31 October 2018
IN THIS NEWS BULLETIN
As of October 17, 2018, cannabis (marijuana) is legal in Canada. The new law does not change your obligations as a dentist, dental therapist or certified dental assistant registered with CDSBC:
- Registrants who are impaired cannot practise or provide patient care.
- Dentists cannot prescribe marijuana as it is not a scheduled drug. Any discussions you have with patients about the potential use of marijuana for dental pain should include the fact that there is no evidence-based support of benefits.
- Patients whose cognitive ability is affected by marijuana, or any other substance, cannot provide the necessary informed consent.
- WorksafeBC regulations prohibit workers from being impaired while they work and require employers to remove impaired workers from the workplace. This is currently the law in B.C.
- It is illegal for anyone under 19 in B.C to buy, possess or use cannabis.
Information about cannabis legalization is available on the Government of Canada website "The Cannabis Act: what you need to know" and the provincial government's website GetCannabisClarity.ca.
If you have questions about what the new law means to you as a registrant of the College, please contact one of our staff dentists at 604-736-3621 (toll free 1-800-663-9169).
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The Board has approved the proposed changes to the Quality Assurance (QA) Program for consultation. The proposed changes apply to the quality assurance requirements for all registrants: dentists, certified dental assistants and dental therapists. If approved, the changes will promote career-long hands-on learning, increase collaboration among colleagues and improve patient outcomes.
The proposed program consists of four key parts:
• Continuing Professional Development
• Required Competencies
• Objective Assessments / Feedback (dentists and dental therapists only)
• Continuous Practice Hours
The consultation period is open until 20 November 2018.
Visit the dedicated consultation page to read the proposed QA Program outline and to read comments in the consultation forum.
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The College has received inquiries about our response to direct-to-consumer aligner therapy (teeth-straightening services) that are currently operating in many U.S. states. In British Columbia, only appropriately qualified health professionals may dispense and fit a dental appliance. In most cases, dental appliances also require a prescription from an authorized prescriber before they can be dispensed, but not before a complete clinical assessment leading to an accurate diagnosis and treatment plan is provided, and informed consent obtained.
While we are actively considering the trend towards direct-to-consumer orthodontic services, our expectations of registrants are the same regardless of the business or service model. Dentists must also ensure that the materials used in the fabrication of dental devices and the devices themselves are licensed with, and meet the requirements of, Health Canada.
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CDSBC has received numerous inquiries asking if Invisalign® falls within the services a CDA can provide. With the exception of radiographs and impressions, only a CDA who holds the orthodontic module designation with CDSBC can assist in providing Invisalign and/or any other service related to orthodontics. More information about the services a CDA with the orthodontic module can provide is available in CDSBC Bylaw Part 8: Delegation and Supervision.
To find out if a CDA holds the orthodontic module, check the Registrant Lookup on our website.
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Since issuing the citation on 17 September 2018, the College has not received a response from Dr. Bin Xu. Anyone with information about the whereabouts of Dr. Xu is asked to contact the College at complaints@cdsbc.org. If Dr. Xu does not attend the hearing, it will proceed in his absence.
A Panel of the Discipline Committee will conduct a public hearing regarding the conduct and competence of Dr. Bin Xu. Dr. Xu is a general dentist who practised in Richmond, B.C. He is currently under a voluntary withdrawal from the practice of dentistry in B.C. The citation (notice of hearing) was issued based on investigations by the College into multiple complaints from former patients of Dr. Xu.
The hearing will be conducted under s.38 of the Health Professions Act and will address allegations that Dr. Bin Xu:
- failed to properly diagnose patients, obtain and/or document informed consent, develop an appropriate treatment plan, maintain adequate records, provide appropriate treatment options, and provide follow up treatment;
- provided substandard dental care;
- provided treatment and/or advice that was unnecessary and/or inappropriate;
- billed inappropriately and failed to refund money to patients for treatments not provided; and
- failed to respond to the College and to patient inquiries, including failing to schedule and/or attend patient appointments.
The hearing is scheduled to begin on 1 November 2018 in Vancouver.
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Approximately half of complaints investigated by the College result in formal action to address concerns raised during the investigation. We have published 450 summaries of complaint investigations to educate registrants and the public about the types of complaints we receive and how they are resolved. Specific and technical detail have been omitted to make these summaries more easily understood by a general audience. The following complaint is file 20 from the 2016/17 Complaint Summaries.
Complaint
The patient complained she received substandard dental care from the dentist which led to bone loss, failed implants, poorly done root canal treatment, gum disease, and a five-unit bridge that is likely to fail.
Investigation
The investigation raised concerns with the dentist's diagnosis and treatment planning of periodontal cases involving implants and concerns with his recordkeeping and informed consent protocols.
CDSBC Investigators found minimal evidence to support the dentist's assessment that the patient's gums were stable prior to implant placement. Periodontal records were minimal, and only two hygiene visits occurred over two years where two units of scaling were provided at each visit. The X-rays and photographs confirmed evidence of gum recession and significant bone loss in several areas of the mouth. There was also evidence of failing treatment or compromised teeth which were not recognized or recorded in the chart.
It was also unclear if the dentist assessed the patient's bite during the evaluation of pain after insertion of the bridge. It also appeared that the dentist did not inform the patient at the initial exam of the failing or less than ideal treatments she had already received. CDSBC Investigators found that there was minimal detail in the treatment notes, no summary of treatment and option discussions, no notes on complete exam findings, and minimal periodontal records.
Resolution
The dentist signed an agreement to take CDSBC's Dental Recordkeeping and More Tough Topics in Dentistry courses, participate in a case review with a periodontist who does implants, followed by a chart review to evaluate his [post-remedial] recordkeeping, diagnosis and treatment planning and informed consent protocols.
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Meetings of the CDSBC Board are open to registrants and the public.
The next meeting is:
Friday, 30 November 2018 at 8:30 am
Terminal City Club, "Terrace B/Wilson Beck", Level 2
837 West Hastings Street, Vancouver, B.C.
To reserve a meeting package and ensure adequate seating, observers should RSVP to Nancy Crosby, Manager of the CEO's Office, at ncrosby@cdsbc.org by 22 November.
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Registrants whose continuing education (CE) cycle ends on 31 December and who have not yet met the minimum requirements for renewal next year still have time. Log in at www.cdsbc.org to review your CE transcript. CE requirements are 90 credits for dentists, 75 credits for dental therapists and 36 credits for certified dental assistants.
You can submit CE credits online, by email or mail. If you are interested in online CE opportunities, the College offers a variety of courses.
More information is available on our website or you can email CE@cdsbc.org.
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Office Closures
Our office will close at 3pm on Wednesday, 31 October, and will be closed on Monday, 12 November for Remembrance Day. We will reopen at 8 am on Tuesday, 13 November 2018.
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This Contact News Bulletin is distributed to registrants for the College of Dental Surgeons of BC. It is one of CDSBC's official methods of notification to its registrants. Registrants are responsible for reading College publications to ensure that they are aware of current standards, policies and guidelines. 