, list the name of each farm, the name of the Detective who made the find and what he found. 1. Ben Houseman made his find on New Farm, which is the next farm clockwise from the one where the Roman statuette of Venus was unearthed. 2. It was at Farm 1 that the Anglo-Saxon metal cauldron was found.

The current AOA slate of officers includes Past President Stephen Roth who is returning as Secretary Treasurer, Vice President and Component Representative to NESO Don Johnston and Past President Brien Stackhouse. The AOA enjoyed having members of the CAO and their staff to the Annual Session in Halifax, Nova Scotia. The dates and location of the next AOA annual meeting are June 22-24, 2012 in Moncton, New Brunswick. In addition to a rich slate of continuing education, the guest band will be Signal Hill. The upcoming meeting promises to be one of the best meetings ever!

3. Reg Jenkins discovered the 15th-century soldier’s helmet on a farm with a lower number than White House Farm. 4. Tom Riley’s find at the farm marked 3 on the map wasn’t the English Civil War musket. 5. Farm 2 on the map is not Poplar Farm. Farms: Castle Farm; New Farm; Poplar Farm; White House Farm Finders: Ben Houseman; Jim Randal; Reg Jenkins; Tom Riley Finds: Cauldron; Helmet; Musket; Statuette 1.

Straight Shooters 1. What do you call an orthodontist from the arctic? A molar-bear.

3. Farm:

Farm:

Finder:

Find:

(courtesy of Mitchell Posluns)

2. When a kid loses a tooth eating Cap'n Crunch that’s … Cereal Extraction! 3. A patient declined orthognathic surgery and requested a refund. The orthodontist complied, but was overheard muttering “This isn’t what I meant by decompensation!”

CAO Bulletin • Fall 2011

Farm:

Finder:

Find:

Last Edition’s Answer Congratulations to Dr. Alan Bobkin and to Dr. Sam Al Fakir for submitting the correct answer to the Fall Bulletin’s Puzzle. 1. 2. 3. 4.

Driscoll, 3 children, Grimbsy Mayhew, 4 children, Poole Abbott, 1 child, Deal Yates, 2 children, Hereford

From the Editor

Dr. James Posluns [Email: james.posluns@utoronto.ca]

Big Nor-Easter Coming Growing up, my mother used a litany of memorable expressions to keep me and my siblings in check. Beyond the standard 'Jimmy go to your room,’ and ‘Wait until your father gets home,’ my all-time favourite was ‘Big Nor-Easter coming’. Back in the ‘70’s when she and my dad were on a ski vacation in New England, a taciturn scruffy-looking local warned them about an approaching winter storm.

less? To suggest otherwise is ignorant, naïve or at the very least, a definite indicator of one’s rapid descent into old age. But while technology is our closest ally, it’s also our biggest threat. It may be overly simplistic, but the recent advances in orthodontics are, to paraphrase Roberta Flack, ‘killing us softly with [their] song.’ Maybe I’m an alarmist, but didn’t they call Titanic’s Captain Smith the same thing when he gave the order to man the lifeboats? It’s time to stop denying there’s an ugly front fast approaching.

Simple: Clincheck. Clincheck takes a crooked set of teeth and sets them straight quicker than Judge Judy hands down a sentence. Everyone knows that yes, it’s not a real set of teeth and no, not all movements are possible with a set of aligners, but how long will it be until the general practitioner has the ability to choose whether he or she uses clear trays, brackets or a mixture of both to achieve the desired result? Not long. It’s already here. Enter SureSmile: robots bending wires to get to the final result. Yikes. Didn’t anyone else see Transformers? What’s to stop a GP from scanning an almost complete case and sending it off over the internet to a galaxy far-far away for final detailing? Ding-dong; wires arrive via FedEx by the end of the week. Case closed. Next.

“Big Nor-Easter coming” he muttered. “Better get outta town while you still can.” Full of the blissful ignorance of youth, my parents laughed him off. It was a beautiful day; not a cloud in the sky. They were there to ski. The guy was obviously a nutter, no doubt happier when the town of Stowe was free of yuppies from Canada.

“Don’t worry”, soothe the naysayers. “There will always be a need for orthodontists.”

My folks spent the next three days stuck in a cabin, buried under three feet of snow. Call me a nutter, but a serious front is approaching fast in orthodontics. Go to any meeting, attend any seminar or simply open the door to any sales representative from company X, Y or Z, the main event is always the latest advancement in technology. This is a good thing, I guess. The world runs on advances in technology and orthodontics is right-instep. Why would one expect anything

So why the sudden increase in confidence?

“General dentists are doing too much orthodontics.” Why is this? Back in the day, the general dentists were too busy saving tooth lives left, right and centre to worry about putting them in the right place; now, not so much. Dentists aren’t being taught any more orthodontics in undergraduate orthodontics than they used to, in fact, one could say they are being taught less.

That’s true. Just not as many. If I were running a big orthodontic company, I’d hire the best and the brightest I could find and keep ‘em happy. They’d sit in a big room, in big comfy chairs, overlooking the biggest bluest sky around. They’d have all the ice-cream they could eat and all the soda pop they could drink. They’d gaze upon their Ferraris and Porsches in the parking lot. For a few hours a day, they’d diagnosis the cases sent in by the GP’s, design the indirect set-ups and finalize the wire sequences. Another team would offer feedback and assist in finishing. Think it can’t happen? The systems are already here: Invisalign, Incognito, Insignia, indirect bonding. It’s the Four ‘I’s

Fall 2011 • CAO Bulletin

of the Apocalypse! By welcoming these admittedly amazing entities into our offices we’re effectively benching our star quarterback. ‘You sure you want to do that, Coach’? “Orthodontics will always attract the best and the brightest”. Not always. Look who wrote what you are reading. For the most part, the number of Canadian applications to accredited programs is down. A decline in applicants may be reflective of any number of factors; the economy, the way orthodontics is taught to undergraduates or simply due to the possibility of chance. Who knows? My favourite question during an orthodontic interview is always ‘Why do you want to do a three-year course in orthodontics when there appears to be a viable alternative right now?” Most candidates orate the desire to do things right, which is admirable, but with proper utilization of the emerging systems coupled with the available support, does not returning to university for three plus years preclude a person with the smarts to be a general dentist from doing orthodontics correctly? It’s hard to say. So, maybe I’m a nutter who simply wants all the yuppie GPs to get the heck out of town. Or maybe I’m an alarmist who sees this storm on the horizon and thinks the worst is yet to come. Or maybe I’m simply becoming a grumpy old man. Yeah, that’s it, even though I still believe a big Nor-Easter is coming. But don’t take my word for it.

Canadian Association of Orthodontists UPCOMING ORTHODONTIC MEETINGS 2012 May 4-8 . . . . . . . . . .AAO Annual Session, Honolulu, Hawaii June 18-23 . . . . . . .European Orthodontic Society Annual Session, Santiago de Compostela, Spain Aug. 3-11 . . . . . . . .MSO Annual Session, Alaska Cruise Sept. 6-8 . . . . . . . .CAO Annual Session, Ottawa, Ontario Sept. 20-23 . . . . . .MASO Annual Session, Baltimore, MD Sept. 27-30 . . . . . .SAO Annual Session, Asheville, NC Oct. 4-7 . . . . . . . . . .PCSO Annual Session, Monterey, CA Oct. 11-14 . . . . . . .GLAO Annual Session, Indianapolis, IN Oct. 18-23 . . . . . . .American Dental Association Annual Session, San Francisco, CA Oct. 25-28 . . . . . . .SWSO Annual Session, Oklahoma City, OK

Ask the good folks down at Kodak. That is, If you can find them.

Nov. 1-4 . . . . . . . . . .RMSO Annual Session, TBA (tentative)

Best of the Season to y’all. Jimmy P

Nov. 23-26 . . . . . . .8th Asian Pacific Orthodontic Congress, New Delhi, India

Nov. 8-12 . . . . . . . .NESO Annual Session, New York, NY

2013 May 3-7 . . . . . . . . . .AAO Annual Session, Philadelphia, Pennsylvania June 26-30 . . . . . . .European Orthodontic Society Annual Session, Reykjavik, Iceland Sept. 19-21 . . . . . .CAO Annual Session, Banff, AB

We’d like to hear from You! Send in your pictures from your local meetings and events. Show us what you’ve got! If something of interest happens in your area, let us know. We are interested and are confident others will be as well.

Sept. 19-22 . . . . . .MSO Annual Session, Kansas City, MO Sept. 26-29 . . . . . .GLAO Annual Session, Colorado Oct. 2-6 . . . . . . . . . .SAO Annual Session, Hilton Head Island, SC Oct. 10-13 . . . . . . .SWSO Annual Session, Dallas, TX Oct. 16-20 . . . . . . .PCSO Annual Session, San Diego, CA Oct. 31- Nov. 5 . . .American Dental Association Annual Session, New Orleans, LA Nov. 14-17 . . . . . . .MASO/NESO Joint Annual Session, Puerto Rico (tentative) 2014 Sept. 4-6 . . . . . . . .CAO Annual Session, Montreal, QC

Send to: James Posluns, Bulletin Editor Email: james.posluns@utoronto.ca

CAO Bulletin • Fall 2011

2015 Sept. 17-19 . . . . . .CAO Annual Session, Victoria, BC