Advancing Excellence in Dentistry Newsletter
Issue 34 | November 2016
Top Left to Right: Dr. Scott Waletzko, Dr. Herbert Edwards, Dr. James Cunnington, Dr. Josh Walker, Dr. Jaci Jensen, Dr. Bob DiGiorgio, Dr. Joe Sepe, Dr. Philip Harper & Dr. Gerald Kennedy Bottom Left to Right: Dr. AnMarie Giddings, Dr. Melissa Haidu, Dr. Lance Timmerman, Dr. Tim Lawhorn & Dr. Kimlea Sara Medlin
Communicating Complexity [pg 12] Dr. Hess “Asks the Experts” [pg 14-15] Implant Systems Hands-On Study Club [pg 17]
YOUR VISION DELIVERED
DR. ALICE CHEN, INSPIRED DENTISTRY
Washington | November C O2N S TA N T AGD I N ENewsletter BUILD E R S . C2016 OM
What’s in this Issue Implants ....................................................................................................................................4 Preparing to Buy a Dental Practice ................................................................................ 7 Are You Being Set-up? ........................................................................................................ 9 Improving the lives of those we touch ............................................................................ 10 Managing by Numbers ...................................................................................................... 11 Is glide path important in endodontics? .......................................................................... 12 NationwideTop 5 Tips to Avoid Risk in Your Dental Practice ....................................... 13 Dr. Hess “Asks the Experts” ........................................................................................14-16 AGD Member Savings & Offers..........................................................................................19 2016 Washington AGD Dentist of the Year .......................................................................20 Washington AGD 2016 Membership Appreciation “Casino Royale” Gala ............. 22 Program Approval for Continuing Education (PACE) ...................................................... 23 Oral Surgery for the General Dentist ...................................................................................24 AGD Member Benefits ......................................................................................................... 25 Washington AGD Hands-On Orthodontic Program .................................................. 26 Membership Application ..................................................................................................... 28 Cruising in Dental Sleep Medicine 2017 ..........................................................................28 Continuing Dental Education Courses & Events Organization ....................................29 Management of The Fearful Dental Patient ...................................................................30 The Premeir Meeting for Dentistry AGD 2017 .................................................................32 Check us out on Facebook, Twitter & Linkedin!
Maxillo-Mandibular Atrophy: Success through Interdisciplinary Planning
Authors: Richard Winter DDS Alan Kimmel DDS, MS Patients that have undergone severe atrophy from trauma, removable prosthetic erosion, surgical bone removal or pathological processes require careful planning to facilitate successful outcomes. With more general practitioners performing implant surgeries and prosthetics it is incumbent on the generalist to select cases for which their training, skill and judgment are suitable. Even with advanced credentialing through the AAID, the ABOI/ID or the ICOI the difficulty of certain conditions warrants collaboration with specialists that have extensive advanced surgical training for complex cases. Whether the dentist is performing the surgery or the restorative prosthetics it is the authors contention that by performing co-diagnosis, working out finances and prosthetics with the surgeon the dentist can act as an advocate for the patient in achieving case education, and the ability to perform highly complex oral rehabilitation. My Teeth were perfect until college! This patient presented for a consultation with a limited budget and the desire to restore his smile. Photo 1,2. After taking a health history with records and photographs the author consulted with an oral surgeon and discussed a myriad of treatment options; which included ridge spreading, block grafting with symphyseal grafts and sinus augmentation and hip grafting in combination with the above. This article will detail the treatment planning and prosthetics of a patient with severe maxillo-mandibular atrophy.
Advanced Treatment Planning While this article may be more appropriate for an implant-centered journal this article will highlight communication with specialists and how it starts with general dentists. The general practitioner should understand and be the quarterback for complex care to expose patients to dentistry they require. Co-partnering in complex implant restoration necessitates collaboration, communication, evaluation and implementation of advanced grafting and implant surgical techniques. In this article, complex surgical treatment planning, collaboration before and during surgery and prosthetic management will be highlighted. Prosthetic treatment planning as well as dynamic treatment changes due to esthetic, phonetic and anatomic complexities require realistic treatment discussions prior to surgical intervention.
1.Pre-op full face
The patientâ€™s medical history was unremarkable and his dental deterioration was quick. He drank a lot of soda and frequently was told teeth were chronically deteriorating and they would require extraction. Advanced treatment Planning A CBCT was ordered and reformatted through 3DDX.com and reformatted within 24 hours and returned to the general dentist. Images were uploaded on Simplant software (Dentsply Implants, Milford CT) for implant manipulation, bone density evaluations as well as assessment of anatomic landmarks and identification of safety zones. Implant foundation development required bilateral sub-antral sinus augmentation, hip grafting with titanium mesh cages to create a substructure for ten BioHorizons 1. internal implants in the maxilla and five mandibular BioHorizons implants. BioHorizons was chosen due to the Laser Lok technology for holding bone and soft tissue, thread design, which optimizes bone implant contact, titanium alloy formulation and flexibility of prosthetic options. The inclusion of
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2. Pre-op retracted view tapered
abutments with the implants would also facilitate impressions and help control costs for the patient. Final surgical conference: At the final pre-operative meeting with the oral surgeon the restorative dentist arrived with mounted diagnostic casts, mounted casts of the first set of dentures, and the Simplant plan with all implants placed for ideal AnteriorPosterior spread corresponding to proper tooth positioning. This plan would be re-created after the sinus lifts and block grafts were completed so surgical guides could be ordered. The general dentist had already gotten the budgetary details from the patient and financial arrangements had been estimated and completed. continued on page 5
3. Interim immediate dentures
Surgical Protocol The Surgeons: Dr. Alan Kimmel and Dr. Peter Wagner, invited me to observe in the operating room and feedback was given as to the amount of bone harvested and optimal recipient sites during the surgery and intra-operative photos were taken. Editorâ€™s note: The following is a description of the surgery involved, the the workds of the surgeopns. Complex implant rehabilitation is dependent upon proper communication between the restorative and surgical dentist. In the case outlined, co-diagnosis and treatment planning was essential to completing this severely atrophic case. Dr. Winter brought in a mounted set of study models, a mounted diagnostic set-up with teeth, a reformatted CBCT scan with implants placed and a budget the patient had approved. The severe lack of bone necessitated a volume of bone grafting that required an extra-oral donor source. The use of titanium mesh cages to fixate the autogenous bone and provide space for bone development as well as tension free primary closure were paramount in establishing a base of bone for implant placement. Iliac crest cortical and trabecular block grafts were chosen as studies have shown that the resorption pattern associated with hip grafts go down with endosseous implant placement. REF1,2. The surgeries were broken up as follows: edentulation with immediate denture placement (Photo 3); bilateral subantral sinus augmentation with block grafting and titanium cage guided tissue augmentation
4. Maxillary atrophy â€œDâ€? ridge
5. Sinus augmentation window
6. Exposure of iliac crest
7A. Outline of hip graft
7B. Chiseling donor graft
7C. Donor Block from hip
8A. Bone block shaped for recipient site
8B. Autogenous block fixated
9. Titanium cage in place for posterior bone augmentation, blocks in place for anterior
10. CBCT post sinus and block graft for implant planning
12. Maxillary bone braced surgical guide stabilized
11. CBCT reformatted for mandibular implant rehabilitation
13. Mandibular BioHorizons implant placement
(Photos 4, 5, 6, 7A, 7B, 7C, 8A, 8B, 9) and lastly, implant planning and placement with bone braced surgical guides Photos 9,10,11, 12A, 12B. Dr. Winter was present for the surgeries and dynamic treatment planning was done intra-operatively as we were able to visualize bone volume and placement and prioritize bone placement decisions. Uncovery was done concomitantly with connective tissue grafts using Alloderm Acellular matrix to increase the zone of keratinized gingiva.
14. Maxillary implants in place with 3-in-1 abutments
The advantages of working with a restorative dentist that had presented with a complete diagnosis and treatment plan cannot be overstated. The time from inception to surgery was minimal as all treatment and finances had been pre-approved before our surgical consultation visit. Furthermore the ability to discuss the prosthetics allowed for a mutually satisfactory prosthetic outcome because the surgeon and restorative dentist were able to discuss all options and prosthetic limitations prior to the continued on page 6 washingtonAGD.org
15. Aquasil Ultra Extra (Dentsply Sirona mandibular impression.
15A. Mandibular screw retained baseplate.
15B. Maxillary screw retained baseplate.
15C. Initial tooth set-up displaying inadequate lip-support.
16E. Verification jig with Sheffield one-screw test initated.
17A. Maxillary verification jig priir to luting
17B. Custom tray for pickup of luted verification jig.
17C. Aquasil Utra Extra open tray pickup of maxillary jig.
Master Impressions Maxillary and Mandibular implants
17A. Tooth try-in, bite registration with labial windows in baseplates
17 B. A-P spread indicates inability to extend mandibular occlusal set up beyond first bicuspid occlusion.
17C. Mandibular Bar with Locator attachments.
18A. Maxillary PMMA provisional displaying potential anterior cantilever
18B. Maxillary PMMA over lower bar overdenture set-up
18C. Facial view of try-in shows deep naso-labial fold and inadequate lip support
18D. Profile view of inadequate lip support, class III tendency and concave facial profile
surgery with the patient present. The ability to step back from a fixed metal ceramic or Zirconia bridge product, due to cantilevers, inadequate lip support, and prosthetic design limitations, highlights the value of co-partnering toward a successful resolution of a complex series of problem sets. Prosthetic Phase Upon getting clearance to begin prosthetic rehabilitation the following steps were employed: Initial impressions were made with ball top screws affixed to BioHorizons 3in1 titanium abutments. (Photos 13, 14) Then Glidewell Dental made base plates and rims, which were screw retained for a maxillo-mandibular bite registration at proper occlusal vertical dimension. (Photos 15A, 15B, 15C) The author has these base plates made with all implants being screw retained and open labial windows so that the implant abutment interface could be visualized directly. This is a secondary
verification to also make sure there is no rocking of the baseplate. When only two screws are used to affix the baseplate an additional verification opportunity is lost. Verification Jigs and the Sheffield One Screw Test The next step was placing acrylic blocks on each implant, luting them together and performing the Sheffield one screw test. (Photo 16A, 16B, 16C) This test allows you to screw in terminal abutments then central abutments then alternating implants to insure the verification jig seats passively. An open tray impression is made using Aquasil Ultra Extra due to its extended working time and excellent tear strength and accuracy and sent to Glidewell to set all the denture teeth for final checking of the esthetics and phonetics of the case. Photos 16D, 16E) Once this was done it was learned that the A-P spread of 1.5x the distance between a line rough the anterior most mandibular implant and a line connecting the two terminal
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implants would only allow for a first bicuspid to first bicuspid occlusion. Zirconia implant bridges that are built with greater than 1.5X A-P distance lose their warranty as they may fracture. Photo 17A, 17B) A bar-over denture would be used for mandibular rehabilitation. The maxillary arch was still treatment planned for a Bruxzir bridge from Glidewell, as with 10 implants, the A-P spread is ideal. Unfortunately, the PMMA prototype temporary bridge had insufficient lip support for proper esthetics and speech. Photos 17C, 18A, 18B, 18C, 18D) The inability to fabricate a PMMA restoration and subsequent bridge necessitated a change of treatment plan and prosthetic design. The cantilever of the prosthesis as well as the ridge-lap design would lead to food impaction and subsequent inability to maintain adequate hygiene for the Bruxzir bridge. Working with GlidewellDental continued on page 8
Preparing to Buy a Dental Practice By Rod Johnston You’ve heard it before, the separation is in the preparation. This is a quote that is typically heard in athletics, but can be applied to other endeavors as well, including buying or starting a new practice. But, what do you prepare for before you jump into dental practice ownership. Just ask any practice owner, there are a lot of things you can prepare for before you buy a dental practice. Here are a few things that will help you separate yourself from the rest of the pack and allow you to hit the ground running when you become a practice owner: 1. Where You Practice Matters - Know where you want to practice and the demographics of the area you are looking to practice. There are a lot of different websites and services you can look to in order to get this information. A lot of commercial brokers (Steve at Omni Healthcare Real Estate) will have data ranging from a breakdown of the age of the population, to ethnicity, income levels, how much money was spent on dog food per person, etc., There are several services such as Scott McDonald’s that will help you gather data as well. Rod Johnston, MBA, CMA Omni Practice Group
2. Know Your Market - Understand what the numbers and ratios of a typical dental practice should look like. Your state or national association has resources that will show how much you should be spending on staff salaries and benefits as a percentage of total collections, as well as rent, marketing and other financial data as a percentage of collections. 3. Basic Accounting - Start educating yourself on basic accounting principles. Specifically, learn how to read a financial statement - profit and loss report and balance sheet. You will be given these by the dental broker when looking at a practice, so you should at least know what they are and what a financially viable practice looks like vs. a not so nice practice. 4. Bank Financing - Contact a bank that specializes in dental practice financing before you start looking. They cannot necessarily pre-approve you for a certain practice, but they can tell you whether you can get a loan, approximately what rate and terms you can get and possibly how much you may be able to qualify for. You don’t want to go after a $2 million practice if you cannot get a $2 million loan. 5. Looking For Red Flags - Knowing where to find the skeletons in the practice is a key element in the process. Where do you look for embezzlement in the practice? How about hidden staff incentives and payments? Over or under treating patients? Uncollected accounts receivable? Etc., 6. Learn About Leases - What is a triple net lease? What is the market rate for leases? How much time is left on the lease? What’s a tear down clause?,etc., 7. Having a Support System - Surround yourself with a good team; CPA, Broker, Attorney, Consultant, etc., Find those that specialize in your specific discipline. They can help you avoid some of the pitfalls you may miss. By preparing yourself ahead of time with some of these things, you can avoid having to spend more than you need to and find a practice that will bring you great professional challenges and rewards in the long run.
19A. Facial ridge-lap of teeth in PMMA temporary would lead to food impaction and inability for hygienic access
19B. Full maxillary ridge-lap was not acceptable
20. Maxillary Locator bar seated and torqued
22. Full face after deliver of first overdenture
23. Spare set of overdentures delivered
24. Before and after of patientâ€™s smile
lab closely helped to identify these issues prior to final bridge fabrication and delivery. The need to access the implants with brushes, oral irrigation and floss would not be possible with a ridgelap design. Photo 19A, 19B. The patient understood and accepted a bar-over denture design for both arches as this option had been discussed in pre-surgical discussions with both the surgeon and restorative dentist present. (Photo 20) The bars were fabricated and tried in and delivered with the denture in wax with Locator attachments cold cured to the baseplates to verify lip support and phonetics prior to processing. The restoration prescribed by the dentist, requested a metal reinforced denture so the dentist worked loosely with the digital design team at Glidewell to insure there was no more than 2 mm. of unsupported acrylic for strength. The digital files were sent for approval, modifications were made and the final denture design was optimized for strength. (Photo 21) An acrylic denture over a titanium bar will be thin in areas and the forces of mastication on a young male with high force factors could lead to denture fracture in short time. Metal reinforcement of the overdenture increases longevity of the prosthesis. Duplicate Overdentures The dentist offered duplicate overdentures to the patient, as wear of denture teeth is a problem with overdentures and the lab had the bars, VDO, shape, shade mold of approved dentures and could easily make cores for tooth placement and the digital
files to re-create the partial denture frameworks The patient accepted a second set of over-dentures at a reduced fee. The author offers embarrassment dentures routinely for the same reasons. There is tremendous value psychologically, financially and emotionally to offering two sets of overdentures at the final delivery. The final delivery day involved trying in the milled bars with the Sheffield onescrew test, (any rocking at this stage requires sectioning and luting the bar or a new impression of the verification jig), radiographic confirmation of complete seating of the bar and seating of the dentures and final torquing of the bar on to the implants twice at five minute intervals. The dentures are tried in and adjusted and the screw access holes are filled in with Teflon tape and composite resin. Both overdenture sets are adjusted and if necessary quick lab remounts are performed to detail the lingualized bilateral balanced occlusion. The patientâ€™s postoperative successes were demonstrated by his postoperative smile for both deliver and 1 year follow-up. (Photo 22) The lingualized occlusion allows sharp 33-degree cusps to intercuspate with 20-degree mandibular fossae so sharp shearing of food may occur. The use of bilateral balancing allows working occlusion to be balanced on the nonworking side during lateral border movement. According to Abitchondoni in The International Journal of European Implantology both schema have been proven advantageous for bar-overdentures designs to decrease implant loads.
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21A. Maxillary and Mandibular metal supported bar-overdentures with Locator attachments
The field of implant dentistry is expanding, as are the cases that benefit from these technological advances. The use of BioHorizons implants allows us to use Laser Lok technologies to hold hard and soft tissues at the hemi-desmosomal level. Thread geometries and surface coatings such as resin blasting improve bone implant contacts. Sophisticated laboratory communication can provide passive bar seating by labs such as Glidewell dental. Computer generated planning and surgical guide manufacturing by 3DDX.com can facilitate prosthetically driven treatment planning. But the use of technology can only work if we use interdisciplinary thinking to build our rehabilitations for long-term success. If the general dentist becomes the quarterback in treatment planning and partners with the implant surgeon after understanding costs, budgets, anatomical limitations and skill sets to complete rehabilitative care, everyone wins. Whether the general dentist does surgery, prosthetics or both, it is imperative to receive the training to accomplish cases within their competency. Mentoring with an oral surgeon is a rewarding relationship that will help identify patients that will benefit from co-diagnostics, co-treatment planning and mid case corrections to successfully complete complex rehabilitations. The rehabilitation of severe atrophy is something that is seen and often times ignored. Improvement of our knowledge base will help us to treat and improve the lives of our patients through advanced treatment design and thoughtful communication. (Photos 23, 24) continued on page 18
Are You Being Set-up? Melissa Moore Sanchez, Manager, Sales and Marketing, Northwest Dentists Insurance Company Are you being set-up by another dentist and you don’t even know it? Or, maybe you’re the one setting up another doctor! Putting each other in a vulnerable position can be pretty easy to do if you employ another dentist, if you’ve formed a partnership with other dentists, or if you share space with other dentists. Did you know that you can be sued for vicarious liability Melissa Moore Sanchez based on the acts of another dentist in your practice, even if you’ve never seen or treated their patient? If any of these scenarios fit your situation or if you have a solo practice and are incorporated, let me give you actual case examples to consider, that were litigated (names have been changed and circumstances modified): Case 1: Dr. Black is the sole owner of 1234 Dentistry, LLC and also employs Dr. Regis. Dr. Regis’ patient sued him and 1234 Dentistry, his employer. A corporate professional liability policy was never added for 1234 Dentistry. Consequently, Dr. Black, who would’ve been responsible for the cost of the defense and any indemnity payment for 1234 Dentistry, was defended under a Reservation of Rights with the understanding that if a jury finds against the corporation for negligent supervision, Dr. Black would be responsible for the indemnity payment.
You can well imagine in Case 1 and Case 2, the doctors affected by the doctor being sued were not happy about unwittingly being pulled into the case and potentially having to bear the cost of defending the corporation, or possibly being reported to the National Practitioner Data Bank if there’s a settlement. And the solution for avoiding this is so simple. If you employ or are in partnership with other dentists, you should have a corporate professional liability policy. If a hygienist, dental assistant or other staff member makes an error and is accused of dental malpractice, you can be sued for, among other things, negligent hiring or supervision. If you only share space and/or staff with other doctors, you should also consider a corporate professional liability policy. When patients perceive that you are a group, the courts tend to side with the patients; if you look like a duck, walk like a duck, and quack like a duck, you’re a duck. To avoid being misinterpreted as a group, make sure deliberate efforts are made to distinguish separate practices. Don’t use the same letterhead or logos for correspondence, business cards, etc. The reception areas should be separate, and phone numbers and signage on the door or building needs to be distinctive for each practice. If you are a solo practitioner but are incorporated, add your corporation as an additional named insured on your individual professional liability policy. If you and your corporation are named in a claim or suit, which is almost always the case, both entities are covered. Additionally, your staff is covered under your malpractice policy providing the work they do is within the course and scope of their duties as an employee of your practice.
Case 2: Seven doctors formed ABCD Dental, LLC without purchasing a corporate professional liability policy. One of the doctors, Dr. Sager, had a patient fatality. The attorney for the patient’s estate filed a lawsuit against Dr. Sager and the LLC. Since there was no corporate policy, each doctor had to open a claim against their own individual professional liability policy, even though they never saw the patient.
If you volunteer or serve on the board of a non-profit organization, they need to have a corporate professional liability policy and a Directors and Officer’s policy.
Case 3: Dr. Juarez and Dr. Teller had a partnership, WXYZ Dentistry, LLC. Dr. Teller sold his share to Dr. Juarez and subsequently was sued by a patient. Although we did not insure Dr. Teller, we do have coverage for Dr. Juarez, and a corporate professional liability policy is in place for WXYZ Dentistry, LLC. The case is going to trial and Dr. Juarez will have to present a defense for his vicarious liability as the partner. However, because WXYZ Dentistry was added as an additional named insured for corporate professional liability coverage, Dr. Juarez will not have to bear the costs of the defense or, if there’s a verdict, any indemnity payment within the limits of the policy.
And finally: 1) corporate professional liability policies are inexpensive (usually factored at a small percentage of each doctor’s individual professional liability premium) and the application process is simple. 2) Corporate professional liability policies add an additional layer of coverage for vicarious liability that may not be covered under a doctor’s regular professional liability policy. And, 3) another great benefit is it moves your staff’s coverage from your individual liability policy to the corporate policy. Many dentists don’t realize that they are sharing their liability limit with their staff. A corporate professional liability policy removes that concern.
Unless you have a corporate policy in place, you may have no defense and indemnification coverage for the corporation.
Three great reasons to carry a corporate professional liability policy and no more excuses for being set-up.
Improving the lives of those we touch WE SPEND HOURS working with the impressions we take, but how much time do we spend thinking about the impressions we make? Your profession allows you to make a profound impact on the lives of thousands of people over the course of your career. Not surprisingly, most dentists agree they are happiest when focusing on the health of their patients, not their practice. In my position with Henry Schein, I get to help dentists who are stressed and frustrated with their dental office return to what they enjoy most—dentistry. What if you had an expert focus on each aspect of your practice so you could focus on providing the best dental care possible? The truth is that experts are at your fingertips. Your sales representatives work in conjunction with experts to cover every aspect of your dental practice. Let them know what areas of your practice you’d like to focus on, and they can introduce you to your specialist.
Now let’s greet your CAD/CAM specialist. One in three dentists are considering digital restorations to enhance the patient experience and increase hourly production. Our CAD/CAM specialists help you determine if digital restorations are right for you and determine how to best integrate the technology into your practice. How will digital impressions impact your patients? You may already know your next specialist: it’s your equipment service technician. Dentists rely on our expert technicians to help prevent and address any concerns with their equipment. Once you’ve invested in the right equipment and technology, our equipment service technicians make sure your office continues to run smoothly so you can focus on patient care. The next expert is your exclusive products specialist. At Henry Schein we offer a comprehensive selection of products designed to meet your needs within your budget, in addition to name brands and exclusive products that can’t be found anywhere else.
Unsurprisingly, most dentists agree they are happiest when focusing on the health of their patients, not their practice.
I’ll use my company’s organizational structure as an example. Let’s meet our first expert you have access to: the equipment sales specialist. You deserve a well-designed, ergonomic, patient-friendly dental office. The right equipment and technology enhances a dentist’s ability to provide quality patient care. Ourequipment sales specialists can help you lay out a plan for transitioning your practice from where it is today to where you’d like it to be. How will you improve more lives with the right equipment and technology in your practice? Next is the digital technology specialist. The right practice management software makes recall, appointing, and reporting easier, so the dental team can remain focused on patient care. Your digital technology specialist can help make sure all of your technology integrates with your practice management software. How will you use practice management software to improve your patients’ lives?
Lastly, say hello to your business solutions specialist. Henry Schein offers a portfolio of unique solutions dedicated to your practice’s business needs. We start by uncovering opportunities to increase production using our Practice Analysis. Then, based on the results, we develop a plan of action that aligns with your personal goals. How will our business solutions help you focus on patient care? At Henry Schein, we believe in improving the lives of those we touch. We focus on practice care so dental professionals can focus on patient care. Use the team of experts at your fingertips. We want to help you improve more lives, starting with your own. DE
During his 11 years with Henry Schein, KEVIN BURNISTON has had the opportunity to work with more than 1,000 dentists. Each one has unique concerns about their practice and family. Kevin’s goal is to help each dentist reach their dreams. Contact him at (800) 372-4346 or email@example.com. Learn more at HenryScheinBusinessSolutions.com . 10 Washington AGD Newsletter | November 2016
Managing By Numbers Rod Johnston
Managing your practice without knowing what your numbers look like, is like driving your car down a busy freeway with your eyes closed. At some point, you’re going to run into something. With your practice, it may be running into a problem with your hygiene program, or not getting enough new patients, or you don’t get any new patients and your production sinks. You’ve seen what typical practice numbers should be. Your payroll should be between 20% and 25% of total production. Your dental supplies, should be around 7% of total production, or less, etc. Your accounting system should be able to provide those numbers. Your practice management system can supply other numbers such as your production per day, number of new patients and other important data. You should also have Key Performance Indicators, or KPI’s for your practice where you can quickly take the pulse of your practice. Hygiene profitability, case acceptance rate, percentage of hygiene patients scheduled, doctor vs. hygiene production, new patients and percentage of answered phone calls are just a few KPI’s that every dentist should know. If you can track these items, real time, you can really tell if your staff is doing their job, the marketing programs are working and the dentist is doing their job. Your practice management system calculates some of these KPI’s. But, you should really have a tool that can help you track at your finger tips, the key KPI’s in a practice. I have used a product called Practice by Numbers (http://www.practicenumbers. com) for practices I am helping to sell or consult in. I’m able to pull all the data I need to quickly see the health of the practice. Many doctors continue to use Practice by Numbers after the sale is complete. So, whether you are in the market to buy a practice, or you own one or multiple practices, you really need good tools that will help you manage your practice quickly and effectively.
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Is glide path important in endodontics? Rodrigo Sanches Cunha DDS MSc PhD FRCD(C) Shaping the root canal can often be a challenge. Even the more experienced clinician can find it hard to shape narrowed and curved canals. Glide path can be described as a smooth uninterrupted patency from the canal orifice to the apical foramen, and it is considered an essential step for the safety of the shaping procedure. Its minimal size should be a “loose #15 hand file”. Achieving and maintaining a predictable glide path can be time consuming, demands patience and good knowledge of the root canal’s anatomy. Small hand-files are commonly used in order to achieve a glide path. Recently, however, several NiTi multi-files and single-file rotary systems have also been introduced for this purpose: - Pathfile system composed of three files (13.02; 16.02 and 19.02) - Tulsa-Dentsply; - ProGlider single file (16 with a progressive taper) - Tulsa-Dentsply; - One G single file (14.03) – Micro Mega; - X-Plorer system composed of four different files (15.01; 20.01; 20.02; 25.02) – Clinician’s Choice Dental Product. There are research studies showing that shaping can be performed with success without prior achieving glide path when using reciprocating systems (De Deus et al, 2013; Rodrigues et al, 2016; Coelho et al, 2016). However, making sure there is a predictable glide path prior to shaping the canal or creating a smooth glide path is a general recommendation in order to avoid procedural errors such as apical transportation and apical perforation (Ruddle et al, 2014). Procedural errors can certainly lead to inadequate cleaning and shaping. Consequently, this can lead to an inadequate filling of the root canal system and thus contribute to reduced success rates of the endodontic treatment (Jafarzadeh & Abbot, 2007). When comparing both hand and mechanized instruments for the glide path management, Alves et al (2012) came to the conclusion that here was no difference with regards to apical transportation. With the aid of a micro CT scanner,
12 Washington AGD Newsletter | November 2016
Alovisi et al (2016) found that a more centered preparation was achieved when using the ProGlider single file, compared to the Pathfile multi-files system and K-files. Additionally, Kirchhoff et al (2015) did not find any difference regarding apical transportation and volume increase when comparing the Proglider and Pathfile systems in curved canals, again using a micro CT scanner. The authors did however; find that the Proglider single-file system achieved glide path significantly faster than the Pathfile multi-file system. The main causes of file separation are cyclic fatigue and torsional stress, for that reason, creating a predictable glide path into a canal before using mechanized instruments in the apical portion is the best way to prevent its occurrence (Bahcall et al, 2005). File separation was also analyzed by Jonker et al. (2014) when using a single-file reciprocating system with and without glide path prior to shaping resin blocks. Glide path was achieved by either hand-files or a multi-file NiTi rotary system and the authors observed that file separation was greater when no glide path was achieved. Postoperative pain after endodontic procedures is an unwanted incident for both patients and clinicians. In a randomized clinical trial, Pasqualini et al (2012) evaluated the incidence of postoperative pain after glide path performed with a rotary NiTi glide path system versus stainless-steel K-hand file. Postoperative pain, analgesics consumption, and the number of days to complete pain resolution were evaluated in a 7 days time frame. The authors observed that the rotary glide path system lead to less postoperative pain and faster symptom resolution. Conclusions • Glide path can be achieved with either small handfiles or mechanized NiTi systems and can assist the shaping procedure during the endodontic treatment, avoiding procedural errors such as apical transportation and file separation. Avoiding these errors results in decreased postoperative pain. 1. Alovisi M, Cemenasco A, Mancini L, Paolino D, Scotti N, Bianchi CC, Pasqualini D. Micro-CT evaluation of several glide path techniques and ProTaper Next shaping outcomes in maxillary first molar curved canals. Int Endod J. 2016 Mar 17. doi: 10.1111/iej.12628. [Epub ahead of print] (continued on page 17)
Top 5 Tips to Avoid Risk in Your Dental Practice The number one defense against fraud and embezzlement is active participation in managing your business affairs. It means taking the time to set up an effective system of internal controls and paying close attention to your financial affairs thereafter. While there are certainly more ways to protect your practice, here’s a short list of tips to safeguard your financial resources: 1. When hiring, conduct thorough background checks including educational achievements, work history, criminal background, and credit references to the extent permitted by law. 2. Educate your employees on out-of-bounds behavior, including stealing, falsifying records, and appropriating company assets for personal use. Make sure everyone knows how to report suspicious behavior. Also, cross-train employees and separate your money management duties across two or more employees so they can monitor and cross-check each other’s work.
4. Make sure you are staying current on insurance filings and all covered services are reported accurately. “Creative” insurance filings – e.g., billing for services not rendered, misrepresenting services to increase claim reimbursement, and billing for fictitious patients – are common forms of embezzlement and could expose you to civil liability. 5. Take personal responsibility for your practice management software. Make sure employees have unique IDs/passwords, and grant (or limit) access to information on a need-to-know basis. Leverage your system’s reports to spot “red flags” in your financial transactions and/or perform random spot checks on activities. For dental practices of all sizes, implementing these operational guidelines may help identify potential blind spots as well as improve the efficiency and effectiveness of your front office. Connect with us at firstname.lastname@example.org
3. Pay close attention to your monthly profit and loss records, take note of things that seem out of line, and follow up on unexpected increases.
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Dr. Hess “Asks the Experts” Each issue of the Washington Academy of General Dentistry Newsletter will feature two of your questions posed to well known dental experts by Dr. Hess. This issue’s questions are being answered by Dr. Eugene Pester and Mr. Richard Lee. Dr. Pester is a graduate of Loma Linda School of Dentistry and a residency in Dental Anesthesiology at Loma Linda University Medical Centers. Dr. Pester currently owns Apex Anesthesia Services which provides mobile anesthesia services for dentists from “Seattle to Spokane and Everywhere in Between”. Mr. Richard Lee has operated the University of Washington Pre-Doctoral Clinical Laboratory since 2001. He acquired his laboratory training through the U.S. Army. His training included dental assisting school, dental laboratory (basic and advanced), and the Army’s DTA (X2 Course).
Question: Removable prosthetic repairs: How do I separate the complex from the simple repair; is there anything I can do before I see the patient; and why do I need to take an opposing and a pick-up impression?
Answer: Thanks for raising such a common concern: What is needed for a removable repair? First, I’d like to share some ACP (American College of Prosthodontists) numbers that might support the importance of wanting to know how to handle removable appliances. * More than 35 million Americans do not have any teeth, and 178 million people in the U.S. are missing at least one tooth. These numbers are expected to grow in the next two decades.” Mr. Richard A Lee RaLee@uw.edu
* In the geriatric population the ratio of edentulous individuals is 2 to 1. About 23 million are completely edentulous and about 12 million are edentulous in one arch. * 90 percent of those who suffer from edentulism have dentures. * The number of partially edentulous patients will continue to increase in the next 15 years to more than 200 million individuals. Partial edentulism affects the majority of adult Americans. Now that we know removable appliances are on a steady rise, let’s review some of our past experiences and challenges with acrylic (PMMA) appliances. I once heard a Prosthodontist reply to a colleague, when asked to evaluate an RPD design, “I don’t do loose!” At first, I laughed seeing the humor in the comment, then I realized, this perspective is common with in our profession and patient population. So, why bring up perception when discussing repairs, because denture patients, like a lot of us, do not see removable appliances as a precision made prosthesis. In as much, as we would like them to leave the repairs to the professional, they will often attempt to adjust and repair their own appliances. No different than a Schwinn bicycle owner views their repair different than a BMW or Tesla owner.
Eugene Pester, DDS email@example.com
These do it yourself (DIY) repairs are influenced by modern pharmacy’s selling over the counter repair kits and YouTube videos proclaiming the ease of fixing it yourself. Home remedy repairs, or, OMG repairs, quite often are performed with excessive amounts of the wrong materials. Some of these recommended materials contain adhesives that actually dissolve acrylic and if over applied can lead to irreversible damage to the appliance. Additionally, we have all heard or may have even used cyanoacrylate to secure a denture tooth, but not all “Super Glues” are the same, nor should we promote it as a final solution and for sure not a billable process. When thermo-dynamics are applied this weak surface bond will fail and probably at the least graceful moment, at dinner with friends. I should
14 Washington AGD Newsletter | November 2016
“Ask the Experts” cont.. add, Home Depot’s Gorilla Glue is great with wood projects, not so handy with flippers!
3. Are you repositioning or changing anything on the occlusal? Opposing impressions are needed!
Simply put, the practicality of being able to hold their appliance in their hands, lends some to listening to that internal crafting voice saying “I can Fix It!” So, if they’re calling you first, or coming in the door with the repair, then your success is achievable!
4. If your patient’s bite is hard to replicate on the casts or there is malocclusion? - Bite registration is probably necessary!
To best handle a repair let’s start with the patient: 1. What type of appliance is it? 2. What needs repair and do you have the parts? 3. How did it happen? 4. When can you bring it in? Once you have collected the patient information, you can determine if the repair can be done by you or if it needs to be sent out!
Consider these two Abraham Lincoln quotes on your next patient repair, the first quote is your front line decision and the latter is what your lab support does daily for your patients: “Determine that the thing can and shall be done, and then we shall find the way.” -(Congress 1848) “I shall try to correct errors when shown to be errors; and I shall adopt new views so fast as they shall appear to be true views.” -(Greeley Letter 1862)
Question: Q: Why should you consider providing anesthesia services in your office?
“Type of appliance” quickly identifies the complexity.
For example, replacing a broken tooth on an RPD or Complete Denture could be a simple repair, providing the patient brought the fractured tooth with them. When the patient’s fractured tooth is not present sending the case to the lab may be the only option, especially if you do not have teeth in inventory.
The simplistic answer is so that you can turn the impossible into the possible: The uncooperative patient becomes cooperative. The anxious patient is relaxed. The patient with the hyperactive gag response can tolerate a throat pack and endotracheal tube. The special needs patient becomes more mainstream-able. The patient who wants everything done in one appointment can now be accommodated.
“What is damaged” will determine the need for an impression. Let’s say a clasp is broken. The lab will need the shape of the abutment tooth to form the wire. In addition, to insure the wire is in the proper undercut position on that anchor tooth, a pick-up impression with the appliance in relative position on the cast will be required. However, no opposing cast would be needed, unless the clasp extends onto the occlusal surface (e.g., Ball clasp).
A stressful, unproductive schedule can become peaceful as well as productive. Your practice will gain referrals from satisfied anesthesia patients. You and your staff will eventually wish that all your patients were under anesthesia!
“How it was damaged” is an important question for separating impact trauma from design concerns, but be cautious in how you ask the patient, as to not imply negligence.
The most important decision you are facing is selecting an anesthesia team that suits your dental practice. Providing anesthesia in a dental office is substantially different from doing anesthesia in a hospital, a surgery center or a specialty medical office. You will be best served by a dental anesthesia provider who has done a lot of anesthesia for dentists.
An example of a design concern: patient says #7 fell out of there metal partial, in asking ‘how’, you determined they were prematurely biting on #7. This would translate to a simple repair, if they have the tooth, followed by a chair side adjustment of the acrylic or maybe a minor enamelplasty. However, if the fractured tooth is not available, a pick-up impression and an opposing is necessary for repositioning the new tooth. You may even need a bite registration if malocclusion is in play. In conclusion, the factors listed below may help you determine the need for impressions and, or, a bite registration for a successful restoration: 1. Do you have all the pieces and they fit together? - No impressions are needed! 2. Does the repair involve the intaglio surface and you’re missing parts? - Pickup impression required!
Sounds good, but what all is involved?
The next step is to print out WAC 246-817-778 that describes the contract that you are required to have with any anesthesia provider that you wish to use in your office. Meet with that provider in your office to determine how your facility and this particular anesthesia provider are going to meet this requirement. Pay particular attention to whether this provider provides any Registered Nurses or Certified Dental Anesthesia Assistants. Perhaps this anesthesia provider is planning to utilize your assistants? All anesthesia providers need additional hands at times. Whose malpractice insurance is covering those extra hands is a legitimate point for discussion.
(continued on page 16)
“Ask the Experts” cont.. While not specifically required in the DQAC mandated contract, but still very important, is determining which practice will coordinate medical consultations and data collection. As our patients are getting older and sicker, this is becoming a significant and labor intensive part of proper planning for safe office based anesthesia services. Bottom Line “If it was easy, everyone would be doing it” rings true for dental office anesthesia services. Most dentists will not choose to do an anesthesia residency. Most dentists will not choose to utilize the services of a dental anesthesia provider. However, the good news is that the exceptional dentist who teams up with an exceptional dental anesthesia provider will occupy a professionally and economically satisfying niche. Do you have a question for the experts? Contact Dr. Hess Please forward your questions to Dr. Hess at
Timothy A Hess, DDS, MAGD Director of the Tucker Institute Affiliate Instructor Restorative Dentistry Affiliate Faculty Oral Medicine University of Washington School of Dentistry
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Patient Communications Software. Websites. Marketing Services. 16 Washington AGD Newsletter | November 2016
(contimued from page 12)
2. Alves Vde O, Bueno CE, Cunha RS, Pinheiro SL, Fontana CE, de Martin AS. Comparison among manual instruments and PathFile and Mtwo rotary instruments to create a glide path in the root canal preparation of curved canals. J Endod. 2012 Jan;38(1):117-20. 3. Bahcall JK, Carp S, Miner M, Skidmore L. The causes, prevention, and clinical management of broken endodontic rotary files. Dent Today. 2005 Nov;24(11):74, 76, 78-80; quiz 80. 4. Coelho MS, Fontana CE, Kato AS, de Martin AS, da Silveira Bueno CE. Effects of Glide Path on the Centering Ability and Preparation Time of Two Reciprocating Instruments. Iran Endod J. 2016 Winter;11(1):33-7. 5. De-Deus G, Arruda TE, Souza EM, Neves A, Magalhães K, Thuanne E, Fidel RA. The ability of the Reciproc R25 instrument to reach the full root canal working length without a glide path. Int Endod J. 2013 Oct;46(10):993-8. 6. Jafarzadeh H, Abbott PV. Ledge formation: review of a great challenge in endodontics. J Endod. 2007 Oct;33(10):1155-62. 7. Jonker CH, Van der Vyver PJ, De Wet FA. The influence
of glide path preparation on the failure rate of WaveOne reciprocating instruments. SADJ. 2014 Jul;69(6):266-9. 8. Kirchhoff AL, Chu R, Mello I, Garzon AD, dos Santos M, Cunha RS. Glide Path Management with Single- and Multiple-instrument Rotary Systems in Curved Canals: A Micro-Computed Tomographic Study. J Endod. 2015 Nov;41(11):1880-3. 9. Rodrigues E, De-Deus G, Souza E, Silva EJ. Safe Mechanical Preparation with Reciprocation Movement without Glide Path Creation: Result from a Pool of 673 Root Canals. Braz Dent J. 2016 Jan-Feb;27(1):22-7. 10. Ruddle CJ, Machtou P, West JD. Endodontic canal preparation: innovations in glide path management and shaping canals. Dent Today. 2014 Jul;33(7):118-23.
Division of Endodontics, College of Dentistry – University of Manitoba. Private Practice Limited to Endodontics in Winnipeg, MB – Canada email:firstname.lastname@example.org
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(contimued on page 21) washingtonAGD.org
ARTICLES Richard Winter DDS MAGD DABOI/ID FAAID DICOI Dr. Winter is a Master in the Academy of General Dentistry; He is a Diplomate in the American Board of Oral Implantologists/ Implant Dentists and has a Fellowship in the American Academy of Implant Dentistry. He also has a Diplomate in the International Congress of Oral Implantologists. Dr. Winter is a Fellow in the Academy of Dentistry International and the International College of Dentists. He graduated from the University of Minnesota School of Dentistry in 1988. Dr. Winter lectures on Upgradeable Dentistry, Advanced Treatment Planning and General Dentistry As A Specialty. He has written many articles on complex implant and restorative dentistry and he lectures and provides hands-on courses throughout the United States. For information on his courses please contact him at firstname.lastname@example.org Bio: Dr. Alan Kimmel D.D.S. Oral Maxillo-Facial Surgeon Dr. Kimmel graduated Cum Laude from Marquette University School of Dentistry in 2002. Dr. Kimmel was elected into Omicron Kappa Upsilon Dental Honor Society and Alpha Sigma Nu Jesuit Honor Society for his committed leadership within the field of dentistry and the community. In 2006, Dr. Kimmel completed his residency training within the specialty of Oral and Maxillofacial Surgery at Cook County Hospital in Chicago, IL. Dr. Kimmel is Board Certified by the American Board of Oral and Maxillofacial Surgery. Dr. Kimmel is an associate professor in Oral Surgery at Marquette University School of Dentistry. Dr. Kimmel is a member of the American Association of Oral and Maxillofacial Surgeons, Wisconsin Oral and Maxillofacial Surgeons, American Dental Society of Anesthesiology, American Dental Association, and the Wisconsin Dental Association. Dr. Peter Wagner In 2003, Dr. Wagner earned his Doctorate of Dental Surgery from Marquette University. He completed his General practice residency at the Veterans Administration Medical Center in Milwaukee. His residency training in oral and maxillofacial surgery was completed at Cook County Hospital in Chicago. Dr. Wagner is Board Certified in Oral Maxillofacial surgery and is a member of the ADA, WDA, Wisconsin Oral and MaxillofacialSurgeons. Dr. Wagner and Dr. Kimmel have a joint practice in Milwaukee, Wisconsin: Oral Surgery Associates. References: 1. Misch CE, Dietsh F: Endosteal implants and iliac crest grafts to restore severely resorbed, totally edentulous maxillae-a retrospective study, J Oral Implantol 20:100-110,1994. 2. Nystrom E, Legrell PE, Forssell A et al: Combined use of bone grafts and implants in the severely resorbed maxilla. Postoperative evaluation by computed tomography, Int. J. Oral Maxillofac Surg 24:20-25,1995 Suggested Reading: 1. Abichandani,S, Bhojaraju,N. Guttal,S. Srilakshmi,J. Implant Protected Occlusion: A Comprehensive review, European Journal of Prosthodontics; Volume 1,(2) pp: 29-36. 2013. 2. Romanos,G, Grizas,E., Nentwig,G. Associaton of Kerinized Mucosa and PeriimplantSoft Tissue Stability Around Implants With Platform Switching, Implant Dentistry Vol. 24(4)pp. 422-426. 3. Tokuhisa M, Matsushita Y, Koyano Kl In vitro study of a mandibular implant overdenture retained with ballk magnet, or bar attachments: Comparison of load transfer and denture stability. Int J Prothodont 2003;16:128-134. 4. Yang TC, Maeda Y, Gonda T, Kotecha S. Attachment systems for implant overdentures: Influence of implant inclination on retentive and lateral forces. Clin Oral Implants Res 2011;22:1315-1319. 5. Zou D, Wu Y, Huang W, Wang F, Wang S, Zhang Z. A 3-year prospective clinical study of telescopic crown, bar, and locator attachments for removable four implant-supported maxillary overdentures.Int J Proshtodont 2013;26:566-573. 6. Molly L, Quirynen,M, Michiels K, Van Steenberghe D. Comparison between jaw bone augmentation by means of a stiff occlusive titanium mesh hip graft: a tetrospective clinical assessment. Clin Oral Implants Res. 2006 Oct;17(5):481-7. 7. Corinaldesi,G, Pieri,F., Sapigni,L., Marchetti,C. Evaluation of Survival and Success Rates of Dental Implants Placed at the Time of or After Alveolar Ridge Augmentation with an Autogenous Mandibular Bone Graft and Titanium Mesh: A 3-to8year Retrospective Study. The International Journal of Oral Maxillofacial Implants 2009;24:1119-1128. 8. Simion M, Fontana F, Rasperini G, Maiorana C. Long-term evaluation of osseointegrated implants placed in sites augmented with sinus floor elevation associated with vertical ridge augmentation: A retrospective study of 38 consecutive implants with 1- to 7-year follow-up. Int J Periodontics Restorative Dent 2004;24:208â€“221. 9. Watzinger F, Luksch J, Millesi W, et al. Guided bone regenera- tion with titanium membranes: A clinical study. Br J Oral and Maxillofac Surg 2000;38:312â€“315. 10. Keller EE, Triplett WW: Iliac bone grafting, review of 160 consecutive cases, J Oral Maxillofac Surg 45:11-14,1987. 11. Nkenke,E,Weisbach V, Winckler,E, Kessler,P, Schultze-Mosgau,S., Wiltfang,J., Neukam, F.W., Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic augmentation procedures: A prospective study, International Journal of Oral Maxillofacial Surgery; Vol 33,(2)2004; pp157-163. 12. Winter,R. Advanced treatment planning one recipe for implant success, Dent Today. 2012 Nov;31(11):114,116-121.
18 Washington AGD Newsletter | November 2016
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2016 WASHINGTON AGD DENTIST OF THE YEAR By Teresa Kang DDS
For those involved in any form of organized dentistry, there is a high chance that you have crossed paths with Dr. Gary Heyamoto. I personally met him just after graduating from dental school. Over the last 10 years, I’ve had the opportunity to work with him through the Washington AGD. His dedication to bettering dentistry is admirable. Those who have worked with him often wonder when he sleeps and how he’s able to do so much, yet always stay positive, calm and gracious.
His list of accomplishments seems endless. Yet, when you meet him, he is one of the most approachable and down to earth persons- never boasting or giving a hint of all he has accomplished or knows. His three loves are family, dentistry and sports. He is dedicated, knowledgeable, trustworthy and loyal.
His time commitment and vision have shaped and laid the foundation for the future of Washington AGD. Dr. Heyamoto has spearheaded many of our most successful programs. His most recent is the 4,000 square foot Washington AGD learning center, where local dentists can rent space for lectures and hands-on training. Washington AGD’s successful MasterTrack and FellowTrack courses are held at the new facility. Our Board meetings and most of our CE programs are held there. It is a place for the Washington AGD members to call home. The facility also is fully functional for hands-on training made possible by a generous donation by ADEC.
This year, much to his surprise, the Board of Directors nominated Dr. Heyamoto to be the Washington AGD 2016, “Dentist of the Year”. There is no one more deserving and more humble - even when his family was present, he did not expect he was being honored. He has given so much time to our organization that it was important for his family to know that we appreciate his contributions and to acknowledge his huge accomplishments.
Here is a biography of Dr. Heyamoto that will give a glimpse of the man who can do it all. “Dr. Gary E. Heyamoto is a native of the Seattle area having been born and raised here. He attended the University of Washington for both his undergraduate degree in zoology (1976) and his doctorate degree in dentistry (1980). Dr. Heyamoto remains active in several dental study clubs and constantly attends continuing education classes to enhance his professional background and knowledge. He belongs to the American Dental Association, Washington State Dental Association, Snohomish County Dental Society, The Academy of General Dentistry, L.D. Pankey Alumni Association, U.W. Dental Alumni Association, the American Society of Forensic Odontology and the American Equilibration Society.
Dr. Heyamoto earned the prestigious Mastership Award in 2002 from the AGD after receiving the Pierre Fauchard Fellowship Award in 2000. In 2005, a Fellowship in the Academy of Dentistry International and a Fellowship in the American College of Dentists was awarded. He earned the Lifetime Learning and Service Award (LLSR) from the Academy of General Dentistry in 2007. In 2012, Dr. Heyamoto earned his second LLSR. and 2015, he was awarded his third LLSR. In addition, he served on the WSDA Board of Directors from 2010-2016.
20 Washington AGD Newsletter | November 2016
Dentist of the Year
Dr. Gary Heyamoto
ARTICLES Outside of dentistry, Dr. Heyamoto is active in the Seattle sports scene. He has participated (eight years) in coaching youth baseball and basketball in Woodinville, WA. Professionally, he is a statistician for both the NFL’s Seattle Seahawks football team and the PAC-12’s University of Washington Husky football team. He also serves as the shot clock operator for the U.W. PAC-12 Women’s basketball team and as the statistician (assists/turnovers/steals/blocked shots) for the UW Men’s PAC-12 basketball team. Dr. Heyamoto has worked in several Western Regional NCAA Basketball Tournaments and one Men’s Final Four. He currently works the Rose Bowl Games as the defensive statistician, worked the final two BCS National Championship football games and has been selected as the defensive statistician for the NCAA National Championship Series Football Games (his first one on January 12, 2015. with Oregon falling to Ohio State). He is scheduled to work the next BCF game January 9, 2017.
In 2014, Dr. Heyamoto participated with the Snohomish County Coroner, using his forensic background, in helping to identify victims of the Oso, WA mudslide. He was awarded AGD’s 2014 President’s Award for his participation.
Among his hobbies is a love for art. He has illustrated his own dental themed calendar since 1982 and distributes it to all patients as a daily reminder of dental health care. He also enjoys creating Ukrainian eggs and was (15 years) the cartoonist for the Seattle-King County Dental Journal. He has also illustrated for the Washington State Dental Association publications on an as needed basis. He had a short story selected as one of 65 (out of 1200 entries) published as “Chicken Soup for the Dental Soul” in 2000. In 2012 he authored a chapter in “Mineralized Tissues in Oral and Craniofacial Science”, a textbook published by Wiley-Blackwell.
Congratulations, Gary Heyamoto, DDS, MAGD, LLSR, FICD, FACD, FCDI, FPFS
We are proud to support the Washington AGD and its members.
900 - 1st Ave. S. Ste. 208 Seattle, WA 98234 P: 206-682-2887 | F: 266-682-1218 INFO@MAXTECHSEATTLE.COM | WWW.MAXTECHSEATTLE.COM washingtonAGD.org
Washington AGD 2016 Membership Appreciation “Casino Royale” Gala By: Teresa Kang DDS, Washington AGD President-Elect On October 14, the Washington AGD hosted its 4th annual Gala at the beautiful Seattle Four Seasons Hotel. The event was a sell-out with over 250 attendees. This wonderful social event brings our members together to network and have fun, but also to raise funds to benefit the AGD Foundation. We extend a huge thank you to all who donated generously to this event.
Our top donors this year were: Drs. Linda & Bryan Edgar Drs. Ravi & Mindy Sinha Henry Schein ADEC Nordic/WDIA Bellevue Endodontics Dr. Todd Yoshino Dr. Wendy Crisafulli Dr. Lisa Buttaro Dr. Minou Karbakhsch Mr. George Constantine & Mrs. Kay Constantine The AGD Foundation is the philanthropic arm of the AGD, and was established in 1972. Its dual objectives are “to improve the oral health of the public and support the efforts of general dentists and the AGD”. The Foundation’s overall mission is to passionately support the efforts of the general dentist toward improving the oral health of the public. We are very proud of Washington AGD’s efforts and encourage other states to take part in promoting oral cancer awareness in our communities and in supporting the AGD Foundation. This year, several luminaries from across the country came to support our event. From National AGD, President-Dr. Maria Smith, Vice President-Dr. Manual Cordero, Region 11 AGD Board Trustee-Dr. Guy Hansen and Region 11 AGD Regional Director-Dr. Ravi Sinha joined us. The Washington AGD thanks them for taking the time from their busy schedules to show their support for our event. The event would not have been possible without generous donations from our corporate sponsors, Henry Schein, Nordic/WDIA, Omni and AKT. We would also like to thank Constantine Construction for the Photo booth sponsorship and Nordic/WDIA as the wine sponsors. At the Gala, we also had the opportunity to honor devoted Washington AGD members who promoted oral cancer awareness and gave time and support to better the Washington AGD. Dr. Linda Edgar: Washington AGD 2016 Appreciation Award Dr. Edmond Truelove: Washington AGD 2016 Distinguished Service Award Dr. Gary Heyamoto: Washington AGD 2016 Dentist of the Year
Please save the date for the 2017 Washington AGD Membership Appreciation “Mad Hatter’s Gala”, Saturday, October 7, 2017 at the Four Seasons. We are currently seeking Gala volunteers as well as silent and live auction items. Sponsorship opportunities are available. Please contact Washington AGD, Executive Director, Valerie Bartoli at washingtonagd1@yahoo. com for more information We look forward to seeing all our members at next year’s event!
22 Washington AGD Newsletter | November 2016
ARTICLES Washington Academy of General Dentistry PACE Approval Representative: Linda Edgar, DDS 220 292nd Street, Federal Way, WA 98023 Office: 206-940-6112 Fax: 253-517-8766 Email: email@example.com
Applying for PACE Approval Approval for CE Credits from the Academy of General Dentistry (AGD). The Academy of General Dentistry (AGD) Program Approval for Continuing Education (PACE) was created to assist members of the AGD and the dental profession in identifying and participating in quality continuing dental education (CDE). PACE approves program provider organizations, not speakers or specific courses. The program provider approval mechanism is an evaluation for the educational processes used in designing, planning, and implementing CE. Approval by the AGD does not imply endorsement of course content, products, or therapies presented, nor does this approval imply that a state or provincial board of dentistry will accept courses. Approved program providers are expected to comply with all relevant state and federal laws. CE offered by approved program providers will be accepted by the AGD for Fellowship/Mastership credit.
Get the Application Go to www.agd.org Click on the Education tab and then PACE Apply/Renew Tab to get the application. To qualify for PACE approval, all organizations should have offered a planned program of CDE activities for at least 12 months. Note: If your organization has not offered a planned program of continuing dental activities during the 12 months immediately preceding the application date, you may apply for a maximum of one year approval.
FEE AGD Members: If you are an AGD Member or Associate Member (Specialists are Associates) the FEE is $195 for 4 years. Please make your check out to Washington AGD. AGD Members do have access to the AGD membership database Non-AGD Members: If you are NOT an AGD Member or Associate Member the FEE is $595 for 4 years. Please make your check out to Washington AGD. Non-AGD Members do not have access to the AGD membership database. If you would like to become an AGD member, please submit the enclosed membership application along with the membership dues of $486. Please make your check out to the AGD.
Your PACE Application Two (2) copies of your PACE Application must be mailed to me along with One (1) copy of your membership application with the appropriate checks.
Mail to: Linda Edgar, DDS Washington AGD PACE Approval Representative 220 292nd Street Federal Way, WA 98023 washingtonAGD.org
Oral Surgery for the General Dentist Making it Easier, Faster & More Predictable
Many extractions look easy, but can become difficult, time consuming and lead to problems. This course reviews the best techniques and instruments to remove “surgical” extractions easily and quickly while conserving bone. It also covers multiple extractions, ridge preparation for immediate dentures, moderate 3rd molar surgery impactions and avoiding or managing common surgical complications, such as sinus misadventures, excessive bleeding and tuberosity fractures. Also included is predictable socket bone grafting.
Dr. Karl Koerner
Course Schedule: March 17 & 18, 2017 “Oral Surgery for the General Dentist Making it Easier, Faster & More Predictable” Premiere Speaker: Dr. Karl Koerner
Register Online: WASHINGTONAGD.ORG OR CALL: 253-306-0730
Location Washington AGD Educational Center, 19415 International Blvd, #410, SeaTac, WA 98188
Tuition: Each session is 8+ credits in both lecture & hands-on. Saturday educational session will run from Friday 8:00 AM-5:00 PM and Saturday 8:00 AM-5:00 PM. * Due to the nature of this course, no refunds of the yearly tuition will be given. Organizers will not be liable for any expenses incurred by the participant due to missed sessions. AGD Member Dentist: $795 (Includes Parking, Breakfast, Lunch and Hands-On Materials for each session)
Our member representatives are available to assist you Monday through Friday from 7:30 a.m. to 5:30 p.m. CST We would love to have you as a member! Please renew or join the AGD, contact the AGD Membership Services Center at 888.243.3368 (toll-free) or 312.440.4300, email us at firstname.lastname@example.org 24 Washington AGD Newsletter | November 2016
Non-AGD Member Dentist: $895 (Includes Parking, Breakfast, Lunch and Hands-On Materials for each session) Military Dentist: $715.50 (Includes Parking, Breakfast, Lunch and Hands-On Materials for each session)
AGD Member Benefits The Academy of General Dentistry (AGD) is the only organization that exclusively represents the interests and serves the needs of the general dentist. Start taking advantage of our member benefits today—join the AGD by visiting www.agd.org or calling 888.AGD.DENT (888.243.3368).
Discover quality continuing education (CE) opportunities—at both the local and national level, and in a variety of formats—to help you provide the best patient care, learn about the latest technologies and procedures, and emerge as the educated voice of general dentistry. Plus, you can submit CE to the AGD in a variety of convenient ways—via the Web, email, mail, or fax—and we’ll track your courses with our members-only CE transcripts.
Stand out among the competition, gain instant credibility in your profession, and establish your commitment to lifelong learning and quality patient care with the prestigious AGD Fellowship and Mastership awards, the only achievement-based awards in general dentistry.
Advocacy and Representation
Join the organization that serves as the voice of general dentistry. The AGD ensures that general dentists and supporters of the profession can speak up when it matters most, helping members unite their voices on legislative and regulatory activities affecting their right to practice within the United States.*
Take advantage of discounted registration to the AGD’s annual meeting, where you can earn CE, checkout the latest products and technology, and network with your colleagues.
Access a variety of tools to help you manage your practice more efficiently: Check the AGD Product Review Directory before you buy, download sample consent, employee, and practice policy forms from the AGD’s Practice Management Library, and get personalized assistance with third party payer problems, as well as free insurance contract analysis.
Take advantage of the AGD Marketplace & Career Center, where dental connections are made. Search available job listings, buy a practice or equipment, post your own résumé at no cost, and find additional resources to help you plan for your next career move.
Get enrolled in the Find an AGD Dentist directory, which is searchable by prospective patients through KnowYourTeeth. com, the AGD’s consumer-facing website. You also may direct your current patients to learn more about their oral health through www.2min2x.org, an educational website created by the Partnership for Healthy Mouths, Healthy Lives—of which the AGD is a proud member—and the Ad Council. Plus, offer educational reading materials in your waiting room with AGD oral health fact sheets, which cover a range of topics and are customized with your practice information.
Publications and Media
Stay informed on the latest general dentistry news and research with complimentary subscriptions to the AGD’s awardwinning print publications, AGD Impact and General Dentistry, along with extra content available exclusively in the digital editions. You also can listen to the AGD Podcast series and read our blog, The Daily Grind.
Receive immediate access to the AGD Member Savings & Offers program, which provides you with exclusive savings and special offers on the personal and professional products and services you need most. *Canadian dues rates reflect limited advocacy benefits.
Washington AGD Hands-On Orthodontic Program Register Now! Space is Limited to 10 participants. Location: Comfort Dental Office of Binh Tran, DDS, FAGD 1014 South 320th street Federal Way, WA
How it Works 11 Sessions per Year in March, April, May, June, July, September, October, November, December, January & February.
Always Second Weekend of each month for 12 months. Starting March 2017.
Dr. Binh Tran DDS, Lily Stefoglo, CDA
8:00am-5:00pm & Sunday 8:00am-12:00. Includes Light Breakfast, Lunches and all Materials.
Tuition: Course tuition:
Friday, March 3, 2017, April 7, May 19, June 9, July 14, September 8, October 6, November 3, December 1, January 12, & February 2, 2018 Maximum attendees: 10, Interview by Dr. Tran for acceptance.
At the completion of this course, attendees will be able to confidently identify orthodontic problems and provide treatment solutions in their own office. This course will provide additional office income while enhancing all other treatment results that the doctor is providing. Course requirement: Attendance, Office capacity, patients’ availability, supporting staff. The doctor is encouraged to select one CDA from the office to attend a staff training course if possible. However, past doctors have trained their own staff to provide care. Disclaimer *As a Non-Profit entity, Washington AGD does not endorse, partner or solely support companies, products or speakers, but rather recognizes speakers, products and sponsors for their their services to our Washington AGD educational programs. The views and opinions of the speaker expressed during the educational program, do not necessarily state or reflect those of the Washington AGD.
26 Washington AGD Newsletter | November 2016
$12,000 for 12 sessions AGD Member Dentist $2,000 for 12 sessions for CDA with AGD Member Dentists $14,000 for 12 sessions for Non-AGD Member Dentist $4000 for 12 sessions for CDA with Non-AGD Member Dentists * Payment Plans are available
Course Content/Objectives: • • • • • • • • • • • • • • • •
Training from initial consultation to final retainer delivery and monitor: Initial orthodontic examination and comprehensive treatment plan. Orthodontic records and management system Photography and Case presentation Orthodontic Office and Financial management system Ceph Analysis and FACE principles Orthodontics Principles and Mechanics for Angle class 1,2, and 3 Clinical Orthodontic practice: from banding to debanding. Orthodontic supplies ordering and managing inventory Post treatment retention and monitor Surgical and TAD in Orthodontic. Pediatric to Geriatric orthodontics. A training manuals and related reference papers is included. Attendee will be trained in how to start orthodontic Attendee will treat and present a minimum of two of Dr. Tran patients. Attendee is requested to start treatment in their own office and present those cases. • Monthly quiz and a final exam will be given to confirm learned concepts • Final Plaque and Certificate presentation with Dinner (spouse invited)
Speaker-Binh Tran DDS Program Director
Washington AGD Approved PACE Program Provider #219331 FAGD/ MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry, AGD or WAGD endorsement. Washington AGD PACE Provider (6/1/2013-5/31/2018). !
CONTINUING EDUCATION Promotional code:_______________________
2017 AGD Membership Application
Referral Information If you were referred to the AGD by a current member, please note his or her information below:
For more information: Join online at www.agd.org. Call us at 888.243.3368 or 312.440.4300.
City, state/province, or U.S. Federal Services branch
Designation (e.g. DDS, DMD, BDS)
Date of birth (mm/dd/yyyy) Required for access to the members-only sections of the AGD website
Do you currently hold a valid dental license in your country of practice? q No q Yes: ____________________________________________________________________________________________ State/province Country Date renewed (mm/yyyy) License number Type of membership (See back page for definitions.): (Check one.) ❑ Active general dentist ❑ Associate (dental specialist) ❑ Resident ❑ Dental student ❑ Affiliate If you are not in general practice, please indicate your specialty: _______________________________ Current dental practice environment: (Check one.) ❑ Solo ❑ Associateship ❑ Group practice ❑ Hospital ❑ Resident ❑ Corporate ❑ Other____________________________ ❑ Faculty _________________________________________________________________ Please indicate institution
❑ U.S. Federal Services ___________________________________________________________________ Please indicate branch
If you are a member of the Canadian Forces Dental Service, please indicate your preferred constituent: ❑ U.S. military counterpart ❑ Local Canadian constituent
Your AGD constituent (local chapter) is determined by your business address, unless one is not available.
Preferred billing/mailing address: ❑ Business ❑ Home Preferred method of contact: ❑ Email ❑ Mail ❑ Phone
Name of business (If applicable)
Are you a graduate of an accredited* U.S./Canadian dental school? ❑ Yes ❑ No ❑ Currently enrolled
Date of graduation (mm/yyyy)
Are you a graduate of (or resident in) an accredited* U.S. or Canadian postdoctoral program? ❑ Yes ❑ No ❑ Currently enrolled Type: ❑ AEGD ❑ GPR ❑ Other ________________________ *See back of form.
__________________________________________________________________________________________________________________________________________________________________________ Postdoctoral institution State/province Country Start date (mm/dd/yyyy) End date (mm/dd/yyyy)
Stay Social With the AGD!
Search “Academy of General Dentistry” to connect with us on:
Gender ❑ Male ❑ Female Ethnicity ❑ American Indian ❑ Asian ❑ African-American ❑ Hispanic ❑ Caucasian ❑ Other I am interested in participating in the AGD Mentor Program as a: ❑ Mentor ❑ Mentee
Please check membership type applying for:
❑ Active General International (in Canadian dollars) Dentist ..................... $386..................$427 ................ $324 ❑ Associate ..................... 386....................427 .................. 324 ❑ Affiliate ....................... 193....................214 .................. 162 ❑ Resident ....................... 77......................86 .................... 65 ❑ 2016 Graduate ............. 77......................86 .................... 65 ❑ 2015 Graduate ........... 154....................171 .................. 130 ❑ 2014 Graduate ........... 231....................256 .................. 194 ❑ 2013 Graduate ........... 308....................341 .................. 259 ❑ Dental Student.............. 17......................22 .................... 17
❑ Check (enclosed) ❑ Visa ❑ MasterCard
❑ American Express
Note: Payments for Canadian members can only be accepted via Visa, MasterCard, or check.
Expiration date (mm/yyyy) Please print name as it appears on the card. I hereby certify that all of the above information is correct, and that by signing this application agree to all terms of membership, including completion of 75 hours of continuing education every three years for active general dentist and associate members.
1. AGD Headquarters Dues:............................. _________ 2. AGD Constituent Dues: ............................... _________ Please refer to back side for constituent dues.
Total Amount Enclosed: ............................. _________
Return this application with your payment to: Academy of General Dentistry, 560 W. Lake St., Sixth Floor, Chicago, IL 60661-6600, USA.
Dues rates effective through Sept. 30, 2017.
If paying by credit card, fax to 312.335.3443.
Advancing in Dental
Sleep Medicine and
Continuing the Journey!
The Academy of General Dentistry Region 11, Dr. John Tucker and OSA University for a week cruise to ALASKA on July 28 ’17!
COME CRUISE with us to ALASKA on 7/28 - 8/4, 2017 & bring your team! SIGN UP TODAY: (800) 422-0711 — OR — registrar@ContinuingEducation.NET Here’s What Participants Learn
— 20 Continuing Education Credits —
Non-AGD Dentist: $1395 AGD Member Dentist Staff with DDS: $395
“Dynamic” calibration of oral appliances
Topics involving vertical dimension
Non-AGD Dentist Staff with DDS: $795
Measuring patient compliance with new technology
Treating the PAP intolerant edentulous and partially edentulous patient 3D Imaging: new understanding of the airway
A deeper understanding of appliance selection, including when to use what
Marketing strategies for your dental sleep medicine practice
Involving your team members to ensure success and building a complete Dental Sleep Medicine Practice.
Bite registration for oral appliances using the patient’s physiology — Heart Rate Variability
Beyond the AHI
“TMJ” treatment and appliance selection
Vitamin D3 and its relationship to sleep
The role of CBCT in sleep
Cruise Pricing: (based on double occupancy) Interior room (L): $1,176.26 Ocean View (I): $1,626.2
Ocean View (H): $1,676.26
Balcony over Ocean (E3): $2,026
(Course & Cruise)
Balcony over Ocean (D1): $2,106.26
Junior Suites w/ Balcony over ocean: $2,426.26
FOR MORE INFO:
Faculty — Dr. John H. Tucker
Diplomat American Board of Dental Sleep Medicine
Dr. Tucker maintains a private practice in Erie, PA. Dr. Tucker has a special interest in the treatment of obstructive sleep apnea and has been actively treating patients
Establishing/maintaining relationships with sleep physicians and sleep labs
Royal Caribbean Explorer of the Seas
AGD Member Dentist: $995
SUBJECT CODE: 162 (Lecture & Participation)
(Not Included with Cruise Price)
for the past ten years. He’s a Diplomat of the American Academy of Dental Sleep Medicine and a member of the American Academy of Sleep Medicine.
PORT OF CALL
Fri., July 28 Sat., July 29 Sun., July 30 Sun., July 30 Mon., July 31 Tues., Aug 1 Wed., Aug 2 Thurs., Aug 3 Fri., Aug 4
Seattle, WA At Sea Alaska Inside Passage Juneau, Alaska Skagway, Alaska Tracy Arm Fjord At Sea Victoria, BC Seattle, WA
28 Washington AGD Newsletter | November 2016
Seattle-Tacoma International Airport
Course Days/Times at Sea: Sat., July 29: 8:00 AM-5:00 PM
Sun., July 30: 8:00 AM-12:00 PM Wed., Aug. 2: 8:00 AM-5:00 PM
Cruise Itinerary DAY
Nearest Airport to Cruise Port:
7am 12 Noon 12 Noon 9pm 7am 8:30pm 7am 12pm 9am 6pm 9am 6pm 6am
Continuing Dental Education Courses & Events Organization 2016 November 3: “The Magic of Composites, Dr. Paresh Shah November 4: “Pearls of Everyday Practice, Dr. Paresh Shah November 5: “Biospy Techniques, What, Where & How, Dr. Jasit Dillon November 11-13: “Oral Sedation Dentistry” DOCS Educational Symposium November 17: “Annual Social & Foundation Fundraiser”, Magician Nash Fung 2017 January 12-15: “Comprehensive Training in Parenteral Moderate Sedation”, Dr. Ken Reed January 19: “Fear and Loathing in the Dental Chair” Dr. Fred Quarnstrom January 20: “Medical Billing for the GP, Dr. Chris Farrugia January 21: “Marijuana “What it is & How it Works, Dr. Carsten January 21: “Medical Billing for the GP, Dr. Chris Farrugia February 2: “Bernie Taylor Pub Night; Evolution of Composites”, Dr. Carmen Pfeifer February 9-12: “Comprehensive Training in Parenteral Moderate Sedation”, Dr. Ken Reed March 10: “Considerations in Achieving Exquisite Restorative Dentistry”, Dr. Mark Murphy March 10: “TBD” Dr. Joel Berg (Honolulu, HI) March 11: “Advances in Dental Pharmacotherapy” Karen Baker (Honolulu, HI) March 11: “Howard Memorial Lecture and Student Competition” Dr. Hugh Flax March 16-19: “Comprehensive Parenteral Moderate Sedation- Clinic”, Dr. Reed March 18-19: “Spring Break; Complex Prosthodontics” Huntington Beach, CA, Dr. Jorge Garaicoa April 20: “Neurotoxin Therapies for the Dentist”, Dr. Tim Hess April 21: “Pontic Site Enhancement, Dr. Steve Rasner April 22: “Pharmacology & Therapeutics, Dr. Mark Do April 22: “Neurotoxin Therapies for the Dentist”, Dr. Tim Hess May 10-13: “Difficult Extractions for the General Dentist”, Dr. Karl K May 12: “Medical Emergencies in the Dental Office”, Dr. Stanley Malamed June 15-17: “Pacific Northwest Dental Conference (Bellevue) July 12-15: AGD Annual Meeting (Las Vegas) July 28-August 4: “Dental Sleep Training”, CE at Sea” 7 Night Alaska Cruise September 21-24: “Washington AGD MasterTrack”, (Seattle) October 7: “Washington AGD Membership Appreciation Gala” (Seattle) November 4: SKCDS Auction & Gala November 16-19: “Washington AGD MasterTrack”, (Seattle)
Washington AGD Washington AGD Washington AGD DOCS Education SCDS Oregon AGD Washington AGD Washington AGD Washington AGD Washington AGD Oregon AGD Oregon AGD SCDS, SKCDS, UWSOD UWSOD UWSOD Oregon AGD Oregon AGD Oregon AGD Washington AGD Washington AGD Washington AGD Washington AGD Oregon AGD UWSOD, SKCDS, WAGD WSDA AGD Region 11 AGD Washington AGD Washington AGD SKCDS Washington AGD
Organization Contacts Contact: DOCS Education Phone #206-971-5300 Contact: Idaho AGD Email: email@example.com Contact Montana AGD # 406-541-2886 Contact: Oregon Academy of General Dentistry (Oregon AGD) #503-228-6266 Contact: Pierce County Dental Society (PCDC) #253-274-9722 Contact: Region 11 Academy of General Dentistry #253-306-0730 Contact: Seattle-King County Dental Society (SCKDS) # 206-448-6620 Contact: Snohomish County Dental Society (SCDS) #844-355-0519 Contact: University of Washington School of Dentistry (UWSOD) #206-543-5448 Contact: Washington Academy of General Dentistry (Washington AGD) #253-306-0730 Contact: Washington State Dental Association (WSDA) #206-448-1914
REGISTER ONLINE: WASHINGTONAGD.ORG OR CALL: 253-306-0730 washingtonAGD.org
Management of The Fearful Dental Patient; Drugs, Death and Dentistry featuring Dr. Stanley F. Malamed, DDS Friday, May 12, 2017 8:30 am – 4:30 pm Credits: 7
Bellevue Westin Hotel – Lincoln Square 600 Bellevue Way NE Bellevue, WA 98004 425.638.1000
Management of The Fearful Dental Patient - AM Session:
Fear of the dentist is one of our most common fears. Many patients have avoided seeking dental treatment because of these fears.
Thanks to our sponsors:
In this program, Doctor Malamed will review the more commonly employed management techniques for dental fear and anxiety, including the oral route of drug administration (e.g. triazolam [Halcion]); inhalation (N20-02); intravenous (IV), intramuscular (IM) and intranasal (IN). Techniques will be compared as to efficacy and safety, as well as their utility in the typical dental practice.
Drugs, Death and Dentistry - PM Session:
The incidence of serious morbidity or of death within the confines of the dental office is, happily, quite low. However, on occasion, such problems do occur. Oftentimes these problems are associated with the administration of drugs associated with dental treatment. In this presentation Dr. Malamed will review actual cases, illustrating what went wrong, and what could have been done either to prevent the incident from occurring in the first place or, failing that, what should have been done to produce a better outcome.
Register early for best prices!
Before May 5, 2017
After May 5, 2017
About our Presenter: Dr. Malamed, a dentist anesthesiologist, graduated from the New York University College of Dentistry in 1969 and then completed a residency in anesthesiology at Montefiore Hospital and Medical Center in New York before serving for 2 years in the U.S. Army Dental Corps. In 1973, he joined the faculty of the University of Southern California School of Dentistry, where he is Emeritus Professor of Dentistry. Dr. Malamed is a Diplomate of the American Dental Board of Anesthesiology, as well as a recipient of the Heidebrink Award  from the American Dental Society of Anesthesiology and the Horace Wells Award from the International Federation of Dental Anesthesia Societies. Doctor Malamed has authored more than 160 scientific papers and 17 chapters in various medical and dental journals and textbooks in the areas of physical evaluation, emergency medicine, local anesthesia, sedation and general anesthesia. In addition, Dr. Malamed is the author of three widely used textbooks, published by CV Mosby: Handbook of Medical Emergencies in the Dental Office (7th edition 2015); Handbook of Local Anesthesia (6th edition 2012); and Sedation - a guide to patient management (6th edition 2016) and two interactive DVD’s: Emergency Medicine (2nd edition, 2008) and Malamed’s Local Anesthetic Technique DVD (2004) (edition 2 - 2012).
1111 Harvard Avenue Seattle, WA 98122 206.448.6620 FAX 206.443.9308
30 Washington AGD Newsletter | November 2016
REGISTRATION FORM Friday, May 12, 2017 Management of The Fearful Dental Patient; Drugs, Death and Dentistry Speaker: Stenley F. Malamed, DDS. Credit Hours: 7 Times: 8:30am - 4:30pm Location: Bellevue Westin Hotel – Lincoln Square - 600 Bellevue Way NE - Bellevue, WA 98004
POSITION IN DENTAL OFFICE
PREFERRED MAILING ADDRESS
[ ] WORK
[ ] HOME
DAYTIME TELEPHONE NUMBER
EMAIL *Email address required for confirmation and receipt
ADDITIONAL ATTENDEES NAME
POSITION IN DENTAL OFFICE
POSITION IN DENTAL OFFICE
DIETARY RESTRICTIONS: [ ] Vegetarian
[ ] Vegan
METHOD OF PAYMENT PRICE: On or before May 5, 2017 [ ] DENTIST $245 [ ] RETIRED DENTIST/STAFF $160 After May 5, 2016 [ ] DENTIST $270 [ ] RETIRED DENTIST/STAFF $185 Dentist(s):
X $245 =
CARD ACCOUNT NUMBER
[ ] VISA [ ] MasterCard [ ] Check enclosed (Checks should be made out to Seattle-King County Dental Society)
FULL NAME (AS IT APPEARS ON CARD) CARDHOLDERS SIGNATURE
Please send this form to: Seattle-King County Dental Society 1111 Harvard Ave Seattle, WA 98122
Or fax to: Seattle-King County Dental Society 206.443.9308
Please note that confirmation emails will be sent to you one week before the course. Receipts available upon request. - Questions? Call SKCDS 206.448.6620. CANCELLATION AND REFUND POLICIES Refunds, minus a $40 processing fee, will be awarded up until five business days before the course. After five business days, no refunds will be awarded.
FOR STAFF USE ONLY Payment processed __
Aptify Entered ____________31 washingtonAGD.org
THE PREMIER MEETING FOR GENERAL DENTISTRY
LAS VEGAS JULY 13 TO 15, 2017 WWW.AGD2017.ORG
“These are world-renowned speakers that we get the opportunity to spend time with, talk to, and listen to their experiences in the dental field. It’s pretty amazing.” Shailain Patel, DMD Sacramento, CA Member since 2013
THE MATERIALS TO SUCCEED Education tailored to your needs Exhibitors vital to your practice Networking events exclusive to you
32 Washington AGD Newsletter | November 2016
MEMBERSHIP APPRECIATION GALA By the order of WAGDâ€™S Secret Service your presence is requested. Your mission if you choose is to attend the 007 celebrations October 14, 2016 Wine Reception & Check In: 6:30PM-7:00PM Casino Table & Entertainment: 7:00PM-11:00PM
Four Seasons Hotel 99 Union Street Seattle, WA 98101
RSVP Contact: Agent Valerie Bartoli
firstname.lastname@example.org 253-306-0730 www.washingtonagd.org
Constituent of the Academy of General Dentistry Valerie A. Bartoli, Executive Director 19415 International Blvd, #410, SeaTac, WA 98188 p (253) 306-0703 | f (206) 212-4969
Pre-Sorted Standard U S Postage PAID Portland, OR Permit #243
Satyrday, October 7, 2017 Four Season’s Seattle Complimentary Ticket for all Active Member Dentists of the Washington AGD
Silent Auction Fundraiser offers something for everyone: hotel getaway packages, state-of-the-art dental equipment, CE courses, artwork, jewelry, & more. Proceeds to benefit the AGD Foundation’s 501© 3 mission to increase oral cancer education, research and public awareness events to end this deadly disease.
Washington AGD Mission: “The Washington AGD provides its membership professional development through quality education for comprehensive patient care.”
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