AGD Impact January 2024

AGD Impact News for the General Dentist

January 2024, Vol. 52, No. 1

10 DENTISTS TO WATCH

The Truth Behind Today’s Social Media Hacks Why Diversity in Marketing Matters

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Contents

10 DENTISTS TO WATCH

By Kelly Rehan

These dentists have different clinical interests and goals, but they all share an unwavering drive to remain lifelong students of dentistry and provide their patients with exceptional care.

10 2 Editor’s Note What Makes a Great Leader?

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The Truth Behind Today’s Hottest Social Media Dental Hacks

22 Testing the Tools

By Gerard Scannell, DDS Dentists today face the challenge of competing with an influx of DIY dental misinformation, often labeled as “dental life hacks,” circulating on social media platforms. They should be armed with knowledge of these hacks and ready to discuss potential benefits or dangers with curious patients.

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Mastering the Art of Communication

8 Marketing Why Diversity in Marketing Matters

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Editor’s Note

What Makes a Great Leader?

R ecently, I came across a quote by author Simon Sinek: “A great leader doesn’t only inspire us to have confidence in what THEY can do. A great leader inspires us to have confidence in what WE can do.”

These words hit home when I think about current and future AGD leaders. I recently attended a number of AGD Board meetings in Chicago, where 24 trustees and Executive Board members met to make important decisions. The dedication exhibited by each member was inspiring. Their intention was to elevate our AGD to new heights each year and to benefit all members of our distinguished organization.

I hope that our current leaders’ work inspires tomorrow’s leaders, many of whom are highlighted in this year’s “10 Dentists to Watch” cover story. These young dentists have already demonstrated great potential, and I’m sure they’re going to lead the profession to new heights.

If a great leader inspires, what other skills does this type of person exhibit?

Traits that are needed for proper leadership include: institutional understanding, creativity, focus, strategic planning, good time management, flexibility, decisiveness, positive thinking, integrity, and confidence in oneself and the decision process. Communication is a key to success in building relationships, helping to understand strengths and weaknesses. The vision of the leader or leadership group will be reflected in the supporting team members if all are elevated to achieve the goals of the group.

Several quotes summarize what I believe is important about leadership. Former U.S. Senator Bill Bradley said, “Leadership is unlocking people’s potential to become better.” German equestrian and Olympic champion Klaus Balkenhol said, “There is a difference between being a leader and being a boss. Both are based on authority. A boss demands blind obedience; a leader earns his/her authority through

understanding and trust.” Finally, former governor of Colorado Bill Owens said, “True leadership lies in guiding others to success — in ensuring that everyone is performing at their best, doing the work they are pledged to do and doing it well.”

Research and advisory firm Brandon Hall Group found that only about 18% of businesses render their leaders “very effective” in meeting the goals of the group. It seems that being voted into a position does not necessarily mean that leadership is always apparent.

So, where does all this lead us? AGD is a strong body made up of smart, dedicated general dentists who give much to our wonderful profession. And, even though it’s anecdotal evidence, I believe the fact that we’re volunteer leaders means we’re able to set the bar much higher than that 18%. As I watched firsthand how the Board worked, I was convinced of every member’s passion to uphold AGD’s mission “to support excellence in general dentistry and pursue professional development through lifelong learning.” We’re here to give our time to further the profession, not collect a paycheck. I hope that passion inspires the next generation of leaders.

To the readers: I hope you enjoy meeting these up-and-coming dentists and recognizing how they embody the traits of the best AGD dentists — indeed, they’re the organization’s lifeblood.

And to this year’s 10 Dentists to Watch: I hope to meet you soon and work with you at a future Board meeting. Congratulations!

Editorial Staff Editor Timothy F. Kosinski, DDS, MAGD Associate Editor Bruce L. Cassis, DDS, MAGD Director, Communications Kristin S. Gover, CAE Executive Editor Tiffany Nicole Slade, MFA Managing Editor Leland Humbertson, MA Associate Editor Caitlin Davis Manager, Production/Design Tim Henney Graphic Designers Robert Ajami Eric Grawe

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How to Reach Us Academy of General Dentistry 560 W. Lake St., Sixth Floor Chicago, IL 60661-6600 agd.org impact@agd.org 888.243.3368 312.335.3427 (fax) DISCLAIMER: The Academy of General Dentistry does not necessarily endorse opinions or statements contained in essays or editorials published in AGD Impact. The publication of advertisements in AGD Impact does not indicate endorsement for products and services. AGD approval for continuing education courses or course sponsors will be clearly stated. AGD Impact (ISSN 0194-729X) is published monthly by the Academy of General Dentistry, 560 W. Lake St., Sixth Floor, Chicago, IL 60661-6600. Canadian Mailing Information: IPM Agreement number 40047941.

Change of address or undeliverable copies should be sent to: Station A, P.O. Box 54, Windsor, Ontario, N9A 6J5, Canada. Email: impact@agd.org. Periodical postage paid at Chicago, IL and additional mailing office. *AGD members receive AGD Impact as part of membership; annual subscription rates for nonmembers are $70 to individuals/$90 to institutions (orders to Canada, add $15). Online-only subscriptions available outside U.S./Canada are $75 to individuals/$115 to organizations. Single copy rates are $17.50 to individuals/$20 to institutions (orders to Canada, add $2.50). All orders must be prepaid in U.S. dollars.

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No portion of AGD Impact may be reproduced in any form without prior written permission from the AGD. Photocopying Information: The Item-Fee Code for this publication indicates that authorization to photocopy items for internal or personal use is granted by the copyright holder for libraries and other users registered with the Copyright Clearance Center (CCC). The appropriate remittance of $3 per article/10¢ per page is paid directly to the CCC, Inc., 222 Rosewood Drive, Danvers, MA 01923, USA. The copyright owner’s consent does not extend to copying for general distribution, for promotion, for creating new works, or for re-sale. Specific written permission must be obtained from the publisher for such copying. The Item-Fee Code for this publication is 0194-729X. Printed in U.S.A. © Copyright 2024, Academy of General Dentistry, Chicago, IL.

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AGD News Governance

AGD House of Delegates Annual Meeting Recap AGD’s House of Delegates installed new officers during its annual meeting, Nov. 10–12, 2023. Merlin P. Ohmer, DDS, MAGD, a general dentist from Florida, was named president.

Other officers elected during the meeting include Marc J. Worob, DDS, FAGD, as vice president; Kimberly R. Wright, DMD, MAGD, as secretary; Robert M. Peskin, DDS, FAGD, as speaker of the House of Delegates; and Timothy F. Kosinski, DDS, MAGD, as editor.

Other members of the 2023–24 Executive Committee include: Chethan Chetty, DDS, MAGD, president-elect, and Joseph A. Picone, DMD, MAGD, treasurer.

The regional election outcomes included the following selections: • In Region 5, Eric Morse, DDS, is the regional director, and Nicholas Russo, DMD, is the trustee.

• In Region 6, David Dear, DDS, MAGD, is the regional director, and Carson Henley, DDS, FAGD, is the trustee.

• In Region 7, Tyler Scott, DDS, FAGD, is the regional director, and Michael Gordon, DDS, MAGD, is the trustee.

• In Region 8, Brenden Moon, DMD, MAGD, is the regional director, and Larry Williams, DDS, MAGD, ABGD, is the trustee.

• In Region 9, Colleen DeLacy, DDS, MAGD, is the regional director, and Dennis Charnesky, DDS, MAGD, is the trustee.

• In Region 10, Thomas St. Germain, DDS, MAGD, is the regional director, and Brad Anderson, DDS, MAGD, is the trustee.

• In Region 11, Puneet Aulakh, DDS, MAGD, is the regional director, and Ravi Sinha, DDS, is the trustee.

• In Region 12, Deidre Snell, DMD, is the regional director.

• In Region 13, William Kushner, DDS, FAGD, is the regional director, and Eric Wong, DDS, MAGD, is trustee.

• In Region 18, Partha Mukherji, DDS, FAGD, is the regional director, and Jeffrey Geno, DDS, MAGD, is the trustee.

Bylaws Amendments The 2023 AGD House of Delegates (HOD) had a light but important docket of resolutions. Some key policies adopted were on dental loss ratios needing 85% of dental insurance premiums and defining AGD’s perception of artificial intelligence. Several existing policies were amended, among them the HPV policy to require oropharyngeal cancer screenings, along with AGD’s licensure and workforce policies. There were also a number of administrative policies adopted, including the creation of a separate Resident membership category, updating AGD’s membership on the Code Maintenance Committee, updating AGD’s Fellowship Award Guidelines, and setting a FY2024 budget and membership dues. The HOD also determined that AGD trustees would no longer be able to serve as delegates to the HOD and defeated a proposed bylaws amendment that would have required AGD officer candidates to have served for at least one full term on the Board before running for higher office. Finally, the HOD also sunset a handful of old policies, some dating back to the 1980s and 1990s.

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AGD News News Dental Practice Advocacy

Dental Practice Council Representative Attends National Meeting on Dental Plans

By Laura Sharbash, DDS, FAGD, DABDSM, member, AGD Dental Practice Council

I attended the National Association of Dental Plans’ (NADP’s) CONVERGE conference Sept. 19–22, 2023, in San Diego, California.

This meeting is the premier professional event in the dental benefits industry and offered programming on the topics of artificial/augmented intelligence, medical/dental loss ratios (MLRs/ DLRs), data monetization and the integration of medical/dental care delivery and communication.

The majority of attendees represented dental insurance industry companies and their affiliated vendors and suppliers. Presentation content focused on issues of concern to the third-party payer industry and, in many cases, was not aligned with the positions and policies of AGD. This recap of key issues discussed during the meeting is intended to provide AGD members with information on trends and priorities from the perspective of third-party payers and does not represent the positions of AGD. • In the ever-evolving landscape of healthcare, the rise of memberpayer platforms is revolutionizing how insurance providers and patients interact. These platforms, offered by companies like NovoDynamics, Fluent and Skygen, to name a few, are designed with multiple goals in mind, such as augmented claim review, member engagement and provider rating systems, as well as serving as a resource for alternative treatment information. One of the primary objectives of these platforms is to streamline the claim review process while enhancing clinical analysis to not only expedite claim decisions, but determine the appropriateness of a service. The expectation is that by using artificial intelligence insurance companies can significantly reduce claim processing, ensure timely reimbursements and increase access to care by expediting preauthorization requirements as well as preventing fraudulent claims.

• Member engagement is another critical aspect of memberpayer platforms. According to several presentations, the goal is to establish a direct and interactive connection between insurance providers and their policyholders by offering user-friendly interfaces and mobile applications.

• Another key feature of member-payer platforms is the ability to rate dental providers. User-generated feedback and data-driven evaluation are promoted as ways to guide members in choosing a provider while simultaneously holding providers accountable for the quality of their services.

• Member-payer platforms are also including resources on alternative treatment options. Not only do they aim to inform members about different ways to manage their oral health, but they also contribute to cost savings for insurance providers. As member-payer platforms continue to evolve, they are likely to play an increasingly significant role in the future of how dentistry is delivered and managed.

• Data in healthcare is growing at a faster pace than in any other field, and how to monetize it was another key topic presented as the value-based approach to data and analytics. Data mon-

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etization is the process of generating measurable value from information. It’s important to analyze what the data is worth, both inside the organization and outside on the open market. It is critical to have the right decision-support process to ensure that a business is serving the right data to the right audience at the right time. Bringing data to the masses can be a new revenue stream for third-party payers. There are vendors who assess the value of data that carriers can sell.

• Lastly, MLRs/DLRs was definitely the highlight of the meeting and widely discussed in a panel at the general session and during a packed breakout session. Many representatives of third-party payer companies questioned whether MLRs were an appropriate measure for dentistry. The NADP is working alongside the National Conference of Insurance Legislators to encourage states to adopt reporting and mediation platforms instead of state legislation mandating specific MLR/DLR thresholds. (During its 2023 House of Delegates annual meeting, AGD adopted a policy supporting legislation requiring DLR minimums of no less than 85%, with some exceptions.)

Next year’s event will be held Sept. 23–26 in Minneapolis, Minnesota.

CDT Code Championed by AGD Takes Effect in 2024 The 2024 Current Dental Terminology (CDT) Code includes a new implant code, D6089, Accessing and retorquing loose implant screw — per screw, that was requested by AGD. In 2022, AGD’s Dental Practice Council (DPC) determined that it would be helpful to have a CDT Code that could be used to report treatment performed in cases when a patient presents with a loose implant crown and the dentist is required to remove material to access the screw, retorque the screw and then replace the access material. Any general dentist who has performed this procedure recognizes that it’s a very different procedure from D6092, Re-cement or re-bond implant/abutment-supported crown.

The DPC collaborated on the development of a request for a new code to report what was initially described as Retorquing implant screw — per screw. The request was submitted to the American Dental Association’s (ADA’s) Code Maintenance Committee (CMC) in 2022, and the CMC reviewed and voted on all submitted code changes in March 2023. AGD’s representatives to the CMC, delegate Ralph A. Cooley, DDS, FAGD, and alternate Arlene O’Brien, DMD, FAGD, worked with voting members of the CMC to modify the proposed code’s nomenclature to allow for the successful outcome. Thanks to the multi-agency collaboration involving the DPC, AGD’s representatives to the CMC and voting members of the CMC, the 2024 CDT Code now includes the new AGDsponsored code.

AGD members who identify what they believe are gaps in the CDT Code and who would like AGD to consider sponsoring a request to add or modify the CDT Code on their behalf are encouraged to share that information with the DPC by emailing practice. management@agd.org. Members are encouraged to review the ADA website for information about the “CMC Process Document” and “Request a Change to the Code” to ensure they’re providing the necessary information in their initial request to the DPC.

Dental Standards Committee Recaps

By Steven G. Feldman, DDS, member, AGD Dental Practice Council

The American Dental Association’s (ADA’s) Standards Committee on Dental Informatics (SCDI) and Standards Committee on Dental Products (SCDP) held meetings Oct. 2–4, 2023, in Orlando, Florida, to discuss national dental standards on a variety of topics. The hybrid event allowed for members of both committees and their many working groups to collaborate and conduct business and attend a joint SCDP/SCDI Plenary meeting.

Standards Committee Reorganization SCDI and SCDP are undergoing a reorganization to improve the standards development process and align international standards managed through the International Organization for Standardization with U.S. standards. A new Oversight Committee has been established to oversee governance functions and assign new work items to consensus bodies composed of subject matter experts. These experts will approve all new U.S. American National Standards Institute (ANSI)/ADA candidate standards and formulate the U.S. position on proposed international standards. The Oversight Committee will also establish policy and procedures for interpreting standards developed by the consensus bodies.

Additionally, SCDP/SCDI is responsible for creating ADA technical reports, which are highly valuable to members. In the coming year, new technical reports on CAD/CAM dental implant-guided surgical devices and maxillofacial prosthetics, as well as guidance for cementation and bonding of CAD/CAMfabricated restorations, will be updated and released.

Augmented Intelligence A proposed ADA Standard 1110, Dentistry Validation Dataset Guidance for Image Analysis Systems, aims to guide the validation of datasets used in training artificial intelligence (AI) image analysis systems for dentistry. This standard addresses concerns about image quality by leveraging AI for analysis and potential enhancement of clinical imaging. At its core, the standard sets a threshold for identifying when an image is considered nondiagnostic, providing clear annotation. This is particularly crucial given that the inner workings of most AI algorithms are a “black box” that remains opaque in terms of which aspects of an image they evaluate or assign varying levels of importance.

Presently, dental practices in the United States have the option to purchase numerous software packages that use AI to make clinical determinations that are often based on insufficient data.

For instance, certain AI algorithms may make judgments about the need for a crown based solely on a single 2D image or may present a periodontal analysis relying solely on the cemento­ enamel junction to bony crest measurement while neglecting soft tissue, pocket depth or recession.

In alignment with ethical principles aimed at safeguarding patients, it is essential for standards related to AI to explicitly account for current limitations of AI systems. This encompasses providing clarity on what these advanced algorithms are

incapable of achieving and delineating scenarios where their utilization would be inappropriate.

To achieve this, the standard will establish comprehensive requirements for content and calculation processes. It will also incorporate confidence analysis to establish ground truth, ensuring the accuracy and capabilities of the AI system while guaranteeing that its training dataset remains free from biases.

Electronic Attachments for Dental Claims The ANSI/ADA Standard 1079 focuses on standard content of electronic attachments for dental claims. Expanding on this standard, SCDI aims to align standards development for eligibility verification and benefit determinations through a patient-centered approach. This ensures accessibility to relevant information at the appropriate times during the treatment process. Expansion of the existing standards for electronic eligibility inquiries in dentistry will address the cumbersome and outdated processes that present barriers to use in modern business models.

Efforts are underway to develop electronic remittance advice standards for both paper and web-based portals. These will incorporate graphical workflows to provide comprehensive information to payers, providers and patients, enhancing transparency in the process.

A review by the AGD Dental Practice Council revealed that, out of the 686 X12 Claims Status Codes currently in use, only about half are pertinent to dentistry. This inefficiency results in a cumbersome system that is impractical for most dental offices. It underscores the need for a claims status code set that is specifically tailored to dentistry. Data from insurance carriers further indicate that claims status inquiries are only a fraction of the total claims submitted, underscoring the limited value of the current system.

Real-time predetermination of benefit eligibility will be available, which will enable accurate discussions about treatment plans with precise representations of patient responsibility for various options. This enhancement will significantly benefit patient-provider interactions and streamline the treatment-planning process.

Additionally, patients with secondary insurances will experience a simplified benefits coordination process. Current challenges related to secondary insurances that SCDI intends to address include the potential for multiple write-off scenarios, uncertainties in out-of-network allowances, and inconsistencies in rules for overpayments and self-funded refunds. This coordinated approach will lead to more accurate patient portion estimations — without being “ping-ponged” between multiple different insurance carriers — as well as a smoother insurance process overall.

Information Blocking Information blocking refers to the practice of deliberately obstructing the access, exchange or use of electronic health information, except where required by law. The federal 21st Century Cures Act established regulations to penalize actions or omissions that hinder the sharing and accessibility of patient health information by authorized providers or patients. These statutes were formed with the intent of ensuring a patient’s COVID-19-related health information would be accessible to agd.org/impact

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AGD News all providers; however, the Department of Health and Human Services deemed it appropriate for application to a patient’s entire electronic health record. While these regulations are not currently applicable to healthcare providers, the Office of the National Coordinator plans to extend these regulations to include providers in the future. Penalties and disincentives for providers engaged in information blocking are being developed

Advocacy

2023 State Legislative Recap All 50 state legislatures met in 2023. As always, a focus of organized dentistry’s advocacy at the state level has been to enact dental insurance reforms.

A common complaint is that insurers lease their networks to third parties without the providers’ approval. In 2023, legislation to limit network leasing was passed in Illinois, Michigan, Minnesota, New Mexico and Oregon. Additionally, bills to allow a patient to assign their benefits to their dentist passed in New Mexico and North Dakota.

Also, an insurer may try to remit payment via a virtual credit card that charges fees, so dentists do not receive all the money they deserve. This year, legislation to stop this practice passed in Illinois, Minnesota, New Mexico and Oregon.

California passed legislation that outlaws waiting periods for new insureds, forbids preexisting conditions clauses in policies and allows the state to find premiums unreasonable. Another new law in California requires insurers to include the words “state-regulated” on insurance ID cards if the patient’s insurance is covered by state law.

The battle over the licensing of midlevel providers continues.

Washington was the only state that passed dental therapist licensing legislation in 2023. Under the law, a dental therapist can only practice in federally qualified health centers and lookalikes.

The passage of Massachusetts Ballot Question 2 in 2022 — which created a medical loss ratio (MLR) of 83% for dental insurance — led to the introduction of MLR bills in 14 states. No bill with a specific loss ratio requirement passed as of Oct. 15, 2023, when this article

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by HHS. AGD is closely monitoring the implementation of these rules for providers, as future rulemaking may impose demanding and administratively burdensome requirements, such as proactively making electronic health information available online through a patient portal.

Also representing AGD in ADA standards activities are Callan D. White, DDS, FAGD, FICD, and Gigi Meinecke, DMD, FAGD.

was authored. Arizona, Colorado and Nevada passed laws requiring that insurers’ loss ratios be posted on the internet. Colorado and Nevada can now determine that premiums are excessive; if premiums are deemed excessive, insurers can be fined in Colorado, and excessive premiums can be returned to insureds in Nevada.

Hawaii, Kentucky, Maryland, Michigan, New Hampshire and Tennessee expanded dental benefits in Medicaid this year.

According to KFF, in fiscal year 2022, 20 states raised rates for dental care in Medicaid.

AGD will continue to assist constituencies in 2024 as they work to pass state legislation that improves the practice environment and the oral health of the populace.

AGD Fact Sheets

Talking to Patients About Allergic Reactions AGD fact sheets provide your patients with all of the information they need to maintain their oral health. Fact sheets on more than 25 oral health topics are available for downloading online and can be customized to include your name and practice information. Download the fact sheet “Avoiding Allergic Reactions in the Dental Office” at agd.org/factsheets.

ALLERGIES

AVOIDING ALLERGIC REACTIONS IN THE DENTAL OFFICE

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tchy, swollen eyes, sneezing and a runny nose may sound like a case of seasonal allergies, but for many, these are the allergy symptoms they experience each time they visit the dentist.

Latex. Latex can be found in many medical or dental supplies and devices, such as masks, gloves and syringes.

Unlike some consumer goods made from synthetic latex, natural rubber latex is derived from a milky substance found in rubber trees. If you are allergic to latex, ask your dentist if he or she has latex-safe products.

Local anesthetic. Local anesthetics numb your mouth and gums during dental treatments. Although allergic reactions to local anesthetics are rare, they can occur.

Allergic reactions often occur more frequently in people who have a family history of allergies.

Substances that don’t bother some people can trigger allergic reactions in others.

What are the symptoms of an allergic reaction?

What is an allergic reaction?

Allergies are sensitivities to a substance called an allergen that makes contact with the skin or is inhaled into the lungs, swallowed or injected. Some allergic reactions are mild, while others can be severe and life-threatening.

Who experiences allergic reactions?

Allergic reactions often occur more frequently in people who have a family history of allergies. Substances that don’t bother some people can trigger allergic reactions in others. It’s important to discuss any allergies in your family history, or any known allergies that you have, with your dentist prior to your visit.

What might cause an allergic reaction in the dental office?

Dental amalgam components. Dental amalgam is used to fill cavities caused by tooth decay. The metals in dental amalgams — silver, copper or tin — may bring about oral lesions or other contact reactions.

In addition to itchy, swollen eyes, a runny nose and sneezing, the development of hives, dermatitis (skin rash) and asthma also are common allergic reactions. The most severe allergic reaction is the potentially fatal condition known as anaphylactic shock, which is characterized by generalized flushing of the skin, hives, mouth and throat swelling, difficulty in swallowing or speaking, changes in heart rate, abdominal pain, nausea and vomiting, anxiety, a sudden feeling of weakness (due to a drop in blood pressure) and unconsciousness.

What should I do if I have allergies or experience an allergic reaction?

Talk to your dentist and the dental staff, and make sure that the information is included in your patient chart. If you have had severe allergic reactions, you should consider carrying an epinephrine kit (EpiPen®) and using a medic alert bracelet that clearly states your allergy. You also may want to carry a letter of explanation from your physician.

If you have allergic symptoms after a dental procedure, consult with your dentist and physician immediately. If you experience a severe allergic reaction after a dental procedure, go immediately to the hospital emergency room.

© COPYRIGHT 2017 BY THE ACADEMY OF GENERAL DENTISTRY. ALL RIGHTS RESERVED.

Leadership

Mastering the Art of Communication

By Amrita Rohit Patel, DDS, FPFA, FICD, FACD

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entistry is not just about repairing teeth; it’s also about building strong dentist-patient relationships. Effective communication is the cornerstone of any successful dental practice. Dentists who excel in the art of communication foster trust, ease fears and empower patients to take control of their oral health. Making sure your patients take responsibility for their treatment follow-up is the only way to ensure the longevity of your work.

But what is communication? I have learned that it is so much more than just talking to someone and waiting for a response.

In a dental practice setting, explaining what you are envisioning for your patient in a way that they can understand it — and its value — is paramount.

Trust is the foundation of any dentist-patient relationship.

Patients need to feel that their dentist genuinely cares about their well-being and concerns. By actively listening and responding with empathy, you can establish trust that makes patients more likely to return to see you — and to follow treatment plan recommendations. Dental health is complex, and what makes our days even more challenging sometimes is that many patients may not fully understand their conditions or treatment options.

I try to use clear and simple language, visual aids, and models to explain procedures, diagnoses and preventive measures. Most dental supply companies and many dental trade shows have models and charts for sale. I’ve found that these are the best places to find guides that I can use for patient education. These models and posters can be helpful in making sure that patients have a clear concept of the treatment they need and what things will look and feel like. Taking the time to listen actively to your patients and encouraging them to share their concerns shows that you value their input. This builds trust and helps you tailor treatment plans for patients’ specific needs. Well-informed patients are more likely to make proactive decisions about their oral health.

Another area that good communication can help with is dental anxiety — an extremely common issue. We can alleviate this fear through gentle communication. By explaining procedures in advance, addressing concerns and ensuring patients are comfortable, we can create a more relaxed atmosphere.

Showing empathy by acknowledging fears and offering reassurance can go a long way in making everyone feel at ease. Encourage patients to ask questions and express their concerns. This not only helps you to understand their needs, but it also fosters a sense of involvement and responsibility in their own care. I try not to use dental jargon that patients might not understand. I use simple, straightforward language to explain diagnoses and treatments.

One of the most common questions I get asked is about pain management and whether procedures are going to hurt. In my experience, it is best to be honest. I communicate that the initial

“By actively listening and responding with empathy, you can establish trust that makes patients more likely to return to see you — and to follow treatment plan recommendations.”

anesthesia portion of the appointment might not feel the most comfortable, but that I will do everything I can to make it as quick and safe as possible. I also check in with my patients during procedures to verify that they are still comfortable. This has helped to reduce dental anxiety in my patients.

I’ve found that effective communication is an art that can lead to improved overall patient satisfaction, greater acceptance of treatment plans and stronger relationships with my patients. By actively listening, showing empathy and using clear language, I’ve been able to create an atmosphere of trust, understanding and compassion. F Amrita Rohit Patel, DDS, FPFA, FICD, FACD, is in private practice with her father, endodontist Rohit Z. Patel, DDS, PC, in Westchester County, New York.

To comment on this article, email impact@agd.org.

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Marketing

Why Diversity in Marketing Matters

By Jackie Ulasewich Cullen

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n today’s evolving marketplace, where patient expectations continue to shape the way dental practices operate, one key aspect has made its way to the forefront: diversity and inclusion in marketing. The call for representation in marketing has grown increasingly louder in recent years, with a majority of Americans demanding more inclusivity, underscoring a fundamental shift in the dynamics of the modern market. This shift in expectations should be a wake-up call for dental practices, prompting them to rethink the way they engage with their target markets and build trust with patients.

Defining Diversity and Inclusion Most people will agree that diversity means representing people of different races and ethnic backgrounds. While this is certainly true, there is much more to it than that. Diversity encompasses gender, ability, religion, age, origin, identity and sexual orientation. We must remember that the United States has always been known as the melting pot of the world; however, that is not often reflected in the marketing that businesses, including dental practices, produce. Inclusion, therefore, means genuinely welcoming all people, regardless of how different they may be from you, to reflect what our society actually looks like.

Keeping an Eye on the Future The future is here. Many baby boomers are well into their 70s, and Generation X has reached midlife. The average millennial is in their 30s, with a career and a family, while the oldest members of Generation Z have graduated college and entered the workforce in earnest. What do the newer generations have in common? They were all raised to respect diversity and inclusion.

In fact, millennials and Gen Z are demanding it, and it shows in the consumer choices they make.

The Growth of Diversity in Business As the consumer landscape changes in general, so does the dental industry. It should be no surprise that business ownership has diversified along with society, which means there are more women- and minority-owned dental practices than ever before. This is a positive shift for the dental industry, but, unfortunately, dental marketing is lagging behind this trend, as it continues to be mostly aimed at limited demographics. It is therefore imperative for practices to adapt their marketing strategies to resonate with the diversity of society and not just their own markets. Targeting a diverse patient base and representing diversity through your team builds trust and authority and ultimately attracts more quality patients to your practice.

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How to Integrate Diversity and Inclusion in Marketing Start at Home Having a diverse team is not only a reflection of a socially responsible practice but also a strategic advantage. If your team members come from different backgrounds, are a mix of genders and ethnicities, represent different abilities, etc., it brings a range of perspectives and experiences that can take your internal and external marketing campaigns to the next level, ensuring that they truly resonate with a diverse target audience and patient base. Diversity and inclusion in your practice is about creating an environment in which individuals from all walks of life can contribute their unique insights, creating more authentic connections with patients.

Review and Adapt Current Marketing The first step to create more inclusive marketing is to look at your existing content. Digital marketing materials can be easily updated to better represent diversity. For instance, videos can have subtitles in different languages and captions for the hearing impaired. Social media posts can also have versions in different languages to connect with a wider variety of people.

In reviewing your current marketing, it is important to look for unconscious biases in the imagery. For instance, if your content predominantly features one demographic, it’s time to make a change so that it represents a diverse range of patients. By thoughtfully adapting your existing content, you can convey the message that your practice is actively striving to be more inclusive.

Create New Content with Diversity in Mind Developing new content provides a fresh canvas to create

“Targeting a diverse patient base and representing diversity through your team builds trust and authority and ultimately attracts more quality patients to your practice.”

marketing materials that are intentionally diverse and inclusive.

This is where you can be proactive by optimizing your website’s accessibility, graphics and written copy to cater to the audiences your practice cares about. By infusing diversity into your creative process, you not only build patient loyalty, but also send a clear message that you value inclusivity and representation.

Add Diverse Voices to Your Team Expanding diversity on your team does not necessarily mean hiring a bunch of new people. An effective approach is to engage consultants — namely, marketing partners — from different backgrounds to inject fresh perspectives into your team without the need to make major staffing changes. Having relationships with a diverse set of vendors and partners can be eye-opening because they see beyond the bubble of your practice and will usually spot trends or shifts in the market earlier than you due to the nature of their businesses.

The Bottom Line: Your Patients Expect More Authentic representation matters. Today’s patients, especially younger generations, demand more. They are increasingly insistent that the places they spend their money and the professionals they choose to trust with their health value diversity and inclusion in their public image and behind the scenes. This shift in behavior has not gone unnoticed by the big brands, which are quickly realizing that a commitment to diversity is paramount to their success. Small businesses, like many dental practices, should be following suit if they want to remain competitive now and in the future.

To achieve diversity in marketing, dental practices must begin by building a diverse workforce, adapting their existing marketing strategies, creating new content with diversity in mind and adding diverse voices to their teams. Dental practices that have not already started changing their strategies should be seriously considering it. Businesses that embrace this trend are not only more likely to succeed in today’s market, but also to contribute to a more inclusive and equitable future. F

Jackie Ulasewich Cullen is co-founder of My Dental Agency, a marketing company specializing in dental practice. To comment on this article, email impact@agd.org.

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10 DENTISTS TO WATCH

They’ve practiced less than a decade but have already made a lasting impact.

By Kelly Rehan

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his year’s group of accomplished young dentists have worn many hats — neuroscience researcher, college baseball player, LGBTQIA+ advocate and U.S. Army Reserve Captain, to name a few.

These dentists have different clinical interests and goals, but they all share an unwavering drive to remain lifelong students of dentistry and provide their patients with exceptional care.

AGD Impact introduces 10 young dentists who have practiced less than a decade and are furthering dentistry’s reputation in healthcare by putting their own unique stamps on the field.

RAVNEET S. DHILLON, DDS

Morgan Hill Dentistry, Morgan Hill, California

“No one looks forward to going to the dentist, and that’s precisely why we aim to make our patients feel at home in our office.”

When Ravneet Dhillon, DDS, was 8 years old, he went with his grandmother to her dental appointment. She had several oral health problems, and he was amazed at how much her dentist improved her quality of life.

“Since then, I decided to become a dentist to help people,” Dhillon said.

Dhillon’s dental education began in India, but he eventually transferred to New York University due to the advanced technology and opportunities available in the United States. Dhillon said that although he uses the latest technology in his office, it’s simple communication that makes the biggest impact on his patients.

“No one looks forward to going to the dentist, and that’s precisely why we aim to make our patients feel at home in our office,” Dhillon said.

A patient-centered approach that creates a welcoming and comfortable environment is essential for building trust, reducing anxiety and delivering the best healthcare, Dhillon said.

“My appointments are spaced out to ensure I can answer any of my patients’ questions,” he said. “Getting to know the patient — and even cracking jokes — helps them feel more at ease.”

Outside the clinic, Dhillon dedicates time to charitable initiatives and dental outreach programs. Dhillon credits his background in the Army Reserve for giving him a strong sense of duty and commitment to service. For example, Dhillon and his team go to area schools to educate children of all ages about oral health.

“It can be gratifying to see the positive impact on children’s lives as they learn about the importance of oral health,” Dhillon said.

His advice to new dentists is to embrace the idea of lifelong learning.

“Don’t limit yourself to what you know today,” Dhillon said. “Remember that as you continue to learn and improve, you’ll not only enhance your career but also contribute to the overall advancement of dental healthcare.”

Through a patient-focused clinical approach and a dedication to continuing education, Dhillon has improved the overall well-being of his patients in much the same way his grandmother’s dentist did for her.

“Our work is not just a profession — it’s a calling,” Dhillon said. “And we have the power to make a difference in the lives of those we care for.”

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JONATHAN FARIS, DMD

Forest Grove Dental Studio, Forest Grove, Oregon

“Without the courses that I’ve taken at Oregon AGD and the community I’ve been a part of, I would not be the dentist I am today.”

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Jonathan Faris, DMD, became a passionate advocate for dentistry and lifelong learning as a student representative on the Oregon AGD board of directors during his third year of dental school.

“I attended board meetings for two years, offering support and insight from a student perspective,” Faris said.

Upon graduating from dental school in 2022, Faris remained a strong proponent for continuing education (CE) and organized dentistry.

“As dentists, our education does not stop when we graduate from dental school,” Faris said. “AGD’s focus on quality CE is one aspect that initially drew me in. Without the courses I’ve taken at Oregon AGD and the community I’ve been a part of, I would not be the dentist I am today.”

Faris was elected Oregon AGD presidentelect in October 2023. He aspires to be a mentor and leader for the organization, aiming

to enhance membership retention efforts and offer high-quality CE in Oregon.

“The passionate group of mentors who are in AGD is a big benefit of the organization,” Faris said. “I want to become the type of mentor and leader that these people have been to me.”

Faris isn’t solely focused on advancing the dentistry field on a large scale — he also emphasizes the small changes he can make in his own practice to improve his patients’ experiences. He recognizes the crucial role communication plays in ensuring patients understand the “why” behind recommended treatments.

“I am always striving to be a better communicator with patients,” Faris said. “In school, we didn’t have any lectures or courses on this subject. However, poor communication can be the difference between a patient getting the care they need and not scheduling treatment. Our goal as dentists is to keep our patients healthy, so clear communication is paramount.”

AARON GLICK, DDS, FAGD

Spira Dental Sleep Therapy, Conroe, Texas

“I decided to shift my attention toward dentistry as a profession because I wanted to directly see positive change through patient interactions.”

Aaron Glick, DDS, FAGD, was a neuroscience researcher at Brandeis University and Harvard University before realizing he wanted a career that offered a front-row seat to the real-world applications of research.

“I decided to shift my attention toward dentistry as a profession because I wanted to directly see positive change through patient interactions,” Glick said.

Glick’s primary area of focus is dental sleep medicine, where he holds the titles of qualified dentist from the American Academy of Dental Sleep Medicine and diplomate of the American Board of Dental Sleep Medicine. Glick sees this field as a unique opportunity to impact overall health by collaborating with medical providers.

“Sleep apnea has an influence on many medical comorbidities, and knowing that dentists have the ability to treat sleep apnea and reverse these comorbidities is extremely rewarding,” Glick said.

Oral health has direct impacts on overall health, but that connection may not be emphasized in the education of other healthcare providers — or the general public. Glick is doing his part to change that.

“I recently had a rewarding experience after lecturing a class of second-year medical students about the oral-systemic link,” Glick

said. “I realized that I had given them their first lecture on oral health throughout their medical school experience. There is a great need to continue to expand the understanding of oral health in other health professions.”

Glick enjoys clinical care, which allows him to understand the key needs of clinicians. As a way to impact patients on a larger scale, Glick has prioritized his research endeavors. A big focus of his work is the intersection of technology, sleep apnea and dentistry. He’s explored the potential of artificial intelligence (AI) since his dental school days, when he created software using AI to automatically diagnose caries in radiographs.

“We are continuing to research the effects of human-machine interaction and how to improve the implementation of AI in the dental office,” Glick said.

“A fundamental breakthrough in research or novel technology can vastly change the way dentistry is performed and the way patients receive care.”

As he looks to 2024 and beyond, Glick envisions a continued commitment to translational research and the intersection of sleep medicine, AI and technology.

“I believe that these new technologies have the potential to positively impact clinical outcomes, increase patient satisfaction and meaningfully improve each dentist’s life,” he said.

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ANDY JANIGA, DMD, FAGD

Center for Dental Excellence, Nashua, New Hampshire

“Each March during Children’s Dental Health Month, I visit the local schools and discuss oral health with the children in our community.”

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When Andy Janiga, DMD, FAGD, was a child, he loved going to the dentist. In high school, he worked for his childhood dentist and saw firsthand the art and science — and athleticism — of dentistry.

“I liked the fact that this was not a desk job, but rather an active career,” Janiga said. “I played sports growing up, and I was drawn to the fact that dentistry could be just as active as playing sports.”

A former college baseball player, Janiga applies many of the teamwork principles he learned in athletics to his dental practice.

“Teammates and coaches who were positive, reassuring and motivating led to winning teams,” Janiga said. “A dental office is very similar. When a dentist brings positive vibes to the office, the staff feeds off of it and is inspired to do the best they can, not just for themselves but for the entire team.

In his young career, Janiga was selected as a “40 Under 40” dentist in 2017 by Incisal Edge magazine, presented at the AGD scientific session in 2022 and became a partner at his practice, Center for Dental Excellence in

Nashua, New Hampshire. Janiga joined his practice during the height of the COVID-19 pandemic but has eagerly introduced himself and integrated his practice into the community.

“Each March during Children’s Dental Health Month, I visit the local schools and discuss oral health with the children in our community,” Janiga said. “Our practice has also taken a greater role in the community by participating in events such as our local farmer’s market and trunk-or-treat events to spread the word about what we can do to help improve the oral health of our community.”

One of Janiga’s goals is to reduce the fear and anxiety that many patients feel when seeing a dentist. Recalling how he loved seeing the dentist as a kid, Janiga aims to create an environment where patients look forward to coming to see the dentist.

“Small things, such as checking in with a patient mid-procedure and including them in the discussions about what may be occurring with their oral health and how they can address it, have helped our patients become healthier and create overall positive, enjoyable experiences in our practice,” Janiga said.

ADAM J. KENNEDY, DMD, FAGD

Yale New Haven Hospital, New Haven, Connecticut

“I hope to continue the legacy of compassionate, person-centered care that has been at the heart of my journey in dentistry.”

From his predental shadowing experiences to his current role, Adam J. Kennedy, DMD, FAGD, credits the pivotal roles his mentors have played in shaping him into the dentist he is today.

“Through their guidance, I came to understand that excellence in dentistry extends far beyond mastering technical skills or achieving clinical milestones,” Kennedy said. “It’s about establishing trust and rapport, creating a safe space for patients to express their needs and concerns, and tailoring treatment plans that align with their unique goals.”

As he progressed from resident to program director and through his roles as an associate and practice owner, the impact of this mentorship has remained a guiding force in Kennedy’s practice. In that spirit, Kennedy is committed to paying it forward by training and mentoring the next generation of dental professionals.

“I hope to continue the legacy of compassionate, person-centered care that has been at the heart of my journey in dentistry,” Kennedy said.

Kennedy, a first-generation college graduate, noted achieving his AGD Fellowship and earning his current role as program director for the general practice residency (GPR) at Yale New

Haven Hospital (YNHH) as two of his proudest professional achievements.

“This role is particularly meaningful to me as it allows me to drive initiatives focused on public health, ensuring that our approach to dental care extends beyond individual treatment and contributes to the broader well-being of our community,” Kennedy said.

At YNHH, Kennedy has helped advance vital public health initiatives, particularly in the realm of enhancing accessibility and inclusivity within the dental community. For example, he and his team secured grant funding to launch a community dental van, prioritizing essential care for veterans.

Looking ahead, Kennedy’s goals include achieving AGD Mastership and strengthening YNHH’s GPR program’s educational offerings to better equip the next generation of dental professionals to provide exceptional care.

“I’m excited about pushing dentistry forward and improving patient care,” Kennedy said.

“With continuous learning, mentorship and targeted outreach, I’m confident we can make a significant and lasting impact on the oral health and well-being of our community.”

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ROBERT SCOTT MCKERNAN, DDS Big Gay Smiles, Washington, D.C.

“When a person has been in pain for months and is able to get a tooth fixed, and the first thing they do is hug you, it’s truly an incredible feeling.”

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Robert Scott McKernan, DDS, began his journey in dentistry as a Mormon missionary in the Dominican Republic. Translating for a group of dentists opened his eyes to the impact of dental professionals.

“Witnessing the immediate impact those dedicated professionals had on the lives of the locals made me want to become a dentist,” McKernan said.

One of McKernan’s proudest professional achievements has been establishing his practice, Big Gay Smiles, alongside his husband, Tyler. This fee-for-service dental clinic aims to provide a welcoming patient environment, particularly for LGBTQIA+ individuals and their allies.

“We’ve had people travel all the way from Florida and Vermont to see us in Washington, D.C., for the safe space we provide,” McKernan said. “They often come with previous traumatic dental experiences due to their gender transitions or sexuality, and it’s an honor to be able to change the narrative that dentistry is often associated with.”

McKernan donates 10% of the practice’s gross revenue to nonprofit organizations focused on finding a cure for HIV/AIDS, such as AIDS United.

McKernan also provides care at Whitman Walker Health, a public health clinic offering high-quality healthcare to the LGBTQIA+ community and individuals affected by HIV/AIDS. “We focus on addressing the oral health needs of our patients and improving their systemic health with compassion, understanding and a commitment to reducing health disparities in these communities,” he said.

McKernan’s dedication to service extends beyond his practice. He still participates in dental mission trips to the Dominican Republic, giving back to the people who initially inspired his dental journey.

“When a person has been in pain for months and is able to get a tooth fixed, and the first thing they do is hug you, it’s truly an incredible feeling,” he said. “These trips have reinforced my dedication to service and have deepened my understanding of the global need for oral healthcare.”

Looking ahead, McKernan aspires to become an AGD Fellow and plans to educate fellow dentists on LGBTQIA+ cultural competency.

Additionally, he aims to expand the outreach of Big Gay Smiles and continue contributing to HIV research, leaving an indelible mark on dentistry and patient lives.

PRIYA PUROHIT MEGHPARA, DMD 512 Smiles, Austin, Texas

“Practice ownership and achieving Fellowship are long-awaited milestones in my career.”

With no personal connection to the field, Priya Purohit Meghpara, DMD, said choosing dentistry felt like a leap of faith.

“It was difficult narrowing down a career choice that would provide both professional and personal fulfillment,” Meghpara said. “I feel incredibly lucky that dentistry has provided me with both.”

In the early days of her career, Meghpara moved frequently, which prevented her from establishing a place in any community. But, in 2022, she purchased her own practice, and, in 2023, she completed the requirements to apply for AGD Fellowship.

“It is an incredible feeling to finally have a practice to call ‘home,’” she said. “Practice ownership and achieving Fellowship are longawaited milestones in my career. It feels like a new beginning.”

Meghpara’s clinical focus on temporomandibular disorders (TMDs) and airway issues started when she took a few CE courses on the topics that led to more questions than answers.

“Taking CE from well-respected, researchbased thought leaders has helped build upon previous knowledge,” Meghpara said. “Patients

returning with reduced and improved symptoms has made the process fulfilling, while the desire to effectively and conservatively treat a wider range of patients has driven my desire for continued learning.”

Meghpara enjoys practicing comprehensive general dentistry as much as she enjoys helping patients with TMD-related concerns. Regardless of the patient’s needs, Meghpara uses the same approach to build relationships with her patients.

“I make it a point to walk away from every conversation knowing the patient understands our discussion and feels comfortable and confident to make a decision about their care,” Meghpara said. “If they aren’t quite there, I always leave the door open for more questions once they’ve had time to process.”

As she looks to 2024, Meghpara said her focus will be on emphasizing the personalized feel that is a major strength of her small private practice.

“Right now, I am focused on giving each person who walks through our front doors the best possible care I can,” Meghpara said. “For me, that means continuing to invest in my education, in the patient experience and in my team.”

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AMANDA S. SONNTAG, DDS, MAGD Compass Dental, Wyomissing, Pennsylvania

“I’ve learned to slow down and really assess the whole patient — not just treat one tooth at a time.”

Growing up, Amanda S. Sonntag, DDS, MAGD, got to see her dad in action at his dental practice. She admired his kind and comforting manner with patients.

“I loved the idea of getting to help patients and make them feel as comfortable as he made me feel while I was at his office,” Sonntag said.

She recalled a memorable patient experience where she was able to do just that.

“We had an autistic patient who didn’t have a great experience at another office in the area,” Sonntag said. “The parents and I spoke, and eventually we were able to do a knee-to-knee exam. We were able to get the patient to open wide and have no fear of us looking in his mouth.

We had won him over. It felt incredible giving the whole family an experience like that.”

Sonntag credits her commitment to CE with helping create such high-quality patient experiences.

“By focusing on a goal like obtaining my MAGD, I became dedicated to learning and growing as a dentist,” Sonntag said. “I’ve learned

to slow down and really assess the whole patient — not just treat one tooth at a time.”

In addition to balancing continuing education and clinical work, Sonntag is involved in Pennsylvania AGD leadership.

“What got me involved in Pennsylvania AGD was just being asked,” Sonntag said.

“Sometimes it’s just about showing up.”

As the Pennsylvania AGD president-elect, she plans to provide mentorship and high-level education tailored to the needs of new graduates, recognizing the challenges they face in balancing schedules and commitments.

In addition to being involved in organized dentistry, Sonntag recently opened her own practice, Compass Dental. She said balancing all the hats she wears in the practice as an owner as well as outside of the office as a mom, wife and coach is a juggling act that’s worth all the challenges it brings.

“I really love what I do and enjoy sharing it with anyone who will listen.”

ADAM WOLL, DDS, FAGD

Wells Family Dental Group, Raleigh, North Carolina

“To impact clinicians who then impact patients’ lives is more than anything I could ever do myself.”

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As a kid, Adam Woll, DDS, FAGD, wanted to be a doctor, but he didn’t know what kind of doctor.

When he took a closer look at dentistry, he realized it was the right path for him.

“I have always loved to work with my hands, and I loved science,” Woll said. “Dentistry is the perfect combination of two of my favorite things.”

Woll’s love of handcrafted work reveals itself in his favorite clinical specialty: implants. He said his proudest career moments are when his craftsmanship comes to life in his patients.

“The hugs from navigating long journeys to better a patient’s overall oral health, the lifechanging smiles and the impact you can make on someone’s life through paradoxically small things are the most impactful to me,” Woll said.

Woll counts earning his AGD Fellowship among his proudest career achievements.

“I’ve worked hard year after year through long days, lunchtime learning, after-work study clubs and weekend CE courses to become the best dentist I can be,” Woll said.

Beyond the clinical side, Woll serves as chief dental officer of his dental group’s six offices.

Leading an ever-growing team has afforded him the greatest challenges and opportunities of his career so far.

“Making a difference in my associates’ lives is different from doing it for a patient, but I actually find it to be more rewarding,” Woll said. “I think that’s because a person’s personality, emotions and skills are far more complex to navigate than any treatment plan could ever be.”

In helping young associates navigate the path to success, Woll stresses the importance of communication, mastering the basics and embracing lifelong learning. Woll said he feels the pressure to be excellent for his associates because that is ultimately how he can deliver the most benefit to the most patients.

“It makes me proud to enable young dentists, hygienists and assistants,” Woll said. “To impact clinicians who then impact patients’ lives is more than anything I could ever do myself.”

LEILA S. ZADEH, DMD, FAGD

Revive Dental Implant Center, Mesa, Arizona

“My favorite aspect of dentistry is the deep human connection that comes with healing and care.”

The path for Leila S. Zadeh, DMD, FAGD, to becoming a dentist was paved with a passion for service and a commitment to making a positive impact on individuals with complex medical conditions. She recalls a childhood tradition of giving gifts to children in local hospitals during the holiday season with her parents.

“This tradition had a monumental impact on me as it not only provided a firsthand look at the positive influence that compassionate care can have on patients and their families, but it was also my first exposure to diverse patient pools with diverse medical presentations,” Zadeh said.

With a degree in neuroscience, Zadeh applied to dental school. She volunteered at the advanced care clinic, where postdoctoral residents treat patients with medically complex conditions and special needs. After finishing dental school, she was accepted to the same advanced education in general dentistry program as a resident. After completing her residency, she was awarded the Dr. Arthur B. Levy Award and scholarship “for demonstrating compassion, love of learning and altruism.” Shortly after, she accepted a position as clinical faculty to teach in the residency program.

These experiences helped prepare her for private practice at Revive Dental Implant Center, where she often treats patients with terminal dentition needing full-mouth rehabilitation.

“I am extremely proud to be part of a highly regarded practice that specializes in functional and esthetic transformations for patients who have often been turned away from other practices due to the complexity of their cases,” Zadeh said. “Seeing our patients’ lives become transformed is immensely fulfilling.”

Having completed over 1,000 hours of CE since being licensed in 2020, Zadeh’s commitment to lifelong learning stems from her belief that staying up to date with the latest in clinical dentistry is essential for delivering the highest quality care.

“My favorite aspect of dentistry is the deep human connection that comes with healing and care,” Zadeh said. “I believe treatment is more than just a mechanical act. I feel an obligation to be a team with my patients and to help them feel empowered to improve their overall health.” F

Kelly Rehan is a freelance journalist based in Omaha, Nebraska. To comment on this article, email impact@agd.org.

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The Truth Behind Today’s Hottest Social Media Dental Hacks

By Gerard Scannell, DDS

H

ousehold do-it-yourself (DIY) projects have gained popularity for their cost-saving and convenience benefits.

Many are useful, such as using soda as a cleaning product in some instances. But applying such tactics to our bodies, especially our mouths, can have irreversible consequences.

Dentists today face the challenge of competing with an influx of DIY dental misinformation, often labeled as “dental life hacks,” circulating on social media platforms.

These shortcuts can not only be ineffective, but also potentially harmful, posing risks to the oral health of our patients. Below I will detail some of these trends and discuss their potential benefits or dangers. Hopefully this information will prepare you if any patients ask about — or have already performed — some of these treatments.

DIY Whitening We all know there are many ways our patients can whiten their teeth at home, including Crest® Whitestrips™ or various whitening toothpastes. However, recent videos show people using a Mr. Clean® Magic Eraser to remove stains on their teeth and create brighter smiles. While this may seem harmless, it is not. The sponges are made of melamine resin foam, which contains a compound known as formaldehyde-melamine-sodium

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bisulfite copolymer. Formaldehyde is considered a carcinogen, so accidental ingestion could be potentially dangerous.

Repeated use could also cause tooth enamel to wear down.1 Another at-home dental hack is using undiluted hydrogen peroxide to whiten teeth. While some of our professional whitening products contain hydrogen peroxide as an active ingredient, this trend includes applying undiluted H2O2 multiple times a day. The Food and Drug Administration approves of the use of hydrogen peroxide as a temporary oral debriding agent, but it is meant to be diluted. I have a bottle at home that has a label that says it can be used “as a gargle or rinse” or as an “oral debriding agent.”

Users are instructed to mix at least an equal amount of water with it. Hydrogen peroxide is a highly reactive compound.

While ingesting a small amount could cause vomiting and stomach aches, swallowing larger amounts of undiluted hydrogen peroxide could cause stomach bleeding or breathing problems, and could even be life-threatening.2 Other DIY techniques encourage using acid-containing fruits or vinegar.

These techniques can erode the enamel away and expose dentin, which is more yellow, causing the opposite effect of teeth whitening.

Teeth Filing Another popular trend is filing teeth with a nail file or emery board to shape them differently. While we do this for our patients to some extent by smoothing any chips of an incisal edge, the most common videos on social media show people sanding down their upper anterior teeth to even out the incisal plane. Without understanding tooth anatomy, many people could easily expose the dentin and cause sensitivity or increase the risk of caries on these teeth. A drastic example could be our younger patients, who still have large pulp chambers, exposing the nerve if they filed too much, which would require a root canal.

Another trend is people filing between teeth Nos. 8 and 9 to create a diastema.

This has become a popular fashion trend often referred to as “gappy teeth.” I’m not critiquing the desire for a diastema, but I am concerned about our patients attempting to create the space at home. By doing this, some people are exposing dentin or injuring the papilla. The most egregious video I saw on TikTok is of a woman creating a diastema on another woman using a fingernail buffing or grinding tool found in a nail salon. The space was at least a few millimeters wide. The video has almost 9 million views. Another concerning part is that people suggest teeth are like fingernails and can grow back after filing them.

DIY Orthodontics Although having a diastema has become a fashion statement, many people still want to close the gaps they naturally have. Most of us have heard horror stories of at-home clear aligners; however, the DIY orthodontics popular on social media mainly includes using tiny rubber bands to close gaps between teeth. This isn’t a new trend.

Years ago, YouTube had videos of teenagers using small elastic hair ties to try to reduce spaces in their teeth. This is essentially the same content circulating these days. You can easily buy orthodontic elastic bands online or at local drug stores.

Improperly moving teeth with elastic bands can apply excessive force on teeth and potentially lead to the absorption of a healthy tooth’s root. The diverse shapes of teeth make it easy for the small bands to also slide under the gums. This can lead to difficulty removing them, destruction of periodontal attachment, teeth extrusion and increased mobility.

Mouth-Taping Unlike most dental hacks, mouth-taping isn’t meant to improve esthetics. This dental hack claims to reduce snoring and improve breathing and overall sleep quality by literally taping your mouth shut while you sleep. Many proponents of mouthtaping argue that it helps promote nasal breathing, which is considered healthier than mouth-breathing. Breathing through your nose can help filter and humidify the air, reducing the risk of dry mouth and throat, especially during sleep. Although this would promote better breathing, it may not be suitable for those with certain medical conditions or breathing difficulties.

A few small studies suggest mild benefits to mouth-taping, but research remains limited, and further investigations are needed.3 Patients who inquire about mouth-taping to help with problems like snoring should be evaluated by a sleep professional.

The Need for Professional Guidance At-home treatments existed long before social media. Using hydrogen peroxide to lighten hair color has been a DIY technique

for years. I don’t want to speak to the safety of it, but it certainly seems to be effective. And I’m sure many of us have patients who have told us they use baking soda when brushing their teeth and swear by it. People will always try shortcuts or cheaper ways of trying to improve the way they look. We won’t be able to completely stop it or control it. But it’s essential to address these risky dental hacks and offer safe alternatives to our patients and community. While we understand the desire to enhance one’s smile, it’s crucial to emphasize the importance of professional guidance and the potential dangers of unverified shortcuts. Many people turn to these hacks due to societal pressures, such as being ridiculed for their smiles, or financial constraints that prevent them from seeking professional solutions.

As dental professionals, our role goes beyond treating dental issues; it also involves educating our patients on safe practices. Instead of solely discouraging such hacks, we should strive to guide our patients and community toward healthier and more effective alternatives. We can also share safe and helpful tips through our own social media presence and engage

with compassion when patients present with issues arising from DIY attempts. For example, an actual useful dental hack I viewed involves cutting Crest Whitestrips in half to maximize their use while only applying them to the facial surface, potentially reducing costs.

While the allure of dental hacks may be understandable, the risks involved should not be underestimated. By staying informed and providing genuine advice for safe smile enhancement, we can play an essential role in promoting oral health and well-being within our communities. F Gerard Scannell, DDS, is a general dentist practicing in his hometown of St. Petersburg, Florida. He is the AGD Impact Communications columnist. To comment on this article, email impact@agd.org.

References 1. Tschinkel, Arielle. “TikTokers Are Using Magic Erasers to Whiten Their Teeth — But Is There Any Way That’s Safe?” Shape, 23 Nov. 2021, shape.com/lifestyle/mind-and-body/tiktok-safe-to-usemagic-easer-on-teeth.

2. “Hydrogen Peroxide: How to Prevent and Treat Unintentional Poisonings.” Poison Control, poison.org/articles/hydrogen-peroxide.

3. “Mouth Taping: Is It Safe?” Cleveland Clinic, 8 Sept. 2022, health.clevelandclinic.org/mouth-taping.

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Testing the Tools

By Ross Isbell, DMD, MBA

Membranes to Help Maintain Graft Cases

A Housing Pickup Material You’ll Want to Pick Up and Try

Kontour™ Sustain and Adapt Membranes Implant Direct™ implantdirect.com

EZ PickUp® Sterngold® sterngold.com

In conjunction with extractions, socket preservation or restoration grafting is an everyday process in my practice. We primarily use a cortico-cancellous bone mixture for the graft and therefore need a membrane of some sort to maintain the graft site fill. The Implant Direct™ Kontour™ membrane line is of porcine origin and is quite effective for this purpose. The Adapt membrane is harvested from peritoneum tissue and is super easy to bend and shape. I like Adapt for smaller sites because I have trouble with it sticking to my gloves after it comes in contact with blood. I prefer the Sustain membrane for sites posterior or larger sites because it is firmer and holds position during delivery more easily. I typically only buy the 15 × 20-millimeter sizes, and, even if I need a longer distance for more than four teeth, I can cut the membrane in half lengthwise since most of my tissue releases come close to primary closure. Try out the Implant Direct Kontour membranes on your next extraction and graft case.

I wrote in the July 2022 AGD Impact about different systems for removable implantretained prosthetics, and that is still my preferred style of connection. To pick up the housings for these solutions, you can obviously use the triedand-true method of hand-mixing acrylic, but I have found that automix resins function just as well with much easier handling. Recently, EZ PickUp® from Sterngold® has been my material of choice. This material is a pink gingiva-colored resin that easily and strongly bonds to acrylic after application of the lightcured primer. The first step to picking up housings is opening the space that they will inhabit. Always ensure that you are attaching the housings onto the abutments prior to opening your spaces in the intaglio. Then, make sure to prep the space enough so that the device is not resting on the housings and only on gingiva. It is OK if you make a hole through the lingual/palatal, but the finish on that access hole will not be as smooth as it was originally. If you are having trouble locating where to hollow out, I have found that using a quick-set polyvinyl siloxane-type material (such as Blu-Mousse®) or an alginate substitute (like AlgiNot FS™) as a thin “reline” impression, can quickly show you the location of exposed implants, abutments or housings. After you confirm seating, rinse and dry all places where you want the EZ PickUp to adhere.

Then place the light-cured primer, air-disperse, let sit for at least 40 seconds and light-cure for a minimum of one minute. If your abutment is 3 mm or less out of the gingiva, the white rubber rings are sufficient to act as a block-out on the abutment and prevent locking of the prosthetic onto the implants. But if you are trying to prevent lock-on of a taller abutment, I would recommend blocking around the abutment base with a high-viscosity impression material so that you can delicately create a custom-sloped entrance/exit path that helps the abutment seat. Lastly, place the EZ PickUp into the holes you have created, and place it fully to seat. It takes about three minutes to reach the rubbery phase but about seven minutes until completely cured. While there isn’t much in the way of time savings, EZ PickUp is an upgrade over standard acrylics because it is so much less messy and easier to dispense. The size of the syringes isn’t great for large-coverage situations like relines, but it’s perfect for housing pickups. It also doesn’t taste, burn or smell aggressively like acrylic or methyl methacrylate. Give EZ PickUp from Sterngold a try for your next implant case.

Ross Isbell, DMD, MBA, currently practices in Gadsden, Alabama, with his father, Gordon Isbell, DMD, MAGD. He attended the University of Alabama at Birmingham (UAB) School of Dentistry and completed a general practice residency at UAB Hospital. Isbell has confirmed to AGD that he has not received any remuneration from the manufacturers of the products reviewed or their affiliates for the past three years. All reviews are the opinions of the author and are not shared or endorsed by AGD Impact or AGD. To comment on this article, email impact@agd.org.

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AGD IMPACT

JANUARY 2024

Upcoming Look for the following article in the January/ February 2024 issue of AGD’s peer-reviewed journal, General Dentistry.

A Winning Combo DryZ® Hemostatic Paste Parkell®

parkell.com

Roeko CompreCap Coltene coltene.com

When prepping for indirect or direct restorations, my goal is always to be conservative and minimally invasive and to avoid the gingiva.

However, I’m not always fortunate enough to stay supragingival, and then hemostatic control becomes a challenge. For hemostatic control and gingival retraction, I employ one of three techniques depending on the depth of gingival removal. For the most extreme cases, with blood thinners and 2 mm or more of reduction, I use a laser. For less than 2 mm and no bleeding issues, I use a retraction cord. For less than 2 mm and in the presence of bleeding issues, my preference is a Roeko CompreCap from Coltene and DryZ® hemostatic paste from Parkell®. In those situations, I finalize my margin with a red- or yellow-stripe diamond bur, rinse with water, dry, inject the hemostatic paste directly into the sulcular area, and cover the prep with a CompreCap. The DryZ paste comes in either blue or green colors to differentiate from blood, gingiva and tooth colors. The blue color is slightly stiffer in consistency, so I prefer the green. For the delivery method, you can select between a compule dispenser gun or a standalone syringe with replaceable tips. I like the syringe because the tips are longer and can more easily reach the margin circumferentially. Also, since the tips are coming in contact with blood, I feel better about disposing of them instead of throwing out the remainder of the compule. Using a combination of aluminum chloride hexahydrate, filler and cellulose gum, DryZ paste effectively stops bleeding within a couple of minutes. After delivery of the DryZ paste, I place a CompreCap and maintain pressure for three minutes. The CompreCap system comes in three sizes to fit teeth snugly and has a semilunar cutout on both sides to allow adequate seating. They are also narrow enough that you can place them on adjacent teeth if you are working on a multipletooth restoration treatment. After removing the CompreCap, rinse thoroughly and dry, and you now have a perfect environment for scanning or impression-taking. Both the DryZ and CompreCap systems can be used as standalone products, but, together, I have zero issues.

Herpes zoster: treatment, management, and prevention with the recombinant DNA vaccine Herpes zoster (HZ) is a reactivation of dormant varicella-zoster virus that most often erupts as painful vesicles in a unilateral dermatomal distribution. A sequela of HZ is postherpetic neuralgia (PHN), which is debilitating and may be persistent. Therefore, vaccination for the prevention of HZ and its sequelae is recommended for adults aged 50 years and older as well as immunocompromised adults. In 2017, the U.S. Food and Drug Administration approved a recombinant DNA vaccine (Shingrix) that is safe to use in immunocompromised individuals and an improvement on the live-attenuated vaccine approved in 2006. This report discusses HZ, PHN, treatment of HZ and PHN, and prevention with vaccines.

Read this article and more at agd.org/general-dentistryonline.

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