The Canadian Dental Association Magazine 2026 • Volume 13 • Issue 2 PM40064661 Tongue-Tie and Breastfeeding: Rethinking Ankyloglossia in Dental Practice Page 18 + IN THIS ISSUE Rebalancing the Oral Microbiome P. 27 Vaccines at Work P. 20 Remembering Dentistry Leaders Dr. Gordon Thompson P. 38
Next-generation, Self-leveling Bulk Fill INTRODUCING Natural Remineralization Support1 Secondary Caries Protection2 • Use as a dentin replacement, or bulk fill in one step3 (unlimited depth of cure4) • Can be used with or without a capping layer • Patented stress reduction monomer (MODULUS™), best-in-class shrinkage stress rate5 Bulk-fill Ease & Efficiency • ShadeFusion™ technology replaces common VITA shades • Optimal chroma and translucency, highly esthetic • Simplifies inventory Universal Shade • Fluoride, Calcium, & Phosphate release & recharge • Defends against microleakage via mineral apatite formation2 • Biofilm modulation6 Remineralization Support Bulk Fill | Self-leveling | Fluoride, Calcium & Phosphate Release & Recharge Dual Cure | Moisture Tolerant | BPA Free | Made in the USA Scan to Watch a Video The Class II Solution You’ve Been Waiting For www.pulpdent.com The Higher Standard of Care 1The remineralization process is a natural repair mechanism to restore the minerals again, in ionic forms, to the hydroxyapatite (HAP) crystal lattice. Source: Arifa MK, Ephraim R, Rajamani T. Recent advances in dental hard tissue remineralization: a review of literature. Intl J Clin Ped Dent. 2019:12(2):139. 2Activa Bioactive physically seals the margin of the material and tooth interface through mineral apatite formation, subsequently protecting against microleakage, the leading cause of secondary caries and recurrent decay. Scanning electron micrographs of the Activa Bioactive-Restorative groups showed a ‘‘thicker acid-base resistant hybrid-like layer with a distinct crystallization pattern.’’ (Raghip AG, Comisi JC, Hamama HH, Mahmoud SH. In vitro elemental and micromorphological analysis of the resin-dentin interface of bioactive and bulk-fill composites. Am J Dent. 2023;36{1}:3-7.) 3“One-step” describes placement after preparation, etching, and bonding steps. Refer to Activa Bioactive Bulk Flow instructions for use (IFU) for complete instructions. 4Dual-cure mode 5Fan Y, Hubler D, Choochaisaengrat S, Giordano II R. Polymerization Shrinkage Stress of Novel Light Curing Dental Composites. Poster presented at American Association for Dental, Oral, and Craniofacial Research Annual Meeting; March 12–15, 2025; New York, NY. 6See: Maher YA, Rajeh MT, Hamooda FA et al. Evaluation of the Clinical Impact and In Vitro Antibacterial Activities of Two Bioactive Restoratives against S. mutans ATCC 25175 in Class II Carious Restorations. Nigerian Journal of Clinical Practice, 2023;26(4):404-411. Mah J, Merritt J, Ferracane J. Adhesion of S. mutans biofilms on potentially antimicrobial dental composites. J Dent Res. 2017;96:2560.
About CDA Founded in 1902, the Canadian Dental Association (CDA) is a federally incorporated not-for-profit organization whose corporate members are Canada’s provincial and territorial dental associations. CDA represents over 21,000 practising dentists nationwide and is a trusted brand and source of information for and about the dental profession on national and international issues. is the official print publication of CDA, providing dialogue between the national association and the dental community. It is dedicated to keeping dentists informed about news, issues and clinically relevant information. 2026 • Volume 13 • Issue 2 Head of Governance & Communications Zelda Burt Managing Editor Sean McNamara Writer/Editor Sierra Bellows Gabriel Fulcher Pauline Mérindol Publications Specialist Michelle Bergeron Graphic Designer Carlos Castro Advertising: For all Display, Online and Classified advertising inquiries, or to request the 2026 CDA Media Kit, contact: Michelle Bergeron, CDA Publications Specialist mbergeron@cda-adc.ca CDA Essentials is available online at cda-adc.ca/essentials. All display and classified advertisements are included in the full PDF version, with direct links to corporate/ product websites. The online CDA Essentials generates >21,000 page views monthly. Contacts: Michelle Bergeron, CDA Publications Specialist mbergeron@cda-adc.ca CDA Essentials email: publications@cda-adc.ca Notice of change of address send to: reception@cda-adc.ca or publications@cda-adc.ca @CdnDentalAssoc canadian-dentalassociation Canadian Dental Association cdndentalassoc cdaoasis cda-adc.ca CDA Essentials is published by the Canadian Dental Association in both official languages. Publications Mail Agreement no. 40064661. Return undeliverable Canadian addresses to: Canadian Dental Association, 1815 Alta Vista Drive, Ottawa, ON K1G 3Y6 Postage paid at Ottawa, ON. ISSN 2292-7360 (Print) ISSN 2292-7379 (Online) © Canadian Dental Association 2026 Editorial Disclaimer All statements of opinion and supposed fact are published on the authority of the author who submits them and do not necessarily express the views of the Canadian Dental Association (CDA). Publication of an advertisement or sponsored content does not necessarily imply that CDA agrees with or supports the claims therein. The editorial department reserves the right to edit all copy submitted to CDA Essentials. Furthermore, CDA is not responsible for typographical errors, grammatical errors, misspelled words or syntax that is unclear, or for errors in translations. Sponsored content is solely produced by advertisers. The CDA Essentials editorial department is not involved in its creation. CDA Board of Directors President Dr. Bruce Ward Dr. Raymon Grewal British Columbia Dr. Brian Baker Saskatchewan President-Elect Dr. Kirk Preston Vice-President Dr. Jason Noel Dr. Joy Carmichael New Brunswick Dr. Jerrold Diamond Alberta Dr. Mélissa Gagnon-Grenier NWT/Nunavut/Yukon Dr. Lesli Hapak Ontario Dr. Paul Hurley Newfoundland/Labrador Dr. Stuart MacDonald Nova Scotia Dr. Marc Mollot Manitoba Dr. Janice Stewart Prince Edward Island 3 Issue 2 | 2026 |
Contents The Canadian Dental Association Magazine 2026 • Volume 13 • Issue 2 8 16 CDA at Work 7 From the President: A Year of Gratitude 8 National Oral Health Month: A Moment to Reaffirm the Importance of Prevention News and Events 11 Dental Digest 14 Catching Up with the Oral Health Community in Canada: The Canadian Association for Dental Research 16 How One Family Turned Dental Anxiety into a Mission Issues and People 18 Tongue-Tie and Breastfeeding: Rethinking Ankyloglossia in Dental Practice 20 Vaccines at Work 27 Rebalancing the Oral Microbiome Classifieds 35 Positions Available / Dental Faculty Positions / Advertisers’ Index Supporting Your Practice 30 Accepting Change is Vital to Your Health and Happiness 33 From Clinic to Culture: Why Dental Leadership Matters More Than Ever Obituary 38 Dr. Gordon Thompson 20 38 5 Issue 2 | 2026 |
Dr. Bruce Ward president@cda-adc.ca A Year of Gratitude I’m grateful that I’ve had the opportunity to serve as president of CDA over the last year. It’s been a privilege to represent dentists across the country and to speak on behalf of the profession. Earlier this year in Chicago, I spoke with colleagues from other national dental associations about the Canadian Dental Care Plan (CDCP) and the advocacy that helped shape this program after it came into existence. Their reaction was striking—they were genuinely impressed that Canada is extending dental care to communities that might otherwise go without. I’m grateful to live in a country that takes oral health seriously enough to pursue a program that can make a difference in people’s lives. This year, I’ve had the opportunity to meet with the federal Minister of Health and the Deputy Minister of Health. The goal of those meetings was to build relationships to ensure that CDA is seen as a trusted source of expertise whenever questions about oral health care arise. I’ve always believed that an open, informal approach encourages meaningful dialogue, and I’ve been encouraged to see how that can lead to greater understanding and more informed decision-making. We saw meaningful progress on several advocacy priorities this year. Dentists are now included in the federal student loan forgiveness program for those who choose to practise in underserved communities, a step toward improving access to care where it’s needed most. The permanent introduction of a national school food program is another encouraging development that will positively impact the oral health of children across Canada. As well, in a period marked by fiscal restraint, it is notable that the new federal Liberal government has maintained dental care as a policy and budget priority, with no reductions to the CDCP. Together, these outcomes reflect the strength of sustained advocacy and the growing recognition of oral health as an essential part of overall health. I’m grateful for the support that I’ve received throughout my tenure from the extraordinary staff at CDA. Their advice and support have been constant and invaluable. I’ve had the privilege of working with an outstanding board of directors. The dedication, thoughtfulness and collegiality of this group have been remarkable. The same can be said of the presidents of the provincial and territorial dental associations (PTDAs). One of the most encouraging developments during my time on the CDA board, and especially this year, has been the strong relationship between CDA and the PTDAs. Every six weeks or so, the presidents gather for an informal “coffee chat” call on Sunday mornings. These conversations keep the lines of communication open and help build trust and understanding among leaders across the country. When I began as CDA president, a solid governance structure and strategic plan were already in place, allowing us to refine how we operate. I’ve especially appreciated the association’s willingness to question long-standing practices and assess whether they still make sense today. Such evolution over the past years has placed CDA in a stronger, more forward-looking position. Serving as CDA president has been one of the great privileges of my professional career. And when I look back, what I’ll remember most isn’t any single meeting, speech or policy discussion. It’s the people—and I’m deeply grateful for them. From the President 7 Issue 2 | 2026 | CDA at Work
National Oral Health Month: A Moment to Reaffirm the Importance of Prevention Every April, National Oral Health Month (NOHM) public awareness campaigns across the country remind Canadians that oral health is essential to overall health. For the profession, it also serves as an opportunity to reflect on dentistry’s preventive mandate and the leadership role that dentists continue to play. A key focus for 2026 is raising awareness about oral cancer, including improving public understanding of risk factors, early detection, prevention, and the connection between human papillomavirus (HPV) and oral cancer. Oral Cancer: The Imperative of Early Detection Oral cancer can affect anyone, and early detection and screening play a critical role in improving outcomes. Comprehensive soft tissue examinations are already embedded in standard oral health care. Clinicians routinely assess the lateral borders of the tongue, the floor of the mouth, the oropharynx, and other high-risk areas. Discussions about risk factors and behavioural habits, such as tobacco use and alcohol consumption, are also common in the dental office. HPV and the Expanding Risk Conversation HPV is a common virus and a known risk factor for oral cancer. Some patients associate it primarily with cervical cancer, while others may not realize how common the virus is or that vaccination is a safe and effective way to protect themselves. The dental office can play an important role in helping patients better understand these connections. Dentists are trusted sources of information and play a key role in prevention and screening. It is important to remind patients that regular self-checks 8 | 2026 | Issue 2
and paying attention to changes in their mouth, lips, or throat can help identify concerns early. Simple steps patients can take to make a meaningful difference include: • Do regular self-checks of their mouth, lips, and throat • Talk to their dental team about screening and prevention • Ask questions, get informed, and make prevention part of their everyday oral care When soft tissue and oral cancer screening are consistently presented as components of comprehensive dental care, it reinforces their importance and can lead to conversations that help shape a holistic risk profile. Prevention has always been the cornerstone of dentistry. Today, that foundation extends further into conversations with patients that can carry lifechanging implications. National Oral Health Month provides an opportunity to reaffirm this commitment. By increasing awareness of oral cancer, promoting screening, and helping patients understand the link between HPV and oral cancer, the dental profession continues to strengthen its role in protecting the health of Canadians. Start the conversation. Encourage patients to check their mouths. Help make prevention part of everyday oral health. For more National Oral Health Month campaign resources, see: bit.ly/3PyZziO CDA at Work
Right and left driver tips adapts the splittips to both sides of the embrasure simultaneously Quad Wedge utilizes a revolutionary split-tip design with flexible wings and a secure gripping block for precise control. Specially engineered teeth and tip geometry allow this versatile instrument to deliver sixteen times the grip strength of standard cotton forceps while maintaining sensitivity for placement and removal without compromise. ADVANCED DESIGN FOR COMPLEX CASES © 2026 Garrison Dental Solutions, LLC Toll-free 888.437.0032 | gds@garrisondental.com | www.garrisondental.com ADCA426CDA Long lasting rings - flash-free results Drawn-wire nickel titanium produces lasting separating pressure plus ultra-adaptive Soft-facetm tips for reduced flash. Enhanced cervical seal The split-tip Quad wedges combined with the driver tip on the Quad rings produce an independent cervical seal on both sides of back-to-back restorations. Quadrant workflow Asymmetrical tip design improves ring fit, matrix stabilization and tooth separation all of which are key for achieving optimal results on challenging multiple-tooth and back-to-back Class II preparations. Techniques for success Scan the code to see Quad cases, technique videos, and frequently asked questions. Advanced Band Wedge Forceps Best for: • Matrix band placement/removal • Wedge placement/removal • All-purpose replacement for cotton forceps BWI
Health Canada introduced new caps on commercial laboratory fee reimbursements under the CDCP in October 2025, to try to curb any inappropriate billing practices. Health Canada stated that the majority of dentists who submit usual and customary fees would not be affected by these actions. However, the policy changes unintentionally affected many dentists in Canada, resulting in significantly higher out-of-pocket costs for some patients. Following a coordinated advocacy effort by CDA and the provincial and territorial dental associations, Health Canada recognized the need to recalibrate the caps on lab fees and confirmed that a significant increase on those levels will be applied, effective April 1, 2026. Although these changes are not retroactive, it establishes a more appropriate framework for lab fee reimbursement and strengthens the foundation for ongoing collaboration with Health Canada to ensure that the CDCP meets the needs of dentists and patients. In March 2026, Health Canada notified CDA and the PTDAs that some preauthorization requests and reconsiderations were being sent directly to Health Canada from dental offices by mail or email. Health Canada does not adjudicate preauthorization requests or reconsiderations, so that federal department can’t accept or process these submissions. All preauthorization requests and reconsiderations must be submitted to Sun Life, following the process outlined in the CDCP Benefit Guide. Some of the confusion may arise from the Sun Life website on the Claims Verification Program and appeals process, which could be misunderstood as instructions for preauthorization reconsiderations. Health Canada is working with Sun Life to update and clarify this website content. In the meantime, please ensure that all preauthorization and reconsideration requests are sent to Sun Life. CDCP Dental Lab Fee Caps CDCP Preauthorization and Reconsideration Requests In addition to a significant increase to the caps on commercial lab fees, effective April 1, 2026, (see below) several other important updates to the CDCP Benefits Grid and Guide will take effect on April 1, including: • A general fee increase, with the exact percentage still to be confirmed by Health Canada. • Updates reflecting the Benefits Guide changes in December 2025, such as revised examination frequency limits. • Implementation of the 2025 USC&LS, including updates to sedation codes for greater clarity and improved coordination of benefits. • Desensitization codes 41301 and 41302 are moving to Schedule B, requiring preauthorization. • Immediate complete dentures, grouped under Schedule A with transitional dentures, limited to one per lifetime. CDCP Benefits Grid and Guide • A new out-of-office code for non-routine institutional visits (e.g., emergency care). • Certain denture liners are moving from exception status to Schedule A. These updates are intended to improve clarity, consistency, and predictability for dental practices delivering care under the CDCP. DENTAL DIGEST See: bit.ly/415mdli See: bit.ly/3PGXjWQ 11 Issue 2 | 2026 |
In January 2026, Health Canada published a new plain language document with evidence-based information on how to choose and use a cannabis product for medical purposes. The resource, Information on the Use of Cannabis for Medical Purposes, is designed to support patients in making informed decisions about lower-risk use of cannabis, and to help health care providers in discussions with patients about cannabis use for medical purposes. To date, Health Canada hasn’t authorized the use of cannabis products to treat any specific diseases or symptoms. However, the available research, although limited, suggests that cannabis might relieve chronic non-cancer pain (mainly neuropathic), insomnia and depressed mood associated with chronic diseases. There currently isn’t enough evidence for Health Canada to recommend which cannabis product to take for any specific health condition. Cannabis Use for Medical Purposes See: bit.ly/47wLgkR A new World Health Organization (WHO) guideline provides evidence-based recommendations for the safe and effective use of mercury free dental materials and minimal interventions to prevent and manage dental caries, in alignment with the Minamata Convention on Mercury and global oral health priorities. The resource, WHO guideline on environmentally friendly and less invasive oral health care for preventing and managing dental caries, evaluates the clinical effectiveness, cost effectiveness, toxicity and environmental impact of fluoride varnish, silver diamine fluoride (SDF), pit and fissure sealants, glass ionomer cements, resin-based composites and related materials. The document incorporates GRADE based assessments and guiding principles, including prevention first, minimally invasive care, shared decision making and the precautionary principle, alongside risk mitigation advice for vulnerable groups and occupational safety measures. It also outlines implementation strategies, sustainability considerations and research gaps to support countries in transitioning toward mercury free, environmentally responsible oral health care. WHO Resource on Preventing and Managing Dental Caries See: bit.ly/4s2eeAj 12 | 2026 | Issue 2
LOAD IT AND LEAVE IT. Free up 6.5 hours per week for patient care. www.scican.com/loaditandleaveit Cut instrument cleaning costs by up to 70%.1 MANUAL WASHING vs. AUTOMATED WASHING Reduce sharps exposure during reprocessing.2 SCAN TO LEARN MORE Save time and money with automated washing. With its increased instrument capacity and intuitive touchscreen, our newest automatic washer delivers a safer, faster, easier way to improve your workflow – and your bottom line. HYDRIM 112W G4+ Instrument Washer HYDRIM is a registered trademark of SciCan Ltd. Manufactured for: Dent4You AG Bahnhofstrasse 2, CH-9435 Heerbrugg Distributed by: Coltene/Whaledent Inc. 235 Ascot Pkwy. Cuyahoga Falls, OH 44223 Distributed by: SciCan Ltd. 1440 Donmills Rd. Toronto, ON M3B 3P9 1 Cleaning costs based on dental practice operating a 5-day work week; comparing automated washing to manual cleaning methods. 2 Younai, F., Murphy, D., Kotelchuck, D. (2001). Occupational Exposures to Blood in a Dental Teaching. Environment: Results of a Ten-Year Surveillance Study.
Catching Up with the Oral Health Community in Canada: The Canadian Association for Dental Research (CADR) We checked in with CADR’s president Dr. Leigha Rock to learn more about the work the association does. Dr. Leigha Rock is president of the CADR and associate professor and director of the School of Dental Hygiene at Dalhousie University. She is also cross appointed to the Department of Pathology in the Faculty of Medicine. She is a scientist at the Beatrice Hunter Cancer Research Institute and holds a scientific appointment at Nova Scotia Health, Department of Anatomical Pathology. Her research focuses on oral cancer prevention, microbiomics, and population health. She is passionate about connecting science, education, and practice to improve oral health outcomes across Canada. What does CADR do, in a nutshell? The Canadian Association for Dental Research (CADR) is a division of the International Association of Dental, Oral, and Craniofacial Research (IADR). CADR’s mission is to advance and promote oral health research, foster collaboration among researchers, and translate scientific discoveries into improvements in oral and overall health across Canada and beyond. CADR is a dynamic community of approximately 250 members from all ten Canadian dental schools and supports researchers at every stage of their careers. CADR maintains strong relationships with members of the dental community in Canada and internationally by ensuring ongoing dialogue with the leadership of the various national dental groups, including the Canadian Dental Association (CDA). How does CADR contribute to the dental profession and oral health in Canada? CADR plays a unique role as a bridge between research and clinical practise. Although many dentists might not think of themselves as researchers, almost everything that happens in a dental office—from the materials used to restore teeth to the guidelines for managing caries or periodontal disease to the ways we integrate oral and systemic health—has its roots in research that CADR members have helped conduct or champion. Through partnerships with organizations like the Canadian Institutes of Health Research (CIHR), the Network for Canadian Oral Health Research (NCOHR) and CDA, CADR helps shape the national research agenda for oral health. We advocate for investment in research and training, support the next generation of clinicianscientists, and showcase Canadian innovation on the global stage. 14 | 2026 | Issue 2
CADR played a key role in the National Oral Health Research Strategy (NOHRS), a collaborative initiative supported by Health Canada that aims to coordinate oral health research across the country. This strategy brings together universities, industry, professional associations, and communities to identify priorities and ensure research addresses real needs—whether that’s access to care in rural areas, prevention of oral cancer, or understanding how oral health connects to chronic diseases like diabetes and heart disease What’s coming up for CADR in the future? The future is bright, and busy! Over the next few years, CADR will continue to expand its collaborations nationally and internationally. A major focus is on implementing the NOHRS and ensuring it creates realworld impact. We’re also growing our efforts to make research more inclusive and accessible. That means amplifying diverse voices, supporting Indigenous and communitydriven oral health research, and ensuring that discoveries reach every corner of the country, not just the major research centres. CADR is also exploring new ways to engage clinicians directly—through webinars, continuing education sessions, and simplified summaries of emerging research that make it easier for dentists to stay on top of new science. At its core, CADR is about connection: connecting ideas, disciplines, and people who share a passion for improving oral health. Whether you’re a researcher, a practitioner, or both, you’re part of a community that is small but mighty, and together, we’re shaping the future of dentistry in Canada. Learn more about the CADR at: iadr.org/CADR How does your work touch the lives of dentists across Canada? Even if you’ve never attended a CADR event, chances are that CADR’s work has already influenced your practice. The scientific evidence that guides clinical decision-making, the “why” behind what you do, is strengthened and advanced through CADR’s support of researchers across the country. We organize the AAODCR/CADR Annual Meeting and Exhibition, and a biennial IADR/AAODCR/CADR General Session and Exhibition, where researchers, students, and clinicians come together to share new discoveries and practical applications. These gatherings often spark collaborations that translate directly into new diagnostic tools, treatment approaches, and policies that shape patient care. CADR also invests heavily in supporting trainees and early-career researchers, the people who will be leading the next wave of innovation. By nurturing this talent pipeline, we’re ensuring that Canadian dentists will continue to have access to cutting-edge knowledge, evidence-based guidance, and new technologies that enhance patient outcomes. Our work behind the scenes helps make your work in the operatory more effective, efficient, and evidence driven. The scientific evidence that guides clinical decision-making, the “why” behind what you do, is strengthened and advanced through CADR’s support of researchers across the country. 15 Issue 2 | 2026 | News and Events
How One Family Turned Dental Anxiety into a Mission What started as an Ottawa family’s anxiety over their child’s dental surgery grew into a family business that reached the reality television show Dragon’s Den. When Stacey Laviolette took her three-yearold daughter Piper to the dentist, she had no reason to expect anything out of the ordinary. “I loved the dentist growing up,” she says. “I would literally fall asleep in the chair. I walked in excited for her.” That confidence vanished in seconds. Piper was diagnosed with multiple cavities, ten in total, and would need treatment under general anesthesia. “I came home crying,” Laviolette says. “I just felt this overwhelming guilt. Like, I’m her mom—how did I let this happen?” “At first I thought, okay, cavities, we’ll just get them fixed,” says her husband, Keith Lanctot. “But when Stacey told me Piper would need surgery, and I saw Piper crying, too—I didn’t know what to do.” Their dental surgeon, Dr. Nabil Achache of Ottawa, reassured them that they hadn’t failed as parents. Some children may have factors that increase their risk of cavities, such as saliva composition or tooth anatomy. “When parents hear that their child needs dental surgery, many feel scared and assume it will become a recurring problem. But that’s usually not the case,” says Dr. Achache. “When treatment is done properly and families follow the recommended changes, it’s often a one-time intervention as well as a turning point,” he says. “Habits improve, risk factors are addressed and many children do not need major dental treatment again. Our goal isn’t to be aggressive; it’s to intervene once, decisively, so the child doesn’t have to go through this on multiple visits.” When parents hear that their child needs dental surgery, many feel scared and assume it will become a recurring problem. But that’s usually not the case. Stacey Laviolette and Keith Lanctot on set of Dragon’s Den. 16 | 2026 | Issue 2
Stacey Laviolette with a My Friend Toothy mascot. Still, the emotional toll lingered. Laviolette struggled with anxiety in the weeks leading up to the first procedure, and Piper began resisting anything related to oral care. “She didn’t want to brush her teeth. She didn’t want to talk about it,” says Laviolette. “Many families don’t realize how technically demanding dental treatment is for young children. We work with needles, sharp instruments and tiny spaces, and if a child is anxious or unable to stay still, treatment can become unsafe without sedation,” says Dr. Achache. “Although families often associate general anesthesia with serious medical issues, in dentistry it’s often the safest, most controlled way to complete all treatment at once, while protecting the child from pain, fear and trauma.” Four years later, that deeply personal mission led the couple to Dragon’s Den, the Canadian reality TV show on CBC where entrepreneurs pitch business ideas to a panel of wealthy investors for funding. It took four applications. “We took the feedback seriously every year,” Lanctot says. “We kept improving, kept pushing.” When they finally got the call, preparation for the pitch took over their lives. “Our kids knew the pitch better than we did,” Laviolette says. “If we messed up, they’d correct us.” The experience itself was chaotic, emotional and unforgettable. Laviolette went off script. She even surprised Lanctot by reenacting how they met, on their high school wrestling team, live on stage. “I was smiling on the outside, but panicking on the inside,” Lanctot says. The judges on the show responded to the couple’s authenticity, energy and story. While they didn’t walk away with a traditional investment, Dragon’s Den judge Arlene Dickinson offered something just as valuable: mentorship. “She said, ‘I want to help you get this to the next level,’” Laviolette says. In many ways, the business is already a success. “When Piper went back to see her dentist a few years later, she had zero cavities,” Lanctot says. The day of the surgery at ToothPark Pediatric Dentistry, Laviolette noticed that she wasn’t alone. “I saw other moms in the parking lot crying,” she says. “There’s so much shame wrapped up in this.” A self-described “fixer,” Laviolette couldn’t stop thinking about why there weren’t more supports available to help children emotionally process dental anxiety. “There was nothing that offered a full experience—something that helped kids understand, prepare and feel safe.” Drawing on her background in child psychology, Laviolette had what Lanctot calls a “lightbulb moment.” Exhausted but energized, she burst into the kitchen with a vision. “She looked like she hadn’t slept in days,” Lanctot says. “She’s talking about books, a character—I didn’t know if I should be scared or impressed.” Laviolette began writing a children’s book to help prepare children for dental treatment and practise daily oral health hygiene with a character, My Friend Toothy, to coach and support them. “This started because I wanted to help my child,” Laviolette says. “And then I realized—if it helped her, it could help other families, too.” A self-described ‘fixer,’ Laviolette couldn’t stop thinking about why there weren’t more supports available to help children emotionally process dental anxiety. 17 Issue 2 | 2026 | News and Events
In pediatric oral health, ankyloglossia, or tongue-tie, is a diagnosis that’s getting more attention in the community and in popular media. But behind the headlines is a complex clinical issue with tangible consequences for infant feeding, speech development and oral hygiene. The Canadian Academy of Pediatric Dentistry (CAPD) issued a Position Statement on Ankyloglossia and Breastfeeding in 2025, developed in collaboration with pediatric medical organizations. Dr. Duy Dat Vu, pediatric dentist and CAPD president, discusses the role that dentists can have with addressing the issues associated with this condition. Tongue-Tie and Breastfeeding: Rethinking Ankyloglossia in Dental Practice “Ankyloglossia is more commonly known to the public as a tongue-tie,” Dr. Vu explains. “It occurs when a small band of tissue connects to the floor of the mouth, underneath the tongue. When that band is unusually short, thick or tight, it can restrict the tongue’s movement.” This type of restriction can impair more than just motion, it can also affect essential functions, particularly breastfeeding. When the movement of the infant’s tongue is restricted, it’s function is impeded and breastfeeding may not be as effective as it could be. Sometimes the infant struggles to latch onto the breast, and it can become painful for the nursing mother. Beyond infancy, tongue-tie can affect speech, swallowing, oral hygiene, and in some rare cases, the growth and development of the jaw. “Early identification and monitoring are important, to make sure kids develop properly,” Dr. Vu adds. “It’s all about prevention.” Complexity and Collaboration The CAPD’s position statement represents a shift, emphasizing that ankyloglossia is not a simple diagnosis, and its treatment must never be approached with a onesize-fits-all intervention. “It’s not as simple as, if you identify a tongue-tie, you simply cut it,” Dr. Vu says. “Sometimes doing nothing is actually the best thing.” The condition can Beyond infancy, tongue-tie can affect speech, swallowing, oral hygiene, and in some rare cases, the growth and development of the jaw. Dr. Duy Dat Vu, is a pediatric dentist and president of the Canadian Academy of Pediatric Dentistry (CAPD). 18 | 2026 | Issue 2
be complex and needs a multidisciplinary or interdisciplinary approach. “A range of health care professionals can be consulted to reach the proper diagnosis and develop the best treatment plan,” says Dr. Vu. The CAPD position statement calls for collaboration between general dentists, pediatric dentists, oral surgeons, pediatricians, lactation consultants and nurses. “We work together as a team to identify the particular reasons for any breastfeeding problems, and to determine if it’s actually the ankyloglossia causing the issue,” he explains. or trends. “I always remind parents that we’ve seen kids with no tongue-tie who still have feeding problems, and others with very short tongues who can speak very well.” The presence of a physical restriction does not automatically mean there is a problem. “Function first. Anatomy second. That’s the approach we need,” he says. CAPD acknowledges that despite clinical experience, there’s still insufficient long-term research on the outcomes of early surgical intervention for tongue-tie. “We need more research and data,” Dr. Vu says. “As in everything in science and medicine, we have to keep asking: is this really the best treatment? Or will something else be better in the future?” Until then, he encourages clinicians to practice humility and focus on collaboration. “We combined our guidelines with the American Academy of Pediatric Dentistry and other medical pediatrician groups because at the end of the day, we all have the same goal: to help children develop and thrive.” Quick Takeaways for Clinical Practice z Look beyond anatomy.A visible tongue-tie does not guarantee functional impairment. z Ask parents or caregivers about function. Is the baby latching? Is the child speaking clearly? Is oral hygiene an issue? z Refer wisely. Don’t try to manage complex cases in isolation. Connect with a multidisciplinary team. z Get informed consent.Always explain benefits, risks, and alternatives clearly. z Stay impartial. Follow evidence, not prevailing trends or attitudes. Read CAPD’s Position Statement at: bit.ly/4bVHKll First Line, Not Final Word Getting the correct diagnosis is important. It’s not just about tongue size, it’s also related to breastfeeding difficulty, speech problems, swallowing and oral hygiene. All the functionalities can be affected. “If you see a child for the first time and you notice a short tongue, don’t rush. Talk to the parents. Ask questions. What are their concerns? Are they noticing anything that affects feeding or speech?” explains Dr. Vu. Such cases often require referral to a multidisciplinary team, especially in urban areas. “If your clinic is located in a part of Canada where you are able to refer the family to a team of clinicians, try to seek out a pediatrician, lactation nurse, nurse consultant, or a specialist like myself,” says Dr. Vu. A key focus of the CAPD statement is on shared decision-making. “Everything we do has to be with informed consent. The parents or caregivers need to be made aware of the benefits, risks and alternatives,” he says. “Obviously, nothing in life comes without risk, but they should consider if it’s worth the risk to have treatment or not. This will depend on the parents and the health care professional and how comfortable they are with the procedure,” adds Dr. Vu. Dr. Vu also cautions against performing procedures without a full assessment. “We have to make sure that the parents agree on how, or even if, to proceed.” The Future: More Research, Better Protocols Laser frenectomy clinics and online testimonials have led to a rise in demand for tongue-tie release procedures. But Dr. Vu urges clinicians not to succumb to such pressures If you see a child for the first time and you notice a short tongue, don’t rush. Talk to the parents. Ask questions. What are their concerns? Watch an interview with Dr. Vu on CDA Oasis: bit.ly/4s46Ww8 19 Issue 2 | 2026 | Issues and People
Vaccines are built on one of biology’s most remarkable features: immune memory. Expose the immune system to a safe version or a fragment of a pathogen, and it learns. When the real pathogen shows up later, the immune response is faster, stronger and more precise. “Vaccines take advantage of the immune system’s capacity for memory,” says Dr. Matthew Tunis, executive secretary to Canada’s National Advisory Committee on Immunization (NACI). “You prime the system in advance so that, at first exposure to the pathogen in the real world, the response is already geared up.” That priming happens through a coordinated network of cells and signals. B cells produce antibodies; proteins that circulate in blood and lymph and can neutralize viruses and toxins before they enter cells. T cells deliver “cell-mediated” immunity, helping orchestrate responses and destroying infected cells directly. Depending on the disease, vaccines are designed to emphasize the arm of immunity that matters most. One of the most remarkable aspects of the immune system, Dr. Tunis says, is how it engineers its own diversity. Immune cells rearrange segments of their own DNA to create an almost limitless range of receptors, each one specialized to recognize a different potential threat. “It’s incredible,” he says. Vaccines at Work Three leading Canadian scientists explain how vaccines prevent disease, protect health care workers and point the way toward a healthier future. “Your immune cells cut and re-stitch parts of their genome to make receptors that all look a little different, each one ‘sticky’ for a particular protein or antigen.” Most of these cells will never encounter the target they’re built for, but that’s the trade-off for flexibility. The result is an immune system capable of responding to nearly anything it might meet over a lifetime, a living library of possibilities, ready to activate when the right match appears. “Different pathogens cause disease in different ways,” Dr. Tunis explains. “Some are best handled by neutralizing antibodies that ‘soak up’ the invader; others require robust T-cell responses. Vaccine design leans into the strategy most likely to overcome the specific pathogen.” Vaccines try to simulate what a natural infection would do, without the risk of the disease. Sometimes we use a weakened version of the virus. 20 | 2026 | Issue 2
Dr. Scott Halperin, a pediatric infectious disease specialist and director of the Canadian Center for Vaccinology, frames it this way: “Vaccines try to simulate what a natural infection would do, without the risk of the disease. Sometimes we use a weakened version of the virus, such as for measles. Other times we use just the problem piece, the toxin or a surface protein, and train the immune system to recognize that.” The measles vaccine uses a live-attenuated virus that can trigger mild, self-limited symptoms in a small fraction of recipients; the immune system learns enough to prevent disease when the wild virus appears. Tetanus vaccines, by contrast, contain a modified, detoxified version of the toxin. “You’re not immunized with the bacterium,” Dr. Halperin says. “You’re immunized against the poison it makes.” For Dr. Sadarangani, the path to vaccine research began with curiosity about the constant struggle between humans and microbes. “These pathogens evolve much faster than we do,” he says. “Some bacteria can double every 20 minutes. They’re always changing.” That dynamic drew him toward infectious diseases, but prevention was what truly captured his imagination. “I’ve always been more of a prevention person than a treatment person,” he explains. “Getting ahead of disease has a far bigger impact than treating it after the fact.” For him, vaccines are the purest form of that idea: using science to give the immune system an advantage in an endless biological contest. A Brief History: From Cowpox to Code The intellectual roots of vaccination reach back to the late 18th century. “It goes back to Edward Jenner and smallpox,” Dr. Tunis says. “And taking a less pathogenic version of a virus and exposing the immune system so it’s ready for the real thing.” Early technologies often used whole organisms that were either killed or weakened. The portfolio of vaccines expanded in the early- and mid-20th century with vaccines against diphtheria, tetanus and pertussis, followed by polio and the measles–mumps– rubella (MMR) combination in the 1960s and 70s. “We went from a handful to a dozen vaccines,” Dr. Halperin says. “Since then, growth has followed an exponential path. The decades near the end of the 20th century brought powerful conjugate vaccines against Haemophilus influenzae type b and Streptococcus pneumoniae; newer formulations steadily widened the serotype coverage and reduced disease. Eradication of smallpox became a public health milestone. Polio has been eliminated from most of the world, with endemic transmission remaining in only two countries, Pakistan and Afghanistan.” Technology has become increasingly precise. Rather than relying primarily on live-attenuated or whole-cell approaches, many modern vaccines deploy purified protein subunits, polysaccharides (often conjugated to proteins to improve immune response), virus-like particles, or most recently nucleic-acid platforms that instruct our own cells to make the relevant viral protein. “As you get more focused on specific components, sometimes you need adjuvants to boost the signal,” Dr. Tunis says. The goal is to present the immune system with the right target, at the right dose, with the right stimulation, which maximizes protection and minimizes risk. The speed and scalability of mRNA platforms during the COVID-19 pandemic were a watershed. Expectations set before those trials, which were 50–70% efficacy, were eclipsed by initial results showing around 95% efficacy against symptomatic disease for the original strains. As we age, immune responses can wane, a phenomenon called immune senescence, so vaccine formulations for older adults may include higher antigen doses or adjuvants. The durability of that immune memory varies. With measles, immunity is “very long lived and robust,” Dr. Tunis says, especially after a two-dose series. But other pathogen–host combinations are less stable. As we age, immune responses can wane, a phenomenon called immune senescence, so vaccine formulations for older adults may include higher antigen doses or adjuvants; ingredients that enhance immune activation. Pathogens can also change. Influenza reshuffles its genetic deck each year; SARS-CoV-2 has evolved rapidly since 2020. Some bacteria exist in multiple serotypes that rise and fall in the population, prompting periodic updates to vaccine composition. But falling antibody levels in an individual do not always mean a loss of protection. “The immune system has to maintain homeostasis,” Dr. Tunis says. “Antibodies naturally decline after a peak, but memory B and T cells remain. On re-exposure, by booster or by the environment, the system quickly snaps back to high output.” Dr. Manish Sadarangani, a pediatric infectious diseases physician and director of the Vaccine Evaluation Center at BC Children’s Hospital, underscores that vaccines are ultimately about prevention, aligning with dentistry’s overarching ethos. “Great vaccines are only great once you can get them into people,” he says. The science prepares the immune system; the vaccination program delivers the protection. 21 Issue 2 | 2026 | Issues and People
“Technology and understanding of how pathogens do their work have expanded the pace of development,” Dr. Halperin says. “We can swap antigens more quickly and pursue a broader range of pathogens.” Another historical shift has been programmatic. Early “universal” programs went after pathogens that affected everyone. Today, as those victories hold, research and policy are also tackling diseases concentrated in subpopulations. “We’re seeing a move toward vaccines for groups at particular risk, including older adults, infants, health care workers, or specific communities hit hardest during outbreaks,” Dr. Tunis says. The result is innovation with a finer point: RSV immunization in pregnancy to protect infants, targeted monoclonal antibody programs for newborns, and agestratified indications for older adults. Vaccine Research Vaccine development is a relay across disciplines and sectors. Dr. Sadarangani describes a lifecycle that begins long before public awareness. “A lot of time is spent in development before anyone’s heard of it,” he says. Preclinical work in laboratories and animal models identifies candidate antigens, refines formulations, and examines dosing strategies. Epidemiologic studies map disease burden and identify the populations most likely to benefit. If a vaccine candidate looks promising, it enters human testing. Phase 1 studies, typically in dozens of healthy adults, assess safety and initial immune responses. Phase 2 trials, with hundreds of participants, continue safety monitoring and probe immunogenicity more deeply. Phase 3 trials, with thousands to tens of thousands involved, demonstrate efficacy against disease, often through randomized, placebo-controlled designs. “Phase 2 and 3 trials are massive undertakings,” Dr. Sadarangani says. Academic networks can and do conduct early trials, sometimes with public funding from agencies such as the Canadian Institutes of Health Research (CIHR) and the Natural Sciences and Engineering Research Council of Canada, or with small biotech partners. As costs and scale grow, large manufacturers usually step in to produce vaccines at greater volume and to execute the biggest trials. Even then, the science is only at the halfway mark. Image: Public Health Agency of Canada 22 | 2026 | Issue 2 Issues and People
“Once implemented, research ramps up, not down,” Dr. Sadarangani says. Post-licensure effectiveness studies test how vaccines perform in the real world as safety surveillance expands to millions of recipients and program optimization studies refine schedules. The HPV vaccine illustrates the point. “We started with three doses because that was assumed necessary,” Dr. Sadarangani says. “Trials showed two doses performed just as well; newer evidence indicates one dose appears to be as effective. That shift improves access and affordability, without compromising protection.” Dr. Halperin’s centre in Halifax is designed to span the arc from lab bench to clinic to communities. “We bring an interdisciplinary lens,” he says, describing a network that includes basic scientists, clinicianscientists, epidemiologists, statisticians, nurses, sociologists, anthropologists, psychologists, health law experts, bioethicists, health economists and public health practitioners. “Our evaluation group does clinical trials and burden-of-disease research,” he says. “Our programs, policy and implementation group looks at how vaccines get into practice, public perceptions, hesitancy, and program evaluation.” At the policy end, Dr. Tunis and NACI serve as the bridge from evidence to implementation. “We’re the interface between the expert panel and the Public Health Agency of Canada,” he says. NACI’s recommendations, published in the Canadian Immunization Guide and public statements, inform provincial and territorial programs, which then adapt schedules to local needs and resources. The through-line in this process is integration. Laboratory insights inform clinical design, clinical outcomes feed policy, policy drives equitable delivery, real-world data loop back to improve the product and the program. “It takes a village,” Dr. Sadarangani says. “Great vaccines sitting on the shelf are not that great.” Health Care Professionals and Vaccines Health care workers face a different risk profile than the general public. They encounter people at their most vulnerable, often before a diagnosis is clear. “We can infect our patients, and our patients can infect us,” Dr. Halperin says. “Some infections are mild; some can be severe. Hepatitis B is a clear example, potentially leading to liver cancer down the road. We used to only target high-risk professions, but infections still occurred. Now we recommend that all health care providers should be protected.” The rationale is two-fold. Immunization helps shield the worker in the course of routine care, when people may be presymptomatic or still shedding virus. And it also protects patients. Dr. Halperin says that keeping vaccines up-to-date is healthy for both the individual and The vaccine pipeline is more diverse than ever, driven by advances in immunology, molecular biology and datarich surveillance. Some of the most tangible near-term gains are in respiratory disease. their community. Some people, he explained, simply can’t respond to vaccines because of genetic immune deficiencies, illnesses like cancer, or treatments that suppress the immune system. “Even if we vaccinate them, their response may be inadequate,” he says. “But we can create a protective environment around them if the rest of us are immunized.” Natural aging itself, he added, weakens immunity, so a growing (and aging) share of the Canadian population is vulnerable. For Dr. Halperin, vaccination is part of a social contract: protecting one another through collective immunity. “You might not need that protection today,” he said, “but someday you or your family might. Keeping up-to-date is an obligation to ourselves and to the people around us.” Dr. Tunis emphasizes that immunization is one layer in a broader infection-prevention strategy. “Vaccination is part of a set of building blocks, alongside PPE and other infectioncontrol measures, that, together, create an ideal environment for protecting workers and the populations they serve,” he says. The Canadian Immunization Guide outlines specific recommendations for health care personnel, reflecting both occupational exposure risk and the imperative to prevent onward transmission in clinical settings. “People have a trusted relationship with their dentist. We know that most people see the same dentist for decades,” Dr. Sadarangani says. “We’ve seen over and over that a recommendation from a health care provider is the most trusted piece of advice. Even if dentists aren’t administering vaccines themselves, knowing where to refer patients—and being willing to raise the topic—can make a real difference.” In some jurisdictions, dentists already play a more direct role. Alberta permits dentists to administer the HPV vaccine, given its link to oropharyngeal cancers. For clinicians who hesitate to initiate vaccine conversations, Dr. Sadarangani offers a practical nudge. “Go in well-armed with a bit of knowledge,” he says. “Even a redirect to a local provider can help. The point is to use that trusted encounter to a maximum benefit.” 23 Issue 2 | 2026 | Issues and People
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