May June 2023 - Northwest Dentistry Journal

Journal of the Minnesota Dental Association Vollume 102, Volume 102 02 Nu Number mber b 3 May-June 2023

Volume 102, Number 3

Summer in Minnesota: Stay as Long as You Like

Northwest Dentistry May-June 2023

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Journal of the Minnesota Dental Association Volume 102, Number 3 May-June 2023

Page 19

Features 12 Summer in Minnesota: Stay as Long as You Like There really is no place like home Steve Brown, D.D.S., Bonnie Moeller, D.D.S., Park Rapids, Roy Hakala, D.D.S., Michael Zakula, D.D.S.,Yvonne Hanley, D.D.S., and Diane Kaufenberg 19 A Widening Horizon: The 2023 MDA Awards Honorees Teresa Fong Sit, D.D.S., Howard W. Taylor, D.D.S., Kirby C.Johnson, D.D.S., Douglas R. Williams, D.D.S., and Jerome L. Appeldoorn, D.D.S. 30 Celebrating the 2023 Minnesota Dental Association Star of the North Meeting 32 The Story of Silver Diamine Fluoride Gary R. Hildebrandt, D.D.S., M.S. 39 Minnesota Dental Foundation Thank you to our donors

ON THE COVER

After our “Enough Already!” winter, it is our absolute pleasure to bring you our long-anticipated (by us!) summer dreaming issue. It should fall into your hands just about the time open windows and dreamy drives home are sending their irresistible message to come away, come away … and let the Universe comb your hair. Bask in the promise of a Minnesota summer. We didn’t invent it, but we think we’ve pretty much perfected it. In “summery”: Wishing you the best one imaginable.

Cover feature begins on page 12.

Departments

Cover image by Steven Brown, D.D.S., Lake City, Minnesota

42 We Are Collecting: The Minnesota Dental Association 100-Year Time Capsule

Resources 4 News Notes 48 “We Are Collecting”/Frost page 53 Author Guidelines 58 Dentists Concerned for Dentists: For Me, The Real Test was Relationships 58 Index to Advertisers 60 Business Opportunities 63 Directory to MDA Officers and Committees 2022-23

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Page 46

6 It’s Okay to Not Be Okay Report from the Trustee to the Tenth District of the American Dental Association Scott L. Morrison, D.D.S., M.S. 9 Editorial: Summer!

If he missed anything in this intro to our summer dreaming issue, we can’t imagine what it is.

John E. Lueth, D.D.S.

43 District News Saint Paul rocks its year-end review; Southeastern catches up with an old friend; Southern puts summer at its center; West Central has it all wrapped up in time for summer; Minneapolis moves forward; Northeastern offers applause all around; and Northwestern celebrates 50 years of the Northwest Technical College DA program 64 Heading Home: A Bird Song With Lyrics A refreshing moment with an honest man

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N E W S

Notes Interactive U.S. Dentist Workforce Dashboard Now Available The Health Policy Institute of the American Dental Association has long tracked the state of the U.S. dentist workforce. Now, for the first time, dentist demographic data from 2001 to 2022 is available in one interactive tool.

In this dashboard, you can: • Visualize demographic data by age, race/ethnicity, gender, and state • Hover over any data point for additional information • Use the icon bar on the left to change filters and expand graphs • Download results in PDF format for your needs • For optimal experience, view the dashboard on a larger screen. A help guide is also available if you have questions about using the tool.

For supply of dentists data in Excel format, you may download our Supply of Dentists in the U.S., 2001-2022 (XLSX) report. Data include number of dentists per state and per 100,000 population, specialty, gender, and age.

For more complete instructions, please download our help guide. ■

Letters to the Editor Readers of Northwest Dentistry are invited to submit Letters to the Editor on topics related to articles or columns previously published in the journal. Letters

Northwest

DENTISTRY

John E. Lueth, D.D.S., Executive Editor Susan Miller, Managing Editor William E. Stein, D.D.S., C.D.E., Editor Emeritus Editorial Advisory Board Norman F. Coates, D.M.D. Amber D. Cziok, D.D.S. Brent L. Florine, D.D.S. Jeanni R. Foss, D.D.S. Gary H. Hildebrandt, D.D.S., M.S. Michael A. Kurkowski, D.D.S., Contributing Editor David H. Lipschultz, D.D.S. Rosalie J. Perpich, D.D.S., Ex Officio Michael J. Till, D.D.S., Ph.D., Contributing Editor Publication office: 1335 Industrial Boulevard, Suite 200, Minneapolis, MN 55413-4801, (612)767-8400 Minnesota Dental Association Staff Carmelo Cinqueonce, Executive Director Whitney Bey, Director of Convention Operations Vicki Capistrant, Director of Operations Linda T. Fomasina, Executive Assistant Dawn M. Jensen, Director of Membership Stephanie Leclair, Communications Director Dan Murphy, Government Affairs Manager Hanna Nguyen-Dao, Regulatory Affairs Manager Mia Stranberg, Membership Services Coordinator Contents of NORTHWEST DENTISTRY ©2023, publication number 395240, published bimonthly by the Minnesota Dental Association, 1335 Industrial Boulevard, Suite 200, Minneapolis, MN 55413-4801, is the official journal of the Minnesota Dental Association. Periodicals postage paid at St. Paul, Minnesota. POSTMASTER: Please send address changes to Northwest Dentistry, 1335 Industrial Boulevard, Suite 200, Minneapolis MN 55413-4801. Northwest Dentistry is published under the supervision of the Northwest Dentistry Editorial Advisory Board.

Neither the Editorial Staff, the Editor, nor the Association is responsible for any expression of opinion or statement of fact, all of which are published solely on the authority of the author whose name or initials are indicated. All content of Northwest Dentistry is copyrighted by the Minnesota Dental Association and may not be reprinted without written permission. Subscription price $20.00 (members) or $35.00 (non-members) per annum in advance. Foreign countries $90.00 per annum. Single copies $6.50 U.S.A./$15.00 Foreign. Website: www.mndental.org.

Advertising Information Classified advertising is available to members at a discounted rate. Visit Hesy-Re.com to view and submit ads. Display advertising information and rates are also available on www.mndental. org under News/Journal or by calling Stephanie Leclair, Communications Director, at (612) 767-8400.

or other agencies will be referred to an appropriate individual, department, or

The acceptance of advertising in Northwest Dentistry does not necessarily imply approval of the advertised product by the Minnesota Dental Association.

committee to directly respond to the author. The views expressed are those of

Printed on recycled paper containing 10% post consumer fiber using domestic soy-based inks.

written to express viewpoints about current policies or actions of the MDA

the writers and do not necessarily reflect the opinions or official policies of the Minnesota Dental Association, the NWD Editorial Advisory Board, or Northwest Dentistry editorial staff. Letters will be accepted by e-mail at info@mndental.org.

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Mission Statement for Northwest Dentistry To educate, entertain, and exchange information with dental professionals by providing a quality publication consistent with the ethical standards of the profession.

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R E P O R T F R O M T H E

ADA It’s Okay to Not Be Okay Scott L. Morrison, D.D.S., M.S.* I recently attended a state dental association meeting that included a wellness track as part of the continuing education sessions.

This track included an emotionally powerful panel discussion where mental health and addiction challenges faced by four dentists were shared. Three of the dentists shared their own stories of seeking help to deal with anxiety, depression, and drug addiction that led to one dentist losing his license to practice and serving time in prison. The fourth story, about a dentist who died by suicide, was told by a family member.

Everyone who attended this session was impacted; by the courage it took for the presenters to share their stories and by the compassion the presenters conveyed in hoping that the telling of their stories will help others to seek help if needed.

I can personally attest to the impact their stories had on me, and I firmly believe that similar presentations in other states can go a long way toward opening the lines of communication for members to feel safe in seeking help for substance abuse and mental health challenges. I also want you to know that within the ADA the well-being of dentists and their families is being discussed as a high priority.

While the ADA considers the well-being of dentists a high priority, the tripartite system and individual members are needed to help identify when colleagues may be struggling and in need of help, and to support

members in seeking help. None of us are trained therapists, but we can become better educated in identifying the signs that a colleague may be struggling and in need of help. We can also become better coached in the appropriate types of language to approach a colleague and offer help.

There are non-profit organizations out there that offer such training, and such training sessions might be worthwhile presentations for state or local dental association meetings. We need to let our colleagues know that it is okay to not be okay. Beyond that, we also need to let our colleagues know that help is available and that we support them in seeking that help.

You don’t have to have experienced a similar challenge to help others; you just need to come with a willingness to listen and an open heart.

The New ADA Faculty Ambassador Program When it comes to ADA membership, I have always felt that one needs to get them early, get them engaged, and you will keep them forever. That does not mean starting to court future members following their graduation from dental school.

The recruitment process needs to begin as soon as one is accepted to dental school, or even earlier. To that end, the ADA is implementing a Faculty Ambassador Program, wherein a full-time faculty member from each dental school will be designated to serve as an ambassador to help promote the value of ADA membership to the student body.

Within the ADA the well-being of dentists and their families is being discussed as a high priority.

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It is anticipated that each faculty ambassador will recruit four or five Scott L. Morrison, other faculty D.D.S., M.S. members to help establish an effective working relationship between the dental school and the local and/or state dental association, helping to facilitate such activities as Lunch and Learn Programs, ADA Signing Day, mentorship programs, and invitations to dental students to attend local and state dental association meetings and continuing education courses. There is evidence to support that over the course of four years, faculty support for and participation in organized dentistry has an impact on how students view the importance of being involved in organized dentistry. It has also been shown that students rely heavily on their faculty members as the most trusted source for information on all aspects of dentistry. It is hoped that this ambassador program will help increase the percentage of dental students who convert their ADA membership from student status to new dentist status following the completion of their dental school education. For those states that do not have a dental school, we want to encourage communication between the Faculty Ambassadors and the state dental associations from where the Continued on next page *Dr. Morrison is the Trustee to the Tenth District of the American Dental Association, representing Iowa, Minnesota, Nebraska, North Dakota, and South Dakota. He is a periodontist in Omaha, Nebraska. Email is morrisons@ada.org No rth wes t Dentis try

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students hail and to where they may return to practice.

A Ripple Effect …

Several of the states within ADA District 10 hold their annual meetings during the months of April and May. It is always a pleasure for me to attend these meetings, affording me the opportunity to meet with state dental association leadership and listen to the discussion of issues that are of importance to each

association. These trips also provide me with opportunities to meet new dentists, some who are beginning their journeys as leaders for their respective associations and others who have served in leadership positions and retain their enthusiastic support for organized dentistry. I hope that each of you will take the time to consider how you might help to serve and support the work of your state dental association. While the work

is meaningful and rewarding, the personal relationships you develop with colleagues and your dental association staff have value beyond measure. And remember to always consider reaching out to give a fellow member a hand up or to serve as a mentor.

Respectfully submitted, Scott L. Morrison, D.D.S., M.S. 10th District Trustee morrisons@ada.org

CORRECTION

What’s your practice worth?

On page 53 in the March-April 2023 issue, in the photo of Dr. Douglas Erickson outside the office of Representative Pete Stauber on Dental Day at the Capitol, MDA president Tim Holland was incorrectly identified as Representative Stauber.

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Editorial Summer!

John E. Lueth, D.D.S.* It’s a sure sign of summer when you can buy DQ treats on the south shore of Lake Bemidji in a spring snowstorm as you watch the ice pile up in a stiff breeze!

The fact is that many locals have done so with big, fluffy spring snowflakes blasting past them.They shiver and look out into a stiff northwest wind coming down the lake … as yet ninety percent covered in black ice … and say to themselves, “I can’t wait for summer!”

Thank goodness that the first three days of May this year whipped up 3040 mph winds out of the northwest to begin to open up the lake!

Spectacular displays of ice piled up on the windward shore. And if you braved proximity to the ice floes, you heard some pretty great sound effects to boot.

It surely must be admitted by true Minnesotans, if their feet are put to the campfire, that our brains click into summer mode just about the time of that first sunny day which is warm enough to wear not more than a light jacket.Truth be told, that can occur on a fine March day while standing on the ice in a long-sleeved flannel shirt, sipping a beverage, and jigging for perch or pout! Or ordering your first Dilly Bar or Peanut Buster Parfait at the outdoor window of your local DQ while still sporting a stocking cap and gloves!

Isn’t that just a classic Minnesotan mindset? You get either the opening of a summer seasonal business, or you get one stinkin’ super-nice weather day, all

while still firmly in the spring season and — Whammo! — your brain jerks to SUMMER! Shortly thereafter, as daylight lengthens a bit further into the evening and several nice mild weather days are strung together, more irrefutable signs of seasonal change begin to appear. Depending upon which way you lean, there are many possible triggers for Summer Dreams: You see posters, balloons, and fluttering, attention-getting Rummage Sale signs at intersections.

As you drive across town, you encounter here-and-there a side street congested with vehicles pulled off to both shoulders of the road and you spot Garage Salers in driveways searching for their next great purchase!

Or while you’re driving your local byways, you realize there are now boats parked in front- or side-yards with For Sale signs on them. It may technically still be spring when this phenomenon begins, but something at that household was decided: One half of the household determined that if he could sell his smaller, older, simpler watercraft, he could upgrade to a bigger, newer, fancier rig. OR the other half knows that, for reasons a-many, one less seldom-used or family-budget-draining “asset” could be pawned off on some eager, willing, before-the-season purchaser … and the sooner the better!

Pre- and early summer offerings of water-related craft appeal to a broad range of prospects, from eager anglers, youthful and hopeful first-time boat

No single essay can describe what summer means to a Minnesotan.

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owners, water skiers searching for that better ski boat, and pontoon party bargers with John E. Lueth, D.D.S. visions of their sightseeing cruise, a selection of brews, and whatever else strikes their muse.

Practitioners of muscle-powered locomotion atop the surfaces of Minnesota’s 10,000 lakes register not a flicker of longing for the aforementioned options. As canoers, kayakers, windsurfers, or paddle boarders, they only feel the call of closeness to water when their preferred craft crosses their field of vision, beckoning them with a quieter siren song.

We continue: Greenhouse and nursery parking lots are crammed with green thumb enthusiasts. Farmers Markets appear in early mornings with the season’s first and freshest produce. Farm auctions, rodeos, county fairs.

The meteorological start of Summer 2023 is at 9:58 a.m. CDT on June 21st. No single essay can describe what summer means to a Minnesotan.

Nor can any multi-volume tome cover all of the possibilities to be wished for or to be experienced. Certainly it will be different for each of us in what way we think about, experience, and enjoy summer in Minnesota.

But maybe if there were a universal, a true consensus, among Minnesotans, descriptions for our summers would Continued on next page *Dr. Lueth is the Executive Editor of Northwest Dentistry. He is a general dentist in private practice in Bemidji, Minnesota.

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Editorial Continued from previous page

include words such as anticipation, appreciation, participation, “stuff you cannot do at other times of the year” … and the totally unrealistic wish that summer could last all year long!

Hey, some will say, that’s easy: Move to Florida or California or Hawaii!

And to be sure, some people do. But Minnesotans who truly love the seasons and the gifts each season bestows upon us understand that if everything is the same … nothing is special.

Summer in Minnesota is special.

And it is revered!!

I’m in grade school. Every classmate is excited about the end of the school year. And what follows that?

Unlimited freedom! (As far as our little brains could comprehend lack of responsibility!!) Biking, swimming, endless hours with our friends doing what WE wanted to do. Maybe a family trip. No school. No homework.

Wow. Summer’ll be great!

High school comes with more responsibilities, sometimes requiring work … to bring in funds for what we think we need. So summer can end up smelling like fresh cut grass – until we’re sick of that smell! Maybe it’s the grease of a chicken frier or bark of a nasty dog as we deliver a newspaper.

A driver’s license may add some range, possibly some freedom. But there can be a few more demands on our time than those carefree childhood summers.

College summers may be the same, but more likely they segue into dental school summers and increasing

responsibilities which leave us with less than unlimited time to bask in summer activities. Now we actually need to plan and schedule.

Soon enough I’m a full-time working stiff.There are children and accompanying responsibilities transitioning from toddler, day care, grade school and high school to college or adult children. Ultimately grandparenthood. Uff Da! One constant? Summer in Minnesota and everything it entails, just viewed from different perspectives.

Therefore, in light of an impossible task of describing what a Minnesota Summer (let’s capitalize it!) may mean to you (as opposed to anyone else), I offer here a (only very) short list of things relating to Summer in Minnesota: Vacation. Campfires. Barbeque, grilling.

Marshmallows. S’mores. Cookouts.

Dinner on the deck or patio. Pop and Beer. Horseshoes.Volleyball.

Rollerblading. Music. Summertime, when the livin’ is easy! Hot Fun in the Summer. Summer Breeze;Those LazyHazy-Crazy Days of Summer ….

Drive-in movies.Waterskiing. Fireflies, fish flies, deer flies or horse flies. Bug zappers. Summer love. Fond memories.

Best friends and time together. Endless summer nights, late light. Beaches, swimming rafts, cold beverages, ice cream and popsicles, warm weather.

Summer camp. Fishing, fish fries. Road

trips: freeways, cross-country, backroads or byways, minimum maintenance or forest logging roads. Softball, baseball.

The Twins at the park or on the radio.

Golf, frisbee, fireworks. Dancing, dance the night away.Theme parks, reunions, weddings, family gatherings. Hotels, waterslides, swimming pools. Sleeping bags, tents, camp stoves, picnic tables.

Parks, trails, hiking, biking. Gardens, corn on the cob, tomatoes and canning of vegetables.

A pond shares the perfect reflection of a beautiful sky on its glassy surface.The splash of a paddle.The squeak of an oarlock or snap of a sail.The squeal of a child catching panfish.Thunderstorms, gentle rains, beautiful sunrises with a cuppa. Perfect sunsets with a glass.

Wind soughing through tall pines.

Quiet. Solitude.The yodeling of loons in the evening on a quiet Minnesota lake!

And all of these only scratch the surface.

Yet so it comes to be, that as much as we were able to pack into This Summer, eventually Pfft – it’s a memory. Great memories to be sure. But no sooner have our minds transitioned to enjoying the other seasons than we cannot fail to dream about Next Summer.

The Minnesota Summer Bucket List — What is yours?

Enjoy this one! ■

What Is Life?

What is life? It is the flash of a firefly in the night.

It is the breath of a buffalo in the winter time.

It is the little shadow which runs across the grass and loses itself in the sunset.

Crowfoot, Blackfoot

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C O V E R

Feature

Northwest Dentistry thanks our summer dreamers for contributing the enchanting come hither (and yon) images in the following pages. To Drs. Steve Brown, Lake City; Bonnie Moeller, Park Rapids; Roy Hakala, Red Wing; Michael Zakula, Minneapolis; Yvonne Hanley, Fergus Falls; and Diane Kaufenberg, Minong, Wisconsin, as well as appearing in this cover feature, your offerings are headed for our MDA time capsule.

We hope they will inspire others to contribute as well. As we begin this delicious warm weather hug, please settle in any place you like for Act One from our tribute to the Theater of Seasons. We guarantee it will be the best seat in the house.

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Summer in Minnesota:

Stay As Long As You Like

When you think about summer when it’s not summer, where do you go?

There are two kinds of summer dreaming.

This is the first: dreaming of those days that feel like they, and the season itself, will never end. What it looks like, yes; smells, tastes, sounds, and then feels like … A siren song, without the sirens.

Having time to watch a sunset all the way to dark and stars.

That mix of feelings being in a lake, in the water, at sunset, vividly aware of the temperatures of air, water, breeze, and your own body.

It’s time to sing a song of summer. First quiet as its wake, then comes the solo of a loon.

The next sound you hear is … ours.

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Cover Feature Continued from previous page

He’ll see you before you see him … if you do. SB

They don’t make brighter spots in the landscape than this. SB

A tangle of perovskias and rudbeckia in a summer garden. MZ

Your summer neighbors are on the road. SB 14

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Nearer neighbors, true, but handsome visitors nonetheless. MZ

Well watched over, and happy of it. SB No rth wes t Dentis try

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Loves me, loves me … don’t finish that.

Minnehaha Falls in all its glory. RH Ma y - J une 2 0 2 3

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ce.

Bring your slippers to the dan SB, BM Continued on next page 15

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Cover Feature Continued from previous page

Front to back or back to fron t, “kayak” spells “Let’s go!”YH

Aw, what can we say? ’23 Ski-Doo! SB

“Up at the lake’’ on a perfect afternoon. DK

BM Remember feeling like this?!

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Dream it, do it. SB No rth wes t Dentis try

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No greater context for “home” than this. SB

Smiles you can see all the way from

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shore! SB

A beauty shot from any of our 10,000 lakes. BM

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Feature A Widening Horizon:

The Minnesota Dental Association 2023 Award Honorees

Introduction When we initiated our series “What Does Leadership Look Like?” it began with a single individual. Anyone finding him- or herself in such a spotlight would tell you no one undertakes “to lead” alone. More is needed.

When leadership is authentic, it creates the “more”. Energy contributes, then becomes, synergy.

Projects evolve; what is accomplished points the way to an even greater good. Set another place at a table so prepared and someone will soon pull up another chair. This is the opportunity of service through organized dentistry.

The Minnesota Dental Association Awards we are presenting are given annually to honor Association members whose contributions are deserving not only of recognition but as examples of what making this kind of work a part of a professional career can add to a life on so many levels.

It is our pleasure to present the Minnesota Dental Association Award Honorees for 2023. What a pleasure to say, quite literally, this is yet another group of accomplished, active, forward-thinking people. They are younger than you; they are older than you; they are around your age …

They have such qualities: commitment and contribution, professionalism and strength of character; they have taken on huge, even seemingly insurmountable, challenges … And oh, what they know.

Winning an award almost always means that the work being honored “so far” is done. In other words, this isn’t Leadership 101, this is the Master Ma y - J une 2 0 2 3

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The Awards The MDA Guest of Honor Award is a long-term service award for extensive and exceptional service to the dental profession and the community.

The MDA New Dentist Leadership Award is given to an MDA member who has served the dental profession through leadership involvement in organized dentistry within ten years of receiving his or her dental degree.

The MDA Humanitarian Service Award is given for service provided to help address the unmet need for dental care within our greater community, be it local, national, or international.

The MDA Outstanding Service Award is given to an MDA member who has elevated the dental profession through his or her leadership contributions in organized dentistry, be it at the district, state, or national level.

The MDA President’s Award is given to an individual at the discretion of the MDA President.

Class. This opportunity to meet our 2023 honorees definitely demonstrates that. Pick a category of service — it’s covered.

Over the years, in fact, these honorees have been people who have hit their stride, and when you do that, you trade worry for wonder:You don’t worry what’s next.You wonder what is.

Because we, and they, believe that answers spring from actions, we suggest not just watching them, but endeavoring to work with them.You will notice the word “for” is not part of that equation. Leaders want support and help, always; true leaders welcome colleagues and allies. Which bring us to the Minnesota Dental Association and the last question on the stack for this installment of “What Does Leadership Look Like?”

How do you lead an association of leaders?

The answer: By example.

The Editors Northwest Dentistry asked the honorees the following questions. Their answers follow the biographical pieces on each of them.

What was your reaction when you heard you had received the award, and what does it mean to you and the people who see you receive it?

This award is something of “after the fact” — the accomplishment is there, and so is the reward. What is the real reward?

Where would you want this recognition to go further? What is your hope for the future in the area of your service?

Continued on next page 19

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Feature Continued from previous page

Dr. Teresa Fong 2023 Guest of Honor

As an outstanding leader and a credit to the profession of dentistry and to her community, Dr.Teresa Fong has been chosen as the MDA’s 2023 Guest of Honor.

Dr. Fong earned her Doctor of Dental Surgery degree from the University of Tennessee College of Dentistry and her pediatric specialty certificate from the University of Kentucky College of Dentistry. For more than 30 years she practiced pediatric dentistry in the Twin Cities metro area with Metropolitan Pediatric Dental Associates, Ltd, while committing endless volunteer hours toward improving access to dental care for underserved children.

Actively involved in organized dentistry throughout her entire career, Dr. Fong served on numerous committees at the state and district levels. She was on the Executive Council of the Minneapolis District Dental Society for many years, and served as its president in 2003-2004. At the Minnesota Dental Association, she served as chair of the Dental Education Committee and the former Children’s Dental Health Committee, where she became the champion of the Dental Home Initiative to ensure that Head Start children received not only the federally required dental exam but were also able to find dental homes for ongoing care. She recently completed a six-year term as the Minneapolis District’s trustee to the MDA Board of Trustees, and currently serves on the MDA ‘s Scientific Session Committee.

Dr. Fong is very involved at the University of Minnesota School of Dentistry, currently serving as an adjunct clinical faculty member in the Division of Pediatric Dentistry three days each week. She serves as the Predoctoral Clinic Director and enjoys working with dental health care students - our future generation of dentists, dental therapists, and dental hygienists! She also serves as the pediatric dental specialist for the new Health Partners AEGD residency program. She was co-chair of the fundraising effort for the new University of Minnesota Pediatric Dental Residency Clinic, which provides opportunities for dental and medical collaboration with the University of Minnesota Children’s Hospital. Her passion for this project is one more example of her dedication and commitment to serving her profession and her community.

Dr. Fong has been an active volunteer at the Hope Dental Clinic, and for Give Kids A Smile Day at Sharing and Caring Hands and also with the student-led GKAS at the University of Minnesota, both in Minneapolis. She has also been very active at Oak Grove Church in Golden Valley. She co-leads a group of elementary-age girls, memorizing Bible verses, developing a relationship with God, strengthening their faith, and building hope for their future. She serves as Secretary/ Treasurer for the American Academy of Pediatric Dentistry 20

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A leader has connections to the best spirits on the planet!

Foundation which provides funding to dental clinics throughout the United States working to provide access to dental care for vulnerable children across our nation.Teresa also serves on the Board of GIVING WoMN, a local group of philanthropic women who through pooled giving, support non-profit organizations working to improve the lives of people and communities most in need of assistance.

Dr. Fong was the recipient of the MDA’s President’s Award in 2022 and Humanitarian Service Award in 2015.

It is with great respect and appreciation that the MDA honors Dr.Teresa Fong as the 2023 Guest of Honor.

Dr. Fong NWD: What was your reaction when you heard you had received the award, and what does it mean to you and the people who see you receive it?

Dr. Fong: My first reaction was, “Wow! I’m being recognized and honored! Why me?”

My second reaction was a bit of panic: “Wait a minute, I didn’t really do anything.Why me?”

There are truly so many MDA members who go above and beyond.They deserve this award much more than me!

They have that true attitude of gratitude, and they have selfless hearts that genuinely love to serve others. It’s not only what they do, but it’s their passion in action that makes the impact. I’m still striving to be one of “those people”, and I’ve seen and gotten to know many of these heroes in organized dentistry along the way.What a beautiful example their lives have been to me! I truly have gained much more than I could ever imagine giving. For those who see me receive this award, I am honored and blessed. I have been blessed by the love and support of my family who have been my encouragement through life. I am honored by friends and students who give words of congratulations and support.

Most of all, my life has been filled with the immeasurable love of the God of the Universe who has a plan for my life and simply requires my faithfulness.

NWD: This award is something of “after the fact” — the accomplishment is there, and so is the reward.

What is the real reward?

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Dr. Fong: The real reward is that when the reward is presented and the ceremony is over, we can all go back to life and continue to work together for the good of our patients and our profession. It’s a “what’s next?” feeling. Considering what the next adventurous project, committee, volunteer opportunity, or job will be. At this time in my life, it’s also about how I can mentor, share, and help others receive all the accolades and awards that dentistry and life have to offer.

NWD: Where would you want this recognition to go further? What is your hope for the future in the area of your service?

Dr. Fong: I don’t have to imagine how this recognition will go further. As long as we have caring members, we can’t help but move forward for good.

The future will keep us all on our toes with the “what’s next?” feeling.We will be considering the next adventurous project, committee work, volunteer opportunities, and how we can keep improving the dental profession for generations ahead. Especially at this time in my life, it’s also about how I can mentor, share, and help others receive all the accolades and honors that dentistry and life have to offer. And when something good happens, I hope you always find me in the audience giving the loudest applause!

Kirby M. Johnson, D.D.S.

2023 New Dentist Leadership Award Graduating from the University of Minnesota School of Dentistry in 2014, Dr. Kirby M. Johnson has held positions at each level of the tripartite, beginning in dental school and continuing throughout his career as a new dentist.

While still in dental school, Dr. Johnson was actively involved in the American Student Dental Association (ASDA) and was a strong advocate of organized dentistry.

Able to effectively encourage his fellow dental students to join in ASDA membership, that enthusiasm carried over into his years as a West Central District Dental Society (WCDDS) leader, where he was instrumental in recruiting new dentists to serve on the WCDDS Executive Council and where he has served as district president.

Dr. Johnson served on the MDA’s former New Dentist and Membership Committee from 2012 until 2015. When the New Dentist and Membership Committee split into two separate entities, he stayed on until 2020 as a member of the Membership Committee. He also served as chair of the New Dentist Committee from 2018-2020, working to encourage each committee member to come up with new ideas that would enhance the value the MDA provides to its new dentist members. In addition, Dr. Johnson served as Student District Trustee to the MDA Board of Trustees in 2013-2014.

Dr. Johnson oversaw the planning of several events for new dentists, including a social at the Star of the North Meeting, the WCDDS Molar and Mulligan Scramble golf outing, a graduate student social event, and a new dentist night at a Saint Paul Saints baseball game. He represented the WCDDS as a delegate at the MDA House of Delegates from 2015-2021, serving as chair of the reference committee in 2020. He also represented the MDA as an alternate delegate to the ADA House of Delegates, a position he held in 2016 and 2017.

Since moving to Spicer, Minnesota in 2015, Dr. Johnson Ma y - J une 2 0 2 3

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A leader knows where the future comes from.

has quietly enriched his community, serving as a member of the Spicer Lions Club, as a Sunday School teacher at his church, and, since 2020, as a volunteer mini-mite coach with the River Lakes Hockey Association.

Additionally, Dr. Johnson has participated in several dental-related volunteer activities, including every annual Give Kids a Smile event since 2015, four Minnesota Mission of Mercy events, and, since 2019, as a Donated Dental Services provider with the Dental Lifeline Network’s Donated Dental Services (DDS) program.

The Minnesota Dental Association is pleased to honor Dr. Kirby Johnson with the 2023 New Dentist Leadership Award.

Dr. Johnson NWD: What was your reaction when you heard you had received the award, and what does it mean to you and the people who see you receive it?

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Feature Dr. Johnson: When I heard I would receive the award, I felt both honored and humbled. As a district leader, I have attended Star of the North and the awards reception multiple times, so I have seen how great a job the MDA does in celebrating the accomplishments of the award recipients. It felt surreal knowing the first-class treatment that was coming my way. Then to be able to celebrate with and see firsthand the support of so many friends, family members, and mentors was heartwarming. In my mind they share in the award, because I wouldn’t be able to serve without them. For every meeting I attend or dial into, there is one day or evening where my wife is flying solo with kid duty. My dad and brother (both are also dentists) have been there any time I need any dental-related advice. My mom has been there at every turn to offer encouragement. My associate and staff have been there taking on extra duties at the office when I’ve been out at a meeting or wanted to do community engagement work. My hope is that each of them left the awards reception knowing they shared a piece of the award.

NWD: This award is something of “after the fact” – the accomplishment is there, and so is the reward.

What is the real reward?

Dr. Johnson: When accepting the award, I briefly touched on this. It almost seems silly that the MDA and organized dentistry is giving me this award for service that has already given me so much.Through my involvement in organized

dentistry, I have had the opportunity to work with some amazing people, from the fellow leaders who were being honored that evening, to the amazing MDA staff, to other leadership in attendance, and people scattered all over the state and nation. Forging relationships through organized dentistry is truly a gift.The MDA and organized dentistry have also given me great leadership training that I’ve been able to use in my practice and in other civic organizations. It has taught me how to conduct meetings and business in a fair and efficient manner, making sure all voices and opinions are heard before coming to a decision on a matter. It has taught me how to see things from other people’s perspectives and respect them, even if we disagree on a matter. In my mind the reward is ongoing, and I reap the benefits of my involvement on a daily basis.

NWD: Where would you want this recognition to go further? What is your hope for the future in the area of your service?

Dr. Johnson: I am certain I will be involved in the West Central District, the MDA, and/or the ADA throughout my career. In what capacity I am not sure. For the immediate future, I am planning on taking over Treasurer duties for the West Central District, continuing service on the New Dentist Committee of the MDA, and serving as a delegate at the MDA House of Delegates. From there, I am up for anything.

We’ll just see what opportunities present themselves.

Jerome L. Appeldoorn, D.D.S. 2023 Humanitarian Service Award

Dr. Jerome “Jerry” Appeldoorn earned his Doctor of Dental Surgery degree in 1969 from the University of Minnesota School of Dentistry. During his 50-plus years of dentistry, his compassion and care for the underserved has led to many individuals receiving dental care to which they normally would not have access.

Dr. Appeldoorn has been a generous volunteer of his time and talents, providing humanitarian care not just locally, but also abroad. His gentle and humble nature has been extremely valuable, too, in providing mentorship to pre-dental and dental students through his efforts at Saint Olaf College and Carleton College, and as a clinical assistant professor for 14 years at the University of Minnesota School of Dentistry. In addition, he served as an officer in the U.S. Air Force Dental Corps.

Along with several professors at Saint Olaf, Dr. Appeldoorn helped to develop and execute an annual medical/dental mission experience to several Peruvian 22

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A leader can handle a major landscape …

and manage “dessert first” along the way.

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orphanages. For more than 10 years, with his guidance, this study-abroad program was one of the most popular for predental students at that college.

More recently, Dr. Appeldoorn has been instrumental in initiating and volunteering in a program for free local dental care through HealthFinders, a local non-profit health program in Rice County. The dental arm of HealthFinders provides relief for Rice County patients who have no other access to dental treatment. Dr. Appeldoorn has served as their lead volunteer dentist.

An active member of the ADA, MDA, and the Southeastern District Dental Society, the latter for which he is a past president, Dr. Appeldoorn has also been a member (and past president) of the Northfield Rotary Club, a member of his local church council and choir, and a board member of the Northfield Community Action Center.

The MDA is honored to present Dr. Jerome Appeldoorn with the 2023 Humanitarian Service Award.

Dr. Appeldoorn NWD: What was your response to receiving the award?

Dr. Appeldoorn: When I received the letter from MDA president Tim Holland informing me about this award, I felt very surprised, overwhelmed, and more than a little embarrassed. I imagined that there must be many other dentists doing volunteer work in Minnesota, and being singled out was a truly humbling experience.

NWD: What does this award mean to you and people who see you receive it?

family, and colleagues have been, again, overwhelming.This award has generated a lot of attention in our community.

The local newspaper published an article about it, and that article included information about the history and mission of HealthFinders Collaborative. It has been very gratifying to know that the work of my colleagues has been acknowledged.

NWD: What is the real award?

Dr. Appeldoorn: Being part of organized dentistry and private practice (45+ years) has been extremely satisfying and rewarding personally. However, the last 20 years of volunteering and helping underserved patients has been a special reward to me.Working with students and other dedicated, passionate providers have been inspirational, and truly life-changing.

NWD: What do you hope for in the future in the area of your service?

Dr. Appeldoorn: It has been my goal and mission, while working with students (both at the undergraduate and dental school levels) to instill and motivate life-long volunteer service, both during and beyond their professional careers.

My hope for the HealthFinders Clinic is to sustain volunteer participation and increase services it provides to its patients.

Lastly, I would like to see increased awareness and support for recruiting more retired dentists as professional volunteers as supported by the Minnesota Dental Foundation. As I previously stated, some of my most satisfying experiences in dentistry have happened to me following retirement.

Dr. Appeldoorn: I found that the responses of friends,

Howard W. Taylor, D.D.S. 2023 Outstanding Service Award

Dr. Howard Taylor was raised in the northeastern area of Minneapolis and initially practiced in that neighborhood before establishing a practice in the Roseville area. His postgraduate training was in advanced restorative skills that served his patients well for 46 years.

Graduating from the University of Minnesota School of Dentistry in 1971, Dr.Taylor was initially involved with the Minneapolis District Dental Society and soon transferred to the Saint Paul District Dental Society (SPDDS) after opening his Roseville office. He served SPDDS as president and also chaired several committees and study clubs, including the Minnesota Academy for Gnathological Research and the SPDDS Speakers’ Bureau. Service has been a core life value since his first job after high school with the YMCA.The Minnesota Mission of Mercy and his faith community have been constant and regular areas of commitment.

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A leader brings the next generation forward.

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Elected in 2011 as the MDA’s Speaker of the House, Dr. Taylor enthusiastically took on his new assignment and was involved with the MDA staff in making regular reviews of the House of Delegates process to keep the HOD relevant and current. In his role of Speaker, he used his knowledge of parliamentary procedure to teach and train MDA and district leadership in the use of parliamentary procedure in an effort to make meetings more productive and efficient while ensuring fairness to all participants.

Dr.Taylor was awarded the MDA President’s Award in 2014. In accepting that honor, he recounted how his own involvement in organized dentistry came via an invitation by another MDA member dentist. He encouraged others to not only remain involved in organized dentistry, but to invite and encourage others to participate in the process of maintaining a strong profession.

A dedicated leader and coach, Dr.Taylor continuously reached out to district leadership and members to inspire greater engagement in the governance process. He remains active on the Constitution, Bylaws and Ethics and Resolution Review Committees.

Retiring from dentistry in 2016, Dr.Taylor and his wife Cherry purchased a home in Florida where he currently serves on his Homeowners Association Board.

The MDA congratulates Dr. Howard Taylor on his selection as the 2023 Outstanding Service Award recipient.

Dr.Taylor NWD: What was your reaction when you heard you had received the award, and what does it mean to you and the people who see you receive it?

Dr. Taylor: My last major role within the MDA was that of Speaker of the House. My final and sixth House was in September of 2017. I was thanked and acknowledged for my service, publicly and privately.The MDA staff gave me a tremendous photo book of my years as Speaker. I was surprised by the outpouring of appreciation, and the kind words and gestures were certainly appreciated.

I recall that pretty promptly, within a few weeks, I had a committee meeting for the Constitution and Bylaws Committee, and a little later the Resolution Review Committee was also meeting. Life at the MDA did not end with the changing of the guard.

When I opened the letter telling me that I had been selected to receive the Outstanding Service Award, I thought it was inviting me to attend the reception where the award would be presented. I kept scrolling through the letter to see the name of the recipient. I presumed I would know the person — I felt like I had met and become friends with just about everyone within the state. I was letting names run through my head to see if I could guess the recipient before I located the name in the letter. I was honored to be invited to 24

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the reception, but I was unprepared to be the recipient.

The people I knew, my friends, they were the people who should have been selected. I knew how hard so many people worked to make the MDA a better association, and I knew the people who were so deliberate about serving the community at large. I knew the people who were at every event and were willing to serve on any committee. I was a little embarrassed but really humbled to be selected.

NWD: This award is something of “after the fact” — the accomplishment is there, and so is the reward.

What is the real reward?

Dr. Taylor: I had received my reward years before for serving within the umbrella of the MDA. I received the tangible reward of travel to many parts of Minnesota; to see parts of our state where I may never have traveled if it were not for a meeting. I also traveled to several parts of the country for the ADA House of Delegates. However, the real reward was the friendships. I have life-long friends I would never have met without my involvement in the MDA. My life, yes, and Cherry’s and my life together, have been enhanced by the relationships developed from serving in and through the MDA network.Those relationships have no price tag, but we recognize that our lives are richer and fuller because of them.

NWD: Where would you want this recognition to go further? What is your hope for the future in the area of your service?

Dr. Taylor: Recognition for service is an interesting topic.

Serving with the objective of receiving an award detracts from the service. Service is synonymous with volunteering; a volunteer has no expectation of a reward for the service or it no longer is volunteering. However, it is poor manners to not thank someone for their service. Herein lies the judgment: how to say thank you without developing a competition to win an award. I think the MDA does quite well. I do believe there are outstanding servants to our profession who are overlooked. I see no easy remedy, because a lot of volunteering is done silently and away from the spotlight.

Perhaps there is a way to recognize our silent servants.

Looking back, I served where I was invited to serve. I felt inadequate on many occasions, but as I became comfortable with my skills and knowledge, I looked for how to improve the area I was serving. I think that is a pretty common trait.

When I was Speaker of the House, I saw an area where I believed we could more fully prepare our current and future leaders. Dentists are almost universally leaders.We must be self-confident and we must be self-reliant to care for our patients.Those traits are key characteristics for leaders. My observation was that some of our members were willing to serve as leaders but lacked some elements of intentional training that would allow them to maximize their innate No rth wes t Dentis try

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Feature leadership ability. Clearly, they were very good leaders, do not get me wrong. I just believe we can improve ourselves and increase our skill sets at any time in our lives.

The MDA does an orientation for all Board members and has recently launched the Leadership Academy for members.

That said, I would love to see the MDA providing leadership

preparedness training for anyone in the Association. Perhaps each year the MDA could hold one or more orientations for board members, committee members, council members, or anyone in leadership.The orientations could refine existing leadership skills and introduce new skills.

It’s just a dream!

Douglas R. Williams, D.D.S. 2023 President’s Award

Each year the current MDA president has the distinct honor of choosing the one member whom he or she believes stands out amongst all others.

Always a challenging decision to make, the president nevertheless carefully considers the various services each member has provided to the Association and to the profession, and chooses accordingly. Dr. Amber Cziok has announced her decision to honor Dr. Douglas R. Williams with her President’s Award.

Dr. Cziok has this to say about her decision: A leader doesn’t have to stand out from the crowd — if it’s the right crowd.P.S. “This year I chose to honor Dr. Doug Williams That’s Dr. Doug second from the right in the back row. with the President’s Award. Dr. Williams is a recognizable face to many as he served as Treasurer of the MDA for six years while I served on the MDA Board Affinity Products Committees, and is a past MDA delegate of Trustees and ascended the executive chairs. As many of to the ADA’s annual meeting. us run private practices or the financials of our households, The MDA congratulates Dr. Doug Williams on his we understand the importance of knowing the details of selection as the 2023 President’s Award recipient. our financial standings and investments and managing Dr.Williams the income/debt ratios. The MDA treasurer is an often overlooked position that requires extensive knowledge of We begin this section of the Q&A with, and we quote, the financials of an organization that you individually have “Doug’s leadership nutshell: A lack of consensus is the very little power to control or adjust. Although some may opportunity to seek understanding.” He continues: find this mundane or burdensome, Doug chose to serve Enter the sport of Leadership; I am a fan! his organization with diligence and precision — and many The rainbow of personalities possessed by leaders is to good anecdotal comparisons. be welcomed.

Consider the different developments needed Dr. Williams is a leader, a retired dentist, a man who for Elmer Fudd and the Tasmanian Devil to grow as leaders. cherishes his family, a storyteller, a mentor, and a friend. I Although their paths have dissimilar origins, with guidance could not let Dr. Williams fade away from his leadership role each can become an admired leader with styles that are at the Minnesota Dental Association without recognition unique, varied, and personal, each with positive attributes. and presentation of an award for his tremendous service.”

Granted, some traits may need to be quelled while others Dr. Williams graduated from the University of may need to be enhanced…

Minnesota School of Dentistry in 1983. Since that time, While the sport of leadership is defined by rules of he has been a member of the ADA, the MDA, and the order, the players are individuals. The leadership path is an Northwestern District Dental Society (NWDDS), serving ongoing learning experience garnering techniques from as NWDDS’ 2010-2011 president. He has held leadership others. Just as a coach may not be as skilled as the athlete he positions within North Country Health Services, the or she is instructing, understanding the subject matter, keen Minnesota Hospital Association, and his faith community. observation, interpretation, and effective communication In addition to being the MDA treasurer for six years, he has are the assets of a great teacher. Now, mix in the quest for served on the MDA’s Legislative Affairs, Peer Review, and Ma y - J une 2 0 2 3

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personal continuous quality improvement, and the journey on the leadership path has begun. Know yourself, observe others, incorporate well-mentored techniques, and celebrate “you” as a leader.

NWD: What was your reaction when you heard you had received the award, and what does it mean to you and the people who see you receive it?

Dr. Williams: Astonishment. The acknowledgment is heightened because of the respect I have for the presenter.

Thank you, Dr. Cziok. I feel honored to be recognized for the role I’ve played with the MDA over the years.

With each MDA service opportunity, I gained a deeper understanding of the value the MDA provides to all dentists, both members and non-members. As I continued to increase my knowledge, I became more confident in my ability to contribute to the MDA and more willing to explore new roles. I would encourage any members who are considering volunteering to try a short-term project, realize the support offered, then advance to on-going service. The MDA executive team is ready and willing to support, teach, guide, and build one’s skills.

NWD: This award is something of “after the fact” — the accomplishment is there, and so is the reward.

What is the real reward?

Dr. Williams: For me, the real reward is that my service has been of value to an organization that I have been proud to represent in different capacities. It is a two-way street: Time associating with mentor colleagues has afforded me a better understanding of the expanse of the vision of our organization.

NWD: Where would you want this recognition to go further?

Dr. Williams: The public recognition in receiving this award is a beautiful gift. The opportunities provided by my work with the MDA will stir my desire to keep improving in other areas of interest in my life.

NWD: What is your hope for the future in the area of your service?

Dr. Williams: My hope is that I continue to be involved in MDA activities that fit with my skills, values, and interests. I always look forward to the next chapter in life’s saga.

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Leanne M. Mathieu Kramer, LDA, CDA, CDPMA, CDIPC 763-271-1924 lmathieukramer@tds.net www.StatementsPlusComplianceSolutions.com

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Feature

Congratulations to the Minnesota Dental

Star of the North Meeting 2023!

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No rth wes t Dentis try

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Congratulations to this year’s Scientific Session Committee. Left to right are Chair Renee Kinney, Vicki Capistrant, Christine Hammer, Kim Harms,Whitney Bey,Teresa Fong, Meghan Schooley, Reilly Cross, Norman Coates, and Anne Kent.

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C L I N I C A L

Feature The Story of

Silver Diamine Fluoride

Gary R. Hildebrandt, D.D.S., M.S.* Silver Diamine Fluoride (SDF) is the latest in a long line of materials that have been employed to combat the lesions of dental caries. To understand why some scientists are so enthusiastic about it, it is best to review the history of the cariostatic therapies from which SDF has arisen.

Silver The antimicrobial properties of silver, both elemental and ionic, have been appreciated as far back as the ancient Phoenicians, Greeks, and Romans.

These cultures stored water in silver bottles because they felt the silver kept the water pure. In the 1700s, silver wire was used as a suturing material, making use of its infection limiting properties. In the 1800s, American pioneers purportedly placed silver dollars in their stored milk to help make it last longer. By the late 1800s, it was a common practice to treat newborn infants with silver nitrate eye drops to prevent infectious conjunctivitis.

During World War I, before the advent of antibiotics, silver leaf and silver compounds were used in wounds to attempt to prevent infection. By 1940, there were four dozen different silver compounds marketed for the treatment of infections.

The antimicrobial properties of elemental silver have been utilized in dentistry. Of the several components

used in the formulation of highcopper dental amalgam alloys, the antimicrobial properties of amalgam restorations are largely attributed to the silver.1,2 Up until the 1980s, many root canal treatments employed silver points for obturation.

Silver in ionic form is also a part of the history of dentistry. In 1891, Dr. E.A. Stebbins observed that dental amalgam caused adjacent caries lesions to darken and stop progressing. Theorizing that this was an antimicrobial effect of the corrosion products of dental amalgam, he experimented with amalgam scrap, combining it with nitric acid and applying the reaction product to caries lesions on live patients. He reported that the material prevented decay advancement in 61% of teeth after three years.3 Extending this work, Dr.Willoughby D. Miller in 1905 demonstrated that silver nitrate could protect dentin against decalcification,4 and Dr. Percy R Howe in 1917 experimented with the direct application of silver nitrate solutions to caries lesions.5 From this work came the practice of cleansing the cavity with silver nitrate to disinfect it prior to placement of the restorative material,6 and for deep cavities, to use the solution to treat carious dentin purposely left behind as part of the indirect pulp capping procedure.7 The treatment of residual carious dentin was effective and

By 1940, there were four dozen different silver compounds marketed for the treatment of infections.

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tended to cause it to harden and turn dark.8 The use of silver nitrate cavity disinfection was popular for about 50 years, during the heyday of dental amalgam.

By the late 1950s, concerns about possible negative effects of silver nitrate solution on the pulp, even through sound dentin, were growing.9 Its use fell out of favor when esthetic composite resin restorations came into vogue because the underlying black staining could no longer be esthetically tolerated.

Amine Fluorides The story of fluoride as a protective ion in dentistry begins with a Colorado Springs dentist, Dr. Frederick McKay, who observed that patients with mottled enamel were resistant to dental decay. His curiosity piqued, he began to investigate the cause of the enamel mottling and the caries prevention. For a time, he enlisted the help of Dr. G.V. Black.

Other communities were found with similar dental anomalies: Oakley, Idaho, and Bauxite, Arizona. McKay’s investigation spanned the bulk of his dental career from 1901 through 1930.

Although he was able to implicate the community water supply, he could not identify what it was about the water that produced the dental effects.

It was H.V. Churchill in 1930, chief chemist at ALCOA Aluminum, who identified high levels of fluoride in the culprit water supplies. Research *Dr. Hildebrandt is Clinical Professor and Director, Division of Operative Dentistry, Department of Restorative Sciences, University of Minnesota School of Dentistry, Minneapolis, Minnesota. Email is hilde014@umn.edu No rth wes t Dentis try

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on the protective role of fluoride on tooth decay led to one of public health’s greatest success stories: water fluoridation. The first community water supply to have fluoride ions artificially added was in Grand Rapids, Michigan, in 1945. This supplementation resulted in a more than 60% reduction in caries rates for community residents within the ensuing 11 years.10,11 Since the Grand Rapids study, research on topical fluorides branched out into several fluoridecontaining compounds, including sodium fluoride, stannous fluoride, sodium monofluorophosphate, and amine fluoride. By the mid 1950s, fluoride compounds were being added to toothpaste. By the late 1970s, a nationwide decline in caries incidence was attributed to fluoridated toothpaste.12 Of the fluoride compounds being investigated, one type stands out as different from the rest: the amine fluorides. Fluoride compounds are generally inorganic salts. Amine fluorides, on the other hand, are an organic type of fluoride. The development of amine fluorides goes back to observations in the early 1950s that enamel was permeable to organic molecules.13 By linking organic molecules to fluoride, superior penetration of fluoride into the tooth was demonstrated.14 The amine fluoride molecule consists of two parts: the organic amine and the fluoride ion (Figure 1).15 The organic amine is made of a long aliphatic chain attached to one or more amine groups (derivatives of ammonia). The organic amine alone has demonstrated antimicrobial effects against cariogenic and periodontal pathogens.16 They exert this effect by interfering with bacterial carbohydrate metabolism. The long chain organic portion of the molecule forms a nonpolar tail, and the amine group forms a polar head, causing the amine fluoride Ma y - J une 2 0 2 3

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Figure 1. Amine fluoride moleculular formula.

to have surfactant properties, allowing it to spread quickly over all surfaces in the oral cavity and to resist rapid clearance (remaining in place three to six hours). These properties give amine fluorides a chlorhexidine-like ability to de-plaque the teeth.17 Ammonia and Urea Central to the etiology of the caries lesions are bacterially derived acids.

Therefore, one of the earliest strategies employed to combat the disease was to increase the alkalinity of the saliva through the use of ammonia (NH3).18,19 One such strategy involved adding the tasteless ammonia precursor urea (NH2-CO-NH2 ) to foods.20 Chewing urea-containing gum was found to quickly reverse the pH drop brought about by a sucrose rinse.21 In addition, ammonia and its derivatives have antimicrobial properties.

Interestingly, ammonia was part of Dr. Howe’s silver nitrate solution, used to treat residual carious dentin. Silver nitrate in solution tends to degrade over time, forming insoluble silver oxides that precipitate out. To prevent this, ammonia was added, making what was then called an “ammoniacal” solution. Ammonia complexes with the silver ion, making it more difficult to reduce, thereby increasing its shelf life.

No doubt the ammonia in the solution (pH 10.0), by increasing the pH of the caries lesion, had cariostatic activity of its own.

Caries Arrestment In the early part of the 20th century, most of the dental research on topical fluorides dealt with protecting the enamel surface from caries attack and

preventing development of visible lesions.22 In the 1960s, using a rodent model for dental caries, researchers learned that topical fluorides not only prevented lesion formation, but that the rate of progression of existing lesions was also modified.23 When topical stannous fluoride was employed to arrest existing enamel lesions, it was noted that treated lesions that stopped advancing developed dark pigmentation, whereas lesions that did not develop or lost this pigmentation progressed.24 In a small two-year study of stannous fluoride, professionally applied and in toothpaste for home use, it was observed that caries lesions in treated individuals did not appreciably change in size relative to a control group, and that the quiescent lesions had hardened, turned dark, and had an altered texture.25 In a 30-month human trial (involving dental students as subjects), topical stannous fluoride was shown to reduce the advancement of existing enamel caries lesions by 70-80%.26 These early studies added a new dimension to experimentation with caries control strategies. In addition to the well-studied efforts to prevent lesion development (caries prevention), an additional interest was developing on halting the advancement of existing lesions (caries arrestment).

Silver Fluoride (AgF) In 1978 in New South Wales, Australia, researchers struggled with devising control strategies for an isolated community of economically disadvantaged school children. These Continued on next page 33

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Clinical Feature Continued from previous page

children had a high incidence of dental caries, a large backlog of unmet treatment needs, and limited ability to cooperate for restorative care.

In developing a minimal treatment program, they looked for a way to halt the growth of existing lesions, prevent the development of new lesions, and reduce the need of reparative services to a bare minimum. What they decided to do was employ the cariostatic one-two punch of silver and fluoride together. Enrolled children, without caries excavation, had caries lesions in posterior teeth treated, one time only, with a 40% silver fluoride solution and then covered by a stannous fluoride paste. After two years without further treatment, a majority of caries lesions did not advance, and 23% of the cavitated lesions that were initially observed within one millimeter of the pulp remained at the same stage. After treatment, the surfaces of cavitated caries lesions turned black, and this color was strongly associated with caries arrestment - any lightening of the lesion was suggestive of caries development.27 A follow-up study in the mid1980s compared the preventive effect of this two-stage silver fluoride/ stannous fluoride program with the simple application of stannous fluoride alone on newly erupted first permanent molars. They found a significantly higher incidence of caries lesions developing among the teeth treated with stannous fluoride alone.28 In 1983, the School Dental Service in Western Australia, building on the experience of New South Wales, instituted an “atraumatic treatment” protocol for primary teeth with deep

dental caries. It involved minimal carious tissue removal, application of silver fluoride solution, and restoration with glass ionomer cement. Studies looking at the depth of penetration of the silver fluoride were unable to find evidence for any penetration into the pulp with this technique.29,30 Silver Diamine Fluoride These various cariostatic agents were finally brought together as one potent treatment in Japan in 1966 when Dr. Yamaga reported on his work with “ammoniacal silver fluoride”, later renamed silver diamine fluoride (SDF), at the Japan Research Society of Dental Materials and Appliances meeting.31,32 SDF brings together the cariostatic ability of silver, ammonia, and fluoride into one elegant molecule.

The first controlled clinical studies of SDF on caries arrestment came from the Department of Operative Dentistry at Osaka University Dental School in 1969. After a onetime treatment on cavitated lesions in anterior teeth of children, cavity growth, both lateral spread and cavity deepening, was stopped for at least three months (the length of observation).33 SDF was then developed into a commercial product called Saforide (Toyo Seiyaku Kasei Co. Ltd., Osaka, Japan) in 1970, containing 38% silver diamine fluoride. Research with this product in Japan34,35 and in China36 demonstrated great effectiveness at hardening and halting dentinal caries for at least one year after a single application. SDF soon became available as commercial products in other countries such as Argentina and Brazil.

It seems clear that the research community and the dental profession are beginning to take an interest in this new material.

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In 2001, a controlled clinical trial of SDF was undertaken in Guangzhou, China. Three hundred seventy-five pre-school children with cavitated caries lesions were treated by painting either SDF (1X/yr) or sodium fluoride varnish (4x/yr) into the lesions, with or without first excavating carious dentin with hand instruments. After 30 months, the SDF group demonstrated superior caries arrestment, whether caries excavation had taken place or not (100%), compared with fluoride varnish (26-66%).37,38 Prevention as a Side Effect It has been noted that when cavitated lesions are treated with SDF, the risk of new lesions developing elsewhere in the mouth diminishes. For example, in a 2005 study in which 373 schoolchildren in Cuba with cavitated caries lesions were treated every six months with SDF placed in the cavitated lesions and on the sound occlusal surfaces of first permanent molars, it was reported that after 36 months there were 79.7% fewer new lesions on untreated surfaces.39 This could be because the shedding of caries pathogens from open lesions ceased, reducing the seeding of new sites with these organisms.

SDF in the U.S. In 2014, the U.S. Food and Drug Administration (FDA) approved the use of SDF for the treatment of “dentin hypersensitivity”. This seemed a bit odd given the mounting evidence for its cariostatic abilities. But, thanks to this approval, in 2015, the first commercial SDF product became available in the US — Advantage Arrest (Elevate Oral Care, LLC, West Palm Beach, FL). Finally, in 2016, SDF received “Breakthrough Therapy Designation” from the FDA, the first time this status had ever been awarded for an oral care product. Breakthrough Therapy Designation is defined as a potential treatment for a serious disease for which there is no medical No rth wes t Dentis try

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Figure 2. Silver Diamine Flouride publications in PubMed by year.

treatment and great public need. This represented a historic step in the treatment of dental caries. By 2017, it was estimated that 16-20% of U.S. dentists had SDF in their offices or clinics.40 The Pace Quickens In the last half decade, the number of papers being published on SDF has skyrocketed (Figure 2). There were only a few sporadic studies on SDF in the 1990s and 2000s. In 2014 there were six published papers on SDF, in 2015 there were 14, and in 2016, the year of the Breakthrough Therapy Designation, there were 21.

In the following years the number of publications escalated: 2017, 33; 2018, 54; 2019, 48; 2020, 79; and 2021, 102.

It seems clear that the research community and the dental profession are beginning to take an interest in this new material. But what is not clear is if they appreciate the unique benefit it has to offer. Much of the research that has been published on SDF has focused on its ability to prevent cavity formation. Focusing on preventive effects misses the true value of this new material. Although it has proven to be a good method for preventing decay, SDF is one of the most powerful caries arresting agents ever tested. Yet, out of 526 citations to do with SDF in PubMed (as of 11/14/22), only 68 mention “arrest,” “arresting,” or “arrestment” in the title.

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Sharma, Puranik, and Sowmya lament in their 2015 review of approaches to arresting dental caries that there had been no systematic investigation of methods for arresting dental caries up until that point in time. Searching the literature, they were only able to identify 21 primary research articles dealing with caries arrest, 11 of which included SDF.41 In general, caries researchers are narrowly focused on caries prevention, and seem slow to appreciate the value of caries arrestment.

Protocols One of the open questions regarding SDF is how to integrate it into clinical practice. That is the current topic being debated by scientists behind the scenes. Some research has hinted that treating pits and fissures with SDF may be as effective as sealants at protecting against future decay.42 Even if this is true, it would be wrong to generalize these results into considering SDF as just another preventive treatment, like in-office topical fluorides and pitand-fissure sealants. SDF is too potent and expensive to deploy more broadly across the dentition, and its ability to prevent decay pales in significance against its ability to arrest decay.

In 2016, the University of California at San Francisco School of Dentistry’s “Paradigm Shift Committee” was one of the first to jump out in front of the SDF

phenomenon and propose protocols for its use, publishing them in the Journal of the California Dental Association.43 The first thing proposed was that a single application of SDF to an active caries lesion was “insufficient”, and that SDF should be applied every six months for at least two years, calling for research to assess the value of even more frequent application and for longer periods of time. This is surprising in that there are many studies that demonstrate one application of SDF to an active dentin caries lesion is enough to bring about dramatic arrestment.44 The published protocol cites five studies as evidence for the call for repeated treatment.

Here is a summary of the cited studies.

1. Lo, Chu, and Lin (2001)37 administered SDF to cavitated lesions twice, at baseline and at one year, and report 98-100% arrestment at 18 months. No other application regimen was investigated.

2. Llodra, Rodriguez, Ferrer et al (2005)39 administered SDF every six months for three years. At three years, they report 97% arrestment.

No other application regimen was investigated.

3. Yee, Holmgren, Mulder et al (2009)45 administered a single application of SDF and recorded arrestment at six months, one year, and two years. Unfortunately, the results are reported as mean numbers of arrested lesions.

Without providing a percentage arrestment value, it is difficult to compare arrestment at the different time intervals, as the mean number of lesions available for arrestment may have changed.

4. Dos Santos, de Vasconcelos, Ribeiro, and Rosenblatt (2012)46 only employed a one-time application with no other application regimens.

After six months, 85% arrestment Continued on next page 35

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Clinical Feature Continued from previous page

was reported, and at one year, 67%.

It is not clear from the paper if the reduction in percent-arrested at one year is due to the development of new primary caries lesions on other teeth.

5. Zhi, Lo, and Lin (2012)47 compared SDF annual and semiannual application rates and reported twoyear arrest rates as 79% and 91%, respectively. However, at the first six-month recall, arrest rates were 31% and 43%, respectively, which is quite low relative to other studies, and it is interesting that the second group already is displaying higher arrest rates than the first group, even though both groups have only had one application. The methodology therefore is suspect.

The five cited studies therefore do not appear to demonstrate that one application is insufficient to arrest a caries lesion, nor does it support the recommendation that application should be repeated every six months for at least two years.

The UCSF protocol makes other recommendations besides frequency of application. It suggests that the patients who would most benefit from SDF treatment include: 1. Patients with rampant caries (from head and neck radiation exposure, Sjogren’s syndrome, methamphetamine abuse, etc.) or severe early childhood caries 2. Patients with medical or behavioral issues that prevent adequate dental treatment 3. Patients whose treatment will stretch over a large number of visits 4. Caries lesions that are difficult to restore due to location 5. Patients without access to care The UCSF protocol also recommends if active caries lesions are treated with SDF, there is no need to apply topical fluoride for caries prevention to the other teeth. They 36

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also suggest treating permanent molar pit and fissures with SDF if sealants are not an option. They did not mention if eventual restorative treatment is recommended for the SDF-arrested lesions.

In 2017, the American Academy of Pediatric Dentistry guidelines for the use of SDF on pediatric patients were published.48 They hedged their bets by publishing “conditional” recommendations - conditional because they felt it was based on “lowquality” evidence. In terms of pediatric patients, they suggested considering SDF arrestment therapy for patients at high caries risk, requiring multiple restorative visits, with behavioral or medical management challenges, and no signs of pulp involvement. They state that carious tissue excavation before SDF treatment was unnecessary.

Their proposed application technique was: establish isolation with cotton rolls, dry the lesion, apply SDF with a microbrush, gently air dry for one minute, blot with cotton to remove excess, and when possible, maintain isolation for three minutes, although they admitted that studies seem to indicate that contact time does not correlate with efficacy. Eating and drinking immediately after application was judged acceptable. Even though they believed the quality of evidence is poor, they nonetheless advocated for annual reapplication.

The American Dental Association (ADA) put together an expert panel to produce guidelines for the nonrestorative treatment of caries lesions, including SDF. The report was published in JADA in 2018.49 The report states a systematic review of the literature was carried out. However, the review was never published.

On the topic of SDF treatment to arrest cavitated coronal caries lesions, only four studies were considered, presumably because all other reports on the topic were considered of low quality.

Only a small portion of the ADA report deals directly with SDF. It recommends semiannual application of SDF for caries arrestment, drawing on many of the same studies as the UCSF protocol. They suggest that SDF arrestment would be beneficial in situations where local or general anesthesia was not possible, where a patient was uncooperative, where access to care was limited, or where less costly or invasive treatment was indicated.

Studies to date suggest that a one-time treatment may be enough to permanently arrest a cavitated caries lesion, and suggestions that reapplication is critical to long-term success seem unfounded. Studies used to support the need for reapplication have been misrepresented. Cavitated lesions that did not appear arrested at recall visits were likely not adequately treated the first time. The most likely reason for inadequate treatment is poor isolation. Since nearly all SDF clinical studies are on children, and often in field conditions, this is not unexpected.

For the studies employing multiple applications of SDF, the lesions not adequately treated are the ones that need reapplication. Reported outcome measures as percentage of lesions arrested can only be improved by treating lesions that appeared not to be arrested.50 There is no study that demonstrates that if a lesion appears arrested it needs another application of SDF at a future date to maintain quiescence. In fact, there is evidence that remineralized caries lesions are more resistant to future caries attack than are sound tooth surfaces.51,52,53 Annual reassessment of treated lesions and re-application if indicated is probably a more prudent treatment strategy than continual retreatment.

The Future What is the future for SDF? What role will caries arrestment play in the No rth wes t Dentis try

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future practice of dentistry? Don’t look to the expert panels and university committees. These institutions are not as grounded in clinical practice as are the practicing dentists. Scientists have discovered something remarkable and researchers have shown it works.

It is now the clinicians, pragmatic, experienced, schooled by tradition and current science, with years of hands-on application, who will figure out the best way to utilize this remarkable new treatment. ■ References 1. Morrier JJ, Suchett-Kaye G, Nguyen D, Rocca JP, Blanc-Benon J, Barsotti O. Antimicrobial activity of amalgams, alloys and their elements and phases.

Dent Mater 1998 Mar;14(2):150-7. doi: 10.1016/ s0109-5641(98)00022-0. PMID: 10023205.

2. Hegde NN, Attavar SH, Hegde MN, Priya G. Antibacterial activity of dental restorative material: An in vitro study. J Conserv Dent 2018 JanFeb;21(1):42-46. doi: 10.4103/JCD.JCD_2_17.

PMID: 29628646; PMCID: PMC5852934.

3. Stebbins EA. What value has argenti nitras as a therapeutic agent in dentistry? Int Dent J 1891; 12:661-670.

4. Miller WD. Preventive treatment of teeth with special reference to silver nitrate. D Cosmos 1905(August); 47:913.

5. Howe PR. A method of sterilizing and at the same time impregnating with a metal affected dentinal tissue. Dent Cosmos 1917; 59:891-904.

6. Rose TP. Sterilization of carious dentine with silver nitrate. Chronicle. 1976 Oct;39(8):151, 159.

PMID: 1068773.

7. Seltzer S, Werther L. Conservative silver nitrate treatment of borderline cases of deep dental caries.

J Am Dent Assoc 1941(October); 28:1586-1594.

8. Langeland K, Langeland LK. Indirect capping and the treatment of deep carious lesions. Int Dent J 1968 Jun;18(2):326-80. PMID: 4969599.

9. Englander Hr, James Ve, Massler M. Histologic effects of silver nitrate of human dentin and pulp. J Am Dent Assoc 1958 Nov;57(5):621-30. doi: 10.14219/jada.archive.1958.0258. PMID: 13587128.

10. Center for Disease Control and Prevention.

(2021, April 28). Timeline for community water fluoridation. Retrieved from https://www.cdc. gov/fluoridation/basics/timeline.html 11. Pierre Fauchard Academy. (2022) Frederick S. McKay. Retrieved from https://www.fauchard. org/publications/21-frederick-s-mckay 12. National Inventors Hall of Fame. (2022). William Nebergall, stannous fluoride toothpaste. Retrieved from https://www.invent.org/inductees/william-

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nebergall#:~:text=Stannous%20fluoride%20 toothpaste%20was%20introduced,of%20 Acceptance%20must%20contain%20fluoride.

13. Wainwright WW. Time studies of the penetration of extracted human teeth by radioactive nicotinamide, urea, thiourea, and acetamide. I. Diffuse penetration from the enamel surface.

J Dent Res 1954 Dec;33(6):767-79. doi: 10.1177/00220345540330060501. PMID: 13211870.

14. Muhlemann HR, Schmid H, Konig KG. Enamel solubility reduction studies with inorganic and organic fluoride. Helv Dontol Acta 1957;1:233–7.

15. Madléna, Melinda. Experiences with amine fluoride containing products in the management of dental hard tissues lesions focusing on Hungarian studies: A review. Acta Medica Academica, [S.l.], v. 42, n. 2, p. 189, nov. 2013.

ISSN 1840-2879.

16. Shani S, Friedman M, Steinberg D. The anticariogenic effect of amine fluorides on Streptococcus sobrinus and glucosyltransferase in biofilms. Caries Res 2000 May-Jun;34(3):260-7. doi: 10.1159/000016600. PMID: 10867426.

17. Stößer L. Antibacterial effects of amine fluoride on dental plaque. Prophylaxis dialogue.

2007;Special ed.:9-11.

18. Kesel RG, O’Donnell JF et al. The biological production and therapeutic use of ammonia in the oral cavity in relation to dental caries prevention. J Am Dent Assoc 1946 Jun;33:695714. doi: 10.14219/jada.archive.1946.0274.

PMID: 20996000.

19. Kesel RG. The effectiveness of dentifrices, mouthwashes, and ammonia-urea compounds in the control of dental caries.

J Dent Res 1948 Apr;27(2):244-58. doi: 10.1177/00220345480270022001. PMID: 18914170.

20. Stephan RM. The effect of urea in counteracting the influence of carbohydrates on the pH of dental plaques. J Dent Res 1943; 22:63-71.

21. Imfeld T, Birkhed D, Lingström P. Effect of urea in sugar-free chewing gums on pH recovery in human dental plaque evaluated with three different methods. Caries Res 1995;29(3):172-80. doi: 10.1159/000262065. PMID: 7621491.

22. Horowitz HS, Heifetz SB. The current status of topical fluorides in preventive dentistry.

Council on Dental Therapeutics. J Am Dent Assoc 1970 Jul;81(1):166-77. doi: 10.14219/jada. archive.1970.0139. PMID: 4392971.

23. Francis MD. The effectiveness of anticaries agents in rats using an incipient carious lesion method. Arch Oral Biol 1966 Feb;11(2):141-8. doi: 10.1016/0003-9969(66)90183-x. PMID: 5226738.

24. Muhler JC. Stannous fluoride enamel pigmentation—evidence of caries arrestment. J Dent Child 1960; 27(3rd quarter):157.

25. Mercer VH, Muhler JC. The clinical

demonstration of caries arrestment following topical stannous fluoride treatments. J Dent Child (Chic) 1965; 32:65-72. PMID: 14285593.

26. Muhler JC, Spear LB Jr, Bixler D, Stookey GK. The arrestment of incipient dental caries in adults after the use of three different forms of SnF2 therapy: results after 30 months. J Am Dent Assoc 1967 Dec;75(6):1402-6. doi: 10.14219/jada. archive.1967.0381. PMID: 4383325.

27. Craig, G.G., Powell, K.R., and Cooper, M.H. (1981), Caries progression in primary molars: 24-month results from a minimal treatment programme. Community Dentistry and Oral Epidemiology 9: 260-265. https://doi. org/10.1111/j.1600-0528.1981.tb00342.x 28. Green E. A clinical evaluation of two methods of caries prevention in newly-erupted first permanent molars. Aust Dent J. 1989 Oct;34(5):407-9. doi: 10.1111/j.1834-7819.1989. tb00696.x. PMID: 2818298.

29. Gotjamanos, T. (1996). Pulp response in primary teeth with deep residual caries treated with silver fluoride and glass ionomer cement (‘atraumatic’ technique). Australian Dental Journal 41: 328-334. https://doi.org/10.1111/j.1834-7819.1996. tb03142.x 30. Afonso, F. and Gotjamanos, T. (1996). An in vitro study of the distribution of silver and fluoride following application of 40 per cent silver fluoride solution to dentine. Australian Dental Journal 41: 388-392. https://doi. org/10.1111/j.1834-7819.1996.tb06024.x 31. Yamaga R. Caries preventive materials “Action of Ag(NH3)2F” read at The Japan Research Society of Dental Materials and Applianaces, 1966.

32. Yamaga R,Yokomizo I. An arresting of dental caries in deciduous teeth and ammoniacal silver fluoride. Dental Outlook 1969; 33:1007-1013.

33. Nishino M,Yoshida S, Sobue S, Kato J, Nishida M. Effect of topically applied ammoniacal silver fluoride on dental caries in children. J Osaka Univ Dent Sch 1969 Sep;9:149-55. PMID: 4245744.

34. Moritani Y, Doi M,Yao K,Yoshihara M, Miyazaki K, Ito M et al. Clinical evaluation of diamine silver fluoride (Saforide) in controlling caries of deciduous teeth. Rinsho Shika 1970; 266:48-53. [in Japanese] 35. Yamaga R, Nishino M,Yoshida S,Yokomizo I. Diamine silver fluoride and its clinical application.

J Osaka Univ Dent Sch 1972; 12:1-20.

36. Li YJ. Effect of silver ammonia fluoride solution on the prevention and inhibition of caries.

Zhonghua Kou Qiang Ke Za Zhi 1984; 19:97100.

37. Lo EC, Chu CH, Lin HC. A communitybased caries control program for pre-school children using topical fluorides: 18-month results. J Dent Res 2001 Dec;80(12):2071-4. doi: 10.1177/00220345010800120901. PMID: 11808764.

Continued on next page 37

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Clinical Feature Continued from previous page

38. Chu CH, Lo EC, Lin HC. Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children. J Dent Res 2002 Nov;81(11):767-70. doi: 10.1177/0810767. PMID: 12407092.

39. Llodra JC, Rodriguez A, Ferrer B, Menardia V, Ramos T, Morato M. Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial.

J Dent Res 2005 Aug;84(8):721-4. doi: 10.1177/154405910508400807. PMID: 16040729.

40. Horst JA, Tanzer JM, Milgrom PM. Fluorides and other preventive strategies for tooth decay. Dent Clin North Am 2018 Apr;62(2):207-234. doi: 10.1016/j.cden.2017.11.003. PMID: 29478454; PMCID: PMC5830181.

41. Sharma G, Puranik MP, Sowmya K R. Approaches to arresting dental caries: An update. J Clin Diag Res 2015 May;9(5):ZE08-11. doi: 10.7860/ JCDR/2015/12774.5943. Epub 2015 May 1.

PMID: 26155592; PMCID: PMC4484184.

42. Monse B, Heinrich-Weltzien R, Mulder J, Holmgren C, van Palenstein Helderman WH. Caries preventive efficacy of silver diamine fluoride (SDF) and ART sealants in a schoolbased daily fluoride toothbrushing program in the Philippines. BMC Oral Health. 2012 Nov 21;12:52. doi: 10.1186/1472-6831-12-52. PMID: 23171244; PMCID: PMC3549940.

43. Horst JA, Ellenikiotis H, Milgrom PL. UCSF Protocol for Caries Arrest Using Silver Diamine Fluoride: Rationale, Indications and Consent. J Calif Dent Assoc 2016 Jan;44(1):16-28. PMID: 26897901; PMCID: PMC4778976.

44. Chibinski AC, Wambier LM, Feltrin J, Loguercio AD et al. Silver diamine fluoride has efficacy in controlling caries progression in primary teeth: A systematic review and meta-analysis. Caries Res 2017;51(5):527-541. doi: 10.1159/000478668.

Epub 2017 Oct 4. PMID: 28972954.

45. Yee R, Holmgren C, Mulder J, Lama D, Walker D, van Palenstein Helderman W. Efficacy of silver diamine fluoride for arresting caries treatment. J Dent Res 2009 Jul;88(7):644-7. doi: 10.1177/0022034509338671. PMID: 19641152.

46. Dos Santos VE Jr, de Vasconcelos FM, Ribeiro AG, Rosenblatt A. Paradigm shift in the effective treatment of caries in schoolchildren at risk. Int Dent J 2012 Feb;62(1):47-51. doi: 10.1111/j.1875-595X.2011.00088.x. PMID: 22251037; PMCID: PMC9374964.

47. Zhi QH, Lo EC, Lin HC. Randomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children. J Dent 2012 Nov;40(11):962-7. doi: 10.1016/j. jdent.2012.08.002. Epub 2012 Aug 11. PMID: 22892463.

48. Crystal YO, Marghalani AA, Ureles SD, Wright JT, Sulyanto R, Divaris K, Fontana M, Graham L. Use of silver diamine fluoride for dental

caries management in children and adolescents, including those with special health care needs.

Pediatr Dent 2017 Sep 15;39(5):135-145. PMID: 29070149.

49. Slayton RL, Urquhart O, Araujo MWB, Fontana M et al. Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: A report from the American Dental Association. J Am Dent Assoc 2018 Oct;149(10):837-849.e19. doi: 10.1016/j. adaj.2018.07.002. PMID: 30261951.

50. Fung MHT, Duangthip D, Wong MCM, Lo ECM, Chu CH. Arresting Dentine Caries with Different Concentration and Periodicity of Silver Diamine Fluoride. JDR Clin Trans Res 2016 Jul;1(2):143-152. doi: 10.1177/2380084416649150. Epub 2016 May 10. PMID: 28989974; PMCID: PMC5615850.

51. Iijima Y, Takagi O. In situ acid resistance of in vivo formed white spot lesions. Caries Res 2000 Sep-Oct;34(5):388-94. doi: 10.1159/000016613.

PMID: 11014905.

52. Iijima Y, Koulourides T. Mineral density and fluoride content of in vitro remineralized lesions. J Dent Res 1988 Mar;67(3):577-81. doi: 10.1177/00220345880670031001. PMID: 3170896.

53. Koulourides T, Cameron B. Enamel remineralization as a factor in the pathogenesis of dental caries. J Oral Pathol 1980 Sep;9(5):25569. doi: 10.1111/j.1600-0714.1980.tb00383.x.

PMID: 6780667.

H A P P Y PAT I E N T S , H A P P Y H Y G I E N I S T S , H A P P Y Y O U !

Get your team all on the same page delivering the same level of care and the numbers will take care of themselves.

CONTACT BROOKE TODAY to schedule your free 30-minute consultation.

She will help you and your hygienists make good things happen.

Telephone: 952-921-3360 mail: Brooke@AdvancedPracticeManagement.com Text: 952-228-9486 Schedule your appointment online at: https://advancedpracticemanagement.com/hygiene-tune-up/ Brooke Ackerman, MSDH

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M I N N E S O T A D E N T A L

Foundation The Minnesota Dental Foundation would like to thank all of those who have supported the Foundation from November 8, 2022 through April 30, 2023.

Together, we CAN make a difference!

Dr. Alejandro Aguirre Dr. Ramon Aguirre-Gaudiano AmazonSmile Dr. Michael Andrews Dr. Bobbi Augustyn Dr. Louis Austin Dr. Patrick Aydt The Charles Babst IRA on Behalf of Dr. Charles & Judyth Babst The Bakdash Charitable Giving Fund on Behalf of Dr. Bashar Bakdash Dr. Jonetta Bakke Dr. Kathleen Bellamy Dr. William Bellamy Dr. Geoffrey Bentley Best Card Dr. Todd Billington Dr. Jon Buck Dr. Brian Burmeister Dr. Jeffrey Campbell Chris Carroll Retirement Plan on Behalf of Dr. Christopher Carroll Dr. Richard Carter Dr. Gerald Cavanaugh Dr. Julie Chavez Dr. Andrew Christensen City Tooth – Dr. Tripti Meysman Dr. Michael Collins Dr. Robert Congdon Dr. Richard Copeland Crooners Lounge & Supper Club Costco Dr. Mark Dale Dr. Ralph DeLong Delta Dental of Minnesota Dr. Kevin Dens Dr. Anthony Di Angelis

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Dr. Bradly Donabauer Dr. Michael Doroschak Dr. Mike Downie Duluth Entertainment Convention Center Dr. Joel Duray Dr. David & Donna Dvorak Dr. Elizabeth Eggert Dr. Jeffrey Eggert Emagine Theaters Endodontic Professionals, PA Drs. Laura & Robert Eng Drs. Pamela & Keith Erickson Dr. Jonathan Fabian Faribault Mill Dr. Jason Friesz Dr. Peder Gaalaas Dr. Sara Gaalaas Dr. Robert Gardetto Gateway Bank Great River Endodontics, PA Dr. Tom Hanson Dr. Michael Hanson Dr. Chad Hanson Haskell’s – Minnetonka Mr. Mark Hayes Dr. Michael Helgeson Hennepin Theatre Trust Dr. & Mrs. Arnold Hill Dr. Bill & Carol Hoffmann Dr. Jeffrey & Kim Holmberg InterContinental MSP Hotel Dr. Geoffrey Iverson Dr. Timothy Jacobson Dr. Joan Jakubas Dr. Lee Jess Jester Concepts

Dr. Stacey Johanson Dr. Daniel Johnson Dr. Paul Johnson Dr. Donald & Monica Johnson Dr. Lisa Johnson Dr. Douglas Jolstad Dr. Michael Jorgenson Dr. Dennis Kaivo Dr. Fred Kalinoff Dr. Robert Kess George & Julie Kinney, Jr Charitable Giving on Behalf of George & Julie Kinney Dr. George & Julie Kinney Dr. Carissa Knutson Dr. Bruce Kudak Dr. Michael & Marcia Kurkowski Mr. & Mrs. Gregory LaBelle Ms. Lori Lindemann Dr. Scott & Anne Lingle Dr. Frank M. & Donna Lynn Lombardo Dr. Gloria Lopez Franco Dr. Richard Lorenz Dr. Michael Lose Dr. & Mrs. Dennis McMahon Dr. Steven Means Dr. Charles Mendes Merwin Liquors MGM Wine & Spirits – Hopkins Dr. Marie Mueske Dr.Virgil Mylan National Camera Exchange Network for Good Dr. Erick Nolting Dr. Jeffery O’Neil Continued on next page

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Minnesota Dental Foundation Continued from previous page

Dr. Daniel Odegaard Dr. William Olson Ordway Center for the Performing Arts Ms. Anastasia Patterson Dr. Olivia Paulsrud Cathy Seward & Tom Peichel Sheldon Peterson & Gaye SkellyPeterson Charitable Fund on Behalf of Dr. Sheldon Peterson & Gaye Skelly-Peterson Dr.Vacharee Peterson Dr. Brian Pierce Dr. Megan Pint Dr. Mackenzie Platt Dr. & Mrs. Robert Plumb Dr. Jill Pucel-Koopman Renstrom Dental Studio Inc Dr. Michael Rohrer Dr. William Rolfe Dr. H. Rudy Ronning Gregg Rosenburg Dr. Byron Rowell Dr. Daniel Schafer Dr. Herbert & Julie Schulte Dr. Robert Schwegler Dr. Tom & Julie Seidelmann Mr. Adam Sekely Dr. Karl Self Mr. James Shamp on Behalf of Dr. Doug Shamp Dr. Douglas & Donna Shamp Dr. Stephen Shuman Dr. Roger Sjulson St. Paul Hotel St. Paul RiverCentre David & Phyllis Steimer Dr. Christopher Stenzel Cindy & Scott Sundet Charitable Gift Fund on Behalf of Dr. Cindy & Scott Sundet The Sundet Foundation on Behalf of Dr. Cindy & Scott Sundet

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James Timothy Swanson IRA on Behalf of Dr. J. Timothy & Kathryn Swanson Scott Swanson Dr. Gregory Swenson Dr. T’s Knives – Dr. David Taber The Howard & Cheryl Taylor Charitable Fund at Schwab Charitable on Behalf of Dr. Howard & Cheryl Taylor Dr. Michael Thomas Dr. Michael Till Dr. James Tomhave Dr. Steven Tomhave Dr. Robert Toutges University of Minnesota School of Dentistry Alumni Society Dr. Brandon Ulstad Valleyfair Amusement Park Dr. Scott Varland Dr. Matthew Vaughn Dr. Douglas Vayda Dr. Patricia Vayda Dr. Derrick Veneman Dr. Paul Vollmer Wachlarowicz Family Giving Fund of Fidelity Charitable on Behalf of Dr. Aaron & Rachael Wachlarowicz Dr. William Wagnild Dr. Lee Weinhold Dr. James Westman White Bear Smiles, PA Dr. & Mrs. Richard Wiberg Drs. Charles & Sandra Wilkinson Dr. Gary Williams Dr. Gerald Wimmer Dr. Larry & Elizabeth Wolff Dr. Robert Wottreng Dr. Thomas Zbaracki Dr. Camille Zelen Dr. Paul Zollinger

Gifts in Appreciation, in Honor or in Memory of an individual In Appreciation of: Dr. Walter Coombs Ms. Sharon Coombs In Honor of: Dr. Steve Litton’s Special Birthday Michael & Rochelle Galinson In Memory of: Dr. Wallace L. Christenson Minnesota Dental Association Ms. Kari Diercks Dr. Stephen Litton Dr. Joseph Dudding Minnesota Dental Association Dr. Stephen G. Finch Minnesota Dental Association Dr. William Girvin Minnesota Dental Association Dr. Max Goldberg Miriam Goldberg Estate Dr. Richard W. Gross Minnesota Dental Association Dr. Jerry Hall Minnesota Dental Association Dr. Anna Hampel Minnesota Dental Association Robert R. Hoover, D.D.S. Dr. Hugh Norsted Dr. Gary Mac Carthy Minnesota Dental Association Dr. Donald H. Nelson Minnesota Dental Association Dr. Lloyd Pearson Dr. John Pike Dr. John L. Seaverson Minnesota Dental Association

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Dr. Robert W. Tjossem Minnesota Dental Association Dr. Todd Tsuchiya LEGACY CIRCLE Dr. Bashar Bakdash Dr. Amber Cziok Dr. David & Donna Dvorak Drs. Laura & Robert Eng Miriam R. Goldberg Estate in Memory of Dr. Max Goldberg Dr. Eric & Barbara Grutzner Dr. William & Carol Hoffmann

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Jeffrey N. & Kim Holmberg DDS Dr. Lee & Mary Jo Jess Dr. Paul & Noreen Jorgensen Estate Dr. Franklin Jung Dr. Edward Kishel Dr. Clark LaChapelle Dr. Stephen & Bonnie Litton Dr. & Mrs. Steven Means Dr. Patrick Morgan Estate Drs. JoAnn & Mark Omlie Dr. Rosalie Perpich Dr. Katie Post

Dr. Robert Reed Estate Dr. Freeman & Shirley Rosenblum Dr. Daniel Shaw & Judith McKloskey Dr. Howard W. & Cheryl B. Taylor Dr. Matthew Vaillant Floyd Wehrman Estate Dr. James & Sonja Zenk We make every effort to be sure this list is accurate. If you are aware of errors, please contact the Foundation.

Thank you.

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D I S T R I C T

News Northeastern District Gary Hedin Associate Editor 12411 Superior Street Suite 828 Duluth, MN 55802 Spring — It’s a Verb Too! Spring has finally arrived in the Northeastern District. Granted, there are still plenty of areas up here with at least some snow on the ground.

It was a long and snowy winter, and I think everyone is excited about the prospects of starting to do more summery things like planting gardens, golfing, camping, and enjoying nonfrozen water activities.

This time of the year also means that the NEDDS Annual Business Meeting took place. This is a yearly meeting during which the activities of various committees of NEDDS, the MDA, and the ADA are summarized and discussed, and the new members of the leadership team are installed.

This year’s NEDDS starting line-up includes: President - Tim Morse; First Vice-President - Mark Phillips; Second Vice-President - Jason Naud; and Secretary/Treasurer - David Haugen.

Dr. Naud was unable to attend the meeting, but our trusty Trustee Kim Lindquist installed the officers, and MDA Executive Director Carmelo Cinqueonce was on hand to provide an update on the MDA and also to referee the annual Steve Dahlgren Invitational Arm Wrestling Tournament. This year’s arm wrestling tag team champions were the Branch Street Bandits (Mark Phillips and Jeff Polzin), who won in a tight match against the Hawk Talons (Brian McDonald and Jeff Johnson).

Congratulations to our new officers, and if you get a chance, please 42

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MDA Executive Director Carmelo Cinqueonce, left, with (left to right,) NEDDS Secretary/ Treasurer David Haugen, First Vice-President Mark Phillips, President Tim Morse, and Trustee Kim Lindquist.

thank them for their service to our profession! Serving in these elected positions can be a lot of work on top of family and work responsibilities, and it is wonderful that we have so many great folks in our district.

Stars of the North Keep Shining for Us Recently the Star of the North Meeting took place in Saint Paul, and it was packed full of great continuing education opportunities. Additionally, it is fun to catch up with former classmates, instructors from dental school, and some of those sales reps you tend to develop relationships with over many years. I enjoyed taking several classes, hearing Olympic Gold Medalist Jessie Diggins speak at the Keynote, and attending a “retirement party” for long-time lab technician Luther Ison. Mike Madden, whom many of you know from preclinical time at the U, set up a wonderful gettogether for Luther at a local brewery.

It was great to catch up with Luther and talk to several former classmates while enjoying some food and drinks.

Summer Suite The upcoming NEDDS Golf, Fishing, and Biking Outing will be taking place in early June, and I

District members Gary Hedin, left, and Nathan Pedersen flank retired School of Dentistry Lab Technician Luther Ison.

hope that many of you can make it.

Always a good time, it will be held at The Wilderness at Fortune Bay and neighboring Lake Vermillion.

Full Disclosure That is all I have for now, so I hope you all have a great summer with your family and friends! Oh, and that arm wrestling I mentioned earlier did not actually take place, but maybe it should take place in the future.

But Of Course!

We have to do a shout-out of thanks to Eileen Patterson for the pics from the business meeting!

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News Northwestern District John E. Lueth Associate Editor P.O. Box 310 Bemidji, MN 56619i

Editor’s note: The following report is sent to us from Ms. Terri Bannor, Program Director of the Dental Assisting program at Northwest Technical College. JEL Dental Assisting Program at Northwest Technical College Marks 50th Anniversary A gathering at Northwest Technical College (NTC) in Bemidji on May 2nd, 2023, celebrated the fiftieth graduating class in the Dental Assisting program.

Judy Damp, founding director of the program, reminisced about the college being part of the public school district with the name Bemidji Area Vocational Technical Institute (BAVTI). The program was created as an option for students moving right from the local high school. At the celebration, Mrs. Damp shared that she began her professional career in education and had returned to school herself to learn the skills of dental assisting. She had been working in the field of dentistry for three years when she was approached to develop the curriculum and teach the dental assisting program. The program started its first cohort in the fall of 1972 and graduated in the spring of 1973.

The program was located in the original footprint of the NTC building from 1972 until 2006, when a Health addition was added and the program moved into its current location. The program facility, the Dental Suite, has been updated over the years as a result of grants and partnerships with local entities.

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The sterilization lab was remodeled December 2018. The Main Clinic was also renovated in August 2022 with an Innovations Grant in coordination with our community clinic, Northern Dental Access Center (NDAC). Northwest Technical College and Northern Dental Access Clinic are currently in the process of writing a grant, and if successful, it will allow for new software for Northern Dental Access Center and renovations for NTC’s dental program Radiology Clinic, front desk area, and repurposing of the processing/dark room areas for a student locker area and changing room.

Dental Assisting (DA) students gain technical knowledge and the manual skills necessary to enter the dental profession as a chair-side clinician, assisting with various clinical functions, laboratory tasks, and business office responsibilities.

Classroom and hands-on training prepare the DA students to perform procedures such as exposing radiographs, placing pit and fissure sealants, taking impressions, and managing patient records. In addition, labs, internships, and servicelearning activities offer students real life experiences and interactions with patients and dental health care professionals. The NTC DA program provides a 100% job placement rate, as there is currently a shortage of dental assistants in every region of Minnesota.

One of the fundamental successes in dental health is preventive dentistry, which has reduced dental disease, improved oral health and the retention of teeth in the geriatric population, and increased awareness

among parents to implement dental prevention efforts with infants and children. Dentists have been employing more dental assistants than ever before to meet the increased demand for dental care.

DAs are essential to the operation of a dental office. Most offices employ at least two DAs. Projected growth of 11% in the career field is anticipated over the next several years. In the United States, there are approximately 44,000 job openings for dental assistants projected each year, on average. DAs now hold more than 330,200 jobs in the U.S. According to the Occupational Outlook Handbook, published by the U.S. Department of Labor’s Bureau of Labor Statistics, careers requiring a specialized diploma are projected to add significant numbers of employment opportunities. In the state of Minnesota, there is a significant need for trained DAs. A unique highlight of NTC’s program has been the program faculty.

Mrs. Damp taught the program alone for a short number of years, and when the program had grown, she hired a former student, Dianne Dappen, to join the DA faculty. Ms. Dappen became the program director upon Mrs. Damp’s retirement in 2001, and brought Julie Dokken, a former student, on board. Upon Dianne Dappen’s retirement, Julie Dokken took on the role of program director and added Terri (Anderson) Bannor to the staff in 2007. Ms. Dokken retired in 2019, with Terri Bannor becoming program director, and Siau Yean Montgomery, a former student, was Continued on next page

Dentists have been employing more dental assistants than ever before to meet the increased demand for dental care.

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Northwestern District Continued from previous page

Congratulations to the Northwestern Technical Institute on Its 50th Anniversary.

hired as faculty in 2020. Bannor and Montgomery continue there today.

In 50 years, these five women have taught and graduated more than 44

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1,000 students from NTC’s Dental Assisting program.

The program also boasts a very active and supportive Advisory

Committee. Comprised of local dentists, licensed dental assistants, a current student, and a public member, the Advisory Committee No rth wes t Dentis try

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offers input and guidance on current skills necessary for the industry, new equipment, and technology needs, as well as curriculum updates. Many of the dentists on the advisory committee, past and present, as well as some other local dentists serve as Clinical Advisors in the Advanced Functions course during the spring semester. The program is always looking for dentists to volunteer to help.

Northwest Technical College, located in Bemidji, Minnesota, is a

two-year higher education institution in the Minnesota State Colleges and Universities system, located in northern Minnesota’s lakes area. NTC provides an inspiring and challenging learning environment with personalized services and access to industry-current technology. Classes are offered on campus, online, or as a combination. An aligned partnership between NTC and Bemidji State University (BSU) offers university perks to NTC students. These benefits include resident housing in the

university dormitories, health care, access to the Gillett RecreationFitness Center, and a BSU activity card providing access to university sporting events and campus activities.

The Northwest Technical College Dental Assisting program is accredited by the Commission on Dental Accreditation of the American Dental Association. The College is accredited by the Higher Learning Commission.

The Dental Assisting program is approved by the Minnesota Board of Dentistry.

The Ear of the Beholder:

The Song of the Bobolink

William Cullen Bryant’s oft-quoted poem contains lines which do some justice to the spirit of the song and of the scene of its delivery, but the refrain, “Bobolink, bobolink; spink, spank, spink” is a feeble effort reduce its notes to spoken words.

Mr. [Robert] Dawson’s transliteration, Oh geezler, geezler, gillipity, onkeler, oozeler, oo, really is a clever rendition, in that it suggests clearly the essentially liquid and vowel character of the opening notes.

But it should be added that, having proceeded thus far, and in a rapid but comparatively restrained manner, Robert is likely to become suddenly a sort of hysterical music box, and to produce a burst of sound polytechnics which make one fear that the next second he is going to explode outright and vanish in a cloud of feathers.

From Birds of America, T. Gilbert Pearson, Editor in Chief

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News Retiring University of Minnesota School of Dentistry lab “Mr. Everything” to dental students across decades Luther Ison at his party, here with Dr. Eric Strand.

West Central District Eric Strand Prairies Edge Dental 106 East Washington Avenue Fergus Falls, Minnesota 56537 Email is strand39@gmail.com

Heading Out to a Sweet Summer WCDDS Style This issue’s theme of “Summer in Minnesota” is a great tie-in to the latest news in our district. When most of us think of a quintessential Minnesota summer, it usually involves lakes, food, and friends. It is about togetherness. Our district has been hoping to foster this sense of congeniality by participating in and arranging a series of informal meetings.

The first highlight is a hearty congratulations to our past District president, Kirby Johnson, on being 46

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awarded the MDA’s New Dentist Leadership Award at this year’s state meeting. Despite not being the most populous district, the WCDDS has a long tradition of making outsized contributions at the state and national levels.

Star of the North is always a great opportunity for dentists to share perspectives and friendship, and this year’s meeting was no exception.

Some alumni also met the Friday of the meeting to give a hearty thank you to Luther Ison and mark his retirement from the dental school lab. As any grad over the last few

decades would know, Luther provided invaluable help to so many dentists now practicing across the Midwest.

The WCDDS has started a program of quarterly get-together/ cocktail hours. We began last winter in St. Cloud, met in Fergus Falls this February, and are looking forward to (at the time of my writing) meeting in Wilmar this May. These meetings are not CE and generally not specifically related to MDA business, but simply a venue for board members to host members from across the region to their various hometowns. This provides an excellent opportunity No rth wes t Dentis try

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How Do You Know When Summer Has Arrived in Your District?

Fergus Falls is home to an egret rookery. Imagine that many of these beautiful creatures in one place!

The MDA’s New Dentist Leadership Award winner for 2023, Kirby Johnson, and his wife Hallie.

to invite local non-MDA dentists to meet with members of organized dentistry from their own area. It’s probably even more useful for recruiting existing MDA members to meet the District’s board and consider becoming more involved at the state level. As most of the readership is probably aware, there is a dearth of new, and younger, members stepping up into leadership positions. This is a trend across many organizations from churches to service clubs, but the best way to encourage participation is through a personal invitation. These meetings provide a venue for that. So far, we’ve had a good response and hope to continue the program for the conceivable future.

Finally, we will also be hosting a Golf Scramble and CE event in Brainerd on August 2nd. Any dentist interested can reach out to our board members or wait for an email later this season. Hope to see many of you there!

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The West Central District is in the heart of Minnesota lakes country and like many folks in the region, my family and I moved here in large part for the geography, so for us the surest signs of summer are centered around the water and fields.

Fergus Falls is the home of an egret rookery, and the return of these birds is often the first A pure summer moment for all harbinger of summer. concerned, including the photog rapher.

My boys and I will be out catching panfish shortly after.

The final sign for us is when the farmers start to turn the earth in the fields. This marks the time for us to pull out our latest vintage tractor project and get ready for The Strand contingent getting ready for the annual vintage tractor parade. the local parade.

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Feature We Are Collecting …

Minnesota dentists love Robert Frost — a simple statement wherein fact and poetry meet. In support of that ever-widening idea, NWD has decided to embark on another of our “We are collecting” adventures, this time along “roads not taken”.

First we need to shake off the layers of false familiarity that may encrust one of the poet’s most admired and beloved pieces, “The Road Not Taken”. Find a quiet place and give it a revisit. Then, ask yourself what came to mind immediately.

Make note of that, and then, if so inclined, let it sink in and reconnect you with your own road “that has made all the difference”.

That is what we would love to hear about.

This has been a year of blow after blow to our established way of doing and even thinking. A reset would do well to include finding, again, and sharing a time/place/incident/ piece of advice that changed your life. This could certainly include thoughts about how well the choice turned out, perhaps even describing a less desirable outcome than anticipated, hopefully with resolution and maybe a silver lining.You may share regrets and how they have been overcome. Allow “The Road” to give a nudge to those occasional musings of how serendipitous life can be, but most of all, “from that moment on”.

Take your time, but please consider doing it. With a picture or two, even better. It could be or have been anything – after all, that is what this inquiry is based on.

Consider it a pause at that fork in the road we all come to to let others know that, like the poem itself, not keeping important ideas to yourself is an important idea in itself.

And we will keep collecting until we can do that right.

Robert Frost would approve. ■

Contributions should be sent to NWD Managing Editor Sue Miller at nwdmiller@comcast.net.

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The Road Not Taken Two roads diverged in a ye llow wood, And sorry I could not tra vel both And be one traveler, long I stood And looked down one as far as I could To where it bent in the un dergrowth; Then took the other, as jus t as fair, And having perhaps the be tter claim, Because it was grassy and wanted wear; Though as for that the pa ssing there Had worn them really ab out the same, And both that morning eq ually lay In leaves no step had trodd en black.

Oh, I kept the first for an other day!

Yet knowing how way lea ds on to way, I doubted if I should ever come back.

I shall be telling this with a sigh Somewhere ages and ages hence: Two roads diverged in a wo od, and I— I took the one less traveled by, And that has made all the difference.

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News Minneapolis District

MDDS Guest off Honor Addele l Delllla Torre, center, withh a lil teral Honor gu g ard off Woodyy Kwon and Andrew Moffffitt.

Andrew R. Moffitt Associate Editor 502 Jefferson Highway North Champlin, MN 55316 A Note from the District On behalf of the District’s Executive Council, we wish to update you on a recent change in the management of the Minneapolis District Dental Society.

Effective May 1st, the operational management of the District has transitioned to the Minnesota Dental Association (MDA). This decision was not an easy one, as it involves moving away from our long-time Executive Director. However, financial stability, stewardship, and fiscal responsibility have led us to this important decision.

The economic efficiencies and subsequent financial savings under a new management model will provide the necessary resources to move the District to heightened levels of success.

This new model allows greater access to the resources and support of the MDA team, while enhancing the benefits experienced as a member of organized dentistry. The MDA team is well-versed in all facets of association management and will provide exceptional service in areas such as event planning and marketing, member communication, accounting services, and governance.

We thank Michelle Quade for her many years of service to the Minneapolis District Dental Society.

We hope to formally acknowledge her years of service at a later date.

Thank you for your continued support of the MDDS, and we look forward to charting a new course for the District.

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The MDDS officers for 2023 are, left to right, Andrew Moffitt, president; Woody Kwon, Secretary/Treasurer; Tasha Strait, president-elect; and Paul Peterson, vice-president.

A Spring Full of Activity Spring Fling As spring comes to an end, we welcome our 2023-2024 officers and Council members, a group of individuals dedicated to leading the

District to new heights of success. Our yearly Spring Fling event was once again a time to install our incoming officers. This year we welcome Drs. Andrew Moffitt, president; Tasha Continued on next page 49

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Minneapolis District Continued from previous page

Our incoming president Andrew Moffitt, left, receives the gavel from outgoing president Woody Kwon.

Strait, president-elect; Paul Peterson, vice-president; and Woody Kwon, Secretary/Treasurer.

Our Spring Fling event also serves as a time to celebrate our 2023 Guest of Honor recipient. Each year the Minneapolis District Dental Society recognizes an individual who stands out amongst his or her peers and has provided exceptional value to organized dentistry and to their community. The Executive Council carefully considers a deserving individual’s contributions to the profession, and the District chooses accordingly. The member we celebrate this year is an outstanding individual who exemplifies dedication to the profession. We are honored to recognize and celebrate Dr. Adele Della Torre as the 2023 District Guest of Honor.

MDA President’s Award Reception We are thrilled that our very own Dr. Teresa Fong, former District president and former MDA Trustee for MDDS, was selected as the Minnesota Dental Association’s 2023 Guest of Honor. Dr. Fong was recognized during the Star of the North festivities in Saint Paul. Her dedication and contribution to dentistry and the District are inspiring.

Congratulations!

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MDDS members and leaders at the Star of the North Meeting to honor Dr.Teresa Fong are, left to right, Drs. Cale Strait,Tasha Strait,Woody Kwon,Venetia Laganis,Teresa Fong, Steve Litton, and Andrew Moffitt.

Save the Date • Plans are underway for the Minneapolis District Annual Trapshoot Tournament, scheduled for Wednesday, August 16th, at the Metro Gun Club in Blaine. Watch your inbox for more information!

• Save the date for the Fall Dental Soirée, to be held at Grace Church in Eden Prairie on Friday, September 29th. The program features nationally MDA Guest of Honor Dr. Teresa Fong and her mother celebrated recognized her award at the Star of the North Meeting. speaker Dr. Drew McDonald speaking on “TMJ • Midwinter Dental Meeting will and Airway-Directed Orthodontic be returning to the Minneapolis Treatment: The Important Role of Marriott Northwest Hotel in Orthodontics in Management of Brooklyn Park on Friday, January TMJ and Airway Issues”.

26th, 2024.

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D I S T R I C T

News Saint Paul District R. David Resch Associate Editor 3427 Snelling Ave. Arden Hills, MN 55112 (651) 485-0987 dr.dresch@comcast.net Almost Done! Ready to Go! Yes, this is the last little communication I will be offering for Northwest Dentistry from the SPDDS. On June 15th I ascend the ranks to president of the District, and our new president-elect, Andrew Lund, will be writing to all of you in the journal.

This past year has gone very fast, perhaps because we’re “inching” out of the COVID pandemic and starting to get back to some normalcy.

What’s happened?

Another award: In 2014, Howard Taylor was awarded the MDA’s President’s Award.This year he is the recipient of the MDA’s Outstanding Service Award.

Dr.Taylor graduated from the University of Minnesota School of Dentistry in 1971, and since opening his practice in Roseville has always considered his involvement in organized dentistry a high priority.

He served the SPDDS as president, and chaired several committees and study clubs, including the Minnesota Academy of Gnathological Research and the coveted SPDDS Speakers Bureau. Service has been a core life value for Dr.Taylor.

Congratulations and thank you for all your years of involvement!

Excellent Spring Seminar: On April 4th the SPDDS had its traditional spring seminar. Our panelists were Heather Horton, Jason Jenny, Brooke Brown, and Scott Rake!

More than 40 individuals attended this CE panel spotlighting orthodontic and Ma y - J une 2 0 2 3

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Dr. Brooke Brown at the SPDDS Spring CE program. surgical collaborative techniques with real-world cases.The SPDDS is certainly fortunate to have excellent specialists willing to share their expertise and educate all of us. And what’s to come?

Don’t forget about the SPDDS Dentispree on June 15th, a fun-filled night to visit with other dentists from the District. I will be officially installed, as will our new Executive Council. It is also a night to recognize MDA Outstanding Service Award winner Howard Taylor, our SPDDS outgoing right, with long-time District buddy Mike Kurkowski. president Erik Davis new officers and Executive Council and thank him for a great year. members. A night to enjoy music, food, Dentispree will take place at 7 and wine. Oh yes, you get two wine Vines Vineyard in Dellwood. Our tickets with your registration! evening starts at 6:00 p.m. with a social time, followed by the installation of Continuedd on nex extt pa page g 51

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Saint Paul District Continued from previous page

Save the Date! Thursday, October 26th, will be our Fall CE Meeting.

More to come about this great event soon!

Friday, January 12th, 2024.The

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Saint Paul District Dental Society’s Midwinter Meeting will feature Bruce Christopher, one of the top dental educators in North America. If you missed his Keynote Address at the 2023

Chicago Midwinter Meeting, and perhaps also at the 2023 Star of the North, this is your chance: It will be a great presentation for the entire team!

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AUT HOR G UID EL INE S Introduction. Northwest Dentistry is the official journal of the Minnesota Dental Association (MDA). Bimonthly distribution includes the member dentists of the Minnesota Dental Association, students and libraries of the University of Minnesota School of Dentistry, and subscribers worldwide. Circulation exceeds 3,000. In addition, manuscripts appearing in the journal are published on the MDA web site. Northwest Dentistry features: scientific and clinical research and discussion, reviews of the literature, and treatment techniques; features on member and Association activities; practice management; professional guidelines including regulatory updates; and news and editorial/opinion articles including Letters to the Editor. All clinical and research articles and abstracts submitted for publication will be reviewed by a peer panel of experts upon submission. Feedback including suggestions for improvement and clarifications to assist the author(s) will be made prior to publication.

Northwest Dentistry is published under the supervision of the Northwest Dentistry Editorial Advisory Board and the Editorial Staff of the Minnesota Dental Association. Neither the Editorial Staff, the Editor, nor the Association is responsible for any expression of opinion or statement of fact, all of which are published solely on the authority of the author whose name or initials are indicated. The Association reserves the right to reduce, revise, or reject any manuscript.

Manuscripts for publication and correspondence regarding editorial matters should be addressed to the Editor. Letters of inquiry are requested for proposed articles, to include a brief description of subject matter, length, and requirements for photos and/or graphic support. Articles and photos published in Northwest Dentistry become the property of the Minnesota Dental Association and may not be reprinted without written permission.

Deadlines for copy supplied by Contributing Editors and other regular contributors are provided by editorial staff prior to start of each new volume.

Manuscript and Illustration Preparation. All manuscripts must be submitted as Word documents, either emailed or sent on disk. The title should be kept short; MDA reserves the right to shorten titles.

An abstract of approximately 50-100 words should be included.

Manuscripts should not be less than 800 words (approximately four double-spaced pages) nor more than 5,000 words (approximately 20 pages).

Use of illustrations and photographs is encouraged. They should be submitted as JPEGs or TIFFs, and should be sent as individual files (one per image) that are not embedded in any other program.

They should be at least 350 dpi at two and one-half inches wide. All illustrations and drawings should be numbered and top and bottom should be indicated. Each illustration should be accompanied by an appropriate legend, which should be listed separately and not on the illustration or drawing. The text of the paper should indicate the preferred points of insertion. The corresponding author’s name, address, fax, phone, and email must accompany the manuscript.

References should be selective. They must be keyed to the text and numbered consecutively with their appearance within the text.

They should include, in order: name of author, title of article, name of periodical, volume, number, date of publication, and page numbers.

For books, the name of the publisher and its location should be included. Up to three authors may be listed. For four or more authors, the first three authors should be listed, followed by et al.

Example: White SN, MacEntee MI, Smithson DS et al. Restorative treatment for geriatric root caries. J Cal Dent Assoc 22(3);1994:55-60.

Authorship Requirements. When a manuscript is submitted, a signed statement on authorship responsibility, a statement on financial disclosure, and one of the two following statements on copyright or

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federal employment must be included. Each of these three statements must be signed by all authors.

Authorship responsibility: “I certify that I have participated sufficiently in the conception and design of this work and the analysis of the data (when applicable), as well as the writing of the manuscript to take public responsibility for it. Neither this manuscript nor one with substantially similar content under my authorship has been published or is being considered for publication elsewhere, except as described in an attachment. If requested, I shall produce the data upon which the manuscript is based for examination by the editors or their assignees.”

Financial disclosure: “I certify that any affiliations with or involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the manuscript (e.g., employment, consultancies, stock ownership, honoraria, expert testimony) are disclosed below. I have listed research or project support in an acknowledgment.”

Copyright transfer: “In consideration of the action of Minnesota Dental Association in reviewing and editing this submission, the author undersigned hereby transfers, assigns, or otherwise conveys all copyright ownership to MDA in the event that such work is published

by MDA in any medium, including, but not limited to, Northwest Dentistry and the MDA web site.”

Publication and Copyright. Contributors will be notified within 90 days if a manuscript is accepted for publication.

In consideration of the action of the Minnesota Dental Association in reviewing and editing this manuscript, the authors transfer, assign or otherwise convey all copyright ownership of the manuscript, excluding photographs, to MDA. In addition, the authors grant permission for manuscripts and all images to be published by MDA in any medium, including but not limited to the web sites of Northwest Dentistry Journal and the Association, as well as third-party publishers of reference materials licensed through the MDA. In all such cases, materials shall bear the Northwest Dentistry volume, issue and page information. If authors do not have copyright ownership of submitted images, authors hereby warrant that such permission has been obtained and a Permission of Use form submitted to the Editor prior to publication.”

Authors will be granted reprint and republish permission upon request whenever possible.

Letters to the Editor. Readers of Northwest Dentistry are invited to submit Letters to the Editor on topics related to articles or columns previously published in the journal. Letters written to express viewpoints about current policies or actions of the MDA or other agencies will be referred to an appropriate individual, department, or committee to directly respond to the author. The views expressed are those of the writers and do not necessarily reflect the opinions of the Minnesota Dental Association, the Northwest Dentistry Editorial Advisory Board, or Northwest Dentistry editorial staff. Letters will be accepted by email at info@mndental.org. Complete Letters to the Editor policy can be found at www.mndental.org.

Reprints. Principal authors of manuscripts published in Northwest Dentistry will receive three copies of the issue in which the article appears. Please see the Northwest Dentistry reprint policy on the MDA web site, www.mndental.org, for further information concerning reprint or other reproduction policy.

Correspondence. Address all manuscripts and related correspondence to: Susan Miller, Managing Editor Northwest Dentistry nwdmiller@comcast.net Northwest Dentistry is indexed in the Index to Dental Literature.

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D I S T R I C T

News Southern District Seth Huiras Associate Editor 110 1st Street North Montgomery, Minnesota 56069 shuiras@gmail.com Ready, Steady, and Go for It! The Southern District is ready for summer! We had a fabulous time getting together at the Star of the North in Saint Paul. The Star of the North dental meeting is back in full force, with a healthy dose of learning and sharing time together as dental professionals. We held our Executive Committee meeting at Patrick McGovern’s Pub over our lunch hour on Friday, and we talked through some of the key events of 2023: Fall Meeting at Sleepy Eye Convention Center on Friday, September 8th.

MDA House of Delegates in Bloomington, Minnesota on Friday, September 22nd.

Appointment of our next Southern District president.

Appointment of our next president-elect, and

Left to right “on the night” at the recent SDDS Executive Council meeting were Gretchen Osboda, David Kirkoff, Mikkel Haugen, Seth Huiras, Bart Johnson, Brandon Karels, Grant Sorenson, and Maureen Sorenson.

Appointment of our next Chair of Exhibitors and Essayists.

We will keep you posted on the specific individuals for each position in the fall, but we are fortunate to have Drs. Gretchen Osboda, David Kirkhoff, and Brandon Karels to take on these new roles within the Southern District.

We are also fortunate to report we filled our delegate roster with ease and have those six delegates and two alternates signed up.

As well, we will keep you posted on a couple of individuals who are

applied for the upcoming MDA Leadership Academy.

And finally — although there is never really a “finally” — we have all our Continuing Education speakers for the next three meetings of the Southern District reserved through Fall of 2024.

We wish everyone a healthy planting and growing season of 2023.

May the sun be warm, the rain be plentiful, and our days be filled with joy and laughter!

Thank you, MDA, for all that you do in our organized dentistry efforts.

How We Know It’s Summer in the Southern District In the Southern District, we know it is summer when the grass is green, the fields are planted, and the smells of barbecues are coming from garages and back yards.

A graduation party has balloons blowing in the wind attached to a mailbox at the end of a driveway, or a farm auction has a line of cars parked in the ditch along a county highway for at least a mile long. The marking poles for plow trucks along driveways and parking lots are put away, and the hedges are trimmed with fresh clean rocks or mulch around the perennials. We also know it is summer when the traffic is thick on a Friday afternoon

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along every state highway that heads north to the lake regions of Wilmar, Alexandria, Detroit Lakes, or even Park Rapids. Summer starts tiring us out after that midJuly town festival with classic car shows, arts and crafts, recreational sports, and the final parade. We get one last breath of summer when the corn is tall and tasseled, the beans are thick with large green leaves, and the animals are all in full prestige being shown at the county fair. Thank goodness for summer because it has us all excited for that next breath of cool air come fall. Thank you, Southern Minnesota, for all that you are.

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News Southeastern District Jasmine Yesil Associate Editor 150 East 4th Street Winona, Minnesota 55987 Summer in Minnesota: On Imagination’s Shoulders “What I love most about rivers is You can’t step in the same river twice The water’s always changing, always flowing.”

From the song “Just Around the River Bend”

by Judy Kuhn, in Disney’s Pocahontas Winona’s Chris Carroll with an earlier model in process.

With summer just around the bend and everyone itching to get out on the water, I thought I would see what our former editor for the SEDDS, Chris Carroll, was up to. It is quite interesting where life leads us when the waters change over time.

NWD: I know that when you retired you had been a longterm associate editor and author for Northwest Dentistry, but I heard you hadn’t quite hung up your pen yet. I understand you published something recently.

Dr. Carroll: Yes, I had a little twopage article that was in the winter edition of in Boundary Waters Journal.

for better or worse I live about two miles from where they make Wenonah canoes. I was going by there one day and they were having a sale out in their yard.They had a beautiful little graphite solo canoe for sale, so I bought it. I got a nice light paddle for it, and I also wanted a yoke, but they were backordered indefinitely.

When I got home, I got on the Internet and tried to find a carrying yoke, but I couldn’t find anything out there that I thought was suitable. Being, and you lovingly call me, a “tinkerer”, I went into my wood shop and came up with a design that solved all the major problems of yoking a solo canoe.

NWD: What are the problems of yoking a solo canoe?

NWD: What was that about?

Dr. Carroll: I invented a better carrying yoke for a solo canoe.

NWD: Sounds like there’s a story there.

Dr. Carroll: Well, I’d been wanting a solo canoe for quite some time, and 56

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Dr. Carroll: In a nutshell, the seat and the yoke want to be in the exact same place, right in the middle of the canoe at the balance point.The way to get around that is either have the yoke off center, which is cumbersome, or to make the yolk removable. Most designs I found chose the latter strategy, but they always required some sort

of latching or unscrewing or bolting or permanently altering your canoe, and none of these are desirable or convenient.

NWD: How did you get around these problems?

Dr. Carroll: Most yokes go straight across the canoe from gunwale rail to gunwale rail. If you do that at the center of a solo canoe, the seat is right where your head needs to go. I designed my yoke with a downward curving bow that pushed both the seat and the canoe up and away from the head.This bow offered another advantage that I wasn’t really expecting.

There was enough spring in both it and the sides of the canoe that I could snap the yoke in place, nearly instantaneously, without having to screw, bolt, fasten, latch, or remove anything.

NWD: What did people think of your innovation?

Dr. Carroll: I personally thought it was a marketable idea, so I got myself No rth wes t Dentis try

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a partner, the friend who sold me the boat in the first place, and he and I went around everywhere trying to find someone interested enough to start producing it.We went to three canoe manufacturers, a couple of canoe outfitters up in Ely, and the world’s largest paddle sports store, Rutabaga, in Madison,Wisconsin.

It got great reviews everywhere we went. Everybody loved it and said they would sell it if we made them, but no one was interested in manufacturing them.The rub is, there aren’t that many solo canoes being sold. It just wouldn’t pay to tool up to manufacture such a limited-demand item.

NWD: Is that why you published the article in Boundary Waters Journal?

Dr. Carroll: Yes. I won’t say I wasn’t disappointed that I couldn’t make a commercial success out of my idea, but what bothered me the most is that I had this idea that was just languishing down here in Winona, so I thought I’d share it.

A laminated bow being glued up.

The yoke being put to use at Fourtown Lake in the BWCA.

NWD: What’s been the response to your article?

Dr. Carroll: I’ve gotten a few responses, but I’m not really interested in making any more of them … been there done that. I did relent, however.

I was contacted by a fellow from Maine, and we became fast friends.

He has some physical problems and thought my yoke would make his solo tripping easier, so I agreed to make him one.

I did have an ulterior motive. I was needing a piece to enter in the Minnesota Woodworkers Guild’s annual exhibition in the cities, so I agreed to make him a yoke and get it to him once the show was over.

It ends up, I’ll be delivering it by hand. It’s just a coincidence, but we are both entering the Boundary Ma y - J une 2 0 2 3

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The commissioned piece that’s going back to Maine.

Waters Canoe Area one day apart from one another in May. I’ll be spending the night at the Cascade Lodge the night before going in, and he and his travel companion will be at

a nearby campsite. We’ll meet up, I’ll hand over the yoke, then the three of us will head up to the Angry Trout in Grand Marais for a wonderful supper — white fish, I think.

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D E N T I S T S C O N C E R N E D

F O R

Dentists

For Me, The Real Test was Relationships When I thought that my alcohol consumption might be getting out of hand, I could go online and find the alcoholism tests. I had to admit to some of the questions being true, but when I totaled my score, I never had a problem. I could search out more tests and find the same results. I didn’t have any of the negative consequences from drinking like DWIs, memory loss, or blackouts. I didn’t have problems at work or at home. Or so I thought.

My alcohol use had been to deal with the stress of the day. Or was it the joy of the day, or did someone say something that I took personally?

Whatever the case might be, it seemed reasonable to have a drink after work.

I always had the ability to stop. I knew how much of a buzz I wanted and would stop at that point. Most of my drinking was alone at home. Since my wife never ever complained about my consumption, I had good reason to believe that I didn’t have a problem and that “not drinking alone” was a stupid rule.

Some days it was a drink before dinner, some days after dinner, and some before and after. I was never visibly drunk, but I knew that I was beyond the legal driving limit. I started spending more of the evening watching the talk shows on TV. I was isolating myself from life.

My rock bottom came when my wife identified and verbalized the personality changes that had occurred. I had become negative and isolated. I wasn’t maintaining friendships. I would rather argue over something simple that I didn’t agree with. I wasn’t enjoying life. She had had about enough.

I wasn’t really surprised. I had seen the same in the mirror but didn’t know or believe that there was a way out. An intervention wouldn’t have really surprised me.

I decided to stop my use of alcohol for six months or more to be able to figure out and fix the things that were wrong with me. Being a dentist meant that I liked to fix things, and that I was above average intelligence. I started my research so that I could prove that I wasn’t an alcoholic. I read about Alcoholics Anonymous, and found that the only requirement for attending was to have a desire to quit alcohol. After my first two weeks of sobriety, I called another dentist who I knew attended AA meetings. We met the next day, and I went to my first AA meeting. He encouraged me to attend the DCD meetings, and I have since then.

What I found at these meetings was that my story and my problems were shared by many. The members accepted me without judgment. I am sure that my Continuedd onn nex extt pa page g

Dentists Concerned for Dentists (DCD) is a group of recovering alcoholic and/or chemically dependent dentists concerned about other dentists who might have problems in their relationships with alcohol and/or other moodaltering drugs. Although we receive our funding, for the most part, from the Minnesota Dental Association (MDA), we are a completely separate organization. Our business and clinical processes are supported by Sand Creek Workplace Wellness, a local provider of employee assistance services, and the administrators of the MDA’s Dentist Wellness Program.They answer our phones and provide a consulting psychologist/chemical health specialist, who also functions as a service coordinator for the group.We adhere to a strict code of confidentiality. No information regarding the cases we become involved with is shared with the Minnesota Dental Association or the State Board of Dentistry.

There are some cases that come to the attention of the Health Professionals Services Program (HPSP) before we are ever involved, and in those cases, and only with the written consent of the dentist concerned, we will provide limited “progress reports” when requested to do so by HPSP as part of their on-going monitoring program. Our primary purpose is to be available to afflicted dentists, helping them effectively address their alcohol and/or other drug problems, while protecting their anonymity and helping them continue in the practice of professional dentistry.To that end we provide supportive services and educational resources to them, their families, and their colleagues.

For confidential help to address alcohol and/ or other drug concerns, please contact Dentists Concerned for Dentists (DCD) at (651) 275-0313 or (800) 632-7643. You can also visit our website at www.dcdmn.com

Some days it was a drink before dinner, some days after dinner, and some before and after.

NEW COPY TO COME

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sobriety would not be going as well as it is without going to the meetings.

Now just four months into sobriety, I have been able to find a happiness that eluded me. I have much to do to improve myself, but the improvement in my life so far has made it clear that I never want to use alcohol again. For some of us alcohol is such a seductive drug that it sucks the life out of us. What I have learned is that the subjective tests are only one type of measurement. For me, the real test was relationships.

What was my relationship to alcohol? What had alcohol done to my relationship with myself, my wife, my children, and others? This was the test that I didn’t

know about, but it was the one that I had failed. I now know and admit that I am powerless over alcohol and that my life has become unmanageable. Help was so close; all I had to do was ask.

DCD has kept my name confidential. I didn’t go through a treatment program. My recovery has been from going to the meetings. HPSP and the Board of Dentistry haven’t been involved. At first I wanted to avoid them, but now I don’t really care about that. I am now discovering healthy responses to the difficulties of life. The practice of dentistry brings unique stresses to us. Dentists Concerned for Dentists gives support for dealing with our issues.

Grateful DCD Member

I N D E X TO ADVE RTISE R S Advanced Practice Management . . . . . . . . . . . Cover II

Minnesota Academy of General Dentistry . . . . . . . . 29

Advanced Practice Management . . . . . . . . . . . . . . . 38

Minnesota Dental Association Hesy-Re . . . . . . . . . . 26

AFTCO Transition Consultants . . . . . . . . . . . . . . . . . 7

Minnesota Dental Association Mobile App . . . . . . . . 52

Business Opportunities . . . . . . . . . . . . . . . . . . . 60-62

Minnesota Dental Association Store . . . . . . . . . . . . . 18

CareCredit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

Minnesota Dental Association Women’s Seminar . . . 41

Dyste Williams . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Minnesota Transitions . . . . . . . . . . . . . . . . . . Cover III

Fortress Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . 28

Shea Practice Transitions . . . . . . . . . . . . . . . . . . . . . . 2

Gateway Bank . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Statements Plus . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Heritage Construction . . . . . . . . . . . . . . . . . Cover IV

TDIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Karkela Construction . . . . . . . . . . . . . . . . . . . . . . . . 1

Winthrop & Weinstine. P.A. . . . . . . . . . . . . . . . . . . . . 5

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B U S I N E S S

Opportunities Placing a Classified Ad in Northwest Dentistry Classified advertisements should be posted directly to the Minnesota Dental Association website: www.mndental.org/advertise You have the option of posting to the website only or posting on the website and in the print edition of Northwest Dentistry. One insertion in the print edition of Northwest Dentistry is for a period of two months.

Complete all required screen fields to submit your ad. MDA members should log in to receive member rate.

Once submitted, your ad will be reviewed by the MDA for content approval.

Member rate for website only is $50/month. Non-member rate for website only is $100/month.

Member rate for print only is $25 for up to 25 words, plus $0.25 for additional words.

Non-member rate for print only is $50 for up to 25 words, plus $0.75 for additional words.

Careers Associate Dentist Needed - Seeking an energetic dentist to join a great team loaded with technology and opportunities to grow in many aspects of dentistry, buying possible.

ASSOCIATE DENTIST WITH BUY-IN OPTION - MAPLEWOOD MINNESOTA - $10,000 Sign-on bonus. 123 Brush Dental is a busy private practice in Maplewood (St. Paul) Minnesota. Friendly and fun atmosphere; a great place to start your dental career. Good mix of family practice procedures and an experienced dentist to mentor you. We emphasize ethical behavior, respect for all our diverse patients and quality care that‘s not rushed. Our clinic accepts most insurance plans and Medicaid. Associate compensation at 36% of collected production; buy-in option for near future. Please send your resume to info@123brushdental.com or call 651330-9571.

Associate Dentist - Fosston, MN $12,000 Sign-On Bonus - Associate Dentist for Prairie Pines Dental in Fosston, MN, located 45 minutes west of Bemidji in one of the most serene places for the great outdoors. Offering a turn-key position with an inherited patient base and full autonomy in treatment planning. Current areas 60

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of practice: General Dentistry, Oral Surgery, and Prosthodontics. Searching for a candidate with an interest and/or proficiency in other areas of practice aside from General Dentistry. Comp benefits: generous daily guarantee for first 12 months with added comp option of 32% net production, $12,000 sign-on bonus, relocation assistance, 401K with 6% match, CE/professional memberships, liability insurance, uniform, CPR, dental benefit (employee and family), clinical mentorship and more. Email inquiries to info@ crowndentalstaffing.com (outsourced professional recruiting partner).

Associate Opportunity in New Prague, MN - FT Associate Dentist for Dental on First in New Prague, MN. Offering a turn-key position with an inherited patient base, full autonomy in treatment planning and the utilization of a fully renovated facility. Current areas of practice: General Dentistry, Cosmetic Dentistry, Oral Surgery, Prosthodontics, Endodontics, Cosmetic Dentistry, and sleep apnea therapy.

Searching for a candidate with an interest and/or proficiency in other areas of practice aside from General Dentistry.Tech landscape:Dentrix,Dexis sensors, rotary endo and more. Comp benefits: 33-35% gross production in addition to generous daily guarantee, $12,000.00 sign-on bonus, 401K with 3% match, medical insurance, CE/

professional memberships, CPR, dental benefit (employee and family), clinical mentorship and more. Email inquiries to info@crowndentalstaffing.com (outsourced professional recruiting partner).

Associate Dentist Opportunity in Bloomington, MN - Associate DDS with buy-in potential for River Bluff Dental in Bloomington, MN. We offer a progressive technology landscape including 4 CEREC machines, full autonomy with treatment planning and a highly skilled Dental Assisting team. Current areas of practice: General Dentistry, Prosthodontics, Cosmetic Dentistry, and Endodontics. Searching for a candidate with an interest and/ or proficiency in other areas of practice aside from General Dentistry including but not limited to implant placement, clear aligner therapy and more. 8 op layout with ability to run multiple treatment rooms in a matrix schedule.

Compensation/benefits: 30% of net production, $10,000.00 sign-on bonus, 401K, medical insurance, CE, CPR, dental benefit, (employee and family), clinical mentorship and more. Email inquiries to info@crowndentalstaffing. com (local MN dental recruiting partner).

HIRING BONUS - LARGE ESTABLISHED PRIVATE GROUP PRACTICE ASSOCIATE No rth wes t Dentis try

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DENTIST - $10,000 Hiring Bonus – Seeking motivated, kind and dedicated Associate Dentist who believes in the value of team work and collaboration.

Our expert team of dentists, advanced dental therapists, hygienists, and support team, have been committed to creating healthy, beautiful smiles just 45 miles south of the twin cities of Minneapolis/ St. Paul in Faribault, MN for more than 40 years. We continue this mission today with the latest advancements in dental treatments and technology.

Our busy, private group practice currently includes 7 DDS, 3 ADT, 18 RDH, and the best group of LDA and admin support team members including our local management team.

Benefits include 401k, profit sharing opportunities, group health insurance, dental benefits, PTO and holiday pay.

Position is full time. Southern Heights Dental Group values work life balance, and therefore our office hours are Monday 8am-7pm, T-TH 8am-5pm and Friday 7am-2pm. Only serious applicants need apply. * Hiring bonus paid after 90 days of employment.

Associate General Dentist Rochester - Crystal Dental Clinic, home to Dr. Billie Vasdev and her wonderful staff, is currently looking for a full or part-time associate dentist to join our practice. We are currently experiencing growing pains and would love to find the right candidate to join our team. It brings us pure joy that we started this practice from scratch not that many years ago. Our office is located blocks away from the famous Mayo Clinic located in downtown Rochester MN. We are also within an hour of St. Paul/Minneapolis area. We are very pleased that we have created a culture here at Crystal Dental Clinic where our entire team is committed to providing the utmost quality dental care to our patients while striving to build relationships based on trust and compassion not only with our patients but also with one another. It is Ma y - J une 2 0 2 3

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imperative we find the ideal candidate who has a passion for dentistry and cares deeply for their patients. We have a modern state-of-the-art practice with digital scanning, intra-oral cameras, digital x-rays, etc. Compensation/ benefits for the right candidate: $10,000 sign-on bonus, guaranteed salary for 3 months commensurate experience, medical insurance, 401K, CE, dental benefits, clinical mentorship, and more.

Path to partnership is available. E-mail inquiries to mat@crystaldentalclinic. net.

Associate Dentist – West Central Minnesota - Bluestem Dental is a growing practice in western Minnesota seeking a dental associate; we are open to part or full-time employment. We are a busy practice with two locations – looking for an associate to work primarily in our Benson, MN clinic.

We have a great staff, and are looking for the right fit to join our team. We currently have 3 dentists who provide the full array of comprehensive dental care for our patients, in a beautiful new clinic setting. Generous guaranteed base salary, with production bonus opportunity and high earning potential.

We also offer benefits and continuing education support. If interested, mentorship and eventual ownership/ partnership opportunities are available.

As an applicant, confidentiality is assured. Please contact Dr. Noah Zehringer at noah@bluestemdental. com for more information. We look forward to meeting you!

Classifieds Excellent Opportunity in the Southwest Metro - The practice is loaded with technology featuring Schick sensors, an iTero scanner and much more. There are 9 fully equipped digital operatories and 2,300 active patients. Collections average over $1,230,000 annually.

CONTACT MATT LAHN AT

APM TRANSITIONS Matt@ avancedpracticemanagement.com or 952-921-3360 FOR MORE INFORMATION. Practice for Sale in Southeastern Minnesota - Outstanding opportunity in Southeastern Minnesota.

Beautiful, brand new building on a growing side of the city with great visibility, easy access, and high traffic counts. It is a fully computerized and digital practice, including Schick digital x-rays, Orthophos digital panoramic, and the latest generation Trios digital impressions. There are four fully equipped operatories, and two more treatment rooms are ready for equipment to be installed. Nitrous oxide is also plumbed into each treatment room. Collections average over $736,000 annually over the past 3 years, with nearly 1,500 active patients. CONTACT MATT LAHN AT APM TRANSITIONS Matt@ advancedpracticemanagement.com or 952-921-3360.

Practice for Sale in Eastern North Dakota - Busy family practice in a 1,000 square-foot facility with 4 fully equipped operatories. Collections average over $523,000 annually over the past 3 years. Over 1,000 active patients. CONTACT MATT AT APM TRANSITIONS Matt@ advancedpracticemanagement.com or 952-921-3360.

HIGH TECH EAST METRO PRACTICE FOR SALE - This busy family practice has 4 operatories in 2,621 square-feet. Collections average over $800,000 annually in the last 3 years. It is modernly equipped and decorated, and has over 830 active patients. CONTACT MATT LAHN AT APM TRANSITIONS Matt@ advancedpracticemanagement.com or 952-921-3360.

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Business Opportunities Continued from previous page

Practice for Sale in North Central Iowa - Second generation family practice located in a vibrant community. The practice has 2 operatories and the dental office space is 1,830 square-feet. Over 1,590 active patients. Collections average over $479,185 annually over the last 3 years. CONTACT MATT LAHN AT APM TRANSITIONS FOR MORE INFORMATION AT M ATT@ A DVA NCED P R AC T I C E M A N AG E M E N T. COM OR 952-921-3360.

Beautiful Practice in the North Country - One of a kind opportunity in a busy and productive practice.

3,189 square-foot facility has 5 fully equipped operatories including 2 suites. Collections average over $1,020,00 annually over the past 2 years. Over 1,700 active patients.

CONTACT MATT LAHN AT APM TRANSITIONS Matt@ advancedpracticemanagement.com or 952-921-3360.

PRACTICE FOR SALE - FARGO/ MOORHEAD AREA - Doctor owned 2,378 square-foot facility with 5 (4 equipped) operatories. This busy practice has collected $779,380 annually over the past 3 years and has 1,650 active patients (in the last 24 months). CONTACT MATT LAHN AT APM TRANSITIONS. Matt@ AdvancedPracticeManagement.com or 952-921-3360.

PRACTICE FOR SALE - WEST CENTRAL MINNESOTA Beautiful modern facility. The practice has collected over $766,915 annually over the last three years. Over 1,200 active patients. 4 fully equipped digital ops, 5th op is partially equipped.

CONTACT MATT LAHN AT APM TRANSITIONS. Matt@ AdvancedPracticeManagement.com or 952-921-3360.

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PRACTICE FOR SALE CENTRAL LAKES REGION Fantastic opportunity in the Central Lakes Region. 2,500 square-foot facility has 4 fully equipped operatories.

Collections average $600,000 annually over the past 3 years. Over 1,100 active patients. CONTACT MATT LAHN AT APM TRANSITIONS Matt@advancedpracticemanagement. com or 952-921-3360.

BUSY PR ACTICE IN N O R T H W E S T E R N MINNESOTA FOR SALE Excellent opportunity! This family practice operates out of an owned building with multiple rental opportunities. The practice has 8 operatories and the dental office space is 4,600 square-feet. Over 3,300 active patients. Collections average over $1,229,000 annually over the last 3 years. CONTACT MATT LAHN AT APM TRANSITIONS: Matt@ advancedpracticemanagement.com or 952-921-3360 Excellent Opportunity in the Southwest Metro - The practice is loaded with technology featuring Schick sensors, an iTero scanner and much more. There are 9 fully equipped digital operatories and 2,300 active patients. Collections average over $1,230,000 annually.

CONTACT MATT LAHN AT APM TRANSITIONS Matt@ avancedpracticemanagement.com or 952-921-3360 FOR MORE INFORMATION. Practice for Sale in Eastern North Dakota - Busy family practice in a 1,000 square-foot facility with 4 fully equipped operatories. Collections average over $523,000 annually over the past 3 years. Over 1,000 active patients. CONTACT MATT AT APM TRANSITIONS Matt@ advancedpracticemanagement.com or 952-921-3360.

Practice for Sale in Southeastern Minnesota - Outstanding opportunity in Southeastern Minnesota.

Beautiful, brand new building on a growing side of the city with great visibility, easy access, and high traffic counts. It is a fully computerized and digital practice, including Schick digital x-rays, Orthophos digital panoramic, and the latest generation Trios digital impressions. There are four fully equipped operatories, and two more treatment rooms are ready for equipment to be installed. Nitrous oxide is also plumbed into each treatment room. Collections average over $736,000 annually over the past 3 years, with nearly 1,500 active patients. CONTACT MATT LAHN AT APM TRANSITIONS Matt@ advancedpracticemanagement.com or 952-921-3360.

HIGH TECH EAST METRO PRACTICE FOR SALE - This busy family practice has 4 operatories in 2,621 square-feet. Collections average over $800,000 annually in the last 3 years. It is modernly equipped and decorated, and has over 830 active patients. CONTACT MATT LAHN AT APM TRANSITIONS Matt@ advancedpracticemanagement.com or 952-921-3360.

WE REUPHOLSTER DENTAL CHAIRS TO LOOK LIKE NEW! - We specialize in Reupholstering dental chairs. Over 30 years of exp. Call Jennell 651-890-2897 or jennell@designcommercialinterior. com. Why buy new when you can renew! Design Commercial Interior has you covered.

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Minnesota Dental Association Directory OFFICERS, TRUSTEES, AND COMMITTEE CHAIRS 2022-2023

Officers

Trustees

Committee Chairs

President

Minneapolis District

Affinity Products

MnMOM

Tim Holland 605 Hillcrest Avenue Suite 230 Owatonna, MN 55060-3680 (507) 451-7250 (office) (507) 451-1011 (fax) timrholland@hollandfamilydental.com

Lee Ann Herbert 1525 County Road 101 N Minneapolis, MN 55447-2707 (763) 475-2820 (office) (763) 475-1037 (fax) drlah@comcast.net

Travis Schmitt 204 4th Street SW Suite 144 Austin, MN 55912-4427 507-437-2023 (office) tschmitt00@gmail.com

Alejandro Aguirre 12545 42nd Pl N Plymouth, MN 55442-2348 Phone: (763) 458-3564 aaguirre2805@gmail.com

Barriers to Care

President-Elect

Saint Paul District

Aruna Rao 3950 Veterans Drive St. Cloud, MN 56303 arunarao611@gmail.com

Affiliated Organizations

New Dentist

Minnesota Dental Foundation

Rosalie Perpich 13481 60th Street North Suite 100 Oak Park Heights, MN 55082-1089 (651) 351-0890 (office) (651) 351-1922 (fax) drp@stillwaterfamilydental.com

First Vice-President Alejandro Aguirre 12545 42nd Pl N Plymouth, MN 55442-2348 (763) 458-3564 (phone) aaguirre2805@gmail.com

Second Vice-President Scott Wagnild 1108 Western Avenue Fergus Falls, MN 56537-4808 (218) 736-4000 (office) swagnild@gmail.com

Treasurer Loren Taple 1227 Northwood Pkwy Eagan, MN 55121-4204 (651) 687-0789 (office) (651) 687-0902 (fax) ltaple@northwooddental.com

Speaker of the House Stephen McDonnell 2456 Haverton Road Saint Paul, MN 55120-1730 (612) 867-7263 (phone) mcdonnellsn83@gmail.com

Executive Director Carmelo Cinqueonce 1335 Industrial Boulevard Suite 200 Minneapolis, MN 55413-4801 (612) 767-8400 (office) (612) 767-4250 (direct line) 1-800-950-3368 (toll free) (612) 767-8500 (fax) ccinque@mndental.org

Geetha Damodaran 4641 White Bear Parkway White Bear Lake, MN 55110-3300 (651) 429-0404 (Office) (651) 429-0472 (Fax) DDS1@birchlakedental.com

Northwestern District Zachary Hazelton 10 Mag Seven Court Southwest Suite 220 Bemidji, MN 56601-4678 (218) 333-8668 (Office) (218) 333-1515 (Fax) zach@tallpinesfamilydentistry.com

Northeastern District Kimberly Lindquist 324 West Superior Street Suite 824 Duluth, MN 55082-1718 (218) 727-7557 (Office) (218) 727-1182 (Fax) kimberlylindquist3412@gmail.com

Stephen Shuman 3737 Bryant Avenue South Minneapolis, MN 55409-1019 (612) 827-8310 (office) (612) 827-8408 (fax)

Board of Dentistry R. David Resch 1371 7th Street W Saint Paul, MN 55102-4205 (651) 222-0351 (office) (651) 222-1556 (fax) dr.dresch@comcast.net

Constitution, Bylaws, and Ethics Michael A. Kurkowski 5835 Saint Albans Court Shoreview, MN 55126-4754 (651) 484-3235 mmkurkowski@msn.com

Dental Education Herbert Schulte 5524 Nicollet Avenue Minneapolis, MN 55419-1930 (612) 823-1816 (office) office@herbschulte.com

Southern District

Environment and Safety

Seth Huiras 110 1st St N Montgomery, MN 56069-1514 (507) 364-8001 (office) shuiras@gmail.com

TBD

Southeastern District John Noack 600 Professional Drive Northfield, MN 55057-2755 (507) 645-5264 (office) jnoack135@gmail.com

Legislative Affairs

Membership

Yazan Alkhatib 4948 34th Avenue Minneapolis, MN 55417-1504 (612) 722-4676 (phone) yaz.alkhatib1@gmail.com

Peer Review George Kinney 1000 Radio Drive Suite 240 Woodbury, MN 55125-8444 (651) 729-1894 (office) (651) 739-5496 (fax) gjkdds@gmail.com

AMERICAN DENTAL ASSOCIATION 10th District Trustee Scott Morrison 2459 N 148th Street Omaha, NE 68116 (402) 658-3550 morrisons@ada.org

Stephen F. Litton, President 9731 Minnetonka Blvd.

Apt. 426 Minnetonka, MN 55305 (612) 868-9580 sflitton@aol.com

MINDENPAC Michael Flynn 560 Debra Lane Lewiston, MN 55952-0607 (507) 523-2267 (office) (507) 523-2206 (fax) mikeflynndds@gmail.com

Resolution Review Howard Taylor 2985 Valley View Ln New Brighton, MN 55112-4460 (651) 442-9905 (phone) taylor.hwt@gmail.com

Scientific Session Anne Kent 701 Park Avenue Minneapolis, MN 55415-1623 (612) 873-6963 (office) kent0071@umn.edu

James Nickman 700 Village Center Drive Suite 110 North Oaks, MN 55127-3019 (651) 484-8611 (office) (763) 786-2302 (fax) james.nickman@comcast.net

West Central District Amber Cziok 623 S Sibley Avenue Litchfield, MN 55355-3339 (320) 693-8131 (office) (320) 693-8999 (fax) adcziok@gmail.com

Student District Brady Hartman University of Minnesota School of Dentistry 515 Delaware Street Southeast Minneapolis, MN 55455 (763) 237-4830 hartm483@umn.edu

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H E A D I N G

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It was a llong ago end-of-season d f dugout interview with legendary Baltimore Orioles manager Earl Weaver. Rough road to the playoffs, and as many or more tough interviews. On the heels of each and every game.

“So do you like a season like this one?” asked an interviewer.

Weaver paused just long enough to let the air clear for his answer. Which was, “No. I’d rather go out ahead in April and stay there.”

Works for us.

Have a great summer!

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See references, articles, listings, surveys and more at AdvancedPracticeManagement.com 23050330_Cover.indd 2

5/27/23 10:55 AM

Journal of the Minnesota Dental Association Vollume 102, Volume 102 02 Nu Number mber b 3 May-June 2023

Volume 102, Number 3

Summer in Minnesota: Stay as Long as You Like

Northwest Dentistry May-June 2023

“Only in the darkness can you see the stars.”

Martin Luther King, Jr.

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