2016 Alberta Dental Association and College - Annual
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Alberta
Dental
Association
and College
2016
Annual
Report
2 | Alberta Dental Association and College 2016 Annual Report
Table of Contents
MISSION AND GOALS......................................................................................................4
HISTORY................................................................................................................................5
PRESIDENT’S REPORT..........................................................................................................6
PUBLIC MEMBER’S REPORT...............................................................................................8
COUNCIL..............................................................................................................................9
NEW COUNCIL MEMBERS.............................................................................................10
STRUCTURE.........................................................................................................................12
HEALTH PROFESSIONS ACT & GOVERNANCE...........................................................13
REGISTRATION AND RENEWAL OF PRACTICE PERMITS............................................14
REGISTRATION STATISTICS..............................................................................................15
CONTINUING COMPETENCE.......................................................................................17
PRACTICE VISITS................................................................................................................17
COMPLAINTS RESOLUTION...........................................................................................18
DENTAL FACILITIES ACCREDITATION........................................................................... 20
SEDATION......................................................................................................................... 22
FACIAL ESTHETIC THERAPIES AND ADJUNCTIVE PROCEDURES.............................. 24
RADIATION HEALTH AND SAFETY................................................................................ 26
DENTAL FEES..................................................................................................................... 28
DENTAL PREPAYMENT PLANS (DENTAL INSURANCE)............................................... 30
GOVERNMENT-ASSISTED PROGRAMS........................................................................31
COMMUNITY ASSISTANCE FUND............................................................................... 33
MOBILE DENTAL CLINIC PROGRAMS.......................................................................... 34
RECOGNITION AND AWARDS..................................................................................... 36
FINANCIAL STATEMENTS............................................................................................... 43
Alberta Dental Association and College 2016 Annual Report | 3
MISSION GOALS
The Alberta Dental Association and College provides Optimizing oral health services for all Albertans through
leadership to the dental profession on professional governance leadership in the profession that ensures safe,
regulations and member services, and provides the appropriate and ethical oral health care.
public with information and services, to ensure that
Albertans receive safe, appropriate, ethical and quality Effective and efficient resolution of problems regarding oral
dental care as an integral part of general health. health services provided by dentists; with patients, dentists,
government, industry, and other health professionals.
VISION STATEMENT In cooperation with patients, dentists, government, industry,
other dental organizations and health professionals, the Alber-
Albertans recognize and regularly use dental services ta Dental Association and College supports effective resolution
as key components of their primary health care. The of health-care delivery issues to ensure that the public does not
dentist-patient relationship is seen as central to the receive unsafe, inappropriate or unethical oral health services.
ongoing health of Albertans. Albertans trust their
dentists, and view them as the leaders in the delivery Effective communication and collaborative relationships with
of the most advanced, evidenced-based and caring dentists, the public, government, industry, other dental organi-
dental services. Dental practices are considered a vital zations and health professionals.
part of Alberta communities, and dentists are active
contributors to community life. Promotion of excellence in the delivery of oral health services.
The Alberta Dental Association and College upholds Positioning of dentists and dental services with all stakeholders
the public trust of dentists, and preserves the integrity as trustworthy, competent, and responsive to personal well-
of the relationship of dentists with government, other ness of Albertans.
service care providers, supporters of dental services,
the business community and the marketplace in general. Effective monitoring and support of continuing competence
and capacity to practice of Alberta dentists.
4 | Alberta Dental Association and College 2016 Annual Report
History
From Sitting Bull to Self-Regulation known and a college degree not located, he claimed The Alberta Dental Association and College
to have “Fifteen years of practical experience.” He was under the Health Professions Act in 2001
In 1883, Dr. Frederick Shaw and Dr. William Wilson forced to retire in the late 1800s due to eye trouble. He
entered the practice of dentistry in the district of Alberta. joined the Calgary Post Office, dying on September In May 1999, the Alberta Legislative Assembly passed
Both had served with the Northwest Mounted Police. 17, 1928. the Health Professions Act to regulate all 30 self-
governing healthcare professions in Alberta. This new
Dr. Frederick Shaw, born in Kentville, Nova Scotia in When the North West Territories Dental Association was law for regulated healthcare professionals required
1856, graduated from the New York Dental College in organized on July 1, 1889, six dentists were practicing in all healthcare professional colleges to follow common
1878. In 1879 he applied to the Northwest Mounted Alberta: W. Haydon, Cochrane; E.C. Holbrook, Calgary; rules to investigate complaints and set educational and
Police for training and services. He made his way to the F.D. Shaw, Fort MacLeod; P.F. Size, Calgary; W. Wilson, practice standards for registered members. The Health
West through the United States to Fort Breton and then Edmonton; and R.H. Zimmerman, Pincher Creek. Professions Act also increased public representation on
to Fort Walsh in the Cypress Hills. While serving at Fort college councils and in disciplinary processes.
Walsh, he provided dental treatment for Chief Sitting
Bull, who required two teeth to be extracted to relieve The Alberta Dental Association Formed in In December 2001, the Alberta Dental Association was
pain. This was some time after the Battle of Little Big Horn 1906 the first profession to be regulated under the Health
in Montana which took place on June 25-26, 1876 Professions Act. The Alberta Dental Association became
when Chief Sitting Bull was delivered to the American After receiving provincial status in 1905, the newly the Alberta Dental Association and College.
authorities. formed Alberta Legislature proclaimed a new Dental Act
on May 9, 1906. The first annual meeting of the Alberta
Dental Association was held on July 9, 1906. Under the Health Professions Act, the Alberta Dental
After several more years in the Northwest Mounted Association and College is the self-regulatory body for
Police, Dr. Shaw obtained an honourable discharge in dentists in the province of Alberta, and currently regulates
1884. He registered himself as a practising dentist in the At the first meeting of the Alberta Dental Association
under the new Alberta Dental Association Act, July over 2,500 dentists in Alberta.
Northwest Territories and received certificate No. 1 in
1889 (the certificate was to practice dentistry and dental 9, 1906, in Banff, the first motion was to establish a
surgery). On buckboard or saddle horse, he travelled university in the Province of Alberta. In 1916, the Alberta Self-regulation is the authority granted by statute (the
to Calgary, Medicine Hat, Lethbridge, Fort Macleod Dental Association’s annual meeting was held in Banff, Health Professions Act) to the dentistry profession to
and Pincher Creek. He eventually built a home on the and meetings with the University of Alberta resulted in protect the public through regulating the practice of its
St. Mary’s River just north of Cardston. Dr. Shaw died in the inauguration of a dental program in the Medical members, and ensuring regulated dentists are qualified,
Lethbridge in 1926. Faculty at the University of Alberta in the fall of that year. competent and ethical.
Over the years, the Alberta Dental Association has The Program Development Committee functions under
Dr. William “Tug” Wilson, born in Quebec, joined the been instrumental in the development of many different
Northwest Mounted Police in Winnipeg in 1875, stating Section 27 of the Health Professions Act where ministerial
government programs for Albertans in need of dental approval has been recieved to negotiate professional
his previous occupation as “dentist.” In December of services. Other programs that have been developed
1883 he retired from the Northwest Mounted Police fees on behalf of some or all of the members; there were
are the Cleft Palate Program, Mobile Dental Clinics and no program considerations in 2016.
to practice dentistry in Calgary. He then moved to the Craniofacial Osseointegration and Maxillofacial
Edmonton and practiced in South Edmonton. Prosthetic Rehabilitatoion Unit.
While Dr. Wilson’s professional qualifications were not
Alberta Dental Association and College 2016 Annual Report | 5
President’s Message
conjunction with Council, to act in a manner that serves a precursor to finding new office space which will
the public interest and provides leadership to the pro- facilitate more functional work spaces that address the
fession. The Council provides direction for the practice current privacy and public access requirements.
of dentistry by the regulated members. Through effective
governance, the ADA&C builds the profession and This year the ADA&C completed the Centennial Pro-
maintains and enforces the Standards of Practice and gram that was initiated in 2006. These actions were
the ADA&C Code of Ethics. Under the Health Profes- acknowledged at the 110th ADA&C Anniversary Gala
sions Act, all dentists must follow the boundaries defined in November. The publication “The First Centennial of
by the Code of Ethics and the Guides and Standards the Alberta Dental Association and College”
of Practice. The ADA&C will always face new issues which was written by Dr. Thompson was unveiled at
both internally and externally generated. External trade the Gala; the book outlines the transitions that the
agreements are an example of issues that we must be profession of dentistry and dentists have gone through
fully cognizant of before they are finalized and imple- in Alberta since the 1880’s and particularly since the
mented. The ADA&C must always act to proactively Alberta Dental Association was formed in 1906. The
protect the profession and the public from those seeking book is in a coffee-table format with stunning archi-
negative change driven by the opportunity for personal val photos and details on the profession’s history. The
gain at the expense of others. ADA&C had provided $3 Million to the University of
Alberta in 2006 for two endowed chairs in the School
The ADA&C acknowledged and thanked Dr. Gordon of Dentistry, Faculty of Medicine and Dentistry at the
The Alberta Dental Association and College is the Thompson for his many years of dedicated service and University of Alberta, and the positions were filled this
Dental Regulatory Authority for the province of his contributions towards making the ADA&C a strong year. The ADA&C Clinical Dentistry Research en-
Alberta. In 2016, the Alberta Dental Association and and viable organization. The ADA&C was pleased dowed chair is Dr. Thomas Dietrich who is leading the
College was involved with many program initiatives in- to have Dr. Randall Croutze elected President of the development of a world-class clinical research pro-
cluding provincial legislation, patient communications, Canadian Dental Association and Dr. Cliff Swanlund as gram that focuses on innovation in oral health delivery.
professional advertising, standards of practice and President of the Canadian Dental Regulatory Authorities The ADA&C Oral Health Translation Research
Council governance. On July 1st, the ADA&C ad- Federation. As an organization we have many out- Endowed Chair is Dr. Owen Addison who will lead the
opted a new Governance model which provides a comes to be proud of including being the first profession development of a world-class dentistry research pro-
framework and operating guidelines and defines the proclaimed under the Health Professions Act which gram with a focus on the active engagement between
roles and responsibilities with the Executive Director/ provided a template for other professions; being the first foundational sciences and clinical restorative dentistry.
Registrar role changed to Chief Executive Officer. province where all dentists can access the provincial
This required significant by-law changes as well. This Electronic Health Record; and receiving the Canadian The new Chief Executive Officer, Dr. Randall Croutze
Annual Report outlines the 2016 regulatory functions Dental Association Oral Health Promotion Award for transitioned into the job in September. He has had
of the Alberta Dental Association and College. producing the Patient Communication Guide which is considerable experience with the Alberta Dental Asso-
used by the other provinces and territories. The ADA&C ciation and College on many committees, the ADA&C
As the ADA&C president, my aspirations were, in Council negotiated the sale of the current building as Council and as President in 2006. Dr. Croutze was
6 | Alberta Dental Association and College 2016 Annual Report
born and raised in Edmonton and obtained a B.Sc. formation to assist dentists with meeting the provincial dation Omnibus Committee was formed to review the
and then a DDS degree at the University of Alberta in requirements of the Health Information Act, and this sedation spectrum from minimal sedation to general
1985. year the emphasis was on the generation of Privacy anesthesia.
Impact Assessments for dental offices. The Health In-
The Alberta Dental Association and College worked formation Act establishes boundaries in that custodians The ADA&C assisted Fort McMurray dentists after the
with Alberta Health on the various levels of communi- must safeguard the health information they hold; only wild fires destroyed parts of the city. All of the dentists
cation between dentists and their patients. The ADA&C disclose what is needed to do the job and no more; were sent emails, and those who had cell phone num-
“Ask Your Dentist” program was a comprehensive provide anonymous information whenever possible; bers on file were contacted by the ADA&C. A Mobile
campaign that promoted prevention and dental health and only provide information to those with a need to Dental Clinic was set up in Fort McMurray to provide
care at all stages of life. The campaign included know. With the extensive resources developed by the dental service to patients by several dentists until they
television, radio and online ads, a patient brochure ADA&C, dentists are able to meet the requirements of were able to reopen their dental practices in Fort
and web based information on the Alberta Dental the provincial government’s Office of the Information McMurray. The Mobile Dental Clinic was operational
Association and College website. The campaign focus and Privacy Commissioner of Alberta. The next step six days a week as dentists provided the full range of
was to promote patient discussions with their dentist for Alberta dentists is to be able to access Netcare, the dental services.
to assist patients in making informed decisions about Alberta government’s Electronic Health Record. In
their dental care treatment, options and costs. The December, Alberta Health Services and the ADA&C
television videos end with Ask Your Dentist and a web approved field tests for dental offices accessing Net-
link to www.askyourdentistalberta.com. With radio, care. As a result, Netcare will be made available to
the 30 second audios aired on radio stations across any dentist who wishes to use it. This will give dentists
the province. Patient brochures were sent to all dental access to Personal Demographic Information; the
offices. The brochure provides information on dental Medication Profile with the Pharmaceutical Information
fees, dental prepayment plans (dental insurance) and Network, allergies, intolerances and immunization
encourages patients to speak with their dentist about history; Diagnostic Imaging, tests and reports; and Dr. Allan Graas
treatment options and fees to assist in making informed Laboratory test results. On a case by case basis, some
decisions. dentists could have access to Hospital Visits; tran-
scribed reports of hospital visits; and e-Referral for
In early December, Health Minister Sarah Hoffman referrals to a medical specialist.
released a fee review of dental services. The ADA&C
worked collaboratively with the government as one This year there was an emphasis on Guides such as the
of several stakeholders that had input into the gov- Guide for Advertising and Promotional Activities for
ernment’s Alberta Dental Review, Average Dental Fee Alberta Dentists and Standards of Practice including
Review Report and the Alberta Dental Consolidation Sedation/General Anesthesia which was initiated
Working Group. in October 2014. The Sedation/General Anesthesia
Standard was reviewed and updated at all of the
The ADA&C has been providing documents and in- ADA&C Council meetings in 2016. In October, the Se-
Alberta Dental Association and College 2016 Annual Report | 7
Public Member’s Report The primary mandate of the Alberta Dental Association and College is to maintain a standard of excellence for the delivery of dental health services in Alberta. As a member appointed by the Government of Alberta, my primary concern is patient safety and public protection. I maintain, without a doubt, that the Alberta Dental Association and College continues to keep this as its primary purpose. There is no question that the Alberta Dental Association and College is fulfilling its obligations under the Health Professions Act. As such, regulated members are enjoying the privilege of self-governance that the legislation offers. I bring a wide range of experience in governance to the position. This includes not-for-profit organizations, volunteer board positions and a role in health care. As a public member, I advocate for the public and endeavor to bring the public’s perspective to the dentistry profession. I try to provide input so that the interests of the Alberta Dental Association and College membership are considered, along with those of the public. Therefore, at Council meetings I participate in discussions, advise on issues, and contribute to strategies to enhance the profile of the Alberta Dental Association and College. The Alberta Dental Association and College is well positioned and strong, due to many individuals. The work of the Council and staff of the Alberta Dental Association and College is an important part of keeping the Alberta Dental Association and College operating efficiently. I feel honored and privileged to be associated with the dentistry profession and to share in a diverse mandate. As a public member, I can attest that members and the public are well served by Council, volunteers, committee members and staff. The Alberta Dental Association and College and its membership are dedicated to the provision of excellent health care services to Albertans, and I acknowledge and commend the efforts I have observed. Ms. C. (Colleen) Sekura 8 | Alberta Dental Association and College 2016 Annual Report
2016
Dr. A.H. (Allan) Graas Dr. T.A. (Troy) Basarab
President, Council Member Council Member,
Calgary District Southern District
Dr. T.F. (Tobin) Doty Dr. R.P. (Randall) Crowell
Past-President, Council Member Council Member,
Council
Calgary District Edmonton District
Dr. G.S. (Mintoo) Basahti Dr. C.A. (Carol) Martin
President-Elect, Council Member Council Member,
Edmonton District Northern District
Dr. A.N. (Anthony) Odenbach Ms. C. (Colleen) Sekura
Vice-President, Council Member Council Member,
Central District Public Member
Dr. J.I. (Jonathan) Skuba
Council Member,
Edmonton District
Dr. S.B. (Bruce) Yaholnitsky
Council Member,
Calgary District
Alberta Dental Association and College 2016 Annual Report | 9
New Council Members Dr. Randy Crowell Dr. Randy Crowell, a General Dentist, is proud of the thriving family practice he has developed over the past 25 years in Edmonton’s west end. Prior to practicing dentistry, Dr. Crowell began his career in health care as a Paramedic. He completed his Emergency Medical Technician training in 1980 from S.A.I.T. and earned his Paramedic diploma (EMT-P) in 1984 from N.A.I.T. He worked as a Paramedic and STARS Flight Medic until 1991 and also became a Basic Life Support (CPR) Instructor that same year. Dr. Crowell obtained his degree in dentistry from the University of Alberta in 1991 where he was the President of his graduating class. From 1994-2000, Dr. Crowell sat on the Edmonton and District Dental Society Board as Director and was President of the Society for the 1998-1999 term. During his Edmonton and District Dental Society tenure, his Board of Directors oversaw programs such as Open Wide and Start School Smiling, to name a few. He is the Founder of the Northwest Dental Exposition which takes place in Edmonton to this day. In 1997, Dr. Crowell earned his Physiology, Monitoring and Intravenous Conscious Sedation Certificate from the University of Toronto and in 2003, he qualified as an Ad- vanced Cardiac Life Support (ACLS) instructor through the Heart and Stroke Foundation of Canada. As part of his commitment to patient care, Dr. Crowell was instrumen- tal in bringing the Intravenous Conscious Sedation Program to the University of Alberta through the support of the Faculty of Medicine and Dentistry’s Continuing Dental Education division. He currently serves as the Chair of the Sedation Standards Review Committee for the Alberta Dental Association and College. He is active in the Faculty of Medicine and Dentistry’s Continuing Dental Education division as a lecturer, where he has taught Intravenous Conscious Sedation, Emergen- cy Airway Management, Basic Life Support and Advanced Cardiac Life Support. Dr. Crowell has run sedation update courses through the University of Alberta in Banff and Kelowna. Dr. Crowell also assists in patient clinics with sedation students for the University of British Columbia. He has delivered various dental office medical emergency lectures to dentists, hygienists and assistants for the University of Alberta, the College of Registered Dental Hy- gienists of Alberta and the Edmonton Dental Assistants Association. He has a special interest in offering general dentistry with intravenous sedation services and recently finished helping the Canadian Dental Association in Ottawa review their office medical emergencies online program Oasis for Canadian Dentists. In his 25 years in dentistry, Dr. Crowell has always been active in the Edmonton and District Dental Society, matters of governance and at the Faculty of Dentistry, provid- ing lectures and courses for dentists, hygienists and assistants in Alberta and abroad. 10 | Alberta Dental Association and College 2016 Annual Report
New Council Members
Dr. Carol Martin
Dr. Carol Martin graudated from the University of Toronto in 1981. From 1981 to 1982 she was Dental Intern at Sunnybrook Health Sciences Centre, a University of
Toronto teaching hospital. She was associate of two general dentistry practices in Calgary from 1982 – 1983. From 1983 to 1988 she maintained a practice of general
dentistry, in Manning. She was an associate in Calgary, from 1988 to 1989. Since 1990 she has operated her own general dentistry practice in Beaverlodge.
From 2001 to 2004 Dr. Martin was a member of the Continuing Competency Committee of the Alberta Dental Association and College. In 2006 she was induced as a
Fellow of the International College of Dentists (Canadian Section). From May 2011 to December 2012 she designed and registered tartans for the Canadian Dental Asso-
ciation and the International College of Dentists (Canadian Section). Since September 2012 she has been a member of the Standing Tartan Committee of the Canadian
Section of the International College of Dentists. In 2014 she was inducted as a Fellow of the Pierre Fauchard Academy, Canadian Section. From 2013-2015 Dr. Martin
was an evaluator for the National Dental Examining Board in Ottawa.
Dr. Martin enjoys walking and playing with her German Shepherd, hiking, snowboarding, gardening (roses, trees, vegetables, flowers), knitting, sewing, reading, tartan
design and photography.
Alberta Dental Association and College 2016 Annual Report | 11Structure
GOVERNMENT OF ALBERTA
MEMBERSHIP MINISTER OF HEALTH
ALBERTANS
COUNCIL
Membership Services Governance Professional Relations Professional Actions
Professional Actions
Confidential Assistance Executive Committee Facilities Accreditation Registration
Alternative Complaint
Dental Congress Radiation Health and Safety
Radiation Health and Safety Resolution
Publications and Complaint Review
Continuing Competence
Communications Committee
First Nations and Hearings Tribunal
Inuit Health
Hearings Tribunal
Representations
Representations
Canadian Dental
Association
Canadian Dental Regulatory
Authorities Federation
National Dental
Examining Board
University of Alberta
NAIT and SAIT
12 | Alberta Dental Association and College 2016 Annual ReportHealth Professions Act Governance
The Alberta Dental Association and College provides leadership to the dental profession on professional
regulations and member services, and provides the public with information and services, to ensure that Albertans
receive safe, appropriate, ethical and quality dental care as an integral part of general health.
Under the Health Professions Act, regulatory responsibilities are:
• establishing entrance requirements for the profession, including academic preparation, and examinations;
• registering of dentists in the province of Alberta;
• maintaining a register of regulated dentists;
• administering the Health Professions Act;
• administering the Dentists Profession Regulation;
• developing, administering and enforcing the bylaws, policies and procedures necessary to fulfil the
requirements of governing legislation;
• adopting a Code of Ethics for the profession;
• establishing and setting Standards of Practice for the profession;
• developing, implementing and monitoring a Continuing Competence Program for the profession;
• investigating, adjudicating and resolving complaints; The Alberta Dental Association and College is governed
• liaising with the Government of Alberta regarding the Health Professions Act and other relevant by a twelve-member council (nine [9] elected dentists,
legislation; and three [3] public members appointed by the
• liaising with other dental regulatory authorities; and Lieutenant Governer in Council).
• liaising with other professional regulatory authorities.
Council uses a policy governance model adhering
to the Health Professions Act, on the responsibilities
related to registration, competence, practice monitoring
and complaint resolution.
Council defines the strategic goals and objectives
(policy) while the Cheif Executive Officer and the
administrative team are responsible for developing and
implementing results (operations).
Council is responsible for governing the dental
profession in Alberta: Council carries out this
responsibility by developing regulations, standards of
practice, codes of ethics and bylaws.
Alberta Dental Association and College 2016 Annual Report | 13Registration and Renewal of Practice Permits
The application and registration process for dentists in Dental Specialties in Canada Oral and Maxillofacial Radiology
Alberta is regulated under the Health Professions Act. The Canadian Dental Association outlines nine (9), Oral and maxillofacial radiologists help diagnose and
The registration requirements are detailed in the Health nationally recognized dental specialties in Canada. treat diseases and disorders of the craniofacial complex
Professions Act. through the use of imaging technologies such as X-rays,
Dental Public Health CT scans and MRIs.
General Dentist Dental public health specialists focus on improving the
To apply for registration in the province of Alberta as a dental health of populations rather than individuals. Orthodontics and Dentofacial Orthopedics
general dentist, an applicant must provide a copy of the They principally serve the community through research, Orthodontists are trained to diagnose, prevent and
certificate from the National Dental Examining Board health promotion, education and group dental care treat dental and facial irregularities, for both functional
of Canada. programs. and esthetic reasons. Treatment options include the use
of dental braces, retainers, spacers and other devices.
Endodontics
Dental Specialist Root canal therapy is the most common procedure Pediatric Dentistry
An applicant for dental specialist requires successful
performed by endodontists. But that’s not all they do. Pediatric dentists provide preventive and therapeutic
completion of the National Dental Specialty Their specialty encompasses the diagnosis, prevention oral health diagnosis, care and consulative expertise
Examination of the Royal College of Dentists of Canada. and treatment of nerve and tissue diseases and injuries. for infants and children through adolescence, including
those with special care needs. They receive training on
General Dentist and Dental Specialist Oral and Maxillofacial Surgery handling the fears or anxieties of some children.
If an applicant wishes to apply for registration as both Oral and maxillofacial surgeons diagnose and
a general dentist and a dental specialist, a copy of the surgically treat disorders, disease, injuries and defects Periodontics
certificate from the National Dental Examining Board impacting the functional and esthetic aspects of the Periodontists focus on the diagnosis, prevention and
of Canada and successful completion of the National mouth, head and neck. For example, they can extract treatment of diseases and conditions that affect the
Dental Specialty Examination of the Royal College of wisdom teeth or broken teeth, treat temporomandibular bones and gums or that lead to loose or lost teeth. They
Dentists of Canada (both) are required. joint disorders, or place dental implants and bone help maintain the health, function and esthetics of these
grafts. structures and tissues. Periodontists also place dental
All members are required to complete an annual implants.
renewal of registration and pay fees as part of this Oral Medicine and Pathology
annual renewal process. Annual renewal is completed Dentists sometimes send specimens to specialists Prosthodontics
electronically through the website. All members must in the area of oral medicine and pathology. These Prosthodontists are trained to diagnosis, restore and
meet the continuing education requirements on a two- specialists rely on clinical, radiographic, microscopic ensure oral function, comfort, appearance and health
year cycle as part of their annual renewal. Two years, and biochemical examinations to establish a diagnosis. by the restoration of the natural teeth or the replacement
from January 1, 2016 - December 31, 2017 is the They focus on the nature and nonsurgical management of missing teeth (e.g. bridges, dentures, implants).
current cycle for continuing education requirements. of disease and disorders that affect oral structures.
14 | Alberta Dental Association and College 2016 Annual ReportRegistration Statistics
The following table summarizes registration data from the 2016 membership year.
REGULATED MEMBERS 2640 NEW REGISTRATIONS 130
General Dentists 2274 Practicing Dentists 63
Dental Specialists 311
Interprovincial 20
Education and Research Registrations* 49
Courtesy Registrations 6 International 43
New Graduates 67
* Of the total 49 Education and Research
Registrations, 12 are residency program students. Canada 50
International 17
There were 3 Volunteer Registrations in 2016.
Dental Specialists 18
Endodontics 1
Orthodontics 10
Pediatric Dentists 3
Periodontists 1
Prosthodontists 2
Oral and Maxilofacial Pathology 1
Registration Appeals 0
Professional Coroporations 2382
Alberta Dental Association and College 2016 Annual Report | 15Continuing Competency Practice Visits
Continuing Competency
Verification by provider is mandatory; attendance at
The Council of the Alberta Dental Association and individual courses is verified or no credits are given.
College continues to review the standards for Con- Credit hours are granted based on one hour of lecture
tinuing Education in terms of the accountability that time equals one hour of credit time. Lectures and
is required under the Health Professions Act and the courses must be provided by:
Dentists Profession Regulation. The Continuing Com-
petence requirement is 60 credit hours over a two- • American Dental Association Continuing Educa-
year period ending in the odd years (e.g. January 1, tion Recognition Program (ADA CERP) approved
2016 to December 31, 2017). Continuing education providers;
requirements must be met prior to registration renewal • Academy of General Dentistry Program Approval
at the end of the two-year term. If a member has not for Continuing Education (AGD PACE) approved
met their required credit hour amount they may apply providers;
for a 60-day extension (while retaining their practice • International, national, provincial and state dental
permit) to be applied to this previous two-year term programs in General Dentistry and Alberta Dental
or the member will be suspended until they obtain the Association and College recognized specialties;
appropriate credit hours. • Alberta Dental Societies;
• Registered Alberta Dental Specialists;
Practice Visits
To obtain program credits, a regulated member may • University of Alberta Faculty of Medicine and
Practice visits are part of the Health Professions Act
undertake professional development activities such Dentistry;
and the Dentists Profession Regulation. The Alberta
as attendance at a dental-related scientific or clinical • Cardiopulmonary Resuscitation (CPR) courses by
Dental Association and College conducted practice
course designed to enhance the professional devel- any recognized provider;
visits as part of the Continuing Competence Program
opment of dentists; attendance at a dentistry-related • Approved Small Group Learning Sessions (or
as directed by Council. The visitations were designed
approved study club; receipt of fellowship by exam- Study Club); and
to assist practitioners in the guidance and implemen-
ination; completion of a graduate or postgraduate • Other activities approved by Council, the Chief
tation of Standard of Practice: Infection Prevention
specialty program; publication of a research paper in Executive Officer or the Continuing Competence
and Control Standards and Risk Management for
a peer-refereed journal; self-directed study and other Committee.
Dentistry and Standard of Practice: Use of Sedation in
activities approved by the Alberta Dental Association Non-Hospital Dental Practice.
and College Council, the Chief Executive Officer or
the Continuing Competence Committee. A total of 73 practice visits were completed in 2016.
Alberta Dental Association and College 2016 Annual Report | 17Complaints Resolution
The Alberta Dental Association and College is the dental regulatory authority for Alberta. The ADA&C administers all complaints within the authority granted by legislation
from the Government of Alberta. The main legislation is the Health Professions Act. Under the Health Professions Act, the ADA&C is unable to publicly disclose information
about a dentist and a complainant.
The public interest is forefront in the complaints process. All regulatory matters must balance protecting the public and ensuring fairness to a dentist.
The complaint process is designed to review a complaint and determine if:
• the conflict can be resolved by the Complaints Director;
• the complainant and dentist can resolve the conflict directly;
• further investigation is warranted; or
• the complaint should be dismissed.
An investigation can take on many forms as follows:
• interviewing the people involved;
• asking for written responses and comments;
• reviewing complete charts and treatment notes; and
• attending at the practice of the dentist.
If a complaint is refered to a hearing:
• the hearing may be held where witnesses, including the dentist and the complainant, may be present and give evidence under oath;
• hearings are open to the public and the date of a hearing is published on the ADA&C website;
• a purpose of the hearing process is to determine if the dentist has engaged in unprofessional conduct. The hearing process is focussed on the conduct of the dentist;
• a hearing tribunal includes one public member who is appointed by the Lieutenant Governor in Council, Government of Alberta and three dentists; and
• if a hearing tribunal determines that a dentist has engaged in unprofessional conduct, a summary of the decision and the evidence from the hearing is shared
publicly, including on the ADA&C website.
18 | Alberta Dental Association and College 2016 Annual ReportDentists are encouraged to address complaints and concerns with their patients early on in their practice with the goal of preventing a complaint but also to address the needs
of the patient. Where complaints are made to the ADA&C, dentists and complainants are encouraged by the Complaints Director, at the onset of the complaint process, to
work together to resolve the complaint. At times, the Complaints Director assists the dentist and the complainant to communicate with each other to resolve the complaint.
The Alberta Dental Association and College encourages resolution of advertising complaints. Advertising complaints are not easily resolved before a complaint is made
because many times notification of a complaint may then encourage a member to review his or her advertising to determine if it is compliant with the Health Professions Act
and the Alberta Dental Association and College Code of Ethics.
2016 Complaint Statistics
Category Total Treatment Advertising
Complaints Complaints
Complaints carried over from previous years and open
as of January 1, 2016 94 83 11
New complaints 2016 140 131 9
Complaints closed 2016 112 102 10
Complaints carried over to January 1, 2017 122 112 10
Breakdown of complaints
Complaints referred to hearing 9 7 2
Hearings partly or completely closed to public 0 0 0
Appeals (Complaint Review Committee) 0 0 0
Members assessed for incapacity 1 0 0
Alberta Dental Association and College 2016 Annual Report | 19Dental Facilities Accreditation
All non-hospital facilities and dental surgical facilities Dental Surgical Facility Accreditation Regulation Section 3(1) of the Health Care Protection Regulation
where general or neurolept anesthesia are used in requires Council to approve and publish standards sets out that minor surgical services are not exempt from
dental treatment must be accredited by the Alberta for dental surgical facilities, and requires regulated needing to be performed in an accredited facility if in
Dental Association and College. This process involves members working in accredited facilities to comply with the circumstances under which the surgical procedure
application, completion of a questionnaire and an those standards. Section 12(1) of Schedule 7 of the is performed, there is significant risk of any of the
inspection to ensure compliance with the Alberta Dental Health Professions Act requires that a dental surgical following:
Association and College Standard of Practice: Dental facility be accredited before a regulated dentist • intra-operative or post-operative hemorrhage;
Facility Accreditation. This process is separate from that provides dental surgical services in it to the public. • intra-operative or post-operative airway
required by the College of Physicians and Surgeons of Dental surgical services include: compromise;
Alberta. • compromise of the patient’s cardiovascular or
1. a professional service that is provided by a respiratory status; and
Accreditation is mandated by law in Alberta in the Health regulated member where an anaesthetic is used • injury to a major vessel in the operative field.
Professions Act and the Health Care Protection Act and that renders the patient unconscious, or where
is carried out by the Dental Facilities Accreditation neurolept anaesthetic is used;
Committee. The Alberta Dental Association and 2. an “insured surgical service” as defined in the The Health Care Protection Act establishes the overall
College carries out the responsibilities of accreditation Health Care Protection Act that is provided regulatory framework for surgical services which apply
(as outlined in the Health Professions Act, Schedule 7) by a regulated member in a facility that must to both dentists and physicians.
by: be accredited under Schedule 7 of the Health
• establishing a Dental Facilities Accreditation Professions Act; or “Insured surgial services” are defined by the Health Care
Committee; 3. any other professional service described in Protection Act. The Health Care Protection Act states that
• establishing the power and authority of the the regulations that is provided by a regulated in order for a facility to provide “insured surgial services,”
Dental Facilities Accreditation Committee to member that in the opinion of the council the facility must:
accredit facilities; and represents a risk to the patient that is greater
• allowing for decisions of the Dental Facilities than usual for a professional service provided 1. be accredited;
Accreditation Committee to be appealed to by a regulated member. 2. have an agreement with Regional Health Authority;
council. and
Dental surgical services include major and minor 3. be designated by the Government of Alberta,
surgical services. Minor surgical services, as set out in Minister of Health.
Schedule 1(1) of the Health Care Protection Act are
exempt from needing to be performed in an accredited
facility if certain anaesthetic and clinical conditions with
respect to the procedure and the patient are met.
20 | Alberta Dental Association and College 2016 Annual Report2016 Dental Facilities Accreditation Statistics
Distribution of Types of Procedures
Total Accredited Facilities 37
Non-Hospital Surgical Facilties 33
Dental Surgical Facilities 4
DFAC Activities
Facility Inspections 8
Existing Facilities Re-accreditation 6
Accreditations Outstanding 2
New Facility Applications 3
New Facilities Accredited 2
Distribution of Procedures Performed for a Given Location
Alberta Dental Association and College 2016 Annual Report | 21Sedation
Dentists offering sedation must adhere to the requirements outlined in Standard of Practice: Use of Sedation in Non-Hospital Dental Practice, produced by the Alberta
Dental Association and College (January 2011). The Standard of Practice: Sedation in Dental Practices applies to dentists who are administering sedation in dental prac-
tices. Sedation is a pharmacologically-induced, minimally to moderately depressed level of consciousness that retains the patient’s ability to independently and continual-
ly maintain an airway and respond to physical stimuli and verbal command.
The standards apply to the administration of sedation in a non-hospital dental practice. Specifically, the Standard of Practice: Use of Sedation in Non-Hospital Dental
Practice apply to:
• dental practices where sedation is administered;
• dentists who administer sedation;
• dentists who administer Modalities 1 through 4 in a dental practice that is within or part of a non-hospital dental practice; and
• clinical personnel who provide surgical or sedation support to dentists administering sedation.
There are four modalities of sedation. The Standard of Practice: Use of Sedation in Non-Hospital Dental Practice, produced by the Alberta Dental Association and College
(January 2011) is divided into four sections for the four modalities. The modality determines the physical equipment and personnel requirements of the dental setting, the
training requirements of the dentist administering the sedation and the clinical personnel assisting the dentist.
The requirements for each modality, when used separately or in combination by a dentist in a non-hospital dental practice, must be met.
The modalities are:
• Modality 1: Nitrous Oxide and Oxygen Sedation.
• Modality 2: Oral Administration of a Single Dose of a Single Sedative Drug (Benzodiazepines or Benzodiazepine-like drugs and Antihistamines only).
• Modality 3: Oral Administration of a Single Sedative Drug with Nitrous Oxide and Oxygen or Supplemental use of a Single Sedative Drug
(upon review, permits are issued).
• Modality 4: Parenteral and Parenteral-like Sedation
(upon review, permits are issued).
o Single Drug IV (4S)
o Two Drug IV (4F - Fentanyl)
The Alberta Dental Association and College issues a permit based on the level of competency achieved for all dentists providing Modality 3 and Modality 4 described by
this Standard.
Where more than one modality of sedation is administered (including pre-sedation) at a single appointment, a dentist may only assess a fee for the highest modality ad-
ministered at that appointment.
22 | Alberta Dental Association and College 2016 Annual Report2016 Sedation Statistics
If a patient’s response to sedation results in depression
Modality Registered Number Registered Permit Modality Number Issued
beyond the level of sedation intended, OR entry of the
patient into levels of deep sedation or general anes- Modality 1 103 Modality 3 329
thesia OR if the patient’s response or an unanticipated Modality 3/4S 46
Modality 1/2 468
event results in the need for transfer of the care of the
patient to another provider, a dental surgical facili- Modality 1/2/3 311 Modality 3/4F 1
ty, a non-hospital surgical facility or hospital, it is a Modality 1/2/3/4S 44 Modality 3/4S/4F 91
reportable incident and must be reported to the Chief
Executive Officer of the Alberta Dental Association Modality 1/2/3/4S/4F 91 Modality 4S 20
and College.
Modality 1/2/4S 1 Modality 4F 5
This sedation modality table does NOT apply to the Modality 1/2/4S/4F 4 Modality 4S/4F 11
administration of neurolept analgesia/general anes-
Modality 1/3 1 TOTAL PERMIT ISSUED 503
thesia (see page 22):
Modality 1/4S 4
Dentists are required to register annually specifying
modality of sedation administered. Of the 2607 den- Modality 1/4S/4F 2
tists registered in 2016, 1398 registered for admin- Modality Description
istration of sedation with the registration breakdown Modality 2 316
below. Modality 1 Nitrous Oxide and Oxygen Seda-
Modality 2/3 15
tion
Modality 2/3/4S 1
Modality 2 Oral Administration of a Single Dose
Modality 2/3/4S/4F 3 of a Single Sedative Drug
Modality 3 Oral Administration of a Single
Modality 2/4S 5
Sedative Drug with Nitrous Oxide
Modality 2/4S/4F 2 and Oxygen or Supplemental Use of
a Single Sedative Drug
Modality 3 8
Modality 4S Parenteral and Parenteral-like Seda-
Modality 4S 2 tion (Single Drug IV)
Modality 4F 4
Modality 4F Parenteral and Parenteral-like Seda-
tion (Two Drug IV - Fentanyl)
Modality 4S/4F 3
TOTAL 1398
Alberta Dental Association and College 2016 Annual Report | 23Facial Esthetic Therapies & Adjunctive Procedures
The Standard of Practice: Facial Esthetic Therapies and Adjunctive Procedures applies to dentists who are administering Schedule 1 drugs such as neuromodulators (e.g.
Botulinum Toxin Type A), dermal fillers, other agents (injected and/or topical) and adjunctive non-surgical and/or surgical therapies used to provide comprehensive ther-
apeutic and esthetic oral and maxillofacial treatment for the restoration of a patient’s appearance in form and function or to enhance their appearance, or both.
Oral and Maxillofacial Surgeons may provide any procedures, so long as their training encompassed said procedures.
The Alberta Dental Association and College issues a certificate based on the level of competency achieved for all dentists providing the levels of treatment described in
the Standard. The Alberta Dental Association and College maintains a list of approved programs at each level.
Levels:
• Level 1: Applied Anatomy Review and Introduction to Neuromodulators
• Level 2: Basic Neuromodulators: Upper Face and Bruxism Treatment
• Level 3: Advanced Neuromodulators: Mid-Face and Lower Face/Neck Regions and Myofascial Pain and Dysfunction Treatment
• Level 4: 4a - Dermal Fillers: Basic Facial Dermal Fillers
4b - Dermal Fillers: Advanced Facial Dermal Fillers
4N - Neuromodulators for Deep Muscles of Mastication
• Level 5: Advanced Non-Surgical Esthetic Procedures
• Level 6: Advanced Surgical Esthetic Procedures
Dentists permitted to administer Facial Esthetic Therapies and Adjunctive Procedures - 2016
Level of Certification Number Registered
Level 1: Applied Anatomy Review and Introduction to Neuromodulators 454
Level 2: Basic Neuromodulators: 415
Upper Face and Bruxism Treatment
Level 3: Advanced Neuromodulators: 101
Mid-Face and Lower Face/Neck Regions and Myofascial Pain and Dysfuntion Treatment
24 | Alberta Dental Association and College 2016 Annual ReportAlberta Dental Association and College 2016 Annual Report | 25
Radiation Health and Safety Program
The Alberta Dental Association and College is an
2016 Radiation Health and Safety Statistics
Authorized Radiation Health Administration Orga-
nization, delegated with certain powers, duties and
functions under the Radiation Health Administration Category Number
Regulation of the Government Organization Act.
Since July 1997 the Alberta Dental Association and
College has provided services in the administration of Active facilities certified 1348
the Radiation Protection Act and Radiation Protection
Regulation to owners of diagnostic x-ray equipment Active owners registered 1175
and class 3b and 4 lasers installed or operated within
dental facilities, including dental education facilities,
but excluding dental facilities owned by Alberta Pieces of active equipment certified 6308
Health Services. excluding lasers
Class 3b or Class 4 lasers 859
The Alberta Dental Association and College maintains
the database of all registered radiation equipment
owned by dentists in the province. Registration cer- Suspended or cancelled 0
tificates are issued after the equipment is inspected registrations/certificates
and registered and must be displayed in all facilities.
The Alberta Dental Association and College monitors Reported overexposures 0
the existence of a Quality Control Program and the
mandatory use of personal dosimetry services in all Investigations undertaken 0
facilities.
Complaints received 0
26 | Alberta Dental Association and College 2016 Annual ReportAlberta Dental Association and College 2016 Annual Report | 27
Dental Fees
The Alberta Dental Association and College commissioned an independent company, Trend Research Inc., to conduct a statistically valid survey of Albertans in August 2015.
The report demonstrated that nearly 75 per cent of Albertans receive dental care on a regular basis. The Alberta specific data are consistent with the national data as reported
in the 2010 Report on Findings of the Oral Health Component of the Canadian Health Measures Survey which showed that over 74 per cent of Canadians went to the dentist
in the previous year. This national Health Canada report indicated that of the 25 per cent of the people who had not visited a dentist, only 17 per cent reported that it was due
to cost. This is very similar to the Alberta survey with approximately 14 per cent saying that they did not go to the dentist due to cost. An analysis of the Alberta survey data
shows that other factors that discourage visits to the dentist are: a) whether or not they feel a visit to the dentist is necessary; b) fear/anxiety; and c) no dentist in the area.
Albertans'
Poor to Value for Money Spent on Dental Care
Good to Very No
Excellent
80 Poor Opinion
73 11 15
70
60
50
Percent
40
73
30
20
10
15
11
0
Good to Excellent Poor to Very Poor No Opinion
Albertans' Value for Money Spent on Dental Care
Trend Research Inc. Survey August 2015
28 | Alberta Dental Association and College 2016 Annual ReportThe Trend Research Inc. statistically valid survey of Albertans demonstrates that:
• 73 per cent of Albertans feel they receive good to excellent value for their money spent on dental care.
• Only 11 per cent of Albertans are concerned with the value for money spent on the dental care they receive.
• Nearly 75 per cent of Albertans receive dental care on a regular basis.
• In Alberta, the single biggest factor determining whether someone visits the dentist is whether they consider
it necessary.
• Dental fees are set like any other business and vary based on cost centres including geographical factors,
U.S./Canada exchange rate and government regulatory requirements. The decrease in value of the
Canadian dollar has increased the cost of operating a dental practice in Canada significantly as the
majority of dental instruments, materials and equipment are manufactured in the U.S.
• The costs of operating a dental practice and dental fees vary by province.
• Dentist salaries in Alberta are on par with salaries in other provinces and with other professions.
• Dentists are socially responsible and for example provide treatment to underprivileged Albertans covered
by the Alberta Health social dental programs for significantly reduced reimbursement levels of between
59 per cent and 66 per cent of the normal and customary fee.
• Insurance companies establish maximum reimbursement levels for a dental procedure that are frequently
lower than the actual fee for the dentist to provide the service. Insurance company maximums are not
necessarily based on the actual cost of providing the dental service.
Alberta Dental Association and College 2016 Annual Report | 29Dental Prepayment Plans (Dental Insurance) Dental insurance is not insurance as it is a prepaid dental benefit plan and is a means to assist patients in paying for dental treatment. Most Albertans (73 per cent) have access to a prepaid dental plan through their employer and the insurance companies that provide them are actually benefit administrators. Insurance companies reimburse patients based on the level of coverage decided by the patient’s employer. Prepaid dental plans were developed to assist patients with paying for dental care, not to pay for 100 per cent of the dental care received. Insurance companies establish percentage reimbursement, e.g. 80 per cent, and the maximum reimbursement level for the various prepaid dental plans. Insurance companies frequently set the maximum reimbursement level below the actual fee to provide the dental service which leads to the patient paying the percentage not paid by the insurer and the gap between the insurer’s maximum reimbursement level and the normal and customary dental fee to provide the service. For example, insurance companies frequently state that they are providing 100 per cent dental coverage but the 100 per cent is limited to a maximum for the procedure that is set far below the actual cost of providing the service. In effect it is really an 80 per cent or 90 per cent reimbursement or even less of the actual cost. This creates confusion for patients as the insurance company says it is a 100 per cent coverage when it is not and leaves the dentist trying to explain to patients that these are actions taken by insurance companies to shift costs from the insurance company to the patient. Dental insurance premiums have gone up year over year but for the most part insurance benefit maximums have remained the same. In effect this means that in current dollars the maximums have actually decreased due to inflation. The Alberta Dental Association and College collaborates with insurance companies by sharing information collected annually through the Alberta survey of dental fees. Dental prepayment plan providers have not kept pace with the fee increases for dental care in Canada. 30 | Alberta Dental Association and College 2016 Annual Report
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