The patient experience begins with their first encounter with your practice and continues through their departure after treatment. Make sure theirs is a positive one every step of the way.
Gary Stough, D.M.D.
For most people, perception is reality. If patients think you are the best dentist in the world, then—until proven otherwise—you are. Many highly skilled clinicians with impressive credentials often wonder why they are underbooked, their practice seems stagnant and they are not where they wanted to be in life, while another dentist down the street, with minimal required continuing education and no special designations, is constantly busy, hires an associate and even limits new-patient intake.
Is there a Chatbot in Your Patients’ Future?
Perhaps, in time, dentists will receive a valuable assist from this AI device.
SHOULD DENTISTS be sending patients home after surgery with a chatbot to assist with their recovery? Seventeen-year-old Mason Schlesinger set out to answer that question after watching his father, periodontist Mark Schlesinger, calling or emailing patients after hours to answer postop questions. What, he wondered, if AI could do the work for dentists and, if so, would patients trust the advice they received?
CONTINUED ON PAGE 17 1
OCTOBER 2025
Volume 38 • Issue 3
EDITOR
Stuart L Segelnick, D D S , M S
MANAGING EDITOR
Mary Grates Stoll
ADVERTISING & SPONSORSHIP MANAGER
Jeanne DeGuire
ART DIRECTOR
Ed Stevens
NYSDA OFFICERS
Maurice Edwards, President
Amarilis Jacobo, President-Elect
Lynn Stacy, Vice President
Paul Leary, Secretary-Treasurer
William Karp, Speaker of the House
Mike Herrmann, Executive Director
Editorial and advertising offices are at Suite 602, 20 Corporate Woods Boulevard, Albany, NY 12211-2370
Telephone (518) 465-0044
Email info@nysdental org
Website www nysdental org
The NYSDA News (ISSN 1531684X) is published quarterly, in February, May, October and December by the New York State Dental Association, Suite 602, 20 Corporate Woods Boulevard, Albany, NY 12211-2370 It is available in digital form only and accessible online in the members-only section of the NYSDA website, www nysdental org, under publications
Why Your Dental Practice Needs Cybersecurity Insurance (But Shouldn’t Stop There)
Gary Salman
Data breaches and cyberattacks have become an unfortunate reality for businesses of all sizes, and dental practices are no exception. With sensitive patient data at the heart of your operations, protecting your digital infrastructure should be a top priority. Cybersecurity insurance is a powerful tool in your defense arsenal, offering a safety net in the aftermath of a breach. But while it’s essential, relying solely on insurance leaves your practice exposed.
To truly safeguard patient data and avoid costly disruptions, dental offices must pair cybersecurity insurance with proactive risk management, industry-specific cybersecurity strategies and robust IT practices. This article highlights why cybersecurity insurance is a must-have, but also why it’s not enough on its own.
What Cybersecurity Insurance Covers
Cybersecurity insurance (or cyber liability insurance) is designed to shield businesses from the financial fallout of a cyberattack. Here’s a snapshot of what it typically covers.
1. Breach Response Costs
Cyberattacks can trigger a wide range of expenses, from engaging forensic experts to investigating the breach to notifying affected patients. Cyber insurance often covers these immediate costs, including compliance with HIPAA’s breach notification requirements.
2. Legal Fees and Regulatory Fines
If your practice is fined for noncompliance with data protection laws or faces lawsuits from patients, insurance can help cover these expenses.
School Dental Treatments Stop
Kids’ Tooth Decay in Its Tracks
Minimal approaches successfully kept most cavities from worsening when given in a school-based program.
Two topical treatments applied to kids’ cavities can stop the majority of them from progressing for years, according to a study led by NYU College of Dentistry and published in JAMA Network Open.
Endorsed Vendors, Exclusive Discounts: Explore the Latest Deals and Save Big with NYSDA’s Trusted Endorsed Vendors.
When Passion Intersects Clinical Practice, The Books Keep Coming
Many dentists pursue unique interests, hobbies, even “callings” during their active clinical years. They may be photographers, sculptors, painters, investors, athletes, entrepreneurs, or may volunteer for many meaningful endeavors. Most are hobbyists; some excel to a high degree. Dr. Herbert Ferber, for example, was an early pioneer in environmental sculptures while he practiced in Manhattan as Dr. Herbert Silvers.
Another accomplished New York City dentist—known for his clinical skills and photography—was the recently deceased Dr. Daniel Budasoff, who was a contributing photographer to the Mets, Yankees and various Latino sports. The arts and business ventures aside, how many dentists are known for writing fiction?
When it comes to dentists who write/wrote fiction while they continued to practice clinical dentistry, the most accomplished name that comes to mind is Zane Grey, author of “Riders of the Purple Sage.” Another is John Haase, who fled Nazi Germany with his family. His novel was turned into the movie “Petula.” Two other present-day dentists who are accomplished writers are Alaa al-Aswany and Gloria Chao.
Admittedly, the list of dentists who write and have published fiction is short, which is why when we heard that lifetime member Alan A. Winter, now a retired periodontist who practiced in Manhattan, is having his seventh novel published, we needed to learn more about the intersection of his dual passions for dentistry and writing fiction. Having known Dr. Winter as a writer, it occurred to us there was no better person to deliver a message about the intersection of a dental career with an avocation than the author himself. What follows is Dr. Winter interviewing Dr. Winter about how and when he became a novelist and the importance of following passions.
When did you first know you wanted to write fiction?
Writing fiction was never a goal of mine. While I was a history major in college, I wanted to be a dentist. That said, some part of me enjoyed writing; language has always been important to me. When I taught PG perio at Columbia for many years, the postgrads knew that when they presented a treatment plan to me for approval, their grammar and spelling had to be correct. I marked up their treatment plans with a red pencil, and all grammatical and spelling mistakes had to be corrected before I reviewed their proposed treatment. For me, being a professional extends beyond skill sets and clinical judgment; it includes knowing English and using it correctly.
My clinical writing was sharpened when I founded and became the first editor of Periodontal Case Reports, a journal published under the auspices of the Northeast Periodontal Society. In addition to clinical teaching, I taught two periodontal literature courses at Columbia and published more than 20 clinical papers.
Writing scientific articles and reviewing dental literature are not the same as writing fiction. How and when did that happen?
I started to practice with two well-known periodontists, Lenny Hirschfeld and Bernie Wasserman.
UB Dental Professor Investigating Persistent Barriers to Adolescent Oral Health
Published findings reveal financial, emotional and logistical reasons behind missed dental visits, more tooth decay.
While overall dental health among young children in the U.S. has improved over the last two decades, adolescents have not experienced the same gains. A recent study led by Rubelisa Oliveira, D.D.S., assistant professor at the University at Buffalo School of Dental Medicine, is uncovering the reasons why.
Despite sharing similar socioeconomic conditions and living in the same household, adolescents ages 12 to 17 show significantly worse oral health outcomes than their younger siblings. According to national data, nearly 60% of adolescents have untreated tooth decay—a slight increase from earlier decades—highlighting widening disparities in oral health-care access and outcomes for this age group, especially among Hispanic and Black youth.
Dr. Oliveira, who joined the Department of Periodontics and Endodontics in 2022, received a $420,000 Harold Amos Medical Faculty Development Award from the Robert Wood Johnson Foundation in 2023 to pursue research on barriers to treatment facing underrepresented adolescents in Western New York. This is a continuation of research she began as a postdoctoral scholar at the University of Kentucky.
She led the interdisciplinary study from 2023 to 2024 in collaboration with the UB Clinical and Translational Science Institute (CTSI), including its Community Engagement (CE) Studio.
Stephen Boese Named to Lead Committee on Professional Assistance
THE NEW YORK STATE COMMITTEE on Professional Assistance has a new executive director. Stephen Boese, who previously served as executive secretary to the State Boards for Medicine, Veterinary Medicine and to the State Committees for Medical Physics, Athletic Trainers, Perfusion and Pathologists’ Assistants, will oversee the group that advises the Board of Regents on matters relating to practice by professional licensees with drug or alcohol abuse problems. He will also administer the Profession Assistance Program (PAP), which assists professionals who have substance abuse problems, but who have not harmed patients or clients.
Prior to joining the Education Department, Mr. Boese served as executive director of the Learning Disabilities Association of New York State and as director of public health for the New York State Senate Health Committee. Other positions he has held include New York State Director of the Healthy Schools Network and associate director of government affairs for the State Medical Society.
Mr. Boese earned a Bachelor of Arts degree from Hartwick College and a Master of Social Welfare (Management) from the University at Albany. z
North Country Oral Surgeon Is Veteran Entrepreneur of Year
Watertown oral surgeon Logan Curtis, D.D.S., is New York’s Veteran Entrepreneur of the Year. The award, presented by the New York State Small Business Development Center, recognizes the 20-year Army veteran for his success in launching his own practice, Upstate Oral Surgery and Dental Implants, in 2019. The practice has grown to include a team of surgeons and 15 employees.
Dr. Curtis enlisted in the Army when he was 17. Among his assignments was a four-year stint at Fort Drum in New York’s North Country. A native of Logan, Utah, Dr. Curtis received a Military Health Specialist’s Bachelor’s Degree from Utah State University and his dental degree from the University of Michigan at Ann Arbor. He completed his residency at Fort Bragg in North Carolina and is certified by the American Board of Oral and Maxillofacial Surgery. z
Board of Regents Announce New Appointment To State Board for Dentistry
KATIE TONKIN, D.D.S., of Niskayuna has received a five-year appointment to the State Board for Dentistry. She will serve through August 31, 2020.
Dr. Tonkin practices general and cosmetic dentistry at Advanced Dentistry of Clifton Park. A Marshall University alum, she received her dental degree from West Virginia University School of Dentistry and completed AEGD at Veterans Affairs Medical Center in Albany. z
Practice Perception
The answer typically comes down to perception and highly effective internal marketing. It’s less about clinical expertise and more about personality, communication skills, overall practice environment, and consistent, exceptional experiences from the moment patients first encounter your practice to the moment they leave. In other words, a well-run business where the entire team understands that the real secret to success is selling oneself before trying to sell one’s product, which, in our case, is our dental services.
Why Touch Points Matter
We call this principle “touch-point choreography.” Every point of contact—from the website to the front desk greeting, from the operatory experience to the checkout—must be positive and memorable. There can be no weak links in the process. Of course, excellent clinical care must back up that warm experience, but let’s be honest, patients expect quality care to be the baseline. What truly distinguishes one practice from another is how consistently you exceed patients’ expectations at every step.
I challenge you to read your or other dentists’ reviews and find “Dr. Smith is wonderful! The margins of her crowns are so precise that, with good oral hygiene, chances of future decay around the crown is minimal.” Or, “Dr. Jones took such care when he filled some deep cavities and placed insulation on the prep floor to help reduce sensitivity.” Rather, you will see comments about how friendly your staff is, how everyone made them feel like family or the dentist explains things well.
Timex versus Rolex
Both Timex and Rolex are reliable timepieces. Both watches keep good time. Timex even offers
some attractive, pricier models but only one becomes an heirloom to be locked in a safe when not in use and considered a tragedy if lost or stolen. In the end, a Timex is just a watch and if lost or stolen, can be easily replaced. Transcend mere function and you become the treasure your patient holds forever special.
Ask yourself: Do patients treat your practice like a Timex—replaceable and ordinary? Or do they see it as a Rolex—exceptional, valued and irreplaceable? Rolex practices inspire patient loyalty, generate ontime payments, earn heartfelt referrals and foster a sense of genuine emotional loss if the dentist retires or no longer practices for any reason. When you’re perceived as a Rolex practice, you hardly worry about the state of the economy or the competition down the street. People are proud to be your patient, never want to go elsewhere, can’t wait to tell others and never want you to retire. Achieving Rolex status requires vision and is only accomplished through the good leadership efforts of the dentist.
Building a Rolex Practice
1. Focus on Internal Marketing
A Rolex-level reputation doesn’t come from flashy ads or designer uniforms alone. It’s driven by internal marketing. That means delivering the “wow factor” at every step. For instance, if a new patient’s first visit is less than ideal, they may tell many others about their negative experience. On the flip side, if they’re blown away, they become an instant ambassador for your practice.
2. Perfect the First Impression
• Online Presence. Your website should be attractive, informative and easy to navigate, conveying friendliness, care and professionalism.
• Initial Phone Call. People should sense a smiling, eager-to-help staff member on the other end, not an impersonal automated menu. Nothing beats a friendly voice saying, “Good morning. Dr. Jones’s office. This is Donna. How can I help you?”
• Office Exterior & Reception. Make sure the property is clean, welcoming and aesthetically pleasing. Regularly walk in through the main entrance to see what patients see and even smell. Inside, create a warm, comfortable reception area (not a “waiting room”) with inviting lighting, nice furniture, plants, lovely pictures, up-to-date reading materials and even an area for coffee, tea and bottled water. A children’s play area is a real bonus if space permits.
3. Choreograph the Patient Experience
A positive patient journey doesn’t happen by chance. It’s the result of intentional planning and attention to detail. From the initial greeting to the final goodbye, each step should reinforce your commitment to comfort, respect and genuine concern.
4. Make Patients Feel Special
• Warm Welcome. Address each patient by title (Mr., Ms., Mrs., Dr.) at all times. We even refer to children as “Mr. Bobby” or “Miss Katie.” This simple gesture conveys respect and sets the tone for a professional relationship.
• Personal Escort. Rather than calling names from across the reception area or pointing down a hallway, the team member initially seating the patient should call the patient’s name, make eye contact, introduce themself with a smile and warm personal greeting and personally guide the patient to the operatory. Every patient should feel like a VIP who deserves your full attention.
• Set an Enthusiastic Tone. A friendly smile and a genuine “We’re glad you’re here” can make patients feel appreciated before they ever sit in the chair.
5. Operatory Prep
• Clear Expectation. Once the patient is seated, explain the planned procedures for the appointment and ask if they have any questions. Knowing the plan eases anxiety.
• Physical Comfort. Attend to the patient’s comfort. Ideally adjust their headrest, offer a blanket if chilly, give them the TV remote or offer a magazine if they will be waiting for a short time and inform them noise-cancelling headphones are available if they wish. Even if a patient declines, simply offering underscores your concern for their comfort. If the patient is to be left alone for any period of time, never leave them lying back with the light in their eyes, an all-too-common experience in offices I have worked with.
• Emotional Reassurance. A calm, empathetic demeanor works wonders for nervous patients. Ask if they have any concerns and listen attentively. Small gestures—like a gentle touch on the shoulder—can help patients feel supported and safe.
6. Doctor Presentation
• Professional Appearance and Demeanor. Your attire, body language and tone of voice are all part of your “presentation.” Patients care less about the clinical details of your training and more about how at ease you make them feel. Every day of my practice life, I have worn a dress shirt, tie and white clinic jacket.
Practice Perception
There is never any doubt who just entered the room. Remember, at every step in the appointment, exceed expectations. How a doctor looks and presents himself has little to do with clinical proficiency, but it does make a positive impact on the patient initially.
• Confidence Without Arrogance. Be self-assured in your clinical expertise but remain approachable. Eye contact, a handshake or warm greeting, and an empathetic smile go a long way in building trust.
7. Listen More, Talk Less
• Open-Ended Questions. Encourage patients to describe their concerns, previous experiences and goals for their dental health. Their answers can reveal underlying anxieties or priorities that might not surface otherwise.
• Validation and Empathy. Acknowledge their feelings (“I understand how this could be stressful…”) before responding. This helps patients feel heard and valued.
• Collaborative Treatment Planning. By actively listening, you can propose treatment options that align with both clinical needs and the patient’s personal comfort level, resulting in higher acceptance and long-term loyalty. Many patients do not return for treatment because they have had a deer-in-the-headlights shock when presented their treatment plan. In extreme need cases, present treatment in stages, attempting to get the patient’s basic dental foundation in order before moving on to the next sequence. This offers additional time to build a personal relationship of trust and confidence in your abilities before proceeding to the next, more comprehensive and expensive phase of treatment and increases treatment plan acceptance.
• Positive Send-Off. The impression you make as patients leave is just as important as how you greet them. Genuinely thank them for trusting you with their care.
• Mind the Audience. Patients leaving most often pass by those in the reception area. A happy patient, smiling and chatting with the team, can have a reassuring effect on those waiting their turn.
• Smooth Checkout. Make scheduling follow-up appointments and processing payments a breeze. A confusing or drawn-out checkout process can leave a sour final impression.
• Encourage Feedback and Referrals. Let patients know you value their opinion and would appreciate any referrals. This not only boosts loyalty but also signals that you’re confident in the experience you provided.
Why It Matters
When patients feel welcomed, heard and genuinely cared for at every step, they’re far more likely to trust your recommendations, accept treatment and refer others. By choreographing each phase of the visit—from warm greetings to thoughtful goodbyes—you transform ordinary office visits into memorable, positive experiences that set your practice apart. That is why it is so important to hire only team members who have the personality and natural care and concern for others, so they can align with your philosophy of patient care.
Ultimately, you’re not just treating teeth, you’re caring for people. The better they feel about their time with you, the more likely they are to become loyal patients who happily share their experiences with family and friends. z
Gary Stough, D.M.D., is a private practitioner in Northeast Georgia. A former Marine Corps aviator, past president of the Georgia AGD, PACE CE provider and practice consultant, his focus is on attaining practice success through a combination of good clinical, leadership, communication and business skills and balancing work-personal life priorities. His new book, Beyond the Chair, is due out before the first of the year. He can be reached at gstoughdmd@gmail.com.
Is there a chatbot
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The question occurred to Mason while a junior at JFK High School in Bellmore, Nassau County, Long Island—he’s now a senior—and enrolled in an AP Research class. His attempt to answer the question is chronicled in a well-researched paper entitled “Patient Perceptions on Generative AI: Chatbots in Postoperative Dental Care.” https://sites.google.com/nyu. edu/gen-ai-postop
The young author conducted a review of literature on the subject and elicited responses from volunteers to dental-specific vignettes. He found, he said, that while dental patients were open to the idea of using generative AI chatbots in postoperative dental care, and expressed satisfaction with a single use of the technology, they were more reluctant to use it again or recommend its use to others. This led him to conclude that “despite positive, intrinsic experiences, people are reluctant to proceed with the technology in the future,” possibly, he reasoned, because they questioned the validity of chatbot responses and preferred continued input from their health care providers.
Mason’s paper, according to his father, received high praise from his teachers and considerable interest from his classmates. What it didn’t do is pique Mason’s interest in a career in health care. Rather, he’s on a business track as he weighs his college options.
Mark Schlesinger, senior clinical support director for Dental 365 and former clinical assistant professor at NYU College of Dentistry, is not without a dental compatriot in his family. His daughter, Mason’s older sister, is a first-year dental student at NYU. z
Why Your Dental Practice
3. Data Recovery
Restoring encrypted or corrupted data after an attack can be complex and expensive. Cyber insurance may contribute to recovering critical patient records and operational files.
4. Ransom Payments
Some policies provide coverage for ransomware payments, should your practice decide to pay (although this decision should only be made with the guidance of cybersecurity experts and legal counsel).
5. Patient Protection Services
Offering identity theft monitoring or credit protection to affected patients can be essential for restoring trust after a breach. Cyber insurance often covers these services.
While these benefits make cybersecurity insurance indispensable, it’s important to remember that your policy only comes into play after an incident occurs. Without strong preventive measures in place, your practice could face avoidable disruptions and patient dissatisfaction.
Cyber Insurance Isn’t a Magic Wand
Some practices view cyber insurance as a catch-all solution to their cybersecurity challenges. This mindset can create a dangerous false sense of security. Insurance is reactive by nature, while modern cyber threats demand a proactive and multi-layered defense strategy. Here’s why cyber insurance alone isn’t enough.
It Can’t Prevent a Breach
Insurance won’t stop hackers from targeting your practice. Whether it’s a phishing attack, ransomware or compromised vendor access, a comprehensive defense system remains your first line of protection.
CONTINUED ON PAGE 19 1
Why Your Dental Practice
You’re Still Responsible for HIPAA Compliance
Health care providers, including dental practices, are legally responsible for safeguarding patient data. Cyber insurance doesn’t absolve you of these obligations. Failing to meet HIPAA requirements due to poor cybersecurity practices can lead to regulatory fines—not to mention reputational damage.
Operational Downtime Can Be Costly
Recovering from a breach takes time, even if insurance covers your financial losses. During this period, patient care can be disrupted, and your practice may lose revenue. Preventative measures significantly reduce the likelihood of these disruptions occurring in the first place.
The Role of Cybersecurity Partners in Reducing Risk
To fully protect your practice and patients, it’s critical to team up with a dedicated cybersecurity provider. These experts bring advanced tools, insights and strategies to the table that most IT teams cannot provide on their own. Here’s how they complement your insurance policy:
• Continuous Monitoring. Cybersecurity companies use real-time tools to identify and mitigate threats before they escalate.
• Vulnerability Management. Regular assessments and daily scans detect weaknesses hackers could exploit, such as outdated software or poorly configured firewalls.
• Phishing Simulations and Training. Employee mistakes often trigger breaches. Cybersecurity providers train staff to spot and avoid phishing attempts and other scams.
• Incident Response Expertise. Should an attack occur, cybersecurity experts quickly move to contain the damage, minimizing downtime and patient impact. By combining cyber insurance with these proactive steps, you can drastically reduce your practice’s risk and ensure smoother operations even in the face of modern threats.
How to Choose the Right Cyber Insurance Policy
Not all cyber insurance policies are created equal. When selecting coverage for your dental practice, consider the following:
1. Understand What’s Covered
Carefully review policy documents to understand what expenses and scenarios are included. Some policies exclude ransomware payments or damages related to third-party breaches unless CONTINUED ON PAGE 20 1
Why Your Dental Practice
2. Evaluate Limits and Exclusions
Does the coverage limit align with the size of your practice and potential financial exposure in case of a breach? Watch for exclusions, such as attacks tied to outdated technology, as these could leave you unprotected.
3. Ensure HIPAA Compatibility
Choose a policy tailored for health care providers. Your insurer should understand the unique risks dental offices face under HIPAA regulations.
4. Collaborate with Cybersecurity Experts
A cybersecurity partner can review your existing defenses and help you understand gaps that insurance won’t cover. They may even assist in negotiating better policy terms that align with your risk profile.
5. Balance Cost with Value
While affordability is important, choosing the cheapest policy isn’t always wise. Look for a provider with a strong track record in the health-care industry and policies that offer practical support during and after a cyber incident.
Integrating Cyber Insurance into a Comprehensive Security Plan
Think of cyber insurance as the safety net, not the trampoline. It should complement rather than replace defensive measures like firewalls, secure software configurations and continuous employee training. Together, they form a holistic approach to cybersecurity that protects your practice at all layers.
To integrate your insurance policy into a comprehensive plan:
• Conduct regular risk assessments with a cybersecurity provider to identify gaps in your defenses.
• Ensure your IT team follows best practices for system updates, backups and user access controls.
• Train your staff periodically on emerging threats and the role they play in preventing breaches.
• Treat cybersecurity as an ongoing priority by setting aside resources for routine upgrades and services.
Final Thoughts
Cybersecurity insurance is an essential safety net, offering financial and operational support when the unexpected happens. However, it’s only one piece of the puzzle. Dental practices must take a proactive, layered approach to combat cyber threats, involving technical defenses, staff education and partnerships with cyber experts. By integrating these strategies with a robust insurance policy, you can reduce risk, protect patient trust and keep your practice running smoothly.
Don’t wait until a cyberattack forces action. Secure your practice today by investing in both prevention and preparation. Remember, the best defense is one that protects your patients and practice long before disaster strikes. z
Gary Salman is CEO and cofounder of Black Talon Security (www.blacktalonsecurity.com). A leader in the cybersecurity field, Mr. Salman has a 30-plus year background in law enforcement and health care technology. His firm monitors and secures approximately 65K computers and networks worldwide and has trained tens of thousands of health care professionals.
School Dental Treatments
Treating more than 10,000 cavities in New York City elementary school students, the researchers found that both atraumatic restorations (ART) and silver diamine fluoride (SDF) kept most dental decay from worsening, supporting the use of nonsurgical approaches for managing cavities.
Children miss an estimated 34 million hours of school each year due to emergency dental care. Bringing cavity prevention programs to schools can improve kids’ oral health and stave off many issues that drive the need for urgent treatment, including extractions due to pain, abscess or risk of infection.
In school-based dental programs, health professionals often use sealants to safeguard against tooth decay. But few programs address existing cavities. ART can be used to stop the progression of cavities by removing tooth decay with hand instruments and applying the same protective material as sealants. SDF has also emerged as a promising tool for cavity prevention and treatment; originally approved by the FDA for treating tooth sensitivity, the liquid is brushed onto teeth to kill decay-causing bacteria and remineralize teeth to prevent further decay.
To compare the use of SDF and ART, researchers at NYU College of Dentistry led a large clinical trial in New York City elementary schools as part of their CariedAway cavity prevention program. At twice-yearly school visits, health professionals examined children’s teeth and applied either ART or SDF, followed by fluoride varnish to any existing cavities, depending on which treatment the school was randomly assigned to receive.
In a previous analysis of the CariedAway study, NYU researchers reported that a single treatment of either ART or SDF kept approximately 50 percent of cavities from worsening over two years.
Their latest analysis, published in JAMA Network Open, focused on more than 1,600 children ages 5 to 13 who had cavities on one or more teeth. Either SDF or ART was applied to the children’s teeth—including more than 10,000 cavities—during biannual school visits. The students were followed for up to four years to see if their tooth decay worsened or stayed the same.
“This study is our most robust analysis of these different cavity prevention techniques, as we focused on decay on each tooth surface and measured it up to four years,” said Ryan Richard Ruff, Ph.D., M.P.H., associate professor of epidemiology and health promotion at the College of Dentistry and a principal investigator of CariedAway.
The researchers found that SDF and ART had similar results when applied to cavities: SDF kept 62 percent of decayed surfaces from worsening over four years, while ART controlled 55 percent.
“Offering ART or SDF in schools can help avoid the need for more invasive dental treatment and improve access to preventive care,” said Tamarinda J. Barry Godín, D.D.S., M.P.H., a research scientist at the College of Dentistry and CariedAway project director. z
When Passion
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Their patients were concerned I did not look old enough to be a periodontist. Translation: Did I have the clinical experience to treat them? To show that I did, I placed photographs of my three sons on the operatory wall and said, if I was old enough to have three children, I was experienced enough to treat them. Of course that made no sense, but that was all I had. I couldn’t make myself look older.
As the weeks passed, patients asked why I had pictures of children on the wall. When I said they were my sons and that they were brothers, I was met with dismay. You see the boys did not look alike then or now, yet I knew they were my sons. Nevertheless, I became obsessed with one question: What if I did bring the wrong baby home from the hospital? I couldn’t stop thinking about it until one day, I decided to create a story about parents taking the wrong baby home. This was in the mid-1980s when this was pretty much unheard of. While I wrote to purge this story from me, I became hooked on the process of writing fiction. It took eight years, but in 1993, 20 years after I finished dental school, my first novel, “Someone Else’s Son,” was published. And I have been writing ever since.
When did you find the time to write, and how many hours did you write each week when you practiced full-time?
I wrote every spare minute I could find, often late at night or early in the morning. I worked four days a week and taught the fifth. I commuted to New York City from New Jersey, so my workdays were long. That said, I managed to write roughly 30 hours a week. When people asked how I found time to write, I would say everyone has enough time to follow their passions. Besides, I don’t golf, ski or play tennis. They would take time away from writing.
Once you realized your passion for creative writing, did you take formal training?
Writing is a craft that can be learned. Imagination is gift that cannot be taught. When I understood this, I took a creative writing class at Columbia’s School of General Studies. It didn’t work for me because the course was cross-registered with undergraduates who I couldn’t relate to. I was 40 at the time. I dropped the course to do something better: I hired a private writing teacher who taught creative writing at Columbia, John Bowers. John and I met every Monday night in a coffee shop where I was not allowed to eat but only have coffee. He gave me a writing lesson each week for two years based chapters from my first manuscript. Each lesson was applied forward. So when we were done with the first pass-through, we repeated the process a second time. When we finished, John said the manuscript was “submittable.” I was fortunate to find a publisher.
Where do your stories come from and why do you write in the genre you do?
My last four novels are historical fiction, so I am applying my love of history to my passion for writing. Each of my books has the same goal: entertain the reader while teaching something they might not have known. While stories come from all sorts of places, I was fortunate that patients brought me stories. If they resonated, I pursued them. That happened with “Savior’s Day,” which was a Kirkus Reviews Best Book Selection and was recently reissued because it leaps from today’s headlines. I co-wrote two well-received books on the Holocaust with former federal judge Herbert J. Stern. And I recently completed the third book in that series, “When Ashes Cried,” which is unique because it is an illustrated novel with 60 historic photos.
What are you working on now?
I am working on an alternative history book. I can’t say anything else about it now.
What advice do you have for dentists who are passionate about something but feel they are too busy to pursue it while they practice dentistry or have family/other obligations?
I will answer that in two ways. First, don’t wait to follow your passions. It is so gratifying to follow a dream. When is it ever the right time to do anything extra? If your dream would benefit from additional training, seek it out. One of the great benefits of following this path, of pursuing a dream, is how much one’s life is enriched. That is priceless. But it can have an expiration date. So the right time to follow a passion is when you can’t stop thinking about or continue to make excuses why you are not pursuing it, no matter the reason.
The second part of the answer is that I have heard individuals from all walks of life, dentists included, say, “I don’t know what I would do with myself if I retire.” That is another reason to explore a passion—if you are fortunate enough to have one. I recognize not everyone does, and that’s understandable. But if one does have other interests or thinks about finding a new one, consider how much better prepared you would be for retirement if you develop that interest while you are still in clinical practice.
I always had the capacity to follow many interests at the same time. I taught at both Columbia and NYU for many years, edited a journal, wrote articles, raised three sons, have grandchildren, traveled, lectured, was involved in organized dentistry and, yet, still had time to write and publish five novels before I retired. I urge my dental colleagues to experience the joys that come from pursuing a passion in their own way. There is no better time to start than now.
To learn more about Alan’s books, visit www.alanwinter.com z
UB Dental Professor
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Dr. Oliveira and her team also performed a secondary analysis of dental visits between 2018 and 2023 made by 825 individuals to UB Dental, a clinical facility within the dental school that offers a range of services to adult and pediatric patients without private insurance.
Dr. Oliveira’s interdisciplinary team is working to identify the root causes of the disparity in oral health outcomes through a combination of community-engaged research and clinical data analysis. Their findings, published in the Journal of Public Health Dentistry and the International Journal of Dentistry, suggest that missed dental appointments are just one visible symptom of deeper structural and social challenges that affect adolescents’ ability to access timely care.
“Adolescents are often overlooked in health-care strategies,” said Dr. Oliveira. “But this is a critical period, when lifelong health behaviors are being formed. We need to understand the broader context shaping their access to care.”
Looking Beyond Missed Appointments
The research team reviewed 7,379 dental visits at UB Dental from 2018 to 2023 and found that adolescents accounted for the highest percentage of missed appointments—24%—compared with younger children. However, Dr. Oliveira cautions against placing blame solely on families or patients.
“Our data show that no-shows are frequently tied to persistent barriers—financial, logistical and emotional—that prevent families from consistently accessing care,” she said.
One of those barriers is caregiver dental anxiety, which the team studied in a companion project involving 167 caregiver-adolescent pairs in Western New York. They found that more than 60% of both caregivers and adolescents had elevated dental anxiety, and that anxious caregivers were nearly four times more likely to have anxious adolescents. This anxiety is linked to poorer oral health outcomes, highlighting the intergenerational impact of dental fear.
Language, Finances and Misunderstandings
The survey also revealed that many families were unaware that children over age 12 remain eligible for Medicaid dental coverage—a misunderstanding more common in households where English is not the primary language. Some parents hesitated to make appointments due to confusion about coverage or out-of-pocket costs.
“Families are often navigating other major concerns like housing, food insecurity or transportation,” Dr. Oliveira said. “Oral health, understandably, takes a backseat.”
She also noted that adolescents themselves may resist dental visits as they age, especially when they have had negative or anxiety-inducing experiences in the past.
Community-based Solutions
As the researchers continue to analyze data, they are also working to remove barriers to adolescent dental care. Recommendations include scheduling family-wide appointments, simplifying Medicaid eligibility explanations and having a staff member on hand to help parents navigate the health system.
Beyond the clinic, Dr. Oliveira and her colleagues are working with middle and high schools across Buffalo and Niagara County to offer dental screenings and oral health education. They’re exploring ways to train school nurses to help identify oral health problems and refer students for care.
“This isn’t just about getting more adolescents into the dental chair,” Dr. Oliveira said. “It’s also about understanding the realities families face and building systems that help monitor and support adolescents who need professional dental care in their communities.” z
