Articulator Volume 24, Issue 1

ARTICULATOR MDDS Connections for Metro Denver’s Dental Profession

3rd Quarter, 2019 Volume 24, Issue 1

WELLNESS Resources for Personal & Professional Transformation

10

Gut Healthy Chairside Conversations

6 Ways to Promote Chaos To 14 From 16 18 Positive Workplace Calm In Your Dental Practice

Culture at Your Company

Resilience: Bouncing Back from Life’s Challenges

B

Let’s Work Together.

Because when independent dentists work together, it can lead to big savings on dental supplies for practices of every shape and size.

TDSC is proud to be affiliated with the Colorado Dental Association to help save members more on supplies than they pay in dues.

E NDOR SED B Y:

SHOP ONLINE AND S TA R T S AV I N G TO DAY

FILE NAME 4686-TDSC_Print_Half_Colorado_WORK.indd

f ixed i nterest r ate

3.89

CLIENT TDSC

DATE 07/11/19

JOB TITLE Let’s Work Together Print PUBLICATION Colorado Dental Assoc.

PUB. DATE August/Sept

ACTUAL SIZE 7.25" x 4.75"

%

LIVE n/a

PROOF

1 2 3 4 5 6 7 8 9 10

LINKS

AD Aris Bajar

various

OUTPUT % 100%

FONTS on the full term of your COLOR 4CP loan — up to 15 years1

JOB TYPE Print, 1/2 Page

Avenir Next Baskerville

________ ________

CW Emily Frei Purchase an existing practice

________ ________

D Aris Bajar

________ ________

AE Wade Bare

________ ________

TRIM n/a

BLEED n/a

APPROVAL/DATE

Act now and save! Use this secured loan to

2 Expand, remodel, add a location or relocate ________ P Lisa Tharp

EP Heather Witzens

________

________ ________

Consolidate debt or purchase equipment 3

Apply by November 30 and close by December 31, 2019

Call 800.497.6076 bankofamerica.com/practicesolutions

1

2

3

For the limited time beginning with applications submitted on July 1, 2019, and ending with applications submitted on or before November 30, 2019, take advantage of a 3.89% interest rate on terms no less than ten years and no greater than fifteen years on qualifying approved Practice Solutions secured term Practice Sales and Acquisitions, Debt Consolidation, Remodels, Relocation, Expansions and Additional Locations and Equipment loans closed by or booked by December 31, 2019. Loan approval amounts must total a minimum of $250,000 on eligible product types in order to qualify. Payoff prohibited in the first year of the loan, and a prepayment fee will apply for each of the following four years of the loan term. Excludes Practice Solutions startup loans, lines of credit, refinances of existing Practice Solutions loans and commercial real estate loans, and any product that contains a variable rate. To be eligible for the interest rate offer of 3.89% the borrower before loan closing must have a demand deposit account with Bank of America that is the primary business operating account of the borrower. Promotional rate is not applicable during the project phase of the loan. Subject to credit approval. Other restrictions may apply.

All programs subject to credit approval and loan amounts are subject to creditworthiness. Some restrictions may apply. The term, amount, interest rate and repayment schedule for your loan, and any product features, including interest rate locks, may vary depending on your creditworthiness and on the type, amount and collateral for your loan.

Bank of America Practice Solutions may prohibit use of an account to pay off or pay down another Bank of America account.

Bank of America Practice Solutions is a division of Bank of America, N.A. Sponsorship of endorser’s products and services is not an expressed opinion or approval by the Bank. All promotional and marketing materials are Bank of America Practice Solutions property, as such, cannot be changed, altered or modified, orally or in writing. All questions regarding these materials should be directed or referred to a Bank of America Practice Solutions Sales Associate.

Bank of America is a registered trademark of Bank of America Corporation. ©2019 Bank of America Corporation ARJ7PWC4 | 07/2019 | PS-313-AD

3rd quarter 2019

what's inside?

18

pg.

10 Gut Healthy Chairside Conversations

pg.14

14 From Chaos To Calm In Your Dental Practice

Advertisers Directory

16 6 Ways to Promote Positive

Workplace Culture at Your Company

18 Resilience: Bouncing Back from Life’s Challenges

24 Better Posture, Better Health, Better Practice

departments 4 President's Letter

ADS Precise Transitions http://adsprecise.com........................ 31

Dente Vita www.denteveita.com.......................... 27

Berkley Risk Services of Colorado http://colorado.berkleyrisk.com.......... 20

Dentists Professional Liability Trust of Colorado http://tdplt.com................................. 15

Carr Healthcare http://carrhr.com.................. Back Cover CDA Enterprises cdaonline.org.............Inside Front Cover Colorado Dental Association cdaonline.org.................................... 29

Denver Implant Study Club http://disc.events/............................. 23 Gheen & CO cpacoloradosprings.com....................... 4 Healthcare Medical Waste Services, LLC hcmws.com....................................... 30

Commerce Bank commercebank.com/dentistry................. 5

Laurel Road LaurelRoad.com/ADA........................ 25

Copic Financial Services Group http://copicfsg.com............................ 27

Northwestern Mutual http://shawncopeland.nm.com........... 13

CTC Associates http://ctc-associates.com/.................. 13

SAS Transitions http://sastransitions.com.................... 20

6 Reflections 7 Member Spotlight 8 Member Matters

Co-Editors Amisha Singh, DDS; Allen Vean, DMD Creative Manager CT Nelson Director of Marketing & Communications & Managing Editor Cara Stan

26 Non Profit News

MDDS Standing Officers

28 Tripartite News

President-Elect Kevin Patterson, DDS, MD

30 Event Calendar 31 Classifieds

President Nelle Barr, DMD

Treasurer Pat Prendergast, DDS Secretary Janie Boyesen, DDS, DMSc

Editorial Policy All statements of opinion and of supposed factare published under the authority of the authors, including editorials, letters and book reviews. They are not to be accepted as the views and/or opinions of the MDDS. The Articulator encourages letters to the editor, but reserves the right to edit and publish under the discretion of the editor.

Advertising Policy MDDS reserves the right, in its sole discretion,to accept or reject advertising in its publications for any reasons including, but not limited to, materials which are offensive, defamatory or contrary to the best interests of MDDS. Advertiser represents and warrants the advertising is original; it does not infringe the copyright, trademark, service mark or proprietary rights of any other person; it does not invade the privacy rights of any person; and it is free from any libel, libelous or defamatory material. Advertiser agrees to indemnify and hold MDDS harmless from and against any breach of this warranty as well as any damages, expenses or costs (including attorney’s fees) arising from any claims of third parties.

Inquiries may be addressed to: Metropolitan Denver Dental Society 925 Lincoln Street, Unit B The Articulator is published quarterly by the Metropolitan Denver Dental Denver, CO 80203 Society and distributed to MDDS members as a direct benefit of membership. Phone: (303) 488-9700 Fax: (303) 488-0177 mddsdentist.com ©2019 Metropolitan Denver Dental Society Printing Dilley Printing

3

PRESIDENT'S LETTER

The Importance of a Plan

By Nelle Barr, DMD

I

love a plan. Don’t you? Doesn’t everyone love to

are all well aware that we are representing you, and we do not take this

have a plan? Your dental society, MDDS, loves a

honor lightly. The MDDS Board of Directors is consistently striving

plan too. We have a strategic plan and we apply

to make your local Society the best it can be. I am looking forward

it. That is our Applied Strategic Plan (ASP). Dr.

to serving as your President for this next year and to our September

Brian Gurinsky wrote about the Board of Director’s

Applied Strategic Planning (ASP) meeting . If MDDS were the best it

upcoming ASP in his final President’s Letter. This is such an important

could be, what would that look like? Please send us your thoughts as

undertaking, that I want to expand on the subject and echo his plea.

we prepare for this important meeting.

Please tell us your vision for MDDS. After all, we are working for you! Without an ASP we would have a leadership and a team with no direction. I am proud to tell you that the Society has fulfilled all of our past ASP goals and we accomplished them ahead of schedule!

I believe this is because we review our goals, action plan and how we are progressing at each board and committee meeting.

In September, the MDDS Board of Directors, volunteer leaders and

"Please tell us your vision for MDDS. After all, we are working for you!"

the

professional

team

will spend a weekend together

with

Dean

Savoca, an ASP facilitator, creating goals for the next five years. This is very exciting! We have the

wonderful challenge and opportunity to come up with new ideas, goals and plans to make MDDS’s future the best it can be. The Board of Directors needs input from the membership. Please contact me or any of the MDDS team with any ideas about future goals you may have for our Society.

At the ASP, we will also be redefining our core values. These values are paramount in fulfilling our mission and are what make accomplishing our ASP goals possible. When you read the mission statement the core values should be easy to identify, right? For example, one of our core values is being ethical. We are. No organization should accept anything less. Living the mission is what drives leadership’s decisions and influences outcomes. That is why MDDS’s mission statement is memorialized on the wall in the board room. It reminds us of our purpose and is read at the beginning of each board meeting.

After a long day at the office, as the evening meeting begins, it is time for us, your elected Board, to focus on why are we here and what thoughts should drive our actions? Hearing the mission statement as we start the meeting, gives us a call to action and an opportunity to remember our goals. The words “for our members” are used repeatedly during these meetings as we discuss important issues. We

4

I

3rd Quarter 2019 mddsdentist.com

MDDS MISSION STATEMENT MDDS is dedicated to supporting our members, promoting the highest ethical practice of dentistry; providing continuing professional education.

A banking relationship to grow your dental practice.

Commerce Bank can help lay the financial groundwork to meet the needs of your growing dental practice. Customized, small business banking, with big growth in mind.

commercebank.com/dental Š 2019 Commerce Bancshares, Inc.

REFLECTIONS

Burnout – The Myths Surrounding the Epidemic

By Amisha Singh, DDS

T

hey say we are all at risk, all the time. They say that the rates for provider burnout are at an all-time high.

Depending on which study you read, they say that more than 50% of dentists are affected, with young professionals being the highest risk category. They speak the truth but all these words are just that… words. They are spoken in hallways of dental schools as precautions and warnings filled with optimism and care. They are "You never really know used prior to breaks in CE classes around the country, a just how life changing public health announcement burnout can be until for our profession woven into our curriculum. But when you experience it." they become a reality for you, their impact resounds. You never really know just how life changing burnout can be until you experience it. When our profession gathers the courage to speak about this subject… passionately, openly, fearlessly… that is when we really see just how prevalent dental professional burnout really is, and how big of a threat it poses to our community. This open communication is the only way to dispel the myths surrounding the growing shadow, to bring it out into the light and to heal.

other words, the risk is multifactorial; it is ingrained in the system itself. High debt, high pressure, a lack of community support and resources for prevention and treatment, gaps in training, and systemic problems in remuneration have all been linked to the inherent risk of burnout of all medical providers. So, experiencing burnout says little about who you are and more about the state of medical care in our communities. Removing the personal stigma behind burnout (and frankly, all mental health issues) is the first and most imperative step to creating a system to heal.

Myth #3 – Burnout is inevitable.

As someone who has felt the impact of burnout firsthand, I will say it feels inevitable. It feels overpowering and uncontrollable. Healing feels out of reach and even, at times, impossible. But I for one refuse to write off the solution for our profession just yet. The solution to each individual’s recovery path is hidden within systemic changes we can make to eradicate the problem from the root.

We need to change who we are and how we practice as a whole. The foundation of healing individuals will be found in healing the system, solutions which organized dentistry, and the MDDS specifically, are already fighting to create.

The solution comes through broaching the subject in this magazine, having courses at RMDC and starting a new wellness group, The Mindful Dentist. But in the meantime, awareness is key. As providers, we should know the signs and symptoms of burnout and instill daily habits of prevention.

Myth #1 – Burnout is clearly differentiated.

Common Signs and Symptoms of Provider Burnout People are either pregnant or they are not. They either have cancer or they do not. Burnout is not as clearly defined nor diagnosed. Instead of being binary, burnout lands on a sliding scale, unfortunately one that is not well understood. One contribution to this ambiguity is research; provider burnout, and dental burnout, in particular, lack significant research and study needed to create clearer diagnostic criteria, risk factors and methods of prevention and treatment. But another reason burnout is not as binary as some other medical conditions is that it presents so differently in different people. The warning signs are different. The rate of acceleration is different. Some providers experience the warning signs for decades. Others become symptomatic in days. The spectrum of burnout is dynamic and feels somewhat unpredictable, especially for those who are in the middle of experiencing it.

Myth #2 – Burnout is a sign of weakness.

Some of the strongest, most incredible dentists I have ever met have experienced burnout. But there is a prevalent stigma surrounding burnout, one that feels like a form of failure. Some have argued that the word itself, “burnout” places the blame on the provider, insinuating a message that “you were not strong enough to resist, to overpower.” Dr. Zubin Damania, better known as ZDoggMD, founder of Turntable Health, has a powerful video on this subject and argues a more apt term would be “moral injury.” His point is well made. One of the reasons that the risk never diminishes to zero, no matter the age, specialty or job setting of the dentist, is that the profession has a risk of burnout which goes beyond the personal characteristics of the provider or their specific situation. In

6

I

3rd Quarter 2019 mddsdentist.com

• Exhaustion: Feeling excessively challenged to get out of bed in the morning or excessively drained during or after a workday.

• Cynicism or Emotional Detachment: Also known as compassion fatigue, it is a feeling of desensitization towards work, your team or your patients.

• Lack of Efficacy: A pervasive feeling of uselessness, meaninglessness, or that you or the work you do does not matter. Having thoughts like, “what is the point?”

• Loss of Motivation or Procrastination: Losing the will to complete daily tasks.

• Physical Changes or Pain: Emotional pain or stress can manifest as physical pain when left untreated.

• Isolation and Detachment: Feeling alone and not connected with your peers.

• Excessive Aggression: Continued burnout can manifest as rage, redirected at family and friends, internally or even at patients or team members.

If you or a colleague you know are feeling any of these or worry about burnout, there are resources for you. Email MDDS at mdds@mddsdentist.com or call (303) 488-9700 to learn more about prevention resources.

MEMBER SPOTLIGHT

After retiring, what influenced your decision to remain so involved in organized dentistry?

Dr. Steven Kilpatrick

"Staying involved in dentistry was a "no brainer." This profession afforded me a quality of life available to very few. Many before me paved the way for dentistry to be elevated to a well-respected profession. It is our responsibility to preserve the profession and its commitment to the care of our patients. I want dentistry to remain a wonderful profession."

General Dentist - Retired Morrison, CO

Now that you are retired, can you share what the biggest thing you miss about practicing is?

"I was in dental practice for 44 years and the same location for 34 years. When I retired, I was treating the grandchildren of my original patients. The long-term relationships are the thing I miss most about retirement. It is hard to give up helping people on a routine basis."

What advice would you give a new graduate?

How did you know it was time to step away from your practice? What influenced that decision?

"Recognize that you have chosen a difficult profession and be willing to spend the time and effort to become accomplished. Seek out colleagues and ask for help and guidance."

If you could change one thing about your dental career what would it be?

"I would have sought out mentors early on. Colleagues have always been willing to help but I did not recognize that valuable asset early in my career and I failed to fully utilize it.

The dental community is always willing to help."

"When my friends and colleagues began to become ill and debilitated. It is apparent that it can happen quickly and without warning.

I love my family and want to spend quality time with them - it was time to enjoy the fruits of my labor."

Where do you see the dental profession headed in the future?

"Dentistry appears to be headed to increasing reliance on technology and mid-level providers. The “dental therapist� model will continue to expand as a way to increase access to care. One of my biggest concerns is the decreasing percentage of dentists electing to be members of the ADA. We need a strong ADA to be our advocate. Leaving the decision making to corporations or legislatures is not in the best interest of the dental profession or our patients."

Is there a moment over your career that you are most proud of?

"The proudest moment of my career was receiving the Distinguished Service Award from the Arkansas State Dental Association. Being selected as the one dentist in the state that your peers believe deserves the award was overwhelming. Having years of hard work validated is a great feeling."

I

2nd 3rd Quarter 2019 2018 mddsdentist.com

77

MEMBER MEMBERMATTERS MATTERS

MDDS Summer Kickoff with the Colorado Rapids

The Colorado Rapids faced-off against FC Cincinnati during the MDDS Summer Kickoff Event and won the game 3-1.

Members and their families and staff enjoy a pre-game BBQ.

MDDS members get ready to cheer on the Rapids.

MDDS/CDA Wine Cheese and Cheese

3rd and 4th year dental students and new dentists enjoyed stunning views of downtown, appetizers, drinks and complimentary headshots at Wine, Cheese & Cheese.

8

I

3rd Quarter 2019 mddsdentist.com

New Members, Welcome!

Dr. Kira Abakumov Dr. John Luck Andrew Dr. Alexandra Bassett Dr. David Bonanno Dr. Sarah Bong Dr. Gabrielle Brandt Dr. Derick Bright Dr. Joseph Burns Dr. Cade Carlson Dr. Karin Clemens Dr. Domonique Coleman Dr. Allison Davis Dr. Kaushal Dhawan Dr. Elizabeth Dunkleberger Dr. Alisa Dvarishkis Dr. Hua Gao Dr. Mark Gilstrap Dr. Staš Grandi Dr. Autumn Gray Dr. Monali Haldankar Dr. Nicole Haydt Dr. Alberta Hernandez Dr. Armando Jauregui Dr. Cody Jorgenson Dr. Elizabeth Kaminsky Dr. Swarada Karmarkar Dr. Marjan Kazemi Dr. Anna Khmil Dr. Dylan Leto Dr. Eric Lomas Dr. Ellen MacDonald Dr. Roxolana Maged Dr. Tim Marshall Dr. Thaddeus McAlpin Dr. John Nesiba Dr. Nangia Nidhi Dr. Stacey Nygaard Dr. Anna Pitz Dr. Lakshmi Reddy Dr. Shreya Ruxmohan Dr. Mei Saelee Dr. Golnaz Samimifar Dr. Brandon Scheer Dr. Shayna Sengewalt Dr. Giselle Serrano Dr. Esha Sethi Dr. Summer Shannon Dr. Hitesh Shoor Dr. Neha Solanki Dr. Thomas Spellman Dr. Joseph Suslik Dr. Liz Tremblay Dr. Ellen Walker

MDDS Shred Event

MDDS and Colorado Orthodontic Foundation (COF) volunteers worked to shred confidential documents for members at the Society’s annual shred event.

More than 46,800 lbs of documents were shredded to raise money for COF.

August MDDS New Member Welcome Event - Historians Ale House

New members and dental students enjoyed quality networking time on the Historians Ale House rooftop at the always popular August New Member Welcome Event.

I

3rd Quarter 2019 mddsdentist.com

9

FEATURE

Gut Healthy Chairside Conversations

By Uche Odiatu, DMD & Mahsa Bakhshandeh, RDH

W

ant to add some variety to your chairside conversations? Want to share cutting edge scientific findings with your patients? Would you like to be seen as a person of influence with a broad knowledge of nutrition and healthy living strategies? “Some patients still see hygienists as teeth cleaners and aren’t aware of the scope of our education, which includes an intense nutrition component,” reports Mahsa Bakhshandeh, RDH. “All disease begins in the gut.”

– Hippocrates How did the first physician, who the Hippocratic oath is named after, have such insight into what has only recently been scientifically uncovered? He didn’t have a microscope or access to the National Institute of Health’s (NIH) groundbreaking initial Human Microbiome Project findings, but he proclaimed, “Let food be your medicine and medicine be your food.”

Key Gut Players Mind your guts. Not the outer abdominals but the gut flora inside your belly. We live in harmony with over 100 trillion single celled bacteria.

Eighty percent of them live in your digestive tract(1) and a recent article in Scientific American reported their influence on our health is shaking the very foundation of medicine and nutrition.(2) The bacteria in your gut play an important role in immune system modulation. Three quarters of the cellular constituents of your whole immune system are located in this area.(3) If you want to build the strongest foundation for your immune system, eat 25 to 30 grams of fiber each day. (The average North American consumes half that amount). Fiber is the gut bacteria’s number one choice of nutrition on which all other interactions depend, reported Justin Sonnenburg, PhD Assistant Professor in the department of microbiology and immunology at

I

10 3rd Quarter 2019 mddsdentist.com

the Stanford University School of Medicine.

“The human microbiome is only recently thought to influence health as powerful as your genes,” `-SK Mazemanian PhD Professor of Microbiology California Institute of Technology.

What is the number one influence on the human microbiome? What we eat!

“The food we eat dictates what bacteria grow in our body. And, our Human Microbiome is predominantly (99%) made up beneficial bacteria,” proclaims gastroenterologist. Robynne Chutkann, MD. (4) What does this have to do with dental patients? Why should we talk food and gut health in its relationship to oral health and overall health? Because the gut flora, our microbiome, or gut garden plays a major role in our immune system health, nutrient absorption, energy levels and emotional well-being.

“Our gut microbiome guides our immune system, metabolism and even our mood and behavior.” J. Sonnenburg PhD microbiologist Stanford University School of Medicine.(5) This is why food is so important. Our single-celled passengers have an intimate relationship with it. Their very survival depends on a regular supply of healthy food. And which health care industry professionals are in charge of the eating apparatus? Is it the chiropodist? Is it the optometrist? The cardiologist? The physiotherapist? No. It is the dental professional - the dentist, dental hygienist and dental assistant. We are the care givers of the teeth, jaw and muscles of mastication. If people want to be able to break down food, digest it and absorb it (6,000 of our enzymes have bacterial origin)(6), they need optimal masticatory function. Eating, digesting and absorption of nutrients is one of the most intimate things we do with our environment.

Questions from patients are a good opportunity to share our total health knowledge about the body-mouth connection. It will also feel less like we are lecturing patients as they will have invited us to share once they have made an

inquiry. Our answers can go beyond the usual (apples and cheese are healthy snacks, avoid juice and pop) when patients ask any of the following questions:

What else can I do between hygiene visits to keep my gums healthy?

has stated that most of the destruction of periodontal structures are from the host and dental professionals need to include host factors when they are creating their treatment plans.(8) Ninety-seven percent of the population does not eat the recommended amount of fiber. Without this keystone nutrient for the gut flora, there will be a poor supply of SCFAs and the patient’s body cannot put out the fires of inflammation. Roller coaster elevations in blood sugar from poor eating habits promotes post meal dysmetabolism, which supports inflammation and disease.(9) Scientists now report chronic inflammation as a major player in most modern degenerative diseases.

"Scientists now report chronic inflammation as a major player in most modern degenerative diseases."

In the days following a dental hygiene appointment – especially if it is a patient that has not been in for regular hygiene, soft tissues may feel tender for 24 hours or more. For adequate healing of their immune systems, they need to be in optimal health. We get calls sometimes from patients asking, “why were my gums tender after the last cleaning?” We can respond, “healing depends on the ability of your immune system to do its job in the healing and repair process. An impeccable diet provides you with the building blocks for healing. Did you know that only 5% of the population eats the recommended 25g of fiber daily?”(7) Our gut flora needs regular fiber intake. This is a foundational relationship.

This is where our gut bacteria make short chain fatty acids (SCFAs). Bob Hutkins, PhD, food scientist at the University of Nebraska, claims these are some of the body’s most powerful anti-inflammatory agents. Ian Chapple

Isn’t once a year hygiene visit enough?

Sixty percent of the population reports not getting enough sleep each night to feel rested. This raises a red flag as “poor sleepers are poor healers.”(10) Seventy percent of the adult population doesn’t eat a single piece of fruit each day(7). Another red flag as there are less phytonutrients, fiber and antioxidants to help douse the flames of inflammation. Only five percent of the population exercises regularly.(11) Red flag waving: Ninety-five percent of patients don’t enjoy the anti-inflammatory benefits of exercise. Anyone Continued on page 12.

TIPS: 1. EAT FREE RANGE, HORMONE FREE MEAT Eating hormone free, free range, antibiotic free meat used to be a very expensive food choice. Gastroenterologist Emaran Mayer, MD reports that it is now seen as a good investment in our overall health and in particular our gut health. Antibiotics fed to animals as animal growth enhancers have the ability to disrupt our delicate gut flora.

2. EXERCISE REGULARLY Regular exercise makes your gut bacteria more diverse in make-up. This adds to the stability and potency and, most of all, keeps pathogens in balance (13).

3. MANAGE STRESS Unmanaged stress also decreases diversity in your gut flora and therefore hampers fabrication of the cellular constituents of your immune system. Poorly managed stress or life events that rock them emotionally can thin the mucus lining of our patients’ stomachs and bring pathogenic bacteria in closer proximity to the general circulation.(14) 4. LIMIT SANITIZING AND BEING HYPER CLEAN AT HOME Limit your use of hand sanitizers outside the operatory. Robynne Chutkan, MD author of The Microbiome Solution wrote that part of developing a balanced gut flora means having them less disrupted by extreme sanitization practices at home.

5. EAT MORE FRUITS AND VEGETABLES There is irrefutable scientific evidence that food and its macro and micronutrients can ramp up or dial down inflammation in the body. Vegetables and fruits are loaded with phytonutrients, antioxidants, polyphenols and most of all fiber – which our gut

flora need to make SCFAs, one of the body’s most important anti-inflammatory agents.

6. GET GOOD SLEEP When you’re awake your body’s repair, recovery and rebuilding systems are running in standby mode. It is only while you’re sleeping that your body launches its powerful offensive where close to 95% of resources are poured into regeneration mode. Without adequate sleep, opportunistic gut bacteria can get the upper hand and cause disruption(15). We encourage patients to reevaluate their sleep habits to ensure they are getting adequate quality and quantity for optimal GI function.

7. TAKE A QUALITY PROBIOTIC Probiotics are good bacteria and can be found in cheese, yogurt, kefir, sauerkraut, miso soup and assorted vegetables.

If consumed regularly, they will support optimal gut health and the fortification of an empowered immune system.

There’s sound scientific evidence for the value of probiotics helping prevent antibiotic associated digestive discomfort. It is a developing science and many different companies are vying for top of mind in the consumer. For everyday use? In a placebo controlled, double blind, random assigned study in the Journal of Strength and Conditioning Research January 2017(17), it looked at thirty hard-driving athletes and showed that probiotic supplementation would help rebuild the first line of defense or humoral immune system that gets beaten up from intense training in the winter months. The athletes who took the probiotic had less respiratory illnesses. The authors went on to say the findings could make a case for the consumption by immunocompromised populations (the very young and the very old) who tend to get sick each winter. There are different formulations and numerous brands of supplements available in health food stores, grocery stores and pharmacies.

I

3rd Quarter 2019 mddsdentist.com

11

Continued from page 11. who doesn’t have healthy lifestyle habits needs to think about increasing their hygiene frequency to lower their inflammatory burden.

I am at a loss, my gums seem to bleed and be tender no matter what I do?

Dental hygienists scale, root plane, debride and floss. All of these procedures require patients to have high functioning immune systems to recover and heal after treatment. Seventy percent of our immune system is located in our GI tract. Our gut flora influences our immune cells. They do this through the TREG cells. This communication can only work well if the gut bacteria are stable and diverse in variety. This communication is facilitated if they haven’t been decimated by a recent course of antibiotics. Antibiotics have been shown to disrupt a third of a person’s good bacteria and it can take up to a year to bounce back.(12)

My mouth has gotten drier over the last year. Should I be worried?

Epidemiologist, Tim Spector, PhD studied 15,000 twins over ten years and reported there are many reasons for the human body deteriorating.

Several aging theories exist. He listed the loss of muscle and changing social circumstances, but also affirmed the loss of dental integrity and lower amounts of saliva as factors.(6) Spector reported that all other factors accounted for, nutrition and diet stood out as the major factor in influencing the microbiome and its impact on the senior’s health. How many times have you heard from patients as they sit down slowly in the chair, “Getting old is not for sissies,” or “The golden years aren’t so golden.” By focusing on the importance of maintaining all their teeth and acknowledging the side effects of medicine that cause dry mouth we can be their health champion.

Patients enjoy and welcome their dental professionals emphasizing total health along with focused attention on oral health. Talking nutrition that is relevant to oral health and overall health is within our scope of practice and, lastly, our patients are hungry for it.

About the Authors Uche Odiatu, DMD is a Toronto area dentist and a professional member of the American College of Sports Medicine. He lectures throughout North America on total patient health.

Mahsa Bakhshandeh, RDH graduated from Durham College and has been in private practice for nine years. She enjoys travelling and exploring the world, its many cultures and their variety of wonderful cuisines.

1. Bermon S et al. “The Microbiota: an exercise immunology perspective.” Exercise Immunology Review 2015.

2. Scientific American 2015 Special report. Pp S1-S15 3. Campbell SC and Wisniewski P “Exercise is a novel promoter of intestinal health and microbial diversity” October 2016 American College of Sports Medicine Journal.

4. Chutkan R. MD., The Microbiome Solution 5. Sonnenburg J and Sonnenburg E., The Good Gut © 2015 Penguin Books 6. Spector T. Diet Myth: The Real Science Behind What we Eat © 2015 Weidenfeld and Nicolson 7. Greger M MD., How Not to Die © 2015 Flatiron Books 8. Chapple L., “Potential Mechanisms Underpinning the nutritional modulation of periodontal inflammation” JADA 2009; 140(2): 178-184 9. O’Keefe J and Bell D., “Postprandial hyperglycemia/hyperlipidemia is acardiovascular risk factor” Am Journal Cardiology 2007;100(5):899-904 10. O’Brien M MD., The Healing Power of Sleep © 2009 Biomed General 11. Chek P., Canada Fit Pro Annual Personal Trainer Summit. Toronto August 2018 12. Mayer E., The Mind Gut Connection. © 2016 Harper Collins 13. Clarke SF et al. “Exercise associated dietary extremes impact on gut microbial diversity.” Gut 2014 14. Enders G., Gut: The Inside Story of Our Body’s Most Underrated Organ © 2016 (audio) Brilliance Audio 15. Stevenson S., Sleep Smarter © 2016 Rodale 16. Canada Food Guide. https:/food-guide.canada.ca 17. Michalickova DM et al “Lactobacillus Helveticus Lafti L10 Supplementation Modulates Mucosal”

Start-up/ Expand & Thrive Petersen Professional Plaza 10219 Parkglenn Way, Parker, CO 80138 (303) 501-2820 - Dr. Mike Petersen Build out is done, 4 ops, new carpet, ready to go! Some equipment still in place.

I

12 3rd Quarter 2019 mddsdentist.com

SELLING your DENTAL PRACTICE? Appraisals • Practice Sales • Partnerships • Buyer Representation • Post-Transition Coaching Start-Up Coaching • Associateships

Your Dental Practice Is Your Legacy.

Larry Chatterley

Marie Chatterley

Randon Jensen

As dental practice transition specialists, we guide you through the complex process of selling your practice to ensure everything goes smoothly with the legacy you have built.

Operating since 1988.

Complimentary Consultation

303-795-8800

“I sold my practice to my associate and Larry and his team were wonderful to work with. They handled the endless details beautifully and made the transition a really easy one for all of us. I highly recommend them and am so thankful they were there to guide us though the process!” - Dr. Naomi Jacobs

13

FEATURE RMDC SPEAKER

FROM CHAOS TO CALM:

EVERYDAY MINDFULNESS IN YOUR DENTAL PRACTICE

By Holly Duckworth, LSP, CAE, CMP

W

e live in a world of bigger, better faster and

saying to yourself, “Yeah, that would be nice but I am just too busy,” start

more. Yet, it doesn’t have to be this way.

small and integrate mindfulness into your day. As you drive to work, instead

In fact, I would argue it can’t be. “Burn

of seeing each stoplight as a stress see it as an opportunity. Mindfully take a

out” is becoming too common of a phrase

moment to focus on breathing in and breathing out periodically throughout

across many professions. And, we are now aware of the personal challenges such as health issues and divorce or the professional challenges such as legal or financial struggles which are plaguing our chaotic lives and impacting our businesses.

the day. Let it bring you back to center.

3) Wash away the stress. As a dentist hand washing happens many, many times a day. Instead of doing this mindlessly, integrate a little mindfulness.

Take that 30 – 60 seconds to see the stress in your shoulders melting and

Being a dentist in today’s world takes strength and stamina in new ways. The

going down the drain. Walk back to your patients each time more renewed.

intersection of personal service for your patients must be balanced with new

In my book, “Everyday Mindfulness From Chaos to Calm in a Crazy World”

online tools available to your patient’s dental care.

there is a quick daily tool to help you set an intention and start each day with

The answer to these problems is mindfulness. Mindfulness is the practice

a mindful quote and story.

of being present in the moment, without judgement. Once tied to eastern

These three actions: setting intention, breathing and washing away stress will

practices, mindfulness is now a mainstream practice in business today.

help you choose to live calm in the appearance of chaos today.

Here are three things to do each day to reduce chaos and create calm:

Mindful matters, and so do you!

1) Set a daily intention. Many of us are reading our email or social media feeds before our feet even hit the floor for the day. Our instant spontaneous response to that is … STRESS. We feel behind even before our day begins.

An intention is deciding with full awareness how we will put our energy in motion. Not so much what will you do today, check-in with patients, x-rays, cleaning, reports, etc. intention is how will you be while you are doing these things. For example, an intention may be joy, peace, fun, ease, happy. A daily intention could be – Today I will be happy in all that I do.

2) Have a daily practice to center yourself. You tell your patients to brush their twice teeth daily. But, do you brush your own life stress off ? If you are

I

14 3rd Quarter 2019 mddsdentist.com

About the Author Holly Duckworth, LSP, CAE, CMP is known as the C-Suite Network Advisor on Mindfulness in the workplace, unleashing human potential through mindfulness techniques. She helps stressed-out leaders find and sustain greater focus, clarity and inner peace, resulting in a more grounded and powerful presence and enhanced profits. As a keynote speaker, facilitator, and coach as an applied mindful leadership advisor.

She is a published and award-winning author and a contributor to the New York Times, Producer/Host of the Everyday Mindfulness Show. She lives in Denver, Colorado. Learn more at www.hollyduckworth.com.

Protect your practice.

Call the Trust today.

There are a lot of differences between being a Member of the Trust and just another policy number at a large, commercial carrier. Both give you a policy the Practice Law requires, but that’s where the similarity ends.

New and Established Dentists Not Currently Trust Members:

$0.00 First Year* *some restrictions apply; subject to underwriting approval.

Convert Now!

Who do I talk to when I have a patient event, claim or question?

The Trust: Local dentists who understand your practice, your business and your needs.

Them: Claims call center (likely in another state).

Besides a policy, what do I get when I buy coverage?

The Trust: Personal risk mitigation training, educational programs and an on-call team that “speak dentist.”

Them: Online support.

Do I have personal input and access to the company?

The Trust: Yes. You are represented by dentists from your CDA Component Society giving you direct, personal access to the Trust.

Them: Yes, via their national board.

How much surplus has been returned to dentists in Colorado?

The Trust: Over $2.2M has been distributed back to Colorado dentists as a “return of surplus” (after all, it’s your Trust, your money).

Them: $0 How long has the company been serving Colorado dentists?

The Trust: We were Established by dentists in 1987.

Them: It’s hard to say... they tend to come and go.

Dr. Randy Kluender · 303-357-2602 Dr. H. Candace DeLapp · 303-257-2604 www.tdplt.com

FEATURE

6

Ways to Prom Workplace Culture

By Chris Brennan, Insperity

Y

ou might think that trying to cultivate a positive workplace is an elusive, time-consuming waste of important resources, but studies show that the opposite is true. Creating a positive company culture begins with fostering happy employees.

Happy employees are 85 percent more efficient, experience a 60 percent drop in absenteeism and stay twice as long in their jobs as their less happy colleagues, creating a measurable impact on engagement, retention, safety, wellness, employer brand and even cost control goals, according to the study, The Science of Happiness, conducted by Globoforce.

Here are six steps you can take toward nurturing happiness, creating a thriving culture and boosting your business.

1. Happiness is based on gratitude Happiness is a habit that needs to be modeled. As a manager or business leader, your demeanor and attitude in the office has an impact on your employees.

When you demonstrate happiness you’re training your employees to follow suit.

Get in the habit of being grateful and showing gratitude for what you have. It can be a small thing – I am thankful for this cup of coffee or for the sun coming out today. When you try to find things to be grateful for, you’re training your brain to be on the watch for more of what is good in your world. By making gratitude a habit, you will set the example for others and create a positive work environment.

Focus on the positive when interacting with your employees. Point out their accomplishments and abilities. Remind them that they are a positive force within your company and that they have much to offer. This is a powerful motivation tool and it will help to create a “can-do” attitude in your workforce.

I

16 3rd Quarter 2019 mddsdentist.com

2. Praise others As a business leader you’re influential – your opinion matters, especially to your employees. Make it a goal to compliment people. Recognizing even small accomplishments and praising your team members in meetings or in an email can make a big impact. It doesn’t have to be a big gesture.

We all know that sometimes work can get monotonous and overwhelming. Say for example that Mike is feeling a bit underappreciated and is frustrated with his current project. He comes to a meeting feeling defeated and unmotivated.

Then you, as his manager, compliment his efforts and praise him for a job well done. The impact is immediate – he feels valued. His demeanor changes, he becomes engaged and leaves the meeting with a newfound energy to tackle his project.

Make it a goal to compliment your employees and you will see remarkable results.

It not only stimulates your brain; it influences the person you are praising.

3. Have a sense of purpose People need to have a sense of purpose at work. Their happiness is directly connected to knowing that they make a difference. It’s not enough for a manager to dole out tasks. Take the time to explain why the individual task is important to the company. This will give your employees a sense of purpose and belonging that will motivate them to strive for more. Engaged employees are efficient, enthusiastic and are willing to do what it takes to help your organization succeed. Creating a sense of purpose for your employees is an investment in developing a positive workplace.

4. Provide social interaction With our busy work schedules, sometimes all we want to do is close ourselves off from the rest of the world, focus on our computer and just get it done. But often the best thing to do when we’re in that mode is to take a break. Although it can seem counter-productive, taking a break can be rejuvenating.

omote a Positive e at Your Company The key here is to seek a bit of social interaction. Encourage your employees to take breaks and provide them with an area in the office to chill out and talk to one another. Taking breaks is important to both mood and concentration.

Helping your employees relax and connect with each other during the day is a great way to help them stay motivated and productive. Everyone needs a break from the daily grind. Encouraging your employees to take breaks can increase productivity, improve mental acuity and even relieve pain.

6. Encourage self-care and exercise

"Happy employees are 85 percent more efficient, experience a 60 percent drop in absenteeism and stay twice as long in their jobs as their less happy happy colleagues." colleagues"

What can you do to overcome the hard times?

Bad things happen — businesses are hit with economic recessions, people get fired, people quit, customers get angry. How do you overcome these situations and maintain a positive workplace?

5. Put things in perspective Encourage your employees to look at the bigger picture. Say an employee is upset that a project didn’t go to her, or that she didn’t get the corner office. Try to direct her toward what she has to be proud of: the project that she excelled at, the tenure she has built with the company, her great leadership qualities.

Putting things in the right perspective can create positive momentum, even when times are tough. Leaders who demonstrate an optimistic attitude in times of hardship can steer their employees toward a more productive mindset during difficult times.

Cultivate a healthy environment at work for all employees to help lower stress.

Encouraging your employees to focus on self-care, such as going for a walk outside during the day, is a great way to keep morale up. Provide them with information on how to reduce stress, the importance of getting enough sleep and eating healthy.

Being proactive as a leader shows you care about your workforce and that you’re there to help. Connecting with your employees and encouraging them to connect with each other during hard times will help lift morale and keep your business moving in a positive direction.

By creating a positive workplace, you will retain top performing employees and increase your business success. For more tips on developing positive and productive employees, get our free e-book, How to develop a top-notch workforce that will accelerate your business.

About the Author Chris Brennan is a Performance Specialist at Insperity, a company that provides Human Capital support to over 100 thousand small and mid-sized businesses across the country. Chris earned his Bachelor of Arts degree at Saint Mary’s College and his continuing studies are in organizational development, leadership development, employee engagement, professional coaching and improvisation for business leaders. Chris has been a human resources practitioner for over 15 years. Chris creates, designs and facilitates workshops and coaching on the topics of strategic leadership, culture alignment, strengths-based performance, talent development, and leadership communication.

I

3rd Quarter 2019 mddsdentist.com

17

FEATURE

RESILIENCE: BOUNCING BACK FROM LIFE’S CHALLENGES

By Laura Brenner, DDS

1818

I

f you've spent a day practicing dentistry, you know how stressful the job is. Despite our best intentions, we often run into harrowing experiences and it's always when we don't have time for them. Maybe it's unscrewing the whole implant when you're removing the healing cap to take an impression, the resin popping out during a prophy with the hygienist, or that inferior alveolar block that just won't take.

I used to struggle with how to handle those stresses almost daily.

I worried what patients would think. Would they think I am incompetent? Were they frustrated with us? How mad was my next patient (who I'm now late for) going to be? I felt overwhelmed and, at times, even traumatized.

1) Practice accepting the fact that we'll have wins and losses.

Failing is part of life. If we resist failing, we only live in denial of reality and we create a no-win situation for ourselves. Then when bad things do happen, we don't have the skills to accept it and move on. Instead we swirl around in worry, self-blame and guilt, which only makes things worse. If we need to do this for a finite period of time in order to process our thoughts and feelings, that's okay. When we accept our failures, we can also learn from them and let them go. I’d bet most experienced dentists will confirm that the mistakes they made and lessons they learned in practice ultimately made them better.

2) Take some of the weight off your shoulders. It's not always all our fault. Some of us tend to punish ourselves for everything that goes wrong, whether it is our fault or not. I remember the teachers in dental school repeatedly teaching us that "once you touch a tooth, it's yours." That's an important What if I told you that all that stuff happens to message, but I always took it way too seriously. make us better people? Not just clinicians, but "If we resist failing, we There's a difference between responsibility people. only live in denial of and blame. We can take responsibility for our reality and we create thoughts, feelings and actions without shaming When we struggle with challenges, we build ourselves into taking the blame for things over resilience. We learn to adapt; we eventually a no-win situation for which we have no control. Things go wrong in bounce back and hopefully thrive. We grow ourselves." life. It's not always you. Knowing that you will from our mistakes and, over time, realize that show up to do what's best for your patient and for we don't have to be perfect nor can we be. yourself is all you need.

It turns out resilience isn't something with which we are 3) Know that you're stronger than you think you are. We never automatically born. It takes practice. really know this until we're put to the test. Think you could never give up eating dessert if your life depended on it? How Many of the dentists I know care so deeply for their patients that about having that difficult conversation with your boss or your they want everything to be perfect for them all the time. We want employee? We worry about facing difficult challenges, but when it so much that this desire can create unbearable stress when we get through it, we realize we made it out alive. We just do it things go wrong. and we survive. Our imagination almost always creates a scarier story than what reality delivers. Reminding ourselves of our own I recently helped a dentist who was experiencing such burnout that strength every day helps us start to believe it’s truth. she wanted to quit dentistry at 40 years old. She had a thriving, successful practice and was ready to create her five year exit strategy.

The next time your patient hates the veneers you did for them, When we broke down what was really getting to her, we realized that think about how you can use that experience to build your she was carrying the weight of the world on her shoulders. She was resilience muscle. Take responsibility for your part, but don't taking on too much responsibility for everything that happened in assume the blame for the things out of your control. Remind her office. yourself that your failures are the very thing that make you better.

Believe in your strength and you’ll start to see your confidence Once she realized that she was "taking on the patient's problem and grow in all areas of your life. making it [her] own," she began to consciously choose to stop owning her patients' problems. When she found herself bogged down with staff issues, she worked with her office manager to teach her how to About the Author co-lead the office. This required having trust in her support team and Dr. Laura Brenner worked in private practice in Denver for 10 years until she letting go of some of the control we all like to maintain. It was worth left clinical dentistry behind for good. As the author of the Lolabees blog and it! Getting support from those around her helped her to lift some of 10 Reasons Your Dentist Probably Hates You Too, she began connecting with the unnecessary pressure she was placing on herself. With that, she other dentists from around the world who wanted more from their careers. stopped letting everyday office missteps take over her life.

This work inspired her to become a Certified Professional Coach who is passionate about helping dentists find joy in their careers again.

She no longer feels the burnout that was taking over her life and she has learned to enjoy what she does again. That is resilience!

How did she do it? Here are three tips that my client used, and that we can all use, to learn to bounce back from the negativity that can bog us down every day.

I

3rd Quarter 2019 mddsdentist.com

19

Are you ready to WORK LESS and TRAVEL MORE? Is this your year to transition?

Selling or Buying a DENTAL PRACTICE? All practice sales are not created equal. Don’t settle for less than you deserve. Put my experience and expertise to work for you!

trave l more !

Susan A. Spear

Licensed Broker/Business Intermediary susan@sastransitions.com

CONTACT SUSAN AT 303.973.2147 WWW.SASTRANSITIONS.COM

There’s a

Better Way to Protect Yourself

Berkley Risk of Colorado is dedicated to serving the dental and medical communities with customized, personal insurance services.

• Malpractice Coverage - Administrator of the Dentists Professional Liability Trust • Workers Compensation • Business owners Package • Life Insurance • Medical Insurance - Personal and Group

• Employment Practices Liability Coverage • Disability Insurance • Long Term Care • Flood • Privacy Data Breach 7807 East Peakview Avenue, Suite 350 Centennial, CO 80111 https://colorado.berkleyrisk.com

20

Phone: (303) 357-2600 Toll Free: (877) 502-0100 denver@berkleyrisk.com

Prof.

KAREN BAKER

Dr.

STEPHEN

CHU

SEE OUR FOUR STAR SPEAKERS AND MORE!

Dr.

DeWitt

WILKERSON

Dr.

NEWTON

FAHL

SAVE THE DATE JANUARY 23-25, 2020

rmdconline.com (303) 488-9700

21

FINANCIAL RMDC SPEAKER

YOU CAN’T RUN A PORTFOLIO LIKE A BUSINESS, PART 1 OF 2

By Scott Middleton, Principal, Director, Innovest Portfolio Solutions

E

ffective leadership, clear strategies and perseverance

“Siris” of their own to avoid being crushed by the competition. Responding

are successful elements of both business and

quickly to consumer demand has so far kept Google and Apple from making

portfolio management. However, some of the skills

the mistakes of Kodak.

needed to run a business are diametrically opposed

to those needed to manage a portfolio. Being a successful

Portfolio Design

long-term investor encompasses not only understanding

With investing, quickly adapting to changing trends and pursuing what is

these distinctions, but practicing the proven, if somewhat counterintuitive,

successful can lead to disaster. For the eight-year stretch from 1991 to 1998

skills of portfolio management. The first of this two-part article examines the

the S&P 500 Index of large cap US stocks had annualized gains of nearly

merits of responding to buyers’ demands.

21%, far outdistancing the 9% annualized returns of high-quality bonds, as represented by the Bloomberg Barclays Aggregate Bond Index. Focusing

Consumer Demand

on what had become successful, investors in 1999 redeemed a net $7 billion

In a free-market economy, businesses need to keep up with consumer

in bond funds and purchased $162 billion in equity funds, according to

demand and innovate or face severe consequences. There are few corporate

Vanguard. In 1999 large cap stocks gained another 21%. In 2000, when the

blunders as staggering as Eastman Kodak. In its hey-day Eastman Kodak

technology bubble began to burst, investors purchased an additional $258

employed 140,000 workers and retained a 90% share of the personal camera

billion in equity funds; bond funds were reduced again, this time by $51

film market. In 1996 the company was ranked as the fourth most valuable

billion. However, from their peak in 2000 to their subsequent low in 2002,

brand in the United States, behind Disney, Coca-Cola and McDonald's.

U.S. large cap stocks dropped by 49%, severely punishing those who had followed the crowd.

However, Kodak’s management refused to quickly embrace the advancements in digital photography and consumer preferences, and by 2012 the company

The flip side of chasing returns occurred after the 2008 credit crisis and the

filed for bankruptcy. Perhaps the most tragic aspect of Kodak's decline was

worst economic conditions since the Great Depression. In 2008 large cap U.S.

that the company invented the digital camera in 1975.

stocks fell 37% and were priced at arguably their cheapest valuations since the early 1980s. How did investors respond to stocks being marked down at

Alternatively, companies like Apple and Google have been quick to embrace

steep discounts? According to Morningstar Direct Fund Flows, in 2009 they

new technologies and consumers’ changing demands. The use of voice-

sold a net $69 billion in U.S. equities and purchased $404 billion in taxable

assisted technology took a big leap forward in 2011 when Apple added Siri

bonds, a decision based on past regret rather than current opportunity.

to its iPhones. Not to be left behind, Google and other companies invented

However, from the end of 2008 to the end of 2016, the average annual gains

I

22 3rd Quarter 2019 mddsdentist.com

for the S&P 500 Index were nearly 15%; for bonds, 4%. It is a powerful and

3) Constantly look for opportunities to improve the risk-reward profile of the

highly unfortunate tendency of human nature to make investment decisions

portfolio, including the addition of asset classes and strategies that improve the

based on what would have been a profitable decision a few years prior.

portfolio’s diversification and risk management. The current environment of low yields—and low future returns--on high-quality fixed income investments

There are three time-proven strategies that effective investors use to avoid the

has made it very challenging to mitigate portfolio volatility and meet long-term

traps of return-chasing and the cycle of market emotions:

return goals. The next bear market in stocks will test how effectively investors have designed their portfolios to manage downside risk.

1) Look ahead, not in the rear-view mirror, to the expected risk-reward of each asset class and especially the whole portfolio. When valuations on equities have

The first of this two-part article has focused on the portfolio skills necessary to

run up (such as in 2000), future long-term returns are likely to be more modest.

avoid chasing consumer demand and to effectively implement asset allocation

Alternatively, expected returns are likely to be brighter after stocks have declined

decisions. In part two, to be published in the Summer Research Report, our

(in 2008 and early 2009, for example). Innovest’s expectations for long-term

attention will turn to hiring and firing decisions and how standard business

equity returns have become more modest in recent years as stocks’ valuations

practices can often be detrimental to effective portfolio management.

have climbed.

Mindful matters, and so do you!

2) Rebalance the portfolio’s allocations back to their strategic targets on an ongoing basis. Portfolio rebalancing avoids being overexposed to stocks and other riskier assets at the peak of a market and underexposed at the bottom of a market. The discipline of rebalancing is one of the best methods to avoid chasing returns and manage volatility, though it is somewhat counterintuitive to trim what has done well to add to what has not.

About the Author For more than 20 years, Innovest has provided excellent client service as well as forward-looking, innovative investment solutions for endowments and foundations, retirement plans and families. We are an independent provider of investment-related consulting services and work on a fee-only basis.

DISC 2019

NATIONAL SPEAKERS / AGD PACE CREDITS / GREAT FORMAT / NEW LECTURES

CLINICAL NUANCES: PRACTICAL SOLUTIONS

For additional information or to register, visit https://disc.events

DISC 2019 Schedule

June 20 - Edward Mills, DDS

Dentist. Atlanta, Georgia Title: Hard and Soft Tissue Vertical and Horizontal Regeneration Approved PACE Program Provider FAGD/MAGD Credit Approval does not imply acceptance by state or provincial board of dentistry or AGD endorsement.

1/1/2018 to 12/31/2019 Provider ID# 217950

September 12 - Rodrigo E. F. Neiva, DDS, MS

Periodontist. Director of the Graduate Program in Periodontics of the University of Florida – College of Dentistry Title: Grafting and Osseodensification

October 10 - Lambert Stumpel, DDS

KNOWLEDGE FACTORY

May 16 - Vincent Celenza, DMD Prosthodontist. New York, New York Title: Long Term Effects – Realistic Expectations with Implant Restorations

July 25 - Aldo Leopardi, BDS, DDS, MS Prosthodontist. Greenwood Village, Colorado Title: Aesthetic Zone Provisionalization Clinical Update: fabrication, immediate vs custom healing abutments and tissue shaping

Dentist. San Francisco, California Title: Fixed Hybrid Prosthesis: the cumulative experience of over 500 cases

DISC IS POWERED BY

April 4 - Isaac Tawil, DDS Dentist. Brooklyn, New York Title: Immediate Implant Placement, Extraction Site Management & Partial Extraction Therapy

November 14 - Steven D. Nytko, DDS, MS

Periodontist. Kentfield, California Title: A New Era in Soft-Tissue Reconstruction

Continuing education credits are available. (Total of 15 and 3/4 hours of AGD PACE credits)

I

3rd Quarter 2019 mddsdentist.com

23

FEATURE RMDC SPEAKER

BETTER POSTURE, BETTER HEALTH, BETTER PRACTICE

By Neil Wolkodoff, PhD

I

n the dental profession, you are either standing or sitting

So, how can you combat poor posture in a profession that requires you to tilt

at a forward angle during most of your work. It is simply

forward? Here are some simple things you can do both at your practice and

unrealistic to expect this forward, tilting position to be

outside the office to combat this constant tilting ahead.

mediated and corrected by sitting properly during the evening. Massage, while a great tool to get tight muscles

Tilt Back and Retract

to relax, will not undo what you

When you break and go to a new patient,

practice for seven to nine hours per

or have a break, stand tall and cognitively

day.

retract your shoulders back and feel your head directly over your spine for five to

Poor posture can affect your life

ten seconds. If you have time, repeat for

outside of work in numerous ways,

two more rounds. Put your elbows at your

none of which are positive. First,

side and think of rotating your hands

it can lead to permanent neck,

backward and pulling with your thumbs.

shoulder and back imbalances

This activates the muscles of the upper

that may cause bone and muscle

back and shoulders, necessary to fight the lousy posture slump. The

changes. Second, it leads to more

result is your muscles will start to pull against the tendency to hold the

stress acting upon the shoulders and back, which can influence your

poor posture, and your work won’t affect your overall posture as much.

disposition. And, just as important, posture speaks about your demeanor

Alternatively, you can stand with back against a wall and retract from

and connection to the patient as health care providers. Your posture can

the shoulders through the head to the wall for a similar effect. For every

imply you are confident, skilled and engaged with the patient.

patient, balance with a short application of this exercise.

II

24 3rd 2nd Quarter Quarter 2019 2019 mddsdentist.com mddsdentist.com

Sit on a FitBall If you can sit on a FitBall rather than an office chair, you naturally will assume

ground up. And, the right combination will reduce your energy expenditure

an upright posture which will reduce the tension in your neck and back. The

overall, so you feel less fatigued at the end of the day.

key is finding the right height ball, so your knees are just a little lower than

Suspension Bridge

your hips when sitting. Additionally, sitting on the ball will have a strength effect on the core. Limited research has found that in a task like typing, people

Just like a suspension bridge, your muscles

perform better sitting on a FitBall than using a standing desk or traditional

form the basis of how the upper back,

office chair. So, the brain gets a boost as well.

shoulders, and neck finally come to rest.

If you don’t lift weights, start. And work

Circulate

with a medical fitness professional to find

In these long, seated sessions, circulation is lessened from holding a position.

the exercises that will help counterbalance

Riding a stationary bike at least 20 minutes, twice per week will improve

your posture in the back up to the head. A simple rule of thumb is to perform

circulation in the legs. The result is you can pump a little more blood in these

five sets of pull exercises for every two sets of push exercises as you are essential

protracted sessions.

pushing forward in your dental work profession.

Base of Support

About the Author Neil E. Wolkodoff, PhD, is the Medical Program Director of the Colorado Center for Health and Sport Science, a medical physiology intervention practice in Denver, CO.

Get your feet evaluated for both how you stand and walk. How you stand affects your posture, as poor foot structure

will

change

spinal,

shoulder and neck orientation and tilt. The same is true for walking or gait. An evaluation can determine if your combination between feet and shoes fits what you need to be in a neutral posture from the

You could save thousands on your student loans 1

ADA members get a 0.25% rate discount2 when refinancing. Check your rates in less than 5 minutes3 at LaurelRoad.com/ADA.

1. Savings vary based on rate and term of your existing and refinanced loan(s). Refinancing to a longer term may lower your monthly payments, but may also increase the total interest paid over the life of the loan. Refinancing to a shorter term may increase your monthly payments, but may lower the total interest paid over the life of the loan. Review your loan documentation for total cost of your refinanced loan.

2. The 0.25% American Dental Association (ADA) member rate discount is offered for applications from ADA members in good standing. The rate discount will end if ADA notifies Laurel Road that borrower is no longer in good standing. Offer cannot be combined with other offers, including the Referral Program.

3. Checking your rate with Laurel Road only requires a soft credit pull, which will not affect your credit score. To proceed with an application, a hard credit pull will be required, which may affect your credit score.

Laurel Road is a brand of KeyBank National Association offering online lending products in all 50 U.S. states, Washington, D.C., and Puerto Rico. All loans are provided by KeyBank National Association, a nationally chartered bank. ©2019 KeyCorp® All Rights Reserved. Laurel Road is a federally registered service mark of KeyCorp.

20190708_ADASLRAD_7.5x5 Member

I

3rd Quarter 2019 mddsdentist.com

25

NON PROFIT NEWS

MDDS Members Give Back to Senior in Need

W

hen you volunteer with Dental Lifeline Network’s Donated Dental Services (DDS) program, you are able to give back to people in your local community who otherwise could not afford dental care.

irritating, and unstable mandibular anterior teeth that she was afraid of losing.

Fortunately, Drs. Prendergast and Christensen were able to help Teri. Dr. Christensen gave Teri a root canal on one of her teeth and extracted another tooth. Dr. Prendergast extracted two teeth, restored six others, and added three crowns thanks to the help of Olympus Dental Ceramics in Highlands Ranch.

From clearing up painful dental infections to being able to eat again – providing comprehensive dental care will make a life-changing difference Thanks to the generosity of this volunteer team, Teri can for people with special needs like Teri, an elderly Teri and Dr. Prendergast now eat again and focus on her health. woman who recently received help from MDDS members Dr. Patrick T. Prendergast and Dr. Shane R. Christensen.

Will you see one patient with Donated Dental Services (DDS)? DLN has 419 dentists who volunteer in the Denver area, and since its inception Recently, Teri underwent a spinal surgery to treat some of her orthopedic in 1985 has provided care for over 6,600 patients in the Denver DDS problems. She also deals with the effects of acid reflux disease, osteoprogram. To join Drs. Prendergast and Christensen in volunteering to arthritis in her hands and neck, and neuropathy in both of her feet. serve people with special needs and to learn more about Donated Dental Services (DDS), visit willyouseeone.org.

Due to her health issues, she can only do minimal part time work as an in-home caregiver and she cannot afford to address her painful dental issues. She had multiple missing and broken teeth that were sharp and

26

Let’s collaborate!

Improve your patient care without adding overhead expense – by partnering with DenteVita and the Practice of Dr. Aldo Leopardi, Prosthodontist. You can trust that you’ll receive the impeccable service you would expect from a seasoned specialist like Dr. Leopardi.

Consider Dr. Leopardi’s expertise as an extension of your professional practice. The level of experience and precision that his Practice offers makes it easy for you to refer your patients with complete confidence.

About Dr. Aldo Leopardi Dr. Leopardi is the founder of DenteVita Prosthodontics. His focus is to provide functionally driven aesthetic solutions to patients requiring tooth borne fixed, removable, aesthetic and implant supported dentistry. With over 30 years of experience, from single tooth to complete rehabilitation, you can be assured that your patients are in the care of a skilled professional.

7400 East Crestline Circle, Suite 235 Greenwood Village, Colorado 80111 P. 720.488.7677 F. 720.488.7717 Visit our website: www.dentevita.com

Interested in how we can collaborate?

My goal is to do everything possible to build your confidence and exceed your and your patients’ expectations.

Please call my office at

720.488.7677.

It will be a great pleasure working with you.

Life

is better with DenteVita

TRIPARTITE NEWS

TAKING A STAND

By Greg Hill, JD, CAE, CDA Executive Director

W

hen I found out this issue of the Articulator was

In addition, we’ve outfitted the office with a small gym with a treadmill and

focusing on wellness, I could not have been more

weights. This provides an opportunity for us to get up and move throughout

excited. The Colorado Dental Association (CDA)

the day. (Truth be told, I am walking on the treadmill while I am writing this

has been working to actively address wellness needs of our

article.) The same benefits of a standup desk are achieved by working while

members and our team and have several exciting programs

on the treadmill, but with the added benefits of walking or running. To

we are working on in this space.

encourage staff to incorporate the office gym into their routine, we have a team competition that will reward staff for exercising four days a

It’s no secret that dentists live stressful lives. Suicide rates for dentists are more than twice the rate for the general population and three times higher than other “whitecollar” professions. Coronary disease and high blood pressure are over 25% more prevalent among dentists than in the general population. The #1 killer of dentists is stress-related cardiovascular disease.

These challenges are the basis for a new wellness program currently in design by the CDA Council on Membership

week while at the office. We’ve also been regularly holding

"Suicide rates for dentists are more than twice the rate for the general population and three times higher than other 'white-collar' professions."

to create a more proactive approach to dentists’ health.

wellness challenges at the CDA and each time, focusing on the positive effects of living healthier.

Another great benefit of the new desks and the gym is quite frankly, creating a positive work environment to maintain top talent. Speaking of which, consider this: each time you hire a new person, your productivity decreases, not to mention the costs of hiring a new member for your team.

The website Dental Compliance estimates that the cost to replace a $15 per hour person on your dental team is

between $2,200 and $5,400. That loss in productivity is greater than the cost of Historically, organized dentistry’s approach has been much more focused on

an investment in a treadmill for your office or standing desks for your team. If

the reaction to alcoholism and drug abuse by its members. We’ve developed

these small changes, or others, can make a difference and help you maintain

programs to help dentists succeed in their professional lives but haven’t focused

your team, then you as a business owner or team manager are happier and you

on the personal needs of the members.

have improved your wellbeing at the same time.

This new program is being designed to help members live healthier, both in

We are finding that this approach is not all that common in other state

their practice and personal lives. We’re focused on mitigating the stressors

associations across the country and I am proud that the Council on

that can cause more significant challenges. If we are to fully empower our

Membership has seen it’s importance to member success. We are also excited

member dentists to build successful practices and careers, we must have the

to help further a culture of health and wellness by practicing what we preach.

foresight to help address their occupational, physical and social wellness needs through education, resources and support through a variety of diverse member benefits.

How can you add wellness into your day at your dental practice? How do you do so already? Let me know by emailing greg@cdaonline.org.

We believe this approach will result in an overall healthier membership while at the same time, providing individual opportunities for members to participate in diverse wellness programs.

Now, what about the CDA team? We’re incorporating wellness into our daily routine here at the CDA headquarters. Each office at the CDA is now equipped with a stand-up desk and team members are encouraged to stand throughout

About the Author

Greg Hill, JD, CAE has served as the Executive Director of the Colorado Dental Association since June of 2014. Prior to joining the CDA, Greg was employed by the Kansas Dental Association for 15 years and served as the Assistant Executive Director of the CDA and Executive Director of its Foundation. Mr. Hill is a 1999 graduate of the Washburn University School

the day while working. Studies show that those who sit a lot are 54% more

of Law in Topeka, KS and a 1994 graduate of Kansas State University with

likely to have a heart attack. Men who sit more than six hours a day have a 20%

a Bachelor of Science in Economics. He became a Certified Association

higher mortality rate; women have a 40% higher mortality rate. If you sit for

Executive (CAE) in 2016. In addition, he serves as Co-Chair and Treasurer

more than 23 hours a week, you are 64% more likely to die from heart disease.

of Oral Health Colorado; on the Board of Directors for the Colorado Dental

I can tell you personally that standing, rather than sitting at my desk all day, has

Lifeline Network and the Colorado Mission of Mercy; and is a member

resulted in less fatigue and more creativity throughout the day.

of the Denver Tech Center Rotary Club. He and his wife, Gwen, are the parents of daughter, Haven, and son, Camden.

I

28 3rd Quarter 2019 mddsdentist.com

Founded by a team of industry professionals who have been providing waste management services to Colorado for over 18 years, HCMWS proudly serves hospitals, clinics, laboratories, blood banks, dentists and funeral homes, as well as any facility that is looking for a safe and cost-effective way to dispose of their medical waste.

PO Box 1385 Colorado Springs, CO 80903-1385 info@hcmws.com 719-445-5044 720-319-9419 www.hcmws.com

EVENT CALENDAR September 27-28 Dental Sleep Medicine Mini Residency Session 1 -Drs. Chase Bennett, Terry Bennett, Mayoor Patel Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am – 5:00pm (303) 488-9700

October 12 Frontline TMJ and Orofacial Pain , Level I -American Academy of Facial Esthetics Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am – 5:00pm (303) 488-9700

November 12 CPR & AED Training -American Workplace Safety Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:00pm – 9:00pm (303) 488-9700

OCTOBER

October 26 Local Anesthetics, Vasoconstrictors and Clinical Considerations -Mr. Tom Viola Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am – 3:00pm (303) 488-9700

November 22 – 23

Take Your Practice to the Next Level with the Benefits of Erbium Lasers -Dr. Terry Alford Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am – 5:00pm and 8:00am – 12:00pm (303) 488-9700

October 4 Moving Forward with New Periodontal Classifications and Treatment -Dr. Maryanne Butler Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am – 3:00pm (303) 488-9700 October 11 Botulinum Toxin (Xeomin, Dysport, Botox) and Dermal Filler Training, Level I -American Academy of Facial Esthetics Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am – 5:00pm (303) 488-9700

30

October 12 Botulinum Toxin (Xeomin, Dysport, Botox) and Dermal Filler Training, Levels II & III -American Academy of Facial Esthetics Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am – 5:00pm (303) 488-9700

NOVEMBER November 1 Navigating the World of 3D Imaging -Dr. Miriam Robins Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am – 3:00pm (303) 488-9700 November 8-9

Dental Sleep Medicine Mini Residency Session 2 -Drs. Chase Bennett, Terry Bennett, Mayoor Patel Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am – 5:00pm (303) 488-9700

DECEMBER December 7 Nitrous Oxide/Oxygen Administration Training -Dr. Jeffrey Young Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am – 4:00pm (303) 488-9700

JANUARY January 23-25 Rocky Mountain Dental Convention

CLASSIFIEDS Jobs

Real Estate

Associate Dentist - Busy general practice in Broomfield, CO looking for an associate dentist. 2 years experience or GPR preferred. Contact Kendall Burns, broadlandsfamilydentistry@gmail.com.

GP for sale in Denver (CO 1906) Beautiful 5 Op in Denver Metro, Dr moving out of the area. For information email: frontdesk@adsprecise.com or call 303-759-8425.

PT General Dentist - PT Dentist needed for growing practice in Englewood. Competitive 1099 commission offered for an experienced practitioner who likes the challenge of highproduction. We perform endo, oral surgery, crown & bridge, etc. We also place implants.

Seasoned staff with a wonderful atmosphere. We utilize Wave One. We also use ImplantDirect. If you can build your patient base with empathy, confidence, and pleasant personality, we want to talk with you! Contact todd@erdentist.com, (303) 503-3184 Associate Dentist and more - Benevis currently seeking FT and PT Associate Dentists, Orthodontists, Endodontists, Pediatric Dentists, Oral Surgeons, and Anesthesiologists for the practices we support in AZ, TX, DC, KS, MA, MD, VA, CT, SC, GA, MS, OK, AR, IN, KY, and LA. We are looking for talented dentists who are interested in making a difference in the communities we serve while maintaining a healthy work/ life balance with our flexible scheduling options. We offer growth and development through mentoring, leadership and practice ownership opportunities. In addition, we offer competitive compensation packages. We may also offer student loan repayment, sign-on bonuses, relocation, 401K, paid time off, health insurance and license and CE reimbursements. We may also provide Visa and Green Card sponsorship if interested, please contact us – edwright@benevis.com.

Lakewood Office Seeking Associate - Do you have a philosophy of practice that puts patients first? Are you honest, ethical, and skilled? Are you looking for dental office space, but don’t want to build out an office? Do you have patients and need a place to treat them? Have you “associated” or work for a “company” and now you would rather do your own thing? I am a semi-retired dentist with office space available for the right doctor. I am not looking to “rent” space but rather provide an opportunity to practice dentistry on a “pay as you produce” basis. Eventually, I anticipate retiring, which could lead to other opportunities. If your situation means you’re looking to do something different and I can help, then we should talk. Call me at 303-699-5907 (cell) and if no answer, please leave me a message. I will return your call and we can decide what is a good fit. Contact roger@rogerandersondds.com, (303) 699-5907.

GP for sale in South Metro Denver (CO 1902) $250K for Beautiful 5 Op in South Metro Denver, Dr moving out of the area. For information email: frontdesk@adsprecise.com or call 303-759-8425 GP Practice: Pueblo (CO 1808). Doctor retiring. Annual revenue $300,000. 3 ops.

Contact frontdesk@adsprecise.com or 303-759-8425.

Associate to Buy-In 50% of Practice in Denver (CO 1806) 3 OPS, 900K in collections. For more information, please call 303.759.8425 or email frontdesk@adsprecise.com GP and free-standing Building (sold with practice) for Sale: West Colorado Springs (CO 1803) Dr retiring, annual revenue $275K, 5 OPS. For information please call 303.759.8425 or email frontdesk@adsprecise.com GP for Sale: North Eastern CO (CO 1735) 4 Ops, approx. 600K in collections, Standalone bldg. sold w/practice. Dr. retiring, 303-759-8425, www.adsprecise.com, frontdesk@ adsprecise.com Highlands Ranch GP Start-Up Practice for Sale: (CO 1723) $229K, Annual Rev. $530K, 4 ops/2 equipped, high-end finished office in desirable neighborhood- 1,964 sq ft. Dr. Retiring. 303-759-8425, www.adsprecise.com, frontdesk@adsprecise.com Perio Practice for Sale: (CO 1723) Denver Suburbs South. NOW $229K- Annual Rev. $530K, 4 ops/2 equipped, beautiful office - 1,964 sq ft. Dr. Retiring. 303-759-8425, www. adsprecise.com, frontdesk@adsprecise.com OMS practice, western mountains near Vail and Aspen, (CO 1350) Annual Collections $840K, 3 ops, 1260 sq ft. email: frontdesk@adsprecise.com, 303-759-8425.

Knowledge • Experience • Credentials • Trust More Completed Transitions and

Years of Practice Transition Experience than any brokerage firm in Colorado.

ADS Precise Transitions P e t e M i r a b i t o D D S , FA G D • J e d E s p o s i t o M B A , C VA

• Practice Sales Since 1986 • Practice Valuations

• Dental Building Sales • Transition Planning

I

3rd Quarter 2017 mddsdentist.com

VALUATIONS l SALES l REAL ESTATE

• Start-Ups • Buy Ins/Buy Outs

Call us - 800.307.2537 Visit us - adsprecise.com All ADS companies are independently owned and operated

I

3rd Quarter 2019 mddsdentist.com

31

Is it time to purchase your office space?

Allow our team of expert brokers to perform a detailed purchase vs lease analysis on your behalf.

CARR Healthcare is the nation’s leading provider of commercial real estate services for healthcare tenants and buyers. Our team of experts assist with start-ups, lease renewals, expansions, relocations, additional offices, purchases and practice transitions.

DENVER METRO Dan Gleissner 303.748.7905 dan.gleissner@carr.us NORTHERN COLORADO Phillip Redmond 970.409.0307 phillip.redmond@carr.us SOUTHERN COLORADO Kent Hildebrand 719.440.0445 kent.hildebrand@carr.us CARR.US