Positions and Special Initiatives

We have developed position statements and produced studies on issues that affect the practice of dentistry in Ontario. These documents describe work with other health professionals, organizations and key stakeholders on public complaints, blood borne viral infections, dental amalgams, water fluoridation and the management of pain in dental practice.

2007-2017 study of public complaints made to RCDSO

The College and the University of Toronto, Faculty of Dentistry collaborated to produce an analysis of public complaints made to RCDSO from 2007 to 2017.

Read the analysis of complaints made by the public to the RCDSO.

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.

College position on the use of botulinum toxin and dermal fillers by Ontario dentists

Ontario dentists may inject botulinum toxin and dermal fillers, but only for procedures that are within the scope of practice of dentistry.

The key points on the College’s position on this issue are:

Members who wish to use botulinum toxin and dermal fillers may do so, but only for procedures that are within the scope of practice of dentistry.
Members may inject botulinum toxin and/or dermal fillers intra-orally for either therapeutic or cosmetic purposes, or botulinum toxin extra-orally for therapeutic purposes, but in either case only if they are appropriately trained and competent to perform the procedure/s.
It is not within the scope of practice of dentistry and members are not authorized in Ontario to inject botulinum toxin or dermal fillers extra-orally for cosmetic purposes.

Members who wish to use these substances as described are expected to successfully complete a course of instruction that adheres closely to the following criteria. The course should:

be conducted by persons who have had recognized education and training, preferably university-based, and significant experience in the parenteral administration of these substances.
include a didactic component with formal evaluation that addresses:
- pharmacology of these substances;
- physiological activity of these substances;
- diagnosis of relevant conditions;
- indications for the use of these substances, as well as other first-line treatment modalities;
- contraindications for the use of these substances;
- related head and neck anatomy;
- adverse reactions and their management;
- include a hands-on clinical or clinical simulation component with formal evaluation;
- promote the critical evaluation of research and literature on related topics

Due to the potential for serious and even life-threatening adverse reactions to this neurotoxin, members who wish to use botulinum toxin extra-orally for therapeutic purposes, such as for the management of certain temporomandibular disorders and other oral-facial conditions, are expected to pursue more extensive training.

Education requirements for the use of botulinum toxin and dermal fillers by Ontario dentists

Dental amalgams

We consider dental amalgam a safe, useful and necessary part of the restorative materials available to Ontario dentists and their patients. Removing existing sound amalgam fillings is not justified in patients who do not have adverse health effects attributable to mercury exposure. Read our policy statement.

Best management practices for the disposal of dental waste

In a dental practice, a variety of wastes may be generated that require special handling. Below are four flow charts developed by Environment Canada that present best management practices for the disposal of these wastes.

Water fluoridation

We support the fluoridation of municipal drinking water as an important approach to oral health promotion and disease prevention. RCDSO joins the Canadian Dental Association in affirming its support for fluoridation of municipal water supplies as an effective means of reducing dental caries in all age groups. Read our policy statement.

Blood borne viral infections

We supported the efforts of a working group developed to understand the risks to patients of contracting blood borne viral infections from dentists and the appropriate approach dentists should take to prevent such risks. The Department of Medicine, University of Alberta, the Faculty of Dentistry, University of Toronto, and the Department of Medicine, University of Toronto contributed to the development of the report.

Management of pain in dental practice

The excessive use of prescription narcotics and controlled substances has emerged as a public health and safety issue here in Canada, in the United States and other jurisdictions around the world. In 2011 the College hosted a symposium on this issue, and in 2015 we developed guidelines on The Role of Opioids in the Management of Acute and Chronic Pain in Dental Practice. The College received prescription dispense data for the calendar years 2014, 2015 and 2016. These were analyzed to assess the level of opioid prescribing by dentists, changes to prescribing patterns over the years and the impact of the Guidelines. The College produced a report on the findings.