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SickKids

Dentistry

Dentist and dental hygienist examining a child's teeth

The Department of Dentistry provides integrated secondary, tertiary and quaternary oral care for children, adolescents and teenagers from across Ontario, Canada and around the world. As oral health is directly connected to systemic health, oral care plays a strategic role in the improvement of child health at SickKids. The department delivers care collaboratively at SickKids, offering the full range of modern specialty services as well as innovative treatment in ambulatory and operating room settings.   

The members of the department are committed to excellence in child health through improved access to care, innovation, research and education. 

- Michael Casas, DDS, MSc, FRCD(C), Dentist-in-Chief

Overview

The integrated specialist dental care provided by the SickKids Department of Dentistry is best delivered in a multidisciplinary hospital setting.  

Dental and craniofacial ambulatory clinics carry out approximately 17,000 patient clinic visits each year, with the vast majority of children seeking care in Dentistry having a medical comorbidity (the simultaneous presence of two chronic conditions in a patient) 

The small number of children treated without a comorbidity are children younger than three years of age with severe early childhood caries who require extensive dental treatment for which general anesthesia is indicated. In addition, the Department of Dentistry completes more than 1,200 elective cases in the OR as well as more than 400 after-hours emergencies, each year. The Department of Dentistry is the largest oral cleft and craniofacial dental treatment center in the province of Ontario. 

- Michael Casas, DDS, MSc, FRCD(C), Dentist-in-Chief

Areas of specialized expertise

Oral anomalies

  • Oral rehabilitation of congenital enamel or dentin anomalies ​ 
  • Endosseous implant restoration for oral clefts and craniofacial conditions 
  • Craniofacial orthodontic correction ​ 
  • Surgical management of jaw cysts and tumours ​ 
  • Correction of acquired or developmental dentofacial deformities ​ 

Dental caries

  • Comprehensive oral rehabilitation of severe early childhood dental caries ​ 
  • Management of medically complex children with dental disease ​ 

Dental trauma 

  • Acute surgical management of dental traumatic injuries 

 

What we do

The Department of Dentistry is a specialized service for the assessment and treatment of children and adolescents with dental disease and related issues. It is made up of an experienced team of paediatric dentists, orthodontists, prosthodontists, oral and maxillofacial surgeons, and endodontists. 

We provide family-centred care and offer treatments and therapies based on the best evidence. 

Dentistry delivers integrated specialist care, partnering with our medical/surgical team members, in the management of our medically complex population. 

Click to explore the two clinics in the Department of Dentistry and see important clinic details: 

Visit the Dental Clinic

Visit the Orthodontic Clinic

Programs and services

 

Expand the sections below to learn about our Dentistry specialties in detail.

Paediatric Dentistry is the specialty of dentistry related to providing primary and comprehensive preventive and therapeutic care for infants and children of all ages and abilities.  Care provided includes (but is not limited to): 

  • Consultations 
  • Restorative and Preventive care for healthy patients under 3 years of age and patients with complex medical conditions or needs through age 18 
  • Management of acute, severe orofacial infections of dental origin 
  • Acute and long-term management of oro-facial trauma 

Orthodontics and Dentofacial Orthopedics is the specialty of dentistry related to the diagnosis, prevention and correction of malpositioned teeth and jaws. 

  • Cleft lip and palate pre-surgical infant orthopedics 
  • Orthodontic preparation for alveolar bone grafts in individuals with clefts 
  • Orthodontic treatment for individuals with clefts and craniofacial conditions  
  • Preparation for prosthodontic and restorative treatment for patients with multiple missing teeth 
  • Orthodontic aspects of interdisciplinary treatment for patients needing craniofacial surgery 

Oral and Maxillofacial Surgery is the specialty of dentistry related to the diagnosis, surgical and adjunctive treatment of diseases, injuries, disorders and defects involving the aesthetic and functional areas of the face, mouth and jaws. 

  • Correction of underlying dentofacial deformities both acquired and developmental 
  • Dento-alveolar trauma surgery 
  • Odontogenic infections of the head and neck 
  • Treatment of benign tumors and cysts of the mouth and jaws 
  • Bone graft reconstruction of the upper and lower jaws 
  • Dento-alveolar surgery. 

Prosthodontics is the specialty of dentistry related to the diagnosis, restoration and maintenance of oral function, comfort, appearance and health of the patient by the restoration of the natural teeth and/or replacement of missing teeth and associated tissues.

  • Management of dental deterioration and absence of teeth as a consequence of an inherited tooth development defect, craniofacial syndrome, trauma, oral cancer, tooth decay or gum disease 
  • Perform complex dental restorations to improve esthetics, compromised chewing function, speech, impaired nutritional intake with tooth supported- and dental implant-supported crowns, bridges and dentures, in addition to fillings and veneers  
  • Coordinate and oversee the reconstructive dental team to formulate and sequence the treatment plan to ensure comprehensive care 
  • Develop effective maintenance strategies for minimizing future recurrence of problems 

Endodontics is the specialty of dentistry related to diagnosing tooth pain and root canal treatment and other procedures relating to the interior of the tooth. 

  • Treating paediatric patients requiring root canal therapy 
  • Treatments often involve complex cases including immature teeth and patients with cleft lip and palate issues 

Oral and Maxillofacial Radiology is the specialty of dentistry related to the application and interpretation of diagnostic imaging of the teeth and jaws. During their visit to the Department of Dentistry, patients may have radiographs acquired in order to assess development, identify disease or plan and follow-up treatment. 

  • Consultations on challenging images 
  • Cone Beam Computed Tomography (CBCT) volume interpretation 
  • Assessments for impacted teeth, implant placement, clefts and post-operative examination 
  • Suggestions for follow-up imaging 

Ontario Cleft Lip and Palate/Craniofacial Dental Program

One in every 700 infants in Ontario is born with a cleft of the lip and/or palate or other craniofacial difference. These conditions can be corrected through surgery, specialized dental treatment and speech therapy.

To assist families of children and young adults who must cope with the expense of specialized dental treatment, the Ministry of Health provides funding for the Ontario Cleft Lip and Palate/Craniofacial Dental Program, managed by the Provincial Council for Maternal and Child Health. This program provides financial assistance for the specialized dental needs of affected individuals.

Learn more about the Ontario Cleft Lip and Palate/Craniofacial Dental Program.

How to make a referral

A dental specialist, physician or surgeon must refer non-emergent patients in writing to the dental clinics. Only online referrals are accepted. Learn how to refer a patient to SickKids Dentistry. Please ensure that we have all available current radiographs at the time of the initial consultation. 

Because SickKids is a university-affiliated teaching facility, a dental resident, fellow or graduate (specialty) student under the direct supervision of a University of Toronto appointed staff may be the treating clinician for the procedures listed. 

The professional fees of the Department of Dentistry at SickKids are consistent with community dental specialists.

Coming prepared for appointment

 

Please bring the following: 

  • Any current dental x-rays that are available 
  • Child’s Ontario Health Card (or other Health Card if not from Ontario) 
  • Dental insurance information 
  • Social assistance forms, if applicable 

Expand the section below for all eligibility criteria information.

All referrals are screened and triaged according to urgency. Referrals that are incomplete or do not meet the eligibility criteria will be returned to the referring clinician within two business days. If the child is eligible, referring clinicians and families will both be notified of an appointment date within 10 business days. The first appointment is always a treatment planning consultation. 

Eligibility for Paediatric Dentistry

Eligible patients include: 

  • patients with a significantly compromising medical condition such as cancer, organ transplant, complex heart disease, cleft lip and/or palate, craniofacial anomaly or physical disabilities. 
  • patients with dental caries and medically diagnosed behaviour management issues, such as developmental delay or autism. 
  • patients who are healthy children under the age of three years with severe early childhood caries. 
  • emergency patients. 

The Department of Dentistry provides complete dental care for eligible children until the age of 18. Healthy children under the age of three years with severe caries will be assessed, treated and referred back to community dentists for continuing care. Options for dental care include treatment awake in the presence of a parent/caregiver, general anesthesia and conscious sedation. 

Eligibility for Orthodontics

This is for patients under the age of 18 with: 

  • cleft lip and/or palate 
  • craniofacial anomalies 
  • significantly compromising medical condition 

Ongoing care requires the child to be cooperative and compliant with the demands of treatment. 

Eligibility for Paediatric Oral and Maxillofacial Surgery

This is for patients under the age of 18 years who require oral surgery. 

Treatment options for oral surgery include treatment awake, general anesthesia, oral sedation and nitrous oxide. Referrals may be addressed to the Paediatric Oral and Maxillofacial Surgery section.  

Eligibility for Prosthodontics

This is for patients under the age of 18 years who require prosthodontic treatment. 

Treatment options for Prosthodontics include treatment awake or under general anesthesia. Referrals may be addressed to the Prosthodontics section.  

For patients with Temporomandibular Joint (TMJ) Symptoms

This is for patients with a: 

  • medical diagnosis of juvenile idiopathic arthritis (JIA)  
  • patients with joint pain in TMJ and additional sites should be referred to a rheumatologist for assessment prior to referral to Dentistry. 
  • history of severe jaw fracture or severe facial trauma. 

Resources

Community Orthodontist resources

Below you'll find details for Community Orthodontists regarding Alveolar Bone Grafts (ABG) and Orthognathic Surgery. 

Rational for an ABG 

  1. Improve bone support around teeth adjacent to the cleft 
  2. Provide bone for the eruption and/or orthodontic repositioning of teeth 
  3. Close oro-nasal fistula and restore the dimensions of the dental arch 
  4. Stabilize the maxilla  

Untreated alveolar cleft could result in: 

  1. Deficient bone support for erupted or erupting teeth 
  2. Palatally displaced alveolar ridge 
  3. Unrepaired residual oro-nasal fistula 
  4. Maxillary segment mobility 

Expansion  

  1. Maxillary expansion is commonly required prior to the ABG to improve the position of the maxillary segments and to correct any crossbite(s).  A SickKids Orthodontist and Plastic Surgeon will help determine whether expansion is required.
  2. If the patient/family decides to be seen by a Community Orthodontist for orthodontic expansion prior to the ABG, it is important to be aware that these children are eligible for funding through the Ministry of Health Ontario Cleft Lip and Palate/Craniofacial Dental Program. Approval must be obtained prior to starting any treatment. You can contact the SickKids Cleft Lip and Palate/Craniofacial Dental Program at 416-813-5882.
  3. More anterior expansion is typically required than posterior expansion. The typical “Hyrax” orthodontic expander is not commonly used in cleft lip/palate patient population in preparation for an alveolar bone graft as this appliance will not expand the anterior maxilla sufficiently. Expanders that allow for more anterior expansion commonly used at SickKids include: 
    • Fan expander
    • Quad-helix 
    • Tri-helix
      Image of a fan expander tool for dentistry.
      Fan expander
      Tri-helix expander tool for dentistry.
      Tri-helix
  4. Prior to starting any orthodontic expansion please inform the patient’s SickKids Plastic Surgeon/Cleft Lip and Palate (CLP) Nurse Coordinator that treatment will begin.
  5. When you believe expansion is complete, please again inform the Plastic Surgeon/CLP Nurse Coordinator. An appointment will be arranged for the patient to see the Plastic Surgeon and a SickKids Orthodontist to assess the expansion, to discuss the ABG, and to be placed on the waiting list for surgery. If expansion is not adequate, further expansion and/or another expander may be necessary. Occasionally multiple expanders are required to ensure ideal expansion.  
  6. Some teeth adjacent to the cleft may require removal. If required, these teeth should be removed 6-8 weeks prior to the ABG. If there are unerupted supernumerary teeth adjacent to the cleft, these teeth may require removal in the 6-8 week time frame as well. Tooth removal can occur in the community or in the SickKids Dental Clinic under the care of a pediatric dentist or oral surgeon. The SickKids Orthodontist and Plastic Surgeon will help determine what teeth, if any, require removal prior to the ABG. If unerupted teeth require removal, this is ideally planned in advance, as sedation options should be reviewed and involve more challenging scheduling.
  7. Please do not remove the expander as further expansion may be required. The expander will typically remain in the patient’s mouth until the day before or the day of the ABG. When the expander is removed, radiographs (Computerized Axial Tomography (CT) scan, panoramic and intra-oral radiographs) will be taken to assist the Plastic Surgeon with the procedure.
  8. In cases for patients with a bilateral cleft lip and palate, a maxillary splint will require fabrication prior to surgery.  These splint fabrication appointments occur approximately 3-4 weeks before the ABG and 1 week before the ABG.  These appointments are arranged by staff at the SickKids Department of Orthodontics. During the ABG procedure the Plastic Surgeon will fix the splint to the maxillary arch. This splint is used to stabilize the maxillary segments during the healing period following the surgery. This splint will typically remain fixed in the mouth for 8 weeks. 

Braces 

  1. Orthodontic brackets/braces are typically avoided until after the ABG due to the risks of moving the adjacent teeth into the cleft.
  2. If braces are absolutely required, off-angle bracket position would be necessary to maintain the roots within the bone.
  3. Braces should be removed at least a week before the ABG to allow for improved oral hygiene and gingival health. Braces will also need to be removed to allow for better visualization on the CT scan. 

Oral hygiene 

  1. To improve the success for the ABG, ideal oral hygiene practices are required.
  2. If oral hygiene is poor and the teeth are compromised, the patient may not be a candidate for an ABG.
  3. Regular visits with the patient’s family dentist, pediatric dentist or SickKids Dental Clinic are required prior to, during and after orthodontic treatment.
  4. Children with cleft lip/palate commonly have hypoplastic teeth which increases caries risk. Increased dental cleaning visits may be required, particularly during orthodontic treatment.
  5. It is ideal for the child to have dental cleaning/fluoride application 2-3 weeks before the ABG. 

Post-operative ABG

  1. The patient will have multiple SickKids visits for a post-op assessment with the Plastic Surgeon and/or Orthodontist.
  2. 6-8 weeks after the ABG the patient will see the Plastic Surgeon and Orthodontist to assess healing. Typically, the patient will be able to resume regular activity after this time. Oral hygiene will be reviewed, as good oral hygiene is important for the success of the ABG.
  3. In bilateral cleft lip and palate patients who have a maxillary splint, the splint will be removed in the SickKids Orthodontic Clinic approximately 8 weeks after the ABG.
  4. Post-op radiographs (CT scan and intra-oral radiographs) will be arranged 6 months after the ABG for assessment.
  5. The patient can return to his/her Community Orthodontist any time after the ABG, however, it is not recommended to begin any active orthodontic treatment until the post-op radiographs have been assessed. 

Contact

Dr. Kyle Stevens
Director of the Orthodontic Clinic 

Alana Black 
Nurse Coordinator, Cleft Lip and Palate Program 
Phone: 416-813-4970
Fax: 416-813-6637 
alana.black@sickkids.ca

Mailing address

Department of Dentistry                                                                                            Attn: Dr. Kyle Stevens
555 University Avenue 
Toronto, ON
M5G 1X8 

SickKids Alveolar Bone Graft Plastic Surgeons 


Dr. David Fisher 
Dr. Christopher Forrest 
Dr. John Phillips
Dr. Dale Podolsky
Dr. Karen Wong                                                                                                              

Orthognathic Surgery (OS) is required in 2/3 of the cleft and craniofacial population to improve skeletal relationships and occlusion. Many patients seen at SickKids associated with the Cleft Lip/Palate and Craniofacial program will undergo OS with the Department of Plastic Surgery at SickKids.  

Those patients who are treated by a Community Orthodontist and not treated in the SickKids Orthodontic Clinic are still eligible for OS at SickKids up to 22 years of age. If the patient/family decides to be seen by a Community Orthodontist for pre-orthognathic surgery orthodontics, it’s important to be aware that these children are eligible for funding through the Ministry of Health Ontario Cleft Lip and Palate/Craniofacial Dental Program. Approval MUST be obtained prior to starting any treatment. The SickKids Cleft Lip and Palate/Craniofacial Dental Program can be reached at 416-813-5882.  

Prior to starting any orthodontic treatment, the patient needs to have been recently seen in the SickKids Orthodontic and Plastic Surgery Clinics. Initially the SickKids Orthodontist and Plastic Surgeon will review the process of OS preparation. A letter should be written to the SickKids Plastic Surgeon/Craniofacial Nurse Practitioner when braces are placed, stating how long you would expect until the patient is ready for OS. This letter will prepare the Department of Plastic Surgery of an upcoming OS procedure. Another letter should be written to the patient’s Plastic Surgeon/Craniofacial Nurse Practitioner and the SickKids Orthodontic Clinic Director Dr. Kyle Stevens (addresses below), when the patient is at least 6 months away from being ready for OS. The more notice given the better.  

Please ensure the necessary wisdom teeth have been removed at least 6 months before OS. Wisdom teeth removal requirements will depend on surgical movements. Please review the surgical movements with the Plastic Surgeon if you wish to keep particular wisdom teeth. If the required teeth are not removed with enough time the OS will be not be scheduled. 

Once the patient is ready for OS, a final letter should be written. The letter should include:  

  1. Patient is ready for OS 
  2. Current archwire (ideally 18x25 or 19x25 Stainless Steel) 
  3. Surgical movement considerations (maxilla and/or mandible movements) 
  4. Send coordination models (stone or 3D printed models)  

Following the letter

A coordinated appointment will then be booked with the SickKids Orthodontist and Plastic Surgeon.  Coordination stone models will be reviewed by both departments (these models can either be shipped to the Orthodontic Clinic prior to the patient’s appointment or given to the patient to take to the appointment). Only after receiving this letter, the models, and attending this combined appointment will a surgery date be booked. 

Busy spring and summer season

As many of the patients undergoing OS are in school, spring/summer surgeries are typically requested. This is why it is essential for the Departments of Plastic Surgery and Orthodontics to be aware of all patients currently in treatment and who will be ready for surgery in the near future.   

Once a surgical date is arranged, there are appointments that will be arranged by the SickKids Orthodontic Clinic for radiographs, photos, splint fabrication, splint try-in and ensuring surgical hooks are placed (either in the Community or in the Orthodontic Clinic). Radiographs (panoramic, lateral cephalometric and posteroanterior cephalometric) will be taken prior to and following surgery. Oral hygiene will be reviewed and is essential prior to/following OS. The surgical splint typically will remain fixed to the maxillary arch for 6-10 weeks depending on healing time, surgical movements and occlusion in the splint. Intermaxillary fixation may be required but it is not regularly performed.   

Post-operation

During the post-operative period, visits with the Departments of Plastic Surgery and Orthodontics will be required. The splint will be removed at SickKids. Once the splint is removed, the patient will return to the Community Orthodontist’s office to complete the remaining orthodontic treatment. 

Ideal communication between the Community Orthodontist, SickKids Plastic Surgeon and SickKids Orthodontist is imperative for effective management of the OS patient. 

Ideal oral hygiene needs to be reinforced not only at the Orthodontist’s office but also with the patient’s dentist. Regular visits with the dentist are required prior to, during and after orthodontic treatment. Children with cleft lip/palate and other craniofacial syndromes commonly have hypoplastic teeth which increase caries risk. These patients typically require more frequent dental cleaning visits, particularly during orthodontic treatment. If oral hygiene is poor and the teeth are compromised, the patient’s OS may be cancelled.   

Contact information for SickKids Orthognathic Surgery

Dr. Kyle Stevens 

Director of the Orthodontic Clinic
Department of Dentistry

 

Shannon Seager

Craniofacial Nurse Coordinator
Department of Plastic Surgery

Phone: 416-813-7491 

Fax: 416-813-6637 

shannon.seager@sickkids.ca

 

Mailing address

 

Department of Dentistry

Attn: Dr. Kyle Stevens
555 University Avenue 
Toronto, ON
M5G 1X8 

 

SickKids Craniofacial Plastic Surgeons 

 

Dr. Christopher Forrest 
Dr. John Phillips  

Dr. Dale Podolsky
Dr. Johanna Riesel

Who we are

The Department of Dentistry is the largest in Canada and has two Divisions – Paediatric Dentistry and Orthodontics 

Dentistry also has specialists in Oral and Maxillofacial Surgery, Prosthodontics, Endodontics and Radiology. The combined clinics register approximately 17,000 patient visits and close to 1,200 dental operations under general anesthesia annually.  

Key staff

Department Head:

Dr. Michael J. Casas - Dentist-in-Chief

Below you can browse a list of our current staff who provide regular care at SickKids. 

  • Director of Paediatric Dentistry: Dr. Edward Barrett 
  • Director of Dental Education: Dr. Gabriella Garisto 
  • Director of Orthodontics: Dr. Kyle Stevens 
  • Clinical Manager: Sharon Samaan 

Paediatric Oral and Maxillofacial Surgery
  • Dr. Daisy Chemaly
  • Dr. Albert Haddad  

Research activities

The mouth is the window to general health, making dentistry play a strategic role in the improvement of health for children at SickKids.

The Department of Dentistry at SickKids is the largest paediatric dental department in Canada, and involves two divisions - Paediatric Dentistry (including oral and maxillofacial surgery and prosthodontics) and Orthodontics. 

Read more by expanding the sections below.

Previous investigations in dental trauma and pulp therapy have provided important contributions to the dental profession’s treatment of healthy children in community settings worldwide. However, oral health is intrinsically linked to systemic health of the medically complex children treated at SickKids. Thus, integrated research between Dentistry and healthcare partners at SickKids is strategic for improvement of healthcare in children within the hospital, provincially, nationally and internationally. A strategic research plan was developed with the goal of improving outcomes for children with medical comorbidities through clinically focused investigations. 

Current strategic areas of research include: 

  1. Oncology 
  2. Cleft/Craniofacial Anomalies 
  3. Sleep Apnea 
  4. Evaluative Dental Sciences 

Low Light Laser Therapy (LLLT) in treatment of Oral Mucositis (OM) in children receiving treatment for cancer

OM develops in 20-40 per cent of patients receiving conventional chemotherapy and 60-85 per cent of patient undergoing Hematopoetic Stem Cell Transplantation (HSCT). 

Our aim is to determine if LLLT application prior to OM development can prevent or reduce oral mucositis. The hope is that the results of this study can provide the evidence and thereby the basis for using LLLT prophylactically to reduce the burden of treatment for patients undergoing HSCT. 

The impact of palatal expanders on speech in the cleft lip and palate population 

It is common for children with cleft lip/palate to have speech problems. Before getting a surgery to add bone to the gums (an alveolar bone graft), an appliance that widens the upper jaw called a palatal expander is commonly needed. However, placing the expander usually changes speech quite a lot. We are doing this study to: 

  1. Figure out how the speech of patients with cleft lip and palate is changed by the placement of the expander before their alveolar bone grafting surgery. 
  2. See how the speech adapts after the expander placement. 
  3. If speech is disrupted by an expander more if there is a hole in the palate or a narrow palate. 
A comparison of anterior pediatric zirconia crowns and bonded composite resin strip crowns: one-year feasibility study

Bonded composite resin strip crowns (strip crowns) are routinely used at SickKids to restore carious primary (baby) incisors. In 2008, zirconia crowns were introduced to pediatric dentistry as an alternative restorative option due to excellent esthetics, resistance to fracture, reduced plaque accumulation and color stability. A feasibility study is needed to establish the clinical outcomes of the zirconia crowns and bonded composite resin strip crowns in primary maxillary incisors. The aims of this study are: 

  1. To statistically compare the one-year survival of resin composite strip crowns and zirconia crowns in primary maxillary incisors. 
  2. To statistically compare the frequency of pulp therapy required for placement of zirconia crowns and resin composite strip crowns in primary maxillary incisors. 
  3. To measure the frequency at which teeth randomized to zirconia crowns are deemed restorable with strip crowns only, and not zirconia crowns. 
Dental morphology in obese and non-obese children with and without obstructive sleep apnea

The purpose of this study is to compare prevalence of dentofacial abnormalities in children with and without obstructive sleep apnea in cohorts of children with and without obesity and Down syndrome. 

Investigating Structural and Molecular Alterations in Enamel Hypomineralization Pathologies

Approximately 8 per cent of children who are seen at SickKids Dentistry have a condition called Molar Incisor Hypomineralization (MIH) that weakens the outer layer (enamel) of their adult teeth. We wish to examine the adult molar teeth that are extracted to treat MIH. We will look at one half of the tooth under the microscope to see the building blocks of the tooth enamel and how it is different than the normal enamel around it. The other half of the tooth will be treated with a special protein solution that we think might strengthen areas affected by MIH. 

Empty lecture hall of 15 rows and a speaking podium

Education and training opportunities

Dentistry offers 3 one-year fellowship programs accredited by the Commission on Dental Accreditation of Canada:  

  1. Orthodontic Craniofacial and Special Care Clinical Fellowship (2 positions)
  2. Paediatric Dentistry Craniofacial and Special Care Clinical Fellowship 

The goals of the fellowship programs are: 

  • To provide additional training for graduate orthodontists and paediatric dentists that involves interdisciplinary clinical activities and interdisciplinary treatment planning. 
  • To familiarize these specialists with and train them to treat children with exceptional medical and dental needs. 
  • To provide a year of clinical investigation and study with the expectation of producing a publication. 

The Division of Orthodontics at SickKids treats patients with cleft lip and/or palate, craniofacial anomalies or significantly compromising medical conditionsStaff Orthodontists all hold university appointments.  

This one-year fellowship accepts candidates who are graduate orthodontists. This is an internationally recognized and sought after program by graduate orthodontists from all over the world. The fellowship has both research and orthodontic service components. Orthodontists internationally have held this position. Children with craniofacial anomalies that include cleft lip and palate are the prime focus of both the clinical and research components of this program. Children with special needs form a smaller component of the program that provides additional educational challenges for the fellow. 

Admission Requirements 

All applicants must have completed a recognized program in Orthodontics, be proficient in English, eligible for an educational license with the RCDSO and be eligible to obtain a student work permit from Canadian Immigration. Learn how to apply for an educational license with the RCSDO.

Application Deadline

The annual deadline for application is October 1. 

Position Start Date

There are two fellowship positions with staggered start dates. 

How to Apply

Apply to Dr. Kyle Stevens by mail at the address below or email  dentistry.fellowships@sickkids.ca, with the following: 

A Letter of Intent, addressed to:
Dr. Kyle Stevens 
The Hospital for Sick Children (SickKids) 
555 University Avenue, Toronto, Ontario 
M5G 1X8 

Curriculum Vitae and letters of recommendation
In addition to your CV, three letters of recommendation must be forwarded under separate cover (one must be from the course director or Head of your graduate program).  
Short listed candidates will be invited to an interview at SickKids in person or virtually. A final decision on the successful candidates will be made prior to December 20.

Salary

SickKids provides funding for this position. The annual salary is based on the PARO PGY5 level. Twenty days are provided for vacation in addition to statutory holidays. 

The Division of Paediatric Dentistry of the Department of Dentistry treats only patients that have a medical co-morbidity, dental emergencies or children who are less than three years of age with severe early childhood caries. All paediatric dentists on staff hold university appointments.  

This one-year fellowship accepts candidates who are graduate pediatric dentists. This is an internationally recognized and sought after program by graduate paediatric dentists. The fellowship has research, education and paediatric dental service components. The fellow will be exposed to and manage a wealth of medically complex and often unique patients. The combination of patient care and research will enhance the paediatric specialty training that the fellow brings to SickKids.   

The fellow registers as a special student at the Faculty of Dentistry, University of Toronto and spends approximately half of their time with clinical responsibilities (treatment, consultations, on-call), and half of their time engaged in research. 

Admission requirements

All applicants must have completed a recognized program in paediatric dentistry or be in the graduating year of their program, be proficient in English, eligible for an educational license with the RCDSO and be eligible to obtain a student work permit from Canadian Immigration. Learn how to apply for an educational license with the RCSDO.

How to apply 

Apply to Dr. Gabriella Garisto - Director of Education, by mail at the address below or email dentistry.fellowships@sickkids.ca, with the following: 

A Letter of intent, to be addressed to:
Dr. Gabriella Garisto - Director of Education 
The Hospital for Sick Children(SickKids) 
555 University Avenue 
Toronto, Ontario, M5G 1X8 

Curriculum Vitae and letters of recommendation
In addition to your CV, three letters of recommendation must be forwarded under separate cover (one must be from the course director or head of your graduate program). 
 
Short listed candidates will be invited to an interview at SickKids in person or virtually. 

Salary

SickKids provides funding for this position. The annual salary is based on the PARO PGY5 level. Twenty days are provided for vacation in addition to statutory holidays.

This program has a strong clinical emphasis where the resident receives comprehensive training in the multidisciplinary management of all aspects of dental care for children in the ambulatory, operating room and emergency settings. We see up to approximately 15,500 international, national, regional and local patient clinic visits annually, which represents the most complex of medically-compromised children, as well as those with craniofacial anomalies, genetic disorders and acute emergencies. In addition, approximately 1,200 patients are treated in the operating room setting. Our program provides an invaluable opportunity for the new graduate dentist to have a year of comprehensive training in management of children with complicated conditions and their families. 
 
Successful candidates from final year undergraduate dental programs from across Canada and the United States develop the skills, knowledge and sensitivities required to provide comprehensive care to the full spectrum of children represented. In addition, they become competent in managing the awake, fearful child as well as providing treatment under sedation or in the operating room. The dental residents also gain in-depth clinical skills in the management of dental trauma while on-call in conjunction with members of the SickKids Dental Trauma Research Group.  Residents who complete this invaluable, one-year program leave with skills and confidences important in community practice as well as having the foundation for success in a graduate specialty program. 
 
The objectives and educational philosophy is to provide a balance between dental education and clinical training. The goals of the dental residency program include: 

  • To provide the educational and clinical opportunities to equip graduate dentists to treat children with special needs in the community or to make appropriate referrals. 
  • To encourage and assist in sound career decision-making whether it involves general practice, postgraduate or graduate studies. 
  • To support resident applications for positions on the staff of community-based general hospitals. 

The largest component of the resident’s education comes from clinical instruction and supervised treatment in the clinics and operating rooms. A rotating team of supervising dental specialists who all hold appointments in the Faculty of Dentistry provide resident supervision. All residents are supervised in the clinic at a maximum three residents to one staff and a one-to-one basis in the operating room. Approximately, 40 per cent of resident time is ‘off service’ for lectures, rounds, rotation or personal time. Dental residents have no teaching or research obligations.

Off-site Clinic:Holland Bloorview Kids Rehabilitation Hospital offers clinical experience in the management of neurosensorimotor compromised patients. 

Operating room: We have operating rooms equipped with state-of-the-art equipment. Dental residents will have the opportunity to provide total patient care under general anaesthesia with one-to-one teaching by university-appointed staff. 

After-hours care: Residents share first call with graduate students in Paediatric Dentistry. The large number of dental injuries, acute dentoalveolar infections and other emergencies treated at our hospital provides the resident with invaluable experience, extensive knowledge and clinical skills in all aspects of management of dental emergencies. 

Application 


Admission Requirements: As described in Faculty of Dentistry admissions. 
Duration: One year, beginning June. 

Application deadline: Determined by the Faculty of Dentistry admissions. 

Application method: All requests for application should be made through Faculty of Dentistry admissions. Interested applicants will be interviewed at SickKids Department of Dentistry. 

Salary: The annual salary is based on the PARO PGY1 level. Twenty days are provided for vacation in addition to statutory holidays. 

Apply for the Paediatric Dental Residency (one-year) program through the University of Toronto's Faculty of Dentistry

Residents in the Oral and Maxillofacial Surgery rotation at the University of Toronto, rotate through SickKids. This rotation provides the paediatric components that is strategic to the OMFS education.   

It is not typical that an OMFS specialty program has an opportunity for their residents to work in a secondary, tertiary and quaternary level paediatric acute care hospital.    

This rotation focuses on development of resident behaviour management skills to compliment the use of sedation or general anesthesia. Treatment is also provided under conscious or general anesthesia when patient appropriate. The residents participate in the full range of clinical and surgical care including pre-treatment consultations on medically complex children, participation in the provision of integrated care and oral surgical interventions including surgical extractions, biopsies, dental implants, trauma and emergency management.   

Apply for Graduate programs in Oral and Maxillofacial Surgery through the University of Toronto's Faculty of Dentistry.

M.Sc Graduate Specialty Program in Paediatric Dentistry

The three-year, Master of Science in Paediatric Dentistry is based at the Faculty of Dentistry, University of Toronto, under the direction of Dr. Iris Daniel, Director, Graduate Paediatric Dentistry.  

The program accepts four applicants each year. A significant component of training comes from rotations at SickKids. Residents rotate through SickKids all three years of their program with the greatest amount of clinical time spent in their second year.   

All residents are supervised at a maximum three students to one staff in the clinics and on a one-to-one basis in the operating room. The didactic program for first year residents in paediatric dentistry includes Hospital Management of the Paediatric Patient, Seminars in Dental Trauma, Division of Emergency Medicine Orientation program and the Privacy Training and Preventing Workplace Violence are part of the SickKids online computer based tutorials.   

First year residents also “buddy” with clinically experienced second year residents to take call in the Spring term to provide experience with management of dental emergencies and to prepare them to provide after-hours call on their own. Residents from all three years attend the Current Literature Review course.

For graduate programs in paediatric dentistry, apply through the Faculty of Dentistry, and via email at paedo@dentistry.utoronto.ca. 

Teaching is also provided to undergraduate dental students, students taking summer externships and medical students/colleagues. Continuing education programs are also provided to the professional community.  

See Professional Resources for information on how we manage specific dental injuries and refer to some papers that guide these treatments. 

Contact Dentistry

Dental Clinic locations and hours

The clinics are together on the Service Floor of the Roy C. Hill Wing (Gerrard Street). To get there from Tim Horton’s on the Main Floor, take the Hill Wing elevators by the Orthopedic Clinic down one floor to Service Floor (S on the elevator).  

The Orthodontic Clinic is directly in front of the elevator doors and the Dental Clinic is a left turn, then down the hall a few steps. 

Regular clinic hours are: Monday to Friday 8:00 am to 4:00 pm 

  • Dental ClinicRoom: S530   Phone: 416-813-7433 
  • Orthodontic ClinicRoom: S515  Phone: 416-813-7435 
  • Accounting Office Phone: 416-813-5023  Fax: 416-813-6375 
Emergency service

During regular business hours call the Dental Clinic. 416-813-7433 for a Dental Emergency.  

Call the Orthodontic Clinic: 416-813-7435 for an Orthodontic Emergency. 

On weekends and after hours go to the Emergency Department for assessment. 

Address 

The Hospital for Sick Children (SickKids) 
Department of Dentistry 
555 University Avenue  
Toronto, Ontario   M5G 1X8 
Phone: 416-813-7433 
Fax: 416-813-6375 

Coming to SickKids?

See Visiting SickKids for more, such as: 

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