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B U L L E T I N

of the Nassau County Dental Society Volume 18 Number 2 November/December 2012 NCDS Subscription Rate: $30. (included in members’ yearly dues) Non-Members Rate: $75.

 Calendar of Events

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 Installation Dinner Dance

2

 President’s Message - Albert L. Granger, DDS

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 From the Editor’s Desk - Donald R. Hills, DDS

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 Executive Director’s Message - James D. Garnett

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 NCDS News

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 New Dentist - Douglas Carlsen, DDS “Financial Planning for the Future: The Young Dentist”

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 Registration Form - Upcoming Meeting/Courses

27

 ADA’s House of Delegates Meeting & 153rd Annual Session – Dr. Meena Jaiswal

35

 ADA News

37

 Legal Practice Tips - Andrew E. Roth, Esq., Danziger and Markhoff “New Comparability Profit-Sharing Plans for Dental Practices”

47

 Health Care and the Dentist Potential Effects of the Affordable Care Act on Dentistry

49

 Practice Tips - Risë and Martin Mattler, Countrywide Practice Brokerage “How Much is My Practice Worth?”

53

 Selling and Salesmanship - Tom Hopkins “How to Speak So Patients Will Listen”

55

 Classifieds

60

CALL FOR VOLUNTEERS – GIVE KIDS A SMILE

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The mission of the Nassau County Dental Society is to promote dentistry by enhancing the integrity of the profession; strengthening the patient/dentist relationship; and making membership the foundation of successful practice; to act as a source of information for the membership and the public; to promote quality dental health care and continuing education; and to be responsive to the changing needs of the public and the profession.

2013 Calendar of Events

Most meetings and courses are held at Society Headquarters unless noted Nassau County Dental Society 377 Oak Street  Suite 204  Garden City, NY 11530 Voice: (516) 227-1112  Fax: (516) 227-1114 e-mail: office@nassaudental.org website: www.nassaudental.org Donald Hills, DDS Editor-in-Chief James D. Garnett Executive Director and Managing Editor Officers Albert L. Granger, D.D.S., President Meena Jaiswal, D.D.S., President-Elect Nicholas Tucci, D.M.D., Vice President Anthony Ienna, D.D.S., Secretary Jakob Charen, D.D.S., Treasurer The Bulletin is the official publication of the Nassau County Dental Society. Readers should be aware that articles published herein are for informational purposes only and the Nassau County Dental Society makes no representation as to their accuracy. Opinions expressed by the authors do not necessarily represent the policies of the Nassau County Dental Society or the Bulletin. Acceptance of advertising in the Bulletin does not constitute an endorsement by the Nassau County Dental Society. The Nassau County Dental Society reserves the right to reject any copy. As a matter of policy, it does not accept advertisements for any product classified as “Unacceptable” by the Council on Dental Therapeutics of the ADA. Annual (six issues) NCDS subscription rate of $30.00 is included in members’ yearly dues. Subscription rate for non-members is $75.00 We welcome submissions. Direct all communications to – office@nassaudental.org Submit material for publication six weeks prior to month of publication. Requests for advertising rates and media kits should be directed to Irene V. Cruz, RPC Advertising Co., Inc. 11 Radburn Drive  Hauppauge, NY 11788-3034 (631) 361-9146  Fax: (631) 979-9171 email: rpcadvertising@optimum.net Published bi-monthly by the NCDS. Periodicals Postage is at Garden City, NY. (USPS No. 013-156) Additional entry at Bethpage, NY POSTMASTER: Send address changes to Bulletin of the Nassau County Dental Society 377 Oak Street  Suite 204  Garden City, NY 11530

Friday, January 18 - (Registration 8:30 am) Membership Benefit Course (4 MCE credit) 9:00 am to 1:00 pm Continental Breakfast “Mandated CPR for the Dentist” James F. Dolin, DDS and Mr. Robert Pollack Monday, March 4 - (Registration 7:00 pm) Membership Benefit Course (2 MCE credits) General Membership Meeting 7:30 pm to 9:30 pm “Grow Your Practice Like Never Before … Total Health Dentistry and So Much More!!!” Jonathan A. Bregman, DDS FAGD Monday, May 6 - (Registration 7:00 pm) Membership Benefit Course (2 MCE Credits) General Membership Meeting 7:30 pm to 9:30 pm “Prosthodontic Problem Solving and Innovations – Concept & Techniques for a Successful Restorative Practice” Ronald C. Haas, DDS Wednesday, May 8 - (Registration 8:30 am) Membership Benefit Course (3 MCE Credits) 9:00 am to 12:00 Noon “Forensics in the 21st Century” David A. Grossman, DDS, FAGD, PC Friday, May 17 - (Registration 8:30 am) Membership Benefit Course (4 MCE Credits) 9:00 am to 1:00 pm “Infection Control” Dr. Harold Edelman Wednesday, May 29 - (Registration 8:30 am) Membership Benefit Course (2 MCE Credits) 9:00 am to 12:00 Noon “Saving Teeth with Little or No Clinical Crowns” Edward Feinberg, DMD Wednesday, June 19 - (Registration 8:30 am) Membership Benefit Course (4 MCE Credits) 9:00 am to 1:00 pm Continental Breakfast “Risk Management” Robert M. Peskin, DDS and Michael Kelly, Esq.

The NCDS Officers and Board wish our members, their families and staff, a very happy and Healthy Holiday season


The Nassau County Dental Society cordially invites all members, family, friends and guests to attend our 66th Annual Officers Installation Gala and General Membership Meeting Saturday, January 5, 2013 Chateau Briand 440 Old Country Road  Carle Place, NY 11514 Officers for Two Thousand Thirteen President Meena Jaiswal, DDS President-Elect Nicholas Tucci, DMD Vice President Anthony Ienna, DDS Secretary Jakob Charen, DDS Treasurer Robert Trager, DDS Installing Officer Deborah Weisfuse, DDS NYSDA President Herbert L. Taub Distinguished Service Award presented to Francis J. Murphy, DDS Reception 6:30 pm  Dinner/Dancing 7:30 pm $100. per person ($75. New Dentists) before December 1, 2012 $125. per person ($100. New Dentists) after December 2, 2012 RSVP  Black Tie Preferred

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President’s Message Albert L. Granger, DDS

An Open Letter to the Society Members Society; streamlining and producing an online Journal; and upgrading office technology so that the main office operates in a more efficient manner. As you have just read, your time and dedication to the Society has allowed us to improve the overall functioning of the Society.

First, I hope that you, your family and friends did not suffer too much of a hardship after Hurricane Sandy broadsided Long Island. Personally, I am incredibly impressed by the overwhelming response from our membership to help their fellow members during this time of need. Dozens of our members have voluntarily donated space in their practices for our displaced members, and many have contributed to the Nassau Academy of Dentistry’s Hurricane Relief Fund. To those of you still recovering from the Hurricane, please know that my thoughts and prayers are with you and yours.

Specifically, the Give Kids a Smile event, in February 2012, provided oral health screenings for more than 1,500 Kindergarten to 2nd grade students from underprivileged areas in Nassau County. Proudly, more than 200 volunteers devoted their time and energy to this annual event dedicated to improving the oral health of children in our communities. We remain grateful to Drs. Joseph Brofsky and Michael Shreck for their leadership and ongoing commitment to this important event.

It is hard to believe that the 2012 year is coming to a close. As President of the Nassau County Dental Society, I am proud to share that we’ve accomplished a lot and the year progressed very smoothly as a result of your ongoing commitment and dedication to the Society. Together, we were able to achieve several objectives which led to our overall goal of ensuring the successful continuation of the Nassau County Dental Society.

In addition to this major oral health screening event, our Society sponsored several other screenings throughout New York State during the year. Oral Health Screenings were held at the Oyster Bay Health Fair, Saratoga Race Track, Eisenhower Park Veteran’s Picnic, and the Dean Skelos Five Town’s Community Health Fair. At this event, we were recognized by Nassau County Executive Edward Mangano for utilizing our professional skills to demonstrate care and concern for our communities. A special thank you to Dr. Robert Trager for organizing and arranging our Oral Cancer outreach Programs.

Several of those objectives included sponsoring several oral health screenings; meeting with Nassau County Executive Edward Mangano; voting for New York State Vice President Dr. David Miller, who will ascend to President in 2015; hosting a successful Executive Board retreat; relocating the General Membership meeting; successfully negotiating a settlement with the Queens County Dental

Continued on page 4  3


President’s Message continued from page 3

in the number of members attending the meeting, but also a significant increase in the number of younger member dentists which is critical to the Society’s longevity.

A meeting was held with Nassau County Executive Edward Mangano and Nassau County Health Commissioner Lawrence Eisenstadt, to bring awareness about how unfair and burdensome the newly enforced permit to store hazardous waste is for practicing dentists. The Nassau County leaders appreciated us requesting the meeting and bringing the ongoing concerns of Nassau County dentists to their attention. This law has been on the books for over 25 years and not enforced. Although the notices have been sent to a number of offices, (dental, medical, veterinary and hospitals) no fines have been levied, and will not be until the full impact of the law is fully understood.

In regards to Queens County Dental Society’s decision to no longer participate as a member of GLIDM and its financial repercussion, we successfully negotiated a deal where QCDS will no longer be a member of GLIDM and a financial penalty was not incurred by either Society. The Publications Committee met and voted that the NCDS Bulletin will be streamlined from six issues to four per year, and a user-friendly, online, flip book version, can be seen at nassaudental.org. This change will increase accessibility for all members and save the Society thousands of dollars per year.

Congratulations again to Dr. David J. Miller, for being elected to serve as New York State Vice President. We are very proud that Dr. Miller will lead the NYSDA as Vice-President in 2013. I was grateful to host the Executive Board retreat at my home in August. During the meeting, the Board members and I revisited existing Society policies and developed initiatives that will be instrumental in shaping the future direction of the NCDS.

Our technology infrastructure was upgraded to integrate our server, new work-stations and copying machines, to create a more fully functioning and less costly office environment. With this upgrade, the website is being upgraded so that it fully integrates our Bulletin, courses and calendar of events, making it interactive and easier for all members to use.

In an effort to increase attendance of new and existing members at monthly meetings, the General Membership meetings were relocated from the NCDS headquarters to the City Cellar restaurant. Our costs are covered by our vendors. This move proved to be very beneficial for the Society because we not only had an large increase

In summary, a special thank you to Executive Director James Garnett, my Executive Board members, Executive Assistant Barbara McCormick, and all of our members for a successful year. I wish Dr. Meena Jaiswal well in the New Year and her role as President of the Nassau County Dental Society.

A Note to our Members and Advertisers Super Storm Sandy hit everyone very hard, including our Society, publisher, printer and mailing house. Because we all lost and regained power at different times, we were set back about three weeks in the printing and mailing of this Bulletin. We apologize if this has caused any inconvenience, but are glad we are back to business as usual. 4


From the Editor’s Desk Donald R. Hills, DDS

The Dentist and Tilapia Go to Mars On August 6, 2012, two thousand pounds of scientific wizardry successfully landed in the Gale Crater on the planet Mars. The latest rover will explore Mars, helping us understand the planet’s past and its present. The knowledge gained by Curiosity will help in the future manned exploration of Mars, an endeavor mankind is certain to take. With a minimum round trip of close to two years, a dentist should be part of that voyage.

would never walk on the moon, I found myself compelled to at least shake the hand of someone who did. Surrounded by geology graduate students, I shook Jack’s hand and confessed I was studying dentistry not pyroclastic eruptions. He welcomed me into the group and shared some dental trivia with me. It turns out that each Apollo astronaut was given a crash course on how to pull a tooth. Apparently, in planning for any possible scenario, NASA instructed the astronauts in the most aggressive of dental treatments.

I figure the reason a dentist must go to Mars is simple, he may be needed. Do the math; it’s not difficult to calculate. When Mars and Earth are at their closest it takes nine months to get to Mars. The voyagers would need to remain on Mars for four months until the two planets again align correctly for a nine month return to Earth. If 20 astronauts travel, the likelihood of at least one astronaut requiring dental treatment is quite high. Let us not forget with 20 astronauts traveling 22 months, there are 74 combined six month periods away from home, and if the traditional six months between dental examinations is adhered to, clearly a dentist needs to go.

Since the days of GV Black, dentists have continually advanced our science, regularly developing new techniques and procedures to improve the care we provide to our patients. On Mars, practicing dentistry will be similar to here on Earth. Martian gravity allows for traditional treatment, albeit in a fantastically untraditional location. The exciting new techniques, however, will be developed for treatment during the years of traveling in zero gravity. Entirely novel methods will be acquired, as even the simplest procedures of irrigating, rinsing and suctioning are impossible in a weightless environment. Some of the new skills and materials will inevitably improve care here at home. The “extraction only” treatment by Apollo astronauts is clearly unacceptable as we go forward in space exploration.

As a dental student, I had the opportunity to speak with Harrison (Jack) Schmidt, an Apollo 17 astronaut and the second to last man to walk on the moon. Mr. Schmidt came to Northwestern to speak to the Geology Department and I was not to be denied entrance to his lecture. I studied up on my anorthositic and basaltic compositions, found a seat in the back of the room and thoroughly enjoyed his slide show of the 17th Apollo mission. At the conclusion of the discussion, knowing I

Now concerning the tilapia, I must admit the title of this editorial is intended to grab the reader’s attention, yet it is entirely possible that a tank full of tilapia will also be part of space travel. Tilapia is an Continued on page 8  5


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Executive Director’s Message James D. Garnett

East Meets West - South of the Border In response to a Membership Program for Growth (MPG) grant from the ADA, Nassau and Queens County Dental Societies partnered to facilitate a Young Dentist Program at KPacho on October 4, 2012. More than 120 young dentists attended the event to hear Dr. Alicja McCrudden speak about Socket Preservation and Ridge Augmentation. NCDS’ New Dentist Committee Chair, Stuart Jay Heimann and Dr. Albert Yoo from QCDS, did an outstanding job hosting and mingling with their peers before, during and after the program. A large portion of the young dentist attendees were Stony Brook graduates and the event served as a mini-reunion. Dr. Maria Maranga, NYSDA Chair of Membership and Communications, and Dr. Mark Bauman, incoming ADA Chair of Membership and Communications, attended and made short presentations representing their respective roles. NCDS’ President Granger, a strong advocate for young dentists, was delighted to see such a large turnout. He was heard saying, “The young dentist is the future of our profession and we need to do everything in our power to engage them and place them in leadership positions.” He continues, “I was hesitant to get involved years ago but I have no regrets. Being an active member of our Dental Society has been a rewarding experience, both professionally and personally.”

processes continuing education credits and ensures courses are CERP accredited to meet New York State licensing requirements.” Director Jay Fitzgerald reviews all courses given in Nassau County to confirm eligibility. The New York State Dental Association (NYSDA) maintains a registry for member’s CE credits. In case of audit, NYSDA will provide a copy of members’ credits to the state. Dr. Sherman also advised his colleagues to participate in NCDS’ professional liability, peer review, and ethics processes if the need arises. He continued, “The Society provides these services to keep members out of the legal system, avoid lawyer fees, save valuable time and money, and most importantly to curtail reporting to the Office of Professional Discipline (OPD). Once a non-member is brought up on legal charges, it’s too late to join the Society and your reputation may be at stake.” Thanks to the MPG grant and our generous sponsors, Colgate, Patterson, Henry Schein, Nobel Biocare, Nu Life Long Island and Bank of America, NCDS and QCDS were able to provide the program free of charge to our young dentist members. I would encourage all of our members to attend NCDS’ next event or a General Membership Meeting. All Board of Directors and General Membership Meetings are open to the entire membership. A great deal of information sharing and networking takes place during the meetings. Please look to the next edition of NCDS’ New Dentist eNews in

I too, enjoyed the opportunity to speak to our young dentist members and the nonmembers that were in attendance. With the help of Director David Sherman, the value of membership and joining tripartite was “pitched” during a break. “The Society

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NCDS News

A New Look and Format for the Bulletin in 2013 We Listened to Your Suggestions .... Starting in January 2013, the Bulletin of the Nassau County Dental Society will have a brand new look. It will be a larger (8-1/2 x 11) booklet, similar in size to the paper in your printer. The typeface and photos will be larger and it will be distributed on a quarterly basis, instead of bi-monthly. The issue dates will now be Jan/Feb/Mar; Apr/May/June; July/Aug/Sept and Oct/Nov/Dec. The Bulletin gives you the information you need, on a local level, and the most up-to-date material for dental practices in Nassau County. The quarterly mailings will save the Society on printing and postage. We are also working on a new look for the website. While the site is under construction, you will be able to access the site and read the Bulletin electronically. If you hadn’t noticed, the Sept/October 2012 issue was uploaded onto our site as a flipbook, and we will do the same for the Nov/Dec issue and each future issue. Those members who prefer a hard copy, will still get the Bulletin mailed, while others can read it online at any time. The Publications Committee, the Officers and Board Members of the Nassau County Dental Society and the Nassau Academy of Dentistry, are committed to making our Bulletin stand out above the ADA and NYSDA journals. The ADA publication offers national information; the NYSDA publication contains state information, but our NCDS Bulletin will have the content you need to successfully practice in Nassau County. Please visit the Society's website and see the start of a new beginning www.nassaudental.org

Executive Director continued from page 7

Editorial continued from page 5

be part of space travel. Tilapia is an excellent source of protein, provides a desired variation from freeze-dried NASA food, and with an ability to survive solely on excrement, is the perfect companion to recycle waste and conserve important resources during confined, extended space travel.

in your inboxes in November. We would like to highlight one of our young dentist members in every edition and suggestions are always welcomed. My email address is jgarnett@nassaudental.org for your convenience. NCDS’ staff and I are always here to assist our members and young dentists as they navigate the choppy waters of the dental profession.

The reality is, although all this sounds like science fiction, we will be going to Mars within the next 30 years, and I have no doubt a dentist will be part of that journey. 8


NCDS News

In Our Society The Nassau County Dental Society extends a warm welcome to the following dentists recently elected to membership …. LoanAnh T. Bui, DDS, 216 Willis Avenue, Roslyn Heights, NY 11577. Dr. Bui, a graduate of SUNY Stony Brook 2010, is a Pediatric Dentist. Tamara Kroboth, DDS, 807 Newbridge Road, North Bellmore, NY 11710. Dr. Kroboth, a graduate of Stony Brook University 2008, is an Orthodontist. Katayoon Noroozi-Leibowitz, DDS, 8 Eastland Drive, Glen Cove, NY 11542. Dr. NorooziLeibowitz, a 1986 Northwestern Graduate, is a General Practitioner. Melissa L. Perrino, DDS, 1808 Merrick Road, Merrick, NY 11566. Dr. Perrino, a graduate of the University of Buffalo 2010, is a General Practitioner. David A. Walls, DDS, 959 Brush Hollow Road, Westbury, NY 11590. Dr. Walls, a 2006 Meharry Medical College graduate, is an Oral and Maxillofacial Surgeon. Congratulations to….. Dr. and Mrs. Eugene Porcelli on the marriage of their eldest daughter, Jacqueline, to Mr. Brian Lemanski. Dr. Steven Canarick who has recently been awarded a degree as a Naturopathic Physician. Mrs. Vivian See on her retirement after 20+ years at the Society. We wish her the best as she takes time to “smell the roses.”

Condolences to –

In Memoriam

The family of Dr. Leonard Koenig. Dr. Koenig was a General Practitioner in Great Neck, graduated from the University of Maryland and a member of organized dentistry since 1942. The family of Dr. Raymond Zambito. He was in charge of the Catholic Medical Center for many years until David J. Miller, DMD, stepped in to assist. His legacy will live on and will be remembered as one of the nicest people in dentistry. A Special Thank You to – Dr. Darshini Shah, for her generous contribution to the Nassau Academy of Dentistry If you have news to share, please email it to “In Our Society” c/o the NCDS at office@nassaudental.org

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NCDS News

New Dentist Event KPacho Mexican Restaurant – October 4, 2012  Dr. Alicija McCrudden (left) presented an informative lecture on Socket Preservation and Ridge Augmentation to a very well-attended new dentist networking event.

Pictured from left are Mark Marinbach,  President, Nu-Life Long Island, Bill Bayer, QCDS Executive Director, Dr. Robert Trager, Jim Garnett and Dr. Maria Maranga, SCDS Past President

Some of the many smiling faces at the New Dentist Event

The evening was very well-attended – peer camaraderie and networking was evident all night!

Pictured right  Past President Dr. Michael Shreck and Dr. Jay Cho

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NCDS News

New Dentist Event continued

The evening was a huge success – We are already planning the next event. Hope to see you there – tell your colleagues – a great time was had by all!

Candid shots from the New Dentist Get-Together

Dr. David Sherman and Jim Garnett

 NCDS President Dr. Albert Granger (right) enjoying the evening

Drs. Michael Shreck, Meena Jaiswal, Maria Maranga and Executive Director Jim Garnett

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TAX TIPS FOR DENTISTS

Stuart A. Sinclair

by Stuart A. Sinclair, CPA

Certified Public Accountant

Here are 4 tips from the IRS to help you prepare if disaster strikes: 1. Backup records electronically. Taxpayers should keep a set of backup records in a safe place away from the original set. 2. Document valuables. Taxpayers should photograph or videotape the contents of their home, especially items of higher value. 3. Update emergency plans. Emergency plans should be reviewed at least once a year. 4. IRS can help. If a disaster strikes, call 1-866 562-5227. Taxpayers can request copies of previously filed taxes by filing Form 4506. More info can be obtained at www.irs.gov.

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Directions to Nassau County Dental Society Headquarters

377 Oak Street, Suite 204  Garden City, NY 11530 Tel: (516) 227-1112  Fax : (516) 227-1114  em ail: NassauDental@aol.com NCDS Headquarters 377 Oak St.

Hofstra University Dorms

O a k S t r e e t

 N

UPS Facility

W S  Westbury Blvd. Nassau Coliseum

Hofstra University

Letter to the Editor

 Hofstra Overpass

E

Marriott Hotel

Hempstead Tpke. Hofstra Overpass

Hofstra Overpass

M e a d o w b r o o k P k w y

From New York - Long Island Expressway or Grand Central Parkway/Northern State Parkway to Meadowbrook Parkway South to Exit M4 (West) Hempstead Tpke. Proceed past Marriott Hotel, Nassau Veterans Coliseum and under two Hofstra University Overpass walkways to first right (Oak Street - traffic light immediately before third overpass). Go North 8/10th of a mile to 377 Oak Street, (red brick building) located on left side of the road (directly opposite the United Parcel Service facility). From Southern State Parkway - to Meadowbrook Parkway M4 (West). Follow above directions.

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NCDS News

Society Highlights continued Nassau County Drug Abuse and Misuse Task Force Press Conference Dr. Peter Blauzvern (left), Nassau County Executive Edward Mangano and NCDS Executive Director Jim Garnett at the Task Force Press Conference on September 28, 2012  Mrs. Donna Hicky, dental hygienist to Dr. John Cerrato, poses with a photograph of her son, lost to prescription drug abuse on December 24, 2011

County Executive Mangano thanked Dr. Blauzvern and Jim Garnett, members of the Task Force for their important work that has brought further awareness to this growing problem

 Nassau County Executive Edward Mangano (center) and other members of the Nassau County Task Force address the press conference about the dangers of drug abuse and their misuse Dr. Blauzvern lectures for the NCDS, NYSDA, ADA-PCSSO, study clubs and North Shore LIJ on this important topic

On September 28, 2012, Nassau County Executive Edward P. Mangano unveiled the results of a year-long work by the Prescription Drug Abuse Task Force, one that the county executive said was unique to New York State and one that he vowed would help to win the declared war on prescription drug abuse. Calling it a “war we can, and will win!,” Mangano and other speakers emphasized education and public awareness as cornerstones to the offensive. Part of the task force’s recommendations includes urging medical professions to secure their prescription pads “so they don’t wind up in the wrong hands.” Mangano was joined by several members of the task force, including Dr. Peter Blauzvern and NCDS Executive Director Jim Garnett. But the drama of the press conference was when parents of young people who lost their lives to substance overdose made their appeals. For more information, contact Dr. Peter Blauzvern at (516) 681-5800 13


NCDS News

Society Highlights Membership Benefit Course – “Precision Based Endodontics” John L. Santopolo, DDS, M.Sc.D. Reps from course sponsor Dentsply Tulsa Dental address the well-attended October 10th course  Lecturer John L. Santopolo, DDS and moderator, John M. Iacono, DDS pose for a photo op after the lecture

Oral Cancer Event – Belmont Park October 5, 2012 A winning team  Jockey Irad Ortiz, Jr., aboard Basalt

 Volunteers pose with winning jockey after the race that was named in honor of the Dental Societies of Nassau, Queens and Suffolk Counties

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Medical Mission to Ecuador Ronald P. Burakoff, DMD, MPH The Nassau County Dental Society Editor, Dr. Donald Hills, asked me to write a little something about my recent mission to Quito, Ecuador on October 13th to 20th. Along with my wife Arlene, who served as an interpreter and Dr. Joseph DiBiase, a senior resident in Pediatric Dental Medicine at Cohen Children's Medical Center, we traveled to Quito, Ecuador, to be part of a 30-person medical mission that delivered cleft palate repair surgery and dental services to indigents who lived in the area. The trip was sponsored by an organization called Medical Missions for Children (MMFC.org) which conducts several missions a year. I was a bit apprehensive about the journey before we departed, but found the venture to be one of the most rewarding experiences of my professional career. The dental contingent provided general dental services, under anesthesia, to 40 special needs children and adults during the five day mission. The recipients of care and their families were so appreciative of our efforts. I urge everyone to look into the possibility of participating in a global health mission. I think you may find the experience extremely rewarding.

Some of the volunteers that were part of the mission – Pictured standing from left are Charles Badoui, DDS., Ronald Burakoff, DMD, Joseph DiBiase, DDS, Andrew Parsons, MD. Seated are Matias Viteri, student translator, Susan Kunewitch, RN, and Celia Whellia, Anesthesia Practitioner

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NASSAU COUNTY DATC DENTAL ASSISTANTS COURSE STARTS MARCH 13, 2013 The Nassau County Dental Society in conjunction with the Dental Auxiliary Training Center, is pleased to announce the 28th year of continuation of the comprehensive dental assisting training course offered for the auxiliary staff of the Nassau County membership FUNDAMENTALS OF CHAIRSIDE DENTAL ASSISTING To meet the demand for trained dental assistants, the dental society co-sponsors this course to assist interested students who have a desire to prepare and work in this exciting career field. Dental assistants, who have been trained on the job, can significantly improve their job and skills performance with this training. The course is designed to train:  already employed dental assistants who have limited or no formal training;  those who are interested in preparing to take the DANB Exam. This all-inclusive course will augment the on-the-job learning experience by giving the theoretical background of the profession of dental assisting and provide hands-on-training in a classroom setting. The course has been structured in such a way that the total time required for completion is only 15 sessions totaling 45 hours plus a 15-hour comprehensive skills study project. The course is a total of 60 hours. Topics covered include:

Dental Terminology Infection Control Dental Specialties 4-Handed Dentistry Dental Office Emergencies

Charting Sterilization Anesthesia Dental Materials Dental Anatomy

Disease Transmission Operative Dentistry Dental Instrumentation Radiology Preventive Oral Hygiene

COURSE CERTIFICATE OF ACHIEVEMENT WILL BE GRANTED UPON SUCCESSFUL COMPLETION OF REQUIRED COURSE WORK, ATTENDANCE AND FINAL EXAM COURSE NUMBER: TIME: COURSE DATES: PLACE: TUITION: TEXT, INS. & LAB FEES:

NC101-3 (WEDNESDAY EVENINGS) 6:30 PM TO 9:30 PM MARCH 13 THROUGH JUNE 19, 2013 NASSAU COUNTY DENTAL SOCIETY HEADQUARTERS BUILDING 377 Oak Street, Suite 204, Garden City, NY 11530 $950.00 Please make checks payable to DATC/NC $495.00 Will be collected on the first night of class

Please call DATC toll-free 1 (888) 595-3282 to register for this program. A payment plan is available. Also call us to discuss the DATC “Special Pathway” for becoming a New York State licensed “Certified Dental Assistant” Mail Course ** Seat Reservations to: DATC, 367 Windsor Highway, Suite 226, New Windsor, NY 12553 DATC TOLL FREE 1-888-595-3282 EMAIL: datcinfo@earthlink.net Name

SS # (last 4)

Home Address City

State

Zip

Course Name Fundamentals of Chairside Assisting, # NC101-3 Dentist Employer Home/Cell

Work No. Deposit Amount $

Check No

This program has been approved as an entry level skills program by the NYSED, BPSS. Eligible students who wish to challenge the National Certification Exam given by DANB will find this course to be helpful. This program alone, is not presently recognized by the NYSED, as a license qualifying course under the NY State Licensed “certified dental assisting” law. DATC has developed a pathway along with this program for assistant’s to become licensed. FOR MORE INFORMATION ABOUT BECOMING LICENSED, please call Lisa Lyle at 1 (800) 595-3282. ** Student will receive written confirmation of seat reservation

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New Dentist

Financial Planning for the Future: The Young Dentist Douglas Carlsen, DDS

Congratulations on your entry into the wonderful world of dentistry. It’s time for your first BMW and mortgage, right? Not so fast. You may be able to cut a prep with a 400,000 rpm handpiece in a couple minutes, yet the full restoration takes time and patience to build longevity.

The number-one mistake I made: Arguing with my wife way too many times about changes that should have been made. If I had listened and made the changes she thought right, we'd have gotten out of that deep hole I dug much sooner. ChipPayet 2/6/2012

The same is true of your financial strategy. Decisions made early in one’s career have huge effects on stability years later.

The Psychology of Debt Psychotherapist Phil Tyson lists two factors pertaining to the psychology of debt: First is a principle he labels future discounting. We often take on debt giving little thought to how we need to change our lives to accommodate it. Madison Avenue has used this approach effectively for years.

In this article, I’ll paint a landscape using the strokes dentists use to build real wealth. But first, let’s have some comments from a 2012 Dentaltown.com thread called “Financial Mistakes I Wish I Had Never Done.” 1. Wish I never bought the home before setting up the office. 2. Wish I bought a small home instead of buying the “dream home.” 3. Wish I bought life insurance and disability when I was younger and healthier. 4. Wish I didn’t buy that swanky car and had my little fun for three years in it. 5. Wish I knew who had the Time Machine… Ntextdent 1/18/2012

Dr. Tyson’s second principle is the relationship between consumption and personal identity. “Advertising has brainwashed us all to consume brands that provide us an identity. Our self-esteem becomes captive to products.”  Student Loans Dentists attending public institutions often graduate with more than $200,000 in student loan debt, while those attending private schools often end up owing $400,000. Should the loan be paid off before taking on other loans or should it be paid off over a long period of time? Low interest rates often entice doctors to pay as slowly as possible. For insight, I provide my favorite comment from Dave Ramsey, author and TV personality. An abridged version: Dear Dave, I’m 33 and a resident with $250,000 in student loan debt. Next year I’ll finish my residency and increase my income dramatically. The interest rate on my student loan is just 3.5 percent, so I’d like to postpone paying it off and make house payments and begin saving for retirement instead.

• At the top of the list for financial mistakes (and general life mistakes) is marrying the wrong woman. Nothing else, other than losing your dental license, will be more expensive. • I totally agree with getting your practice established before buying your house. • Never spend more than 16 percent of your income on your mortgage. • Pay cash for your toys. If you can’t pay cash, save until you can. • If you are over 35 pay cash for everything that isn’t a home. Everything. Boat, CEREC, kitchen remodel … everything. bkoenitzer 2/07/2012

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Continued on page 19 


NCDS News

Millie Thaw, RDH and Dr. Robert Trager pose for a photo at one of our General Membership Meetings

Drs. Michael Shreck, David J. Miller and Albert Granger present Dr. Harris Canarick with a plaque from the New York State Dental Foundation for his hours of continuing education

JACOBSON GOLDBERG & KULB, LLP Attorneys and Counselors at Law 585 Stewart Avenue Garden City, New York 11530

(516) 222-2330

Serving the Legal Needs of the Dental Profession for 50 years OFFICE OF PROFESSIONAL DISCIPLINE

PURCHASE & SALE OF PRACTICES

LICENSURE AND LICENSE RESTORATION

BUSINESS AGREEMENTS

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MEDICAID

THIRD PARTY AUDITS & TERMINATION

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PARTNERSHIP, EMPLOYEE and INDEPENDENT CONTRACTOR AGREEMENTS

Miles R. Jacobson Daniel M. Goldberg

Amy T. Kulb Jeffrey A. Granat

18


Continued from page 17

How Much Debt is Appropriate? Auto An example involves two dentists, Dr. I.B. Smart and Dr. Wanda Beemer, who became financially prudent at slightly different ages. The first dentist, Dr. Smart, from age 30 until age 65, always paid cash for a two-year-old moderately priced, yet nice vehicle, such as a Toyota Highlander, and replaced every four years. The second dentist, Dr. Beemer, did the same, except for one slight difference. She splurged at age 30 and took out a four-year loan for a new BMW 7 series. Four years later, she became enlightened to the high depreciation inherent in a luxury auto and prudently bought two-year-old Highlandertype vehicles for the remaining 31 years of her career. That one-time purchase created a difference in savings of $35,480 for those four years between our two dentists that compounded to $309,000 (in age 30 dollars) by age 65, or the equivalent of $14,000/year for life! After all fees and taxes, the average sale amount of a dental practice is near $300,000. In other words, an expensive capital purchase early in one’s career can have an effect as powerful as the sale of a dental practice. A dentist will spend vast amounts of potential retirement savings taking out loans or leasing new autos frequently. Start a good habit. Always pay cash. Consumer Reports repeatedly states that the worst way to buy a car is via lease with its hidden fees. Second worst is dealer financing. The best way to buy is cash.

off paying the student loans as long as possible. Is this a good idea? -Derrick Dear Derrick, That loan hanging over your head is unbelievable. I’ve worked with many doctors over the years where 20 years later they are still playing math games with the student loans like they’re a stupid pet! .. if you’re not careful, you might catch a nasty disease called “doc-itis.”… Some of the symptoms include two or three leased BMWs and a fully furnished house with a pool on the golf course. That student loan can just wait a while to be paid. It’s a financially debilitating disease. You’ve been used to living on nothing (less than $40,000) for a while now. Just keep on doing that for a little bit longer… you can have that student loan debt knocked out in a few years. I’d postpone any retirement savings and buying a home until you’ve completely knocked out the loan and have an emergency fund ($50,000+) in place… – Dave One who stretches out that first loan as long as possible has two strikes against him. First is the fact that debt structure will be more complex and saving more difficult in the future. Second, the young dentist will set up an insidious mental framework of debt being a natural part of life. It isn’t. If you tie your identity to debt, you’ll end up needing to work 10 to 15 more years than the dentist that doesn’t. This is the most important message in the article: Debt is never your friend. Many will tell you to use debt for leverage, tax advantage and other ploys. Nonsense!

Practice Loan Brian Hufford, CPA, CFP of Hufford Financial, provides guidance with his Financial Balance Guide. From a dentist’s net income, Hufford indicates that one should designate 25 percent to personal living expenses; 25 percent to all loans, personal and business; 20 percent to savings; 25 percent to taxes; and five percent to large personal or practice purchases. For a young dentist, age 35, with a $180,000 income, total annual loan

The only reasonable use for debt is a home mortgage and a practice loan. What can a young dentist do with onerous student debt? Unfortunately, suck it up and live like a student for a few years after becoming a doctor. One who pays off student debt quickly will have real savings by age 50. 19

Continued on page 21 


27th Annual BIg aPPLe denTaL MeeTIng sponsored by

New page 20 Bronx County Big Apple Meeting

Reduce to fit 5-1/2 x 8-3/4 as close as possible The ad Bronx county Center all ways on page dental

society

Wednesday, March 13, 2013 Thursday, March 14, 2013 The sheraTon MahWah. MahWah, neW Jersey

• Two full days of education • Morning, afternoon and evening seminars • commercial exhibits • rebate coupons for exhibitors • Free Parking: Indoors and outdoors • Free Breakfast and Free Buffet Lunch

2013 partial list of Speakers

For Full day seminars

• exhIBIT hours: 9:30 a.m. to 7:00 p.m. For further information, contact: The Bronx county dental society 718-733-2031 • 718-733-0186 (fax) email: bronxdental@optonline.net Website: www.bigappledentalmeeting.us

secure online registration on our website.

1. MATERIALS AND ESTHETICS Dr. Lee Ann Brady Dr. Gordon Christensen Dr. Rella Christensen Dr. Howard Glazer Dr. Mark Pitel Dr. Daniel Ward Dr. Marty Zase

9. RISK MANAGEMENT Dr. Kenneth Treitel

2. ENDODONTICS Dr. Gregori Kurtzman Dr. Ali Nasseh

12. EMERGENCIES Dr. Anthony DiAngelis

3. PROSTHETICS Dr. Jeffrey Hoos 4. PERIODONTICS AND HYGIENE Wendy Briggs, RDH Dr. Serio Ward

10. TMJ AND PAIN Dr. James Uyanik 11. DENTAL INSURANCE Teresa Duncan, MS

13. ORAL PATHOLOGY Dr. Robert Kelsch 14. PHARMACOLOGY Mr. Tom Viola

15. MEDICAL EMERGENCIES IN THE OFFICE 5. PRACTICE MANAGEMENT Dr. Joel Friedman Dr. Douglas Carlsen Dr. Steven Katz 16. PEER REvIEw Ms. Lisa Philips Dr. Stephen B. Harrison Dr. Rhonda Savage Drs. Steven and Troilo - KISCO SEMINARS 6. IMPLANTS AND ORAL SURGERY Dr. John Minichetti Dr. John Cavallaro, Jr. 7. ORTHODONTICS FOR THE SPECIALIST Dr. Thomas Mulligan 8. INFECTION CONTROL Dr. Harold Edelman

pple Big A 13 20 eeting tal M Den Sponsored by The Bronx County Dental Society

★ Special BonuS For ★ attending our SeminarS

Continuing eduCation Credits will be given to all attendees. these Credits will be appliCable for dentist and dental hygienist requirements as allowed by state law. 20

A $25 exhibitor’s coupon will be given to each dentist for attending a full-day seminar and a $10 coupon to each dentist attending a half-day or evening seminar. When presenting your $25 or $10 coupon for full day, half day and evening paid seminars — any purchase made at the exhibitor’s booth will be discounted at the $25 or $10 rate. You will receive a coupon for every paid course that you attend and no minimum purchase is required!


Continued from page 19

account, not the size of your kitchen, master bath accessories, or the money you owe to Bank of America.

payments should be no more than $45,000. Two auto loans at $1,250 per month eats up $15,000. A student loan of $2,500 per month ends the process. No practice or home loan is possible. Kill that student loan early, docs! For a young dentist with no student loan or auto debt and an expected net income of $180,000, a 10-year $300,000 practice loan at a rate of seven percent would have $3,500 monthly payments with a total yearly loan burden of $42,000. That’s within Hufford’s guidelines. Yet, there isn’t enough left for a home loan yet. Please be careful to take out a reasonable practice loan, with plenty of wiggle-room in your personal and practice budget, in case your practice production falls short of projections.

Carlsen Debt Recommendations • Read The Total Money Makeover by Dave Ramsey. • Pay off student loans as quickly as possible and before taking out any other loan. This means always paying cash for autos. That BMW X6 M is a wonder, yet pay cash. • Set up an emergency fund. • Take out a practice loan, if applicable. • Take out a home mortgage. The home mortgage always comes last and should be for 15 years. Why have I spent over half the article beating you guys up on debt? Debt is the main block to savings and real wealth. If you have nothing to save, investing is not important. And there are many dentists, age 50, with little savings.

Mortgage Charles Farrell, JD, LLM, in Your Money Ratios: 8 Simple Tools for Financial Security, points out that the maximum amount of mortgage debt should never be more than twice your net family income. By age 50 it should be down to 1.5 times income to retire by age 65. By age 65 it should be completely paid off. Below are ratios for different ages. Therefore, our 35-year-old dentist making $180,000 per year should not have a mortgage of more than $360,000. And that’s contingent on Hufford’s total loan amount, including any practice loan or auto loans, of 25 percent of $180,000, or $45,000. Not easy, is it?!

Savings Emergency Fund This is funded after paying off student loans and before taking out a mortgage. It may be funded along with a practice loan. Remember the mortgage always comes last. Have the emergency fund in liquid form (money market account) of at least six months of your expenses. For the young doctor, this is normally $25,000-plus. Why? I personally know three doctors, who suffered a ski injury, a stroke and cancer, which caused three to six months of disability. Disability policies paid little and they lost a huge chunk of income to medical copays and loss of work. This is not an “emergency-trip-to-theCaribbean fund” or “I-really-need-a-newgolf-membership” fund. It’s strictly for medical and family emergencies.

Take out a 15-year mortgage. The monthly interest isn’t that much more than a 30-year loan and will provide additional savings in your 50s. Farrell also makes it clear that your primary residence value increases only at the rate of inflation over many years. You will not be able to fund your retirement via your personal residence. And the more mortgage you have, the less you’ll have for retirement. Never buy more home than you need. It’s great to look successful, yet real wealth is measured by your Vanguard

Retirement Savings How much is appropriate? Those who I’ve worked with that have saved 20 percent consistently, have no trouble retiring between age 55 and 58. But 20 percent is very difficult for many of us! For an article titled, “Only Four Percent of 21

Continued on page 22 


Continued from page 21

Where Does One Invest? I need to be blunt. You need to read two books before funding retirement savings. The Elements of Investing by Burton Malkiel and Charles Ellis The Only Guide to A Winning Investment Strategy You’ll Ever Need by Larry Swedroe. This is paramount before choosing where to invest. Excerpts from Swedroe’s book on active management (timing the market by buying and selling individual stocks and/or mutual funds): Fortunately, there is a sure way to win the loser’s game of active management. Don’t play! Rather than attempt to time the market or pick individual stocks, it is more productive to invest and stay invested. Warren Buffet said: “We continue to make more money when snoring than when active.” Mr. Buffet also said: “Most investors, both institutional and individual, will find that the best way to own common stocks is through an index fund that charges minimal fees. Those following this path are sure to beat the net results delivered by the great majority of investment professionals”. We have seen that the average actively managed fund underperforms its benchmark by close to two percent per annum… With the availability of taxmanaged funds, which improve on the tax efficiency of index and passive asset-class funds, we can now raise our underperformance estimate to perhaps as much a three percent per annum. My comments: A three percent annual loss of capital over a working career of 30 years means a loss of about 60 percent of one’s total portfolio. $2.5 million in savings invested with a buy-and-hold strategy would be reduced to $1.4 million if managed actively. Please don’t fall for the hype. Of all investment firms I talk to, 98 percent of them use only active management, as if it’s better. It’s worse docs; normally much worse.

Dentists Able to Retire at 65? Nonsense,” I used Monte Carlo software to analyze savings scenarios for a hypothetical doctor. Savings would be held in index funds with a 50/50 mix of stocks to bonds at a discount brokerage such as Vanguard with passive, buy-and-hold investing. A typical dental couple needs around $140,000 per year in retirement to keep his or her lifestyle intact. This is less than the working incomes listed, yet lack of mortgage, savings and decreased taxes lower the income needed substantially in the non-working years. From the article: Let’s next look at a young dentist, Dr. Anita Know, age 30, with an income that starts at $125,000, increasing to $170,000 at age 40, $230,000 at age 50, and $310,000 at age 60. These are fairly normal averages for dentists (four percent real increase per year). If she saves 10 percent per year starting at age 30, she will be able to retire with $140,000 income at age 63 using a 50/50 stock-bond portfolio throughout her career. Saving 15 percent per year will provide retirement at age 60. .Ibid Saving 20 percent will provide retirement at age 57. If Dr. Know waits to start saving until age 35 at 10 percent per year, she will be able to retire as above at age 65. If Dr. Know doesn’t start saving until age 45 with at 10 percent per year, she will be able to retire at age 69. If she wishes to retire at age 63, though, she will have to save 21 percent per year. If using active management investment strategy, add one to two years to retirement ages above (see Swedroe comments); if using a traditional broker or insurance agent, add another two years due to high fees/commissions. The bottom line is to make a commitment, as soon as student loans are paid off, to save at a rate of 15 percent per year and you’ll never look back. As far as savings for children’s education, it takes second place to saving for retirement and there isn’t space for coverage of the topic in this article.

Continued on page 24  22


NCDS News

Board of Director’s Meeting

During NCDS' Board of Directors' meeting on Monday, December 5th, Dr. Steve Gournardes, ADA Trustee to the Second District presents the ADA's coveted Golden Apple Award for Excellence in Access to Care Programs. Drs. Albert Granger as President, Nicholas Tucci as Chair of Access to Care, Joseph Brofsky as Chair of GKAS, Michael Shreck as Co-Chair of GKAS, and Robert Trager as Chair of Oral Cancer Awareness, proudly accept the award. This is the second consecutive year the Nassau County Dental Society/The Nassau Academy of Dentistry has won the ADA Golden Apple award. Last year, the Golden Apple was awarded for Excellence in Membership Recruitment and Retention programs.

The Nassau Academy of Dentistry's Chair Dr. Eugene Porcelli and NCDS President Dr. Albert Granger award Edward Reilly a certificate of appreciation for Henry Schein's support of the Academy's Access to Care Initiatives.

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Continued from page 22

portfolio is diversified, it’s automatically rebalanced periodically and the fees are low. An even lower cost is to devise your own portfolio from Fund Advice or Lazy Portfolios listed above and rebalance on your own once a year. Please, don’t fall for anyone who promises to beat the market. Academically, almost all trail their benchmark indices by a wide margin.

• Owning individual stocks and sector funds is speculating, not investing. • Never work with a commission-based advisor (stock broker or insurance agent) – there is a misalignment of interests. • Before acting on seemingly valuable information, ask yourself why you believe that information is not already incorporated into prices. Where does one go for financial advice besides the above-mentioned books?

Dark Pits of Financial Depravity Insurance Companies: Please steer clear of any insurance product touted as an investment. Annuity is normally a moniker for “sucker.” There are valid reasons for annuities, but only in retirement. The fees are hidden and atrocious. HELOCs (Home Equity Line of Credit): These were really fun for many during the housing boom. It was like free money for new kitchens, cruises, Cerecs, and paying off credit cards. Yet many lost their homes because of HELOCs they couldn’t afford in later years. Free Seminars with Meals Attached: Content, beef-fed dentists are favorite prey for annuity, commodity partnership and time-share salesmen. Be sure to get a second opinion from a neutral third party before “investing” in something presented with any freebee. Day Trading: Jim Cramer and his gang may be fun to watch on CNBC, yet any type of market timing is anathema to your savings. And it looks so easy! Yet there are countless illustrations of PhD mathematicians and engineers diving headfirst into trading, followed quickly by an unremitting plunge due to the competition of institutions’ algorithmic computer programs. It’s a no-win game, docs. Vacation Timeshares: The maintenance, special assessments and taxes are normally higher than the rental rate at the same resort. And dare I mention depreciation? It’s higher in the first year than purchase of a luxury auto. Yes, I know that you can

Podcasts “Sound Investing” provides clear, concise advice on money and retirement, and includes interviews with the most influential people in the money business including Vanguard’s Jack Bogle, Kiplinger’s Knight Kiplinger, and Money Magazine’s Jason Zweig. “Man vs. Debt” provides wonderful commentary on the perils of debt and how to escape its ugly clutches. The Web Fund Advice (www.fundadvice.com) provides free model portfolios for Vanguard, Schwab, T. Rowe Price and Fidelity investors. Lazy Portfolios (www.marketwatch.com/lazyportfolio) provides even simpler portfolios that beat the street easily in the last decade. Financial Adviser? It often makes sense for one who doesn’t want to take the time to invest on one’s own to hire an adviser, yet be aware that the airwaves are full of sharks. Your best bet is to work with a Certified Financial Planner or a CPA with a Personal Financial Specialist certificate. For dentists specifically, Thomas Wiring Doll at 877-939-2500 has a bevy of planners who offer ethical advice with reasonable fees. Discount brokerages offer the lowest cost financial advice. Examples are Vanguard, Schwab and Fidelity. Can one invest effectively on one’s own? It’s fairly simple. The easiest way is to use a target retirement fund from a discount broker. There is virtually no work, your 24

Continued on page 25 


Continued from page 24

About the Author

trade for other resorts whenever you like. Yet, I’ll normally find a better price through AAA or Kayak for the Grand Hyatt next to your condo without the trading hassle. You are entering a very honored profession. There is little taught in school of practice management or personal finance. Please keep this article in a special place to refer to in the years ahead. I’m always available at the listed e-mail in my bio.

Dr. Douglas Carlsen has delivered independent financial education to dentists since retiring from his prac- tice in 2004 at age 53. For Dentists’ Financial Newsletter, visit – www.golichcarlsen.com and find the “newsletter” button at the bottom of the home page. Additional Carlsen Dentaltown articles are at www.towniecentral.com. Search “Carlsen.” Videos available at www.youtube.com/user/DrDougCarlsen Contact Dr. Carlsen at drcarlsen@gmail.com or 760-535-1621.

Reprinted with permission of Dentaltown Magazine and Dentaltown.com

References: 1. Phil Tyson, Ph.D., “Do You Understand the Psychology of Debt?” (4/11) downloaded at – www.mens-wellbeing.com/2010/02/do-you-understand-the-psychology-of-debt.html 2. Brian C. Hufford, CPA, CFP, “Maximize Your Wealth: Improving Upon the Reality of Your Finances,” AGD Impact, February 2010. 3. Charles Farrell, J.D., LL.M., Your Money Ratios: 8 Simple Tools for Financial Security. New York, NY: Avery, 2010, page 79. 4. Ibid, page 85. 5. Douglas Carlsen, DDS, “Only 4% of Dentists Able to Retire at 65? Nonsense!” Dentaltown, March 2012. 6. Larry Swedroe, The Only Guide to Winning Investment Strategy You’ll Ever Need, 2005,Truman Talley Books, NY, NY, page 229. 7. Ibid., page 242. 5.5 x 4.25 B&W oral cancer ad:Layout 1 5/11/11 1:02 PM Page 1 8. Ibid., page 236.

Thank You

FOR SHINING THE LIGHT ON THE FIGHT AGAINST ORAL CANCER

Henry Schein and LED Dental VELscope want to thank: Add Thank half page ad here • Dr. Robert Trager,you DDS Center copy within this area • Dr. James F. Dolin, DDS • Dr. Maria C. Maranga, DDS President Suffolk County Dental Society for generously volunteering their time to provide free oral cancer screenings to the students and faculty of Adelphi University on April 13th. Oral cancer screenings are a powerful tool to reduce the impact of oral cancer in our community. Henry Schein and LED Dental VELscope were proud to co-sponsor the Nassau County Dental Society initiative to screen high-risk college-age students for this deadly disease and urge you to screen your patients for this deadly disease.

25


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Continuing Education Registration Form Tuition prices are discounted, or, in many cases, free-of-charge to Nassau County Dental Society members. Non-NCDS Members: If you attend a course at non-member rates and join the NCDS within 30 days of the seminar, you may apply the tuition differential you paid to your first year’s NCDS dues. American with Disabilities Act: If you plan to attend a program and need assistance related to a disability provided for under the American with Disabilities Act, please let us know. Call the Society at (516) 227-1112. If you require special accommodations, kindly inform the NCDS at the time of registration. Note: Please pre-register - Seating is limited. Walk-ins will be admitted subject to space availability. In order for credit to be processed toward NYS mandatory requirements, it is necessary for doctors to attend the entire Nassau County Dental Society seminar. Doctors who arrive late and/or leave early will not receive continuing education credit. You may register by sending this form to bmccormick@nassaudental.org or by mail to Nassau County Dental Society, 377 Oak Street, Suite 204, Garden City, NY 11530  fax: (516) 227-1114 RETURN THIS PORTION TO REGISTER -

Name

ADA Number

Address

AGD Number

City

State

Phone  NCDS Member

Zip E-mail

 Non Member

 ADA Member of

Check off your selected courses and indicate your fee NCDS Members/Associate Members - NO FEE (unless otherwise indicated on course page) ADA Members: $50. Non-ADA Members: $150. (unless otherwise indicated on course page) Program

Date

Fee

 “Mandated CPR for the Dentist”

Friday, January 18, 2013

______

 “Grow Your Practice Like Never Before …..”

Monday, March 4, 2013

______

 “Prosthodontic Problem Solving and Innovations”

Monday, May 6, 2013

______

 “Forensics in the 21st Century”

Wednesday, May 8, 2013

______

 “Infection Control”

Friday, May 17, 2013

______

 “Saving Teeth with Little or No Clinical Crowns”

Wednesday, May 29, 2013

______

 “Risk Management”

Wednesday, June 19, 2013

______

Method of payment:  Check - No.

TOTAL:  Charge my Credit Card:

 MasterCard

Credit Card Account No.

 Visa

 American Express

Exp. Date:

Signature

_____

3-Digit Security Code on back of card

Print Your Name as it appears on credit card

 VOLUNTARY CONTRIBUTION TO THE NASSAU ACADEMY OF DENTISTRY $

The New York State Dental Foundation is an ADA CERP Recognized Provider ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complains about a CE provider may be directed to the provider or to ADA CERP at www.ada.org/goto/cerp 27


Upcoming Meetings/Courses Membership Benefit Course (4 MCE Credits) Friday, January 18, 2013 9:00 am to 1:00 pm ď‚– Registration 8:30 am Continental Breakfast Society Headquarters TOPIC Mandated CPR for the Dentist INSTRUCTORS James F. Dolin, DDS

Dr. James Dolin, an oral and maxillofacial surgeon practicing in Plainview and Massapequa Park, New York, has been a certified CPR instructor for more than 15 years, providing CPR certification to hundreds of local dentists and their staff.

Robert Pollack

Mr. Bob Pollack is an American Heart Association training center faculty member for the North Shore LIJ Health system, as well as an instructor trainer. He has certified several thousand students over the years.

SYNOPSIS Heart disease is the number one killer in the United States today. Many fatalities could be prevented with basic lifesaving techniques. This course provides dentists and their staffs with the knowledge and skills needed to properly respond to cardiopulmonary emergencies. This program utilizes hands-on practice sessions for all participants. OUTLINE Hands on basic life support CPR appropriate for dentists and staff. We will provide instruction in adult and child CPR, obstructive airway and AED (Automated External Defibrillator) certification. GOALS Dentists and staff will feel confident to provide adult and child CPR, handle obstructive airway emergencies and become familiar with an AED (Automated External Defibrillator). Upon successful completion of the course, participants will gain the knowledge and hands-on experience needed to administer CPR safely and effectively. Participants will receive an American Heart Association Certificate of Completion for CPR as well as continuing dental education credits. Dentists completing this course will have fulfilled the New York State mandated requirement. Registration NCDS Members and Associate Members: $85.00 ADA Members: $85.00 Non-ADA Members: $225.00 Pre-Registration Required - Use Registration Form on page 27 28


Upcoming Meetings/Courses Membership Benefit Course (2 MCE Credits) General Membership Meeting Monday, March 4, 2013 7:30 pm to 9:30 pm  Registration - 7:00 pm NCDS Headquarters TOPIC GROW YOUR PRACTICE LIKE NEVER BEFORE … TOTAL HEALTH DENTISTRY and SO MUCH MORE!!! INSTRUCTOR Dr. Jonathan A. Bregman

Jonathan A. Bregman, DDS, FAGD, is a clinician, speaker, author, trainer, and personal coach who has personally led successful dental practices for more than 30 years. He has worked as a part time Adjunct Faculty member at the University of North Carolina, School of Dentistry, and a faculty member at the University of North Carolina Hospital Dental Clinic. Dr. Bregman presented over 150 programs on early oral cancer detection in over 45 states and abroad in just the past three years. While dedicated to improving the dentist, team, and patient experience, he has a strong passion for educating dental professionals about enhanced oral assessment/early oral cancer detection. To Dr. Bregman, the goal for all dental practices must be to maximize the quality of patient care, which then will directly enhance the financial bottom line.

OUTLINE In any profession, there are routines that we follow. Your work in dentistry is no different. There are all of the “standard” duties that encompass an important part of each patient encounter. Many are repeated numerous times each day. So how do you remain excited or energized n your profession? Two simple words: CONTINUING EDUCATION. Continuing education opens the door to new and exciting advancements that challenge your current thinking and move you beyond where you are today - providing patient care. Opening your mind up to new possibilities and technologies is a must in our fast paced world. LEARNING POINTS • Brief update: enhanced oral cancer detection technology: what is new; what has changed. • Oral-systemic connection: the NINE areas of connection of periodontal disease and systemic disease and your practice • What is new in sleep disorder understanding that are “must knows” for total patient care that goes beyond teeth and gums • Activating and reactivating your patient base: the newest and best systems and what’s in it for you • Grow your new patient referrals like never before: a patient and team incentive system that really works Registration NCDS Members and Associate Members no charge ADA Members: $50.00  Non-ADA Members: $125.00 Pre-Registration Required - Use Registration Form on page 27 29


Upcoming Meetings/Courses Membership Benefit Course (2 MCE Credits) General Membership Meeting Monday, May 6, 2013 7:30 pm to 9:30 pm  Registration - 7:00 pm NCDS Headquarters TOPIC Prosthodontic Problem Solving and Innovations – Concepts & Techniques for a Successful Restorative Practice INSTRUCTOR Ronald C. Haas, DDS

Dr. Ronald C. Haas is a member of the American College of Prosthodontists, American Dental Association, and the Academy of Osseointegration. He has been voted Outstanding Teaching Attending at North Shore University Hospital and Teaching Attending of the Year at Stony Brook University Hospital Department of Dentistry. He also serves as a Prosthodontic Mentor and Lecturer for numerous Dental Study Groups. He graduated from Stony Brook Dental School with High Honors, and the University of Medicine and Dentistry in New Jersey, where he received his Specialty Certificate in Prosthodontics. He returned to teach at both schools as a Clinical Instructor with the academic appointment of Assistant Clinical Professor. He presently teaches Advanced Prosthodontics and Implant Dentistry one day each week to the Dentists in the General Practice Residency at Stony Brook University Hospital. Dr. Haas has lectured nationally to General Dentists and Specialists on a variety of topics including Dental Implants, Full Mouth Rehabilitation, and the successful treatment of patients with Difficult Dental Problems. His hospital affiliations include North Shore University Hospital in Manhasset and University Hospital at Stony Brook.

OUTLINE  Case Selection  Provisionalization  Case Evaluation  Prosthesis Fabrication  Laboratory Work-up  Delivery and Maintenance  Case Design and Materials Selection OBJECTIVES  How to determine whether your patient is a good candidate for prosthetic or cosmetic treatment  How to predictably evaluate occlusion and esthetics  How to properly design for stable occlusion and optimum esthetics  How to properly design, fabricate and place Provisional & Final Prostheses SYNOPSIS This presentation is designed to give the Restorative Dentist the latest information to efficiently provide optimum quality Fixed, Removable and Implant Supported Prostheses. Proper case selection, evaluation and work – up will be reviewed as the foundation for successful treatment. Practical techniques and dental material selection criteria will be presented to efficiently and predictably place Provisional Restorations and Final Prostheses for a successful General Dental Practice. Registration NCDS Members and Associate Members no charge ADA Members: $50.00 Non-ADA Members: $125.00 Pre-Registration Required - Use Registration Form on page 27 30


Upcoming Meetings/Courses Membership Benefit Course (3 MCE Credits) Wednesday, May 8, 2013 9:00 am to 12:00 Noon ď‚– Registration 8:30 am Continental Breakfast Society Headquarters TOPIC Forensics in the 21st Century INSTRUCTOR David A. Grossman, DDS, FAGD, PC

Dr. Grossman maintains a private practice in Baldwin and has been a member in such professional organizations as D.M.O.R.T. (Federal Disaster Mortuary Operational ResponseTeam) Region 2, InfraGard (Federal Bureau of Investigation Program), Nassau County Medical Reserve Corps., American Academy of Forensic Sciences, American Society of Forensic Odontology as well as the Suffolk Society of Forensic Dentistry. He is a graduate of the FBI Citizen’s Academy. Dr. Grossman has lectured at the Greater New York Dental Meeting, as well as the Yankee Dental Conference. He graduated from New York University College of Dentistry.

SYNOPSIS Forensic science has come to the forefront of our lives with the popularity of television shows such as CSI, The Mentalist and Cold Case, as well as recent disasters including 9/11, Hurricane Katrina, and high-profile criminal cases in the news. This lecture will look at the various disciplines of forensic science and the specific role dentistry plays in mass disaster response and victim identification. Registration NCDS Members and Associate Members no charge ADA Members: $50.00 Non-ADA Members: $125.00 Pre-Registration Required - Use Registration Form on page 27

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Upcoming Meetings/Courses Membership Benefit Course (4 MCE Credits) Friday, May 17, 2013 9:00 am to 1:00 pm  Registration 8:30 am Continental Breakfast  Society Headquarters TOPIC Infection Control INSTRUCTOR Dr. Harold Edelman

Dr. Edelman was in an active practice for 32 years and a consultant in infection control for 14 years. He provided infection control services and programs for over 800 dental offices. Dr. Edelman is certified by OSHA to teach “Voluntary Compliance in the Private Sector” and “Biohazards.” He has been retained as an expert witness in multiple cases of litigation alleging disease transmission in a dental facility, and has been involved in 71 OSHA inspections of dental offices to date.

SYNOPSIS SO…WHAT’S NEW IN INFECTION CONTROL? As we all know, dentistry has a very low risk of disease transmission. However, implementation of appropriate infection control protocols is considerably more important and has greater impact today than in previous times. Evidence based studies and statistics verify this! Folks …. It’s not the 50’s, 60’s & 70’s anymore. We are living in a different, more aggressive microbial world today! The “Golden Age” of antibiotics has passed. Having Consequences for failure to comply with an OSHA Regulation of CDC guidelines will likely never happen in your office but have happened to some of our colleagues. We will tell you about some of these. So … having said all this let us bring you up to date on those issues getting the most attention today in our professional journals and by our regulator agencies. If you have been to our courses in the past then you know Dr. Edelman will address only the clinically relevant issues and leave the rest to the researchers and scientists. FOLKS …. WE REALLY DON’T WANT TO WASTE YOUR TIME, and we must be doing something right because over the past ten years more and more of you are coming back to us for your updates.

• • • • • • • • •

HOT ISSUES Hand hygiene…boy, do we need help! So….what about swine flue? More importantly, the seasonal flu Proper coughing/sneezing etiquette Higher risk patients out there today, you should be a little more concerned about exposure incidents. Statistics verify this Are you following proper disinfecting guidelines…we’ve had in dentistry a documented case of Hepatitus B transmission….inappropriate disinfection appears to be the culprit Dental aerosols … yuk! Updated OSHA compliance directives that is relevant to us. OSHA, CDC, State Boards of Examiners … please clear up the fog! Registration NCDS Members and Associate Members: $85.00 ADA Members: $85.00  Non-ADA Members: $225.00 Pre-Registration Required - Use Registration Form on page 27 32


Upcoming Meetings/Courses Membership Benefit Course (2 MCE Credits) Wednesday, May 29, 2013 9:00 am to -12:00 Noon  Registration - 8:30 am NCDS Headquarters TOPIC SAVING TEETH WITH LITTLE OR NO CLINICAL CROWNS INSTRUCTOR Edward Feinberg, DMD

Dr. Edward Feinberg is a graduate of Tufts University and has practiced Dentistry in Scarsdale, New York for more than 34 years. For 23 years he practiced with Dr. Elliot Feinberg, a master and pioneer in the field of full coverage restorative dentistry. He is the Director of the Westchester Academy of Restorative Dentistry. Dr. Feinberg is a nationally recognized lecturer and a noted author of scientific and educational articles for dental publications. He is also a reviewer for the Journal of Oral Implantology. In addition to educational activities, Dr. Feinberg has served NYSDA as a delegate and chairman of two councils. He has also served on 4 Councils of the American Dental Association and currently represents New York State on the ADPAC Council. Dr. Feinberg is a past president of the Ninth District Dental Association, a component of the New York State Dental Association with 1600 members.

SYNOPSIS Teeth that have little or no clinical crowns are quick to be condemned as unsalvageable and extracted. Too often these teeth are extracted in favor of implant placement. Many of these teeth have such good bone and root structure that they are easily salvageable with conservative treatment. Some teeth with little or no clinical crowns may have periodontal bone loss or poor root anatomy. Even though these teeth have a questionable prognosis, they often can be saved for the patient. The ability to save questionable teeth allows the practitioner to provide more options for patients and create more comfortable transitional restorations. Not all patients will be candidates for implants. Patients may be better off when “questionable” teeth are retained as long as possible – even when they are not good candidates for sophisticated dentistry. This course will demonstrate how “questionable” teeth can be saved with clinical examples from a library of more than 100,000 slides and digital pictures taken since 1950. Emphasis will be placed on how to achieve retention for restorations on teeth with little or no clinical crowns. PARTICIPANTS WILL LEARN: How the ability to retain “questionable” teeth offers new treatment options that can really help patients • How to achieve retention on teeth with no clinical crowns • How saving questionable teeth can facilitate implant therapy and ease the transition to other types of prosthetic restorations. Registration NCDS Members and Associate Members no charge ADA Members: $50.00 Non-ADA Members: $125.00 Pre-Registration Required - Use Registration Form on page 27

33


Upcoming Meetings/Courses Membership Benefit Course (4 MCE Credits) Wednesday, June 19, 2013 9:00 am to 1:00 pm  Registration 8:30 am Continental Breakfast Society Headquarters TOPIC Risk Management INSTRUCTORS Robert M. Peskin, DDS & Michael Kelly, Esq. This Risk Management Course on Professional Liability (Malpractice Claims) is Sponsored by the New York State Dental Association

• • • •

SYNOPSIS Pre-registration required, seating limited (pre-registration deadline: June 1, 2013) All participants must stay for the entire four-hour presentation Course Code will be announced at the conclusion of the seminar Certificates of completion will be distributed at the end of the course

All who successfully complete the course will receive a certificate entitling them to a Ten Percent (10%) Discount on their renewal from MLMIC and most other insurance companies, for three (3) years (please check with your individual carrier to ascertain applicability of this program) Registration NCDS Members and Associate Members: $135.00 ADA Members: $135.00 Non-ADA Members: $285.00 Pre-Registration Required - Use Registration Form on page 27

34


ADA’s House of Delegates Meeting and 153rd Annual Session Dr. Meena Jaiswal, NCDS President-Elect

Palmaccio and Michael Shreck members Legal, Legislative and Public Affairs chaired by Anthony Chilluri – James Dolin member Membership and Planning chaired by Mark Bauman – Lidia Epel and Meena Jaiswal members Dental Benefits, Practice and Health chaired by Andrew Vorrasi – Eugene Porcelli member Dental Education and Science chaired by Frank Barnashuk – David Miller member

The House of Delegates, as the legislative and governing body, is the supreme authority of the American Dental Association. The HOD represents more than 157,000 members of the Association and the dental profession in the United States. The HOD is composed of official certified delegates of the 53 constituent dental associations; two official certified delegates from each of the five federal dental services; and five student members of the American Student Dental Association. In all there were over 25,700 attendees at the ADA’s House of Delegates and 153rd Annual Session on October 18 – 21 in San Francisco including approximately 7,000 dentists.

Following the Second Trustee District Caucus was the Mega Topic Discussion about Oral Care in Five Years – Who Pays for it and How Will it Impact the Practice of Dentistry. The Mega Topic Discussion preceded the American Dental Association’s first meeting of the House of Delegates at 3:30 pm. The first meeting is devoted to matters relating to the organization of the House, presentation of the reports of the President, the Board of Trustees, councils, commissions and the resolutions of the constituent associations. Nominations for the elective offices, as well as further nominations to councils and commissions, are presented during this meeting.

Prior to the first session of the ADA HOD, there was an abundance of meetings and activities for Nassau County Dental Society’s Delegates, Alternate Delegates, NYSDA Trustee and Speaker of the House. The Second Trustee District Caucus, encompassing all of New York State components and the New York State Dental Association, debated over topics including; budget, business and administrative matters, legal, legislative and public affairs matters, dental benefits, practice and health, dental education, science and related matters, membership and planning.

The second and third meetings of the House of Delegates were called to order by the ADA Speaker of the House, J. Thomas Soliday, followed by the introduction of distinguished guests and the presentation of honorary membership. More than 135 resolutions were submitted, debated, amended, and voted on during the four meetings of the House of Delegates Annual

Our own, Dr. Gene Porcelli was on the Reference Committee on Governance to hear testimony on the related resolutions that were to be presented to the 2012 ADA House of Delegates. The Reference Committee was sequestered to consider all testimony received and to analyze the Westman Governance Study. Budget, Business and Administrative chaired by Mark Weinberger – Frank

Continued on page 36  35


House of Delegates continued from page 35

5) Dues for active life members to go up to 75%, 6) ADA dues to go up $22, instead of $80, due to Mark Bauman of Second District.

Session. Anyone interested in any or all of the resolutions can go to the ADA’s website www.ADA.org. Go to the members only section, click on “Governance and Leadership” then click on “2011 Board Reports and Resolutions”. There you will find a list of all resolutions submitted. If any of you have questions about these resolutions or their outcomes, please contact the Dental Society. The question will be directed to the delegate or alternate delegate, who chaired, or was a member of the Caucus Study Group for that particular resolution.

Resolutions NOT passed were: 1) To sunset the Council on Members Insurance and Retirement Programs, as recommended in the Westman Governance Report. 2) Reduction of the size of the House of Delegates to a target of 300. 3) Dental Anesthesia as a dental specialty. I want to thank all of NCDS Delegates that took time out of their practices to attend this all encompassing and important meeting. The next ADA HOD Meeting and Annual Session are scheduled to be held in New Orleans October 31 - November 3, 2013.

Some of the resolutions passed were: 1) Guidelines governing the conduct of campaigns for all ADA offices. 2) Urge all constituents to implement term limits for Delegates and Alternate Delegates. 3) The Speaker of the House will be limited to two terms of three years each. 4) The President is urged to create an Ad Hoc Task Force to investigate issues concerning all Councils raised in the Westman Governance Report.

Editor’s Note – We thank Dr. Jaiswal for her contribution to the Bulletin and look forward to her installation on January 5, 2013  Posing for an informal photo at the ADA House of Delegates are from left to right – Drs. Michael Shreck, David J. Miller, Lidia Epel, Frank Palmaccio, William Calnon, Meena Jaiswal, Eugene Porcelli and NCDS Executive Director Jim Garnett  Pictured bottom left – President-Elect Dr. Meena Jaiswal and past president Dr. Michael Shreck at the ADA HOD Meeting in San Francisco  Pictured below – Immediate Past President Dr. Eugene Porcelli stands to testify about reducing the size of the House

36


ADA News

American Dental Association Installs President, President-Elect and Second Vice President at October ADA House of Delegates Meeting The American Dental Association (ADA) recently installed Robert A. Faiella, D.M.D., M.M.SC., of Osterville, Mass., as President and Charles H. Norman III, D.D.S., of Greensboro, N.C., as President-Elect. The installations took place during a meeting of the ADA House of Delegates in San Francisco. Dr. Robert A. Faiella As the ADA’s new President, Dr. Faiella will lead the 157,000-member organization, America’s leading advocate for oral health, for one year. Prior to becoming president, Dr. Faiella served as the ADA’s President-Elect from 2011-2012. Dr. Faiella’s prior roles with the ADA include serving for four years on the ADA Board as the trustee from the First District, which represents Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont. He has served on various councils and committees, including terms as chair of the Compensation Committee and the ADA Electronic Health Record Workgroup. In addition, Dr. Faiella served from 2009 to 2011 as chairman and sole director of ADA Business Enterprises, Inc., (ADABEI), a wholly-owned subsidiary of the ADA. Dr. Faiella is a former president of the Massachusetts Dental Society. He earned his predoctoral education from Villanova University, receiving two Bachelor of Science degrees and a D.M.D. degree from Fairleigh Dickenson University School of Dental Medicine. He earned his graduate training in periodontology as a Post-Doctoral Fellow at Harvard School of Dental Medicine, as well as a Masters of Medical Science degree from Harvard Medical School. Dr. Charles H. Norman III In balloting at the House of Delegates Monday, Oct. 22, Dr. Norman was voted the ADA’s President-Elect. After serving a one-year term as president-elect, Dr. Norman will be slated to succeed Dr. Faiella as ADA President when the ADA’s House of Delegates reconvenes in New Orleans in 2013. An ADA member for 35 years, Dr. Norman is immediate past trustee of the ADA’s 16th District, which represents Virginia, North Carolina and South Carolina. As trustee, he served on several Board committees, including Administrative Review, Strategic Planning and ADABEI Structure/Governance. Dr. Norman chaired the Budget and Finance Committee and served as a Board liaison to the Council on Members Insurance and Retirement Programs, as well as the Council on Dental Education and Licensure. He is a past chair of the ADA Council on Dental Practice and has chaired the ADA Well-Being and Dental Practice Indicators committees. A 1977 graduate of the University of North Carolina at Chapel Hill School of Dentistry, Dr. Norman is a past president of the University’s Foundation Board. He also is a past president of the North Carolina Dental Society and its Third District Dental Society. Continued on page 38  37


ADA Officers continued from page 37

Letters to the Editor

Dr. Norman is a member of the North Carolina State Healthcare Commission, the Academy of General Dentistry, American College of Dentists, International College of Dentists and the Pierre Fauchard Academy.

Dear Doctors, Jaiswal, Epel and Maranga, On behalf of the Stephen B. Gold Dental Clinic, we thank you for your generous donation. Most importantly, thank you for thinking of us when deciding who to donate to. With great appreciation, Keri A. Logan, DMD St. Charles Foundation

CALIFORNIA DENTIST INSTALLED AS ADA SECOND VICE PRESIDENT Brian E. Scott, D.D.S., a general dentist based in Palo Alto, Calif., was recently installed as second vice president of the American Dental Association (ADA). Dr. Scott’s installation took place in San Francisco at the ADA's 153rd Annual Session and World Marketplace Exhibition.

Editor’s Note: St. Charles Foundation received a portion of the proceeds from our successful Scrubs & Stilettos event.

Dear Jim and everyone – I was delighted to be present at such a great event. Great example of the potential of collaboration at so many levels. This is exactly the type of program the MPG grants are meant for. Congratulations to all involved. Mark A. Bauman, DDS Incoming Chair, ADA Council on Membership

Dr. Scott will serve on the ADA Board of Trustees as the second vice president. The ADA Board formulates and reviews policies and programs and makes recommendations to the members of the ADA's governing body, the House of Delegates. As a member of the ADA Board, Dr. Scott will play a major role in the ADA's organizational objective of being America’s leading advocate for oral health.

Editor’s Note: Dr. Bauman attended our New Dentist event held at KPacho.

Dr. Scott is a past president of the California Dental Association and has served in the ADA House of Delegates. He also served as chair of the California Dental Association Foundation. Dr. Scott earned his dental degree from the Case Western Reserve University School of Dental Medicine and has been an ADA member since 1974.

PENINSULA DENTAL SOCIETY 2013 Seminar Schedule (ABC4DE.org)

 January 11, 2013 - Dr. Vince Kokich, Jr. “Interdisciplinary Teamwork to Create Esthetic Success in the Ortho-Restorative Patient”  February 1, 2013 - Dr. John Kanca, III “State of the Art Adhesive Dentistry, 2013: Where We are and Where we Are Going”  March 1, 2013 - Dr. Jay Lerner “The Functionally Esthetic Smile: Veneers, Complex Rehabilitations, and Occlusion”

OOPS!

Full year’s tuition for all six seminars is $1095, payable to: The Peninsula Dental Society, 141-B Franklin Place, Woodmere, New York 11516 (516)569-1111

The spelling of the Nassau County Dental Society Executive Director Emerita, Gabriele K. Libbey, was misspelled in the September/October issue of the Bulletin. After her retirement in 2009, Gaby was honored by the Society when she received the Herbert L. Taub Distinguished Service Award.

All seminars are held on Fridays at The Sands, Atlantic Beach, New York from 8:30 AM-3:30 PM and qualify for 6 c.e.u. Tuition includes breakfast, sumptuous luncheon, handout materials and free parking. For further information and registration details, call Laurel Wittig at 718 734-2776 38


ADA News

Dentists await IRS device tax rules Craig Palmer

Washington - Dentists and the dental industry await IRS regulations implementing a 2.3% medical device excise tax that takes effect Jan. 1, 2013. The Internal Revenue Service, among other regulatory agencies, is expected to issue post-election rules implementing Affordable Care Act provisions, the excise tax among them.

supplies purchased by a dentist for use in the office will be subject to the tax; such as, restorative materials, hand instruments, surgical instruments and endodontic filling materials, the ADA Washington Office said. It appears that completed dental prosthetics will not be taxed but the materials that are used to make dental prosthetics will be subject to the tax.

The dental profession and industry are basing member and customer guidance on proposed rules issued by the IRS on Feb. 3, 2012 defining a "taxable medical device ‌ in general" as a device approved by the Food and Drug Administration for human use. The FDA regulates dental devices as well, and the IRS said those, too, are subject to the tax.

While the completed crown or denture may not be taxed, according to this interpretation of the proposed rule, the materials used to make the crown or denture - such as the metal alloys, acrylic and porcelains, will be taxed. But these interpretations await clarification from the Internal Revenue Service. However, the IRS clearly rejected profession-industry exemption requests.

The medical device excise tax is a manufacturer's excise tax, the IRS said, and the manufacturer or importer of a taxable medical device is responsible for reporting and paying the tax.

The ADA and a coalition that included the Academy of General Dentistry, the American Academy of Oral and Maxillofacial Surgeons, the American Association of Orthodontists, the Dental Trade Alliance and the National Association of Dental Laboratories asked the Secretary of the Treasury to "‌ exercise the authority in Section 4191(b)(2) of Public Law 111-152 to determine that the excise tax does not apply to dental devices manufactured by dental laboratories and orthodontic manufacturers."

Dr. Daniel Collado and Dr. John Reitz told the ADA News that they received letters from dental laboratories attempting to explain the tax and how it will be applied. "Each lab has the option of including the MDT in their charge to the dentist or separately itemizing the MDT on their invoice to the dentist," the National Association of Dental Laboratories said in an advisory on "steps a dental laboratory should take between now and January 1, 2013." These steps recommend filing of several relevant tax forms, although the forms had not been updated as of September, and the filing frequency was uncertain.

"A commentator requested that the proposed regulations provide a blanket exclusion for dental instruments and equipment," the Notice of Proposed Rulemaking said. "The proposed regulations do not adopt this suggestion. There is no statutory basis for treating dental devices differently from other taxable devices. Many dental instruments and

The proposed rule appears to indicate that dental equipment, materials and 39

Contnued on page 40ď‚„


IRS tax rules continued from page 39

equipment are subject to the FDA's listing requirement. Accordingly, those devices that are listed as devices with the FDA pursuant to FDA requirements are 'taxable medical devices' under the proposed regulations, unless they fall within an exemption under Section 4191(b)(2), such as the retail exemption."

The ADA News and ADA.org will continue to report on developments concerning the medical device excise tax.

The Affordable Care Act exempts eyeglasses, contact lenses, hearing aids and "any other medical device determined by the Secretary to be of a type which is generally purchased by the general public at retail for individual use" from the taxable medical device definition.

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ADA News

Statement from Dr. William Calnon, President, American Dental Association on New York City’s Ban of Large-size Sugary Beverages The American Dental Association (ADA) applauds New York City Mayor Michael Bloomberg for shining a spotlight on the issue of frequent and excessive consumption of soda and other sugary beverages which raises the risk of adverse health conditions such as obesity, diabetes and tooth decay.

promote increased access to soft drinks for children. Progress has been made, but additional public education efforts related to nutrition are needed. Eating a balanced diet is critical to overall health and wellness. A single sugary food or beverage cannot be blamed for causing tooth decay, obesity and other serious health conditions. Almost all foods have some type of sugar. You cannot and should not remove all sugar from your diet. Many foods and drinks, like apples, carrots and milk, are naturally sweet and have vitamins and nutrients that your body needs.

When it comes to a ban related to a particular food or beverage, is a stick rather than a carrot approach the best way to get people to adopt healthier diets? Perhaps not, but the attention alone that the mayor’s ban has generated on this issue is certainly a huge step in the right direction. Health professionals, including dentists, have long stressed the importance of a healthy diet; yet obesity and lack of exercise - associated with chronic diseases and conditions such as heart disease, cancer, diabetes and hypertension - remain high.

Yet, from a dental perspective, a steady diet of sugary foods and drinks, including juice and sports drinks, can damage teeth. Cavity-causing bacteria in the mouth feed on sugar and produce acids that attack tooth enamel for up to 20 minutes after you eat or drink. Sipping sugary beverages or eating sugary foods all day results in repeated acid attacks that weaken tooth enamel, which can lead to cavities.

In addition, more than one in five Americans have untreated cavities, according to a new report from the U.S. Centers for Disease Control and Prevention. People aged 20 to 44 had the highest rate of untreated cavities, at 25 percent. It is estimated that pain from untreated dental disease results in millions of missed school and work hours.

To help reduce the risk of tooth decay, read the labels of foods and beverages and make sure they are low in added sugar. If you have a sugary food or drink, have it with a meal. Limit between meal sipping and snacking on sugary beverages and foods. Additional guidelines on a healthy diet are available from the U.S. Department of Agriculture (USDA) at – www.choosemyplate.gov.

For decades, ADA policies have expressed concern and a need to educate the public about the effect nutrition has on oral health. Specific to soda consumption and risk of tooth decay, the American Dental Association adopted a policy in 2000 opposing contractual arrangements between schools and soda manufacturers (known as "pouring rights contracts") that influence consumption patterns and

The American Dental Association also recommends brushing twice a day with ADA-Accepted fluoride toothpaste, flossing daily, eating a balanced diet and visiting your dentist regularly. 41


ADA News

Survey: Kids’ Perceptions of Halloween Include "Too Much Candy" and Desire for Other Types of Treats The American Dental Association (ADA) and PopCap Games (leading global developer, publisher and operator of casual video games) announced the results of a new survey targeting trick-or-treating children (ages 5 to 13) in the U.S., looking at kids’ views and perceptions of Halloween. Approximately 94% of all American children participate in trick-or-treating, and 65% of them consider Halloween the best holiday of the year. At the same time, the survey found that a significant majority of kids are primed for changes to the holiday. Among the top findings, two-thirds of kids surveyed agree that they eat too much candy around Halloween, 89% say they would still like the holiday if it was less about candy and more about other types of fun, and fully 93% would prefer to receive a video game instead of candy while trick-or-treating. "Children themselves are asking us as adults to help curb sugary snacks," said Dr. Jonathan Shenkin, ADA spokesperson on pediatric dentistry. "The Stop Zombie Mouth campaign is an excellent way to bring together an alternative treat for Halloween with an opportunity to increase awareness among parents and children about the benefits that practicing good oral hygiene can have on overall health. Learning and practicing good oral hygiene habits now will pay dividends later in life." Following are highlights from the survey, conducted by Information Solutions Group and involving more than 750 children ages 5 to 13 throughout America; full survey results can be found here: ADA/PopCap Halloween Consumer Children's Study Kids’ Favorite Holiday For two thirds (65%) of U.S. children, Halloween is considered the best holiday of the year. Among all children surveyed, the three most-liked Halloween activities are "Trick-ortreating" (75%), "Dressing up in a costume" (71%), and "Getting lots of candy" (66%). Health-Conscious Kids More than three fourths (78%) of kids surveyed agree with the statement "too much candy is bad for me," and two thirds (67%) say they eat too much candy around Halloween. Girls who were surveyed were somewhat more likely to respond in the affirmative than boys: 82% of girls agreed with the statement "too much candy is bad for me," compared to 74% of boys. Kids: Halloween Could Be About Other Types of Fun 89% of responding children indicated that they would still like Halloween if it was less about candy and more about other types of fun. Further, 93% of all kids surveyed stated they would rather receive a free video game than a piece of candy while trick-or-treating. 42% of children surveyed said they worry about getting cavities from eating too much candy around Halloween.

42


ADA News

ADA Honors State and Local Dental Societies for their Outreach Programs 2012 Golden Apple Awards

The American Dental Association (ADA) continues to honor state and local dental societies across the nation with the 2012 Golden Apple Awards. The Golden Apple Awards program, now in its 24th year, recognizes outstanding achievement in dental society activities and excellence in leadership. The 2012 Golden Apple Awards will be presented through the end of the year to the following Societies:  Legislative Achievement –The Michigan Dental Association “Grassroots Development Program,” received the award in the constituent society category with a total membership of more than 1,000 dentists.  Excellence in Membership Recruitment and Retention Activity –The Michigan Dental Association, “Nonmember Five Pillars Campaign,” received the award for membership recruitment. The North Carolina Dental Society “Ambassador Program” received the award for membership recruitment and retention.  Excellence in Dental Health Promotion to the Public - The Massachusetts Dental Society’s “Shining a Spotlight on Oral Health” received the award in the constituent society category. The Seventh District Dental Society (Steuben County, NY), “Rock Your Smile with Rock and Bowl” received the award in the component society category with less than 1,000 members.  Excellence in Member-Related Services/Benefits – The California Dental Association received the award for a dental society with total membership fewer than 1,000 dentists for “Guide for the New Dentist.”  Outstanding Achievement in the Promotion of Dental Ethics – The Texas Dental Association, “Dental Ethics: The Strength of our Profession.”  Achievement in Dental School/Student Involvement in Organized Dentistry – The Maryland State Dental Association, “Every Step of the Way.”  Excellence in Science Fair Program Support and Promotion – The Washington State Dental Society and the Kitsap County Dental Society received the award for “Promoting a Science Fair.”  Open Category – The North Carolina Dental Society, “Membership Focused Gazette” received the award in the constituent category. The Greater Houston Dental Society, “Media Relations Committee” received the award in the component category.  Excellence in Access to Dental Care Programs – The North Carolina Dental Society received the award for their “MOM Program” in the constituent category. The Nassau County (NY) Dental Society received the award in the component category with less than 1,000 dentists.  The Green Apple – Excellence in Environmentally Sustainable Programs and Education The North Carolina Dental Society received the award for “It’s Not Easy Being Green.”  Outstanding Achievement in the Promotion of Diversity and Inclusion – In the constituent category, the Maryland State Dental Association received the award for “Wine, Women and Song.” In the component category, the San Antonio District Dental Society received the award for “Diversity in Dentistry Celebration.”  Inspiring Careers in Dental Education – Dr. Paul J. Berson from the University of Pennsylvania School of Dental Medicine received the award. 43


ADA News

ADA Statement Provides Comprehensive Overview of Community Dental Health Coordinator Pilot Program The ADA today released the fourth in a series of papers that examine the challenges and solutions to bringing good oral health to millions of Americans who, for multiple reasons, lack access to regular dental care. Breaking Down Barriers to Oral Health for All Americans: The Community Dental Health Coordinator (CDHC) takes a close look at the ADA's pilot project to educate, train and deploy a new type of community health worker, one with a focus on oral health education, disease prevention and patient navigation. This paper examines the history of the ADA CDHC pilot project, including:  Its underlying concept  The development of a comprehensive curriculum  Recruiting students  The roles of the participating organizations and institutions in the education and training process

 How the project is being evaluated, and  The results reportable at this stage in the project. While a formal evaluation of the pilot project has yet to be completed, the initial evaluation of CDHC activities in various practice settings shows great promise. The ADA and state dental societies are working to encourage state governments, the higher education community and the charitable and private sectors to begin funding and operating CDHC programs. Doing so in sufficient numbers could affect marked improvement in the oral health of Americans, who currently lack both adequate access to dental care, and the knowledge that empowers people to take charge of their own oral health. A PDF of Breaking Down Barriers to Oral Health for All Americans: The Community Dental Health Coordinator is available at ADA.org.

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Dental News/Views

Federal lawsuit claims Aspen Dental operating illegally Donna Domino

A federal lawsuit filed in New York claims Aspen Dental Management and the private equity firm that controls it illegally operates dental clinics across the U.S. because it violates laws that require clinics to be owned and operated by dentists.

The suit claims Aspen engages in aggressive, misleading profit-driven practices, including getting patients to consent to expensive treatments after they've been attracted to the clinics by free exam and x-ray promotions.

The lawsuit was filed October 18th in U.S. District Court in Albany against Syracusebased Aspen Dental and private equity firm Leonard Green and Partners in Los Angeles.

Aspen and other private-equity-owned chains have been the subject of investigations by U.S. Sen. Charles Grassley (R-IA). He voiced concerns that the company promotes unnecessary treatment plans with expensive credit arrangements.

It was filed on behalf of 11 patients in 11 states, but their lawyers are seeking classaction status that could cover tens of thousands of current and former patients.

A CPI/Frontline investigation of Aspen found that its business model of serving patients who cannot afford a dentist, had led to complaints of overtreatment and loading patients with heavy debt.

The suit claims Aspen's "so-called 'Practice Owners' are nothing more than de facto employees and/or independent contractors" of the company, which controls its 358 clinics' marketing, hiring, training, and bookkeeping.

New York Attorney General Andrew Cuomo investigated GE Money's CareCredit service in 2010, which Aspen Dental promotes. After receiving hundreds of complaints from patients who said they were billed for procedures they didn't receive, billed for work done improperly, overbilled for services, or were signed up for such cards without their consent.

Aspen spokeswoman Kasey Pickett called the suit "entirely without merit" in an email to DrBicuspid.com. She said the company provides "business support services to dentists who own and operate" the clinics, whose "singular commitment is to do what's right for their patients."

An 87-year-old woman described going to Aspen Dental to get two teeth fixed and how she was pressured into signing up for $12,000 worth of work on a third-party credit card.

"Aspen Dental Management is proud that the business support services that it provides allow dentists to spend more time focusing on patient care, rather than accounting, IT, and the other administrative responsibilities associated with running a dental practice," the statement read.

In 2010, Aspen Dental paid a $175,000 settlement following an investigation by Pennsylvania state investigators over misleading information about discounts, coupons, and interest-free financing.

Leonard Green and Partners did not return a call for comment.

If you’ve read an article and you feel it is important enough for your colleagues to be aware of, please email it to our Editor at the Society for review – office@nassaudental.org 45


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Legal Practice Tips

New Comparability Profit-Sharing Plans for Dental Practices Andrew E. Roth, Esq., Danziger & Markhoff LLP

The vast majority of owners of dental practices who already have or who are thinking of setting up a tax-qualified retirement plan, such as a profit-sharing plan, have one major goal in mind. They want to make significant tax-deductible contributions for their own benefit, which will reduce their current income tax bill and serve as a nest egg for their future. At the same time, they are not interested in maintaining a plan if the staff costs are too great. This goal of making significant contributions for owners and other key employees, while keeping staff costs under control, is not easily achieved under the Internal Revenue Code (“Code”). The Code generally requires that a tax-qualified retirement plan not discriminate in favor of highly compensated employees. This article discusses how the dental practice owner's goal can often be achieved, in whole or in part, through the creative use of a "new comparability" profit-sharing plan which satisfies the Code’s requirements.

their employees. While these tests are sensitive to demographics and do not always yield favorable results, in many situations -- particularly, if the group that the owner wants to favor is predominantly older than the rest of the employees -- they allow higher contribution rates for the owner and other key employees than for the rank and file staff. In addition, new comparability often provides a plan with flexibility and allows different groups of owners and highly compensated employees to have different contribution rates. To demonstrate this, assume that there are two dental practice owners and four employees for a total of six plan participants. One of the employees is the wife of one of the owners. The compensation and contributions under a new comparability plan are set forth in table on page 48. The owner who is 46 is older than each of his employees by six years or more. That “age spread” is one of the key components to successfully maximizing the contributions for the owners while minimizing staff contributions.

Traditional profit-sharing plans and Simplified Employee Pension Plans ("SEPs") require that a level percentage of compensation be contributed on behalf of all plan participants. As a result, in a traditional arrangement, if the owners of dental practices want to increase contributions on their own behalf, they need to also increase the contributions for their staff.

In our example, a new comparability formula has been devised that gives the owners the maximum allowable contribution under the Code. For 2012, that means a contribution per owner of $50,000. Under the facts in the example, the contribution rate for the owners is 20% of compensation. Applying actuarial crosstesting, contributions for the other employees are set at 5% of compensation. This results in the owners and the wife receiving 94% of the total contribution that is made to the plan and the staff employees receiving only 6% of the total contribution.

In a new comparability plan, actuaries use certain IRS-blessed “cross-testing” rules, and demonstrate compliance with the nondiscrimination requirements by converting the contributions that are made under the plan to their equivalent benefits under a defined benefit pension plan. All of this is done “behind the scenes” so that the plan is easily understandable by dentists and

Continued on page 48  47


Profit-Sharing continued from page 47

Compare this to a traditional profitsharing or SEP: in order for the owners to receive $50,000, each staff member would have to receive a contribution of 20% of compensation. The staff cost for a traditional plan utilizing the demographics in the case study would be approximately $25,500 versus approximately $6,400 in the new comparability plan. In this example, the new comparability plan design results in a staff cost savings of over $19,000 per year!

existing retirement plan arrangement to see if they are really maximizing their own benefits. If you do not yet have a profit-sharing plan, or if you have a profit-sharing plan or SEP that uses a formula other than new comparability and you would like to see what new comparability can do for you, kindly contact Andrew E. Roth, Esq. at (914) 948-1556 or at his email – aroth@dmlawyers.com. Mr. Roth is a partner at the White Plains, New York law firm of Danziger & Markhoff LLP. This firm is a business and tax-oriented law firm that has been representing dentists in the New York metropolitan area for over 50 years.

Thus, an owner of a successful dental practice who does not yet have a qualified plan should consider establishing one, utilizing a new comparability design. In addition, owners of dental practices who already have a plan should review their

New Comparability - Case Study Employee

Compensation

Contribution [% of Compensation]

Owner [Age 46]

$250,000

$50,000 [20%]

Owner [Age 55]

$250,000

$50,000 [20%]

Wife [Age 53]

$ 19,200

$

Staff [Age 40]

$ 48,346

$ 2,417 [ 5%]

Staff [Age 32]

$ 38,500

$ 1,925 [ 5%]

Staff [Age 26]

$ 40,500

$ 2,025 [ 5%]

48

% of Total

$100,960 94%

960 [ 5%]

$6,367 6%


Health Care and the Dentist

Potential Effects of the Affordable Care Act on Dentistry Health Care Delivery and Financing A major goal of the ACA is to better integrate and coordinate health care delivery and financing by expanding the level of health care provided under an Accountable Care Organizations (ACO) umbrella. ACOs are designed to align provider incentives with provision of quality and coordinated care and to shift reimbursement away from volume of services toward health outcomes and quality. ACOs are also meant to improve the infrastructure underlying care delivery. To date, the ACO models that have emerged have largely focused on health care services for the Medicare population. Expert analysis recently completed indicates that there are very few ACO type models of care that include any dental services. Looking forward, it is uncertain when and to what degree ACOs will integrate dental care delivery and reimbursement as part of the core health care services they provide.

The Affordable Care Act has the potential to reshape health care in America. The expansion of medical insurance coverage, a move toward more integrated care delivery, and significant changes to how health care is financed are some of the main changes expected. Several aspects of the ACA have important implications for dentists as oral health care professionals and small business employers, as well as consumers of medical care. While much of the effect of the ACA on health care in general and on dentistry in particular remains uncertain at this stage, it is important to highlight some of the potential changes that are likely to occur. Medicaid The ACA provides for the expansion of Medicaid to cover people with incomes below 133 percent (138 percent, net of income disregards) of the federal poverty level (FPL). The federal government, will pick-up 100 percent of the cost of covering this additional population initially and 90 percent of the cost long term. The actual expansion of Medicaid coverage will vary significantly depending on how states respond to the Supreme Court ruling last June, which held that the federal government could not withhold all federal Medicaid funds from states that refuse to expand their programs. According to various policy experts, the number of children and non-elderly adults added to the Medicaid roles could be as high as 24 million or as low as 11 million, depending how many states accept the ACA money and expand their Medicaid program. Actual increases in monthly enrollment will likely be lower than these numbers because of the frequency with which beneficiaries enter and leave Medicaid as their financial circumstances change.

The ADA has taken the lead in developing the Dental Quality Alliance to ensure that specific concerns of dentistry are adequately addressed. The Association is likewise engaged with federal health information technology officials to represent dentistry’s interests. Health Insurance Exchanges Exchanges must be in place in time to begin enrolling beneficiaries by October, 2013. Initially, the exchange will be available to individuals and small businesses only allowing the purchasers to select from various private health care plans. Under the ACA, people with incomes between 100-400 percent of the FPL are eligible to receive federally subsidized coverage through the exchange. A key aspect of the ACA is the individual Continued on page 50  49


Affordable Care Act continued from page 49

benefits (Washington state and Colorado), and determine whether to include adults as an add-on to the essential benefit package (Vermont).

mandate to obtain health insurance covering ‘essential’ health benefits. The law includes pediatric dental care in a list of essential health benefits to be provided by small and individual group health plans but dental care for adults is not included in that essential benefit package.

Dentist Employers The ACA does not require small businesses with 50 or fewer employees to provide health insurance. More than 99 percent of dental practices have 50 or fewer employees. Small business employers who pay at least 50 percent of the premium for employee coverage may qualify for a small business tax credit. To qualify, the employer must have fewer than 25 full-time equivalent employees whose average annual wage does not exceed $50,000 per employee. The tax credits, which disappear after 2016, will be available on a sliding scale to assist the purchase of health insurance.

To ensure a consistent level of consumer protections, stand-alone dental plans must offer the pediatric oral essential health benefit without annual and lifetime limits. Stand-alone dental plans will also likely have to meet certain marketing requirements, ensure a sufficient choice of providers, and perhaps meet performance quality measures. Further, they may be required to use a single enrollment form and a standard format for presenting health benefits plan options. It is estimated that three million children will gain dental benefits through the health insurance exchanges by 2018, or roughly a 5% increase over the current number of children with private dental benefits. It is important to note that a significant portion of children will also gain dental benefits outside of the health insurance exchanges through, for example, employer-sponsored dental benefits with dependent coverage, although the number is uncertain at this time. The effects for dentistry could be significant if, for example, the ACArequired essential pediatric dental benefit is inadequate or too expensive or if plans with inadequate dental networks dominate the exchange marketplace.

Taxes and Limits on Tax Preferred Accounts Flexible spending accounts allow employees to set aside tax-free money to pay medical and dental bills. Starting in 2013, the FSA set-aside will be limited to $2,500 a year and increased annually by a cost-of-living adjustment. The ADA continues to support repeal of ACA provisions that are inconsistent with Association policy. This includes the 2.3 percent medical device excise tax scheduled to take effect Jan. 1, 2013. The ADA and members of the Organized Dentistry Coalition have opposed implementation of the tax, and the U.S. House of Representatives has passed legislation, which is stalled in the Senate, to eliminate the tax. The coalition estimates that the tax will increase the cost of dental care by more than $160 million annually. The IRS has yet to issue final regulations.

The ADA offers advocacy materials and shares best practices with constituent dental societies to encourage maximum competition in the exchanges that gives consumers a real choice of benefit plans with robust dental networks. Case studies are shared with constituents on how a state society can ensure an adequate essential dental benefit for children (California), advocate for maximum competition within the exchange that includes stand-alone plans and plans with embedded dental

In 2013, there is 0.9 percent payroll surtax on wage and salary income over $200,000 for single filers or $250,000 for joint filers. The 2012 Medicare Hospital 50

Continued from page 51 ď‚„


Affordable Care Act continued from page 50

Public Health Infrastructure ACA provisions consistent with Association policy include:  increased funding for public health infrastructure, including Centers for Disease Control and Prevention oral health programs and national oral health surveillance programs;

Insurance (Part A) tax for the Medicare Hospital Insurance (HI) Trust Fund is 1.45 percent of all salary income, with an equal 1.45 percent paid by employers. Starting January, 2013, the tax will be 2.35 percent on all earnings above $200,000 and $250,000 respectively. For the selfemployed, the rate increases from 2.9 to 3.8 percent.

 additional funding for school-based health center facilities;

There is also a 3.8 percent tax in 2013 on some investment income of taxpayers whose modified adjusted gross income exceeds $200,000 for single and $250,000 for joint filers. Investment income includes rents, dividends, interest, royalties and capital gains on property sales (with a partial exclusion for primary residence sales).

 increased grant opportunities for general, pediatric or public health dentists;  funding for National Health Service Corps loan repayment programs;  CDC initiation, in consultation with professional oral health organizations, of a five-year national public education campaign focused on oral health prevention and education.

Dentists as Health Care Coverage Consumers Plans in the individual and small group market could include prohibitions on refusal to cover pre-existing conditions, excessive waiting periods, copayments or deductibles for certain preventive services and on coverage rescissions, and comprehensive coverage, guaranteed issue and renewability, premium rating limits on rate increases based on age, gender or health condition and required coverage for dependents up to age 26.

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Many of these new programs have not been funded. The ACA also authorizes federal spending to support a state alternative provider demonstration project, which is inconsistent with Association policy. Money has not been appropriated by Congress to support the demonstration.

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Practice Tips

How Much is My Practice Worth? Risë & Martin Mattler Countrywide Practice Brokerage

appraisal is being conducted and how it will be used 2. Practice history: when it was established, how long the dentist has been there, any partners or associates 3. Description of facility: Location, type of building, size and layout of office, condition and age of equipment 4. Work schedule: office and work hours for owner, associates, hygienists 5. Fee structure: participation in plans, fees for common procedures 6. Gross/net income: gross and net income figures for last several calendar years and expected profit for a purchaser 7. Patient profile: patient demographics, number of active patients, new patients gained monthly 8. Employees: staff description, including salary, benefits and tenure; and likelihood of staying with practice 9. Marketing: description of activities to maintain and grow practice patient flow

Dentists interested in bringing in a partner or selling a practice should have an accurate practice valuation before making key career decisions. In our experience, when a dentist asks what his practice is worth, he typically wants a fast, simple answer using industry rules of thumb. Most dentists think that all practices are valued the same, using the common technique known as Gross Multiplier method. This technique typically uses last year’s gross income to establish a practice value by taking a percentage of that revenue. The problem with this approach is that it doesn’t take the practice profit or its market desirability into account, which are key indicators of its value. Ironically, most dentists would never undertake a patient’s treatment planning using simple rules of thumb. They would examine their patient, take x-rays, and then make a presentation of recommendations and alternatives.

Based on an evaluation of all these practice characteristics, the appraisal report should enumerate both the positive aspects of the practice and any areas of concern.

The same considerations go into valuing a practice. When we appraise a practice, we start with the understanding that the seller is entitled to receive the maximum value for his or her practice. In addition, the buyer is entitled to fully understand the key aspects of the practice in order to understand what he or she is getting by purchasing the practice.

The appraisal must then establish a fair market value for the practice. We do this using the “Composite Valuation Method,” which compares common elements found in dental practices to an ideal practice in order to develop a percentile rating, which is multiplied by 1.0 to 1.5, a standard market factor for net profit. The practice is rated on 15 categories (i.e. location, profitability, etc.) using a 1-10 scale.

A comprehensive appraisal should include the following components – 1. Purpose and scope of the report: why 53

Continued on page 54 


Practice Tips continued from page 53

attracting prospective dental candidates who appreciate and are seeking the practice attributes that you are offering. And, it will help the purchaser to obtain the bank financing that is needed to make it a win-win for both buyer and seller.

The resulting percentage is applied to the practice’s net income and the resulting value is added to the value of the tangible assets to arrive at the fair market value of the practice. In our experience, a comprehensive appraisal is the best way for a seller to approach the sale of his or her practice.

About the Authors - Martin and Risë Mattler are the principals of Countrywide Practice Brokerage, an independent practice sales and appraisal firm based in Manhattan. Visit their website at www.ddsbrokers.com.

It will help the seller to obtain the maximum value for the practice, by

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• How can I get the most value for my practice? • How will I find the best dentist to take over my practice? • What should I do to get ready to make my move? Countrywide half page ad here Box is for positioning Contact usonly for a – Ad has border Free Consultation with No Obligation • By phone: 800.222.7848 • By e-mail: ncds@ddsbrokers.com • On the web: www.ddsbrokers.com/ncds We have three decades of experience representing both buyers and sellers of dental practices throughout New York, New Jersey and Connecticut.

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Selling and Salesmanship

How to Speak So Patients Will Listen Tom Hopkins

Words create mental images in our minds – and those images directly affect patient behaviors. Tom Hopkins presents the best words to use when selling your dental services to patients.

success in helping a large number of patients benefit from your services and the financial success you can achieve with strong revenue-generating practices. Knowing that the use of that term “sell” in the previous paragraph might have sent a shudder down your spine, from this point forward, I will refer to what you do as “getting patients involved in your services.” Do you feel the difference those words make? I took your mental picture of either fear or some other negative emotion related to the word “selling” and created a positive mental image of you helping your patients enjoy the results of your work. That’s really what you want to have happen, right?

Description: We’ve all heard the old cliché, “It’s not what you say that matters – it’s how you say it that counts.” When trying to motivate patients to take better care of their teeth, mouths and gums, “what you say” is the foundation from which you figure out how to say it. So, we can’t ignore that aspect of communication. As a highly skilled dental professional, you think and act according to the particulars of your training. Understanding and using the terminology specific to dentistry is like knowing a foreign language. In fact, it is foreign to the vast majority of your patients. Very few of your patients will know what deciduous teeth are or the numerical notations used in your practice every day.

All words create mental pictures in our minds. When I have you read the word “tree” here you might have a mental picture of a giant oak tree come to mind. The people sitting next to you might picture a pine or an orange tree. It doesn’t matter. The point is that no one pictures the letters T.R.E.E. in their mind when I refer to a tree. Our minds work in pictures and those pictures create emotions. The emotions generate thoughts which cause people to take certain actions. My goal in this article is to get you to pay attention to the pictures you create in the minds of your patients directing the actions they cause. Those actions might include having specific dental treatments or they might involve doing a better job of brushing and flossing at home.

Even though dental shorthand is helpful when making notes and communicating with your hygienist or other staff members, it confuses patients. And, when patients are confused, they either tune you out or start building walls of resistance between you and them as if you just landed on the planet and have antennae sprouting from the top of your head. Neither of those situations is good for your practice. Your goal is to communicate with your patients in such a way as to draw them to you – to build their trust in you and want to do as you advise.

We’ll review some standard dental terms that probably turn your patients off and go over some more acceptable (and less threatening) options for replacement terms. In my basic sales training programs, I refer to the negative terms as being fearproducing or in some cases “the nasty

After all, you invested many years of your time and a lot of money to develop your expertise. If you don’t know how to “sell” it to others, you won’t be any- where near as successful as you could be. And by “success” I’m referring both to personal

Continued on page 56 55


How to Speak to Patients continued from page 55

words.” The outcome of using them is to create fear and possibly rejection of whatever is being “sold.” They contribute mighty bricks to the wall of sales resistance that keeps people from making wise and prudent decisions regarding their dental health.

The word “appointment” makes most of your patients wonder when and how this can be most convenient for them. If you don’t have evening or weekend hours, there may not be a super convenient time for them. Do you feel the stress that one word that is so common to your practice can create?

I would suggest having everyone on your staff refer to the list of terms here and to begin using the positive, acceptancebuilding terms as soon as possible. You might even challenge your staff members to come up with additional terms that might give your clients new ways of saying those things. Make a game of it. Reward your staff members for using the new terms with the additional revenue you’ll have from patients who feel good about what you say and take action to follow your advice.

So, I’m going to ask you to try using a different word. Substitute the word “visit” for “appointment.” What comes to mind when you think of visiting someone? It’s usually something positive, isn’t it? It generates a softer emotional response in your mind and body … and it will for your patients as well. “Mrs. Smith, it’s time for Billy to visit with Dr. Tim again. He has time available next Thursday at 7 a.m. or Friday at 3:30 p.m. Which would be most convenient for you?”

Appointment – The mental image of this word for most people is that of a calendar. The feeling it often generates is that of “inconvenience.” They have to carve time out of their daily schedules in order to see you. Even though most of your patients will believe seeing you is a necessary thing, for many the initial reaction to setting an appointment will be that it’s an interruption of their normal schedule – their habitual routine – that feels very comfortable to them. Even though they might be in your office less than an hour, they have to include time for driving to your location and back to whatever this appointment took them from.

Problem – No one wants to have one, do they? Never say, “Sally, there’s a problem with that incisor and we need to fix it right away.” That makes you sound like a car mechanic. Try the word “challenge” instead. “Sally, the last thing I would want to have happen is for you to have an emergency situation arise with this incisor (pointing to X-ray) at a time that is inconvenient for you. Since it’s impossible to predict when that challenge might arise, why don’t we arrange a convenient visit within the next 10 days to take care of it?” Feel the difference? So will Sally. Cost – The word “cost,” for most people, generates the image of money leaving their wallets or credit card bills increasing. Yuck! Never use that word or allow your staff to use it either. Replace it with the word “amount” or “total amount.” They know you’re talking about the amount of money but it creates a kinder, gentler image and a usually more proactive response. People know your services aren’t free. But they just don’t create the kind of memories a trip to the amusement park would (with that same money).

For some people they will be taking time off work to come to see you. For others, they will take time off work, pick up little Billy from school so he can see you, take him back (maybe with a detour through McDonalds because having dental work makes kids hungry) and then going back to work themselves. That could involve half a day of inconvenience. Of course you will have patients who are enthusiastic about their dental health and look forward to their routine examinations. However, as you know, they are the minority.

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How to Speak to Patients continued from page 56

quality. Instead use the terms “more economical” or “most economical.”

Down Payment or Monthly Payment – If any of your patients are in a situation where they need to make multiple “payments” for your services and you make that option available to them, please refer to them as “initial amounts” and “monthly amounts.”

Many words in the English language have more than a single meaning. Once you start thinking about them, you’ll probably be amazed. The goal is to get you thinking about those mental images you are putting into the minds of your patients. In reality it’s more than “every picture tells a story.” Every word you use creates a story. If you want your patients to follow your advice, be treated sooner rather than later, and keep coming back to you, pay attention to how you speak with them.

Extraction – This is a fun mental image, isn’t it? Hopefully, you already refrain from using this word within earshot of patients. When you are speaking with them or within their hearing range, use “remove” or as one oral surgeon I know of says, “sneak them out.” His focus is on taking care of the little buggers causing the challenge for the patient – the results the patient will have of no future pain from those teeth – rather than on the discomfort of the actual removal and healing process.

Sometimes it’s easier to observe the impact of words used by others than to pay strict attention to what comes out of our own mouths. Practice that with the very next conversation you hear. Once you begin paying attention to the resulting actions from words that are used, you will come up with many others that can be replaced with better mental pictures, which will result in more of the actions you want. More than just tone, volume and speed of speech make an impression. Substituting a few words with the “happier picture” words suggested here will make a difference in the results you are getting.

Sign – As in paperwork. Take into consideration the mental images of “signing on the dotted line” and “signing your life away” or mom and dad’s admonition to “never sign anything without reading the fine print.” Rather than allow those negative mental images to permeate the minds of your patients, use the terms “approve,” “authorize,” “endorse” or “okay.” “If you’ll just okay the paperwork, Marvin, we’ll get you taken care of as quickly and easily as possible.” If you just want to have a little fun with people, ask them for their autographs. If it fits your personality, smile and say, “I’d like to help you enjoy a moment of fame, Mrs. Johnson, by asking for your autograph right here.” Point to the paperwork. Keep smiling. She will smile, too. And, she’ll give you her signature. It happens all the time.

Author's Bio: Tom Hopkins is a worldrenowned expert and authority on selling and salesmanship. His simple yet powerful strategies have been proven effective in many industries, including the dental industry, and during all types of economic cycles. The foundation of his training includes both the “people skills” of proper communication and nuances that impact every situation where trying to persuade others. Tom’s style of delivery is practical and entertaining – making the strategies easy to remember and implement. (www.tomhopkins.com/blog)

Cheaper, Cheapest – As you know, with fillings and crowns there are options for those treatments. If your patient is concerned about the “amount” required for these various services, never refer to the lowest cost version as being “cheaper” or “the cheapest.” The mental image for that term can be something that is of poor 57


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Nassau Dental January 2013 Edition  

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