Issuu on Google+

GDAction February 2009 USING

3/9/09

11:16 AM

Page 1

1859

2009

ACTION

THE JOURNAL OF THE GEORGIA DENTAL ASSOCIATION

FEBRUARY 2009

C e l e b r a t i n g 1 5 0 Y e a r s o f Se r v i c e & A d v o c a c y

GDAction Feb 2009 FINAL.pdf 1

2/10/2009 9:43:54 AM


GDAction February 2009 USING

GDAction Feb 2009 FINAL.pdf 2

3/9/09

11:16 AM

Page 2

2/10/2009 9:43:56 AM


GDAction February 2009 USING

3/9/09

11:17 AM

Page 3

VOLUME 29, NUMBER 2 • FEBRUARY 2009

ACTION GDA ACTION (ISSN 0273-5989) The official publication of the Georgia Dental Association (GDA) is published monthly. POSTMASTER: Send address changes to GDA Action at 7000 Peachtree Dunwoody Road N.E., Suite 200, Building 17, Atlanta, GA 30328. Phone numbers in state are (404) 636-7553 and (800) 432-4357. www.gadental.org. Closing date for copy: first of the month preceding publication month. Subscriptions: $17 of membership dues is for the newsletter; all others, $75 per year. Periodicals postage paid at Atlanta, GA. Dr. Jonathan Dubin GDA Editor 2970 Clairmont Rd Suite 195 Atlanta, GA 30329

Delaine Hall GDA Managing Editor 7000 Peachtree Dunwoody Rd NE Suite 200, Building 17 Atlanta, GA 30328

2008-2009 Georgia Dental Association Officers Mark S. Ritz, DDS, President Kent H. Percy, DDS, President Elect John F. Harrington Jr., DDS, Vice President James B. Hall III, DDS, MS, Secretary/Treasurer Jonathan S. Dubin, DMD, Editor

GDA/GDIS/PDRS Executive Office Staff Members Martha S. Phillips, Executive Director Lisa Chandler, Director of Member Services Nelda H. Greene, MBA, Associate Executive Director Delaine Hall, Director of Communications Skip Jones, Director of Operations (PDRS) Barbara Kaul, Property and Casualty Accounts Manager Courtney Layfield, Director of Administrative Services Victoria LeMaire, Medical Accounts Manager Melana Kopman McClatchey, General Counsel Denis Mucha, Director of Operations (GDIS) George Stewart, Operations Manager (PDRS) Phyllis Willich, Administrative Assistant Pamela K. Yungk, Director of Membership & Finance GDA Action seeks to be an issues-driven journal focusing on current matters affecting Georgia dentists, patients, and their treatment, accomplished through disseminating information and providing a forum for member commentary. © Copyright 2009 by the Georgia Dental Association. All rights reserved. No part of this publication may be reproduced without written permission. Publication of any article or advertisement should not be deemed an endorsement of the opinions expressed or products advertised. The Association expressly reserves the right to refuse publication of any article, photograph, or advertisement.

on the cover Malls are no longer simply filled with clothing and home goods stores. Non-dentist employees at shopping malls, warehouse clubs, and even beauty salons are now selling Georgians fast and potentially dangerous teeth whitening treatments. GDA members are concerned about the safety of consumers who may visit these kiosks, if the kiosks are legal, and what can be done to stop the unauthorized practice of dentistry. Turn to page 14 to see how the GDA is tackling this issue on behalf of dentists and consumers.

other features

sections

17

4

Parting Shots

5

Editorial

6

ADA Commentary

8

Executive Director’s Report

10

News and Views

23

Minutes

24

Event Calendar

27

Classifieds

22

History Spotlight: GDA and Children’s Dental Health Help Protect Your Practice During an Economic Recession

25

Annual Meeting Hotel Room Reservation Form

31

Buy Your GDA 150th Anniversary History Book

Member Publication American Association of Dental Editors

index of advertisers Note: Publication of an advertisement is not to be construed as an endorsement or approval by the GDA or any of its subsidiaries, committees, or task forces of the product or service offered in the

advertisement unless the advertisement specifically includes an authorized statement that such approval or endorsement has been granted.

ADS South . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

GDA Dental Recovery Network . . . . . . . . . . . .21

Paragon Dental Practice Transitions . . . . . . . .28

Atlanta Age Management Medicine . . . . . . . . .13

Georgia Association of Orthodontists . . . . . . .13

Professional Debt Recovery Services . . . . . . .11

Center for TMJ Therapy . . . . . . . . . . . . . . . . . .23

Georgia Dental Insurance Services . . . . . . . . .32

Professional Practice Management . . . . . . . . .19

The Doctor’s Safety Net . . . . . . . . . . . . . . . . . .18

Great Expressions Dental Centers . . . . . . . . . .29

Southeast Transitions . . . . . . . . . . . . . . . . . . . .29

Dunwoody Area Office Available . . . . . . . . . . .30

Hungeling & Sons PC . . . . . . . . . . . . . . . . . . . . .7

Entaire Global Companies . . . . . . . . . . . . . . . . .2

Law Office of Stuart J. Oberman . . . . . . . . . . .26

GDA 150th Anniversary History Book . . . . . . .31

Miles & Associates . . . . . . . . . . . . . . . . . . . . . .16

GDAction Feb 2009 FINAL.pdf 3

2/10/2009 9:43:56 AM


GDAction February 2009 USING

3/9/09

11:17 AM

Page 4

4 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 4

2/10/2009 9:43:57 AM


GDAction February 2009 USING

3/9/09

11:17 AM

Page 5

editorial perspective A Bright Future for Dentistry

Jonathan S. Dubin, DMD

xx

In Europe, a person cannot go to a pharmacy and purchase any form of peroxide meant to be placed in the mouth for the purpose of bleaching or whitening one’s teeth without first having a dental examination and receiving a prescription from a doctor for the product to be used. In Georgia a person can go to Sam’s Club, many malls, or even tanning salons and have an untrained, uneducated salesperson hand them powerful peroxide and maybe even direct an intense light at their mouth to activate whitening chemicals. I don’t need to list what is wrong with this. We have been educated to know the consequences of peroxides placed improperly and without proper examination of the teeth, any restorations, and periodontium. We have a GDA position paper listing all of our concerns about unlicensed, uneducated persons interacting with the public to provide cosmetic dental services. We also operate under a code of law that governs our actions as professionals in Georgia. This law deems supplying a dental appliance usable on human teeth to an ultimate user for the purpose of changing the shade of teeth the practice of dentistry. You can look it up. The law doesn’t need interpretation. Practicing dentistry without a license is a felony. I think that is serious. So where is the disconnect? Why don’t we see outrage? Part of the problem is perception. I believe that whitening procedures are viewed in the public’s eyes as similar to tanning salons, nail salons, and beauty salons. Perhaps this is due to the intent of the procedure, to beautify the individual, and to whitening products being readily available at pharmacies, other retail stores, and over the Internet. Whitening chemicals aren’t just ‘makeup,’ however. And just because the service being provided by these unlicensed, uneducated persons is basically cosmetic in nature doesn’t

make it right, legal, or any less a health risk to Georgia patients. This is the crux of the matter—only a person trained in the science of oral health can examine a person’s hard and soft oral tissues, and the state of any restorations present in an individual, to diagnose and determine the appropriateness of any dental treatment and the strength of any product that is required. That person is a licensed dentist. That is the law. This law is in place to protect the citizens of Georgia. In my understanding, the Georgia Board of Dentistry acknowledges that the operations of certain companies that offer whitening services directly to the public violate the Georgia code of law. I also understand that Board members do wish to stop the activities of these operators. (And it is only the Georgia Board of Dentistry and district attorneys who have standing under the law to take appropriate action to stop the unauthorized practice of dentistry; the GDA cannot prosecute any cases.) We dentists must encourage the Board to exercise their charge of power to stop this unlawful practice of dentistry and the endangerment of the public by sending specific complaints about illegal dental operations in our area. Other states, such as Oklahoma, Iowa, and North Carolina, have enjoyed success pursuing actions against operators of certain whitening kiosks under their dental practice laws. The issue is serious, but our law is beyond clear and our resolve is obvious—let us create our own success story in Georgia.

GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 5

2/10/2009 9:43:57 AM

5


GDAction February 2009 USING

3/9/09

11:17 AM

Page 6

ada commentary ADA Board of Trustees Meeting Report ADA Fifth District Trustee Dr. Marie Schweinebraten is using this month’s column to discuss the big issues of the December 2008 ADA Board of Trustees meeting. If you have any comments or questions regarding the issues discussed below, please contact Dr. Schweinebraten at drmaries@aol.com. The first Board meeting after the ADA House of Delegates met in October 2008 was in early December. This always seems to be a transition meeting, with new members joining the Board and initiatives from the House moving forward. I would like to touch on a few of these new initiatives to give you some perspective of what will be on the table in the months to come.

Dental Quality Alliance Marie C. Schweinebraten, DMD ADA Fifth District Trustee

There has been much discussion regarding a Dental Quality Alliance (DQA) proposed by the Centers for Medicare and Medicaid Services (CMS). For obvious reasons, most dentists are hesitant to travel down a road that brings problems such as those in medicine. A DQA has the potential for evolving into a pay-for-performance type system, which the profession would be adamantly against. The proposal by CMS is for evaluation of programs and not individual providers. It also allows the ADA to have an authoritative leadership role in developing and operating the DQA. After consultation with the Council on Dental Benefit Programs, the Council on Dental Practice, and the Council on Governmental Affairs, the Board voted that the ADA should cautiously move forward only if guarantees are obtained from CMS that the ADA will have the lead in these activities. The Council on Dental Benefits in conjunction with the Board will have the responsibility of developing and monitoring the program with input from the other two councils. The Board also feels strongly that members should be educated and informed of the DQA’s development and activities.

ADA Advertising / Sponsorship Programs Over the past several months there has been much discussion at the Board level concerning the corporate relations activities of the ADA. The policies regarding these corporate relations, including the advertising policy for JADA and the ADA News, have been revisited. An advisory panel, which includes members of the Board as well as councils, will review advertising submissions if there is any concern after the publishing and science departments review them both for content and accuracy. The current Smile Healthy Program started at the ADA which is similar to the American Heart Association’s Heart Healthy Program is also being revisited. Although corporate relations through advertising and sponsorships can be a very valuable source for non-dues revenue, the Board feels strongly that the professional status and ethical standards of the ADA should not be compromised and wants to ensure that this does not happen.

Caries Risk Assessment After considerable work by both the Council on Dental Practice and the Council on Scientific Affairs, caries risk assessment forms are available for member use through www.ada.org. It is anticipated that over the next six months, additional feedback on the forms and tools can be obtained to further refine this caries risk assessment process so it can be released for general use.

Diagnostic Codes SNODENT (System of Dental Nomenclature), the ADA’s diagnostic code set developed in the 1990s but never fully tested or utilized, is also under discussion. Although the dental profession in general has never been required to use diagnostic coding in day-to-day administration, the medical field utilizes diagnostic codes extensively. SNODENT was

6 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 6

2/10/2009 9:43:58 AM


GDAction February 2009 USING

3/9/09

11:17 AM

incorporated into the SNOMED code set many years ago. Recently there have been negotiations for transfer of ownership of SNOMED, and thus the dental diagnostic codes contained within, to the International Health Terminology Standards Development Organization, based in Denmark. The ADA was concerned about the profession’s ability to retain intellectual property rights to SNODENT, which could affect future modifications of the code set as well as income potential for the ADA if the code set is ever utilized to its full potential or a new code set is developed using SNODENT as a starting point. Agreeing with the recommendation from the Council on Dental Benefit Programs, the Board rejected the proposal from IHTSDO and will monitor the situation to assure that SNODENT is removed from SNOMED before ownership is transferred.

Antitrust Issues The ADA’s legal department has printed a brochure updating constituent and component societies on the McCarran-Ferguson Act. This law grants partial exemption from antitrust lawsuits to the insurance industry.

Page 7

For many years, ADA policy has been in support of repeal of this act. Since the exemption granted is limited, particularly in today’s climate, a repeal could have a negative effect on the dental profession. If lawsuits increased against third party payers, the potential would exist to curb abuses, but there would also be an increased likelihood of greater scrutiny on claims to counterbalance third party’s increased litigation costs, and ultimately, increased costs to both the policy holders and providers. The Council on Governmental Affairs will continue to monitor and examine the McCarranFerguson Act and its complicated relationship to the dental profession.

Challenges to Paffenberger Research Funding The ADA’s research facility within the National Institute of Dental and Craniofacial Research outside of Washington, DC, the Paffenberger Research Center, is being challenged on multiple fronts. Paffenberger relies on grant money for a large portion of its funding. Over the next few years, many of the scientists who work at Paffenberger will be retiring, thus causing

the center to lose a great deal of its financial base. These scientists are difficult to replace. Up to $390,000 per year of additional funding will be needed until new researchers are recruited and grants are obtained. The Board requested that the ADA Foundation explore additional funding for Paffenberger until the grant changes can be addressed. An additional concern at Paffenberger is the need for facility renovation. Without updated, state-of-the-art equipment for both clinical and research needs the center will find it more difficult to recruit new scientists. Paffenberger is of vital importance to the ADA, being the go-to source for those outside the profession when scientific data is needed. Last year, for example, when lead content in crowns was questioned, Paffenberger provided scientific data to the media and other groups. Dentistry has always taken pride in being a sciencebased profession and Paffenberger has supported this claim multiple times on such issues as amalgam, fluoride, and lead content.

Trust and Transparency The Board heard a presentation in December by Keith Murnighan, PhD, from the Kellogg School of Management on building trust and creating transparency within an organization. Many times I question the value of these presentations, but in this case, it was not only interesting but helpful. President Findley has made transparency within the ADA one of his primary focuses, and I look forward to the changes we will see in 2009. The year is getting off to a great start in this area with the Collaborative Planning Conference this past week. This meeting is a unique opportunity for the ADA officers, the Board, and the councils, through their chairs and vice-chairs, to meet and work through priority issues, have open discussion, and network. Georgia was represented well by Dr. Mark Ritz, Vice-Chair of Dental Practice, and Dr. Ed Green, Vice-Chair of Communications. It is an exciting time to be on the ADA Board of Trustees as well as an exciting time to be a member of our organization. I encourage all of you to be involved in whatever way you feel you can contribute. Thank you for the opportunity to represent you at the Board level.

GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 7

2/10/2009 9:43:58 AM

7


GDAction February 2009 USING

3/9/09

11:17 AM

Page 8

executive director ’s report Spotlight on Dental Trends Affecting Georgia Practices Below are excerpts from GDA Executive Director Martha Phillips’ report to the January 2009 House of Delegates. To read the full report, visit www.gadental.org.

For the profession and the GDA to plan for the future, it is critical to analyze and track trends that could affect dentistry and health care in general. Since dentists do not practice in a vacuum, national, state, and local events have an impact on your ability to provide dental care and to remain economically viable. While it is not an exhaustive list, this report examines issues that we have identified as trends that bear discussion and monitoring.

Martha S. Phillips GDA Executive Director

State Board Withdraws From the ADEX Examination “The Georgia Board of Dentistry voted at its December 5, 2008, meeting to post a rule withdrawing Georgia from the ADEX examination effective June 30, 2009, for all dental examinations.” The Georgia Board of Dentistry dropped its affiliation with the Southern Regional Testing Agency (SRTA) in 2005 to join the Central Regional Dental Testing Service (CRDTS). CRDTS began administering the ADEX exam to the dental students at MCG in October 2005. Dr. John Cosby, President of CRDTS, issued a letter on November 24, 2008, announcing that CRDTS is withdrawing as a regional testing agency member of the ADEX examination effective June 30, 2009. According to Dr. Cosby’s letter, ADEX was established and was intended to be an autonomous entity derived by state dental boards for the paramount purpose of examination development with funding derived primarily from that activity. The letter stated that CRDTS was withdrawing from ADEX because the governing structure of the organization did not allow for equal representation in the decision-making process.

The Georgia Board of Dentistry voted at its December 5, 2008, meeting to post a rule withdrawing Georgia from the ADEX examination effective June 30, 2009, for all dental examinations. After that date, the Georgia Board will not accept or consider dental examinations administered by ADEX. At the same meeting, the Georgia Board of Dentistry also voted by “policy” to cease accepting the ADEX examination for dental hygienists after December 31, 2008. On December 11, 2008, the Board voted via conference call to post the hygiene examination change by rule. A public comment hearing was held Friday, January 16, 2009.

Charity Health Care “While dentists should continue to provide their share of charitable care, we must not let the government think that charitable care is a substitute for a health care delivery system.” Many communities are making extra efforts to provide dental services to the indigent thanks to the rising cost of health care, a recessionary economy, and a 7.6% unemployment rate. However, this often isn’t enough. According to a report from the Center for Studying Health System Change (HSC), “Efforts to meet the dental needs of low-income residents face an uphill battle because demand for services far exceeds available resources.” HSC reports that according to their data, dental access is generally grim. About 120 million Americans lack dental insurance. And for the low-income population it’s not much better. Although most states provide dental care for the low-income population, the report noted that few dentists participate because of low reimbursement levels.

8 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 8

2/10/2009 9:43:59 AM


GDAction February 2009 USING

3/9/09

11:17 AM

Access to dental care has been a priority for a number of years yet federal and state governments seem unwilling or unable to pay for this service. Health care providers are being strongly encouraged and in some cases incentivized to provide free care to the uninsured population. Some legislators view charity health care as a viable safety net to support government subsidized plans. In a down economy governments may resort to a carrot and stick philosophy to push health care providers into seeing more patients at no or reduced cost. This model currently exists in hospitals. Hospitals cannot refuse treatment to a patient who shows up in the emergency room seeking care and often the hospital and attending physicians are never paid for the service. While dentists should continue to provide their share of charitable care, we must not let the government think that charitable care is a substitute for a health care delivery system.

Retail Medical Clinics “It is highly likely that within the next 12 months in states where dental hygienists work under general, collaborative, or independent supervision that dental hygiene services will be added to retail clinics. One hygienist using a one chair operatory would use minimum space and provide a highly sought after service by the public and employees.” Retail medical clinics operating in CVS pharmacies, Kroger grocery stores, and Wal-Mart stores seem to have found a profitable niche after the initial failure of some of the original clinic models. The move away from leasing space and into franchising or direct ownership has breathed new life into this thriving business model. Market branding which provides standardization and central oversight of the clinics, much as has occurred in the fast food industry, has contributed to their success. Most clinics are staffed by registered nurses and operate through a collaborative practice with a physician. Generally there are no limitations on how many RNs one physician can oversee. Branding and standardization are not the only reasons the clinics continue to prosper. The retail clinics are widely accepted by the public and viewed as a convenient way to obtain basic health care

Page 9

services. Consumers enjoy the easy access and extended hours of these facilities. Insurance companies like and support the concept and are quick to provide coverage for services delivered in retail clinics because they believe this delivery mechanism lowers the cost of health care. Stores where the clinics exist tout the clinic as an employee benefit providing employees quick access to prevention and basic care while on the job. Employers benefit because employees lose fewer hours seeking basic health services. The retail clinics can also contribute to the bottom line of the stores by drawing the public to their facility and creating a potential customer for other products and services. Although there was initial resistance and opposition to retail clinics from physicians, many have now accepted this delivery method and pose little or no opposition to the growth of the retail clinics. In fact, many physicians are actively involved in ownership or management of the clinics. If the financial success of the retail clinics continues at its present pace, it is likely to push them to expand their services. Profitability coupled with a move to expand access to dental services will create the perfect scenario to add a dental component to the clinic. It is highly likely that within the next 12 months in states where dental hygienists work under general, collaborative, or independent supervision that dental hygiene services will be added to retail clinics. One hygienist using a one chair operatory would use minimum space and provide a highly sought after service by the public and employees. On January 14, 2009, the Walgreen Company (parent of Walgreen’s drugstores) announced a network of pharmacies, in-store clinics, and company health centers it will market to corporate and government employers nationwide. Under the drugstore chain’s “Complete Care and Well-Being” program, participating employees at work would be able to get checkups, preventive care, and other services, such as dentistry and optometry. Walgreen’s Take Care health clinics would be available for basic services outside of business hours, and the chain would offer discounted prescriptions at Walgreen‘s pharmacies. Retirees and employees’ family members also would be eligible for the services. In addition, the customers would receive a 15% discount on Walgreen’s privatelabel products such as toothpaste and dia-

pers. Walgreen, based in Deerfield, Illinois, is targeting employers for its new program, having gained the largest market share of work-site health centers with acquisitions last year. The chain expects to appeal to employers by offering a clearer pricing structure than other health-care programs, which frequently sell bundled services or prescription plans. Walgreen executives said customers will know in advance how much they are paying for each drug or service.

Dental Tourism “…It is logical to assume that some consumers may decide to seek dental care outside the U.S. based on price alone. Such a change in patient acceptance of how and where they receive care could create a climate of acceptance of alternative oral health care providers. “ Dental tourism is a recently coined phrase to define Americans who travel to foreign countries to receive dental care. Consumers living in border towns have traveled to Mexico to receive dental care for several years. This phenomenon is not limited to dental services. Many travel abroad for medical procedures. Talk show hosts, such as Atlanta’s Clark Howard, have devoted a significant amount of talk time discussing the benefits of obtaining health care in foreign countries and touting the savings to the consumer. On one of Clark Howard’s recent shows he specifically discussed and encouraged consumers to go out of the country for their dental care. As more and more Americans have traveled abroad for cheaper medical care, health insurers and employers have mostly watched from the sidelines. However, now the nation’s second-biggest health insurer, Indianapolis-based Wellpoint, Inc., is dipping a toe in the medical tourism marketplace. Starting in January 2009, Wellpoint will offer employees of Wisconsin-based Serigraph Inc. the option of traveling to India for nonemergency procedures such

DIRECTOR’S REPORT Continued on page 19 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 9

2/10/2009 9:43:59 AM

9


GDAction February 2009 USING

3/9/09

11:17 AM

Page 10

members in the news Members celebrate GDA anniversary at dinner President Mark Ritz presided over a black tie dinner January 10 celebrating the 150th anniversary of the Georgia Dental Association. The event, held at the Cherokee Town and Country Club courtesy of Club members Dr. Donald and Jan Johnson, featured a cocktail reception, four-course meal, recognition of doctors who contributed cases to the GDA 150 Faces Campaign, and the presentation of a GDA Sesquicentennial history book and commemorative leather bookmark to each dentist attendee. The group also witnessed the debut of the video highlighting the GDA 150 Faces Campaign, with cameos by President Ritz and GDA 150th Task Force Chair Dr. Celeste Coggin. (To view the video online, visit www.gadental.org and click on the 150th anniversary link.) “It was an amazing evening, and a wonderfully appropriate way to begin our anniversary year,” said Dr. Ritz. “Dr. Coggin, her husband Houston Lennard,

and our other 150th Task Force members Dr. Kara Moore, Dr. Jim Hall, Dr. Carole Hanes, Dr. David Remaley, Dr. Doug Giorgio, and Dr. Edward Paris did an outstanding job of creating a beautiful, memorable event.” Attendee Dr. Michael Vernon walked away with more than fond memories and a history book—he was the winner of the drawing held for a 42” Vizio HDTV donated by Atlanta Business Bank. All proceeds from the sales of the television raffle tickets will go to support the dental school building fund of the Medical College of Georgia. The GDA will continue to celebrate its 150th anniversary throughout 2009. Visit the GDA Web site www.gadental.org to find out about all the celebration plans, purchase a commemorative lapel pin, view the cases submitted for the 150 Faces Campaign, and buy your own copy of Sesquicentennial.

President Mark Ritz (r) with 150th Task Force Chair Dr. Celeste Coggin and her husband Houston Lennard at the GDA’s anniversary dinner.

Ivey honored for long-time ADA Delegation service Ty Ivey, DDS, a GDA Past President, was honored during the 2009 Winter GDA House of Delegates for his 15 years of service as a member of the GDA delegation to the American Dental Association House of Delegates. Dr. Ivey, a general dentist in Macon, took part in his final ADA House of Delegates during the 2008 ADA meeting in San Antonio. Dr. Ivey was presented with a plaque to honor his long years of service that said in part “the Georgia Dental Association

respectfully and gratefully commends Dr. Ivey for his valiant leadership on issues vital to dentistry, dedication to the ideals of the dental profession, and tireless advocacy on behalf of all dentists who desire the freedom to deliver the highest quality dental care available.” Kudos to Dr. Ivey for his years of service, and for leaving a legacy of passion for dentistry and excellence in leadership for his fellow delegates to carry onward. President Mark Ritz (r) with long-time ADA Delegate and GDA Past President Dr. Ty Ivey.

10 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 10

2/10/2009 9:43:59 AM


GDAction February 2009 USING

3/9/09

11:17 AM

Page 11

Butler receives Georgia Tech award M. Forest Butler, DDS, a periodontist in Lilburn, was recently honored by Georgia Tech as a distinguished engineering alumnus. Dr. Butler graduated from Georgia Tech with a master’s degree in biomaterials engineering in 1979 as part of a joint Emory University / Georgia Tech program where he conducted research on cylindrical dental implants in monkeys. The program was part of an award from the National Institutes of Health and the National Institute of Dental Research. Dr. Butler along with a team of student researchers developed techniques for thin sections of bone and implant blocks without demineralization, as well as a cylindrical implant design to mimic natural teeth. Dr. Butler had previously earned his DDS degree and certificate in periodontics at Emory. He was an adjunct professor of biomaterials engineering at Georgia Tech from 1973 to 1982.

Dr. M. Forest Butler (r) accepts a Georgia Tech distinguished engineering award from Don P. Giddens, Dean of the Georgia Tech Engineering Department.

GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 11

2/10/2009 9:44:01 AM

11


GDAction February 2009 USING

3/9/09

11:17 AM

Page 12

GDA dentists, Alliance members take part in Dental Health Day The state legislature “opened for business” on January 12, a date also proclaimed as Dental Health Day by Governor Sonny Perdue. In honor of this annual day, GDA and Alliance volunteers and GDA staff GDA & Alliance Members GDA President Dr. Mark Ritz Alliance President Sherry Kendrick Dr. Jack and Molly Bickford Dr. Tom and Linda Broderick Dr. Nelson Conger Rose Marie Dougherty Dr. Tom Field Dr. Janine Bethea-Freihaut Dr. Timothy Fussell Dr. Greg Goggans Dr. Jay Harrington Dr. Ben Hawkins and family Dr. Lee and Sharon Hawkins and family Dr. Lindsay Holliday Dawn Hutchinson Janelle Kauffman Cindy Laesser Dr. Donna Thomas Moses Dr. Kent and Mary Percy Dr. Richard Sugarman Dr. Jimmy and Tammie Talbot Dr. Doug and Debbie Torbush Dr. Richard Weinman Holly Winter

members distributed dental kits to each legislator and legislative staffer at the Capitol. All the kit volunteers then gathered on the Capitol steps for a photo with State Senators and Georgia dentists Greg

A GDA tradition: Past President Dr. Donna Thomas Moses and President Dr. Mark Ritz at the Capitol’s shoeshine stand.

Goggans and Lee Hawkins. Kudos to everyone who visited the Capitol to help hand out kits and participate in this timehonored tradition:

Alliance members had a great turnout on Dental Health Day. Kudos to President Sherry Kendrick and Legislative Chair Dr. Janine Bethea-Freihaut, and attendees Molly Bickford, Linda Broderick, Cindy Laesser, Sharon Hawkins, Dawn Hutchinson, Janelle Kauffman, Mary Percy, Tammie Talbot, Debbie Torbush, and Holly Winter.

GDA Staff Martha Phillips Nelda Greene Delaine Hall Courtney Layfield Melana McClatchey Pam Yungk

GDA President Dr. Mark Ritz and Alliance President Sherry Kendrick join dentist Senators Dr. Lee Hawkins and Greg Goggans and the 2009 dental kit volunteers on the Capitol steps on January 12. (Dentist Senator Dr. Lester Jackson could not attend due to a prior commitment.)

12 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 12

2/10/2009 9:44:03 AM


alth Day. ve Chair Bickford, s, Dawn e Talbot,

GDAction February 2009 USING

3/9/09

11:18 AM

Page 13

News for GDA Members Hebron Community Health Center celebrates fifth birthday The charitable Hebron Community Health Center in Lawrenceville recently celebrated five years of ministering to the medical and dental needs of uninsured, low income, and homeless citizens in the northern Gwinnett County area. Since its inception in November 2003, the clinic has provided services for approximately 4,000 individuals. The clinic does not charge for

its services, and is supported by contributions from individuals, businesses, and foundations, and by the efforts of volunteer physicians, dentists, and support staff. The dental clinic is always eager for additional dentists, dental hygienists, and dental assistants to volunteer their time. If you are interested in volunteering to provide dental care at the clinic, or assisting the clinic with a financial or other donation, call (770) 277-4675.

In Memoriam The GDA extends sympathy to the family and colleagues of the following individual. For full obituaries on this same member dentist, visit www.gadental.org or call the GDA office. Robert Hampton Wright Jr., DDS, who died February 17, 2008, at the age of 76. Dr. Wright was a member of the GDA through the Western District (Columbus).

The 1955 Emory University School of Dentistry graduate and OKU inductee was a retired ADA Life Member.

GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 13

2/10/2009 9:44:03 AM

13


GDAction February 2009 USING

3/9/09

11:18 AM

Page 14

Whitening Kiosks: What You Need To Know Melana Kopman McClatchey GDA General Counsel

Malls are no longer simply filled with clothing and home goods stores. Non-dentist employees at shopping malls, warehouse clubs, and even beauty salons are now selling Georgians fast and potentially dangerous teeth whitening treatments. Calls have been pouring in from GDA members with concerns over retail whitening kiosks. Our members are primarily concerned about the safety of the public. Over the last six months, the GDA has received numerous inquiries about these kiosks, whether they are legal and what can be done to stop the unauthorized practice of dentistry. Rest assured that the GDA understands your concern and is fighting for you.

Whitening Kiosks: The Illegal Practice of Dentistry? The law and regulations of the Board of Dentistry in Georgia define dentistry in part as “the evaluation, diagnosis, prevention, or treatment, or any combination thereof, whether using surgical or nonsurgical procedures, of diseases, disorders, or conditions…” State laws further provide that supplying an appliance to the consumer for the purpose of changing the shade of teeth is the practice of dentistry. As you may have guessed, when such an appliance is provided to a consumer by a non-dentist to whiten teeth, the result seems to be the unlicensed practice of dentistry. Georgia’s Dental Practice Act clearly makes the unlicensed practice of dentistry a felony. Anyone convicted of practicing dentistry without a license is punishable by a fine of not less than $500 and not more than $1,000 or by imprisonment from two to five years or both. If whitening kiosks are potentially being operated in violation of Georgia law, you may ask why the GDA has not taken legal action. Only the Georgia Board of Dentistry and an appropriate district attorney have standing under the current law to take legal action to halt the unauthorized practice of dentistry. While the Georgia Dental Practice Act makes the unlicensed practice of dentistry a felony, the law only allows the

district attorney in the appropriate county (the county in which the non-dentist is selling whitening treatments) to bring charges against the non-dentist. Neither licensed dentists nor the GDA can prosecute crimes, including the unauthorized practice of dentistry. Aside from criminal prosecution, the law offers one remaining alternative— civil injunctive relief. Injunctive relief, essentially, is an equitable remedy in the form of a court order, whereby a party is required to refrain from doing something. In this case an injunction obtained against a whitening kiosk would require the whitening kiosk to stop providing teeth whitening services. The Georgia Dental Practice Act bestows the right to file a civil action to enjoin the unlawful practice of dentistry only on the Georgia Board of Dentistry.

What is Happening Outside of Georgia? This problem is not unique to Georgia. Many states are experiencing an epidemic of the unauthorized practice of dentistry. The dental boards in many states including Oklahoma, North Carolina, Tennessee, and West Virginia have all already successfully obtained injunctions against whitening kiosks. As reported in the Oklahoma Dental Association’s October 2008 Journal, the Oklahoma Board of Dentistry successfully obtained an order permanently enjoining a company by the name of Glamour White from ever again engaging in the unauthorized practice of dentistry. According to the OKDA’s Journal, the order required that “Glamour White, its respective agents, servants, and all persons acting by and under their authority or in concert with them” forever cease “performing or engaging in the practice of dentistry,” “providing teeth whitening products, providing services or treatment at shopping malls or any other location in the State of Oklahoma, providing any type of promotional material for teeth whitening, employing any persons to provide teeth whitening products, services

or treatment, providing any professional instructions for teeth whitening or offering or undertaking, by any means or methods, to remove stains or discolorations from the teeth.”

GDA Efforts to Address This Issue In an effort to encourage the Board to take action, the GDA has lobbied the Board to investigate people practicing dentistry without a license. Beginning in May 2008, the GDA began sending written correspondences to the Board which included: • Georgia law pertinent to the provision of teeth whitening treatments by unlicensed individuals and the importance to the public’s safety that the Board of Dentistry take immediate action; • Reasons why whitening treatments probably constitute the unauthorized practice of dentistry; • Hundreds of pages of laws and regulations from other neighboring states showing the Board that Georgia’s laws are sufficient to take appropriate legal action and are more stringent than those in states which have already obtained injunctions; • Examples of other states which have taken legal action against whitening kiosks; • Actual legal pleadings submitted in the legal actions the other states have initiated;

KIOSKS Continued on page 16

14 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 14

2/10/2009 9:44:03 AM


GDAction February 2009 USING

3/9/09

11:18 AM

Page 15

Georgia Board Rules Governing Whitening Services Many state laws governing the practice of dentistry are not clear on whether dental whitening services performed by non-dental personnel are a violation of the Dental Practice Act. Some states are in the process of taking legislative action to define these services as the practice of dentistry. Georgia’s law and the supporting Board rules are clear that providing tooth whitening services by non-dentists is a violation of the Dental Practice Act and that these people are engaged in the practice of dentistry. The rules are listed below.

(c) Definitive prosthesis: Prosthesis to be used over an extended period of time. (d) Fixed prosthesis: Non-removable dental prosthesis that is solidly attached to abutment teeth, roots or implants. (e) Fixed-removable prosthesis: Combined prosthesis, one or more parts of which are fixed, and the other(s) attached by devices that allow their detachment, removal and reinsertion by a dentist only. (f) Interim prosthesis: A provisional prosthesis designed for use over a limited period of time.

Board of Dentistry Rule 150-14-.01 Definitions. (1) “Appliance” means any fixed or removable structure which may or may not be made with an impression of a human mouth or extraoral facial structures or any portion of the human mouth, teeth, gums or jaw used to prevent adverse dental conditions, including but not limited to changing the appearance of teeth, changing the shape and shade of teeth, protect teeth, effecting the position of teeth or repairing or replacing missing or damaged teeth. In addition, appliances shall also include any device that gains a desired dental or medical result by using the teeth or surrounding oral structures as support. (2) “Cap” shall mean any fixed or removable artificial structure created with a model or impression of a natural or artificial tooth and used or worn as a covering on that natural or artificial tooth. (3) “Cosmetic covering” means any fixed or removable artificial structure or product used or worn as a covering on natural or artificial human teeth created with a model, impression or any other measuring device including but not limited to computer assisted design (CAD), of the human mouth or any portion thereof and used solely for cosmetic purposes. Cosmetic covering shall include, but not be limited to, such structures commonly known as “grills.” (4) “Covering” means any item that is used to permanently or temporarily place over a natural or prosthetic tooth. (5) “Dentist” shall mean an individual who is licensed in this State pursuant O.C.G.A. §43-11-1(9). (6) “Fabricate” means to create, design or construct any structure, whether artificial or naturally occurring, defined by this rule as a dental appliance, cap, covering, prosthesis or cosmetic covering.

(g) Removable prosthesis: Complete or partial prosthesis, which can be removed and reinserted by a patient. (8) “Theatrical purposes” shall mean any fabricated product defined by this rule that is only used during activities of the performing arts and removed immediately after such use.

Board of Dentistry Rule 150-14-.02 Fabrication of Dental Appliances, Caps, Coverings, Prostheses and Cosmetic Coverings is Practice of Dentistry. (1) The fabrication of any dental appliance, cap, covering, prosthesis or cosmetic covering, as defined by this chapter, is included in the practice of dentistry as defined by O.C.G.A. § 43-11-17. (2) No person shall fabricate any dental appliance, cap, covering, prosthesis or cosmetic covering, as defined by this chapter, unless he or she is licensed to practice dentistry or working under the prescription of a licensed dentist. Nothing in this chapter shall prohibit a physician licensed pursuant to Article 2, Chapter 34, Title 43 of the Official Code of Georgia from performing any act within the scope of his or her license. (3) This rule shall not apply to any structure that is used solely for theatrical purposes as defined by this chapter.

Board of Dentistry Rule 150-14-.03 Responsibility of Licensed Dentist.

(7) “Prosthesis” means: (a) Prosthesis: Artificial replacement of any part of the human body. (b) Dental prosthesis: Any device or appliance replacing one or more missing teeth and/or, if required, associated structures. This term includes but is not limited to abutment crowns and abutment inlays/onlays, bridges, dentures, obturators, and gingival prostheses.

The dentist is responsible for the safety of the patient when he or she fabricates or directs any other person to fabricate and the dentist delivers any dental appliance, cap, covering, prosthesis or cosmetic covering under this chapter.

GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 15

2/10/2009 9:44:03 AM

15


GDAction February 2009 USING

3/9/09

11:18 AM

KIOSKS Continued from page 14

• An offer to supply to the Board the name and number of the attorney involved in one such legal action on behalf of a dental board; and • A complaint which included a photograph from a local newspaper of a spa employee performing a whitening treatment. Continued concern about what action has been taken to halt this type of unauthorized practice of dentistry prompted GDA President Dr. Mark Ritz along with President Elect Dr. Kent Percy and Vice President Dr. Jay Harrington; Drs. Don Benton, Jack Bickford, Chris Hasty, Lindsay Holliday, Kara Moore, and Doug Torbush; and GDA Executive Director Martha Phillips and General Counsel Melana McClatchey to attend the Board of Dentistry’s monthly meeting in Macon on January 16, 2009. Dr. Ritz addressed the Board of Dentistry regarding concerns over the safety of whitening procedures done by unlicensed individuals, concerns about what legal action the Board of Dentistry has taken to protect the citizens of Georgia from this type of unlicensed practice of dentistry, and the other states which have successfully taken legal action. Important facts came to light. The Board of Dentistry has recently issued several cease and desist orders for performance of whitening treatments without a dental license. In fact, the Board indicated that it has referred one such case for criminal prosecution. Additionally, the Board showed their commitment toward taking legal action by acknowledging that they will follow-up on situations in which a cease and desist order is issued. If the individual or entity against whom such an order was entered has not stopped engaging in the unauthorized practice of dentistry, the Board of Dentistry will use such evidence to seek a civil injunction. The Board gave due consideration to Dr. Ritz’s comments and appeared to understand the gravity of this issue.

Page 16

What Can Member Dentists Do to Help? Dentists have the right to file a complaint with the Board of Dentistry regarding numerous infractions including the unauthorized practice of dentistry. Many of you have already filed complaints when confronted with individuals practicing dentistry without a license. Continue to submit complaints to the Board against those individuals, organizations, and companies. Submitting complaints is an efficient mechanism by which the Board can be informed of individuals who are jeopardizing the safety of the public. The Board encourages all individuals to use the complaint procedure. You may contact the Board of Dentistry by phone at (478) 207-2440 or visit their Web site at http://sos.georgia.gov/plb/dentistry. Please be aware that this article is for informational purposes only and is not intended to provide legal advice. Dentists must consult with their private attorneys for such advice.

16 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 16

2/10/2009 9:44:03 AM


GDAction February 2009 USING

3/9/09

11:18 AM

Page 17

Children’s Dental Health and the History of the Georgia Dental Association In 2009, the GDA journal will examine various aspects of the GDA’s 150-year history. Efforts to promote and protect the dental health of children have been a hallmark of GDA activities since its founding. In honor of February as Children’s Dental Health Month, enjoy reading some highlights of GDA activities. Do you want to read the longer chapter on GDA public health and public relations advocacy on behalf of children, and more about GDA history in general? Visit www.gadental.org to purchase the newly published GDA history book Sesquicentennial for only $25!

1920 Atlanta philanthropist Cator Woolford told dentist Dr. J.G. Williams that he wanted pay for the services of a part-time dentist to develop a dental health education program in Atlanta’s Grant Park School. The GDA component Fifth District Dental Society approved the concept and provided volunteers. School superintendent Willis Sutton organized a demonstration project that was eventually adopted by the entire school system of 50,000 children.

1932 The state employed Annie Taylor to establish a comprehensive dental education program in all of the state’s school systems. The GDA paid Miss Taylor’s salary in 1933 when the budget of the State Board of Health was cut by 10 percent.

1935 The GDA adopted a policy stressing the importance of inspection of children’s mouths. The policy pointed out that since the dental profession was the only group trained to render this service adequately the GDA would cooperate with the state Departments of Health and Education in a program to give free dental inspections to school and preschool aged children.

Governor Jimmy Carter signs the 1973 statewide fluoridation bill which has aided generations of children across Georgia. Shown are Governor Carter (seated), GDA members Dr. Hal Raper, Dr. Eugene Newman, Dr. Steve Carter, Dr. Harold Lanier, Dr. John Savage, and Dr. Charlie Smith, and ADA President Dr. Lou Saporito. The desk on which the bill was signed resides in the GDA office.

water supplies to help control dental caries, especially in school aged children.

1971

The GDA instituted its first statewide Children’s Dental Health Day recognition.

The GDA and Alliance introduced the Wanda Wondersmile puppet show, written by Mrs. Peggy Callahan and GDA member Dr. Jack Rousso. In 1972, WETV in Atlanta aired a version of the puppet show to 57,000 schoolchildren around the state. Over 30 years later, the show’s characters—Wanda Wondersmile, Benny Badtooth, Tartar Pete the Terrible, and Dr. Dan—continue to educate and entertain young audiences.

1950

1973

1948 The GDA instituted its first statewide Children’s Dental Health Week recognition.

1949

The GDA adopted a formal resolution recommending the fluoridation of public

Governor Jimmy Carter signed the Fluoridation Act which the state legislature

passed earlier that year. The law empowered the state to require fluoridation of potable public water supplies in certain incorporated communities, a goal the GDA had long supported as an important weapon in the war on children’s dental decay.

1983 The GDA began its Free Dental Screening Program, where volunteer dentists provide a screening, at no charge, for Georgia students entering public school for the first time. The program’s intent, apart from helping students to fulfill state require-

CHILDREN’S DENTAL HEALTH Continued on page 18

GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 17

2/10/2009 9:44:04 AM

17


GDAction February 2009 USING

3/9/09

11:18 AM

CHILDREN’S DENTAL HEALTH Continued from page 17 ments, was to make parents aware of dental problems, increase the dental awareness of the public, promote preventive methods and early treatment of dental disease, and promote a positive image of dentistry. Dr. Anne Hanse, Chair of the Council on Dental Health at the time, noted that “Once in a great while an opportunity comes along which enables us to have a tremendous impact on the dental health of the children of our state. The statewide free dental screening program being implemented by the GDA this year gives us that opportunity … to demonstrate that as a profession, we are genuinely interested in promoting optimal oral health in our community. This program is an example of [a] Public Education Program at its best and can be immensely valuable in promoting the prestige and credibility of the dental profession in Georgia.”

Page 18

1985

2000

The GDA co-sponsored a School Nutrition Dental Health Seminar, where school personnel from across the state who taught health or prepared meals learned about children’s dental health and the effects of sugar intake.

The GDA successfully lobbied the legislature for much needed reimbursement increases and administration changes for the dental Medicaid program. The reimbursement increase was the most significant increase in the dental Medicaid budget in more than 15 years.

1997 The Department of Human Resources and the Governor’s Fiscal Year 1998 budget proposal cut the state’s Dental Public Health program completely. However, once GDA member dentists brought this issue to the attention of their legislators, there was never a question about the desire of the legislators in the House or the Senate. They agreed it was unthinkable to cut dental care for the over 92,000 children served by Dental Public Health. Persuaded by GDA dentists, the legislators found the $1.2 million needed to reinstate the program in a proposed budget loaded with severe cuts and protected it throughout the session.

2003 The GDA supported the first annual American Dental Association “Give Kids a Smile Day!” Public service projects across Georgia called attention to the oral health needs of underserved children and dentists’ efforts to meet those needs. The largest GDA effort took place in Vidalia where 45 dentist volunteers provided approximately $19,000 in treatment. This timeline is not intended to be inclusive. Visit www.gadental.org for the complete GDA history.

18 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 18

2/10/2009 9:44:04 AM


GDAction February 2009 USING

3/9/09

11:18 AM

DIRECTOR’S REPORT Continued from page 9

as joint replacement surgery. Serigraph will waive the insurance deductible and coinsurance for employees who agree to go, paying all medical costs as well as travel expenses for the patient and a companion. Linda Buntrock, Serigraph’s senior vice president, said, “This is a leap of faith, obviously, to say if you go to India, we’ll pay for the whole shebang. But the cost difference is so monumental.” According to Jill Bechner, a Wellpoint spokesperson, knee replacement surgery that costs between $60,000 and $70,000 in the U.S. is performed in India for $8,000 to $10,000. Wellpoint joins a handful of U.S. insurers offering medical travel benefits. United Health Group, Inc., the biggest U.S. health insurer by revenue, said it doesn’t yet have an international travel program but is seriously looking into it. According to a report in the Minnesota

Page 19

Star Tribune, some 750,000 Americans traveled abroad for medical care in 2007, and that’s expected to rise to 6 million by 2010 according to the consulting firm Deloitte. Almost all are individuals doing so at their own expense. “Going abroad can cut 30% to 90% from the medical bill,” said Robin Elsham, managing director of Patients with Passports, a Mendota Heights startup that arranges foreign care for individuals. However, it is still a radical idea. Ms. Elsham said that it’s hard to get people to understand cheap doesn’t mean inferior. It would be difficult to show a significant savings by traveling outside the U.S. for most dental care. However, with the new implant procedures and “teeth in a day” being highly touted by many, it is logical to assume that some consumers may decide to seek dental care outside the U.S. based on price alone. Such a change in patient acceptance of how and where they receive care could create a climate of acceptance of alternative oral health care providers.

Is Dentistry Moving to the Medical Model? “If the trend is to model the medical delivery system, dentistry will have to create multiple levels of providers and work in collaborative practices with much less decision making about the patient’s oral health.” More and more we read and hear leaders who believe that moving dentistry more toward the medical model is the future. This trend toward the medical model fits with the proposals for Community Dental Health Coordinators, Advanced Dental Hygiene Practitioners, Expanded Duty Dental Assistants, and Oral Health Preventive Aides. If we look closely at how

DIRECTOR’S REPORT Continued on page 20

GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 19

2/10/2009 9:44:05 AM

19


GDAction February 2009 USING

3/9/09

11:18 AM

DIRECTOR’S REPORT Continued from page 19

the medical model is faring in the U.S., one should question whether this is where dentistry really wants to go. Physicians no longer treat the whole body and many patients suffer due to the lack of coordination of care. The medical model has changed the way health care is delivered, and not necessarily for the better. Medicine has so many specialties and layers of ancillary medical personnel that no one physician has the responsibility for the patient’s overall health. Patients do not seem to be faring better under this medical model and physicians aren’t expressing more satisfaction with their profession. In fact over the last several years the Medical College of Georgia has admitted a number of physicians as freshmen dental students. Physicians have delegated responsibilities for much of patient care to physician assistants, medical assistants, registered

Page 20

and practical nurses, nurse midwives, nurse anesthetists, and several other categories of ancillary health care personnel. Is this where dentistry is headed? To remain viable physicians must belong to multiple provider networks and are required to accept the fees set by the insurance companies that own these networks. The largest examples of “universal care” and fee setting are Medicare and Medicaid. These programs provide care to the aged population and to the indigent population and comprise the majority of the patients in many practices. Most patients with insurance are covered with managed care plans that require the patient to see a health care provider within a network so there is no place for the physician to go. Advances in medicine have come with a price for the patient and the physician. How would the dental model look if we emulated the medical model? Would patients receive their preventive care in a dental office? Would non-dentists provide most restorative care? Would every dentist

have to belong to provider networks and accept fees set by insurance companies? If the trend is to model the medical delivery system, dentistry will have to create multiple levels of providers and work in collaborative practices with much less decision making about the patient’s oral health. Dentists would follow medicine and move to national credentialing and “pay for performance” based on outcome criteria determined by a third party. Would the ADA philosophy of “we must be at the table or be on the menu” work in our favor and help to keep dentistry as the “Healthcare Profession That Works”? Or does this show a willingness to move toward the medical model with the idea that we must provide input? Should dentistry resist the need to sit at the table and offer our own solutions as a better way? The dental profession is at a critical juncture. The medical model should be thoroughly analyzed and discussed at the grassroots level before leadership makes a decision of which direction to go.

20 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 20

2/10/2009 9:44:05 AM


GDAction February 2009 USING

3/9/09

11:18 AM

Medicaid: Death by a Thousand Cuts “The state of Medicaid and PeachCare dental care in Georgia is in a severe crisis. . .The GDA will continue the pursuit of a carve out [from the current Medicaid managed care model], but it is highly unlikely in the current economic situation and with the current administration.” The infrastructure of Medicaid has been dying a slow death for years. Occasionally there will be an attempt to revive the dying program with an infusion of dollars or a promise to eliminate administrative problems that make providing care difficult if not impossible. One such rescue was made in 1999 when the state proposed a 33% increase on 64 codes and 10% increase on the remainder of the codes for the FY99 budget. While this was a significant increase, it only raised the reimbursement closer to 50 cents on the dollar, and was not enough to entice dentists, who were already disenchanted with the administrative hassles, back into the program.

Page 21

In 2002 a proposed 5% increase in dental fees was deferred to save the public health dental program that was threatened with elimination. In 2003, the dismal lack of access to dental care forced the state to provide a 3.5% cost of living increase for dental fees, despite a monumental state budget shortfall. In 2004, the dental budget took a 7.5% budget cut but this time dentistry named its own poison and proposed the elimination of 11 codes to maintain fees for the other codes that would starve the program but not quite kill it. In 2005, dentistry was faced with the total elimination of the small amount of adult dental services provided under Medicaid as well as the complete elimination of dental care in PeachCare for Kids, the state’s SCHIP program. With the help of a coalition of advocates, the GDA succeeded in saving the adult program and dental coverage in the PeachCare program. In 2006, the elimination of the limited adult dental program and dental coverage under PeachCare were again threatened. Governor Sonny Perdue ultimately added adult dental coverage in his budget but cut dental coverage in PeachCare by $1.74 million with the elimination of additional dental codes. On June 1, 2006, an infamous day, the state of Georgia moved all of their plans, except coverage for the aged, blind, and disabled, into an “at risk” managed care program. Three Care Management Organizations (CMOs) and two dental administrators took charge of the dental program. The movement into managed care speeded up the death by a thousand cuts of dental care in the Medicaid and PeachCare program. From January 1 to August 31, 2007, the three CMOs sent out 14 letters outlining changes to their dental plans that involved cuts in fees and limitations on services and frequency of treatment. The CMO panels were closed and 123 dentists were dropped from the plans. Additional fee cuts followed from January 1, 2008, to the present. Georgia’s dental program in Medicaid and PeachCare has been cut and slashed to the point that it is barely alive. The state Department of Community Health responded to a national survey in October 2008 and reported that only 499 Georgia dentists have filed dental Medicaid claims for more than $10,000. If

the threshold had been $100,000, it is likely that number would have dropped into the 200s. The state of Medicaid and PeachCare dental care in Georgia is in a severe crisis. Although the Centers for Medicare and Medicaid Services (the federal agency that manages these programs) and other agencies have audited the state’s dental Medicaid and PeachCare programs, no data has been made available. The State Senate ordered an audit of the program last year and the results were revealed in December 2008. The state’s own auditors substantiated many of the claims of an inadequate provider network and lack of quality data that have been asserted by the GDA. An analysis of this audit will be presented to the Senate leadership with a request for further study. An all-out GDA attempt to “carve out” dentistry from the state’s Medicaid managed care plan came to a screeching halt in 2008. The GDA worked with the American Dental Association and two well-respected Atlanta public relations firms in a coordinated effort to use the media and various other mechanisms to accomplish a carve out for dentistry. The efforts were effective to a point. Most legislators were on board with the carve out and would have voted on legislation that would accomplish this goal. However, we were unable to get the carve out over the final hurdle that would have allowed the bill to be signed. The GDA will continue the pursuit of a carve out, but it is highly unlikely in the current economic situation and with the current administration.

GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 21

2/10/2009 9:44:05 AM

21


GDAction February 2009 USING

3/9/09

11:18 AM

Page 22

Help Protect Your Practice During the Economic Recession In the November 2008 and January 2009 issues of GDA Action, the GDA published articles offering practice management tips for dentists trying to weather these tough economic times. This month, the GDA culls some useful tips from a Collier, Sarner & Associates newsletter. Thanks to Dr. Byron Colley of Savannah for arranging the reprint of this information. While plenty of dental practices continue to produce at record levels, there is no doubt that many practices are hurting. In dentistry, the soft economy has particularly affected specialists. Families are delaying orthodontic treatment, slow general dentists are referring out less endodontic cases, and cosmetic practices often have little or no hygiene work to fall back on when times get rough. The following are some ideas worth considering to help weather the (hopefully short-term) storm: Be Proactive In Converting Potential Treatment Into Completed Cases: Obviously, this doesn’t mean promoting unnecessary procedures, but we know too many doctors who go too far in the opposite direction and fail to persuade their patients when certain care is appropriate. In dentistry, an intraoral camera is the best way to teach the patient what needs to be corrected. Some doctors show patients short films prepared by their professional societies describing the problems in plain English. These help give the patient a sense that you are giving them your unbiased, objective opinion. Eliminate Unnecessary Business Expenses: We tend to rationalize every big equipment purchase. But if revenues are shrinking or stagnating, profitability will do the same unless we spend more judiciously. The tax rules are now very favorable for new equipment purchases, but remember that no tax advantage is worth having if the cost of getting it outweighs the value of the tax advantage. If you can live without expensive new equipment, consider delaying the purchase. Rather than taking the entire staff cross-country to attend a practice management seminar, consider bringing the consultant to the office or scheduling an Internet-based presentation. However, if you have an unused operatory or examination room that has become storage space, spend the money to

turn it into productive space. What tends to happen is that the extra space does get used for emergency or “difficult” patients, a part-time associate, or for a hygienist to use the intraoral camera to help patients better understand the treatment they need. If the renovation costs $30,000, the fees from just one extra patient per day will more than pay for it. Advertise More Effectively: Our experience is that external marketing, like mass mailings, tends to be a big waste of money. Our existing patients are the best source of new patients. All doctors should ask their patients for referrals. There’s a tasteful and a distasteful way to do this, but there’s nothing wrong with prominently posting a sign in the office saying “We Welcome New Patients” and with the doctor telling each patient something like, “While we are certainly busy, new patients are the lifeblood of our practice, and we always have room for them.” This is especially important for an older doctor whose patients may incorrectly assume that he or she is not looking for new patients. (We know of several doctors who give complimentary movie passes or Barnes & Noble gift cards for each referral as a token of their appreciation—and these are always well received.) Yellow Pages advertising seems to be ‘ but effective Web sites becoming passe, are crucial. They won’t bring in a lot of new patients by themselves, but your patients will refer their friends and these friends will surely look up your Web site before scheduling an appointment. If they have two doctors’ names, they’ll look at both sites before making their decision. Most doctors’ Web sites are boring. The effective ones are not only visually attractive, but contain real heartfelt messages from the doctor about why he or she got into their chosen profession, what he or she loves most about it, and what makes their practice unique.

Hustle Just A Bit More For That Last Patient Of The Day: This is often the only major difference between a practice with revenues of $600,000 and one with revenues of $800,000. There is still room in the larger practice for patients to receive excellent clinical care. But if you can squeeze in just one or two more patients at the end of each day, practically the entire fee drops to the bottom line as profit. Why? Because the only new expenses incurred are some supply costs. Most other expenses, like rent, staff, and utilities, remain fixed. The Best Long-Term Practice Builder Is To Make Short Follow-Up Evening Calls To Patients Or Clients: This is especially true when you just performed some invasive procedure or where you expect the patient to be feeling pain. The calls should average under one minute. You will distinguish yourself as the only “caring” doctor they have ever had. They will tell their friends and relatives. The only reason doctors tell us they stopped doing this is because it worked so well that their practices got big and they got lazy. Notwithstanding the Emphasis Here On Profitability, Do Not Obsess Over Money: If you must obsess over something, obsess over your patients. It’s amazing how doctors who focus most on what’s important for their patients find that the money always follows. The information contained in this newsletter must not be construed as advice or consultation. Consult with your attorney, accountant, or financial advisor. Collier, Sarner & Associates may be reached at (216) 765-1199 or www.csanews.com.

22 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 22

2/10/2009 9:44:05 AM


GDAction February 2009 USING

3/9/09

11:18 AM

Page 23

board minutes Notes from the November 8, 2008, Board of Trustees Meeting Editor’s Note: Only the persons present and resolutions produced are printed here. Full minutes are available at www.gadental.org in the member’s only section, and can be provided upon request to those members without access to the Internet. Call (800) 432-4357 or (404) 636-7553, or email hall@gadental.org. Present: Dr. Mark Ritz, chair; Drs. Kent Percy, Jay Harrington, Donna Thomas Moses, Erik Wells, Mike Loden, Kent Simmons, Robin Reich, Bruce Camp, Larry Schmitz, Matt Adams, Ben Jernigan, Chris Hasty, Celia Dunn, Roy Lehrman, Robert Carpenter, Ben Duval (for Byron Colley), Richard Weinman, Jim Hall, and Jonathan Dubin. Absent: Dr. Steve Sample. Guests: Drs. Jack Bickford, Celeste Coggin, Lindsay Holliday, and Ed Green. GDA Staff: Martha Phillips,

Melana McClatchey, Courtney Layfield, Skip Jones, Denis Mucha, and Pam Yungk.

Agenda [08-11.01] Dr. Mark Ritz moved to approve the agenda as listed in the Board of Trustees packet. The motion passed unanimously.

Minutes The minutes of the August 23, 2008, Board of Trustees meeting were approved by

general consent and the notes from the September 20, 2008, conference call were approved by general consent as amended to reflect participation by Drs. Roy Lehrman and Kent Simmons on the conference call.

President’s Report Dr. Mark Ritz discussed the current position papers and deferred the new position papers on excused absences, tooth whitening, and dental labs until later in the meeting. [0811.02] Dr. Mark Ritz moved to approve all position papers as presented with the exception of the excused absences, tooth whitening, and dental labs position papers. The motion passed unanimously. Dr. Ritz also explained that when a member wishes to have membership in a district other than the one in which he or she practices, the GDA has followed the intent of current policy and has been giving dues to the district in which dentists receive services and that a certain portion of the GDA Bylaws must be amended to reflect the way in which dues are apportioned for members who belong outside of their appropriate district. [08-11.03] Dr. Ritz moved to refer to the Constitution and Bylaws Committee the issue of modification of the GDABylaws to accurately reflect the way in which component dues are apportioned for members that join districts other than the one in which he/she practices. The motion passed unanimously.

MINUTES Continued on page 26 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 23

2/10/2009 9:44:06 AM

23


GDAction February 2009 USING

3/9/09

11:18 AM

Page 24

24 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 24

2/10/2009 9:44:07 AM


GDAction February 2009 USING

3/9/09

11:18 AM

Page 25

GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 25

2/10/2009 9:44:07 AM

25


GDAction February 2009 USING

3/9/09

11:18 AM

MINUTES Continued from page 23

Page 26

for Dental Assistants. The motion passed unanimously.

Awards Committee Dr. Ritz also discussed the Board of Dentistry’s proposed changes to the sedation guidelines. [08-11.04] Dr. Richard Weinman moved that the Board of Trustees accept the Board of Dentistry’s recommendation for mandatory requirement of AEDs (automatic electronic defibrillators) for sedation permits thus rescinding the previous policy of endorsing the ADA Guidelines as presented. The motion passed.

Dr. Jay Harrington reviewed the slate of proposed nominees for the GDA Award of Merit, Honorable Fellow, and the Community Service Award as presented in the committee’s written report. [08-11.06] Dr. Jay Harrington moved to approve the awards slate for 2008-2009 and to forward the slate to the January House of Delegates for approval. The motion passed unanimously.

Expanded Duties

Constitution and By-Laws Committee

Dr. Ritz presented to the Board the modifications to Georgia Board of Dentistry Rule 150-9-.02 on Expanded Duties for Dental Assistants. It was explained that the Board of Dentistry voted at their meeting on Friday, November 7, 2008, to post the rule. [8-11.05] Dr. Ritz moved to endorse the Board of Dentistry’s proposed changes to the rules concerning Expanded Duties

Dr. Celia Dunn presented the following proposed changes to the GDA Policy Manual: [08-11.07] Dr. Celia Dunn moved that the GDA Policy Manual be amended by removing the Georgia Board of Dentistry from Section 3 of the Public Relations Duties Section and that the Governmental Relations portion of the Policy Manual be

amended to state that “The Committee on Governmental Affairs shall have the responsibility of monitoring legislation pertaining to dentistry and take an active role in the legislative, regulatory, and rule making process. The Committee’s responsibilities shall include, but not be limited to, the Georgia Board of Dentistry, the GDA Contact Dentist System, LAW Day program, GADPAC, and GDA’s involvement in the ADA Grassroots Program” and that these amendments be forwarded to the January 2009 House of Delegates for approval. The motion passed unanimously.

Dental Labs Position Paper [08-11.08] Dr. Mark Ritz moved to approve the Dental Labs Position Paper. The motion was unanimously approved.

Excused Absences Position Paper [08-11.09] Dr. Mark Ritz moved to approve the Excused Absences Position Paper. The motion was unanimously approved.

26 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 26

2/10/2009 9:44:07 AM


GDAction February 2009 USING

3/9/09

11:18 AM

Page 27

classified ads DENTAL RELATED SERVICES How GDA members can place classified ads AD FORM: Submit all ads on a GDA Classified Advertisement Form. To obtain a form, call Lisa Chandler at (800) 432-4357 or (404) 636-7553, or email chandler@gadental.org. (Note: The GDA may accept or reject any ad for any reason and in its sole discretion.)

AD DEADLINE: Ads and ad check payments are due by the first of the month before the publication month (i.e., Dec. 1 for January).

AD RATES: ADA member dentists pay $75.00 per 60-word ad per month. There is a 25 cents per-word charge for each word over 60. Non-dentist-owned companies (real estate firms, etc.) pay $195 per 60-word ad per month (additional word charges as above). Non-member dentists may not place ads.

LATE FEE: Ads for which full prepayment is not received by the first day of the ad’s publication month (i.e.; Nov. 1 for a November ad) will incur a $25 late fee in addition to the ad rate.

FORMS OF PAYMENT: Submit a check or money order with the ad form. (Make checks payable to GDA.) Credit cards are not accepted as payment.

WEB SITE PLACEMENT: Prepaid ads will appear on the GDA Web site www.gadental.org for the month the ad appears in print. Non-prepaid ads will NOT be placed online.

X-RAY SAFETY CERTIFICATION for dental assistants. Complies 100% with Georgia law. This 6 hour course has certified over a thousand x-ray machine operators. Send $139.99 per registrant with name(s) to: Dr. Rick Waters, 385 Pinewood Circle, Athens, GA 30606. For next-day delivery, credit card payment, or the NEW! online version, visit www.acteva.com/go/laser. Call (706) 255-4499 for more information.

DENTISTS AVAILABLE FOR FILL IN WORK / LOCUM TENENS Dentist Available Daily (DAD): Dentist available during vacations, emergencies and CE courses. Leave your practice in well-trained hands. I am licensed, insured, and have a DEA registration number so I can write prescriptions. Call Dr. Richard Patrick at (770) 993-8838. Locum tenens: Filling the hole and bridging the gap. So you can be out, I will be in. I have a Georgia license, DEA number, and insurance. Benefit from 38 years of general practice experience. Call B. Reighard, DDS, at (404) 786-0229 or (912) 634-6304.

EQUIPMENT FOR SALE / LEASE Orthopantomograph OP100 with linear tomography for cross-sectional imaging. Excellent for quadrant implant diagnosis. Multiple views of the TMJ. Nine year old unit; $11,500.00. Contact Dr. J. Denton Hardie, 705 North Westover Boulevard, Albany, GA. Please call cell number (229) 344-8000 or email: dentonhardie@bellsouth.net or call 1-800-510-8801. EQUIPMENT: Sirona Orthophos Panorex with Ceph 2003, $10,000, or best offer A/T 2000 XR Processor 2003, $500, Pan Size Duplicator $150. All equipment in excellent condition, changing to digital. Call (706) 265-1700 or email JPFOXDDS@msn.com.

For Sale: Used Peri Pro developer with day light loader and used Air Technique T2000 developer with automatic replenisher. Will price to sell quickly!! Call David G. Hochberg, DDS at (404) 874-6464. Ezlase 940 soft tissue diode laser and full warranty—includes MGG6 6mm tips, power supply, hand piece with tips, foot piece and switch, safety glasses— Brand new—Still in case—Normally sells for $9000—Will sacrifice for $7900—Fax info to (404) 633-3943.

POSITIONS AVAILABLE Associate Dentist position available for a family and cosmetic dental practice located in the metro Atlanta area. Large patient base, new-build out, state-of-theart facility, exceptional support staff. This is your opportunity for career-high income. Please fax resumes to (770) 944-0343. Associate dentist needed in fee for service practice near historic Marietta Square. Newly remodeled, paperless office with Dentrix and Scan-X digital radiography. Excellent opportunity for motivated leader and future buy-in potential. www.mariettadentalassociates.com. Full Time General Dentist needed in the Marietta area, high tech office, great environment, prefer someone with GPR or experience, will sponsor H1 visa if needed. Please email resume to LAKEPOINTE@GMAIL.COM. East Metro Atlanta—Associate Dentist. Established dynamic practice offers a unique opportunity for motivated professionals. No empty chairs…No insurance claim problems…With career high income potential. New graduates welcome…No debt and no initial practice setup. Contact Tina Titshaw at tina@myrockdale.com or call (678) 413-8130 or fax resume to (770) 760-1375.

CLASSIFIEDS Continued on page 28 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 27

2/10/2009 9:44:07 AM

27


GDAction February 2009 USING

3/9/09

11:18 AM

CLASSIFIEDS Continued from page 27

EAST METRO HEALTH DISTRICT— COVINGTON, GA. Full Time Dentist wanted to direct a public health dental program in Gwinnett, Newton, and Rockdale counties. This position involves supervision of a school based prevention program and providing clinical services in health department facilities. The Prevention program provides pit and fissure sealants in elementary schools using portable equipment. The position also involves working with the District hygienist who provides the educational portion of our prevention program in the schools. Mail or fax a completed state application from our Web site www.emhd.com to (770) 277-2089 or contact Melanie O’Steen at (678) 442-6906.

Page 28

Established General Dentist Practice with 1,700 active fee-for-service patients seeking new graduate or experienced dentist for associate position. The position is available for either three or four days per week. Two outstanding locations: South Fulton County adjacent to Hartsfield-Jackson Atlanta Airport and Stone Mountain, GA. Earning potential $100,000.00 to $175,000.00 / year. Caring, fun-loving staff and patient base. Please call Melissa Ellis @ (404) 762-1554 Mon.—Thurs.

Visit gadental.org to view all GDA classifieds online!

PRACTICES / SPACE / LOTS FOR SALE / LEASE / SHARE PRACTICE FOR SALE—SANDERSVILLE, GEORGIA. Free standing building with 4 fully equipped operatories. Beautiful, efficient T.H.E. design. Priced below Southeast Transitions appraisal. Partial owner financing available. Ideal start up practice or satellite / specialist opportunity. Walk into a well-established practice of 27 years in a nice family-oriented small town. Owner is retiring but will stay to introduce. (478) 552-1230 Day, (478) 552-2289 Evening.

Alpharetta / Roswell Dental Office with loft. 1700 sq ft, 3 (4) operatories. Move in condition. No costly buildout. LEASE or SALE—reasonable. Contact jsdds@comcast.net.

28 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 28

2/10/2009 9:44:07 AM


GDAction February 2009 USING

3/9/09

11:18 AM

North Georgia Mountains: Well-established practice for sale in beautiful, consistently growing area. Modern equipment. Computers in all operatories. Mountain views. Enthusiastic cross-trained staff. Ideal for solo or group practice. Also for sale eight year old eye-catching glass professional building available separately or with practice. National recognition for office design. 10,000 square feet housing this practice plus a dental specialist and a state agency. Highly traveled highway frontage. The best of a big-city practice in a relaxed country atmosphere and a warm, friendly patient environment. (706) 745-6848. ROSWELL, GA—RARE OPPORTUNITY! Newly renovated 4-operatory facility with new Midmark cabinets. Free standing building on high traffic road. Busy, fast growing practice grossing $750,000 with a mix of FFS / PPO and Medicaid patients. High volume emergencies / walk-ins, large Hispanic patient base. Opportunity to purchase real estate. Low overhead, well trained bilingual staff. Serious Inquiries (678) 793-2993 Steve.

Page 29

Dental Practice / Office Condo, Jonesboro, GA. Southern Regional Hospital area. Attractive office space, 1100 sq. ft., 3 operatories plumbed / 2 equipped, large lab, and private office with shower. Pay yourself rent. Move right in. Buy practice or real estate only. Close to interstate and short walk to public transportation. Contact Dean Cox (678) 584-4477. Excellent opportunity for a general dentist or specialist to rent / buy 30006000 sq. ft. of space in a class A building just off I-85 and Clairmont Road. Office building is located at a traffic light facing Century Center. Also 2000 sq. ft. of finished space in Cartersville and Hiram. Call (678) 640-5466 or (770) 590-4884.

CLASSIFIEDS Continued on page 30

GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 29

2/10/2009 9:44:08 AM

29


GDAction February 2009 USING

3/9/09

11:18 AM

CLASSIFIEDS Continued from page 29 PRACTICES FOR SALE—for more information, call Dr. Earl Douglas, ADS South, (770) 664-1982: ATLANTA #8557: Gross $770,141; 4 days 3 operatories; 1,131 sq. ft. office space. CARROLL COUNTY #8428: Gross $609,663; 4 days 4 operatories; 2,000 sq. ft. office space. Additional plumbed but unequipped operatory. DULUTH OFFICE SPACE & EQUIPMENT FOR SALE #8393: Five (open-bay) operatory office with a Planmeca pan/ceph. Equipment will include 4 chairs, 5 delivery units, 10 computers, and misc. office equipment. LILBURN #8516: Gross $1.07 Million; 5 days 8 operatories; 3,000 sq. ft. office space. RIVERDALE #8517: Gross $836,285; 4 days 8 operatories; 4,030 sq. ft. office space. Two additional plumbed but unequipped operatories. SOUTHEASTERN GEORGIA #8172: Gross $796,640; 4 days 5 operatories; 1,732 sq. ft. office space. ALSO ASSOCIATE POSITIONS AVAILABLE, contact Vikki Howard (910) 523-1949.

Page 30

MANY GREAT OPPORTUNITIES NOW AVAILABLE: Duluth: Gross $700K; Covington: $500K; Dunwoody: $1.2M; Cumming: $900K; Roswell: $750K; Cumming: Foreclosure; Buford: $500K; Atlanta: Pedo. Call Southeast Transitions at (678) 482-7305 or email info@southeasttransitions.com or visit www.southeasttransitions.com for more details on those and other opportunities.

SEEKING ASSOCIATESHIP / JOB (DENTISTS) / WANT TO BUY PRACTICE Female dentist seeks associate position in Atlanta area. I have eleven years of experience and recently relocated from the northeast. I enjoy adult dentistry with emphasis on cosmetic and implant dentistry. Please contact Neda at (508) 3800036 or email at Nedar97@yahoo.com.

30 GDA ACTION FEBRUARY 2009

GDAction Feb 2009 FINAL.pdf 30

2/10/2009 9:44:08 AM


GDAction February 2009 USING

GDAction Feb 2009 FINAL.pdf 31

3/9/09

11:18 AM

Page 31

2/10/2009 9:44:11 AM


GDAction February 2009 USING

3/9/09

11:19 AM

Inside This Issue • Executive Director Martha Phillips on Trends in Dentistry

Page 32

ACTION Suite 200, Building 17, 7000 Peachtree Dunwoody Road Atlanta, Georgia 30328-1655 www.gadental.org

• Reserve Your 2009 Annual Meeting Hotel Room

DATED MATERIAL PLEASE DELIVER AS SOON AS POSSIBLE

GDAction Feb 2009 FINAL.pdf 32

2/10/2009 9:44:14 AM


GDA Action February 2009