The Canadian Dental Association Magazine 2025 • Volume 12 • Issue 5 PM40064661 Rethinking Dentistry in the Age of Climate Change Page 24 + IN THIS ISSUE Dentists’ Role in Measles Prevention P. 13 Adaptive Tools for Children with Special Needs P. 20 Imposter Syndrome in Dentistry P. 31
About CDA 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. 2025 • Volume 12 • Issue 5 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 Canadian Dental 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 2025 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 or sponsored content 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 solely produced by advertisers. The CDA Essentials editorial department is not involved in its creation. CDA Board of Directors President Dr. Bruce Ward Dr. Raymon Grewal British Columbia Dr. Brian Baker Saskatchewan President-Elect Dr. Kirk Preston Vice-President Dr. Jason Noel Dr. Joy Carmichael New Brunswick Dr. Jerrold Diamond Alberta Dr. Mélissa Gagnon-Grenier NWT/Nunavut/Yukon Dr. Lesli Hapak Ontario Dr. Paul Hurley Newfoundland/Labrador Dr. Stuart MacDonald Nova Scotia Dr. Marc Mollot Manitoba Dr. Janice Stewart Prince Edward Island 3 Issue 5 | 2025 |
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Contents The Canadian Dental Association Magazine 2025 • Volume 12 • Issue 5 13 20 CDA at Work 7 From the President: Building Lasting Relationships with Patients News and Events 9 JCDA Summary: Initial Findings from the Canadian Dental Care Plan 13 Dentists’ Role in Measles Prevention 17 Dental Digest 18 Catching Up with the Oral Health Community in Canada: NCOHR Issues and People 20 Halifax Initiative Delivers Adaptive Tools for Kids with Special Needs 24 Rethinking Dentistry in the Age of Climate Change Supporting Your Practice 28 Managing Pediatric Dental Emergencies 31 Imposter Syndrome in Dentistry 34 Metabolizing Stress: A Dentist’s Guide to Resilience and Recovery Classifieds 37 Positions Available, Advertisers’ Index 28 34 Obituaries 38 Dr. Frank Hohn 5 Issue 5 | 2025 |
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Dr. Bruce Ward president@cda-adc.ca Building Lasting Relationships with Patients Our calling is to care for people, and it is our patients who sustain both our practices and profession. Staffing, training and equipment are all essential, but they serve their purpose only when they help us forge strong relationships with the people we care for. The real measure of our work is the trust our patients have in us and the loyalty that comes with it. In many urban areas across Canada, the ratio of patients to dentists has dropped below 1,000:1. That means every new patient who walks through your door has likely left another practice to do so. And if a patient leaves your practice, they are likely headed into the care of a colleague down the street. Patients rarely judge us by our technical skills alone. Most cannot distinguish between a perfectly contoured filling and one that is merely adequate. But what they do notice is if the procedure was comfortable, if they felt listened to, and if their concerns were taken seriously. The patient’s experience is shaped far more by how we make them feel than by the precision of our work. Of course, technical skills matter, especially when something goes wrong. If a restoration fails within days, or a filling makes a tooth sensitive, patients will understandably be upset. Yet even in those moments, what determines the quality of the dentist/patient relationship is not the complication itself, but how we handle it. Dismissing discomfort or delaying an appointment erodes trust. But responding quickly, taking ownership, and showing genuine concern reinforces the patient’s belief that they are in good hands. I’ve seen patients on the weekend or after hours because they were in pain or had urgent needs. I’ve squeezed them in over my lunch hour because that’s what I would want from my own dentist. Although dentistry is often framed as a technical profession, it is fundamentally relational. Simple gestures—recalling a name, asking about a recent trip—create personal connections that keep patients returning for years. A quick phone call or message the day after an extraction, even if it lasts less than a minute, can make a profound impression. And it’s not only the dentist who builds these bonds. A long-term, stable team at your practice amplifies the sense of familiarity and comfort. When patients are greeted by name and welcomed into a familiar environment, the dental office begins to feel like a community space. We are entrusted with the privilege and responsibility of guiding our patients’ oral health. That responsibility means ensuring that every treatment plan we recommend is designed with our patient’s best interests at heart—not our own. By recommending treatments that are optimal for each patient, we strengthen the relationship that lies at the heart of everything we do. Not every patient is easy to care for. Some arrive with dental fear rooted in trauma, others with personalities that challenge even the most patient practitioner. And yet, working through those difficulties often yields the strongest advocates if you take the time to treat those patients with patience and compassion. The lifetime value of a single patient to a dental practice can be extraordinary due to the ripple effect. A patient who feels cared for becomes an advocate, sending family and friends, and speaking positively about your office in the community. By contrast, a patient who departs takes more than their own file with them. They may share their dissatisfaction with others, leaving not just a vacancy in your schedule, but also a mark on your reputation. At the end of the day, dentistry is about showing up as human beings for other human beings. If we focus not just on the technical aspects of what we do, but on how we make people feel, we can build practices that thrive due to the strength of our relationships. From the President 7 Issue 5 | 2025 | CDA at Work
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JCDA Article Summary Initial Findings from the Canadian Dental Care Plan The following is a summary of a JCDA article published in July 2025. JCDA is Canada’s only peerreviewed dental journal—an open access publication that publishes original research articles indexed in Medline, Journal Citation Reports and Science Citation Index. Read the full article at: jcda.ca/p15 When the Canadian Dental Care Plan (CDCP) began its phased rollout with a commitment of roughly $13 billion from the federal government, the program promised to expand access to oral health care for millions of people in Canada. A recent JCDA article1 takes a critical look at the program’s first nine months, exploring patient eligibility and uptake based on filed income tax returns; provider enrollment and participation; the capacity of dental practices to meet increased demand; and the limitations of existing data, highlighting the need for ongoing evaluation as the program expands and evolves. The Oral Health Context The CDCP was launched into a landscape where oral disease remains one of the world’s most common health burdens. Caries and periodontitis affect billions globally, and, in Canada, 96% of adults have experienced caries, while more than 1 in 5 live with moderate to severe periodontitis. Poor oral health in Canada causes significant productivity deficits: each year, about 2.2 million school days and 4 million workdays are lost to oral disease. Low-income Canadians, those without insurance, people living with disabilities, and historically underserved communities are far more likely to go without care (often due to cost) and many lack a regular dental provider. Financial barriers are only part of the story: stigma, fear, discrimination, and lack of awareness all contribute to unmet needs. The Program Eligibility for the CDCP hinges on filing a Canadian income tax return—a requirement that may itself exclude some of the people the plan aims to reach. The Poor oral health in Canada causes significant productivity deficits: each year, about 2.2 million school days and 4 million workdays are lost to oral disease. JCDA article authors (L. to r.): Dr. Mario Brondani, Dr. Abbas Jessani, Dr. André Luis Faria-e-Silva, Dr. Diego Ardenghi 9 Issue 5 | 2025 |
felt able to take on the additional patients CDCP would bring. Practices planning to expand were the most confident in accommodating more patients, while those experiencing longer wait times or planning to scale back were less likely to accept new ones. Promise and Pressure Points The JCDA authors see early signs of success: rapid uptake by patients, growing awareness, and strong provider participation. Yet several challenges remain. Awareness of the CDCP remains incomplete, especially among those most in need. The income tax filing requirement may exclude 10–12% of Canadians—many living in poverty or in marginalized groups—who would benefit most but face barriers such as language, awareness, or lack of support. Without adequate claims data, the program’s impact on types of care, oral health outcomes, and frequency of visits is unknown, and patient experiences around affordability, stigma, and satisfaction have yet to be measured. As well, dental training programs face risks as patients find care closer to home, reducing visits to university clinics and limiting student experience. Policy Implications The JCDA authors recommend targeted awareness campaigns, program navigation support for applicants, and close monitoring of billing practices. Once available, claims data should be analyzed for patterns in utilization, outcomes, and equity impacts. Cost-effectiveness studies will help determine whether the public investment delivers lasting value. The authors also stress the need to sustain training opportunities for dental students through grants and patient recruitment, and to track variations in access between urban and rural areas. Looking Ahead In less than a year, the CDCP has scaled up both enrollment and provider participation at a high pace. Yet, without complete data, the fundamental question—whether it will reduce oral health inequities—remains unanswered. plan offers three tiers of coverage (additional fees may be charged by providers): z Full coverage (0% copayment): family incomes under $70,000 z 40% copayment: family income between $70,000–$79,999 z 60% copayment: family income between $80,000–$89,999 Coverage spans diagnostics, hygiene, restorative care, endodontics, and dentures, although certain procedures require preauthorization. CDCP’s payment rates are lower than many provincial or territorial dental association fee guides. In British Columbia, the example cited in the JCDA article, CDCP rates cover about 70% of the suggested fee, which may lead to “balance billing” where patients pay the difference. The plan is administered federally by Sun Life and delivered through the private sector. To support training for future providers, Health Canada has introduced the Oral Health Access Fund, which offers grants to dental schools to address competency gaps in the knowledge and skills of students and adapt to provide students with sufficient hands-on training opportunities. The Data So Far The JCDA article’s analysis draws on two main sources: Health Canada’s CDCP Summative Data, which tracks approved applicants, those receiving care, and participating providers; and Statistics Canada’s Survey of Oral Health Care Providers (SOHCP), conducted in mid-2024 with around 5,100 randomly selected dental professionals. The study focuses on descriptive data— totals, percentages, and averages—since claims data and patient perspectives are not yet available. Between August 31, 2024, and May 23, 2025, the program grew substantially: z Approved applications: from 2.3 million to 4.075 million (up 77.2%) z Applicants receiving care: from 450,000 to over 2 million (up 344.6%) z Participating providers: from 19,150 to 25,668 (up 34.0%) By late May 2025, Ontario (792,689 patients) and Quebec (627,707) had the highest patient volumes, reflecting their relative population size in the country. The SOHCP survey found over 60% of dental practices Reference 1. Brondani MA, Jessani A, Faria-e-Silva AL, Ardenghi DM. Initial findings from the Canadian Dental Care Plan: Policy in Action. J Can Dent Assoc 2025;91:p15. The views expressed are those of the authors and do not necessarily reflect the opinions or official policies of the Canadian Dental Association. 10 | 2025 | Issue 5 News and Events
Reevaluate RinseTM It’s Time For An Evidence-Based Recommendation Systematic reviews, meta-analyses, the European Federation of Periodontology S3 level clinical practice guidelines, and a recent consensus report from global experts, support the adjunctive use of antiseptic mouth rinses.1-3 Clinically Proven Formula with Essential Oils Eliminate Germs Learn More 1. Treatment of stage I-III periodontitis. The EFP S3 level clinical practice guideline. J Clin Periodontol. 2020 Jul;47. 2. Figuero, E., Roldán, S., Serrano, J., Escribano, M., Martín, C., & Preshaw, P. M. (2020). Efficacy of adjunctive therapies in patients with gingival inflammation: A systematic review and meta-analysis. Journal of clinical periodontology, 47 Suppl 22, 125–143. 3. Bosma, M.L., McGuire, J.A., DelSasso, A. et al. Efficacy of flossing and mouth rinsing regimens on plaque and gingivitis: a randomized clinical trial. BMC Oral Health 24, 178 (2024). https://doi.org/10.1186/s12903-024-03924-4 Always read and follow the label. © Kenvue Canada Inc. 2025
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Dentists’ Role in Measles Prevention Canada is dealing with its largest measles outbreak since the disease was declared eliminated in 1998, with over 4,000 confirmed cases reported across several provinces, according to Dr. Marina Salvadori, senior medical advisor with the Public Health Agency of Canada (PHAC) and professor in the division of pediatric infectious diseases at McGill University. “The outbreak began in October 2024 when someone visited from overseas for a wedding in New Brunswick attended by a large group of people who are generally under-vaccinated or unvaccinated,” she says. The celebration, part of a tightly knit Anabaptist community, is believed to be the epicentre of sustained transmission. The outbreak has since spread within other undervaccinated communities in Ontario, Alberta, Manitoba, Saskatchewan, Texas and Chihuahua, Mexico, with occasional spillover into the general population. Dr. Salvadori notes that about 94% of infections are among unvaccinated people and about 75% of cases are among minors under age 18. While most cases remain contained within the affected communities, the scale of the outbreak is unprecedented in modern Canadian public health. “By far, this is the largest outbreak we’ve had in our professional lives,” she says. The primary driver of the outbreak, Dr. Salvadori explains, is low vaccine uptake among certain groups. Large gatherings, including events marking the 500th anniversary of the Anabaptist movement, have created ideal conditions for transmission. Although this outbreak is concentrated in specific populations, Dr. Salvadori cautioned about other demographic vulnerabilities, including children who missed routine vaccinations during the COVID-19 pandemic and have not yet caught up, as well as growing vaccine hesitancy fuelled by misinformation, political polarization and pandemic fatigue. “Only vaccination can prevent large outbreaks,” she says. The primary driver of the outbreak is low vaccine uptake among certain groups. Large gatherings have created ideal conditions for transmission. Dr. Marina Salvadori 13 Issue 5 | 2025 |
How to Help During a Measles Outbreak Dentists may not be the first health professionals the public thinks of in an infectious disease outbreak, but Dr. Salvadori believes they are well-positioned to contribute. “The most important thing is to make sure that the whole dental team is immune to measles,” she says. Dr. Salvadori’s recommendations for dental practices begin with verifying that all staff are immune to measles—everyone with direct patient care should have two doses of measles-containing vaccine or an IgG positve for measles, regardless of year of birth. “You work in very close range with your team for long periods of time. This is an airborne disease, one of the most infectious diseases that we know of,” she says. Having 2 doses of a measles-containing vaccine is almost 100% effective at preventing measles. Dr. Salvadori encourages direct contact with local public health units in any case of suspected measles, as these teams can offer immediate advice and support tailored to the specific situation. immune and encounter the virus will become infected. The virus can spread to others before the characteristic rash appears, meaning people can pass it on before they even know they have measles. Be an Advocate for Vaccines Dr. Salvadori suggests other practical steps dentists may consider, such as posting vaccine information in waiting rooms, asking new patients about their vaccination status, and expressing your own beliefs about the benefits of vaccination. When addressing misinformation, she cautions against blunt refutation, explaining that “just refuting can actually polarize people more.” Instead, she recommends starting with an open-ended question like, “Tell me what you’re most worried about,” and responding directly to those concerns. Dentists can also refer patients to physicians or specialized vaccine hesitancy clinics. To stay informed, Dr. Salvadori recommends several reliable sources that can help dentists keep their knowledge current and respond effectively during outbreaks. The Canadian Immunization Guide, published by PHAC, provides comprehensive information on vaccines and immunization protocols. Dentists can also benefit from regularly checking provincial and local public health websites and subscribing to their newsletters for updates and guidance. Finally, she encourages direct contact with local public health units in any case of suspected measles, noting that these teams can offer immediate advice and support tailored to the specific situation. Dr. Salvadori believes that a dental office is a high-risk setting for measles transmission, and any suspicion of measles should prompt immediate contact with the local public health unit. “People at the public health unit have built strong relationships with the affected communities and are doing a good job of working with them,” she says. Her final message to dentists: a subtle word from a dentist to a patient about the effectiveness of vaccines and their importance to long term public health can make a difference. She also advises screening patients, postponing nonurgent care for anyone suspected of having measles, and, in urgent cases, coordinating with hospitals to follow infection control protocols, including the use of negative pressure rooms, if possible. Dentists can also monitor local outbreak activity by subscribing to public health updates, particularly in high-risk areas. Dr. Salvadori also suggests that dentists consider having the best protective measures, including N-95 masks and enhanced air exchanges. “The only way to protect yourself in addition to being vaccinated is to wear an N-95 and have good air exchanges,” she says. Beyond the typical early symptoms—fever, cough, runny nose and conjunctivitis—dentists can look for Koplik spots. “These are little white dots on the buccal mucosa that appear two to three days before the rash,” Dr. Salvadori says. These are symptoms specifically characteristic or indicative for measles and more likely to be noticed by dental professionals than physicians. Anyone who contracts measles can develop complications, but some people are at greater risk of severe illness. These include children under age five, especially infants who are too young to be vaccinated, pregnant individuals, and people with weakened immune systems. More than 90% of people who are not The views expressed are those of the author and do not necessarily reflect the opinions or official policies of the Canadian Dental Association. Watch an interview with Dr. Salvadori on measles on CDA Oasis at: bit.ly/4ntP8sc 14 | 2025 | Issue 5 News and Events
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DENTAL DIGEST On August 22, 2025, Dr. Bruce Ward, CDA president, published an article in National Newswatch about the Canada Dental Care Plan (CDCP). The CDCP represents a substantial federal investment in public dental coverage, yet several challenges remain, such as treatment delays, administrative issues, and preauthorization requirements that can slow down or even deny certain care for patients. Dr. Ward highlighted the risk posed if employers scale back private dental benefits and also noted human resource challenges reported by dental professionals. Read more to discover the recommendations that CDA has put forward to help improve the CDCP and ensure it becomes a lasting pillar of the national health care system. The recommendation include CDA urging the federal government to: • Streamline preauthorization and processing claims to reduce delays A Patient-First Dental Program Still Needs Work • Protect existing private benefits through policy safeguards • Invest in workforce training and recruitment, particularly for dental assistants and dental hygienists • Support dental schools to ensure students can complete their training As part of CDA’s ongoing efforts to ensure that all dental offices using CDAnet/ITRANS have access to the latest features and benefits, ITRANS v.1 will be officially retired on June 30, 2026. ITRANS is CDA’s secure service that enables dental offices to submit insurance claims through their practice management software. Since its introduction in 2004, the ITRANS system has evolved significantly. In 2019, ITRANS 2.0 was launched, providing a higher level of service and offering additional features, such as: • Smoother performance: ITRANS 2.0 improves the speed of transactions and is less prone to system slowdowns. • Automatic carrier updates: Your practice management software stays aligned with the latest carrier claim options– no manual updates required. (Available when implemented by the dental software). • Auto-renewal of CDA Digital IDs: With auto-renewal, your CDA Digital ID stays active without manual intervention, saving time and eliminating administrative hassles. • Streamlined setup: ITRANS 2.0 installs quickly with fewer configuration requirements, minimizing downtime and ensuring a seamless transition for dental offices. Original Version of ITRANS Retiring in 2026 • Quick access: The CDA Practice Support application includes the installer for new CDA Digital IDs, and quick access to the CDA PSS website at services.cda-adc.ca. These ITRANS 2.0 enhancements provide a smooth, secure and efficient claims experience for your practice. If your office is currently using ITRANS v.1, contact your dental software vendor to request an upgrade to ITRANS 2.0 before June 30, 2026, to avoid any claim transmission disruptions. Step-by-step instructions on how to determine if your office currently uses ITRANS v.1 or ITRANS 2.0 are available at: bit.ly/3Kc7rnr If you have any questions or need support, please contact your dental software vendor or the Help Desk at 1-866-788-1212 or support@goitrans.com. See: bit.ly/4mpwPDI 17 Issue 5 | 2025 |
Catching Up with the Oral Health Community in Canada: The Network for Canadian Oral Health Research (NCOHR) We checked in with NCOHR’s director Dr. Ana Velly and members of the research network’s executive committee to learn more about the work they do. Dr. Ana Velly, is the director of NCOHR, an associate professor at McGill University, faculty of dental medicine and oral health sciences, and director of research for the department of dentistry, SMBD— Jewish General Hospital. Contributors to this article also include members of the NCOHR executive committee Drs. Maryam Amin, Laurent Bozec, Abbas Ali Jessani and Petros Papagerakis. Q. What is NCOHR and what do you do, in a nutshell? Since 2012, the Network for Canadian Oral Health Research (NCOHR) has brought together people who care about oral health—patients, researchers, dental professionals, educators, students, industry experts and policymakers. This nationwide network helps share knowledge, spark innovation, and improve oral health and overall well-being for people in Canada and beyond. Our current strategic plan is all about inspiring and supporting the next generation of oral health leaders—researchers, clinicians and students alike. We’re focused on fresh ideas, teamwork, and building a better future through innovation. Here’s what we’re working toward: z Growing talent by making training more meaningful and rewarding z Building strong teams by connecting people across different fields and backgrounds z Sharing knowledge in exciting new areas of science and technology to improve oral health By investing in people, partnerships and big ideas, we’re aiming for real change in oral and overall health across Canada. The network receives support from the Canadian Institutes of Health Research (CIHR). 18 | 2025 | Issue 5
At the heart of this work are our 10 dedicated working groups and our Citizen Advisory Board for Oral Health Advancement. These groups bring valuable knowledge, advice and voices from the community to help guide and support everything we do. Q. Please tell us more about the core work that NCOHR does. We’re all about helping our research community grow through education, research, and sharing knowledge in meaningful ways. That’s why we offer a variety of programs designed to spark curiosity, build skills and turn ideas into action. Whether it’s short training internships, research awards for students, student-led research groups, summer institutes, seed funding for new projects, or team-building workshops, our goal is to help discoveries make their way from research to real-life improvements in oral health and overall health. Since we got started, NCOHR has supported: z 166 student research awards z 29 early-stage (seed) research projects z 14 team-building workshops z 5 student-led workshops z 1 workshop on technology and knowledge transfer z 1 workshop on trainee development and knowledge exchange z 8 summer research institutes Each year, we invest in these programs by providing funding that directly supports Canada’s oral health research community. Q. How does NCOHR contribute to the dental profession and oral health in Canada? We know that powerful ideas come to life when people from different fields work together. That’s why NCOHR initiatives focus on building strong collaboration between researchers, dental professionals, doctors, public health experts, patient representatives and policy makers. By combining their perspectives and skills, they’re driving real progress in oral health and overall health. These partnerships are uncovering important links between oral health and overall health, leading to the development of better treatments and smarter ways to prevent disease. They’re also harnessing new technologies to transform care, while identifying and breaking down the barriers that prevent people from accessing the oral health services they need. But even the best ideas need a little help to get started. That’s where NCOHR comes in. By offering support, resources and a strong network, we help oral health researchers launch their work and turn innovation into tangible impacts. We also were instrumental in creating Canada’s National Oral Health Research Strategy 2024–2030, which is a pioneering plan aimed at improving oral health across the country. The strategy was launched at the Canadian Oral Health Summit in Halifax, Nova Scotia, in June 2024, following the World Health Organization’s call for countries to develop such strategies. Q. What’s coming up for NCOHR in the future? We’re in an exciting period of growth. We will launch two training programs: the ACFD-NCOHR Short Training Internships Program, in partnership with the Association of Canadian Faculties of Dentistry, and CATAPULT—the Canadian Oral Health Academy Program for Universal Virtual Training. These programs are designed to energize research training by giving students and faculty direct access to the latest breakthroughs in oral health research and education. The content is always evolving, regularly updated to reflect new evidence, cutting-edge technology and emerging health priorities. We’re also expanding our influence through a growing set of strategic research themes. These focus on bigpicture questions—how oral health connects to overall health, how treatments perform in the real world, why some people face more barriers to care than others, and how to make dental care more equitable and accessible. We’re also exploring the future of science with “omics” approaches—advanced tools that explore the molecular makeup of biological systems to unlock powerful insights into health. We’re training the next generation of researchers, health professionals and leaders, all while championing bold ideas and strong partnerships. Learn more about NCOHR at: ncohr-rcrsb.ca 19 Issue 5 | 2025 | News and Events
Halifax Initiative Delivers Adaptive Tools for Kids with Special Needs What began as a research project in dental school has blossomed into an initiative making a tangible impact on the lives of children with disabilities—and their families—across Atlantic Canada. Spearheaded by Dr. Jenna McNutt, a recent dental graduate, and pediatric dentist Dr. Tracy Doyle, the program delivers customized oral health care tools designed specifically for children who face barriers to routine oral care and hygiene. The project emerged while Dr. McNutt was a dental student at Dalhousie University. “We were assigned a research project where we worked with a mentor,” she says, recalling how her interest in helping people with disabilities shaped her project focus. Under the supervision of Dr. Doyle, she began searching for adaptive products that could improve at-home oral health care. “We found some exceptionally helpful tools,” she explained. “And then we successfully obtained funding to actually put these packages together for patients in need, which was incredible.” 20 | 2025 | Issue 5
Knowledge Translation in Action For Dr. Doyle, the experience represented a high point in translating academic knowledge into real-world impact. “This was my best example of knowledge translation,” she says. “Instead of focusing on an article in a scientific publication, we pursued funding to make this a reality. The result has been far more tangible and meaningful.” Based at the IWK Health Centre, Atlantic Canada’s largest pediatric hospital, Dr. Doyle sees a large population of children with intellectual and developmental disabilities—patients who often face significant oral care challenges at home. “I get calls and emails all the time from parents and caregivers asking what they can do to help with home care,” says Dr. Doyle. “Many of these children have taste sensitivities, oral aversions, or are completely uncooperative with toothbrushing. It’s a daily battle for parents.” Funding from the IWK Health and the Thistledown Charitable Foundation made procuring the kits possible. tell parents what to do. You have to show them, and you have to equip them.” Discovering Adaptive Tools That Work Among the most effective adaptive oral health tools were three-sided toothbrushes that clean multiple surfaces of the tooth simultaneously, non-flavoured fluoride toothpaste that reduced sensory discomfort, and an innovative flossing device called “gum chucks,” which resemble tiny nunchucks and allow for improved dexterity. Dr. McNutt found these especially compelling. “They were probably my favourite discovery,” she says. “They make flossing easier and more fun, especially for people who struggle with manual dexterity.” Dr. Doyle confirmed that the gum chucks have been a standout success. “For some, traditional flossing can be nearly impossible,” she notes. “Even floss picks can be a challenge. They are especially helpful for those hard-toreach posterior areas of the mouth.” Education Meets Empowerment Each kit is tailored to the needs of the individual child and includes more than just innovative products. Dr. McNutt also developed a colourful brochure with instructions for positioning, frequency and general diet and hygiene advice. “There’s a little hourglass timer to encourage brushing for a full two minutes, advice about drinking fluoridated water, and general dietary recommendations,” she says. “We wanted to provide both the tools and the education.” It was apparent that caregivers are actively looking for information and support. But often, they can’t implement the advice they’re given because they lack the tools or don’t know how to apply them effectively. Researching the Need Dr. Doyle tasked Dr. McNutt with identifying available tools and resources that could help make at-home care easier and more effective. Together, they approached the issue from multiple angles: distributing a survey to members of the Canadian Academy of Pediatric Dentistry (CAPD) and the Canadian Society for Disability and Oral Health (CSDH), conducting market research, and reviewing online blogs and caregiver forums to find innovative products. Although the response rate to the survey was modest, the data was clear. “It was apparent that caregivers are actively looking for information and support,” Dr. McNutt says. “But often, they can’t implement the advice they’re given because they lack the tools or don’t know how to apply them effectively. We learned that it’s not enough to Three-sided toothbrush that cleans multiple surfaces of the tooth simultaneously. 21 Issue 5 | 2025 | Issues and People
Dr. Doyle is also deeply involved in the CSDH, an allied organization of CDA. “CSDH does tremendous work advocating for equitable oral care for people with disabilities,” Dr. Doyle explains. “We encourage dental professionals and caregivers to join forces. We offer webinars, collaborate with international partners, and do policy advocacy to ensure that vulnerable populations are not overlooked.” At Dalhousie, that advocacy also extends to students. The university’s CSDH student chapter—of which Dr. McNutt was an early member—has built a strong reputation for engagement. “We’ve continued outreach with facilities like Prescott House and hold a Healthy Athletes event every October, at Dalhousie’s Faculty of Dentistry” says Dr. Doyle. “This year, we even included women’s health support. It’s a first for Special Olympics programming.” As Dr. McNutt begins her dental career in New Brunswick, the impact of her school project continues to resonate. “I was looking for a way to help people and it’s incredible to see how far this has gone,” she says. For Dr. Doyle, the work is far from over. “We’re compiling a list of interested families, working on outreach, and trying to make sure these kits get to those who need them,” she says. “Because when we empower parents with the right tools and knowledge, we empower children to thrive and live healthier lives.” Responding to Overwhelming Demand After an article about the kits was published by CBC, demand has grown dramatically. “The day my interview aired on the CBC, the calls started flooding in,” says Dr. Doyle. “We heard from people all over Nova Scotia and beyond.” Though they’ve had to limit distribution due to funding constraints, the team is working to secure more sustainable support so the initiative can continue. Currently, the kits are distributed to IWK patients and through Autism Nova Scotia, which received half of the funded kits. The team has also seen interest from other demographics. “A friend of mine saw the CBC interview and ordered surround toothbrushes for her father, who has dementia,” Dr. Doyle says. “It’s a reminder that these tools have applications far beyond pediatrics.” Dr. McNutt echoed this broader applicability. “Our focus was on kids with developmental and intellectual disabilities, but many of these products would be useful for elderly patients or anyone with dexterity challenges,” she says. Advocacy, Inclusion and Community Outreach The project dovetails with Dr. Doyle’s broader advocacy efforts. As clinical director for the Special Smiles program through Special Olympics Canada, she’s working to bring adaptive oral health tools to athletes with disabilities. “We’re aiming to have some of these products at the upcoming provincial games,” she says. A colourful brochure has instructions for positioning, frequency and general diet and hygiene advice for children with special needs. Learn more about the Canadian Society for Disability and Oral Health at: csdh.ca Access CDA’s tools and resources for providing dental care for persons with special needs at: bit.ly/4kukehy Dr. Jenna McNutt graduated from Dalhousie University’s faculty of dentistry in 2024. She was president of the school’s chapter of the Canadian Society for Disability & Oral Health. Dr. Tracy Doyle is an assistant professor and head of pediatric dentistry at Dalhousie University faculty of dentistry. She received CDA’s Oral Health Promotion Award in 2019. 22 | 2025 | Issue 5 Issues and People
FROM COAST TO COAST TO COAST CONNECTING CARE NATIONAL ORAL HEALTH CONVENTION APRIL 16 18 TRADE SHOW REGISTRATION OPENS AUGUST 22, 2025 ManitobaDentist.ca APRIL 16 Evening Keynote & Trade Show Opens APRIL 17 CE Lectures & Trade Show APRIL 18 CE Lectures & Trade Show APRIL 18 EVENING Presidents Gala
Rethinking Dentistry in the Age of Climate Change Dr. Christophe Bedos began reading about sustainability after being prompted by a structural shift in Quebec’s research funding strategy during the COVID-19 pandemic. As co-director of the provincial oral health research network (Réseau Québécois de recherche intersectorielle en santé buccodentaire et osseuse durable – RiSBOd), Bedos and his colleagues were told by the Fonds de recherche du Québec – Santé (FRQS) that research networks needed to reinvent themselves. The directive was clear: move away from narrow, diseasebased approaches and instead focus on intersectoral, population-relevant challenges, issues like climate change, socioeconomic inequality, aging and artificial intelligence. This shift forced Bedos to reassess his network’s priorities and, in turn, his own. Although his background was rooted in public health, access to care, and social justice, he realized he had never seriously considered environmental sustainability as a core part of oral health research. As he began exploring the topic, he experienced what he describes as a profound personal awakening. Reading scientific reports—including Intergovernmental Panel on Climate Change assessments—shattered his earlier indifference. “I was in denial,” he admits. “I thought, one or two degrees warmer, so what? But I hadn’t understood the full consequences. It was like being hit by a truck.” That period of reflection and learning—across climate science, biodiversity, economics, history, and even philosophy—reshaped his worldview and led to a reorientation of his research. Today, Dr. Bedos leads a series of interlocking sustainability initiatives at McGill University’s Faculty of Dental Medicine and Oral Health Sciences, including a transformation of its teaching clinic into a more environmentally sustainable clinic. His main collaborator is Dr. Newsha Toreihi, a PhD student and dentist whose passion for environmental justice is rooted in her own early clinical experience during the COVID-19 pandemic in Iran. “I saw how much waste we were producing in the name of infection control,” says Dr. Toreihi. “It made me ask: who’s caring for the planet while we care for the patient?” Dr. Christophe Bedos Dr. Newsha Toreihi 24 | 2025 | Issue 5
Understanding the Mindset of Dental Professionals Dr. Toreihi completed a qualitative and quantitative research study to address a simple, but critical question: What do dental professionals in Quebec think, know, and feel about sustainability in dentistry? Although sustainable dentistry has gained traction in the UK and parts of Europe, most Canadian dental professionals have not received formal training in environmental sustainability. Drs. Toreihi and Bedos realized they needed to understand the current landscape in Canada. The qualitative phase, which is now complete and should be published in the coming months, involved focus groups and interviews with a diverse group of dental professionals—dentists, dental hygienists, and dental assistants—from both the private and public sectors in Quebec. to learn more. They expressed interest in training programs—especially if offered online, for CE credit, and grounded in clinical evidence. They also wanted practical tools: simple guides, checklists, or decisionmaking frameworks they could implement in their own clinics along with supportive policies to facilitate and sustain these practices. Most participants expressed personal concern about the environment. Many referenced visible environmental changes, like wildfires and air pollution, especially after the record wildfire seasons in Canada. “They do care and feel responsible for their children and future generations,” Dr. Toreihi said. “They see the world changing and want to do something about it.” While participants supported the idea of being more environmentally responsible, few had a clear or structured understanding of what sustainable dentistry actually involved. Their knowledge was mostly informal, based on intuition or what they had picked up from general media, rather than clinical guidelines or formal training. Some oral health professionals were taking self‑initiated actions that they hoped were helpful, like separating waste or using certain “green” products, but these actions weren’t grounded in evidence or best practices. Nearly all participants emphasized a desire One Clinic as a Case Study At McGill’s teaching clinic, the effort to measure environmental impact is already well underway. With funding from the McGill Sustainability Projects Fund and support from Synergie Santé Environnement (SSE), a Quebec-based nonprofit that helps health institutions reduce their ecological footprints, Drs. Bedos and Toreihi are auditing all aspects of the clinic’s operations—from transportation habits and waste to procurement chains and water use. Dr. Toreihi details the steps: “We surveyed patients to understand how they get to the clinic, checking postal codes and mode of transportation. Same for staff and students. Then we looked at the waste: how much, what kind, how often. Procurement is especially complicated. We’re trying to track the origins of dental materials, what they’re made of, how they’re packaged, how far they travel.” Participants supported the idea of being more environmentally responsible, but few had a clear or structured understanding of what sustainable dentistry actually involved. Switching to reusable gowns and bibs, adopting teledentistry for some follow-ups, and analyzing whether fewer, larger shipments of supplies might be more sustainable than frequent smaller orders. Even the ubiquitous model teeth that dental students practice on are under review. “SSE took a sample and sent them to a recycling company,” Dr. Bedos says. “Some of them are barely used. Can we recover them?” The goal is to create a comprehensive carbon footprint for the clinic—something they’ll revisit after changes are implemented. Among the early modifications implemented: switching to reusable gowns and bibs, adopting teledentistry for some follow-ups, and analyzing whether fewer, larger shipments of supplies might be more sustainable than frequent smaller orders. Dr. Toreihi hopes to have SSE’s baseline report later in 2025. After that, the real work begins. 25 Issue 5 | 2025 | Issues and People
Counting Carbon to Drive Change Data is the cornerstone of strategy, not only in the clinic but beyond. Drs. Bedos and Toreihi are also building a carbon footprint calculator for dental offices, known as Carbo‑Dent, in partnership with collaborators in France. It’s designed to help clinics across Quebec (and eventually elsewhere) calculate their greenhouse gas emissions based on inputs like staff and patient commutes, electricity use, waste, and dental supply chains. “It’s not just about awareness,” Dr. Toreihi says. “It’s about numerical evidence. Dental professionals need to see a graph and chart that says, ‘Here’s the breakdown of your clinical and non-clinical carbon footprint and which source of emissions is the largest.’ Only then can we change habits.” From One Clinic to Many While McGill’s dental clinic has the support of a large institution, implementing change in private practices presents different challenges, and Dr. Toreihi is studying that, too. Her PhD thesis project focuses on helping private clinics across Quebec adopt eco‑responsible practices using the training modules, the carbon calculator, and case studies developed at McGill. “Private clinics don’t have the same resources,” she says. “There’s no one to allocate funding or assign a sustainability committee. Everything depends on the clinic owner, on their time, their budget and their motivation.” Many practitioners, she’s found, care deeply about planetary health. But they’re overwhelmed or unsure where to start. In interviews, they expressed frustration over the higher cost of sustainable products and the lack of standardized guidance. “They’re doing what they can, based on general knowledge, recycling here and there, but nothing structured,” Dr. Toreihi says. That’s where Drs. Bedos and Toreihi’s educational efforts come in. They’re building a continuing education course with support from the Institut national de santé publique du Québec. The online, for-credit training will introduce dental professionals to sustainable practices and how to track their impact over time. “We want sustainability to be embedded in professional identity,” Dr. Bedos says. “It’s not just a checklist, it’s a way of seeing.” The tool is currently being tested, and early versions have shown just how substantial emissions from transportation can be. “In dentistry, transportation can account for 60% of a clinic’s footprint,” she explains. “Waste, despite all the plastics, is usually less than 1%. That surprises many people.” Still, waste matters, particularly because it’s so visible. Reusable items, digital recordkeeping, and other waste reduction initiatives all factor into the changes they’re piloting. But the digital shift brings trade-offs, Dr. Toreihi cautions. “Digital tools reduce chemical and paper waste, but they require electricity and rare minerals. Same with electric cars: better for air quality, but the batteries are complex to produce and recycle.” Many practitioners care deeply about planetary health. But they’re overwhelmed or unsure where to start. In interviews, they expressed frustration over the higher cost of sustainable products and the lack of standardized guidance. A Philosophy as Much as a Program Though grounded in data, Dr. Bedos’ outlook is philosophical. “The process of measurement compels us to pause and reflect; not only on transportation and material consumption, but ultimately on the structure of our society itself,” he explains. “We must ask: what kind 26 | 2025 | Issue 5 Issues and People
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