Royal College of
Dental Surgeons of Ontario
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College Meeting Highlights

A meeting of RCDSO Council members was held in Toronto on November 15, 2018.

President Ron Yarascavitch opened the meeting by recognizing the traditional lands of Indigenous peoples in Ontario.  He noted that the Executive Committee had decided that this is a respectful thing to do and confirms the Call to Actions of the Truth and Reconciliation Commission.

Ron went on to welcome and congratulate Council members and staff for their work.

Registrar Irwin Fefergrad told council members that, in the words of writer Thomas Friedman, we must not be mired in the mindset of the 20th century.  Leadership, he said, is asking tough questions and looking for different approaches and ideas to provide the answers. Irwin noted how organizations like Airbnb, Uber, and Apple use advances in technology to reinterpret and to transform. He praised Council for following the advice of Harry Cayton, of the UK’s Professional Standards Association, and using simple principles to ensure we fulfil our mandate of working in the public’s interest. Cayton recommends that we identify the problem that we are trying to solve; assess the risk, consider unintended consequences and use regulation only as needed. With that in mind, Irwin commented how forward thinking the College was in examining our traditional third party providers to see if the tasks can be accomplished more efficiently and cost effectively.

Ron delivered the Executive Committee report which presented four recommendations.

  • A new PET Advisory Group will include at least two experts in developing examination questions and the Director of Quality Assurance, to create questions needed by the College to develop and to maintain the PET for General Practitioners and Dental Specialists.
  • Staff had been asked to look into guidelines for members who have been suspended. The Executive Committee was concerned with the messaging that some members under suspension are giving patients, as well as billing practices during a member’s suspension. In an era of greater transparency, the College wished to enhance the guidelines for members under suspension. The College has been informed that some members under suspension are withholding information from patients who need to have appointments rescheduled and from patients trying to make new appointments. New guidelines will clarify the rules. The College will be sharing those shortly.
  • The College’s current Registration regulations on incomplete renewal forms raise concerns. The College is not able to suspend members for failing to answer mandatory questions on the annual renewal questionnaire. A number of RHPA Colleges already have similar provisions to suspend.  Legal counsel was asked to prepare draft regulation amendments to amend existing provisions regarding resignation and reinstatement and to add new provisions regarding administrative suspensions. College bylaws will also need to be amended. Members will have an opportunity to comment on the draft regulation to be circulated

Carlos Quinonez, Associate Professor and an epidemiologist at the Faculty of Dentistry, University of Toronto, presented interim results from a study on what causes the public to complain about their dentist and what the issues are. Dr. Quinonez said there was great benefit in hearing from the patients in their own words. Work has been done elsewhere on complaint outcomes but the Ontario study appears to be unique in looking at trends and content from when the complaints are first reported to the College.

Developing a taxonomy specific to dentistry is one of the most significant parts of this work. The data show that quality of care, clinical outcomes and patient interactions are the top three areas of concern and complaint.

The work done on this study will prove extremely helpful in future data analysis and will help the College determine how to shape policies, communications and strategies for years to come. The study should be complete shortly.

Other highlights of the meeting include:

  • As part of the joint effort with Public Health Ontario on Infection Prevention and Control Prevention (IPAC), College staff are developing a strategic plan for IPAC. The three main areas planning will be communication, education and enforcement. A core 1 course will be encouraged to be developed online as an educational component.
  • A comprehensive budget report was presented. The College is in very sound financial shape with a projected surplus in 2019 to handle contingencies and space expansion to accommodate a growing increase in responsibilities.
  • There was discussion about a revised accommodations policy to address the needs of people involved in the discipline process. This should provide for more flexibility in the decision-making process. The policy will also be revised to allow parties to request that a panel of the Inquiries, Complaints and Reports Committee (ICRC) review accommodation decisions made by the Registrar or Assistant Registrar. This revision will clarify the role of ICRC in accommodation decisions. The final decision makers will be the statutory committee.

Council members were told the results of three important consultations.  The Standard of Practice on the Use of Sedation and General Anesthesia in Dental Practice, the Standard of Practice on Infection Prevention and Control in the Dental Office, and the Guidelines on the Diagnosis and Management of Temporomandibular Disorders have each been edited to respond to the consultation and will now be distributed to members.

A new set of Guidelines, on Dental Recordkeeping, will be circulated to members and other stakeholders for at least sixty (60) days for comment.

The Standard of Practice on the Use of Sedation and General Anesthesia includes new requirements for all dentists who administer minimal sedation, including nitrous oxide and oxygen sedation and oral minimal sedation, to obtain authorization from the College. In addition, all facilities where minimal sedation is administered will be subject to random on-site inspections and evaluation by the College. These new requirements will become effective April 1, 2020. This date will allow the time necessary to make amendments to our By-Laws, which are required to implement and enforce the Standard.

Following the special meeting, Executive Committee met in open session to implement the recommendations of council members.