Spring 2012
Bulletin
CANADIAN ASSOCIATION OF ORTHODONTISTS / ASSOCIATION CANADIENNE DES ORTHODONTISTES
Site of the 64th Annual CAO Scientific Session Fairmont Chateau Laurier Hotel Ottawa, Ontario
• Message from the President • Committee Reports • CFAO - Your Donation Dollars at Work • CAO Bylaw Revision Required • CFAO Graduate Student Posterboards - Part 2 of 2 • Component Society Reports • From the Editor • Letter to the Editor
Message from the President
Dr. Ritchie Mah
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 [Email: ritchiemah@yahoo.ca]
According to cinematic terminology, “All’s Quiet on the Western Front”, but I am assured by Diane and Alison that the next few months will be busy. Nevertheless, here are some of items of interest to the membership:
External Communications:
2011/2012 Board of Directors OFFICERS 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
Dr. Dan Pollit
Nominations
Dr. Howard Steiman
President CFAO
Dr. Stephen Roth
CAO/AAO Liaison
Dr. Garry Solomon
Insurance
Dr. Robert Cram
Planning & Priorities
Dr. Ritchie Mah
Membership
Dr. Paul Major
Policy & Procedures
Dr. Amanda Maplethorp
Sponsorship
Dr. Michael W. Patrician
World Federation of Orthodontics
Dr. Ritchie Mah
National Scientific Meeting Coordinator
Dr. Richard Marcus
CDSA Liaison
Dr. Ritchie Mah
Canadian Orthodontic Educators Liaison Dr. Gerry Solomon COSA Liaison
Dr. Bob Cram
New & Younger Members Rep
Dr. Susan Tsang
CAO Web Master
Dr. Daniel Pollit
Bulletin Editor
Dr. James Posluns
Historian/Archivist
Dr. Garry A. Solomon
CAO Helpline Task Force
Dr. Howard Steiman
GST Advisor
Dr. Michael W. Patrician
The current CAO Executive roster was updated and sent to other orthodontic, dental, regulatory, and governmental organizations. As the Holiday Season approached through our CAO staff, Season’s Greetings cards were sent to Board members and various contacts within other organizations. Acting as the CAO Canadian Dental Specialties’ Association (CDSA) representative, there have been two lengthy conference calls since September regarding the CDSA’s current and future objectives and activities. The most recent call was February 12th, 2012. For details, please refer to the CDSA/COSA-CDA reports.
Media Requests The Nickel Institute. A quarterly publication entitled Nickel requested an interview for a report on the use of shape memory alloys (superelastic wires) in orthodontics. The request was made to the CDA, who then forwarded it to the Committee on Specialist Affairs (COSA), then to the COSA representative, Dr. Bob Cram, who responded to the interview. Bankrate.ca – An online publication for consumers requested an interview on the financial aspects of orthodontic treatment and the writer was granted a telephone interview with the CAO president. Dr. Warren Roberts, a Vancouver dentist together with his partner Dr. Jan Roberts, requested that the CAO offer a course in clinically applicable Botox practice. The CAO Board unanimously rejected their proposal. Provincial meetings - The Alberta Society Meeting was held in Banff AB, on March 9th, 2012, and the Winnipeg-based Manitoba Society meeting took place on April 19th, 2012. Invitation to attend CDA President’s Installation Dinner in April, 2012. The CDSA meeting was attended by the CAO President as the CAO/CDSA representative who also attended the CDA dinner.
Internal Communications: A CAO officers conference call was held on December 1st, 2011 to update all on the ongoing actions items from the September Board meeting. Discussions ensued regarding the advertising restriction concern from ASO, the success of the webinar series, the content of the Bulletin, the format of the Annual General Meeting, overall sponsorships as well as others. The financial arrangement of the Annual Scientific Session was discussed within the CAO budget. Most items were revisited and updated at the ad interim meeting held in Toronto February Continued… 25th, 2012.
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IT’S YOUR CIVIC DUTY!
On January 16th, 2012 Dr. Amanda Maplethorp convened a meeting of the Bylaws Committee to discuss upcoming changes required by the new not-for-profit legislation. David Petrie, of Taylor Enterprises, governance consultant to the CAO, contributed and presented to the Board at the ad interim meeting. Dr. Stephen Roth, CFAO President, convened a CFAO Board Meeting on December 15th, 2011. Much of the discussion revolved around the current distribution of funds by the CFAO to Canadian graduate orthodontic programs and the implementation of the new undergraduate orthodontic awards. The CAO WebMaster, Dr. Dan Pollit, together with Dr. Howard Steiman, have launched the new and improved BraceSpace discussion forum on the CAO website. All CAO members were signed up, with the option to opt out, to encourage contribution in an effort to make the discussions more relevant and interactive. It is only through discussions that reach ‘critical mass’ that the forum becomes effective and becomes a ‘go to’ option for the membership. In particular, the New and Younger members are asked to use the forum to have their enquiries addressed.
What is more patriotic and in line with Canadian ideals than giving? Canadians are a giving bunch and Canadian orthodontists even more so! Dr. Stephen Roth, CFAO President, is asking all CAO members to consider donating an item to the CFAO Auction to be held again at this year’s CAO President’s Banquet, in Ottawa. Items that would be more than welcome are: • • • • •
One of a kind art/jewellery pieces Use of a resort condo or “Time Share” Tickets to sporting events or live theatre Spa/restaurant certificates Sports memorabilia (think “The Goal Heard Round the World”!)
All items collected will be used in this year’s Silent Auction in support of the CFAO. If you are willing to support our CFAO President (he’s quite the nonpartisan leader), as well as the CFAO in general, please contact the CFAO Office at (416) 4913186 or cao@taylorenterprises.com
DO IT FOR YOUR COUNTRY…DO IT FOR ORTHODONTICS!
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CAO Bulletin • Spring 2012
Dr. Steiman in conjunction with the CAO staff is continuing to work on the new Policies and Procedures manual. The main objective is to develop more concise job descriptions and an expanded Code of Ethics to be given to new Board members. Updates will be provided as new positions are created or where existing roles require alteration. Dr. Steiman also continues to attend to the CAO Helpline.
Rapport du président
Ritchie Mah Comme le dit un film réputé, À l’Ouest, rien de nouveau, Diane et Alison m’assurent qu’au contraire les prochains mois seront chargés. Voici néanmoins quelques sujets d’intérêt destinés aux membres.
Communications externes La composition actuelle de la direction de l’ACO a été mise à jour et les changements apportés ont été communiqués aux autres organismes des domaines orthodontique, dentaire, réglementaire et gouvernemental. À l’approche des fêtes, l’ACO, par l’entremise de son personnel, a envoyé des cartes de souhaits aux membres du conseil et à diverses personnes d’autres organismes. À titre de représentant de l’ACO auprès de l’Association canadienne des spécialités dentaires (ACSD), j’ai participé à deux longues conférences téléphoniques depuis septembre dernier à propos des activités et des objectifs actuels et futurs de l’ACSD. La seconde de ces conférences a eu lieu le 12 février 2012. Pour en savoir davantage à ce propos, veuillez consulter les
rapports de l’ACSD, du CAS et de l’Association dentaire canadienne.
Demandes des médias Le Nickel Institute. Une publication trimestrielle, Nickel, a demandé une entrevue aux fins d’un rapport sur l’utilisation des alliages à mémoire de forme (fils superélastiques) en orthodontie. La demande a été formulée à l’ADC qui l’a transmise au Comité sur les affaires liées aux spécialistes (CAS), puis, au représentant du CAS, le Dr Bob Cram, qui a accordé l’entrevue. Bankrate.ca – Cette publication en ligne destinée aux consommateurs a demandé une entrevue sur les volets financiers des traitements orthodontiques; son rédacteur a obtenu une entrevue téléphonique avec le président de l’ACO. Le Dr Warren Roberts, dentiste de Vancouver, et son associée, la Dr Jan Roberts, ont demandé à l’ACO d’offrir un cours portant sur les applications cliniques acceptables du Botox. Le membres du conseil a rejeté la demande à l’unanimité. Assemblées provinciales. J’ai assisté à l’assemblée de la section de l’Alberta qui a eu lieu à Banff, le 9 mars 2012, et des projets sont en cours en vue de ma participation à l’assemblée de la section du Manitoba, qui aura lieu à Winnipeg, le 19 avril 2012. Invitation au souper d’intronisation du président de l’ADC le 22 avril 2012. Le président de l’ACO assistera à l’Assemblée de l’ACSD à titre de représentant de l’ACO de l’ACSD et il sera également présent au souper de l’ADC.
autour de l’affectation actuelle des fonds par la FCAO aux programmes d’études supérieures en orthodontie et de l’adoption des nouveaux prix en études de premier cycle dans cette discipline. Le webmestre de l’ACO, le Dr Dan Pollit, et le Dr Howard Steiman, ont lancé une version améliorée du forum BraceSpace dans le site Web de l’Association. Tous les membres de l’ACO ont été inscrits, avec possibilité de retrait, en vue d’encourager leur apport et de rendre les discussions plus interactives et encore plus pertinentes. Ce n’est que par la tenue de discussions atteignant la « masse critique » que le forum gagne en efficacité et qu’il devient une « référence » pour les membres. En particulier, les membres nouveaux et plus jeunes sont invités à utiliser le forum pour obtenir des réponses à leurs demandes de renseignements. En collaboration avec le personnel de l’ACO, le Dr Steim poursuit son travail sur le nouveau manuel des normes et des méthodes. Le principal objectif de cette initiative consiste à rédiger des descriptions d’emploi encore plus concises et une version enrichie du Code de déontologie qui sera remise aux nouveaux membres du conseil. Des avis seront diffusés au fur et à mesure que des postes nouveaux seront créés ou lorsqu’il faudra apporter des changements aux postes actuels. De plus, le Dr Steim continue de contribuer à la ligne d’aide de l’ACO.
Communications internes Le 1er décembre 2011, une conférence téléphonique réunissant les dirigeants de l’ACO a eu lieu en vue de faire le point sur les initiatives recensées à l’occasion de la réunion du conseil tenue en septembre. Par la suite, des entretiens ont porté sur les préoccupations qu’a formulées l’ASO à propos de la restriction en matière de publicité, de la réussite de la série de séminaires en ligne, du contenu du bulletin, du déroulement de l’Assemblée générale annuelle, de partenariats dans l’ensemble et sur d’autres sujets. Les modalités financières entourant l’Assemblée scientifique annuelle ont fait l’objet d’entretiens à l’intérieur du budget de l’ACO. La plupart des sujets ont été réexaminés et mis à jour à l’occasion de la réunion intérimaire qui a eu lieu à Toronto, le 25 février 2012. Le 16 janvier 2012, la Dre Amanda Maplethorp a convoqué une réunion du Comité des règlements en vue de traiter des changements futurs que rendra nécessaires la nouvelle version de la Loi canadienne sur les organisations à but non lucratif. David Petrie, de Taylor Enterprises, conseiller juridique de l’ACO, s’est livré à une présentation au conseil à l’occasion de la réunion intérimaire. Le Dr Stephen Roth, président de la FCAO, a convoqué une réunion du conseil de cette association le 15 décembre 2011. Une large part des entretiens à cette occasion ont gravité
In Memoriam
Dr. Michael Pawliuk Dr. Michael Pawliuk was born January 10th, 1930 in Meacham, Saskatchewan. He graduated from the University of Alberta in 1957 with a D.D.S. followed by a Master's degree in orthodontics in 1962 from Northwestern University. Dr. Pawliuk was one of three founders of the graduate orthodontic program at the University of Alberta. His private practice in orthodontics spanned more than forty years during which time he was also a professor of orthodontics at the University of Alberta. Michael was a beloved mentor, teacher, and friend to both students and staff. He enjoyed flying, fishing, as well as numerous hobbies during his lifetime. Dr. Pawliuk died on January 14, 2012, leaving behind his wife Janet, his three children David, Douglas and Robert and five grandchildren.
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CANADIAN ASSOCIATION OF ORTHODONTISTS BYLAW REVISIONS In 2011, following many years of discussion, debate and public consultation, Parliament proclaimed the new Canada Not-for-Profit Corporations Act (NPCA). Existing not-for-profit corporations (including CAO) will have three years to file for continuance under the new Act. In order for the CAO to comply, the bylaws must be completed, the letters patent changed, an approval from the membership must be obtained and then the bylaws must be accepted by Ottawa.
Overview of Changes Letters Patent - The changes that need to be made to the Letters Patent that become the Articles of Continuance are to specify the membership classes and their respective voting rights and to specify the size of the Board. Board structure – The full Board of Directors must be elected at the annual general meeting. The current bylaws provide that component societies may appoint directors to the board of directors and may appoint alternates in the event the original appointees are unable to attend. Neither appointments nor alternate directors are permitted under the new Act. Membership classes voting - It will be required that normally non-voting classes of members are allowed to vote by themselves as a class in certain circumstances affecting their rights and privileges. Where more than one existing class of members becomes entitled to vote, all classes must vote in favour of the action. In order to avoid the situation where there are membership categories with only a few members, it is proposed that there be a reduction in the number of membership categories in the bylaws while maintaining the same membership benefits and rights of different categories in the CAO database. The CAO currently has seven membership categories described in the bylaws but over twenty categories in the database. Meetings of members – The notice period for all general meetings must change as do the circumstances under which members can requisition a
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CAO Bulletin • Spring 2012
meeting of members and the number of members needed to occasion a secret ballot. Other changes have been recommended to permit electronic notices of meetings to be delivered. Additional changes dictated by the Act include extended provision for conflict of interest, broader indemnities to directors and to others, regular financial review of statements by a public accountant and numerous small housekeeping detail changes. The CAO has struck an ad hoc bylaws committee, which has begun the revision process. The plan includes development of the key concepts, identification of the changes required, a review of the legal implications, a presentation of the findings to the membership, division of the task into manageable pieces and a vote at the upcoming Annual General Meetings in 2012, 2013 and possibly 2014. It is planned that the membership categories be addressed at the 2012 AGM. The proposed new Active membership category will include all current Active and Academic members as well as all practicing Life Active members and all Practicing Life members. The Retired Membership category will include the existing Retired and all Retired Life active and all Life members. The Student Membership category will remain unchanged. There are currently no Honorary Members; that category will be handled by a status change and an award process. All dues and benefits will be assigned by a data base status. Once a member qualifies for Life Active status the changes will occur as they did previously. The only change that will affect a small number of members will affect those who were currently practicing under the Life and Life Active category will now be able to vote and to hold office for as long as they maintain licensure. Upon retirement, these members will transfer to the Retired category but will retain the designation and distinction of attaining the Life or Life Active status. More information will be forthcoming and the ad hoc committee welcomes input from the membership at any time.
Committee Reports \
CFAO Report Dr. Stephen Roth CFAO President [Email: stephenfroth@mac.com] The Canadian Foundation for the Advancement of Orthodontics (CFAO) held a meeting of the Board of Directors via conference call on December 15, 2011. The silent auction in Halifax raised approximately $1900.00 and plans are underway for the 2012 edition of the auction this September in Ottawa. Please contact the CFAO with any ideas for inclusion. The CFAO has finalized details of the Undergraduate orthodontic awards. Thank you to Kathy Russell, Mike Patrician and to the undergraduate educators for their assistance in drafting the proposal. The award will be offered annually commencing in 2012 to each of the 12 Canadian undergraduate programs and will recognize outstanding achievement in
orthodontics by a third or by a fourth year dental student. Awards will consist of a $200.00 prize and a certificate from the CFAO. The value of the award is anticipated to increase with increased donations to the CFAO. The CFAO has fulfilled its obligation to the CRA special distribution. The 2012 distribution quotient was determined following the completion of the CFAO audit in February. The CFAO is always on the lookout for projects to support. Good ideas spurn healthy donations. Increased awareness of the CFAO is the key to increased support. Promotion of the McIntyre Fellowship program to newer CAO members is planned for the near future. The expansion of the CFAO section on the CAO website is underway, including the designation of a domain name for the CFAO and the provision for donations on-line. The CFAO will have a greater presence in the Bulletin through letters from graduate students describing how CFAO funds are being used for research and the CFAO will continue to play a major role at the New and Younger Members luncheon and at the annual golf tournaments in the fall.
Treasurer’s Report Dr. Michael Patrician Treasurer
CFAO Donations
[Email: drpatrician@bellnet.ca]
(since October 2011)
As of December 31st, 2011 the general operations of the CAO generated net revenues of $41,254.23. The Annual Scientific Session generated a net loss in revenue of $13,460.39. The net income of the CAO in 2011 was $27,793.84. The members’ equity is $577,537.72. CAO dues have increased by $30.00 to $575.00 plus HST. The increase in dues was brought about in response to expenses generated by the Canadian Dental Specialty Association (CDSA), the new CAO governance model, bylaw changes and media training in 2012.
CAO In Honour of Dr. Sarah Davidson’s Webinar CAO In Memorium of Dr. Michael Pauliuk CAO In Memorium of Dr. Theodosy Wachna Dr. Donald G Cronin McIntyre Fellow
The total hours accumulated by Taylor Enterprises for 2011 was 1,207.25, down from 1,343.5 hours in 2010. Taylor Enterprises contracts for 1200 hours per annum.
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Committee Reports HST Report
New and Younger Members
Dr. Michael Patrician Treasurer
Dr. Susan Tsang New and Younger Members Representative
[Email: drpatrician@bellnet.ca]
[Email: s_tsang2@hotmail.com]
In 2011 there was no communication with CRA with regards to HST and the CAO has not been made aware of any changes to the HST rebate mechanism. A small number of general inquiries were made by CAO members seeking guidance as to how to best manage an HST audit, yet these inquiries necessitated no specific accounting details.
Join us at the annual CAO meeting in Ottawa. On September 7th, 2012, the NYM luncheon will feature speakers from the information technology firm Marketing Breakthroughs, who will bring you up to date on web marketing and search engine optimization, essential to all practices interested in keeping their websites current.
The CDA is no longer publishing the GST/HST manual for its members.
As always, post any comments, questions, or thoughts through the BraceSpace discussion forum on the CAO’s website (canadabraces.org).
Insurance Report Dr. Robert Cram Chair, Insurance Committee
The CAO is here to be a resource to you as you start your careers and if we can assist in any way, please feel free to contact us.
[Email: drbob@reddeerortho.com] CAO Past President Gerry Zeit voiced a concern arising from a patient who was recently denied the deduction of orthodontic fees as a medical expense for tax purposes. The denial was based on the contractual monthly fee structure, which in the CRA’s eyes was more in line of a loan or of an insurance premium. In this particular case, CRA accepted the initial payment for deduction, but not the monthly payments thereafter. Neither Past President Howard Steiman, nor future President Garry Solomon had heard of this objection previously. Hopefully this was a one-off rejection and is not indicative of a new initiative by CRA. An orthodontist from Ontario again challenged the long-held position of the CAO to rejoin (after 30 years) general practitioners using procedure codes in order to submit claims electronically. Perhaps the end-game is to also to join the general practitioners in accepting the assignment of benefits. The use of the Standard Information Form and the policy of claims submission will continue to be discussed at future meetings of the Board of Directors. The new CAO Standard Information Form has been posted on the CAO website, and software providers are in the process of being contacted to update their respective programs. A signed licensing agreement is required prior to the release of the PDF file. Feel free to forward the contact information of any software firm you feel may be interested.
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Canadian Orthodontic Educators Report Dr. Gerry Solomon Canadian Orthodontic Educators Liaison [Email: solomonstr8ner@rogers.com] The CCOE/CCGOPD ad interim meeting, once again hosted by Mr. Silvano Brecevic and generously sponsored by 3M Unitek was held on the weekend of April 13th to 15th, 2012 in Niagara-on-the- Lake, Ontario. A report will follow in the fall edition of the Bulletin.
CAO/AAO Report Dr. Garry Solomon CAO/AAO Liaison [Email: hellener@lks.net] The Consumers Awareness Program (CAP) was initiated by the AAO in 2006 by partnering with the Schupp Company of St. Louis, Missouri. The initial campaign was designed to
Committee Reports educate and to direct the consumer towards the AAO website. The subsequent campaign was designed to increase the market share of AAO members by steering the public directly towards the offices of members through television advertisements. The final campaign used radio, magazines, internet, mailings, posters and puzzles all incorporating the tag line “Our Expertise Will Make You Smile”. AAO members could personalize these advertisements with their own names and their own logos. The campaigns all produced disappointing results. For 2012 the AAO switched media companies to Athorn, Clark & Partners of New York City. The $650.00 special assessment will remain in place until 2014. Athorn, Clark and Partners have specific campaign objectives and will make exclusive use of the tag line “My Life, My Smile”. In particular, this campaign will market to the mothers’ of teens to maintain the eighty percent market share that orthodontists currently enjoy as well as to individual adults seeking orthodontic treatment. The campaign will stress the two to three years of additional training for an orthodontist versus the general dentist and will define and refine the role of social media in marketing. Unique to this venture, the campaign will adapt the key marketing messages to satisfy individual regional needs. At the AAO-CAO Liaison Meeting in Chicago in May 2011, AAO President Mike Rogers was asked if the AAO would consider redistributing some of the Canadian members’ special levy to the CAO or to local provincial associations for individual local media campaigns, in part arising from the coupon campaign that was deemed illegal in Canada. Dr. Rogers and the other members of the board of trustees present, rejected the request. First because the funding for the year was already budgeted and in place and second, because the complete budgeted funds would be needed to support the complete CAP program. Recently, an initiative was put forth to the AAO Board of Trustees in an attempt to assist the Ontario CAP program based on a number of key reasons. The Ontario Association of Orthodontists (OAO) has set aside $100,000 in its budget to be allocated to cable television and internet audiences. The OAO is asking the AAO to partner with the OAO or with all of the provinces for a Canada-wide cable TV media buy that requires a budget of $180,000. The AAO budgeted $268,000 for CAP in Canada incorporating print media in its entirety. The American program encompasses 18 and 66 percent for print and cable television respectively. There are 551 Canadian members of the AAO of which 221 are OAO members representing 40 percent of the total. 40 percent of $268,000 is $107,000 in effect representing Ontario’s share of the Canadian AAO CAP program funding. Finally, the OAO proposal plans to use $75,000 of its $100,000 budget for cable television and requests that the AAO fund the
remaining $107,000 for the total $180,000 required. The OAO will deliver the tag line “My Life, My Smile” throughout Ontario. The OAO proposal was turned down by the 2012 budget of AAO Board of Trustees. The AAOF has exceeded its goal of $1,500,000 in donations to support the Legacy 300 Craniofacial Study. The AAO has established its own credit union for the membership and are filing for a federal charter. It is expected to be operational by the Annual Session in Hawaii.
CDSA Report Dr. Ritchie Mah CAO/CDSA Liaison [Email: ritchiemah@gmail.com] The CDSA BOD has had two conference calls since the last CAO meeting, the latest on February 12th, 2012. The main objective of establishing CDSA as the recognized national dental specialists’ association continues to encompass several discussions with current CDA President, Dr. Rob MacGregor and current CDSA President Dr. Aaron Burry. The roles of COSA within the CDA and the CDSA as a separate national entity are slowly being understood more clearly by the CDA. Efforts have been made to differentiate these two specialist groups by having COSA as the scientific information base and CDSA as the political voice. Two important steps have been taken by Dr. Burry in clarifying to CDA the role of CDSA. Firstly, the CDA has agreed to start constructing a joint forum to identify and to discuss specialists’ needs and concerns. It is anticipated that all nine national dental specialties’ executives will be asked for input in formulating an agenda for this discussion. Potentially, it will take up to two years to organize this endeavour, but it will be meaningful to all specialty organizations. The second step is to educate and enlighten the CDA Executive Director, Mr. Claude-Paul Boivin in the needs and concerns of specialists versus general dentists as the executive director position remains constant while presidents and boards change annually. At present, the CDSA consistently faces the challenge of re-explaining and reidentifying concerns to incoming CDA executives. Ideally, going forward, the CDA executive director will update each incoming CDA president on specialists’ concerns through his or her consistent presence at the CDA. Although there is universal support by all dental specialty
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CFAO Your Research Donation Dollars At Work The CFAO has been fortunate enough, for the past three years, to be able to provide grants in a total of $152,000 to the six orthodontic graduate schools in Canada. The universities have been extremely appreciative and below describe what the grant money has been used for. University of Manitoba: the CFAO 2010 grant enabled support of five research presentations by the University at the European Orthodontic Society Conference in Istanbul, Turkey. The EOS is one of the premier orthodontic research conferences held internationally for peer reviewed research and Manitoba was proud to deliver three oral and two poster presentations. All three third year orthodontic residents were able to present their masters research at this highly prestigious international forum. The 2011 grant was used for attendance and travel to present orthodontic research at the International Functional Association Conference in Buenos Aires, Argentina where the University delivered four research based presentations. University of Montreal: In 2010, the grant was used to help purchase an iCAT Cone Beam which was installed in 2011 for use in research projects studying the influence of SARPE on young people at school and RPE on patients showing evidence of sleep apnea. The University started a national team approach on subjects related to sleep apnea with the University of Alberta. U of Montreal hopes, with the research being done, and working with national teams, that they can make early diagnosis of different problems related to sleep apnea and help young people correct these problems at an early age to increase their quality of life. University of Alberta: Donations from the CFAO for the past three years have benefited the graduate students’ educational experience in the orthodontic graduate program. In 2009 the Program used the money to buy equipment for a small animal anesthesia surgical suite; in 2010 the grant money was used partly to buy a 3D Model Scanner and also for Statistical Analysis Services for Ortho Grad Students/Faculty research projects; in 2011 the research grant was entirely for Statistical Analysis Services resulting in manuscripts in preparation or under review consideration in peer-reviewed journals.
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University of Western Ontario: The Orthodontic Graduate Program was pleased to receive financial support from the CFAO and in 2011 this funding was used primarily to purchase research equipment. Any remaining funds from the grant were to be used for materials in statistical analysis and computer time fees, and/or as a means to offset student travel expenses in relation to presenting their research to scientific meetings. University of British Columbia: The 2011 grant was used to finance research expenses of the MSc and PhD students in the Orthodontic program. The 2010 grant funds were assigned for research project expenses in the university’s initial first year class. The funds were budgeted for students’ expenses to present their research abstracts at the spring research association (IADR/ AADR/CADR) allowing them an opportunity to share their research with colleagues in the same area and to develop those networks that facilitate future orthodontic research and possibly academic careers. University of Toronto: Grant monies for 2009 and 2010 were used to financially support the orthodontic graduate students in their research projects in such areas as research start-up costs, lab services, statistical support and poster preparations. The CFAO 2011 grant was used to allow orthodontic students to attend orthodontic conferences, for publication and research costs, and for tutorial presentation expenses. The students of today are the orthodontists of the future and the CFAO is pleased to be able to support them through the Canadian graduate orthodontic programs. For information on how to donate, please visit the CFAO website at: www.cfao.ca
Committee Reports organizations for CDSA, there remains a concern that not enough qualified individual specialists are volunteering to participate. The need to strengthen CDSA will depend on future CDSA board members who have had some experience with organized dentistry at a national level. Unfortunately, the smaller specialties have identified the lack of members as a concern to their effective representation, both in CDSA and in COSA at CDA. The new not-for-profit (NFP) legislation was a topic of discussion for CDSA. The Alberta lawyer that was used to incorporate CDSA has ensured that there will be compliance with the new legislation by CDSA. Both the Canadian Association of Pediatric Dentists (CAPD) and the Canadian Association of Oral and Maxillofacial Surgeons (CAOMFS) representatives assured the group that the new legislation was appreciated when the incorporation papers were filed. There remain several national dental specialty organizations that are not incorporated. The CDSA AGM was held on April 26, 2012 in Ottawa and coincided with a meeting with CDA Executive. Updates on these issues will be discussed at that time.
WFO Report Dr. Amanda Maplethorp WFO Committee [Email: a_maple@shaw.ca] The World Federation of Orthodontists (WFO) launched the Journal of the World Federation of Orthodontists (JWFO) in March 2012. The JWFO will be offered exclusively online on a quarterly basis, and WFO members will have complete access to the peer-reviewed journal’s content as a membership benefit. Elsevier, the journal’s publisher will manage the journal’s website, www.jwfo.org. The new WFO website is predicted to be launched early in 2012. In September 2011, the WFO Executive Committee selected Dr. Jorge Faber of Brasilia Brazil to serve as the editor-in-chief. Prior to accepting this position, Dr. Faber was the editor-inchief of the Dental Press Journal of Orthodontics (DPJO). Dr. Faber is an adjunct professor of orthodontics at the University of Brasilia and has been in private orthodontic practice since 1994. He has also published more than 70 scientific articles and has given more than 150 lectures and courses worldwide. Dr. Faber was voted unanimously by the WFO Executive Committee as the best choice among 19 candidates bidding for the post.
The JWFO Editorial Board is now accepting article submissions. Interested authors should review the author guidelines and submit articles at http://ees.elsevier.com/jwfo. Additional information on the JWFO and WFO activities may also be found in the most recent issue of the WFO Gazette. The WFO Executive Committee is in the process of choosing the location for the 2020 IOC from seven qualified applications.
RCDC Report Dr. Hugh Lamont Orthodontic Councillor, RCDC/RCDC Liaison The current members of the Royal College Executive are Garnet Packota (President), Lee McFadden (Vice President), Rick Emery (Past President), Pat Main (Registrar), Ernie Lam ( Secretary-Treasurer), Paul Jackson (Examiner-in-Chief), Hugh Lamont (Council Representative) and Mr. Peter McCutcheon (Chief Operations Manager). Current members of Council include Garry Aslanyan (Dental Public Health), Dorothy McComb (Dental Sciences), Herb Borsuk (Endodontics), Chris Robinson (Oral and Maxillofacial Surgery), Adel Kausman (Oral Medicine/Oral Pathology), Grace Petrikowski (Radiology), Hugh Lamont (Orthodontics), Robert Barski (Pediatric Dentistry), Murray Cuff (Periodontics) and Izchak Barzilay (Prosthodontics). New questions are being added yearly to the database for the examinations in the various specialities. Examiners, especially new examiners, attend workshops with resident RCDC psychometrician Dr. Phil Bashook, that deal with exam structure, new question construction and effective methods of testing. The new Chief Examiner in orthodontics is Lesley Williams who has assumed the role from Ron Sperber, who held the post for the previous six years. Ron and his team of examiners made significant improvements to the structure and to the format of the examinations. Lesley is looking forward to carrying on the tradition and to tweaking the system where appropriate. The RCDC must comply with the Government of Canada’s mandated changes in governance and in by law structure for not-for-profit organizations. There are numerous issues to consider and multiple changes that will need to occur over the next few years. Dr. Patricia Main gave notice in 2011 that she will be stepping down as Registrar. A formal search was conducted to find a
Spring 2012 • CAO Bulletin
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Committee Reports
WEBINAR UPDATE Dr. Gerry Zeit
replacement for Pat, who has done an exemplary job under sometimes trying yet always dynamic circumstances. All candidates applying for the position were well-qualified and were thought to bring a unique perspective to the table. After much deliberation, the new RCDC Registrar is Dr. David Precious of Halifax, Nova Scotia.
The Female Orthodontist: Work Life Balance The Female Orthodontist: Work Life Balance webinar presented by Dr. Sarah Davidson was held on Friday, November 4th, 2011 at 12:00 EST and repeated on Tuesday, November 8th, 2011 at 7:00 pm EST. It is likely that between 40 and 50 individuals participated in the seminar, with the majority preferring the Tuesday
Communications Report Dr. Daniel Pollit, CAO Web Master [Email: dpollit@sympatico.ca] The reintroduction of the BraceSpace Discussion Forum with the assistance of Dr. Howard Steiman was buoyed by the incorporation of all members of the CAO into the latest version. Members were given the option to opt out of email notification of new postings. As of February 14th, 2012, 79 members opted out while 62 messages have ‘bouncedback.’ Please confirm your e-mail address with the CAO office, and check your ‘spam-blockers’ if you are uncertain as to the delivery of your messages. So far, the level of activity on BraceSpace has been encouraging. The Video Scholarship contest entitled “Why I Want a Beautiful Smile” continues in development. Some concerns with respect to the contest include the estimated costs involving the prize, legal, marketing, postage and administrative expenses. Once legal queries have been addressed, additional planning will take place at the Board level.
Helpline Report Dr. Howard Steiman Helpline Liaison [Email: straightsmile@sympatico.ca] The Helpline continues to work very well with no major incidences to report as of late. Jim Posluns is the new Ontario representative, replacing Stan Markin.
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CAO Bulletin • Spring 2012
evening timeslot. Dr. Davidson was a knowledgeable and well-prepared speaker. The presentation was of very high quality and was received with interest. Continuing education certificates were distributed and the presentation is currently archived and available for viewing on the CAO website. All participants were invited to complete an online survey via Survey Monkey following the presentation. All aspects of the webinar including production technology, content and the speaker’s delivery were rated either above average or excellent by the majority of the small number of respondents. One hundred percent of respondents said they would participate in a subsequent webinar if offered by the CAO, particularly if focused on clinical orthodontics and on practice management. Webinar production continues to be technically challenging. Prior to the actual webinar, a live video feed of the speaker was investigated. It does not appear that the bandwidth available from typical commercial ISPs will allow for smooth video during the presentation, which is unfortunate as it would seem likely that participants would find the presentation more engaging if they could see a live image of the speaker. In addition, Dr. Davidson had included some engaging video content embedded in her presentation but this did not behave smoothly on the Adobe platform. Thank you to Dr. Davidson for her excellent presentation, to Dr. Anthony Mair for his support, and to Alison Nash and Jackie Wilmore for their administrative assistance in operating the Adobe software. A webinar by Toronto periodontist Dr. Elliot Weinstein to discuss issues common to the two specialties was also held in April, 2012. The webinar committee remains open to suggestions for speakers and topics of interest for future presentations.
CFAO Graduate Student
Posterboards Abstracts from the 2011 CAO Annual Scientific Session – Part 2 of 2 part series
University of Manitoba A CLINICAL OUTCOMES ASSESSMENT COMPARING GROWTH MODIFICATION AND ORTHOGNATHIC SURGERY IN CLASS II DIVISION 1 SUBJECTS
University of Manitoba THE EFFECT OF CROSSHEAD SPEED, LOAD CELL CONFIGURATION AND CURING TIME ON THE SHEAR BOND STRENGTH OF ORTHODONTIC BRACKETS
Authors: William A. Wiltshire and Andrew Bernas*
Authors: Dr. Vivek Cheba*, Dr. William Wiltshire, Dr. Robert Schroth, Dr. Noriko Boorberg
After more than a century of Functional Appliance use in orthodontics, recent orthodontic literature and Randomized Clinical Trials (RCT’s), are challenging the value of this treatment modality. Accordingly, the present study evaluated the clinical outcomes of severe skeletal Class II subjects treated using an initial growth modification protocol with functional appliance therapy. SUBJECTS AND METHODS: The treatment group included the retrospective evaluation of eleven skeletal Class II subjects, with severe overjets, treated via growth modification with a “Headgear Activator of van Beek” removable orthopedic appliance, followed by full-fixed orthodontic appliance therapy. The growth modification subjects were contrasted and compared to ten similarly matched post-PHV control subjects where growth modification was not undertaken. These subjects were treated via full fixed orthodontic appliances in combination with orthognathic surgery. RESULTS: In the growth modification subjects, after both treatment phases, profile and dental improvements were obtained. The surgery control subjects required regular orthodontics in combination with orthognathic surgery to correct their facial disharmonies. The orthopaedic phase [phase 1], varied in duration from 4 to 11 months (x= 6.45± 2.07). Total treatment time (TTT) for phase 1 and phase 2, varied from 19 to 38 months (x= 25.09 ± 6.38 months). TTT for the combined orthodontic/orthognathic surgery subjects, varied from 21 to 37 months (x = 28.6 ± 5.82). TTT was compared with the paired t-test and was not significant (p>0.05) CONCLUSION: Growth modification, remains a valuable clinical adjunct and alternative for the treatment of severe Class II malocclusions, particularly as an alternative to surgical intervention.
OBJECTIVE: The purpose of this study was to evaluate the effect of crosshead speed, load cell configuration and curing time on the shear bond strength of orthodontic brackets MATERIALS AND METHODS: One hundred and eighty human molars were randomly divided into 20 second and 40 second photopolymerization time and stored in artificial saliva at 37°C in incubator for two weeks before bonding. The teeth in both groups were bonded using regular primer and Transbond XT (R) adhesive and adhesive curing time was either 20 or 40 seconds. Each group was further divided into 10kN or 1kN load cell groups and each of those groups were divided into 0.5mm/min or 5mm/min crosshead speeds. Teeth were then stored in artificial saliva and subjected to shear-testing 24 hours after using a Zwick Universal Test Machine. Pre- Liminary Results: In the photopolymerization subgroups, the mean shear bond strength were 19.22 ± 4.14 MPa and 21.01 ± 3.43 MPa for the 20 seconds and 40 seconds, respectively. Meanwhile, in the crosshead speed subgroups, the mean shear bond strength were 23.61 ± 2.87 MPa and 21.66 ± 4.42 MPa for 0.5mm/min and 5mm/min, respectively. Lastly, in the load cell configuration subgroup, the mean shear bond strength were 21.11 ± 3.47 MPa for 1kN load cell and 10kN load cell subgroup results will be analyzed in near future. The data collection is ongoing. CONCLUSION: The 24-hour debonding results indicated that slower cross-head speeds with longer photopolymerization times produced higher shear bond strengths.
(*Presenter)
Spring 2012 • CAO Bulletin
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CFAO Graduate Student Posterboards University of Alberta TREATMENT OPTIONS FOR PEDIATRIC PATIENTS WITH OBSTRUCTIVE SLEEP APNEA (OSA): INDICATIONS, PROS, CONS, AND ORTHODONTIC CONSIDERATIONS Author:
Mohammed Korayem*, Carlos Flores-Mir
AIM: The purpose of this to review currently available treatment options for pediatric patients with Obstructive Sleep Apnea (OSA). Overview descriptions, indications, advantages, disadvantages, and orthodontic considerations are reviewed. METHODS: A comprehensive literature review examining current treatment methods for pediatric patients with sleepdisordered breathing conditions such as Obstructive Sleep Apnea (OSA) was conducted. Electronic database searches were conducted to identify the most commonly-used treatment modalities in the treatment of pediatric sleep-disordered breathing. Similar searches were then conducted separately for each of the identified treatment methods to review indications, clinical procedures, outcomes, advantages, disadvantages, and alternatives. RESULTS: Four primary treatment modalities were identified and selected for detailed review. These were Tonsillectomy/Adenoidectomy, PAP therapy, oral appliances, and orthognathic surgery. The individual characteristics of these treatment methods are reviewed and comparisons are made with regards to success rates, long-term prognosis, invasiveness, cost, and patient acceptance. CONCLUSIONS: This review serves to summarize current knowledge on the treatment of pediatric sleep-disordered
Thanks to GAC for their support of the CFAO Posterboards
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CAO Bulletin • Spring 2012
breathing. Current mainstream treatment modalities for these conditions vary in effectiveness, with more invasive procedures being generally more effective. The morbidity and risks of invasive procedures such as tracheostomy, tonsilloadenoidectomy, and orthognathic surgery, make other non-invasive treatment options (PAP, oral appliances) more attractive. Proper case selection, clinical training, and patient cooperation are critical to the success and predictability of any of these treatment modalities.
University of Montreal COMPARAISON DES EFFETS SUR LA CROISSANCE DES MAXILLAIRES DE L'UTILISATION DU FORSUS® VERSUS CELLE DES ÉLASTIQUES DE CLASSE II Authors: Dr. Dubois, Audrey* OBJECTIVE : To compare the effects on jaw growth of using Forsus Springs versus class II elastics. Material and Method : A sample of 30 patients was treated non extraction. Following a preliminary alignment phase with full fixed braces, 23 patients were treated with Forsus and 7 patients were treated with class II elastics. Cephalometric radiographs were taken at the end of the alignment phase and at the end of the functional phase. Radiographic measurements were taken to assess the effects of both appliance types. Questionnaires to assess comfort with the appliances were given to the patients approximately halfway through treatment. RESULTS : No statistically significant differences in maxillary or mandibular growth were noted between groups. Both treatments proclined lower incisors and retroclined upper incisors, with the Forsus causing more retroclination of the upper incisors. Forsus caused a statistically significant steepening of the occlusal plane. With respect to patient comfort, there was no statistically significant difference between the two treatments, although maintaining oral hygiene was easier in the elastics group. CONCLUSIONS : The effects of the Forsus and class II elastics are similar with respect to maxillary and mandibular growth. However, the Forsus produced a statistically significant increase in occlusal plane steepening and greater retroclination of upper incisors.
CFAO Graduate Student Posterboards University of Toronto DENTAL ANXIETY IN FUTURE AND CURRENT ORTHODONTIC PATIENTS
patients. This study supports the belief that dental anxiety is multifaceted and contributing factors extend beyond traditionally accepted stimuli of drills and needles.
Author:
University of Western Ontario CROSSTALK BETWEEN EXTRACELLULAR NUCLEOTIDE AND SPHINGOSINE-1-PHOSPHATE SIGNALING PATHWAYS IN OSTEOBLASTIC CELLS – IMPLICATIONS FOR ORTHODONTIC TISSUE REMODELING
J Roy*, B Tompson, V Leblanc, L Dempster
Dental anxiety is the most common psychological condition seen in clinical practice; however it is not typically associated with orthodontic treatment because of the lack of evoking stimuli (i.e., drills, needles). Its prevalence in orthodontic patients has not been studied but is reported anecdotally. OBJECTIVE: To assess the prevalence of dental anxiety and factors contributing to dental anxiety in current and future orthodontic patients. METHODS: Patients from the Faculty of Dentistry undergraduate and graduate orthodontic clinics and a private orthodontic office completed a questionnaire including the Modified Dental Anxiety Scale (MDAS); a Modified version of the MDAS adapted for orthodontic treatment (MDASO) (both scored 1not anxious to 5-extremely anxious; sum score >15=dentally anxious); and a ranking of concerns about orthodontic treatment (scored 1-not at all to 5-very much). Participant inclusion criteria included subjects >12 years and able to read the questionnaire. Results: 675 patient questionnaires were collected (60.4% private practice; 64.3% female; 24.9% new patients; 85.5% between 12-20 years). 22.8% were dentally anxious and 18.7% anxious about orthodontic treatment. University clinic (public) patients reported higher MDAS and MDASO scores (p<0.05), no significant difference was found between future and current patients, gender, and age. Dentally anxious patients reported their relationship with the orthodontist, perceptions of treatment and treatment factors as contributing to their anxiety. CONCLUSIONS: Dental anxiety related to orthodontic treatment was prevalent in both populations, especially in public
2012 CFAO Poster Program The CFAO is now accepting submissions for the 2012 Poster Program to take place at the 64th Annual Scientific Session in Ottawa, ON. Abstracts are due to the CFAO office by June 15, 2012 to be considered. We are hoping to have representation from all six Graduate Orthodontic Program at this year’s poster program, so apply today! Send your abstract to cao@taylorenterprises.com
Author:
M.E. Polymeris1* and S.J. Dixon2, Division of Graduate Orthodontics, and 2 Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON 1
OBJECTIVE: Nucleotides are released from cells in response to mechanical stimuli. P2 receptors for nucleotides have been implicated in mechanotransduction and biological responses to orthodontic forces. Sphingosine-1-phosphate (S1P) is a potent lipid mediator that plays an important role in osteoclastogenesis and osteoblast-osteoclast coupling. Our aim was to investigate the interaction between nucleotide and S1P signaling in osteoblastic cells. METHODS: Both P2 receptors and S1P receptors signal in part through transient elevation of cytosolic calcium ([Ca2+]i). To monitor [Ca2+]i, UMR-106 rat osteoblastic cells were loaded with indo-1. Responses to S1P with and without pretreatment with nucleotides (ADP, ATP, CTP, TTP, UDP or UTP) were monitored by spectrofluorometry. Ca2+ responses were quantified as the area under the curve (AUC, R·s). RESULTS: As previously reported, certain nucleotides (ADP, ATP, UTP) induced robust elevation of [Ca2+]i lasting 1 min. In contrast, S1P alone induced a small [Ca2+]i elevation. However, pre-treatment with nucleotides (150-200 s) dramatically increased the amplitude of the S1P response, without markedly affecting its duration. AUC for S1P (1 M) alone was 1.2±0.3 R·s; whereas, following ATP (100 M), AUC for S1P was 10.5±0.9 R·s (p<0.001). Of the nucleotides tested, ADP, ATP, UDP and UTP significantly potentiated S1P responses. Conversely, CTP and TTP had no significant effect, indicating specificity. CONCLUSIONS: This is the first report of crosstalk between nucleotide and S1P signaling in any cell type. Calcium controls important cellular functions, such as proliferation, differentiation and migration. Thus, this crosstalk may regulate osteoblast function in situations such as orthodontic tooth movement where high levels of nucleotides are present.
Spring 2012 • CAO Bulletin
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Component Society Reports British Columbia Dr. Rick Odegaard
posted and are available for review on the College website. At present, the guidelines are very onerous. All BC dentists are encouraged to review the guidelines and to provide feedback to the College.
[Email: dr.odegaard@shawcable.com]
The British Columbia Society of Orthodontists (BCSO) held meetings on September 19th and November 14th, 2011, as well as February 20th, 2012. There has been an update in the BC Health Professions Act, specifically a clarification in the bylaws concerning the roles of certified dental assistants (CDAs). CDAs can use any impression material in a clinical session. They are governed by a 60 day rule, meaning that for a CDA, any treatment prescribed by a doctor must be completed with 60 days of the time of the order. (Dental hygienists are governed by 365 day rule). A doctor does not need to be present for a CDA to address poking wires, prophies, radiographs, or the gross removal of supra gingival cement, however, a doctor does need to be present for the taking of impressions. CDAs can use slow speed hand piece to remove cement or adhesive. The BCSO New Members Committee’s mandate is to encourage orthodontists new to BC to join the BCSO. The identification of new orthodontists has become more difficult without a provincial specialty exam and because of the stringent privacy rules regarding College registration. The committee has implemented a mentorship program to pair new members with existing ones, and has updated the BCSO manual with respect to professional and ethical guidelines. A survey to obtain membership feedback with respect to guidelines for ethical practice, professional conduct, professional development and cohesive professional relationships has been designed by the committee and was distributed to the BCSO membership in February 2012. Results are forthcoming. The BC College of Dental Surgeons requested that the BC Dental Association prepare sterilization guidelines for dental offices in the province. The documents were submitted to the provincial government and were accepted as fair and thorough. The College was instructed to formalize the guidelines but prepared their own guidelines with the assistance of an outside consultant instead. The guidelines have now been
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CAO Bulletin • Spring 2012
The critical issues concerning the PCSO include attendance at the Annual Session, the promotion of the specialty and leadership development. The PCSO Annual Session held in Vancouver, September 2011 drew 399 doctors, 505 staff, 261 exhibitors, registered spouses and others.
Alberta Dr. Phil Williamson [Email: drphil@telusplanet.net] The 2011-2012 Executive of the Alberta Society of Orthodontists (ASO) includes President Cory Liss, Vice President Warren Cohen and Secretary Treasurer Ivan Hucal. The Annual Scientific Meeting of the ASO was held in Banff on March 9th to10th, 2012 and featured Dr. Lisa Alvetro who spoke on Class II treatment using the Forsus appliance and Dr. Mark Berkman who presented on evidence-based research in esthetics. The ASO was pleased to host the current president of the CAO, Ritchie Mah, at their Annual Session. The ASO is still planning on having their website hosted by the CAO, however there have been some unidentified delays in the process. There is no word yet on when the new website will be up and running. The updated ADA&C Infection Prevention and Control (IPC) Standards were to be fully implemented by all dental offices by January 1, 2012. No specific issues regarding these standards have been brought to the ASO’s attention. The ASO has recently forwarded a copy of the legal opinion on the Alberta ‘advertising issue’ (CAO/AAO membership identification) to the CAO Board seeking feedback. ASO members were briefed on the contents of the opinion at the Annual Session in March.
Component Society Reports Saskatchewan
partnership to aid in funding a cable television campaign was turned down for 2012. The campaign would utilize ‘My Life, My Smile, My Orthodontist’ creative promoted by the AAO.
Dr. Mike Ziglo [Email: mikeziglo@hotmail.com] Saskatchewan enjoyed an unusually warm winter. In orthodontic circles there is nothing new to report.
Manitoba Dr. Susan Tsang [Email: s_tsang2@hotmail.com] The Manitoba Orthodontic Society (MOS) bylaws have been approved and the AAO Affiliation Agreement has been submitted to the AAO constituent office. MOS President, Dr. Conny Athanasopulous, has accepted the position of Manitoba director to the Midwestern Society of Orthodontists. The fall Manitoba Orthodontic Society dinner meeting was held on October 27th, 2011. A concern was voiced regarding the restrictions that some provinces levy regarding the use of CAO and AAO logos. The spring MOS meeting took place on April 19th , 2012. At the University of Manitoba, Drs. Wick Alexander, Leslie Will and Paul Kuo presented lectures to residents and orthodontists in November of 2011. Marc Oliver Aucoin, Laura Duncan, and Robert Ward have accepted positions for the incoming orthodontic class starting in July 2012.
Ontario Dr. Sheila Smith [Email: stuart.smith4@sympatico.ca] The new RCDSO Quality Assurance Program was officially implemented on December 15th, 2011. Details appeared in the fall edition of the Bulletin. The Public Awareness Campaign (PAC) committee has made presentations to the OAO Board of the in an effort to determine the best modality to deliver the public awareness message. A proposal made to the AAO in an effort to form a
The OAO Board will continue the tradition of hosting graduate student dinners at both the University of Toronto and the University of Western Ontario. An informal meeting was held January 20th, 2012 for New and Young Members in Toronto. Drs. Peterson and Posluns hosted a roadshow dinner in Ottawa on February 9th, 2012 for OAO members in eastern Ontario. Dr. Jim Posluns, OAO Past President, has returned to the University of Toronto as Assistant Dean/ Director of Clinics. He has agreed to assume the role of Helpline Mediator in Ontario.
Quebec Dr. Jean-Marc Retrouvey [Email: jeanmarcretrouvey@gmail.com] On October 14th, 2011 Drs. Debra Morrison and Pierre Mayer gave a presentation to the Association of the Orthodontists of Quebec on sleep apnea just ahead of the Third Annual Gala. Over 400 guests attended the traditionally successful Gala, raising over $100,000 for the Montreal Children’s, the Sainte Justine’s and the Quebec Enfant Jesus Hospitals by the close of the evening. Additional funds will be distributed to the Dr. Julien Foundation. On November 25th, 2011 the Quebec Association held an all-day conference with Dr. Hugo De Clerck who spoke eloquently on a novel method of correcting Angle Class III malocclusions using miniplates and elastics. The majority of the audience stayed until the end of the day; the true indication of presentation quality. On January 27th, 2012 the Paul Geoffrion –Université de Montréal Alumni Day featured Quebec City orthodontist Dr. Charles Rodrigue who spoke on self-ligating brackets and the treatment of Angle Class II and Class III malocclusions with the Forsus appliance. The AOQ is in the process of building an informative website aimed at promoting orthodontics by orthodontists as the competition from general practitioners intensifies. The majority of Quebec orthodontists have contributed to the website fund and are anxiously awaiting its publication.
Spring 2012 • CAO Bulletin
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Component Society Reports Rapport de la province de Québec l’Association des orthodontistes du Québec (AOQ) sur l’apnée du sommeil avant le troisième Gala annuel. Au-delà de 400 invités ont assisté au gala, qui a été un franc succès, , et qui a permis de réunir au terme de la soirée plus de 100 000 $ destinés à l’Hôpital de Montréal pour enfants, au CHU Sainte-Justine et à l’Hôpital de l'Enfant Jésus, à Québec. Des sommes additionnelles seront versées à la Fondation du Dr Julien. Le 25 novembre 2011, l’AOQ a tenu une conférence d’une journée avec le Dr Hugo De Clerck qui a traité avec éloquence d’une nouvelle méthode de correction des malocclusions de classe III d’angle au moyen de petites plaquettes et d’élastiques. La majorité de l’auditoire est demeurée sur les lieux jusqu’à la fin de la journée, ce qui témoigne clairement de la qualité de la présentation. Le 27 janvier 2012, à l’occasion de la journée Paul Geoffrion– anciens de l’Université de Montréal, le Dr Charles Rodrigue, orthodontiste de Québec, a effectué une présentation sur les boîtiers autoligaturants et le traitement des malocclusions des classes II et III d’angle au moyen de l’appareil Forsus. Compte tenu de l’intensification de la concurrence de la part des généralistes, l’Association des orthodontistes du Québec est en train de préparer un site Web informatif destiné à l’autopromotion de l’orthodontie. La majorité des orthodontistes du Québec ont contribué à financer le site Web et ils ont bien hâte à son lancement.
In Memoriam
Dr. Theodosy (Ted) Wachna Dr. Theodosy (Ted) Wachna passed away peacefully on January 18, 2012. Born in Stuartburn, Manitoba in 1925, Ted graduated from the University of Toronto, Faculty of Dentistry in 1946 and received his degree in orthodontics from the University of Montreal in 1952. Returning to Windsor, Ted established and enjoyed a very successful orthodontic practice for over forty years. Ted was a long time Rotarian and served for many years as a board member of the Royal College of Dental Surgeons. Predeceased by his wife Anne, Ted will be greatly missed by his children and by his grandchildren.
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CAO Bulletin • Spring 2012
Atlantic Report Dr. Dan Stuart [Email: danstuart96@hotmail.com] The Atlantic Orthodontist’s Association (AOA) held its latest Annual General Meeting in Wallace, Nova Scotia at the Fox Harb’r Resort June 24th and 25th, 2011. The AOA was honoured to have CAO President Dr. Howard Steiman as a guest where he tore up the golf course as well as the dance floor. Doctors and their partners enjoyed a golf tournament, a cooking lesson, a kitchen party with the Maritime band Pogey and a day of continuing education with Dr. ‘Wick’ Alexander. The current slate of officers for the AOA includes Past President Stephen Roth, who has returned as Secretary Treasurer, Vice President and Component Representative to NESO Don Johnson and Executive Committee member Brien Stackhouse. The AOA enjoyed and appreciated the enthusiastic attendance at the CAO Annual Session in Halifax last September. The date of the next AOA annual meeting, to be held in Moncton, New Brunswick is June 22nd to 24th, 2012. As per tradition, continuing education and a golf tournament are in the works for both doctors and staff. Engaging speakers experienced in Invisalign, Incognito and Insignia are featured on this year’s docket, along with guest band Bittersweet.
DID YOU KNOW??? You can list your practice in our classifieds! 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. 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.
Letter to the Editor I read your column in the Fall 2011 Bulletin. There is a serious weather front approaching fast in orthodontics but I disagree about its origin. Yes, there have been many advances in technology that have affected our profession. Orthodontics, however, is not unique in that regard, every aspect of modern life has been affected by huge advances in technology. A modern airliner can fly itself from take-off to landing. One could say that flying an airplane has never been easier. There doesn’t seem to be any question, however, that qualified pilots are still needed. There are a million accounting programs out there but no one doubts the need for qualified accountants. A lot of brain surgery is done by robots but brain surgeons still do the surgery. There are thousands of such examples. So, if technology has made the jobs of pilots, accountants and brain surgeons much easier why isn’t there the perception that pilots, accountants, and brain surgeons are no longer needed, but there is a fairly common perception that orthodontists are no longer needed? There are two reasons. One is the egregious lack of responsibility of the dental regulatory bodies in . They [seemingly] take their responsibility less seriously then those who regulate the building trades. There is no way a framing carpenter is going to be allowed to wire a house after taking a couple of weekend courses about electric circuits and vice versa. The dental regulatory bodies, which are largely politically selected, have used the excuse that general practitioners are licensed to do everything as are medical general practitioners, and use that to pander to general dentists who are the majority in the profession. The only reason they have this broad licensing is, and has always been to allow a general practitioner to handle an emergency. Only the dimmest of dim wits could think that anyone could ever know how to do everything. The second reason is that our profession hasn’t had the guts to say what I just said. Why is this? There are probably a million reasons, not the least of which is that by the time anyone gets to be an orthodontist they have proven that they are the penultimate conformist, having always been exceptional at doing what they’re told to do as they went through school and certainly not risk takers. The reason that orthodontists have failed to defend their profession and stand up for the public’s interest doesn’t make a lot of difference. The reality is that we’ve failed. As always, however, what is most important is what we do in the future. No matter how sophisticated technology gets there will always be the need for qualified pilots and for qualified orthodontists. We just need to take our seat back.
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CAO Bulletin • Spring 2012
The can wait for the AAO to take the lead, individual orthodontists can wait for our association to take the lead; there are always reasons to wait. Or, we can all individually and collectively take responsibility. We need to tell those that regulate dentistry to stick to their mandate. We can start explaining to the public the farce they’re being duped into accepting and the betrayal of their trust that’s happening daily in our profession. Sincerely yours, Jay Winburn The opinions expressed in the above letter are those exclusively of the author and do not necessarily represent those of the CAO, its Board or the Bulletin staff.
Fill in the missing numbers with the digits 1 to 9. A diamond shape in the middle means that the four numbers around it add to 20. Each uses a different way to add to 20, i.e. if there is already 1 + 3 + 8 + 9, then there will not be another using the digits 1, 3, 8 and 9 (in any order). The same digit isn't allowed to touch, even diagonally.
From the Editor Dr. James Posluns [Email: james.posluns@utoronto.ca]
How Much is that Doggie in the Window? On my last official day of dental school, I had a meeting with Dr. Edward G. Sonley, Director of Clinics. Dr. Sonley sat on one side of the desk while I sat, somewhat lower, directly across. Dr. Sonley quietly, yet efficiently, reviewed my stack of about thirty charts. I stared at the walls, shaking ever-so-slightly, praying that this would be, in fact, my last official day of dental school. After what had to be the longest twelve minutes of my life, Dr. Sonley looked up from his charge. “Your patients owe more money than any other patients in the school.” An awkward silence filled the room. Either he was waiting for me to say something, or the floor was about to part, casting me to the ravenous sharks that reportedly lurk beneath the time-ravaged tiles of 124 Edward Street in Toronto. “Umm, yeah, right” I muttered, looking down, suddenly experiencing that unique menopausal combination of being both hot and cold at the same time. Not that I really know what that feels like. “Sorry about that”. More profound words were never spoken. Another awkward silence ensued. “Congratulations” he announced suddenly, thrusting his hand across the desk. “You’ll never make it in private practice”. Looking back over more than 20 years,
Dr. Sonley was right; sort of. The real world is a tough place. My practice was always small. Patients became more like friends. And, you know, friends never ask friends for money… Anyways, enough about me. Dr. Sonley was a wise man. I needed a different sort of job. So I took his. Irony aside, and forget, for a moment the old adage about those who cannot do, in fact teach, most folks in Canada have a pretty good handle on the basic rules of supply and demand. I think I get this fairly simple concept. When there is a lot of product around, sellers get nervous, and prices start to fall, until those with the weakest lines of credit fall by the wayside leaving the strong to ride the wave of prices back up. Remember the gasoline wars of late ‘80’s? My 1979 Mustang loved that battle. So did my piggy bank. Not seeing gas prices falling too often these days are ‘ya? In Ontario, and especially in the greater Toronto area, orthodontists are well represented. Add in a steady supply of Invisalign Premier Providers (aka general dentists) and no one in the Center of the Universe need to go untreated unless he or she desires to appear so hideous. Orthodontic fees are all over the map, as practitioners straddle that fine line between busy-ness and profitability. It’s a tough go for the established; imagine the struggle for the newly graduated. But new grads are smart. They are resilient. They have too much invested in their futures to sit back and take it on the chin. They use their creativity and ingenuity to change the profession. Enter Groupon. On-line coupons have exploded in Ontario. The most recent episode involved a savvy recently graduated general den-
tist in North Toronto. When the provincial orthodontic association got wind of his offer of cut rate Invisalign treatment through the purchase of a Groupon, a call was made to set this fellow straight. Coupons of any sort demean the profession, and besides, according to the gospel of the Royal College of Dental Surgeons of Ontario, they are illegal. But are they? “Cease and desist” was the request from the association. “Bring it on” was the response from the brash young dentist. “I got the all-clear from the College”. Forty-five people bought the Groupon. The dentist has $240,000.00 sitting in his bank account. Right now. As we speak. So what’s an organization to do? Write a letter of complaint? Sounds like a good idea. We got right on that. But while the powers that be were busy constructing a letter that pleased everyone around the table, another social online coupon blasted in from cyber-space. This time its owner was an orthodontist and a member of the organization to boot. I’m still wiping up the mess made by the fan sitting across my desk. Now what? Complain about one’s own member? That doesn’t paint us orthodontists in a very pretty light. “Call the orthodontist” was the cry from the floor. So he or she was called. But he or she had done his or her own due diligence. “The College gave me the green light”. Sound familiar? Bring it on…Again. continued…
Spring 2012 • CAO Bulletin
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Remember gay marriage? Of course you do. Once it was out there, there was nothing that was going to stop that train from leaving the station despite the yelling, screaming and fist-pounding of individual politicians thinly hiding their own agendas. And where are these politicians now? Who cares? The point is that one cannot simply ignore what is. On-line coupons are out there and they are, I’ll bet, here to stay. Only history and good judgement can decide if they are right or wrong for the profession. One thing is for sure. Groupons are definitely not the end of the road. Recently, the question regarding orthodontics and the taking of assignment has resurfaced from the depths of discussion. Should we or shouldn’t we? Think about it. Think about it long and hard. Before you shake that hand reaching across the desk. Have an awesome summer folks. A day without breeze is just a day.
Canadian Association of Orthodontists UPCOMING ORTHODONTIC MEETINGS 2012 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
Jimmy P
Oct. 4-7 . . . . . . . . . .PCSO Annual Session, Monterey, CA Oct. 11-14 . . . . . . .GLAO Annual Session, Indianapolis, IN Oct. 18-23 . . . . . . .American Dental Association Annual Session,
Straight Shooters
San Francisco, CA Oct. 25-28 . . . . . . .SWSO Annual Session, Oklahoma City, OK
1. I never have trouble convincing a teenager that a bonded expander and coloured Bank Lok is cool. I just tell them that they are getting the original BlueTooth! 2. I am certain that Darth Vader has sleep apnea. He wears a Cpac all day long.
Nov. 1-4 . . . . . . . . .RMSO Annual Session, TBA (tentative) Nov. 8-12 . . . . . . . .NESO Annual Session, New York, NY Nov. 23-26 . . . . . . .8th Asian Pacific Orthodontic Congress, New Delhi, India 2013 May 3-7 . . . . . . . . . .AAO Annual Session, Philadelphia, Pennsylvania
3. Do you think there is something subliminal in the name Forsus? 4. Patient: “Doc. You’re a genius. My sleep apnea is totally gone. I’ve never slept better. Unfortunately, the monthly bill is a little steep.”
June 26-30 . . . . . . .European Orthodontic Society Annual Session, Reykjavik, Iceland Sept. 19-21 . . . . . .CAO Annual Session, Banff, AB Sept. 19-22 . . . . . .MSO Annual Session, Kansas City, MO Sept. 26-29 . . . . . .GLAO Annual Session, Colorado
Doc: “What monthly bill?”
Oct. 2-6 . . . . . . . . . .SAO Annual Session, Hilton Head Island, SC
Patient: “For cable.”
Oct. 10-13 . . . . . . .SWSO Annual Session, Dallas, TX
Doc: “What are you talking about?”
Oct. 16-20 . . . . . . .PCSO Annual Session, San Diego, CA
Patient: “You said to hook up the CPAC every night. Those guys knock me right out!”
Oct. 31- Nov. 5 . . .American Dental Association Annual Session, New Orleans, LA Nov. 14-17 . . . . . . .MASO/NESO Joint Annual Session, Puerto Rico (tentative) 2014
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.
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CAO Bulletin • Spring 2012
Sept. 4-6 . . . . . . . .CAO Annual Session, Montreal, QC 2015 Sept. 17-19 . . . . . .CAO Annual Session, Victoria, BC