Cover: New York State is home to the largest population of Jewish people outside of Israel, making it an appropriate laboratory for studying the conduct of pediatric dentists and dental residents regarding their treatment of Hasidic, Haredi and Ultra-Orthodox Jewish patients.
20 Attitudes of New York State Pediatric Dentists Toward Treating Hasidic Patients
Gideon Turk, D.M.D.; Michelle Goldstein, D.M.D.
Authors surveyed pediatric dentists and dental residents in New York State concerning their clinical interaction with Hasidic, Haredi or UltraOrthodox Jewish patients. They uncovered significant variations in aspects related to their treatment of these patients.
26 A Qualitative Assessment of the Role of Dental Specialists in U.S. Opioid Epidemic
Dental School Faculty and Postdoctoral Trainee Perspectives
Rochisha Singh Marwaha, D.D.S., M.P.H., FICD; Gunnar Hasselgren, D.D.S., Ph.D.; Sarah Douglas-Broten, D.M.D., M.P.H.; Sidney B. Eisig, D.D.S.; Kavita Ahluwalia, D.D.S., M.P.H.
Research targeting opioid-related knowledge, opinions and behaviors of oral surgery and endodontic faculty and postdoctoral trainees uncovered variations in frequency of prescribing opioids for pain management and use of prescription drug monitoring programs.
32 Revolutionizing Dental Operatories
How Do We Do More
Using Less?
Michael Zidile, D.D.S.; Brian Choi, D.D.S.
Expansion project presented authors with opportunity to reimagine traditional operatory design by eliminating ergonomic and hygienic barriers and implementing a clutter-free layout across eight operatories.
35 An Update on Non-Cigarette, Nicotine-Containing Products and the Periodontal Patient
As Americans are giving up cigarettes, they are increasing their use of non-cigarette nicotine-containing products. An understanding of the potential negative periodontal outcomes related to these newer nicotine delivery systems is crucial to educating and treating patients.
Is Ageism a Problem in Dentistry?
It would appear that no one or no segment of society is immune from acting questionably—and, possibly, illegally—toward seniors.
While attending local, state and national dental meetings through the years, and even the most recent NYSDA House of Delegates meeting, I am repeatedly surprised to hear comments from senior society officers decrying the “old men in the room” and declaring they have had “enough of the old whitehaired men” dominating the higher echelons of our organization. The younger dentists listening nod their heads in approval. What these well-meaning, experienced dentists were trying to highlight was the need to have younger and more diverse dentists involved in organized dentistry.
It seems reasonable, on the surface, to want younger dentists to replace older, retiring dentists—if these dentists are indeed stepping away from practice, academia, research, dental societies voluntarily, as opposed to being pushed out because of their age.
One concern is baby boomers, born from 1946 to 1964, who range in age from 61 to 79
years old and currently comprise 24 percent of practicing dentists, according to unpublished data from the ADA Health Policy Institute, may soon be retiring. Will there be enough newer dentists to take their place? Granted, we have more graduating dentists in New York State than we did 20 years ago, with one new dental school (Touro 2016) and one on its way (Yeshiva University 2026?).
Yet, according to the ADA “Supply of Dentists in the U.S.: 2001-2023 (XLSX) Data Report,”[1] New York had 14,146 dentists in 2023, fewer than the 14,356 dentists 20 years prior. Only two other states, California and Texas, have more dentists, with Florida fast approaching at 11,668.
New York State’s general population has shown minimal increase in the past 20 years. In 2023, New York had 19.74 million inhabitants vs. 2003 when there were 19.18 million residents. These statistics do not bode well for the access-to-care argument for increasing the
number of dentists, since there has been a slight decrease in the number of dentists and a small increase in the general population in New York these past 20 years—although, there was fluctuation during this time.
The average age of dentists who took part in this year’s HOD meeting was 56, according to NYSDA Executive Director Michael Herrmann. Some reasons for having younger, diverse dentists involved in organized dentistry are to bring in a different perspective, a more tech savvy and modern outlook, develop a pool of people who will be around for more years of service and to entice the next generation of volunteers to become active. However, this would need to be accomplished without excluding or unfairly treating our older, less diverse population of dentists.[2]
Many younger dentists have told me it is difficult to become involved in organized dentistry because of where they are in their lives. They have young families, new practices to run, bills to pay and just don’t have time for the commitment necessary to become involved or more involved than they currently are. On the other hand, older dentists may have more time to give, more experience and, possibly, greater stability in their personal and professional lives.
One way my local dental society has been able to have fair turnover in Board of Trustee and committee appointments is by instituting term limits, giving all dentists an opportunity to apply or run for these positions.
What the Law Says
Forcing someone via your actions to leave a job, organization position, or refusing to hire or promote someone due to their age is illegal. The New York State Division of Human Rights handles age discrimination complaints thought to violate the New York State Human Rights Law. That law applies to people 18 years and older, with exemplary damages available and civil penalties of up to $100,000.[3]
Separately, the New York City Commission on Human Rights addresses complaints of violations of the NYC Human Rights Law, which includes “…protections against age discrimination for all workers, regardless of one’s age….” Here punitive damages can also be levied, along with civil penalties of up to $125,00 and willful ones of up to $250,000.[4]
The federal government has the Age Discrimination in Employment Act (ADEA), which is enforced by the Equal Employment Opportunity Commission (EEOC). This law protects people 40 years and older in workplaces with 20 or more employees with awarded damages of back pay and, for willful violations, liquidated damages equal to the amount of back pay awarded.[4]
EDITOR
Stuart L. Segelnick, D.D.S., M.S.
MANAGING EDITOR
Mary Grates Stoll
ADVERTISING/SPONSORSHIP MANAGER
Jeanne DeGuire
ART DIRECTOR
Ed Stevens
EDITORIAL REVIEW BOARD
Frank C. Barnashuk, DDS. Past Clinical Assistant Professor, Department of Restorative Dentistry, University at Buffalo School of Dental Medicine, Buffalo, NY.
David A. Behrman, DMD. Chief, Division Dentistry/OMS, Associate Professor of Surgery, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY.
Michael R. Breault, DDS. Periodontic/Implantology. Private Practice. Schenectady, NY.
David Croglio, DDS. Clinical Assistant Professor, University at Buffalo School of Dental Medicine, Buffalo, NY. Private Practice (retired), Amherst, NY.
Jennifer Frustino, DDS, PhD. Director, Oral Cancer Screening and Diagnostics, Division Oral Oncology and Maxillofacial Prosthetics, Department of Dentistry, Erie County Medical Center, Buffalo, NY.
Michael F. Gengo, DDS. Board-certified Endodontist, Clinical Assistant Professor, Department of Endodontics, University at Buffalo School of Dental Medicine, Buffalo, NY. Private Practice, Hamburg, NY.
G. Kirk Gleason, DDS. General Dental Practice (retired), Clifton Park, NY.
Kevin Hanley, DDS. Orthodontic Private Practice, Buffalo, NY.
Stanley M. Kerpel, DDS. Diplomate, American Board Oral and Maxillofacial Pathology, Associate Director, Oral Pathology Laboratory, Inc. Attending, Section of Oral Pathology, New York-Presbyterian, Queens, NY.
Mohini Ratakonda, DDS, Clinical Assistant Professor, University at Buffalo School of Dental Medicine, Buffalo, NY. Endodontics.
Joseph Rumfola, DDS. Clinical Assistant Professor, AEGD Program Director, University at Buffalo School of Dental Medicine, Buffalo, NY. Private Practice, Springville, NY.
Jay Skolnick, DMD. Board-certified Pediatric Dentist. Attending dentist, Rochester General Hospital. Private Practice, Webster, NY.
Lisa Marie Yerke, DDS, MS. Diplomate, American Board Peiodontology, Clinical Associate Professor, Director Advanced Education Program in Periodontics, University at Buffalo School of Dental Medicine Department Periodontics & Endodontics, Buffalo, NY. Private Practice, East Amherst, NY.
PRINTER
Fort Orange Press, Albany
NYSDJ (ISSN 0028-7571) appears two times a year in print: January and June/July. The March, April, August/September and November issues are available online only at www.nysdental.org. The Journal is a publication of the New York State Dental Association, 20 Corporate Woods Boulevard, Suite 602, Albany, NY 12211. In February, May, October and December, members have online access to the NYSDA News. Subscription rates for nonmembers: $75 per year or $12 per issue, U.S. and Canada; $135 per year foreign or $22 per issue. Editorial and advertising offices are at Suite 602, 20 Corporate Woods Boulevard, Albany, NY 12211. Telephone (518) 465-0044. Email info@nysdental.org. Website www.nysdental.org.
Ageism permeates all areas of life. The Washington Nationals baseball team settled a lawsuit (for 3 million dollars) last year for denying older fans a 30% discount on tickets.[5,6] Workday AI is currently involved in a class action lawsuit alleging discrimination against older work applicants within their AI algorithms.[7] And, recently, a 78-year-old receptionist in Columbus, GA, was fired and replaced by a younger receptionist. The EEOC brought a lawsuit that her company wound up settling for $78,000.[8]
Gov. Kathy Hochul reported that in 2023, “a salesperson at a Long Island trucking and logistics firm was awarded $24,435 after being found to have experienced age discrimination. The employer pressured her to retire early, made derogatory comments about her ability to learn due to her age and, ultimately, replaced her with a younger employee during a restructuring. The Division of Human Rights also imposed a civil penalty of $10,000 on the company.”[9]
Even New York City Fire Department chiefs and a deputy director of the EMS sued the city for age discrimination in September 2024.[10] And, finally, the ADA settled an agediscrimination lawsuit brought by employees for 195 million dollars.[11]
According to employment discrimintation.com, examples of age discrimination include reducing hours and responsibilities, talking to employees about early retirement, hiring and promotion prejudices, adverse remarks about an employee’s age, restructuring or targeted layoffs. This can happen in your own dental office.[12] How we treat patients can be a problem if we incorrectly offer lesser treatment to older patients, factoring in how long they have to live!
Choose Your Words Carefully
In her article, “Don’t Call Me ‘Old.’ Avoiding Ageism when Writing about Aging,” Stephanie Morrison advises against calling people elderly, the aged, senior citizen, boomer, elders and geriatric. She recommends using terms like older adults, people over age X and older populations.[13]
We should be aware of problems of ageism; recognize its effects on all ages; and be careful of what and how we talk about age.[14] We must be mindful of how we interact with each other, our staff and patients. All of these are protected groups from age discrimination.
Age may be a mindset that helps you age gracefully and even live longer,[15] and age may “just be a number” but, remember, that number, if used to discriminate can turn out to be costly to you, your practice and your reputation.
THE NEW YORK STATE DENTAL JOURNAL thanks the members of its Editorial Review Board (page 3) as well as its ad hoc reviewers, listed below, for their expertise and time they gave to the manuscript review process. Their work is critical to maintaining the high standards of The Journal and helps to improve our publication.
Glen Donnarumma, DDS
Oral and Maxillofacial Surgery, Private Practice Amherst, NY
Mea A. Weinberg, DMD, MSD, RPh
Clinical Professor
Periodontology and Implant Dentistry
New York University College of Dentistry New York, NY
Ye Shi, BDS, MS
Clinical Assistant Professor
Periodontology and Implant Dentistry
New York University College of Dentistry New York, NY
Robert Salehrabi, DDS
Endodontist Denver, CO
Babak Hamidi, DDS
Clinical Associate Professor
Periodontology and Implant Dentistry
New York University College of Dentistry New York, NY
Pierre Wohlgemuth, DDS
Clinical Assistant Professor Endodontics
New York University College of Dentistry New York, NY
Nicole Hinchy, DDS, MS
Clinical Assistant Professor
Department of Oral Diagnostic Sciences
University at Buffalo School of Dental Medicine Buffalo, NY
Colin LaPrade, DDS, MSc
Clinical Assistant Professor
Oral & Maxillofacial Pathology, Radiology & Medicine
New York University College of Dentistry New York, NY
Rachelle Wolk, DDS, MBA
Clinical Assistant Professor
Oral & Maxillofacial Pathology, Radiology & Medicine
New York University College of Dentistry New York, NY
Gail E. Schupak, DMD
Adjunct Clinical Assistant Professor Orthodontics
New York University College of Dentistry New York, NY
Keith Murtagh, DDS
Director, Oral & Maxillofacial Surgery
OBH Dental & Oral Surgery at Brookdale Plaza Brooklyn, NY
Aaron Yancoskie, DDS
Associate Professor Dental Medicine, Oral & Maxillofacial Pathology
Associate Dean for Academic Affairs
Director Oral & Maxillofacial Pathology
Touro College of Dental Medicine
Hawthorne, NY
Andrew Marks, DDS
Oral & Maxillofacial Surgery
OBH Dental & Oral Surgery at Brookdale Plaza Brooklyn, NY
Peter Starkey, DDS
Clinical Assistant Professor
Restorative Dentistry
University at Buffalo School of Dental Medicine Buffalo, NY
Natalia Elson, DDS
Clinical Assistant Professor General Dentistry & Comprehensive Care
New York University College of Dentistry New York, NY
Ronald Boyd, DDS
Clinical Assistant Professor
Department Restorative Dentistry
University at Buffalo School of Dental Medicine Buffalo, NY
Paul Canallatos, DDS, MS
Maxillofacial Prosthodontist Erie County Medical Center Buffalo, NY
Bill W. S. Kim, DMD, MSc
Dental Anesthesiologist and General Dentist
Department Dental Medicine, One Brooklyn Health Department Anesthesiology, SUNY Downstate Medical Center Brooklyn, NY 11213
Robert Buhite II, DDS
Clinical Instructor Implant Dentistry
Department Restorative Dentistry
University at Buffalo School of Dental Medicine Buffalo, NY
Mitchell J. Bloom, DMD, JD
Clinical Associate Professor
Department Periodontology & Implant Dentistry
New York University College of Dentistry New York, NY
Douglas Sheahan, DDS
Assistant Professor Dental Medicine
Touro College of Dental Medicine Hawthorne, NY
The Battle Over Water Fluoridation Comes to New York City
Organized dentistry is quick to respond to ill-conceived effort to end 60-year practice and vows to stay with it until the threat passes.
Lance Plunkett, J.D., LL.M.
Water fluoridation has been experiencing its woes lately, beset by an adverse court decision, questionable science, collapsing federal public health priorities and public suspicion often fueled by hysteria. Against all this, New York City stood strong as a pioneering large municipality safely fluoridating its water since 1965 for the benefit of the public and reducing dental caries significantly over decades.
And then, on September 10, the New York City Council saw Int. 1379-2025, a bill to eliminate water fluoridation in New York City introduced by City Council members James Gennaro (D-Queens County) and Frank Marano (R-Richmond County). This may prove that bad ideas can be bipartisan.
Int. 1379-2025 adds a new Section 17199.29 to the New York City Administrative Code that provides as follows:
Ҥ 17-199.29 Fluoridation of municipal water supply.
a. Definitions. For purposes of this section, the term “municipal water supply” means all drinking water for human consumption within
pipes, mains, and structures owned or maintained by the city.
b. No fluoride compound shall be added to the municipal water supply. Prior to implementation of subdivision b of this section, the department shall take all actions required by subdivision 3 of section 1100-a of the public health law.
d. The department shall establish a program to provide fluoride supplements at no cost to individuals who request them.”
The new law would take effect one year after enactment. The law is very simple, proving that simple ideas can be as bad as overly complex ones.
There was really no explanation or reasoning stated in support of the bill. To cover for that obvious deficiency, the bill itself provides that Section 1100-a of the New York State Public Health Law must be followed. Section 1100-a of the Public Health Law allows local governments to decide whether to fluoridate their water supply, but, once having done so, there are strict re-
quirements for deciding to change course and eliminate water fluoridation. Those requirements are also in Section 1100-a of the Public Health Law and require the following:
1) to issue a notice to the public of the preliminary determination to discontinue fluoridation for comment, which shall include the justification for the proposed discontinuance, alternatives to fluoridation available, and a summary of consultations with health professionals and the New York State Department of Health concerning the proposed discontinuance; and
2) to provide the New York State Department of Health at least ninety days prior written notice of the intent to discontinue and submit a plan for discontinuance that includes but is not limited to the notice that will be provided to the public of the determination to discontinue fluoridation of the water supply, including the date of such discontinuance and alternatives to fluoridation, if any, that will be made available in the community, and that includes information as may be required under the New York State Sanitary Code.
The notice to the public referenced above may be published in local newspapers. The referenced “consultations with health professionals” may include formal studies by hired professionals, informal consultations with local public health officials or other health professionals, or other consultations, provided that the nature of such consultations and the identity of such professionals shall be made known in the public notice. The referenced “alternatives to fluoridation” may include formal alternatives provided by or at the expense of the local government, or other alternatives available to the public. Any public comments received in response to the public notice provided shall be addressed by the local government in its ordinary course of business. It is clear that the reference in the New York City bill to the requirements of the Public Health Law is a gimmick designed to replace providing any underlying justification for the bill. Instead, it just defers the debate to others. Similarly, the bill’s inclusion of an extremely
NYSDA Directory
OFFICERS
Maurice Edwards, President 30 East 60th St., #1401, New York, NY 10022
Amarilis Jacobo, President-Elect 824 East 181st St., Bronx, NY 10460
Lynn Stacy, Vice President 7504 East State St., Lowville, NY 13367
Paul Leary, Secretary-Treasurer 80 Maple Ave., Ste 206, Smithtown, NY 11787
William Karp, Speaker of the House 4500 Pewter Ln., Bldg 6, Manlius, NY 13104
BOARD OF TRUSTEES
Prabha Krishnan, Immediate Past President 11045 Queens Blvd., Ste 108, Forest Hills, NY 11375
Brendan Dowd, ADA Trustee 3435 Main St., Squire Hall, Room 235G, Buffalo, NY 14214
NY – James E. Jacobs 10 East 53rd St., Ste 2500, New York, NY 10022
2 – John P. Demas 8814 Fort Hamilton Pkwy, Brooklyn, NY 11209
3 – Geoffrey Gamache 24 Eastview Rd., Averill Park, NY 12018
4 – Adrienne L. Korkosz 1309 Union St., Schenectady, NY 12308
5 – Steven Stacey 6702 Buckley Rd., Ste 120, Syracuse, NY 13212
6 – Louis Giordano 864 Hooper Rd., Endwell, NY 13760
7 – David Ramjattansingh 71 King Arthurs Ct., Rochester, NY 14626
8 – Raymond G. Miller 122 Covington Rd., Buffalo, NY 14216
9 – Gary M. Scharof f 1255 North Ave., Ste A1H, New Rochelle, NY 10804
N – Donald R. Hills 136 Woodbur y Rd., Ste L3, Woodbury, NY 11797
Q – Mitchell S. Greenberg 11966 80th Rd., #1A, Kew Gardens, NY 11415
S – Martin Dominger 5225 Nesconset Hwy., Suite 57, Port Jefferson Station, NY 117776
B – Jacqueline J. Samuels 120 Alcott Place, Bronx, NY 10475
COUNCIL CHAIRPERSONS
Dental Benefit Programs
Dental Education
Joseph A. Craddock 3325 East Main St., Attica, NY 14011
Robert M. Peskin 601 Franklin Ave. #225, Garden City, NY 11530
Dental Health Planning Maria Maranga 8 Rolling Meadow Ln., Northport, NY 11768
Dental Practice
Ethics
Governmental Affairs
Membership & Communications
Nominations
Peer Review
OFFICE
Mina Kim 2 West 46th Street, #501, Br yant Park Dental Assoc., New York, NY 10036
Julie A. Connolly 115 East 61st Street, Fl. 8, New York, NY 10065
Radha Sachdeva-Munk 203 Smithtown Blvd., Nesconset, NY 11767
Christopher W. Calnon 3220 Chili Ave., Rochester, NY 14624
Prabha Krishnan 11045 Queens Blvd., Ste 108, Forest Hills, NY 11375
Lawrence J. Lehman 7303 197th St., Fresh Meadows, NY 11366
Suite 602, 20 Corporate Woods Blvd., Albany, NY 12211 (518) 465-0044 | (800) 255-2100
Michael Herrmann Executive Director
Lance R. Plunkett General Counsel/Director Governmental Affairs
Mar y Grates Stoll Managing Editor
Jenna Bell Director Meeting Planning
Jacquie Donnelly Director Dental Practice Support
Heather Relation Director Outreach Membership & Engagement
Stacy McIlduff Executive Director NYS Dental Foundation
expensive fluoride supplement alternative is designed to satisfy the Public Health Law as a legitimate substitute for water fluoridation. Ironically, it comes in the wake of the federal government trying to restrict drug products that supply fluoride. The bill is a clever form of sophistry. Can it be defeated?
Enter the New York State Dental Association, the American Dental Association, the New York City component dental societies and our grassroots members. Nothing is being spared to defeat this foolish bill. Thanks to local grassroots efforts, one sponsor of the bill is already wavering in favor of potentially just having New York City do its own study of water fluoridation. However, that too seems foolish given the mountain of credible scientific studies already available for many years. Of course, even lunacy may want a face-saving off ramp.
NYSDA formally filed its opposition and stressed the already existing credible science in its response. NYSDA pointed out that community water fluoridation at the recommended level of 0.7 mg/L is safe and has been rigorously studied for nearly 80 years. More than 100 respected health organizations, including the ADA and the American Academy of Pediatrics, support its continued use. Community water fluoridation has been hailed as a great public health achievement, and extensive research shows fluoridated water reduces tooth decay by 25% to 30% across all populations, regardless of income or access to care.
NYSDA also stressed that, unlike fluoride supplements that require individuals to opt in, obtain, administer them properly and keep them consistent over a lifetime, water fluoridation reaches everyone, every day. NYSDA noted that this is particularly important for children, seniors and lowincome families. In fact, for those who lack reliable access to dental care, eliminating water fluoridation and replacing it with an “on request” supplement program would increase disparities in oral health. Experience shows that voluntary programs fail to achieve the same reach or impact as systemic water fluoridation.
The ADA has estimated that the elimination of fluoride from public water supplies in the United States would result in nearly $10 billion in additional dental spending over five years due to the increased prevalence of cavities. While it may seem that dentistry would logically just want to say go ahead and get rid of water fluoridation so that there will be an economic boom for dentists with people needing more dental services, the profession of dentistry has always cared more about the health of the public, dental science and ethics than about self-serving greed.
The ADA joined the fight by filing its formal opposition to this bill, focusing on the history and importance of public health initiatives like water fluoridation. The associa-
tion pointed out that fluoridation was introduced in New York City in 1965, and that the city maintains the largest engineered water system in the nation. This represents a 60-year track record of New Yorkers’ oral health benefiting from this proven and effective policy. However, opponents, utilizing faulty interpretations of inconclusive evidence, falsely believe fluoride is dangerous. In fact, nearly 80 years of the best available, peer-reviewed scientific evidence shows otherwise: community water fluoridation is safe. And extensive studies of the possibility of adverse health effects from long-term, low-level consumption of fluoride have found no causal relationship or biological mechanism linking fluoride exposure to cognitive development issues, children’s intelligence quotient (IQ) or autism.
The ADA further noted that opponents of community water fluoridation continue to use the same playbook: make outlandish claims that are not based on reliable science and hope they are mistaken as fact. Over the years, claims that fluoridation causes a list of human illnesses, including bone cancer, autism, lower intelligence, kidney disease, thyroid disease and bone fractures have grabbed media attention. None of these claims has a basis in fact. These allegations are frequently misconstrued so that they become mistaken for facts not opinions.
The ADA also pointed out that in a recent nationwide poll by the CareQuest Institute for Oral Health, 81% of Americans reported they either support or are not opposed to the practice of adding fluoride to water, and nearly all respondents (96%) said they trust their family doctor or pediatrician to educate them on fluoride in drinking water. Most people recognize how they benefit from this cavity protection regardless of age, race, education, political party or income and do not support efforts to ban fluoride. Today, nearly 73% of the population in the United States (207 million people) has access to public water at optimal levels of fluoride necessary to prevent tooth decay.
The fight against Int. 1379-2025 will be an ongoing one until this unwise effort to eliminate water fluoridation in New York City is dead in the water. NYSDA has never registered to lobby in New York City before—the city has its own lobbying registration process separate from that of New York State—but is doing so immediately so as to be better able to intercede directly in this water fluoridation battle, as well as in other city legislative and regulatory matters affecting dentistry. These days, where any matter of public health is concerned, the complacency of just letting things take their course is no longer an option. p
The material contained in this column is informational only and does not constitute legal advice. For specific questions, dentists should contact their own attorney.
LETTERS
Intersection of Genetics and Periodontal Disease
I appreciated reading Dr. Roger Warren’s article in the June/ July Journal (“Practicing Dentistry in the Age of Periodontal Risk Management,” by Warren, et al.) I found it to be a thorough compilation of the many systemic factors contributing to periodontal disease.
The next-to-last factor the authors discussed was a statement that “some people have a genetic predisposition to periodontal disease.” Their last reference is to an article by Dr Robert Genco about “Risk Factors for Periodontal Disease,” published in 2000. At an American Academy of Periodontology annual meeting, Dr. Genco alluded to a strong genetic component recently described and documented in a case report published by this writer entitled “Three Generations of Periodontitis.” He said it showed the first evidence of a direct generation component to a form of periodontal disease. It may well be that a person’s genes do have a greater effect on periodontal disease than has previously been studied.
Dr. Warren mentions that DNA methylation or histone modifications are possibilities for the future outcome of many inflammatory diseases. This indicates that research into the possible genetic component is warranted.
Harold I. Sussman, DDS, MSD, FACD West Palm Beach, FL Former Clinical Professor, Department Periodontics NYU College of Dentistry
Association Activities
New York State Editors Honored for Journalistic Excellence
NEW YORK STATE DENTAL JOURNAL editors Chester Gary and Stuart Segelnick walked away winners, capturing top prizes awarded by the American Association of Dental Editors and Journalists (AADEJ) and American Dental Education Association ADEAGies Foundation. The prizes were given out at the AADEJ Annual Meeting in September in San Diego.
Dr. Gary, Journal editor from 2016 to 2024, took first place in the editorial competition for his commentary, “True Confessions of an Artificial Intelligence System,” an appraisal of the shortcomings of AI’s incorporation into dentistry, which appeared in January 2024, and second place for his November 2024 editorial, “I’m Mr. Brightside,” a musically inspired look at the relationship between dentists and insurance companies.
Dr. Segelnick, who assumed the title of Journal Editor in January of this year, was recognized for achievements in his previous position as editor of the Second District Dental Society Bulletin. He received an award for excellence in newsletter publishing, as well as third-place honor for his editorial, “Sepsis is Serious: Recognize the Signs,” which appeared in the SDDS Bulletin and was reprinted in The NYSDJ
The Gies Editorial Award has been presented yearly since 1958. It recognizes the contributions of dental editors and journalists who share and demonstrate commitment to the establishment and encouragement of responsible editorial policy.
Current and former New York State Dental Journal editors Stuart Segelnick, left, and Chester Gary were top winners at American Association Dental Editors and Journalists Annual Meeting in September in San Diego, CA.
Journal Editor Stuart Segelnick with award he received from ADEAGies Foundation for editorial on sepsis. He is flanked by Chris Smiley of Michigan, immediate past president AADEJ, and Kathy Gibson of Texas, AADEJ member.
Double winner at AADEJ Annual Meeting, Dr. Segelnick was also recognized for his work as editor of Second District Dental Society Bulletin. With him as he receives his award are, from left: Eliot Paisner, president, USA Section International College of Dentists; Leighton Weir, chairman, ICD Journalism Award Committee; Richard Roadcamp, ICD Editor.
Association Activities
In Memoriam
NEW YORK COUNTY
Michael Alfano
University of New Jersey ‘71
148 Laguna Lane
Beach Haven, NJ 08008
July 28, 2025
John Eader
New York University ‘69
5622 SW Boundary Street
Portland, OR 97221
January 1, 2024
Tilda Loew
Foreign Dental School
303 E 57th Street, #16G
New York, NY 10022
January 1, 2025
William Rakower
Ohio State University ‘45
3104 Kendal Way
Sleepy Hollow, NY 10591
January 1, 2025
Barry Wolinsky
New York University ‘78
PO Box 427
Rock Hill, NY 12775
September 1, 2025
SECOND DISTRICT
Fredric Harris
New York University ‘57
4005 Avalon Pointe Drive
Boca Raton, FL 33496
September 26, 2025
THIRD DISTRICT
Howard Tocker
Temple University ‘67
6828 Spruce Lane
Bath, PA 18014
August 17, 2023
FOURTH DISTRICT
Edward Horstkotte
University of Michigan ‘46
1340 Wemple Lane
Schenectady, NY 12309
May 25, 2024
FIFTH DISTRICT
Ruben Cowart
Howard University ‘69 PO Box 581244
Kissimmee, FL 34758
July 15, 2025
Richard Zogby
University of Buffalo ‘54
100 Hahnemann Trail, #146
Pittsford, NY 14534
August 4, 2025
SIXTH DISTRICT
Andrew Colucci
Georgetown University ‘56
700 Dry Run Road
Pine City, NY 14871
September 11, 2025
Dennis Dore
Tufts School of Dental
Medicine ‘73
5811 Bower Road
Trumansburg, NY 14886
March 31, 2025
Frederick Lacey
University of Pennsylvania ‘80 11 Shipwatch Point
Hilton Head Island, SC 29928
August 28, 2025
EIGHTH DISTRICT
Carl Gugino
University of Buffalo ’53
10510 Boardwalk Loop, #305
Bradenton, FL 34202
August 4, 2025
Robert Laudico
University of Buffalo ‘62 5939 Transit Road
Depew, NY 14043
July 31, 2025
Howard Noonan
University of Buffalo ‘65 4030 Key Largo Lane
Punta Gorda, FL 33955
July 23, 2025
Norman Schaaf
University of Buffalo ‘60
110 S Jerge Drive
Elma, NY 14059
September 20, 2025
NASSAU COUNTY
Perry Goldberg
New York University ‘68
11 Wood Acres Road
Glen Head, NY 11545
September 14, 2025
BRONX COUNTY
Morhlon Harris
Stony Brook University ‘89
2321 Belmont Avenue, #5E
Bronx, NY 10458
June 14, 2025
Vendor Updates
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Video
The NYSDA Diversity and Inclusion Task Force marked the observance of Hispanic Heritage Month in October with activities recognizing the rich cultural contributions of Hispanic and Latino communities to the dental profession and society at large.
It also chose the occasion to highlight the accomplishments of NYSDA member Chantal Tavarez, D.D.S., owner of Tava Dental NY in New York City. Originally from the Dominican Republic, Dr. Tavarez earned her dental degree from PUCMM in Santiago de los Caballeros, completed her D.D.S. at Columbia University College of Dental Medicine and a three-year residency in general dentistry at New York-Presbyterian Hospital.
Dr. Tavarez shared reflections on her career, her commitment to serving her community and the importance of celebrating diversity in dentistry.
Q. Can you tell us a bit about your journey in dentistry so far and what inspired you to become a dentist?
Dr. T. My journey in dentistry has been full of passion, challenges and milestones. As a child, I spent a lot of time at the dentist because of my love for sweets. Unlike most kids, I felt comfortable in the chair, and my curiosity grew. After high school, I shadowed my cousin, who had just become a dentist, and that inspired me to follow the same path.
I studied at PUCMM in Santiago de los Caballeros, Dominican Republic, and became a dentist there. Just two weeks after graduating, in 2011, I moved to the U.S. I thought the transition would be simple, but it was long and demanding. While preparing for my dental boards, I worked as a dental assistant for four years. In 2015, I was accepted into Columbia University College of Dental Medicine, then completed a three-year residency at New York-Presbyterian Hospital, graduating in 2018.
For six years, I worked as an associate dentist, gaining experience and growing both personally and professionally. Then, in January 2025, I reached one of my biggest milestones: I became the proud owner of my own practice, Tava Dental NY.
Q. What motivated you to start your own private practice, and what have been some key lessons along the way?
Dr. T. I’ve always wanted my own practice so I could dedicate myself fully to patients. When someone sits in my chair, I don’t see “just another patient.” I see my own family. Dentistry should never feel scary. My goal is for every patient to feel cared for, respected and safe.
One of the most important lessons I’ve learned is to trust myself—my instincts, my inner voice. Not every situation or job is right, and listening to that feeling has helped me make better decisions and live with authenticity.
Q. How has your background and heritage influenced your approach to care?
Dr. T. In the Dominican Republic where I grew up, dentistry was once considered a luxury. My parents made sure I always had proper care; my dad wouldn’t let me go to bed without brushing and flossing. On my mom’s side, periodontal disease runs in the family, so I also learned prevention early.
I’ve had my share of dental treatments—extractions, fillings, a root canal—so I know what it feels like to be the patient in the chair. That perspective shapes how I treat others. I care for every patient the way I would want to be cared for.
Q. What challenges have you faced as a new dentist? What advice would you give to other new dentists or dental students?
Dr. T. Technically, yes, I’m considered a new dentist in the U.S., but I’ve been in dentistry nearly two decades. The real challenge is earning trust from institutions. Banks may hesitate to give loans, and not every workplace is the right fit.
Another big challenge is the business side. Dental school trains you clinically, but not for management, payroll or running a practice. I believe our curriculum should include more courses in economics and practice ownership. Also, always educate yourself, update yourself and seek guidance from those who’ve already walked the path. Learn from mentors who share not only their successes but also their failures. And, remember, you’re not alone. Having a network makes the load easier.
Above all, be kind to yourself. Starting out is hard—loans, cost of living, building independence. None of us can do it alone. Lean on mentors, colleagues and friends. And don’t forget to enjoy life outside of dentistry. Balance starts with being kind to yourself every day.
Q. Who or what has shaped your career most?
Dr. T. The first person was my mom, who always said, “If you’re going to do something, do it right, or don’t do it at all.” That phrase has guided me my whole life.
I’ve also been inspired by mentors like Dr. Dennis Tarnow at Columbia and Dr. Albert Granger, a successful endodontist on Long Island. Their excellence showed me what is possible. My friend Dr. Mariel Valerio inspires me too; she runs her own practice, serves as a health director, trains future assistants, and balances life as a wife and mother. She reminds me that with passion and commitment, so much is possible.
Q. How do you hope to make a difference in your community?
Dr. T. Every patient is welcome in my practice, and I feel a special mission to serve the Hispanic community. Many say they wait to return to their home country for dental care. My message is, you don’t need to; I’m here for you.
I also serve on the board of Somos Amigos Medical Missions, which provides care in the mountains of the Dominican Republic. Four times a year we spend a week treating patients with everything from fillings to dentures. Right now, we’re building a hospital to provide care year-round. Seeing someone smile again with gratitude is the greatest reward.
Q. Why is celebrating diversity, like Hispanic Heritage Month, important to you?
Dr. T. At the end of the day, we are all human beings—souls and hearts wanting to share the love we carry inside. That’s one reason I love New York; people from every corner of the world come together here.
As Hispanics, we are hardworking. My father came to the U.S. when I was 4 and worked tirelessly to give us a better life. Now, here I am, a dentist in the United States— something I never could have imagined.
One of my proudest moments was standing at Columbia University during my residency and thinking, “Wow. Here I am, a Dominican at Columbia University.” My journey is a reflection of sacrifice, resilience and the beauty of blending cultures. p
Attitudes of New York State Pediatric Dentists Toward Treating Hasidic Patients
Gideon Turk, D.M.D.; Michelle Goldstein, D.M.D.
ABSTRACT
Purpose: This survey investigated variations in practices among pediatric dentists and dental residents in New York State concerning the treatment of Hasidic, Haredi or Ultra-Orthodox Jewish (HHUOJ) patients. Methods and Results: The 16-question survey was distributed to 641 AAPD pediatric dentists and residents via email. Results were analyzed across six variables using the Mann-Whitney U Test. Statistically significant differences were observed in the responses to 14 of 16 questions.
Conclusion: The study revealed statistically significant variations in various aspects related to the treatment of HHUOJ patients, suggesting the need for further education among providers in New York State.
New York State is home to the largest population of Jewish people outside of Israel, including Hasidic, Haredi and Ultra-Orthodox Jews (HHUOJ).[1] A central tenet of the HHUOJ lifestyle is strict interpretation of the laws set forth in the Torah and Talmud, the two books from which the majority of Jewish custom is derived. One stringent belief is that seg-
regating themselves from modern society—through unique garb and language, limited technology, private schooling and other items—will allow their population to thrive and avoid assimilation with the outside world.[2] Because of this, available studies into their health practices are limited.
A 2010 study of the North London HHUOJ population concluded that the community’s oral health literacy (OHL) was lacking compared to others in London, but also that the community was willing to learn more.[3] Seven years later, a group found that 5-year-old children in the same HHUOJ community had oral health that was “significantly worse than their counterparts across Hackney, London and England.”[4] Investigating the oral health literacy of the HHUOJ population in New York, an unpublished survey run by a team at New York University (NYU), found that “dental knowledge [seemed] to be poor within [the Hasidic] community, highlighted by the number of incorrect responses regarding the recommended age of the first dental visit and of dental hygiene practices.’’
A systematic review determined that the HHUOJ community “may be less educated concerning health care and illness prevention than members of the wider population,” highlighting this group as one that is ripe for further education efforts.[5] The lower starting point means broad gains can be made in education efforts if providers are willing.
Proper oral hygiene instruction (OHI) has been shown to be of utmost importance to improve the oral health of adolescents.[6] Knowledge of proper nutrition guidelines are also key to improving health, as research has found that “junk food [becoming] a daily staple of young children’s diet [contributes] to a high rate of early childhood caries (ECC).”[7]
This study aimed to build on NYU’s work studying the HHUOJ population in New York by surveying pediatric dentists and pediatric dental residents in New York State who are members of the American Academy of Pediatric Dentistry (AAPD) to see how they attempt to adequately tailor their OHI, nutrition guidance and other patient education efforts to bring about culturally competent and effective care for HHUOJ patients.
Methods
A research protocol was developed and found to be exempt by the Institutional Review Board (IRB) of NYU. A 26-question survey was emailed to the 641 pediatric dentists or pediatric dental residents who, according to the AAPD, had addresses in New York State (Figure 1). Of the 26 questions, 10 asked about the identity of the respondent, while 16 dealt with the topic.
Study data were collected and managed using REDCap electronic data capture tools hosted at NYU.[8,9] REDCap (Research Electronic Data Capture) is a secure, web-based software platform designed to support data capture for research studies, providing: 1) an intuitive interface for validated data capture; 2) audit trails for tracking data manipulation and export procedures; 3) automated export procedures for seamless data downloads to common statistical packages; and 4) procedures for data integration and interoperability with external sources.
To participate in the survey, respondents needed to meet specific criteria, including being a practicing pediatric dentist or pediatric dental resident with an address in New York State consistent with
their AAPD membership information. Respondents also needed to have had at least one appointment with a HHUOJ patient, and they needed to complete enough survey questions for REDCap to recognize the survey as completed.
Conversely, individuals were excluded if they were not currently practicing pediatric dentists or pediatric dental residents with an address in New York State, had never had an appointment with a HHUOJ patient or failed to answer enough questions for REDCap to consider the survey completed.
Participation was voluntary, and surveys were completed anonymously. A consent statement was shown at the beginning of the survey and consent was assumed when participants proceeded with the survey. All questions were set
Figure 1.
to a Likert scale with 1 representing “strongly disagree” and 5 reflecting “strongly agree.” Data analyses were conducted using Microsoft Excel and an online Mann-Whitney U Test calculator. Statistical significance was set to P < .05. Assumptions made for the data analyses were that the questions involved one-tailed hypotheses, and each test was composed of two random independent samples.
Results and Discussion
Of the 641 surveys that were sent out, 93 were opened. Twenty-four surveys were marked as incomplete by REDCap and, thus, were discarded from the data analyses. Of the remaining 69 surveys, two were from dentists who were not currently practicing, and 12 had never had an appointment with a HHUOJ patient and, thus, did not meet the inclusion criteria. This left 55 surveys to be analyzed (Figure 2). Some of the questions were not answered by certain participants but were still marked as completed by REDCap; thus, the n value fluctuates from 55 to 54 in certain questions.
Except for question 16, which only dealt with gender, each question was analyzed to compare answers from the following six variables:
• Gender (male versus female)
• Age (45 and under versus 46 and above)
• State of Dental School (New York versus other)
• State of Pediatrics Residency (New York versus other)
• County of Practice (Kings and Rockland counties versus other)
• Number of HHUOJ Patients Seen Per Month (5 and below versus 6 and above)
New York was chosen as the data group to compare versus all others in the state of dental school and residency analysis as New York is home to the largest group of Jews in the United States. Kings County (Brooklyn) and Rockland County were grouped together for the county analysis as they are the two counties with the largest share of Hasidic Jews in New York State.[12]
Of the 55 surveys, 19 were completed by males and 36 by females, with zero respondents identifying as nonbinary or “other” in the questionnaire. Thirty-six respondents were 45 years old and under, while 19 were 46 and older. Despite those groups having the same number of participants in each category, they were not the same respondents in each group. Of the males, 11 were 45 years old and under, while 8 were 46 and older. Of the females, 25 were 45 years old and under, while 11 were 46 and older. Of the females, 25 were 45 years old and under, while 11 were 46 and older.
Thirty-one participants attended dental school in New York State, with the other 24 going elsewhere. Forty-five
5.
Figure 2.
Figure 3.
Figure 4.
Figure
currently attend or attended a pediatric dental residency in New York, while 9 did not (data was not available for one respondent). Twelve currently practice in Kings or Rockland counties, while 42 practice elsewhere (data was not available for one respondent). Finally, 39 providers noted that they saw 5 or fewer HHUOJ patients per month, while 15 said they see 6 or more.
With six variables measured for 15 questions, and one variable for the question on gender, a total of 91 MannWhitney tests were run. Of those, 16 returned statistically significant results with P<.05. Interestingly, 13 of the 16 significant results were shown with the test variable of age, while one was for county of practice, and two for gender.
Each question had at least one significant result except for questions 1 and 6, which were asking whether the providers offer the same nutritional guidance and OHI to all patients, respectively.
When the Mann-Whitney test was run to evaluate whether gender influenced the results of question 7, the results indicated that females were significantly more comfortable than their male counterparts (U=180.5, P =.004). In question 16, this held true again, with the results showing
that females felt on the whole, less like their gender had a negative impact on their interactions with HHUOJ, compared to the males (U=244, P=0.042) (Figure 3).
The null hypothesis was rejected on both fronts, as the assumption made at the beginning of this project was that males would feel more comfortable with this community due to the uneven gender roles prominent in Hasidism.[13] Perhaps this reflects the nature of pediatric dentistry itself in relation to HHUOJ patients. Because women in the HHUOJ community are “expected to contribute… by taking care of the household,” the female providers feel more comfortable in situations that ultimately are about ensuring the health of the child in front of them.[14] Female parents or guardians may also be more comfortable engaging female practitioners due to societal norms.
The only data set which indicated a significant difference based on county of practice was question 2, asking about a child consuming sugary snacks on Shabbat (Figure 4). This too led to the null hypothesis being rejected, with providers in Kings and Rockland counties being less comfortable than those in other New York State counties addressing this scenario (U=156, P= 0.023). It was assumed
that those immersed in the HHUOJ culture, those in Kings and Rockland counties, would be more comfortable talking about this scenario, but the data suggests otherwise. A child condensing all their sugary sweets into one day, like one might do on Shabbat, might actually lower their caries risk, similar to how the Vipeholm Study has resulted in Lördagsgodis in Sweden.[15,16]
All questions that returned statistically significant results while testing provider age showed results in the same direction. The younger age group was more comfortable with addressing the situations posed in the questions, while they also reported they felt respected, listened to, valued and had their treatment plans accepted as much by HHUOJ patients relative to non-HHUOJ patients.
Questions 2 (U=236.5, P=0.031), 3 (U=232.5, P=0.036), 4 (U=213.5, P=0.012), 5 (U=191.5, P=0.004), 7 (U=193.5, P=0.008), 8 (U=224, P=0.034), 9 (U=207, P=0.016) and 10 (U=171, P=0.003) can be generalized into a category of counseling, and the data suggests this younger cohort is more willing to engage in the “uncomfortable” scenarios presented, addressing each patient’s needs individually. Possible explanations for this discrepancy could be that the younger generation has been trained in an era where parents are more involved in their children’s care than those in the past, as well as the increase in cultural competency skills being taught in dental schools today.[17,18]
For questions 11 (U=164, P=0.001), 12 (U=139, P=0.0004), 13 (U=182.5 P=0.002), 14 (U=190, P=0.004) and 15 (U=232, P=0.026), which can be described as asking the providers
about their perceptions of their relationship with HHUOJ patients and their guardians, once again, the younger generation reported they felt their relationship was better with this patient population than the older group (Figure 5). If one connects the dots, perhaps it is because the older cohort is less comfortable addressing the unique needs of each patient who sits in their chair, that they then feel less comfortable, listened to less, valued less, respected less and they feel their treatment plans are not accepted as much, when they see these patients compared to nonHHUOJ patients.
The study found no statistically significant differences when testing where the provider completed their training— both dental school and pediatric residency. Additionally, nothing of note was found based on the number of HHUOJ patients seen per month.
A limitation of this study was that it relied on the dentists to identify if they have ever had an appointment with a HHUOJ patient and then reflect on those experiences. No criteria were provided to the practitioners to describe the HHUOJ community; it was left to the provider to accurately reflect on their past appointments. It is possible that some dentists who were excluded from the study mistakenly answered that they had not had an appointment with a HHUOJ patient without knowing, and also that providers who were included could have assumed some of their patients fit the bill of HHUOJ without that being the case, and let those experiences, be it positive or negative, color their answers.
Another weakness was the limited sample size. Although statistically significant data was found, the data set in question only reflected 55 practicing providers who have had appointments with HHUOJ patients in New York State. The experiences of those who did not respond to the questionnaire may not have aligned with those who did, and response bias in an emailed survey is always something to consider when weighing these results.
From the data that was gleaned, it is important that providers in New York State examine their past interactions with HHUOJ patients and take time to reflect. AAPD defines a dental home as “the ongoing relationship between the dentist and the patient, inclusive of all aspects of oral health care delivered in a safe, culturally-sensitive, individualized, comprehensive, continuous, accessible, coordinated, compassionate, and patient and family-centered way regardless of race, ethnicity, religion, sexual or gender identity, medical status, family structure, or financial circumstances.”[19] HHUOJ patients deserve a dental home like all other patients. Even in the counseling scenarios asked about on the survey, or if the provider does not feel like they are respected, listened to, or valued as much as they are by other patients, it is the provider’s duty to still cultivate the relationship belonging in a dental home.
Conclusions
The results discussed above suggest the following:
• Female practitioners in New York State are more likely than their male counterparts to feel comfortable with HHUOJ patients, and males feel like their gender has a negative impact on their interactions with HHUOJ families.
• Location of training, practice and number of HHUOJ patients seen per month does not seem to impact how providers interact with these patients, except for one specific question posed regarding the Jewish Sabbath. Concerning this question, dentists practicing outside of the heavily-HHUOJ-populated Kings and Rockland counties felt more comfortable addressing this topic than those practicing inside these communities.
• Age is the most significant criteria when evaluating for differences in how providers interact with HHUOJ families. Dentists above the age of 46 years seemed to have the biggest disconnect between their own thoughts on their interactions with HHUOJ patients and what occurs in practice. CE courses dealing with culturally competent care for HHUOJ patients that are offered in New York State should be marketed to dentists in this older age group to improve this facet of their care. p
The authors thank all participants, who took time from busy clinical days to respond to this survey. They also thank Liz Best, grants and research manager at NYU College of Dentistry, Department of Pediatric Dentistry, for her support and guidance in seeing this project through from its initial stages through the end, and Jill Fernandez, R.D.H., M.P.H., for her mentorship at the beginning stages of this project. Queries about this article can be sent to Dr. Turk at Gideon.s.turk@gmail.com.
REFERENCES
1. Berger J. Aided by Orthodox, city’s Jewish population is growing again. The New York Times 12 June 2012. www.nytimes.com/2012/06/12/nyregion/new-yorks-jewish-population-isgrowing-again.html.
2. Britannica, The Editors of Encyclopaedia. Orthodox Judaism. Encyclopedia Britannica 2 Feb. 2024, https://www.britannica.com/topic/Orthodox-Judaism. Accessed 11 February 2024.
3. Scambler S, Klass C, Wright D, Gallagher JE. Insights into the oral health beliefs and practices of mothers from a north London Orthodox Jewish community. BMC Oral Health 2010 Jun 7;10:14. doi: 10.1186/1472-6831-10-14. PMID: 20529247; PMCID: PMC2894741.
4. Klass C, et al. Oral health and oral health behaviours of five-year-old children in the Charedi Orthodox Jewish Community in North London. 2017.
5. Coleman-Brueckheimer K, Dein S. Health care behaviours and beliefs in Hasidic Jewish populations: a systematic review of the literature. J Relig Health 2011 Jun;50(2):422-36. doi: 10.1007/s10943-010-9448-2. PMID: 21249524.
6. Soldo M, Matijević J, Malčić Ivanišević A, Čuković-Bagić I, Marks L, Nikolov Borić D, Jukić Krmek S. Impact of oral hygiene instructions on plaque index in adolescents. Cent Eur J Public Health 2020 Jun;28(2):103-107. doi: 10.21101/cejph.a5066. PMID: 32592553.
7. Tsang C, Sokal-Gutierrez K, Patel P, Lewis B, Huang D, Ronsin K, Baral A, Bhatta A, Khadka N, Barkan H, Gurung S. Early childhood oral health and nutrition in urban and rural Nepal. Int J Environ Res Public Health 2019 Jul 10;16(14):2456. doi: 10.3390/ijerph16142456. PMID: 31295932; PMCID: PMC6678585.
8. Harris PA, Taylor R,Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap) – A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009 Apr;42(2):377-81.
9. Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, McLeod L, Delacqua G, Delacqua F, Kirby J, Duda SN. The REDCap consortium: building an international community of software partners. J Biomed Inform 2019 May 9 [doi: 10.1016/j.jbi.2019.103208].
10. Mann-Whitney U Test Calculator. Social Science Statistics, Jeremy Stangroom. https://www. socscistatistics.com/tests/mannwhitney/default.aspx.
11. Jewish population in the United States by state. www.jewishvirtuallibrary.org/jewish-population-in-the-united-states-by-state. Accessed 11 Feb. 2024.
12. The growth of the Orthodox Jewish community in New York State over the last twenty years, ojpac.org/updates/the-growth-of-the-orthodox-jewish-community-in-new-york-state-overthe-last-twenty-years. Accessed 11 Feb. 2024.
13. Nir SM,Pulwer S. A glimpse inside the hidden world of Hasidic women. The New York Times, 19 Sept. 2018, www.nytimes.com/2018/09/19/nyregion/a-glimpse-inside-the-hiddenworld-of-hasidic-women.html.
14. Shaked M, Bilu Y. Grappling with affliction: autism in the Jewish Ultraorthodox community in Israel. Cult Med Psychiatry 2006;30:1–27. https://doi.org/10.1007/s11013-006-9006-2.
15. Gustafsson BE, Quensel CE, Lanke LS, Lundqvist C, Grahnen H, Bonow BE, Krasse B. The Vipeholm dental caries study; the effect of different levels of carbohydrate intake on caries activity in 436 individuals observed for five years. Acta Odontol Scand 1954 Sep;11(3-4):23264. doi: 10.3109/00016355308993925. PMID: 13196991.
16. Savage M. Lördagsgodis: Sweden’s Saturday-only candy tradition. BBC News, BBC, 28 Feb. 2022, www.bbc.com/worklife/article/20211004-lrdagsgodis-swedens-saturday-only-candytradition.
17. Miller CC. The relentlessness of modern parenting. The New York Times 25 Dec. 2018. www. nytimes.com/2018/12/25/upshot/the-relentlessness-of-modern-parenting.html.
18. Mariño RJ, Ghanim A, Barrow SL, Morgan MV. Cultural competence skills in a dental curriculum: a review. Eur J Dent Educ 2018 Feb;22(1):e94-e100. doi: 10.1111/eje.12263. Epub 2017 Mar 6. PMID: 28261942.
19. American Academy of Pediatric Dentistry. Policy on the dental home. The Reference Manual of Pediatric Dentistry. Chicago, IL: American Academy of Pediatric Dentistry. 2023:35-7.
Gideon Turk, D.M.D., completed his residency at NYU College of Dentistry, Department of Pediatric Dentistry, in June 2024 and now practices in Ontario, Canada.
Michelle Goldstein, D.M.D., is director of pediatric outreach and prevention programs at NYU College of Dentistry, Department of Pediatric Dentistry, New York, NY. Dr. Turk
A Qualitative Assessment of the Role of Dental Specialists in U.S. Opioid Epidemic
Dental School Faculty and Postdoctoral Trainee Perspectives
Rochisha S. Marwaha, D.D.S., M.P.H., FICD; Gunnar Hasselgren, D.D.S., Ph.D.;
Sarah Douglas-Broten, D.M.D., M.P.H.; Sidney B. Eisig, D.D.S.; Kavita P. Ahluwalia, D.D.S., M.P.H.
ABSTRACT
This research used qualitative methods to compare the prescription opioid-related knowledge, opinions and behaviors of oral surgery (OS) and endodontics (E) faculty and postdoctoral trainees. Semi-structured interview guides were used to conduct 10 key-informant interviews with faculty and focus group discussions with 18 postdoctoral trainees. Interviews and focus group discussions were recorded, transcribed and coded for thematic content. E faculty reported infrequent use of opioids for dental pain management, while OS faculty frequently prescribed opioids. Conversely, E faculty were more likely to use prescription drug monitoring programs to track patients’ potential for addiction compared to OS. In conclusion, the frequency of opioid prescribing for dental pain management varies among the two dental specialties.
The United States is in the midst of an opioid epidemic predicated on both illegal and prescription drug abuse. Forty-four people die each day due to prescription opioid overdoses, and the mortality has increased by a factor of five over the past 17 years, resulting in the declaration of an opioid epidemic by the U.S. Department of Health and Human Services.[1,2] Prescription opioids are efficacious pain relievers used to manage acute and chronic pain. Individuals misuse prescription opioids by taking doses other than prescribed, using a family member/friends’ prescription, or taking the medicine for the euphoric effect that may result.[3,4] Dentists (12%) are the second highest prescribers of immediate-release opioids after family physicians (15%),[5] and reports suggest that 45% of the initial-fill opioid prescriptions were written by dentists.[5,6] While the role of dentists in prescribing opioids is documented, there is limited information regarding their opioid prescribing knowledge, opinions and behaviors among dental specialists, and how their dental training impacts future practice.[5] Among dentists, oral and maxillofacial surgeons (oral surgeons) and endodontists are more likely to prescribe opioids postoperatively for management of acute pain.[5,7]
The most common dental procedures for which oral surgeons prescribe opioid analgesics are third molar and surgical extractions.[5,6,8,9] Historically, oral surgeons routinely prescribed approximately 20 opioid tablets for impacted third molar extractions. Prescriptions of these many tablets may result in leftover doses, with increased potential for abuse.[9,10] However, these prescribing practices have changed since the recent implementation of prescription drug monitoring programs (PDMPs).
Endodontists are most likely to prescribe narcotics for severe pain associated with a necrotic pulp, acute periradicular abscess, postoperative flare-up and postsurgical pain.[11] A Canadian study revealed that a significant proportion of endodontists prescribed opioid analgesics to manage postoperative endodontic pain when not indicated.[12] Also, a combination of opioid analgesics and acetaminophen is usually prescribed for treating odontogenic pain in patients for whom nonsteroidal anti-inflammatory drugs (NSAIDs) may be contraindicated.[7,13,14]
Prescription drug monitoring programs (PDMPs) are statewide databases that monitor the prescription of controlled substances such as opioid analgesics and can, therefore, be used to determine if a patient is seeking opioid drugs.[6,15] In New York State, the use of PDMPs was mandated on Aug. 27, 2013; however, there are no penalties for a practitioner who does not consult the PDMP before prescribing an opioid medication.[16]
Furthermore, only a five- or more day supply of a controlled substance prescribed from a dental office, private practice or urgent care facility requires PDMP consultation before prescription.[16] Since a five-day supply would cover much of the prescribing by dentists, it would seem the PDMP system would rarely apply to them. Also, a recent study indicated that the frequency of opioid prescriptions almost halved, and the number of opioid pills prescribed was reduced by 78% when the PDMP system was implemented; however, whether PDMPs were utilized by dentists before prescribing opioids was not assessed.[15]
Additionally, what is not known is the proportion of dental specialists, specifically oral surgeons and endodontists, who use PDMPs and their effectiveness and impact on practice. Furthermore, oral surgeons’ and endodontists’ opinions and knowledge, all of which may impact their propensity to screen and educate patients regarding abuse, are not known.[5,6,17,18]
The objective of this study was to compare the prescription opioid-related knowledge, opinions and practices of oral surgery and endodontic faculty and postdoctoral trainees at Columbia University, College of Dental Medicine. Since oral surgeons and endodontists are key dental
specialties involved in acute pain management secondary to oral interventions, targeting them can play an important role in promoting non-narcotic pain management.[5,7]
Materials and Methods
This qualitative study was approved by Columbia University Medical Center’s Institutional Review Board (Protocols: AAAR5513 & AAAR5572). Data were collected through (a) key-informant interviews with faculty and (b) focus group discussions (FGDs) with oral surgery and endodontics postdoctoral trainees. Data were recorded, transcribed and coded for thematic content.
Development of semi-structured guides:
Semi-structured guides were developed by conducting literature reviews and interviews with oral surgery and endodontics faculty.
Data collection:
• Key-informant interviews: All attending oral surgery and endodontics faculty were requested to participate in the project via email by the chair of their respective departments. A semi-structured interview guide was used to conduct the interviews in a private space. Interviews were recorded and transcribed.
• Focus group discussions (FGDs): The study team worked with chief residents to recruit postdoctoral trainees in each dental specialty. One FGD was conducted for each of the specialties. FGDs, which were led by a moderator, were conducted in an enclosed, private space and were recorded and transcribed.
Analysis:
Transcriptions were hand-coded by two individual coders and compared for agreement. Themes gleaned from the key-informant interviews and FGDs were explored among team members and were followed by a discussion for quality assurance purposes. Additionally, themes were examined for patterns; quotes were used for interpretive purposes.
Results
Key-informant interviews were conducted with oral surgery (n=5) and endodontic (n=5) faculty; two focus group discussions (FGDs), which were restricted by specialty, were conducted with oral surgery (n=8) and endodontics (n=11) postdoctoral trainees.
Oral surgery faculty and postdoctoral trainees report that third molar and surgical extractions are the most common procedures for which opioids are prescribed; the opioid of choice is Percocet (oxycodone and acetaminophen).
Oral surgery faculty and trainees say they overprescribed opioid analgesics in the past as they were not aware of the CDC guidelines for acute pain management but are less likely to overprescribe now. Endodontics faculty and postdoctoral trainees report prescribing opioids for periapical flare-ups, pain due to severe pulpitis and surgical endodontics; Vicodin (hydrocodone bitartrate and acetaminophen) is their opioid of choice[15] (Table 1). Both endodontics faculty and trainees believe they rarely prescribe opioids and are not contributing to the opioid epidemic.
Nine themes emerged from the data and received consensus among the study team. The themes were segregated by specialty and faculty/trainee status for clarity and comparison (Table 2).
Theme 1: Patient Expectations
Faculty and trainees in both specialties consider managing patient expectations to be challenging; they believe that patients expect opioids following a surgical procedure and feel pressured to fulfill these expectations both to mitigate pain and build their practices.
Theme 2: Finger-Pointing
“Finger-pointing” or blame-shifting is a common theme among all interviews and focus group discussions. While endodontists blame oral surgeons for overprescribing, the oral surgeons, in turn, suggest that all surgical specialties in medicine and dentistry overprescribe. Additionally, both specialties believe that general dentists overprescribe due to lack of adequate training for acute pain management.
Theme 3: Private versus Academic Practice
Although both specialties concede they don’t overprescribe in their academic practices, faculty say they prescribe more frequently in private practice to retain patients. Trainees in
both specialties find prescribing opioids inconvenient due to faculty oversight. Endodontics postdoctoral trainees say they would be more likely to prescribe opioids in private practice.
Theme 4: Training
Currently, there are no specific courses on opioid prescribing at university, but postdoctoral trainees receive experiential training through practice with faculty. Recently, online training and courses provided by the American Association of Oral and Maxillofacial Surgery (AAOMS) and American Association of Endodontics (AAE) have increased awareness among some faculty and postdoctoral trainees.
Theme 5: Utilization of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) over Opioids
Both specialties are more likely to use NSAIDs as their firstline medication, with opioids being prescribed as a rescue drug for breakthrough pain. However, the two medications are frequently prescribed simultaneously, and instructions to take the opioid as needed for pain if the NSAIDs alone do not provide adequate relief are provided.
Theme 6: Use of PDMPs
Both oral surgery and endodontics faculty are aware of the PDMP policy in New York State. However, endodontists are more likely to use them compared to oral surgeons, who report time to be a deterrent to the use of PDMPs. Both specialties feel that the process of using PDMPs should be made less cumbersome in order to track patients’ previous use of opioids.
Theme 7: Screening Patients for Addiction before Prescribing Opioids
Both specialties report screening patients for addiction before prescribing opioids. Oral surgeons use patients’
medical and social histories, and endodontists examine their prescription histories through PDMPs. Additionally, oral surgeons mentioned that even if their patients’ histories indicate drug-seeking behaviors, they are entitled to receive an opioid for pain management following a painful procedure.
Theme 8: Identifying “Red Flags”
Both oral surgeons and endodontists focus on noticing warning signs of drug-seeking behaviors among patients, including reviewing prescription history through PDMPs, and a history of switching providers.
Theme 9: Contribution to the Opioid Epidemic
Oral surgery faculty and postdoctoral trainees report overprescribing opioids in the past but have changed their practices post-declaration of the epidemic. Endodontics faculty and postdoctoral trainees believe they are more conservative in prescribing opioids for pain management compared to other surgical specialties. Additionally, endodontics trainees believe that opioid addiction has more to do with chronic pain and long-term prescription.
Discussion
To the best of our knowledge, this study is the first qualitative assessment of prescription opioid-related knowledge, opinions and practices among oral surgery and endodontics faculty and postdoctoral trainees in an academic setting. While not generalizable, this pilot data presents valuable insights into opioid-related prescribing practices among dental specialists in practice and training. The study provides information that is worth exploring in a subsequent hypothesis-driven effort that could, in fact, contribute more robust data that might be used to address gaps in knowledge and practice among oral surgeons and endodontists in practice.
Patient expectations and demands emerge as a major challenge for faculty and trainees in both specialties; prescribing opioids in many cases is equally about patient and pain management. Finger-pointing is a common phenomenon among both dental specialties—while the oral surgeons blame all surgical specialties for overprescribing, endodontists pointed to general dentists and oral surgeons. Both finger-pointing and perceived pressure from patients shift ownership, precluding the need for action.
Our data suggests that there are no specific courses that target acute pain management using non-opioid alternatives; the primary model used for postdoctoral training is an apprenticeship model in which trainees learn experientially. Professional specialty groups, however, have pro-
vided online continuing education courses for dentists and specialists in practice. Additionally, the pain management and prescription opioid courses required to renew Drug Enforcement Administration (DEA) licenses have helped dentists and specialists keep their knowledge updated. While these courses may be useful in targeting specialists in practice, given the rise in opioid abuse in the United States, including pain management and prescription opioid training in advanced education dental program curriculum would be important for trainees.
Our data suggest that although practitioners are aware of PDMPs, there are differences in utilization and perceived utility of PDMPs by specialty. Oral surgery faculty and trainees report time constraints as a deterrent to using PDMPs, but endodontics faculty use PDMPs whenever they prescribe opioids. Additionally, endodontics trainees indicate that since faculty oversight restricts opioid prescribing in academic settings, they almost never prescribe opioids, and their use of PDMPs is, therefore, limited.
Oral surgery faculty and postdoctoral trainees in both specialties report that using PDMPs is time-consuming— efforts to streamline the use of PDMPs, and easy integration with electronic medical and dental records, could be considered. Alternatively, opportunities for more effective utilization of auxiliaries to monitor patient use of opioids should be explored. The utilization of PDMPs is not standardized across the United States; efforts to develop standard policy regarding their utilization across states should be considered because their consistent utilization has successfully been used to reduce the frequency of opioid prescribing among dentists and physicians.[16]
Our data suggest that endodontists believe they do not specifically contribute to the opioid epidemic because they feel that long-term opioid abuse is a consequence of chronic pain management. Recent studies indicate, however, that acute pain management can lead to long-term opioid use.[16,26,27] A study conducted by the Centers for Disease Control (CDC) suggests that the chance of long-term opioid use increases within the first days of therapy, including among individuals whose first episode of use was less than/equal to eight days.[27] It is, therefore, essential to increase awareness among dental specialists regarding the addictive potential of short-term opioid use for acute pain management and, in turn, educate their patients regarding the risks of opioids before prescribing.[16,27]
It is important to note that this pilot study included a sample of oral surgery and endodontics faculty and postdoctoral trainees from one dental school; therefore, this qualitative work is not generalizable to oral surgeons and endodontists at other dental schools, or providers in prac-
tice. Regardless, these data do provide important insight into the opioid prescribing behaviors of oral surgery and endodontics specialties both at the faculty and trainee levels and suggest that training is not standardized across specialties and time constraints, patient expectations, and state and local policies targeting the use of PDMPs impact opioid prescribing among specialists. Furthermore, the information gathered can be used to inform the development of instruments for quantitative studies of provider prescribing knowledge, opinions and practices, and, potentially, to then implement and test future educational interventions targeting dental specialists in training and practice.
Conclusion
This pilot qualitative research, while not generalizable, provides initial interesting data that requires further study and could eventually have implications for academia, policy and research. The disparity in utilization of prescription drug monitoring programs (PDMPs) among the oral surgery and endodontics specialties, and perceived impact on the epidemic by specialty, suggests that a more unified approach towards training and education of postdoctoral trainees and dentists-in-practice may be an important first step in mitigating the role of dentistry in the current epidemic. Additionally, if these results are confirmed by more generalizable studies, training that specifically addresses pain management, use of opioids, addiction and alternative therapies should be incorporated in the dental curriculum at the pre- and postdoctoral levels. Since sustained use of PDMPs can result in lowered rates of prescription, incorporation of the use of PDMPs in dental training and practice should be explored, and a single national PDMP policy should be considered. p
Queries about this article can be sent to Dr. Marwaha at marwaha@uthscsa.edu.
REFERENCES
1. Centers for Disease Control and Prevention. Prescription opioid overdose death maps. 2022, June 6. Available at: https://www.cdc.gov/drugoverdose/deaths/prescription/maps.html.
2. U.S. Department of Health and Human Services. HHS Acting Secretary Declares Public Health Emergency to Address National Opioid Crisis. October 26, 2017. Available at: https:// www.hhs.gov/opioids/about-the-epidemic/.
3. National Institute on Drug Abuse. 2018. Available at: https://www.drugabuse.gov/publications/drugfacts/prescription-opioids.
4. McCabe SE, Teter CJ, Boyd CJ, et al. Nonmedical use of prescription opioids among US college students: prevalence and correlates from a national survey. Addictive Behaviors 2005;30(4):789-805.
5. Denisco RC, Kenna GA, O’Neil MG, et al. Prevention of prescription opioid abuse: the role of the dentist. Journal of the American Dental Association 2011;142(7):800-810.
6. McCauley JL, Hyer JM, Raakrishnan VR, et al. Dental opioid prescribing and multiple opioid prescriptions among dental patients: administrative data from the South Carolina prescription drug monitoring program. Journal of the American Dental Association 2016;147(7):537-544.
7. American Association of Endodontics. Position paper: A 3-D approach for treating acute pain. 2015. At: http://www.aae.org/specialty/wp-content/uploads/sites/2/2017/07/ecfeacutedentalpain.pdf. Accessed: May 25th, 2018.
8. Maughan BC, Hersh EV, Shofer FS, et al. Unused opioid analgesics and drug disposal following outpatient dental surgery: a randomized controlled trial. Drug & Alcohol Dependence 2016;168:328-334.
9. Baker JA, Avorn J, Levin R, Bateman BT. Opioid prescribing after surgical extraction of teeth in Medicaid patients, 2000-2010. Journal of the American Medical Association 2016;315(15):1653-1654.
10. Mutlu I, Abubaker AO, Laskin DM. Narcotic prescribing habits and other methods of pain control by oral and maxillofacial surgeons after impacted third molar removal. Journal of Oral and Maxillofacial Surgery 2013;71(9): 1500-1503.
11. Mickel AK, Wright AP, Chogle S, et al. An analysis of current analgesic preferences for endodontic pain management. Journal of Endodontics 2006;32(12):1146-1154.
12. Buttar R, Aleksejūnienė J, Shen Y, Coil J. Antibiotic and opioid analgesic prescribing patterns of dentists in Vancouver and endodontic specialists in British Columbia. Journal Canada Dental Association 2017;83(h8):1488-2159.
13. Sethi P, Agarwal M, Chourasia HR, Singh MP. Effect of single dose pretreatment analgesia with three different analgesics on postoperative endodontic pain: a randomized clinical trial. Journal of Conservative Dentistry 2014;17(6):517.
14. Ryan JL, Jureidini B, Hodges JS, et al. Gender differences in analgesia for endodontic pain. Journal of Endodontics 2008;34(5):552-556.
15. Rasubala L, Pernapati L, Velasquez X, et al. Impact of a mandatory prescription drug monitoring program on prescription of opioid analgesics by dentists. PloS One 2015;10(8):e0135957.
16. New York State Department of Health. I-STOP/PMP - Internet System for Tracking OverPrescribing - Prescription Monitoring Program. 2013. At: https://www.health.ny.gov/professionals/narcotic/prescription_monitoring/. Accessed: May 31st, 2018.
17. Deyo RA, Hallvik SE, Hildebran C, et al. Association between initial opioid prescribing patterns and subsequent long-term use among opioid-naive patients: a statewide retrospective cohort study. Journal of General Internal Medicine 2017;32(1):21-27.
18. Gabay M. Prescription drug monitoring programs. Hospital Pharmacy 2015;50(4):277.
19. Holstein A, Hargreaves KM, Niederman R. Evaluation of NSAIDs for treating post-endodontic pain. Endodontic Topics 2002;3(1):3-13.
20. Moore PA, Hersh EV. Combining ibuprofen and acetaminophen for acute pain management after third-molar extractions: translating clinical research to dental practice. The Journal of the American Dental Association 2013;144(8), 898-908.
21. Paulozzi LJ, Mack KA, Hockenberry JM. Vital signs: variation among states in prescribing of opioid pain relievers and benzodiazepines-United States, 2012. Morbidity and Mortality Weekly Report 2014;63(26):563-568.
22. Daubresse M, Chang HY, Yu Y, et al. Ambulatory diagnosis and treatment of non-malignant pain in the United States, 2000–2010. Medical Care 2013;51(10).
23. Au AHY, Choi SW, Cheung CW, Leung YY. The efficacy and clinical safety of various analgesic combinations for post-operative pain after third molar surgery: a systematic review and meta-analysis. PLoS One 2015;10(6):e0127611.
24. Mehlisch DR. The efficacy of combination analgesic therapy in relieving dental pain. The Journal of the American Dental Association 2002;133(7): 861-871.
25. Cooper SA, Precheur H, Rauch D, et al. Evaluation of oxycodone and acetaminophen in treatment of postoperative dental pain. Oral Surgery, Oral Medicine, Oral Pathology 1980;50(6):496-501.
26. Edlund MJ, Martin BC, Russo JE, et al. The role of opioid prescription in incident opioid abuse and dependence among individuals with chronic non-cancer pain: the role of opioid prescription. The Clinical Journal of Pain 2014;30(7):557.
27. Shah A, Hayes CJ, Martin BC. Characteristics of initial prescription episodes and likelihood of long-term opioid use-United States, 2006-2015. Morbidity and Mortality Weekly Report 2017;66(10):265-269.
Rochisha Singh Marwaha, D.D.S., M.P.H., FICD, is clinical associate professor, Comprehensive Dentistry, and assistant director, postdoctoral DPH residency program, University of Texas Health, San Antonio, School of Dentistry. She was a postdoctoral resident, Columbia University, College of Dental Medicine, New York, NY.
Gunnar Hasselgren, D.D.S., Ph.D., is professor of dental medicine, interim director of endodontics and chair, Section of Cariology and Restorative Sciences, Columbia University College of Dental Medicine, New York, NY.
Sarah Douglas-Broten, D.M.D., M.P.H., is a postdoctoral trainee, Section of Population Oral Health, Columbia University College of Dental Medicine, New York, NY.
Sidney B. Eisig, D.D.S., is chair, Section of Hospital Dentistry, and director, Division of Oral and Maxillofacial Surgery, Columbia University College of Dental Medicine, New York, NY.
Kavita P. Ahluwalia, D.D.S., M.P.H., is associate professor of dental medicine and director, postdoctoral program in dental public health, Columbia University College of Dental Medicine, New York, NY.
Revolutionizing Dental Operatories
How Do We Do More Using Less?
Michael Zidile, D.D.S.; Brian Choi, D.D.S.
ABSTRACT
The authors present a transformative approach to modernizing dental operatories as part of their practice’s recent expansion. Aimed at enhancing efficiency and patient-centered care, the project reimagines traditional operatory design by eliminating ergonomic and hygienic barriers, notably, the use of keyboards and mice. Key innovations include the implementation of touchscreen PC displays, high-power PCs with graphics cards, magnetic USB cables for rapid data transfer, omnidirectional microphones linked to AI scribes and wireless intraoral scanning.
The design prioritizes a standardized, clutterfree layout across eight operatories, utilizing A-Dec Inspire Series cabinets for ergonomic supply management. By removing countertops and pullout trays, the approach fosters a seamless workflow, reduces contamination risks and supports clinician mobility. Early results indicate significant improvements in clinical speed, documentation accuracy and patient engagement. This model offers a blueprint for dental practices seeking to optimize technology and space.
The expansion of our periodontal practice required us to rethink traditional approaches. One goal was to create a patient-centered environment that redefines how our periodontal team uses operatory technology. We needed to transform each of the operatories into highly efficient
spaces that eliminate traditional barriers to workflow. One such barrier is the computer keyboard and mouse, which we found to be ergonomically difficult to use in an operatory setting. This article outlines this new thought process, along with others, including:
• Implementation of touchscreen PC displays
• High-power PCs in each operatory
• Magnetic style USB cables for quick data transfer
• Omnidirectional microphones linked to AI scribes
• Wireless intraoral scanning
• More efficient operatory supplies management
Where’s the Mouse?
The project aimed to greatly improve clinical speed and efficiency. Traditional dental operatories often rely on standard interfaces typically used in a seated, desk-oriented position. The dental operatory is not like a traditional office, and often the staff are in a standing position when interacting with the PC. Keyboards and mice are cumbersome to use when standing and are prone to contamination. We envisioned a keyboard- and mouse-free environment where technology integrates more seamlessly, allowing clinicians to focus on face-to-face interaction.
The operatories needed to be functional, hygienic and aesthetically modern, aligning with the expectations of today’s patients. Standardizing workflows across eight dental chairs was critical. Of high importance was ensuring each operatory was identical. This would enable staff to move effortlessly between rooms, reducing training time and ensuring consistency. The challenge was to design an intuitive system that supports advanced dental technologies while maintaining a sleek, uncluttered aesthetic.
Stuck on the Countertop
A cornerstone of the design was for the clinician to avoid using a countertop or pullout trays. Mice and keyboards are
notoriously difficult to adequately clean, and they use up precious operatory real estate. In addition, they are difficult to use while standing without undergoing various uncomfortable and unhealthy contortions. This is due to the fixed height of the pullout shelves or countertop surfaces, which are designed for use in a seated position.
To Touch, or Not to Touch?
We all use our phones and tablets, which have touchscreens; however, most desktop monitors lack native touch input capabilities. To properly implement this design, it is, therefore, necessary to invest in dedicated touchscreen monitors.
The authors found one commercially available monitor (Dell 24 P2424HT 23.8” Multi-Touch Monitor) to be the right size for most dental applications. To use these monitors in the operatory, additional cabling is required. An HDMI and power cable are usually enough to operate properly. For touchscreens, we need one more data cable.
Wiring this additional (USB) cable from the monitor to the PC is needed to transmit “touch” inputs back to the computer. Once a computer is already installed in an existing operatory, it can be difficult to retrofit another USB cable from a touchscreen monitor back to the PC. Pre-installing these cables during the initial installation is, therefore, usually required.
We’ve found that the closest and most intuitive location for these touchscreen displays is both on the side of the patient and behind the patient. The first monitor, posi-
tioned for patient interaction, is on the side and serves as the primary monitor for case presentation and treatment plans. This side placement ensures patients can view imaging comfortably, fostering transparency and improving case acceptance.
The second touchscreen monitor is located behind the patient and allows clinicians to interact with digital records and scanning software in real time without turning away from the patient, maintaining a personal connection. It’s also important that each monitor be fixed to a monitor arm that can be moved easily into the best viewing position.
Do You Need Pen and Paper?
To further reduce use of a keyboard, each operatory is also equipped with an omnidirectional microphone connected to AI scribe technology. Commercially available AI software automatically transcribes patient visits in real time, capturing patient interactions and producing HIPAA-compliant clinical summaries without manual typing. The AI scribe enhances efficiency by drastically reducing documentation time, ensuring accurate and timely chart records. AI-enhanced periodontal charting is also now available without expensive custom software purchases. The authors have some early experience AI scribes like Bola.ai and Denti.ai. There are many others currently available as well.
Will Any PC Work?
To improve efficiency, it is the authors’ opinion that each operatory should be powered by a PC with its own graph-
Figure A. Rethinking traditional operatory design with free countertops and no keyboard or mouse.
ics card. The term “integrated graphics” used by PC manufacturers is the industry code word for underpowered. PCs with a graphics card are capable of handling more demanding imaging and intraoral scanner software.
For intraoral photography, digital SLR cameras capture the best high-resolution images. Quick disconnect magnetic USB-C cables were implemented specifically for the DSLR cameras, allowing rapid connection and disconnection to speed up image transfer compared to manually removing a native SD card. The magnetic cable design ensures durability and ease of use, enabling auxiliary staff to upload images to the PCs for immediate review in front of the patient.
Ergonomic Design and Supply Management
To further optimize the operatories, we collaborated with Design Ergonomics (www.designergonomics.com) for room layout and supply management. Their expertise ensured ergonomic placement of equipment and supplies, minimizing clinician movement and fatigue by stocking each operatory with a week’s worth of the most common dental supplies. The A-Dec Inspire Series cabinets were selected for their modular design and narrow footprint, accommodating the PCs while providing ample storage, nitrous integration and an automatic vacuum line cleaning system.
Future Trends
This article details the renovation and expansion of our periodontal and implant practice and how transforming eight new operatories allowed us to significantly speed up routine tasks and save the doctors, hygienists and assistants in the practice valuable time. As we rely more heavily on hardware design to speed daily operations, other technology will further improve how we interact with patients. Smart glasses, AI radiologic software and simple robotic systems will further shorten appointment times and eliminate the time spent looking for the keyboard and mouse. p
The authors declare no financial interests or conflicts of interest related to this work. This research was conducted independently, and no external funding was received. The views expressed in this article are those of the authors only. The authors extend special thanks to Chris Schramm of Masserano Development and Charlie Vota of Pemco Dental for their invaluable support and contributions to this work. Queries about this article can be sent to Dr. Zidile at michaelzidile@gmail.com.
Michael Zidile, D.D.S., and Brian Choi, D.D.S., are proprietors of Brooklyn Periodontics & Implant Dentistry, PC, in Brooklyn, NY.
Figure B. Typical uncomfortable position of user in dental operatory with traditional keyboard and mouse setup.
Dr. Zidile Dr. Choi
An Update on Non-Cigarette Nicotine-Containing Products and the Periodontal Patient
Brendan Keeney, D.D.S.; Ryan Schure, D.D.S., M.Sc. (Perio), F.R.C.D. (C)
ABSTRACT
The adverse general and oral health effects from traditional cigarette smoking are supported by decades of research. However, the use of cigarettes in the United States is on the decline, and current research and literature is relatively lacking with respect to novel nicotine consumption methods. Given the increasing and significant use of non-cigarette nicotine-containing products, such as electronic cigarettes, oral nicotine pouches and hookah pipes, attention from oral healthcare providers is warranted. An understanding of the potential negative periodontal outcomes related to these newer nicotine delivery systems is crucial to properly educating and treating patients today.
Health concerns related to cigarette smoking have been well-documented and published for many decades. In fact, direct warnings from the Surgeon General concerning smoking and the increased risk of cardiovascular and respiratory cancers and diseases have been publicly advertised since the mid-1900s.[1] In the dental literature, associations
have also been well-established, with smoking being linked to increases in oral cancers,[2-4] periodontal diseases[5-9] and tooth loss.[10,11]
Specifically, smoking is known to increase both periodontal disease progression and severity, and lead to poorer periodontal-related treatment outcomes.[12-18] Studies have shown the damaging effects nicotine has on human gingival fibroblasts, with exposure inducing cellular apoptosis.[5-9] Nicotine has also been shown to increase the inflammatory response in human periodontal ligament (PDL) cells, through the upregulation of interleukin-β and downstream osteoclastogenesis, leading to bone resorption.[19]
Nicotine may also affect neutrophil function, increasing the release of proteases, and contributing to the progression of periodontal disease.[20] Neutrophils are critical in host immune regulation, and while total neutrophilic blood cell counts remain high in the systemic circulation of smokers, their typical protective characteristics are mitigated in favor of more destructive properties, which, ultimately, accelerate periodontal bone loss.[21] Epigenetic mechanisms could also be at play in nicotine-induced periodontitis, as further research into the dysregulation of certain microRNAs could clarify pathways that result in extensive disease.[19]
While smoking remained popular in mainstream society through the initial propagation of this knowledge,
more recently, cigarette smoking has seen diminishing trends among U.S. teens and adults.[12-18] Concurrently, the advent of non-cigarette nicotine-containing products (NCNCPs) has occurred, some heralded as being safer alternatives to cigarettes. Three NCNCPs that have increased usage in the U.S. in the 2000s are electronic cigarettes, oral nicotine pouches (ONP) and hookah. While without tobacco, these products still contain nicotine and subject their users to its harmful effects. For example, ecigarettes and hookah pipes deliver nicotine absorption via inhalation, while the newer oral nicotine pouches allow for direct mucosal absorption.[22,23]
The actual amount of nicotine absorbed varies by product; some electronic cigarettes appear to expose consumers to less nicotine than a cigarette equivalent (approximately 1.54 mg to 2.60 mg per cigarette); however, other devices can deliver the nicotine equivalent of an entire pack of cigarettes (more than 30 mg) with a single cartridge.[24,25] Being the newest product on the market, ONPs have been shown to deliver extremely high concentrations of nicotine, approaching 50 mg per pouch in some instances, which is much higher than what was previously reported by manufacturers.[26]
Nicotine levels from hookah smoking appear to be highly variable based on multiple factors, including differ-
ent cultural styles of use and inconsistent manufacturing regulations, but studies have shown that a single hookah session can induce a plasma nicotine concentration up to 10 times higher than a cigarette would.[27-29] Knowing this, along with the usage trends, it is prudent for dentists and their teams to understand the effects of NCNCPs on periodontal diseases, as well as the periodontal-related treatment outcomes.
Electronic Cigarettes
Electronic cigarettes, colloquially known as “e-cigarettes,” “e-cigs” or “vapes,” were introduced to U.S. markets around 2007.[30] First-generation e-cigarettes were designed to mimic the appearance and tactile feeling of a traditional cigarette, garnering the nickname “cig-a-likes” (Figure 1).[31,32] Currently, fifth-generation products are on the market and feature devices with “pods” or cartridges, housing the nicotine-containing liquid.[33] According to the National Youth Tobacco Survey (NYTS) in 2011, the percentage of middle and high school students in the U.S. using electronic cigarettes was just 0.6%, compared to 4.3% for conventional cigarettes.[13] In the most recent 2023 survey data, these percentages were reported as 7.7% and 1.6%, respectively.[18] The usage trend for adults follows a similar trajectory, with e-cigarettes now far outpacing traditional cigarettes (Figures 2, 3).[12-17]
Figure 1. Representations of evolution of electronic cigarettes: 1st generation (cig-a-like), disposable e-cigarette units; 2nd generation with refillable system; 3rd generation more advanced, customized settings; 4th generation e-cigarettes closed systems. [32]
E-cigarettes and Periodontal Diseases
While e-cigarettes eliminate some of the harmful health effects from tobacco smoke, these systems still contain nicotine, along with other dangerous chemicals, such as formaldehyde, acetaldehyde and acrolein, all of which have been implicated in contributing to higher levels of periodontal diseases in users.[34] Additionally, e-cigarettes have an added concern of toxicity from the heating of metal components within the devices, something not considered with cigarette smoking but that also may contribute to disease.[35]
Studies have shown that intraoral blood flow to mucosal tissue is decreased in e-cigarette users.[36] Other studies have analyzed the content of gingival crevicular fluid (GCF). In e-cigarettes users, there is increased expression of receptor activator of NF-kappa B ligand (RANKL) and osteoprotegerin (OPG) in the GCF, in addition to higher levels of inflammatory biomarkers that are commonly seen in periodontitis.[37,38] Research has also demonstrated that the vapor emitted by e-cigarettes can have toxic effects on human epithelial gingival cells, leading to apoptosis.[39] Further, e-cigarette vapors have been shown to have negative effects on the oral microbiome, such as increasing microbial diversity that ultimately leads to an increase in gingival inflammation.[40,41] Cumulatively, these mechanisms all contribute to a noted increased periodontal disease in e-cigarette users.
E-cigarettes and Periodontal Treatment Outcomes
A 2020 study demonstrated that scaling and root planing may be less efficacious in patients using e-cigarettes, as nonusers showed greater improvement in disease parameters following therapy.[42] Moreover, intraoral healing after periodontal surgery can be compromised in these patients. Nicotine from traditional cigarettes is known to induce vasoconstriction, creating a hypoxic tissue environment, which impairs wound healing.[36] In some studies, e-cigarettes have been shown to produce even poorer tissue responses than traditional cigarettes.[43] Patients who use e-cigarettes may also have higher levels of cotinine (a nicotine breakdown product) and can have a more acidic salivary pH, which can alter the oral microbiome to a point where certain periodontopathogenic bacteria can thrive and negatively impact healing.[44,45]
A 2024 study examined e-cigarette users and their healing following palatal punch biopsy procedures. The subjects were 18 to 50 years old and had never smoked traditional cigarettes. Results showed that those using ecigarettes had statistically higher levels of postoperative bleeding and swelling and delayed wound healing, com-
Figure 2. Data from the NHIS (2011-2022) shows percentage of U.S. adults who report “everyday” or “some day” use of either traditional cigarettes or electronic cigarettes.
Figure 3. Data from NYTS (2011-2019) shows percentage of high school students who report use of either traditional cigarettes or electronic cigarettes “within last 30 days.”
Figure 4. Data from NYTS (2020-2023) shows percentage of high school students who report use of either traditional cigarettes or oral nicotine pouches “within last 30 days.”
pared to nonsmokers.[46] Thus, e-cigarette use should be avoided in the postoperative healing phase.
Dental implant treatment may also be compromised by e-cigarette use; studies have shown that these patients have increased probing depths, radiographic bone loss and plaque index, in addition to an increased amount of pro-inflammatory cytokines present in the peri-implant sulcus fluid.[47-49] Research has also shown that the accumulation of advanced glycation end products in peri-implant tissues, and the subsequent formation of reactive oxygen species (ROS), is significantly higher in cigarette and e-cigarette smokers compared to nonsmokers, suggesting that e-cigarette use may lead to detrimental and destructive metabolic changes in the soft and hard tissue that supports dental implants.[50]
Oral Nicotine Pouches
ONPs, a newer product also designed to divert from cigarette smoking, are gaining popularity as they are typically marketed as “tobacco-free” or “tobacco leaf-free” products.[51] These products may be useful to current cigarette smokers seeking a healthier alternative, as the lack of a combustion process in ONPs theoretically limits the toxins that users are exposed to.[52] And while some international marketing programs directed at adolescents have encouraged exchanging cigarettes for ONPs, this may not in fact be advantageous.[53] ONPs still contain nicotine, and the concern of addiction remains, especially in younger populations, given the variety of attractive flavors available.
A study from the UK in 2022 showed some harm reduction with the use of ONPs compared to traditional cigarettes, but also recommended putting a ceiling on the nicotine content allowed in these products.[54] Due to an influx of some extraordinarily highly concentrated ONPs, there are countries that have banned the products altogether.[55] In the U.S. in 2024, the FDA issued warning letters and civil money penalty complaints against retailers with suspected involvement in the sale of ONPs to underage individuals.[56] Despite ONPs not fully emerging into the U.S. market until 2016, popular brands such as Swedish-manufactured Zyn, rendered ONPs with a 4% share of the smokeless tobacco market by 2019.[57]
The 2021 National Youth Tobacco Survey (NYTS) revealed that American youth who perceive cigarettes and e-cigarettes to be harmful may be turning to ONPs instead, so it is critical that research continue to examine the health effects of these products, and that dentists are aware of the evidence.[58] Data from the NYTS shows that in 2023, cigarette and ONP use was essentially equal among high school students (Figure 4).[18, 59-61]
ONPs and Periodontal Diseases
Similar to e-cigarettes, ONPs have been increasingly marketed as a safer method of nicotine exposure; however, unlike cigarettes, e-cigarettes or hookah, ONPs produce nicotine absorption directly into the blood via oral mucosa, more similar to traditional smokeless tobacco products.[62] A 2022 study examined oral mucosal health of nicotine pouch users and noted significant mucosal changes and increased salivary biomarkers in this group, but did acknowledge that it is difficult to separate traditional smokeless tobacco users from the novel ONP product users.[63]
A 2024 study specifically looked at ONPs and found that they may lead to higher amounts of periodontopathogenic bacteria in the saliva of users and, thus, could play a role in the progression of periodontal disease.[64]
ONPs and Periodontal Treatment Outcomes
Nicotine dramatically represses cell viability and increases apoptosis in human PDL cells and, thus, ONPs may interfere with periodontal healing, where regeneration of PDL is crucial.[65] A 2022 study tested the effects of a multitude of different flavors of ONPs on human gingival epithelial cells. It was determined that many nicotine pouch flavors resulted in higher levels of inflammation and ROS production, in addition to increased cytokine production, suggesting that chronic use of flavored ONPs is likely to cause systemic and local toxicological responses that would affect oral healing.[66] Therefore, the use of these products should be avoided when periodontal healing is required.
Hookah
Hookah, also known as water pipe, has collected many different names over the years and in different cultures. Hookah has been around much longer than e-cigarettes, probably over 1,000 years, originating in India, moving through the Middle East and gaining popularity in the Western Hemisphere more recently.[27] A 2017 study demonstrated that the 15- to 34-year-age group had the highest percentage of its members holding the perception that hookah is less harmful than cigarettes, and, predictably, this age group contained the highest percentage of current or ever hookah users.[67]
A 2022 study showed a similar connection between hookah perception and prevalence of use in American youth.[68] There has been an overall uptick in hookah use in the U.S. since the late 1900s, particularly among young adults. In a study examining hookah use among American college students from 2008 to 2009, hookah was reported as the second most common form of tobacco use, behind only cigarettes.[69] By 2015, a study from California revealed
that 16% of college students reported use of hookah in the past 30 days, compared to just 12% for cigarettes.[70] Thus, current trends and attitudes regarding hookah should be of concern to oral health professionals.
Hookah and Periodontal Diseases
The idea that hookah smoking is healthier than cigarette smoking, from a periodontal perspective, has been proven false. Studies have shown negative outcomes with respect to mean periodontal bone height and prevalence of vertical bone defects in cigarette smokers and hookah smokers compared to nonsmokers.[71,72] Another study, from 2015, looked at the gingival health of both cigarette and hookah smokers. Like the earlier findings, the hookah smoking group had a higher prevalence of periodontal disease indicators compared to the nonsmoking group, and was comparable to the cigarette smoking group.[73] Other studies have confirmed that those using hookah experience greater marginal bone loss and have more missing teeth, compared to nonsmokers.[74]
A 2024 study attempted to compare the oral health of different types of smokers (e-cigarettes, traditional cigarettes and hookah). Interestingly, it found that self-reported oral symptoms, such as taste changes and bad breath, were least frequent among hookah smokers, perhaps because hookah smokers tend to smoke less frequently.[75] However, hookah smokers showed a significant amount of cellular damage, even more so than e-cigarette smokers. In fact, hookah users showed the most significant amount of cellular damage of all study groups, including traditional cigarettes, as determined by hyperchromatism and increased nuclear:cytoplasmic ratio.[75] This likely contributes to the higher levels of periodontal diseases seen in users.
Hookah and Periodontal Treatment Outcomes
Sparse research has been conducted considering the effects of hookah smoking on nonsurgical periodontal treatments but, nonetheless, hookah appears to have deleterious effects on periodontal surgery outcomes, similar to other forms of smoking.[76,77] For example, hookah smoking can impact the success of dental implants, with patients demonstrating increased peri-implant soft-tissue inflammation and crestal bone loss during healing.[77] Hookah smoking (as well as cigarette and e-cigarette smoking) was shown to increase expression of RANKL and OPG in the GCF, inflammatory markers related to periodontal disease and limiting oral healing.[37] Therefore, patients who smoke hookah should be informed of possible impaired healing and poorer outcomes after periodontal surgery.
Conclusions
While cigarette smoking is on the decline in the U.S., the use of non-cigarette nicotine-containing products (NCNCPs) is increasing; therefore, an understanding of their impact on oral health becomes extremely important. E-cigarettes, ONPs and hookah all contain nicotine and can produce similar, or even more severe, negative effects, compared to traditional cigarettes. Therefore, it is critical for oral health professionals to be aware of and monitor their patients’ nicotine consumption habits, regardless of the modality of intake.
It may be beneficial to broaden typical patient history questions such as “Do you smoke cigarettes or marijuana?” to include questions such as “Do you currently use any nicotine-containing products, including but not limited to cigarettes, e-cigarettes, nicotine pouches and/or hookah?” to ensure comprehensive screening. This will allow professionals to properly educate and inform their patients. Fur-
ther, it would be prudent for the oral health professional to recommend that the patient stop using NCNCPs, similar to the smoking cessation strategies currently employed. Depending on the practitioner, this may include things like patient education, referral to the patient’s primary care provider or local organization (i.e., New York State Quitline), prescription of pharmacotherapy and/or follow-up.
As NCNCPs continue to rise in popularity, more research is required to fully understand their consequences. For example, the negative impact of nicotine on periodontal diseases may differ based on the mechanism of absorption (i.e., inhalation versus mucosal absorption), or if tobacco is included or not (i.e., traditional chewing tobacco versus ONP products). However, from the literature available, there are clear increases in periodontal disease parameters and decreases in healing capabilities, resulting in worse treatment outcomes for patients using NCNCPs. While patients may view NCNCPs as a safer alternative to cigarettes, from a periodontal perspective at least, there appears to be little difference in the deleterious effects. p
The authors declare no conflict of interest in the preparation of this manuscript. Queries about this article can be sent to Dr. Keeney at brendankeeney52@gmail.com.
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65. Ge X, et al. Impact of nicotine on the interplay between human periodontal ligament cells and CD4+ T cells. Hum Exp Toxicol 2016;35(9):983-90.
66. Shaikh SB, et al. Flavor classification/categorization and differential toxicity of oral nicotine pouches (ONPs) in oral gingival epithelial cells and bronchial epithelial cells. Toxics 2022;10(11).
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68. Kuk AE, et al. The effect of perceptions of hookah harmfulness and addictiveness on the age of initiation of hookah use among Population Assessment of Tobacco and Health (PATH) youth. Int J Environ Res Public Health 2022;19(9).
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74. Javed F, et al. Comparison of clinical and radiographic periodontal status between habitual water-pipe smokers and cigarette smokers. J Periodontol 2016;87(2):142-7.
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76. Akram Z, Javed F, Vohra F. Effect of waterpipe smoking on peri-implant health: a systematic review and meta-analysis. J Investig Clin Dent 2019;10(3):e12403.
77. Alahmari F, et al. Soft tissue status and crestal bone loss around conventionally-loaded dental implants placed in cigarette and waterpipe (narghile) smokers: 8-years’ follow-up results. Clin Implant Dent Relat Res 2019;21(5):873-878.
Dr. Keeney
Dr. Schure
Brendan Keeney, D.D.S., is a graduate of the University at Buffalo School of Dental Medicine and holds a Bachelor of Science degree in Biology from Boston College. He currently is a postgraduate dental resident at SUNY Upstate Medical University, Syracuse NY.
Ryan Schure, D.D.S., M.Sc. (Perio), F.R.C.D.(C) is a clinical assistant professor in periodontology at the University at Buffalo School of Dental Medicine. He maintains a private practice limited to periodontics and implant dentistry in Toronto, Canada.
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Second District cont.
EIGHTH DISTRICT
Life-Changing Care
Kevin J. Hanley, D.D.S.
The Erie County Dental Society held an evening meeting and seminar on Oct. 1 at the Eighth District office. Drs. Paul and Jessica Canallatos discussed “Unlocking Advanced Treatment Options: Digital Dentistry and Custom Prostheses for Comprehensive Patient Care.” The lecture highlighted innovative advancements in full-arch rehabilitation with dental implants, focusing on digital workflows simplifying treatment and delivering exceptional outcomes for edentulous patients.
The speakers also explored the world of maxillofacial prosthetics, including custom eyes, ears and noses, as well as advanced prosthetic solutions for craniofacial conditions and nasoalveolar molding appliances for cleft care. Attendees gained valuable insights not only into identifying patients who could benefit from these transformative treatments, but also collaborating with specialists to provide comprehensive, lifechanging care. This continuing education program awarded 1.5 hours of MCE.
Purely Social
The Eighth District Dental Society held a new dentist evening social on Oct. 16 at Big Ditch, Lockport. New dentists enjoyed an evening interacting with each other, learning about local brewery techniques, sampling craft food and taking a chance on door prizes. It was a good time all around.
Lifesaving Remedial
The Erie County Dental Society will hold its final quarterly “Basic Life Sup-
port for Health Care Providers” course for the year at the district office on Nov. 3. The course fulfills New York State requirements for CPR retraining. All participants will be asked to complete a skills test and written exam to qualify for recertification. Those who complete the course will receive 4 MCE credits and a two-year certification in CPR.
Alumni Gather for Meeting and Awards
The University at Buffalo Dental Alumni Association will hold its annual Buffalo Niagara Dental Meeting Nov 5-7 at the Convention Center in downtown Buffalo. This annual meeting brings together nationally known speakers covering all aspects of dentistry and offers a trade show with exhibitors from all the national dental companies.
Five-year reunion classes are recognized at the annual Alumni Dinner Dance. During the dinner dance, Dr. Raymond Miller, Class of 1985, will receive the Alumni’s Honor Award for his outstanding professional work, particularly as a forensic dentist, his positive promotion of the School of Dental Medicine and his contributions to the community.
Also being honored is Dr. Paul DiBenedetto, Class of 1979, who will receive the Distinguished Service Award for his dedication to the Alumni Association over his extensive career and his contributions to the dental community and the public.
Those who attend the Buffalo Niagara Dental Meeting can earn a maximum of 15 MCE hours if they are present for all two and a half days of the meeting.
Memorial Lecture Topics Announced
The Buffalo Marriot Hotel in Amherst will be the site of the 2025 Dr. Rick Fink Memorial Lecture on Friday, Dec. 5. Dr. Peter Auster will present “AI and More—Growing Trends in Dentistry” and “Be Your Own Prosthodontist: Keep Big Cases in House.”
Dr. Auster will be discussing how AI can assist in elevating the practice of dentistry to the highest levels. He is expected to cover the best retraction pastes, the best pulp-capping agents, the newest lasers and other advances in technological dentistry.
In “Be Your Own Prosthodontist,” Dr. Auster will review difficult cases presenting in everyone’s offices. He will offer guidance on deciding where you want to go and how to reach those goals, tips and pathways to becoming a better dentist, and a systematic approach to simplifying and successfully treating any case. This promises to be an excellent opportunity for learning. Those in attendance will receive 7 hours of MCE.
Holiday Spirit
The Eighth District will hold its annual Children’s Holiday Party at Transit Valley Country Club in East Amherst on Saturday, Dec. 6. This is always a popular event for members and their offspring. There will be a magician, and it is expected that Santa Claus will make an appearance with toys for all the children present.
Mark your calendars so you don’t miss the festivities. They begin at 10 a.m. and will continue until noon.
SECOND DISTRICT Leadership Transition in the Works
As noted in a previous report from the Second District, SDDS Executive Director Bernard Hackett will be retiring at the end of this year. Bernie has been ED since September 1991. He came to our association after having served in administrative positions in Brooklyn
SECOND DISTRICT
and Staten Island hospitals. His experience with health insurance clearly positioned him to guide SDDS through a most difficult time, with the termination and unwinding of the society’s sponsored Blue Cross medical health insurance plan. The demise of Blue Cross plans in New York and subsequent legislation effectively put an end to the business in the state.
Nonetheless, SDDS thrived under his leadership as chief staff person. “I’ve had the opportunity to work with the finest professionals dentistry has to offer over the past four decades locally, statewide and nationally,” Bernie said. “My thanks go to the many elected leaders and members of Second District Dental Society and its branch, Richmond County Dental Society, for the years of support and lasting friendships that will stay with me forever.”
As Bernie rides off into retirement, our membership should be assured that we have been placed in good hands. The SDDS Board didn’t have far to look when it promoted Associate Executive Director Christine Terrio to take over as the new Executive Director in January. Christine, a graduate of RIT in Rochester, brings over four years of staff experience with Second District, preceded by nearly 10 years of management experience with the Hilton Corp. She has been a familiar presence at membership meetings, as coordinator of new dentist activities, the Loan Forgiveness program and interfacing
SECOND DISTRICT
with our many standing committees and component leadership. Christine has also established connections with NYSDA staff and executive directors throughout the state. The society will not skip a beat going forward.
Familiar Occasions
It’s that time of year when the volunteers of SDDS join forces with their counterparts from the New York County Dental Society to preside, direct and otherwise serve as goodwill ambassadors during our co-sponsored Greater New York Dental Meeting. We’ll begin GNYDM activities with the annual volunteer appreciation dinner on Monday evening, Nov. 24, prior to Thanksgiv-
ing, at the Marriott Marquis hotel in Times Square. Assignments in hand, scores of volunteers will descend upon the Jacob Javits Convention Center in Manhattan beginning Friday, Nov. 28, and remain there through Wednesday, Dec. 3, to help conduct the largest dental education and trade exposition in the country.
The meeting is overseen by General Chairman Dr. John Young Jr. from New York County Dental Society, Chairelect Dr. Lorna Flamer-Caldera from Second District, General Manager Tom Loughran and the core group of eight volunteers from the Organization Committee: Drs. Butt, Mistretta, Gounardes and Flaum from Second District; and Mentzelopoulou, Jackson, Minoli and Lee from New York County.
Over 35,000 registrants are expected to visit the exhibit floor, where close to 600 companies will have their products available for inspection, and over 200 continuing dental education seminars will be available to visiting dental professionals looking to expand their knowledge. This is the 101st presentation of the GNYDM. All are invited to attend free of charge if they pre-register. Examine the courses offered and list of exhibiting com-
SECOND DISTRICT
Bernard Hackett
Christine Terrio
Greater New York Dental Meeting embarks on its second century Nov. 28.
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Second District cont.
panies by visiting the meeting website at www.GNYDM.com.
Changing of the Guard
The annual SDDS Installation of Officers and Awards Luncheon is scheduled for Sunday afternoon, Jan. 11, at Giando on the Water in Williamsburg, Brooklyn. Dr. Valerie Venterina will succeed Dr. Paul Teplitsky as president of the society. Fifteen newly minted life members will be honored, along with a small group of volunteers, who will be concluding terms of service in elected positions.
Spectacular views of the city skyline will be featured at this, the component’s premier social event of the year.
The Richmond County Dental Society will conduct its annual Installation of Officers and Dinner Dance on Saturday evening, Jan. 31, at the Richmond County Country Club. Dr. Brian Perrone takes over the reigns as RCDS President and will be sworn in, along with the other new officers.
On the Calendar for 2026
SDDS’s three education chairs, Drs. DeSantis, Merlino and Shekib, have put together a great series of continuing education offerings for 2026. Included among featured clinicians are Dr. Julianna Bair, Dr. Luke Shapiro, Dr. Fred Puccio and Dr. Bernadette Sawa. There will be special sessions on fiscal management, practice management, and a few hands-on demonstration courses.
More of these presentations will be held at society headquarters to utilize the upgraded facilities at Fort Greene Place as opposed to relying on costly space at Dyker Golf Course. The Hilton Garden Inn on Staten Island will continue to be used for presentations in Richmond County.
SECOND DISTRICT
Online registration for all 2026 presentations will open in late December.
Congratulations
Congratulations to Dr. Louis DeSantis, a SDDS Life Member and a past president of the Richmond County Dental Society. Dr. DeSantis has been elected vice president of the American College of Prosthodontists Board of Directors. He was installed at the ACP Annual Awards and Presidents Dinner on Oct. 24 in New Orleans.
SUFFOLK COUNTY Seminar Series
Devin J. Klein, D.D.S., M.S.
The Sept. 10th entry in our Seminar Series featured a presentation by Dr.
Nathalia Andrade on “Artificial Intelligence in Dentistry.” SCDS thanks Henry Schein, Mid-Cape Dental Labs and Straumann for their support and the 50 dentists who joined us that day.
New Dentist Outing
New dentist members got together on Sept. 14 at Riverhead Ciderhouse for fun and learning. Eric Mastanduono, D.D.S., presented the lecture, “Imaging Advancements, Artifacts and Clinical Applications.” And the Ciderhouse provided a perfect destination for a fall outing. Many thanks to MLMIC, TargetRock Wealth Management, Bank of America Practice Solutions and Straumann for sponsoring this and all our new dentist events.
St. Charles Dental Clinic Visit
On September 30, Dr. Keri Logan led us on a tour of the beautifully renovated and expanded Stephen B. Gold Dental Clinic at St. Charles Hospital. We had lunch with the residents and discussed the benefits of ADA membership. We are very proud of the care the residents provide and pleased that they are all ADA members.
A Fitting Finale
The final installment in our 2025 Seminar Series took place Oct. 8. Dr. Robert
SUFFOLK COUNTY
Dentists who turned out for September seminar offering presentation on AI and dentistry.
Louis DeSantis
SUFFOLK COUNTY
Vogel presented a lecture on implant dentistry to an audience of more than 50 professionals in our Media Center in Hauppauge. Many thanks to our sponsors Straumann, Henry Schein Dental, M&T Bank, Precision Dental Implants and DDSMatch.Com.
Feedback was outstanding for Dr. Vogel and his lecture. It was a fitting close to our 2025 Seminar Series. We’ll be using the same venue for our Compliance Day event on Dec. 3.
Check out all our events on https:// www.suffolkdental.org/calendar.
Don’t Miss a Thing
We continue to make a significant push to better communicate and connect with our members in methods that more easily integrate with their lifestyle. You can find us on Facebook, X, Instagram, LinkedIn and Spotify, in addition to our traditional www.SuffolkDental.Org presence.
Take
through NYSDA Endorsed Services
BANKING
Bank of America
800-932-2775
800-497-6076
US Bank
888-327-2265
FINANCIAL SERVICES
CareCredit
800-300-3046 (#5)
Altfest Personal Wealth Management
888-525-8337
Best Card
877-739-3952
Laurel Road
855-245-0989
INSURANCE SERVICES
MLMIC
800-683-7769
888-263-2729
888-744-6729
Arthur Gallagher
888-869-3535
Long-term Care
844-355-2596
OTHER
Henry Schein
800-734-5561
ProSites
888-932-3644
www.prosites.com/nysda
Mercedes
866-628-7232
Lands’ End
800-490-6402
UPS
800-636-2377
The Dentists Supply Company
888-253-1223
Volvo
800-550-5658 ada.org/volvo
OnDiem
hub.ondiem.com
Practice Mojo
888-932-3644 practicemojo.com
For further information about NYSDA Endorsed Programs, call Jeanne DeGuire at 800.255.2100
Lunching following tour of renovated Gold Dental Clinic at St. Charles Hospital.
Cider and a lecture were order of day at new dentist event in September.
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NEW YORK COUNTY Lecture Offers Second Look at Cemental Tears
Egidio Farone, D.M.D.
Members gathered Sept. 8 for the September General Membership Meeting. The atmosphere was energetic and welcoming as familiar members reconnected after summer, new attendees joined the group for the first time, and everyone enjoyed exchanging stories and updates from the past few months.
NEW YORK COUNTY
The featured speaker was Dr. Pierre Wohlgemuth, clinical assistant professor in the Department of Endodontics and assistant director of the Advanced Education Program in Endodontics at New York University College of Dentistry. Members were especially interested in his presentation, “Cracking the Code of Cemental Tear: When and How to Treat?” which continued the discussion from the April General Membership Meeting. That earlier lecture, “Cracking the Code of Cemental Tear: A Guide to Detection and Diagnosis,” was presented by his wife, Dr. Ye Shi, D.D.S., who approached the topic from a periodontics perspective. Dr. Wohlgemuth provided the endodontics approach, giving attendees the opportunity to see how two specialties, and even a husband-andwife team, examine the same condition from different clinical viewpoints.
NEW YORK COUNTY
New dentists gather with their older colleagues before beginning immersive chocolate tasting.
Catching up at September General Membership Meeting are, from left: NYCDS Past President and NYSDA Trustee James Jacobs; members Stacy Spizuoco and Robert Sadowsky; NYCDS President Vera Tang; NYSDA President Maurice Edwards.
Celebrating Hispanic Heritage Month at NYCDS are from left: Past President and chair of NYSDA Diversity and Inclusion Committee Ioanna Mentzelopoulou; Luz Meja from Ninth District Dental Association; presenter Stephanie Navarro Silvera; member Rita Taliwal; NYSDA President Maurice Edwards.
NYCDS President Vera Tang with General Membership Meeting presenter Pierre Wohlgemuth
New Dentists Enjoy Evening of Chocolate Indulgence
The New Dentist Committee hosted a delightful offsite chocolate tasting on Sept. 15 that turned out to be a sweet success. The evening brought together new dentists and seasoned members who share a love for chocolate. It started with casual conversation and time to browse around the chocolate shop, which featured an incredible variety of flavors sourced from around the world.
All the attendees then moved into a tasting room, where a chocolate sommelier shared insights into the origins of chocolate, how it is fermented and what makes fine chocolate stand out in terms of flavor, aroma and texture. Each attendee sampled four varieties, ranging from dark chocolate to white. The night gave everyone a chance to learn something new and appreciate the craftsmanship behind every bite.
Career Guidance for New Dentists
Mandelbaum Barrett PC and Bank of America Solutions hosted a free program for new dentists and residents on Nov. 5 designed to instill confidence as the new practitioners take the next steps in their careers. Attendees were provided with real-world advice on contracts, financing and other key parts of starting out, all while networking with fellow young professionals in a supportive setting.
Hispanic Heritage Month Celebration
On Oct. 8, NYSDA and NYCDS invited members to come together and celebrate Hispanic Heritage Month at NYCDS headquarters. This was a meaningful evening, all about recognizing the diversity and strength within our dental community. Attendees honored the outstanding contributions of Hispanic dental professionals and the broader
Hispanic community, sharing great conversations over flavorful Cuban cuisine. The highlight of the evening was a presentation by Dr. Stephanie A. Navarro, professor of public health at Montclair State University. Her lecture, “Bias, Privilege, Intersectionality and Health,” opened an important discussion about how our backgrounds, experiences and assumptions can shape health outcomes. Her presentation left a lasting impression and reminded all attendees that awareness and inclusion make both our profession and our communities stronger.
NYU Fall Networking Night
The NYU Dentistry Alumni Association and the New York County Dental Society hosted members at Fall Networking Night. This event brings together NYU dentistry students, alumni and practicing dentists from across Manhattan, encouraging them to share experiences, build connections and give back to the profession.
Don’t Forget to Register for GNYDM
The Greater New York Dental Meeting is just around the corner. Have you registered for your classes yet? Experience the largest continuing education program in the U.S., featuring cutting-edge courses, hands-on workshops and expert-led seminars. There is something for everyone. Don’t miss out. Register today!
Meeting Dates:
November 28th – December 3rd
Exhibit Dates:
November 30th – December 3rd
JACOB K. JAVITS CONVENTION CENTER 11th AVE BETWEEN 34th & 39th STREET
Component
New York County cont.
Volunteer at Special Olympics
Join us at the Jacob Javits Center on Dec. 6 to screen, provide fluoride varnish and promote good oral hygiene habits to the amazing Special Olympics athletes. Get ready for a day filled with energy, passion and determination as athletes compete in this year’s Special Olympics 2025: Peter Aquilone Winter Classic.
Give Kids A Smile 2026
Our biggest event of the year returns Feb. 6. Our goal is to bring smiles to more than 1,400 underserved elementary school children from 12 East Harlem schools. Each child will receive an essential dental screening, preventative fluoride treatment and oral hygiene education in a fun-filled atmosphere. This event wouldn’t be possible without our incredible volunteers. If you’re a licensed dentist with a team, we invite you to join us for a meaningful day that goes far beyond teeth—it’s about creating a lasting impact in the community.
Winter Continuing Education Schedule & Special Events
• 1/13 7–9 pm: OSHA-mandated update for dentists and staff—“What You Need to Know to Comply with the Law,” with Dr. Peter Mychajliw (ZOOM).
• 1/28 9:30 am-4:30 pm: “Innovations in Aesthetic Dentistry: Everything You Need to Know About Veneers,” with Dr. Ghalili (In-Person).
• 2/05 6–8 pm: “How to Build a 5-Star Team,” with Denise William-Jones (ZOOM).
• 2/06 7:45 am-12:30 pm: Give Kids A Smile 2026.
• 2/06 9:30 am-12:30 pm: Mandated Infection Control, with Dr. Gwen Cohen Brown (In-Person).
• 2/27 9:30 am-3:30 pm: Hands-On Workshop in Composite Injection Moulding Utilizing Digital Workflows, with Dr. Rahul Kallianpur (In-Person).
• 3/27 9:30 am-4 pm: Easy Pedo for the GP Workshop, with Dr. Carla Cohn (In-Person).
New courses are added regularly, so be sure to visit https://www.nycdentalsociety.org/ for the latest schedule.
FOURTH DISTRICT Out for Golf and Learning
The Fourth District Dental Society annual CE & Golf event took place on a beautiful September day and attracted a full house of members for both courses. Co-chairs Drs. Jim Galati and Mark Roschinsky thank MLMIC for sponsoring the morning risk management course. The society is grateful also for the support provided to the district by
FOURTH DISTRICT
New dentists, friends and family gather around Emack & Bolio ice cream truck.
On hand for CE & Golf event are, from left, Drs. Taylor, Arpei-McHugh, Hargraves, Cochair James Galati, Cocozzo
New Dentist Chair Tahina Mukit welcomes members to October social.
the following: Adirondack Oral & Maxillofacial, Adirondack Orthodontics, Adirondack Staffing, Alexander Orthodontics, Ameriprise Private Wealth Advisory, Crane Dental Labs, Cooney & Tyner Orthodontics, DDSmatch, Dunning Family Dental, Empire Oral Surgery, Henry Schein, Jim Kasper, O’Connell & Aronowitz, SCOMSA, Straumann Group, TD Bank and V O C O.
Ice Cream, Too
Our newly appointed new dentist chair, Dr. Tahina Mukit, jumped in with both feet and organized a terrific event in October for our younger members, their friends and families. It included a visit from Emack & Bolio, who pulled up with their ice cream truck and dished out a generous serving of their delicious ice cream.
November Women’s Program
Coming in November is our annual Women Dentists Meeting. Chair Dr. May Hwang has organized a dinner lecture with guest Dr. Amrita Patel presenting on “Effective Patient Communication.”
SEVENTH DISTRICT
Implant Complications
Becky Herman, Executive Director
Dr. Bart Silverman presented on “Prevention and Management of Dental Implant Complications” at the Seventh District’s Annual Meeting on Oct. 17.
During the meeting, Business Chair Dr. Jordan Antetomaso recognized Seventh District Board President Dr. Matthew Valerio for his hard work and dedicated service as president this year.
Thank you to our event sponsors: BioHorizons, DDSmatch, Empire Dental Administrators, Kuraray, RTG, Urgent Dental, Vision Financial Group and Walsh Insurance.
Cayuga County Dental Society Reconvenes
Members from Cayuga and Steuben counties, along with colleagues from
SEVENTH DISTRICT
Dental implant complications were dissected at Annual Meeting in October by presenter Bart Silverman, seen here with Seventh District President Matthew Valerio, left, and Business Chair Jordan Antetomaso, right.
Members from Cayuga and Steuben counties reconvene after extended hiatus for meeting of Cayuga County Dental Society.
Seen at CE program sponsored by Steuben County Dental Society are from left: President Melissa Brown; attorney presenters Matthew Feldman and Al Anthony Mercado; Seventh District Executive Director Becky Herman.
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Seventh District cont.
the Fifth District, came together at the Plaza of the Arts in Auburn for the Cayuga County Dental Society meeting. The dental society reconvened after an extended hiatus, bringing members together to share updates, exchange ideas and renew connections. Seventh District Board President Dr. Matthew Valerio, NYSDA Trustee Dr. David Ramjattansingh and Executive Director Ms. Becky Herman were also in attendance.
A special thank you to Dr. Theresa Casper-Klock, who led a thoughtful and dynamic discussion on the state of or-
ganized dentistry, as well as advocacy initiatives at the state and local levels.
Steuben County Gathers in Corning Members of the Steuben County Dental Society and colleagues in the Sixth District gathered at the beautiful Corning Country Club for an engaging CE program, “Survival Guide for Dentists: Avoiding Malpractice and Administrative Pitfalls,” presented by attorneys Al Anthony Mercado and Matthew Feldman of Feldman Kieffer.
Hitting the Road!
Seventh District staff have been on the road, reconnecting with members in their offices across all eight counties. We’re “Carving Out the Future Together,” asking members for their feedback, discussing ways the society can better serve members, and saying thank you for being a part of the society with a little gift for the office.
The team has also reached out to nonmembers to highlight the advantages of joining the tripartite.
Community Outreach
Monroe County Dental Society members Drs. Lisa DeLucia, Taylor Squires, Katie Strong and Brian Lawson volunteered at the 15th annual Community Health Fair hosted by the Rochester Jamaican Organization.
Seventh District staff and Eastman Institute for Oral Health resident Dr. Sanjana Kumar participated in Sen. Jeremy Cooney’s End of Summer BBQ & Family Fun Day at Mt. Olivet Church to distribute toothbrushes, toothpaste and various wellness items while sharing information about how the dental society supports its community members.
Staff on listening tour, connecting with members and “carving out the future together.”
Residents Learn Benefits of Membership
Dr. Christopher Calnon, NYSDA Membership & Communications Chair, and Becky Herman, Seventh District Executive Director, have educated residents this past month at the Eastman Institute for Oral Health and Rochester Regional Health on the value of organized dentistry and the benefits of membership in the tripartite. We are proud to partner with our local residency programs to encourage the next generation of dentists to become involved in organized dentistry.
FIFTH DISTRICT
Meeting in Central New York
Janice Pliszczak, D.D.S., M.S., M.B.A.
Summer came to an impressive finish in Central New York with staging of the Central New York Dental Conference Sept. 12 at the OnCenter in Syracuse. The event drew more than 200 dentists, hygienists and assistants, eager to take advantage of the all-day seminars. An added bonus were the 35 exhibitors on hand to show off the latest dental-related products and services.
Speed Dating
The annual Fifth District Speed Dating event held at the Brae Loch in Cazenovia on Sept. 16 brought together 13 residents exploring career opportunities and nine dentists hoping to fill associate positions. Five vendors of dental-related products and services attended as well. All residents were encouraged to join the ADA or update their membership information.
Hygiene School Update
The dental hygiene program at Mohawk Valley Community College in Utica remains on track to open in the fall of 2026. The school has received the necessary permit to begin construction. Despite the late beginning, officials are hopeful they will be able to make the mid-March deadline for inspection by the Commission on Dental Accreditation (CODA).
Future Courses
The district is finalizing the schedule for its 2026 CE program. The following dates and locations have been confirmed: Feb. 2, Syracuse; May 1, Cazenovia; Sept. 11 CNYDC, Syracuse; and Nov. 13 Cazenovia.
The directory will be going to press soon. If you need to update your contact information, please get in touch with the 5th District office as soon as possible.
NINTH DISTRICT
Still Working out the Bugs
Monica Barrera, D.D.S.
It has now been just over a year since we began operating with the new Fonteva system, and we continue to address various technical issues and functionality challenges. The Ninth District has compiled a comprehensive list of outstanding concerns, which we are currently managing through manual workarounds, with the expectation that these items will be incorporated into future system updates.
For example, enhancements like the ability to generate patient and doctor referrals for specific needs—such as locating an oral surgeon in Tarrytown with handicap-accessible facilities who
accepts Medicaid—remain high priorities. Similarly, the ability to produce complete event attendance sheets in a single report, rather than merging multiple reports manually, continues to be a significant need.
Still Shredding
This summer, the Ninth District again offered members the benefit of HIPAAcompliant file shredding services at association headquarters. This program has been extremely well-received, and we intend to continue providing it annually. Members are encouraged to monitor their email for details regarding upcoming events and to reserve their time slot early, as appointments fill quickly.
Still Learning
Our fall continuing education program is underway. This year, we were pleased to offer three mandated courses through live webinars, enabling members to fulfill these requirements without affecting the 18-credit maximum for self-study courses. This approach provides members with greater flexibility to pursue additional online learning opportunities for personal enrichment and to satisfy relicensure requirements. We will also be offering two Addendum courses, presenting the most
NINTH DISTRICT
Volunteers prepare to welcome youngsters to Give Kids A Smile event in Peekskill.
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Ninth District cont.
recent updates to the Child Neglect and Abuse Reporting Mandate, followed by the full two-hour course this coming spring to ensure that all members have access to this essential training.
We extend our sincere appreciation to the speakers who generously contribute their time and expertise. Their willingness to present without compensation has allowed us to reduce fees for our continuing education offer-
NINTH DISTRICT
ings, thereby increasing accessibility for members and their staff.
Still Putting Smiles on Kids
The Ninth District again hosted a highly successful Give Kids A Smile (GKAS) event at B’Above in Peekskill. This venue has welcomed our program since its inception a few years ago and has continued to invite us back each year. The staff’s hospitality and the number of children in need make the event especially meaningful and impactful.
Still Getting Together
We look forward to our upcoming Annual Meeting at the Westchester Country Club in Rye on Nov. 12, when the 2026 Ninth District officers will be installed. Dr. Bharat Joshi will lead the Ninth into a new year of service to our members and their patients, continuing our mission: to serve and support our members and the public by improving the oral health of our community through advocacy, continuing education and camaraderie.
Our New Dentist Annual Reception is slated for Thursday, Nov. 20, at Vida restaurant in Thornwood. All new dentists regardless of residence are invited to attend.
BRONX COUNTY Coming this Year and Next
Don Safferstein, D.D.S.
All BCDS members are invited to attend the free meeting and lecture set for Tuesday, Nov. 18, at Maestro’s Caterers in the Bronx. The presentation by Dandy-The Digital Denture Lab, will provide insight into launching your practice into the future of denture treatment.
BCDS will host its annual Job Fair from 6:30 to 9 p.m., Thursday, March 19, at Maestro’s Caterers. The fair is open to all dental residents and young dentists looking for career opportunities. It is also a great event for older dentists looking to expand their practices or thinking about career transitions. Booths are available for the evening. Contact Joy at bronxdental@ optonline.net
BRONX COUNTY
Ninth District provided volunteers for New York State Dental Foundation oral cancer screening in September at Hudson Valley Renegades baseball game. They included (top photo), left to right, Drs. Helen Chiao, William Maloney, Rosa Martinez, Alex Pilavsky; Executive Director Stephan Cancian. NYSDF Executive Director is at right.
BCDS members learn while dining at recent society-sponsored dinner lecture.
FOR SALE
WESTCHESTER: Larchmont. Dental co-op for sale. 800 square feet with 2 ops and room for third. Ideal location; corner unit with separate entrance. Monthly maintenance under $1,000, including electricity. Priced to sell. Practice optional. For more information, email: esr77@optonline.net.
ALBANY: Thriving, well-established practice in Capital Region of New York State. Located in Albany, practice boasts 1,560 active patients and six fully equipped operatories, supporting both owner doctor and associate. With $1.9M in collections and $530K in EBITDA, practice offers strong profitability and growth potential. Currently open only four days per week; significant opportunity to increase revenue by extending hours. Freestanding building available for purchase, making compelling investment opportunity. Contact for more information. Reference #NY83023. Contact: Bailey Jones, Professional Transition Strategies, by phone: (719) 694-8320; or email: bailey@professionaltransition.com.
LONG ISLAND: Established, multi-generational practice in Greater Long Island, with strong community ties. With almost no advertising, practice attracts 15-20 new patients per month and maintains 1,120 active patients, creating solid foundation for growth through marketing or expanded services. Freestanding building includes three operatories and consult room. Real estate available. Owner doctor open to staying for up to three years to mentor incoming dentist, ensuring smooth transition. With collections of $600K and true take-home of $145K, rare opportunity for buyer or group seeking established presence in Long Island market. Reference #NY91025. Contact: Bailey Jones, Professional Transition Strategies, by phone: (719) 694-8320; or email: bailey@professionaltransition.com.
BRONXVILLE: Dental/professional office for sale at 915 Palmer Road. Located 3 blocks from New York PresbyterianWestchester Hospital. Great space for dental practice. Near train station and bus stop in front of building. 3,500 square feet includes 3-5 exam rooms, office, 2 storage rooms, 3-5 bedrooms, 3.5 bathrooms, kitchen/dining room/conference room. Parking lot in back holds 6 cars; ample on-street parking. Asking: $1.3M. Contact: Realtor Amanda Samuel, RE/MAX Distinguished Homes & Properties, by phone: (914) 589-8133; or email: AmandaSamuelRealEstate@ gmail.com.
WATERTOWN/THOUSAND ISLANDS: Dental practice for sale in beautiful northern NY. Desirable location approximately 1 hour north of Syracuse in close proximity to Thousand Islands and Canadian border. Modern, well-designed, attractive, standalone building with ample parking. 3,395 square feet. Main floor offers 9 ops with digital X-ray, CBCT, Eaglesoft, Schick Sensors, 3D printing and CEREC. Finished 1,500-square-foot basement includes conference room, laundry/locker room, kitchen and 2 additional offices. Building available for sale or lease. Reputable practice can run 1-2 dentists with gross revenue in excess of $1M annually on 4-day week. Experienced, highly motivated team of 8 willing to remain after sale. Owner retiring and willing to help with transition. Contact Robert Schonfield, DDS, by phone: (315) 771-4012; or email: rob@docschonfield.com.
CLASSIFIED
Online Rates for 60-day posting of 150 words or less — can include photos/images online: Members: $200. Nonmembers: $300. Corporate/Business Ads: $400. Classifieds will also appear in print during months when Journal is mailed: Jan and July.
JEFFERSON COUNTY: Long-established, profitable practice is must-see. Located minutes from downtown Watertown. Well-equipped 4-operatory practice sits on busy road, with great curbside appeal. Large private parking lot. Practice fully digital with pano X-ray and utilizes Eaglesoft. Revenue $730K with one FT Hygienist. Doctor only works 3 days/week (20 hours max). Seller refers out all endo, ortho and oral surgery. Practice positioned for growth. Primarily FFS, with 2,000 active patients. 2-story building also for sale with vacant apartments upstairs. Contact Dental Practice Transitions Consultant Michael Damon at (315) 430-9224; or email: mike.damon@henryschein. com. #NY3385.
ONTARIO COUNTY: Long-established, highly productive practice with 2022 revenue of $1.4M. Nestled in backdrop of beautiful Finger Lakes wine-making country. Fully computerized, fully digital office with 7 well-equipped treatment rooms. Utilizes Dentrix Ascend PMS; Planmeca CBCT and digital impression systems added in recent years. 3,500 active patients and combination of insurance and FFS. Strong hygiene program. Well-trained team available for transition. Contact Dental Practice Transitions Consultant Michael Damon at (315) 430-9224; or email: mike.damon@henryschein.com. #NY3395.
ONEIDA COUNTY: Bright, immaculate, all-digital, 100% FFS practice with great curb appeal. Highly desirable location and convenient access to highways. $900K+ revenue on 4-day workweek. Seller in practice for 30 years and committed to aiding in very successful transition. Four wellequipped operatories and Dentrix all in efficiently designed 1,100-square-foot space. Thriving general practice averages 30+ new patients per month. Contact Transitions Sale Consultant Mike Damon at (315) 430-9224; or email: mike.damon@henryschein.com. #NY3513.
SENECA COUNTY: Charming practice in heart of Finger Lakes region. 45-minute drive to both Rochester and Syracuse city centers. Digital practice offering 3 equipped ops with 2022 revenue $653K on 3 clinical days/week. Softdent, 2D pano and diode laser. 1,700-square-foot practice offers comprehensive dental care in welcoming environment. Full-time Hygienist and full administrative staff, all with excellent systems and training in place. 50% FFS. Specialties referred out. Real estate also available. Contact Transition Sales Consultant Michael Damon at (315) 430-9224; or email: mike.damon@henryschein.com. #NY3572.
WESTERN NEW YORK: Fantastic opportunity to own well-established, thriving practice in beautiful area. Growing practice has loyal patient base made up of 86% insurance and 14% FFS. Fully digital Pan, sensors, intraoral cameras and paperless charting, all integrated with Eaglesoft. Building with off-street parking and additional rental units
also for sale or lease. Contact Practice Transition Consultant Brian Whalen at (716) 913-2632; or email: brian.whalen@ henryschein.com. #NY3665
CAPITAL REGION: Turnkey opportunity for wellestablished dental practice located in growing and desirable area convenient to downtown Albany, Saratoga and Schenectady with revenue of $800K. Attractive, efficient 2,505-square-foot space with 5 fully equipped treatment rooms. Standalone building offers excellent visibility on busy two-lane main road and also available for purchase. Digital office using Dentrix with pano X-ray, upgradable to 3D. Four dedicated full-time employees and three parttime willing to stay after transition. Doctor refers out most specialties on 39-hour week. Must-see opportunity for any interested buyer looking to acquire successful primarily FFS practice. Contact Transition Sales Consultant Michael Damon: (315) 430-9224; or email: mike.damon@henryschein.com. #NY3942
NORTHERN NEW YORK: High-grossing, high-tech 7-op operatory general practice in standalone building. Located near Canadian border. Beautiful practice offers great visibility and curb appeal. 3,000 square feet. 100% digital practice utilizes Eaglesoft with CBCT and CEREC. Highly trained, experienced team of professionals awaits, including 3 full-time Hygienists expected to transition with practice. Open 4 days/week with 3,300 active patients and healthy new patient flow. Doctor willing to stay to assist with transition. Great turnkey opportunity. Contact Transition Sales Consultant Michael Damon at (315) 430-9224; or email: mike.damon@henryschein.com. #NY3673
OSWEGO: High-visibility, established general practice with convenient access to I-81. Growing community located less than 10 miles from future Micron SemiConductor plant, which will be one of country’s largest. $1.1M revenue on just 28-hour week. 5 well-equipped operatories with recent addition of new hygiene room. 100% digital practice with newly added pano X-ray and iTero scanner. Refers out all specialties. Mix of FFS/PPO. Don’t miss out. Contact Transition Sales Consultant Michael Damon at (315) 430-9224; or email: mike.damon@henryschein. com. #NY4023.
ST. LAWRENCE COUNTY: Well-established, highly profitable, 100% FFS general practice with just 52% overhead. Turnkey. Annual revenue $750K+ on 4-day week. Standalone building with large parking lot located right on main road. Building also available for sale with approximately 3,000 square feet of dedicated dental space. Room to double practice size based on recent clinic vacancy on other half of building. 4 fully equipped treatment rooms in 100% digital practice with Sirona Pan/Ceph imaging. Refers out some endo and oral surgery. Doctor willing to stay for extended period of time. Contact Transition Sales Consultant Michael Damon at (315) 430-9224; or email: mike.damon@henryschein.com. #NY4019.
MONROE COUNTY: Well-established, standalone general practice with wonderful curb appeal. Conveniently located in front of Wegmans Plaza. 1,400-square-foot dental space with commercial renters downstairs available for sale or lease. Located in one of Rochester’s fastest growing suburbs. Digital practice offers four fully equipped treatment rooms and 4-day week with 6 days of hygiene.
Primarily PPO with FFS. Motivated seller refers out all specialties. Contact Transition Sales Consultant Michael Damon at (315) 430-9224; or email: mike.damon@henryschein.com. #NY4035
SYRACUSE: Long-established, highly visible general practice in desirable neighborhood. $725K+ revenue practice with great curb appeal and ample parking. 2,100-squarefoot leased space just 10 minutes from downtown. Offers 4 well-equipped treatment rooms, with ability to add 5th. 100% digital practice and CAD/CAM. Well-trained, experienced team awaits with strong full-time hygiene program. Mix of FFS/PPO. Refers out most specialties. Very motivated seller seeking retirement. Contact Mike Damon at (315) 430-9224; or email: mike.damon@henryschein. com. #NY4142
SYRACUSE AREA: Attractive general practice in desirable, vibrant suburb of Syracuse primed for growth. Situated on busy main road with ample parking. 15 minutes to downtown Syracuse and one mile to Township 5, where shopping, dining and entertainment options abound. Toprated school district. 4-op digital practice is a must-see with affordable, 2,300-square-foot leased space. Room to expand to 2 more ops. Utilizes Eaglesoft PM with Schick sensors and 100% paperless. Refers out most endo, implants, perio and some extractions. Experienced team of professionals await post-transition. PPO-based practice open just 3.5 days per week. Very motivated seller. For more information contact Mike Damon at (315) 430-9224; or email: Mike.damon@henryschein.com. #NY4235
ONTARIO COUNTY: Long-established, efficiently designed 1,800-square-foot leased space with 4 fully equipped treatment rooms and plumbed room for additional 5th room. Located in scenic community described as Gateway to beautiful Finger Lakes Region and just 25 minutes from downtown Rochester. Insurance-based practice. Utilizes Eaglesoft PM software. Refers out all specialties. Averages 15-20 new patients per month with zero marketing. Strong hygiene program with practice positioned for growth. Contact Practice Transition Consultant Mike Damon at (315) 430-9224; or email: mike.damon@henryschein.com. #NY4198
NASSAU COUNTY: Modern general practice built out less than five years ago in a standalone building. 5 operatories with plumbing in place for 6th, and equipped with state-of-the-art technology, including an iTero scanner, CBCT imaging, and digital X-rays. Located on high-visibility main road. Practice experiencing rapid growth making it excellent opportunity for doctor just starting out or seasoned practitioner looking to expand portfolio. For more information, please contact Practice Transition Consultant Jim Higgins at (914) 496-4856; or email: jim.higgins@ henryschein.com. #NY4134
JEFFERSON COUNTY: Well-established, spacious, 3,500-square-foot general practice in beautiful, historic building. 7 equipped treatment rooms with 8th op plumbed. Utilizes Dentrix PM software. FFS/PPO and only in-network with 2 insurances. Strong hygiene program with dedicated team ready to stay after transition. All specialties referred out. $837K revenue and positioned for continued growth. Stunning property also for sale includes 4 fully occupied residential apartment units. Doctor looking to stay for extended period. For more information, contact Practice
Transition Consultant Mike Damon at (315) 430-9224; or email: Mike.damon@henryschein.com. #NY3719
LIVINGSTON COUNTY: Wonderful opportunity to own well-established, thriving GP practice residing in beautiful, historic building with great curb appeal. $1.8M practice located in heart of town center in Western NY. Located less than 1 hour from downtown Rochester. 3,0000-square-foot clinical space offers 5 updated treatment rooms. Additional 1,500-square-foot space upstairs for apartment rental. Building for sale. 100% digital practice utilizing Dentrix software and other technologies. 60% FFS/40% PPO mix. Must see. Schedule visit today. For more information contact Mike Damon by email: Mike.damon@henryschein.com; or call (315) 430-9224. #NY4251
ONEIDA COUNTY: Excellent opportunity to purchase bustling $1.2M general practice. Located in high-traffic shopping plaza in attractive Utica suburb. Great visibility on main boulevard with ample free parking. 4,500-square-foot space houses 9 fully equipped operatories. Utilizes Dentrix and 100% digital practice with 3D Pan/Ceph. Robust hygiene program and affordable lease. Primarily PPO practice. Contact Practice Transition Consultant Mike Damon at (315) 430-9224; or email: mike.damon@henryschein.com. #NY4269
ONEIDA COUNTY: Wonderful opportunity to own profitable, efficiently run practice with beautiful 2-bedroom apartment upstairs. Located on main road with attractive curb appeal. Standalone building and immaculate 3,200-square-foot space offers 5 well-appointed treatment rooms. 100% FFS, digital office utilizes Dentrix. Open 4 days/week. Refers out most specialties. Building for sale. Contact Practice Transition Consultant Mike Damon by phone: (315) 430-9224; or email: Mike.damon@henryschein.com. #NY4277
CHEMUNG COUNTY: Wonderful opportunity to own 100% FFS general practice housed in attractive standalone building. Great visibility on busy main road with ample parking and less than one mile from major interstate. Just 10-minute drive to nearby regional airport. Well-designed 2,500-square-foot space offers 6 fully equipped operatories with modern A-dec equipment in relaxing atmosphere. Digital practice utilizes Eaglesoft PM and CBCT. Welltrained, experienced team of professionals, including 2 full-time hygienists, expected to transition with practice. Building available for purchase. Contact Practice Transition Consultant Mike Damon by phone: (315) 430-9224; or email: mike.damon@henryschein.com. #NY4297
CAPITAL DISTRICT AREA: Wonderful opportunity to own thriving $1.7M general practice. Residing in remodeled brick building with main street visibility and off-street parking, practice located in vibrant college town within 1 hour of Albany. Well-designed 2,800-square-foot space has much to offer. 6 treatment rooms equipped with updated A-dec equipment. 100% digital, 100% paperless practice utilizes latest technologies. 60% FFS/ 40% PPO mix. No Medicaid. Experienced team of professionals expected to stay on after transition. Building for sale. Contact: Mike Damon, Practice Transition Consultant, (315) 430-9224 Mike.damon@henryschein.com. #NY4414.
LIVERPOOL SUBURB: Well-established, highly profitable general practice in desirable suburb of Liverpool. 4-op, 1,800-square-foot office located on highly trafficked road with spacious parking lot. 100% digital. Utilizes Dentrix PM software and operates primarily PPO. Approximately $800K revenue generated on 3.5-day week with most specialty procedures referred, including endo, extractions, implants and ortho. Attractive location less than 7 miles from Micron Technologies, future site of what will be NY’s largest semiconductor plant, bringing thousands of new jobs. Wonderful opportunity to own your own practice. Motivated seller. Contact Mike Damon, Practice Transition Consultant, (315) 430-9224; Mike.damon@henryschein.com. #NY4394
FOR RENT
DOWNTOWN BROOKLYN: Dental space available to rent in downtown Brooklyn office building. Landlord will build out basic construction with tenant responsible for plumbing, dental equipment, etc. Long-term leases available. Please contact to discuss options. Call Joe Schachter at (646) 529-3632; or email: joe@courtmgmt.com.
DOWNTOWN BROOKLYN HEIGHTS: Modern, turnkey dental office available for rent. Walk in and start practicing. Downtown Brooklyn Heights with views of lower Manhattan. Available now. Fully furnished with 3 ops, A-dec chairs, Nitrous. New server and computers included. Near all trains. Call or text for more information: (347) 712-0778.
MIDTOWN MANHATTAN: Newly decorated office with windowed operatory for rent FT/PT. Pelton Crane equipment, massage chair, front desk space available; shared private office, concierge; congenial environment. Best location on 46th Street, between Madison Avenue and 5th Avenue. Please call or email: (212) 371-1999; karenjtj@aol.com.
OPPORTUNITIES AVAILABLE
CAPITAL DISTRICT AREA: Sitwell Dental, patient-centered family practice with multiple locations across Upstate New York, seeks Endodontist to join in late Fall 2025. We offer comprehensive care using advanced technology and collaborative, supportive culture led by Drs. O’Brien and Cami. Why join us? Flexible schedule (part time or full time), competitive compensation with base + production bonuses, health/dental/vision benefits, 401(k) match, malpractice coverage, CE support, mentorship and state-of-the-art tools with access to modern endodontic systems. No practice management responsibilities. Responsibilities: Diagnose and treat root canals, retreatments, and pulp therapy; manage emergency cases; collaborate with general dentists and staff; maintain accurate records and stay current with evolving techniques through CE. Requirements: DDS/DMD from accredited dental school, active state license, completion of Endodontic residency and proven experience in advanced root canal and pulp therapy. Strong diagnostic, case planning, and communication skills required; specialty license preferred. For more information, contact Meredith Brown-Parsons by email: Meredith.brown-parsons@saltdentalpartners.com; or call (859) 613-3029.
ALBANY AREA: Sitwell Dental, leading family practice with locations in Albany, Clifton Park, Malta and Saratoga Springs, seeking full-time General Dentist to join our Albany team in Fall 2025. We provide compassionate, patient-first care with services ranging from preventive and restorative dentistry to implants, cosmetic, orthodontics and emergency care—all in modern, supportive environment. What we offer: Competitive base salary, health/ dental/vision benefits, 401(k) match, malpractice coverage, paid CE, mentorship and access to state-of-the-art technology. No practice management responsibilities. Responsibilities: Deliver preventive, restorative, cosmetic, implant, pediatric and emergency dentistry. Lead treatment planning, collaborate with team members and provide Invisalign® and other orthodontic care. Requirements: DDS/DMD from accredited school, active NY license, DEA certification, 2+ years’ experience preferred. Proficiency in restorative, preventive, cosmetic and implant dentistry required. Strong communication skills and commitment to CE; Invisalign®/Six Month Smiles® experience preferred. For more information, contact Meredith Brown-Parsons by email: Meredith.brown-parsons@saltdentalpartners.com; or call (859) 613-3029.
SULLIVAN COUNTY: Part-time dentist needed for children’s dental health program. Provide preventive and restorative care in a fully equipped clinic. Hours: 9 am – 4 pm. Experience treating children required. Rewarding work with competitive pay. Should you be interested in learning more or would like to apply, call (845) 434-0376 ext. 210; or email: prasad@prasad.org.
STATEN ISLAND: Seeking Program Director, General Practice Residency Program. The Department of Dental Medicine at Northwell Health, in conjunction with the Zucker School of Medicine at Hofstra/Northwell, seeks visionary Program Director for the General Practice Residency Program at Staten Island University Hospital in Staten Island, New York. Northwell Health, New York’s largest health care provider and private employer, is dynamic place to practice and maintains true dedication to its academic mission. We value insights and education from thought-leaders to ensure quality, compassionate care while maintaining focus on innovation, research and education. Northwell Health Department of Dental Medicine at Staten Island University Hospital is premier clinical and academic department comprising hospital-based faculty and growing network of community providers and multidisciplinary oral health professionals. The General Practice Resident (GPR) Program is accredited by Commission on Dental Accreditation (CODA). Please send CV to lappelman@northwell.edu.
SOUTHERN TIER: Join the Guthrie Clinic Section of Dental Medicine, providing high-quality patient care to Northern Tier of Pennsylvania and Southern Tier of New York. The Guthrie Clinic seeks GPR-trained dentist for fulltime position with our dental team. Join our group practice, which provides traditional full-scope dental care and hospital-based practice components, such as inpatient and emergency department consultations and operating room privileges. Base salary starts at $190K, commensurate with experience. Practice alongside three general dentists, one orthodontist, two oral surgeons and five dental hygienists. Offer dental services to adults and children, including those with special needs; provide hospital-based consultations
with inpatient and emergency departments; build fulfilling clinical practice within collegial environment with supportive administration. Participates with both commercial and state insurance. CME time and money allowances provided. Relocation expenses paid up to $15K. Contact Troy Gordon, Sr. Physician Recruiter, by email: Troy.Gordon@Guthrie.org.
Peer Review and Quality Assurance
What is It and Why is It an Important Member Benefit?
Lawerence Lehman, D.D.S.
Upholding Excellence: Why NYSDA Members Must Engage in Peer Review
By participating in the New York State Dental Association’s Peer Review and Quality Assurance Program, member dentists affirm their commitment to the highest standards of patient care and professional integrity. This essential program not only protects patients, it also strengthens the dental profession by providing a fair, confidential and effective mechanism for resolving disputes.
Peer Review: A Professional Obligation and Privilege
Participation in peer review is a requirement of NYSDA membership, reflecting the Association’s dedication to quality assurance and public trust. The process is a form of binding arbitration that evaluates the appropriateness and quality of dental care provided by NYSDA members. It is conducted by impartial committees of professional peers who volunteer their time and expertise to uphold the standards of the profession.
A Confidential and Credible Process
One of the most compelling aspects of peer review is its confidentiality. Neither the proceedings nor the outcomes are reported to outside agencies or the public. This ensures that disputes are resolved discreetly and professionally, without reputational harm to the dentist or undue stress for the patient. Moreover, peer review decisions are final and have been upheld in court, offering immunity from subsequent litigation.
Protecting Patients, Supporting Dentists
Peer review offers patients a trusted alternative to legal action, while providing dentists with a structured, impartial forum to address concerns. When treatment is found to be inconsistent with the standard of care, the committee may direct a refund of fees. Conversely, when care is deemed appropriate, the dentist is vindicated, and outstanding fees are remitted. The process also allows for educational interventions, such as continuing education requirements, to support professional growth.
A Model of Professional Self-Regulation
The peer review system exemplifies the dental profession’s ability to self-regulate with fairness, transparency and accountability. It fosters public confidence and reinforces the ethical foundation of dental practice. By participating in peer review, NYSDA members not only fulfill a professional obligation, they contribute to a culture of excellence that benefits patients, practitioners and the profession as a whole.
Ethical Conduct in Peer Review: Respecting Colleagues and Patients
In accordance with the New York State Dental Association’s Code of Ethics, member dentists are expected to approach peer review with professionalism, discretion and respect for all parties involved. This includes refraining from disparaging colleagues, whether in formal proceedings or informal discussions. Constructive, unbiased evaluation is essential to maintaining the integrity of the peer review process and upholding the dignity of the profession.
Dentists must also communicate with patients about peer review in a tactful and informative manner, avoiding language that could undermine trust in the dental community. The goal is to resolve concerns while preserving the patient ’s confidence in the profession and ensuring that ethical standards are upheld throughout the process. By adhering to these principles, NYSDA members reinforce the values of collegiality, fairness and ethical responsibility—cornerstones of both the peer review system and the broader dental profession. p
Dr. Lehman is chair of the NYSDA Council on Peer Review and Quality Assurance. Queries about this article and/or the Peer Review Council and process can be sent to Patty Marcucia at pmarcucia@nysdental.org.
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New York State Dental Foundation
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