GDA Action May 2013

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ACT ION

THE JOURNAL OF THE GEORGIA DENTAL ASSOCIATION

MAY 2013

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VOLUME 32, NUMBER 5 • MAY 2013

ACTION

on the cover

ACT ION

THE JOURNAL OF THE GEORGIA DENTAL ASSOCIATION

GDA ACTION (ISSN 0273-5989) The official publication of the Georgia Dental Association (GDA) is published monthly.

POSTMASTER: Send address changes to GDA Action at 7000 Peachtree Dunwoody Road N.E., Suite 200, Building 17, Atlanta, GA 30328. Phone numbers in state are (404) 636-7553 and (800) 432-4357. www.gadental.org.

Closing date for copy: first of the month preceding publication month. Subscriptions: $17 of membership dues is for the newsletter; all others, $75 per year. Periodicals postage paid at Atlanta, GA. Dr. David Bradberry GDA Editor 1070 Woodlawn Dr NE Suite 250 Marietta, GA 30068

Delaine Hall GDA Managing Editor 7000 Peachtree Dunwoody Rd NE Suite 200, Building 17 Atlanta, GA 30328

2012-13 Georgia Dental Association Officers Sidney R. Tourial, DDS, President Marshall H. Mann, DDS, President Elect Douglas B. Torbush, DDS, Vice President James B. Hall III, DDS, Secretary / Treasurer R. David Bradberry, DMD, Editor

GDA/GDIS Executive Office Staff Members Martha S. Phillips, Executive Director Nelda Greene, MBA, Associate Executive Director Delaine Hall, Director of Communications Skip Jones, Director of Marketing (GDIS) Courtney Layfield, Director of Member Services Victoria LeMaire, Medical Accounts Manager Judy Lively, Administrative Assistant (PT) Melana Kopman McClatchey, General Counsel Denis Mucha, Director of Operations (GDIS) Margo Null, Property and Casualty Accounts Manager Meg Robinson, Director of Governmental Affairs Patrice Williams, Administrative Assistant Phyllis Willich, Administrative Assistant Pamela Yungk, Director of Membership & Finance

MAY 2013

Do you want to learn about key dental business topics such as how to bill PPOs, disciplining an employee, asking questions of prospective staff members, or protecting your online reputation in three minutes or less? In June, the GDA will debut the Association Business Brief just for GDA members. The briefs are short, information-packed videos delivered via email twice a month that address burning business issues dentists face within their practices. Read more about this new membership benefit on page 12.

other features

sections

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Sleep Apnea and the Dentist’s Role in Patient Education and Referrals

4

Parting Shots

5

Editorial

Register for the GDA Annual Meeting in Hilton Head, South Carolina

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News and Views

10

Calendar of Events

26

House of Delegates Minutes

30

Classifieds

18

GDA Action seeks to be an issues-driven journal focusing on current matters affecting Georgia dentists, patients, and their treatment, accomplished through disseminating information and providing a forum for member commentary. © Copyright 2013 by the Georgia Dental Association. All rights reserved. No part of this publication may be reproduced without written permission. Publication of any article or advertisement should not be deemed an endorsement of the opinions expressed or products advertised. The Association expressly reserves the right to refuse publication of any article, photograph, or advertisement.

Member Publication American Association of Dental Editors

index of advertisers Note: Publication of an advertisement is not to be construed as an endorsement or approval by the GDA or any of its subsidiaries, committees, or task forces of the product or service offered in the American Academy of Facial Esthetics . . . . . .13 Atlanta Age Management . . . . . . . . . . . . . . . . . .2 Atlanta Dental Imaging . . . . . . . . . . . . . . . . . . .11 AFTCO Transition Consultants . . . . . . . . . . . . .27 Center for TMJ Therapy . . . . . . . . . . . . . . . . . .29 Craniofacial Pain Center of Georgia . . . . . . . .11 Dental Care Alliance . . . . . . . . . . . . . . . . . . . . .33 Fidelity Bank . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

advertisement unless the advertisement specifically includes an authorized statement that such approval or endorsement has been granted.

GDA Dental Recovery Network . . . . . . . . . . . .10 Georgia Academy of Cosmetic Dentistry . . . .32 Georgia Dental Insurance Services . . . . . . . .36 Georgia Denture & Implant Specialists . . . . . .16 Great Expressions Dental Centers . . . . . . . . . .31 Heartland Dental Care . . . . . . . . . . . . . . . . . . .15 Hospital Dentistry—Dr. Kurtzman . . . . . . . . . .25 Law Office of Stuart J. Oberman . . . . . . . . . . .17

Officite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 National Practice Transitions, LLC . . . . . . . . . .34 Dr. Mark Padolsky—TMD Dentist . . . . . . . . . .31 Paragon Dental Practice Transitions . . . . . . . .28 PNC Bank . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35 Professional Practice Management . . . . . . . . .28 Southeast Transitions . . . . . . . . . . . . . . . . . . . .33 UBS Financial Services . . . . . . . . . . . . . . . . . .24

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editorial perspective

It’s a New World

R. David Bradberry, DMD

We’ve gone from clunky paper and postage driven insurance filings to electronic health records updated with a single click. We’ve traveled from fiddling with the dials of a transistor radio to bring in the static-filled broadcast of a single ballgame to enjoying instantaneous global social media communication and scores from every game you would ever want to monitor. Dentistry started with crude barber tools. Where are we headed?

The world is changing rapidly. Seems to me we hear that statement almost daily.

Knowledge is increasing at an exponential rate. In 1965, the co-founder of Intel Gordon Moore predicted that processor speed for computers would double every two years. This has been so precise a prediction that it has been named Moore’s Law, and came only a decade or so after the invention of the transistor. We live in a period of constant connection thanks to the invention of that transistor not so long ago. Dental science has meanwhile rapidly evolved from single practitioners testing early materials for placement in “cavities” to implants, early work with pulpal regeneration, and initial attempts at creating teeth structures through genetics in the lab.

The business side of dental practice started with little to no records, moved on to paper records, and is now moving to digital records. For many years there was no dental or medical insurance, then insurance conducted with paper mailings. Now, insurance filing is done primarily via computers that 40 years ago would have had 1,000 transistors and filled a small room. Now they contain billions and fit on a small desk. Quite a change from paper and postage.

And speaking of paper…Last month I discussed the topic of letters. I addressed how different letters can be grouped to make us feel great about our professional accomplishments or give us heartburn when they represent

oppressive regulations. That editorial was written in part as a response to the March 2013 Action article by Laney Kay about the significant changes coming to the Health Insurance Portability and Accountability Act. (If you have not read her HIPAA article yet, you can catch up with back Action issues at www.gadental.org.) Laney’s summary and wish for good luck at the end took several paper pages of the journal. On the U.S. Health and Human Services (HHS) web site one HIPAA Administrative “Simplication” publication alone is more than 100 pages long.

Another five-letter word I addressed is PPACA (the Patient Protection and Affordable Care Act). That Act is some 2,500 pages long. The HHS rules interpreting it can now be stacked floor to ceiling in one room (for now) and are growing daily.

This is not just happening at the federal level. Our just-ended state legislative session was packed with bills flying through (or being held up) in committees. There were 974 bills and 1,769 resolutions introduced in the Georgia House and Senate this year. Heaven knows how many rooms those stacks of paper would fill.

Society as a whole enjoys increasingly seamless access to vast pools of information as well as those crucial ballgame scores.

Meanwhile, dentists face a sea of increased expectation, fragmentation, and regulation with very little simplification. It seems as if we each need a team advising us daily. Luckily, due to the hard, dedicated work of GDA staff members and many dentists, dental students, and Alliance members, the outcome was largely positive for dentists at the state level

EDITORIAL Continued on page 29

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general news GDA UBS Wins Honor GDA endorsed service provider UBS Financial Services, Inc. /. Wile Consulting Group, was selected by the Asset International publication PLANSPONSOR as part of its “Top 100 Retirement Plan Advisers” list. A spokesperson for the Wile Consulting Group commented “This is quite an honor for us. [The notice] signifies that our constant efforts towards business excellence are paying off. We are proud to be included in this recognition.”

The Georgia Dental Association endorsed UBS / Wile Consulting Group in 2002 to provide guidance to GDA member dentists about wealth management and retirement planning. Since their endorsement, they have worked with dozens of dentists to prepare them for life after dentistry. UBS offers a complimentary Financial Goal Analysis for member dentists that serves as a financial roadmap and is the foundation and required first step in building a relationship. Once a relationship is formed, UBS can assist members with services such education funding, estate planning, banking services, retirement planning, tax guidance, and securities backed lending.

GDA members can make more beneficial decisions about their financial futures when they are guided by Wile Consulting Group Financial Advisors.

Give them a call at (404) 760-3000 ext.

3094, or call Denis Mucha or Skip Jones with Georgia Dental Insurance Services for additional information. Reach them at (800) 432-4357 or (404) 636-7553.

MEDIA REQUESTS

Dr. Brian Hall discusses infection control in the dental office during a University of Georgia journalism school broadcast. You can see his interview at http://gradynewsource.uga.edu/blog/ 2013/04/11/dental-safety.

Dr. Richard Weinman was filmed in February at Atlanta’s Ben Massell Dental Clinic discussing how charitable dental clinics can assist patients who might otherwise seek help for dental pain in hospital emergency departments. See his interview at www.myfoxatlanta.com/story/21422508/ too-many-toothaches-taking-over-ers.

GDA Speakers Media outlets have contacted the GDA office three times since January for dental spokespersons. Fox 5 News in Atlanta came calling concerning an uptick in consumers with dental pain seeking treatment at hospital emergency departments. Dr. Richard Weinman did

an excellent job of discussing how patients also have the option of seeking care through outlets such as charitable dental clinics. A Fox 5 news team filmed Dr. Weinman treating a patient at the charitable Ben Massell Dental Clinic in Atlanta. A University of Georgia journalism student conducted an interview with

Georgia Mission of Mercy Co-Chairs Dr. Jonathan Dubin and Dr. Karyn Stockwell about the charitable care event. The media outlet will hold the interview until closer to the event in June 2013. UGA’s journalism department did film, and broadcast, a segment with Athens general dentist Dr. Brian Hall about infection control practices in the dental office. The story was prompted by the national media attention given to dental patients who may have possibly been exposed to HIV and / or hepatitis at an oral surgery practice in Tulsa, Oklahoma.

Dr. Hall did a wonderful job talking about how dentists keep patients safe and encouraging patients to ask questions in the dental office.

GDA / GRU Faculty Social GRU College of Dental Medicine Liaison Dr. Celia Dunn (she works with the Public Relations Committee) reports that the GDA hosted a social in February for faculty members. GDA President Dr. Sidney Tourial and CODM Dean Dr. Connie Drisko spoke to the 50 attendees.

Faculty members and GDA private practice members enjoyed heavy hors d’oeuvres, wine, beer, soft drinks, and conversation.

The GDA hopes that this social and similar events will encourage faculty members to join the GDA by demonstrating how strongly the Association supports GRU.

GDIS and GRU Educating Students Georgia Dental Insurance Services (home of your GDA-endorsed medical, professional liability, overhead, property, and other fine coverages) participates regularly in activities at the GRU College of Dental

NEWS AND VIEWS Continued on page 8

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Medicine. GDIS staffers took part in Clinic Day this February, and GDIS sponsored a tee during the ASDA Spring Golf Tournament. GDIS and Medical Protective conducted a well-received risk management seminar for the junior dental students taking Dr. Richard Callan’s practice management course. Most recently, GDIS Director of Marketing Skip Jones participated in Transition Day in April (along with Associate Executive Director Nelda Greene and Director of Membership Pamela Yungk) to inform the soon-to-be graduated dental seniors of the importance of membership in the GDA and obtaining professional liability and medical insurance. Look for updates on other activities where the GDA and GDIS help support the school, faculty, and students.

GDA COMMITTEE Members Work

CONTRACT ANALYSIS DentaQuest Addendum The GDA office was recently contacted by several GDA members who received an Addendum Contract from DentaQuest regarding participation in their Health Insurance Exchange plan. While this plan is separate from their Medicaid plans as currently administered, in the GDA’s review of the addendum contract, there were also a number of similarities. While there are a number of critical provisions that GDA members should be aware of prior to signing the contract, one unexpected aspect was that the rates and covered services mimic those of Georgia’s dental Medicaid program. As more and more plans start to come into the market with the October 1 open enrollment date for the health exchanges created by the Affordable Care Act fast approaching, the GDA expects to see more plans with similar provisions like this emerge.

The GDA and ADA have performed a contract analysis of the DentaQuest addendum and this analysis is available to members free of charge.

The GDA also has analyses of other contracts available. Before you sign,

(L to r): GDA Recruitment and Retention Committee members Dr. Margaret Moore, Dr. Cecil Stanton, Dr. Tom Jagor, Dr. Erin Pickwick, and Dr. Kara Moore (the chair), along with GDA Director of Membership Pamela Yungk, attended an April conference at the American Dental Association headquarters in Chicago. The intent—to learn about the benefits of ADA membership and how to convey those benefits to dentists at the district and state level. The ADA is trying to break a string of seven years of stagnant membership numbers.

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call GDA General Counsel Melana McClatchey at (800) 432-4357 or (404) 636-7553.

MEDICARE CLAIMS Denial Process On May 1, Medicare will “turn on” a claim denial process that affects dentists and other health care providers ordering particular Medicare-covered items or services for Medicare beneficiaries. As of that date, a provider of a covered clinical laboratory, imaging, durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) or home health service will not be paid if the ordering or certifying practitioner has not enrolled in Medicare or properly opted out. The announcement of Phase 2 implementation in a special edition of Medicare Learning Network Matters includes guidance on orders or referrals by dentists. For more coverage, please read the http://www.ada.org/ news/8481.aspx.

ALLIANCE ASDA Booth The GDA Alliance (dental spouses) had a booth at the American Student Dental Association (ASDA) Annual Session in March in Atlanta. Past Alliance of the American Dental Association President Debbie Torbush and Past GDA President Shari Carter met with students from around the country and educated many who were unaware of the Alliance about the group’s oral health education projects and legislative advocacy efforts.

“We were in a perfect location on a corner and near the food,” said Mrs. Torbush. “We were swamped with students, thanks to the draw of the Dipper Dan heads showing the progression of oral cancer due to the effects of smokeless tobacco, the Meth Mouth Mary heads, our candy, and of course our dazzling personalities!” Debbie commented that Meth Mouth Mary was by far the most photographed booth worker.

The duo collected the names of potential new student spouse members and heard from several dental students from Georgia Regents University that they

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CORRECTION Dr. Goldstein The Georgia Academy of Cosmetic Dentistry (GACD) honored Atlanta’s Dr. Ronald Goldstein with the chapter’s first Lifetime Achievement Award during its January meeting. He was also honored as the chapter’s first Honored Lifetime Member.

“We bestowed these honors on Dr. Goldstein to recognize his contributions to esthetic dentistry in Georgia as well as throughout the world,” said GACD President Dr. Joe Chafin. “Our January speakers, Drs. Dennis Tarnow and Stephen Chu, have collaborated with Dr. Goldstein, and Dr. Chu has a chapter in Dr. Goldstein’s book Esthetics in

GDA Alliance members Debbie Torbush and Shari Carter (left) staffed a booth during the recent ADSA Annual Meeting in Atlanta. The “Meth Mouth Mary” heads, which show the effects of methamphetamine use over time, shocked many visitors, including attendees Diane Lee and Sameet Peet Gill.

enjoyed hearing a presentation by GDA President Dr. Sidney Tourial.

“This was a wonderful opportunity to make a connection with dental students, both for their future participation in their state dental association as well as their spouses’ participation in the Alliance,” said Mrs. Torbush. Thanks to the Alliance for their outreach and networking.

Dr. Ronald Goldstein (fifth from right) was honored in January with the GACD’s first Lifetime Achievement Award and as the chapter’s first Honored Lifetime Member.

Shown are board members Brian Lindke, Dr. Hugh Flax, Rhonda Mullins, Belinda Bryant, Dr. Joe Chafin, Dr. Chris Sholota, Dr. Jim Forester, Pinhas Adar, Dr. Jim Merriman. Not pictured: board members Drs. Sarah Roberts and Jill Golsen.

Dentistry. This made it the perfect time for the GACD to honor Dr. Goldstein.”

Dr. Goldstein is known as a ‘teacher of teachers’ especially with regards to expanding the horizons of esthetic dentistry of already practicing clinicians.

Dr. Goldstein is considered a pioneer in making dentists aware of their patients’ need for more attractive smiles in modern society. Dr. Goldstein and his family endowed the Georgia Regents University Ronald Goldstein Center for Esthetic and Implant Dentistry in order to educate future dentists on how esthetic teams can provide patients with optimum cosmetic and functional results.

“Many colleagues and family members enjoyed the Lifetime Achievement Award presentation and reception the GACD held in Dr. Goldstein’s honor,” said Dr. Chafin. “It was a wonderful day for our GACD members to have such wonderful speakers, and to honor our good friend Ronald Goldstein.”

NEWS AND VIEWS Continued on page 10

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DENTISTS In Memoriam The GDA extends sympathy to the family and colleagues of the following individuals.

James David Hay, DDS, who died April 25, 2013, at the age of 72. Dr. Hay was formerly a member of the GDA through the Central District and resided in Florida. He was a 1967 Emory University School of Dentistry graduate and a general dentist.

He was an American Dental Association Life Member. Memorial contributions may be made to Catholic Relief Services.

Hudson John Powell Sr., DMD, who died April 13, 2013, at the age of 59. Dr. Powell was a member of the GDA through the Southeastern District. He was a 1978 Medical College of Georgia School of Dentistry graduate and a general dentist.

Memorial contributions may be made to the Statesboro First United Methodist Church Building Fund, Ogeechee Area Hospice, or the Boys and Girls Club of Bulloch County.

Upcoming GDA / Dental Events JUNE 2013 Thurs-Sun, June 13-16: Georgia Mission of Mercy, North Atlanta Trade Center, Norcross.

Fri-Sat, June 14-15: GDA Expanded Duties Assistants Course, Athens.

See www.gadental.org to print your registration packet.

Fri, June 21: LEAP Course, GDA Office.

Sat, June 22: GDA Board of Trustees Meeting, GDA Office.

Sat, June 22: Emile T. Fisher Foundation for Dental Education Board Meeting, GDA Office.

JULY 2013 Wed, July 4: GDA Office Closed for Independence Day Holiday.

Mon, July 8: Northern District Executive Council Meeting, GDA Office.

Thurs, July 25: GDA House of Delegates, Hilton Head, South Carolina.

Thurs-Sun, July 25-28: GDA Annual Meeting, Hilton Head, South Carolina.

See www.gadental.org for registration details.

AUGUST 2013 Sat, Aug 10: GDA Board of Trustees Meeting / Committee Orientation, GDA Office.

Sat, Aug 24: Northern District “Boots and Bling Ball,” Druid Hills Golf Club, Atlanta.

Sat, Aug 24: Special Olympics Special Smiles Dental Screenings, Warner Robins.

SEPTEMBER 2013 Mon, Sept 2: GDA Office Closed for Labor Day Holiday.

GDA ACTION MAY 2013

Wed, Sept 11: Northern District CE Program, Villa Christina, Atlanta.

OCTOBER 2013 Thurs, Oct 10: Western District OSHA Course, Green Island Country Club, Columbus.

Thurs-Sat, Oct 10-12: ADA Fifth District Caucus (GA, AL, MS Delegations) Meeting, Atlanta.

Wed, Oct 16: Northern District CE Program, Villa Christina, Atlanta.

Mon, Oct 28: Northern District Membership Meeting / GDA Officer Visit, Villa Christina, Atlanta.

Thurs-Sun, Oct 31-Nov 3: ADA Annual Session, New Orleans, LA.

NOVEMBER 2013 Fri, July 12: White Coat Ceremony, GRU College of Dental Medicine.

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Mon, Sept 9: Northern District Executive Council Meeting, GDA Office.

Wed, Nov 6: Northwestern District Membership Meeting / GDA Officer Visit, Clarence Brown Conference Center, Cartersville.

Mon, Nov 11: Northern District Executive Council Meeting, GDA Office.

Fri, Nov 15: GDA Spokesperson Training Program, GDA Office.

Fri-Sun, Nov 15-17: GDA Alliance Wellness Retreat, The James Madison Inn, Madison.

Sat, Nov 16: GDA Board of Trustees Meeting, GDA Office.

Tues, Nov 19: Eastern District Legislative Reception, Athens.

Thurs-Fri, Nov 28-29: GDA Office Closed for Thanksgiving Holiday.

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Gain Insight into Business Topics Important to Dentists with New GDA Benefit Do you want to learn more about dental business topics such as how to bill PPOs, discipline an employee, ask questions of prospective staff members, or protect your online reputation in three minutes or less?

In June, the GDA will debut the Association Business Brief just for GDA member dentists. The briefs are short, information-packed videos delivered via email twice a month for 12 months that address business issues dentists face within their practices.

GDA members are scheduled to receive their first Business Brief email on June 4, 2013.

If you do not have an email address on file with the GDA office, now is a great time to contact the GDA office and provide an email address!

Call (800) 432-4357 or (404) 636-7553, or email Phyllis Willich at willich@gadental.org.

“These Business Briefs are a wonderful resource that the GDA Public Relations Committee has identified as a way to give a lot of valuable information fast to timestrapped dentists,” said Committee Chair Dr. Robin Reich. “We are confident that members will realize the value in these videos.”

The Public Relations Committee initiated a test of the Business Brief video education service late in 2012. Member

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dentists who have email addresses on file with the GDA office were sent a series of educational videos and then surveyed about the value of the information. Of the doctors who received and viewed the videos, 84.2% of GDA members stated that the Business Brief “provided added value to their membership” and 82.8% of GDA members stated that they wanted to continue to receive the Business Brief emails.

“We were thrilled to see this response,” said Dr. Reich. “Based on the positive feedback, we knew that we wanted to roll out the Business Brief member benefit on a regular basis.”

As part of the Business Brief test rollout in 2012, GDA members were asked about what topics they would like to see addressed by future Business Briefs.

The answers were as follows: • 65.3 % sought information on third party payer issues such as billing and referral gifts • 63.2% sought more information on practice management • 77.5% wanted more information on employment law issues • 63.2% wanted more information on regulatory compliance and record keeping • 65.3% sought more details on risk management in the business and clinical arenas Using this input, the GDA has scheduled 24 videos to be emailed to GDA members twice a month over the next year. The Georgia Dental Association is continually searching for membership benefits that help dentists increase revenue, save money, and increase productivity. These videos have the potential to serve all three purposes by covering topics such as: • If I’m under contract with a PPO, should I submit claims using my full fees or PPO contracted rates?

• What are some effective ways to build my practice?

• Can a dentist offer gifts to encourage patients to refer friends to my practice?

• What should I include in an employee disciplinary warning?

• How do I develop an employee handbook?

• What is the proper procedure to terminate an employee?

• Does my practice need a social media policy to address personal staff accounts?

• How do I combat negative online comments about my practice?

• What is the difference between exempt and non-exempt employees?

GDA members are scheduled to receive their first Business Brief email on June 4, 2013. If you do not have an email address on file with the GDA office, now is a great time to contact the GDA office and provide an email address! Call (800) 4324357 or (404) 636-7553, or email Phyllis Willich at willich@gadental.org.

A video library will be created as Business Brief emails are sent to GDA members. Dentists will be able to access the video library via the GDA web site and view videos that interest them an unlimited number of times. Please note that the Business Brief videos will only be added after they are emailed to members, so the library will build gradually over time.

Dentists will be able to search for a past video or specific video using a search feature within the library.

“We look forward to the value that this growing library will create for GDA members,” said Dr. Sidney Tourial, GDA president. “I believe the Business Brief videos have a lot to offer to my fellow dentists. The GDA will continue to explore ways to bring value to member dentists.”

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Obstructive Sleep Apnea and the Dentist’s Role in Patient Education and Professional Referrals Are your patients feeling sleepy without the benefit of nitrous oxide administered by your capable professional hands? Odds are good that at least one patient in your practice may suffer from one or more health issues caused by a sleep disorder.

Dentists can play a significant role in helping to identify patients, both adult and pediatric, who may benefit from a sleep disorder diagnosis from a physician, but building a knowledge base about sleep disorders and learning about Georgia laws and rules governing sleep apnea treatment are important actions to take before talking to your patients.

Q: What is sleep apnea?

A: Obstructive sleep apnea (OSA) is the most common type of sleep disorder.

Productive sleep means the body relaxes— and that relaxation includes the body’s muscle structure. Human airways are composed of collapsible walls of soft tissue. Normally, these muscles do not relax enough to obstruct airflow during sleep.

However, for a number of reasons, some individuals experience closed airways during sleep. Some reasons may include having low muscle tone, a large neck, fatty tissues bunched around the soft palate and neck, a retruded lower jaw, an enlarged tongue, and / or enlarged tonsils or adenoids. Apnea is defined by the American Academy of Sleep Medicine (AASM) as the cessation of airflow for at least 10 seconds. Apnea may last for 30 seconds or even longer. Hypopnea is defined as a recognizable transient reduction (but not complete cessation) of breathing for 10 seconds or longer, a decrease of greater than 50% in the amplitude of a validated measure of breathing, or a reduction in amplitude of less than 50% associated with oxygen desaturation of 4% or more.

Q: What are some health effects that OSA can cause?

A: Common symptoms of someone with OSA can include loud snoring and restless

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sleep, and then sleepiness after waking.

Sleepy individuals can exhibit moodiness and belligerence, suffer from headaches, experience short term memory loss, and experience impaired concentration.

Patients may grind their teeth as they clench their jaws during sleep in an attempt to restart the breathing process.

Therefore, dentists may observe symptoms such as worn teeth, tori of the hard palate and mandible, and buccal exostosis. Left untreated, OSA can be associated with an increased risk of cardiac, respiratory, and metabolic conditions, including hypertension, stroke, congestive heart failure, and even sudden death, as well as depression and sexual dysfunction. Excessive daytime sleepiness can impair daily functioning at home, in the workplace, and even while driving a motor vehicle.

Children with untreated OSA may exhibit symptoms of hyperactivity. There has been a great deal of recent media attention given to the idea that some children diagnosed as having attention deficithyperactivity disorder are actually sleepdeprived due to OSA, particularly as caused by enlarged adenoids or tonsils.

Q: Are some groups of patients more at risk of having OSA? A: Elderly patients may be more likely to have OSA due to their loss of muscle tone, their use of medications that may depress bodily functions such as respiration, and other health issues. Men may be more at risk for OSA than women and children, although OSA may be found in any population. The risk of someone having OSA rises as body weight increases, and when someone smokes. In addition, the American Diabetes Association notes that many men with diabetes also suffer from OSA. Research conducted by the Yale University School of Medicine in 2007 found that patients with OSA are at increased risk for developing type II diabetes, independent of other risk factors.

a Q: How can I determine if my patients are experiencing symptoms that may be related to OSA? A: Dentists may ask any patient about any health related matter that could impact their dental health or dental treatment.

Adding questions about sleepiness or snoring on a patient’s medical history, and following up with the patient about their answer, is one way to elicit information.

Depending on your practice model, the dental hygienist could ask about sleepiness or snoring during the prophylaxis portion of an appointment, and update the doctor about what the patient said, or the doctor could ask directly during the examination.

Since individuals are not likely to be aware of snoring, or want to admit to it, or are not aware of having disordered sleep, dentists may want to determine if there is a way to elicit information from a family member present in the office. Bed partners can be extraordinarily eager to share whether their significant other has snoring issues if they think a resolution may be found. Ironically, one study on OSA noted that individuals with OSA may regard themselves as “good sleepers” because they “can sleep anytime, anywhere” —for example in a doctor’s waiting room, in traffic, in class, or at the office. (http://emedicine.medscape.com/ article/295807-overview.)

While caring for a pediatric patient, a dentist could ask the parent or guardian if they have observed restless sleep, snoring of any type, or mouth breathing in their child. If they have not watched their child during sleep, a dentist might suggest the parent do so at the next opportunity.

Q: I have a patient—an overweight male—who answered affirmatively when I asked about daytime sleepiness. He seemed very concerned. How do I diagnose him?

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A: The short answer is that in Georgia dentists cannot diagnose a sleep disorder.

They, however, can have appropriate concerns about the health of a patient and refer that patient appropriately.

“OSA is a medical, not a dental, disorder,” said Dr. Jeff Prinsell, a GDA member board-certified oral and maxillofacial surgeon licensed in both medicine and dentistry who assists patients with OSA in his practice. “Though a medical disorder, certain OSA patients can be treated using oral appliance therapy by a dentist. However, OSA is part of a broad spectrum of sleeprelated breathing disorders, which can be complex, and treatment is more involved than simply placing an appliance in a patient’s mouth.”

The Georgia Board of Dentistry established a policy in 2005 regarding whether prescribing sleep apnea appliances falls within the scope of practice of dentistry. The policy states that “The diagnosis of a person’s type and severity of apnea appears to fall appropriately under the definition of practicing medicine. The determination of the type of appropriate

treatment, which depends upon the type and severity of the apnea, also more appropriately falls under the definition of the practice of medicine.”

The policy goes on to state that “Depending upon the diagnosis of type and severity, one possible treatment option for obstructive apnea is the use of oral appliances. The design, fitting, and use of oral appliances, and the maintenance of oral health related to the appliance falls within the scope of practice of dentistry.

[However,] The continued evaluation of the person’s sleep apnea, the effect of the oral appliance on the apnea, and the need for, and the type of, alternative treatment do not fall within the scope of dentistry.”

Therefore, the Board of Dentistry has determined that a dentist may only fabricate a sleep appliance for a patient under the orders of a physician, and that a dentist may not evaluate the effectiveness of an oral appliance in addressing sleep apnea. A dentist may design and fit the appliance, and work with the patient to address adjustments the appliance may need.

Q: A dentist cannot determine whether a patient needs a sleep appliance. May a dentist determine a patient’s need for an appliance to address snoring?

A: It is unclear from the Georgia Dental Practice Act and the Regulations promulgated by the Georgia Board of Dentistry whether dentists may diagnose and treat snoring. A good rule of thumb might be for dentists to refer patients who self-describe as snorers, or who may talk about excessive sleepiness due to snoring, to a physician for a diagnosis to rule out OSA or other sleep-related breathing disorders before the dentist discusses potential treatment options with a patient.

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Q: What should I think when I see dentists advertise sleep centers in their practices or tout their expertise with sleep apnea?

A: There are dentists who are dual degreed as dentists and physicians who may offer a full suite of services to patients in the area of sleep disorders, everything from diagnosis to appliance therapy and follow up. There are dentists who may form working relationships with “sleep physicians” in their communities. The dentists refer patients who may have symptoms indicating OSA to these physicians for diagnosis. The diagnostic process may include a sleep test, called polysomnography, where a patient spends time at a sleep center sleeping while having their breathing, heart rate, blood oxygen content, leg movements, and eye movements studied.

In turn, the sleep physician may prescribe

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an oral appliance for the patient to address OSA that the dentist can fabricate and place. There are dentists who may pursue continuing education in the field of sleep disorders and mention an awareness of OSA as part of their practice services.

These dentists would need to work with physicians who actually would perform the diagnosis of a sleep disorder.

A “sleep center” may mean different things to different dentists and adding “sleep services” to the offerings of any practice requires careful consideration and research before implementation. This service is likely not something that can be a part of a practice after a single weekend course. The key to remember is that dentists may not diagnose or treat OSA independently of a physician.

Q: What does the term “sleep physician” mean?

A: The Sleep Medicine Certification Program is jointly developed by the American Board of Internal Medicine and the American Board of Family Medicine,

the American Board of Pediatrics, the American Board of Psychiatry and Neurology (ABPN), the American Board of Otolaryngology, and the American Board of Anesthesiology. The examination is administered to candidates from all Boards at the same time in the same testing centers. Pulmonologists, subspecialists within internal medicine, may also become certified in sleep medicine after following a prescribed field of study.

From the ABPN web site (www.abpn.com), a definition of sleep medicine reads: “sleep medicine is a subspecialty that involves having expertise in the diagnosis and management of sleeprelated clinical conditions, including circadian rhythm disorders. This subspecialty includes the clinical assessment, polysomnographic evaluation, and treatment of sleep disorders including insomnias, disorders of excessive sleepiness (e.g. narcolepsy), sleep related breathing disorders (such as obstructive sleep apnea), parasomnias, circadian rhythm disorders, sleep related movement disorders and other conditions pertaining to the sleepwake cycle.”

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Additionally, there are currently four boards of the American Osteopathic Association Bureau of Osteopathic Specialists that administer Sleep Medicine Certification exams—Family Medicine, Internal Medicine, Neurology & Psychiatry, and Ophthalmology & Otolaryngology (www.osteopathic.org).

Q: I don’t want to start a sleep center, but I do want to help my patients who may have OSA. What may I do?

A: A dentist may assist a patient in their practice with potential symptoms by referring them to a physician with experience and expertise in OSA, or their family physician. Dentists may also encourage overall healthy habits in their patients.

Since obesity is an OSA risk factor, dentists can encourage patients to adopt a healthy diet, which has numerous dental-related benefits as well. Snoring can increase when patients sleep on their back (http://www.aaoms.org/sleep_apnea.php).

Dentists can encourage patients to research ways to improve their sleeping positions. Certain sedative drugs and the use of alcohol can cause muscle relaxation over and above that created by natural sleep. Dentists can encourage patients to seek guidance from their physicians about how medicines they may be taking can affect their health and sleep.

Smoking can induce a host of problematic oral and overall health issues, including the swelling of air passages. The Georgia Board of Dentistry considers the use of behavior modification techniques to address smoking cessation, the use of nicotine replacement therapy using nicotine patches or chewing gum, and the use prescription drugs approved for smoking cessations including but not limited to bupropion (Zyban® or Wellbutrin®) to be within the scope of practice of dentistry in Georgia.

A: A patient may be advised by a physician to use a Continuous Positive Air Pressure, or CPAP, device. This device attempts to control OSA by providing a stream of air through a tube into the nose. The positive air pressure the CPAP creates aims to keep the tissues in the back of the throat open during sleep. A patient may also be advised by a physician to obtain an oral appliance that moves the lower jaw forward relative to the upper jaw. The jaw movement opens the airway and positions the tongue forward. Should the physician issue a prescription for the creation of an oral appliance, a dentist may design, fit, and seat the oral appliance for the patient, and work with the patient on maintaining their oral health in relation to the appliance. The dentist should advise the patient to work with the prescribing physician to determine if the appliance is addressing the OSA issue.

Q: What are the treatments that a physician may prescribe for a patient to address sleep apnea?

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SLEEP APNEA Continued from page 17

Q: How do insurers view the increasing interest in sleep apnea?

A patient may also be advised by a physician in some instances to pursue surgery and the American Association of Oral and Maxillofacial Surgeons web site www.aaoms.org provides an excellent reference about the surgeries that may be recommended. One such procedure, maxillomandibular advancement surgery (MMA), is highly therapeutic as a treatment of OSA because it pulls forward the pharyngeal soft tissues suspended from the upper and lower jaws, thereby enlarging the entire upper airway. The AAOMS site notes that for some individuals, the MMA is the only technique that can create the necessary air passageway to resolve their OSA condition.

A: There have been recent media stories discussing insurer concerns that in-patient, overnight sleep testing is being over-prescribed. The American Academy of Sleep Medicine said in 2012 that the organization had 2,485 accredited sleep-disorder centers, nearly five times the 502 that were accredited in 2000 (www.dispatch.com).

Medicare payments alone to sleep clinics nearly quadrupled between 2001 and 2009, from $62 million to $235 million, according to the U.S. Department of Health and Human Services’ Office of Inspector General.

Some health insurers are looking at more at-home sleep studies that at around $400 are lower priced than overnight tests

at a free-standing sleep center or in a hospital outpatient setting (www.dispatch.com).

One story broadcast on National Public Radio earlier this year estimates that a night at a hospital sleep lab can cost a patient’s insurer around $1,900. NPR also noted that some patients may spend two nights at a lab—one to test for apnea and the second to test-drive a CPAP machine if one is prescribed. The upshot is that with the increased interest in the field, insurers could be concerned about the potential abuse of overnight sleep studies and complex treatment options. Dentists should err on the side of caution in forming relationships with physicians and specialists in the field and ensure that any suggestion or referral given to a patient is centered on the best interest of the patient.

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house minutes Unofficial Minutes of the Winter 2013 GDA House of Delegates Please note: This report includes persons present, all resolutions considered, and key actions taken. The full minutes may be found at www.gadental.org in the Member’s Only section.

President Sidney Tourial called the House of Delegates to order at 9:05 a.m. on January 13, 2013. Dr. Marshall Mann gave the invocation and led the pledge of allegiance to the flag.

Guests Dr. Tourial recognized the following guests: Dr. Connie Drisko, Dean of the GRU College of Dental Medicine; Dr. Barry Stacey, President of the Georgia Board of Dentistry; Dr. Don Seago, 5th District Trustee; Mr. Dale Crail, President of the Fisher Foundation; GRU scholars Patrick Barnes, Meagan Chaffins, Worth Straughan, Jason Strever, Bridget Lyons, John Ensley, India Lamonthe, Molly Hawkins, Ray Cornay, Ray Wallace, and Stephanie Silva.

Roll Call Dr. Jim Hall called the roll for delegates and alternate delegates and declared a quorum.

The following persons were present: Central (delegates) Drs. Paul Fraysure, Ty Ivey, Mike Loden, Kendrick Mathews, Deena Smith; (alternates) Drs. Lindsay Holliday, Amber Lawson, Amy Loden; Eastern (delegates) Drs. Lee Andrews, David Brown, Celia Dunn, Brad Hall, Carole Hanes, Grant Loo, David Perry, Rhoda Sword; (alternates) Drs. Greg Clepper, Erik Wells; Northern (delegates) Drs. Chris Adkins, Sarabess Baumrind, Donald Brown, Henry Benson, Brook Corbett, Jonathan Dubin, Max Ferguson, Hank Goble, James Granade, III, James Granade, Jr., Kathy Huber, Tom Jagor, Ben Jernigan, Paul Kudyba, Amy Kuhmichel, Matt Mazzawi, Roy McDonald, Bob O’Donnell, David Pumphrey, Troy Schulman, Richard A. Smith, Victor Van Greuningen, Richard Weinman, Marvin Winter, Carol Wolff; (alternates) Drs. Evis Babo, Neil Browning, Ron Cavola, David Carithers, Joe G. Looper, Greg Marks, Marie Schweinebraten, Richard

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Sugarman, Rebecca Weinman; Northwestern (delegates) Drs. Bruce Camp, Celeste Coggin, David Drew, Stan Halpern, Jim Hutson, Howard Jones, Ben Knaak, Elizabeth Lewis, Jason Oyler, Peter Shatz, Jason Young; (alternates) Drs. Hank Bradford, Brenda Fritz, Casey Hart, Stuart Loos, Dave Mason, Todd Mullikin, Freddie Padilla, Kumar Patel, Joe Peluso, Chris Rautenstrauch, P.J. Schaner, Larry Tilley; Southeastern (delegates) Drs. Cara DeLeon, Mark Dusek, Jay McCaslin, Matt Rosenthal, Julie Ann Routhier; Southwestern (delegates) Drs. Bo Broadfoot, Keith Crummey, Greg Morris, Steve Sample, Alan Sanders; (alternates) Dr. Chris Hasty, Jay Phillips, Bonita Richter; Western (delegates) Drs. Jay Harris, Jim Lopez, Ed Smith; (alternates) Drs. Robert Carpenter and Mark Lawrence; ASDA Amir Lamei; (alternate) Alena Reich.

Report of the President • Resolution 2013-01 Minutes (passed): Passed by general consent: Resolved that the minutes of the July 19, 2012, House of Delegates meeting be approved.

Report of the Executive Director • Resolution 2013-02 Members Emeritus (passed): Passed on motion by general consent: Resolved that the following persons be designated Members Emeritus of the Georgia Dental Association without dues: Southeastern—Paul Kulbersh, DMD; William Wege, DMD.

Report of the Board of Trustees • Resolution 2013-03 Position Papers (passed as amended): Passed on motion

by Dr. Sidney Tourial as amended by Dr. Peter Shatz: Resolved that the House of

Delegates approves the position papers with the exception of the Teledentistry Position Paper as presented and approved by the Board of Trustees. Suggested modifications to the Teledentistry position paper will be made and presented to the House for approval in July 2013.

• Resolution 2013-04 Actions of the BOT (passed): Passed on motion by Dr. Sidney Tourial: Resolved that the actions of the GDA Board of Trustees as reported in the minutes of the August 11 and November 10, 2012, meetings and the December 10, 2012, conference call are ratified by the House of Delegates.

• 2013-11 Actions of the January 12 BOT (passed) Passed on motion by Dr. Sidney Tourial: Resolved that the following motions from the January 11, 2013, Board of Trustees are ratified by the House of Delegates: • Response to Dr. Henri Treadwell concerning the July 2012 Conference, “Unmet Oral Health Needs” [13-1.01] Dr. Erik Wells moved for the GDA Board of Trustees to strongly support the letter to Henri M. Treadwell, PhD as presented that responded to Dr. Treadwell’s notes from the Conference, “Unmet Oral Health Needs, Underserved Populations, and New Workforce Models: An Urgent Dialogue,” and for the letter to be from the GDA Board of Trustees with the signatures of the GDA President and Executive Director. The motion passed unanimously. ª GDA Workforce Study Media Strategy Plan: [13-1.02] Dr. Marshall Mann moved for the GDA Board of Trustees to approve the Talking Points, Media Strategy Plan and Press Release as presented concerning the GDA’s Workforce Census and Report. The motion passed unanimously.

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• Finance Committee GDA Audit: [131.03] Dr. Jim Hall moved for the Board of Trustees to accept the Finance Committee’s recommendation to approve the audit. The motion passed unanimously.

• Constitution and Bylaws Parliamentary Rules of Order: [13-1.04] Dr. Sidney Tourial explained the need to make a housekeeping change to Resolution #201305 to delete the word ‘published.’ The Board of Trustees voted unanimously to approve the recommendation to delete ‘published’ which will be considered by the House of Delegates on January 13, 2013.

Constitution and Bylaws Resolution 2013-05 Policy Manual, ADA Delegation (passed): Passed on motion by Dr. Robert O’Donnell: Resolved that the GDA Constitution be amended as follows: • ARTICLE IX RULES OF ORDER: The rules contained in the most current edition of “Sturgis Standard Code” shall govern the professional conduct of all members.

The parliamentary rules of order adopted by the American Dental Association shall

be used to govern all meetings and operations of the Georgia Dental Association.

Nominating Committee Dr. Tourial reported on the following slate from the Nominating Committee. The committee offered the nomination of Dr. Greg Goggans for GDA vice president. Voting will occur at the July 26, 2013, GDA Business Meeting at the Annual Meeting. The Nominating Committee received the nomination for the ADA At-large delegate position (term expires 1/17) and accompanying CV from Dr. Jack Bickford, who is a member in good standing. Since there were no nominations from the floor, Dr. Bickford was elected by acclimation (his second term). ª Resolution 2013-08 Board of Trustees (passed): Passed on motion by Dr. Sidney Tourial: Resolved that the following candidates be approved for a three-year term of office on the GDA Board of Trustees effective July 28, 2013: Dr. Robin Reich, Northwestern District (term expires 7/16); Dr. Jim Lopez, Western District (term expires 7/16)

• ADA Delegation Election by Acclimation: The following candidates were elected to the ADA Delegation by acclimation: Dr. Kara Moore (Central District Delegate, term expires 1/17; second term); Dr. Donna Thomas Moses (Northwestern District Delegate, term expires 1/17; second term) Dr. Julie Ann Routhier (Southeastern District Delegate, term expires 1/17; first term); Dr. Jonathan Dubin (Northern District Alternate Delegate, term expires 1/17; second term); Dr. Ben Jernigan (Northern District Alternate Delegate filling the unexpired term of Tom Field, term expires 1/15; first term); Dr. Evis Babo (Northern District Alternate Delegate filling the unexpired term of Doug Torbush who moves into the Officer Position as President Elect, term expires 1/15; first term).

• Resolution 2013-10 Georgia Board of Dentistry (passed): Passed on motion by Dr. Sidney Tourial: Resolved that the

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following candidates be approved for submission to the governor for consideration as members of the Georgia Board of Dentistry: Central District (term expired 1/4/13, held by Stephan F. Holcomb): Stephan Holcomb, John H. Ferguson, Robert W. Vedder, Michael M. Wright; Eastern District (term expires 8/1/13, held

by Logan Nalley, Jr.): Logan Nalley, Jr., J. David Brown, Annette Rainge, S. Craig Taylor; Western District (term expired 1/4/13, held by Isaac Hadley) Leo Berard, Jim Lopez, Don Campbell.

Awards Committee ª Resolution 2013-06 Honorable Fellows (passed): Passed on motion by Dr. Marvin Winter: Resolved that the GDA hereby confirms the following dentists as Honorable Fellows to recognize their distinguished service to the Association: Donald F. Brown, DDS (Northern); Jay A. Harris, DMD (Western); A. Stuart Loos,

DDS (Northwestern); Jay McCaslin VI, DMD (Southeastern); John H. Muse, DDS (Northern); Erik H. Wells, DMD (Eastern); Michael M. Wright, DDS (Central).

• Resolution 2013-07 Community Service Awards (passed): Passed on motion by Dr. Marvin Winter: Resolved that the GDA hereby confirms the following dentists as Community Service Award honorees in recognition of their significant charitable activities: Richard G. Bennett, DMD (Northern) for his extensive work with the Good News Clinics/Green Warren Dental Clinic; and John D. Peacock, DDS (Northwestern) for his work with Woodstock First Baptist Church’s “LoveLoud” health care mission projects, Georgia Baptist Mobile Health Ministry, and numerous overseas mission trips.

Adjournment Being no further business, the House of Delegates adjourned at 11:45 a.m. The next meeting is scheduled for Thursday, July 25, 2013, 8:30 a.m. at the Marriott Hilton Head Resort and Spa.

EDITORIAL Continued from page 5

this year. The GDA monitored hundreds of bills related to professional scope and business issues that could impact dentists. They also took one bill, House Bill 132, all the way over the finish line and to Gov. Nathan Deal’s desk. It took virtually all of the session, from January through March, to convince legislators how a seemingly simple thing as redefining what department the Georgia Board of Dentistry falls under will greatly benefit Georgians.

A group of GDA dentists and staff members, meanwhile, are traveling in May to Washington, DC along with hundreds of dentists from across the country to lobby Congress about dental issues. On their platter—provisions of the PPACA like the medical device tax that are negatively impacting dentistry and dental patients, the elimination of the antitrust exemption for health insurers, coordination of benefits for dental care, and a grant program to help low income adults obtain medically recommended dental care.

Another organized dentistry team in action for us.

Dentistry is headed toward a perfect storm of tangled regulations and the waves are mounting rapidly. Do you remember that movie and book? “The Perfect Storm” was based upon the events surrounding a massive weather storm in 1991 where two weather fronts and a hurricane wreaked tremendous havoc. There are rough seas ahead. How many sailors can we count on to help steer the dental ship? We have 20 Georgia dentists traveling to Washington.

We had 201 dentists participate in LAW Day. These volunteers are incredibly dedicated and we all should appreciate them. We have 3,300 member dentists however—we need all hands on deck.

Will we come out of it for the better, worse, or just different? The perfect storm is brewing, are you ready? You need to be.

Stay tuned for more.

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classified ads How GDA members can place classified ads AD FORM: Submit all ads on a GDA Classified Advertisement Form. To obtain a form, call Skip Jones at (800) 432-4357 or (404) 636-7553, or email jones@gadental.org.

(Note: The GDA may accept or reject any ad for any reason and in its sole discretion.)

AD DEADLINE: Ads and ad check payments are due by the first of the month before the publication month (i.e., Dec. 1 for January).

AD RATES: ADA member dentists pay $75.00 per 60-word ad per month. There is a 25 cents per-word charge for each word over 60.

Non-dentist-owned companies (real estate firms, etc.) pay $195 per 60-word ad per month (additional word charges as above).

Non-member dentists may not place ads.

LATE FEE: Ads for which full prepayment is not received by the first day of the ad’s publication month (i.e.; Nov. 1 for a November ad) will incur a $25 late fee in addition to the ad rate.

FORMS OF PAYMENT: Submit a check or money order with the ad form. (Make checks payable to GDA.) Credit cards are not accepted as payment.

WEB SITE PLACEMENT: Prepaid ads will appear on the GDA Web site www.gadental.org for the month the ad appears in print. Non-prepaid ads will NOT be placed online.

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Dentists Available for Locum Tenens Dentist will fill in for illness, vacation, or continuing education. Licensed, insured, DEA #. Call (404) 786-0229 or email breighard@gmail.com.

DENTIST: Need Part Time Fill In? Vacation, Illness, Maternity? GENERAL DENTIST SOLD LONG ESTABLISHED PRACTICE. GA & DEA LICENSED. (Available Expanded Atlanta Area.) Cell: (404) 219-4097. Home: (404) 842-1196. Jesse Hader, DDS. Dentist available during emergencies, vacation, CDE courses. I have a current license, DEA certificate, and insurance.

Contact me at (706) 291-2254 or cell (706) 802-7760. I hope I can be of service to you.

Patrick A. Parrino, DDS, MAGD.

Equipment for Sale Available: 6 orthodontic / periodontic dental chairs for sale. Unitek / Metal craft brand with pump bases and electric backs.

Light blue vinyl color in good condition.

Will email photos. Four chairs have gray plastic backing and two cream-colored.

Will divide. $600.00. Email: samdds@aol.com.

Positions Available Expanding Pediatric Dental Group Seeking Dentists for our AtlantaBased Practices! Large and collegial dental group in the Atlanta region seeking GENERAL Dentists for expansion. Brand new, state-of-the-art facilities, clinical autonomy, advanced technology, comprehensive billing & insurance department / welltrained administrative support are a few benefits this opportunity has to offer.

Compensation is in the 80%. Offer will include comprehensive benefits package including PTO, sign-on bonus, and relocation. Full and / or part-time positions available. New grads welcome to apply.

Please email cover letter and CV to hr@tebodental.com. You can visit us on the web at www.tebodental.com.

Specialist or General Dentist for our Atlanta-Based Practices—Endo / Perio Preferred! Large and collegial dental group in the Atlanta region seeking Endo / Perio Dentists for expansion. Brand new, state-of-the-art facilities, clinical autonomy, advanced technology, comprehensive billing & insurance department / welltrained administrative support are only a few benefits this opportunity has to offer.

Compensation is in the 80%. Offer will include comprehensive benefits package and potential for sign-on bonus and / or travel expenses covered. This is a parttime position. Please email cover letter and CV to hr@tebodental.com. You can visit us on the web at www.tebodental.com.

Associate Dentist Needed: General family practice with locations in Peachtree City and Newnan looking for a part-time general dentist. Two days per week with future growth. Candidate must practice all aspects of dentistry. Please email resume to aberdeendental@bellsouth.net.

Join our team of professionals who are passionate about providing quality dental care to underserved communities! We are located across the Southeast! For more information, please contact Joanna Lea at jlea@cshm.com or call (615) 986-1733.

Full time associate dentist needed for a fee-for-service practice focused on comprehensive dentistry and great patient service in Stockbridge, GA. Associate to replace a retiring dentist and will take over his existing patient base. Applicants should be experienced with implants, root canal treatment, extractions, dentures, and partials. Office has great stable staff with most employed over 10 years. Ideal candidate should be looking for long term associateship and establishing a relationship with the patients. Options available for future partnership or buyout. Email CV / resume to newnandentistry@yahoo.com.

SAVANNAH: General dentist with a caring, patient focused approach to join busy practice. Associate and / or buy-in opportunities are available. Please contact Nick Cease, (502) 254-8514, ncease@mfdc.net.

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Mature family practice in Gwinnett County seeks independent dentist for 1-2 days a week. Well equipped modern office. Great staff. Bonus. Excellent opportunity! Send resumes to: mydentalmailbox@gmail.com.

Do you have a love for kids? We are seeking a skilled Pediatric Specialist or General Dentist with pediatric experience to join our successful, qualityoriented, multi-location practice. We are offering a competitive salary, health insurance, 401(k) plan, paid vacation, malpractice insurance, and CE and professional organization allowance. If interested, please send your C.V. to pcdentistry@ yahoo.com or call (770) 497-0110.

Need help: Ready to retire after 43 years.

Need a dentist to work for salary or percentage until he / she can take over the practice. I will continue to work a few days a week during the transition period.

Financing is available. Located in south central GA, in Fitzgerald. Call Fri-Mon (229) 424-5888.

GEORGIA—ATLANTA. Multiple pediatric dental offices in Metro Atlanta are seeking pediatric dentists and general dentists to work in an extremely successful, expanding business. We offer a team motivated working environment and a competitive salary. We believe in a high level of patient and parent education and making sure that children have an excellent dental experience at each visit. Our practice provides all levels of care, including oral sedation, IV sedation, and general anesthesia at local hospitals.

Candidate must have excellent communication skills, be enthusiastic, and motivated.

For more information please call (678) 923-4466 or email brian.friedman@ dentistry4children.com. Visit our web site at www.dentistry4children.com.

Associate Dentist Needed: Busy general dentistry practice NW of Atlanta is looking for an associate to add to our practice.

Immediate full time employment; must be skilled and practice all aspects of general dentistry. Our office is a beautiful, modern facility with an experienced staff. Come join us! Please email beiges66960@mypocks.net or call (770) 546-2775.

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Coast Dental is one of the largest providers of general and specialty dental care in the United States with practices in California, Florida, Georgia, Nevada, and Texas. Coast Dental is currently looking for General Dentists and Specialist to practice in the greater Atlanta area.

We have full and part-time opportunities available for experienced dentists to practice where contributions are valued and the sky is the limit on opportunities to grow. Coast Dental offers competitive wages with sign-on bonuses available for select locations, a great benefits package, and a chance to work with advanced technology and devoted people who take a visionary approach to making every patients smile a work of art. If you are interested in an opportunity in one of our practices, please email psherberg@ coastdental.com or apply online at www.coastdental.com/careers/dentists.

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Pediatric Dentist Needed: We have an outstanding full time opportunity for a Pediatric Dentist in our successful, well-respected, quality oriented private pediatric dental practice for the right candidate. We are seeking a special, motivated, personable full time pediatric dentist to join in our success. We are a booming practice with tremendous growth and earning potential. We offer in office sedation. We offer excellent compensation and benefits. For more information, please contact Dr. Vishant Nath at (678) 763-2600 or email drnath@kidshappyteeth.com or you can contact Amanda at (678) 3521090 or (678) 352-1090 / (678) 429-9931.

Associate—Atlanta: Lucrative opportunity for an experienced general dentist.

Large patient base, well-established practice, high income area. Extensive crown and bridge, CAD / CAM, implant restorative, composite operative, esthetic dentistry including DaVinci Veneers. Ability to perform rotary endo a plus. Excellent compensation package. Please email resumes to 1careerinfo@gmail.com or fax to (770) 926-8483.

Practices/ Office Space Available Available: COLUMBUS AREA #8824— Gross Collections $389K; NORTH ATLANTA #8880—Gross Collections $554K. NORTH ATLANTA #8902— Associate needed for Duluth general practice. Prefer experienced dentist capable of most skills. Practice is fee for service.

ATLANTA ORAL SURGERY #8887— Gross Collections $1.1M; ATLANTA PERIO #5241—Gross Collections $1.3M. ALSO: SAVANNAH ASSOCIATE NEEDED * AWESOME OPPORTUNITY #8903; STOCKBRIDGE ASSOCIATE NEEDED #8894; ATLANTA / DUNWOODYAREA ASSOCIATE #8887— Board certified / eligible OMS needed immediately. For more information, call Dr. Earl Douglas (770) 664-1982 or email earl@adssouth.com.

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CLASSIFIEDS Continued from page 32 Available Dental Spaces for Specialist!

Stockbridge, Fayetteville, Duluth, and Riverdale locations. Ideal for Pediatric Dentist, Periodontist, Endodontist, or Oral Surgeon looking to add satellite location or new startup. Already plumbed & fully equipped with 4 operatories and room for 2-3 more. Save time and money by sharing space in these new multi-specialty locations. Contact us at: dentalspecialist2@gmail.com. *NEW* COBB COUNTY PRACTICE FOR SALE: Beautiful, 10 operatory, state of the art facility with Adec equipment, collecting over $2M annually in a great location. Don’t miss out on this opportunity! Please call or email for details using reference #GA-1029. For more information call (678) 482-7305, email amanda@southeasttransitions.com, or visit www.southeasttransitions.com.

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GDA ACTION MAY 2013

*NEW* COBB COUNTY GEM: Long term, bread & butter practice, in a fantastic location with lots of room for growth!

Staff will stay on after the transition. Don’t miss out on this great opportunity to grow in a very desirable area! Please call or email for details using reference #GA1031. For more information call (678) 4827305, email amanda@southeasttransitions.com, or visit www.southeasttransitions.com.

Dental Space Available! Duluth, GA. Already built-out and plumbed with dental equipment! Convenient location off Sugarloaf Parkway near I-85. Built in 2007, 3-6 operatories, sterilization, consultation room, kitchen. Front office and private doctor office. Split design dental space, perfect for new dentist or specialist satellite office. Upscale building in a high growth area with excellent demographics.

Move in ready! Contact Aubrey Scher at (404) 384-8800.

Available: CANTON: Beautiful office grossing $393,000, 4 operatories. LAKE OCONEE AREA: Exceptional opportunity, grossing $823K. NORTH ATLANTA: Gorgeous new facility with 6 operatories, grossing $1.4M with high volume of cosmetics and implants. WOODSTOCK: Beautiful 5 operatory office grossing $400K. Richane Swedenburg, New South Dental Transitions: (770) 630-0436 or info@newsouthdental.com. Check new listings: www.newsouthdental.com.

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Inside This Issue • Register for the GDA Annual Meeting Today!

• Obstructive Sleep Apnea and the Dentist’s Role in Patient Education and Professional Referrals DATED MATERIAL PLEASE DELIVER AS SOON AS POSSIBLE

ACTION

Suite 200, Building 17, 7000 Peachtree Dunwoody Road Atlanta, Georgia 30328-1655 www.gadental.org