This page is included to re-affirm and explain a long standing policy of the orthodontic community in British Columbia. The policy is a simple one.

Namely that orthodontic specialists in B.C. and elsewhere in Canada should deal directly with their patients on financial matters. We are against direct assignment of fees from the insurance carrier to the practitioner.

This policy is supported by the BCSO and has been along standing policy of organized dentistry in Canada, including the Canadian Dental Association. Until recent years, orthodontists have stood solidly behind it. A recent survey of our members suggests that this policy is again in need of promotion, explanation and endorsement so that our members clearly understand that we would all be better off in the long run if we stand united against direct assignment of benefits from carrier to orthodontist. It is easy to understand the arguments that have led some orthodontists to disregard this stand and accept assignment:

1. The "fear of competition"; the fact that "the other guy is doing it", and the other guy might be an orthodontist or a local general practitioner heavily involved in orthodontics.
2. The "demand" of the patients that assignment must be accepted or they will go elsewhere.
3. The fact that building a practice today is far more difficult and any marketing edge is a great temptation.

There are a lot of possible reasons that may influence people to accept assignment. Let's re-examine the guts of the issue.
The contract we establish when we initiate treatment is between the professional and the patient or parent. We do not have a contract with an insurance carrier. We should not be establishing or modifying our proposed treatment plans in any way based on the insurance a patient has available. We should not be establishing or modifying fees in any way according to the coverage a patient has available. We have an obligation to assist the patient in every way to take the maximum advantage of their benefits; however, we are not treating or entering into a contract with a dental plan.

We have a unique opportunity to avoid some of the pitfalls of direct assignment. If we don't control our own destiny by firmly establishing that our contractual arrangements are with our patients, we run the risk of slowly loosing our identity and our ability to maintain control over such fundamental areas as treatment planning and fee structures. Do you really want to get to a stage where a corporation tells you what you can and can't do and what your fee is going to be? This scenario is not farfetched when one looks at the battles that have been fought provincially and nationally to maintain the integrity of our profession in the face of increasing third party pressures.

When you get right down to it, you won't lose many, (if any), patients. You won't have that many more problems with respect to payment of accounts. It really comes down to whether this is a principle worth preserving. It is important to take the long view and protect our fundamental way of practice not only for ourselves but for those who want to practice quality orthodontics in the future. We are also acting in the best interests of the patient. They are, after all, the people who deserve the very highest standard of care. They are getting it now. Let's keep it that way. Think about it.

-BCSO Insurance Committee

Part 1: Interpretation

1. In these by-laws, unless the context otherwise requires,
   

• "directors" means the directors of the Society for the time being;
• "Societies Act" means the Societies Act of the Province of British Columbia from time to time in force and all amendments to it;
• "registered address" of a member means his address as recorded in the register of members.

2. Words importing the singular include the plural and vice versa: and words importing a male person include a female person and a corporation.
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Part 2: Membership

3. The members of the Society are the applicants for incorporation of the Society, and those persons who subsequently have become members, in accordance with these by-laws and, in either case, have not ceased to be members.
4. 1) During the first six months following the date of the incorporation of the Society, an application for membership in the Society shall be submitted in writing to the secretary of the Society together with the first membership dues, of such portion of the first membership dues as may be determined by the directors. The directors may vote on the application for membership without referring the same to the members, and a majority affirmation vote of the directors, providing there is a quorum, shall be necessary for election to membership.
   2) After the expiration of the period of six months following the date of the incorporation of the Society, all applications for membership shall be made in writing and shall be submitted to the secretary of the Society together with the first membership dues. The secretary of the Society shall invite the applicant for membership to be a guest at the next general meeting of the members of the Society where the applicant will be introduced to the other members present at the meeting as an applicant for membership. The name of the applicant for membership shall be set forth in the Minutes of the said general meeting which are to be circulated to all the members of the Society as soon as possible following the date of the meeting. Any member of the Society who objects to the applicant becoming a member of the Society must notify the secretary of the Society of such objection and the reason for the same within 30 days of the mailing of the Minutes of the General Meeting to the members. Upon the expiration of the period of 30 days, the directors, at their next meeting, shall consider the application for membership and any objections received, and shall vote on the application for membership. A majority affirmative vote of the directors, provided there is a quorum, shall be necessary for election to membership. The first membership dues shall be returned to the applicant, if the applicant fails to be elected.
5. The members of the Society shall be composed of those persons who are from time to time qualified for membership according to the following requirements:
   1) “Active members”:  An Active Member shall be one who has been certified as a certified specialist in orthodontics by the College of Dental Surgeons of British Columbia and who is an applicant for incorporation of the Society or subsequently has been elected to membership by a majority vote of the directors of the Society in accordance with By-law 4.
   2) “Retired Members”:  A Retired Member shall be an active member who has retired from practice, and who has submitted a written request to the secretary of the Society for retired status. Upon acceptance of such a request by a majority vote of the directors the Retired Member shall be exempt from dues.
   3) “Honorary Members”:  Honorary Members shall be persons who have been so elected by the membership in recognition of valuable service to orthodontics.

6. A member of the Society other than Honorary Members and Retired Members shall become a member in good standing in the College of Dental Surgeons of British Columbia and must continue to hold a certificate as a certified specialist in orthodontics as issued by the College of Dental Surgeons of British Columbia. Failure to comply with this section shall be sufficient grounds for expulsion from the Society.
7. Every member shall uphold the Constitution and comply with the By-laws.
8. The amount of the first annual membership dues shall be determined by the directors and thereafter the annual membership dues shall be determined at the annual general meeting of the Society.
9. A person shall cease to be a member of the Society
   1) by delivering his resignation in writing to the secretary of the Society or be mailing or delivering it to the address of the Society, or
   2) on his death, or
   3) on being expelled, or
   4) on having been a member in not good standing for 12 consecutive months.
10. 1) A member may be expelled by a special resolution of the members passed at a general meeting.
    2) The notice of special resolution for expulsion shall be accompanied by a brief statement of the reason or reasons for the proposed expulsion.
    3) The person who is the subject of the proposed resolution shall be given an opportunity to be heard at the general meeting before the special resolution is put to the vote
11. All members are in good standing except a member who has failed to pay his current annual membership fee or any other subscription or debt due and owing by him to the Society and he is not in good standing so long as the debt remains unpaid.
12. A request for a change of status to Retired membership shall be presented in writing to the secretary of the Society.
13. Upon recommendation by the directors a person may be elected to Honorary membership in the Society. The directors shall send the name of the person proposed for Honorary membership to each Active Member no less than one month prior to the Annual General Meeting. A three-quarter affirmation vote at the Annual General Meeting shall be required for election to Honorary membership
14. Honorary and Retired Members shall have all the privileges of the Society except those of voting and holding office. Honorary and Retired Members shall be exempt from the payment of membership dues and assessments.
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Part 3: Meetings of Members

15. General Meeting of the Society shall be held at such time and place, in accordance with the Societies Act, as the directors decide.
16. Every general meeting, other than an annual general meeting, is an extraordinary general meeting.
17. The directors may, whenever they see fit, convene an extraordinary general meeting.
18. 1) Not less than 14 days notice of a general meeting or any special resolution to be considered at a meeting of the members shall be given to the members (subject to the right of all the members to consent in writing to reduce the period of notice) and such notice shall specify the place, the day and the hour of meeting, and, in case of special business, the general nature of the business.
    2) The accidental omission to give notice of a meeting to, or the non-receipt of a notice by, any of the members entitled to receive notice does not invalidate proceedings at that meeting.
19. The first annual general meeting of the Society shall be held not more than 15 months after the date of incorporation and thereafter an annual general meeting shall be held at least once in every calendar year and not more than 15 months after the holding of the last preceding annual general meeting.
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Part 4: Proceedings at General Meetings

20. Special business is
    

1. all business at an extraordinary general meeting except the adoption of rules of order, and
2. all business that is transacted at an annual general meeting, except,

• the adoption of rules of order,
• the consideration of the financial statements,
• the report of the directors,
• the report of the auditor, if any,
• the election of directors,
• the appointment of the auditor, if required, and
• such other business as, under these by-laws, ought to be transacted at an annual general meeting, or business which is brought under consideration by the report of the directors issued with the notice convening the meeting.

21. 1) No business, other than the election of a chairman and the adjournment or termination of the meeting, shall be conducted at a general meeting at a time when a quorum is not present.
    2) If at any time during a general meeting there ceases to be a quorum present, business then in progress shall be suspended until there is a quorum present or until the meeting is adjourned or terminated.3) A quorum is 10 Active Members present or such greater number as the members may determine at a general meeting.
22. If within 30 minutes from the time appointed for a general meeting a quorum is not present, the meeting, if convened on the requisition of members, shall be terminated; but in any other case, it shall stand adjourned to the same day in the next week, at the same time and place, and if, at the adjourned meeting, a quorum is not present within 30 minutes from the time appointed for the meeting, the members present shall constitute a quorum.
23. Subject to By-law 24, the president of the Society, the vice-president, or in the absence of both, one of the other directors present as chosen by the members present, shall preside as chairman of a general meeting.
24. If at a general meeting
    1) there is no president, vice-president, or any other director present within 15 minutes after the time appointed for holding the meeting, or
    2) the president and all the other directors present are unwilling to act as chairman, the members present shall choose one of their own number to be chairman.
25. 1) A general meeting may be adjourned from time to time and from place to place, but no business shall be transacted at an adjourned meeting other than the business left unfinished at the meeting from which the adjournment took place.
    2) Where a meeting is adjourned for 10 days or more, notice of the adjourned meeting shall be given as in the case of the original meeting.
    3) Except as provided in this by-law, it is not necessary to give notice of an adjournment or of the business to be transacted at an adjourned general meeting.
26. 1) Resolutions proposed at a meeting must be seconded and the chairman of a meeting may move or propose a resolution.
    2) In case of an equality of votes the chairman shall not have a casting or second vote in addition to the vote to which he may be entitled as a member and proposed resolution shall not pass.
27. 1) An Active Member in good standing present at a meeting of members is entitled to one vote.
    2) Voting is by show of hands.
    3) Voting by proxy is not permitted.
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Part 5: Directors and Officers

28. 1) The directors may exercise all such powers and do all such acts and things as the Society may exercise and do, and which are not by these by-laws or by statute or otherwise lawfully directed or required to be exercised or done by the Society in general meeting, but subject, nevertheless, to the provisions of

• all laws affecting the Society,
• these by-laws, and
• rules, not being inconsistent with these by-laws, which are made from time to time by the Society in general meeting.
  2) No rule, made by the Society in general meeting, invalidates a prior act of directors that would have been valid if that rule had not been made.

29. 1) The president, vice-president, secretary, treasurer and one or more other persons shall be the directors of the Society.
    2) The number of directors shall be 5 or such greater number as may be determined from time to time at a general meeting.
30. 1) The directors shall retire from office at each annual meeting when their successors shall be elected.
    2) Separate elections shall be held for each office to be filled.
    3) An election may be by acclamation; otherwise it shall be by ballot.
    4) If no successor is elected the person previously elected or appointed continues to hold office.
31. 1) The directors may at any time and from time to time appoint a member as a director to fill a vacancy in the directors.2) A director so appointed holds office only until the conclusion of the next following annual general meeting of the Society, but is eligible for re-election at the meeting.
32. 1) If a director resigns his office or otherwise ceases to hold office, the remaining directors shall appoint a member to take the place of the former director.
    2) No act or proceeding of the directors is invalid only by reason of there being less than the prescribed number of directors in office.
33. The members may by special resolution remove a director before the expiration of his term of office, and may elect a successor to complete the term of office.
34. No director may be remunerated for being or acting as a director but a director may be reimbursed for all expenses necessarily and reasonably incurred by him while engaged in the affairs of the Society.
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Part 6: Proceedings of Directors

35. 1) The directors may meet together at such places as they think fit for the despatch of business, adjourn and otherwise regulate their meetings and proceedings, as they see fit.
    2) The directors may from time to time fix the quorum necessary for the transaction of business and unless so fixed the quorum shall be the majority of the directors then in office.
    3) The president shall be chairman of all meetings of the directors; but if at any meeting the president is not present within 30 minutes after the time appointed for holding the meeting, the vice-president shall act as chairman, but if neither is present the directors present may choose one of their number to be chairman at that meeting.
    4) A director may at any time, and the secretary, on the request of a director, shall, convene a meeting of the directors.
36. 1) The directors may delegate any, but not all, of their powers to committees consisting of such director or directors as they see fit.
    2) A committee so formed in the exercise of the powers so delegated shall conform to any rules that may be from time to time imposed on it by the directors, and shall report every act or thing done in exercise of those powers to the earliest meeting of the directors to be held next after it has been done.
37. A committee shall elect a chairman of its meetings; but if no chairman is elected, or if at any meeting the chairman is not present within 30 minutes after the time appointed for holding the meeting, the directors present who are members of the committee shall choose one of their numbers to be chairman of the committee
38. The members of a committee may meet and adjourn as they think proper.
39. For a first meeting of directors held immediately following the election or appointment of a director or directors at an annual or other general meeting of members, or for a meeting of the directors at which a director is not appointed to fill a vacancy in the directors, it is not necessary to give notice of the meeting to the newly-elected or appointed director or directors for the meeting to be duly constituted, if a quorum of directors is present.
40. A director who may be absent temporarily from British Columbia may send or deliver to the address of the Society a waiver of notice, which may be by letter, telegram, telex, or cable, of any meeting of the directors and may, at any time, withdraw the waiver, and until the waiver is withdrawn,
    1. no notice of meeting of directors shall be sent to that director, and
    2. any and all meetings of the directors of the Society, notice of which has not been given to that director shall, if a quorum of the directors is present, be valid and effective.
41. 1) Questions arising at any meeting of the directors and committee of directors shall be decided by a majority of votes.
    2) In case of an equality of votes the chairman does not have a deciding or casting vote.
42. Resolutions proposed at any meeting of directors or committee must be seconded and the chairman of a meeting may move or propose a resolution.
43. A resolution in writing, signed by all the directors and placed with the minutes of the directors is as valid and effective as if regularly passed at a meeting of directors.
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Part 7: Duties of Officers

44. 1) The president shall preside at all meetings of the Society and of the directors.
    2) The president is the chief executive officer of the Society and shall supervise the other officers in execution of their duties.
45. The vice-president shall assist the president and shall carry out the duties of the president during his absence.
46. The secretary shall
    

1. a) conduct the correspondence of the Society,
2. b) issue notices of meetings of the Society and directors,
3. c) keep minutes of all meetings of the Society and directors,
4. d) have custody of all records and documents of the Society except those required to be kept by the treasurer,
5. e) have custody of the common seal of the Society, and
6. f) maintain the register of members.

47. The treasurer shall
    1. a) keep such financial records, including books of account, as are necessary to comply with the Societies Act, and
    2. b) render financial statements to the directors, members and others when required.
48. 1) The offices of secretary and treasurer may be held by one person who shall be known as the secretary-treasurer.
    2) Where a secretary-treasurer holds office the total number of directors shall not be less than five or such greater number as may have been determined pursuant to By-law 29.
49. In the absence of the secretary from a meeting, the directors shall appoint another person to act as secretary at the meeting.
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Part 8: Seal

50. The directors may provide a common seal for the Society and they shall have power from time to time to destroy it and substitute a new seal in place of the seal destroyed.
51. The common seal shall not be affixed to any instrument except in the presence of the president and the secretary or such other officers of the Society as may be prescribed from time to time by a resolution passed by a majority of the directors of the Society.
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Part 9: Borrowing

52. In order to carry out the purpose of the Society the directors may, on behalf of and in the name of the Society, raise or secure the payment or repayment of money in such manner as they decide and in particular without limiting the generality of the foregoing, by the issue of debentures.
53. No debenture shall be issued without the sanction of a special resolution.
54. The members may by special resolution restrict the borrowing powers of the directors but a restriction so imposed expires at the next annual general meeting.
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Part 10: Auditor

55. This Part applies only where the Society is required or has resolved to have an auditor.
56. The first auditor shall be appointed by the directors who shall also fill all vacancies occurring in the office of auditor.
57. At each annual general meeting the Society shall appoint an auditor to hold office until he is re-elected or his successor is elected at the next annual general meeting.
58. An auditor may be removed by ordinary resolution.
59. An auditor shall be informed in writing of appointment or removal.
60. No director and no employee of the Society shall be auditor.
61. The auditor may attend general meetings.
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Part 11: Notice to Members

62. A notice may be given to a member, either personally or by mail to him at his registered address.
63. A notice sent by mail shall be deemed to have been given on the second day following that on which the notice is posted, and in proving that notice has been given it is sufficient to prove that the notice was properly addressed and put in a Canadian post office receptacle.
64. 1) Notice of a general meeting as required by by-law 18 shall be given to

• every member shown on the register of members on the day notice is given, and  
• the auditor, if Part 10 applies.
  2) No other person is entitled to receive a notice of general meeting.

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Part 12: Books and Records

65. The books and records of the Society may be inspected by the members of the Society at such time as may be fixed from time to time by the directors.
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Part 13: By-laws

66. On being admitted to membership, a member is entitled to and the Society shall give him, without charge, a copy of the Constitution and By-laws of the Society.
67. These By-laws shall not be altered or added to except by special resolutions of which nature has been given in accordance with By-laws 18 and 64.

The BCSO has a two-tiered annual membership dues structure. The Participating dues are for members who attend one or more of the four meetings throughout the year.  The higher dues over the non-participating dues are allocated to the meeting function meals. The Non-Participating dues are for those members who do not attend the meetings - traditionally, for people who do not live near enough to come to meetings.

It is important to note that both members in both categories have identical rights and powers.

The dues have remained modest over the years and historically are as follows:

In 2012, by a majority vote, the BCSO instituted a shift to increase our presence on the interweb with a brand new website, with both a public site and members only site.  The public site was overhauled to provide accurate and up-to-date information about our organization, and our specialty.  The members only site was created to allow improved access for members to pertinent documents and membership information.  As part of the vote, each BCSO member contributed a levy of $350 for the new interweb program.  All new applying members, and renewing members who have not yet paid the levy, will be required to make the one-time contribution of $350 to the ongoing development and maintenance of the interweb program, in addition to the annual dues.  In 2015, a one time $600 levy was paid by all members. The levy is currently $300.

Dental Practice Guidelines and Scope of Practice

Dental practice guidelines for all of dentistry have been created by the Association of Dental Surgeons (now the BC Dental Association). While these documents were not created for use in the legal arena, it is likely they will be used as a reference and for that reason they are included here. Please the College of Dental Surgeons website for more comprehensive information http://www.cdsbc.org/dentists_regulation/

ORTHODONTICS

Orthodontics is the branch of dental practice concerned with space maintenance, tooth guidance, interceptive procedures and full orthodontic procedures. The relationship between and among teeth and facial bones may be altered by the application of forces and/or stimulation and redirection of functional forces and treatment may be coordinated with surgical alteration of the jaw relationship. Fixed and/or removable appliances may be used.

A. DIAGNOSIS & TREATMENT PLANNING

All information in the sections on History & Clinical Examination, Diagnosis & Treatment Planning, and Management of Pain & Anxiety apply to orthodontic treatment and will not be discussed in detail in this section. Only those aspects that have specific importance for this area have been included. A satisfactory result in orthodontics is dependent upon the combination of professional skill and patient cooperation during all phases of treatment. The age of the patient, the severity of the presenting malocclusion, the desired treatment objectives, and individual osteogenic patterns occurring during treatment, will also determine the degree of success attained.

A practitioner must recognize the limits of her/his ability to diagnose and treat orthodontic cases. Consultation and/or referral for treatment to other dental professionals is appropriate when the nature of the disease, complexity of treatment or health of the patient is beyond the ability of the practitioner.

Diagnosis and treatment criteria should include recording of baseline conditions by means of:
•    Any specific family history
•    Radiographs including a lateral cephalogram and its analysis, a panoramic radiograph or full mouth survey when indicated
•    Oriented study casts
•    Photographs: intraoral, and full face and profile extraoral
•    Other records as necessary

B. TREATMENT PROCEDURES

Orthodontic treatment should be in keeping with the patient's concerns and general and oral health. The ideal treatment plan may not always be possible or practical. The timing of orthodontic treatment is of particular importance. Orthodontic treatment may be initiated in the deciduous dentition, the mixed dentition and/or the adult dentition. Consideration must be given to minimizing the number of stages of orthodontic treatment. The patient and/or patient’s guardian must be informed of all phases of treatment proposed, their overall financial obligation, the patient compliance required and any limitations to the treatment planned.
All principles and practices of prevention should be employed during treatment. Plaque control should be given careful and continuous consideration and regular dental recall visits should continue. Active orthodontic treatment should be followed by retention appliances where applicable, along with supervision for a period of time to help maintain the stability of the correction.

C. THERAPEUTIC GOALS

The objectives of orthodontic treatment should be directed towards the attainment of an optimal result for each patient within the limits of the current treatment plan. Results should be aimed at: optimizing the supporting bone relationship, periodontal and odontogenic condition, arch form and occlusion while minimizing risks, such as gingival recession, loss of supporting bone, root resorption, and caries or decalcification of the teeth. The patient and/or guardian should be kept informed of any undesirable treatment effects. The completeness of post treatment records should be based on the complexity and magnitude of the treatment performed. Treatment objectives ideally include:

• A balanced skeletal relationship of maxilla and mandible within the facial  complex
• An optimal dental arch form
• Optimal intercuspation, overbite and overjet
• Axial inclination of the anterior and posterior teeth such that optimal aesthetic and functional results are achieved
• Interproximal spaces (contacts) closed unless  circumstances such as tooth size discrepancies, periodontal conditions, etc., exist
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Scope of Practice

The BCSO has adopted the Scope of Practice statement of the American Association of Orthodontists:

Orthodontics/Dentofacial Orthopedics:  

That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of the teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations of their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimal occlusal relations in physiological and esthetic harmony among facial and cranial structures.