Articulator Volume 22, Issue 2

ARTICULATOR MDDS Connections for Metro Denver’s Dental Profession

4th Quarter, 2017 Volume 22, Issue 2

HOW GENERATIONAL DISPARITY IS MAKING BUYING AND SELLING A CHALLENGE 14

Emerging Legal 11 An Threat to Dentists Pillars of Leading 20 5Practice Success

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4th quarter 2017

what's inside?

28

p. features

11 An Emerging Legal Threat to Dentists

AN EMERGING LEGAL THREAT TO DENTISTS pg.11

14 How Generational Disparity . is Making Buying and Selling a Challenge

18 Biorthosis® Digital ................

Registration and Design of a .

Advertisers Directory

TMJ Positioning Splint B:11.25”

T:11”

S:10”

20 5 Pillars of Leading Practice Success

28 Infection Control and

........

OSHA Compliance Solutions/Immunizations for DHCP

departments

ADA ada.org/findadentist.......................... 27

CTC Associates ctc-associates.com/............................ 29

ADS Precise Consultants adsprecise.com................................. 31

Dentists Professional Liability Trust of Colorado tdplt.com.......................................... 13

Berkley Risk Services of Colorado berkleyrisk.com................................... 5 Carr Healthcare Realty carrhr.com........................... Back Cover Catalyst Retirement Advisors, LLC catalystretirement.com......................... 4

Denver Implant Study Club https://disc.events/............................ 29 Healthcare Medical Waste Services, LLC hcmws.com....................................... 21

Colorado Dental Association cdaonline.org.................................... 22

Northwest Mutual shawncopeland.nm.com.................... 21

4 President's Letter

Commerce Bank commercebank.com/dentistry....Inside Front Cover

SAS Transitions sastransitions.com............................... 5

6 Member Matters

Copic Financial Services Group

Vitality Laboratories viatalitydentalarts.com.................. 16-17

copicfsg.com..................................... 25

8 Reflections 10 Member Spotlight 20 The Relentless Dentist

Guest Editor Allen Vean, DMD Creative Manager & Managing Editor CT Nelson Director of Marketing & Communications Cara Stan

23 Peer Review Puzzler

MDDS Executive Committee

24 Clinical

President-Elect Brian Gurinsky, DDS, MS

26 Nonprofit News 30 Event Calendar 31 Classifieds

President Nicholas Chiovitti, DDS

Treasurer Nelle Barr, DMD Secretary Kevin Patterson, DDS, MD

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 Printing Denver, CO 80203 Dilley Printing Phone: (303) 488-9700 Fax: (303) 488-0177 The Articulator is published bi-monthly by the Metropolitan Denver Dental Society and distributed to MDDS members as a direct benefit of membership. mddsdentist.com ©2017 Metropolitan Denver Dental Society Executive Director Elizabeth Price, MBA, CDE, CAE

Member Publication

3

PRESIDENT'S LETTER

Changing Face of Dentistry Make Music

By Nicholas Chiovitti, DDS

T

he landscape of dentistry is very different

such as the quarterly New Member Welcome Events or annual Family

today than what I faced almost 40 years ago.

Fun Event. Learn about the latest techniques and technology in dentistry

At that time, our choices after graduation were to associate

with

another

dentist, start a new practice or join the military. While we also had debt, it was not nearly as daunting as what new dentists face today. Our profession has become far more diverse, not only in gender and ethnicity, but in employment options. Now, dentists can choose private practice, associateship, Dental Service Organizations (DSO) or public health. Graduating dental students have a lot of options following dental school.

The Metro Denver Dental Society (MDDS) stands

at the Rocky Mountain Dental Convention (RMDC)

"As President of the Society, I encourage you to become more involved. As a dental society, we seek to represent all our members and this cannot be accomplished without your involvement and feedback."

or at one of our many CE events at the Mountain West Dental Institute (MWDI). These events and CE courses provide members several avenues to connect with other dental professionals from all walks of life and career stages; sharing a common passion for dentistry and oral health.

With a quarter of my term as President complete, I am happy to say I have met several members at various MDDS events. I am proud of the diversity of our membership. I look forward to furthering communication with you as your feedback and

with the American Dental Association (ADA) and the

opinions can only continue to improve MDDS. For

Colorado Dental Association (CDA) to keep dentistry

those of you who I have not had the chance to meet,

strong in today’s marketplace. Our organization is here to help members.

know your opinion is valued and we want to hear from you! Please feel

The stress each and every one of us face daily is tremendous. This stress

free to reach to me through MDDS staff by calling (303) 488-9700 or

affects our lives and health in many ways. Do not try and shoulder that

emailing mdds@mddsdentist.com.

stress by yourself. Contact MDDS - our staff and volunteer dentists stand ready to help. Together, MDDS members make a difference.

As President of the Society, I encourage you to become more involved.

MDDS seeks to represent all members and this cannot be accomplished without your involvement and feedback. What is your passion in dentistry? Is it learning and education? The Continuing Education or RMDC Programming Committees could use your input. Do you enjoy connecting with colleagues? Our Member Services Committee is looking for a diverse group of individuals to help maximize your membership.

Retirement Planning for Dental Professionals

BEYOND INVESTMENTS:

A retirement roadmap built for dentists.

We are dedicated to consulting with dental professionals. We design personalized retirement strategies that serve people not products.

What about community outreach? The Community Outreach & Public Relations Committee could use your unique perspective and suggestions.

If leadership is important to you, we are always looking for fresh voices on the Board of Directors and encourage you to consider this position as your dental career progresses.

Additionally, our Society has many opportunities for you to network with other members throughout the year. You can attend social gatherings

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4th Quarter 2017 mddsdentist.com

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4th Quarter 2017 mddsdentist.com

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MEMBER MATTERS

Shredding for COF’s Angels

MDDS and Colorado Orthodontic Foundation (COF) volunteers donated time to provide a member benefit and raise money for a good cause.

Dr. Allen Vean makes a donation to COF.

Paul Jerez helps dispose of sensitive documents brought in by MDDS members.

Drs. JR Franco and Nick Chiovitti get their hands dirty at the MDDS Shred Event.

Rooftop Fun At MDDS’s Largest New Member Welcome Event

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spring 2016 mddsdentist.com

MDDS and ASDA members enjoy the rooftop at Historians Ale House.

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4th Quarter 2017 mddsdentist.com

New members soak up some of the final days of summer.

MDDS Members Achieving Excellence with the Pierre Fauchard Academy New Members, Welcome!

Dr. Lauren Basile Dr. Lacey Bowen Dr. Nicholas Brassard Dr. Melanie Churinetz Dr. Wade Elton Dr. Michael Fiala Dr. Joseph Fink Dr. John Harrison Dr. Nadeen Jamal Dr. Robert Jefferies Dr. Cara Jones Dr. Ardavan Karami Dr. Neda Karami Dr. Sat Kartar Khalsa Dr. Christopher Klekamp Dr. Jeremy Lowy Dr. Lynn Miller Dr. Renee Moran Dr. Ashley Parker Dr. Therese Pham Dr. Nikhil Reddy Dr. Jackie Richmond Dr. Kevin Schwandt Dr. Greg Sefcik Dr. Nikita Singh Dr. Shabnam Soltani Dr. Derren Tippets Dr. Priya Uppal Dr. Robin Yamaguma

Dr. Terry Brewick addresses attendees at the Pierre Fauchard Academy Meeting and Induction.

Drs. Eric Dale, Karen Franz, Stephanie Walker and Jayme Glamm are inducted as the newest Pierre Fauchard Fellows.

ASDA Social at the Stanley Marketplace

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spring 2016 mddsdentist.com Students and MDDS members gather at Cheluna Brewing Co. for brews, tacos and networking.

3rd and 4th year dental students mingle with members and discuss life after graduation.

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4th Quarter 2017 mddsdentist.com

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REFLECTIONS

Challenges

By Allen Vean, DMD

A

lmost daily, we are faced with challenges in both dentistry

talkies. If you had an antenna on your car signifying that you had a mobile phone, people

and as business owners. Scheduling conflicts, equipment

thought you were somebody important. Initially, technology grew on a linear basis. Today,

issues

and

patient

and

staff

interactions, to name a few, demand

that we consistently perform at the highest level.

We are not allowed to have a bad day.

Throughout my career, I have found that one of the biggest challenges has been, and continues to be, staffing. Dental school does not

"The ability to recognize a competent staff member can be more difficult than doing a beautiful restoration."

the field is growing exponentially. One of our profession’s biggest challenges is keeping up with this growth. I reviewed marketing newsletters and it appears that voice technology will be making a big impact as soon as 2018. Apple, Amazon, Google, etc., have or will be introducing this technology in the near future. Seeing how this new phenomenon will impact patient care and how we do business is going to be exciting to observe.

include Human Resources 101. The ability to recognize a competent staff member can be more difficult than doing a beautiful restoration. In fact, many times,

Included in this issue is a reprinted article from Dental Economics. The Department of

the restoration is easier. Once you have identified a potential staff member and deem they

Justice has ruled that the Internet is now subject to the American Disabilities Act. As you

are a good fit for your practice, the retention of this employee becomes paramount. You

will read, the challenge for dentistry is bringing our websites into compliance. There is

must make the position desirable enough so that they – and every member of your staff

already a lawsuit taking place in Texas. It does not appear that this is going to be one of

– feel appreciated and have a positive attitude toward their work. At the end of each day,

those simple fixes.

I make it a point to personally thank my staff and tell them how much I appreciate what they do!

While on the subject of various challenges, our thoughts go out to our colleagues who have been effected by the recent hurricanes and storms. We hope that they are safe and able to

When I began practicing, technology was an infant. Cell phones were the size of a walkie

MEMBER BENEFIT

HIGHLIGHT 110th

rebuild as soon as possible.

Celebrating its 110th year, the Rocky Mountain Dental Convention (RMDC) draws dental industry professionals from across the country to the heart of Denver for three days of soughtafter continuing education, a world-class exhibit hall and networking. MDDS members are able to enjoy all that RMDC has to offer as part of their annual membership dues.

To take advantage of the most popular member benefit and register for the 2018 Rocky Mountain Dental Convention visit rmdconline.org and follow @RMDConline on Facebook.

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REGISTER NOW! Registration for the 2018 RMDC is now open.

Visit rmdconline.com to View the dynamic speaker line-up Register for cutting edge courses Learn about the NEW CE and demo stage – The Summit

110th

Make your hotel reservation HOSTED BY:

And much more!

January 18-20, 2017

rmdconline.com

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MEMBER SPOTLIGHT

Stacy Jackson, DDS Children’s Dentistry, Westminster, CO

What influenced your decision to go into dentistry?

"My mom is a dental hygienist in Topeka, KS, so I grew up around teeth and the dental field. I always admired the relationships she’d built with her patients and the influence she had on other peoples’ lives."

Do you have any mentors in the profession? If so, how has their guidance made an impact on you?

"I’ve been very lucky to have some great teachers and mentors on my dental journey. The two pediatric dentists I work with now have been amazing and my attendings in residency have really helped me to become a better dentist. You can learn something new from anyone, and this can help make you a more well-rounded clinician if you keep an open, positive mindset. "

What is the most rewarding aspect of your job?

"Interacting with all the kiddos. I love the way they see the world and are always so honest! It’s an honor to watch them grow up and be a part of their lives—to see them accomplish milestones and goals brings a smile to my face."

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10 4th Quarter 2017 mddsdentist.com

What is one challenge you face as a young dentist?

"Coming into a well-established practice and being the new dentist can be challenging at first. Proving yourself to the staff, patients and parents takes time. I feel very lucky everyone at Children’s Dentistry has been so warm and welcoming."

Why was it important for you to join organized dentistry?

"I enjoy meeting people and we all work together as a team for the best for our patients. Being a member of dental organizations helps us learn and build connections that ultimately benefit our patients."

What is one trend in the industry that you are most excited about?

"It’s not a new trend, but I love that we can offer in-office oral sedation to our patients. A lot of kids fall in between needing nitrous oxide and GA, so to be able to offer this service is something I think is valuable and very helpful to the patient and parent. "

What would you be doing if you were not in the dental industry?

"I love to decorate for all the seasons (I frequent Hobby Lobby and Pier One way too often!) and bake. So something crafty where I could do these two things and interact with people."

AN EMERGING LEGAL THREAT TO DENTISTS This is a reprint from Dental Economics, August 8, 2017

By By Graig Presti, CEO, Local Search For Dentists

H

ave you ever lied on your taxes? Misled the IRS? Said to

would really like to push this under the rug. But regardless of what state you practice in,

yourself, “Chances are I won’t get audited. Who’s going to

what type of practice you have, or what size of practice you run, right now your website is

know?”

likely in noncompliance with the ADA, and it needs to be compliant. This can be true even if you hired someone to build your website. Why? Because making a site compliant can cost

Of course not. You try to run your practice as ethically and aboveboard

extra, or it isn’t discussed when designing the site, or the site isn’t kept up to date.

as possible. However, what you don’t know is that your website could very well be violating federal law as you read this.

We’ve been fielding phone calls from dentists who report that there are many website firms who are unaware of this situation, and who are in disarray on this topic. We’ve even heard

Recently, I learned that a Dallas-area dentist (whose privacy is being withheld for obvious

companies telling customers they’re compliant when they’re not, just to save that customer

reasons) was threatened with a federal lawsuit by a military veteran. The veteran charged

from leaving their company - and subsequently putting that customer (you) at risk. After

that the dentist’s website was inaccessible to people with disabilities and in violation of

careful research and direct inquiries, it appears some dental website providers don’t even

the Americans with Disabilities Act (ADA). This has been an expensive endeavor for the

know what “compliance” is.

dentist; it’s costing him thousands to settle this legal battle and make it go away. The kicker is that he still must make his website accessible. Plus, if the state dental board learns of this

At the end of the day, you are not exempt from the law, and failure to take the appropriate

pending federal lawsuit, it could compound the repercussions.

action could be extremely expensive and stressful. This is a very real threat, and you need to take this seriously, as this law is not going away. If nothing else, it could get more stringent

A little background: Title III of the ADA provides for people with disabilities to have equal

and specific.

access to buildings, public restrooms, restaurants, and more. Recently, the Department of Justice demonstrated and a federal court has ruled that the law applies directly to the

If you don’t have a website that complies 100% with the accessibility standards set forth

Internet (specifically your dental practice’s website).1 For example, those who are visually

by the Web Content Accessibility Guidelines (WCAG) 2.0 AA, which puts your site in

impaired have difficulty seeing website images, so the website should include appropriate

compliance with the ADA, you are 100% at risk. And just a word of warning: it’s likely a lot

tags and data that “speaks” what those images look like.

cheaper to make your website compliant, because these federal lawsuits are typically settled out of court for large sums - sometimes as high as $70,000, not including legal fees.4'

While the ADA does not provide for monetary damages to private parties bringing ADA lawsuits, it allows for “reasonable” attorney fees, which means big money is on the line. The

I spoke to Karl Kronenberger, JD, a partner at Kronenberger Rosenfeld LLP. His law firm

major retailer Target was sued by the National Federation of the Blind and had to settle for

specializes in Internet law, and has seen this issue come to the forefront in recent years.

millions because of ADA website compliance violations. The court substantiated the award

“Adding an accessibility link to your website is not going to get someone compliant,” he says.

by declaring that the “plaintiffs have broken new ground in an important area of law.”2

In other words, this is a real issue that requires real attention.

More recently, the supermarket chain Winn-Dixie was found liable in federal court

My team and I have spent hours tracking the efforts of these attorneys. Unfortunately, we’ve

under Title III of the ADA. The trend suggests that dentists and other brick-and-mortar

found a pattern of who they go after. They specifically target dentists, because they know

businesses should focus on accessibility efforts now.

dentists’ websites are not compliant with ADA standards. They also know dentists don’t

2

3

have deep corporate pockets to fight back, so they’ll probably just cave in and settle.

What you need to know I understand that this is frustrating to have to comply with another regulation, and you

Continued on page 12

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4th Quarter 2017 mddsdentist.com

11

Continued from page 11 Dental practices are “easy pickings” for these law firms. That means if your practice website

website for DE subscribers that will show you what actions you need to take. To learn more,

is noncompliant with WCAG 2.0 AA accessibility standards (which read like a Harvard

visit DentalWebsiteCompliance.com/de.

law textbook), your practice is wide open and vulnerable to these opportunists’ expensive

Disclaimer: This article is for informational purposes only and does not constitute legal

shakedowns.

advice. For legal advice, always consult an attorney.

There is also a real impact when it comes to your referrals and new patient flow, because

About the Author

this is not “just another regulation” or “just another law” you have to comply with. It also

Graig Presti is CEO of three-time Inc. 500/5000-recognized company Local

happens to be the right thing to do, especially when it comes to making your website

Search For Dentists (LSFD), one of the fastest growing companies in dentistry.

accessible to disabled readers, just like having accessible bathrooms is the right thing to

LSFD helps thousands of dentists all over the world gain dominance in their local

do for your patients.

markets. LSFD’s proprietary marketing systems have helped dentists achieve more freedom, greater new-patient numbers, and the ability to reach their income goals.

According to the Centers for Disease Control and Prevention, one in five American adults live with a disability,5 which means you have patients right now who are disabled trying to access your noncompliant website, putting you even more at risk.

Download a free Google reviews cheat sheet at localsearchfordentists.com/de12.

References 1. Sullivan CC. Don’t be fooled by DOJ delays, your website must be ADA compliant. FindLaw website. http://blogs.findlaw.com/in_house/2015/07/dont-be-fooled-by-doj-delays-your-website-must-be-ada-

You must lend a helping hand to these individuals because they want to become devoted

compliant.html. Published July 23, 2017. Accessed April 30, 2017.

patients, and that is why they are visiting your website in the first place. They have teeth just like the rest of us! Without the ability to browse through your website like everyone else, they won’t become patients, and neither will their friends and family - but they may be more likely to report you to the government or hire an attorney.

2. Finnerty K. Setting your sites on web accessibility. Greenberg Traurig white paper. http://media. insidecounsel.com/insidecounsel/historical/whitepaper/558.pdf. Published August 2009. Accessed April 30, 2017.

3. Gil v. Winn Dixie Stores, Inc., No. 1:2016cv23020 - Document 63 (S.D. Fla. 2017). Justia website. http://

Having an accessible website actually gives you a competitive advantage. You know that

law.justia.com/cases/federal/district-courts/florida/flsdce/1:2016cv23020/488749/63/. Accessed July 16,

your competition is unlikely to be compliant and unable to properly serve this patient base,

2017.

which opens up an entirely new opportunity for practice growth and goodwill in your community.

The ADA-compliance issue is not going away, and I strongly urge you let me or someone else help you start addressing this problem now while it’s on your mind.

4. Randazzo S. Companies face lawsuits over website accessibility for blind users. Wall Street Journal website. https://www.wsj.com/articles/companies-face-lawsuits-over-website-accessibility-for-blindusers-1478005201. Updated November 1, 2016. Accessed April 30, 2017.

5. Calfas J. CDC: 1 in 5 American adults live with a disability. USA Today website. https://www.usatoday.

Author’s note: If you’d like to see if your website is ADA compliant, we’ve created a special

com/story/news/nation/2015/07/30/american-adults-disability/30881975/#. Published July 30, 2015.

Accessed April 30, 2017.

MDDS

CAREER CENTER

Check out the newest member benefit at careers.mddsdentist.com

Find Qualified Practice Help Search Resumes Browse Open Positions Resume Tips and Interview Advice

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4th Quarter 2017 mddsdentist.com

13

HOW GENERATIONAL DISPARITY IS MAKING BUYING AND SELLING A CHALLENGE

By Amisha Singh, DDS

M

eet Dr. Smith. Dr. Smith dedicated his

long overdue. It is time for him to pass on his legacy and he looks forward

entire life to dentistry to care for patients

to seeing who will inherit it.

as if they were family. He has come to work every day for the past 41 years

Enter Dr. Jones. She is still getting used to the title “Doctor” in front of her

taking a grand total of four days off - each

name. Earning that title took a lot of time, a lot of work and a lot of money.

for the birth of his four children. He has loved every

She graduated three years ago and has been employed as an associate ever

moment of it. Dentistry is at the very core of who he is. He is so proud

since. It was a good place to start, but she noticed the practice did several

of the many smiles he has restored. Dr. Smith has many patients who

things she didn’t necessarily agree with. Dr. Jones believes in building a

are the third generation to call him their dentist; the grandparents and

good culture. She wants her staff to love coming to work as much as she

grandchildren alike have benefited from his care. Sure, he hasn’t really

does. She realizes it is time for her to stop building someone else’s dream

taken a vacation in over 40 years and he has seen some tough times when

and start building her own. Unfortunately, Dr. Jones’ current employers

the economy dipped. But he took his role in the lives of his patients and

did not teach her much about the business side of dentistry. She doesn’t

his staff seriously. His last hygienist even went on to dental school and he

know where to begin. She calls a few colleagues for advice on how they

contributed to her tuition. Dentistry is the method he chose to give back

went about purchasing their practices and gets three different answers

to the world that has given him so much. He loves his work, but his wife

from three different people. She is confused, but figures out which brokers

has told him for years that it is time to retire. She wants to travel and now

she needs to call. She makes a to-do list, touches up her CV and begins to

is the time. He worries, “If I don’t practice, am I no longer a dentist? What

get excited. This is it! This is what she worked so hard for. Yes, there will be

if the new dentist who comes in doesn’t take good care of my patients? I

a learning curve, but it’s going to be worth it. She is going to do some good

have known most of them for decades.” Silently, he deals with this stress

for this world. It is time.

and calls his broker. He doesn’t feel 100% ready, but is looking forward to spending more time with his wife and seeing the world. That vacation is

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3rd Quarter 2017 mddsdentist.com 14 4th

Dr. Smith and Dr. Jones are on two sides of the same equation: buyer and

seller. They cannot achieve their goals without each other. But, just like

Establishing common ground is key. In any buyer-seller relationship, once

any other relationship, communication is imperative; and communicating

serious intent to purchase has been established, there should be a mutual

across experiences and generations is challenging. They come from two

meeting between the buyer and seller. Here they can discuss practice

eras, their experiences in dental school and in the work force have most

philosophies, time frame of transition, additional expectations as well as

likely been very different.

lay out their action plan and timeline for closing.

For starters, Dr. Smith and Dr. Jones’ tuition for their dental education likely varied by tens of thousands of dollars. According to the American Dental Education Association (ADEA), the average amount of debt incurred in dental school in 2016 was $261,149. Over 80% of graduating seniors had over $100,000 in debt and more than 30% had over $300,000. This number incites outrage among many programs because it is an average; many graduating students accrue debt double or even triple these amounts! This financial burden

"Just like any other relationship, communication is imperative; and communicating across experiences and generations is challenging."

Gratitude Goes a Long Way. If there is one thing I have seen be the kiss of death for practice transitions, it is entitlement. The seller has worked extremely hard to build this practice and deserves a fair price for their efforts.

The buyer has also worked hard for their credentials and is ready to put hard work into the practice. Both buyers and sellers tend to focus on what they “deserve.” But, just like in a marriage, empathy can change the course of the relationship. A buyer can voice their dedication to the seller’s patients and staff with something as simple

places huge amounts of pressure on new dentists to

as an email, card or letter stating their appreciation of

succeed financially. Monthly payments for student

this opportunity. They can outline their visions for

loans this large are often one of the highest expenses a dentist faces post-

growing the seller’s legacy. A seller can use this information to be more

graduation and, in many cases, they are higher than the cost of food or

welcoming and empathetic to the buyer’s concerns. This business was built

housing. According to the National Association of Student Financial Aid

in connection with the seller’s work. It is to the benefit of both parties to

Administrators (NAFSAA), the prices of higher education have increased

establish mentorship and communication, no matter the time frame, to

at an average rate of 7% per year since 1988. This is double the rate of

maintain continuity of care and decrease attrition.

inflation and this challenge makes “debt” a bad four-letter word for many young buyers. More debt carries stigma and fear. For new dentists,

Fair is Fair. It is important to note that dental transitions are, at the

education is one of the greatest investments they have made thus far.

very core, a business transaction. It is hard to separate emotions from

The practice(s) they aspire to purchase will potentially be an even larger

something that has been and will continue to be a large part of the dentist’s

investment. Students graduating in recent years have a very real need to

identity and life, but business is business. There has to be a fair and equal

make money and make it fast due to crushing debt. This changes how they

exchange. As much as the buyer wants to get a good deal, and as much as

view potential practices and their expectations for earning.

the seller wants a copious sum to supplement retirement, they must meet somewhere in the middle. If both parties start off with this expectation, the

Another factor is Dr. Smith and Dr. Jones have very different life

road becomes much easier to travel.

experiences. Age is a factor in many of life’s decisions. Dr. Jones is starting out in her career and this market which has vastly changed compared to 40

Buying a practice in this market may seem like an insurmountable

years ago. Competition and saturation are at an all-time high, insurance has

challenge, and it does come with its fair share of trials and tribulations.

a more competitive influence, society as a whole is more litigious and the

Communication gaps may arise but learning how to traverse them will

costs of practicing and living continues to increase. These factors influence

serve both the young and more experienced alike.

Dr. Jones’ decisions for practicing. Dr. Smith grew up in a different time and likely experienced more scarcity. As a result, their priorities will not

About the Author

be the same.

Dr. Amisha Singh is a Denver native and loves living in beautiful Colorado.

She is currently a member of the ADA, CDA and MDDS. She serves on the

Both doctors have worked hard for their current achievements and

CDA New Dentist Committee and Membership Counsel and MDDS Member

both have their patients’ best interests at heart. The downfall comes in

Services Committee. She is a blogger and professional speaker who works with

communicating these needs and expectations to one another. How is this

IgniteDDS and IgniteDA to inspire other dental professionals and provide them

challenge best faced?

resources to be the best clinicians possible. When not practicing dentistry she loves to get lost in a good book, cook and do all things creative.

Outlining Expectations. Many times, both the seller and buyer are experiencing their first dental transition and do not know what to expect or understand the rules of the game. To make matters more complicated, these expectations and rules can change with personality, location, lack or presence of a broker, the broker’s experience and countless other variables.

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BIORTHOSIS DIGITAL REGISTRATION AND DESIGN OF A TMJ POSITIONING SPLINT ®

By Bernhard Egger, MDT

T

emporo

mandibular

dysfunction

(TMD)

is a general term for structural, functional, biochemical and psychological disorders in regulating

temporomandibular

muscle

or

midmost position” in the joint socket (centric position of the TMJ) at the end of the chewing process.

• All of the teeth in the upper and lower jaw come in contact with each other simultaneously without impeding the centric position of the TMJ.

temporomandibular joint (TMJ) functionality.

Teeth, masticatory muscles and TMJ are part of a highly sensitive and complex functional unit of the body.

Consequently, biomechanical dysfunction in static and dynamic occlusion, psychological and orthopedic causes have an impact on primary TMJ disorders in addition to traumatic influences. Ultimately, when the body is no longer able to compensate for these disorders, a number of diseases and symptoms may arise, including: • Muscle tension/headaches and neck pain affecting the entire spine • Various types of damage to the TMJ (pain, cracking or rubbing noises, restricted movement)

• Tinnitus (ringing in ears) • Worn or chipped teeth, sensitive necks of the teeth, constant loss of fillings, etc.

• Damage to tooth sockets (loose teeth, signs of wear on jawbones and receding gums)

Therapeutic treatment is indicated in case of pain symptoms or restricted function. This treatment is provided as part of standard dental medicine and medical procedures today. The aim is to eliminate improperly or overly stressed teeth and TMJs and to reposition and stabilize the joint heads (condyles).

If a masticatory system does not meet these prerequisites, the individual tissues and anatomical structures will be subjected to unnatural forms of stress. Possible first dental procedures include reversible treatment using occlusal splints and other types of bite splints.

Therapeutic splint requirements Bite splints are used to treat myoarthopathy and other diseases of the

The masticatory apparatus can only work properly and remain stable throughout a person’s lifetime if: • The TMJs can reach what is known as the “uppermost, foremost and

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masticatory (craniomandibular) system. The aim is to eliminate improperly or overly stressed teeth and TMJs and to reposition and stabilize the condyles. Although splints do not transmit proprioceptive information as well as natural teeth do, they continue to be an indispensable part of therapy. The bite splint is designed to eliminate all static and dynamic

interferences to position the condyles as high and as close to the front and

contact and simultaneously determine its exact position. Alongside this

center of the joint cavity as possible in a stable condylar position – (SCP)

approach, physiotherapeutic treatments have also become viable options

via the muscle system.

because the masticatory system is not an isolated area. Rather, what are known as ascending and descending musculoskeletal phenomena (e.g.

Ideally, it deprograms dysfunctional motion patterns if it is worn

spinal disorders) exist all the way down to the pelvic region. In some

continuously for the entire period required to achieve stabilization. The

cases, the splint treatment can lay the very groundwork that makes

centerpiece of this course of treatment is the repeated readjustment of the

physiotherapeutic measures successful long term.

bite splint using special techniques until all functional symptoms have Objectives

disappeared and a stable, reproducible condylar position has been achieved.

However, conventional bite splints are often made of thermoplastic, which has a negative effect on stability and hardness. These splints are usually not adapted to patients’ joints and lack a biomechanically adequate design. This may lead to

"Patients want an appliance that is comfortable to wear and does not restrict them in their day-to-day life."

a variety of problems due to the high masticatory

TMD treatment must meet the equally high demands of both patients and dentists. Patients want an appliance that is comfortable to wear and does not restrict them in their day‐to‐day life. Dentists place their focus on the quality of the splint, and an easy and predictable workflow ‐ Biorthosis® addresses all of these demands.

The computer‐aided splint manufacturing process comprises four key steps:

force.

1. Direct or indirect (model scanning) generation of 3D data Biorthosis®

2. Direct or indirect recording of the jaw relation (articulation)

The digitally designed and manufactured Biorthosis is made using

3. 3D design process

biocompatible, dimensionally stable and bisphenol‐ free PMMA. It

4. Digital manufacturing

trains the masticatory muscles thanks to its specific design features and enables simulation of a biomechanically efficient chewing process.

The development of digital 3D data processing, where patient impressions

Since the chewing process is a learned behavior, splint therapy can

are scanned in first, will eventually be replaced by intra‐oral scanning

help patients retrain masticatory motion patterns. Biorthosis also has

procedures. The development of intraoral scanning in the past two years

an integrated veneer and makes tooth erosion in the anterior region

allows now to take full arch scans and export them to a suitable 3D design

visible. This considerably improves acceptance among patients as the

software.

desired objective of the treatment is immediately visible, thus creating an esthetic appearance even during treatment. Moreover, dentists benefit

The data can be merged with CBCT scans to virtually simulate jaw motion

from modern digital manufacturing technologies that reduce the time

and allows virtual adjustments to optimize the splint design. Digital

required for the procedure. Conversely, Biorthosis® trains the masticatory

designing involves determining a variety of parameters:

muscles via guide tracks with optimized interincisal angles in proximity to the anterior teeth and enables simulation of a biomechanically efficient

• Vertical dimension (opening of the bite)

masticatory process. The punctiform occlusal design in the posterior area

• Number and position of occlusal contacts

enables the important symmetrical introduction of chewing forces at the

• Shape and expansion of occlusal relief

base of the skull. This allows the TMJ, masticatory muscles and teeth to

• Anterior to cuspid guidance

work together just as they would in the presence of an ideal equilibrium

• Size or shape of splint

of forces.

Biorthosis appliances are milled on 5x axis milling machines; this The splint is made from a crystal clear, dimensionally stable material is

process makes it possible to produce very thin splints. The benefits of

nearly invisible so that the treatment is practically imperceptible to the

milling technologies are improved physical properties such as highly

eye. Thanks to state‐of‐the‐art digital manufacturing technologies, these

homogeneous surface and hardness, which increases the durability of these

splints can be produced to fit with accuracy within 0.015 mm. This means

splints compared to conventional methods. The dense microstructure

maximum comfort for the wearer without any impairment.

guarantees low plaque affinity and makes the splint completely tasteless.

The development of Biorthosis® reflects the technological development of

At regular intervals the splint is readjusted in the mouth and the design

digital dentistry.

is revised to ensure continuous regeneration of the masticatory system tissue; these adjustments are the focal point of the treatment. One or more thin strips of tin foil (0.3 mm) are applied to the anterior region to identify whether posterior primary contacts are present. The layers of tin foil create a small vertical opening on the splint, while the defined thickness of the

About the Author Bernhard Egger is a European Dental Association (EDA) Certified Specialist. Mr. Egger is the General Manager of Natural Esthetics, Germany. He is also a Board Member of the OBI Foundation.

foil can be used to draw conclusions about the strength of the primary

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THE RELENTLESS DENTIST

5 PILLARS OF LEADING PRACTICE SUCCESS

By David Maloley, DDS, FAGD

E

very dentist faces challenges in his or her practice.

2. Align your Team - Allow me to reiterate: no man is an island. Businesses

We often feel overworked. Clinical frustrations,

rarely flourish without a group of highly skilled individuals guided by the

demanding patients or an unaccountable team

relentless leadership of the business owner. You cannot view your role solely

member can wear down even the strongest

as a dentist. You are the leader of your team and patients. The right people

practitioner.

must comprise your team. Unite them in a common mission and purpose.

No man is an island. We must understand that we are first and foremost

3. Implement Systems - Have you seen the movie “The Founder” with

running a business and no owner can logistically survive without the support

Michael Keaton? It tells the story of Ray Kroc who revolutionized the fast

of a great team. Reflect on these five tenets of leading a dental practice and

food industry worldwide when he assisted in franchising McDonald’s. You

consider their impact:

can eat tastier burgers at competitive prices at countless other chains, yet, people still come back to McDonald’s. Kroc ultimately joined the billionaire

1. Create a Vision - Do you have a clear, written plan for the future of your

club because of the systems he implemented in every single McDonald’s

practice? You should know which objectives you intend to accomplish in

restaurant. He created practices that were simple and so precise that even

one year, three, five, 10 and into retirement. Otherwise, you will struggle to

teenagers with minimal work experience could take, make and deliver orders

attain any feeling of success as your focus is not on the cornerstone reasons

in a timely fashion. No chefs or hosts are required. This made Ray Kroc

you became a dentist. We are not just fixing teeth; we are extending and

wealthy. You too must put procedures in your office that permit a natural but

improving lives. Search your soul and discover the passion behind your

precise flow, allowing your team to complete tasks efficiently and effectively.

practice. Chart out a course of continued growth and fulfillment.

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Continued on page 21

MOST FINANCIAL COMPANIES WANT YOU TO INVEST IN THEM. WE’D RATHER INVEST IN YOU.

Shawn Copeland CLTC Financial Advisor (303) 996-2385 shawncopeland.nm.com 05-4011 © 2017 Northwestern Mutual is the marketing name for The Northwestern Mutual Life Insurance Company (NM), Milwaukee, WI (life and disability insurance, annuities, and life insurance with long-term care benefits) and its subsidiaries. Northwestern Mutual Investment Services, LLC (NMIS) (securities), a subsidiary of NM, broker-dealer, registered investment adviser, and member of FINRA and SIPC. Shawn Wayne Copeland, Insurance Agent(s) of NM. Shawn Wayne Copeland, Registered Representative(s) of NMIS. Shawn Wayne Copeland, Representative(s) of Northwestern Mutual Wealth Management Company®, (NMWMC) Milwaukee, WI, (fiduciary and fee-based planning) subsidiary of NM and a federal savings bank.

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

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SATURDAY DECEMBER 2 CDA NEW DENTIST COMMITTEE

BLACK

WHITE G.V. BLACK TIE EVENING

7:30 PM

GRANT-HUMPHREYS MANSION

RSVP REQUIRED TO ATTEND

770 Pennsylvania Street Denver, CO 80203

cdaonline.org/blacktie2017 303-996-2842 or erica@cdaonline.org

This evening is especially for new dentists - those who are 10 years or less out of dental school.

$35 CDA member, spouse, guest $70 Non-CDA member dentist Hotel block also available.

Continued from page 18 4.

Delegate - You did not create a team of

highly skilled people so that you, as the business owner, would perform the vast majority of daily tasks. You are a dental professional. Focus your efforts on providing great customer service and excellent clinical care. Train your team to take on responsibilities that can be shared and don’t require a dental license. You can delegate many of the clinical activities, administration, management and even

"No man is an island.

We must understand that we are first and foremost running a business and no owner can logistically survive without the support of a great team."

marketing. Voice your intentions and guide your

It is also wise to keep your practice ahead of the curve with advancements in techniques, materials and technology. A consistent schedule of continuing education for both you and your team is crucial for continued success.

No longer should you act passively with your team or practice. Be active. Listen. Acknowledge that you are a business owner with a vision to provide quality services and care. Take steps to ensure you consistently offer this to patients alongside a reliable team. All of this will allow for

team to execute these tasks. You hired these sharp employees because you

sustainable growth in your practice, but not without you steering the ship.

believed they could address matters in the best interest of the practice. Let

Remember, everything in your practice rises and falls on leadership.

them.

5. Adapt - The world is changing. The markets change. People change.

You can guarantee it. Your level of success exists in direct proportionality to your level of adaptability. Do you have a Facebook page? Do you have a YouTube channel? Do you post photos and videos (informational or entertaining) on Instagram? Are you asking for online reviews? The industry has transformed digitally and your new “storefront” is your online presence. However, do not stress yourself with an overload of online work. This falls under marketing, so recall the previous tenet of leadership. Adapt to the changing markets and delegate these tasks to your team.

About the Author Dr. David Maloley hosts the very popular podcast, The Relentless Dentist Show. David grew up working on a family farm in Lexington, NE. He attended the University of Nebraska in Lincoln, where he earned his bachelor’s degree and later his DDS. In 2003, Dr. Maloley completed an Advanced Education in General Dentistry residency in Ft. Jackson, SC, then served as a Dental Officer in the US Army for the next five years. While in the Army, Dr. Maloley was stationed in Giebelstadt, Germany for two years and Vicenza, Italy for another two years, providing general dentistry services for the local military communities. After he returned to the US in 2007, he worked at a private practice near Charlotte, NC for two years before relocating to Colorado to open Vail Valley Dental Care.

CLINICAL

PEER REVIEW PUZZLER

Peer Review is a member benefit of the Metro Denver Dental Society (MDDS). The following is a sample of an actual event, with real patients and real dentists that was reviewed and mediated by the MDDS Peer Review Committee.

Case Patient reported no dental care for some time due to a lack of financial resources.

After receiving a marketing piece and the promise of financial assistance from a family member, the patient visited Dr. A’s office for pain in a front tooth. Dr. A informed the patient that an extraction was necessary and a temporary flipper could be placed while the rest of the restorative work was completed.

On the day of the extraction, the patient was introduced to Dr. B, who would be completing the extraction and flipper placement. The patient reported an ill-fitting flipper and made four visits to Dr. B for adjustments.

The patient returned home and reported that the wire of the flipper had broken where the adjustment was made. They reported this to Dr. B who replied further

After several months the patient again returned to Dr. B with the same complaint

adjustments could not be made to a temporary appliance. The patient is seeking

of an ill-fitting flipper. The patient informed the office that after further financial

a refund of $657, so they can seek the opinion and treatment at a different dental

set-backs, they would not be able to complete the necessary restorative work

office.

for some time and would thus be relying solely on the flipper. After numerous complimentary adjustments, the dental office informed the patient that this would

Peer Review answer on page 27

be the final adjustment before further payment would be required.

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CLINICAL

TEAMWORK TO

SUCCESS

By Steve Kelly, Technical Operations Manager, Peebles Prosthetics Inc.

T

his is an example of

The happy team with Kristen's new smile

how good case planning

The try-ins all went very smoothly with the exception

and teamwork leads to

of the bite registration. Kristen did not have “normal”

a

outcome.

occlusion for quite some time and was not biting

“Working with Kristen on this case was such a joy and this

Kristen is an extreme case

on her right side for over a decade. We confirmed a

experience reminded me of why I love dentistry.

that touched all of us involved

repeatable bite registration and decided to build her in

Our multi-disciplinary team was able to give Kristen her

in her reconstruction. Diagnosed with a lower right

this position, as it had been a comfortable place for her

smile back and the end result was so rewarding!”

mandibular tumor at age five, Kristen learned to

up until that point.

successful

live with the tumor as it grew larger. She remembers standing in front of the mirror at a young age and

The thought process was; we would start her at this

practicing talking in a way that would not show her

position and see if we were able to realign her enough

lower teeth and tumor. Her Doctors believed that the

that she could get her natural teeth to move into a more

tumor would stop growing when she did.

normal cusp-fossa position. This was also a factor in the decision to a removable appliance, and to make adding

Flash forward to about four years ago, Kristen, now in

or subtracting materials easier and more cost effective.

her late twenties, had started seeing Dr. Stratil at The Dentist on Pearl. Dr. Stratil quickly saw that she needed

The attention to detail by the surgeon, and open

to see a specialist as soon as possible.

communication between the dental office, laboratory and the patient was a key factor in a very successful

The resection and reconstruction was done by a Head

reconstruction. The case was delivered with minimal

and Neck specialist. Kristen was referred to Colorado

adjustments and Kristin has been doing great and loves

Oral Surgery for the implant surgical portion of her

her new smile!

treatment. Dr. Gregg Lurcott placed Straumann implants using a guided surgical technique to allow us

"As a laboratory manager and technician of over thirty

to make a very stable appliance. This was accomplished

years, I have learned the importance of pre-case planning

by taking impressions and having a barium guide

and careful attention to the smallest of details. This case

fabricated that was scanned during her cone beam CT

demonstrates what good teamwork can achieve and we

scan. Because the barium demonstrated the location of

wanted to share Kristin’s success story with our dental

the teeth radiographically, we were then able to place the

community. I feel that applying this type of approach to

implants virtually directly under the occlusal table.

all your lab cases, not just the difficult ones, can give a better sense of accomplishment and pride in the work we

The decision was made to do a removable prosthesis, so changes could be made as needed and for better oral hygiene as well. We chose a titanium CAD/CAM bar with Locator attachments and a milled super structure for added stability. Custom impression copings had to be made due to the implants being so far sub gingival.

Prior to milling the bar and sub structure, normal implant bar protocol was followed to insure a passive fit.

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24 4th Quarter 2017 mddsdentist.com

deliver."

-Steve Kelly Technical Operations Manager Peebles Prosthetics Inc.

-Stephanie Stratil, DDS “It’s hard to describe the feeling when a substantial feature of your body is removed and you lack the ability to perform typical functions normally. Losing my teeth at the age of 30 was difficult on so many levels. It took a year and quarter to get them back after having gone through the initial jaw surgery to remove the fibrous dysplasia. The day I got them back I was beyond ecstatic! I drove down Pearl St. and I-25 wanting to feel over and over again my new ability to make contact with teeth on all sides. We all shed tears of joy that day because the road to a new bite, new speech, and all other teeth related functions had finally come to a successful end!”

- Kristen About the Author Steve Kelly was born and raised in central Illinois. He moved to Denver in 1995 to focus on advancing his knowledge in all phases of dental technology. Steve has worked with some of the top prosthodontists in the country helping him to build a well-rounded knowledge of dentistry. He joined Peebles Prosthetics in 2013 as the Technical Operations Manager to further challenge his passion for dental technology.

Open top custom tray made from a study cast of the healing abutments

Free shaped cad - cam milled titanium bar with locator attachments

Final soft tissue model made at implant level

Barium guide and 3D printed model

Verification jig with the wax set up

Hip graft with guided surgical guide

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NON PROFIT NEWS

MDDS MEMBER HELPS FORMER NURSE SMILE AGAIN

G

enevieve, 72, is

to give her a new full set of dentures that will help her chew. Genevieve was

a kind woman

so grateful and happy with her treatment and new smile that she made knit

who lives in a

hats for Dr. Johnson and each member of his staff. She also knitted a hat for

senior

DDS program coordinator as a tribute for helping her through the process of

living

facility in Westminster. She

getting new dentures.

was a registered nurse for over 40 years and worked

“Helping Gene has brightened all of our spirits and made us all feel good! If

in hospitals and care centers

another dentist was on the fence about this, I would ask what their concern was.

all over the country focused

The entire process with DDS was easy and seamless. I would tell the dentist to

on addiction recovery. Due to osteoporosis and some other issues with her bones, Genevieve recently had to stop working. She is an active woman who runs various programs for entertainment in her facility and does not slow down. Because she lives on a fixed income, she could not afford dental care.

She had the same set of dentures for over 15 years which became worn down and helpless for eating and produced sores in her mouth. Genevieve applied to the Donated Dental Services (DDS) program, and a coordinator matched her with volunteers that helped her get back to eating right and smiling more.

just do it! They have nothing to lose!”

– Dr. Ted Johnson, DDS volunteer “My experience was excellent, it couldn’t have been better. The service was wonderful and the staff and Dr. Johnson were cheerful and welcoming. I can now chew food. My dentures were making my mouth so sore and I couldn’t even chew a salad and now I’m back to eating normal and my new dentures look so nice. It was the best the thing that ever happened to me. I didn’t know I could get so lucky with such a great dentist.”

How DDS Helped Dr. Ted Johnson donated his time and talent taking impressions of Genevieve’s upper and lower dentures and Oral Creations Lab volunteered

– Genevieve, DDS patient

DENTAL NEEDS FOR NEW REFUGEE ARRIVALS AT DENVER HEALTH REFUGEE CLINIC

A

family of five arrives for a standard refugee

The above scenario is all in a day’s work at Denver Health’s

health examination at the Denver Health

Refugee Clinic. Over 500 arrivals were screened at the

Refugee Clinic (DHRC). They landed at

DHRC this past year, hailing from countries including

Denver International Airport three weeks

Burma, DRC, Ukraine, Ethiopia, Honduras and Iraq. The

ago after having gone through an extensive two-year

overwhelming majority of the screened refugees arrivals

vetting process to be allowed to come to the United

have never seen a dentist and have not had access or

States as refugees. They are from the Democratic

education on preventive dentistry or proper oral hygiene.

Republic of Congo (DRC) but fled 10 years ago and have been living in a refugee camp in Tanzania since

The MDDS Community Outreach & Public Relations

that time. Two of their three children were born in the

Committee is humbled to promote a volunteer program

camp.

at Denver Health and the Refugee Clinic at Lowry Family Health. Volunteer dentists would work alongside the medical providers to

A Denver Health physician welcomes the family to the United States, takes an

provide dental screening vital to a patient’s systemic health. To learn more

extensive medical history, then performs head-to-toe physical examinations

about the volunteer program, visit mddsdentist.com. If you are interested

on the entire family. The 35-year-old mother has several teeth with significant

in becoming a volunteer dentist with our team, please contact Dr. Michael

decay. When asked, the mother states that it is painful to chew but that this

Raizen at Lowry Family Health by calling (303) 602-4599 or via email at

has been going on for over eight months.

michael.raizen@dhha.org.

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26 4th Quarter 2017 mddsdentist.com

Don’t miss out on new patients! Update your NEW ADA Find-a-Dentist® profile.

The new Find-a-Dentist tool makes it easier than ever for patients to find you. Take 5 minutes to update your profile with the information patients look for most: ü ü ü ü ü ü ü

Photo Business address Office hours Practice email Payment options Insurance types Languages spoken

IS THIS YOU? Don’t be left out.

To update your profile and access resources to help promote your practice, visit ADA.org/findadentist November 17-18, 2017

Presented by Chase Bennett, DDS

DENTAL SLEEP PRINCIPLES: WHERE THE RUBBER MEETS THE ROAD

For more information go to mddsdentist.com

Answer to the Peer Review Puzzler (continued from page 23) Resolution The Peer Review Committee conducted interviews with both the patient and Dr. B, after informing them of the complaint filed. Dr. A refused to grant a refund. However, since the patient was able to have the flipper fixed at no cost elsewhere, they dropped the complaint and agreed to sign a liability waiver protecting Dr. A against future litigation.

Litigation and claims on a dentist’s malpractice insurance can be an expensive and lengthy process – one that is best avoided. If you have questions about the peer review process or are interested in joining the committee, please contact Marlene Pakish, MDDS Finance & Operations, at finance@mddsdentist.com or (303) 488-9700.

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OSHA

INFECTION CONTROL AND OSHA COMPLIANCE SOLUTIONS/ IMMUNIZATIONS FOR DHCP

By Dr. George G. Gatseos II, CEO, Safe Dental Services LLC

W

hen discussing strategies for infection control, dentists and clinical staff must refer to the universal chain of infection. Any method that breaks or blocks a step in the chain of infection will help reduce the risk of occupational disease transmission. Vaccinations administered with the prescribed dosage and series of injections will usually elicit a host immunological response that renders the host unsusceptible to disease. The host response of an individual’s functioning immune status is a critical determinant in preventing disease. An adult acquires immunity by 1) developing symptomatic or asymptomatic infection and "Dental professionals recovering with their immune system actively producing an need to recognize immune response (natural active the importance of immunity); 2) receiving injections immunization in of antibodies from an immune individual to prevent the onset preventing disease and of infection (artificial passive educate staff as well as immunity); or 3) administering patients about the health a specific antigen and having the advantages of these immune system stimulated to produce an immune response vaccinations." without manifesting disease (artificial active immunity).

Immunization Schedule from the previous year’s schedule include new or revised ACIP recommendations for influenza, human papillomavirus, hepatitis B and meningococcal vaccines.2

The latest immunization recommendations for dental healthcare personnel, as issued by the U.S. Center for Disease Control and Prevention (CDC), specifically ACIP, the CDC’s Advisory Committee on Immunization Practices, were posted on the CDC’s website in February 2017 as a Morbidity and Mortality Weekly Report Early Release. The 2017 ACIP Adult Immunization Schedule lists the recommended immunizations for all healthcare personnel: Influenza, Td/ Tdap (for tetanus, diphtheria and pertussis), MMR (for measles, mumps and rubella), VAR (for varicella), HCZ (for zoster), HPV – male and female (for human papillomavirus) and HepB (for hepatitis B). Changes in the 2017 Adult

About the Author George G. Gatseos II, DDS, MSBA, is Chief Executive Officer of Safe Dental Services, a Colorado-based dental infection control and practice consulting firm specializing in Occupational Safety and Health Administration training and compliance for dental professionals. An author and lecturer, Dr. Gatseos recently spoke for the Council on Dental Practice for the 2016 American Dental Association Annual Meeting in Denver. He is also a past board member of the Organization of Asepsis & Prevention (OSAP) and is currently serving on OSAP’s Program Development Committee for their Annual Symposium.

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28 4th Quarter 2017 mddsdentist.com

To make it easier for clinicians to access the vaccine schedules, a free CDC Vaccine Schedules app is available. Though optimized for tablets, it is also useful on smartphones. The app shows child, adolescent and adult vaccines recommended by ACIP and visually mimics the printed schedules. For more information, visit cdc.gov/vaccines/schedules/hcp/schedule-app.html.

Dental professionals need to recognize the importance of immunization in preventing disease and educate staff as well as patients about the health advantages of these vaccinations. Clinicians should be educated on the immunization recommendations by the CDC and ACIP in order to deliver accurate information regarding the benefits for patients. The challenge lies within each provider’s beliefs and actions in terms of being vaccinated and making sure recommendations are followed. We must also be aware of the Occupational Safety and Health Administration requirements regarding hepatitis B virus immunization for healthcare workers.

REFERENCES 1. Molinari JA, Terezhalmy GT. Immunizations for dental health care personnel. In: Molinari JA, Harte JA,eds.

Cottone’s Practical Infection Control in Dentistry. 3rd ed. Baltimore, MD: Lippincott Williams & Wilkins; 2010:89-100.

2. Kim DK, Riley LE, Harriman KH, Hunter P, Bridges CB. Advisory committee on immunization practices recommended immunization schedule for adults aged 19 years or older- United States, 2017. MMWR Morb Mortal Wkly Rep. 2017;66: 136-138.

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29

Be sure to check out the RMDC HANDS-ON COURSES being held at the:

MOUNTAIN WEST DENTAL INSTITUTE!

Visit MDDSdentist.com for a full schedule of other upcoming courses at the MWDI! • 140-seat Auditorium (can be divided in two)

• Planmeca PlanScan™ (mill & scanner)

• Banquet Hall

• Equipped to capture and stream live video

• 20-seat Executive Board Room • Hands-on Learning Lab Benches for 40 participants

• MDDS members receive a 15% discount • Multi-day & multi-room discounts

• Large Wet Lab

• A/V always included

• Four (4) Educational Operatories including one (1) equipped for surgery

• No catering restrictions

• 2D/3D Digital Imaging Suite

• Two (2) free parking structures

• Free Wi-Fi

MWDI.ORG Metro Denver Dental Society | 925 Lincoln Street, Unit B, Denver, CO 80203 (303) 488-9700

EVENT CALENDAR OCTOBER October 12 Freedom Day USA All Day (303) 488-9700 October 13-14 COMOM Pueblo, CO All Day (720) 648-0918 October 26 New Member Welcome Event Bremen's Wine & Tap 2005 W 33rd Ave, Denver, CO 80211 (303) 488-9700 October 27-28 SOLD OUT Advanced Grafting and Implantology Utilizing a Cadaver Specimen -The Perio Institute/ Dr. Charles Schelesigner Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-5:00pm/day (303) 488-9700

November 14 CPR & AED Training Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:00pm-9:00pm (303) 488-9700 November 17-18 Dental Sleep Principles: Where the Rubber Meets the Road -Dr. Chase Bennett, DDS Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-5:00pm/day (303) 488-9700

DECEMBER December 2 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 NOVEMBER November 11 CBCT Boot Camp: The Implant Edition -Dr. Dania Tamimi Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 9:00am-4:00pm (303) 488-9700

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January 18-20 Rocky Mountal Dental Convention Colorado Convention Center 700 14th Street Denver, CO 80202 All Day (303) 488-9700

FEBRUARY February 23 Basic Radiation Training for Dental Personnel Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-12:00pm (303) 488-9700

MARCH March 3-4 Fundamentals of Bone Grafting and Socket Preservation, Level I/ Bone Grafting and Sinus Elevation, Level II - Dr. Brian Gurinsky Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 9:00am-5:00pm/day (303) 488-9700 March 9-10 Dental Laser Certification: Utilize Today's Dental Lasers in Managing Periodontal/Soft Tissue Conditions - Dr. Sam Low Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-5:00pm Friday 8:00am-12:00pm Saturday (303) 488-9700 March 24 Growing Your Practice Through Endodontics - Dr. John West Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-5:00pm (303) 488-9700

APRIL April 6-7 Recognition and Management of Medical Emergencies: Participate in an Advanced & Realistic Clinical Simulation - Dr. Jeffrey Young Children's Hospital Colorado 13123 E 16th Ave. Aurora, CO 80045 9:00am-4:00pm/day (303) 488-9700

CLASSIFIEDS Practice Sales/Real Estate: Start-up in North Metro Denver dental office for sale. 10 operatories plumbed, 5 currently equipped, stand-alone bldg. w/ lease, no patient base.

Start-up North Colorado Springs dental office for sale. 8 operatories plumbed, 5 currently equipped, leased retail space, great location.

General Practice: SE Metro Denver, CO (CO 1621) Annual Revenues $800K, 4 Ops + room for 1 more, 1,500 square feet, Condo sold with practice, Dr. Retiring. ADS Precise Consultants, adsprecise.com, email: frontdesk@adsprecise.com, 800-307-2537.

OMS practice, western mountains near Vail & Aspen, Annual Revs $840K,Price $449K, 3 ops, 1260 sf, MTTF 8a-5p, bus. office open Wed (no pts). ADS Precise Consultants, email: frontdesk@ adsprecise.com, 800-307-2537, www.adsprecise.com.

General Practice for Sale: Aurora (East), CO (CO 1732) $830k collections, 5 Ops, Dr. relocating out of region. ADS Precise Consultants, 303-759-8425, www.adsprecise.com, email: frontdesk@adsprecise.com.

General Practice for Sale: Lakewood, CO (CO 1730) $485k collections, 6 Ops, Dr. relocating out of region. ADS Precise Consultants, 303-759-8425, www.adsprecise.com, email: frontdesk@adsprecise.com.

General Practice for Sale: Ken Caryl (East), CO (CO 1731) $730k collections, 5 Ops, Dr. relocating out of region. ADS Precise Consultants, 303-759-8425, www.adsprecise.com, email: frontdesk@adsprecise.com.

Visit mddsdentist.com/classifieds to place an ad.

General Practice for Sale: Littleton, CO (1722), 3 ops + room for one more, annual revenue $750k, 1,400 sq ft, Dr. retiring. ADS Precise Consultants, 303-759-8425, www.adsprecise.com, email: frontdesk@adsprecise.com.

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Knowledge • Experience • Credentials • Trust More “Completed Transitions” and

“Years of Practice Transition Experience” of any brokerage firm in Colorado.

ADS Precise Consultants D D S , FA G D • J e d E s p o s i t o M B A , C VA • S t e v e S t e i n b r u n n e r C N E Pe t e M i r a b i t o

• Practice Sales Since 1986 • Practice Valuations

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• Start-Ups • Buy Ins/Buy Outs

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

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