MDDS Articulator Volume 16 Issue 1

ARTICULATOR MDDS

Connections for Metro Denver’s Dental Profession

Sept./Oct. 2011 Volume 16, Issue 2

Reflections from the President 4

Diagnosis Challenge–Oral Pathology 5 Popping Our Leadership 6 Invest in Your Bond 19 Considerations in Employee Terminations 20 COMOM Cares 23 Keeping Fit for Productivity 24

LEADERSHIP ISSUE LEADERSHIP NUGGETS FROM COACH KARL pg.8 INSIDE THE CDA SNOWMASS SUMMIT pg.14

B

Metro Denver Dental Society & Dr. Barry Glassman Present:

Oral Sleep DO NOT Medicine & MISS THIS! Nov. 18-19, 2011 Appliances 8:00 am - 4:00 pm

Metropolitan Denver Dental Society 3690 S. Yosemite St. Denver, CO 80237 (303) 488-9700

Barry Glassman, DMD, is a Diplomate of the Academy of Dental Sleep Medicine and is Board Certified in Dental Sleep Medicine. Dr. Glassman presents internationally on this subject. We are very fortunate to have him join us in Denver!

ARTICULATOR MDDS

Connections for Metro Denver’s Dental Profession

Volume 16, Issue 2

MDDS Articulator Editor Carrie Seabury, DDS Managing Editor Jason Mauterer Creative Manager Chris Nelson Communications Committee Anil Idiculla, DMD, Chair Michael Diorio, DDS Karen Franz, DDS Kelly Freeman, DDS Brandon Hall, DDS Kyle Klepacki, DDS Jeremy Kott, DDS Maria Juliana DiPasquale, DMD Nicholas Poulos, DDS Maureen Roach, DMD MDDS Executive Committee President Charles S. Danna, DDS President-Elect D. Diane Fuller, DDS Vice President Mitchell N. Friedman, DDS Secretary Larry Weddle, DMD

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Sept./Oct. 2011

Inside This Issue:

A Letter From Our President……………4

Material Matters......….........................19

Clinical......….............................................5

Practice Management….....................20

Reflections………………………………………..6

Non-Profit News...........…....................22

New News - Leadership Nuggets........8

Personal Wellbeing.....…......................24

Member Matters…................……………10

Classifieds..............................................26

Personal Wellbeing….................…………13

CDA News..............................................27

New News........….......................…………14

Member News...........…........................ 28

Event Calendar….….............................18

Financial News..................................... 30

Treasurer Scott M. Maloney, DMD Executive Director Elizabeth Price, MBA, CDE Printing Dilley Printing The Articulator is published bi-monthly by the Metropolitan Denver Dental Society and distributed to MDDS members as a direct benefit of membership.

Editorial Policy All statements of opinion and of supposed fact are 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 3690 S. Yosemite St., Suite 200 Denver, CO 80237-1827 Phone: (303) 488-9700 Fax: (303) 488-0177 mddsdentist.com ©2011 Metropolitan Denver Dental Society

Get To Know Your MDDS Staff

Jennifer Wissel - Events & Membership Manager In this edition’s staff highlight, we would like to introduce you to Jennifer Wissel, the Events and Membership Manager at MDDS. Jennifer, or “Jenni” as she is affectionately called around the office, is a Colorado native, having grown up in Fairplay (more famously known as South Park – yes, it’s real). She joined our MDDS team in April, 2010.

Jennifer wears many hats here at MDDS. She was originally hired as the Office Manager and was soon promoted to Events & Membership Manager. She now runs the registration process for the RMDC and all of the MDDS CE courses and events. One of her most recent accomplishments, and the reason she was chosen for this month’s staff spotlight, was for her work in seating 62 delegates at the 2011 CDA House of Delegates. This is the most delegates that MDDS has ever sat at the house!

Jennifer worked with volunteers (thank you volunteers!) throughout the entire membership year to recruit and remind delegates of the

meeting. Her determination to have a full house for MDDS truly paid off! She has also spent the last year restructuring and revamping the MDDS Ambassador Program. She serves as a staff-liaison to the Member Services Committee and plans our popular New Member Networking Events.

Jennifer attended the University of Northern Colorado and earned her Bachelor’s degree in Journalism, with an emphasis in Public Relations & Advertising Media. While at UNC, she helped create the Justin Lee Steffen Foundation inspired by the passing of Justin Lee Steffen, a very close friend. This Foundation helps provide scholarships at UNC and support to programs helping under privileged and at-risk youth. She continues to be involved in the JLS Foundation and is an active participant in the planning and execution of its two annual fundraisers.

If you ever have a membership or event question, would like to volunteer for a committee or become an Ambassador to our new MDDS members, please give Jennifer a call at (303)488-9700 or email her at jwissel@mddsdentist.com.

Member Publication

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A LETTER FROM OUR PRESIDENT Reflections from the President

By Charles Danna, DDS

L

eadership in our dental profession, what does this mean? When people talk about leadership they envision a lieutenant leading a charge over the hill or a coach leading their team to a winning season. What about the dentist, quietly leading in multiple arenas on a daily basis? The dentist is someone who is systematically achieving their goals, directing their dental team and leading their patients to optimal dental health.

We have all chosen a profession that has given us an opportunity to be a leader. We may not have realized this when we first applied to dental school. I know that when I think back about my process of choosing this vocation, I was not thinking of the leadership that the career involved. I chose this profession to provide care for people, to have freedom in my schedule, for the chance to be creative and to be my own boss. It dawned on me during my first year of practice that I had to also be a leader. If my practice was going to be successful, I would have to make the decisions on which paths to follow. This is when I found out that the leader sometimes has to swim against the current to achieve results. A leader has to make decisions that are not always popular and set tasks that may not be easy to accomplish.

Whenever I get together with a group of dentists, I am always impressed with the collection of leaders I am rubbing shoulders with. Through being involved in organized dentistry I experience the leadership of my fellow volunteers daily. All of the volunteers of MDDS show a passion for the tasks they have to accomplish. I feel that the organization is blessed with the commitment that our volunteers display regularly. After a full day in their practices, our volunteers

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show up in the evenings to discuss and plan events, guide our organization or perform peer review. Some of these meetings last late into the night. This is a dedicated form of leadership from our volunteers that probably goes unnoticed by a large segment of our membership. These volunteers are not doing this for recognition; they are doing it to leave the organization in a better place than when they began. This, to me, is the true definition of a leader.

Being involved with MDDS gives one the opportunity to use their leadership skills regularly. One of the organizations formed

by MDDS is the MDDF (Metropolitan Denver Dental Foundation). This is an

“Whenever I get together with a group of dentists, I am always impressed with the collection of leaders I am rubbing shoulders with." organization that is giving back to the community by providing dental education at schools, providing treatment to victims of domestic violence and introducing young people to our dental profession as a possible career choice. This organization gives our members the chance to step forward and make a positive change in our community.

When this foundation was formed, a young dentist stepped forward and started a golf tournament to raise funds yearly. Dr. Scott Whitney took it upon himself to host, sponsor and plan this fundraising event which has helped MDDF grow, resulting in services for many in our community.

Dr. Whitney is not alone in helping MDDF. Hundreds of members have volunteered to help with patients, give presentations to schools or act as mentors to young people interested in dentistry. Dr. Jennifer Garza stepped forward and started the Explorers

program to educate young people on dentistry as a career. When treating a victim of domestic violence, dentists are realizing that it is an opportunity to show compassion and charity to a segment of our population that is in need of care.

I think it is interesting that when trying to reach a decision with our board of directors, we have a room full of leaders, and sometimes it is like herding cats. There are a lot of strong personalities involved and a lot of opinions. However, the good thing about this group is that they do not put their opinions above the needs of the organization and its members. The determining factor is always what is best for the organization regardless of how it affects the leadership.

Our organization is constantly changing; this is an entirely different society than when I had joined. We are always trying to meet the evolving needs of our members and address the challenges of dentistry today.

To accomplish these changes we need input and leadership from our members. We are always looking for members to become more involved with MDDS or MDDF. If you are interested in becoming involved with MDDS or MDDF at any level, please contact us. One’s involvement could entail greeting people at the RMDC or serving on a committee whose mission is of interest.

MDDF is constantly looking for volunteers to treat victims. Treating these patients is probably one of the most fulfilling aspects of my career.

In the online ethics course that The American College of Dentists hosts, one of the first definitions of ethics it gives for the professional is to be supportive of their organization. In closing, I would like to salute all of my fellow leaders and encourage all of you to become more involved in our organizations.

Sincerely, Chuck Danna

Articulator

Sept./Oct. 2011

CLINICAL Diagnosis Challenge–Oral Pathology

By John D. McDowell, DDS

A

25 year-old female presents with a chief complaint of, “My lips, throat and gums are extremely painful. This problem started 3 days ago when I started to feel bad. About 2 days ago, I also developed a sore throat. I also have had a mild fever for 2 days and my glands are swollen. Right after the sore throat started, I noticed small blisters forming on my lower lip and on my tongue. I’ve never had anything like this before.

My throat has been so sore that it has been difficult to swallow anything including liquids. I’ve lost my appetite, too. I’ve taken a few aspirin every day to keep my temperature down. The aspirin has also helped with the pain.”

She has had routine dental examinations every six months for as long as she can remember. She has no restorations and even with the presenting condition, she appears to have excellent hygiene.

Her medical history is non-contributory. She has never been hospitalized nor has she had any surgeries other than her “wisdom teeth” removed at age 17. She says she healed quickly after the extractions.

Her vital signs are within normal limits with the exception of a temperature recorded as 100.2 degrees F.

She denies a history of heart, lung, liver or kidney disease. She says she has never had hepatitis and she tells you that she is not diabetic.

She denies a history of malignancy, immune disorder, neurologic disorder or bleeding disorder. She says she has no known drug allergies. She does not believe she has any food allergies.

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She states she does not now nor has she ever used tobacco or illicit drugs. She says she has an occasional glass of wine with meals.

She additionally reports that no one else with whom she has contact has shown similar signs or symptoms. She denies any other lesions on her skin, eyes, nose or in her genital region.

The extraoral exam is positive for bilateral submandibular, submental and superficial cervical lymphadenopathy. All nodes are firm (but not bony hard), freely-movable and slightly tender to palpation.

Suggested Differential Diagnosis on page12

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Sept./Oct. 2011

5

REFLECTIONS Popping Our Leadership

By Carrie Seabury, DDS

O

ur favorite stories often tie into a common theme. We love to hear stories about finding leadership and heroism in the least likely place. Stories like this inspire us to believe that we may also possess the qualities of the great leaders. I’m here to convince you that you do. Let me tell you the ultimate inspirational leadership story.

The scene opens in early autumn at a high school in a peaceful small mountain town in Colorado. Without warning, evil paratroopers sail onto the football field and the majority of the teachers, students and other town members quickly succumb to a well-coordinated Russian attack.

A band of teenagers leads a counterattack and emerges as the town’s new leaders. Are you with me so far? I am describing the plotline of one of America’s most important documentaries, Red Dawn. OK, I admit it is not quite a documentary since it didn’t actually ever happen but rather a poignant statement piece about the emergence of great leaders. This brave group of teenagers is the reason why I sometimes spontaneously shout “Wolverines!” at the top of my lungs. Though many people don’t understand the reference and I am left with a room full of people wondering if I am losing my bananas, I feel I am conveying an important message to my surrounding companions.

Leadership can often come from the most unlikely sources.

How about a real life example?

(Let’s not be too hasty to discount the validity of Red Dawn’s plot though. It could totally happen.)

Recently a group of video gamers in

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the World of Warcraft online game raided an Ulduar 25 Hard Mode group with the intention of getting the Meta achievement completed for an Iron-Bound Proto Drake.

They were successful and the epic victory brought honor to their family and made the babes weep. What is interesting to note is that the majority of the group participants were over 30 years old; however, it was a thirteen year old who lead this group to success.

“ Please join me in encouraging our colleagues to sign up for leadership positions in organized dentistry.”

You see, the world of online video games gives an unusual opportunity for leadership development. In the majority of the group settings, fellow players have no idea of the leader’s age, gender, race, religion, or physical appearance. The freedom from these potential prejudices allows many people to display their true talent for leadership in these games. These same people might be intimidated to seek leadership positions in real world situations. When barriers are broken down, leadership can pop into existence with less resistance.

People who become effective leaders remind me of popcorn. Prior to stepping up to a leadership position, leaders-to-be already contain all they need to become a wonderful leader.

Popcorn kernels contain everything they need to turn into one of Orville Redenbacher’s best and tastiest. It just takes a little energy to pop that kernel into its full potential.

join me in encouraging our colleagues to sign up for leadership positions in organized dentistry. Also, investigate the popcorn kernel potential in yourself. I bet you have a leader in you just waiting to be popped into action!

SPECIAL DELIVERY

YOU SPOKE, WE LISTENED This year we are mailing the Rocky Mountain Dental Convention badges and tickets directly to YOU. There won’t be any standing in lines; just bring your badge and walk right into opening session. Go online to rmdconline.com to register for 2012 RMDC TODAY!

Rocky Mountain Dental Convention

20 CONNECT 12 RMDC ▶ DENVER,CO

I ask you to do two things now. Please Articulator

Sept./Oct. 2011

Share Your Knowledge – Share Your Passion!

Teach interested young students (ages 14-21) specific skills and help them understand how fulfilling a career in dentistry truly is. Volunteer to participate in the Metro Denver Dental Foundation 2011 Careers in Dentistry Explorer Post 269 this fall.

Provide hands-on opportunities for young people to help them gain insights and practical experience while considering a career in dentistry. Giving students an understanding of what a dental career is really like can help them make the right educational choices now to succeed later.

This program is co-sponsored by MDDF and the Colorado Dental Association through an alliance with Exploring, a national subsidiary of the Learning for Life program.

To get involved please contact Amy Boymel, MDDF Executive Director, at 303.957.3272 or aboymel@mddf.org.

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In many cases, a cone beam CT scan may be necessary for more accurate diagnosis and planning.

Dr. Debra Gander maintains a practice limited to oral and maxillofacial radiology with emphasis in imaging for dental implants.

Expand your patient offerings without expanding the walls of your own practice.

Offer your patients precision 3D dental imaging by referring them to us.

Refer a patient.

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Visit thefauchardcenter.com and click Refer A Patient.

303.741.3300

Articulator

Sept./Oct. 2011

7

Photo Courtesy of the Denver Nuggets

LEADERSHIPNUGGETS FROM COACH KARL

By Anil J. Idiculla, DDS

A

s you might notice, the Communications Committee is trying to unify each issue of the Articulator around a central theme. This is only one of the many ways that the all new Articulator has been enhanced for our members.

The theme of this particular issue is Leadership.

In an effort to get an outside opinion on this sought after topic, we decided step out of the box and take a broad look around the Metropolitan Denver area for elite leaders. Our extensive search brought us to none other than George Karl, head coach of the Denver Nuggets, and a man in a real leadership hot seat.

NBA coaching legend George Karl was introduced as the 19th

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head coach in Nuggets history on Jan. 27, 2005 and has since overseen one of the most successful eras in team history, and has become a fixture in the Denver scene.

Coach Karl’s 278 wins are already the second-most by a coach in Denver’s NBA history, while his .618 winning percentage is unmatched.

His run of six-straight postseason appearances is the secondlongest in Nuggets history to Doug Moe’s nine-consecutive (198290). Denver joins Dallas and San Antonio as the only teams in the NBA to have made seven-straight playoff appearances.

Articulator

Sept./Oct. 2011

NEW NEWS The seventh-winningest coach in NBA annals, Karl has amassed 986 wins in his 22 seasons in the NBA. In fact, of the six men ahead of him on the all-time wins list, only three: Phil Jackson, Pat Riley and Jerry Sloan have a better winning percentage. He has also notched 74 career playoff victories, good for 12th all-time.

Unfortunately, Karl’s 2009-10 season was cut short because of throat and neck cancer. He made the diagnosis public two days after the All-Star Game but coached the Nuggets for three weeks while going through radiation and chemotherapy treatment.

I hit up Coach Karl for a quick interview to see how he views and, more importantly, handles his role as a leader, especially considering his personal battle with cancer.

Dr. I: Coach Karl, What are some tips and strategies for us dentists to be better "coaches"?

Coach Karl: So much of being a leader of a team and leader of an office would be budgeting your energy and your time. It’s not just about you. It’s about how you present an attitude that’s contagious. Motivated and intelligent employers need three things: First, they need to make their staff feel that they’re a part of the process, not just someone told to do the motions of the process. Second, you need to bring positive mental energy into the building every day and not any type of negative energy. Everyone has to learn that what happened yesterday or last week can’t be a part

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of your attitude on a daily basis.

Hiring people who have a positive perspective is important. Then third, it’s important to show appreciation – show appreciation for their talents. You usually do that through communication and celebration.

People like to be appreciated. They like to be communicated with. And I think when they do something at a special level, they like to be celebrated.

Dr. I: Do you have any specific quotes that you live by?

Coach Karl: It is our attitude at the beginning of a difficult undertaking which, more than anything else, will determine the outcome.

Dr. I: How do you cope with stress while staying positive?

Coach Karl: I’m a big believer in thought processes of staying above the line and not beneath the line. I could show you 100 words that are above the line and 100 words below the line and you’d be amazed how close the thought process is. I just really believe that thinking good things are going to happen will make good things happen. There’s a karma to it. Your energy patterns and thought patterns should stay away from the past. Past thoughts create a thought process that’s like being in mud – slow motion.

Future thoughts or goal-oriented thoughts or present intentions are energizing. Staying on that side of energy is really important.

Dr. I: How did battling throat cancer change your perspective on dentistry and leadership?

Coach Karl: So much of the medical profession side is education and prevention. Dentists can be a part of preventing head and neck cancers.

I know they’re expanding that facet of it. When you get your teeth cleaned, can they put a 10-minute or 15-minute exam into it to check your neck and be a part of the process of prevention?

To me, cancer gave me a feeling of how privileged I am, what a great life I have. I have an opportunity to do what I love to do. The perseverance of going through the process has awakened the desire to celebrate on a daily basis that I have a pretty special life.

I would like to personally thank Coach Karl on behalf of the entire Metropolitan Denver Dental Society.

You are a role model that all of us can gain valuable insight from. We are rooting for you professionally and personally, and of course, GO NUGGETS! Anil J. Idiculla Chairman, Communications Committee

Want to contribute an article to the MDDS Articulator?

We would love to hear from you!

Contact Jason Mauterer at jmauterer@mddsdentist.com or call 303.488.9700 x3270

Articulator

Sept./Oct. 2011

9

MEMBER MATTERS MDDS Night with the Rockies was a Hit!

Dr. George Gatseos and wife Janet

Three of the new member ticket winners: (from left) Drs. Amir Jafari, Greg Hurtzberg and Kevin Varley

Attendees enjoyed a picnic at Coors Field and a win over the Washington Nationals on August 6, 2011. The MDDS Member Services Committee generously paid the way for five new member dentists to attend. It was a sell-out with 84 attendees.

Membership Spotlight: Dr. Karen Foster 1) Why is being involved in organized dentistry important to you? What motivates you to take the time to volunteer?

Organized dentistry offers several benefits including opportunities to learn from your colleagues, gain knowledge through attending CE courses, be among the first to hear of new techniques and receiving alerts about new reporting requirements. I truly believe to be an effective member of a profession one must participate in the organizations pertinent to that profession. Then if you have an issue, you have an avenue to address the issue and reach a solution. Dentistry is my passion. Everyone has 24 hours per day; I feel strongly enough about dentistry to dedicate my time to making a difference.

4) Were you ever intimidated about becoming active in organized dentistry? If so, what helped you overcome it?

Yes, speaking publicly is a challenge for me. Dr. Charles Danna and Dr. George Gatseos have been very encouraging. They have both been instrumental in opening my eyes to opportunities within MDDS/CDA. With these new roles, I am working to overcome my fear of public speaking.

5) How does your staff react to your involvement? Your patients?

My staff is very supportive; they provide encouragement and express pride in my accomplishments. They often serve as an attentive audience when I practice a presentation. As a pediatric dentist, my patients are much more interested in hearing about my puppy. Their parents do indicate they follow my activities on our Facebook page.

2) Who do you credit for encouraging your involvement in MDDS/ CDA? As a young child, I lived across the street from Dr. Ken Versman.

He’s an excellent role model for participation in organized dentistry.

3) What was the best/most fun MDDS/CDA event you have attended?

I have greatly enjoyed being a speaker host the past 2 years at RMDC. Spending one on one time with the excellent, quality speakers RMDC attracts is an incredible opportunity.

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Dr. Foster and her staff at her practice, Saddle Rock Pediatric Dentistry's 1st open house.

Articulator

Sept./Oct. 2011

New Members - Welcome!

Dr. Sally Abouassaf Dr. Justing L. Baltz Dr. Brady D. Bichon Dr. Jared J. Bruggeman Dr. Jungsoo Byun Dr. Adam G. Clarke Dr. Lindsay M. Compton Dr. Rena M. Curtis Dr. Justin Evanson Dr. Melissa Farbod Dr. Adam M. Firestone Dr. John M. Flanigan Dr. Amy M. French Dr. Robert E. Gartland Dr. Amy I. Hazen Dr. Gregory A. Herzberg Dr. Barbara D. Heupel Dr. Kayee Ho Dr. Amir A. Jafari Dr. Marilyn V. Ketcham Dr. Avani H. Khatri Dr. Lina K. Kulkarni Dr. Naomi L. Lane Dr. Ryan T. Leary

Dr. Allen J. Lee Dr. Jean Link Dr. Eugene Liu Dr. Zoulfia Magaril Dr. Matt R. Mauck Dr. Michael B. McKee Dr. Christina McMillon Dr. Nicholas W. Miner Dr. W. Patrick Misischia Dr. Dwayne A. Moore Dr. Ian W. Morse Dr. Marc A. Nelson Dr. Tram Nguyen Dr. Lana J. Nysse Dr. John J. Picard Dr. Darcy B. Rehn Dr. Erin M. Sain Dr. Nevin T. Sebastian Dr. Theodore R. Shille Dr. Brian C. Trommeter Dr. Joseph D. Uker Dr. Kevin M. Varley Dr. Eric L. Walker Dr. Kristin T. Wiseman

The Rocky Mountain Dental Convention exhibited at CDA Presents San Francisco this year September 22-24, 2011. Pictured above is the crowd gathered around our booth waiting to get a postcard of themselves skiing in the Rocky Mountains.

Turn Key Dental Office 3,247 SF FOR LEASE Low Introductory Rate: $14.00 NNN 6 months free rent!!

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Jason Kruse, CCIM jason@coloradogroup.com

The MDDS kickball team at the Howard Dental Center's Kickin’ for a Cause tournament on August 28, 2011

Todd Walsh, CCIM walsh@coloradogroup.com

The Colorado Group, Inc. • 303.449.2131 www.coloradogroup.com 3434 47th Street • Suite 220 • Boulder, CO 80301 The information above has been obtained from sources believed reliable. While we do not doubt its accuracy, we have not verified it and make no guarantee, warranty, or representation about it. It is your responsibility to independently confirm its accuracy and completeness.

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Diagnosis Challenge–Oral Pathology

By John D. McDowell, DDS

Suggested Differential Diagnosis from page 5 Diagnosis: • Acute (primary) herpetic gingivostomatitis • Erythema multiforme • Allergic reaction from oral or systemic exposure to an allergen The history of the acute and initial presentation with fever, malaise, difficulty swallowing from a sore throat and “swollen glands” along with the physical examination confirming the history of fever, the easily detectable generalized lymphadenopathy, generalized fiery red gingiva, multiple punctate shallow ulcers with vesicles on multiple surfaces including the vesicles and bulla clearly demonstrated on the lower lip/ labial mucosa support the working diagnosis of primary herpetic gingivostomatitis.

The most effective plan in this case is to provide information about primary herpes including the potential for systemic involvement. Additionally and as a minimum, the treating dentist should provide palliative care including instructions on nutrition and hydration. For adults, a palliative rinse with equal parts of benadryl, Maalox (or Kaopectate) and viscous lidocaine can provide temporary relief from symptoms.

Analgesics and antipyretics can be recommended or prescribed as necessary. Aspirin or other NSAIDS are often contraindicated in younger patients with some viral diseases but are usually both safe and effective in adults. A low dose of acetaminophen (possibly in combination with other “stronger” analgesics) for a short period of time is generally considered as safe treatment.

In severe cases presenting with significant oral/pharyngeal pain, a topical spray with 0.5% or 1.0% dyclonine has been reported to temporarily decrease oral pain. Some authors have recommended not using viscous lidocaine in pediatric patients because of the risk of lidocaine-induced seizures.

Patients should always be informed about the potential for transmission of this disease through exposure to the infected patient’s saliva and/or vesicular fluids. The signs and symptoms of recurrent herpes should also be part of the informed consent process.

Want to contribute an article to the MDDS Articulator?

We would love to hear from you!

Contact Jason Mauterer at jmauterer@mddsdentist.com or call 303.488.9700 x3270

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Articulator

Sept./Oct. 2011

PERSONAL WELLBEING Protect That Bite

By Karen Franz, DDS & Kyle Klepacki, DDS

D

id you know that each year there are seven million sports and recreation related injuries, half of which occur in patients between the ages of 5 and 24? The Center for Disease Control reports that collision and contact sports have the highest injury rates with baseball, soccer, basketball, and football accounting for about 80 percent of all sportsrelated emergency room visits for children between 5 and 14 years of age.

Surprisingly, cheerleading accounts for 65 percent of all injuries in high school girls' athletics!

In March, 2011 the American Association of Orthodontists commissioned a new sport safety survey which found a much greater need for education of parents and coaches about the need for mouth guards in youth sports. Below are some of the most surprising findings of the new study: • Safety is a top concern, but action isn’t following. Seventy-six percent of parents say the thing that concerns them most about their child participating in sports is that he/she will get hurt, yet only 33 percent of parents surveyed reported that their children wear mouth guards during organized sports (unchanged from a 2008 survey).

• More parents today think their child doesn’t need a mouth guard. Of the parents surveyed that reported their children do not wear mouth guards during organized sports, 59 percent (up seven percent from 2008) reported that their children don’t wear mouth guards because they “don’t need that

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level of protection.”

• Coaches are key influencers when it comes to sports safety, but fewer than one coach out of three (29 percent) recommends that athletes wear a mouth guard during practices and competitions. Forty percent of parents admitted that their child doesn’t wear a mouth guard because “the coach hasn’t recommended it.”

• Some parents are surprised that mouth guards protect more than just teeth.

Ninety-five percent of parents surveyed reported that they believe a mouth guard

“...the best mouthguard is the one that is worn! ” could help prevent damage to teeth, however thirty-four percent did not know that a mouth guard could help protect against jaw injury. (Results courtesy American Association of Orthodontists) According the ADA, a properly fitted mouth guard is important because 80 percent of dental injuries occur to maxillary incisors. Traumatic injuries to the teeth may never heal completely, and it can create a lifetime of expensive, long-term problems for the patient. The National Youth Sports Safety Foundation estimated the cost to treat an avulsed permanent tooth and provide follow-up care is between $5,000 and $20,000 over a lifetime!

Given the strong influence of coaches and peers on young athletes, these attitudes present considerable barriers to patients’ compliance and mouth guard use. It therefore becomes

important for the dentist to take an active role in advocating mouth guard usage. Although a custom fitted, dentist made mouthguard (such as a vacuum formed guard or the new Under Armour lab-made guards) offers the best fit and most protection, the cost can be a holdup for many parents. “Boil and bite” and readyto-wear styles offer less protection and comfort, but tend to be far more affordable alternatives.

In general, there have been few changes in mouth guard “technology” over recent years, but don’t tell the manufacturers that. Under Armour brand mouth guards have gained popularity over the last few years with claims that their patented “ArmourBite Technology” gives athletes an edge over their competition. While the benefits they claim may apply to all mouth guards on some level, Under Armour claims their technology prevents excess cortisol release which in turn results in increased strength and endurance, as well as faster reaction time. In addition, they even claim better concussion protection for the athletes that use their sport-specific designs. Despite manufacturers’ claims of additional benefits to mouth guard wear, independent peer-reviewed research is very limited on the topic.

The key educational message from the ADA is that the best mouth guard is one that is worn!

Articulator

Sept./Oct. 2011

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INSIDE THE CDA

SNOWMASS SUMMIT

Delegate Review from the CDA Annual Session

T

his year's CDA Annual Session was held on June 10-12, 2011 in the beautiful Snowmass Village.

Being a new member of CDA/ MDDS and starting my own private practice within the last year, I was eager to get my feet wet and involve myself in the political and legislative arenas of organized dentistry. Overall, it was a great experience and I learned a lot about what goes on "behind-the-scenes" in organized dentistry that is affecting and will affect how dentists practice and patients receive dental care.

As a newbie, I gleaned information from several "veterans" such as Dr. Eric Rossow, Dr. Ian Paisley and Dr.

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By Brandon Hall, DDS

Brian Gurinsky. They were very helpful in describing the delegate process and explaining some of the important issues facing organized dentistry.

Dr. Brandon Owen ( CDA Editor) was also very approachable and he seems very excited about all of the new dentists that are becoming part of the process. He debriefed all of the new delegates the night before the House of Delegates Session.

The morning session began around 8:30 and started off with several speeches and addresses including ones by ADA President Dr. Raymond Gist and CDA President Dr. Pasco Scarpella. I was able to catch-up on

all of the main issues and challenges facing organized dentistry. The overriding sense was that this is a VERY important time for us as dentists and we need to be very aware of what's going on. Three huge issues that seemed to permeate through were mid-level providers, non-covered services and reimbursement cuts from insurance companies. All three of these are looming large not only on the national level but the local and state levels as well. These three issues could/ will potentially affect each and every one of us dentists. On the lighter side, there was quite a lot of witty banter between the officers which made it Articulator

Sept./Oct. 2011

NEW NEWS entertaining. There were at least a hundred delegates from all over the state. I met several delegates from other consituent societies as well.

After the morning speeches, the resolutions that were to be voted on in the afternoon session were discussed.

Among them were the fiscal year operating budget, a proposed dues increase, changes in membership retention/payment plans and dues for retired members.

Following presentation of each resolution, delegates then debated and gave their opinions on why they were for or against the resolution. Two of the most heated debates were about a possible dues increase and how to structure payments for current and potential new members. Many of the delegates (especially newer) feel as though the cost of joining organized dentistry can be overbearing for the first years out in the "real world."

On top of school loans and other debt, several hundred dollars can be overbearing for new dentists. I know this from experience. However, I strongly believe once people see the benefits of joining and participating in organized dentistry the cost of dues pales in comparison.

The afternoon session consisted of voting on the resolutions, organization reports (ADPAC, ADA, UCSDM, etc.) and installation of new officers. Awards were also given to several

upstanding members who have contributed outstanding service towards organized dentistry. Finally, several issues were touched upon that would be upfront in the coming years.

These three issues could/will potentially affect each and every one of us dentists.

All-in-all the day was chock full of information to absorb and it was all very important to us as dentists. I'm excited about being an integral part of CDA/MDDS/ADA going forward. With enormous challenges ahead such as the "non-covered services" bill, mid-level provider legislation/education and cuts in insurance reimbursement it's more vital now than ever for not only new dentists but established dentists to get involved with organized dentistry and voice their opinions. I feel I have to stand up against legislation and changes that will negatively impact our profession.

We cannot let insurance companies and corporations dictate our livelihood. Now that I have experience first hand, I feel as though I'm prepared to educate other dentists and voice my opinion. For anyone looking to get involved, The House of Delegates meeting at the CDA Annual Session is a great start!

15

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Metro Denver Dental Society ~ 10 X 7.5 ~ 4C ~ Aug/Sept 2011 ~ Portland Dental ~ Scott Beard & Amanda Mombert

PLAYRELAX SAVE DATE

THE

@DEVIL’S THUMB RANCH MDDS mddsdentist.com June 21-24, 2012 in beautiful Tabernash, CO

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Annual Me eting & Dinner th

1. Dr. Michael Scheidt receiving the Honus Maximus Award

2. Dr. Gene Bloom receiving the Chairman of the Year Award for his work on the CE & Events Committee. Dr. Bloom also received an Outgoing Chairman Certificate for his work on the same committee.

3. Dr. Michael Poulos as the night’s emcee

4. Dr. Michael Varley receiving an Outgoing Chairman Certificate for his work on the 2011 Convention Arrangements Committee 5. Dr. Kenneth Peters receiving an Outgoing Chairman Certificate for his work on the 2011 Convention Arrangements Committee

6. Drs. Mitchell Friedman and Michael Scheidt 7. Dr. Michael Petersen receiving an Outgoing Board Member Award

8. Dr. Jeffrey Lodl receiving the Chairman of the Year Award for his work on the RMDC Program Committee.

9. Ms. Korinna Milam and Ms. Shelly Fava receiving Outstanding Staff Member Awards from Ms. Elizabeth Price, MDDS Executive Director 10. Dr. Charles Danna, 2011-2012 MDDS Incoming President

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EVENT CALENDAR OCTOBER 2011 October 17

Colorado Prosthodontic Society - Current Concepts in Esthetic Implantology Presented by Dr. Gerhard Iglhaut Doubletree by Hilton Hotel Denver 3203 Quebec Street Denver CO 80207 9:00 am - 4:00 pm More Info: coloradoprosthodonticsociety.com

October 18

Metro Denver Dental Society: Western Caribbean Cruise Reception Metropolitan Denver Dental Society Headquarters (303) 488-9700 6:30 pm - 7:30 pm More Info: http://www.mddsdentist.com/ continuinged/MDDSCECruiseNight.asp

October 19

Metro Denver Dental Society: CPR & AED Training Metropolitan Denver Dental Society Headquarters (303) 488-9700 6:00 pm - 9:00 pm More Info: http://www.mddsdentist.com/ continuinged/cpr.asp

October 29

Metro Denver Dental Society: Behavior Management Strategies in Pediatric Dentistry with Special Consideration of Medical Immobilization Presented By: Dr. Ulrich Klein Metropolitan Denver Dental Society Headquarters (303) 488-9700 8:00 am - 3:00 pm More Info: http://www.mddsdentist.com/ continuinged/medicalimmobilization.asp

NOVEMBER 2011 November 12

Metro Denver Dental Society: Dental Accounting Metropolitan Denver Dental Society Headquarters (303) 488-9700 9:00 am - 12:00 pm

November 14

Colorado Prosthodontic Society: Oral Pathology for the Joy of It: You are the Object of My Infection Presented by Dr. John Svirsky Doubletree by Hilton Hotel Denver 3203 Quebec Street Denver CO 80207 9:00 am - 4:00 pm More Info: coloradoprosthodonticsociety.com

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November 18 &19

Metro Denver Dental Society: Oral Sleep Medicine & Appliances Presented By: Dr. Barry Glassman Metropolitan Denver Dental Society Headquarters (303) 488-9700 8:00 am - 4:00 pm Both Days (One hour lunch) More Info: http://www.mddsdentist.com/ continuinged/DentalSleepMedicine.asp

November 29

Metro Denver Dental Society: Dental Real Estate Metropolitan Denver Dental Society Headquarters (303) 488-9700 6:00 pm - 8:30 pm

DECEMBER 2011 December 9 & 10

Metro Denver Dental Society: Nitrous Oxide/ Oxygen Administration Training Presented By: Drs. Jerome Greene & John Forney Children’s Hospital - Dental Clinic 13123 East 116th Avenue Aurora CO 80045 US 8:00 am - 5:00 pm Friday (One hour lunch) 8:00 am - 12:00 pm Saturday

JANUARY 2012 January 19-21

RMDC - The 2012 RMDC is going to sport a heavy-hitting educational lineup plus the natural winter attractions and beauty of Denver, Colorado.

Some of the speakers include: Dr. Peter E. Dawson & The Dawson Academy The Pankey Institute Dr. Gordon Christensen Dr. Terry Tanaka rmdconline.com

February 28

Metro Denver Dental Society: CPR & AED Training Metropolitan Denver Dental Society Headquarters (303) 488-9700 6:00 pm - 9:00 pm

MARCH 2012 March 2 & 3

Metro Denver Dental Society Hands-on Course: Pankey Institute: Introduction to Bonded Porcelain Restorations Details TBD

March 21

Metro Denver Dental Society: CPR & AED Training Metropolitan Denver Dental Society Headquarters (303) 488-9700 6:00 pm - 9:00 pm

APRIL 2012 April 21

Metro Denver Dental Society Clinical Course: How to Choose the Right Laser Wave Length for Your Practice Metropolitan Denver Dental Society Headquarters (303) 488-9700 8:00 am - 4:00 pm

MAY 2012 May 3

Metro Denver Dental Society: CPR & AED Training Metropolitan Denver Dental Society Headquarters (303) 488-9700 6:00 pm - 9:00 pm

May 17

FEBUARY 2012 February 10

Metro Denver Dental Society: Basic Radiation Presented By: Dr. Brad Potter Metropolitan Denver Dental Society Headquarters (303) 488-9700 8:00 am - 11:30 am

February 13

Colorado Prosthodontic Society - Laser Dentistry Today: What we can Achieve with this Technology in Restorative & Implant Dentistry Presented by Dr. Georgios Romanos Doubletree by Hilton Hotel Denver More Info: coloradoprosthodonticsociety.com

Metro Denver Dental Society: Annual Meeting Inducting Dr. D. Diane Fuller The Brown Palace 321 17th Street Denver CO 80202 US 5:30 pm - 9:00 pm

MAY 27 - JUNE 3

Metro Denver Dental Society: CE Cruise Dr. Henry A. St. Germain, Jr., DMD, MSD, MEd Round Trip from Port Canaveral, Florida Invite your family and friends to join you on the beautiful beaches and sparkling blue waters of Labadee (Rccl Private Island), Jamaica, Grand Cayman and Cozumel

JUNE 2012 June 21-24

Metro Denver Dental Society: Family Fun Event Devil’s Thumb Ranch 3530 County Road 83 Tabernash, CO 80478

MATERIAL MATTERS Invest in Your Bond

By Sheldon M. Newman, DDS, MS Esthetic general dentistry relies on bonding procedures for both direct and indirect esthetic restorations. Bonding has two goals: 1) retention of the restoration in/on the tooth and, 2) sealing of the restoration with the tooth. To fully achieve these goals one must not only choose an effective vehicle or type of bonding agent, but must also invest in the delivery of that chosen agent. That investment is time.

Because of the importance of the bonding system not only to the initial acceptance of the restoration, but also to its long term prognosis, it is imperative that one does not short change the time invested in the bonding process. Time is money and dentists want the bonding system to be simpler, easier and faster. But a single failure can be much more costly than a few extra minutes per restoration.

The nomenclature for bonding agent classification has changed over the last several decades. Differentiation used to be 4th, 5th, 6th, 7th, etc. generation which has been relegated to marketing claims. The 4th and 5th generations are now referred to as "total etch” technique. In the 4th generation there were three agents (EPA technique): acid Etchant, Primer (mostly organic solvent with a little monomer), and Adhesive (polymerizable bonding resin).

In the 5th generation the primer and adhesive were combined (PA system), but a separate acid-etchant was still needed. The 6th generation and 7th generation introduced “self-etching” bonding systems. The 6th generation still had two bottles, the first containing the acid-monomers for etching plus the primer, the second bottle containing the adhesive. The 7th generation achieved a one agent delivery system. This series of changes has made bonding simpler and easier and maybe somewhat faster, but one must always maintain respect for the bonding no matter what delivery system is chosen. They all require time to achieve effective bonding.

The total etch systems demand time to achieve a sufficient etch of the enamel, while limiting the etching of dentin to 15 seconds max. The washing required after etching must be thorough. After an initial few drops of just water to remove the blue etchant into the high-volume suction, the surface should be washed for at least 15 seconds, before the inexact instruction of remove excess water but don’t dehydrate. The primer application required complete coverage of the tooth surfaces to be bonded, requiring 2 to 7 coats, and then a thorough drying. Instructions would state primer drying times of 5 to15 seconds, but these times are inadequate to achieve the goal of a shiny surface with no movement in response to a final force of strong air. That goal could require as long as 30 seconds or longer. In the PA system, the solvent still has to be evaporated, but now must be eluted from a resin solution. The recommendations of 3 to 15 seconds are highly inadequate to elute the solvent from this resin system, no matter whether the solvent is ethanol or acetone, and there are no clinical

mddsdentist.com

indicators as to when that process is complete. When you think you have sufficiently gently-blown drying air over the PA application, do it longer. Then these PA solvent/resins may require repeat applications. To get good adaptation of the PA solution it is recommended to “scrub” the dentinal surfaces, just don’t scrub the enamel or you risk breaking enamel retention prisms.

The self-etching systems may be faster, but still require sufficient time to work. They can NOT be applied splash-and-dash. The selfetching acid-monomers may not be aggressive enough for enamel, and a pre-etch of the enamel only with phosphoric acid may still be required, with the obligatory wash. They are to be applied with a “scrubbing” motion, but be careful on the enamel. They must remain in place long enough to achieve the etch and penetration of the tooth surface prior to any curing step. The solvents, which now include a significant amount of water for the acid, will definitely require longer drying times than 5 seconds. These agents may also require multiple coats.

When curing these adhesives for any of these systems, 10 seconds is commonly recommended. But the curing light guide is not a magic wand to wave over the preparation. It must be close to the surface to be effective, and the floor of a simple class II box is already at least 4 to 6 mm away, compromising the irradiance of the surface, demanding longer curing times. Definitely light cure the bonding agent prior to the placement of the first layer of composite. This curing step should be avoided before the placement of an indirect restoration, but in such cases one must use a dual-curing adhesive.

The instructions from the manufacturer for these materials produce a good result with their product under ideal laboratory conditions. Dentists never work under those conditions in the mouth. Most of the instructions are laced with terms of “at least” the recommended time, or for larger restorations increase the time or the number of applications.

If one follows all of these recommendations to take more time, recognize that these suggestions may only increase the total restoration time by about 2 minutes. If you wish to ignore such recommendations, please under no circumstances should one short change the times. Make a proper investment of time in your bonds.

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Sept./Oct. 2011

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PRACTICE MANAGEMENT Considerations in Employee Terminations

By Tina Harkness, Esq., Mountain States Employers Council

T

erminating an employee is never easy.

Termination is the most serious and, as a result, the most often challenged decision employers make. And, no matter how bad the employee, terminating him or her means that you have lost your investment of time, energy, and money in that employee and have to start over. For these reasons, termination should be an employer’s last resort in addressing all but the most serious employee performance problems.

Before terminating an employee, ask yourself the following questions: 1. Did the employee know the rule or policy for which they are about to be terminated?

- Did the employee receive training? How much specialized education/licensing is required to do the job? Is the training documented?

- Is the work rule or standard of performance published to employees?

- If published, did the employee receive a written copy (e.g., in handbook)?

- Was the employee otherwise informed of the rule or standard of performance?

- Should the employee have known the rule or standard, e.g., previous counseling or obvious rule (e.g., theft or violence) 2. Is the rule or policy reasonably related to business or the employee’s job?

3. Do you have a discipline policy and, if so, have you followed the policy, written or unwritten, to the letter?

4. Unless discipline is for a very serious violation (e.g., gross misconduct), has the employee received prior oral or written counseling or warnings?

5. Are similarly-situated employees (e.g., same department, job title) performing at the same standard or under the same set of work rules?

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6. Is this action consistent with what you have done with other employees in the same or similar situations? Inconsistency can lead to claims of unfair treatment and unlawful discrimination.

7. Have you documented the employee’s departure from expectations as you have or would other employees?

8. Did you give the employee a chance to explain and investigate the matter thoroughly?

9. Did you clearly communicate the consequences of a failure to comply?

10. Is the person in a protected class or has the person exercised any legal right against the company?

11. Does documentation in the employee’s personnel file clearly reflect the reason for the discharge?

12. Have there been any promises that the employee could claim have been violated?

13. In phrasing the discipline or termination, have you adhered to the job-related observable facts and refrained from subjective conclusions that could be viewed as an invasion of privacy or defamation?

14. Would an uninvolved person think that the action you are taking is fair?

Some termination decisions are more problematic than others because they raise red flags with enforcing agencies and attorneys for employees.

Here are typical factual scenarios that may warrant another look before taking action: - Discharge in the heat of the moment - be wary of the angry supervisor who is making the decision to discipline/discharge.

- On-the-spot discharge - avoid snap decisions without the benefit of review.

- “House-cleaning” - be wary of hasty decisionmaking by inexperienced or new supervisors.

- Long-term employee with marginal work record – when combined with a new supervisor who wants to “clean house,” often a recipe for litigation.

- Highly-compensated employee - potential for large back pay award and prone to breach of contract or promise allegations based on documents or discussions with upper management which could alter at-will status.

-Employee within a legally-protected group especially when being replaced by someone outside of that protected group.

-Lay-off of one employee – may be seen as a disguise for getting rid of a problem employee.

Practically, there is no way for employers to predict or prevent legal challenges from employees.

Employers should manage this risk by developing good employee relations policies and practices, enforcing these policies and practices consistently, documenting employee performance, and consulting Human Resources and legal counsel’s help when making tough termination decisions.

Once the decision is made, the employer must communicate it to the employee. Unless there is a reason not to, the termination meeting should be done in person. It is recommended that more than one member of management attend this meeting – usually the direct supervisor and the person in charge of human resources. The employer should communicate the termination decision and give a brief explanation of the reason why. The employer can give the employee a chance to respond, but the employee should understand that the decision has been made. The employer should not engage with the employee in any argument or debate about the decision. Then, the employer should move on to final logistics like arrangements for delivery of the employee’s personal items, final pay, insurance continuation options and wind up of other benefits, return of company property, and verification of address for W-2 purposes.

Good management practices and a little planning can ease an employer’s burden at termination.

Articulator

Sept./Oct. 2011

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Articulator

March/April 2011

21

NON-PROFIT NEWS The Explorer Post 296 Program needs your extra/expired stuff!

Explorer Post 296 Program Returns to MDDF

Help each student have an amazing experience by donating any of the materials listed below that you can:

By Amy Boymel, MDDF Executive Director

T

he MDDF Board of Directors is pleased to announce the return of Explorer Post 296 this fall. Tremendous thanks go to Dr. Jennifer Garza for her commitment to taking the lead in planning the upcoming series of sessions that will take place.

The Explorer Program is more than just an amazing opportunity for students aged 14-21 to get hands-on practice and real-life insights into the rewards of a career in dentistry. It’s also a terrific opportunity for you and the members of your team to participate in a fun and rewarding educational experience with potential dental professionals.

Volunteer to help teach one (or more!) of the sessions outlined below. Each session is scheduled for a Monday evening from 6:00 pm to around 8:00 pm, and we’ll provide the pizza! Please join us for one of the most meaningful and enjoyable ways you can be involved with MDDF this year.

The Explorer Post 296 Program needs you!

You and members of your staff can share your passion and expertise with students considering a career in dentistry by volunteering to help teach one of this year's sessions: • Monday, Oct. 24 - Periodontics/Oral Surgery/Dental Hygiene (MDDS Building)

General Items: Goggles, Light Curers, Expired PVS material (in a gun if possible), Scalers, Alginate, Disposable or Plastic Impression Trays, Nitrile Gloves - all sizes (samples welcome), Orange Solvent, Patient Napkins, Bib Clips, Green Mixing Bowls, Plastic Spatulas Orthodontic/Pediatric/Cosmetic Items: Pontics or old Shade Guides, Expired Composite, Expired Primer, Plastic Instruments or Hollenbacks, Sealant Materials, Polishing Disks, Micro Brushes, Bonding Brushes, Waxed Mixing Pads, Disposable Prophy Angles, Disclosing Solution or Tablets, Prophy Paste, Waxing Instruments, Articulating Paper Oral Surgery Items: Expired Sutures, Disposable Scalpels, Extracted Teeth (well intact), Extraction Forceps How else can you help?

• Involve your staff for an extraordinary experience you'll all enjoy!

• Contact counselors at your local high school to invite them & their students to participate!

• Monday, Dec. 5 - Cosmetic Dentistry (MDDS Building)

Please contact Amy Boymel at aboymel@mddf.org or 303-957-3272 to sign up or learn more about how you and your team can be involved.

• Monday, Jan. 9 - Pediatric Dentistry (Dr. Barr's Office, Westminster)

Thanks for supporting MDDF!

• Monday, Nov. 14 - Orthodontics/Dental Technology (Dr. Garza's Office, Castle Rock)

• RMDC - January 19-21 at the Convention Center

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Participants of the September 26, 2011 Explorer Post 296 practice injections on oranges

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Articulator

Sept./Oct. 2011

COMOM Cares

By Dr. John Hanck, COMOM Board President After half a decade, the Colorado Mission of Mercy (more widely known as COMOM) needs little introduction. What started in 2007 in Alamosa, CO, has continued annually for the past four years. This year, COMOM will host its fifth annual clinic event at Brush High School in Brush, CO. If you’re new to the area or wanting to get more involved with charitable dental programs, COMOM is a large-scale, portable dental clinic boasting more than 100 dental chairs. The COMOM clinic travels annually to different areas of Colorado offering donated dental treatment and oral health education to lowincome adults and children struggling with access to dental care.

COMOM has provided care in Alamosa, Loveland, Brighton and Colorado Springs. Its next event in Brush, CO is on Oct. 21-22, 2011 (clinic set-up occurs on Oct. 20 and clinic tear-down occurs on Oct. 23).

The stories that surface at COMOM each year can bring tears to your eyes. These patients have been without dental care for years and decades; they’re in pain, and they’re desperate for the chance to be helped by COMOM. Patients are seen on a first-come, first-served basis. They come from great distances and many wait overnight for dental care.

COMOM provides the dental chairs, lights and units, in addition to disposable supplies, but it’s the volunteers that power this

program to success. The heartfelt gratitude you receive in return for your services at COMOM will make you a volunteer for life. COMOM helps eliminate pain and suffering, improves self esteem, and literally gives patients something to smile about.

There is no other program in Colorado like it, and I guarantee COMOM will make a difference in your life, as well as the hundreds of patients you help.

How to Volunteer

COMOM depends on volunteers – over 800 of them. We need dentists (GPs and specialists), hygienists, dental assistants, front office personnel, lab technicians, dental coders, nurses, doctors, pharmacists and a huge amount of non-clinical volunteers. This is a fantastic team building opportunity for your entire staff and their families. While patients are provided with free treatment and oral health services, they also need to be registered, escorted throughout the clinic, provided with education, and interviewed about their history and experience as they exit. This is truly a team effort and there is a volunteer opportunity for everyone (ages 14 and older). We are also seeking translators to help with our patients when a language barrier may be present.

Please visit cdaonline.org/COMOM to learn more about the 2011 event and to register. We look forward to having you as part of our COMOM team!

COMOM volunteers donating their time to the under-served

mddsdentist.com

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Sept./Oct. 2011

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PERSONAL WELLBEING Keeping Fit for Productivity

By Clint Gehde, NCSA-CPT

I

t is most important to physically train with someone who understands the demands that your profession and life bring so that your workouts are not counter intuitive. Here are the top reasons to work with a specialized personal trainer if you work in the dental profession:

Elevated stress: Grabbing a workout before, during, or after work will help you handle the daily patient flow. A lot of times I have personally witnessed the stress and demand for production while still maintaining quality patient care and service. Your workouts will help eliminate stress thus helping you take on more throughout your day.

Recovery and regeneration may be the most important part of your workout. We have to work the body in all planes of motion: forward and backward, left and right, up and down, diagonal and rotational. It is important when training to emphasize mobility and stability in all joints. In our training we implement ‘dynamic’ movements in every workout, which speaks to all specific motions mentioned above. Some pieces of very inexpensive equipment to make sure and have are: tennis balls, stretch ropes, and foam rollers to help with these reparative processes.

Too much sitting: If it was only that! Dentists and their team members tend to sit in a very abnormal position for a prolonged period of time. Believe it or not there is a way through training effectively that will help create more of an ergonomic position resulting in improved production and quality care.

HRD (Hip Rotation Deficit): HRD can kill your entire foundation

"Get lean, healthy, and start to positively impact your career." from your ankles up to your neck. The hips and how they track throughout the kinetic chain have a critical roll in how the body feels and functions. It is important to incorporate hip work in every workout.

Poorly Designed Exercise Routines: Let me ask you a question.

Have you ever considered yourself an athlete even in your current profession? Why not? You already understand that your shoulders, hips, back, and mind are toast after a long day!

We need to work to correct all these areas and we do that by implementing a comprehensive assessment in order to evaluate your strengths and weaknesses. Once you have completed an assessment you can workout with purpose and achieve results much quicker and have purpose every time you approach a new day. Get lean, healthy, and start to positively impact your career. It is amazing what one hour in a day can do! We will talk later about the seven phases of a fitness routine.

Stretching: This really follows the HRD nicely. I am sure by now you are starting to see how all these things are closely related.

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Nutrition: (In a nutshell) These are the top rules to live by: - Eat three main meals and two or three snacks per day. Keep these meals and snacks small. This will keep the metabolism high and provide you with the energy needed to be very productive throughout your day.

- Combine Protein in every meal. This will help promote active and progressive recovery for your muscles considering you are working out daily.

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Sept./Oct. 2011

- Eat fresh produce as frequently as possible. Cut out processed foods considering your body has nowhere to store them so you guessed it...they turn into fat!

- Do not avoid fats! Good fats have a huge impact on your diet.

Especially nuts (cashews, walnuts, and almonds), avocado, olive oil, and nut butter. These are just a couple of examples. Snacks should always include a protein source as well as a fat source in effort to keep your metabolism functioning at the high level that you need throughout your day.

- Combine carbohydrates and proteins before and after workouts for optimal performance and recovery. The easiest way to do this is through either a meal replacement or recovery shake.

Hydration: The number one rule for water intake is to try and drink half of your body weight in ounces everyday. This will ensure proper hydration levels for optimal efficiency, especially when those days run long. Having adequate amounts of water running in the body help process nutrients and also keeps your appetite at bay during those long days.

So, how do you know if you’re doing the right things for your workouts? Here’s a great checklist for each workout and also how to plan the exercises for your workouts.

Dynamic warm-up

DON’T MISS OUT! THERE’S ONLY ONE

MORE EDUCATIONAL

SEMINAR FOR 2011!

The 2011 DISC seminar series is almost over. Until next spring, there is only one remaining seminar to attend. Sign up NOw so you don’t miss out!

10

NOvEMBER

Joint Integrity and Corrective Work (Activation techniques) Core Training Strength and Tone Power and Plyometrics Metabolic Training (Functional) Recovery and Flexibility Each workout need not take any longer than 45 minutes to accomplish all of these goals, which leaves you with plenty of time to get back to the practice, patients, and life.

Please stay tuned into futurefitnesstraining.com for upcoming video links with descriptions and demonstrations for each phase of a workout with Clint Gehde. Also, for questions please comment on either my facebook page or website.

Clint Gehde, Certified Professional Trainer NSCA-CPT, Certified Professional Trainer with the Titleist Performance Institute. B.S. Kinesiology in Exercise Management from the University of Wisconsin Eau-Claire. Twelve years experience in the fitness industry, specializing in exercise program/design for today’s busy professional. Clint has been consulting and training multiple dental professionals over the years. He has met with several dentists and dental team members in order to help improve their posture, practice efficiency, and overall health.

mddsdentist.com

IMPLANT ABUTMENT SELECTION: THE A TO Z OF IMPLANT RESTORATIvE DENTISTRY IN THE gENERAL DENTAL PRACTICE. Dr. Jason Bortolussi, Prosthodontist, London, Ontario, Canada Astra Tech

Location: MDDS Building, 3690 S. Yosemite Street Denver, CO 80237 Time: 5:30 PM to 8:30 PM Complimentary light dinner at 5:30 PM. Lecture begins promptly at 6:00 PM. CE credits are available.

Fees for 2011 are waived due to corporate sponsorship.

The Denver Implant Study Club (DISC) c/o Aldo Leopardi, BDS, DDS, MS 7400 E. Crestline Circle, Suite 235 Greenwood Village, CO 80111 Please Note: Capacity is limited. If you are interested in attending, please call 720.488.7677 to reserve your place.

The Denver Implant Study Club had another phenomenal year.

We are looking forward to shaping up the 2012 seminar series by working alongside great sponsors and fantastic speakers presenting on new and improved topics of interest.

Visit http://www.knowledgefactoryco.com/discschedule for additional detailed information. And remember to check back often.

The 2012 DISC schedule, along with course titles and descriptions, will be completed by December 2011.

FOR ADDITIONAL INFORMATION vISIT: www.kNOwLEDgEFACTORYCO.COM/DISCSCHEDULE

2011

Aldo Leopardi, BDS, DDS, MS Prosthodontist /// P. 720.488.7677 /// F. 720.488.7717

Articulator

Sept./Oct. 2011

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CLASSIFIEDS 1,900 SF corner dental space available expandable to 2,800 SF in Parker. Movein ready with existing millwork and improvements - only chairs required.

Located adjacent to a large pediatric dentist.

A generous TI allowance and signage is available. Building features secured access, T-1 lines, Comcast cable, modern lobby, music and satellite TV broadcasting.

Contact Todd Faestel (303) 841-7600.

2,300 SF dental/orthodontic space available in a Super Target anchored development in Parker. Move-in ready with existing millwork and improvements - only chairs required. Six chair positions, central millwork station, large reception area, custom reception desk, two private patient consultation rooms, X-ray room, lab room, private office, break room. Signage and TI allowance available. Contact Todd Faestel (303) 841-7600.

Denver Rescue Mission Dental Clinic needs volunteer dentists, oral surgeons, hygienists and dental assistants to come in for three hours per month. Also needed: x-ray film, x-ray machine, portable cabinetry and hand pieces. Please contact Melanie Aronhalt at 303-294-0157 ext 2103 or maronhalt@ denrescue.org.

Space Sharing: Broomfield, Colorado Share space in “high end” facility in excellent location! Future opportunity for practice purchase! Includes disposable supplies and computer support! Digital radiography, Pano, Staff availability negotiable. Susan 303-973-2147 or susan@sastransitions.com PRACTICES FOR SALE: Northeastern Colorado, Englewood, Littleton, Metro Denver! Call today for specific information.

Inventory changes before my ads! Susan Spear, Practice Transition Specialist / Licensed Broker, SAS Transitions, Inc. 303.973.2147 susan@sastransitions.com Pediatric Dental Practice: Eureka, California Great ownership opportunity, exceptional income, in modern pediatric dental office! Revenues $1.5M, low overhead, SELLER RETIRING AND WILL CONSIDER ALL REASONALBLE OFFERS! Susan Spear, SAS Transitions, Inc., PC, Inc. of California, 303.973.2147 email susan@sastransitions.com

Need Help BUYING a Practice? Help with Appraisals, Reports, Financing and More! I provide expert advice on how to Purchase Your Practice, Negotiate on your behalf, and help you successfully become the New Owner! Why go it alone? Susan Spear, Practice Transition Specialist / Licensed Broker SAS Transitions, Inc. 303.973.2147 susan@sastransitions.com Hire me to SELL your practice! Choose a Broker You Can Trust! Direct Sales!

Associate to Partnerships! Associate Buy-outs! 16 Years Experience in Dental Transitions! I get results! Ask your friends!

Susan Spear, Practice Transition Specialist/ Licensed Broker SAS Transitions, Inc. 303.973.2147 susan@sastransitions.com Aurora, Colo. Professional dental office spaces consisting of 900 sq. ft. and 1003 sq. ft. will soon become available for lease.

Currently partitioned, plumbed, and wired for dental chairs, etc. Ideal location with high traffic visibility and easy access. Call Dr. Trompeter at 303-688-3838 or e-mail at trompeternotes@msn.com.

For Sale: Enter the digital age for less cost!

Both of these items are in perfect condition, up-to-date servicing and available only because I have upgraded and consolidated equipment. Planmeca Digital Promax Panograph with tomography features. Best machine on the market, easily upgradable to 3D CBCT. Also, newer CEREC Acquistion Scanner/CPU and all current software, Compact Milling unit and many accessories.

Call Lori or Ann-Mari at Dr. Carpenter’s office. 303-427-4120

For information about the Articulator Classifieds contact Jason Mauterer at jmauterer@mddsdentist.com or call 303.488.9700 x3270

Advertise with US! Market your business to the Metro Denver dental profession!

For more details visit mddsdentist.com or contact Jason Mauterer at jmauterer@mddsdentist.com or call 303.488.9700 x3270 Download the ad kit at this address mddsdentist.com/articulator/advertising.asp

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Articulator

Sept./Oct. 2011

CDA NEWS

Ladies in the Loupe

O

n July 16th, the CDA hosted the very first Ladies in the Loupe function at the Denver Botanic Gardens. Female dentists from all over the state of Colorado attended this popular event. There were a whopping 93 attendees and 54 of those were MDDS members. All 12 components of the CDA were represented.

A garden tour kicked off the morning, and once seated in the dining tent area, the women were treated to talks from CDA president, Dr. Tom Pixley followed by ADA executive director, Dr. Kathleen O’Loughlin. Brunch was served followed by table discussions led by the head of each table.

The atmosphere was both nurturing and supportive and clearly the women who attended were ready to have fun together.

Dr. O’Loughlin’s message was clear: women make up approximately half the total ADA members, but the number of women active in organized dentistry is abysmally low. Out of over 900 seats in the ADA House of Delegates, just over 100 are women. Unfortunately, the CDA House of Delegates does not boast better trends. There was some discussion on why this is the case. Barriers keeping women from being more active in organized dentistry include a lack of support from colleagues and a lack of support from home.

Women have reported that they feel intimidated or unwelcome at organized dentistry events. Dr. O’Loughlin asked each dentist present at the Ladies in the Loupe to try to

reach out to fellow women and encourage them to attend the next organized dentistry event, then follow up and contact them during and after the event. She stressed that women members don’t all need to sign up for leadership positions within MDDS, CDA or ADA, however it is very important to support women who would like to attain a leadership position within organized dentistry. If more women can make a grassroots effort, they will be able to increase the number of active female participants in organized dentistry.

Many women have reported that their duties at home, oftentimes caring for their children, prevent them from being able to attend committee meetings, annual sessions, and other organized dentistry events. One dentist at the Ladies in the Loupe event stated she has brought her children to several committee meetings since her husband is a pilot and there is no one at home to watch the children. A shift needs to be made to accommodate the large number of female dentists with young children. Support needs to be given to the unfortunate home partners of female dentists who stare longingly at their empty dinner plate on committee meeting nights.

After the speeches were completed, the women began their table discussions and networking session. Dialoguing came very easy to the participants and it was difficult to capture everyone’s attention to close the Ladies in the Loupe’s first session. You could hear laughter throughout the tent and a flurry of business cards and emails were exchanged at the end of the meeting.

Left: The Colorado Dental Association Ladies in the Loupe inaugural event was held on July 16, 2011 at the Denver Botanic Gardens. Attendees of this women’s networking event enjoyed a breakfast buffet in the gardens prior to the program with keynote speaker Dr. Kathleen O’Loughlin, American Dental Association executive director.

Above: CDA and MDDS dentists touring the Denver Botanic Gardens prior to the program.

mddsdentist.com

Articulator

Sept./Oct. 2011

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MEMBER NEWS CU General Practice Residency Program Award Recognizes Dr. Paul Bottone’s Service

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n June 24, 2011, the University of Colorado School of Dental Medicine held its graduation ceremony for the general practice residents of 2010-2011. Two special awards were also presented. One was a retirement award to honor Dr. Paul W. Bottone for his service and dedication to the school as a part-time associate professor since 1975, with the last 14 years as the O.R. attending for the residents. The second was the first annual Dr. Paul Bottone service award, presented to the resident who provided excellent care and follow up to patients with health care needs.

In making the presentations, the director of the GPR program, Dr. Edward Minitsky, noted that despite significant advances in bringing complex dental therapies to patients in the dental operatory over the last decades, there is a specific population of patients who still face significant barriers in receiving care. For patients with developmental and physical disabilities who require dental care in operating room settings, finding a provider to render the care is often difficult. Dr. Paul Bottone has been one of a rather limited number of individuals in the area who, for well over a decade, has treated those with special health care needs. Dr. Bottone taught the residents to treat these patients in the operating room.

Expect more...

Karlton D. Childress, CFP®, helps dentists plan for their financial futures. He was raised in a dental family; he understands dentists.

Karlton is another reason why you can expect more with us.

CALL TODAY FOR A FREE FINANCIAL CONSULTATION

303.639.5100

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Dr. Colleen Halligan is the first recipient of the Dr. Paul Bottone service award.

Denver Paid Sick Leave Proposal

On November 1st Denver will vote on this city ballot initiative. MDDS would like your opinions. Read the arguments and email director@mddsdentist.org to cast your opinion.

• If the proposal passes, all full- and part-time employees within Denver city limits would be able to earn one hour of paid sick leave for every 30 hours they work, capped at nine days per year for large companies (10+ employees) and five days per year for businesses with less than 10 employees.

• Many businesses and groups oppose the measure, along with the Denver Metro Chamber of Commerce, because of its potential impacts on Denver’s economy.

• A coalition of workers’ rights and health-related organizations that collected the needed signatures to get it approved for the ballot support the initiative because of its potential effects on public health.

Denver Paid Sick Leave Information Links: • Opposition website: keepdenvercompetitive.com/join.html • Supporters website: campaignforahealthydenver.com/ • 9News: http://www.9news.com/news/ article/211448/188/Heated-debate-begins-overDenver-sick-time-proposal Above excerpt taken from csaenet.org/index.cfm/ ID/136 Colorado Society of Association Executives

Articulator

Sept./Oct. 2011

MARK YOUR

CALENDAR January 19 ▶ 21, 2012

Rocky Mountain Dental Convention

20 CONNECT 12 RMDC ▶ DENVER,CO

Check out our heavy-hitting educational lineup at the Rocky Mountain Dental Convention!

Photo by: Steve Crecelius and VISIT DENVER

Learn more at RMDCONLINE.COM

▶ Dr. Peter Dawson & The Dawson Academy ▶ Dr. Gordon Christensen ▶ Dr. Terry Tanaka ▶ The Pankey Institute

Above: The Convention Center’s Famous “Blue Bear” Sculpture Below: The Beautiful and Modern Colorado Convention Center

INTRODUCING the 2012 RMDC FREE Mobile App! Features: • Speaker and course information • Course handouts • RMDC schedule and personal scheduler • Interactive floor plan of expo hall and classrooms • Exhibitor listing • Updates • Much more!

Available November 2011!

Avaliable for iPhone, iPad, Android, Blackberry and mobile site

See You Here at the RMDC this January!

Photoby: by:Scott ScottDressler-Martin Dressler-Martinand andVISIT VISITDENVER DENVER Photo

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FINANCIAL NEWS Managing a Practice: By the Numbers

By: Bill Schwartz, President/CEO of Twin Pillars Wealth Management

M

any of you are familiar with the famous quote, “There are 3 types of lies; lies, damned lies, and statistics.” There is a good amount of truth to that phrase and we are pummeled with statistics every day that prove or dis-prove some point or another.

Your practice is not immune to this since most of you monitor your “statistics.” I believe that you can take statistics and spin them every which way to get the outcome you hope or hoped for. What I hope to accomplish here in a short space, is to give you some numbers, not statistics, to look at when making management decisions in your practice. With these numbers defined you will be able to more fully develop your practice plan so that you work toward reaching your ultimate goal(s).

The first number is the number of patients you need in your practice. In managing your practice you need to determine the number of patients you need to have. How many of you know your average profit margin per patient? Oh wait….is that another number? You will understand where I am going with this in a minute, because at the end of the day, numbers are what drive our goals in practice. We might need to take a step back and understand what profit margin per patient is first. Profit margin per patient is not only the revenue you receive minus the hard costs (labor, supplies, labs, etc.), but you need to factor in what your time is worth as well. The ultimate goal here is to make an honest living plus some sort of rate of return on your practice. Once you know your average profit margin per patient, you should be able to reasonably back into the formula to know how many patients per month you need to add. Knowing the number of patients you

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need in your practice will give you the ability to strategically look for patients that fit the next number.

The second number is the type of patients you want to attract to your practice. That does not sound like a number at all, but hear me out. You all know what type of patient you work best with and which procedures, etc. you offer. The type of patient can be general or as specific as a marital status, occupation, income, etc. My suggestion is to be more specific because you can target these people so that you don’t throw your advertising dollars at a dartboard.

Depending on the type of patient you work best with and which type you attract will determine how many of these you need to reach your goals. Once you know the answer to this question, you should own that market.

The third number is the number of referrals you want to generate in your practice. This should be broken down by year, quarter, month, and week so you know how hard you need to work each week to reach this goal. Referrals are generally the best and easiest patients to get. All practices have a ratio of referrals to what I would call “walk-in” patients. Most doctors tend to like a referral heavy practice better due to the profit margin per patient. Referrals can be a great way to increase that percentage and will be your best source for your next referral. Referrals should be a portion of your overall marketing strategy and will play into the total costs you invest in your practice to generate revenue.

The final number is the value of each patient to your practice. This may sound a lot like the profit margin per patient, but it is

actually different. You have to put a value on the number and type of patients you are getting and where they are coming from.

A patient’s value will include net profit margin, but should also include intangible items. You should try to assign some type of a value to your relationship and think about the company they work for and if they can increase your exposure to your target market. There are way too many things to list in this category and it is very subjective since quite a few of the components of a patient’s value are intangible.

Your dental practice is driven by numbers and having the ability to forecast those numbers will make your career much more rewarding. You should take time with an accountant that specializes in health care practices to understand all of the pieces I discussed to really understand how you can use numbers to manage your practice. I will submit that if you understand the numbers and how they fit together, you will take a leap ahead of your colleagues when it comes to achieving your ultimate goals.

If this interests you, you can call me at 720.210.9220 anytime for a complimentary discussion on how you can better manage your practice finances.

Twin Pillars Wealth Management is a strategic planning based accounting firm located in South Metro Denver that assists health care professionals to build and maintain wealth through the use of sound accounting practices and decisions. We can be contacted at 720.210.9220 or by email at information@twin-pillars.com Please take a look at our website twin-pillars.com to better understand our philosophy on financial management.

Articulator

Sept./Oct. 2011

Hosted by:

Join MDDS On a 7-Night

Western Caribbean Cruise!

MAY 27 - JUNE 3, 2012 Round Trip from Port Canaveral, Florida Invite your family and friends to join you on the beautiful beaches and sparkling blue waters of LABADEE (RCCL PRIVATE ISLAND), JAMAICA, GRAND CAYMAN and COZUMEL. 8 CEU’s offered to Dentists and Dental Team Members Education Fee: $350 Dentists and $195 for Dental Team For more details about this and other events visit:

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Excellence in Dental Architecture

3650 Wadsworth Boulevard Wheat Ridge, Colorado, 80033 (303) 428- 4895 www.battistadesign.net

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