CAO BULLETIN - Spring 2015

CANADIAN ASSOCIATION OF ORTHODONTISTS / ASSOCIATION CANADIENNE DES ORTHODONTISTES Your Smile is Our Specialty!

Bulletin Spring 2015

In this Issue…

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Message from the President

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Committee Reports

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Component Society Reports

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A Senior Resident’s Perspective

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Notice of Assessment

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Student Posterboards

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The Hicks Agreement of 1991: The ABC’s of GST, HST and ITCs Congratulations to our 40 year Member

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In Memoriam

CAO hits the air waves with its Consumer Awareness Program!

Message from the President Canadian Association of Orthodontists Association canadienne des orthodontistes 2800 14th Avenue, Suite 210 Markham, Ontario L3R 0E4 Telephone (416) 491-3186 / 1-877-CAO-8800 Fax (416) 491-1670 E-mail cao@associationconcepts.ca Website www.yoursmileourspecialty.ca AND www.canadabraces.ca

2014/2015 Board of Directors OFFICERS President President Elect Past President 1st Vice President 2nd Vice President Secretary/Treasurer

Dr. Helene Grubisa Dr. Jean-Marc Retrouvey Dr. Garry A. Solomon Dr. Robert D. Kinniburgh Dr. Rick Odegaard Dr. Michael Patrician

REGIONAL DIRECTORS British Columbia Alberta Saskatchewan Manitoba Ontario Quebec Atlantic

Dr. Helene Grubisa Email: drgrubisa@sympatico.ca

Spring is a happy and an optimistic time of year. The difficulties of the long (very long in Eastern Canada) winter are behind, and there is so much to look forward to with the welcomed warmth of extended summer nights. One can always use longer days, not to work, but for the enjoyment of doing the other “fun” things in life.

There are several projects in the works and the CAO committees are hard at work attending to the website, to CRA issues affecting GST/HST and to new insurance protocol to name just a few.

The CAO website is being updated and upgraded to make it more comprehensive for our members, as well as more user-friendly and more educational for the public. Quick test: what is the website address of the CAO? If you didn’t know, then you should go see the members’ site at www.cao-aco.org and the public site at www.yoursmileourspecialty.ca. A great deal of content has been added to the member site. One can find the advertisements from the current public awareness campaign and the Global News piece on the potential dangers of using a general dentist for orthodontics. The public site is fully bilingual and has both patient education information and ‘Find an Orthodontist’ features, including testimonials from patients. Please visit the new site and see how great this resource can be for your practice and your patients.

Dr. Gerald Philippson Dr. C. Todd Lee-Knight Dr. Michael Wagner Dr. Susan Tsang Dr. Sheila Smith Dr. Michel Di Battista Dr. Donald E. Johnston

There have been reports from a number of members that they have had thorough GST/HST audits and visits to their offices by auditors. Please refer to the GST/HST report included in this issue for more details. If you are audited, please let the CAO know of your experience and what you have been told by the auditor or by CRA. The CAO treasurer has a meeting planned with CRA and will report in more detail shortly thereafter. Rest assured, the CAO is actively involved in discussions with CRA and is strongly advocating on behalf of the membership

President CFAO CAO/CDSA Liaison Insurance Committee

Dr. Stephen Roth Dr. Robert D. Kinniburgh Dr. Mike Wagner Dr. Don Johnston

The Insurance Committee has been working on bringing the predetermination process into the digital age. There have been no changes in the CAO guidelines on insurance; what is being proposed is a digital predetermination submission process rather than having to mail in the form and wait for the “snail mail” reply.

Membership Committee

Dr. Helénè Grubisa Dr. Todd Lee-Knight

Sponsorship Chair

Dr. Michael W. Patrician

COMMITTEES

WFO - Country Rep

Dr. Helene Grubisa

WFO - Member-at-Large Conference Advisory Committee Chair New & Younger Members Rep CAO/AAO Liaison Planning & Priorities Communications Nominations Canadian Orthodontic Educators RCDC Liaison

Dr. Jean-Marc Retrouvey Dr. Howard Steiman Dr. James Posluns Dr. Rick Odegaard Dr. Helénè Grubisa Dr. Dan Pollit Dr. Garry Soloman Dr. James Posluns Dr. Thomas R. McIntyre

CAO Web Master Bulletin Editor Parliamentarian/Historian/Archivist CAO Helpline Task Force GST/HST Advisor

Dr. Daniel Pollit Dr. James Posluns Dr. Amanda Maplethorp Dr. Howard Steiman Dr. Michael W. Patrician

The CAO is continuing its Consumer Awareness Program on national television in both English and French. Several provinces have elected to piggyback on the national program, buying airtime in their respective regions. The campaign is planned to continue for three more years.

The CAO has a hard-working and dedicated Board of Directors. The Board is a collegial and a diverse group with a wide range of experiences in organized dentistry and orthodontics. Please take the time to read the included reports to keep up to date on what is going on around the country and on how the national association is working to help its member orthodontists.

Orthodontics is changing and all of us have to adapt, taking the good with the bad.

Orthodontic treatment is still highly valued by patients. But the improved technology that makes orthodontics more efficient benefits orthodontists as well as other practitioners; we become victims of own success. All orthodontists are aware of the diffiContinued…

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culties facing the profession; it’s imperative that regional and national organizations work together. But it’s just as important that orthodontists work as collegial partners to better serve the specialty for the next generation.

l’ACO sur l’assurance demeurent les mêmes; on y propose l’établissement d’un processus de prédétermination numérique plutôt que la mise à la poste d’un formulaire et l’attente d’une réponse par le courrier escargot.

Returning to the optimistic theme of this Spring Message, anyone with children can appreciate the joyous arrival of spring.

Longer daylight hours means more time to play outside without 22 layers of winter clothing, but it also means the return of that delightful bedtime protest of,

L’ACO poursuit sa campagne de sensibilisation des consommateurs à la télévision dans les deux langues. Plusieurs provinces ont choisi de nous emboîter le pas en achetant du temps d’antenne dans leur région. Il est prévu que la campagne s’étende sur trois années de plus.

“No maman, I CANNOT go to sleep, it is still light outside”.

L’ACO dispose d’un conseil d’administration dévoué qui travaille d’arrache-pied. Il s’agit d’un groupe collégial diversifié dont les membres possèdent un large éventail d’expériences tant en administration de la dentisterie qu’en orthodontie. Je vous invite à lire les rapports ci-joints pour vous tenir au courant des initiatives en cours au pays et comment notre association nationale œuvre pour épauler ses orthodontistes membres.

Message de la président Le printemps est évocateur de bonheur et d’optimisme. Les aléas du long hiver (voire du très long hiver dans l’est du Canada) sont derrière nous, et la chaleur bienvenue des longues soirées d’été suscite de grands espoirs. Le prolongement des jours est toujours opportun, pas tant pour travailler que pour profiter des agréments qu’offre la vie.

Plusieurs projets sont en cours, et les comités de l’ACO travaillent ferme, entre autres tâches, à la mise à jour du site Web, aux enjeux que soulève l’Agence du revenu du Canada (ARC) aux chapitres de la TPS/TVH et au nouveau protocole d’assurance.

Le site Web de l’ACO est mis à jour et à niveau tant pour en accroître la portée à l’intention de nos membres que pour le rendre encore plus convivial et formateur pour le public. Test rapide : quelle est l’adresse du site Web de l’ACO? Si vous l’ignorez, vous devriez visiter le site des membres, à www.cao-aco.org, et celui réservé au public, à http://yoursmileourspecialty.ca/fr. Le contenu du site des membres a été considérablement enrichi. Vous y trouverez les annonces de notre campagne de sensibilisation du public actuelle et le reportage de Global News sur les dangers de confier ses soins orthodontiques à un dentiste généraliste. Entièrement bilingue, le site public offre de l’éducation destinée aux patients, un service de localisation des orthodontistes et des témoignages de clients qui ont reçu des soins. Je vous invite à visiter le nouveau site pour constater à quel point il s’agit d’une ressource précieuse pour votre exercice et pour vos patients.

L’orthodontie évolue et nous devons tous nous adapter aux avantages et aux inconvénients nouveaux. Les patients tiennent toujours les traitements orthodontiques en haute estime. Mais les avancées technologiques qui rendent l’orthodontie plus efficace avantagent les orthodontistes tout autant que d’autres professionnels et nous devenons les victimes de notre propre succès.

Tous les orthodontistes connaissent bien les difficultés qui se posent pour la profession; il est essentiel que les organisations régionales et nationales œuvrent de concert. Et il est tout aussi important que les orthodontistes agissent en partenaires qui s’épaulent pour le plus grand bien des spécialistes de la prochaine génération.

Et pour en revenir au thème optimiste de mon message printanier, tous les parents peuvent goûter le retour joyeux du printemps. Si le prolongement des heures de clarté nous permet de jouer à l’extérieur sans 22 pelures de vêtements d’hiver, il est aussi synonyme du retour de cette délicieuse protestation qui se manifeste à l’heure du coucher : « Non, maman, JE NE PEUX PAS aller me coucher, il fait encore clair! »

Certains membres ont signalé qu’ils ont fait l’objet de vérifications portant sur la TPS/TVH et qu’ils ont reçu la visite de vérificateurs à leur cabinet. Veuillez consulter le rapport sur la TPS/TVH joint au présent bulletin pour en savoir davantage. Si vous faites l’objet d’une vérification, veuillez relater votre expérience à l’ACO et lui rapporter les propos des vérificateurs ou de l’ARC. Une rencontre avec l’ARC est prévue à l’agenda de notre trésorier. Peu après, il nous en brossera un tableau complet. N’ayez crainte : l’ACO poursuit des entretiens activement avec l’ARC et défend ses membres avec énergie.

Le comité de l’Assurance s’est attaché à amener le processus de prédétermination à l’ère numérique. Les lignes directrices de

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CAO Bulletin • SPRING 2015

Getting 4 people to look in the same direction is about as easy as getting 4 orthodontists to come up with the same treatment plan!

A Senior Resident’s Perspective Dr. John Scalia, University of Toronto Everyone has his or her own personal journey “en route” to graduate school. Interestingly, whether one has children to bathe, a significant other to enjoy, and/or a family to attend to, common goals bring residents together to maximize learning, productivity, and clinical experience in preparation for a wonderful career. I use the word “wonderful” proudly and cautiously, yet without hesitation.

Graduate school feels like a wonderful trance: spiraling from the excitement of acceptance, to re-adaptation to student-life, to graduate exams in statistics, to the completion of graduate courses, to designing research and publishing research, and best of all, to providing orthodontic treatment to amazing patients. Many (many) years of university, striving for excellence, soaking in knowledge, heart and soul, with one purpose: to understand how to provide a beautiful smile.

Residency opens one’s eyes: whether it’s when a teenager shrugs his or her shoulders saying “I don’t know, my parents told me I need braces,” or when a patient strives to change his or her facial appearance. We really do allow smiles, and people, to blossom. We really do allow self-confidence to sparkle.

We really do straighten teeth, yet at the same time, we do not perform miracles.

Perhaps this last statement sounds somewhat cliché. Am I living in a bubble? Fundamentally, the truth is that as young orthodontists we must be strong, proud, positive, realistic, and united. That is, if we want to protect our specialty.

When I received word that I had been accepted to the University of Toronto, I received two very different, yet interesting, reactions from clinical instructors in my general residency program. The first, “Wow! Congrats! Dr. Woodside established a legacy! You will learn about functional appliances!” The second, “Ha! Another orthodontist! Where do you think you’re possibly going to work?” The second reaction is the greatest puzzle of all. Where will new graduates work?

Fortunately (or unfortunately), traditional employment options have diversified so that they now include: operating an independent orthodontic clinic in a dental or a specialty clinic, associating in a corporate orthodontic clinic, part-time general dentistry, and/or purchasing or creating a general dental clinic.

Revolutionary employment options may include trucks with a mobile orthodontic clinic in the cargo. Let us imagine a day where in addition to Facebook postings to increase exposure, we will have to drive a truck to a high school parking lot and treat patients in a 12’ x 12’ box. Will we also serve hot dogs?

I can hear the rumbling.

Anything is possible. Real challenges lie ahead. We have even more reason to communicate, to share experiences, to share concerns, and to unite. See you at the New and Younger Members luncheon at the Annual Scientific Session in Victoria!

I N M EMORIAM Dr. John S. Little Dr. Little was born in Viking, Alberta in 1929 and was raised in Edmonton. He obtained his DDS from the University of Alberta in 1954 where he was awarded the Harry Gilchrist prize in prosthetic dentistry. Upon graduation, Dr. Little established a general dental practice while still finding the time to lecture in the departments of restorative, prosthetic and dental hygiene at the University of Alberta Faculty of Dentistry. Dr. Little returned to the University of Michigan to specialize in orthodontics, graduating in 1963.

Jack was a past president of the Canadian Association of Orthodontists (1973) and the Alberta Dental Association (1976). He also served on the Board of the Royal College of Dentist (1983-1989) and was a Fellow of the International College of Dentists.

Jack was married to Stella and together they had five children.

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CAO Bulletin • SPRING 2015

Committee Reports

Treasurer’s Report Dr. Michael Patrician Treasurer Email: drpatrician@bellnet.ca As of December 31, 2014, the general operations of the CAO had generated net income of -$34,165.07 and the Scientific Session had generated net income of $5,611.71. The net combined revenue of the CAO as of December 31, 2014, was -$28,553.36. The total members’ equity was $553,264.19 and the total current assets are $760,000.26.

The dues for 2015 were increased by $20.00 to $635.00+ HST partly in response to the continuing anticipated costs of the Consumer Awareness Program (CAP), the future website redevelopment and a possible communications audit in 2015.

The CAO general operations are proceeding according to plan. The Board anticipated a decrease in operating net income by year end primarily as a result of additional CAP expenditure. The membership committed to a three year CAP expenditure that started in 2014 and will continue until 2016.

Three contingency funds are being initiated to safeguard future CAO operations. It is prudent to segregate these funds as they commit to specific projects or ongoing operational member benefits. The three contingency funds are the General Operations fund, the Scientific Session fund and the CAP fund.

Insurance Report Drs. Mike Wagner & Don Johnston Co-Chairs, Insurance Committee Email: wagner.orthodontics@gmail.com johnston.donald@gmail.com Chairing the recently formed insurance committee has not been an easy task. Positive change is on the horizon as we move into the age of technological convenience. The mission is to move into the digital realm with insurance predetermination and claim submission.

The committee has been working diligently with multiple professional groups including the CDA, CLHIA, multiple software developers and the CAO Board to pioneer a digital system that is based on the current submission system but is quicker, more reliable, and more convenient. The committee’s mandate is to preserve the current rapport with all Canadian insurance providers whilst streamlining the process towards instantaneous or near instantaneous predetermination. The ultimate goal is electronic predetermination by 2017.

Aside from this new venture, the insurance committee will continue to advocate on the members’ behalf when dealing on insurance-based issues. Assistance is available when completing the current CAO form or any other challenge no matter how big or how small. Should you have any questions regarding insurance processing, predetermination or other related concerns, please do not hesitate to get in contact with either representative.

CAO/AAO Report Dr. Rick Odegaard CAO/AAO Liaison Email: dr.odegaard@shawcable.com The AAO has launched a new and improved version of its consumer website, mylifemysmile.org. The site attracts about 300,000 visitors per year. The site emphasizes the advanced education and specialty qualifications of orthodontists. The new design of the site is compatible with mobile devices.

The AAO Consumer Awareness Program has a new look with a newly designed website, and the availability of promotional materials for member use and customization. A guide has been produced to facilitate member’s customization of AAO Consumer Awareness materials including print advertisements, television and radio commercials and web banner ads.

The materials are available online at aaoinfo.org.

AAO Services Incorporated helps broaden the array of member benefits. These benefits include an endorsed practice finance program, an endorsed agreement with Social Finance Incorporated (to address student debt), approved credit card Continued…

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Committee Reports processing, a reduction in MedjetAssist rates and additional insurance, human resource, and management products available to AAO members at discounted rates.

Customers can support their favourite registered charities and non-profit organizations when making purchases on amazon.com The AAO Foundation has registered and the AAO Donated Orthodontic Services Program is in the process of registering. Amazon donates 0.05 percent of purchases back to the registered organization.

Currently 90 percent of qualified American orthodontists are members of the AAO. Ensuring that the governance process meets the needs of future orthodontists is one key element to maintaining strong membership levels. Beyond governance, it has been determined that the AAO will need to convey the benefits of AAO membership to future orthodontists.

To ensure that the AAO maintains sufficient membership numbers it is placing an increased emphasis on the recruitment and the engagement of younger members. The AAO will focus on communication with younger members, specifically about what membership can offer and what they have to offer to the AAO. This process is especially important for residents as they often do not have the time to examine AAO member benefits.

The most recent AAO survey indicates that nearly 32 percent of members in practice for less than five years are employees of large corporations and multidisciplinary practices and the concern is that these entities may not place high value on professional memberships. The AAO has developed a number of strategies for communication with younger members and an extensive list of benefits of membership in the AAO. Refer to the AAO Bulletin, Vol. 32, No. 2 April 2014, for more information.

CFAO Report Dr. Stephen Roth CFAO President

Notice of Assessment Any assessment to be imposed on the general membership must first be approved by the Board and then sent to the general membership in writing at least three months in advance of the Annual General Meeting. At the AGM, a vote will be held to approve the assessment.

The Canadian Foundation for the Advancement of Orthodontics (CFAO) held a meeting of the Board of Directors via conference call on February 17, 2015. The CFAO CRA mandated Distribution Quotient for 2014 was $9480.12. The actual amount of distribution was $21,222.

An assessment of $250.00 in addition to the annual dues for 2016 and 2017 for full active members was passed in principle by the Board of Directors at the 2015 ad interim meeting. The assessment is to support the financial commitment made by the CAO to the Consumer Awareness Program (CAP).

The silent auction in Montreal raised $3,890. This amount is lower than the previous year, as a major item generating significant bidding, as was the case in 2013, was absent in 2014.

Thanks again to all the individuals and the component associations who donated items to the auction.

For all other membership categories, the assessment is levied according to the following proportions:

Congratulations to the organization committee for the success of the Student Research Symposium at the 2014 Scientific Session. The CFAO was pleased to financially support this worthwhile event.

AC1

0 percent

($0)

AC2

25 percent

($62.50)

AC3

50 percent

($125.00)

Academic

50 percent

($125.00)

A member who resigns his or her membership during the assessment years is responsible for fulfilling the requirement for reinstatement as outlined in the policy and procedures manual of the CAO.

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Email: stephenfroth@mac.com

CAO Bulletin • SPRING 2015

A special letter was included with the mailings for annual membership to retired and life members and cards were sent thanking those who made their annual contribution to the CFAO while renewing their membership. There are six new McIntyre Fellows.

The CFAO Board of Directors passed a motion to provide up to $25,000 for the implementation of the Smiles 4 Canada

Committee Reports program. The National Program Board of Directors has been working hard to prepare the program for launch. Nova Scotia, New Brunswick and Prince Edward Island have been chosen as the location for the pilot program. A logo has been developed, construction of the website is underway and the application package is nearly complete. At present, legal counsel is developing the consent and release form and individuals have volunteered to act as the Regional Program Director and Regional Committee members. A volunteer is required from Quebec to join the National Program Board of Directors prior to launch of the program.

CAP Report Dr. Sheila Smith Email: stuart.smith4@sympatico.ca The Consumer Awareness Program has several different arms this year. The AAO has purchased airtime exclusively on the “W” network for the English commercials and will run October 2014 through to May and June, 2015.

The CAO has purchased airtime on the CBC and E! Channel in English and on RDC in French. The CBC programming included Heartland, various figure skating competitions and award programs with E! Channel including specialty award programs as well.

British Columbia, Alberta and Ontario are supplementing the CAP program. Each province purchased extra airtime from December, 2014, through to late March, 2015. BC and Alberta have additional airtime on CBC while Ontario selected CHCH which airs both provincially and nationally.

The funds invested for the CAP program by jurisdiction is the AAO ($ 307,000 USD) the CAO ($ 73,325), BC ($ 32,000), Alberta ($ 25,000) and Ontario ($ 30,387). Both the CAO and AAO purchase airtime for French commercials based on the percentage of Quebec membership in the organization.

Discussions with Athorn Clark indicate that the same creative will be used throughout the current year. If this is the case then the budget for next year should include a five percent increase for possible increased media costs.

RCDC Report Dr. Tom McIntyre Orthodontic Councillor, CAO/RCDC Liaison The 49th Annual Convocation of the RCDC occurred on the September 20, 2014.

Thirty-three candidates were awarded Fellowship in Orthodontics. Unfortunately only a few attended the ceremony. The Annual General Meeting was held the next day. Dr. Hugh Lamont was installed as President and subsequently Dr. Jim Posluns has assumed the role as Treasurer. Dr. Keith Morley has recently been selected as the new Registrar.

Chief Examiner Dr. Lesley Williams and her team are preparing for the upcoming exams. The Component I written exam was held March 7, 2015. The Component II oral exam is scheduled for June 19 and 20, 2015. The entire examination team is to be commended for their dedication to providing a current, fair and equitable exam for all candidates.

The 50th Annual Convocation of the RCDC will be held in Toronto on Saturday September 19, 2015 with the Annual General Meeting to follow on Sunday. Unfortunately these dates conflict with the CAO Scientific Session in Victoria.

New and Younger Members Report Dr. James Posluns New and Younger Members Representative Email: james.posluns@utoronto.ca This year’s presentation at the New and Younger Members Luncheon at the Scientific Session on Friday September 18, 2015 is a panel discussion entitled “Practicing in a Competitive Area: It Can Be Done”. The panel is made up of four individuals from across the country who have recently established successful practices. The speakers include Stephen Budd (Langley BC), Austin Chen (Vaughan, ON), Lorne Kamelchuk (Calgary, AB) and Bruno Venditelli (Toronto, ON).

The presentation will take approximately one hour with time for discussion to follow.

The New and Younger Member’s group is diverse and spread across a large geographical area. It is a challenge to connect on a regular basis outside of the Scientific Session. One of the initiatives in the works is to arrange regular conference Continued…

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Committee Reports calls with those new and younger members interested in participating in discussing issues relevant to this unique group.

WFO Report

In this edition of the Bulletin, be sure and see the article from a senior resident ‘straight from the trenches’.

Email: a_maple@shaw.ca

Communications Report Dr. Daniel Pollit Communications Chair Email: dpollit@rogers.com The Committee has started to revise the current CAO website. The goal is to remove content meant for public viewing and to reorganize the remaining content to give it a new look. The revised Members Only website is to be presented at the Scientific Session. A sample of the landing page and a subsequent page layout were presented at the Board of Directors Meeting in February. The direction of the website was positively met, and the Committee continues its work.

The Committee has considered the addition of a selfie submission section to the public website. There is a modest initial start-up cost followed by minimal maintenance costs thereafter. The program is analogous to the AAO selfie submission section, “What Makes Me Smile”. Of principle importance is in acquiring appropriate consent for younger individuals. Unique names under consideration for this section include “Show Us Your Smile, Eh” and “Share Your Smile”. Suggestions are always welcome.

Eric Selnes surveyed a segment of the membership to explore social media and to assess how it can be used by the CAO. At present Bracespace, the initial CAO social media endeavour, is relatively quiet. If traffic continues to be light, Bracespace may be discontinued.

Dr. Amanda Maplethorp WFO Committee Come to London September 27 to 30 for the 8th International Orthodontic Congress.

This is a great opportunity for doctors and staff to see London and attend a world class meeting. Early bird registration ends June 2. Check out http://wfo2015london.org/ for more information.

The CAO is well represented at the WFO. Dr. Garry Solomon attended the WFO Breakfast Meeting held in conjunction with the AAO meeting in New Orleans on our behalf. In London, Canadian orthodontists will be represented by Drs. Michael Patrician and Ritchie Mah. I will be there as a North American representative to the Executive Committee. Come and join us in London!

HST Report Dr. Michael Patrician GST/HST Advisor Email: drpatrician@bellnet.ca The CAO has started negotiations with the CDA and the CRA to clarify the GST/HST, ITC (Input Tax Credit) Program for Canadian orthodontists. In response to the increased frequency of GST/HST audits, a meeting was proposed with CRA to investigate how to best submit ITC's for GST/HST rebates.

The CAO and the CDA are working with the CDA's accounting/tax advisory firm KPMG in formulating a position. A letter was recently received from CRA in support of the meeting but also warning that the national GST/HST, ITC program for dentists/orthodontists may be terminated. The goal is to maintain the ITC program, and to receive clarification on what is required to enable a smooth ITC system.

The CAO CDA and KPMG are composing a letter in response to CRA’s letter that confirms the meeting and outlines the history of the terms of the GST/HST program that were initially negotiated. The thought process is that by refreshing the memory of those key individuals in the central CRA office of how the program was initially negotiated by Dr Brian Hicks and the CDA, the position to save the ITC rebate system may be strengthened.

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Committee Reports CDSA Report Dr. Robert Kinniburgh CDSA Liaison

I N M EMORIAM

Email: drbob@ncortho.ca

Dr. Roderick H. Florence

The CDA is preparing to lobby for tax exemption status for private healthcare insurance. Additionally, the group is looking into complaints about foreign-trained dentists. The CDA is working with the dental regulators to determine what can be done, so that complaints do not become a government issue, but rather one of regulation.

The CDSA is looking for representation on any provincial specialty organization in order to provide guidance and support.

The CDA is currently reviewing their Code of Ethics, and should be done by late spring. The CDA will be funding the CDSA representatives travel to their meeting in April for the next two years, where issues of HST and NIHB will be discussed.

Dr. Florence was born in Edmonton in 1943. He obtained his DDS from the University of Alberta in 1967 and practiced general dentistry in his home town for 11 years.

Rod completed his training in orthodontics at the University of Alberta in 1983. Upon graduation, Dr. Florence practiced full-time in Edmonton. He also was a part-time instructor initially in pediatric dentistry and later in undergraduate orthodontics at the University of Alberta dental clinic.

Dr. Florence was married to Edyth and together they had two children.

Helpline Numbers Available for Member Assistance Programs (MAP)

CFAO Donations Since Fall 2014 Dr. Brent Cote McIntyre Fellow Dr. James F. Hickman McIntyre Fellow Dr. Robert D. Kinniburgh McIntyre Fellow

Nova Scotia Professional Support Program (PSP) 902-468-8215 Quebec (Medi-Secours) - 514-440-4520 Ontario and Manitoba (CDSPI) English - 1-800-265-5211 French - 1-800-363-3872 Saskatchewan (PAR Consulting) – Saskatoon: 1-800-978-8282 or 306-652-3121 Regina: 1-877-352-0680 or 306-352-0680

Dr. Rajean Labrie McIntyre Fellow

Alberta (Confidential Assistance Program – CAP) 1-800-226-6433

Dr. Stephen Miller McIntyre Fellow

British Columbia (CDSPI) – English - 1-800-265-5211 French - 1-800-363-3872 or Dental Professional Assistance Plan (DPAP) 1-800-661-9199

Mr. & Mrs. William Hergott In Honour of Dr. Jeffrey S. Corbett

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This list of contact numbers will provide support to any CAO member who might need or seek additional support in a crisis situation affecting their personal lives. These are anonymous contacts and will provide support and resources for a variety of situations.

CAO Bulletin • SPRING 2015

Student Posterboards Abstracts from the 2014 CAO Annual Scientific Session – Part 2 of 2 part series

University of British Columbia MICROSENSOR TECHNOLOGY TO EVALUATE PATIENT ADHERENCE WITH REMOVABLE ORAL APPLIANCES Authors: Kirshenblatt SJ1*, Chen H2, Lowe A2, Pliska B2, and Almeida F2 1Graduate Orthodontics, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada; 2Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada OBJECTIVE: The aim of this study was to evaluate the accuracy of 3 thermosensitive microsensors, which record “weartime” of removable oral appliances (OA).

METHODS: In vitro testing was undertaken for TheraMon (Sensor T, n=20), AIR-AID SLEEP (Sensor A, n=30) and DentiTrac (Sensor D, n=16) microsensors, which were placed in a water bath to simulate long and short durations of “wear” of OA. Their accuracy when embedded into 3 different materials, acrylic, polyvinylchloride, and thermoactive acrylic, was also assessed. In vivo testing included 14 volunteers who wore maxillary retainers embedded with Sensor A and D for 30 nights. Logs of appliance usage were compared to the sensors’ readouts.

RESULTS: In the in vitro long durations of “wear” assessment, Sensor A, with a mean absolute response difference (MARD) of 1.67 ± 1.41 mins, was significantly more accurate than Sensor T, with MARD of 3.53 ± 9.80 mins, and Sensor D, with MARD of 4.48 ± 8.46 mins. For short durations of “wear”, Sensor A (MARD of 1.41 ± 3.60 mins) and Sensor T (MARD of 1.68 ± 7.64 mins) were equal in accuracy and significantly better than Sensor D (MARD of 14.07 ± 10.20 mins). There was no effect of the embedding material on the recording accuracies of the microsensors. In the in vivo phase, there was no significant difference between Sensor A and Sensor D.

University of Alberta THIS STUDY EVALUATED THE AMOUNT OF APPARENT ROOT RESORPTION (RR) IN THE INCISORS THAT DEVELOPED FOLLOWING NON-EXTRACTION TREATMENT TO CORRECT CLASS II MALOCCLUSIONS WITH EITHER THE FORSUS OR XBOW APPLIANCE Authors: Long, Dr. Tieu Objectives: This study evaluated the amount of apparent root resorption (RR) in the incisors that developed following nonextraction treatment to correct class II malocclusions with either the Forsus or Xbow appliance.

Methods: 70 Pre-treatment (T1) and post-treatment (T2) panoramic radiographs of consecutively treated patients were assessed for RR. RR was calculated by subtracting tooth length (T1 from T2) and multiplying it by the adjusted crown length (T1 divided by T2). Additionally, Two titanium beads were placed on a rapid prototyping (RP) model of the maxillary and mandibular incisors at the apical and incisal edge. The apparent radiographic length was measured from the midpoint of the beads on the incisal and apical edge. This value was compared to the known length and adjusted for magnification using the calculation mentioned previously.

Results: Of the clinical cases assessed, 1.4% showed no resorption, whereas 62.9% reported mild to moderate resorpContinued…

CONCLUSION: All 3 microsensors have high accuracy and reliability and can be used to record the wear-time of a removable OA fabricated from different materials. (*Presenter)

Poster presenter, Dr. Tieu Long, Alberta

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CFAO Graduate Student Posterboards tion (32.9% mild resorption, 30% moderate resorption). Finally 35.7% of the cases studied, had at least one incisor with severe resorption, with 80% of the severe cases involving the mandibular incisors. RP tooth models, measuring the effects of angular changes of incisors on the projected length of tooth, confirmed the clinical findings that as the mandibular incisors procline, the angular change produces an apparent RR when visualized on a panoramic film.

Conclusions: By developing an appreciation for the amount of radiographic foreshortening that may occur due to incisor angulation, clinicians may better recognize cases of true RR vs. cases of apparent RR due to foreshortening.

University of Alberta ASSESSING RISK OF BIAS OF CLINICAL TRIALS INCLUDED IN ORTHODONTIC SYSTEMATIC REVIEWS: CROSS SECTIONAL STUDY Authors: Humam Saltaji; Susan Armijo-Olivo; Greta G. Cummings; Maryam Amin; Carlos Flores-Mir BACKGROUND AND OBJECTIVES: Assessing the methodological quality of clinical trials is an essential step when selecting the best clinical evidence and conducting systematic reviews (SRs) of orthodontic interventions. The objectives of this study were to: (1) describe all SRs published in orthodontics; and (2) identify the tools used to assess risk of bias of studies included in these SRs. METHODS: An electronic search of seven databases was performed. Studies were included if they were therapeutic or non-therapeutic orthodontic SRs. Data were extracted from all the included SRs on key descriptive characteristics and methodological quality assessment tools used in these SRs.

Poster presenter, Dr. Saltaji Humam, Alberta

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CAO Bulletin • SPRING 2015

RESULTS: 138 orthodontic (15 Cochrane and 123 nonCochrane) SRs were identified. 81.9% of the SRs were categorized as therapeutic, with 92.9% examining non-drug interventions, while approximately third (n = 8/25; 32%) of the non-therapeutic SRs were classified as epidemiological SRs. The SRs included a median of 11 studies, with a meta-analysis conducted in 31.2%, in which a median of 7 studies/ 1 RCT were included. Risk of bias assessment was performed in 60.6% of the SRs. 11 (8%) of the SRs used the Cochrane tool/Handbook, 10 (7.2%) used methodological quality items adapted from more than one risk of bias tool, while almost quarter (n = 22; 33.3%) of the SRs used a non-validated methodological checklist.

CONCLUSION: Methodological and descriptive characteristics varied extensively. There is a clear need for more orthodontic primary studies, and for a methodological quality assessment tool designed specifically for assessing quality of orthodontic trials.

University of Alberta MEASUREMENT TOOLS FOR THE DIAGNOSIS OF NASAL SEPTAL DEVIATION CAUSING AIRWAY OBSTRUCTION: A SYSTEMATIC REVIEWS Author: Aziz, Dr, Tehnia OBJECTIVE: To perform a systematic review of measurement tools utilized for the diagnosis of nasal septal deviation (NSD) causing airway obstruction in orthodontic patients.

METHODS: Electronic database searches were performed until August 2013, using MEDLINE, EMBASE, Web of Science and all Evidence Based Medicine Reviews Files (EBMR); Cochrane Database of Systematic Review (CDSR), Cochrane Central Register of Controlled Trials (CCTR), Cochrane Methodology Register (CMR), Database of Abstracts of Reviews of Effects (DARE), American College of Physicians Journal Club (ACP Journal Club), Health Technology Assessments (HTA), NHS Economic Evaluation Database (NHSEED). The search terms used in database searches were ‘nasal septum’, ‘deviation’, ‘diagnosis’, ‘nose deformities’ and ‘nose malformation’. The studies were reviewed using the updated Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.

RESULTS: A total of 8 studies were identified, selected and systematically reviewed. Diagnostic modalities such as acoustic rhinometry, rhinomanometry and nasal spectral sound analysis may be useful in identifying NSD in anterior region of the nasal cavity. However, compared to anterior rhinoscopy, nasal endoscopy, and imaging the above mentioned index

CFAO Graduate Student Posterboards tests lack sensitivity and specificity in identifying the presence, location, and severity of NSD.

University of Manitoba FACIAL SOFT TISSUE EFFECTS OF A DISTALIZING APPLIANCE Author: Ward RJD*, Wiltshire WA, Graduate Orthodontics, College of Dentistry, University of Manitoba.

OBJECTIVES: To quantitatively compare the soft tissue effects observed in patients treated with a molar distalizing appliance that exhibit either brachycephalic, mesocephalic, or dolichocephalic facial patterns.

SUBJECTS AND METHODS: A retrospective chart review consisting of 80 subjects with Class II malocclusions where subjects were categorized into three growth types based on their pre-treatment cephalometric variables (MPA, Y-axis); 20 brachycephalic, 40 mesocephalic, and 20 dolichocephalic were all treated with a X-bow appliance (manufacturer). Bolton growth predictions of 30% of the sample served as the control group. Data was compiled using digital cephalmetric analysis on the pre-treatment (T0) and post-treatment (T1) radiographs. A one way ANOVA test was used to investigate the differences between the three facial groups at T0 and T1 time points.

RESULTS: Soft tissue effects induced by the appliance during Class II correction included; reduction of soft tissue convexity (2.1-2.6±0.6o p<0.05), increase in the mentolabial angle (8.013.9 o ±0.3 o p<0.05), increased distance of Rickett’s E plane to upper (0.8mm-1.0mm±0.13mm p<0.05) and lower lip (0.3mm-0.4mm±0.1mm p<0.05). Mesocephalics were found to have significantly greater reduction in soft tissue convexity, increase in the mentolabial angle, and increase in the distance of Rickett’s E plane to upper and lower lip, than dolichocephalics (p<0.05). Mesocephalics were also ob-

Thank you to GAC for their support of the Latest Advances in Canadian Orthodontic Research Symposium and the CFAO Posterboards

served to have significantly increased distance of Rickett’s E plane to upper and lower lip than brachycephalics (p<0.05).

CONCLUSIONS: Soft tissue effects observed appear mainly due to retroclination of the upper incisor (retrusion of upper lip including subnasale, lower lip, and increased mentolabial angle). Differences between facial patterns, although statistically significant in regards to soft tissue effects observed, may not be clinically significant. Nevertheless, clinicians should be aware of appliance induced effects.

University of Manitoba PREVALENCE OF INCIDENTAL FINDINGS IN PANORAMIC RADIOGRAPHS IN AN ORTHODONTIC POPULATION Author: Senye, M., Ahing, S., Pinheiro, F., Sam, A., Wiltshire, W. INTRODUCTION: About 90% or more orthodontists request pre-treatment imaging, usually a panoramic radiograph. The prevalence of incidental findings on panoramic radiographs in an orthodontic population as well as image quality was assessed.

MATERIALS AND METHODS: panoramic radiographs of 300 males and females between 10-60 years were selected using an electronic research aid website. Exclusion criteria were systemic disease or a craniofacial syndrome. The "prevalence and bias-adjusted kappa" (PABAK) test showed high intraand inter-rater reliability (>0.8) for every analyzed item, except for some technical or exposure errors. A customized data entry form was used to systematically record and analyze the radiographs independently by 2 observers.

RESULTS: The most common findings were unerupted or impacted third molars (14%), missing third molars (12%), calcified stylohyoid ligament (8%), mandibular idiopathic osteosclerosis (7.5%) and maxillary sinus opacification (7%).

Discussion: Individualized monitoring or referral may be needed for (a) unerupted third molars since predictive criteria for impaction are unreliable (b) missing third molars or idiopathic osteosclerosis in case tooth-bud development is delayed in the former and symptoms occur in the latter (c) long and symptomatic calcified stylohyoid ligaments (d) maxillary sinus opacification since the panoramic technique facilitates artifacts CONCLUSION: 25% of the patients in this study showed at least one abnormal finding. The most common findings were related to development and eruption of third molars and opacifications of the stylohyoid ligament, mandible and maxillary sinus. A referral was merited in 14.5% of cases. Technical and exposure errors were common in the non-dentition areas.

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CFAO Graduate Student Posterboards University of Western Ontario AN IN-VITRO INVESTIGATION OF MECHANICAL MEASURES USED TO ASSESS ORTHODONTIC MINI-IMPLANT STABILITY Authors: Yara K. Hosein 1,4, Ali Tassi 1,4, S. Jeffrey Dixon 1,2,4, Amin Rizkalla 1,3,4 1 Division of Graduate Orthodontics, 2 Department of Physiology and Pharmacology, 3 Department of Chemical and Biochemical Engineering, 4 Schulich School of Medicine and Dentistry Western University, London, Ontario, Canada, N6A 5C1 Stability of orthodontic mini-implants used for skeletal anchorage is achieved by mechanical retention that occurs at the implant-bone interface. Within the literature, numerous techniques for measurement of mini-implant mechanical stability have been utilized; however, few studies have compared these mechanical measures to determine their agreement in predicting mini-implant success. This study aims to investigate the various methods currently available to assess orthodontic mini-implant stability.

Self-drilling mini-implants from three different manufacturers (Aarhus, Medicon; Dual-Top, Jeil Medical Corporation; OrthoEasy, Forestadent) will be inserted into artificial bone blocks (Sawbones®, Pacific Research Laboratories) using a custommade device. A load sensor (6 DOF, Advanced Mechanical Technology Inc.) at the base of the bone block will measure insertion torques experienced during mini-implant insertion. Immediately following insertion, mini-implant mobility will be assessed using the Periotest® Stability Measurement System (Periotest®, Medizintechnik Gulden). Subsequently, the inserted mini-implant will be placed in a materials testing machine (8874 Axial-Torsion System, Instron ) for pull-out testing.

During pull-out testing, an optical measurement system will be used to track the displacement of the mini-implant relative to the surrounding bone block. Multiple Bland-Altman plots will be used to determine agreement between the various stabil-

ity measures, and intraclass correlation coefficients (ICC) will be used to assess the reliability of the various measures, for each mini-implant group tested.

Statistical comparisons of the stability measures are expected to show varying degrees of agreement and reliability. Overall, it is anticipated that this study will provide useful information to researchers and clinicians when deciding on appropriate measures to be used in determining mini-implant stability.

University of Montreal VALIDITY, RELIABILITY AND REPRODUCIBILITY OF DIGITAL MODELS OBTAINED WITH ITERO (ALIGNTECH) AND LAVA DIGITAL (3M) IN COMPARISON WITH PLASTER MODELS Authors: Vincent-Claude Péloquin*, Pierre Rompré, Athena Papadakis, Normand Bach, University of Montreal Objective: The primary objective of this study was to evaluate validity, reliability and reproducibility of dental measurements obtained on the digital models with iTero and Lava Digital in comparison with those obtained on the plaster models (gold standard). The secondary objective was to compare two different impression materials -alginate and polyvinylsiloxane (PVS)- and determine whether the impression material used affects accuracy of the measurements.

Methods: The first part of the study (laboratory) involved iTero and Lava digital models, which were all obtained from 25 pairs of plaster models randomly selected from one of the authors' private practice. Alginate and PVS impressions taken on plaster models have been scanned by Lava. The second part of the study (clinical) sought to compare iTero digital models (intraoral scans) with plaster models (alginate and PVS impressions) based on 25 patients from the Orthodontic clinic of the University of Montreal requiring orthodontic treatment. The operator time involved in scanning teeth with iTero and measuring digital models on a computer vs taking traditional impressions and measuring stone casts manually was noted to evaluate the clinical efficiency of iTero. In both parts of the study, Bolton 6 and 12 analyses, arch length, intermolar and intercanine distances, overbite and overjet were measured by two authors.

Results/Conclusions: All results and statistics will be available by next August and therefore be presented at the 66th Annual CAO Scientific Session.

Poster Presenter: Dr. Yara Hosein, UWO

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CAO Bulletin • SPRING 2015

The Hicks Agreement of 1991: The ABC’s of GST, HST and ITCs Think back to what was new in 1991 and what is the first thing that comes to mind? Cellular telephones? Nope. Saturn cars? History. The Simpsons? Aye Carumba! The list is long but one item launched in 1991 is still with us today and is as popular with dentists as an ice cream stand in Antarctica; the beloved Goods and Services Tax (GST) also known today in some provinces as the Harmonized Sales Tax (HST).

If you still have the CDA Communique from October 1990, congratulations, you are officially a hoarder. But besides this somewhat scary revelation, you also have the source of this retrospective bit on how Revenue Canada, also known as the Canada Revenue Agency (What’s with this; changing the name to protect the innocent?) brought this delightful tax to the wonderful world of dentistry. So sit back, relax and enjoy the trip down memory lane.

Dr Robert Hicks, then Chairman of the CDA Taxation Committee, was charged with auspicious task of figuring out it all worked. In general, dentistry provided two types of services; tax-exempt and taxable. Tax-exempt services include all consultative, diagnostic or any other health care service, not including cosmetic procedures. Taxable services included cosmetic dentistry, all professional activities outside of clinical treatment and all commercial activities affiliated with the practice.

Dental practices incurred GST that applied to some, but not all expenses, depending whether or not they were classified as tax-exempt or zero-rated. Zero-rated meant that the expense was taxed at a rate of 0 percent. Exempt status meant that the consumer did not pay GST but the provider of this service or goods was required to pay GST on their supplies and services. Therefore a dental practice would pay the 7 percent GST on all of its taxable goods and services. Examples of taxexempt expenses included association and license dues, continuing education courses required to maintain licensure and all wages and non-taxable benefits. Examples of zero-rated expenses included orthodontic devices.

All orthodontic treatment services rendered to an individual were exempt from GST. All removable orthodontic appliances and supplies, instruments and equipment used to provide removable orthodontic appliances were unconditionally zerorated including orthopedic, removable, retaining, headgear and habit appliances.

All fixed orthodontic appliances that involved bands, brackets arch wires and all similar items were conditionally zero-rated.

Equipment, instruments and supplies used to provide or con-

struct orthodontic appliances were also taxable at zero percent and included bands, brackets, tubes, ligatures, attachments, screws, pins, headgear separators, stones, plasters, acrylics, waxes, study models, acids, gels, cements, sealants, pliers and cutters.

Through input tax credits, or ITCs, the percentage of the total orthodontic fee represented by the fee for the hard costs of the orthodontic appliances could be used to claim back that percentage of the GST on the portion of expenses that are not ‘appliances’ such as rent and office supplies. Historically the appliance cost represented by the initial payment of the total orthodontic fee had to be identified as a percentage of the total orthodontic fee. At each year end this percentage, represented by the initial payment/total fee was to be reconciled from all orthodontic fees charged and used as the percentage value for the above calculation on non-appliance/support costs. In orthodontic offices the initial payment (appliance fee) is charged at the beginning of treatment and the balance of the fee charged on a monthly basis. This has been the standard approach for forty years at least.

Since the inception of the Hicks Agreement, CRA has continued to reassess this agreement in detail. What appears relatively straightforward looking back from the comfort of 2015 was in fact the result of countless hours of negotiation between the CDA and Revenue Canada. Dr. Hicks was chair of the Taxation Committee since its inception in 1978. While not talking taxes with the government, Dr. Hicks was busy practicing orthodontics in British Columbia, but his role at the CDA was on behalf of all dentists in Canada.

Dr. Hicks accepted the invitation of the taxation committee because he was concerned about his practice being audited by Revenue Canada. Over time, his fear diminished and his skill in dealing with Revenue Canada evolved a result of his ability to speak the complex language of tax with those in the know.

His moderate, reasonable approach is proof positive that one really can catch more bees with honey. Scores of dentists across Canada have benefitted from Dr. Hicks’s tireless and skillful efforts in tackling the intricacies of this complex tax.

But in the world of government, tax and law, everything is subject to review. Dentistry is at risk of losing its unique status within the GST / HST taxation structure and this loss, should it occur would cost us all dearly. Like everything in 2015, with respect to GST/HST, the future remains uncertain.

Aye Carumba!

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Component Society Reports

British Columbia

Alberta

Dr. Jay Philippson

Dr. Todd Lee-Knight

Email: drgphilippson@shaw.ca

Email: todd@drlee-knight.com

Fall meetings for the BCSO were held on September 29 and November 24, 2014.

At the September meeting the CAP initiative for BC was discussed and an appeal was made to the membership. A levy of $250.00 per member was requested. $42,000.00 was allocated after the November meeting and the CAP advertisements have been running on BC airwaves.

The concern initiated by the CAO regarding GST audits was presented in September with the warning that the appliance fee must be included in the contract presented to the patient.

The BCSO is continuing its mentorship program and is requesting that volunteers to be available in order to strengthen support to its recently graduated members.

Pacific Blue Cross (PBC) is continuing to push the boundaries of the information required as part of the standard dental claim form. It appears to be less of a policy by PBC and more of a strict interpretation of the rules by individual assessors. Recently an orthodontist was asked to include Angle’s classification on a claim. In most instances the rejection is questioned and the denial is reversed without issue.

The Spring BCSO meeting was held March 6, 2015 and the AGM is scheduled for June 15, 2015, at the Mayfair Lakes Golf Club and the LuLu Winery and Spa.

Membership Milestones Congratulations to Dr. James S. Borovay, of Ottawa, Ontario on celebrating the 40 year milestone in your CAO membership in 2015!

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CAO Bulletin • SPRING 2015

The Alberta Society of Orthodontists held its Annual Scientific Session and Meeting on Friday April 10 and Saturday April 11, 2015 at the RimRock Hotel in Banff. Both days featured guest speaker Dr. James Mah, an alumnus of the University of Alberta Orthodontic Graduate Program. Dr. Mah is currently a Clinical Professor and the Program Director in Orthodontics at the University of Nevada, Las Vegas. His theme for the weekend was ‘New Vistas in Orthodontics’.

The ASO has continued to support the CAO Consumer Awareness Program by supplementing the national campaign with additional funding to enhance coverage within the province. The ASO has also continued its support of the CFAO through the donation of a weekend stay for two in Banff to the silent auction fundraiser at the CAO Annual Scientific Session.

Saskatchewan Dr. Mike Wagner Email: wagner.orthodontics@gmail.com Everything is relatively quiet on the home front as the Saskatchewanians eagerly await springtime. Planning continues for the Saskatchewan Society of Orthodontists Annual Meeting that is scheduled for November 6, 2015, in Regina. The SSO is looking forward to hosting our AGM this year in the capital city.

The transformation to all-digital communication is progressing.

A new website is beginning to materialize and plans are in the works to unveil the site later on in the year.

The SSO welcomes Brian Phee back to the province as an orthodontic specialist.

Component Society Reports Cont’d

Manitoba Dr. Susan Tsang

1, 2015. The concern centres on a potential conflict that may exist between the RCDSO standards and the EU Free Trade Agreement.

Email: s_tsang2@hotmail.com The fall Manitoba Orthodontic Society (MOS) dinner meeting was held on November 21, 2015. The meeting included a short continuing education component from Dr. William Kottemann, who presented on clear aligner therapy. The spring MOS meeting was held on April 23, 2015.

The MOS is pleased to see the first pro bono cases being started through the Manitoba Chapter of the Smiles for a Lifetime Foundation. The Foundation’s Board of Directors reviewed applications to determine those who best met the criteria to receive orthodontic treatment through the program. The applications demonstrated the tremendous need for programs such as this to assist low-income families and teenagers with severe malocclusion. Applications and information are available on the MOS website (www.mbbraces.com).

Ontario Dr. Sheila Smith Email: stuart.smith4@sympatico.ca The Ontario Association of Orthodontists has prepared the corporate bylaws that comply with the ONCA regulations. The final draft of the new bylaws has been disseminated to the membership and was unanimously passed at the Annual General Meeting in April 2015.

The Ontario Association of Dental Specialists has been resurrected and has resumed meetings to discuss common issues. Many specialties are unaware that CDSA exists.

Both of Ontario’s orthodontic chairs, Bryan Tompson (Toronto) and Antonios Mamandras (Western) recently addressed the OAO Executive. Both indicated that undergraduate training would have limited or no patient treatment and that the undergraduate program focus will be on diagnosis.

The purchase of orthodontic practices by dental corporations continues to be of concern as does the proposed CanadaEU Free Trade agreement that is to come into effect October

The OAO is in the planning stages of a second Scientific Session to be held in 2016.

Ontario mourns the sudden passing of Sol Laski, a recent OAO past president. Dr. Laski epitomized true ‘joie de vivre’.

He was an avid skier, golfer and traveler. See you at the bottom of the run, Sol.

Quebec Dr. Michel Di Battista Email: micheldibattista@gmail.com

On January 16, 2015, Barry Dolman, president of the Quebec Order of Dentists, called on the presidents of all of the province’s specialist associations to share ideas and recommendations that could help him to fulfill his mandate.

The president of the ADQ, Martin Rosseau, emphasized the fact that too many patients still falsely believe that, now, as in the past, that they are being treated by a specialist when this is not the case. Many recommendations were made on the subject.

The ADQ has asked Align Technology to remove from its website the provider grades because it suggests that some practitioners are better practitioners than others. The fact is that it is clearly contrary to the Quebec Code of Ethics. Yet in other countries, such as France, they comply with the local code of ethics.

Project ‘Bouche B’ was recently created by the Quebec Order of dentists to assist individuals who do not have access to orthodontic treatment. The highly respected Dr. Julien Foundation is now associated with ‘Bouche B’. The ‘Smile for a Lifetime Foundation’ has a division in the greater Montreal area. In addition the CAO is in the process of developing a ‘Smiles 4 Canada’ campaign. The ADQ wishes to unify these foundations under the single banner of ‘Bouche B’.

The feedback from the membership regarding the ADQ advertisements in La Presse has been positive overall.

Suite…

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Component Society Reports Cont’d Rapport de la province de Québec Le 16 janvier dernier, président de l`Ordre des dentistes de Québec, Barry Dolman, a convié tous les présidents des associations de spécialistes pour entendre les recommandations qui pourraient le guider dans sa mission premiére ; protéger, informer et promouvoir l`excellence en santé dentaire.

Notre président, Martin Rosseau, a remis en évidence, à cette occasion, un fléau qui a la vie dure. La fausse représentation, qui conduit encore et toujours de nombreux patients à croire à tort que leur dentiste est un spécialiste. Il a fait plusieurs recommandations.

déjà une division active dans la grande région de Montréal. Et, de la CAO vient s`ajouter `` Smiles 4 Canada``. Le souhait de l`ADQ est de rapprocher et d`unifier ces deux fondations à «Bouche B».

La publicité et les articles parus en octobre dans le journal «La Presse» ont été appréciés par nos membres.

Atlantic Report Dr. Don Johnston Email: info@taortho.ca

Conséquemment, nous avons demandé à Align Technology d`enlever les grades de «providers« afin que les dentistes ne puissent étre comparés avec les orthodontistes uniquement en fonction de leur expérience «quantitative». Ceci es aussi contrarie au code de déontologie du Québec. En France, la compagnie s`est pliée aux lois similaires aux notres. Il n`ya donc pas de «Doc locator» dans ce pays.

Projet « Bouche B » : La fondation de l`Ordre veut, par les biais de cette initiative, aider les plus démunis. La fondation du Dr Julien, dont la notoriété es immense, s`est associée au projet «Bouche B». Par ailleurs, La fondation «Smile for a Lifetime» a

The Atlantic Orthodontic Association (AOA) meeting was held on April 24, 2015, at the Delta Barrington Hotel in Halifax. An optional doctor and spouse meal followed at a local restaurant that evening.

Currently, the AOA is working with the CAO to amend the existing bylaws to conform to the newly enacted CAO bylaws.

Are you as smart as a 7 year old?

Straight Shooters

Each side of the triangle is comprised of 4 circles. Use each of the following numbers from 8 to 1 once to fill the circles so each side adds up to 20.

Why did the orthodontist sell his office to the veterinarian?

His practice was going to the dogs.

When trying to decide between Trident and Extra, defer to the periodontist.

He or she is a gum specialist.

A patient reported that they had sensitive teeth.

The dentist suggested they “toughen up” a bit Many thanks to Dr. Howard Tenenbaum for his contribution to Straight Shooters this time around.

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CAO Bulletin • SPRING 2015

– Answer on page 22 –

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

Hubris We finally really did it.

YOU MANIACS! YOU BLEW IT UP! AH, DAMN YOU! GOD DAMN YOU ALL TO HELL! Charlton Heston, Planet of the Apes, 1968

It is with great trepidation that I offer commentary on the recent events that occurred at the Faculty of Dentistry, Dalhousie University. Just in case you were either shipwrecked, visiting some other planet or just got back from a protracted visit to Disneyland, a select group of knuckle-draggers known paradoxically as the Gentleman’s Club thought it was a good idea to post multiple inappropriate and categorically offensive materials about their female classmates on the highly secure social media site, Facebook. At the time of this writing, the media has moved on to more pertinent events like Bruce Jenner’s gender, but this, in itself, is not surprising. Even the Twin Towers became old news eventually.

But the damage remains. Beyond what this scandal did at the local level, affecting young female victims in ways impossible to quantify, there is no denying that these thirteen male dental students did more damage to the profession in a matter of months than any one of us could have done in a lifetime. Dentistry already had an image problem, what with Zoom Whitening, cut-rate Invisalign and the inevitable transition to corporate America, but the Gentleman’s Club is arguably the iceberg that could down the unsinkable ship.

One wonders if our collective reputations can or will ever recover. Joan Rush’s article, Dentistry has a far larger

‘boys’ club problem (The Globe and Mail, December 24, 2014) is a shot straight through the heart of the profession. Ms. Rush warms up by scolding organized dentistry for its lack of diversity, then moves on to commend us on what a great job we are doing selling cosmetic dentistry and Botox to the rich and famous while withholding essential treatment to “Canadians who are poor, disabled, elderly or living in remote communities”.

After reading this article I was incensed.

The author is a lawyer. Now if that ain’t the pot calling the kettle black. I wrote to the editor, proverbially beating my chest (not too violently of course) in an effort to enlighten the public on how out-of-touch this barrister was and how she needed to be brought up to speed. I failed to see how the existence of ‘The Club’ meant the whole profession was in trouble. I informed Ms. Rush that dentistry was in fact diverse. I was proud to say that the CAO has many female directors and has a history of female presidency. Further, grass-roots programs, like the new CFAO

Smiles 4 Canada continue to rapidly emerge, augmenting the social programs that currently exist. To this letter, I received no response. Not surprising.

Authors like Ms. Rush are known as Trolls, published knowing that their articles generate fiery dialogue. Who knew Joan Rush was short, had orange hair and lived under a bridge? Not me.

Dalhousie stuck with its plan of restorative justice despite mounting public pressure and mercifully, the scandal began to fade. Then I opened the paper to Heather Mallick’s Dalhousie ‘cultural code’ another reason to be wary of the dentist (The Toronto Star, January 23, 2015).

In the interest of full disclosure, Ms. Mallick and I are acquainted and we conversed via email about Dalhousie.

Her article centered on the actions of one of the so-called ‘Gentlemen’ to distance himself from the rest of ‘The Club’, but the ubiquitous theme that dentistry is in trouble and that dentists, now more than ever, aren’t to be trusted came through loud and clear.

“Now even the kindest dentist is alarming. When I was 6, I went for my first visit and the dentist choked me so badly that I didn’t go back until I was in my 30’s”, reports Ms. Mallick. “Dentists are frightening because they enter your body, with your stated permission and chat away while you answer “gggnnnnhh” which emphasizes the power imbalance. Open wide they say and no one wants to do that, especially not with the segregated male students inhabiting Dalhousie at the moment”. I Continued…

SPRING 2015 • CAO Bulletin

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From the Editor Cont’d.

September 27-30th 2015 did mention that Heather is a friend of mine, didn’t I? It’s easy to brush off the opinions of these two authors and to categorize them as ‘Lone Wolves’; paid assassins with some sort of weird vendetta against the dentally inclined. That’s what I thought at first. Then it dawned on me. These writers are speaking from the trenches, imploring with us to wake the heck up.

Call Dalhousie whatever you want; a scandal, a bunch of evil misogynists or just a bunch of boys doing what boys have done since Adam took the first bite; the categorization doesn’t matter. What does matter is that this profession, and all the professionals that work so hard to uphold its core values, is so fragile that it apparently takes but a mere thirteen flawed dental students to bring it to its knees. And that’s a serious concern.

But don’t take my word for it. Read the plethora of posts that follow these aforementioned articles and count the number of ‘Likes’. Very scary stuff.

The people have spoken. It’s high time we listened.

Happy (niti) Spring!

Jimmy P

The WFO is active on behalf of orthodontists around the world, working with over 100 orthodontic organizations through networking, opening lines of communication and providing resources.

In less than one year from now, London England will be the host of one of the most interesting orthodontic meetings of the year. Since the IOC meetings only happen once every five years, they are unique – with exceptional scientific sessions, fabulous exhibits and the city itself, full of opportunities for social events- not just with the convention – but everywhere (including theatre, rugby games, and more.)

The meeting takes place in London’s premier conference venue, ExCeL, which is located in an area of the city that has undergone a renaissance as a result of the Summer Olympics in 2012 including a brand new transport system that whisks attendees into central London in mere minutes.

Visit http://wfo2015london.org to learn more about the 8th IOC.

Canadian Association of Orthodontists

UPCOMING ORTHODONTIC MEETINGS 2015 May 15-19 . . . . . .AAO Annual Session, San Francisco, CA Sept 10-13 . . . . .NESO Annual Session, Providence, RI Sept 17-19 . . . . . .CAO Annual Scientific Session, Victoria, BC Sept 27-30 . . . . .International Orthodontic Congress, London, UK October 8-10 . . .MSO Annual Session, Rochester, MN Puzzle Answer from page 31:

2016 Sept 15-17 . . . . .CAO Annual Scientific Session, Charlottetown, PEI

2017 Sept 14-16 . . . . .CAO Annual Scientific Session, Toronto, ON

2018 Sept 6-8 . . . . . . . .CAO Annual Scientific Session, Vancouver, BC

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CAO Bulletin • SPRING 2015

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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.