TDA
Texas Dental Journal JANUARY/FEBRUARY 2024 12 TDA MEETING PREVIEW SLEEP APNEA SIGNS & SYMPTOMS SPEAKER: ERIN ELLIOTT, DDS
17 NEW JOURNAL FEATURE: ASK THE POWERS CENTER RADE PARAVINA, DDS, MS, PHD
19 THE 2024 TDA MEETING MAY 16-19 | SAN ANTONIO
36 CAN MACHINES THINK? AKSHAY THUSU, DDS
40 CHAT GPT HAS ENTERED THE CHAT LINDA BRADY, TDA EXECUTIVE DIRECTOR
COVER: Sunset over Benbrook Lake in North Texas. Credit: Dean Fikar, istock.
www.tda.org | January/February 2024
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2 Texas Dental Journal | Vol 141 | No. 1
Anesthesia Education & Safety Foundation Two ways to register: Call us at 214-384-0796 or e-mail us at sedationce@aol.com Visit us on the web: www.sedationce.com
NOW Available: In-Office ACLS & PALS renewals; In-Office Emergency Program
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OUR GOAL: To teach safe and effective anesthesia techniques and management of medical emergencies in an understandable manner. WHO WE ARE: We are licensed and practicing dentists in Texas who understand your needs, having provided anesthesia continuing education courses for 34 years. The new anesthesia guidelines were recently approved by the Texas State Board of Dental Examiners. As practicing dental anesthesiologists and educators, we have established continuing education programs to meet these needs.
New TSBDE Requirement of Pain Management Two programs available (satisfies rules 104.1 and 111.1)
Live Webcast (counts as in-class CE) or Online (at your convenience)
All programs can be taken individually or with a special discount pricing (ask Dr. Canfield) for a bundle of 2 programs:
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Use and Abuse of Prescription Medications and Provider Prescription Program
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SEDATION REPERMIT PROGRAMS: LEVELS 1 and 2 (ONLINE, LIVE WEBCAST AND IN CLASS)
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OUR MISSION STATEMENT: To provide affordable, quality anesthesia education with knowledgeable and experienced instructors, both in a clinical and academic manner while being a valuable resource to the practitioner after the programs. Courses are designed to meet the needs of the dental profession at all levels. Our continuing education programs fulfill the TSBDE Rule 110 practitioner requirement in the process to obtain selected Sedation permits.
AGD Codes for all programs: 341 Anesthesia & Pain Control; 342 Conscious Sedation; 343 Oral Sedation This is only a partial listing of sedation courses. Please consult our www.sedationce.com for updates and new programs.
Two ways to Register: e-mail us at sedationce@aol.com or call us at 214-384-0796
www.tda.org | January/February 2024
3
Editorial Staff Jacqueline M. Plemons, DDS, MS, Editor Juliana Robledo, DDS, Associate Editor Nicole Scott, Managing Editor
contents FEATURES
HIGHLIGHTS
12
8
TDA MEETING PREVIEW SLEEP APNEA SIGNS & SYMPTOMS SPEAKER: ERIN ELLIOTT, DDS
17
NEW JOURNAL FEATURE:
10
Official Call for Nominations TDA Grant Availability
Barbara Donovan, Art Director Lee Ann Johnson, CAE, Director of Member Services
Editorial Advisory Board Ronald C. Auvenshine, DDS, PhD Barry K. Bartee, DDS, MD Patricia L. Blanton, DDS, PhD William C. Bone, DDS Phillip M. Campbell, DDS, MSD Michaell A. Huber, DDS Arthur H. Jeske, DMD, PhD
44
Oral and Maxillofacial Pathology: Case of the Month
Larry D. Jones, DDS Paul A. Kennedy, Jr., DDS, MS Scott R. Makins, DDS, MS Daniel Perez, DDS William F. Wathen, DMD
46
ASK THE POWERS CENTER Rade Paravina, DDS, MS, PHD
Oral and Maxillofacial Pathology: Case of the Month Diagnosis and Management
Robert C. White, DDS Leighton A. Wier, DDS Douglas B. Willingham, DDS
The Texas Dental Journal is a peer-reviewed publication.
19
THE 2024 TDA MEETING
48
Swallowed and Aspirated Objects: A Growing Area of
MAY 16-19 | SAN ANTONIO
36
CAN MACHINES THINK? Akshay Thusu, DDS
Value for Your Profession:
52
Established February 1883 • Vol 141 | No. 1 Texas Dental Association 1946 S IH-35 Ste 400, Austin, TX 78704-3698
Concern in Dentistry
Phone: 512-443-3675 • FAX: 512-443-3031
Classifieds
Texas Dental Journal (ISSN 0040-4284) is published monthly except
Email: tda@tda.org • Website: www.tda.org
January-February and August-September, which are combined issues, by the Texas Dental Association, 1946 S IH-35, Austin, TX,
58
Index to Advertisers
78704-3698, 512-443-3675. PeriodicalsPostage Paid at Austin, Texas and at additional mailing offices. POSTMASTER: Send address changes to TEXAS DENTAL JOURNAL, 1946 S IH 35 Ste 400, Austin, TX 78704. Copyright 2023 Texas Dental Association. All rights reserved. Annual subscriptions: Texas Dental Association members $17. In-
40
CHAT GPT HAS ENTERED THE CHAT
state ADA Affiliated $49.50 + tax, Out-of-state ADA Affiliated $49.50. In-state Non-ADA Affiliated $82.50 + tax, Out-of-state Non-ADA Affiliated $82.50. Single issue price: $6 ADA Affiliated, $17 Non-ADA Affiliated. For in-state orders, add 8.25% sales tax. Contributions: Manuscripts and news items of interest to the
Linda Brady, TDA Executive Director
membership of the society are solicited. Electronic submissions are required. Manuscripts should be typewritten, double spaced, and the original copy should be submitted. For more information, please refer to the Instructions for Contributors statement included in the online September Annual Membership Directory or on the TDA website: tda.org. All statements of opinion and of supposed facts are published on authority of the writer under whose name they appear and are not to be regarded as the views of the Texas Dental Association, unless such statements have been adopted by the Association. Articles are accepted with the understanding that they have not been published previously. Authors must disclose any financial or other interests they may have in products or services described in their articles. Advertisements: Publication of advertisements in this journal does not constitute a guarantee or endorsement by the Association of the quality of value of such product or of the claims made.
4 Texas Dental Journal | Vol 141 | No. 1
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www.tda.org | January/February 2024
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Board of Directors Texas Dental Association PRESIDENT Cody C. Graves, DDS 325-648-2251, drc@centex.net PRESIDENT-ELECT Georganne P. McCandless, DDS 281-516-2700, gmccandl@yahoo.com PAST PRESIDENT Duc “Duke” M. Ho, DDS 281-395-2112, ducmho@sbcglobal.net VICE PRESIDENT, SOUTHWEST Richard M. Potter, DDS 210-673-9051, rnpotter@att.net
JKJ Pathology Oral Pathology Laboratory
John E Kacher, DDS ¥ Available for consultation by phone or
VICE PRESIDENT, NORTHWEST Summer Ketron Roark, DDS 806-793-3556, summerketron@gmail.com VICE PRESIDENT, NORTHEAST Jodi D. Danna, DDS 972-377-7800, jodidds1@gmail.com VICE PRESIDENT, SOUTHEAST Shailee J. Gupta, DDS 512-879-6225, sgupta@stdavidsfoundation.org SENIOR DIRECTOR, SOUTHWEST Krystelle Anaya, DDS 915-855-1000, krystelle.barrera@gmail.com
email ¥ Color histology images on all reports ¥ Expedited specimen shipping with tracking numbers ¥ Reports available online through secure web interface
Professional, reliable service with hightechnology solutions so that you can better serve your patients. Call or email for free kits or consultation. jkjpathology.com 281-292-7954 (T) 281-292-7372 (F) johnkacher@jkjpathology.com
Protecting your patients, limiting your liability
SENIOR DIRECTOR, NORTHWEST Stephen A. Sperry, DDS 806-794-8124, stephenasperry@gmail.com SENIOR DIRECTOR, NORTHEAST Mark A. Camp, DDS 903-757-8890, macamp1970@yahoo.com SENIOR DIRECTOR, SOUTHEAST Laji J. James, DDS 281-870-9270, lajijames@yahoo.com DIRECTOR, SOUTHWEST Melissa Uriegas, DDS 956-369-9235, meluriegas@gmail.com DIRECTOR, NORTHWEST Adam S. Awtrey, DDS 314-503-4457, awtrey.adam@gmail.com DIRECTOR, NORTHEAST Drew M. Vanderbrook, DDS 214-821-5200, vanderbrookdds@gmail.com DIRECTOR, SOUTHEAST Matthew J. Heck, DDS 210-393-6606, matthewjheckdds@gmail.com SECRETARY-TREASURER* Carmen P. Smith, DDS 214-503-6776, drprincele@gmail.com SPEAKER OF THE HOUSE* John W. Baucum III, DDS 361-855-3900, jbaucum3@gmail.com PARLIAMENTARIAN** Glen D. Hall, DDS 325-698-7560, abdent78@gmail.com EDITOR** Jacqueline M. Plemons, DDS, MS 214-369-8585, drplemons@yahoo.com LEGAL COUNSEL Carl R. Galant *Non-voting member **Non-voting
6 Texas Dental Journal | Vol 141 | No. 1
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www.tda.org | January/February 2024
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OFFICIAL CALL FOR NOMINATIONS OFFICIAL CALL FOR CANDIDACY ANNOUNCEMENTS AND SUBSEQUENT NOMINATIONS: SPEAKER OF THE HOUSE, SECRETARY-TREASURER, AND EDITOR OFFICIAL CALL FOR SPEAKER OF THE HOUSE CANDIDACY ANNOUNCEMENTS AND SUBSEQUENT NOMINATIONS
6.
To appoint members of reference committees in consultation with the president, president-elect, and the immediate past president by the Board of Directors’ first meeting of the calendar year.
7.
To notify the divisional officers and the Committee on Credentials, Rules and Order, prior to the annual session,
Candidacy announcements for the statewide elective office
the number of delegates and alternates necessary to
of Texas Dental Association (TDA) Speaker of the House may
constitute a quorum.
be submitted to TDA Secretary-Treasurer Dr Carmen P Smith
8.
To meet with the divisional officers prior to the meeting
for the upcoming 2024 House elections. Only an active, life,
of the divisional caucuses at the annual session to review
or retired member in good standing of this Association shall
the Rules for Caucus Procedures, Nominations, And
be eligible. A curriculum vitae (CV) must be submitted, and
Elections.
the candidate will also have to sign a conflict of interest statement. Nominations are in order at the first meeting of the House of Delegates and remain open until the close of
9.
To appoint a parliamentarian pro tem, should it become necessary for the parliamentarian to be absent during a session of the House of Delegates.
the second meeting of the House of Delegates; however,
10. To serve as presiding officer of the TDA Candidates
announcements of candidacy should be made as early as
Forum, unless the Speaker is in a contested race, at
possible so that membership eligibility may be verified. To
which time the Speaker Pro-tem will preside.
become a nominee, a delegate must place the name of the candidate in nomination at the first meeting of the House
11. To be a certified parliamentarian or be in the process of certification
of Delegates. Please see the Manual on Caucus, Campaigns, Nominations and Elections at tda.org for full details.
Candidacy announcements are to be mailed to TDA Secretary-Treasurer Dr Carmen P Smith, Texas Dental
Duties of the Speaker of the House are enumerated in the
Association, 1946 S IH-35 Ste 400, Austin, Texas 78704; or,
Bylaws and include the following (excerpt):
emailed to TDA Executive Director Linda Brady: lbrady@
1.
tda.org.
To serve as an ex-officio member of the Board of Directors without vote or the privilege of proposing
2.
resolutions.
(See TDA Bylaws, Chapter IV, House of Delegates—Sections
To serve as an ex-officio member of the Executive
100 (Officers), 110A (Duties), 150C(3), 150D, Chapter V, Board
Committee without vote or the privilege of proposing
of Directors—Sections 10 (Composition); TDA House Manual;
resolutions.
Speaker Manual).
3.
To preside at all meetings of the House of Delegates.
4.
To determine the order of business for all meetings, subject to the approval of the House of Delegates, in accordance with Section 140B of this chapter.
5.
To appoint tellers to assist him/her in determining the result of any action taken by vote.
8 Texas Dental Journal | Vol 141 | No. 1
OFFICIAL CALL FOR SECRETARY-TREASURER CANDIDACY ANNOUNCEMENTS AND SUBSEQUENT NOMINATIONS
Candidacy announcements are to be mailed to TDA
Candidacy announcements for the statewide elective office
70A-B (Notice and Publication-Official Call & Publication of
of Texas Dental Association (TDA) Secretary-Treasurer may be submitted to TDA Secretary-Treasurer Dr Carmen P Smith for the upcoming 2024 House elections. Only an active, life, or retired member in good standing of this Association shall be eligible. A curriculum vitae (CV) must be submitted, and the candidate will also have to sign a conflict of interest
Secretary-Treasurer Dr Carmen P Smith, Texas Dental Association, 1946 S IH-35 Ste 400, Austin, Texas 78704; or, emailed to TDA Executive Director Linda Brady: lbrady@ tda.org. (Ref. TDA Bylaws, Chapter IV, House of Delegates—Sections Actions, 110B (Duties); Chapter V, Board of Directors—Sections 10 (Composition), 80B (Officers-Secretary); Chapter VI, Elective Officers—Section 90G (Duties); Chapter VIII, Fifteenth Trustee District American Dental Association Delegates and Alternate Delegates—Section 80 (Delegation Secretary); Board Manual; Secretary-Treasurer Manual).
statement. Nominations are in order at the first meeting of the House of Delegates and remain open until the close of nominations at the end of the second meeting of the House of Delegates; however, announcements of candidacy should be made as early as possible so that membership eligibility can be verified. To become a nominee, a delegate must place the name of the candidate in nomination at the first meeting
OFFICIAL CALL FOR EDITOR CANDIDACY ANNOUNCEMENTS AND SUBSEQUENT NOMINATIONS
of the House of Delegates. Please see the Manual on Caucus, Campaigns, Nominations and Elections at tda.org for full
Candidacy announcements for the statewide elective office
details.
of Texas Dental Association (TDA) Editor may be submitted to TDA Secretary-Treasurer Dr Carmen P Smith for the
Duties of the TDA Secretary-Treasurer are enumerated in the
upcoming 2024 House elections. Only an active, life, or
Bylaws and include the following (excerpt):
retired member in good standing of this Association shall
1.
To serve without vote as member of the Board of
be eligible. A curriculum vitae (CV) must be submitted, and
Directors and the House of Delegates.
the candidate will also have to sign a conflict of interest
2.
To serve without vote as chair of the Budget Committee.
statement. Nominations are in order at the first meeting of
3.
To examine the income and expenses of this Association
the House of Delegates and remain open until the close of
and report at each meeting of the Board of Directors.
nominations at the end of the second meeting of the House
To ensure that the minutes of the House of Delegates
of Delegates; however, announcements of candidacy should
and the Board of Directors be maintained.
be made as early as possible so that membership eligibility
To be responsible and perform such other duties as shall
can be verified. To become a nominee, a delegate must place
be specified by the Board of Directors and the Bylaws.
the name of the candidate in nomination at the first meeting
4. 5.
of the House of Delegates. Please see the Manual on Caucus, Other duties as Secretary include the following:
Campaigns, Nominations and Elections at tda.org for full
•
details.
Serve as recording officer and custodian of the records of the House of Delegates and the Board of Directors. Serve as secretary to the Executive Committee, without
Duties of the editor are enumerated in the Bylaws and include
the right to vote.
the following (excerpt):
•
Serve as secretary to the House of Delegates.
1.
•
Serve as the secretary of the American Dental Association
the Association and exercise full editorial control over
Fifteenth Trustee District Delegation.
such publications, subject only to policies established by
•
To be editor-in-chief of all journals and publications of
the House of Delegates, Board of Directors, and these Bylaws and provided such content is not in conflict with
www.tda.org | January/February 2024
9
or contrary to the TDA’s established policies, legislative agenda, or advocacy efforts. 2.
To control the selection of scientific material published in the Journal. The
TEXAS DENTAL ASSOCIATION NOTICE OF GRANT AVAILABILITY 501(C)(3) NONPROFIT DENTAL ORGANIZATIONS
editor may appoint associate editors, with the concurrence of the Board
The Texas Dental Association (TDA) announces availability
of Directors, to gather and/or review
of financial assistance for qualifying 501(c)(3) non-profit
material for publication. Such associate
organizations affiliated with dentistry. The monies are derived
editors shall serve as long as the editor deems necessary; but never longer than the term of the editor. 3.
from TDA Relief Fund interest income earned over the 2023 fiscal year. Grantees will be determined by the TDA Board of Directors.
To attend all open meetings of the Board of Directors and the House of
Eligibility: Grantees must be 501(c)(3) non-profit organizations
Delegates of this association, and the
affiliated with dentistry.
annual session of the American Dental Association. 4.
To hold no other office in this association or the American Dental Association while serving as editor, except the editor may be elected as delegate or alternate delegate to the
5.
Application: Letters of interest detailing the proposed project(s), including a budget, should be mailed to: TDA Board of Directors C/O Mr Terry Cornwell
ADA House of Delegates from his/her
1946 S. IH 35, Ste. 400
respective division.
Austin, TX 78704
To cooperate with his/her successor upon termination of the Editor’s term
Deadline: Letters of Interest must be postmarked or emailed
of office.
(tcornwell@tda.org) no later than January 31, 2024.
Candidacy announcements are to be mailed to TDA Secretary-Treasurer Dr Carmen P Smith, Texas Dental Association, 1946 S IH-35 Ste 400,
Approval: All letters of interest will be reviewed by the TDA Relief Committee and considered by the TDA Board of Directors.
Austin, Texas 78704; or, emailed to TDA
Notification: All recipients will be notified in writing on or before
Executive Director Linda Brady: lbrady@
May 15, 2024.
tda.org.
Previous Recipients: In 2023, grants totaling $14,200 were (Ref. TDA Bylaws, Chapter VI, Elective Officers—Section 90I (Duties); Policy Manual).
awarded to the following organizations in Texas for charitable patient care: Capital Area Dental Foundation (Austin), The Family Place (Dallas), Greater Killeen Community Clinic (Killeen), Network of Community Ministries (Richardson), Rotary Club of Grand Prairie Saving Smiles Program (Grand Prairie), and San Jose Clinic (Houston). For more information, please contact Mr Terry Cornwell, TDA Governance Manager, 512-443-3675, Ext. 146, or email tcornwell@tda.org.
10 Texas Dental Journal | Vol 141 | No. 1
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www.tda.org | January/February 2024
11
TDA Meeting Preview sleep apnea signs & symptoms
By erin elliott, dds It’s another gorgeous day in north Idaho, and my schedule is packed with restorative dentistry and hygiene checks. On today’s schedule is one of my favorite patients, Will. I usually see him only every 6 months, and I’m always prepared to exchange jokes with him. I have a good one for this visit, but thankfully I’m not seeing his daughters today. I usually have to do a really bad cartwheel for them in the waiting room. All 3 are amazing gymnasts, and after I told them that I got kicked out of gymnastics because I couldn’t figure out how to do a cartwheel, they made me prove it by showing them my “cartwheel” but only if they didn’t have any cavities. In addition to his 3 teenage daughters, Will has a wonderful wife and a great job. He travels often, but he’s wondering why he feels more and more rundown. When I checked Will during his routine 6-month visit, I asked about his girls, wife, job, how he was feeling, and finally how his teeth were. Of course he said they were fine; they’re always fine. Will is a healthy, middle-aged male with a clean health history. Certainly, he has no problem. Does this sound familiar? Ever since I finished my training to treat sleep apnea and now screening and treating it for the last 14 years, I’ve been looking at teeth, tongues, and throats completely differently. What I noticed about Will that I hadn’t before was that his canines had bruxing wear that we had discussed at one time but dismissed my concern, he had a large scalloped tongue, and he had a constricted mandible. But he was thin and tall with a small neck, not a stereotypical sleep apnea patient. I figured there was no way he had sleep apnea. His medical doctors didn’t mention it. Certainly there was nothing to pursue. Or was there? It is my mission to spread the message that SLEEP APNEA IS NOT AN OLD
Speaker: Erin Elliott, DDS Event:
Sleep Apnea: It’s Time to Wake Up!
Date:
Thursday, May 16
Time:
8:30 AM – 11:00 AM
Event:
Beyond the Basics: The Next Steps in Treating Sleep Apnea in
FAT MAN’S DISEASE!
Your General Practice Will saw that I had a poster in my waiting room about snoring and sleep apnea,
Date:
Thursday, May 16
so he mentioned that he’d been having trouble feeling rested and that he felt
Time:
1:30 PM – 4:00 PM
rundown. Also, he falls asleep immediately when the plane takes off on his business trips. Will was wondering if it’s because he snores at night. However, he’s getting older, he works hard, and he has teenage daughters. Why wouldn’t he be getting tired? We think, certainly there’s no problem; he’s just getting older. I contemplated all this a bit further. His wife says his snoring is getting worse, that he complains about fatigue, and I find signs in his oral cavity that suggest sleep apnea. I recommended that he get a sleep study done. An oral appliance
12 Texas Dental Journal | Vol 141 | No. 1
is a dental solution for sleep apnea,
the tongue and cheeks for oral cancer,
I hear “My family snores, everyone I
but sleep apnea is a medical problem
and finally the bone levels, gums, and
know snores, I’m fine.” I’m still trying to
that requires a medical diagnosis. Oral
teeth. What about the airway? We’re
figure out why there is such resistance
appliances help open a closing airway
most certainly right there looking at
and denial. I digress. Without a sleep
(and serendipitously help snoring),
it, but do we ever pause and wonder?
study to know exactly what is going on,
which is called obstructive sleep apnea.
If we do, we may discover one of
we may be creating a “silent apneic,”
Some with sleep apnea have breathing
the 400+ undiagnosed sleep apnea
which is a patient that does not snore
disorders that are unable to be treated
patients currently in our practice. There
at night, but his or her oxygen levels
by an oral appliance. In addition, with
are approximately 2,000 patients in
are dangerously low and obstructions
the advent of wearables that track sleep
a modest dental practice, and about
continue untreated. Fortunately, we
many can get a false sense of security
20%+ of those have sleep apnea
have sleep studies to address these
as it can provide a false negative just
or sleep disordered breathing and
unknowns, and home sleep studies are
as a pulse ox screener can do. A sleep
approximately 80-90% of those patients
becoming more common, and this helps
test is the ONLY way to screen for
go undiagnosed. These patients go
address patient follow through issues.
obstructive sleep apnea.
undiagnosed because, like Will, we don’t Thankfully, Will accepted my
believe there can be a problem.
recommendation and had a home sleep
We see many patients in my office, and we have almost the same routine for
There are some hurdles. The
study performed that was read and
every exam. We’re supposed to check
uneducated patient may resist a sleep
diagnosed by a sleep physician. I was
the medical history, the throat and jaw
study and may tell you to “just treat
anxious to see his results because I’m
for soft tissue abnormalities, under
my snoring.” Or even worse is when
rarely wrong in identifying sleep apneics
Elliott Evaluator Sleep Apnea Signs & Symptoms
Forward head posture Bags under the eyes Overbite- >80%
Bruxing Anterior maxillary gingivitis
Class II Retrognathic
High Arched Palate
Lingualized dentition
“Battered” uvula
“Turkeywattle” waddle” “Turkey
Acid erosion/ Cupping in cusp area Scalloped tongue Abfraction Premolar extraction
Vaulted palate
Periodontal Disease
Airway- tonsils and retropharyngeal walls
Forward wear pattern
Gag reflex
Lingual tori
Large tongue
Other Factors Clenching Full dentures Mouth-breathing
Overclosure due to wear Overclosure due to full dentures
www.tda.org | January/February 2024
13
WHAT TO ASK YOURSELF AT THE NEXT RECALL EXAM: SIGNS OF HYPOXIC DISTRESS
SIGNS OF AIRWAY DISTRESS
SIGNS OF DENTAL DISTRESS
• Fatigue
• Vaulted arched palate
• “Turkey wattle”
• High blood pressure
• Narrow arch
• Overbite
• Poor concentration
• Large neck
• Bruxism
• Bags under the eyes
• “Uvula engorgement”
• Erosion
• Snoring
• Mouth breathing
• Scalloped tongue
that were unaware before I spoke with them. What were his
and I bet he didn’t tell a joke, either. Because we know our
results? Will was in fact one of the 20%+ of undiagnosed sleep
patients and their families and see them often, we can help
apneics in my practice. In fact, he had moderate sleep apnea in
them breathe better by asking ourselves and our patients
which he stopped breathing for 10 seconds or more 99 times a
a few simple questions. Sleep apnea was subtle to catch in
night, and subconsciously tried to wake himself up to breathe
Will, but he’s just the tip of the iceberg. Join me at the Texas
better 57 times a night. No wonder he was tired!
Dental Association annual meeting where I will be teaching “Sleep Apnea: Wake Up to the Problem” followed by “Beyond
After receiving his oral appliance, Will returned for his 1-week
Basics: The Next Step in Treating Sleep Apnea in your General
follow-up with his wife. Almost immediately she said, “I can
Practice “ where I can help you discover an often silent
sleep with him in the same room again!” Will proclaimed, “I’ve
disease (that’s not so silent, ironically) within your own patient
stopped falling asleep on the plane when I travel for my job.
population in a fun, no nonsense, practical way. And although
I’m so much more productive.” Will couldn’t stop thanking me,
I am an Idahoan, I have a son at Texas A&M and am very
and his wife and kids couldn’t stop thanking me. I love changing
excited to be in that great state again.
lives! There are potentially 400 or more undiagnosed people in your practice. Dentists are on the front line. The medical doctors need us. They are farther downstream than we are. Will admitted he never would have gone to the doctor for his complaint, and he goes to the doctor only when he’s sick. Even at his biannual checkup the doctor didn’t ask about his sleep,
14 Texas Dental Journal | Vol 141 | No. 1
Terry Watson, D.D.S.
Jeremy Brown, J.D.
Frank Brown, J.D., LL.M.
Free Dental Practice Valuation Take the 1st step in selling your dental practice. Contact us to receive a free practice valuation.
WatsonBrownSales.com
469-222-3200
www.tda.org | January/February 2024 15 * Call us for details on this offer.
Recruit for Rewards
Caring • Connections • Create • Commitment You know first-hand the value you receive from your ADA membership. Through the community and resources you’ve come to count on, the ADA provides the support you need to help achieve your goals. You can help colleagues and friends thrive by inviting them to join the ADA.
For every 5 new members
For each new member
you recruit, you’ll receive a chance to win a 7-day interisland Hawaiian cruise* for you and a guest.
you recruit, you’ll be entered into a quarterly drawing for a chance to win $1,000 in prizes from ADA-endorsed providers or products from the ADA Store.
Eligibility
Program Rules
Who can recruit? Any ADA member dentist (including graduate student, resident, active licensed, active life, retired and retired life) is eligible to participate as a recruiter
• This program will run January 1 – August 31, 2024.
Who can be recruited? Any degreed dentist who was not an ADA member in 2023 (including graduate students, residents) Who is not eligible to be recruited for this program? • A renewing member (someone who was a member in 2023) • Dental students • Retired dentists
How to Participate • Newly recruited members are required to indicate the recruiter’s name and contact information as a referral on the membership application. • ADA member recruiters will receive an email notification after the dentist referred has been accepted into membership. • A raffle entry for quarterly drawings will be awarded for each new, active member recruited who pays national dues (as applicable) in the current year. Recruiters will receive a chance to win a 7-day Hawaiian cruise* for every five new recruited members who pay national dues (as applicable).
Recognition • All recruiters will be recognized at SmileCon 2024. Top recruiters will receive additional recognition. • Quarterly winners and top recruiters will be announced in ADA Morning Huddle.
• For each new, active member who joins in that timeframe, the referring member’s name will be entered into quarterly drawings for a chance to win $1,000 in prizes from ADAendorsed providers or products from the ADA Store. Referring members will also receive a chance to win a 7-day interisland Hawaiian cruise* for every five new, eligible members they recruit. • Referring members will receive a qualifying entry each time their name is listed as the “referring member” on the new member’s application (one entry for quarterly drawings for every one member recruited, one entry for the grand prize drawing for every five members recruited). There is no limit to the number of new members who can be recruited or entries in the drawing. • Referring members will automatically win a quarterly prize (up to $1,000 value) when they recruit 25 eligible new members. Quarterly prize winners are also eligible to win the grand prize should they recruit at least five new members. • The grand prize drawing will take place at SmileCon® 2024 in New Orleans. SmileCon attendance is not required to win. * The grand prize winner will receive a 7-day interisland Hawaiian cruise with a balcony room and airfare for two to be redeemed in 2025, an estimated value of $7,500. If winners do not wish to claim the Hawaiian cruise package, they are able to select another trip from AHI’s catalog at equal or lesser value, or take a cash prize option of $3,500. Learn more about the available cruises provided by ADA Member Advantage endorsed partner, AHI Travel. The ADA Member Recruitment Initiative is subject to all applicable federal, state and local laws and regulations, and is void where prohibited by law. Visit ADA.org/R4R for more details.
© 2023 American Dental Association All rights reserved.
16 Texas Dental Journal | Vol 141 | No. 1
Updated: 12/11/2023
New Texas Dental Journal Feature
Ask the Powers Center UTHealth Houston School of Dentistry John M. Powers, PhD, Center for Biomaterials & Biomimetics
Dear Texas Dental Journal Community, We are excited to introduce a new Texas Dental Journal feature, “Ask the Powers Center.” In collaboration with UTHealth Houston School of Dentistry (UTSD) and its John M. Powers, PhD, Center for Biomaterials and Biomimetics (Powers Center, PCBB), TDJ will be publishing hot topics in dentistry starting with the March 2024 issue. These contributions will include an overview of research and case reports from UTSD and selected papers from the Journal of Esthetic and Restorative Dentistry (JERD – in collaboration with Wiley), focusing on the “Holy Trinity” of the present-day dentistry: function, longevity, and esthetics. In addition to a reader-friendly style, each “Ask the Powers Center” feature will provide take-home messages. We thank UTHealth Houston School of Dentistry Dean Dr John A. Valenza, Editor Dr Jacqueline M. Plemons, and the Journal of Esthetic and Restorative Dentistry (JERD) for supporting and encouraging this endeavor. We look forward to a fruitful, long-term collaboration aiming to benefit dental professionals and patients alike. Sincerely, Rade Paravina, DDS, MS, PhD Guest Editor, Ask the Powers Center
UTHealth Houston School of Dentistry Since its founding in 1905, UTHealth Houston School of Dentistry has graduated more than 10,000 dentists, dental hygienists, and postgraduate generalists and specialists. The dental school is part of The University of Texas Health Science Center at Houston (UTHealth Houston), and offers 11 accredited programs including DDS, dental hygiene, 2 primary care general residency programs, and 7 advanced education programs; several dual-degree and joint certificate programs, and preceptor programs. For additional information, please visit https://dentistry. uth.edu. John M. Powers, PhD, Center for Biomaterials and Biomimetics John M. Powers, PhD, has been a fixture at UTHealth Houston School of Dentistry for over 3 decades. He was the founding director of Houston Biomaterials Research Center in 1994 and developed the center’s research program focused on evaluating oral biomaterials. In 2021, John and Susan Powers made a generous naming gift to support the center. In honor of their commitment, the school renamed the center the John M. Powers, PhD, Center for Biomaterials and Biomimetics. Moving to a new building in 2012, UTHealth Houston School of Dentistry has created new, state-of-the-art laboratories in support of the center and its clinical and laboratory research. The center’s activities align with dentists’ needs in care delivery to patients, ranging from everyday restorative therapy to the most complex cases involving cosmetic and functional corrections, teeth whitening, and rebuilding supporting structures of the face and mouth. Rade Paravina, DDS, MS, PhD Dr Paravina is a tenured professor at UTHealth Houston School of Dentistry in the Department of Restorative Dentistry and Prosthodontics, and he serves as director of the John M. Powers, PhD, Center for Biomaterials and Biomimetics. He is vice president of the American Academy of Esthetic Dentistry (AAED) and serves as editor-in-chief of the Journal of Esthetic and Restorative Dentistry (JERD, Wiley, Impact Factor, IF=3.2). Contact: 713-486-4477| Rade.Paravina@uth. tmc.edu
www.tda.org | January/February 2024
17
18 Texas Dental Journal | Vol 141 | No. 1
Advance Your Knowledge. Advance Your Career.
2024 TDA MEETING May 16-18 | San Antonio
www.tda.org | January/February 2024
19
THANK YOU
2024 TDA MEETING
MEETING SPONSORS AND DONORS
Thank you to our TDA Meeting Sponsors. Their generous support and donations help us provide you with cutting edge education and one of the best dental meetings in the country. The TDA regrets the omission of any sponsors or donors due to print deadlines.
GOLD
SILVER
BRONZE
EDUCATIONAL FUNDING PROVIDED BY: Align Technology | Alliance of the TDA | Bentwood Investment Advisory | Burkhart Dental | Buyers Club | Carestream Dental | Deka Dental Lasers | DentaQuest | Hispanic Dental Association | Ivoclar | Megagen | Nobel Biocare | Pearl | Planmeca | Prexion | Real World Endo | Sedation Resource | Sprint Ray | Texas Dental Association Smiles Foundation Beverly Bane Lecture Series
EDUCATIONAL SUPPORT PROVIDED BY: Brasseler USA | Nobel Biocare
20 Texas Dental Journal | Vol 141 | No. 1
Welcome to the 2024 Texas Dental Association Meeting! The annual meeting will be held at the Henry B. Gonzalez Convention Center on the beautiful San Antonio Riverwalk May 16-18, 2024. The Council on the Annual Meeting and Continuing Education Programs and the professional staff of the TDA have worked hard to provide an eventful and unrivaled educational experience. We extend an invitation to dentists and all team members as there is something for everyone at the 2024 TDA Meeting.
The educational presentations at the 2024 Meeting will feature some of the best speakers in the country. These three days are packed with courses for everyone including Dentists, Hygienists, Assistants, Office Managers, and Lab Technicians. Many of the speakers are new to the TDA Meeting, but we have also included favorites from years past. The Council has been sure to include several of the courses required for licensing including human trafficking, opioids, and medical emergencies. We also have a number of hands-on workshops which combine and reinforce learned techniques, in applied practice procedures that assistants, hygienists, and dentists can take back to patients immediately after the meeting. Once again, the Exhibit Hall will be at the center of the meeting with many opportunities. Hundreds of exhibitors will be present to showcase the latest materials, equipment, and technology. When visiting the hall, check out the new Technology Hub. The “Hub” will feature several companies to explain and demonstrate the latest dental technology. Catch up with friends and coworkers and play a few friendly games in the Relaxation Lounge. The CE Express classroom, located in the Exhibit Hall, will feature shorter CE presentations. The TDA Perks staff and exhibitors will be on hand to provide support and expertise. Enjoy your stay in San Antonio. Take a stroll along the Riverwalk, take in the art and historic architecture, and dine at one of the award-winning restaurants. Visit the historic Alamo or take a spooky ghost tour. Jump on a river taxi and explore the Pearl Brewery with many bars, restaurants, shops, and live entertainment. Bring the entire family for a vacation the kids will not forget. Check out some of my family’s favorite spots including the San Antonio Zoo, Botanical Gardens, and the DoSeum. Whether you are looking to improve the systems in your practice, want new ideas on how to improve patients’ oral hygiene, discover new composite techniques, or even improve your own health, we truly have something for everyone. So, grab your team, colleagues, and friends and head to San Antonio. I look forward to seeing you. Susan Putthoff, D.D.S. 2024 Scientific Chair
Advance Your Knowledge. Advance Your Career.
www.tda.org | January/February 2024
21
MEETING INFORMATION MEET THE COUNCIL ON THE ANNUAL MEETING AND CONTINUING EDUCATION PROGRAMS TDA’s Council on the Annual Meeting and Continuing Education Programs (CAMCEP) is comprised of six members, one new dentist representative and three consultants. Each member serves a 4year term. They meet quarterly to plan all continuing education programs with TDA staff. Throughout each year they travel to other dental meetings across the country to search for new speakers, exhibitors, and innovative ideas. They spend countless hours on speaker evaluation, exhibit floor design, and execution of networking events. Pictured L-R: Dr. Katie E. Stuchlik, Dr. Yeri Guak, Dr. Partha Mukherji, Dr. Susan L. Putthoff (Chair), Dr. Shelley L. Seidel, Dr. Elizabeth “Missy” D. Jaynes, and Dr. Taylor G. Cook (New Dentist). Not Pictured: Dr. Edwin A. McDonald III (Consultant), Dr. Robert C. Beatty (Workshop Consultant), Dr. Cindy Flanagan (Consultant) and Dr. Jodi D. Danna (Board Liaison)
@TDAmeeting
@tdameeting
THE TDA MEETING Brought to you by the Texas Dental Association 1946 S. IH 35, Ste. 400 Austin, TX 78704
TDA MEETINGS STAFF SHANNAN COOK, CMP Director of Meetings and Continuing Education scook@tda.org
@tda-meeting
TDAmeeting.com
(512) 443-3675 tda@tda.org www.tdameeting.com 8:30 am – 4:30 pm, M-F (CT)
MEETING INFORMATION MEETING LOCATION Henry B. Gonzalez Convention Center 900 E. Market Street San Antonio, TX 78205 PARKING
NICOLE GILBERT Meetings & Exhibits Manager ngilbert@tda.org
REGISTRATION & HOUSING SERVICES
Parking is available at area hotels for overnight guests. In addition, there are multiple parking garages available within walking distance of the convention center. Visit www.sahbcgg.com/visit-us/location-directions-parking for more information.
(678) 341-3039 tda@prereg.net prereg.net/2024/tda
Provided by Eleventh & Gather 6840 Meadowridge Court Alpharetta, GA 3005
22 Texas Dental Journal | Vol 141 | No. 1
9:00 am – 4:00 pm, M-F (EST)
All events will be held at the Henry B. Gonzalez Convention Center unless otherwise noted.
5:00 PM – 9:00 PM
Annual Healthy Smiles Classic, Top Golf Fundraiser 5539 N. Loop 1604 West, San Antonio, TX
7:00 AM – 5:00 PM
Registration Hours
8:00 AM – 10:00 AM
TDA House of Delegates
8:00 AM – 5:00PM
Continuing Education Courses
8:30 AM – 8:30 PM
Alliance of the TDA Program, Grand Hyatt
10:00 AM – 6:00 PM
Exhibit Hall Open
10:00 AM
Reference Committees
4:30 PM – 6:00 PM
TDA Speakeasy - Join Us in the Exhibit Hall
7:00 AM – 5:00 PM
Registration Hours
8:00 AM – 7:00 PM
TDAA Program, Marriott Riverwalk Hotel
8:00 AM – 4:30 PM
Continuing Education Courses
8:30 AM – 4:30 PM
Alliance of the TDA Program, Grand Hyatt
10:00 AM – 5:00 PM
Exhibit Hall Open
1:30 PM – 4:30 PM
House of Delegates
5:30 PM
Divisional Caucus Meetings
7:00 AM – 8:30 AM
TDA Past Presidents & Past Vice Presidents Breakfast
8:00 AM – 10:00 AM
TDA House of Delegates
8:00 AM – 10:00 AM
Registration Hours
8:00 AM – 12:00 PM
Continuing Education Courses
8:00 AM – 5:00 PM
TDAA Program, Marriott Riverwalk Hotel
10:30 AM – Close of Business
TDA House of Delegates
www.tda.org | January/February 2024
23
REGISTRATION
Registration Opens January 15, 2024 Register Online at www.tdameeting.com. Online registration will be available January 15 through May 18, 2024. Seats in continuing education courses are available on a first-come, first-served basis. Register early to save money and guarantee a spot in popular CE courses! Eleventh & Gather is our official registration provider. They will manage pre-registration and onsite registration of attendees and exhibitors. Beware of fraudulent companies who may reach out to you to book registration or sell attendee lists. Questions regarding registration can be directed to Eleventh & Gather at: By Email: tda@prereg.net
Hours: Mon-Fri: 9:00 am – 4:00 pm EST
By Phone: 678-341-3039
EARLY BIRD Before Feb 16
PRE-REG
Before March 31
STANDARD
Register between January 15 and February 16 and SAVE! TDA members and their staff register for free during the this time period. Discounted fees available for everyone.
Register between February 17 and March 31 Registration fees go up slightly
Register between April 1 and May 18 Full-price registration fees apply
After April 1
CATEGORY
EARLY BIRD Register by February 16
PRE-REG Register by March 31
STANDARD Registration
DENTISTS
TDA Member Dentist (includes Retired) ADA Member (outside of Texas) Non-ADA Member Dentist* Active-Duty Military or Federal Dentist
A B C D
$0 $125 $750 $0
$50 $150 $775 $50
$75 $175 $800 $75
STAFF of TDA Member Dentist
Hygienist Dental Assistant Lab Tech Business Assistant/Front Office
I J K L
$0 $0 $0 $0
$25 $25 $25 $25
$50 $50 $50 $50
STAFF of Non-TDA Member Dentist
Hygienist Dental Assistant Lab Tech Business Assistant/Front Office
M N O P
$50 $50 $50 $50
$75 $75 $75 $75
$100 $100 $100 $100
STUDENTS
Post Graduate Student (Non-TDA Member) Student (Dental, Hygienist, Assistant, Pre-Dental)
E F
$0 $0
$15 $15
$25 $25
FACULTY
Faculty Non-TDA Member
H
$125
$150
$175
GUESTS
Non-Dentist Family Member of TDA Member Dentist
G
$0
$25
$50
2024 Registration Fees
* Registration fee can be applied toward active membership if you join within 30 days after the meeting. Contact rachael@tda.org for more details.
24 Texas Dental Journal | Vol 141 | No. 1
REGISTRATION REGISTRATION POLICIES: Dentists may not register under any category other than “dentist”. You must be registered under a dentist or team member registration category in order to earn CE credits. You must register on or before April 30 in order to receive your badge in the mail. After this date, registration materials can be picked up onsite in registration. The deadline for early bird discounted registration is February 16, 2024. The deadline for pre-registration is March 31, 2024. Photo identification is required for onsite registration. By registering for the meeting, you authorize the TDA to add you to their email marketing list to receive convention updates for 2024 and subsequent years. You can opt-out at any time, but you will not receive pertinent information regarding your registration. 2024 TDA dues must be paid before you can attend the meeting at the member rate.
CANCELLATION POLICY: A full refund (less a 20% administrative fee) will be issued if cancelled on or before March 31, 2024. No refunds will be approved after this date. In the event of an emergency or death, cancellations will be reviewed on an individual basis.
Be sure to follow us on social media for the latest updates and information: @TDAmeeting
@tdameeting
@tda-meeting
TDAmeeting.com
SAVE THE DATE 2024 TDA MEETING MAY 16-18
2025 TDA MEETING MAY 8-10
www.tda.org | January/February 2024
25
HOTELS
TDA MEETING HOTELS Support TDA by booking your room within the annual session hotel room block. TDA has secured special rates with these official hotels.
6840 Meadowridge Court, Alpharetta, GA 3005 678-341-3039 tda@prereg.net prereg.net/2024/tda 9:00 am – 4:00 pm, Monday thru Friday (ET)
Eleventh & Gather is the official housing provider for the 2024 TDA Meeting. Beware of fraudulent companies who may reach out to you to reserve hotel rooms or sell attendee lists.
RESERVE YOUR ROOM Housing Reservations Monday, January 15
Online Reservations: https://www.prereg.net/2024/tda
Phone Reservations: 678-341-3039
SINGLE/ DOUBLE RATE
TRIPLE RATE
QUAD RATE
Grand Hyatt San Antonio 600 E. Market St. Headquarters Hotel
$235
$260
$285
Complimentary in-room Wi-Fi for World of Hyatt Members.
Marriott Riverwalk 889 E. Market St.
$219
$219
$219
Complimentary in-room Wi-Fi for Marriott Bonvoy Members.
La Quinta by Wyndam 303 Blum
$184
$184
$184
Complimentary breakfast and Wi-Fi for guests.
Menger Hotel 204 Alamo Plaza
$179
$179
$179
Complimentary Wi-Fi for guests.
HOTELS
EXTRAS
All rates are per room and are subject to a 16.75% occupancy tax.
26 Texas Dental Journal | Vol 141 | No. 1
PROGRAM AT A GLANCE
THURSDAY
CODE
TOPIC
SPEAKER LAST
EVENT
TIME
DENTIST FEE
HYG FEE
STAFF FEE
$40
T01
Forensics
Cardoza
An Overview of Contemporary Forensic Dentistry
8:00 am - 10:30 am
$65
$50
T02
Lasers
Cardoza
Laser-Assisted Dentistry Workshop
1:00 pm - 4:00 pm
$225
$225 $225
T03
Practice Management
Collins
Let's Get Organized
1:30 pm - 3:30 pm
$55
$45
T04
Photography
Cone
Emotive Clinical and Laboratory Dental Photography
8:30 am - 4:00 pm
$375
$375 $375
T05
Insurance
Duncan
Dental Insurance in a Day
8:30 am - 11:30 am
$65
$50
T06
Practice Management
Duncan
Foundations of Dental Office Management
1:00 pm - 3:30 pm
$65
$50
$40
T07
Sleep Medicine
Elliott
Sleep Apnea: Time to Wake Up!
8:30 am - 11:00 am
$75
$60
$50
T08
Sleep Medicine
Elliott
The Next Steps in Treating Sleep Apnea
1:30 pm - 4:00 pm
$75
$60
$50
Hargreaves
Issues in Managing the Persistent Endodontic Infection
8:00 am - 11:00 am
$75
$60
$50
T09
Endodontics
$35
$40
T10
Endodontics
Hargreaves
Successful Management of Acute Dental Pain
1:00 pm - 4:00 pm
$75
$60
$50
T11
Oral Pathology
Huber
Update on Antimicrobial Prophylaxis & Therapeutics
9:00 am - 11:00 am
$65
$50
$40
T12
OSHA
Huber
OSHA Review
1:30 pm - 4:00 pm
$65
$50
$40
T13
Practice Management
Kelley
Management Myths & Fateful Fallacies
8:30 am - 9:30 am
$45
$35
$25
T14
Practice Management
Kelley
D-I-Right Your Employee Handbook
10:00 am - 11:30 am
$55
$45
$35
T15
Practice Management
Kelley
Compete with Culture
1:30 pm - 4:00 pm
$65
$50
$40
Kohner
Crown Lengthening WILL Enhance Restorative Results
8:00 am - 11:00 am
$75
$60
$50
T16
Periodontics
T17
Periodontics
Kohner
Crown Lengthening Workshop
1:00 pm - 4:30 pm
$450
$450 $450
T18
Occlusion
Kwiecen
Every Case is a Big Case
8:00 am - 11:00 am
$75
$60
$50
T19
Occlusion
Kwiecen
Predictable Dentistry: Is Occlusion Really the Key?
1:00 pm - 4:00 pm
$75
$60
$50
T20
Sedation
Luce
Minimal (Lvl 1) Enteral Sedation Review Course
8:00 am - 4:00 pm
$225
--
--
1:30 pm - 4:00 pm
$65
$50
$40 $40
T21
Communication/Team
Mausolf
Systems & Strategies that Build High Performing Teams
T22
Dental Assisting
McDonald, III
Provisional Restorations for Assistants
8:00 am - 11:00 am
$65
$50
T23
Dental Assisting
McDonald, III
Provisional Restorations for Assistants Workshop
1:00 pm - 4:00 pm
$175
$175 $175
T24
Spanish
Meiners/Rodriguez
Dental Spanish for Beginners
9:30 am - 11:30 am
$55
$45
T25
Spanish
Meiners/Rodriguez
Intermediate Dental Spanish
2:00 pm - 4:00 pm
$55
$45
$35
T26
Nutrition/Health
Odiatu
The Human Microbiome
8:30 am - 11:00 am
$65
$50
$40
T27
Nutrition/Health
Odiatu
50 Shades of Inflammation
1:00 pm - 3:30 pm
$65
$50
$40 $50
$35
T28
Technology
Sabbah
Digital Workflow for the Modern Dental Practice
8:00 am - 11:00 am
$75
$60
T29
Hygiene
Sanders
Cracking Periodontal Codes with Class
8:00 am - 10:30 am
$75
$60
$50
T30
Hygiene
Sanders
All Together Now: The Oral Systemic Connection
1:00 pm - 3:30 pm
$75
$60
$50
T31
Medical Emergencies
Shufflebarger
Managing Medical Emergencies in the Dental Office
8:30 am - 11:30 am
$65
$50
$40
T32
Pharmacology
Shufflebarger
Developing a Framework for Opioid Prescribing
1:30 pm - 3:30 pm
$65
$50
$40
T33
Lab Technician
Tabakovic
Bringing Dentures to Life with SR Nexco
8:00 am - 12:00 pm
$375
$375 $375
T34
Lab Technician
Tabakovic
Bringing Dentures to Life with SR Nexco
1:00 pm - 5:00 pm
$375
$375 $375
T35
Esthetics
To
Cosmetic Flowable Composite Workshop
8:00 am - 12:00 pm
$450
$250 $250
T36
Esthetics
To
Cosmetic Flowable Composite Workshop
1:00 pm - 5:00 pm
$450
$250 $250
T37
Hygiene
Void-Holmes
Stay Sharp - How to Maintain Your Edge Workshop
8:00 am - 11:00 am
$175
$175 $175
T38
Hygiene
Void-Holmes
Selecting Instruments to Increase Productivity
1:00 pm - 3:30 pm
$75
$60
$50
T39
Medical Emergencies
Help-a-Heart
American Heart Association BLS Certification
1:30 pm - 4:30 pm
$90
$90
$90
T40
Technology
Technology Hub
Digital Technology Hands-on Workshop
1:00 pm - 2:30 pm
$50
$50
$50
T41
Technology
Technology Hub
Digital Technology Hands-on Workshop
3:30 pm - 5:00 pm
$50
$50
$50
T42
Networking
Alliance of the TDA
Fun Trivia Experience
2:30 pm - 4:30 pm
$40
$40
$40
www.tda.org | January/February 2024
27
FRIDAY
PROGRAMS AT A GLANCE
CODE
TOPIC
SPEAKER LAST EVENT
TIME
DENTIST HYG FEE FEE
STAFF FEE
F01
Digital Dentistry
Al Matny
Open Your Eyes to 3D Imaging
8:00 am - 10:00 am
$65
$50
F02
Occlusion
Bender
Triaging the TMD Patient: From Diagnosis to Red Flags
8:00 am - 11:00 am
$75
$60
$40 $50
F03
Occlusion
Bender
The Many Faces of Orofacial Pain: Beyond TMD!
1:00 pm - 4:00 pm
$75
$60
$50 $45
F04
Marketing
Berlin
Social Media Marketing for Dentists
9:00 am - 11:00 am
$55
$45
F05
Esthetics
Berlin
Advanced Smile Design Principles and the Smile Test Drive
1:00 pm - 4:00 pm
$75
$60
$50
F06
Orthodontics
Blacher
Integrating Invisalign Workflows
8:30 am - 11:00 am
$75
$60
$50 $50
F07
Orthodontics
Blacher
Invisalign Clinical Confidence
1:00 pm - 3:30 pm
$75
$60
F08
Hygiene
Braswell
Exploring the Mouth/Body Connection
8:00 am - 11:00 am
$75
$60
$50
F09
Vet Dentistry
Braswell
Zoo and Aquarium Exotic Animal Dentistry
1:00 pm - 3:30 pm
$45
$35
$35
F10
Lasers
Cardoza
Twenty-first Century Laser-Assisted Dentistry Workshop
8:00 am - 11:00 am
$225
$225 $225
1:00 pm - 3:30 pm
$65
$50
$40
F11
Forensics
Cardoza
Dentistry's Role in the Mass Disaster Scenario, Child Abuse and Intimate Partner Violence Recognition
F12
Prosthodontics
Cone
Functional Foundations for Removable Dental Prosthetics
8:30 am - 11:30 am
$75
$60
$50
F13
Prosthodontics
Cone
Creating Fake Teeth for Real People
1:00 pm - 4:00 pm
$75
$60
$50
F14
Pharmacology
Donaldson
Cannabinoids, Illicit Drugs and the Dental Patient
8:30 am - 11:00 am
$65
$50
$40
F15
Pharmacology
Donaldson
Money Makes the World Go Round
1:00 pm - 3:30 pm
$65
$50
$40
F16
Ergonomics
Eads
Training to be a Dental Athlete
1:30 pm - 3:30 pm
$65
$50
$40
F17
Practice Management Gunn
Money In, Money Out
8:30 am - 11:00 am
$85
$75
$75
F18
Practice Management Gunn
Managing Revenue & Accounts Payable
1:30 pm - 4:00 pm
$65
$50
$40
F19
Oral Pathology
Common Lesions Encountered in Dental Practice
8:30 am - 11:30 am
$65
$50
$40
F20
Practice Management Johnson
Become an Office Manager that Leads with Confidence
8:30 am - 11:00 am
$65
$50
$40
F21
Practice Management Johnson
Take Your Office Manager Role to the Next Level!
1:00 pm - 3:30 pm
$65
$50
$40
F22
Periodontics
Kohner
Crown Lengthening Workshop
8:00 am - 11:30 am
$450
$450 $450
F23
Periodontics
Kohner
Beating Up on Your Patient's Periodontal Disease
1:30 pm - 4:30 pm
$75
$60
F24
Occlusion
Kwiecien
Systematic Equilibration: Hands-on Workshop
8:00 am - 11:00 am
$375
$375 $375
F25
Medical Emergencies
Luce
Sedation Emergency Workshop
8:00 am - 9:30 am
$175
$125
$75
F26
Medical Emergencies
Luce
Sedation Emergency Workshop
10:00 am - 11:30 am $175
$125
$75
F27
Medical Emergencies
Luce
Sedation Emergency Workshop
1:00 pm - 2:30 pm
$175
$125
$75
F28
Medical Emergencies
Luce
Sedation Emergency Workshop
3:00 pm - 4:30 pm
$175
$125
$75
F29
Pediatrics
MacLean
Nonsurgical Caries Management
8:00 am - 10:30 am
$75
$60
$50
F30
Pediatrics
MacLean
Minimal Intervention Workshop with Silver Diamine Fluoride
12:30 pm - 3:30 pm
$375
$275 $225
F31
Prosthodontics
Massad
Throw Away the Screws & Traditional Verification Procedures 1:30 pm - 4:00 pm
$75
$60
$50
F32
Communication / Team Mausolf
Delivering W.O.W. Service
8:30 am - 11:00 am
$65
$50
$40
F33
Communication / Team Mausolf
Communication Solutions
1:00 pm - 3:30 pm
$65
$50
$40
F34
Dental Assisting
McDonald
Provisional Restorations for Assistants Workshop
8:00 am - 11:00 am
$175
$175 $175
F35
Endodontics
Evans
Modern Root Canal Therapy
8:00 am - 11:00 am
$75
$60
F36
Endodontics
Evans
Modern Root Canal Therapy Workshop
1:00 pm - 4:00 pm
$375
$375 $375
Huber
$50
$50
F37
Ergonomics
Odiatu
Transform Your Body - Transform Your Practice
8:00 am - 10:30 am
$65
$50
$40
F38
Infection Control
Sanders
Infection Control
8:30 am - 11:00 am
$75
$60
$50
F39
Medical Emergencies
Shufflebarger Making Sense of Cardiac Physiology & Pathology
8:30 am - 11:30 am
$65
$50
$40
F40
Anesthesia
Shufflebarger Local Anesthesia
1:30 pm - 3:30 pm
$65
$50
$40
F41
Human Trafficking
Swarthout
1:30 pm - 4:00 pm
$55
$55
$55
Confronting the Human Trafficking Crisis
28 Texas Dental Journal | Vol 141 | No. 1
PROGRAMS AT A GLANCE
FRIDAY-SATURDAY
CODE
DENTIST FEE
HYG FEE
STAFF FEE
$65
$50
$40
$75
$60
$50
$375
$275 $225
TOPIC
SPEAKER LAST
EVENT
TIME
F42
Medically Complex
Thompson
Building a Team and Practice for Neurodiversity
1:30 pm - 3:30 pm
F43
Restorative
Ward/Ward
Single Implant Restorations
8:00 am - 11:00 am
F44
Restorative
Ward/Ward
Single Implant Restorations Hands-on Workshop
1:00 pm - 4:00 pm
F45
Risk Management
Panel
Risk Mgmtt, Record Keeping, Medicaid and CHIP
1:00 pm - 4:00 pm
$65
$50
$40
F46
Medical Emergencies
Help-a-Heart
American Heart Association BLS Certification
8:30 am - 11:30 am
$90
$90
$90
F47
Technology
Technology Hub
Digital Technology Hands-on Workshop
10:30 am - 12:00 pm
$50
$50
$50
F48
Networking
ACD/ICD/PFA
ACD/ICD /PFA Breakfast
6:45 am - 8:30 am
$50
--
--
TIME
DENTIST FEE
HYG FEE
STAFF FEE
$50
SATURDAY CODE
TOPIC
SPEAKER LAST
EVENT
S01
Occlusion
Bender
Management of TMDs: From Simple to the Complex 8:30 am - 11:30 am
$75
$60
S02
Esthetics
Berlin
Smile Design Principles and the Smile Test Drive Workshop
8:00 am - 11:00 am
$375
$375 $375
S03
Periodontics
Braswell
Cosmetic Periodontal Procedures
8:30 am - 11:00 am
$75
$60
S04
Practice Management
Chandler
Texas' Future Demographics and Economics
8:30 am - 11:00 am
$45
$35
$25
S05
Pharmacology
Donaldson
Appropriate Antibiotic and Analgesic Prescribing
8:00 am - 11:00 am
$65
$50
$40
S06
Practice Management
Gunn
The Mind of an Embezzler: Unrelenting Greed
8:30 am - 11:00 am
$65
$50
$40
S07
Pharmacology
Jeske
The Opioid Epidemic and Dentists
8:00 am - 12:00 pm
$185
$95
$65
S08
Prosthodontics
Massad
Hands-on Mastery of Full Mouth Fixed Hybrid Dentures
8:00 am - 11:00 am
$375
$375 $375
$50
S09
Oral Surgery
Moore
Oral Surgery Pearls for the General Dentist
8:00 am - 11:00 am
$75
$60
$50
S10
Medically Complex Patients
Swarthout
The Origins of Dental Fear
8:30 am - 11:00 am
$65
$50
$40
S11
Medically Complex Patients
Thompson
Treating Patients with IDD and Neurodiversity Desensitization Workshop
8:30 am - 10:30 am
$65
$50
$40
S12
Restorative
Ward
Shade Matching for the Modern Dentist
8:00 am - 11:00 am
$75
$60
$50
Hands-on courses will be identified in the course write-ups with this symbol.
www.tda.org | January/February 2024
29
SPEAKERS BY TOPIC Are you looking to meet your licensing requirements? Then we have you covered! Check out the chart below for all of the CE Topics offered at the 2024 TDA Meeting. The topics are listed in alphabetical order, then scan over to view the day and the speakers last name. Individual course descriptions as well as speaker bios can be found in the Preliminary Program book available online. TOPIC
THURSDAY
FRIDAY
Communication/Team
Mausolf
Mausolf
Cosmetics/Esthetics
To
Berlin
CPR
Help-A-Heart
Help-A-Heart
Dental Assisting
McDonald
McDonald
Endodontics
Hargreaves
Evans
Ergonomics
SATURDAY
Berlin
Eads
Forensics
Cardoza
Cardoza
General Interest
Meiners/Rodriguez
Braswell
Human Trafficking
Swarthout
Hygiene
Sanders Void-Holmes
Infection Control/OSHA
Huber
Lab Technology
Tabakovic
Insurance/Coding/Billing
Duncan
Lasers
Cardoza
Marketing/Social Media
Braswell Sanders
Cardoza Berlin
Medically Complex Patients
CE Express
Thompson
Medical Emergencies
CE Express Shufflebarger
Luce Shufflebarger
Nutrition/Health
Odiatu
Odiatu
Occlusion/TMD
Kwiecien
Bender Kwiecien
Oral Pathology/Oral Med
Huber
Huber
Oral Surgery
CE Express
Orthodontics
Blacher
Pediatrics
MacLean
Thompson Swarthout
Bender
Moore
Periodontics
Kohner
Kohner
Braswell
Pharmacology
Shufflebarger
Donaldson
Donaldson Jeske
Photography
Cone
Practice Management
Collins Duncan Kelley CE Express
Gunn Johnson CE Express
Chandler Gunn
Prosthodontics
Cone Massad
Massad
Restorative
Ward
Ward
Risk Management
Panel of Speakers
Sedation/Anesthesia
CE Express Luce
Sleep Medicine
Elliott
Technology
Sabbah
Treatment Planning
30 Texas Dental Journal | Vol 141 | No. 1
Shufflebarger
Al Matny CE Express CE Express
PAGE TITLE GOVERNMENT The House of Delegates convenes meetings during the Annual Session of the Texas Dental Association. PRELIMINARY* HOUSE OF DELEGATES SCHEDULE:
Thursday, May 16
Friday, May 17
Saturday, May 18
*The start time of any meeting of the House may be changed by the TDA Speaker with House approval, depending on the extent of House business being considered.
8:00 AM – 10:00 AM
1:30 PM – 4:30 PM
8:00 AM – 10:00 AM 10:30 AM – Close of business
The House of Delegates is the legislative and supreme governing body of the TDA. The 2024 House of Delegates is composed of 130 voting members, which includes duly elected and installed delegates from each of the 26 components of the Texas Dental Association and the 15 voting members of the Board of Directors. The Speaker of the House of Delegates is the presiding officer and is without vote. The TDA secretary-treasurer is also a non-voting office of the House of Delegates and serves as the Secretary of the House. Finally, there are four student delegates, each elected and installed by their respective dental school; student delegates have full privilege and access to the floor of the House of Delegates but are without the right to vote and may not introduce resolutions.
HOUSE MATERIALS
REFERENCE COMMITTEES
Delegates and alternates will receive their House book in a searchable PDF format. Reference committee reports will be emailed in PDF format to all participants and these reports can be downloaded from any location with internet access.
Reference committee hearings offer an opportunity for any member to participate in the TDA policy-making process. All members are encouraged to attend the hearings scheduled on Thursday, May 16. All 2023-2024 resolutions will be discussed in up to potentially five Reference Committees before presentation to the 2024 TDA House of Delegates for policymaking decisions. The number of Reference committees is dependent on the volume of House business and is at the discretion of the Speaker.Starting times are tentatively:
For more information, contact TDA Governance Manager Mr. Terry Cornwell at 512-443-3675, or tcornwell@tda.org.
ADA/TDA LEADERSHIP CANDIDATES FORUM Friday, May 17
10:30 am – 12:00 pm
In the event there are no contested TDA statewide elections and no participation by candidates for ADA elected offices, the candidate’s forum will not be held.
CAUCUS MEETINGS Friday, May 17
5:30 pm
Get involved by attending divisional caucus meetings and selecting your representatives on the state and national levels. ADA delegates and alternates from your division and the divisional directors of the TDA Board of Directors are nominated in this forum.
REFERENCE COMMITTEE A: 10:00 AM* Administration, Budget, Building, House of Delegates, Membership Processing REFERENCE COMMITTEE B: 11:30 AM* President’s Address, Miscellaneous Matters, Component Societies, Subsidiaries, Strategic Planning, Annual Session REFERENCE COMMITTEE C: 1:00 PM* Dental Education, Dental Economics, Health and Dental Care Programs REFERENCE COMMITTEE D: 2:00 PM* Legislative, Legal and Governmental Affairs REFERENCE COMMITTEE E: 3:30 PM* Constitution, Bylaws, Ethics & Peer Review
*Reference Committee assignments and starting times are subject to change, please visit www.tdameeting.com for the latest information.
www.tda.org | January/February 2024
31
EXHIBIT HALL Thursday, May 16 - 10:00 am – 6:00 pm Friday, May 17 - 10:00 am – 5:00 pm Visit the TDA Meeting Exhibit Hall to network with your favorite dental reps, discover new products and services for your practice, find career solutions, and have fun! Stop by the 200-aisle featuring our TDA Perks Program partners to learn more about discounts available to you as a TDA member and access resources with compliance and supplies; insurance and dental benefits; marketing; finance; real estate and more!
EXHIBITOR LIST AND FLOOR Visit tdameeting.com for a current list of our 2024 exhibitors and view our interactive floor plan online. Map out the companies you want to visit to maximize your time in the exhibit hall. Search for products and services offered by our exhibitor partners.
DON’T MISS THESE GREAT FEATURES… CE EXPRESS CLASSROOM Attend 1-hour CE courses in the Exhibit Hall. See page 53-54 for the full schedule of speakers and topics.
32 Texas Dental Journal | Vol 141 | No. 1
TDA RELAXATION LOUNGE Relax, play a quick game, or recharge your phone at the TDA Relaxation Lounge.
PAGE TITLE EXHIBIT HALL DON’T MISS THESE GREAT FEATURES… TECHNOLOGY HUB Interested in the latest technology for your practice? Join several companies who will showcase new advances in CBCT, CADCAM, AI, 3D Printing, Lasers, and more! Sponsored by Midwest Dental and their partnership companies.
TDA SPEAKEASY Join us Thursday, May 16 from 4:30 pm – 6:00 pm for for drinks, food and prizes in the Exhibit Hall. Sponsored by TDA Perks.
PUPPY SNUGGLES Did you miss cuddling the cute pups last year? Well, they are back and cuter than ever. Stay tuned for when and where to meet your next fur-ever friend. Sponsored by Cloud Dentistry.
www.tda.org | January/February 2024
33
34 Texas Dental Journal | Vol 141 | No. 1
UT
H E A LT H
SAN
ANTONIO
Oral and Maxillofacial Pathology Laboratory Anne Cale Jones, DDS and Juliana Robledo, DDS » Histochemistry, immunohistochemistry, direct immunofluorescence, and Sjogrën syndrome focus scoring
» Free biopsy bottles, consultation request forms, biohazard bags, and mailing containers » Telephone or email consultation available
» Free local courier or overnight FedEx service » Most cases receive a diagnosis within 24-hours following receipt of specimen CALL OR EMAIL FOR ADDITIONAL INFORMATION 11567387
210-567-6681 or STRLclientservices@uthscsa.edu SCAN QR CODE TO VISIT WEBSITE
LAW OFFICES OF MARK J. HANNA EXPERIENCED LEGAL REPRESENTATION FOR TEXAS DENTISTS •
Representation Before the Texas State Board of Dental Examiners
•
Medicaid Audits and Administrative Hearings
•
Employment Issues—Texas Workforce Commission Hearings
Mark J. Hanna JD Former General Counsel, Texas Dental Association
•
Administrative (SOAH) Hearings and Counsel
•
Professional Recovery Network (PRN) Compliance
•
Employment/Associateship Contract Reviews
•
Practice Acquisition and Sales
•
Business Organizations, PAs, PCs, and PLLCs
•
Civil Litigation
2414 Exposition Blvd., Suite A1 • Austin, Texas 78703 • Phone: 512-477-6200 • Fax: 512-477-1188 • Email: mhanna@markjhanna.com Not Board Certified by the Texas Board of Legal Specialization
www.tda.org | January/February 2024
35
36 Texas Dental Journal | Vol 141 | No. 1
can machines
think? Akshay Thusu, DDS
“Can machines think?” This question was asked by the father of computer science, Alan Turing, in his paper titled Computing Machinery and Intelligence in 1950.1 Soon afterwards (1952), a computer scientist named Arthur Samuel developed an independent learning program for the popular game of checkers. It wasn’t until 1955 that the term “artificial intelligence” was coined by John McCarthy during a workshop at Dartmouth. Since then, AI has been a mission embraced by computer scientists from defense departments to corporations. AI has been incorporated into various parts of our daily life, including dentistry. From CBCT to CAD/CAM to teeth movement algorithms, our profession has made tremendous strides in providing top notch care to our patients using AI. Today, I hope to shed light on one such program that I have had the fortune of using for almost 6 months—Pearl AI. Pearl is a company with many products in multiple aspects of dentistry—clinical, administrative and laboratory. The founders Ophir Tanz, Cambron Carter and Kayle Stanley, DDS, came together in 2015 with a vision of the “next AI revolution: healthcare”.2 This article is geared mainly on their disease detection product—Second Opinion®. However, I will give a brief review of their other product Practice Intelligence®. There are many good dental AI software products on the market that detect conditions such as caries, bone loss and more. However, Pearl Second Opinion® is the “only dental AI company that has FDA clearance for patient-facing detection of numerous dental conditions”.3 It is important to note that the FDA clearance applies only to its use in: 1. permanent teeth; 2. patients age 12 years or older; and 3. bitewing and periapical radiographs. The opinions noted in this article are based on my personal experiences as I discuss the product’s clinical use in detection of common conditions. The software uses radiographs directly from most dental imaging software as its source material. Hence, if source material is flawed, the software will not work at its optimum ability. No radiographic errors such as cone cuts, elongations, missing apices or foreshortening are useful. It is important to remember that the software is only one tool in your entire diagnostic repertoire. Trust your clinical judgement, you are a licensed healthcare professional for a reason. All the images used are of patients I have treated in my office.
www.tda.org | January/February 2024
37
Figure 1. Tooth parts.
Figure 2. Pearl Enchanced View. Original (L), Adjusted (R).
The AI software does a great job of detecting existing restorations which can be used for patient education. How many times have we had a patient in the chair who does not believe they have had any previous dental work on a tooth while you can clearly see a restoration? The software detects bridges, crowns, fillings, implants and root canals allowing us to draw a patient’s attention to existing dental work. My favorite part is its ‘tooth parts’, which highlights tooth anatomy in different colors (Figure 1). The software also allows you to alter the radiographs like any other dental imaging software. One is able rotate images and zoom in and adjust an image’s contrast and brightness. Radiograph inversion is also available. Figure 3. Overhang margin.
38 Texas Dental Journal | Vol 141 | No. 1
My most appreciated feature of image alteration is the Pearl Enhanced View. You can appreciate the differences from original radiography as Enhanced View automatically adjusts image sharpness, contrast, and brightness for optimum diagnostics (Figure 2). One of the detection capabilities need little discussion such as margin detections. It detects open and short margins as well as overhangs with a box around the margin of the appropriate restoration (Figures 3,4). Another detection feature which is very straightforward is made for calculus detection and is also highlighted with a box (Figure 5). To stay within the periodontal realm, it also shows measurements from CEJ to alveolar
Figure 4. Open margin.
bone crest (Figure 6). In addition, it does a good job with periapical pathology detection with the box feature (Figure 7) and, if large enough, highlighting the entire lesion (Figure 8). My favorite detection capability of the software is caries detection for a couple of reasons. First, it uses no box detection. It actually highlights the entire carious lesion so you can see its extent (Figure 9). Why is this important to me? I can highlight and undo it to show patients their cavity in the operatory to better educate them. It distinguishes by shade whether caries has extended into dentin and needs restoration (dark pink on Figure 9) or if enamel only for incipient decay
Figure 5. Calculus detection.
(light pink on Figure 9). If that distinction isn’t enough, the nerd in me loves that one can hover the mouse cursor over the lesion and it shows the percentage of the decay in each layer of tooth (Figure 9). As stated before, the FDA clearance does not include its use for panoramic radiographs. However, it does a pretty good job of detecting impacted teeth (Figure 10). Unfortunately, it seldom highlights fully erupted 3rd molars as impacted (figure), adjacent teeth as impacted teeth, or an inclined molar that is fully erupted. This is why they have disclosure of no FDA clearance for Panoramic radiographs. Figure 6. Measurement CEJ-Alveolar bone.
www.tda.org | January/February 2024
39
Figure 7. Periapical pathology.
Figure 8. Caries detection.
40 Texas Dental Journal | Vol 141 | No. 1
Figure 9. Caries percent detections.
The Practice Intelligence® product is
standardize clinicians. I can see this
their website and learn more in-depth
similar to many practice management
helping in a multi practitioner offices,
abilities of these products. The ROI of
software systems on the market. It
practices with multiple doctors across
time and money for these products are
helps you with morning huddle, call
multiple locations and small and large
such that I believe you cannot afford to
sheets for patients (overdue hygiene,
dental service organizations.
ignore them.
unscheduled treatments etc.), opportunities for treatment and much more.
I believe the next step for AI detection software is the ability to detect teeth
Special thanks to my employer Dr Tony Thomas for investing in these products and a practice that has been truly revolutionary. Also thanks to Dr
numbers off the radiographs. Once AI
Chad Allen for sharing his research on dental AI
The Second Opinion® software is
is able to do that, it will be coupled with
technologies.
amazing and every day its AI advantages
disease/condition detection and lead
Disclosure: I have no conflicts of interest nor
are only getting better. I have seen the
to an exponential increase in usage by
financial disclosures. Our office is a paid user of
increase in accuracy of these detections
insurances to verify and/or deny claims
since we started using this system in
for dental treatments. The AI software
our practice. The obvious advantage of
is only going to better, and I have
of any organization.
this product is the increased accuracy
witnessed this first-hand since I started
in diagnosing. However, the other not
using it.
References
so obvious benefit is using the software in patient education which has led to higher treatment acceptance rates. Working in a group practice, another great advantage is that it has helped
the products mentioned. This is a non-scientific article. The opinions in this article are that of my own and do not reflect that of my employer or that
1.
Yes, it is an added cost to your bottom
2.
line, but I believe it pays for itself
3.
and then some more when used
A. M. Turing (1950) Computing Machinery and Intelligence. Mind 49: 433-460. Website https://www.hellopearl.com/ about. Accessed January 9, 2024. Website https://www.hellopearl.com/. Access January 9, 2024.
appropriately. Request a demo from
Figure 10. Impacted teeth. Good (L), Fully erupted (R).
www.tda.org | January/February 2024
41
Chat GPT Has Entered the Chat Linda Brady, TDA Executive Director
Truth is stranger than fiction these days. Rather, fiction has met reality. What we once thought a radical techno marvel in the future is here and now with Chat GPT and artificial intelligence (AI). It’s 2024, and at this point in the space-time continuum, we’re used to Zoom meetings, though we might wish they’d disappear into the work black hole. We’re accustomed to sending emails and Teams messages day in and day out, somehow our words and thoughts instantaneously fly through cyber space to arrive at someone’s desktop, laptop, or phone hundreds of miles away. We don’t think much of it, though, still amazing all the same. A text? A gif? Now, ubiquitous. NBD! And, now, what was once revolutionary to the modern workplace pales in comparison to what’s on the horizon. Chat GPT and AI tools can boost productivity and efficiency in your dental office. Even if you’re wary of letting a robot of sorts take the wheel and drive your business hands free, hear me out. Intrigued by the potential of Chat GPT and AI, I recently begun exploring and testing these options at TDA. Content writing and editing emerged as an obvious starting point, considering our roles. Chat GPT can generate initial drafts or refine grammar, conciseness, and coherence, depending on the topic. It has also proven effective in crafting captivating marketing subject lines, social media posts, and calls to action. This is merely the beginning of AI’s transformative impact on our workplaces. How might you leverage it within your dental practice?
42 Texas Dental Journal | Vol 141 | No. 1
To answer this question, I turned to an expert. Not a human
updates, newsletters, and other materials that
expert, but Chat GPT. I composed a prompt that said, “Write a
educate and engage patients. Dentists can leverage
250-word article explaining how dentists can use Chat GPT to
this content to position themselves as authorities in
market their dental practice.” Chat GPT provided the following
their field, attracting and retaining patients through
verbatim response:
valuable information.
Harnessing Chat GPT to Transform Dental Practice Marketing
5.
Dentists can use Chat GPT to analyze patient data and preferences, enabling targeted advertising
In the ever-evolving landscape of dental practice
campaigns. The model can help identify
marketing, innovative tools are essential for dentists to
demographics, interests, and behavior patterns,
stand out and attract new patients. One such tool is Chat
allowing dentists to tailor their marketing messages
GPT, an advanced language model that offers a range
and strategies accordingly. This targeted approach
of possibilities to revolutionize marketing strategies. This
maximizes the effectiveness of advertising efforts and
article explores how dentists can leverage Chat GPT to
ensures optimal return on investment.
effectively market their dental practices and drive growth. 1.
Enhanced Patient Engagement:
6.
platforms to automate responses, engage with
patients in a personalized and interactive manner.
followers, and manage online interactions. The
By integrating the model into their website or
model can reply to comments, answer frequently
messaging platforms, dentists can provide instant
asked questions, and offer general dental advice.
responses to patient inquiries. This fosters a positive
This automation saves time and resources while
experience, showcasing the practice’s commitment
maintaining a consistent online presence that
to patient care and increasing the likelihood of
resonates with potential patients.
converting leads into new patients. 24/7 Availability and Immediate Responses: With Chat GPT, dentists can offer round-the-clock availability to potential patients. The model can provide instant responses to inquiries about services, treatments, insurance, and more, even outside of office hours. This ensures that prospective patients receive timely information, allowing them to make informed decisions and potentially choose the dentist’s practice over competitors. 3.
Personalized Treatment Recommendations: Chat GPT can be trained with specific dental knowledge, allowing dentists to offer personalized treatment recommendations. By considering a patient’s symptoms and dental history, the model can suggest appropriate treatments or procedures. This not only demonstrates the dentist’s expertise but also creates a tailored approach that resonates with potential patients, increasing the chances of conversion.
4.
Content Creation and Distribution:
Social Media Management and Automation: Chat GPT can be integrated with social media
Chat GPT enables dentists to engage with potential
2.
Targeted Advertising Campaigns:
7.
Reputation Management and Reviews: Chat GPT can monitor and analyze online reviews and feedback about the dental practice. By promptly addressing concerns or negative reviews, dentists can mitigate any potential damage to their reputation. Additionally, the model can identify positive feedback, which can be leveraged to enhance the practice’s reputation and attract more patients.
Incorporating Chat GPT into dental practice marketing strategies provides dentists with a powerful tool to engage with patients, offer personalized recommendations, automate processes, create targeted campaigns, and manage their online reputation. Leveraging this technology empowers dentists to thrive in the competitive dental landscape and achieve sustainable growth. It clearly missed the mark on only producing 250 words (it’s 513 words!) but what do you think about Chat GPT’s response? I’m curious to hear how dentists are using AI tools in their practices. You can write to me at lbrady@tda.org to share your examples and experiences. I would love to do a follow-up
Chat GPT can assist dentists in creating engaging
column to share the information with our members!
and informative content for marketing purposes.
Portions of this article were originally printed in the July 2023 TDA Today.
The model can generate blog posts, social media
www.tda.org | January/February 2024
43
ORAL
and maxillofacial pathology case of the month
CLINICAL HISTORY A 58-year-old female was seen by an oral and maxillofacial surgeon with a chief complaint of “I need this evaluated.” The patient presented with a well-defined, partially corticated, multilocular expansile radiolucency in the anterior mandible between #22 and #23. The lesion had been present for an unknown duration of time and the patient exhibited no symptoms. There was no sign of damage to the adjacent teeth other than mild displacement of the roots without resorption. The clinical impression by the oral and maxillofacial surgeon was either an odontogenic myxoma or an ameloblastoma and the patient was scheduled for surgical excision of the radiolucency.
AUTHORS Kian Valizadeh, BS Fourth-year dental student, School of Dentistry, UT Health San Antonio, San Antonio, Texas
Anne Cale Jones, DDS Distinguished Teaching Professor, Department of Pathology and Laboratory Medicine, UT Health San Antonio, San Antonio, Texas
Jesus A. Gomez, DDS Oral and Maxillofacial Surgeon, private practice, Oral and Maxillofacial Surgery, Corpus Christi, Texas
Juliana Robledo, DDS Assistant Professor, Clinical Department of Pathology and Laboratory Medicine, UT Health San Antonio, San Antonio, Texas
Figure 1. Panoramic radiograph—1.06 x 1.17 x 1.8 cm radiolucent lesion located apical and interproximal to #22 and #23. The root of #23 displaced mesially.
44 Texas Dental Journal | Vol 141 | No. 1
The patient’s pertinent medical history included osteoporosis, temporomandibular joint disease, and acute rhinosinusitis due to seasonal allergies. The patient’s social, surgical, and familial history were unremarkable. Current medications included multivitamins, calcium, and vitamin D3. A panoramic radiograph revealed a 1.06 x 1.17 x 1.8 cm radiolucent lesion located apical and interproximal to #22 and #23. The root of #23 was displaced mesially (Figure 1). Upon surgical excision, the size of the specimen was reassessed as 1 cm with a white coloration. The tissue was Figure 2. Odontogenic tumor composed of haphazardly arranged spindle shaped cells in an abundant, loose myxoid stroma (H&E: original magnification 4X).
submitted for histopathologic evaluation.
PATHOLOGICAL FINDINGS The specimen was received in a container of formalin and contained 3 tan-brown gelatinous pieces of soft tissue measuring 2.2 x 1.5 x 0.5 cm. The specimen was submitted in a single cassette. Histopathologic examination revealed sections of a mesenchymal specimen composed of haphazardly arranged spindled and stellate shaped cells in an abundant, loose myxoid stroma (Figures 2 and 3).
What is the most likely diagnosis? Figure 3. Haphazardly arranged spindle shaped cells in an abundant, loose myxoid stroma (H&E: original magnification 20X).
See page 46 for the answer and discussion.
www.tda.org | January/February 2024
45
ORAL
and maxillofacial pathology
the cyst wall, complete surgical removal is often difficult.1 Literature has stated that Carnoy’s solution (CS) has been used as a chemical adjunct to reduce the recurrence of an OKC; however, because of the potential carcinogenic properties of CS, the FDA has banned the use of CS.
diagnosis and management—from page 45
This has led to use of a modified Carnoy’s
DIAGNOSIS: ODONTOGENIC MYXOMA
Evidence suggests that the topical use
DISCUSSION Based on the clinical and radiographic findings, the differential diagnosis for this specific case included: lateral periodontal cyst (LPC), odontogenic keratocyst (OKC), and ameloblastoma. A lateral periodontal cyst (LPC) is a rare developmental odontogenic cyst that usually forms adjacent to the lateral root surface of a tooth. It is thought to emerge from remnants of the dental lamina and represents the intra-bony equivalent of the gingival cyst of the adult (GCA). This specific cyst makes up less than 2% of all cysts found within the jaw. In most instances, a LPC presents as an asymptomatic lesion that is found on radiographic examination.3 Radiographically, most lesions present as a well-defined, circumscribed, round or ovoid radiolucency, usually with a sclerotic margin.2 A LPC most often occurs in individuals in the fifth through the seventh decades of life with 75%-80% of the cases occurring in the mandibular premolarcanine-lateral incisor region.1 A botryoid odontogenic cyst (BOC) is a variant of LPC; while it presents with a multilocular radiographic appearance, it can also be seen
solution (MCS) and 5-Fluorouracil (5-FU). of 5-FU reduces the risk of recurrence of an OKC in compared to MCS or surgical therapy alone.6,7 Ameloblastoma is an odontogenic tumor that comprises 10% of all benign tumors that occur in the mandible and the maxilla. Even though an ameloblastoma is benign and typically grows slowly, they have a high recurrence rate and may be locally aggressive. This tumor was first recognized in 1827 by Cusack.12 Three clinical and radiographic presentations exist: unicystic, multicystic (conventional solid) and peripheral (extraosseous) with the multicystic variant being the most common form of ameloblastoma.1,8
with a unilocular pattern. LPC and BOC are best treated with complete surgical
Most patients with a unicystic
enucleation with preservation of the involved teeth.1,3 The GCA, LPC, and BOC share
ameloblastoma are diagnosed in the
similar histopathologic findings and are lined by flattened squamous epithelium with
second decade of life, with the most
focal plaque-like thickenings. The epithelial cells in the plaque-like thickenings often
common location being the posterior
exhibits a clear cytoplasm due to the presence of glycogen.
mandible. The lesions are typically
An odontogenic keratocyst (OKC) is also an uncommon developmental odontogenic cyst that arises from the cells of the dental lamina; an alternative theory is that hamartomatous islands of basilar epithelium play a role in the development of an OKC but the pathogenesis is not fully understood.4 OKCs must often present as a solitary lesion while multiple lesions are associated with the nevoid basal cell carcinoma syndrome (Gorlin syndrome). OKCs make up 3-11% of all odontogenic cysts and have a greater potential for growth and recurrence compared to other similar cysts.1 These cysts tend to grow in the anterior-posterior direction in the path of least resistance by hollowing out the mandible, thus replacing the bone marrow, instead of periosteal bone formation, which would result in bone expansion.5 Radiographically, OKCs display a well-defined radiolucent area with smooth and frequently corticated margins. In the posterior mandible, specifically near the ramus and the body, these lesions tend to be multilocular. In cases associated with an unerupted tooth, radiographic features similar to a dentigerous cyst may be seen; however, root resorption tends to be less common with an OKC. Due to the ability of an OKC to radiographically mimic other odontogenic cysts or tumors, the diagnosis requires histopathological confirmation.1 An OKC is lined by a uniform layer of stratified squamous epithelium that is a few cell layers thick. The luminal surface of
asymptomatic and may cause a painless swelling of the jaw. This variant of ameloblastoma is diagnosed based on radiographic features and histopathologic findings. Histopathology reveals a cystic structure lined by ameloblastic epithelium. The basal cells are prominent and exhibit subnuclear vacuolization and reverse polarization. The luminal epithelium is more loosely arranged and resembles stellate reticulum. Occasional islands of ameloblastic epithelium may be seen in the adjacent connective tissue wall. Treatment for unicystic ameloblastoma is enucleation and curettage. Patients should receive long-term follow-up examinations due to the high recurrence rate of these lesions.1
the cystic structure contains parakeratin while the basal cell layer is prominent. No
Multicystic (conventional solid)
rete peg formation is seen. Treatment for an OKC is similar to other odontogenic
ameloblastoma is the predominant variant
cysts with complete enucleation and curettage. Due to the thin and fragile nature of
of ameloblastoma accounting for 75% to
46 Texas Dental Journal | Vol 141 | No. 1
86% of all cases. This tumor occurs over
unilocular or multilocular radiolucency
60 months.9 Occasional examples
a wide age range but it is rare to arise in
that may displace or cause resorption
have been described of odontogenic
children younger than 10 years of age.
of the teeth adjacent to the tumor.
myxomas exhibiting cellular atypia,
Resembling its unicystic counterpart, it
The margins of the radiolucency
and these neoplasms are known as
is typically painless and asymptomatic
are typically irregular or scalloped.
myxosarcomas. These atypical and
with the ramus of the mandible being
Larger lesions exhibit a “soap bubble”
rare neoplasms tend to exhibit a more
the most common location. If this
appearance radiographically and are
aggressive local course compared to the
neoplasm is untreated, it will slowly
indistinguishable from the radiographic
usual odontogenic myxoma.1
grow and cause a painless expansion
appearance of an ameloblastoma.1,9,10
of the buccal and lingual cortical plates. The most 2 common histopathologic patterns are follicular and plexiform. It is composed of similar ameloblastic epithelium as described with the unicystic ameloblastoma. Radiographically, it appears as a multilocular radiolucency with a “soap bubble” or “honeycombed” pattern. Typically, these lesions are treated with marginal resection but some oral and maxillofacial surgeons prefer a
Grossly, an OM shows a white/gray gelatinous loose tissue. Histopathologic examination reveals haphazardly arranged spindled-shaped, stellate, and/ or round cells set in an abundant, loose myxoid stroma that contains a minimal amount of collagen. Some tumors
Our patient was treated with wide local excision and removal of the surgical specimen in one piece through a supraperiosteal dissection. Followup one month after surgical excision revealed an uneventful healing process and no radiographic evidence of recurrence or persistent disease.
have a greater amount of collagen and are referred to as a fibromyxoma or a myxofibroma.1,11 The ground
Follow-up examinations at 3 months and 6 months post-surgical excision also showed no radiographic evidence
substance seen in an OM is composed
of recurrent or persistent disease. A
of glycosaminoglycans, hyaluronic acid,
9-month follow-up is scheduled unless
and chondroitin sulfate. Rarely, small
the patient reports any changes in the
islands of inactive odontogenic epithelial
present condition or any associated
A peripheral ameloblastoma is uncommon
rests are present within the myxoid
symptoms. The patient will continue
with most cases resembling a smooth
ground substance, but these islands are
to be followed every subsequent 6
surface mass similar to a fibroma or a
not needed for establishing a definitive
months for the following 2 years in order
pyogenic granuloma. Like the other two
diagnosis.1,10,11 An OM may sometimes be
to monitor bone regeneration of the
types of ameloblastoma, the peripheral
confused with other myxoid neoplasms
variant is typically painless and occurs
of the jaw due to similar microscopic
surgical defect.
with an average age of 52. These are
features, such as a chondromyxoid
typically seen in the posterior gingival
fibroma or a myxoid neurofibroma. A
and alveolar mucosa. Histopathology
chondromyxoid fibroma has areas with
reveals islands and cords of ameloblastic
cartilaginous differentiation while a
epithelium infiltrating the connective
myxoid neurofibroma exhibits fascicles
tissue underneath the overlying stratified
that are S-100 positive.1,11
squamous epithelium. Often the
Our case was rather unusual in that it
more conservative approach of removing the tumor followed by a peripheral ostectomy.1
ameloblastic epithelium fuses with the overlying mucosa. Treatment involves complete surgical excision and most patients respond well to the therapy. A 1015% recurrence rate is still common.1
2.
3.
5.
was radiographically more consistent 6.
with a cystic process. Treatment options for an OM include enucleation and curettage, wide excision, and/ or resection, depending on the size
revealed the definitive diagnosis to be
of the lesion. More radical surgery
an odontogenic myxoma (OM). An OM
may be required due to the fact
is a benign odontogenic tumor of the
that an odontogenic myxoma is not
jaws, derived from ectomesenchyme.
encapsulated and it may be hard to
This tumor can occur in both females
distinguish the exact margins of the
and males equally, and most often in the
lesion. A recurrence rate of 25% has
second and third decade of life.
been reported. With close follow-up
OM
1.
4.
presented in the anterior mandible and
The histopathologic examination
1,9
REFERENCES
7.
8.
9.
10.
was first described in 1947 by Thomas E.
examinations, especially over the first
Goldman.10 The OM is more commonly
2 years, the recurrence rate drops
seen in the mandible compared to the
from 24% to 8.3% for patients who
maxilla with a radiographic appearance of
were closely monitored for more than
11.
Neville B, Damm D, Allen C, Chi A, Oral and Maxillofacial Pathology.5th edition. 2024 Elsevier Inc. St. Louis, MS. Mendes, Rui Amaral, and Isaac van der Waal. “An unusual clinicoradiographic presentation of a lateral periodontal cyst-report of two cases.” Medicina oral, patologia oral y cirugia bucal vol. 11,2 E185-7. 1 Mar. 2006 de Andrade, Márcia et al. “Lateral periodontal cyst: report of case and review of the literature.” Oral and maxillofacial surgery vol. 16,1 (2012): 83-7. doi:10.1007/s10006-010-0257-2 Stoelinga, P J W. “The odontogenic keratocyst revisited.” International journal of oral and maxillofacial surgery vol. 51,11 (2022): 1420-1423. doi:10.1016/j.ijom.2022.02.005 Stoelinga, P J. “Long-term follow-up on keratocysts treated according to a defined protocol.” International journal of oral and maxillofacial surgery vol. 30,1 (2001): 14-25. doi:10.1054/ ijom.2000.0027 Caminiti, Marco F et al. “5-Fluorouracil Is Associated with a Decreased Recurrence Risk in Odontogenic Keratocyst Management: A Retrospective Cohort Study.” Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons vol. 79,4 (2021): 814-821. doi:10.1016/j.joms.2020.07.215 Singh, Ashutosh Kumar et al. “How effective is 5-Fluorouracil as an adjuvant in the management of odontogenic keratocyst? A systematic review and meta-analysis.” The British journal of oral & maxillofacial surgery vol. 60,6 (2022): 746-754. doi:10.1016/j. bjoms.2022.02.001 Ghai S. Ameloblastoma: An Updated Narrative Review of an Enigmatic Tumor. Cureus. 2022 Aug 6;14(8):e27734. doi: 10.7759/cureus.27734. PMID: 36127985; PMCID: PMC9481193. Martins HD, Vieira EL, Gondim AL, Osório-Júnior HA, da Silva JS, da Silveira ÉJ. Odontogenic Myxoma: Follow-Up of 13 cases after conservative surgical treatment and review of the literature. J Clin Exp Dent. 2021 Jul 1;13(7):e637-e641. doi: 10.4317/ jced.58080. PMID: 34306525; PMCID: PMC8291164. THOMA, K H, and H M GOLDMAN. “Central myxoma of the jaw.” Oral surgery, oral medicine, and oral pathology vol. 33,7 (1947): B532-40. doi:10.1016/0096-6347(47)90315-3 Banasser AM, Bawazir MM, Islam MN, Bhattacharyya I, Cohen DM, Fitzpatrick SG. Odontogenic Myxoma: A 23-Year Retrospective Series of 38 Cases. Head Neck Pathol. 2020 Dec;14(4):1021-1027. doi: 10.1007/s12105-020-01191-7. Epub 2020 Jun 6. PMID: 32506377; PMCID: PMC7669973.
www.tda.org | January/February 2024
47
value
for your profession Provided by:
PERKS
P R OG R A M
Swallowed and Aspirated Objects: A Growing Area of Concern in Dentistry
48 Texas Dental Journal | Vol 141 | No. 1
Underlying facts
After uneventfully inserting the first
Dr D was a well-experienced general
process of bringing the second fixture
dentist who practiced in a small rural
to the #30 site, when T unexpectedly
town, in which she was the only dentist.
cleared his throat, causing him to move.
As a result of the lack of any dental
Dr D lost control of the implant fixture,
specialists located less than nearly an
leading immediately to T coughing
hour away, and having kept up-to-date
profusely for nearly a minute, with both
with the current state of dentistry, she
Dr D and her assistant losing sight of
was familiar with practicing the full
the fixture. Once T “calmed down” and
scope of dentistry, including implant
said that he was “alright to continue”,
placement and restoration.
Dr D did just that, spending the next
fixture at the #31 site, Dr D was in the
90 minutes placing the remaining 3 T was a longstanding patient in Dr
implants and suturing the gingival
D’s office; a middle-aged man whose
tissues. At the completion of the day’s dental
with oral medications, he had worn a
treatment, T said that he felt a nearly
removable partial denture for many
constant urge to cough, so Dr D
years, to serve as a replacement for lost
suggested that he go to a local hospital
lower molars bilaterally. He and his wife
emergency room for evaluation, and
recently became empty-nesters, so T
T did exactly that. At the ER, a chest
felt that he was in a financial position
X-ray was taken, which clearly showed
to be able to have implants placed
a dental implant in the patient’s right
and restored, and finally be able to
lung. Shortly thereafter, T was taken
throw away his removable appliance.
to the operating room where, under
After clinical and radiographic exams,
general anesthesia, a bronchoscopy
Dr D proposed placing implants at
was performed which led to successful
the sites that teeth # 18, 19, 30 and
removal of the implant. T remained
31 had previously occupied, with the
in the hospital for 2 days, receiving IV
subsequent placement of individual
antibiotics and respiratory therapy;
crowns after osseointegration. T agreed
after discharge, T was followed by a
to the plan.
pulmonologist for what T described as
was provided, but T claims that the
local anesthesia, T sat in the dental
symptoms never fully abated.
showed a dental implant in the patient’s right lung. Shortly
the operating room where, under general anesthesia, a bronchoscopy was performed which led to successful removal of the
chest discomfort and periodic coughing. which would be accomplished with
which clearly
was taken to
mild hypertension, both controlled well
No further respiratory treatment
X-ray was taken,
thereafter, T
medical history included diabetes and
On the day of implant placement,
At the ER, a chest
implant.
chair and was placed in a nearly supine position. That day, Dr D was assisted by a per diem dental assistant because her usual assistant was in the midst of serving jury duty. Dr D methodically made osteotomy sites to accommodate implant fixtures in all 4 of the planned locations.
www.tda.org | January/February 2024
49
Legal steps taken T initially contacted Dr D’s office, asking for reimbursement of the hospital expenses because that hospital was outside of his insurance network. Dr D responded to T that she did not see why she should have to pay him for an event that occurred because T
The dental expert told the attorney
had suddenly moved.
that there was
Upset at Dr D’s response, T contacted a local attorney who obtained all of T’s dental
“no justifiable
and medical records and the opinions of dental and pulmonology experts. The dental expert told the attorney that there was “no justifiable excuse” for not adequately protecting against the aspiration event—by setting up an oropharyngeal drape to prevent passage into the trachea and beyond, by having attentive dentist and assistant vigilance and suctioning, and by assisting a more gravitationally favorable path for the implant to take with the patient in a sitting rather than supine position; the pulmonology expert, who happened to be T’s treating physician, concluded that the aspiration event created all of T’s respiratory problems to date, and expected that his respiratory function would never return to normal and subjected him to a greater risk of respiratory infections going forward. On behalf of T, his attorney filed a lawsuit against Dr D. Upon being served with papers, Dr D contacted her malpractice carrier, which assigned defense counsel. After meeting with Dr D and hearing her views, her attorneys obtained their own opinions from experts in the same fields of practice. Multiple potential defense expert dentists concluded, as did T’s dental expert, that Dr D’s actions could not be successfully defended; similarly, a potential defense pulmonologist agreed with T’s treating physician’s opinions, but was not as convinced that T was at greater subsequent infection risk. After several discussions between Dr D and her defense counsel, during which the opinions of all consulted doctors were considered, Dr D decided that it would be in her best interests to ask her carrier to make an offer of settlement, once his attorneys communicated a demand. In the end, all parties agreed that T would settle the case if paid a sum of money that would cover his hospital expenses and a small amount for his post-dental-treatment experience and potential future problems. The portion of the money that T ultimately received, after attorney and expert fees, and initial litigation costs, was actually less than the sum he requested directly from Dr D over a year prior.
Takeaways This case raises a number of issues, the first of which is the continually growing number of swallowing/aspiration events during dental treatment. The opinions provided by the various experts in this case exemplify what is being seen in many swallow/aspiration situations, namely that it is very difficult, if possible at all, to defend these types of events. (It is not hard to imagine the impact upon a jury when its members would be shown that chest x-ray with the implant being where it never should be.) While T’s sudden movement—at a most inopportune time—could not specifically have been foreseen, the loss of grip of an implant fixture, or endodontic
50 Texas Dental Journal | Vol 141 | No. 1
excuse” for not adequately protecting against the aspiration event
file or actually any small object dentists
viewpoint with which she disagreed,
For more
routinely use in patients’ mouths, is
she would still have availed herself of
information
readily foreseeable, such that prevailing
the knowledge of those who work with
regarding
expert thought is that dentists ought to
those very issues every day. There is
MedPro Group—
have protective barriers and procedures
no way to know whether an immediate
the strongest
in place to stop the object from traveling
call to the carrier would have changed
malpractice
and to be able to immediately retrieve
anything, but it is always a good idea—
insurance
them safely.
and sometimes even required by policy
protection available to Texas
language—to inform the carrier when
dentists—please visit https://www.
It is worth pointing out that, once an
potentially serious problems arise.
tdamemberinsure.com (Business:
object dropped in the mouth is lost from
Carrier staff are there to assist dentists
Professional Liability) or call (800) 677-
sight, there is no way to know, without
through waters that are, for them,
8644.
medical radiographic studies, whether
uncharted. Note that this case presentation includes
that object was swallowed, aspirated,
circumstances from several different closed
suctioned or dislodged safely out of the
Finally, we address the “sticky” issue
mouth. The longer an aspirated object
of working with assistants or other
remains in the respiratory tree, the
office staff personnel who are not
facts and personal characteristics were modified
more likely it is to serve as a nidus for
familiar with the way a dentist practices,
to protect identities. The content within is not
infection. And the longer a swallowed
clinically and/or administratively.
object remains, the more likely it is to
It is a fact of practice life that
travel beyond the stomach and into the
treatment cannot come to a halt if
intestines, potentially piercing through
one key employee is out for a day or a
that wall; while medical professionals
prolonged period. But the dentist needs
may determine that, in some situations
to realize the implications of an often
differ, please contact your attorney or other
regarding swallowed objects, the
last-minute change, and raise the level
professional advisors if you have any questions
preferred approach is to watch and
of vigilance and oversight. In a litigation
wait for the object to pass in feces, such
setting, where the dentist will be viewed
decisions should be left entirely to those
as the “supervisor” of anyone working
Group is the marketing name used to refer
physicians rather than become the
with that dentist, the dentist will most
to the insurance operations of The Medical
sole available course due to delays in
likely be treated as the responsible
dentists’ referrals. Here, Dr D completed
party, even if the employee’s actions
what was essentially an elective set
occur outside of the dentist’s immediate
of procedures, which took 90 more
space, and even if the employee’s
minutes, thereby delaying needed
actions are not what the dentist
medical care: that period of time did not
would have sanctioned if aware of the
or regulatory approval and/or may differ among
complicate the recovery of the aspirated
circumstances beforehand.
companies. © MedPro Group Inc. All rights
risk management principles, and that identifying
the original work of MedPro Group but has been published with consent of the author. This document should not be construed as medical or legal advice and should not be construed as rules or establishing a standard of care. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may
related to your legal or medical obligations or rights, state or federal laws, contract interpretation, or other legal questions. MedPro
Protective Company, Princeton Insurance Company, PLICO, Inc. and MedPro RRG Risk Retention Group. All insurance products are underwritten and administered by these and other Berkshire Hathaway affiliates, including National Fire & Marine Insurance Company. Product availability is based upon business and/
reserved. 11/2023
implant, but it might have done so had the implant instead been swallowed.
cases, in order to demonstrate certain legal and
As the nation’s leading dental malpractice insurance carrier, MedPro Group has
When T initially approached Dr D,
unparalleled success in defending
seeking that his expenses be covered,
malpractice claims and providing patient
Dr D decided to act on her own, without
safety & risk solutions. MedPro is the
consulting with her malpractice carrier.
nation’s highest-rated malpractice carrier,
Dentists do not have expertise in
rated A++ by A.M. Best. The Berkshire
managing the business—and potentially
Hathaway business has been defending
litigation—effects of many untoward
dentists’ assets and reputations since
events, but malpractice carrier staff
1899 and will continue to for years to
members do. Even if Dr D would
come.
have heard from that consultation a
www.tda.org | January/February 2024
51
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PRACTICE OPPORTUNITIES ALL TEXAS LISTINGS FOR MCLERRAN &
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52 Texas Dental Journal | Vol 141 | No. 1
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reputation in north San Antonio. The practice
Houston. The 2,500+ sq ft office features 7 ops,
serves a large, majority fee-for-service patient
computers throughout, digital pano, digital
base with over 1,900 active patients and sees
X-rays, digital scanner, intraoral cameras,
approximately 20 new patients per month. The
and paperless charts. If you’re looking for a
fully digital office has 5 equipped operatories
centrally located, profitable practice with a
with computers in all ops, digital radiography,
dedicated patient base and room to grow, call
intra oral cameras, paperless charts, and a
us now for more details. NORTHEAST TEXAS
digital pano. TEXAS HILL COUNTRY, ORTHO
www.tda.org | January/February 2024
53
classifieds (ID #616): Rare opportunity to purchase an
area. Majority of patients are 30 to 65 years
orthodontic practice located in a serene,
old. Practice has operated at this location for
rapidly growing community in the Texas hill
over 38 years. Practice sees patients about 16
country (Austin, San Antonio, and the Texas
days a month. Collection ratio of 100%. The
wine country all available within a short
practice is a fee-for-service practice. Building
drive). State-of-the-art facility with extensive,
is owned by dentist and is available for sale.
modern upgrades and top-of-the-line digital
Contact Christopher Dunn at 800-930-8017
technology. The buyer will have the option
or christopher@ddrdental.com. HOUSTON
of purchasing or leasing the real estate. The
(SHARPSTOWN AREA): GENERAL (REFERENCE
current owner will be retiring but is available
“SHARPSTOWN GENERAL”) MOTIVATED SELLER.
to provide a transition period to the incoming
Well-established general dentist with high-
buyer. TO REQUEST MORE INFORMATION
6 figure gross production. Comprehensive
ON MCLERRAN & ASSOCIATES’ LISTINGS:
general dentistry in the southwest Houston
Please register at www.dentaltransitions.
area focused on children (Medicaid). Very, very
com or contact us at 512-900-7989 or info@
high profitability. 1,300 sq ft, 4 operatories
dentaltransitions.com.
in single building. 95% collection ratio. Over 1,200 active patients. 20% Medicaid, 45%
BEAUMONT: GENERAL (REFERENCE
PPO, and 35% fee-for-service. 30% of patients
“BEAUMONT”). Small town practice near a
younger than 30. Office open 6 days a week and
main thoroughfare. 80 miles east of Houston.
accepts Medicaid. Contact Christopher Dunn
Collections in 7 figures. Country living, close
at 800-930-8017 or christopher@ddrdental.
enough to Houston for small commute.
com. HOUSTON (BAYTOWN AREA): GENERAL
Practice in a stand-alone building built in
(REFERENCE “BAYTOWN GENERAL”) MOTIVATED
1970. The office is 1,675 sq ft with 4 total
SELLER. Well-established general practice with
operatories, 2 operatories for hygiene and 2
mid-6 figure gross production. Comprehensive
operatories for dentistry. Contains reception
general dentistry in Baytown on the east side of
area, dentist office, sterilization area, lab
Houston. Great opportunity for growth! 1,400
54 Texas Dental Journal | Vol 141 | No. 1
sq ft, 4 operatories in single story building.
neighborhoods. Located within a beautiful
100% collection ratio. 100% fee-for-service.
single-story, free-standing building, built in 1996
Practice focuses on restorative, cosmetic and
and is ALSO available for purchase. Natural light
implant dental procedures. Office open 3.5 days
from large windows within 2,300 sq ft with 4
a week. Practice area is owned by dentist and
operatories (2 hygiene and 2 dental). Includes
is available for sale. Contact Christopher Dunn
a reception area, dentist office, a sterilization
at 800-930-8017 or christopher@ddrdental.
area, lab area, and break room. All operatories
com. WEST OF AUSTIN: ORTHODONTIC
fully equipped. Does not have a pano but
(REFERENCE “HILL COUNTRY ORTHO”) Located
does have digital X-ray. Production is 50% FFS
in a rapidly growing small town, this practice
and 50% PPO (no Medicaid), with collection
is in the heart of the Texas Hill Country. This practice serves the youth of the area. There are 4 operatories in the practice. The practice is 100% fee-for-service. Orthodontic care is the only service provided at this office. 1,300 sq ft Open 4 days per week. Digital X-rays and pano and Cloud9Ortho software. The practice has excellent visibility and is located near a hospital.
McLerran & Associates is the largest dental practice brokerage firm in Texas. When it’s time to buy or sell a practice, we’ve got you covered.
Contact Christopher Dunn at 800-930-8017 or christopher@ddrdental.com. HOUSTON, COLLEGE STATION, AND LUFKIN
DS O
P RAC T I C E S AL E S C S
Austin
512-900-7989
DFW
214-960-4451
other DDR Dental listings and visit www.
Houston
281-362-1707
DDRDental.com for full details. LUFKIN:
San Antonio 210-737-0100
(DDR DENTAL Listings). (See also AUSTIN for
General practice on a high visibility outer loop highway near mall, hospital and mature
P RAC T I C E AP P RA ISA LS
South Texas 361-221-1990 E m ai l : t ex as@ den t al t r an si t i o n s.co m www.dentaltransitions.com
www.tda.org | January/February 2024
55
classifieds ratio above 95%. Providing general dental and
plumbed for 5 operatories. Digital pano and
cosmetic procedures, producing mid-6 figure
digital X-ray. Contact Christopher Dunn at
gross collections. Contact Christopher Dunn
800-930-8017 or christopher@ddrdental.com
at 800-930-8017 or Christopher@DDRDental.
and reference “Pearland General or TX#538”.
com and reference “Lufkin General or TX#540”.
HOUSTON: PEDIATRIC (NORTH HOUSTON).
HOUSTON: GENERAL (SHARPSTOWN). Well
This practice is located in a highly sought-
Established general dentist with high-6 figure
after upscale neighborhood. It is on a major
gross production. Comprehensive general
thoroughfare with high visibility in a strip
dentistry in the southwest Houston area
shopping center. The practice has 3 operatories
focused on children (Medicaid). Very, very
for hygiene and two for dentistry. Nitrous is
high profitability. 1,300 sq ft, 4 operatories
plumbed for all operatories. The practice has
in single building. 95% collection ratio. Over
digital X-rays and is fully computerized. The
1,200 active patients. 20% Medicaid, 45%
practice was completely renovated in 2018.
PPO, and 35% fee-for-service. 30% of patients
The practice is only open 3.5 days per week.
younger than 30. Office open 6 days a week
Contact Christopher Dunn at 800-930-8017
and accepts Medicaid. Contact Chrissy Dunn
or christopher@ddrdental.com and reference
at 800-930-8017 or chrissy@ddrdental.
“North Houston or TX#562”. WEST HOUSTON:
com and reference “Sharpstown General or
MOTIVATED SELLER. Medicaid practice with
TX#548”. HOUSTON: GENERAL (PEARLAND
production over 6 figures. Three operatories
AREA). General located in southeast Houston
in 1,200 sq ft in a strip shopping center.
near Beltway 8. It is in a freestanding building.
Equipment is within 10 years of age. Has a pano
Dentist has ownership in the building and
and digital X-ray. Great location. If interested
would like to sell the ownership in the building
contact chrissy@ddrdental.com. Reference
with the practice. One office currently in use
“West Houston General or TX#559”.
by seller. 60% of patients age 31 to 80 and 20% 80 and above. Four operatories in use,
56 Texas Dental Journal | Vol 141 | No. 1
LAKE JACKSON: Located 40 minutes outside
will stay, been with practice since 2019. Digital
Houston. Are you seeking a dental practice that
X-rays, paperless, Newtom 3D/Panorex, (3) X-ray
is fee-for-service, located in a great community
sensors. Practice is in older house, which can be
with a robust economy (Dow Chemical, BASF,
leased or purchased. Great starter practice or
and Freeport LNG), and strongly rooted in the
for someone slowing down and wants to live on
community with an exceptional reputation?
the coast. Send inquires to jim@jlongdds.com
Would you like to work with well trained and
or call: 281-726-1812, leave message.
tenured staff? If yes, this is a great opportunity for you, we are seeking a dentist committed
WATSON BROWN PRACTICES FOR SALE:
to excellence and providing the best possible
Practices for sale in Texas and surrounding
dentistry available. The practice has blended
states, For more information and current
a strong cosmetic and implant practice
listings please visit our website at www.
with family dentistry. Seeking associate for
adstexas.com or call us at 469-222-3200 to
a busy and ever expanding practice. Great
speak with Frank or Jeremy.
compensation, sign on bonus, and benefit package. AGD or GPR preferred or 2 yearsí
INTERIM SERVICES
experience. To inquire about this opportunity contact Dr Brian Bell at bkbellgolf@hotmail.
HAVE MIRROR AND EXPLORER, WILL TRAVEL:
com; office phone: 979-297-1201; 102 Flag Lake
Sick leave, maternity leave, vacation, or death, I
Dr, Ste C, Lake Jackson, TX 77566.
will cover your general or pediatric practice. Call Robert Zoch, DDS, MAGD, at 512-517-2826 or
ROCKPORT: Practice for sale in Rockport.
drzoch@yahoo.com.
Two chairs, plumbed for 3. Currently being worked 3 days a week producing near mid6 figures. Fee-for-service, no DMO, HMO or PPO contracts. Hygienist 3 days a week and
www.tda.org | January/February 2024
57
YOUR PATIENTS TRUST YOU.
ADVERTISERS Anesthesia Education & Safety Foundation, Inc....3
WHOM CAN YOU TRUST? If you or a dental colleague experiences impairment due to substance use or mental illness, the Professional Recovery Network is here to provide support and an opportunity for confidential recovery.
Choice Transitions.........................Inside Back Cover JKJ Pathology................................................................6 Law Offices of Mark J. Hanna..................................35 McLerran & Associates.............................................53 MedPro Group............................................................5 Proconsult Group......................................................18 Professional Services Technologies........................14 TDA Perks.......................................Inside Front Cover Texas Health Steps.....................................................7 Texas Pharmacy Association/ Professional Recovery Network........................58 United Midwest.........................................................11 UTHSC SA/South Texas Pathology Lab...................35 UTSD Houston...........................................................11 Watson Brown...........................................................15
PRN Helpline Visit us online (800) 727-5152 www.txprn.com
58 Texas Dental Journal | Vol 141 | No. 1
Since 1996, our team of experts have provided successful transition services exclusively to dentists. Choice prides itself on its reputation for integrity, service and results.
Considering selling to a DSO? Scan the QR code to watch a brief and informative video to help you decide.
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