MDDS Articulator Volume 19 Issue 3

MDDS

Connections for Metro Denver’s Dental Profession

RMDC EDITION 2014 Volume 19, Issue 3

RMDC15 EDITION Maternity Leave In The Dental Office: A (Pregnant) Female Doctor’s Perspective

10 Every Child Deserves a Healthy Start 14 The Total Wellness Dental Practice is Coming to Denver in 2015 20 Overcoming No-Shows & Cancellation 22 The Challenges and Successes of Pediatric Root Fractures 39

Rocky Mountain Dental Convention

January 22, 23, 24 2015

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20 CONNECT 15 RMDC ▶ DENVER,CO

“After returning from the first seminar, I changed the way I looked at cases, looked at patients, & went about diagnosis.”

Join us to discover the untapped potential in your practice, and write your own success story.

Call 866.879.1238 or visit TheDawsonAcademy.com/Success

See Dentistry With New Eyes “All of a sudden, as a practitioner, you begin to see reasons for the maladies facing your patients, whereas most of the time, it goes undiagnosed, unnoticed. The level of confidence and understanding gained through completing the core curriculum at The Dawson Academy is immeasurable.”

KEVIN KROSS DDS ALLENDALE, MI

FLORIDA VIRGINIA UNITED KINGDOM ILLINOIS CALIFORNIA JAPAN COLORADO

MDDS

Connections for Metro Denver’s Dental Profession

Volume 19, Issue 3

MDDS Articulator

mddsdentist.com

Inside This Issue:

Creative Manager & Managing Editor CT Nelson

A Letter From Our RMDC Chair .......4

Director of Marketing & Communications Jason Mauterer

Member Matters ..............................5

Communications Committee Brandon Hall, DDS, Chair Maria Juliana DiPasquale, DMD Karen Franz, DDS Jeremy Kott, DDS Carrie Seabury, DDS Jennifer Thompson, DDS MDDS Executive Committee President Larry Weddle, DMD President-Elect Ian Paisley, DDS Treasurer Sheldon Newman, DDS Secretary Nicholas Chiovitti, DDS Executive Director Elizabeth Price, MBA, CDE, CAE 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.

RMDC EDITION 2014

Do It Well. Make It Fun. ........................7 Maternity Leave In The Dental Office: A

Beauty & the Beast................................. 26 Non Profit News ............................ 31 Event Calendar ...................................... 32

(Pregnant) Female Doctor’s Perspective 10

The Covered Smile Lady ................34

MWDI News.........................................12

FOCUS! ........................................36

Every Child Deserves a Healthy Start...14

The Challenges and Successes of

How to Put Your Practice in the Top 10%

Pediatric Root Fractures .....................39

- A Formula for a Successful Practice...16

Integrating Sensible Orthodontic

The Total Wellness Dental Practice is

Practice ..................................................41

Coming to Denver in 2015 ..............20

Thinking into the Pediatric Dental

Classifieds.............................................43

Overcoming No-Shows & Cancellation ..................................... 22

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 Denver, CO 80203 Phone: (303) 488-9700 Fax: (303) 488-0177 mddsdentist.com ©2011 Metropolitan Denver Dental Society

K

ids in Need of Dentistry and the Metro Denver Dental Society will be hosting a Give Kids a Smile event at the Mountain West Dental Institute on February 6, 2015. The event will be in the KIND Dental Clinic which is generously sponsored by Anil Idiculla, DMD I-orthodontics.

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A LETTER FROM OUR RMDC CHAIR

By Michael Scheidt, DDS – Chairman 2015 RMDC

D

ear Convention attendee,

You may be interested to know that at your MDDS, five committees totaling over 25 volunteer dentists and eight dedicated staff members, including Shelly Fava, Director of Convention & Events, as well as Elizabeth Price, MDDS Executive Director, have been preparing for the 2015 RMDC since February 2011. Their work has been exceptional and I know that you are going to enjoy it.

By now you should have received your Registration Kit and Program.

You should also have checked your office schedule to be sure that you, your staff and any significant others do not have conflicts, which would interfere with attendance. Our Opening Session, on Thursday January 22nd featuring keynote speaker, Mr. Paul Moya, begins at 8:00am in the Four Seasons Ballroom of the Colorado Convention Center. The RMDC Programing Committee has chosen Paul from many possible speaker candidates, based on his excellent references and by watching video of his inspirational presentation. You can preview this dynamic and motivating individual by checking out his web site at paulmoya.com. Don’t miss this entertaining and motivating event to start your 2015 RMDC experience.

Our first convention day is packed with great CE from outstanding speakers; be prepared to learn, critique and discuss new dental care ideas with your colleagues.

9:00pm-2:00am. Make sure you pick up your After Party Survival Kit, sponsored by Pacific Dental, before heading home.

Save some energy for Saturday, the final day of your 2015 RMDC experience. CE programs begin at 8:30am so check your schedule and don’t forget to visit the Exhibit Hall for last minute deals. Make your vendor connections early (use the “Find your Vendor” Kiosk) and follow-up before the Hall closes at 2:00pm.

Other important reminders to enhance your convention experience: Free RMDC Mobile App is available for your iPad, iPhone, Android and mobile site: Sponsored by UMB Bank. Use the QR code below.

Free Wi-Fi at network RMDC2015: Sponsored by BIOLASE.

"Remember, Continuing Education is now a requirement for licensed Dentists and Hygienists in the State of Colorado. Don’t get caught short of the 30 hours of CE required every two years. "

To end this first day of the RMDC, enjoy a friendly reception, sponsored

by BVB General Contractors from 4:00-5:30pm in the Exhibit hall. Don’t miss the free drinks.

Later that evening, our MDDS Awards Gala & President’s Dinner will follow at 6:30-10:00pm, in the lobby of the Ellie Caukins Opera House.

Dr. Larry Weddle, MDDS President, asks you to join him for a fun and magnificent evening filled with live music, a reception, dinner and Society awards ceremony for only $72/pp. Be sure to come dressed to impress.

On Friday, plan for a day of more educational, interactive, hands-on learning and networking events concluding with even more after meeting festivities. Your first choice is the always-popular Friday Night Party at the Hyatt Regency, sponsored by Henry Schein Dental and Children’s Dentistry. Following “The Party” join the club scene, if you dare, at an MDDS favorite, The Friday Night After Party, at Chloe, from

Free Shuttle Buses for transportation to Lobby D from all convention hotels and The Mountain West Dental Institute.

Free Tote Bags are available outside the Expo Hall: Sponsored by the Colorado Dental Association and Wells Fargo Bank.

“Find Your Vendor,” the Interactive Floor Plan Kiosk, located just inside the Exhibit Hall entrance: Sponsored by Lifeline Sciences.

Don’t worry about coats. January may be balmy in our fair city but just in case, a convenient coat check is available, with proceeds going to our wonderful Metropolitan Denver Dental Foundation headed by Dr. Nelle Barr.

A local restaurant lunch is often a planned event for many of our dental office staffs at the RMDC, but if you want to stay close to the CE and Exhibit Hall action, lunch options are available in the Exhibit Hall.

Remember, Continuing Education is now a requirement for licensed Dentists and Hygienists in the State of Colorado. Don’t get caught short of the 30 hours of CE required every two years. Be sure to claim your CE credits, which are awarded and verified by a code announced at the conclusion of each course and available to registered attendees on the RMDC Mobile App or the online Attendee Services Center.

Having the best experience at the RMDC means being prepared.

Get those schedules blocked off now, make your course registrations on-line tonight and plan for a great CE experience, meeting old friends, shopping for state-of-the art dental equipment and just having a great time. See you there.

CORRECTION: In the Winter Issue the article "Sink Your Teeth Into Saving a Life" the article was incorrectly attributed to Dr. Lisa Bennett, the article was written by Ms. Eva Grayzel. We apologize for this error.

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Articulator

2015 RMDC EDITION

MEMBER MATTERS

JOIN MDDS IN SUPPORTING BRENT'S PLACE

E

ach year, MDDS employees choose a local charity to support during the holidays. This year, we are partnering with Dr. Charles Danna's office to support Brent's Place, where kids being treated for life threatening cancer can still be kids. It offers families hope and healing during a difficult time. This charity is near and dear to Dr. Danna’s heart because the boy whose parents started Brent’s Place was a patient of his and he passed away from complications to a bone marrow transplant. “This is a charity that really humbles me every time I get to help them,” explained Dr. Danna.

We're asking you, as members, to help us make an even greater impact on these families! Show your support with either a toy donation or a pre-ordered meal from Whole Foods. Since Brent's Place struggles to provide for teens aged 12-19, we would like to focus our attention on this group along with meals for the families.

Please drop off your donations to one of the following locations by December 17th: Mountain West Dental Institute Dr. Charles Danna's Office Dr. Larry Weddle's Office 925 Lincoln Street, Unit B 7761 Shaffer Parkway, Suite 250 905 West 124th Avenue, Suite 180 Denver, CO 80203 Westminster, CO 80234 Littleton, CO 80127 For large group donations, MDDS is happy to pick up items from your office or you can deliver your gift to Brent's Place no later than December 21st.

Visit brentsplace.org/2014HolidayGiftDrive for more information about the Holiday Gift Drive.

Since its inception, Brent's Place has remained the only Children's Hospital Colorado approved "Safe-Clean" housing facility for immune compromised patients and their families, providing a living environment that is essential to healing and recovery.

Visit brentsplace.org for more information.

Congratulations, Dr. Brandon Linn!

Dr. Linn attended Vanderbilt University where he received his B.A. in English, the University of Illinois where he received his D.D.S. with honors, and Marquette University, where he received his M.S. degree and Certifificate in Orthodontics. Dr. Linn is a Fellow of the World Federation of Orthodontics, and a member of the ADA, COA, CDA and MDDS. He has received many awards such as “Best

ሺ͵Ͳ͵ሻ ͸͵͹ǦͲͻͺͳ ̷ Ǥ Orthodontist” by 5280 Magazine and “Best of the Best” by Orthodontics Products Magazine.

Recently, he opened his 3,450 square foot office in Castle Pines. The office includes two private operatories, a six chair open bay, a pan room, a brushing station, a kids area, two treatment coordinator rooms, a records room, a sterlization and lab, a break room, a reception/waiting area, and a private office.

BOOTH # 529

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Make your way down the path to

The CDA 2015 Annual Session Park Hyatt Beaver Creek Resort & Spa

June 11-13, 2015

• Get Informed! Mega topic discussion about dentistry today and the hot issues that impact YOU. • Get Involved! Be a delegate at the CDA’s governing meeting.

Your voice counts and will be heard.

• Get Away! Bring your family, bring your dental team and enjoy the family friendly activities offered by this luxurious resort.

More information can be found at www.cdaonline.org/annualsession. ĐŽŵŵŝƚŵĞŶƚ ƚŽ ĐĂƌŝŶŐ ĨŽƌ ŽůŽƌĂĚŽ͛Ɛ DĞĚŝĐĂŝĚ ĂĚƵůƚƐ͕ ĐŚŝůĚƌĞŶ ĂŶĚ ĨĂŵŝůŝĞƐ ĚƵůƚ DĞĚŝĐĂŝĚ ĞŶƚĂů ĞŶĞĮƚ ǀĂŝůĂďůĞ EKt /Ŷ ϮϬϭϰ͕ ϯϬϬ͕ϬϬϬ ŽůŽƌĂĚŽ ĂĚƵůƚƐ ƋƵĂůŝĮĞĚ ĨŽƌ ŶĞǁ ĚĞŶƚĂů ĐŽǀĞƌĂŐĞ ƚŚƌŽƵŐŚ ƚŚĞ ƐƚĂƚĞ͛Ɛ DĞĚŝĐĂŝĚ ƉƌŽŐƌĂŵ͘ DĂŶLJ ŽĨ ƚŚĞƐĞ ĂĚƵůƚƐͶŝŶĐůƵĚŝŶŐ ƉĂƌĞŶƚƐ͕ ĞdžƉĞĐƚĂŶƚ ŵŽŵƐ͕ ĂŶĚ ƉĞŽƉůĞ ǁŝƚŚ ĐŚƌŽŶŝĐ ĂŶĚ ĚĞǀĞůŽƉŵĞŶƚĂů ŚĞĂůƚŚ ĐŽŶĚŝƟŽŶƐͶǁŝůů ďĞ ůŽŽŬŝŶŐ ƚŽ ĂĐĐĞƐƐ ŵƵĐŚ ŶĞĞĚĞĚ ƉƌĞǀĞŶƟǀĞ ĂŶĚ ƌĞƐƚŽƌĂƟǀĞ ĚĞŶƚĂů ĐĂƌĞ͘ ĂůůƐ ŽŶ DĞŵďĞƌ ĞŶƟƐƚƐ ƚŽ dĂŬĞ ϱ tĞ ŶĞĞĚ LJŽƵƌ ŚĞůƉ ƚŽ ĞŶƐƵƌĞ ƚŚĂƚ Ăůů ŽůŽƌĂĚĂŶƐ ŚĂǀĞ ĂĐĐĞƐƐ ƚŽ ƚŚĞ ŵŽƐƚ ƋƵĂůŝĮĞĚ ƉƌŽǀŝĚĞƌƐ ŽĨ ĚĞŶƚĂů ĐĂƌĞͶƚŚĞ ĚĞŶƟƐƚƐ͘ dŚĞ ͛Ɛ dĂŬĞ ϱ ƉƌŽŐƌĂŵ ĐĂůůƐ ŽŶ ŵĞŵďĞƌƐ ƚŽ ĂĐĐĞƉƚ Ă ŵŝŶŝŵƵŵ ŽĨ ϱ DĞĚŝĐĂŝĚ ƉĂƟĞŶƚƐ ŝŶƚŽ ƚŚĞŝƌ ƉƌĂĐƟĐĞƐ͘

dŚĞ ƉƌŽŐƌĂŵ ŝƐ ĚĞƐŝŐŶĞĚ ƚŽ ŵĂŬĞ ŝƚ ƉŽƐƐŝďůĞ ĨŽƌ ĞǀĞƌLJ ŵĞŵďĞƌ ƚŽ ƉĂƌƟĐŝƉĂƚĞ͕ ĚŽ ƚŚĞŝƌ ƉĂƌƚ ĂŶĚ ĐŽŵŵŝƚ Ăƚ Ă ůĞǀĞů ƚŚĂƚ ǁŽƌŬƐ ďĞƐƚ ĨŽƌ ƚŚĞŝƌ ƉƌĂĐƟĐĞ͘ ĞŶƚĂYƵĞƐƚ ŝƐ ƚŚĞ ĂĚŵŝŶŝƐƚƌĂƚŽƌ ŽĨ ƚŚĞ ŽůŽƌĂĚŽ DĞĚŝĐĂŝĚ ĞŶƚĂů WƌŽŐƌĂŵ͘ /ƚ ŚĂƐ ƌĞŐŝŽŶĂů ĮĞůĚ ƌĞƉƌĞƐĞŶƚĂƟǀĞƐ ƚŽ ƉĞƌƐŽŶĂůůLJ ĂƐƐŝƐƚ ĚĞŶƚĂů ŽĸĐĞƐ͕ ĂŶĚ ĞĚƵĐĂƚĞ ĚĞŶƚĂů ƐƚĂī ŽŶ ďĞƐƚ ƉƌĂĐƟĐĞƐ ĨŽƌ ĞĸĐŝĞŶƚ ďŝůůŝŶŐ ĂŶĚ ƉĂƟĞŶƚ ŵĂŶĂŐĞŵĞŶƚ͘ ĞŶƚĂYƵĞƐƚ ĂĚŵŝŶŝƐƚĞƌƐ ĚĞŶƚĂů ďĞŶĞĮƚƐ ŝŶ Ϯϴ ƐƚĂƚĞƐ͘

:ŽŝŶ ĐŽůůĞĂŐƵĞ ĚĞŶƟƐƚƐ ĂĐƌŽƐƐ ŽůŽƌĂĚŽ ŝŶ ĐĂƌŝŶŐ ĨŽƌ ƚŚĞ ƵŶĚĞƌƐĞƌǀĞĚ͘ WůĞĚŐĞ LJŽƵƌ ĐŽŵŵŝƩŵĞŶƚ ŽŶůŝŶĞ Ăƚ ĐĚĂŽŶůŝŶĞ͘ŽƌŐͬdĂŬĞϱ

2015 RMDC SPEAKER

DO IT WELL. MAKE IT FUN.

By Ron Culberson, MSW, CSP, CPAE

L

ife is short.

In a relative, big picture kind of way.

So, we must make the most of the short time we have in this world. Whether you’ve just begun your career or you’ve been at it for decades, there is always time to change the way you approach your work (and your life for that matter). Abraham Lincoln said, “It’s not about the days in your life, but the life in your days.” Apparently under his stoic appearance was a party animal.

Richness. Success. Responsibility. They’re all about making the most of your days no matter how many days you have left in your life. That’s the foundational principle of “Do it Well. Make it Fun.” The idea that excellence plus fun equals a valuable and valued existence.

I spent a decade in hospice care (as an employee, not a patient). I began that work as a 25-year-old social worker and eventually moved into a senior leadership position. I couldn’t have asked for a better job to begin my professional career. Hospice taught me to value life. Hospice taught me that time is limited. And hospice taught me that we don’t want to have regrets when we get to the end of our lives. In fact, I had a button displayed in my office that read, “Live each day as if it were your last. Because one day, you’ll be right.”

I love that concept. It combines a sacred truth with a bit of humor for a profound concept worth paying attention to. Because, you just never know.

You never know what tomorrow will bring. So why not prepare for the unknown by making the most of the known - today? Eckhart Tolle, in his book The Power of Now, refers to it as paying attention to the “now” because now is all we have.

Do it Well, Make it Fun refers to the now. It suggests that in everything we do (like right now), if we do it well while making the experience, or the process, more fun, we will achieve even more. It begins with excellence but it’s more than that. It’s also about joy, or en-joy-ment. It’s recapturing the childhood sense of fun and wonder that many of us lost after entering into the bitter, cynical, depths of adulthood. We shouldn’t have listened to those who admonished us to just grow up and act like an adult. Instead, we should have grown up and had fun.

If we want to add more life to our days, then we need to find both the best and the funnest in who we are. It’s not rocket surgery.

mddsdentist.com

Do it Well. Stephen Covey’s book The 7 Habits of Highly Effective People is a classic - and one of my favorite books. Right beside it, on my bookshelf, is The Road Less Traveled by M. Scott Peck. Both books explain how to become a better person. And since the books sold billions of copies, it seems that most of us have a desire to be better. But knowing how and what to improve is often a stumbling block to doing things well.

I tend to be self aware - sometimes to a fault. I adopted this skill during graduate school when I was being trained as a therapist. In addition to learning about different therapeutic techniques, I was constantly reminded that my own “issues” were obstacles to objectively helping someone else with their emotional and psychological problems. Time and time again I was asked to determine the motives for my own behaviors as a way to make sure my issues didn’t interfere with my work. Of course the down side of that today is that I’m continually asking myself, “How do I feel about this? How do I feel about that?”

Nonetheless, being self aware is the first step to excellence. You cannot improve something if you’re not aware that it needs improvement. Unfortunately, most people are not as self aware as they need to be. Even if we are aware, we have blind spots that prevent us from seeing our true selves.

I had a supervisor who had serious blind spots. She was forever saying things out loud that were better left in her head. Her comments hurt and offended others creating a work environment that was unhealthy. When I suggested that she could improve her communication skills, she looked at me as if I really didn’t know what I was talking about. She felt her communication skills were fine and did not see the need to change them. So, she had two problems.

Not only did she have poor communication skills, but she had no ability to recognize it. Eventually, she was fired. I can’t help but wonder if she ever saw the relationship between her inability to improve and her firing. Somehow I doubt it.

To do things well, we must constantly seek insightful feedback and look objectively at the things we do to determine where we need to improve. Do we show up on time? Do we follow through? Do we thank others? Do we put the toilet seat down? Look at the areas in your life and work that are not going as well as you wish and explore ways to improve them. If you constantly seek to do things well, you will live a rich life and what’s more, you will enrich the lives of those around you. That’s the power of excellence.

Make it Fun. I’ve been studying the benefits of humor and laughter for more than 20 years. And while there is a difference between humor and fun, I

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2015 RMDC EDITION

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believe humor is one of the most effective ways of having fun. According to Webster, fun is defined as “that which provides amusement and enjoyment.” Humor, on the other hand, is defined as “the quality which appeals to a sense of the ludicrous or absurdly incongruous.” It’s also defined as “something designed to be amusing.” So, amusement is the common thread.

But why is fun important?

Life contains joy and tragedy. To appreciate one, you have to appreciate the other. Those who do not have the ability to experience tragedy cannot truly experience joy. And vice versa. Joy, fun, humor and enjoyment are all necessary for a rich and balanced life.

And when combined with excellence, humor creates an approachability and an effectiveness that is extraordinary. If you’ve ever had a boss that was really good at what he or she did but was fun to be around as well, you would do anything for them. You wanted to work for that person and you wanted to come to work. That’s the power of fun and excellence. The integrity is there but so is the joy.

Southwest Airlines has cracked this excellence-fun code by running a profitable and successful company in which people want to work. The culture is fun but does not sacrifice the success of the organization to achieve the fun.

I was on a Southwest flight one day when the plane landed roughly. The pilot came on the intercom and said, “I’m really sorry about that landing folks but it wasn’t my fault. And it wasn’t the co-pilots fault. It was the asphalt.”

The passengers were cracking up and we very relaxed after the comic relief.

In a recent training session, I took the group through the experience of making a boring, routine process more enjoyable. They chose the task of walking the dog. As we outlined the different steps to the process, we got to the step of securing a “poop bag” to clean up after the dog. Then we discussed ways to make the different steps more fun. My favorite idea was putting a picture of someone you don’t like on the poop bag. Then, the disgusting process of cleaning up seems much more enjoyable. That’s how you take one step in a process you don’t enjoy and turn the entire process into something more tolerable.

Everything in life is a process. If you do every process well while making it more fun, I truly believe you will add life to your days.

About the Author Ron Culberson, MSW, CSP, CPAE is a speaker, humorist, and author of three books including his most recent Do it Well. Make it Fun. The Key to Success in Life, Death, and Almost Everything in Between. His mission is to change the workplace culture so that organizations are more productive and staff are more content. He shows people how to have more FUN while preserving the integrity of the work they do and the lives they lead. For more information, visit www.RonCulberson.com

Dental Construction Specialists Ask us how we can save you time and money on your next office project.

Phone: (303)637-0981 Web: www.bvgci.com

The perfect icing on the excellence cake is a bit of fun.

Everything is Process. Everything we do is a process. Every process has steps. Every step can be improved and can be more fun. It’s that simple and does not need to be more complicated.

For instance, pick a process. Go ahead. Any process.

How about Driver’s Ed? Remember how the manual took you through the steps for starting the car? It went something like this: 1. Put your seat belt on.

2. Check your mirrors.

3. Put your foot on the brake.

4. Put the key in the ignition.

5. Turn the key.

6. Push on the accelerator.

7. Etc. Etc. Etc. Today, we do these things automatically and don’t realize that we’re going through each step of the process. But if you want to ultimately do things well and make them fun, you must break down the processes in your life and work into steps. And then analyze the steps for possible changes.

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BOOTH # 529

Articulator

2015 RMDC EDITION

,OPXMFEHF r &YQFSJFODF r $SFEFOUJBMT r 5SVTU More “Completed Transitions” and

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

"%4 1SFDJTF $POTVMUBOUT Pete Mirabito DDS, FAGD

r 1SBDUJDF 4BMFT 4JODF r 1SBDUJDF "QQSBJTBMT r 1BSUOFSTIJQT

r 5SBOTJUJPO 1MBOOJOH r %FOUBM #VJMEJOH 4BMFT r #VZ *OT #VZ 0VUT

Jed Esposito MBA, CVA

Visit us in January at the

RMDC booth #647!

Call us - 888.886.6790 Visit us - adsprecise.com All ADS companies are independently owned and operated

RECOGNITION AND MANAGEMENT OF MEDICAL EMERGENCIES Participate in an Advanced Clinical Simulation Presented by Dr. Jeffrey Young Friday, March 6 - Saturday, March 7, 2015 Children’s Hospital Colorado 9:00am - 4:00pm

For more information go to mddsdentist.com mddsdentist.com

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MEMBER PERSPECTIVE MATERNITY LEAVE IN THE DENTAL OFFICE: A (PREGNANT) FEMALE DOCTOR’S PERSPECTIVE

By M. Juliana DiPasquale, DMD - Denver Metro Oral and Maxillofacial Surgery

I

never gave too much thought to when I would have children until a couple of years ago. I was so preoccupied with my education, postgraduate training, residency and fellowship that having children did not cross my mind very often, unless it was brought up by the occasional comment from family members wondering when my husband and I would begin our own family. Even then, I usually brushed those comments aside and replaced them with thoughts of how I would continue to improve on patient care and the next steps in advancing my career. And one day, out of nowhere, my biological clock started ticking, and fast! At first it became just a topic of conversation with my husband over a nice dinner and glass of wine. Then it became reality: We are pregnant!

Oh my, and on top of that, twins! All of the sudden, the faint idea of beginning to think about a family became the state of preparing for a family.

As a professional female with a wide range of female friends, I get many different opinions and advice that covers the spectrum. Some female friends and family members who do not work out of the house, continually tell me that this is going to be the hardest thing in my life and they cannot seem to understand how I can plan to return to work in 6 weeks (if health conditions allow). “Jeez, thanks for the vote of confidence,” is what I think to myself. And then there are the professional women who have corporate jobs or own their own business and returned to work anywhere between 2-6 weeks of maternity leave. Then I think “What? Only two weeks!” Well, they tell me, “I can’t afford to stay home because my family depends on my earnings,” or “I need to get back to my practice and care for my patients.” Funny thing is you never hear comments about new dads returning to work too soon after their children are born and there are some who don’t even take any time off work to stay home and

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support their partners. It still feels to me like our culture does not see women in the same way as their male counterparts as far as being able to have a fulfilling career and a family at the same time. Why can’t we ladies have it all: a family, a career, a social life? My own father asked me on several occasions, "how are you going to make this work?" I can’t help but hear all of these comments and not start to freak out a bit. But deep down inside I know it will all work out. People have kids every day – many of them with much less financial, family and social support than I am thankful to have.

We are in a profession that has been dominated by males until fairly recently, however the gender gap is closing rapidly. This means we now need to bring attention to maternity leave at the doctor level, not just the adjunct staff.

In 2010, there were 15 out 58 dental schools (29%) enrolling 51% females in their first year classes. In 2013, females comprised 48.1% of the graduating class (*ADEA survey).

The average amount of graduating debt for a dental student at completion of dental school in 2013 was $215,145.00, on top of an average of $45,397.00 debt carried over from undergraduate studies (*ADEA survey). These numbers definitely influence new dentists' ability to take time away from work to start a family. In the graduating class of 2013, 48.4% of females plan to practice dentistry in private practice (versus 52.7% of males) and 45.1% plan to practice full time (as compared to 51.7% of males). 36.5% of 2013 graduating females plan to obtain higher dental education such as residency program or internship, versus 31.8% of males (*ADEA survey). Based on these surveys, it seems graduating female dentists are very interested in pursuing further education and being productive members of the work force.

In most US corporations, employees are entitled up to six weeks of maternity leave or three months medical leave. Paid maternity leave is unusual in the United States, but despite

not being legally required, some corporations do offer paid leave up to six weeks. The FMLA (Family and Medical Leave Act) was passed in 1993 and entitles many workers up to 12 weeks of job-protected leave in case of childbirth and adoption, however this guarantees only unpaid leave. Since the law does not cover most small businesses, the FMLA law does not apply to most dental offices. Specific states also have their own laws regarding medical and disability leave and they usually mirror federal FMLA. But again, since most dental offices are considered small business, the law does not typically apply. Colorado state law does not require private employers to provide time off for birth or adoption of a child, and companies with less than 50 employees are free to provide paid or unpaid leave at their own discretion.

The Pregnancy Discrimination Act (PDA) is an extension of the Civil Rights Act of 1964 and covers discrimination based on pregnancy, childbirth and other related medical conditions. Unlike the FMLA, this law may apply to certain practices as it covers corporations with 15 or more employees.

Similarly, The Americans with Disabilities Act (ADA) made discrimination based on race, religion, sex, national origin and other characteristics illegal. This act is more broad and would cover most dental practices and is something that employers should be aware of.

When discussing maternity leave for a doctor who is a parter in a practice, the situation may be very different. In those cases, similar to mine, the female partner has a vested interest in the growth and financial stability of the practice. They are also interested in maintaining personal production to meet financial goals, which often will drive them to take less time away from work. Also, at the top of the priority list is the interest in maintaining continuity of care for their patients.

Short term disability should be a consideration in a dental office where female doctors are share holders or employees. Short term

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disability policies can be purchased privately or may be provided by the state. The policy can help cover the expenses of a doctor out of work due to childbirth up to six weeks, or longer in case of pregnancy complications such as bed rest and cesarean delivery.

Deciding to have a child is a big decision regardless if you are a participant of the workforce, a home-maker or partner in a dental practice. It is a big financial investment with the enormous responsibility of raising and educating a responsible and productive member of society. Being a business owner adds to the demand and responsibility since balancing a career and healthy family life can be very challenging in todays complex, fastpaced world. I personally am looking forward to this challenge as it is a big goal of mine to work very hard to balance work and family life and to succeed in both to the best of my ability.

Most working females worry that co-workers,

bosses, staff and clients/patients may not be as supportive as we would like. This was certainly a concern of mine and is shared by many female colleagues I speak with in the dental field. We are concerned about losing patients and referrals due to the assumption that we will not be around to provide needed care for a certain unknown period of time.

With a few exceptions, I have been mostly pleasantly surprised that most patients are very supportive of my decision to have a family.

Perhaps because they see you in a different light as a fellow mother, fellow family member and potentially a more caring individual. As long as you are not gone from the office for too long!

Ultimately, the decision to start a family and the moment it becomes a reality is one of the most incredible times of life. I truly believe, that like with most things in life, there are those who have been through it that will try to scare you and those that have not who will brush it off and have no idea what you are going through.

The reality is that the same dedication, passion and drive that led us to become doctors in an incredible profession, will also help us reach our goals with balancing work life with a “new� family life.

About the Author Dr. Juliana DiPasquale is a graduate from College of Charleston in South Carolina, and went on to attend Nova Southeastern University to earn her Doctor of Dental Medicine Degree.

She completed her four-year residency in Oral and Maxillofacial Surgery at the University of Florida and was honored as the very first female to complete the program. After residency in Oral and Maxillofacial Surgery, she completed a fellowship where she received advanced training in facial cosmetics and reconstructive surgery.

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11

MWDI NEWS MWDI DONOR APPRECIATION EVENT November 6, 2014

Mingling in the Banquet Hall before the program. Chatting in the foreground are Mitch Laycock (COPIC Financial Service Group) and Alexandra Gage (The Colorado Orthodontic Foundation).

Dr. Nelle Barr and Karen Foster saying “Cheese!”

MDDS President Dr. Larry Weddle emceeing the event with MDDS President Elect Dr. Ian Paisley and Past President Dr. Charles Danna.

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John Reinhardt (Cornerstone Dental Solutions) raving about the impressive eats.

David Heese (US Bank), Kerrie Bunce (UMB Bank), Tamara Cook (Pacific Dental Services) and Anthony Naes (US Bank) getting a group shot.

MDDS Executive Board members Drs. Ian Paisley, Larry Weddle, Sheldon Newman and Nicholas Chiovitti flanking MDDS Executive Director Ms. Elizabeth Price.

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2015 RMDC EDITION

WE NEED YOUR

SUPPORT

THANKS TO OUR MWDI SPONSORS!

Go to mwdi.org

to donate!

Includes cash donations and sponsorships; this does not include donated service and equipment.

Mile High Founding Members (Contributions of $5,280+) 1st Impressions Orthodontics Terry L. Brewick, DDS - Governor's Park Dental Group Brighton Smiles - Jaci Spencer, DDS Burnham Oral Surgery - Dr. Michael Burnham, DDS, MD David Chavez, DDS Charles Danna, DDS Denver Metro OMS The Doctors at Mountain Range Dentistry, Dr. Nicholas Chiovitti & Dr. Paul K. Mizoue Mark S. Ehrhardt, DDS Mitchell Friedman, DDS Louisa I. Gallegos, DDS Larry Gayeski, CPA Alan Gurman, DDS Jepson, Murphy and Associates Nestman & Eng Orthodontics Dr. Roger D. Nishimura Ohmart Orthodontics Ian Paisley, DDS Shon Peterson, DMD Rocky Mtn. Dental Partners - Aspen/Aurora/Cherry Creek Robert Rudman, DDS Michael Scheidt, DDS & Kathryn Scheidt, MSN Christopher J. Sakkaris, DDS, PC Stamm Dental, Dr. Heather Stamm & Dr. Kai Kawasugi Tennyson Pediatric Dentistry Larry Weddle, DMD, MS Dr. Mark Wheeler & Dr. Matt Johanson Cassady Wiggins, DMD Young Dentistry for Children

Benefactors (Contributions of $2,000+) 2013 MDDS Delegates to the CDA Kimberly Danzer, DMD The Dental Center Troy A. Fox, DDS Anil Idiculla, DMD Sheldon Newman, DDS & Linda Newman Sean W. Shaw, DMD, Periodontics Dental Implants Joseph K. Will, DDS

DENTAL INSTRUMENTATION

Patrons (Contributions of $500+) Alpha Omega Dental Fraternity Bank of America Jack W. Choi, DDS Colorado Society of Oral & Maxillofacial Surgeons, Inc. Karen D. Foster, DDS George G. Gatseos, DDS GHP Investment Advisors Paul Glick, DDS HJ Bosworth Company Thomas Maier, DDS Michael McKee, DDS James C. Nock, DDS Alexander Park, DDS Ridgeview Pediatric Dentistry Michael Poulos, DMD Edward F. Rosenfield, DMD, MS Eric W. VanZytveld, DDS Dr. Gregg Lewis Jacob Williams Dr. Herbert T. & Lenore Williams

The MWDI is owned and operated by the Metro Denver Dental Society

13

NON PROFIT NEWS

EVERY CHILD DESERVES A HEALTHY START

By Nelle Barr DDS, DMD and Sean Whalen, DMD

F

ebruary is almost here and that means Children's Dental Health Month! For pediatric dentists it is more of a reason to celebrate than Valentine’s Day. For all dentists, it is an opportunity to encourage the age one dental visit and renew our commitment to preventing decay in children. This year MDDS is celebrating with us.

For approximately 20 years the ADA, AAPD ( American Academy of Pediatric Dentistry) and the AAP (American Academy of Pediatrics) have recommended children have their first dental exam no later than age one or six months after the eruption of their first tooth.

Unfortunately most children are still being seen for the first time closer to age three or four. According the Center for Disease Control cavities have increased in 2-5 year olds over the past 25 years. Despite the 20 year old first birthday/first dental visit policy, fifty percent of all children have never seen a dentist.

As a profession we know more about the transmission of decay, when and how this occurs, early childhood caries (ECC) and how to prevent it than ever before. We unfortunately have not effectively communicated these facts or the importance of early dental visits to the general public. We can do a better job educating families. Early exams are instrumental in assessing the risk of decay and preventing caries. Tooth decay is still the single most common chronic childhood disease. It is five times more common than asthma, four times more common than childhood obesity and 20 times more common than diabetes.

We realize that decay is not as serious a disease as cancer but it can be heartbreaking to parents to hear that their young child has cavities.

This disease can present challenges to any family, especially ones with limited financial resources. We must remember that this is their baby and all families have different financial circumstances and beliefs regarding health care. We feel it is important to be open minded when talking with parents. For example, when discussing nursing or bottle caries do not alienate parents by making them feel they have been neglectful or "bad," that is off-putting and does not help the child.

The parents usually feel extraordinarily guilty. We feel it is best to be compassionate and stick to the facts. If the family has no intentions of stopping this habit in the near future, counsel them about the

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appropriate home care. It may be necessary to treat the disease as soon as possible or the decay may be at an early stage that can be remineralized with fluoride, xylitol wipes and oral hygiene. It may be necessary to see the baby again in six weeks to three months. The family may be opposed to fluoride. For these patients we recommend xylitol wipes. In this American melting pot, you will encounter families that have philosophies that are different than yours. We feel it is important to consider all the options available for each specific case. If treatment can not be postponed, it is even more upsetting for the parents to learn that in most cases the best way to accomplish this care is with an oral sedation or general anesthesia. We all know that untreated decay can cause pain, swelling, difficulties eating and malocclusions. Children's Dental Health Month is a time to raise awareness about these problems and how they can correlate to poor school performance and absenteeism. Our partner, Dr. Betty Barr, has been a pediatric dentist for 38 years and she has personally witnessed ECC increase to the tune of about 30%. We have heard her say often, "Since I have been in practice, ECC has definitely gotten worse not better". It is really hard to believe that in 2015, practitioners still see young children with rampant decay on a regular basis.

Any general dentist can examine a one year old. Do not be afraid, you are perfectly qualified to do this and consult with the family. Parents need to be informed about how to prevent the transmission of decaycausing bacteria and the most common times this inoculation occurs.

The best way to examine a baby is with a knee to knee exam. They are quick, safe and give parents an up close and personal look at their child’s dentition. If you are unsure about how to do this, we are happy to help, plus on the Internet and YouTube, there are numerous accurate examples that demonstrate the technique. During a comprehensive knee to knee exam you can identify soft and hard tissue pathology such as white spot lesions and hypoplastic teeth. Take this opportunity

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to give home care instructions. One of the best ways to evaluate how a parent is brushing their child’s teeth is to ask them to demonstrate how they brush at home. Most young parents love advice on improving their brushing skills. We do not want parents making up a brushing technique or putting oral hygiene on the back burner until a problem occurs. Seeing young children is rewarding. The age one dental visit is a service that you can provide to your patients and it shows your commitment to oral health at all ages.

Please take the time to promote Children's Dental Health Month in your office, on your website and on your social media sites and discuss it with your patients.

The first birthday/first check up logo that was developed for our office by Cody Ash is available to you. visit mddf.org to download our logo. We have also provided some additional information that we find very helpful in our private practice. It is the AAPD's policy on ECC and it has excellent information that you can share with your patients. It contains statistics on the prevalence of decay and its consequences.

We all know that ECC is costly and can take an emotional toll on the family. The AAPD's policy also clearly states the home care necessary to keep infants and toddlers cavity free. In our office we use a brochure and a handout that we created from these recommendations. It is in an easy to read

format and gives clear instructions to the parents. Please feel free to print and use them.

So let's put a stop to this preventable disease once and for all. Together we can inform the public about the importance of the age one dental visit and get these babies

in for exams. We believe that every child deserves a healthy start. We are happy to help any way we can, just give us a call.

Enjoy Children's Dental Health Month!

About the Authors Dr. Nelle Barr received her dental degree and her pediatric dental certificate from the University of Kentucky. She is a Board Certified Pediatric Dentist. She is a past president of the Adams County Dental Society and the Colorado Academy of Pediatric Dentists. Dr. Nelle is President Metro Denver Dental Foundation.

Dr. Sean Whalen is active in the Colorado Dental Association and the American Academy of Pediatric Dentistry; he is Board Certified in Pediatric Dentistry.

Although Dr. Sean now considers Denver his permanent home, he will always be an avid Iowa Hawkeye fan. Dr. Sean and his wife, Brandy, live in Denver and enjoy an active lifestyle with their Ewan, Holden and Emmett.

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SPEAKER

HOW TO PUT YOUR PRACTICE IN THE TOP 10% - A FORMULA FOR A SUCCESSFUL PRACTICE

By Joan Forrest, President and CEO, The Dawson Academy

T

oday, more than ever, it is imperative that you differentiate your practice from the typical, usual and customary practice if you wish to thrive – not just survive. At The Dawson Academy, we call this being in the Top Ten%.

And we don’t just mean in the Top Ten % of Gross Production Dollars. We mean in the Top Ten% of the dentists in your community who know how to solve patients’ problems – even the toughest ones. We mean in the Top Ten% of dentists who LOVE DENTISTRY, and who have built their practices around their lives, not their lives around their practices.

And we mean in the Top Ten% of dentists who have an abundance of joy and fulfillment in life. You will be amazed that when these things are present your Net Production Dollars, regardless of your Gross Production Dollars, will be more than adequate to support your lifestyle.

CLINICAL EXCELLENCE Too often dentists are misled into believing that practice success can be guaranteed by bringing large numbers of new patients into the practice each month. In our experience, trying to treat too many patients is the most common obstacle to clinical excellence, which we believe is the single most important factor that determines how successful a practice can become. Patients seek out dentists who cannot only make them look good, but who can also make them feel good. The dentist who knows how to solve any masticatory system problem, and who does what is needed in a predictable time period, at a fair fee, will thrive.

"We mean in the Top Ten % of the dentists in your community who know how to solve patients’ problems – even the toughest ones."

After more than 50 years of teaching dentists The Concept of Complete Dentistry®, the Dawson Academy has identified the four factors that, when added together, compose the formula for creating a Top 10% Practice. These four factors are: 1. Know how to solve your patients’ problems 2. Develop an effective team 3. Structure your organization so it can be monitored and controlled 4. Make slow but steady improvement for each part of the practice We call the first three factors the triad of skills that must be mastered to achieve Top Ten%. Clinical skills, people skills and management skills make up the triad.

These factors are not in random order. The first factor, knowing how to solve your patients’ problems, is the most important and also forms the foundation of The Dawson Academy’s philosophy of practice success - clinical excellence.

Clinical excellence in the Dawson Philosophy cannot be explained in the limited context of teeth alone. The teeth cannot be isolated from the muscles and joints. To be predictably successful, dental treatment must result in comfort, health and equilibrium of all the parts of this system. This is why to reach the needed level of competence for a truly successful practice; dentists must become proficient in comprehensive diagnosis and treatment planning.

Complete examinations and thorough diagnoses are the blueprint for case presentation, effective scheduling, and increased production.

Learning how to incorporate procedures for really thorough examinations is the first step to major practice improvement. Dentists who adopt our protocols for a complete examination are routinely amazed at how dramatically implementing a complete exam process can change a practice for the better.

What is a complete examination? We consider an examination complete when it allows for identification of all active factors that are capable of causing or contributing to the deterioration of oral health or function. It is incomplete if it does not provide enough information to develop a total treatment plan aimed at optimum maintainability of the teeth and their supporting structures. The complete exam does not rely solely on symptoms because signs almost always precede symptoms.

(Continued on pg. 18)

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17

(Continued from pg. 16) It is the dentist’s responsibility to observe signs of deterioration before they cause symptoms.

PEOPLE SKILLS For many Dentists, the people skill component of the triad of skills is the least comfortable and most troublesome. Managing the team is a responsibility that falls squarely on the doctor’s shoulders, and success in this arena will only occur with open, honest, direct communication. Often times a dentist will let a problem within the team fester rather than address it in a timely manner. Just like a dental problem, no personnel problem ever gets better by watching it. Swift communications about the problem is always the best approach.

Start by clarifying expectations. Typically, whenever there is disappointment in a relationship, it is rooted in the lack of clarification of expectations. It is the doctor’s responsibility to paint a picture with words of what he/she expects from each team member. Be sure that the desired outcome of every task is mutually understood. Describe what a successful result will look like to you. Determine if the individual shares the same vision of accomplishment and give specific feedback, positive and negative, as soon as the work is completed. Keeping the focus on the task, rather than the personality, is the key to reducing the emotionality that often accompanies performance feedback.

As the leader, establish early and often that the primary reason each person is employed by the practice is to serve the needs and expectations of the patient. The secondary reason is to help the doctor be more productive. If a team member is not enhancing the patient’s experience and the practice’s productivity, question the need for that individual.

MANAGEMENT SKILLS Do you know, for certain, the percentage of your gross income that goes to facility expense, administrative staff, production staff, business supplies, clinical supplies, laboratory costs? Knowing specific data about the costs of running your business will enable you to manage expense rather than letting it manage you. Too often we see dentists who pay themselves what ever is left over after paying the monthly bills. The lack of predictability in financial management is as painful, if not more painful, than the lack of clinical predictability.

An age-old management adage states “what you measure, you improve” and this is very true in dental practices. Monitors are necessary for control. They are a way of measuring results, and it is axiomatic that what we measure we improve.

Productivity per hour (average) is the ultimate measurement for analyzing the effectiveness of treatment planning and the coordination of the schedule. It is affected adversely by ineffective planning and inadequate quality control.

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Another important measure is the amount of treatment diagnosed and the amount scheduled per new patient. The first will give you an indication of the thoroughness of your examination and diagnosis and should increase as your clinical skills improve.

The later is a good reflection of co-diagnostic and patient communication skills.

With regard to managing expenses, the most effective and flexible method is to use percentage based budgeting. There are guidelines for what percentage of income should be allocated for things such as facility costs, materials and supplies – clinical, materials and supplies – nonclinical, personnel costs, marketing, etc. By utilizing percentage formulas, it is possible to evaluate a practice regardless of the amount of income.

It should always be considered an “absolute” that productivity should never be increased at the expense of quality care.

Furthermore, it doesn’t have to be. Increased productivity is the payoff for better management of the doctor’s time.

One of the greatest joys for all of us at The Dawson Academy is seeing dentists come alive and start enjoying life and enjoying their practice. The difference between burnout and loving what you do is often no more than a handful of basic skills that need to be learned well, then all the other details fall into place. Any dentist committed to learning and practicing the basic foundational skills can find excitement and joy in the practice of dentistry and put the practice in the Top Ten%.

About the Author Ms. Joan Forrest, BA, MS is President and CEO of The Dawson Academy. Prior to joining the Academy, she was founder and President of Prime Performance, a training and consulting company specializing in developing self-directed work teams and facilitative leadership. Joan’s career has also included management positions with AT&T and United Technologies.

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2015 RMDC SPEAKER

THE TOTAL WELLNESS DENTAL PRACTICE IS COMING TO DENVER IN 2015

By DeWitt C. Wilkerson, DMD

T

he Dawson Academy is pleased to bring the Total Wellness Dental Practice seminar series to the Mountain West Dental Institute, beginning in April 2015.

How did this come about?

In 2012, we attended the second annual conference of the American Academy for Oral Systemic Health(AAOSH). It was held at the Cleveland Clinic, featuring some of the top medical clinicians and researchers in the world on the subject of total wellness.

The meeting changed the way we view Dentistry. Michael Roizen MD, Medical Director of the Cleveland Clinic Wellness Institute, shared statistics proving that our nation will soon be bankrupt due to the rising cost of healthcare, especially the cost of managing chronic diseases associated with metabolic syndrome/obesity, diabetes, heart disease, dementia, physical inactivity, smoking and stress. He stated there will only be two options to manage this growing crisis: rationing of health care by the federal government and insurance companies, or the public gets rationale, and we start taking responsibility for own health through personal lifestyle changes. Dr. Roizen pointed out that a large study showed that 89% of people with adult, type 2 diabetes can lower their blood sugar levels to within normal, without medications, by implementing a few simple lifestyle changes. Recent DNA studies have also proven that lifestyle is more important to longevity and quality of life than is our genetic predispostion. He challenged dental teams to be on the frontlines fighting this battle that is destroying our nation, pointing out that we spend more time with our patients than any other health professionals. We left the conference with an enlarged vision of Dentistry.

In January 2015, we will be presenting a half day session (Thursday PM, repeated Friday AM) at the Rocky Mountain Dental Convention, entitled The Exceptional Dental Team. We will be introducing some of the amazing links between Dentistry and total wellness. This session will be a tremendous eye opener for your whole team. We promise that your perspective on the role of dental professionals will dramatically change.

You will be very encouraged with the potential for elevating your dental practice to heights you’ve never considered. It will also expand your business model as you consider the possibilities of forming strategic relationships throughout the medical community. We look forward to interacting with you and your whole team at the Conference.

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In April 2015 The Dawson Academy will bring scholars, researchers, and clinicians, to the Mountain West Dental Institute, personally training dental teams to expand their practice mission to include total wellness screening, coaching and therapy. Our newest course series, The Total Wellness Dental Practice, will assist dental teams in becoming patient advocates for total health and gatekeepers of systemic inflammation. Systemic inflammation is the fire within that feeds accelerated aging, lowered energy levels, poor memory, chronic pain and disease. Common causes are oral pathogenic bacteria in the bloodstream, sleep apnea, a pro-inflammatory western diet, physical inactivity, smoking and stress. Dental teams can effectively address all these sources of chronic inflammation. The participants in this course series will learn from noted authorities including Bradley Bale MD, Steven Masley MD, DeWitt Wilkerson DMD, Tom Nabors DDS, Tony Iacopino DMD, Susan Maples DDS, David Seaman DC, MS, Stephanie Lodding RDH and Gy Yatros DMD, how to use salivary testing to guide antimicrobial periodontal/systemic therapy; home sleep studies to guide screening and monitoring of treatment of obstructive sleep apnea; principles of prevention of diabetes, heart attacks, and strokes; exercise physiology; stress management techniques; nutritional principles; smoking cessation counseling; networking within the medical community, and many other principles of Dental Medicine.

For more information contact www.TheDawsonAcademy.com.

the

Dawson

Academy,

You are urged to accept the challenge to create The Total Wellness Dental Practice in your own office. Wouldn’t it be wonderful, if in addition to saving teeth, you could also save lives? We would be thrilled to help you!

About the Author Dr. DeWitt C. Wilkerson is Senior Faculty/Director of Dental Medicine for the Dawson Academy for Advanced Dental Study, in St. Petersburg, Florida. He is Past President of the American Equilibration Society and serves on the Board of Directors for the American Academy for Oral Systemic Health(AAOSH).

He can be contacted at dwilkerson@thedawsonacademy.com.

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2015 RMDC SPEAKER

OVERCOMING NO-SHOWS & CANCELLATION

By Lisa Philp, RDH, CMC

T

hroughout my time as the President of Transitions Group North America, the one common thread I have come across after working with over 1,500 dental practices is that most of them experience some form of difficulty when attempting to maintain an organized and stress-free way of keeping their patients true to their appointment slots. However, there are ways of doing this, but first we have to understand why our patients are canceling, or failing to show up to their scheduled time in the first place.

Of course everyone is different and will have different reasons as to why they put their oral care on hold. There are those who may not be aware of the importance of the dental work they are to receive, are financially strapped and unsure as to whether they can afford the treatment or not, and in some scenarios, those who have their own jobs during dental hours who may not want to sacrifice any of their daily wages. Interestingly though, us dental professionals can also be guilty of giving our patients more excuses for not showing up, as a result of how we run our practices.

Such situations as minimizing the importance of a patient’s visit, having a member of the dental staff make their visit uncomfortable, or failing to make the patient responsible for remembering their own appointment as well as your cancellation policy, can harm your practice if you do not find a clear and concise way of dealing with

these occurrences. Your goal here is to give your patients a reason as to why they should come back when they are supposed to, and it all starts with how you and your staff handle an individual while they’re in your presence.

What I have found to be a truly effective process is the 3-5 Minute Checkout and Confirmation that should be handled by the clinical team. After completing the patient’s work for the day, sit them up, but leave the bib on them so that they remain seated while you take their paper work to reception. When you return from reception, it is imperative that you confirm with the patient the work that was just completed, ask them if they have any questions about it and prepare them for the next visit by letting them know what they will be having done, as well as how much time it may take – don’t stop here though.

It is at this juncture that you should stress the importance of the next appointment, while noting its benefits once completed and the consequences that go along with non-completion.

Now it is time to walk the patient to the reception area and verbally communicate with your administrative person what is required for the next visit, including any financial details. What has to be remembered here is that being organized is the key to your success.

If everything in the 3-5 minute Checkout and Confirmation is executed as described, it’ll make your patient’s day at the dentist an easier one and will save you from asking obvious procedural questions with other staff in front of the patient, that should already have been handled prior to their departure.

(Continued on pg. 24)

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(Continued from pg. 22) Another step to think about here is how you are scheduling and confirming these appointments. First, never ask a patient when they want to come in. Instead, use the method that I like to call “Alternative Choice.” This is where you give the patient appointment options based on your employees’ schedules, making the individual feel as if they are in charge. Secondly, erase the words, “I,” “We,” “Us,” “Our” and “The” from your vocabulary. By doing this you are transferring ownership of the schedule making process, therefore making it the patient’s responsibility – for example, such a phrase as “what will work for you” will go a long way in the scheduling scheme of things.

you’re surprised that such a change has occurred – then attempt to re-schedule them within the next two weeks. “B” patients, while not the most difficult to handle, need to be dealt with by asking how you can help them keep their appointment and perhaps remind them of the importance of scheduling times that work for everyone involved.

As for “C” patients, communicate to them that you are aware that this isn’t their first cancellation and rather than giving them a specific appointment well in advance, you’d prefer putting them on a short call list, which is accessed when there are last minute changes to your office’s schedule.

Thirdly, use the word “reserved.” If you can get your patient to concede to the idea of the time “they” reserved for their appointment, they can then be held more accountable for the way their dental appointments look. Once all of these steps are complete, please realize that it is extremely important that you call to confirm these appointments closer to the actual time that it is scheduled.

In addition to the short call list, there are three others that can further assist you in making sure that you keep as full of a schedule as possible, while keeping track of your patients’ attendance. The noshow list is designated usually for “C” patients that do not call to cancel appointments or don’t arrive for them – do your best to re-book these patients one month from their original appointment. Then you have the short notice list, which is a group of people who don’t mind being called on any given day when there’s an opening, therefore giving you easier ways to fill any downtime. Finally, you have the cancellation list that includes people who have cancelled and not rescheduled a new appointment after the fact.

What’s inevitable after this though is certain patients deciding to cancel the aforementioned appointment as their time draws closer. I’m a firm believer in solidifying a 48 hour, two working days cancellation policy, because at least that way your office will have a chance at filling in that downtime. Keep in mind that downtime is the amount of hours that your practice is being unproductive during the course of each working day, and should remain below 10% each month in order to fully optimize your time.

In regard to the policy that you create, see that it’s displayed everywhere for your clients to see – the more awareness patients have about your professional needs, the better chance you have at getting your patients to respect them. On top of that, be sure that the policy is explained clearly and if it makes you more comfortable, you can create a cancellation agreement that you need to have signed by each and every patient.

What do you do though, even if cancellation issues continue to show up within your practice? Well, one surefire way of learning how to do deal with this, is by learning how to classify your patients based on their personal attendance tendencies. In dentistry, you have three kinds of patients – the A, B, and C patients. The “A” patient always arrives on time, has high regard for preventative hygiene services and gives proper notice when an appointment needs to be adjusted.

The “B” patient is relatively good, occasionally misses appointments, is sporadic about their hygiene visits, and has made or broken one or two appointments on short notice. Then you have the “C” patient, who comes in for emergencies only and has a large history of breaking appointments.

Considering how diverse A, B and C patients can be, you need to learn how to deal with each one of them individually when they either cancel last minute or don’t show up for an appointment. With an “A,” you show concern and enquire if the person is okay and that

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Once you have everyone properly classified, you can then focus on your re-calling, reactivation list, which will help you further build your schedule and make sure that no patients get lost in the fold. On the first day of each month, run lists for those due for appointments in the current month, the previous month, 60 days prior, and one for those who were due 90 days prior, dating back to 18 months. Then each of the next four subsequent weeks, try to reach these patients via phone or through a reactivation letter, if need be. This may seem like a tough task to manage, but it is situations such as these that make an automated messaging service for your practice look that much more beneficial.

Overall, please remember that dealing with no-shows and cancellations is something that everyone in the dental field has to put up with on some level. The real key here is to get everyone on your team on the same page as to the pre-booking and cancellation policies that you create and then find a way to get your patients to adhere. Not everyone will adjust accordingly right away, but the sooner you make the effort to evolve, the sooner you’ll be seeing fuller schedules.

About the Authors Ms. Lisa Philp is the President of Transitions Group North America; a full service coaching company for dentistry. She graduated from East Tennessee State University as a Registered Dental Hygienist. Her career began with clinical hygiene in United States and Canada and moved to the creation of a periodontal disease management program where she coached thousands of dental professionals.

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PROFESSIONAL MARKETING AND APPRAISAL

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CLINICAL

BEAUTY & THE BEAST

By Dave Andrus, CDT

"S

o what was that ugly crown you have?” was the question Stuart Winter, DDS located in Arvada, Colorado asked, After a brief moment of reflection on my part and delightful chuckle, I realized he was referring to the “Beast” in what we call our “Beauty and the Beast” crown. (Figure 1a) This is a zirconia crown style we developed which is a full contour zirconia crown with the facial window cut back where we layer translucent veneer porcelain for aesthetics far superior to a monolithic full Figure 1a: Beauty and the Beast maxillary lateral incisor with solid zirconia linguai contour zirconia crown. We call and protectedlabial veneer porcelain. this our “Beauty and the Beast” crown (Figure 1b) because of its beautiful layered veneer porcelain and beastly strength of the full contour zirconia.

From my experience and research I have concluded that the weakest link in porcelain fused to zirconia crowns is the single mode of bond between the veneer porcelain and the zirconia. As a comparison, PFM alloys have three modes of bond with dental porcelain; chemical, mechanical and compressive.

significantly more surface area per square millimeter than an alloy surface which has not been ground on. (Figure 2) Compressive bond is developed due to very specific co-efficient of thermal expansion values between the alloy substructure and the veneering porcelain. Co-efficient of thermal expansion, in this case is the rate the two materials expand while being fired in a porcelain oven and more importantly the rate of shrinkage and volume of shrinkage the alloy and the porcelain achieve as a combined unit as they are cooling after being fired in a porcelain oven. If the two very different materials don’t have a CTE that matches, the porcelain loses the co-efficient battle and cracks or fractures off. Dental porcelain and dental alloys are designed to work together in a way that as the PFM crown cools after being fired in a porcelain oven the porcelain is left under slight compression adding strength to the porcelain and making the porcelain much stronger than its standalone flexural strength when it is not supported by a metal substructure.

For example, a sheet of glass lying on a perfectly flat table can hold thousands of pounds of pressure because it is under a compressive load. If the same sheet of glass is moved so 25% of it is suspended off the edge of the table, the unsupported portion can break with relatively light pressure, because glass, like dental ceramic, does not survive well when subjected to flexural forces. This is one reason incisal edges break more easily than the mid-occlusal surface of a crown because the incisal edges are subjected to flexural forces rather than compressive forces like the mid-occlusal surface of a crown.

Figure 1b Maxillary lateral incisor crosssectioned showing the zirconia substructure with the protective zirconia cap over the incisal veneer porcelain and the layers of aestheticporcelain on the labial surface.

The chemical bond comes from the metal oxides in the opaque porcelains bonding chemically with the oxide layer which forms on the surface of the alloy as it is fired in the porcelain oven.

Mechanical bond is achieved by roughing the surface of the alloy coping/framework by grinding on it with stones, carbide burs and sand blasting the alloy with aluminum oxide. These processes create a roughened surface on the alloy creating

Figure 2 Ground on dental alloy ingot after being sandblasted and fired in a porcelain oven to develop an oxide layer ready to apply dental porcelain.

Figure 3: Example of a zirconia lateral incisor that has been milled, colored, sintered, and is readyto have veneer porcelain applied to it. Note, the smooth, shiny zirconia surface to which the veneer porcelain would be applied.

This demonstrates why Diamond Dental Studio designs their Beauty and the Beast crown so no occlusal forces come into direct contact with the veneer porcelain to avoid fracturing the veneer porcelain off of the crown.

There are two primary weak links with porcelain fused to zirconia, which we have been able to overcome with our Beauty and the Beast crown, single mode of bond and CTE (co-efficient of thermal expansion). The single mode of bond achieved by porcelain fused to zirconia is mechanical.

The problem is that the surface of zirconia is very smooth and offers very little opportunity for the veneer porcelain to physically hold on to the surface of the zirconia. (Figure 3) Compared to a dental alloy that is easily manipulated to have a rough surface texture which provides significant mechanical retention of the layered porcelain. The (Continued on pg. 28)

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BOOTH # 218

CLINICAL (Continued from pg. 26) co-efficient of thermal expansion (CTE) with layered porcelain to zirconia can be death to the veneering porcelain if one simple procedure is not followed in the fabrication process. Technicians must SLOW COOL the last glaze bake of a porcelain to zirconia crown (Figure 4). Zirconia stays hot much longer than the veneer porcelain, so if the crown is cooled too quickly, it develops residual stress at the veneer porcelain and zirconia Figure 4: PFZ crowns must be slow cooled when exiting a porcelain oven to eliminate interface resulting in the veneer porcelain residual stress which can result in layered fracturing off the zirconia substrate. veneer porcelain cracking or popping off.

The interesting thing is that the residual stress may not show up for months after the crown/bridge is in the patientâ&#x20AC;&#x2122;s mouth. PFZ (porcelain fused to zirconia) crowns require a six minute cooling cycle whereas most PFMâ&#x20AC;&#x2122;s can be taken out of the oven immediately. So, if the technician is not aware of the differences between the two materials or rushes the cooling cycle, they can inadvertently cause a future failure. This is also vitally important to know when PFZ crowns are Figure 5: All zirconia crowns should always be adjusted with water to help avoid residual being adjusted in the mouth or chairside. stress that may not show up for months after If a PFZ crown is ever adjusted without the adjustments have beenmade. water, the same residual stress issue can be caused by localized superheating resulting in immediate or future fracture of the veneer porcelain. If you see the little sparks while adjusting PFZ crowns, you could have set the crown up for failure. Even monolithic zirconia crowns can be fractured by aggressive grinding, without water chairside. (Figure 5) Why did we design the Beauty and the Beast crown?

First, Beauty; I wanted to be able to offer our clients a zirconia crown that would be suitable in the aesthetic zone. (Figure 6) Second, the Beast; I wanted to protect the veneer porcelain from any and all occlusal, or flexural forces in the mouth so it would be as strong and long lasting as a monolithic crown that didnâ&#x20AC;&#x2122;t have Figure 6: Beauty and the Beast crown with facial layered porcelain for superior aesthetics veneering porcelain on it. The veneering in the aesthetic zone. porcelains we use on PFM crowns have an unsupported flexural strength of about 60-70 Mega Pascals (MPa) but are very durable when properly bonded to an alloy substructure and properly supported by the alloy frame design. Milled e.max has a flexural strength of about 360 MPa. Pressed e.max has a flexural strength of about 400 MPa. The zirconia we are using has a flexural strength of about 1100 MPa. The design of the facial window cutback of the incredibly strong zirconia is designed to completely surround and protect the more vulnerable veneer porcelain leaving no chance of fracture on posterior and anterior crowns and bridges.

(Figures #7a, 7b)

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We use a technique that allows us to color the incisal portion of the zirconia to blend with the enamel shading and the gingival to match the dentin color leaving the zirconia to porcelain junction virtually undetectable. (Figures #8-13) The Beauty and the Beast design works equally well for bridges. Figures 14 and 15 shows a six unit maxillary anterior bridge from teeth numbers 6 through 11 including teeth numbers 6, 7, 10 and 11 as abutments and teeth numbers 8 and 9 ovate pontics. This bridge was made for Jonathan Bishop, DDS located in Steamboat Springs, Colorado.

About the Author Dave Andrus, CDT has been a technician for 36 years with a broad background in the dental laboratory arena as well as the operatory.

In 1978, Dave started his career working in dental laboratories and went on to be a research and development technician for Coors Biomedical where he became a technical director responsible for teaching courses, answering technical calls, writing instruction manuals and working with ceramic engineers to help develop and refine dental porcelain. He was also technical director for SS White and Ceramco Porcelain.

In 2003, a US patent #6,547,649B1 was granted to Dave involving dental and jewelry noble and high noble alloys.

Dave has served on the editorial board of the National Association of Dental Laboratories for their Journal of Dental Technology; a peer reviewed publication, is a past president of the Colorado Dental Lab Association. He has been widely published in National and International dental technology publications and has studied occlusion under numerous theories. He has given clinics and lectures for the past 30 years and has owned Diamond Dental Studio, a five person lab, for 28 years; along with Andrus Technologies, a research and development company and is dedicated to the advancement of the dental industry as a whole.

Figure 7a: Cross-section of a maxillary lateral incisor showing the sold zirconia lingual with the Incisal capped with zirconia so no occlusal forces are able to contact the labial layered porcelain veneer.

Figure 7b: Six-unit Beauty and the Beast bridge in the un-sintered state before colorant is applied.

Figure 8: Lateral incisor showing the virtually undetectable junction of the zirconia and the translucent veneer porcelain on the mesial proximal surface.

Figure 9: Milled zirconia molar Beauty and the Beast crown with colorant applied before sintering.

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2015 RMDC EDITION

Figure 10: Shaded Beauty and the Beast zirconia molar crown after sintering, ready for veneer porcelain application to the buccal surface. Note, the buccal cusp tips of protective zirconia designed to protect the veneer porcelainâ&#x20AC;?.

Figure 11: Completed Beauty and the Beast molar with shaded zirconia and facial veneer porcelain. Note, the slightly detectable protective cap of zirconia over the buccal cusp tips.

Figure 13: Six-unit Beauty and the Beast zirconia bridge colored, sintered and ready for porcelain application.

Figure 14: Six-unit Beauty and the Beast bridge with teeth numbers 6,7,10, and 11 abutments, and teeth numbers 8 and 9 ovate pontics.

Figure 12: Six-unit Beauty and the Beast zirconia bridge after being milled and colored, prior to sintering.

Figure 15: Six-unit upper anterior Beauty and the Beast finished bridge.

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Stability · Strength · Service

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NON PROFIT NEWS

MDDF AT THE 2015 RMDC AND BEYOND!

The Metro Denver Dental Foundation has a lot going on at the 2015 RMDC and into the New Year! There’s something for everyone, so join in the fun.

The good times continue even after RMDC.

• Make your first stop each morning of RMDC the Coat Check in Room 701. For a small donation, we’ll take good care of your coat, hat and bags while you attend sessions.

• The 2nd annual Feed the Foundation event will be held in April 2015 – look for all of the delicious details to be announced soon on our website, www.mddf.org.

• Relax with friends at the Friday Night Party at the Hyatt Regency from 5:30pm – 8:30pm on the 23rd. There will be music, dancing and prizes – be there!

• The Shred Event will be held on Saturday, June 6, 2015. Details will be available at our RMDC Booth.

• Visit the MDDF booth outside the Expo Hall and learn more about what MDDF – your Foundation, does in your Community – and how you can be involved.

• MDDS is hosting a Casino Night at MWDI on Friday, March 20, 2015 benefitting MDDF. We’re betting you’ll have a great time.

• Mark your calendar for the 10th Anniversary Molars Golf Tournament on Friday, September 11, 2015 at the home of Molars – The Ridge at Castle Pines North.

CARING PROFESSIONALS SERVING OUR COMMUNITY

TOOTHFUL TALES, BECOMING ME CAVITY FREE! DEBUTS AT RMDC Written and Illustrated by Jeanette Courtad, DDS in collaboration with the Horowitz Center for Health Literacy at the UMD School of Public Health

T

he award-winning Toothful Tales book series is about to launch a new addition to its list of children’s dental books. Member dentist, Dr. Jeanette Courtad, has just completed a collaboration with Alice Horowitz, RDH, MA, PhD and her department at the Horowitz Center for Health Literacy at the UMD School of Public Health. The Center approached Dr. Courtad after reviewing the currently available dental picture books, with the request that she use her tooth characters to teach underserved, new mothers about how to care for their newborn’s oral health. Toothful Tales, Becoming Me Cavity Free! is the result of this collaboration.

The new book serves as a prequel to the other two books in the series by taking reader back in time to when the tooth characters were baby teeth. “Baby mouth” is the setting for this story, told as the previous books are, from the tooth’s point of view – where the tooth characters

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arrive, one by one, until the mouth is filled with well cared for teeth.

They are introduced to tooth-healthy foods and habits like Lift-theLip, being brushed with a smear of toothpaste and going to their first dental visit before “Baby” turns one. “Mom” has a starring role in this tale, but the teeth make the astute observation that “Mom” can go by other names like “Dad”, “Grandma” or “Bob” (except for the pregnancy guidelines), since all members of the caregiving team should be aware of the recommendation so that “Baby” can be cavity free!

Dr. Courtad will have her new book for sale in paperback at the MDDF booth at RMDC, along with her other two books in hardcover and Spanish editions. A percentage of all Toothful Tales book sales at the RMDC is donated to the foundation to help with its educational component along with its mission to help underserved women in its Smile Again Program®.

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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) • Banquet Hall • 20-seat Executive Board Room • Hands-on Learning Lab Benches for 40 participants • Large Wet Lab • Four (4) Educational Operatories including one (1) equipped for surgery • 2D/3D Digital Imaging Suite • Planmeca PlanScan™ (mill & scanner) • Equipped to capture and stream live video • MDDS members receive a 15% discount • Multi-day & multi-room discounts • A/V always included • No catering restrictions • Free Wi-Fi • Two (2) free parking structures

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

EVENT CALENDAR JANUARY 2015

MARCH 2015

January 22-24 2015 Rocky Mountain Dental Convention Colorado Convention Center, 700 14th Street, Denver, CO 80202 The Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 (303) 488-9700

March 6- 7 HANDS-ON Recognition and Management of Medical Emergencies Participate in an Advanced Clinical Simulation Chldren's Hospitial 13123 E. 16th Ave. Aurora, CO 80045 9:00am - 4:00pm (each day) (303) 488-9700

FEBRUARY 2015 February 10 CPR/AED Training Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:00pm - 9:00pm (303) 488-9700 February 13-14 Introduction to Dental Sleep Medicine – Dr. Barry Glassman Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am - 4:00pm (each day) (303) 488-9700 February 18 MDDS New Member Networking Event Location TBD February 27 Basic Radiation Education for Unlicensed Dental Personnel – Dr. Brad Potter Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am - 12:00pm (303) 488-9700

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March 20 MDDS Casino Night Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:30pm - 10:00pm (303) 488-9700 March 27 Botulinum Toxin (Xeomin, Sysport, Botox) and Dermal Filler Training Level 1 & Level 2 -American Academy of Facial Esthetics Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am - 5:00pm (303) 488-9700

March 13 HANDS-ON Soft Tissue Grafting: Enhancing Restorative Results – Dr. James Kohner Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 9:00am - 4:30pm (303) 488-9700

March 28 American Academy of Facial Esthetics Frontline TMJ & Orofacial Pain Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am - 12:00pm (303) 488-9700

March 14 HANDS-ON Crown Lengthening: Creating Predictable Restorations – Dr. James Kohner Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 9:00am - 4:30pm (303) 488-9700

APRIL 2015 April 3 Straightforward Ultrasonic Debridement – Ms. Cynthia Fong & HANDS-ON A Simplified Approach to Ultrasonic Instrumentation – Ms. Cynthia Fong Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 First course: 9:00am – 1:00pm & Second course: 2:00pm – 4:00pm (303) 488-9700

March 19 CPR/AED Training Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:00pm - 9:00pm (303) 488-9700

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BOOTH # 345

SPEAKER

THE COVERED SMILE LADY

By Sonja Lauren, Author

W

hen The Covered Smile came out 10 years ago, I was often introduced as “Sonja Lauren, the author who wrote a book about herself.”

I quickly reminded the audience, “while The Covered Smile is a true account of my deeply personal story about my tragic truths of being a child who survived severe dental neglect, it is also the story of millions of hurting souls who have had no voice.”

Truth be known, I am rather an introvert and prefer to not be in the spot light, but because I have dedicated my life to sharing my story to help others, I stand tall on the stage and speak of my horrible experiences of wearing dentures since the tender age of 12 years and 3 months and having endured implant surgeries, gum and bone grafting surgeries and having to deal with stich removals, and denture impressions well over 300 times. There were months and years of which solid foods were not part of my diet, and in fact there were months I could only wear “party teeth.” All of these procedures as well as the associated specialized treatments and resulting life adjustments led to astronomical financial difficulties, emotional distress and pain and suffering which occurred and will continue to be present throughout my life.

After the birth of my daughter in 1987, as I stared into her precious eyes, I realized that I didn’t know much, and in fact I didn’t even know how to read very well. However, I did know that I was committed that she would not suffer as I had. For example, I had a bleeding ulcer by first grade and suffered from child abuse and neglect. I failed the entire 7th grade as I missed most of the year as a result of being kicked in the jaw which led to my face swelling beyond normal human appearances and then had all four quads of my natural teeth removed at the age of 12 years and 10 months. I failed to thrive as a student and didn’t learn to read until after my daughter was born. Wise enough to realize I needed counseling to overcome the physical and emotional damage that had been done, I was encouraged to return to college by my trusted counselor and it was there, in the classroom, that I learned I had a gift of being able to write.

After the “normal” 91 rejections to find a solid book contract, The

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Covered Smile was born. Dr. John Ward, who is now retired from the Medical College of Virginia’s School of Dentistry and Dr. Terry Dickinson, (founder of Mission of Mercy) helped me gain my first speaking events in the Richmond area. I honed my speaking skills and overcame my insecurities by becoming a member of the round tables at state level events. It was really amazing that I was able to open my mouth and speak, let alone become recognized with awards for what I said and how I presented it. Speaking for several years, I became known as “The Covered Smile Lady - A lady with a mission to help others.”

The Covered Smile lecture series has expanded to also include educational and informational topics for dental professionals including, but not limited to dental assistants and office managers.

Lecture series topics include: “Treatment Planning Without Guilt,” “Dealing With The Angry Patient,” “The Psychology Behind The Covered Smile,” “Just A Dental Assistant-Not!” and “Stopping The Gossip Wheel Before It Spins Out Of Control” and were created once I learned from a very special mentor that my lectures series needed to be expanded to half and full day series.

After years of working a full-time job, raising a daughter and writing late into the night, the fruit of my efforts has begun to be not only noticed but actively sought after across the nation. I am a simple West Virginia girl who has a story to tell and the response literally astounds me at every lecture. I am so thankful to be alive, to be standing tall and to be able to share my story with those who have an ear to hear it. I have received thank you notes from as far away as South Africa and Bangladesh - Life is truly amazing! Once, a child written off as “the troubled child” and even written off by my childhood dentist as ‘Situation-Hopeless’, my life has dramatically changed. For those whom I have touched by sharing The Covered Smile book and/or Lecture Series, many have written me or told me directly that my words and messages have also dramatically changed their lives. This impact has been felt by the general public but also by those who work in one of the most important fields in the helping profession – the field of Dentistry! I am not bitter about my early horrific dental experiences but instead provide support, encouragement and praise for those who work in this noble and under- appreciated field.

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2015 RMDC EDITION

“When Ms. Lauren speaks, the room is silent, no one can move as they become captivated by her powerpoint lecture, the sincerity of her lecture, the truth behind her story-which is often the story of so many others. You won't regret inviting Ms. Lauren to intrigue your audience as her lecture will surely impact and inspire their lives for years to come...”

And so, the little girl I once was, the little girl labeled as the “troubled child,” the young teen marked off as ‘situation-hopeless’ and the young woman who suffered from low self-esteem and became involved in a series of dysfunctional relationships, has worked endlessly to become - The Covered Smile Lady. A Lady who is willing to share her heart and soul and her tragic stories in order to share the triumphs of overcoming pain and suffering and bring inspiration to others. This is why I find myself standing tall as The Covered Smile Lady in front of broad audiences with lectures full of inspiration, educational information, laughter, sincere concern for all who are suffering due to dental ignorance and or neglect and lastly, to inspire and recognize dental professionals for their critical roles within dentistry and the lives of their patients and communities.

“Ms. Lauren shares a one of a kind true story that cannot be found elsewhere. She intertwines her gut wrenching story, educational experiences as a dental office manager, humor and inspiration.

Sonja brings with her lectures a profound compassion and respect for professionals working within the field of dentistry.”

Thank you for taking the time to read my article. I look forward to meeting each and everyone one of you during my lectures at the wonderful RMDC in January 2015. You may contact me at SONJL36@msn.com if you so wish or check out my website at www.thecoveredsmile.com.

“Today, Ms. Laurens speaking engagements are a personal and powerful testimony about the importance of good oral health and the role of those working within dentistry. Ms. Lauren’s ability to captivate, mesmerize and educate her audiences, have created a mass call for her lectures across America since the release of The Covered Smile in 2003”.

About the Author Ms. Sonja Lauren is the author of The Covered Smile who shares her true story of childhood abuse, neglect, recovery, forgiveness and triumph. At the age of 12, a dentist wrote "Situation-Hopeless" on her dental records and extracted all her teeth leaving her wearing dentures at the age of 13.

The following comments are just a few samples of what my efforts have brought to those who choose to be part of The Covered Smile series lectures. I thank each and every attendee for choosing to be part of my educational lectures, my story and my recovery. I realize that each attendee has many courses to choose from, and each time I walk into a room to lecture, I am overwhelmed with thankfulness.

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. mddsdentist.com

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2015 RMDC EDITION

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2015 RMDC SPEAKER

FOCUS!

By Ginny Hegarty, SPHR

W

e’ve all heard the old adage that “most people don’t plan to fail, they fail to plan.” However, in dental practices I find that most people actually do care enough to plan, they just don’t come together to all focus on the same plan.

This results in a group of people working in the same practice with great passion and purpose, but going in different directions with different priorities. This inevitably leads to miscommunication, frustration, and stress.

“Stay focused! Keep your eye on the ball.” It’s pretty simple advice in theory, so why is so difficult in practice? It’s not uncommon for teams to lose one of their best people to these misunderstandings. You and your best people deserve so much better than this. You’re not alone; miscommunication is the number one obstacle to business success across industries, not just in the dental practice. It’s for these reasons that it’s so important to provide your teams with communication skills training and development.

When I survey the teams I work with across the country, the number one request that team members have is “Please help us to all get on the same page!” I think Steve Jobs was on to something when he famously said, “People think focus means saying yes to the thing you’ve got to focus on.

But that’s not what it means at all. It means saying no to the hundred other good ideas that there are. You have to pick carefully. I’m actually as proud of the things we haven’t done as the things I have done. Innovation is saying ‘no’ to 1,000 things.”

Here are three telltale signs I look for when observing a team in action: #1: The most successful teams share a common bond, strong foundation, a clear purpose that brings them together. You can see it, feel it and know it almost instantly. Rather than having an office staff, these practices have a palpable team spirit. #2: You can also tell right away when a practice is lacking the team spirit gene. They're not missing the skill, talent and dedication - they are missing the X-factor. These practices are also not producing the great results or having as much fun as those working as a cohesive team.

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#3: The doctors who lead great teams have discovered that people work for money, but they excel for recognition and appreciation. These doctors also know that most people want to be part of something bigger than them; they want to make a difference. This is the X-factor!

Interestingly enough, the practices that have the most loyal and tenured team members are often the ones that have run into a series of speed bumps that hold them back. They very often describe themselves as being ‘like a family.’ It’s precisely because they care so much about each other that they hold back and don’t talk about the upset or the proverbial “elephant in the room.” They choose to focus on their own path and avoid confronting the bigger issues for fear of hurting someone’s feelings. This creates a sense of artificial harmony that will definitely hold you back.

Have you heard statements like this from your team?

• "It seems like all we do is talk about changing things...but we never follow through" • "We keep revisiting problems; why can't we solve our problems once and for all?"

• "We have the best of intentions, but who has the time and energy to stay focused?"

• "We should just stop having meetings since nothing we talk about ever gets done."

These roadblocks will affect morale and profitability. Helping your team to lean into these issues and have clear, productive conversations, the tough conversations about the real issues, challenges and decisions that need to be made is the answer. Most doctors will tell me this is not a conversation they are comfortable stepping into. Yet, as the leader of your team, it’s critical that you create an opportunity for growth and learning. Clearly, if the team is not on the same page, this will spill over into patient communications.

In my program at the 2015 Rocky Mountain Dental Convention, I will be presenting “Simple Changes – Big Rewards: 7 Steps to Breakthrough Communication Success.” We will be rolling up our sleeves to enhance our communication skills to positively impact the patients, the team and YES, the bottom-line.

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2015 RMDC EDITION

Our course objectives include: • Defuse potential drama and focus on results – it’s easier than you think • Get much better at delegation so your expectations are understood and met • Coach personal and team accountability turning excuses into results

She is a Faculty Presenter for the ADA/Notre Dame University Executive Certificate Program & her podcasts on HR Best Practices are available on the Academy of General Dentistry website. While Ginny is grateful to work with clients in over 40 states, Canada, and the UK, she and her family are loyal Phillies, Eagles and Flyers fans and call the Philadelphia area home. Ginny is pleased to address your questions at Ginny@ GinnyHegarty.com

• Increase team member engagement and morale so meetings are upbeat and productive • Create a practice culture that attracts and retains the very best people • Improve communication with each other and patients in 7 simple, yet powerful steps • Enhance verbal skills to improve new patient enrollment, case acceptance and minimize cancellations With all the changes we are seeing in dentistry, there are some principles that stand strong and constant, focus is definitely one of them. Please join me; let’s come together and “adapt to the prevailing level of light to be able to see more clearly." 1 1

Oxford Dictionary definition of focus

About the Author Ginny Hegarty, SPHR (Senior Professional in Human Resources) is the Founder and President of Dental Practice Development, Inc. which has provided practice and team development services to dentistry since 1997.

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2015 RMDC EDITION

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Metro Denver Dental Society & Dr. Barry Glassman Present:

INTRODUCTION TO DENTAL SLEEP MEDICINE Friday, February 13 - Saturday, February 14, 2015

Register today at mddsdentist.com or call (303) 488-9700

Barry Glassman, DMD, maintains a private practice in Allentown, PA, which is limited to chronic pain management, head and facial pain, temporomandibular joint dysfunction and dental sleep medicine. He is on staff at the Lehigh Valley Hospital where he serves as a resident instructor of Craniomandibular Dysfunctions and Sleep Disorders.

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2015 RMDC EDITION

2015 RMDC

THE CHALLENGES AND SUCCESSES OF PEDIATRIC ROOT FRACTURES

By Keaton Howe, DDS, MS

I

n an ever-changing world of increased activity, higher intensity sports, and insufficient dental protection, dentists are seeing more oral-related traumas than ever. Because of the variety of potential outcomes, the most difficult of these traumas to treat is the root fracture of a tooth. In addition, the most difficult patient to treat is the traumatized pediatric patient. At the Rocky Mountain Dental Convention this January, pediatric dentist, Dr. Keaton Howe, and endodontist, Dr. Mark Wood, will shed light on how pediatric patients are retaining fractured teeth longer and what new cutting-edge methods have been developed and implemented by private dental clinicians.

The triage of the pediatric patient is the first key to success for long term prognosis of a fractured tooth root. This first challenge in triaging a fractured root is determining it's existence in the absence of other oral destruction. Often occurring after regular clinic hours during a sporting event or after school activity, a root fracture can go unnoticed without concurrent enamel or dentinal fractures. In pediatric patients, the first symptoms of a fractured tooth may actually occur the following day or week when pain intensifies and interferes with normal eating and functioning. Another challenge to diagnosing a fractured root is accurate imaging. Because a single radiograph may not coincide with the angle of the fracture, two or more periapical X-rays may need to be taken to diagnose a root fracture. To diagnose a root fracture in a timely manner and also achieve multiple quality periapical X-rays with slight changes in angulations can be a challenge for most pediatric patients as well as staff.

Once triaged, the fracture must be accurately diagnosed in either the coronal-third, mid-root or apical-third of the tooth root. The

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treatment of the tooth is dependant upon the location of the root fracture. Coronal-third root fractures tend to cause more mobility and discomfort to functioning and may be salvaged with extrusion of the tooth. The mid-root fracture carries the worst prognosis of all. In the past, attempts to save these teeth have been regarded futile. Mid-root and apical-third tooth root fractures may cause less initial symptoms, but can be challenging to treat once infection or root resorption occurs.

To add to the ambiguity of protocols, the treatment of a fractured tooth is not only dependant on location of the fracture but also whether the fracture is vertical or horizontal, the number of fractures, whether the fractured pieces approximate, and whether it is a primary or permanent tooth. If the fracture is diagnosed on a permanent tooth, it is becoming more and more important to establish the natural healing potential prior to treatment. Recent research has proposed new ideas and methods to stabilize such teeth and harness natural healing if the tooth has an open apex. Pushing the boundaries of existing clinical studies, Dr. Howe and Wood will discuss original clinical cases that maximize tooth and nerve regeneration while minimizing early root and nerve desecration. Join these two clinicians as they explore the challenges and pitfalls of treating one of the most challenging traumas in dentistry: the pediatric root fracture.

About the Author Dr. Keaton Howe received his dental degree and pediatric specialist certificate from the University of Illinois at Chicago. During his residency, he achieved a Master of Science for researching The Effects of Dental Traumatic Experiences upon Dental Attendance. He is currently a managing member and full time clinician of a pediatric dental specialty practice in Westminster and Louisville, Colorado.

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Metro Denver Dental Societyâ&#x20AC;&#x2122;s Awards Gala and Presidentâ&#x20AC;&#x2122;s Dinner

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Ellie Caulkins Opera House Lobby Thursday, January 22, 2015 6:30pm â&#x20AC;&#x201C; 10:00pm

oin MDDS President, Dr. Larry Weddle, at this premier RMDC social event. Attendees will be dressed to impress for live music, reception, dinner and society awards ceremony.

Enjoy this unique and fun event for only $72/pp.

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Benco Dental, Cornerstone Dental Solutions, American Orthodontics, BVB General Contactors, Cain, Watters & Associates, Carr Healthcare Realty, Fortune Management, Joe Architect, Summit Accounting Solutions, Topline Management, UMB Bank

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2015 RMDC SPEAKER INTEGRATING SENSIBLE ORTHODONTIC THINKING INTO THE PEDIATRIC DENTAL PRACTICE

By Henry W. Fields, Professor, DDS, MS, MSD

T

he lectures provided for the 2015 Rocky Mountain Dental Convention (RMDC) in Denver, Colorado for the Pediatric Dentistry Group in January 2015 have a focus of practical orthodontically related topics for the pediatric dental practitioner. The point is not to convert pediatric dentists into orthodontists, but to discuss treatment options that they may find applicable to their practices or options that they may want to propose to their collaborators in patient care.

First, a lecture will cover basic growth and development issues that affect the practitioner’s decision making. This will set the stage for some of the problems we will discuss during the day. These are basic facts that determine how problems are address and solved, like how to approach palatal expansion, when to manage space, how to design space maintainers, or when to consider beginning early skeletal treatment.

The next lecture deals with mixed dentition treatment worth doing.

The top eight problems that usually arise for this age group and the way forward will be described. These problems include anterior crossbites, both dentoalveolar and Class III skeletal. These problems usually deserve early, basic intervention, but become more complex when skeletal components are involved. Although some seem to advocate a facemask for every Class III patient, we will look at the facts about what can reasonably be achieved for the patient’s benefit.

Posterior crossbites have many approaches, but most have similar outcomes no matter the approach if addressed based on patient maturity. Extraoral habits still can benefit from intervention, but treatment should be on the practitioner’s terms and lead to success.

Mixed dentition space issues including excess spacing, space maintenance, space management, space regaining and management of ectopic molar eruption may require intervention and should be addressed with simple and effective treatment. The indications for these types of treatment can be reasonably defined and then the treatment is straight forward. Arch expansion, extractions and serial extractions are more complex, but again, key diagnostic facts should help point the way.

Excess overjet and Class II skeletal problems are a common bookend to the Class III problems and should have a good justification for early treatment. Certainly, there are compelling cases to justify this treatment approach in selected cases. Those will be explored.

A difficult and often overlooked problem is ankylosed primary teeth

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without permanent successors. This is a niche issue, but one that needs careful monitoring and intervention so long term harm is avoided.

Another lecture will be provided on missing teeth, supernumerary teeth and ectopic canine eruption that causes resorption. These are age old problems that now have multiple solutions that should be explored. Knowing how to sort through the diagnostic problem and the imaging choices along with sensible mechanics to solve them is important.

Because we are discussing some skeletally related growth topics, there will be a portion of the presentation aimed at using the cervical vertebra as a guide to treatment timing. This is a method that has been around for a long time. It became popular in the last couple of decades and then fell into disuse due to its detractors who claimed it was totally unreliable and clinically useless. It appears there is now good science to show its usefulness and clinical utility. It is also “free” data from a routine image that is often available.

The final segment of the lecture series will deal with traumatic injuries to permanent teeth and the place for orthodontic treatment as an adjunct to the injured teeth. This lecture will face questions of epidemiology, prevention and timing and types of treatment.

The issues that accompany different types of injuries as well as those presenting prior to and during orthodontic treatment will be addressed. This is a complex topic and it is well known that treatment options and approaches continue to change as more information is collected.

The information for the lectures is based on Contemporary Orthodontics, 5 ed. by Proffit, WR, Fields HW and Sarver D. and the author’s research and clinical experience. During the lecture, opinion will be separated from more factual information.

About the Author Dr. Henry W. Fields is professor of orthodontics and served as dean of The Ohio State University College of Dentistry from 1991 through 2001.

He currently teaches undergraduate and graduate students in pediatric dentistry and orthodontics and maintains an intramural practice.

Additionally, Dr. Fields assumed the position of Division Chair of Orthodontics on November 1, 2006. A native of Tipton, Iowa, Dr. Fields received his BA from Dartmouth in 1969, his DDS and MS in pediatric dentistry in 1973 and 1975 respectively, and his MSD in orthodontics from the University of Washington in 1977. He was engaged in teaching, research, patient care and administration at the University of North Carolina from 1977 until 1991.

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BOOTH # 610

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Springs, and Fort Collins. Additional opportunities available in mountain towns throughout the state. We also have opportunities in New Mexico, Utah, Idaho, Wyoming and Hawaii. For a summary of each current practice opportunity, go to www.ctc-associates.com or call Larry Chatterley and Susannah Hazelrigg at (303)795-8800.

ADS Precise practices for sale: Colorado & Wyoming including Denver, Boulder, Cheyenne, Cody, Casper, Westminster, Arvada, Englewood, Aurora, Lakewood, Littleton, Parker, Greenwood Village, Ft. Collins, Colorado Springs & South, Mountains and Western Slope. For detailed information on practices for sale visit www.adsprecise.com or call Jed Esposito MBA, CVA or Peter Mirabito DDS, FAGD at 888-886-6790.

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Announcements & Services Transition Services with CTC Associates: For more information on how to sell your practice or bring in an associate, or for information on buying a practice or associating before a buyin or buy-out please contact Larry Chatterley and Susannah Hazelrigg at (303)795-8800 or visit our website for practice transition information and current practice opportunities www.ctc-associates.com.

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