Download annual report 2014 - Dental Health Alberta

ANNUAL
REPORT
2014
Alberta Dental Association and College
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101, 8230-105 Street
Edmonton, AB T6E 5H9
PH: (780) 432-1012
FAX: (780) 433-4864
www.dentalhealthalberta.com
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2014 Annual Report - Alberta Dental Association and College
TABLE OF CONTENTS
INTRODUCTION
3
Mission and Goals
5
President’s Report
6
Public Members’ Report
8
Council
9
Structure
10
Background/Overview
11
GOVERNANCE AND REGISTRATION
14
Governance
15
Registration and Renewal of Practice Permits
15
CONTINUING COMPETENCE
19
Practice Visits
19
COMPLAINTS AND DISCIPLINE
20
Complaints Resolution
21
REGULATORY FUNCTIONS 22
Radiation Health and Safety
23
Sedation
24
Facilities Accreditation
26
Other Activities
27
FINANCIAL REPORTS
28
Summarized Financial Statements
29
Report of the Independent Auditor on the Summarized Financial Statements
30
Summarized Statement of Financial Position
32
Summarized Statement of Operations and Changes in Unrestricted Fund Balance
33
Summarized Statement of Operations and Changes in Restricted Fund Balances
34
Note to the Summarized Financial Statements
35
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INTRODUCTION
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2014 Annual Report - Alberta Dental Association and College
MISSION AND GOALS
T
he Alberta Dental Association and College registers dentists and ensures that the oral health of
Albertans is advanced through safe, available, affordable, quality and ethical dental services.
MISSION
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.
VISION STATEMENT
Albertans recognize and regularly use dental services as key components of their primary health care.
The dentist-patient relationship is seen as central to the ongoing health of Albertans. Albertans trust
their dentists, and view them as the leaders in the delivery of the most advanced, evidenced-based and
caring dental services. Dental practices are considered a vital part of Alberta communities, and dentists
are active contributors to community life.
The Alberta Dental Association and College upholds the public trust of dentists, and preserves the
integrity of the relationship of dentists with government, other service care providers, supporters of
dental services, the business community and the marketplace in general.
GOALS
Optimizing oral health services for all Albertans through
governance leadership in the profession that ensures
safe, appropriate and ethical oral health care.
Effective communication and collaborative relationships
with dentists, the public, government, industry, other
dental organizations and health professionals.
Effective and efficient resolution of problems regarding
oral health services provided by dentists; with patients,
dentists, government, industry, and other health
professionals.
Promotion of excellence in the delivery of oral health
services.
In cooperation with patients/consumers, dentists,
government, industry, other dental organizations and
health professionals, the Alberta Dental Association
and College supports effective resolution of health-care
delivery issues to ensure that the public does not receive
unsafe, inappropriate or unethical oral health services.
Positioning of dentists and dental services with all
stakeholders as trustworthy, competent, and responsive
to personal wellness of Albertans.
Effective monitoring and support of continuing
competence and capacity to practice of Alberta dentists.
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PRESIDENT’S MESSAGE
E
a c h y e a r, t h e
Alberta Dental
Association and
College addresses many
regulatory matters,as
required by the Health
Professions Act, and other
Government legislation.
In 2014 the Alberta
Dental Association and
College has completed
re q u i re m e n t s u n d e r
Occupational Health and Safety, Sedation, and
Infection Prevention and Control. This report
outlines the 2014 regulatory activities of the
Alberta Dental Association and College.
Guide for Developing a Practice Privacy
and Security Policy for the Health
Information Act
The Alberta Dental Association and College
developed the Guide for Developing a Practice
Privacy and Security Policy for the Health
Information Act to provide Alberta dentists a stepwise process for developing the necessary items for
their individual clinic circumstances. The Guide for
Developing a Practice Privacy and Security Policy
for the Health Information Act includes:
• Summary: Developing and Implementing a
Clinic Privacy Program;
• Developing and Implementing Privacy
Programs for Alberta Dentists;
• Site Privacy and Security Assessment: Sample;
• Health Information Registry Form - Sample;
• Clinic Privacy Assessment: Sample;
• Dentist Office Information Privacy and
Security - Policies;
• Alberta Dental Association and College
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- Standard of Practice: Privacy and
Management of Patient Health Information;
• Alberta Dental Association and College Guide for the Alberta Health Information Act:
Privacy and Confidentiality;
• Privacy Impact Assessment Requirements Office of the Information Privacy Commissioner
of Alberta; and
• Additional Sample Documents.
Occupational Health and Safety - Video
The Alberta Dental Association and College
has produced the video Occupational Health
and Safety Responsibilities Best Practices for the
Assessment and Control of Hazards in Dentistry
to Alberta dentists. This video reviews the hazard
assessment process, from identification of hazards,
identifying control strategies, and additional
documentation required to meet Occupational
Health and Safety requirements. The printed
document, The Dentist’s Guide to Occupational
Health and Safety Responsibilities accompanies
the video. The document and video are a guide
to completing a hazard assessment review of a
dental office.
Sedation
The Alberta Dental Association and College
registered members for sedation modalities as
outlined in Standard of Practice: Use of Sedation
in Non-Hospital Dental Practice. These standards
apply to dentists who administer sedation and
clinical personnel who provide support to dentists
administering sedation. In 2014, a total of 1,128
members were registered to administer sedation
in Modality 1, Modality 2, Modality 3, Modality
4, or a combination of Modality 3 and 4.
2014 Annual Report - Alberta Dental Association and College
Practice Visits
Practice visits remained a priority throughout the
year. Dentists in Alberta must follow Standards
of Practice: Infection Prevention and Control
Standards and Risk Management for Dentistry.
Standards of Practice
The following Standards of Practice were approved
by the Council of the Alberta Dental Association
and College:
• Standard of Practice: Privacy and Management
of Patient Health Information;
• Standard of Practice: Informed Consent; and
• Standard of Practice: Patient Records.
Practice Guides
Practice Guides to assist Alberta dentists in meeting
Standards of Practice were developed:
• Guide for Patient Records and Informed
Consent; and
• Guide for the Alberta Health Information Act
Privacy and Confidentiality.
Dr. L.K. (Larry) Hodinsky
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PUBLIC MEMBERS’ 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 members appointed by the Government of
Alberta, our primary concern is patient safety and
public protection. We 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.
We bring a wide range of backgrounds and
experience in governance to our position. This
includes not-for-profit organizations, volunteer
board positions and healthcare positions. As public
members, we advocate for the public and bring
the public’s perspective to the dentistry profession.
We provide our 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
we actively participate in discussions, advise on
issues, and contribute to strategies to enhance
the profile of the Alberta Dental Association and
College.
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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. As well, we
appreciate the time, talent and contribution that
many volunteers provide with their contribution to
numerous committees and other activities.
We are proud to be associated with the dentistry
profession and to share in a diverse mandate. As
public members, we 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 we acknowledge and
commend the efforts we have observed.
Ms. L. (Loraine) Oxley
Ms. C.(Colleen) Sekura
2014 Annual Report - Alberta Dental Association and College
COUNCIL
Dr. L.K. (Larry) Hodinsky
President, Council Member
Northern District
Dr. G.W. (Gary) Fong
Past-President, Council Member
South District
Ms. L. (Loraine) Oxley
Public Member
Ms. C. (Colleen) Sekura
Public Member
Dr. T.D. (Terry) Carlyle
President Elect, Council Member
Edmonton District
Dr. T.F. (Tobin) Doty
Vice-President, Council Member
Calgary District
Dr. G.S. (Mintoo) Basahti
Council Member, Edmonton District
Dr. B.K. (Brian) Kucey
Council Member Edmonton District
Dr. A.H. (Allan) Graas
Council Member, Calgary District
Dr. A.E. (Tony) Odenbach
Council Member, Central District
Dr. C.Y. (Craig) Young
Council Member, Calgary District
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STRUCTURE
MEMBERSHIP
Membership Services
Confidential Assistance
COUNCIL
Governance
Dental Congress
GOVERNMENT OF ALBERTA
MINISTER OF HEALTH
ALBERTANS
Professional Relations
Facilities Accreditation
Radiation Health and Safety
Dental Congress
Radiation Health and Safety
Publications and
Communications
Continuing Competence
First Nations and
Inuit Health
Professional Actions
Actions
Professional
Registration
Alternative Complaint
Resolution
Complaint Review
Committee
Hearings Tribunal
Hearings
Tribunal
Representations
Representations
Canadian Dental
Association
Canadian Dental Regulatory
Authorities Federation
National Dental
Examining Board
University of Alberta
NAIT and SAIT
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2014 Annual Report - Alberta Dental Association and College
BACKGROUND/OVERVIEW
From Sitting Bull to Self-Regulation
In 1883, Dr. Frederick Shaw and Dr. William
Wilson entered the practice of dentistry in the
district of Alberta. Both had served with the
Northwest Mounted Police.
Dr. Frederick Shaw, born in Kentville, Nova
Scotia in 1856, graduated from the New York
Dental College in 1878. In 1879 he applied to
the Northwest Mounted Police for training and
services. He made his way to the West through the
United States to Fort Breton and then to Fort Walsh
in the Cypress Hills. While serving at Fort Walsh,
he provided dental treatment for Chief Sitting Bull,
who required two teeth to be extracted to relieve
pain. This was some time after the Battle of Little
Big Horn in Montana which took place on June
25-26, 1876 when Chief Sitting Bull was delivered
to the American authorities.
After several more years in the Northwest Mounted
Police, Dr. Shaw obtained an honourable
discharge in 1884. He registered himself as a
practising dentist in the Northwest Territories and
received certificate No. 1 in 1889. (the certificate
was to practice dentistry and dental surgery).
On buckboard or saddle horse, he travelled to
Calgary, Medicine Hat, Lethbridge, Fort Macleod
and Pincher Creek. He eventually built a home
on the St. Mary’s River just north of Cardston. Dr.
Shaw died in Lethbridge in 1926.
Dr. William “Tug” Wilson, born in Quebec, joined
the Northwest Mounted Police in Winnipeg in
1875, stating his previous occupation as “dentist.”
In December of 1883 he retired from the Northwest
Mounted Police to practice dentistry in Calgary.
He then moved to Edmonton and practiced in
South Edmonton.
While Dr. Wilson’s professional qualifications
were not known and a college degree not located,
he claimed to have “Fifteen years of practical
experience.” He was forced to retire in the late
1800s due to eye trouble. He joined the Calgary
Post Office, dying on September 17, 1928.
When the North West Territories Dental Association
was organized on July 1, 1889, six dentists were
practicing in Alberta:
W. Haydon, Cochrane;
E.C. Holbrook, Calgary;
F.D. Shaw, Fort MacLeod;
P.F. Size, Calgary;
W. Wilson, Edmonton; and
R.H. Zimmerman, Pincher Creek.
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The Alberta Dental Association
Formed in 1906
After receiving provincial status in 1905, the
newly 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.
In the first 25 years, from 1906-1930, the Alberta
Dental Association provided discipline of its
members for the protection of the public, kept
abreast of advances in education by establishing
and supporting a dentistry program at the
University of Alberta and formulated a public
relations program acceptable to the people of the
new province, Alberta.
During the Depression, while regulating itself for
the protection of the public, growth in dentistry was
minimal. As many men and women joined the war
efforts, both the incoming and present student body
in dentistry was nearly non-existent. The Alberta
Dental Association and the University of Alberta
worked diligently to maintain its student status.
The clinical aspect of dentistry changed more
rapidly during the years prior to the war. Equipment
and organization of the office enabled the
dentist to provide a greater amount of treatment
rendered in less time. Also, more non-professional
organizations were involved in the administration
of the dental practice.
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The Alberta Dental Association and
College Under the Health Professions Act
In May 1999, the Alberta Legislative Assembly
passed the Health Professions Act to regulate all 30
self-governing healthcare professions in Alberta.
This new law for regulated healthcare professionals
required all healthcare professional colleges to
follow common rules to investigate complaints
and set educational and practice standards for
registered members. The Health Professions Act
also increased public representation on college
councils and in disciplinary processes.
In December 2001, the Alberta Dental Association
was the first profession to be regulated under
the Health Professions Act. The Alberta Dental
Association became the Alberta Dental Association
and College.
Under the Health Professions Act, the Alberta Dental
Association and College is the self-regulatory body
for dentists in the province of Alberta, and currently
regulates over 2,200 dentists in Alberta.
Self-regulation is the authority granted by statute
(the Health Professions Act) to the dentistry
profession to protect the public through regulating
the practice of its members, and ensuring regulated
dentists are qualified, competent and ethical.
2014 Annual Report - Alberta Dental Association and College
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;
• liaising with the Government of Alberta
regarding the Health Professions Act and
other relevant legislation;
• liaising with other dental regulatory
authorities; and
• liaising with other professional regulatory
authorities.
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14
GOVERNANCE AND
REGISTRATION
2014 Annual Report - Alberta Dental Association and College
GOVERNANCE
T
he Alberta Dental Association and College is governed by a twelve-member council (nine [9]
elected dentists, and three [3] public members appointed by the Government of Alberta, Minister,
Health).
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 Executive Director/Registrar 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.
REGISTRATION AND RENEWAL OF PRACTICE PERMITS
T
he application and registration process for
dentists in Alberta is regulated under the
Health Professions Act. The registration
requirements are detailed in the Health
Professions Act.
General Dentist
To register in the province of Alberta as a
general dentist, an applicant must provide a
certificate from the National Dental Examining
Board of Canada.
Dental Specialist
An applicant for dental specialist requires
successful completion of the National Dental
Specialty Examination of the Royal College of
Dentists of Canada.
General Dentist and Dental Specialist
If an applicant wishes to apply for registration as
both a general dentist and a dental specialist, a
certificate from the National Dental Examining
Board of Canada and successful completion
of the National Dental Specialty Examination
of the Royal College of Dentists of Canada
(both) are required.
All members are required to complete an annual
renewal of registration, complete forms and pay
fees as part of this annual renewal process.
Annual renewal is completed electronically
through the website. All members must meet the
continuing education requirements on a two-year
cycle as part of their annual renewal. Two years,
from January 1, 2014 - December 31, 2015 is
the cycle for continuing education requirements.
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Dental Specialties in Canada
The Canadian Dental Association outlines nine
(9), nationally recognized dental specialties in
Canada.
Dental Public Health
Dental public health specialists focus on improving
the dental health of populations rather than
individuals. They principally serve the community
through research, health promotion, education
and group dental care programs.
Endodontics
Root canal therapy is the most common procedure
performed by endodontists. But that’s not all they
do. Their specialty encompasses the diagnosis,
prevention and treatment of nerve and tissue
diseases and injuries.
Oral and Maxillofacial Surgery
Oral and maxillofacial surgeons diagnose and
surgically treat disorders, disease, injuries and
defects impacting the functional and esthetic
aspects of the mouth, head and neck. For
example, they can extract wisdom teeth or broken
teeth, treat temporomandibular joint disorders, or
place dental implants and bone grafts.
Oral Medicine and Pathology
Dentists sometimes send specimens to specialists
in the area of oral medicine and pathology.
These specialists rely on clinical, radiographic,
microscopic and biochemical examinations to
establish a diagnosis. They focus on the nature
and nonsurgical management of disease and
disorders that affect oral structures.
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Oral and Maxillofacial Radiology
Oral and maxillofacial radiologists help diagnose
and treat diseases and disorders of the craniofacial
complex through the use of imaging technologies
such as X-rays, CT scans and MRIs.
Orthodontics and Dentofacial
Orthopedics
Orthodontists are trained to diagnose, prevent
and treat dental and facial irregularities, for both
functional and esthetic reasons. Treatment options
include the use of dental braces, retainers, spacers
and other devices.
Pediatric Dentistry
Pediatric dentists provide preventive and
therapeutic oral health diagnosis, care and
consulative expertise for infants and children
through adolescence, including those with special
care needs. They receive training on handling the
fears or anxieties of some children.
Periodontics
Periodontists focus on the diagnosis, prevention
and treatment of diseases and conditions that
affect the bones and gums or that lead to loose or
lost teeth. They help maintain the health, function
and esthetics of these structures and tissues.
Periodontists also place dental implants.
Prosthodontics
Prosthodontists are trained to diagnosis, restore
and ensure oral function, comfort, appearance
and health by the restoration of the natural teeth
or the replacement of missing teeth (e.g. bridges,
dentures, implants).
2014 Annual Report - Alberta Dental Association and College
REGISTRATION
The following table summarizes registration data from the
2014 membership year.
REGULATED MEMBERS
2458
General Dentists
2139
Dental Specialists
Education and Research Register
Courtesy Register
283
33
3
NEW REGISTRATIONS FOR 2014
176
Practicing Dentists
100
Interprovincial
54
International
46
New Graduates
76
Canada
61
International
15
Dental Specialists
26
Endodontists
5
Oral and Maxillofacial Surgeons
2
Orthodontists
8
Pediatric Dentists
6
Periodontists
5
Registration Appeals
Professional Corporations
0
2077
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CONTINUING COMPETENCE
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2014 Annual Report - Alberta Dental Association and College
CONTINUING COMPETENCE
T
he Council of the Alberta Dental Association
and College continues to review the standards
for Continuing Education in terms of the
accountability that is required under the Health
Professions Act and the Dentists Profession
Regulation. The Continuing Competence
requirement of 60 credit hours over a two-year
period ending in the odd years (e.g. January
1, 2014 to December 31, 2015). Continuing
education requirements must be met prior to
registration renewal at the end of the two-year term.
If a member has not met their required credit hour
amount they may apply for a 60-day extension for
the two-year term. If the member has not met the
required credit hour amount they are struck from
the register.
To obtain program credits, a regulated member
may undertake professional development activities
such as attendance at a dental-related scientific
or clinical course designed to enhance the
professional development of dentists; attendance
at a dentistry-related approved study club; receipt
of fellowship by examination; completion of a
graduate or postgraduate specialty program;
publication of a research paper in a peer-refereed
journal; self-directed study and other activities
approved by the Alberta Dental Association and
College Council, the Registrar or the Continuing
Competence Committee.
Verification by provider is mandatory; attendance
at individual courses is verified or no credits is
given. Credit hours are granted based on one
hour of lecture time equals one hour of credit time.
Lectures and courses must be provided by:
• American Dental Association Continuing
Education Recognition Program (ADA
CERP) approved providers;
• Academy of General Dentistry Program
Approval for Continuing Education (AGD
PACE) approved providers;
• International, national, provincial and state
dental programs in General Dentistry and
Alberta Dental Association and College
recognized specialties;
• Alberta Dental Societies;
• Registered Alberta Dental Specialists;
• University of Alberta Faculty of Medicine
and Dentistry;
• Cardio Pulmonary Resuscitation courses by
any recognized provider;
• Approved Small Group Learning Sessions
(or Study Club); and
• Other activities approved by Council, the
Registrar or the Continuing Competence
Committee.
Practice Visits
Practice visits are part of the Health Professions
Act and the Dentists Profession Regulation.
The Alberta Dental Association and College
conducted practice visits as part of the Continuing
Competence Program as directed by Council. The
visitations were designed to assist practitioners
in the guidance and implementation of Standard
of Practice: Infection Prevention and Control
Standards and Risk Management for Dentistry September 2010 and Standard of Practice: Use of
Sedation in Non-Hospital Dental Practice. - January
2011.
A total of 16 practice visits were completed in
2014.
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COMPLAINTS AND DISCIPLINE
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2014 Annual Report - Alberta Dental Association and College
COMPLAINTS RESOLUTION
Disposition of Complaints
The Alberta Dental Association and College is
mandated to regulate Alberta dentists and address
complaints made by patients or the public. Once
a complaint is received and if it is not resolved,
it is investigated. An investigation can take on
many forms:
• interviewing the people involved;
• asking for written responses and
comments;
• reviewing complete charts and treatment
notes; and
• attending at the practice of the dentist.
complaints are made, members 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 member and the complainant
to communicate with each other to resolve the
complaint.
The Alberta Dental Association and College also
encourages resolution of advertising complaints.
Advertising complaints are not easily resolved
before a complaint is made because many times,
it takes a complaint sent to a member before a
member is willing to look at his or her advertising
practices to determine if the practices are compliant with the Health Professions Act and the Alberta
Dental Association and College Code of Ethics.
Members 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
2014 Complaints Statistics
Category
Total
Treatment
Complaints
Advertising
Complaints
Complaints carried over from previous years
and open as of January 1, 2014
183
130
53
New complaints 2014
155
143
12
Complaints closed 2014
193
161
32
Complaints carried over to January 1, 2015
145
112
33
10
7
3
Hearings partly or completely closed to public
0
0
0
Appeals (Complaint Review Committee)
3
3
0
Members assessed for incapacity
0
0
0
Breakdown of complaints
Complaints referred to hearing
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REGULATORY FUNCTIONS
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2014 Annual Report - Alberta Dental Association and College
REGULATORY FUNCTIONS
Radiation Health and Safety
In 1998 the Alberta Dental Association and
College completed an agreement with the Alberta
government to be an Authorized Radiation Health
Administrative Organization under the Radiation
Health Administration Regulation. A change
in the Radiation Protection Regulation by the
Government of Alberta in June 2003 has removed
the exemption for dentistry from compulsory
dosimetry monitoring by radiation workers. All
dental personnel using x-ray equipment must use
dosimetry monitoring and records must be kept
for five (5) years.
The Alberta Dental Association and College
maintains the database of all registered radiation
equipment owned by dentists in the province.
Registration certificates are issued after the
equipment is inspected and registered and must
be displayed in all facilities. The Alberta Dental
Association and College monitors the existence
of a Quality Control Program and the mandatory
use of dosimetry services in all facilities.
2014 Radiation Health and
Safety Statistics
Category
Active facilities certified
Active owners registered
Pieces of active equipment
certified
Class 3b or Class 4 lasers
Suspended or cancelled
registrations/certificates
Reported overexposures
Investigations undertaken
Complaints received
Number
1254
1283
5741
779
0
0
0
0
The Radiation Health and Safety Manual and
the Quality Assurance Program is updated on a
regular basis.
23
Sedation
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). This document is the
standard of practice for administration of sedation
with respect to dental services in Alberta.
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.
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The requirements for each modality, when used
separately or in combination by a dentist in a nonhospital 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 Benzodiazepinelike drugs and Antihistamines only).
Supplemental use of a single oral sedative
drugs falls under Modality 3.
• 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).
* Oral Single Drug with Nitrous (3)
• Modality 4: Parenteral and Parenteral-like
Sedation (Administration of Sedative Drugs
other than Oral [intravenous, intramuscular,
subcutaneous, submucosal or intranasal])
(upon review, permits are issued).
* Single Drug IV (4S)
* 2Drug IV with Fentanyl (4F)
2014 Annual Report - Alberta Dental Association and College
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 administered at that appointment.
If a patient’s response to sedation results in
depression beyond the level of sedation intended,
OR entry of the patient into levels of deep sedation
or general anesthesia OR if the patient’s response
or an unanticipated event results in the need
for transfer of the care of the patient to another
provider, a dental surgical facility, a non-hospital
Modality registered for
Modality 1
Number registered
87
Modality 1, 2
345
Modality 1, 2, 3
211
Modality 1, 2, 3, 4S
52
Modality 1, 2, 3, 4S, 4F
65
Modality 1, 2, 4S
11
Modality 1, 2, 4S, 4F
4
Modality 1, 4S
4
Modality 1, 4S, 4F
1
Modality 1, 4F
1
Modality 2
Modality 2, 3
Modality
Description
Modality 1 Nitrous Oxide and Oxygen Sedation
Modality 2 Oral Administration of a Single Dose of a
Single Sedative Drug
Modality 3 Oral Administration of a Single Sedative
Drug with Nitrous Oxide and Oxygen or
Supplemental Use of a Single Sedative Drug
Modality
Parenteral and Parenteral-like Sedation
4S
(Single Drug IV)
Modality
Parenteral and Parenteral-like Sedation
4F
(2Drug IV with Fentanyl)
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1
Modality 2, 3, 4S, 4F
2
Modality 2, 4S
7
Modality 2, 4S, 4F
2
Modality 3
9
Modality 4S, 4F
The Alberta Dental Association and College
Dental Facilities Accreditation Standards and/or
College of Physicians and Surgeons Non-Hospital
Surgical Facilities Standards and Guidelines must
be met when administering neurolept analgesia/
anesthesia. This document does NOT apply to the
administration of neurolept analgesia/anesthesia.
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Modality 2, 3, 4S
Modality 4S
surgical facility or hospital, it is a reportable
incident and must be reported to the Registrar of
the Alberta Dental Association and College.
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3
Total number of dentists registered to administer sedation in 2014 was 1128
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Facilities Accreditation
All non-hospital facilities where general or neurolept
anesthesia are used in dental treatment must be
accredited by the Alberta Dental Association
and College. This process involves registration,
completion of a questionnaire and an inspection
to ensure compliance with the Alberta Dental
Association and College standards which are
available to the dental operators of such facilities.
This process is separate from that required by the
College of Physicians and Surgeons of Alberta.
Accreditation is mandated by law in Alberta
in the Health Professions Act and the Health
Care Protection Act and is carried out by the
Facilities Accreditation Committee. The Alberta
Dental Association and College carries out the
responsibilities of accreditation (as outlined in the
Health Professions Act, Schedule 7) by:
• establishing a Dental Facilities
Accreditation Committee;
• establishing the power and authority of the
Dental Facilities Accreditation Committee
to accredit facilities; and
• allowing for decisions of the Facilities
Accreditation Accreditation Committee to
be appealed to council.
Dental Surgical Facility Accreditation Regulation
requires Council to approve and publish standards
for dental surgical facilities, and requires regulated
members working in accredited facilities to comply
with those standards. Section 12(1) of Schedule 7
of the Health Professions Act requires that a dental
surgical facility be accredited before a regulated
dentist provides dental surgical services in it to the
public. Dental surgical services include:
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1. A professional service that is provided by a
regulated member where an anaesthetic is
used that renders the patient unconscious,
or where neurolept anaesthetic is used, or
2. An “insured surgical service” as defined
in the Health Care Protection Act that is
provided by a regulated member in a facility
that must be accredited under Schedule 7
of the Health Professions Act; or
3. Any other professional service described
in the regulations that is provided by a
regulated member that in the opinion of
the council represents a risk to the patient
that is greater than usual for a professional
service provided by a regulated member.
Dental surgical services include major and minor
surgical services. Minor surgical services, as set
out in 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.
Section 3(1) of the Health Care Protection
Regulation sets out that minor surgical services
are not exempt from needing to be performed in
an accredited facility if in the circumstances under
which the surgical procedure is performed, there
is significant risk of any of the following:
• intra-operative or post-operative
hemorrhage; and
• intra-operative or post-operative airway
compromise; and
• compromise of the patient’s cardiovascular
or respiratory status; and
• injury to a major vessel in the operative
field.
2014 Annual Report - Alberta Dental Association and College
The Health Care Protection Act establishes the
overall regulatory framework for surgical services
which apply to both dentists and physicians.
The Health Care Protection Act defines “insured
surgical services.” The Health Care Protection
Act also states that in order to operate a surgical
facility at which insured surgical services are
provided, the facility must:
1. be accredited;
2. have an agreement with a Regional Health
Authority; and
3. be designated by the Government of
Alberta, Minister, Health.
Facilities Accreditation Statistics
In 2014, 9 (nine) facility inspections were
completed and 7 (seven) facilities received
approval to provide specific services in accredited
facilities.
OTHER ACTIVITIES
Program Development Committee
The committee functions under Section 27 of the Health Professions Act where ministerial approval has
been received to negotiate professional fees on behalf of some or all of the members; there were no
program considerations in 2014.
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FINANCIAL REPORTS
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2014 Annual Report - Alberta Dental Association and College
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101, 8230-105 Street
Edmonton, AB T6E 5H9
PH: (780) 432-1012
FAX: (780) 433-4864
www.dentalhealthalberta.com
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2014 Annual Report - Alberta Dental Association and College