The Canadian Dental Association Magazine 2024 • Volume 10 • Issue 6 The Value of Mentorship Page 20 PM40064661
AboutCDA Founded in 1902, the Canadian Dental Association (CDA) is a federally incorporated not-for-profit organization whose corporate members are Canada’s provincial and territorial dental associations. CDA represents over 21,000 practising dentists nationwide and is a trusted brand and source of information for and about the dental profession on national and international issues. is the official print publication of CDA, providing dialogue between the national association and the dental community. It is dedicated to keeping dentists informed about news, issues and clinically relevant information. 2024 • Volume 11 • Issue 6 Head of Governance & Communications Zelda Burt Managing Editor Sean McNamara Writer/Editor Sierra Bellows Gabriel Fulcher Pauline Mérindol Publications & Electronic Media Associate Michelle Bergeron Graphic Designer Carlos Castro Advertising: All matters pertaining to Display or Online advertising should be directed to: Mr. Peter Greenhough c/o Peter Greenhough Media Partners Inc. pgreenhough@pgmpi.ca 647-955-0060, ext. 101 All matters pertaining to Classified advertising should be directed to: Mr. John Reid jreid@pgmpi.ca 647-955-0060, ext. 102 Contact: Michelle Bergeron mbergeron@cda-adc.ca Call CDA for information and assistance toll-free (Canada) at: 1-800-267-6354 or 613-523-1770 CDA Essentials email: publications@cda-adc.ca @CdnDentalAssoc canadian-dentalassociation CanadianDental Association cdndentalassoc cdaoasis cda-adc.ca CDA Essentials is published by the Canadian Dental Association in both official languages. Publications Mail Agreement no. 40064661. Return undeliverable Canadian addresses to: Canadian Dental Association, 1815 Alta Vista Drive, Ottawa, ON K1G 3Y6 Postage paid at Ottawa, ON. Notice of change of address should be sent to: reception@cda-adc.ca or publications@cda-adc.ca ISSN 2292-7360 (Print) ISSN 2292-7379 (Online) © Canadian Dental Association 2024 Editorial Disclaimer All statements of opinion and supposed fact are published on the authority of the author who submits them and do not necessarily express the views of the Canadian Dental Association (CDA). Publication of an advertisement does not necessarily imply that CDA agrees with or supports the claims therein. The editorial department reserves the right to edit all copy submitted to CDA Essentials. Furthermore, CDA is not responsible for typographical errors, grammatical errors, misspelled words or syntax that is unclear, or for errors in translations. Sponsored content is produced by Peter Greenhough Media Partners Inc., in consultation with its clients. The CDA Essentials editorial department is not involved in its creation. CDABoardofDirectors President Dr. Joel Antel Dr. Lesli Hapak Ontario Dr. Brian Baker Saskatchewan President-Elect Dr. Bruce Ward Vice-President Dr. Kirk Preston Dr. Jerrold Diamond Alberta Dr. Mélissa Gagnon-Grenier NWT/Nunavut/Yukon Dr. Raymon Grewal British Columbia Dr. Stuart MacDonald Nova Scotia Dr. Marc Mollot Manitoba Dr. Matthew Moore New Brunswick Dr. Jason Noel Newfoundland/Labrador Dr. Janice Stewart Prince Edward Island 3 Issue 6 | 2024 |
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Contents The Canadian Dental Association Magazine 2024 • Volume 11 • Issue 6 9 18 CDA atWork 7 A Reflection on Service 9 Days on the Hill 13 Q&A on Community Water Fluoridation News and Events 16 Dental Digest Issues and People 18 Profiles of Dentists in the Royal Canadian Dental Corps 20 The Value of Mentorship Did You Know? 35 Famous Teeth in Western History Supporting Your Practice 27 Know the Law: Termination Without Cause 30 Don’t Pay Unnecessary Taxes: 6 Tax Minimization Tips for Dentists 33 Tips and Tools for Great Decision Making Classifieds 36 Offices and Practices, Positions Available, Miscellaneous, Advertisers’ Index 20 33 5 Issue 6 | 2024 |
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Dr. Joel Antel president@cda-adc.ca AReflectionon Service As the calendar year draws to a close, I reflect on the many ways that we as dentists contribute to our local communities and to our profession. Every day, we help our patients lead healthier lives. Many of us also serve our communities in volunteer positions and through other service organizations. We provide support and friendship to our colleagues, in both formal and informal contexts, at study clubs or even with just a quick text or call. This edition of CDA Essentials highlights the mentorship program that the Manitoba Dental Association (MDA) and the University of Manitoba (U of M) Dr. Gerald Niznick College of Dentistry have been providing for dental students for almost 30 years (p. 20). I’ve volunteered both as a mentor and a guest lecturer for the program here in Winnipeg. One of the student mentees that I was paired with was in the two-year International Dentist Degree Program and after the program was complete, we stayed friends. This dentist saw the mentorship program as a way to learn more about the profession but also an opportunity to learn more about Canadian culture. We talked about how to effectively communicate with people in a way that made them feel not only understood, but valued. He has since gone on to become a successful prosthodontist. I really enjoyed my time as a mentor; it felt good to be involved in something that has shown its worth and really works. Mentorship helps new dentists feel greater satisfaction in their chosen profession and helps them navigate their early careers. When I was a dental student, I visited the dental office of a mentor through a program of the Alpha Omega fraternity and ended up working at that office as a new graduate. I was also fortunate to have many professors and colleagues who, though we weren’t in formal mentorship relationships, often guided and encouraged me through my early career challenges. One of the best presentations at the U of M mentorship program that I heard was a dentist talking about the importance of getting involved. It focused on how to contribute as a member of a community and build meaningful relationships. I must’ve heard this message at the right moment in my life because he inspired me to join my local Rotary Club more than 25 years ago now. I imagine that some of the students who attended that lecture might remember it 10 or 20 years into their own careers and find that it’s just as relevant now as it was then. Mentorship is not only about helping new dentists be successful, but also about transmitting the shared culture and values within our profession. For dentists like me, it provides an opportunity to share hard-won knowledge from many years of experience, but it also allows me time to consider what matters most. What values do I want to share with the dentists of tomorrow? I believe the culture of both dental education and dentistry itself is evolving in a positive direction; it asks the best of each of us. As the holiday season and new year approaches, I reflect on what I’m grateful for: my family, my community and a love of music that I share with both family and friends. I also appreciate my patients, my staff and our profession for the way it shaped my life into one of service. I’m thankful for the community of dentists across Canada who make this profession so meaningful and fulfilling. From the President 7 Issue 6 | 2024 | CDA atWork
#1 water losser brand1 (And because it’s the easiest, most effective way to floss.) Become a WaterpikTM Insider and discover the benefits your colleagues are already enjoying. Sign up at waterpik.ca/sign-up The only water flosser brand backed by 80+ studies! Waterpik™ is: When compared with string floss! 2x more effective for improving gum health around implants2 Up to more effective in removing plaque around braces3 3x Up to It works because theyuse it. © 2024 Water Pik, Inc. All rights reserved. The only water losser to earn the CDA Seal. The following bene its are validated by the CDA: • Removes up to 99.9% of plaque from treated areas. • Up to 50%more effective for improving gum health vs. string loss. • Up to 2X more effective for improving gum health around implants vs. string loss. • Up to 3X more effective for removing plaque around braces vs. string loss. It works because it’s a 1. Based on units sold; Data on file. Water Pik Inc. 2. Rosema NAM et al. The effect of interdental cleaning devices on gingival bleeding. J Intl Acad Periodontol. 2011;12(31):2–10. Available from: https://www.perioiap.org/publications/38-january-2011/38-the-effect-of-different-interdental-cleaning-devices-on-gingival-bleeding? downloadarticle=download. 3. Sharma NC et al. Effect of a dental water jet with orthodontic tip on plaque and bleeding in adolescent patients with fixed orthodontic appliances. Am J Orthod Dentofacial Orthop. 2008;133:565–571. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18405821.
Days on the Hill InOctober, CDA held its annual Days on the Hill advocacy event. Over two days and in more than 20 high-level meetings, members of the CDA Advocacy Working Group and CDA staff met with members of parliament (MPs) and other senior officials on Parliament Hill to press for changes to improve the oral health of Canadians. The main recommendations that the CDA delegation shared were: z That the federal government take steps to mitigate the risk of employers dropping their insurance plans for employees, due to the Canadian Dental Care Plan (CDCP), by establishing tax credits, especially for smaller employers. The government could also change eligibility requirements so that individuals are not eligible for the CDCP if their employer provides coverage for any employee, including those with high salaries. z That the federal government support the oral health care sector in addressing critical workforce challenges. z That the federal government prioritizes and advances Canada’s Healthy Eating Strategy, including fully implementing restrictions on unhealthy food advertising to children. (L. to r.): Dr. Kirk Preston, CDA vice-president, Dr. Joel Antel, CDA president, Dr. Lesli Hapak, member of CDA’s board and advocacy working group, the Honourable Mark Holland, Minister of Health, and Dr. Stuart MacDonald, member of CDA’s board and advocacy working group. (L. to r.): Dr. Jason Noel, member of CDA’s board and advocacy working group, Laila Goodridge, Conservative Party MP, Dr. Hapak, Dr. MacDonald and Dr. Bruce Ward, CDA president-elect. 9 Issue 6 | 2024 |
The CDA delegation had meetings with the prime minister’s office, the finance minister’s office, the health minister’s office, the privy council office, and the office of the leader of the opposition, among others. This year, CDA also set up a booth in the lobby of Wellington Building, where many committee meetings are held, to engage with an even greater number of MPs and staff. “Our Days on the Hill was a huge success with many positive outcomes. We made sure that Canada’s dentists were represented, and their concerns known to key federal decision makers,” says Lucas Veiga, head of government relations and policy at CDA. “This year, we innovated and organized a display at one of parliament’s busiest buildings, which helped increase our reach and engagement with MPs beyond traditional meetings. My personal highlight was our meeting in the prime minister’s office with one of Trudeau’s top senior advisors. We even had to lock our phones in a box before entering the meeting room.” “The event gave us an incredible opportunity to build and strengthen relationships with key decision-makers,” says Taylor Provak, government relations strategist at CDA. “Through high-level meetings, we raised pressing issues affecting dentistry, including human resource shortages Days on the Hill was a huge success with many positive outcomes. We made sure that Canada’s dentists were represented, and their concerns known to key federal decision makers. and the growing concern of de-insurance. This event allowed us to educate parliamentarians on the challenges impacting our profession and advocate directly on behalf of Canadian dentists. We’re grateful for the chance to make a meaningful impact and to continue representing the voice of dentistry at the national level.” “It was a busy round of meeting with Canadian government cabinet ministers, MPs and senior staff members across the full political spectrum. It was tiring but I know it was time well spent,” says Dr. Joel Antel, CDA president. “The event is an important opportunity for an exchange of information on the many issues that affect our profession.” (L. to r.): Lucas Veiga, head of government relations and policy at CDA, Dr. Aaron Burry, CDA CEO, Dr. Kirk Preston, CDA vice-president, Dr. Joel Antel, CDA president, and the Honourable Jean-Yves Duclos, Minister of Public Services and Procurement. 10 | 2024 | Issue 6 CDA atWork
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Q&A on CommunityWater Fluoridation Dr. Aaron Burry, CDA’s CEO, a general dentist and dental public health specialist, answered questions in October 2024 about recent developments regarding community water fluoridation. Q Why has community water fluoridation (CWF) been in the news? Dr. Aaron Burry (AB): Water fluoridation has been debated for decades, but three recent events have brought this debate more strongly into the public consciousness: a U.S. legal case in September that we’ll discuss in more detail, Robert F. Kennedy Jr. saying that if Donald Trump was elected U.S. president in November, Kennedy would put a stop to CWF, and finally there was an updated Cochrane review in October indicating that CWF is less beneficial to oral health than it once was. The best scientific evidence currently available indicates that CWF is safe and effective. The increased public attention on CWF is driven by recent media coverage. Legal and political arguments have returned fluoride to the spotlight. Q Could you tell us more about the recent legal case in the United States? AB: In September 2024, a U.S. federal judge in California ruled that the Environmental Protection Agency (EPA) must respond to a citizens group’s petition about the safety of fluoride in drinking water. A change in U.S. legislation meant that as of 2016, U.S. citizen groups could petition the EPA to take action and respond to any risk they believed might exist. The ruling in September stems from a case that began in 2017 asking the court to assess whether the citizen group provided enough evidence to warrant an EPA response to its petition. The basis of the petition are studies that have contradictory findings: one set of studies indicating a potential association between even low levels of fluoride and decreased IQ levels in children, while the greater number of other studies that found no such association. Dr. Aaron Burry The best scientific evidence currently available indicates that community water fluoridation is safe and effective. 13 Issue 6 | 2024 | CDA atWork
The scientific literature indicates that fluoride levels greater than 1.5 mg/L is consistently associated with lower IQ levels in children. In many of these studies the water being consumed was several times greater than 1.5 mg/L. In addition, many of the subjects of these studies are drinking water that would be considered unsafe, by North American standards, not only because of unacceptably high levels of fluoride but also with other contaminants associated with negative impacts on neurodevelopment. To clear up the confusion related to the current level of CWF (0.7 mg/L commonly), we need new studies designed to control for bias, that are based on reliable measures of neurological function. What’s notable is that the court did not offer an opinion on the relative merits of the scientific evidence presented, but rather reasoned that since potential exposure to fluoride in water is frequent, continuous and long-lasting, the EPA should take further action under the 2016 legislation. The court was clear that the ruling did not mean that CWF is not safe, just that there are arguments on both sides of the debate. The court ruling does not impact CWF practises in the U.S. or Canada. QCould you talk about the updated Cochrane review of water fluoridation for the prevention of dental caries that was published in October 2024? AB: Cochrane reviews offer a gold standard of evidence-based guidance from a very reputable organization. The update to an existing Cochrane review in October reported that levels of dental disease in the U.S., Canada and other high-income countries have dropped substantially since CWF was introduced about 60 years ago, and, accordingly, suggests that the relative effectiveness of CWF is less apparent than in past. Between the 1950s and 1970s, when CWF was first being introduced as a public health measure, a tremendous oral health benefit was evident to the public. Reports of a more than 50% decrease in childhood dental caries from the combined effects of fluoride in water and toothpastes were widespread. One weakness of the updated Cochrane review is that it’s limited to studies of children. A finding of reduced benefit to childhood decay is not unexpected, given the growing number of children who never experience tooth decay in high-income countries. The long-term, lifelong benefit of drinking fluoridated water among adults has not been studied to the same extent. One reason for the focus on children was the belief that fluoride was incorporated into teeth during their development, which made enamel more resistant to caries. We now know that only represents a minor part of fluoride protection, and that ongoing exposure to trace levels of fluoride provide the primary anti-caries benefit in many populations. When the average level of decay is very low, like it is now, the overall benefit of CWF is less evident. As with all public health measures, when the risk falls, public support also declines, and individuals are more likely to focus on a potential individual risk, even if it’s negligible, rather than the broader benefits for others. In Canada and the U.S., there are antifluoridation groups who believe that because dental decay is low, there’s no reason to have fluoridated water. This makes fertile ground for political debate, particularly when the benefits are less absolute than they once were. QHow has CDA responded to the recent increased coverage of fluoride in the media? AB: CDA worked directly with our newly formed advocacy and policy committee, who review scientific information related to oral health, such as with fluoride. With a topic like this, CDA also consults with its network of external experts, particularly when the scope is outside of dentistry or dental public health. This is done on an ongoing basis. If there is any new information or evidence that necessitates a change to CDA’s official positions on any scientific matter, it is revised accordingly and circulated for review. On this issue, at this time, there’s no new science that would warrant an update. As with all public health measures, when the risk falls, public support also declines, and individuals are more likely to focus on a potential individual risk. 14 | 2024 | Issue 6 CDA atWork
It’s good to remember that CWF is just one of many factors involved in the prevention of oral disease. Sugar consumption has grown at an alarming rate for the past 25 years, which has increased dental caries. Dentists are certainly seeing this clinically and there’s also scientific evidence that is clear. Once sugar in the daily diet reaches a certain level, fluoride is not going to be sufficient to control caries. At CDA, we advocate for better nutrition, limits to advertising for children of unhealthy foods, and making water the drink of choice. QWhat would you say to dentists who have patients coming to their practice with questions or concerns because of misinformation about fluoride? AB: Canada and the dental profession have done an excellent job of managing the most common side effect of fluoride: dental fluorosis, with most cases being mild or very mild types of fluorosis. The most crucial knowledge that a dentist should have is a better understanding of the particular circumstances of your own community. In addition to discussing the use of toothpaste with families of young children, it is important to know if patients in your community rely on private wells and nonmonitored community water sources. If they do, you should advise patients to get their water tested. Local experts should be able to advise on frequency, but most wells will remain stable over a number of years. There are communities in Canada where naturally occurring fluoride levels far exceed the optimal 0.7 mg/L and approach 1.5 mg /L, which should not be consumed daily. Other naturally occurring minerals and metals in well water are associated with high fluoride and may have significant health implications, so thorough testing is a good idea. For other communities, there is no naturally occurring fluoride and the use of oral health care products that contain fluoride becomes even more important. In most major cities in Canada, fluoride in the local water supply is controlled in a precise and systematic manner optimizing the benefit, while minimizing risk. Related Resources: CDA Position on Water Fluoridation bit.ly/4eyCWSr Public Statement onCommunityWater Fluoridation bit.ly/4i6ViwE CochraneDatabase of Systematic Reviews Review: Water fluoridation for the prevention of dental caries bit.ly/3Obndhi Health Canada: Fluoride and Oral Health bit.ly/40PRwSa 15 Issue 6 | 2024 | CDA atWork
ColonelGenevièveBussière, ChiefDentalOfficer, RCDC World Antimicrobial Resistance Awareness (AMR) Week, a global campaign to improve awareness and understanding of AMR and encourage best practices among the public, took place November 18–24. CDA and Choosing Wisely Canada (CWC) collaborated for World AMR Awareness Week to help promote the responsible use of antibiotics within dentistry. “CWC and CDA’s coordinated action to enhance awareness and understanding of AMR speaks to the seriousness of this global health challenge,” said Dr. Joel Antel, CDA president in a joint press release. “AMR is a growing public health threat, and as dental professionals, we have a crucial role to play to help reduce AMR and stopping the emergence of drug-resistant infections.” With support from CDA, CWC hosted a webinar on November 20, on managing toothache pain and tools for CDA and ChoosingWisely Canada Collaborate forWorld AMR AwarenessWeek New RCDC Chief Dental Officer In a ceremony held October 4, 2024, Colonel Geneviève Bussière was officially appointed as the first female Chief Dental Officer (CDO) of the Royal Canadian Dental Corps (RCDC), following Brigadier General Jean-Pierre Picard who had held the role since June 2018. Col Bussière obtained her DMD at Université de Montréal in 1997, completed a one-year multidisciplinary residency in general dentistry at Université Laval in 1998, followed by private practice and employment as a clinician at Université de Montréal in the undergraduate fixed prosthodontics department, before joining the Canadian Armed Forces (CAF) in 1999. In 2008, Col Bussière completed a two-year post-graduate studies program with the United States Army (Advanced Education in General Dentistry 2-Year) at Fort Hood, Texas, and was subsequently certified by the American Board of General Dentistry (ABGD) in 2009. Throughout her assignments in the CAF, accounting for deployments and various levels of clinical and command positions up to 1 Dental Unit Commanding Officer, followed by strategic activities as Director Dental Services since 2022, Col Bussière has maintained a high level of clinical involvement, providing a wide range of clinical services, including lecturing opportunities in Canada and abroad. From 2013 to 2017, she was the RCDC Forensic Odontology Consultant, and from 2017 to 2021, the RCDC Senior Clinical Practice Leader. In July 2021, Col Bussière completed two, 3-year terms as a Director/Examiner for the ABGD, where, throughout that time, she held various executive roles, including serving as ABGD president between 2019-20. Col Bussière is a graduate of the CAF Joint Command and Staff Program, a recipient of the Order of Military Merit, and is a Fellow of the International College of Dentists, which recognizes dentists for their “professional achievement, meritorious service and dedication to the continued progress of dentistry for the benefit of humankind.” DENTAL DIGEST improving antibiotic prescribing in the community. On the CDA Oasis website, Dr. Susan Sutherland, dentistry co-lead for CWC, discussed AMR and introduced a new CWC toolkit for dentists, Taking the Bite Out of Tooth Pain. This toolkit has practical guidance and resources for dental health professionals, including FAQs, an educational poster and patient information on alleviating toothaches without antibiotics. See: bit.ly/40Vdymm 16 | 2024 | Issue 6
On November 1, 2024, a wider range of essential treatments, including partial dentures, crowns, and higher levels of sedation, became available to Canadian Dental Care Plan (CDCP) patients through the launch of preauthorization. Although this expansion offers CDCP patients access to more care options, the final decision to provide coverage rests with Sun Life and/or Health Canada. Prior to the November 1 launch of preauthorization, 74% of dentists surveyed by CDA indicated that they would be submitting preauthorization requests that have been delayed since the CDCP launch in May. For patients, this preauthorization process may require additional waiting periods. CDA recommends that patients discuss potential treatment options with their dentist in advance. A new CDCP Look Up Tool was also launched in November, accessible for all participating dentists in both the CDCP Preauthorization Launched claim‑by‑claim and registration pathways. The tool allows dentists to verify a CDCP patient’s coverage start date, copayment level, and covered services. Dentists will need a Sun Life Direct account to access the new tool. See: cda-adc.ca/en/oral_health/cdcp 17 Issue 6 | 2024 | 41st International Dental Show inclusive IDSconnect english.ids-cologne.de Koelnmesse Inc. · 8770 West Bryn Mawr Ave., Suite 1300 · Chicago · IL 60631 Tel. +1 773 326 9920 · info@koelnmesse.us BUY TICKETS! MARCH 25-29, 2025 COLOGNE, GERMANY LEADING DENTAL BUSINESS SUMMIT
Profiles of Dentists in the Royal Canadian Dental Corps CDA spoke to some current and former RCDC dentists about their service. “My two tours in Afghanistan in 2009 and 2011 were the highlights of my career. I got to experience things that most people never get to,” says Dr. Antonella Trache, who served for 21 years and retired as a Major. “During our deployment, my certified dental assistant Sgt. Angela Brownell and I were able to offer a range of treatments, including direct restorations, root canal therapy, dental extractions, and basic denture repairs, to help maintain the well-being and readiness of NATO soldiers,” says Dr. Jesse Barker, a Major who deployed to Iraq in 2021. “I appreciate the ability, as an RCDC dentist, to work closely with other specialists, both dental and medical alike, for a more collaborative health care approach to Since 1915, the Royal Canadian Dental Corps (RCDC) has played a pivotal role in both World Wars, as well as in Korea, Afghanistan, and in various peacekeeping and humanitarian operations around the world. RCDC dentists have cared for the oral health needs of Canada’s military personnel, both at home and abroad. ensure patient-partnered care,” says Dr. Danial Shirvani, a Captain who has served in Ottawa, including at the Canadian Forces Health Services headquarters. “Military service is an exceptional way of giving back to your community and showing appreciation and respect for the sacrifices of our soldiers in having secured the freedoms we enjoy today as Canadians,” says Dr. Lancelot Brown, who retired with the rank of Captain and is now a dental surgeon in Toronto. In recent years, the RCDC has supported our military personnel by providing care during natural disasters and other crises in Canada, as well as playing a key role in Health Canada’s Canadian Health Measures Survey. CDA honours the contributions of military dentists in the service of Sanitas in ore, the RCDC motto, both in times of war and peace. 18 | 2024 | Issue 6
Dr. Antonella Trache (Maj) served as an oral and maxillofacial trauma surgeon in the Canadian Armed Forces (CAF) during two tours in Afghanistan. “We didn’t turn anybody away who came to the hospital in the Kandahar region, so we treated Canadian, American, European and Afghan military personnel, but also many Afghan civilians,” she says. Dr. Trache retired from the military in 2013 after 21 years of service, and now teaches at the University of Alberta School of Dentistry as the discipline lead for oral and maxillofacial surgery. Dr. Danial Shirvani (Capt) served in various locations in Ottawa, including at the dental clinics in Montfort Hospital, the National Defence Headquarters, and, most recently, in a staff officer position at the Canadian Forces Health Services headquarters, working directly for the CAF Chief Dental Officer. “The biggest privilege of serving in the CAF, especially being an immigrant to this country, is honouring those who came before us and made the ultimate sacrifice so that we may enjoy the peace and freedoms of today,” says Dr. Shirvani. Dr. Lancelot Brown (Capt) provided general dentistry to troops at CFB Chatham, New Brunswick, deployed in a mobile dental van to the field at CFB Gagetown, New Brunswick, in support of Air Defence Artillery troops, and served as the Officer in Charge of the Royal Military College Dental Clinic at CFB Kingston, Ontario. “In 1986, during phase training at CFB Gagetown, I had the privilege of spending a day on the artillery range operating a towed M105 Howitzer, as well as an M109 mobile Howitzer,” he says. “This experience gave me a unique perspective into the daily lives of the soldiers to whom I provided care.” Dr. Jesse Barker (Maj) and Angela Brownell (Sgt), certified dental assistant, were deployed to Erbil Air Base, Iraq, in 2021. Their clinic was a fully equipped facility, housed in a repurposed shipping container, designed to provide general dental care, including fillings, radiography, and sterilization. During their deployment, the pair provided oral health care to help maintain the well-being and readiness of NATO soldiers. Dr. Antonella Trache (Maj) Dr. Danial Shirvani (Capt) Dr. Lancelot Brown (Capt) Dr. Jesse Barker (Maj) 19 Issue 6 | 2024 | Issues and People
The Value of Mentorship A program inManitoba has been buildingmentorship relationships for nearly 30 years Since it was founded in 1996, the Manitoba Dental Association (MDA) and the University of Manitoba Dr. Gerald Niznick College of Dentistry Dental Student Mentorship Program has provided mentorship opportunities for almost 900 dental students. Each student is matched with a practising dentist for all 4 years of their dental school. During the course of the program, a mentorship relationship develops through formal structured events— including seminars, workshops, continuing education programs, panel discussions, and special events where all mentors and mentees come together—and informal activities arranged by the mentor-mentee pairs. Manitoba Dental Association pins. 20 | 2024 | Issue 6
The Mentorship Program Dr. Huma Sharief and Dr. Craig Fedorowich, who were co-chairs of the program from 2019 until this year, were honoured with the 2023–24 CDA Mentorship Advancement Award for their tireless efforts in building the program, which nurtures a sense of community and a network of supportive relationships as students prepare to enter the profession. “Credit for the success of the program is due to the collaboration of the MDA and the university,” says Dr. Fedorowich. “The contributions from administrators and faculty at the dental school have been invaluable.” What starts as a mentor-mentee relationship often grows into a significant friendship and the program provides an important add-on to the dental education experience. Mentors support the dental students with personalized guidance and advisement. The students receive exposure to organized dentistry and professional leadership, which provides a better understanding of the opportunities available to build healthier communities. At the end of program, there is a graduation dinner where mentors welcome new graduates into the profession. “Our formal events are held at the Manitoba Club or the St. Charles Country Club,” says Dr. Sharief. “The students and our dentists look forward to getting dressed up and seeing each other outside of our scrubs!” “When it began, the mentorship program was just for 4th-year students, to help them make the transition into the workforce,” says Dr. Fedorowich. “We wanted to make sure that new dentists had the support they needed to prepare themselves for entering the profession.” In 2006, the program expanded to include 3rd-year students and then, in 2011, all four years. The first formal event of the program welcomes first-year students and international students to dentistry in Canada. Then, there is a session modelled on a speed dating format, where students meet a number of prospective mentors for a few minutes to chat and figure out if and how they connect. There are about 85 mentors participating in the program, which includes a good cross section of dentists who work in rural and urban settings, general practitioners and specialists, and dentists of diverse ages and ethnicities. Mentors sign a contract to formalize their commitment to the mission of the program. Ultimately, the mentees and mentors choose who they’d like to be paired up with. The students receive exposure to organized dentistry and professional leadership, which provides a better understanding of the opportunities available to build healthier communities. Dr. Craig Fedorowich (centre) and twoUniversity of Manitoba dental students taking part in a mentorship program event. 21 Issue 6 | 2024 |
“We have three lectures per year,” says Dr. Sharief. “They’re an opportunity to talk about important parts of being a dentist that may not be emphasized in course material. For example, how do we make sure to use social media responsibly as dentists?” “We talk about real-world dilemmas,” says Dr. Fedorowich. “The students find it helpful to hear about when things may have gone wrong and how to fix problems that come up. They enjoy a little bit of reality especially while they’re still at the stage of drilling plastic teeth!” Dr. Sharief says that when graduates who have been mentees return to the program as volunteer mentors, the program really shows its effectiveness. “It’s a cycle of positive change that builds upon itself,” she says. Why Mentorship is Important “Life in dentistry is complicated,” says Dr. Fedorowich. “And it has grown even more complicated since I began my career. Dental students have the pressure of ever-expanding scholastic activities, but still only have 4 years to complete their education. Dentists are balancing the expectations of patients, social media and employers. I think dentists tend toward perfectionism, but we are human and sometimes we need help, which can be hard when we expect perfection from ourselves. A mentorship relationship is a place where we can talk through complicated situations with a confidant.” “Students face the technical challenge of developing their clinical skills, but they also have to learn how to work with people successfully,” says Dr. Sharief. “How do you talk to patients? How do you tell someone that a treatment didn’t go as planned? I think mentorship is increasingly important as students have to deal with a much higher student debt load. Mentors act as a safety net. They’ve walked a similar path, so they can give frank, honest advice.” Students face the technical challenge of developing their clinical skills, but they also have to learn how to work with people successfully. Dr. Huma Sharief at the podium addressing a group of 2nd year dental students andmentors. 22 | 2024 | Issue 6
I don’t think mentors always show up in our lives with the formal title of mentor. They are people who share their knowledgeandlifeexperiences, andwe only realize later on that they’ve been our guides. When Dr. Fedorowich was first entering the profession, he didn’t have a formal mentorship relationship to lean on. “But I had amazing instructors in dental school who I continued to talk to after I graduated, and a friend who was a wonderfully generous dentist who was recently retired,” he says. “Dr. Bob Glenn farmed during the warmer months and spent time at the dental school during the cold months. I had the luxury of bending his ear, and he had the wisdom to be a good listener. Now I realize that I’ve had several excellent mentors, even though they didn’t have the official title.” “I don’t think mentors always show up in our lives with the formal title of mentor,” says Dr. Sharief. “They are people who share their knowledge and life experiences, and we only realize later on that they’ve been our guides.” Dr. Sharief graduated from dental school in Zimbabwe before being accepted into the University of Manitoba for a qualifying program. “Everyone I met at the U of M took me under their wing and helped me navigate those years of study,” she says. “And I was paired with a mentor who was a rural dentist, Dr. Chris Kiazyk, who invited me to visit his practice to see how it was run. I’ll never forget when I visited his family home and the sense of belonging I felt. Mentorship was life changing for me.” Being a Mentor “I enjoy the time I spend in the company of dental students very much, as an instructor or as a mentor,” says Dr. Fedorowich. “It’s energizing and I feel like I’m getting as much out of it as I’m giving.” “The life-changing support and encouragement that I got from my own mentor motivated me to become one as well,” says Dr. Sharief. “I’m especially excited to work with international students. I created a checklist of what I needed to succeed blending in with a new culture, and I want to the share that knowledge.” Dr. Sharief feels that dentists by nature are givers, not takers. Dentist care for patients, give back to the profession and strengthen their communities. “I’m a dentist Dr. MurrayWhite giving a talk to dental students andmentors in attendance. 23 Issue 6 | 2024 |
in everything that I do. It’s part of my personality, the very fabric of who I am,” she says. “I can reassure, reaffirm, support, share and encourage other dentists. It comes naturally. There are moments in everyone’s life when you need someone to build you up, shine you up, and set you back on your path. And that’s what good mentors do.” Both Dr. Sharief and Dr. Fedorowich say they give advice on career planning, evolving technology in dentistry, and how to become involved in community service and organized dentistry. “We have new graduates showing their associate contracts to their mentors and saying, ‘Can you go through this with me?’” says Dr. Sharief. Dr. Fedorowich says the mentorship program helps keep him current on trends and how dentistry is evolving. Both dentists say that in a world where information is increasingly accessible and overwhelming, having fellow dentists to talk with and navigate issues with is helpful. “The greatest outcome of mentorship is a sense of community,” says Dr. Fedorowich. “Isolation can be very hard on us, so putting an emphasis on building relationships, and doing so early in a dental career, can make a huge difference.” What Makes a Mentorship Relationship Successful? Dr. Fedorowich warns that one potential pitfall is not making enough time for a variety of interactions. “Our program is structured, in part, but it’s also important that the pair get together on their own to have casual openended conversations,” he says. “As a mentor, I want to be able to help with the unique needs of my mentee.” “A good fit between two personalities helps a lot,” adds Dr. Sharief. “Which is why we do the speed-dating type session at the outset instead of assigning students to mentors arbitrarily. Often students want to be paired with people who have chosen a career path that they also plan to do.” Dr. Sharief notes that it is important to feel you can be vulnerable in front of your mentor. “Do you feel safe enough to say when you don’t know what you are doing?” she says. “Will you feel safe saying that you’re struggling with something?” A mentor needs to be available, both practically and emotionally, to their mentee. “From my experience, it’s usually a good fit when the mentor listens more and talks less,” says Dr. Fedorowich. “Often, people can find their own solutions if you simply listen and ask questions. Mentorship is not really a teacherstudent relationship. It’s a two-way relationship where ideas and knowledge are actually coming from both people.” When they received their CDA award, Dr. Fedorowich thanked Dr. Sharief, calling her the best colleague that he could hope for. Dr. Sharief called Dr. Fedorowich her “guiding-light mentor.” Though their terms as co-chairs of the program have ended, both Dr. Fedorowich and Dr. Sharief have chosen to stay on as mentors. Listen to a podcast with Dr. Huma Sharief and Dr. Craig Fedorowich on CDA Oasis: bit.ly/3ALDjer Learn more about the Manitoba mentorship program at: bit.ly/3AEN2Dl Isolation can be very hard on us, so putting an emphasis on building relationships, and doing soearly inadental career, can make a huge difference. Dr. Huma Sharief (DMD, University of Manitoba, 2014) is a general dentist at Assiniboine Dental Group inWinnipeg, Manitoba. Dr. Craig Fedorowich (DMD, University of Manitoba, 1986) is a general dentist at Mountain Dental in Neepawa, Manitoba. 24 | 2024 | Issue 6 Issues and People
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Join us in Vancouver, BC Three days of varied and contemporary continuing dental education sessions are offered (something for your whole team) Fantastic line-up of speakers / topics to choose from in open sessions and hands-on workshops, as well as the Live Dentistry Stage in the Exhibit Hall Spacious PDC Exhibit Hall with all your favourite exhibiting companies looking forward to connect with you again Lunches & Exhibit Hall Receptions (Thurs/Fri) included in the registration fee Fantastic shopping, beautiful seawall access within blocks of your hotel, and great spring skiing, golfing and cycling Pacific Dental Conference March6-8, 2025 Save these Dates! pdconf.com Registration and program information at... Amber Riley Forensics/ Pathology Featured Speakers Anthony Cardoza Lasers JimGrisdale Periodontics Lois Banta Practice Management Lee Ann Brady Dental Assisting Todd Snyder Restorative/Operative Joyce Bassett David Rice Kevin Henry Jackie Dorst John Alonge Dimple Desai Jason Goodchild Chrissy Ford Nekky Jamal David Patrick Tarek El-Bialy Tiara Anderson Tieraona Low Dog Aviv Ouanounou Thomas Viola Sherry Priebe Timothy Caruso Mark Lin
KNOWTHE LAW Termination Without Cause Inna Koldorf is a partner at Miller Thomson LLP in Toronto. Her work includes helping employers with managing their workforce, providing advice, representing employers in litigation, and conducting workplace investigations. The views expressed are those of the author and do not necessarily represent the opinions and official policies of CDA It is never easy to have to let go of a valued member of your team. But when this becomes necessary, it’s important to know how to manage the situation with respect and within the parameters of the law. “We are sometimes asked to clarify the differences between terminations with cause and without cause,” says Inna Koldorf. “The most significant difference is notice. When an employee is terminated with cause, they’re not entitled to any notice or compensation by law. And if an employee is terminated without cause, they’re entitled to notice or pay in lieu of notice.” Most terminations, approximately 90%, are without cause. Sometimes a business reorganizes internally and needs to eliminate some roles. Other times, a termination is tied to performance but there isn’t quite enough of a problem to terminate with cause. “I’ve seen situations where people simply don’t get along and so a solution is that one person needs to exit the situation,” says Koldorf. “No one has done anything wrong, but change is needed, thus without cause is appropriate.” 27 Issue 6 | 2024 |
Terminating with or without cause can be a tough judgment call for an employer. Acommonexample iswhen an employee has had performance issues that aren’t too serious but persist over a long period of time. “Bardal Factors,” as they are known, include character of employment, length of service, age, and availability of similar employment, having regard to the experience, training and qualifications of the employee. More notice is required if an employee is closer to retirement age and if they are likely to experience significant barriers to finding new employment after being terminated. Provincial employment standards legislation sets out the minimum notice and compensation that an employee is entitled to during termination, and common law often provides for more, especially if it is difficult for the employee to find another job. “Common law hopes to provide a bridge, so to speak, between two jobs,” says Koldorf. “The employee has an obligation to look for work during this time.” 3. Common (Civil) Law A misconception often held by employers is that common law will require one month of pay per year of service. That may be true for an older employee who has been with a business for a long time and is approaching retirement age. But for a younger employee who hasn’t been with a business for many years and can likely find a new job easily, common law will not require such a significant entitlement. Some employers limit common law entitlements by helping former employees find new employment. There are outplacement agencies that can help people with their resumes, jobs searches, job interview preparation and other transitional tasks. When employers provide a service such as this as part of a termination package, former staff members are more likely to find a job more quickly, which limits what the employers need to pay in common law entitlement. Termination costs can also be decreased by offering fixed term contracts. Instead of hiring employees indefinitely, you would hire employees for one year or another predetermined amount of time. At the end of the fixed term contract, the contract expires but then you have the option of renewing the contract. But if you don’t want to renew it, there is no termination or severance pay. “When a contract is complete, everybody just moves on,” says Koldorf. Terminating with or without cause can be a tough judgment call for an employer. A common example is when an employee has had performance issues that aren’t too serious but persist over a long period of time. Or an employee sometimes meets expectations for performance but struggles to meet expectations at other times. “In cases like this, we often advise employers to terminate without cause because there is a high threshold to prove that low performance is cause for termination,” says Koldorf. “So without cause termination is often faster and more cost effective. You want to try to avoid an accusation of wrongful dismissal.” There are three distinct sources of rights that employees have when it comes to termination. The first is provincial legislation. The second is dictated by an employment contract. The third is common (or civil) law. 1. Provincial Legislation Employment standards legislation provides the minimum entitlements for all employees. Each province has its own employment standards legislation, though they have commonalities, except Quebec. This legislation provides minimum notice that an employer must give an employee based on the employee’s length of service. To use Ontario as an example, a terminated employee is entitled to roughly a week of notice (or pay in lieu of notice) for every completed year of service. In Ontario, there is also severance pay for employees who have been with the employer for at least five years and the employer has a global annual payroll of at least $2.5 million. 2. Employment Contract If you have an employment contract with an employee (which is always recommended) you should check whether it contains a termination provision. A properly drafted termination provision could limit what an employer must pay a terminated employee to the minimum required by provincial legislation. If it does have a termination provision, check whether it is enforceable. “In Ontario and a few other provinces, laws related to whether termination provisions are enforceable have been a moving target,” says Koldorf. “When a court issues a decision on a termination provision, the law might change.” If there isn’t an enforceable termination provision or an employee didn’t sign an employment contract, then the employee is subject to common law. In Ontario, the 1960 case of Bardal v. Globe & Mail Ltd. (1960 Carswell Ont 144 [Ont. H.C.]) sets out the key factors in determining an employee’s reasonable notice period. The 28 | 2024 | Issue 6 SupportingYour Practice
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