Articulator Volume 20 Issue 1

ARTICULATOR MDDS

Connections for Metro Denver’s Dental Profession

Fall 2015 Volume 20, Issue 1

Giving a Child a Chance at Life 6 Important Upcoming ADA Elections 7 MDDF - What's it's All About 8 Smile Again - In My Own Words 13 50 Shades of Gray - How to Get Shades Right the First Time 20 The Unfunded Buy - Sell Agreement: A Ticking Time Bomb 24

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ARTICULATOR MDDS

Connections for Metro Denver’s Dental Profession

Volume 20, Issue 1

MDDS Articulator Editor Brandon Hall, DDS Associate Editor Jeremy Kott, DDS

Creative Manager & Managing Editor CT Nelson Director of Marketing & Communications (outgoing) Jason Mauterer, CDE Director of Marketing & Communications (incoming) Cara Stan MDDS Executive Committee President Ian Paisley, DDS President-Elect Sheldon Newman, DDS Treasurer Nicholas Chiovitti, DDS Secretary Brian Gurinsky, DDS

mddsdentist.com

Fall 2015

Inside This Issue:

President's Letter .............................4

Calling All Foodies & Philanthropists! ..14

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

Presidents' Perspectives ..................16

Giving a Child a Chance at Life ........6

50 Shades of Gray - How to Get Shades

Important Upcoming ADA Elections .....7 MDDF - What it's All About.........................8

Right the First Time ................................ 20 The Unfunded Buy - Sell Agreement: A Ticking Time Bomb .................... 24

Pathology Puzzler ............................ 12

Event Calendar ...................................... 26

Smile Again - In My Own Words ....... 13

Classifieds.............................................31

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. 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 ©2015 Metropolitan Denver Dental Society

Member Publication

Get To Know Your MDDS Staff

Cara Stan, Director of Marketing & Communications This issue we would like to welcome Cara Stan to the MDDS staff. Cara joined the MDDS in July 2015 and will be filling the Director of Marketing & Communications role with the departure of Jason Mauterer this August. Cara has called Colorado home for the past three years, but grew up in South Florida.

Cara received her Bachelor of Science degree in Advertising and Public Relations from the University of Central Florida. She has spent her entire career working in the association industry. Most recently, Cara joins us from the National Board of Surgical Technology & Surgical Assisting (NBSTSA), where she led national marketing campaigns and planned organizational events. Additionally, Cara has previous experience in the dental industry having worked with the Florida Academy of Cosmetic Dentistry (FACD) and several dental laboratory groups including the National Association of Dental Laboratories (NADL).

Cara and her husband, Paul, spend their weekends enjoying Colorado's many activities including hiking with their dog, Bella, visiting breweries, enjoying live music and dining out. She is a college football fan and bleeds garnet and gold for the Florida State Seminoles.

As Director of Marketing & Communications, Cara is responsible for all marketing efforts for MDDS including the RMDC, MWDI, MDDF, advertising sales for the Articulator and much more. She is thrilled to join the MDDS team and can be reached at (303) 488-9700 ext. 3270 or marcom@mddsdentist.com.

On Life, MDDS and Everything Beyond

by Jason Mauterer, CDE

The year was 20...10... Obamacare was a hot topic. The oil companies were fighting to prove their relevancy in a growing landscape of cleaner fuel options. It was the Twenty-first Century! Ok, so not a whole lot has changed in the world in the last five years, but I'm definitely proud of everything MDDS has accomplished since I came aboard in October of 2010.

My training could definitely have been considered a trial by fire approach when I stepped into that office that had been empty for the better part of the year. The first RMDC we did entirely as a team was a hit and they've continued to get better every year. The Articulator that you are reading now is a product of the changes we made, I hope you like it. Awards have been won. We created this little thing called the Mountain West Dental Institute (MWDI). More awards.

I even found the love of my life here. The list goes on; I'm proud of every bit of it.

And now, as it has done many times in my life, the road in front of me forks again, and I'm heading in a new direction (well, sort of). I'm actually just getting back on the path I started on with such enthusiasm a lifetime or two ago. All of my stars seem to be aligning and what was once a very hard decision to make now appears to be an obvious choice. So I'm on board, again, with enthusiasm. In the immortal words of the galactic hitchhiker himself: "I may not have gone where I intended to go, but I think I have ended up where I needed to be." ~Douglas Adams This isn't really goodbye. That love of my life that I referred to happens to be a member of MDDS. I'll still be around as a +1.

Thank you for letting me be a part of the team — it was truly a pleasure. I'll see you guys at some upcoming event!

PRESIDENT'S LETTER

WORK WORTH DOING

By Ian Paisley, DDS

T

heodore Roosevelt remarked, “Far and away the best prize that life has to offer is the chance to work hard at work worth doing.” As I enter my last year as an officer of our Society and become President, I find myself grateful for the opportunity to have served our members working hard at work that was certainly worth doing, but the job is not finished yet.

the fundraising campaign for the Mountain West Dental Institute (MWDI) has concluded, I encourage members to make a yearly contribution to MDDF. The easiest time to do this is when renewing your membership. In fact, there is a space on the on the renewal application where you can indicate your desired contribution to MDDF. Wouldn’t it be great if every MDDS member could make a $20 contribution? It would go a long way in maintaining the success of our Foundation.

It was about two years ago that a leader in the dental community asked me what my “plans” would be as President of MDDS. I really could not give him an answer. Reflecting on the question later, I realized that I don’t have MY plan for MDDS. Instead, I aim to do my part to execute the goals created by our Strategic Planning Committee, goals that have been designed to provide the maximum value for our membership.

In our mission statement, MDDS strives to provide our members with excellent continuing education opportunities, including a premier annual dental convention. We also seek to promote the highest ethical practice of dentistry. These are both values that I hold dear in my heart and plan to pursue vigorously during my term as President.

I am very proud to be part of the group of leaders who made the creation of the MWDI a reality. It was the direct result of strategic planning goals stemming from multiple MDDS member surveys. It provides our members with countless educational opportunities for years to come and this strikes right at the heart of our mission.

I am a 2003 graduate of the Arthur Dugoni University of the Pacific School of Dentistry. I will be the youngest member to ever serve as President, and have spent my entire dental career engaged in organized dentistry leadership. During dental school, I served locally and as a national consultant for the ASDA. After completing a GPR at the Denver VAMC, I opened a private practice with a business partner and it was not long before I was volunteering on MDDS committees. In 2005, I was appointed to serve on the ADA New Dentist Committee and represented the seven states of the 14th District until 2009. After serving on the MDDS Board of Directors and chairing the 2012 RMDC, I was elected to serve as Secretary of the Society. Organized dentistry is something I am very passionate about and it will be an honor to serve as your President this year.

This is an exciting year because it happens to be the 10th anniversary of the Metro Denver Dental Foundation. The MDDF is our own dental charity organization and has been electrified by the dedicated work of its current President, Dr. Nelle Barr. Now that

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I also hope to lead a society that embraces community among the membership. Some of my favorite memories as a dentist come from MDDS events, sharing great times with my colleagues. While serving as Chairman of the 2012 RMDC, we implemented a revamped Friday Night Party and created the Friday Night After Party. This year I look forward to quarterly member events throughout the metro area, an amazing President’s Banquet at the RMDC, a family fun event next May along with other events throughout the year. As your President, I ask all members to keep an eye on their email, visit mddsdentist. com often and "like" MDDS on Facebook to see what events MDDS has in store. Make an effort to come out and interact with your dental colleagues this year. We are going to have some fun, I can assure you of that!

Articulator

Fall 2015

MEMBER MATTERS MDDS Annual Spring Family Fun Event (5-30-15)

New Members, Welcome!

Dr. Ashley D. Barefoot Dr. David R. Bundy Dr. Taher Q. Dhoon Dr. Parminder K. Dulay Dr. Casey Klein Dr. Kimberly K. Miyamoto Dr. Stephen M. Schacht Dr. Chong Shao Dr. Daniel S. Valiceric Dr. David K. Wetherington

Attendees enjoyed face painting, magic and games at Lowry Beer Garden

Future MDDS member, Michael Paisley

Good food and good friends

Sun and smiles!

Drs. Makala Hubbell and Brian Gurisnky

Dr. Larry Weddle and event sponsors, Paul Jerez and Robin Wandschneider, with Commerce Bank

Dr. Ian Paisley, MDDS President, and his father, Dr. Jim Paisley

Balloon fun and games!

CDA Annual Session - 6-13-15

2015 CDA House of Delegates

mddsdentist.com

Dr. Nick Chiovitti received the CDA Colorado Mission of Mercy Award from CDA President, Dr. Brett Kessler

Dr. Kessler presented the Exceptional Trustee Award to Dr. Michael Scheidt

Articulator

Fall 2015

5

REFLECTIONS

GIVING A CHILD A CHANCE AT LIFE

By Brandon Hall, DDS, Editor

I

remember the first day Judson became part of our family and my brother for almost two years. He was five years old and weighed barely 25 pounds. He was emaciated, malnourished and had a look of devastation on his face. Then there was his arm, he held it in protection almost as if he was scared someone was going to hurt him again.

adopted by a family in Tennessee.

We didn’t have much contact with him after he left; perhaps we knew our duty was finished and we needed to move on. That, and having multiple families in his life, perhaps would have been overwhelming.

I hadn’t really seen him in a while, but a search on Facebook turned up a picture of him with a beaming, white smile. He must have a fantastic dentist!

When I was a junior in high school, my family decided to take part in Healing the Children (healingthechildren.org), an organization that provides critical medical care to children all over the world. The children cared for often are very near death or have debilitating diseases that can impair them for life.

Judson was part of a seven-sibling family outside of Port Au Prince, Haiti. They lived in a home smaller than most people’s garages. His mother and father couldn’t provide for him.

There is no running water or electricity in that part of the world. He was dying and needed help fast. Somehow when he was younger, he had sustained a third degree burn of his left arm and elbow. We think it may have been a voodoo medical practice because his sister had a very similar burn. His burn wasn’t healing and it was preventing him from growing and becoming a healthy weight.

The first night he was in our house, he spoke a very soft rendition of French. We had no idea what he ate, only to discover that he liked peanut butter and eggs soon thereafter. Both are very caloric food items, so we went with it. Our first job was to get him nourished and gaining weight.

Over the next year, the medical community in Dubuque, Iowa came together and helped Judson. This was not an easy task considering my hometown was 99% white and Judson was black. Not only that, but Dubuque had a history of racial tensions in the 80's and 90's. So it was certainly an undertaking in the face of adversity. I would hear students at my high school say racial things under their breath about how they didn’t agree with what we were doing. That only cemented our resolve to help.

My father, a physician, and my mother, a nurse, helped spearhead a team that discovered what was causing the infection. He saw infectious disease doctors, endocrinologists, plastic surgeons and pediatric physicians. There were tons of biopsies and painful skin grafts that didn’t take. He underwent daily bandaging of his arm and cleansing of the wound. It was a round-the-clock ordeal. Weekly whirlpool baths were routine to allow the wound to be cleansed of any dying tissue.

It was one of these whirlpool bath sessions that perhaps changed my life forever and the direction I chose for my profession. For anyone not familiar with burn treatments, whirlpool therapy is one of the cornerstones of healing. It allows debridement of a wound, ridding toxins and allowing proper circulation to initiate closure of wounds that are extensive or unable to heal on their own. Typically, the water temperature hovers around 100 degrees and there’s agitation of the water for mechanical debridement. As you can imagine, it is not your post-ski soak in a hot tub with beers. Yeah, it’s painful. As a result, Judson would cry and wail things in French that we didn’t understand. Until we brought in a French interpretor.

The interpreter asked us, “Do you really want to know what he’s saying?” Cautiously, we said “Yes.” Judson was screaming, “Please God, let me die. It hurts so much. Please, please, I just want to die.” Everyone was shocked. It was silent. At that moment, I cried. Even though I was only 17, I truly grasped the gravity of the situation and what it meant to Judson to save his life.

I think deep down, I made an internal decision that no matter what career path I chose, it was going to be one of medical or dental service.

Fast forward almost 15 years, Judson is now a healthy college-aged man doing what he loves: playing and refereeing soccer. After his time with our family, we made the heart wrenching decision to let him go. He was originally set to return back home to Haiti, and did, but only briefly. His parents didn’t have the capacity to care for him. Therefore, he was permanently

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As we come upon MDDF’s 10 year anniversary, I thought I would share My mother, Jane, with Judson this story with you because it comes soon after we got him. full circle. While helping Judson was a massive and emotional undertaking, I encourage all of you to find someone to help; perhaps start on a smaller level. That might be a patient in your office who you decide to do pro bono work on. Or maybe it’s volunteering at COMOM, Freedom Day, Smile Again/MDDF or Give Kids a Smile (GKAS). Whatever it is, it can have an everlasting effect on that person’s life path. And, it just makes your heart feel really good.

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Articulator

Fall 2015

IMPORTANT UPCOMING ADA ELECTIONS

By Kevin Sessa, DDS

E

very year, the ADA House of Delegates elects a person to become

and bring clout to the ADA from our states. With issues such as Medicaid, non-covered

the ADA President-Elect. This person then serves as President

services and mid-level providers at our doorstep, it would be extremely beneficial to have

the following year for a one year term. This year is particularly

district representative voiving our concerns at the national level.

important for our society and state because we have a candidate

So who gets to vote? Well, it’s the ADA House of Delegates.

from the 14th District (includes

Our district is the third most populous district of the 17,

Colorado) that is running for this

allowing us to have 32 of the 435 representing delegates.

position: Dr. Gary Yonemoto, an

Colorado has 10 of the 32. These delegates vote on the elected

endodontist from Hawaii.

positions such as the aforementioned President-Elect.

The body that manages the ADA is the Board of Trustees.

If any of you are an ADA delegate, we ask that you vote

They are comprised of 17 districts. The State of Colorado

for Dr. Yonemoto when you are in Washington, D.C. this

is within the 14th District (which also includes Arizona,

November. If you are not a delegate but happen to know one,

Utah, Wyoming, Nevada, New Mexico and Hawaii.

please make them aware of our candidate.

The Trustees conduct all business of the ADA as well as

Running for this position is not a light endeavor

serving on part of all 11 councils, which can be found here

and the state of Colorado has helped contribute a

at

lot of resources to help him succeed. Let’s do that!

ada.org/en/member-center/leadership-governance/.

Among the councils are the Council of Government

Dr. Gary Yonemoto

About the Author

Affairs and Council of Dental Practice. Obviously, these councils are very crucial to us as dentists and to our future.

Kevin Sessa is a past president of the Boulder/ Broomfield County Dental Society and CDA and a past member and chair of the ADA Council on Dental Practice. Dr. Sessa is also a past member

The last time a trustee from the 14th District ran and won was in 1986. Since then, a 14th

of the ADA Council on Annual Sessions and an ADA Delegate or Alt. Delegate for 23 years

District trustee has lost three close elections, so it’s important this year that we elect Dr.

representing the 14th District.

Yonemoto to ADA President-Elect. He would then serve as President in the year 2016-17.

Having a president from our district would elevate our political standing as the 14th District

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NON PROFIT NEWS

WHAT IT'S ALL ABOUT?

By Amy Boymel, MDDF Executive Director

W

hat a privilege it is to work with dedicated, generous, compassionate volunteers who bring hope, confidence and new opportunities to those who have suffered abuse at the hands of others. What a joy it is to be part of an organization that truly makes a difference, rebuilding lives one smile at a time. It is my honor to serve as the first Executive Director of the Metro Denver Dental Foundation (MDDF).

Since its inception as a 501(c)(3) organization in the Summer of 2005, MDDF has endeavored to fulfill its mission and remains, "...dedicated to influencing positive health outcomes through quality patient care and education." Over the years, MDDF has offered programs, services and events in our community including the Smile Again ProgramTM, Explorer Post 296, Education Station, the Shred Event and our newest event, Feed the Foundation. The Smile Again ProgramTM sparked the creation of the Foundation by the Metro Denver Dental Society and remains MDDF’s hallmark effort. Almost 400 survivors of domestic abuse have been helped by more than 150 MDDS member dentists.

Their words can tell you, far better than mine ever could, how MDDF has changed their lives.

“Before I became part of the Smile Again Program, my teeth were all broken and decayed from years

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of abuse and neglect to my own personal care. As I began to grow in my recovery, I was fixing the inside, but became more self-conscious about my outside appearance. It was only when Dr. J took on my case and literally gave me back my smile that I could go out and look for job. My front teeth have been built back into a real smile and I no longer feel bad about my appearance. With every dental visit I was made to feel respected, appreciated and like my comfort mattered. I have confidence in myself again today and I am grateful to the Smile Again Program for being a part of that and giving me the confidence to pursue a reconstructed life style.

This is an awesome program that gives women the opportunity to grow physically and mentally. ” – Teresa

Articulator

Fall 2015

“…Such kind people, treating me so nicely, with such

problem, no confidence and it was very embarrassing

care. I feel so fortunate and grateful that words could not

to smile or talk. I went through the Smile Again

possibly explain. Please use any portion of this letter as a

Program, and thanks to Dr. A, I have a new smile.

testament to the great work that is accomplished through

I can’t stop using it! It has taken the years from my

this program. Thank you so very much. So very, very

face that having no teeth had left me with. Today,

much. I can smile again. This has changed my life.”

I feel great! I have confidence in myself and I know

– Kathy

that I look great, too! I can eat anything. The impact “I have been living with pain for over 12 years. I had lost my smile and self-esteem. People would not look me in the eye when they talked to me, and when I looked

for work, I was judged instantly. And now, going through your program, I have my smile back. At age 53, I am told I look 10 years younger and my self-esteem is coming back. My Smile Again dentist is the best dentist ever! I am attending school and learning about computers and will soon be job hunting with a smile on my face. Thank you

of the program in my life is phenomenal. I look in the mirror and I like myself again. I feel alive and have a newfound sense of freedom in my life, as my health and appearance are no longer a setback. You have made my life wonderful! This program can really change the lives of a lot of people for the better. I have never smiled this much and don’t plan to stop!”

– Megan That is what it’s all about.

About the Author Amy joined MDDF in May 2010. She has worked in the non-profit sector for more than 25 years and, since coming to Denver in 1988, has served as a development officer for Jewish Colorado (formerly the Allied Jewish Federation of Colorado), the Anti-Defamation League, Colorado Public Radio and Mental Health America of Colorado. Amy has also consulted with numerous non-profit organizations in the metro area and is an active community volunteer. She has extensive experience with non-profit management, resource development and board relations.

for my new teeth.”

– Sandra

OCTOBER 2015 = EMV LIABILITY SHIFT

“This program has brightened up my world. I smile more and my daughter comments on how much more confident I am. I feel fabulous absorbing all the compliments I’ve been getting.”

– LaVerta “I did not have any teeth due to years of domestic violence and self-neglect. I had a very bad self-esteem

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Articulator

Fall 2015

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Thank You to everyone who has volunteered their time in support of MDDF Programs, services and events including The Smile Again ProgramTM, Explorer Post, The Education Station, The Shred Event, Feed the Foundation and all of our activities at RMDC. They simply wouldn’t be possible without the many volunteers who generously donate their time.

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Dr. James Abramowitz

Dr. Yuki Dykes

Dr. Malgorzata Korosciel

Dr. Gary M. Radz

Dr. Morton O. Sperling

Dr. Jack L. Wasinger

Dr. Eric Adler

Dr. Daniel Esposito

Dr. Jeremy Kott

Dr. Thomas B. Redd

Dr. Christopher Sprout

Dr. Adam F. Weaver

Dr. Annette M. Alford

Dr. Angela S. Evanson

Dr. Beth F. Kreider

Mr. Jason Reiss

Dr. Heather L. Stamm

Dr. Dawn Wehking

Dr. Jack M. Allen

Ms. Lori Everett

Dr. Jodi Lampert

Dr. Ryan Reyes

Dr. H. S. Stewart

Dr. E. Marc Weideman

Dr. Rodney L. Allen

Dr. Karen D. Foster

Dr. Michael J. Larson

Dr. Jamie D. Ring

Dr. David Sugiyama

Dr. Jonathan R. Weinbach

Dr. William Ames

Dr. Troy A. Fox

Dr. Julie A. Lesnick

Dr. Karla C. Ring

Ms. Sue Swanson

Dr. Sara Weinstein

Dr. Roger V. Anderson

Dr. Mitchell Friedman

Dr. James R. Lessig

Dr. Maureen Roach

Dr. Robert I. Teitelbaum

Dr. Sarah J. Werner

Dr. Ken Andow

Dr. Stephen M. Friedman

Ms. Andrea Levine

Dr. Paul A. Rocke

Ms. Christine Thomas

Ms. Brandy Whalen

Dr. M. Steven Anundsen

Dr. Brian A. Furgason

Dr. Mark E. Levine

Dr. James Rodgers

Dr. Marc Thomas

Dr. Sean R. Whalen

Dr. Steven B. Aragon

Dr. Nicole Furuta

Dr. Kenneth E. LeVos

Dr. Sharon S. Russell

Dr. Steven A. Tilliss

Dr. Daniel J. Wherley

Dr. Jack C. Armstrong

Dr. Jennifer Garza

Dr. Jeffrey T. Lodl

Dr. Ellen Sachs

Dr. Lori M. Trembath

Dr. Dawn M. White

Dr. Robin M. Asbury

Dr. George Gatseos

Dr. Scott Maloney

Dr. Pasco W. Scarpella

Dr. Kurt Tsumura

Dr. Jon L. Whiteley

Dr. Justin Baltz

Dr. Jayme Glamm

Dr. Shawn P. Maloy

Dr. Frank P. Scavuzzo

Dr. Michael Unser

Dr. Scott I. Whitney

Dr. Elizabeth S. Barr

Dr. Andrew Glassick

Dr. Carrie Mauterer

Dr. Michael J. Scheidt

Dr. Mark A. Uremovich

Dr. Cassy B. Wiggins

Dr. Nelle V. Barr

Mr. Chris Goodale

Dr. Bruce C. Mc Arthur

Dr. Landis C. Scholes

Dr. Milan Uremovich

Dr. R. Jeffrey Wilkin

Dr. Edward J. Barrett

Dr. Alan C. Goral

Dr. Kevin F. McAuliffe

Dr. Amy Schulte

Dr. Eric W. Van Zytveld

Dr. Joseph K. Will

Dr. Hilary M. Baskin

Dr. Leana Grace

Dr. Eileen A. McGinty

Ms. Carol Scott

Dr. Jason VanWagenen

Dr. Matthew Wimmer

Dr. Steven Baumgart

Dr. Peri M. Greenstein

Dr. Deborah Michael

Dr. Kent Sellers

Dr. Michael R. Varley

Dr. Stephen M.Winber

Dr. Amy Becker

Dr. Mark D. Gregston

Dr. Michael J. Miller

Dr. Purvi Shah

Dr. Catherine Vieregger

Dr. Jesse Witkoff

Dr. Helena Becker

Mr. Tad Griffith

Dr. Ben Mollner

Dr. Jonathan D. Sierk

Dr. Gilbert E. Vigil

Dr. Robert Wurtzebach

Dr. Darren Bennett

Dr. Gregory B. Grossman

Dr. James B. Moses

Dr. David M. Singer

Dr. Walt Vogl

Dr. Marianne M. Yancey

Dr. Lisa Bennett

Dr. Brian S. Gurinsky

Dr. Barbara A. Moyer

Dr. Bradley R. Smith

Dr. Paul Wagenaar

Dr. Jeffrey O. Young

Dr. Mark D. Berman

Dr. Julie Haberstroh

Dr. Rick Murdoch

Dr. Douglas W. Smith

Dr. Stefanie Walker

Dr. Lynelle J.Zabel

Dr. Kary L. Berry

Dr. Brandon Hall

Dr. Ivan S. Naiman

Dr. Scott D. Smith

Ms. Robin Wandschneider

Dr. Edward J. Bertagnolli

Dr. David R. Hartman

Dr. Timothy P. Nary

Dr. Ann Somers

Dr. John G. Warner

Dr. Jennifer Berwick

Dr. Richard Harvey

Dr. Steven R. Nelson

Dr. Jennifer Berwick

Ms. Wendy Heckman

Dr. Sheldon Newman

Dr. Gregory R. Bevans

Dr. Douglas A. Heller

Dr. Richard A. Newman

Dr. Voytek Bobak

Dr. Donald H. Hoch

Dr. Trang Ngo

Dr. Thomas A. Bonbright

Dr. Gary S. Hoffman

Dr. Leanne Nichols

Dr. Carl L. Boymel

Ms. Judy Holmes

Dr. Kurt Nielsen

Dr. Brian Brada

Dr. Gary M. Holt

Dr. James C. Nock

Dr. Terry Brewick

Dr. Scott H. Horsley

Dr. Haeman Noori

Dr. Cherie A. Brown

Dr. Wade Housewright

Dr. Jacqueline M. O'Beirne

Dr. Matthew Bunchman

Dr. Makala Hubbell

Dr. Shawn O'Berry

Ms. Ellie Burbee

Dr. Timothy S. Hubble

Ms. Shirley Okita

Dr. Victor H. Burdick, Jr.

Dr. Autumn Hurd

Dr. Kevin K O'Neill

Dr. James W. Burquest

Dr. Jeffery M. Hurst

Dr. Angela Osborn

Dr. Brian C. Butler

Dr. Anil Idiculla

Dr. Kendra Ousley

Dr. Kendal Carlson

Dr. Gregory K. Ingalls

Dr. Cameron Pangborn

Dr. Lisa Carlson-Marks

Dr. Jerolyn Ipson

Dr. Gary P. Pascoe

Dr. Perri L. Carnes

Mr. Paul Jerez

Dr. Sanjay Patel

Dr. Marc Carpenter

Dr. Harald Joesaar

Dr. Kevin M. Patterson

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PATHOLOGY PUZZLER

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A

61-year-old white male presented to his local dentist for lesions of his mouth, localized to the palate, of one day duration (Figures 1-3). The patient’s past medical history was uneventful and not related to his present oral condition. He is a 40 pack-per-year smoker and continues to smoke.

The lesions were painful, interfered with eating and sleeping and located only on the maxilla.

He had never had anything like this before.

Which of the following should be included in your differential diagnosis?

Figure 1

Figure 1

Aphthous ulceration Benign mucous membrane pemphigoid (BMMP) Contact stomatitis Erythema multiforme (EM) Lichen planus (LP) Primary herpes Squamous cell carcinoma Answers on pg. 29 Reprinted with permission from the Virginia Dental Journal Volume 91 Number 1

Figure 2

Figure 3

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IN MY OWN WORDS

NON PROFIT NEWS

By Shaina Gonser, Smile Again Patient

P

rior to coming to Smile Again, I was a lost soul. Growing up I considered my life normal. My parents were young when they had my brother and I, so we moved a lot during my childhood. In 1997, my family suffered a tragedy when my cousin was brutally murdered

at the age of 14. This tore my entire family apart. My mother, grandmother, aunts and uncles all turned to drugs and before I knew it, we lost our home.

My dad also began using drugs and my mom was in and out of prison. When I was 14, my dad became completely strung out. I moved back in with my mom, who had just been released from prison, and her new husband. My mom relapsed and her husband started physically abusing both of us.

I couldn’t take it anymore. I felt like I had nowhere to go so I moved in with my boyfriend and his mom when I was 15. I was emotionally and mentally abused for what seemed like forever. My family deteriorated and I had no belief in myself. I thought I would never amount to much.

My dad was hit by a train and killed when I was 17 and my mom was in prison, so I too began to abuse drugs. Abuse and misery were now normalcy.

Then I was saved. Two weeks after my 18th birthday, I found myself at The Haven and my life was changed.

Going to a behavior modification program was exactly what I needed, but I was still broken. My smile was a huge insecurity. I knew with my past and my scars, a smile would make a big difference; but I knew I'd never be able to afford dental work. The program coordinator at The Haven, Tracey, found Smile Again – she believed it could save me. I needed confidence and a chance

After my braces were removed I was still missing my front lateral. With so many years of dental work, I thought I was done and I’d never get my tooth.

I reached out to the director at Smile Again, Amy Boymel. Despite the many thousands of dollars of work and the many years I had been with the program, she connected me with more amazing doctors to help me. Dr. (Nick) Poulos and Dr. Furuta opened their doors to help complete my smile. They have all

to be looked at in a different light.

treated me like family and made my experience remarkable. These doctors

First impressions are everything! I owe a life of change to Smile Again. I truly

without expecting in return and that is what makes a difference in this world.

did for me what I could never have done for myself. All of my doctors gave

believe this.

I know it does, because it changed mine.

My first dentist, Dr. Anundsen, took me in with so much love and promised

I am now 26 and have a career as a health consultant. I am married, have a

to help me get braces - which he did! Dr. Allen was my orthodontist through Smile Again. He never lost hope. I endured over five years of orthodontic work, surgeries from Dr. Nelson and an experimental slow expansion (that

family and will soon be a homeowner. I changed my family pattern and the statistic my past said I would become. I know the opportunities I found began with my smile. I am a living testimony of overcoming domestic abuse, drug

worked). All of this was free to me!

addiction, institutions and death.

All of my doctors gave and gave without expecting anything in return. Every

Because of Smile Again I believe in myself and my smile will never show the

time, every visit, they showed me love, care and were grateful to me for doing everything as I needed to do. Their hope, work and belief in my smile helped me grow and admire myself. They showed me that people are AMAZING. Life didn’t have to be what I once thought it was. I also discovered that people believed in me.

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things I have fought to change. A smile is worth a thousand words and I was given the opportunity of a lifetime with Smile Again. I now live to smile!

Thank you to those who worked with me for years, for believing in me. Thank you to Amy, Smile Again and the doctors who loved and believed in me. My life and my dreams have come true and I owe it all to you!

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Fall 2015

13

NON PROFIT NEWS CALLING ALL FOODIES & PHILANTHROPISTS!

By Amy Boymel, MDDF Executive Director

I

n the fall of 2012, Feed the Foundation (FTF) was launched as a collaborative effort between MDDS’s Communications Committee (Chairman, Anil Idiculla, DMD; Editor, Carrie Mauterer (Seabury), DDS; Director of Marketing and Communications & Staff Photographer, Jason Mauterer; Creative Manager & Managing Editor, Chris Nelson; MDDS President D. Diane Fuller, DDS; Communications Committee members: Karen Franz, DDS; Kelly Freeman, DDS; Brandon Hall, DDS; Kyle Klepacki, DDS; Jeremy Kott, DDS; Maria Juliana DiPasquale, DMD; and Maureen Roach, DMD) and a small committee of the MDDF Board of Directors (Board President Pat Prendergast, DDS; Board Members Andrea Levine and Mike Poulos, DMD; and Executive Director: Amy Boymel). Nick Poulos, DDS, a member of the MDDS Communications Committee and the MDDF Board, served as the liaison between both groups and was its unofficial leader. The goal was to raise money for MDDF by providing great dining experiences for member dentists as well as their friends and families at some of Denver’s hottest restaurants. After partnering with several top spots over the course of a year, an annual event was created.

Feed the Foundation is now one of MDDF’s signature annual events each year. In March of 2014, almost 60 people gathered at Parallel 17 (now P-17) for the first annual FTF event. Guests enjoyed a five course meal with wine

pairings created by chef/owner Mary Nguyen. Elyse Warren, Director of Family Services at Warren Village, shared her thoughts on how MDDF benefits our community and truly changes the lives of those it helps, especially through The Smile Again ProgramTM, MDDF's hallmark program.

The evening was a success on all fronts. It raised both funds and awareness, and guests had so much fun that by the time the party was winding down it was clear a bigger venue would be needed next time.

This past April, in the midst of a Spring snowstorm, 113 hearty Coloradans ventured out to Chinook Tavern for FTF’s second annual event. What an amazing night! The evening marked the premier of MDDF’s first video, the story of how one young woman’s life was forever changed by her participation in The Smile Again ProgramTM participants enjoyed delicious appetizers followed by a three course gourmet meal prepared by Chef Markus assured that no one went home hungry. Though it was cold outside, the room was filled with warmth as colleagues and family members of Dr. Mike Poulos recognized him for his dedication to the Foundation with the MDDF Award of Excellence, proudly presented to him by his son, Dr. Nick Poulos.

Next Spring’s Feed the Foundation event will be the grand finale of MDDF’s 10th Anniversary Celebration year. Stay tuned to the MDDF website and Feed the Foundation's Facebook page for details and plan on joining us for what’s sure to be another evening of delicious food and great fun for all!

MDDF EVENTS — OVER THE YEARS

MDDF BOARD OF DIRECTORS

A beautiful Molars morning at The Ridge at Castle Pines North

Molars Golf Tournament founder, Dr. Scott Whitney, presents a check to Amy Boymel

MDDF at the Rocky Mountain Dental Convention

Volunteers hard at work at The Shred Event

14

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Front Row (L-R): Dr. Nicole Furuta, Vice President, Dr. Nelle Barr, President, Ms. Amy Boymel, Executive Director Back Row: (L-R): Dr. Edward Barrett, Dr. Kevin Patterson, Dr. Michael Poulos, Dr. Sheldon Newman, MDDS Board Liaison, Dr. Pat Prendergast, Dr. Nicholas Poulos Not pictured: Ms. Judy Holmes, Mr. Paul Jerez, Ms. Andrea Levine, Treasurer/Secretary, Ms. Brandy Whalen

MDDF and MDDS leadership enjoying making MDDW (Metro Denver Dental Wine) together

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NON PROFIT NEWS

S

Presidents’ Perspectives

even individuals have accepted the challenges and responsibilities of serving as the President of the Board of Directors of the Metro Denver Dental Foundation. Each one has helped shape MDDF into the organization it is today. We thank them for their commitment, their tireless efforts on behalf of MDDF, and the thoughts they share here about their experiences.

Michael Varley, DDS, 2005-2006 In 2005 I received the honor of being the 108th president of the Metropolitan Denver Dental Society (MDDS). At the time, the Colorado Dental Association (CDA) was acting as our fiscal agent or custodian of grants received from donors such as the Anschutz Family Foundation and the Rose Community Foundation. We were deeply appreciative of CDA’s contribution; however, it became clear that MDDS needed its own tax exempt entity.

In the fall of 2005, MDDS launched the Metropolitan Denver Dental Foundation (MDDF), a 501(c)(3) tax exempt entity. Its mission was to operate exclusively for educational and charitable purposes to enhance access to care for the promotion and advancement of dentistry through continuing education, scientific research and the dissemination of educational information to dental professionals and the general public.

In essence, the Foundation is dedicated to supporting goals that have been at the heart of MDDS’s mission since 1897 – to provide quality education and to enhance the standard of care for the public we serve.

The main focus at the time was the Domestic Violence Dental Care Program (DVDCP) now known as the Smile Again ProgramTM, which was originally established in 2002. This program’s focus was to address the dental health and cosmetic needs of domestic abuse survivors with cost-free dentistry to assist in their recovery. This award winning program has gained attention with funders and advocates for community health awareness since this time. For example; this program had received a national award from the American Society of Association Executives in 2004. In addition, in 2006 I received, on behalf of the Foundation, the CWEE Partner of the Year Award here in Denver.

The initial management of the Foundation was performed by the 2005-2006 MDDS Executive Board. While it was a manageable task at the time for me to serve as MDDS President and MDDF President in the incipient stages of MDDF, I felt that as the Foundation matured the management plan would need to evolve.

With approval of the MDDS Board of Directors, I set forth changes in the Bylaws that would name President-Elect, Dr. Terry Brewick, to the position of MDDF President while Dr. David Klekamp would continue as MDDS President. These changes and appointments were approved by the membership at the 2006 Annual Meeting. My thought (shared by my board) was a long term plan for MDDF. When funding allowed, MDDF would establish a separate Foundation board with a separate Executive Director. MDDF would then provide the organizational updates to the MDDS Board.

I continue to thank MDDS for the opportunity to have served in the above manner and in view of the MDDF 10 year anniversary, I offer you my most profound congratulations.

Terry Brewick, DDS, 2006-2007 It was very exciting to be involved with MDDF in its early years. We were trying to create something new that would, first and foremost, serve members of our community whose lives and smiles had been devastated by domestic violence. We also believed the Foundation would provide natural volunteer opportunities for MDDS member dentists, creating a unique bond between these two organizations. In addition, our relationships with other dental organizations

served to enhance and strengthen MDDF. This aspect has proved to be very helpful, especially through my own involvement with the Pierre Fauchard Foundation. Having served as Colorado Section Chair and 10th Region Trustee for the Pierre Fauchard Academy, I feel I have fostered that relationship and helped MDDF gain both much needed funding and an awareness of its good works in the larger dental community. This has continued to be the case as a number of MDDF presidents, past and present, are also involved with the Pierre Fauchard Academy.

What a joy it is to be celebrating MDDF’s 10th anniversary, and to remain connected to this vital organization and its dedicated leaders and volunteers!

Troy Fox, DDS, 2007-2008 and 2009-2010 As a charter board member and twice-acting President, I fondly remember serving the Metropolitan Denver Dental Foundation during its inception. In the beginning, the board of MDDF was also the Executive Board of MDDS. We were unsure of how to form the Foundation and what type of board structure would be in the best interest for its future. As time progressed, we were able to iron out the details and start a fabulous community minded organization. Our ultimate goal was to have a free standing foundation that would be independent of its parent society, and serve our community through various need-based projects. The problem was having little to no money in the Foundation, and the start of one of the worst recessions in our nation’s history. One can only imagine how difficult it was to go to people and organizations during this time and ask for money for our start up Foundation. Due to an incredible staff at MDDS, a great group of board members and some key contract employees, we were able to secure various grants and contributions during the early years to start the organization.

We were off and running!

My first tenure as President was in 2008 when I was also serving as PresidentElect of MDDS. The Foundation was slowly moving forward and required constant supervision by myself, the staff and other board members. It was a labor of love so to speak, and at times we questioned whether or not it would survive.

My second term as President was in 2010 when it was decided to let MDDF break free of MDDS (a goal we established from the start), and begin to survive on its own as a true non-profit. I was approached by the staff at MDDS and asked to serve as President during this new start.

This proved to be the more difficult of the two terms I served. I was charged to help form a new board and search for, and hire, MDDF’s first Executive Director.

We had no trouble finding a great group of dedicated dentists to comprise that first board. During that formation period, I was also actively interviewing candidates for the ED position with the help of the MDDS staff. There were many applications and only a few qualified people. Remember, this was taking place during the mother of all recessions and applications came from all walks of life. After many interviews and meetings, one candidate kept popping up in my mind: Amy Boymel. She had experience in foundation work and I had a good feeling about her, from the moment I met her. I truly thought she would fit the position and work hard to get the Foundation started. I presented her name and qualifications to the Board, and after interviewing her, they voted unanimously to hire her, as the first Executive Director of MDDF. I am very proud to say she is the current and only ED the foundation has ever had. Her contribution and dedication to her position were what was needed to launch the Foundation and guide it through its early years.

I am so proud of the work by the many dedicated people who had a vision for the community based programs of MDDS to be centralized into their own Foundation. We now have a presence in our community through the Foundation that allows our profession to contribute in ways a dental society would not normally be able to do. Kudos to all.

(Continued on pg. 18)

16

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(Continued from pg. 16)

Michael Scheidt, DDS, 2008-2009 My memories of the early days of MDDF are filled with all of the hope and promise of a new and expanding charitable initiative for our MDDS organization. The MDDS Board sought to dramatically improve our assistance to members of our community in a better funded and more focused way than we had been doing through local grant contributions by our charitable fund committee. The Smile Again ProgramTM grew out of those early discussions as did our hopes to raise vast sums of grant money, which we could use to directly assist those with special dental needs.

As with so many new endeavors, we didn't know what we didn't know about the complexities and complications of establishing a foundation, seeking grant money to make it effective and administering it once it was launched. This all came with experience and the very hard work of many people who have dedicated so much of their time and money to making MDDF sucessful. Our current Foundation President, Dr. Nelle Barr, MDDF Board of Directors, and Executive Director, Amy Boymel, deserve great credit for continuing these efforts. They have worked diligently to find innovative ways of funding the organization, managing its resources and recruiting both eligible patients and volunteer doctors to continue this needed and deserving dental treatment.

We can be proud of the planning and efforts which have gone into establishing MDDF and maintaining it as a charitable community benefit for which MDDS and dentistry want to be known.

Michael Poulos, DMD, 2010-2012 I believe it was six years ago when I became part of a group of dentists tasked with bringing the Foundation back to life. Having served as President of MDDS, I was known as a trouble-shooter and had continued to serve as an advisor after completing my term. When MDDS asked me to help find an Executive Director for MDDF and reorganize the Foundation to be an independent arm of our Society, I accepted the challenge and joined the MDDF board in 2009 as President-Elect. We were a small group of committed dentists: Troy Fox, President; Dr. Pat Prendergast, Vice President; Dr. Nelle Barr, Secretary; Dr. Jeff Hurst, Treasurer; Dr. Chuck Danna, MDDS Board Liaison; and me.

In April 2010, we interviewed and hired MDDF’s first Executive Director, Amy Boymel, who remains in that position today. Much like a child, the Foundation began the arduous process of learning to stand, grow and develop. As we all know, that is a life-long process. Though MDDF technically existed since 2005, this was the first time it was functioning and being managed on its own, not

by MDDS staff. There were growing pains and there were accomplishments. Of course there were some frustrations, but there have been many more successes.

Our Board grew to include not only dedicated member dentists, but passionate community leaders who brought new ideas and new perspectives to the table.

Our financial dependence on MDDS has lessened each year, as our own fundraising efforts have grown; but the intrinsic relationship between our two organizations continues to progress and mature. We each recognize that while we are separate organizations with specific objectives, we share a common goal: to strengthen the dental community and enhance the lives of those we serve.

As MDDF moves into its second decade, I am appreciative of the many people who have supported and helped us get to where we are and I look forward, with great anticipation, to what the future holds.

Patrick Prendergast, DDS, 2012-2014 I served as President of the MDDF Board from May 2012 until May 2014. The evolution of this charity has been a wonderful process in which to participate. While several of us have held the position of President of the MDDF Board, we have all been constantly and actively engaged in this very talented board of diverse people. To me, the Board is truly of one mind, and that is to help as many people as possible while advancing the image of MDDS in our community.

in every conceivable direction. So, to that end, some board members set about tackling our “identity crisis” and helped more MDDS members realize that we are YOUR charity, and your talents as well as financial support are deeply needed and greatly appreciated. Many of the city’s social agencies had lost awareness of who we are and what we offer to those citizens who have few other places to turn.

This problem is constantly addressed as we strengthen our relationships with the agencies that identify people for The Smile Again ProgramTM. We have addressed the need for a simple method of contributing to your charity in a “painless” manner; you can have monthly amounts deducted from a bank account or paid by your credit card if you prefer travel rewards. Finally, the Board has realized that today’s dentist wants fun entertaining ways to help support any charity. The Molars Golf Tournament and the wildly popular Feed the Foundation dinner have become “must attend” events each year.

For me, this board has represented an opportunity to work with like-minded people to build and grow something far better than my individual efforts could ever total. I’m proud of the fact that we operate a successful charitable organization that continues to grow while remaining nimble to the needs of our community and the wishes of MDDS membership. As our strategic planning facilitator so correctly pointed out, we are a very young organization. As such we are not perfect, much like a teenager trying to learn how to be a successful adult. But, we are committed to the process of growth and willing to change along the way as deemed appropriate to insure we represent great value to our membership as their charity of choice. It is an honor to be of service to MDDS through MDDF. Nelle Barr, DMD, 2014-2016 The hand that we are dealt in this life, the universal order of things, fate or whatever you would like to call it, has lots of unanswered questions. Why was I born into the Barr family?

Why are other people born into abusive families? Why do certain people find themselves in abusive relationships? Why does domestic violence have to exist? These questions have no answers. One thing I know for certain, I was born into a wonderful family and I have lead an easy, some may even say, charmed life. I feel compelled to help people who are less fortunate.

I am also a huge propionate of organized dentistry. MDDS is a fabulous dental society and I am proud to be a member. But I am honored to be President of MDDF, the charity founded by MDDS in 2005. I believe that it is important to be active in organized dentistry. As President of MDDF, I can fulfill that need and help someone who, for whatever reason, has not been as fortunate as I have been. My sister, Susan, who has worked in the Head Start Program for 20 years, has witnessed people rise above hardship and overcome obstacles when just one person has believed in them. Is a dentist rebuilding a mutilated smile that one person? I believe so. That is why I was eager to be President of MDDF. I am very grateful to serve in this role and I take it very seriously. My goal, as leader of the Foundation, is to make every MDDS member proud to have MDDF as their charity.

At MDDF, we are rebuilding lives one smile at a time. This 10 year anniversary milestone is an opportunity for all MDDS members to take pride in the fact that their Foundation has treated almost 400 patients through The Smile Again ProgramTM. The beauty of all MDDS dentists working together is that we can do more as group than one person can alone.

Every MDDS member can play a role in making someone's life better. You can help raise awareness by telling your friends, family and colleagues about the important work MDDF is doing or become one of our volunteer dentists. When you think of donating, make MDDF a place you give. To learn more about the Foundation please visit MDDF.org. There you can watch a short video featuring one of the patients who was treated in The Smile Again ProgramTM. It is well worth your time. While you are on the website you can also make a donation. I promise that your gift will be used prudently.

As MDDF was newly organized, we quickly realized that we needed to grow

18

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CLINICAL

50 SHADES OF GRAY

How to get shades right the first time

By Dave Andrus, CDT

W

hat should our ultimate goal be when it

enamel transmits that darkness.“50 shades of gray” fairly describes the

comes to anterior esthetics in dentistry?

result of the over use of ultra- translucent porcelain on restorations.

In this authors opinion it should be to give the patient what they want, usually “pretty

Ultra-translucent enamel at the incisal edge of a tooth can be identified

teeth” (Figures 1, 2 and 3). Getting everything right

by placing a white object with printing on it behind the tooth in question.

the first time is a beautiful thing; having to remake,

If the printing is clearly identifiable, the enamel is ultra-translucent. If

rework or settle for something

the printing is blurred the enamel

that “will do” is not.

has

a

normal

translucency

(Figure 5). After 37 years as a This article is a collection of

dental technician, having taken

principles that have served me,

hundreds of shades on patients

my clients and their patients well

and fabricated roughly 50,000

through the years.

First, something to be aware of; Ultra-translucent incisal edges on crown and bridge restorations is a reoccurring fad that has

Figure 1: Before photo of 8 unit upper anterior case. It’s important to recognize patients who are interested in anterior esthetics are after replacing old opacious crowns, composites, or veneers. Restorations with too much translucency may not be accepted.

restorations, I would estimate Figure 2: After photo of 8 unit upper anterior teeth with translucency that matches the lower natural teeth.

there have probably been fewer than a dozen patients who truly required ultra-translucent incisal edges on a restoration (Figure 6).

gained momentum in dentistry

• If you can’t pick the anterior

once again. Ultra-translucent

shade on a single central of a high

incisal edges is NOT a “one size

esthetic demand patient in two

fits all” approach to beautiful

minutes, have the ceramist take

anterior restorations. If a patient

the shade. In these cases it is likely

has ultra-translucent enamel at the incisal edge of their natural teeth and adjacent teeth are being restored, it is incumbent

Figure 3: Translucent incisal porcelain can be used without being overwhelming.

on us as dental professionals to

Figure 4: If ultra-translucent incisal porcelain is necessary it should be used. It is important to understand that the effect will be a gray look to the incisal of the restoration.

match it (Figure 4). While Ultra-

the shade and overall look of a tooth is more involved than can be communicated with a basic shade tab because there are subtle nuances that if not replicated can make a restoration not match

translucent incisal edges may be awe inspiring in photographs,

• If you can’t send a shade tab

on models or in the crown box,

to the lab that exactly matches

they tend to create a dull gray

the unique characteristics of the

appearance, that is not fully realized until the restorations are tried in the patient’s mouth.

Incisal translucency is very much

patient’s teeth, send the patient to Figure 5: A translucent left lateral incisor showing a natural level of translucency.

Figure 6: Cross-sectioned pre-molar demonstrating a normal translucency of the enamel.

the lab or make an appointment to have the technician come to your office for a custom shade.

a “Goldie Locks” issue; if it isn’t “just right” it can ruin the esthetics of a case and be rejected by the patient. Ultra-translucency in teeth,

• On critical esthetic restorations, shade descriptions of “a little more,

crowns and veneers is translated to the observer’s eye as grey because

not as much as or kind of like…” won’t do it unless the patient is willing

the anterior are in the front of a dark oral cavity and ultra-translucent

to accept a crown that is “sort of close.”

(Continued on pg. 22)

20

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Articulator

Fall 2015

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(Continued from pg. 20)

• Never ever, ever, ever, ever, ever…EVER take a shade on a dehydrated tooth.

• Be sure those responsible for shade selection know how to do it.

In 10-15 seconds of a patient’s mouth being open I have seen the appearance of teeth change to the point that an erroneous shade could be taken. If you

• Ask your ceramist to give your office a quick 30-minute class on shade

are going to take the shade the same day as the preparation, schedule 10

taking.

minutes extra for that procedure and be sure the shade selection is done prior to anesthetizing. Anesthetizing presents two issues that can alter the normal

• Don’t take a final shade on a bleaching patient for three weeks after that last

shade of teeth: 1) dehydration 2) the blood flow to the teeth is altered.

bleach application.

• A patient should be instructed to keep their lips closed and front teeth wet

• If you are doing restorations on six upper anterior teeth or more, use the

with saliva until you hold the shade tab to their mouth.

patients complexion for shade range (A,B,C or D) selection by placing shade tabs A2, B2, C2 and D2 on the patient’s cheek with their mouth closed. Pick

• If you forget to take a shade and you have anesthetized or prepped a patients

the shade group A, B, C, or D that looks the best with their complexion then

tooth, the shade must be taken another day to be accurate

select the brightness in that range. (i.e. A1, A2, A3, A3.5, A4)

• Do not use the operatory light to take a shade.

• For easy shade selection choose the “value” (gray level) first. Arrange your Vita classic shade guide in the following order: A1, B1, A2, B2, C1, A3, D2,

• Shut the blinds when you are taking a shade! Office windows are tinted

B3,D3, D4, B4, C2, A3.5, D4 C3, A4, C4 When picking shades, move the

which can cause inaccurate shade selection, often leaning toward the gray

shade guide left and right until you can select the appropriate “value” (gray

(C or D) shades. “Natural daylight” is not what comes through your office

level) then, simply choose the matching color within that area of shade tabs. If

window glass, it is colored light.

you can’t find a shade to match, use an alternate shade guide such as the Vita 3D Master shade guide.

• Taking a patient outside to take a shade is only effective if you can bottle that exact light scenario and send it to the laboratory. Day light at 9:00 am is

• Vita Classic shade guide Colors are; A=Brown yellow, B=Yellow, C =Gray,

different than it is at 4:00 pm overcast days will cast more of a gray light than

D=Pink

a clear day. Refer to the next point for a better solution • Vita classic shade guides have a gingival neck area past the CEJ that is more • A shade taking devise I strongly recommend, which I have no financial

opaque and lighter than the shade tab. This can cause poor shade selection

interest in is Rite Light 2™. It is extremely affordable (around $300), convenient

usually resulting in crowns being too dark when they come from the lab.

and easy to use. It has three different types of light that are activated with the

Grind the neck off and polish it or send it to your lab and ask them to do it

push of a button and allows you to see if your shade selection is correct in five

for you

seconds.

About the Author • The average smart phone used well can produce far superior shade photos

Dave Andrus, CDT has been a dental technician for 37 years with a diverse

than a $5,000 camera used poorly.

background in the dental industry. He has served on the board of the National Association of Dental Laboratories (NADL) and is a past president of the

• If you know how to use your sophisticated camera and are well practiced

Colorado Dental Laboratory Association (CDLA). He has worked in research

at it use it.

and development and has been a technical director and instructor/lecturer for numerous porcelain and alloy companies. He has studied numerous occlusal

• Photos are only helpful for matching shades if they: 1) Have a shade tab or an

theories, has been course instructor and laboratory facilitator for the International

old crown next to the tooth which we can hold in our hand in the laboratory

Partnership for the Study of Occlusion (IPSO), has lectured nationally and

to see what effect the photo is describing. If you are using a unique or old

internationally and been widely published in dental technology and dental

denture shade guide, or something similar send it with the case. 2) If the shade

publications.

is visible on the shade tab in the photo or if we are told what shade tab is in the photo. 3) If the photo is not over/under exposed. 4) If the photo is in focus.

Dave has owned Diamond Dental Studio for 29 years. He can be reached at (303) 822-6666, (866) 431-5111, andruscompanies@netecin.net, Facebook Dave

• Significantly more males are “color blind” than females. Those responsible

Andrus or Diamond Dental Studio.

for taking shades should take color recognition tests on the Internet to see if they have good color recognition.

22

mddsdentist.com

Articulator

Fall 2015

$0

New Graduate 1st Year Rate

THE UN-FUNDED BUYSELL AGREEMENT: A TICKING TIME BOMB

By David Richards, Financial Advisor and Disability Insurance Specialist

24

mddsdentist.com

Articulator

Summer 2015

PRACTICE MANAGEMENT

O

ne of the most significant business decisions that any professional can make is to begin a business venture with a partner. Many professionals start up or buy into existing practices with a friend or colleague.

With dreams of success and an entrepreneurial spirit, they borrow several hundred thousand dollars together and realize their dreams of business ownership.

Hard work and dedication can pay off in a big way for people willing to take the risk. Making sure an attorney has drawn up proper partnership agreements is an essential step in protecting each individual partner’s interests in the business. Even when business partners are best friends, written agreements are necessary.

Installment payments to heirs by buyer: The business may fail due to the loss of the other partner and the payments may stop as a result. As with borrowed funds, the principal and interest payments may be too burdensome.

Life and Disability Buy-out policies: A specified amount of financing is guaranteed from the beginning of the agreement with insurance coverage. This method is generally the most economical method of funding because proceeds from the policies are generally income tax-free and benefits can be purchased for a modest annual outlay. In addition, if permanent (cash-value) life coverage is used, then the cash values can also be used for a buyout due to retirement of a partner. Where the policies are owned by the partnership, the credit position of the partnership is strengthened because the cash value in the policies is an asset to the business and the proceeds of the policy can help guarantee that the business will survive.

One of the most overlooked areas of a business partnership agreement is the funding provision of the buysell agreement or buy-sell clause within the The most common and most affordable method that business partners use to partnership agreement. Most attorneys who draft these agreements include the fund their buy-sell agreement is disability and life buy-out coverage. It can be buy-sell provision, but often neglect to counsel their the most affordable and fail-safe method. In addition to the Hard work and dedication can pay clients on the most important consideration: how will methods for funding the buy-sell agreement listed above, the partner who is buying out a deceased or disabled there are also two different types of agreements. These off in a big way for people willing to partner’s share of the business pay for it? This article will take the risk. Making sure an attorney include the Stock Redemption Plan and the Cross-Purchase detail the methods used to fund Buy-Sell agreements.

Buy-Sell Agreement. Our next article on the subject will has drawn up proper partnership detail these agreements as well as discuss the advantages and agreements is an essential step in Background disadvantages protecting each individual partner’s A buy-sell agreement is a separate agreement or clause of each. within the larger partnership agreement that details interests in the business. Even when how the individual partners will deal with the death or Don’t wait until it’s too late business partners are best friends, disability of the other partner. Many buy-sell agreements As the name of this article implies, the un-funded buy– written agreements are necessary. also deal with retirement and lifetime sale of a sell agreement is a ticking time bomb. Think about it for a partnership interest. Generally speaking, the agreements minute: if your business partner died or became disabled, will stipulate that the surviving or non-disabled partner has the obligation or how would you handle it? Your partner is of no economic value to your business guaranteed right to purchase the deceased or disabled partner’s interest in the if he or she is gone or can’t work. Yet your business partner or their estate still business. This is often referred to as a mandatory buy-out provision or a “right of owns 50% of the business. Think of it from the disabled partner or his estates’ (if first refusal.” This allows the surviving or non-disabled partner to wholly own the deceased) point of view as well. He or she or their family deserves the fair value of business without the interference of the deceased partner’s estate or without the the business that the partner helped build if he or she dies or becomes disabled. drain of a disabled and non-productive partner. A mandatory buy-out provision also assures the business interest of the disabled or deceased partner will be If you do not have a separate buy-sell agreement, the first thing we suggest you do purchased. is review your partnership agreement to make sure there are buy-sell provisions related to death and disability. If the provisions aren’t there, enter into a separate Methods of Funding a Buy-Sell Agreement buy-sell agreement. If the agreement is there, then make sure it is funded. After all, There are several ways of funding a buy-sell agreement. These methods include what good is the agreement if there’s no money to back it up? Specially designed personal funds of buyers, a sinking fund within the business, borrowing funds, life and disability policies are the easiest and most efficient means of funding these installment payments to the disabled partner or his/her heirs or special insurance all important agreements. Don’t wait until it’s too late and the bomb blows up. policies.

Defuse.

Personal funds of buyers: Most successful business owners do not keep large sums of liquid assets on hand. They have their money working in their businesses and other investments. This method is simply not feasible for most business owners because such a significant amount of cash is not available.

About the Author David Richards is a Financial Advisor and Disability Insurance Specialist for dental professionals since 1993. He can be reached for comment at (303) 714-5875 or (1-877) 402-0485 ext. 3211 or at ddsdi.com

Sinking fund: Such a fund will be inadequate if death or disability is premature and the time of need is uncertain. For corporations, an accumulated earnings tax problem may develop over time.

Registered Representative and Financial Advisor of Park Avenue Securities LLC (PAS). Securities products and advisory services offered through PAS, member FINRA, SIPC. Financial Representative of The Guardian Life Insurance Company of America® (Guardian), New York, NY. PAS is an indirect, wholly-owned subsidiary of Guardian. Wealth Strategies Group is not an affiliate or subsidiary of PAS or Guardian. 2015-8553 Exp 7/17

Borrowed funds: Loss of a key person (owner) may impair the credit worthiness of the business and other partners or shareholders. Interest costs may be excessive, and interest expense of shareholders or partners may not be deductible. This is by far the most expensive method for funding a buy-sell agreement.

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Articulator

Fall 2015

25

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

MWDI.ORG

EVENT CALENDAR SEPTEMBER 2015

NOVEMBER 2015

JANUARY 2016

September 11 Molars Golf Tournament 1414 Castle Pines Parkway Castle Rock, CO 80108 9:00am-3:00pm (303) 397-7668

Novemver 5-10 ADA 2015 – America's Dental Meeting Walter E. Washingten Convention Center Washington D.C. All Day

January 21-23 2016 Rocky Mountain Dental Convention Colorado Convention Center 700 14th Street Denver, CO 80202 & Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 (303) 488-9700

September 25 Straightforward Ultrasonic Debridement & Hands-on: A Simplified Approach to Ultrasonic Instrumentation – Ms. Cynthia Fong Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 9:00am-4:00pm (303) 488-9700

OCTOBER 2015 October 3-4 Hands-on: Bone Grafting – Dr. Brian Gurinsky Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 9:00am-4:00pm (303) 488-9700 October 8 New Member Welcome Event Angelo’s Tavern 620 East 6th Avenue Denver, CO 80203 6:00pm-8:00pm (303) 488-9700

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November 6-7 Botulinum Toxin & Dermal Fillers Level I & Frontline TMJ & Orofacial Pain Level I – American Academy of Facial Esthetics Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 Nov 6th 8:00am-5:00pm Nov 7th 8:00am-12:00pm (303) 488-9700 November 13 Hands-on: Lasers for Hygienists – Dr. Robert Convissar Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:30 am-4:30pm (303) 488-9700 November TBD Business of Dentistry Day – Various Speakers Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:30 am-4:30pm

FEBRUARY 2016 February 26 Basic Radiation for the Unlicensed Dental Personnel – Dr. Brad Potter Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00 am-12:00pm (303) 488-9700 February 26-27 Hands-on: Recognition and Management of Medical Emergencies: Participate in an Advanced Clinical Simulation – Dr. Jeff Young Children's Hospital Colorado 13123 E 16th Avenue Aurora, CO 80045 Feb 26th 9:00pm-4:00pm Feb 27th 9:00pm-4:00pm (303) 488-9700

DECEMBER 2015 December 12 Women Dentist Event Details TBD

Articulator

Fall 2015

Need CE?

The Colorado Dental Association, Metro Denver Dental Society and Colorado component societies are excited to offer a new opportunity to help members fulfill continuing education!

In a partnership with JADA Live, the publishers of The Journal of the American Dental Association, we will present an exciting day of CE (6.5 hours) for a very minimal fee! $125 for ADA/CDA Members and $165 for non-members.

This Survey Style Course Includes: • Carries Detection: Digital Age Solutions to Ancient Problems • Adhesive Dentistry: A Guide to Clinical Success • Entering the Digital 3D Ecosystem, the Utopian Dental Experience • More to be announced soon!

You will receive 6.5 units of continuing education credit upon successful completion of this course.

American Dental Association is an ADA CERP Recognized Provider.

ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

Register at www.JADALive.org/denver 28

mddsdentist.com

Mark your Calendar!

October 30, 2015 8:00 a.m. - 5:30 p.m.

DoubleTree Denver Tech Center 7801 E. Orchard Dr. Greenwood Village, CO 80111

Have questions?

Contact the CDA at 303-996-2842 or jeanne@cdaonline.org Articulator

Fall 2015

PATHOLOGYPUZZLERWITH DR. JOHN SVIRSKY (from pg. 12) Based on the clinical appearance and explosive onset (1 day duration), I would include contact stomatitis and erythema multiforme as the most likely candidates. EM might have occurred previously with an outbreak of oral ulcerative lesions and “targetoid” or "bullseye” skin lesions. The lesions probably would not be localized to the palate and skin lesions are typically present.

Aphthous stomatitis would have the clinical presentation of small (up to 1 cm) ulcerations with a red halo surrounding the ulceration. The lesion would be not be found on tissue bound down to periosteum and not present as confluent lesions of the palate. Additionally, aphthous stomatitis has a recurrent history and the patient has no history of previous lesions.

Benign mucous membrane pemphigoid (BMMP) would occur in this age group, more commonly in women. The lesions usually exhibit a positive Nikolsky sign (rubbing or blowing air on affected tissue causes it to separate). The lesions of BMMP typically have only moderate sensitivity and the patients will mention bleeding from the lesions. The one thing that can be found in BMMP is large areas of ulceration when the bullae break which could show the appearance of these lesions.

BMMP does not usually show up quickly like in this case.

Lichen planus occurs in this age group but the appearance and location are not consistent with the disease. The lesions typically are lacy with areas of ulceration if painful. The more common locations of LP are the buccal mucosa, tongue and gingiva. Lichen planus is more common in women.

Figure 4

tissue sloughing under the denture. This was a contact stomatitis from the sulfamic acid in the cleaning solution.

This case was submitted by Dr. Laura Tolusso Garden, a general dentist in practice in Midlothian, VA

PROFESSIONAL MARKETING AND APPRAISAL “specializing in professional practice sales and appraisal"

Buying or Selling a Dental Practice 25 Years Colorado Dental Transition Experience

Primary herpes could occur on the palate but would present following a fever and illness prior to other oral lesions. The lesions would normally affect the gingiva (in this case the patient was edentulous). Additionally, the lesions would be clusters of small vesicles and not a confluent mass.

The age of the patient also makes this unlikely although “diseases do not always read textbooks.” Recurrent herpes lesion could appear on the palate but would be clusters of vesicles/erosions and not multiple confluent areas.

Squamous cell carcinoma (SCCa) does not come up quickly or hurt until late in the disease process. Also a SCCa of this size would be irregular, elevated and show a red granular appearance and not be multifocal.

Well I did withhold some essential information. This patient was seen by a dental offices’ hygiene department who cleaned his maxillary denture with Premier Cleaning Solution. The patient reported a bitter taste when the denture was returned and a burning sensation when driving home. He presented the next day (Figures 1-3) and was given Lidex gel to be placed on the lesions. He was seen two weeks later with complete resolution of the disease (Figure 4). In the interim he reported lots of

mddsdentist.com

The demand for successful dental practices is at an all time high, and We at PROFESSIONAL MARKETING & APPRAISAL are working daily with qualified buyers!

If you are thinking of retiring, moving, or a career change we will counsel you as to the fair market value of your practice at NO COST TO YOU. We will discuss our TIME TESTED strategies for a seamless transition. We will explore your options and take into consideration your personal and professional needs in a private and confidential manner.

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Articulator

Fall 2015

29

CLASSIFIEDS

Items for Sale

Real Estate

Ortho Shell For Sale: Price $150K, Furniture, Fixtures, Equip, 5 Ops - brand new - built Sept 2014. 2,256 square feet. Desirable Lowry neighborhood. ADS Precise Consultants, 888-9092545, adsprecise.com, frontdesk@adsprecise.com.

Two Spaces Just South of Dry Creek on Yosemite: Both built out for medical; can be demised to suit. Just west of I-25 off Dry Creek Road. Easy in, easy out and easy to find. Call Bob, Kelmore Development, at (303) 779-1800.

Job Board

General Practice: Maui, HI - Annual Revenues: $636K, 3 Ops, 782 square feet, 4 staff, 4 days/ week. ADS Precise Consultants, 888-909-2545, www.adsprecise.com, frontdesk@adsprecise. com.

Front Desk: Answering phone, making appts, filing insurance with Eaglesoft, statements and billing via Eaglesoft. For more information contact Dr. Jeffrey Lodl at (303) 424-0767.

Associate Dentist: Established busy private practice has a full time Associate Dentist position available. There are 3 beautiful offices located in Golden, Denver and Wheat Ridge. All locations have excellent staff and great patients! I invite you to visit my web page at www. gentlesmilesofcolorado.com. Please fax your resume and CV to Dr. Wachuta at 303-278-8448.

PERIO Practice - Annual Revenues $611K, Dr. Retiring. ADS Precise Consultants, 800-3072537, frontdesk@adsprecise.com, www.adsprecise.com.

PERIO: Denver Metro (CO 1438) Annual Revenues $850K. ADS Precise Consultants, 800307-2537, frontdesk@adsprecise.com, www.adsprecise.com

Pedo Associateship: Metro Denver, CO (CO 1521) Must be open to new dental knowledge in Ortho/Pedo dentistry, mini-residency in New Orthodontics(TM) included, competitive pay/ benefits, avail immediately, DDS with emphasis on pediatric dental care required, specialty degree not essential. ADS Precise Consultants, www.adsprecise.com, 888-909-2545.

GP-Eastern Plains, Sale Price $390,000,Annual Revenues $599K,1,000 sq ft, 3 ops fully equipped,2 staff, Mon-Th 8:30a-5p, Fri 8a-12p (no patients), space available to expand (CO 1327) ADS Precise Consultants, 800-307-2537, frontdesk@adsprecise.com, www.adsprecise. com

Dental Assistant II: Tri-County Health Dept. Senior Dental Clinic, Englewood, seeks dental assistant (prefer EDDA). Ideal candidate works well as part of a team, is energetic, compassionate, and enjoys senior citizens. 4 days per week (off Weds). Excellent benefits, including medical, dental, vision insurance, paid holidays, 401(k), and PTO. Submit a cover letter and resume or a job application to humanresources@tchd.org or FAX: 303-741-2351.

GP for sale in Arvada, Colo. (CO 1123). Annual revenue $135,000, three ops, 950 square feet.

ADS Precise Consultants, 800-307-2537, frontdesk@adsprecise.com, www.adsprecise.com

Dental Hygienist: General practice solo, fee for service practice is looking for a quality experienced licensed RDH to fill a 4/day week full-time position hygienist retiring after 20 years. Patient-oriented established quality practice with up to date equipment and friendly established team. Benefits include: Life and health insurance, bonuses, paid vacation, sick and personal time. For more information contact Carlson Dentistry at (303) 932-6018.

GP in South Central Mountains (CO 1326): Price: $30K, annual revenues $95K, adjusted net income $65K, net income after loan payments $56K, 1 op, 2-2.5 days/wk, dr. moving out of state. Price $30,000. ADS Precise Consultants, 800-307-2537, frontdesk@adsprecise.com, www.adsprecise.com.

Visit mddsdentist.com/classifieds to place an ad.

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6 N Tejon, Suite 501 Colorado Springs, CO 80903 info@hcmws.com 719-445-5044 720-319-9419 www.hcmws.com

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