2016 May/June Northwest Dentistry Journal

Journal of the Minnesota Dental Association Volume 95, Number 3 May-June 2016

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Journal of the Minnesota Dental Association Volume 95, Number 3 May-June 2016

“Keeping Out of Harm’s Way”: Pearls, Pitfalls, and Lurking Perils of a Life in Dentistry

Page 31

Features 14 Keeping Out of Harm’s Way

A far-reaching look at Things Everyone Should Know, from a roster of experts Kimberly A. Harms, D.D.S., Hillary Harms Becchetti, J.D., Ashley Harms O’Connor, J.D., and Anna Hermann, R.N., B.S.N., M.B.A. 21 Minnesota Dental Association 2016 Guest of Honor Richard Wiberg 22 The Minnesota Dental Association’s Star of the North Meeting 2016

Our yearly tribute to the MDA’s big days 25 Minnesota Dental Foundation 2015 Donors 29 Xerostomia and Depression

Sorting out cause and effect to create a management strategy for a growing population of sufferers Satbir S. Grover, M.S., M.B.A., and Nelson L. Rhodus, D.M.D., M.P.H., F.I.C.D 37 Making the List

Pros and cons of participating in “Top Dentists” lists Jack L. Churchill, D.D.S. 39 Well Remembered: Northwest Dentistry is Looking for Your Grandparent Stories

Invitation extended; RSVP

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ON THE COVER

There are many inspirational watchwords on the path as we pursue excellence in our careers and our lives, but every so often we need to step back and listen to the simple admonition “Watch out!” What — what — where? Who said that?? This issue, our cover article’s steady voice belongs to Dr. Kim Harms and company, who have put together a foundation discussion of what needs to be on every dentist’s radar in order to navigate the ebb and flow of the everyday and not get caught off guard. Consider it an invitation to do yourself a favor, call it another layer of awareness, use it as you will. Then go enjoy that waiting cup of tea. Feature begins on page 14.

Page 22

Departments 7 The ADA Council on Access, Prevention, and Interprofessional Relations

Report from the Trustee to the Tenth District of the American Dental Association James K. Zenk, D.D.S. 11 Editorial: Invest (A Verb!)

Being in it to win it John E. Lueth, D.D.S. 41 Recruitment and Retention Conference Sparks Ideas for Innovation

Report from the New Dentist Committee 45 District News

Resources 4 News Notes

Imodium® for a Legal High is as Dumb and Dangerous as it Sounds 36 Author Guidelines 52 Index to Advertisers 61 Dentists Concerned for Dentists: The Promises Are Real

A walk-through of the proffered hope and realized changes the Alcoholics Anonymous “Promises” can make a daily reality 63 Business Opportunities 71 Directory to Minnesota Dental Association Officers, Trustees, and Committee Chairs 2015-2016

West Central looks at the breadth and depth of who we are together; Saint Paul offers another definition in the “outreach” column; Minneapolis throws a Spring Fling to relish; Southeastern has a ball at the Star of the North Meeting; our students acknowledge mixed emotions at the end of another year; and Northwestern reports on Boys and Girls Club kids meeting their area dentists, refreshes with a touch of the Lake of the Woods outing, and sends us into summer with a heads-up for that meeting too!

72 Heading Home

Greetings from the 800-pound you-know-what

3

N E W S

Notes Imodium® for a Legal High is as Dumb and Dangerous as it Sounds Washington - The over-the-counter anti-diarrhea medication Imodium®, or its key ingredient loperamide, is increasingly abused by people attempting to self-treat their opioid addiction, with sometimes fatal results. Two case studies outlining the phenomenon were published online in Annals of Emergency Medicine in early May. “Loperamide’s accessibility, low cost, over-the-counter legal status and lack of social stigma all contribute to its potential for abuse,” said lead study author William Eggleston, Pharm.D., of the Upstate New York Poison Center in Syracuse, New York. “People looking for either self-treatment of withdrawal symptoms or euphoria are overdosing on loperamide with

sometimes deadly consequences.

Loperamide is safe in therapeutic doses, but extremely dangerous in high doses.”

The paper outlines two case studies of patients with histories of substance abuse who attempted to self-treat opioid addictions with massive doses of loperamide. Both patients overdosed and emergency medical services were called. The patients were treated with cardiopulmonary resuscitation, Naloxone, and standard Advanced Cardiac Life Support. Both patients died.

Oral loperamide abuse postings to web-based forums increased ten-fold between 2010 and 2011. A majority of user-generated content Continued on page 42

Loperamide is safe in therapeutic doses, but extremely dangerous in high doses.

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 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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Northwest

DENTISTRY

John E. Lueth, D.D.S., Executive Editor Susan Miller, Managing Editor Editorial Advisory Board Yvonne S. Hanley, D.D.S. Ryan M. Henrichsen, D.D.S. Thomas D. Larson, D.D.S. David H. Lipschultz, D.D.S. William E. Stein, D.D.S. Jeffrey J. Taylor, D.D.S. Publication office: 1335 Industrial Boulevard, Suite 200, Minneapolis, MN 55413-4801, (612)767-8400 Minnesota Dental Association Staff Carmelo Cinqueonce, Executive Director Vicki Capistrant, Accounting Manager Rachel Czech, Advertising and Marketing Coordinator Carol Embertson, Communications Director Linda T. Fomasina, Executive Assistant Kyle Gaffaney, Director of Administration Majda Hodzic, Regulatory Affairs Manager Dawn M. Jensen, Director of Membership Stephanie Leclair, Communications Manager Juli Schneider, Exhibits and Meetings Manager Contents of NORTHWEST DENTISTRY © 2016 by the Minnesota Dental Association.

Published bi-monthly as the official journal of the Minnesota Dental Association. 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. Periodicals postage paid at St. Paul, Minnesota. Publication No. 395240.

POSTMASTER: Please send Form 3579 for undeliverable copies to Northwest Dentistry, 1335 Industrial Boulevard, Suite 200, Minneapolis, MN 55413-4801. Website: www.mndental.org Advertising Information Classified advertising is available to members at a discounted rate. Visit the Career Center at www. mndental.org for job postings and the Member Center for other classified ads. Display advertising information and rates are also available on the website under News/Journal or by calling Rachel Czech, Advertising and Marketing Coordinator, at (612) 767-8400.

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

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

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

ADA

T H E

The ADA Council on Access, Prevention, and Interprofessional Relations James K. Zenk, D.D.S.*

Hopefully this is going to be a nice long beautiful summer. After all, we are coming off the longest and nicest spring in years: early ice out/dock in early April, bikes off the hooks in the garage, planting done before Mother’s Day, weekly mowing, golfing in Minnesota before the Masters — it doesn’t get any better.

I have also completed my annual spring trustee’s tour to Nebraska, Minnesota, Iowa, South Dakota, Washington, D.C., and Chicago – all fantastic meetings, but whoosh, there went the spring.

ADA’s Legislative Call to Action for Dental Health Initiative. This liaison assignment has been a perfect fit for my passion and philosophy of how I practice dentistry. As a dentist, I see myself as a teacher sharing my love for preventive dentistry. My favorite procedure in dentistry is to not cut a tooth. I like to use my skills and expertise as leader of a highly skilled dental team in order to teach our patients not to just fight disease, but promote good quality of life.

I get a huge sense of accomplishment when a parent asks for the same preventive program for their children as their parents had given them — a healthy mouth with no disease that leads to a healthy body.

The council’s primary purpose is to broaden the scope of oral health care within the total health care system.

The Right Place at the Right Time With each of my trustee’s reports I have tried to focus on one main topic that I hope is of some interest. One of my trustee liaison positions this year is with the Council on Access, Prevention and Interprofessional Relations (CAPIR). The council’s primary purpose is to broaden the scope of oral health care within the total health care system and to promote preventive dentistry as a cornerstone of oral health care.

CAPIR provides leadership, vision, and coordination of the American Dental Association’s activities in the areas of access to dental care, public/ private collaboration, community oral health, inter-professional relations, community water fluoridation, dental health literacy, tobacco use prevention/cessation, and oral cancer prevention. CAPIR also supports the M ay- J une 20 16

CAPIR Core Activities for 2016 At its first meeting this year, CAPIR identified six core activities that the council and staff would focus on in 2016: 1. Community water fluoridation 2. Medicaid 3. Medical-dental collaboration 4. Community Dental Health Coordinator (CDHC) 5. Emergency room referral 6. Oral health literacy These 2016 goals for CAPIR align with the ADA 2020 Strategic Plan goals in that the public will recognize the ADA and its members as leaders and advocates in oral health. These goals will align public awareness efforts across the tripartite concerning oral health issues and promote oral

health through advocacy and science.

Community James K. Zenk, D.D.S. Water Fluoridation The well-established benefits of community water fluoridation are widely known. The Centers for Disease Control (CDC) has named fluoridation one of the ten great public health achievements of the 20th century because of its contribution to the decline in tooth decay. New CDC statistics released this spring highlighted that 74.7% of the United States population - more than 215 million people - received the benefits of fluoride in their water.

In Minnesota, according to the ADA Health Policy Institute’s State-by-State Analysis, we lead the country in that 99% of Minnesota’s population having community water systems receive fluoridated water. Dr.Valerie Peckosh, the ADA 10th District Representative on CAPIR, a pedodontist from Dubuque, Iowa, serves as chairperson of the ADA National Fluoridation Advisory Committee. She states, “It’s exciting to see the number of Americans receiving fluoridated water continue to rise.”

Patterns of Use of Dental Insurance According to data collected by the ADA Health Policy Institute, Continued on next page *Dr. Zenk is the Trustee to the Tenth District of the American Dental Association, representing Iowa, Minnesota, Nebraska, North Dakota, and South Dakota. He is a general dentist in Montevideo, Minnesota.

Email is zenkj@ada.org 7

Report from the ADA Continued from previous page

traditional dental insurance is not showing a strong growth pattern. It is Medicaid coverage that is growing and presenting business challenges to dentists. This is not “new news” for Minnesota dentists. Minnesota ranks dead last in reimbursement for charges for children’s dental services. This is a very serious issue that will continue to take the lead in our legislative efforts.

The Community Dental Health Coordinator A Community Dental Health Coordinator (CDHC) is a community health worker with dental knowledge and skills. This new member of the dental team may be a dental hygienist, dental assistant, social worker, or lay person, who enrolls in an online curriculum, performs a communitybased internship, and receives a certificate of completion. The true value of this new team member is in patient navigation and case management - in other words, helping inform people about how to access dental services and making sure they arrive to those visits, in addition to sharing individual and communitybased preventive education. Several Minnesota community colleges are exploring the idea of implementing this new program in their course offerings.

Emergency Room Referral Successful programs are being developed to divert dental patients from hospital emergency rooms

into dental offices where definitive solutions exist. The ADA has identified several model programs, and is willing to share and modify to help implement when asked. Dr. Jane Grover, the director of the ADA CAPIR, was the keynote speaker at the Minnesota Dental Association’s Spring Leadership Forum. She shared with the attendees that potential savings of more than a billion dollars per year could be recognized by deflecting and redirecting dental pain from hospital ERs into dental homes. In Minnesota, statistics have been shared from the Department of Health that dental expenses in ERs amounted to more than 135 million dollars in the past three years. If you and your local hospital have developed an ER referral/diversion program, please share it with the MDA — it may be a model that others could implement.

The true value of this new team member is in patient navigation and case management.

Oral Health Literacy A strong relationship between medical and dental professionals is crucial in the prevention of oral diseases. A lack of dental health awareness lingers in the medical communities, making it important for dentists to work closely with medical professionals to help their patients realize the interdependence of oral health and overall health. The

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medical community should be aware that our patients with diabetes, for example, need to practice excellent oral hygiene. The same is true for pregnant women, because the mother’s poor oral health can affect the baby’s health. Medical and dental teams can support each other in treating the whole patient more effectively.

Making It Personal Makes It Work It is an exciting year for me to be working with the ADA Council on Access, Prevention and Interprofessional Relations. This work acknowledges “back to the basics” even as it provides a roadmap of future strategies to promote greater access to dental care for underserved populations and promotes prevention for healthier communities. The above listed initiatives all link the dentist to the center of patient care, while emphasizing the connectivity of the mouth to the rest of the body.

I am excited for our future, and see more successes to follow as these opportunities for action expand to additional communities throughout the country. As more patients are able to access dental treatment and learn new prevention strategies, increasing improvement of oral health is the goal to be expected. n

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Editorial Invest (A Verb!)

John E. Lueth, D.D.S.* There was a man who was so poor that he prayed to God, “Please, let me win the lotto, otherwise I’ll die. I can’t do anything else, and I have no business skills by which to make my living.” He kept praying like this for 30 years!

Finally he got fed up with God, and said, “God! This is the last time I’ll pray to you to win the lotto. If you don’t let me win the lotto this time, I’ll give up my faith! I’ll never believe in You again! Give me a break!”

So God said, “Okay, you have to also give me a break!”

The man responded indignantly, “What do You mean, give You a break?”

God said, “During the entire 30 years, you’ve only prayed and talked and talked and prayed. But you never once went out and bought a lotto ticket!”

This joke, in the same way that many jokes function, not only makes us laugh, but it conveys another message.

Wikipedia describes a joke as “words … used within a specific and well-defined narrative structure to make people laugh. It takes the form of a story, usually with dialogue, and ends in a punch line. It is in the punch line that the audience becomes aware that the story contains a second … meaning.”

In its simplest form, this joke could be summed up by saying, “If you don’t invest, you can’t win”.

A similar but to me a more nebulous concept has been triggering

deeply situated synapses in my cranium throughout the past few weeks. In particular, after the most recent Star of the North gathering and accompanying MDA leadership meetings, a “feeling” emerged from the murky depths of my frontal lobe to coalesce into something more recognizable to me … my own personal “thought bubble”! More than once during the convention while listening to a presentation I was moved by the effort, passion, care, skill, and knowledge that was displayed by the person speaking to his or her audience.

It is not debatable that the Star of the North Meeting is top notch and attracts top notch speakers, exhibitors, and participants. It is! It does! And the lectures, seminars, hands-on experiences, and other offerings provide glimpses into the “investment” that their presenters have made in order to bring something of value to their listeners and participants. Because presenters have invested themselves in the learning, the researching, and in the crafting of presentations to advance their experience and knowledge, others can “win” that knowledge for themselves.

You may not have thought of it in quite this way, but in the Star of the North the MDA has invested heavily in you — its member.There need not be only one return on that investment, such as helping to maintain a high standard of oral health care in our state through the offering of great educational opportunities to

I have a tremendous appreciation for the dedicated women and men who invest so much of their time, talent, and energy toward helping the MDA be the best it can be.

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Association members, but — “If you don’t invest, you can’t win”.

So what John E. Lueth, D.D.S. does it mean to invest?

One dictionary provides the following definition. Invest: (1) To commit (money or capital) in order to gain a financial return. E.g.,They invested their savings in stocks and bonds. (2) To spend or devote for future advantage or benefit. E.g.,They invested much time and energy in getting a good education.

(One definition they did not give, however, may be remembered well – but perhaps not so fondly — by dental students who invested their precious wax carving in a plaster-like substance with the hope and prayer that upon casting with precious metal they would have the perfect gold crown, onlay, or inlay that they needed to pass tomorrow’s gold practical! But I digress … apologies to those of you now softly crying while rocking back and forth.)

Back to my point. If you expend time and effort in the training and advancement of your dental office staff, you are probably doing so for a number of reasons, not the least of which is the pleasure of working well together toward common goals and the satisfaction of doing your best.You are not simply paying people to be workers to some end, you have invested in them with the intent of future benefit for all concerned.

We would probably all agree that it is not “One And Done” when speaking Continued on next page *Dr. Lueth is the Executive Editor of Northwest Dentistry. He is a general dentist in private practice in Bemidji, Minnesota.

Email is luethdds@gmail.com 11

Editorial

Continued from previous page

of this in our workplaces.Time and effort must be expended – i.e., invested – continually in order to obtain the best results.

“If you don’t invest, you can’t win.”

The other synaptic activity I experienced recently along these lines relates to what I might call my “peek behind the curtain” of the MDA organization and its leaders. Having been privileged to represent my district colleagues and the patients we serve over some span of years at the district level, as well as the state committee and board levels, I have a tremendous appreciation for

the dedicated women and men who invest so much of their time, talent, and energy toward helping the MDA be the best it can be.

In my frontal lobe spotlight very recently has been one great example of a leader who has made a huge investment on behalf of MDA members.

Our Speaker of the House Dr. Howard Taylor has spent hours uncountable by me in the clarifying, codifying, and conveying of the content of MDA Bylaws, the importance and operation of the House of Delegates, and the resolution process whereby all members of the MDA have

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12

a say in its operation. He has made a big investment in us, the members of the MDA. I commend Dr.Taylor for his commitment, his clarification, his cajoling and coaxing, and ultimately his concern, all for the well-being of our association. Let me be clear here, that Howard is one of many, many others over the years who also have done, and continue to do, the same.They invest so that we all can win.

Another dictionary states that the origin of the word invest in Latin (investire) is to clothe or surround. As examples of the word invest used as a verb, Merriam-Webster provides: 1. to commit (money) in order to earn a financial return 2. to make use of for future benefits or advantages <invested her time wisely> 3. to involve or engage especially emotionally <were deeply invested in their children’s lives> To invest is a verb.Verbs are action words. A verb does something.To invest, you need to do something. A good investment on your part will result in a return on that investment.

Consider member value in our context.The MDA has invested in providing member value to a degree of which only a few people are fully aware. Let that be your cue to do some exploring. Clothe yourself in the many values offered. Invest in learning what those values are specifically for you.

Add to this discovery a look into the resources available.The MDA has invested in top notch staff.They give us many advantages, and we benefit from their skill and commitment. Surround yourself with tools for success. Invest in utilizing those resources.

Members remain the foundation of the Minnesota Dental Association.

The MDA has invested greatly and comprehensively for the benefit of its members. Be a verb, be active, invest some of your effort on behalf of yourself and your colleagues, and you will indeed receive a return on your investment. n Northw est Dentis try

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C O V E R

Feature

“Keeping Out of Harm’s Way”: Pearls, Pitfalls, and Lurking Perils of a Life in Dentistry

If vigilance and planning aren’t your cup of tea, may we offer a courteous word to the wise?

Everyone knows there is a lot to learn on the road to life as an adult, and everyone agrees there is a lot to handle once you get there.What just about everyone would like to ignore is the attention required to maintain that good forward momentum before the red lights start going off and “attention required” takes on a whole different meaning.The authors of our cover feature have put together a walk-through of stuff everyone should be prepared to revisit over and over on the journey. Expect asterisks, make having a Plan B second nature, respect the unexpected, and remember, there are a lot of other agendas out there just waiting to take a bite out of yours.

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Keeping Out of Harm’s Way Kimberly A. Harms, D.D.S.* Hillary Harms Becchetti, J.D.,** Ashley Harms O’Connor, J.D.,† and Anna Hermann, R.N., B.S.N., M.B.A.‡

In 2016, the U.S. News and World Report magazine ranked orthodontics and dentistry as the number one and number two best jobs in the U.S. According to the report, “A comfortable salary, low unemployment rate, and an agreeable work/life balance boost dentistry to a top position on our list of Best Jobs.” I couldn’t agree more! But even with great professions, there are pitfalls. Staff management, partnerships, associateships, third-party interference, OSHA, taxes, and patient expectations can all result in daily headaches and sleepless nights. How do we enjoy the full benefits of our great profession and maintain our personal peace and happiness throughout life? How do we stay out of harm’s way and maintain emotional, legal, and physical health?

It takes a lot of preparation, knowledge, and focus to survive a career and thrive in retirement.

Following are 10 tips to help you do just that.

Tip #3. Be an Intentional Leader Many of us would prefer to just be left alone to provide clinical care. Some of us are in practice situations that allow this. But those who own their practices must lead their staffs in a way that focuses on practice goals. This also includes taking responsibility to make sure your office follows all OSHA and HIPAA regulations.

According to Dr. Mary Smith, a former ADA Trustee, dental offices should not only have designated time devoted exclusively to regulation updates, they should have additional time in every staff meeting devoted to reviewing these regulations. These meetings should be documented, and this should include the staff members present.

Even if all educational protocols are followed, the dentist is held responsible if a staff member violates an OSHA recommendation.

If staff members refuse to comply, it is the dentist’s responsibility to terminate that staff member. When it comes to HIPAA rules and regulations, however, if the dentist complies with all education protocols and properly documents them, it is the staff member who bears responsibility for the violation.

When it comes to staff management, maintaining trusting relationships, setting clear expectations of behavior, keeping patient needs as the practice’s first priority, and holding all staff members accountable for their performance is essential.

By allowing low-level performance to continue in one staff member, you encourage low-level performance to become the standard.

Continued on next page

Trust is your number one practice builder and your number one relationship builder.

Tip #1. Focus on Building Trust in Your Personal and Professional Relationships Trust is your number one practice builder and your number one relationship builder. The most important thing patients want in a dentist is a caring attitude. They want to know that their dentist puts their needs first.

David Horsager, in his book The Trust Edge, describes eight essential pillars of trust: • clarity • compassion • character • competency • commitment • connection • contribution • consistency All are required to build trust, but the loss of just one pillar can destroy it.

Tip #2. Beware of “Get Rich Quick” Dental Programs Although the vast majority of practice management consultants focus on helping us provide excellent patient care in an efficient and effective manner, there are a few practice management groups that focus on profit over compassionate care. These programs recommend breaking almost all of the trust building pillars, and frequently damage long-term patient relationships. Stick with management techniques that help you deserve high levels of patient confidence.

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*Dr. Kim Harms practiced dentistry for 30 years in both public health and private practice settings. She is a past president of the Minnesota Dental Association and has been a National Spokesperson and Consumer Advisor for the American Dental Association for more than 20 years. Email is kimh04302@gmail. com **Ms. Harms Becchetti is a graduate of Hamline University School of Law. She is an attorney in private practice and has experience in dental contract law and property management. †Ms. Harms O’Connor is a graduate of the University of St.Thomas School of Law and is a former Assistant Prosecutor in Kansas City, Missouri. She currently works in the field of criminal law. ‡Ms. Hermann is Director of Nursing, Cardiac Care, United Hospital, Saint Paul, Minnesota.

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Cover Feature Continued from previous page

Tip #4. Identify (and Eliminate) the Elephants in the Room Dentistry is a people profession. Passive-aggressive and grumpy behavior is not acceptable. Do your best to help those who do not understand this that a pleasant demeanor is required. Patients have more leeway here, but they should not be abusive to staff. Make sure you document your corrective efforts in a compassionate way and in writing.

However, it is also true that you cannot make unhappy people happy. If people can’t be happy in your office, you need to help them move to a new job (or to a new dentist) where they can be happier. Of course, this assumes that you follow the same standards of pleasant behavior and are faithfully demonstrating all of the trust pillars.

Tip #5. Clear the Air on a Regular Basis A safe and effective system of conflict management is essential to keep a staff team working well. Have daily huddles, monthly staff meetings, and regular staff evaluations. If a problem arises, make sure you have a written plan in place, and that everyone knows how to proceed to bring “resolution instead of revolution”.

transactions as well. According to Tom Junilla, a dental real estate specialist and president of Junilla Company Incorporated, mistakes made in this area can have dire consequences.

“One dentist,” Mr. Junilla reports, “failed to insist on a term for her lease and found herself forced to leave her office suite shortly after she moved in.” Imagine the cost in that case.

Beware of verbal agreements. If you make an agreement with someone, there is no downside to writing it down — unless one party does not plan to honor that agreement.

Tip #8. Practice Gratitude in Thought, Word, and Deed Gratitude is one of the most important characteristics you can develop in your life. It lifts your spirit and the spirits of those around you. It is healing. It is an unfortunate fact of life that disaster can happen at any time. Our family has been through our share of tragedy, including the loss of a child, and practicing intentional gratitude through every difficult time has had an amazing effect on our emotional recovery. How often do we focus our attention on a loss or what we don’t have? Those thoughts sometimes become a constant ticker tape in our heads.

By learning to intentionally focus on replacing those thoughts with thoughts of gratitude for what we do have, we can change our lives in a positive direction. It is also important to express and show our gratitude. Imagine how much we can lift the mood in our offices by thanking every patient and thanking staff members for their service. We have so much for which to be thankful: We work in one of the best professions; we live in a free country; the list goes on, and each of us, I am sure, has his or her own version of it. If you need any help in internalizing your observations and thoughts in this area, just visit a third world country. I would recommend Rwanda.

It is Africa’s happiest country, and has the best model of forgiveness anywhere.

It is absolutely essential that important agreements are clarified in writing.

Tip #6. Understand Basic Employment Law Whether you are an employer or an employee, it is essential that you understand basic employment law, especially the big ones: Wage garnishment, embezzlement, and sexual harassment are just a few examples.

Employment law can be regulated by both federal and state governments. Go to an employment law class, or get a reference book and read it. When in doubt, contact your attorney. Ignorance of the law is not a defense.

If you do something illegal, even if you didn’t know it was illegal, you are still liable. Don’t get yourself into a situation where you are sued, or worse, arrested, because you did something to violate employment law. Educate yourself.

Tip #7. Read Your Contracts, All of Them, the Important Ones with your Attorney It is absolutely essential that important agreements are clarified in writing. Most big corporations have their own attorneys or attorneys on retainer to review agreements.

Many dentists are slow to get legal help, but when you are making decisions that could affect your life for many years, it is important to have an expert in the field of contract law help you. If you are buying or selling a practice, if you are hiring an employee or accepting an associate position, every significant component of your job should be clarified in writing. This includes working hours, hygiene checks, scheduling protocol, staff assignments — the list is long.

It is just as important to read the fine print in real estate 16

Tip #9. Prepare for the Future!

Dentistry is changing all the time. When I started dental school, scientists were predicting that a vaccine against dental caries was imminent and our profession would be eliminated.

That was almost 40 years ago, and we are still here.You never know what will happen, but it is important to keep abreast of changes in our profession and plan accordingly.

The number of dental graduates, retirement trends, the influence of corporate dentistry, government coverage, insurance trends, student debt, and the economy all affect dental practices. Patient trust also plays a big role. Make sure you are aware of the information your patients are paying attention to outside of your office. Some internet sites, such Northw est Dentis try

as Choosing Wisely, will consult with organized dentistry.

Some present their recommendations without researching them at all. If your patient wants to look up something about dentistry on the internet, wouldn’t it be great for them to check your website (or ADA.org) first?

Tip #10. Keep in Mind That Dentistry is Your Profession, Not Your Life Due to an unfortunate radiculopathy in my drilling fingers, I had to retire from clinical practice at the age of 54. It was not a happy time for me. Dentistry does not prepare us for retirement. As dentists, we are the kings or queens of our own little practice castles. Our team members plan our days, prepare the rooms, and prepare the patients in anticipation of our arrival. Our assistants clean up our mess when we are done. We don’t even have to reach for our instruments; they are handed to us! No wonder the retirement age has been going up the last few years! Who wants to leave one of the world’s best professions and lose all that attention? But retirement can be wonderful as long as you have planned properly both financially and emotionally. Get a hobby, begin volunteering in something about which you are passionate, and keep your personal relationships strong. One of the biggest predictors of lifetime happiness is maintaining close personal (including family and friends) relationships. Taking people for granted is as silent a killer of positive energies as other types of unhealthy borderline habits, and should it fall into a pattern with one or more addictive behaviors of any kind, can contribute to destroying those relationships.

Trite as it sounds on the face of it, the advice to stay on the straight and narrow, and if you fall, do everything in your power to get back up has stood the test of time.

We start our dental careers with every opportunity to enjoy our work and our lives. By focusing on intentional leadership, compassionate patient care, continuing education in all areas of dental practice, and maintenance of our character, we can steer our way through a life of significance both during our career in dentistry and beyond. n

attorney if you have not already done so, and let him or her take care of it. If your legal issue is with someone with whom you work, a partner, employer, or employee, do not discuss the case with that person unless absolutely necessary.

Do not bring your dispute into work. If the dispute gets heated, do not lose your head. If issues arise, let the attorneys handle it. I realize this is perhaps easier said than done at times, but almost always in a legal dispute, cooler heads prevail. Do not make a bad situation worse. Hang in there, and trust your attorney.You hired that professional for a reason.

Crimes and Misdemeanors Ashley Harms O’Connor, J.D., Criminal Attorney, Former Assistant Prosecutor Q: Please explain the difference between criminal and civil offenses and how the most common criminal complaints against dental professionals are classified.

A: We are a nation of laws, and it is important that all business owners are aware of the laws that govern them and the consequences for breaking them.

A civil offense is against a wronged party, and is frequently punishable by the payment of money or other recompense.

A criminal offense is considered an offense against the state or society as a whole and the victim. The punishment for a criminal offense is typically jail time or probation.

Contract issues are typically civil matters.

Malpractice is more often than not a civil matter rather than a criminal matter. In order for malpractice to cross over from the civil to the criminal, there must be a “gross or flagrant deviation from the standard of care”.

Larceny involves the wrongful taking of property with the intent to permanently deprive the owner of that property.

Swindle means taking something through a fraudulent method or “larceny by trick”.

With embezzlement, the property is taken by someone already entrusted with it.

All three are a form of stealing. The only difference is how the perpetrator got the goods to begin with.

Embezzlement is a criminal offense and could be a misdemeanor or felony depending upon the amount of money or goods taken. Most dentists understand that embezzlement can be committed by an employee, but a partner or employer can also be an embezzler. The American Dental Association has great online resources designed to help dentists prevent embezzlement.

Continued on next page

Dentistry does not prepare us for retirement.

Other (Younger) Professionals Weigh In Keep your Temper Hillary Harms Becchetti, J.D., Civil Attorney Q: If a dentist finds him- or herself in a dispute or facing legal trouble, what would be your most important recommendation?

A: If you are facing legal trouble in your practice, whether it be disputed contract negotiations or malpractice, the best piece of advice I can give is to stay calm! Contact an M ay- J une 20 16

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Cover Feature Continued from previous page

A misdemeanor is a less severe offense than a felony, and is typically punishable by less than a year in jail, a fine, or probation. Felonies are punishable by one year to life in jail (although probation is still available). As well, after committing a felony, you lose certain rights, such as the right to own a gun.

Fraud is an intentional deception, and negligence is the failure to exercise the care that a reasonable person would expect. In a dental office, fraud or negligence can occur in many areas, including billing of either the patient or insurance company, or paying taxes. Fraud is typically a more serious offense, and in some cases can be considered a felony.

Be Passionate About Your Goals Anna Hermann RN, BSN, MBA Director of Nursing, Cardiac Care, United Hospital, Saint Paul, Minnesota

Q: What is the best advice you can give to convince team members to enthusiastically accomplish your goals?

A: Whether you are a new leader or an experienced one, it is imperative that you have the support and trust of your

team to enthusiastically execute your goals. True leaders invest quality time with their employees and make personal, genuine connections with them. This first step must happen before one can expect “followership”.Your team needs to have faith that you are looking out for their best interests.

People are more likely to support and follow leaders they “like”.

Human beings often make decisions based on emotion first and rational or objective thinking second. So while it is imperative that leaders have a personal connection with their employees, it is just as important that leaders are knowledgeable and invested in their own goals. It is often stated that leaders need employees to “buy in” to initiatives and goals set by leadership. The term “buy in” infers that there is something to be “sold”. In my experience, this scenario does not exactly exude ideas that would in turn lead to inspiration in employees. Stellar leaders should be passionate about their goals and articulate the reason the initiatives are necessary. Invest quality time and build trusting relationships with employees, and in turn they will be invested in helping leadership achieve their goals. n

Women & We-laxation Weekend

October 14-16, 2016  Grandview Lodge in Nisswa, Minnesota

Meet the Speaker: Kim Harms, DDS Dr. Harms is a national spokesperson and consumer advisor to the American Dental Association. She is also a certified grief counselor and a past president of the Minnesota Dental Association. She was the recipient of the MDA’s Distinguished Service Award and the ADA’s Access to Care Award.

Dates

October 14-16, 2016

Location Grandview Lodge Nisswa, Minnesota

Cost

$40 + lodging/food costs Includes CE, event materials and wine and cheese reception

Register today to ensure your spot: mndental.org 18

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David M. Aafedt (612) 604-6447 daafedt@winthrop.com winthrop.com/Aafedt

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The hallmark of our practice is client responsiveness, and an innovative, yet practical, approach to the law. When you choose David to represent you, you’ll feel at ease. Contact David now and take your practice to the next level.

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Capella Tower | Suite 3500 | 225 South Sixth Street | Minneapolis, MN 55402 Main: (612) 604-6400 | www.winthrop.com | A Professional Association

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Feature Minnesota Dental Association 2016 Guest of Honor

Richard Wiberg

Dr. Richard (Dick) Wiberg has been a dedicated servant to the dental profession through active involvement and leadership for nearly five decades.

He is known by his colleagues and friends as a man of great sincerity, humility, knowledge, and hard work.

Dr. Wiberg received his Doctor of Dental Surgery degree from the University of Minnesota School of Dentistry and had a successful general dentistry practice in Saint Paul until his retirement in 2012. Throughout his professional career he was actively involved at the district, state, and national association levels. At the Saint Paul District Dental Society he served not only as its president in 1993-94, but also for many years on district committees, as the Midwinter Committee Chair, and as a delegate to the MDA House of Delegates. Dr. Wiberg was awarded the Outstanding Service Award by the Saint Paul District in 2008.

His involvement with the Minnesota Dental Association included service as a district trustee,

as a delegate to the ADA House of Delegates, and as a board member of the Minnesota Dental PAC and the Minnesota Dental Foundation. He served as MDA president in 2006-07, and during his term was instrumental in the decision making and planning involved with the purchase of land and construction of the current MDA headquarters building.

Dr. Wiberg has been involved over the years in many charitable dentistry activities, most notably as a volunteer dentist for Give Kids a Smile, Minnesota Mission of Mercy, Union Gospel Mission, and Donated Dental Services (DDS). In particular, he helped nurture and grow the Minnesota DDS program which, since its inception in 2003, has treated 1,680 vulnerable, elderly, and disabled patients.

In 2006, Dr. Wiberg was inducted as a Fellow of the American College of Dentists. Approximately 3.5% of dentists are Fellows of the ACD, a distinction awarded to those dentists who have exemplified excellence

Gateway Bank is a community bank focused on providing our clients with exceptional service and competitive rates to help you develop the practice that best suits your needs.

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M ay- J une 20 16

Richard Wiberg, D.D.S., 2016 Minnesota Dental Association Guest of Honor.

through outstanding leadership and exceptional contributions to dentistry.

It is with great appreciation for his dedicated service to the profession that the MDA honors Dr. Richard Wiberg as its 2016 Guest of Honor. n

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S T A R

OF

T H E

N O R T H

Meeting

Congratulations to the 2016

MDA Star of the North Meeting

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Nationally Known, Close to Home

Join us for Star of the North 2017 April 28-30 M ay- J une 20 16

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Join us in Austin!

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See us for a day of education, food, socializing and more at the historic Hormel House in beautiful Austin.

Friday, August 19, 2016

Hormel Historic Home in Austin 208 4th Ave. NW, Austin, MN 55912

Registration 7:45 a.m.

Program 8:30 a.m. - 12:30 p.m.

Cost $90 for doctors & $45 for staff

Dr. Mark T. Murphy

Neal Jeffrey

Dr. Mark T. Murphy’s presentation, “Supercharging Hygiene: Improving Patient Retention,” will explore the impact of improving patient retention and how to develop skills to motivate patients to keep their “re-care” appointments.

Neal Jeffrey, a former All-American quarterback at Baylor University and quarterback for the San Diego Chargers, will be giving a powerful and passionate speech inspiring us to go “higher, swifter, stronger” in the critical areas of our lives.

Register by sending payment to Dr. Rich Mitchell at 607 1st Drive NW, Austin, MN 55912 Questions? Call 507-437-6312 24

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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 made contributions to the Foundation from October 1, 2015 to May 2, 2016.

Thank you to all of our donors!

Annual Donors of Cash & In-Kind Donations Anonymous (6) Dr. John Aamodt Dr. Keith Abrahamson Affordable Care, Inc. Dr. Ramon AguirreGaudiano Dr. Amanda Allen Ms. Angela Amann AmazonSmile Dr. Debra Amundson Miss. Kathryn Andersen Dr. Brian Anderson Dr. Jeanne Anderson Dr. Kenneth Anderson Dr. Paul Anderson Dr. Richard Anderson* Dr. Trent Anderson Dr. Karl Andreasen Dr. Michael Andrews Dr. Paul Arnesen Dr. Andrew Atchison Dr. Patrick Aydt Dr. Charles Babst Dr. Bashar Bakdash* Dr. Bruce Baker Ms. Sarah Baker Dr. Jonetta Bakke Dr. A. Richard Ballin Dr. Bruce Bates Dr. David Bates Miss. Lindsay Bates Dr. Christine Baylon Dr. Robert Beattie Dr. William Becker Dr. Greg Beinlich Dr. Stephen Bejarano Dr. Kathleen Bellamy Dr. William Bellamy Dr. Kurt Bender Dr. David Bengtson Dr. Steven Benke

Dr. Michael Bennett Dr. Geoffrey Bentley* Dr. Michelle Bergsrud* Dr. James Block* Dr. Chad Boger Dr. Kimberly Bohlig Dr. Andrew Bohnsack Dr. Terry Bongard Drs. Adena Borodkin & James Miller Dr. Riley Bosch Dr. Kristin Bothun Dr. Bernard Bouquet Dr. Benjamin Bowling Dr. Mark Brahs Dr. Craig Brandenburg Dr. Heidi Brandenburg Dr. Roger Bromaghim Dr. Michael Brooks Dr. Tim Brown Dr. John Brownfield Dr. Thomas Bruss Dr. Mark Bruzek Dr. Brian Burmeister Dr. Peter Butkus Dr. Daniel Callstrom Dr. Jeffrey Campbell Dr. Peter Cannon Dr. Paul Carlson Dr. Scott Carlson Dr. Timothy Carlson Dr. Tricia Carlson Dr. & Mrs. Dennis Carreras Dr. Heather Carr Dr. Christopher Carroll* Dr. Richard Carter Dr. Robert Casper, Jr. Dr. Olga Castro Dr. Paul Chadbourn Dr. Kim Chart* Dr. Jay Clark Dr. Julie Clouse Dr. Ryan Clouse

Dr. Norman Coates Dr. Grant Colling Dr. Michael Collins Dr. Jerry Conroy Dr. David Cook Dr. Bret Cooper Dr. Veronica Cooper Dr. Richard Copeland Dr. Paul Craven Dr. Amber Cziok Dr. Mark Dale Dr. James Dau Delta Dental of Minnesota Foundation Dr. Kevin Denis Dr. Kevin Dens Dental Depot, Inc Dental Experts Dr. Robert Derr Dr. Anthony Di Angelis Dr. Reed Dill Dr. David Ditch Dr. Elisabeth Dommer Dr. Bradly Donabauer Dr. Robert Donsker Dr. Michael Doroschak Dr. Michael Doty Dr. Scott Doyle Dr. Daniel Drugan Dr. Kathrynne Dryke Dr. Bruce Dumke Dr. Kevin Dunlavey Dr. Curtis Dunn Dr. Joel Duray Eagan Valley Dental Center Dr. Kyle Edlund Dr. Steven Edlund Dr. Elizabeth Eggert Dr. Jeffrey Eggert Dr. Daniel Einerson Dr. Lowell Einerson Dr. Laura Eng* Dr. Manuel Englander

Dr. Michael Enich Dr. Chelsea Erickson Dr. Ronald Erickson Dr. William Erickson Dr. Marty Espe Dr. Roger Ettel Dr. Jerry Euteneuer Dr. Jonathan Fabian Dr. Jonathan Falkowski Family HealthCare Dr. & Mrs. David Fihn Dr. Reynolds Fischbach Dr. Philip Flodin* Dr. Michael Flynn Dr. Teresa Fong* & Ron Sit Dr. Jodi Fonkert Dr. Jeanni Foss Dr. Jeffrey Fox Dr. Patrick Foy* Dr. Michael Freischel Dr. Peder Gaalaas Dr. Robert Gardetto Dr. Michael Gardner Dr. & Mrs. Raymond Garland Dr. John Gawlik Dr. John Giebenhain Dr. Daniel Glenn Dr. Eugene Gomes Dr. & Mrs. Michael Goodoien Dr. James Gores Dr. Steven Gorman Dr. Derek Grabowski Greenwald Wealth Management Roger Griebel & Darlene Walters Dr. Jeff Griffith Dr. Kristy Griffith Dr. Donald Grote Dr. Eric Grutzner Dr. Stephen Gulbrandsen Continued on next page

M ay- J une 20 16

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Minnesota Dental Foundation Continued from previous page

Dr. John Gustafson Dr. Marcus Gustafson* Dr. Catherine Guy Dr. Frederick Haas* Dr. Steven Hagerman Dr. Michael Hagley Dr. Roy Hakala Dr. & Mrs. Kevin Hallstrom Dr. Brooke Hamann Dr. Michael Hamann Dr. Yvonne Hanley* Dr. Chad Hanson Dr. Michael Hanson Haskell’s Dr. Thomas Haugen Dr. James Haugo Dr. Jon Heezen Dr. Shana Heisler Dr. Michael Helgeson Dr. Julio Heller Henry Schein Dental Supply Dr. Steven Henseler* Dr. Lee Ann Herbert Dr. Christine Hermanson Hermanson Lemke Dental Dr. Thomas Herzig Dr. Sarah Heuer Dr. Arnold Hill* Dr. Angela Hilo Dr. Gregg Hipple* Dr. William Hoffmann* Dr. Tim Holland Dr. Jeffrey Holmberg Miss. Janna Holmgren Dr. Sandra Houck Dr. Michael Hoxie* Dr. Gregory Hueler Dr. Paul Huey Dr. Eric Hunter Dr. Jason Huse Dr. Corey Husu Dr. Melissa Hutchens Dr. Daniel Iverson Dr. Geoffrey Iverson Dr. John Iverson Dr. Joan Jakubas Jakubas Dental James Perry Vineyards Dr. Robert Jensen* Dr. Bartholomew Johnson

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Dr. & Mrs. Bryan Johnson Dr. Curtis Johnson Dr. Karlene Johnson Dr. Lisa Johnson Dr. Paul Johnson Dr. Ted Johnson Dr. Todd Johnson Dr. Tiffany Jonasen Dr. Kelly Jones Dr. Ernest Juean Dr. Michael Junker Dr. Brenda Junnila Dr. Charles Kaminski Dr. Robert Kaufman Dr. Perri Kauls Dr. John Keller Dr. Ronald Kent Dr. James Kernik Dr. Robert Kess Dr. George Kinney* Dr. Paul Kirkegaard Dr. Gregory Kjellberg Dr. Deborah Knaup Dr. Shawn Knorr Dr. Carissa Knutson Ms. Kim Kuehl Dr. Michael Kurkowski Dr. Brett Kurtzman Dr. Brent Kvittem Dr. Woojin Kwon Dr. Stephen L’Abbe Dr. Jennifer La Berge Dr. Leilani LaBelle* Dr. Samuel LaChance Dr. Venetia Laganis Dr. Douglas Lambert* Dr. Timothy Langguth* Dr. Kale Langley Dr. Robert Larson Dr. Eva Lau Dr. Barbra Lee Dr. & Mrs. Dean Leonard* Dr. Michael Leonard Dr. Deborah Lien Dr. David Linde Dr. Kimberly Lindquist Dr. Philip Lingle Dr. Scott Lingle Dr. Stephen Litton* Dr. Robyn Loewen

Dr. Gloria Lopez Franco Dr. Jeffrey Loveless Dr. John Lueth Dr. Michelle Lund Dr. Jerald Lyng Dr. Gary Madison Dr. Sarah Magnuson Maguire Refining, Inc Dr. Mark Malterud Dr. Ryan Manke Dr. Robert Marolt Dr. Scott Martinka Dr. Bruce Martinson Dr. Mark Matsumoto Dr. Jeffrey Mattson Dr. Michael McDermott Dr. Christopher McDonald Dr. Peter McDonald Dr. Stephen McDonnell Dr. Todd McGovern Dr. Robert McNab Medica Foundation Dr. Tammy Meister* Dr. Charles Mendes Dr. Candace Mensing* Dr. Jill Merrill Merwin Liquors Dr. Joel Michelson* Dr. David Miller Dr. Gregory Miller Dr. James Miller Dr. Todd Miller Minneapolis District Dental Society* Dr. Brian Mondale Dr. Roger Mondale Dr. Alan Montgomery Dr. Catalina Morarasu Dr. Mark Morgan Dr. Frank Mork Dr. Marie Mueske Dr. Kimberlee Murphy Dr. Virgil Mylan Dr. John Nei* Dr. Paul Nelson Dr. Stephen Nelson Dr. Timothy Neuner Miss. Lucy Nevanenen Dr. Dennis Nierengarten Dr. Howard Noack

Dr. John Noack Dr. Frederick Nolting* Northern Star Oral & Maxillofacial Surgery Northwestern District Dental Society* Dr. John Nydahl* Dr. Roger Ollila Dr. Susan Olson Dr. Jo Omlie* Dr. Mark Omlie* Dr. Jeffrey O’Neil* Dr. Joseph Opack Dr. Shirene Orandi Dr. Marc Orjansen Dr. L. Robert Ostlund Dr. Larban Otieno-Ayim Dr. Saul Ovalle Dr. Mary Owen Dr. Ellen Parker Dr. Eileen Patterson Patterson Dental Supply Patterson Foundation Dr. Andrew Pearson Dr. Susan Penniston Dr. Jorge Perdigao David and Pamela Perell Family Fund of Hibbing Foundation Sylvia Perell Fund of Hibbing Foundation Dr. Michael Perpich* Dr. Sheldon Peterson Dr. Timothy Peterson Drs. Vacharee & Andy Peterson Dr. William Peterson Dr. Phuong-Giang Pham Dr. Robert Phillips Dr. Brian Pierce Dr. Gary Plotz Dr. Donald Popovich Dr. Jaime Preble Dr. & Mrs. Duane Price Dr. Charles Puffer Dr. Duncan Puffer Dr. P. Angela Rake Dr. Scott Rake Dr. Gerald Rauchwarter Dr. Charles Reichert

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Dr. & Mrs. Richard Render Dr. R. David Resch Dr. Kristine Riewer Dr. Christopher Ripley Dr. David Rischall Dr. Ryan Ritchie Dr. Paul Roggow Dr. Curtis Rohrer* Dr. Daniel Rose Dr. James Rostvold Dr. Byron Rowell rsvpBOOK.com Dr. Jeffrey Rud Dr. David Russell Saint Paul District Dental Society* Dr. Daniel Sampson Dr. Daniel Schafer Dr. Michael Schafhauser Dr. Joel Schieck Dr. Travis Schmitt Dr. John Schoeneberger Dr. Herbert Schulte Dr. Lee Scotland Dr. Thomas Seidelmann* Dr. Mary Seieroe Dr. Frederick Severson Dr. Victoria Severson Dr. Douglas Shamp Dr. Roopali Sharma Dr. William Shea Dr. Stacy Shearen Dr. Gregory Sheehan* Dr. Matthew Sievers Dr. Michael Sievert Dr. Roger Sjulson Dr. Michael Skadron Dr. Erik Skatvold Dr. Kevin Skjei Dr. Blake Smith Dr. Thomas Smyth Ms. Cathy Snyder Dr. Michael Solbrack Mr. Brian Song Dr. Drew Spencer Dr. James Spitzmueller Star of the North Dr. Garrett Starr Dr. Jeffrey Steele Dr. Franklin Steen

Dr. Christopher Stenzel Dr. Eric Stich Dr. Patricia Stone Dr. Cale Strait Dr. David Streif Dr. Kurt Sundeen Sundet Foundation on behalf of Scott Sundet and Dr. Cindy Trosen Sundet* Dr. Bradley Sundick Sunset Dental Technologies Dr. J. Timothy Swanson Dr. Justin Swanson Dr. Osman Swedeh Dr. Gregory Swenson Dr. James Swenson Dr. Loren Taple Dr. Howard Taylor Team Liquor Fran & Bill Thelen Dr. Jason Thimjon Dr. Michael Thomas Dr. David Thorfinnson Dr. Ted Thull Dr. Kyle Tidstrom Dr. & Mrs. Michael Till Dr. Richard Timm Dr. Tracy Toft Dr. James Tomhave Dr. Steven Tomhave Dr. Robert Toutges Dr. Steven Tran Dr. David Trebisovsky Dr. Todd Tsuchiya Dr. Dennis Tucker* Dr. Thomas Turry Dr. Brandon Ulstad Dr. Matthew Vaillant Dr. Kou Vang* Dr. Roderick Vansurksum Dr. Matthew Vaughn Dr. Douglas Vayda Dr. Patricia Vayda Dr. Derrick Veneman Dr. Paul Vollmer Dr. Marshall Wade Dr. Scott Wagnild Dr. William Wagnild Dr. Gerard Weingartner

Dr. Tiffany Weyandt Dr. Richard Wiberg Dr. & Mrs. Carlin Wiemers Dr. Leslie Wilcox Dr. Gary Williams Dr. Kevin Williamson Dr. Mark Wilson Dr. Gerald Wimmer Dr. Carol Winegar Dr. Joseph Winegar Dr. Michael Winge Dr. Steve Winther Dr. John Woell Dr. & Mrs. Larry Wolff Dr. Robert Wottreng Dr. Catherine Wurm* Dr. Angela Zagorski Dr. & Mrs. Michael Zakula* Dr. Thomas Zbaracki Dr. James Zenk* Dr. Cassandra Zirbel Dr. Paul Zollinger Gifts in Honor or Memory of an Individual In Honor of: The Doctors at Endodontic Specialists Ms. Julie Anderson Ms. Marion Broman Ms. Carrie Chayer Ms. Shelley Dupey Ms. Jennifer Fisher Ms. Lesa Verdoorn Ms. Anne Voelker Ms. Jen Wright Dr. Michael Furey The Staff of Dr. Michael Furey In Memory of: Dr. Aaron Gimpel Minnesota Dental Association Dr. John Isaacson Dr. Stephen Litton Dr. Clarence Ketterling Minnesota Dental Association

Dr. Melinda Larsen Minnesota Dental Association Dr. Edgar Lechner Minnesota Dental Association Dr. Elizabeth McCauley Minnesota Dental Association Dr. Fred Requa Minnesota Dental Association Dr. Robert Schell Minnesota Dental Association Dr. Earl Weibeler Minnesota Dental Association Legacy Circle Dr. Bashar Bakdash Dr. Amber Cziok Dr. Lee Jess Dr. Franklin Jung Dr. Edward Kishel Dr. Clark LaChapelle Dr. Stephen Litton Dr. Steven Means Dr. JoAnn Omlie Dr. Mark Omlie Dr. Katie Post Dr. Daniel Shaw Dr. Matthew Vaillant Dr. Richard Wiberg

We make every effort to be accurate. If you are aware of errors, please contact the Foundation.

* Founders Members M ay- J une 20 16

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The smile you give.

“For me, contributing to the Foundation is about more than writing a check.

It’s about touching and improving somebody’s life.”

— Bill Stein, D.D.S., Aitkin

Give Kids a Smile Day, Open Door Health Center, Minnesota Mission of Mercy and Ronald McDonald Care Mobile® are just a few examples of how the Minnesota Dental Foundation is helping adults and children who need dental care most. Help us grow the Foundation’s endowment. Help us increase our ability to give back to our communities with your new or continuing financial support.

mndentalfoundation.org

Make a tax-deductible gift today.

Yes, I want to support the Minnesota Dental Foundation with a tax-deductible gift in the amount of $100

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My check in the amount of $ ___________, made payable to the Minnesota Dental Foundation, is enclosed.

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Credit Card No. ___________________________ Exp. Date _________ Cardholder Signature __________________________________ I am interested in including the Minnesota Dental Foundation in my estate plan. Please send me more information.

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C L I N I C A L

Feature Xerostomia and Depression Satbir S. Grover, M.S., M.B.A.,* and Nelson L. Rhodus, D.M.D., M.P.H., F.I.C.D.**

Xerostomia is considered a subjective dry-mouth sensation and generally refers to an oral symptom felt primarily by the patient rather than observed by a dentist or physician.

Almost all drug classes used in our day-to-day life have some side effects in conjugation with the benefits of the treatment of a medical condition.

Oral reactions to medications are fairly common, and dry mouth, or xerostomia, is most common to all of them. Among the classes of drugs notoriously famous for xerostomia are antidepressants, anti-hypertensives, hypnotics, and diuretics. Xerogenic prescriptions and over-the-counter (OTC) medications are frequently used in response, particularly by adults over 65 years of age living in long-term care facilities. These living conditions directly or indirectly have an impact on the oral hygiene and eventually quality of life of this patient population.1 It is generally observed that people who are clinically diagnosed with mild to severe depression are those who become overly anxious and frequently have lower percentage of salivary flow.

According to one study, a statistically significant association was found among the subjective sensation of dry mouth and a low, unstimulated flow rate, xerogenic medications, and the presence of at least one medical condition connected to dry mouth sensation.2 The subjects with dry mouth were found to have a strong perception of poor health and often had high depressive symptoms.

Hyposalivation, or reduced salivary flow, can have the following effects on the mouth, depending upon its severity and chronicity: • Difficulty in chewing, speaking, and swallowing (dysphagia) • Burning mouth (glossodynia) and inflammation of the tongue • Sores in the mouth • Swollen salivary glands • Angular cheilitis • Impaired sense of taste • Significant increase in tooth decay, plaque, gum disease, bad breath • Erythematous and atrophic mucosa • Oral candidiasis 29,30,31

This being a wide area of study, this article will focus on depression, xerogenic medications used in its therapy, and the connection to xerostomia.

Depression According to the World Health Organization (WHO), depression is a “common mental disorder, characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration”. 3 Depression is not a normal part of aging. It commonly co-occurs with other serious illnesses, such as heart disease, stroke, or Parkinson's disease.

Yet depression is neither recognized to the degree to which it occurs nor treated with other medical illness.

Because many older adults face some medical complications along with socioeconomic challenges, depression

Depression is not a normal part of aging.

M ay- J une 20 16

is generally perceived as a part of the normal aging cycle.4 Adults and elderly patients have the highest rates of depression, with that for long-term care residents ranging from 12% to 30%.5 Contributing factors include the following: 5,6,7 • Gender. Women experience clinical depression at a rate that is nearly twice that of men. Reasons for this are unclear, but may be related to hormone changes or stress.

• Cognitive behavior. Individuals with negative thinking patterns, low self-esteem, and who are dependent upon others are more likely to develop clinical depression.

Continued on page 31 *Dr. Grover is currently a full time Network Consultant with Anthem, Inc. Email is grover.satbir@yahoo.com **Dr. Rhodus is Adjunct Professor, Department of Otolaryngology, University of Minnesota School of Medicine, and Adjunct Professor, Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis, Minnesota 55455.

Email is rhodu001@umn.edu 29

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• Genetics and family history.

There is a tendency for depression to run in families. Genetics researchers point toward the vulnerability and the influence of multiple genes acting together with environmental factors impacting the children of clinically depressed parents.

• Medications.

Polypharmacy used in treating medical conditions such as high blood pressure and arthritis are notoriously famous for causing some depressive symptoms.

• Life events. Chronic sadness and grief related to various life events generally result in some depressive disorder.

that the differences in rates for major depression across countries are heavily dependent upon the cultural differences and risk factors that may directly or indirectly impact the expression of the disease.14 As per one report, patients with diagnosed cases of depression have to miss on an average 4.8 workdays in a threemonth period due to their symptoms or medical appointments, a situation that not only hampers the productivity of the hiring company but impacts the family as a whole.The total lost workdays can cost the employers about $17 to as much as $44 billion in any given fiscal year.12,13 According to Robert Kessler (2014), lifetime prevalence is generally found to be higher in high income versus low-tomiddle income countries.15

There is no observable trigger leading to depression.

Background and Epidemiology According to some scholars, depression is estimated to affect approximately 350 million people in the United States, and the diagnosed cases are rising at astonishing rates all across the globe. Depression is associated with substantial impairment, co-morbidity, declined health status, and even mortality. More women than men are affected by depression, and at its worst, depression always holds the potential to drive an individual to a high suicidal tendency or even suicide. 8,9,10 More than one out of 20 Americans age 12 years and older suffers from some form of depressive disorder due to the continuously challenging and competitive environment we live in.11,16 Similarly, depression is also one of the most prevalent mental health problems among older adults, especially after age 55.16,17 Even with its high predominance rate, only a small percentage of people prefer to contact their physician for any intervention or treatment.

In a major study conducted across 10 countries and 38,000 participants, the authors concluded M ay- J une 20 16

Signs and Symptoms Although the course of symptoms varies for each person, symptoms of depression in older adults can include the following cognitive, behavioral, and physical changes: • A persistent sad or "empty" mood • Loss of interest or pleasure in ordinary activities • Decreased energy, or feeling "slowed down" • Sleep problems with eating disorders • Difficulty concentrating, remembering, or making decisions • Feelings of hopelessness or pessimism • Thoughts of death or suicide; a suicide attempt • Irritability with occasional crying 18 Etiology Depression itself is a complex condition with a plethora of reasons working together toward the final diagnosis. It is not known exactly what causes depression, as a variety of factors may be involved. Among them: • Genetic, neurological, hormonal,

immunological, and neuroendocrinological mechanisms appear to play a role in the development of major depression, and many of these factors are centered on reactions to stress and the processing of emotional information.

• Additional factors may include a history of sleep disturbances, medical illness, chronic pain, anxiety, attention deficit hyperactivity disorder (ADHD), alcoholism, or drug abuse.

• There is no observable trigger leading to depression. It may occur spontaneously following, or be completely un-associated with, any life crisis, physical illness, or other currently known risks.

• Etiological processes may be modified by gender and developmental factors. 19 Treatment Along with treatment modalities such as Electroconvulsive Therapy (ECT) and Transcranial Magnetic Stimulation (TMS), markets are flooded with medications claiming to solve the mystery of an ever-growing epidemic of depression.

Depression is a complex medical condition. We still do not have a “golden pill” to solve all forms of it.

Any therapy is customized for the patient depending upon the root cause and the symptoms shown by the individual of concern. There are numerous treatment modalities available today, and anti-depressant medications paired with psychological counselling is considered to be an effective mode of treatment.

The most commonly prescribed anti-depressant drug categories include medications such as: • Selective serotonin reuptake inhibitors (SSRIs) • Serotonin and norepinephrine reuptake inhibitors (SNRIs) • Norepinephrine and dopamine reuptake inhibitors (NDRIs) Continued on page 33 31

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• Tricyclic antidepressants (TCAs) • Monoamine oxidase inhibitors (MAOIs) Physicians may use these medications solely or in conjugation with other anti-psychotic medications or mood stabilizers to enhance the overall effect or speed up the recovery period. 20 Patients, especially the elderly, who are taking prescription antidepressives, are always susceptible to some side effects. In addition to dry mouth, adverse side effects may include constipation, dizziness, nausea, tremors, confusion, and even severe allergic reactions.

for anxiety or depression, but also joint pains, allergies, common colds (i.e., decongestants, antihistamines), hypertension (i.e., diuretics), urinary incontinence, asthma (i.e., bronchodilators), and Parkinson's disease, to name a few. Similarly, medicines frequently used to lessen the severity of epileptic episodes, acne, obesity, and an elevated use of muscle relaxants and sedatives can also lead to xerostomia.24 Cancer therapy. Chemotherapy drugs and radiation therapy to the head and neck region are known to change the amount and nature of saliva produced by the salivary glands during and after the treatment. However, this change in the salivary glands’ functioning may be temporary depending upon the severity of the treatment delivered, and in some cases, salivary flow may return to normal after the completion of treatment. Along with chronic xerostomia, other long-term complications associated with cancer therapy may include oral infections, mucosal atrophy, ageusia or loss of taste, and other related problems.25 Systemic conditions and infections.

As discussed, xerostomia is closely associated with many systemic medical conditions such as depression, chronic diabetes (polydipsia), renal or liver disease, AIDS/HIV, depression, nutritional deficiencies, and organ and bone marrow transplants. Likewise, common autoimmune disorders such as Sjogren's syndrome, systemic lupus erythematosus (SLE), and fibromyalgia are among those most often linked with having a direct or indirect impact on the saliva-producing cells of the oral cavity, and thus potentially cause various degrees of xerostomia. 36

Regular use of methamphetamine is also associated with chronic xerostomia.

Xerostomia According to the Oral Cancer Foundation, xerostomia can be defined as “dry mouth resulting from reduced or absent saliva flow”. The researchers highlighted the fact that xerostomia itself is not a disease; however, it can be a serious side effect symptom due to various medical conditions, radiation to the head and neck region affecting the salivary glands, or from a wide variety of medications.21 Many researchers also believe that xerostomia often is a subjective sensation which can be assessed by questioning individuals about their awareness of the existence of dry mouth. 22,23 Etiology There are several causes of xerostomia.

These may include, but are not limited to, all the following factors: Medications: More than 1,100 medications, including many prescription and non-prescription drugs commonly used on a day-today basis, are the leading causes for xerostomia. These drugs, which are used to control or treat a range of ailments, include not only medications M ay- J une 20 16

Apart from the above mentioned common causes, there are many other reasons for an individual to either feel or suffer from various degrees of acute or chronic xerostomia. Among them:26,27,28 Aging. The normal aging process does not always guarantee xerostomia.

However, considering the associated medical conditions and number of medications taken by elderly people, this segment of the population is more likely to suffer from some degree of dry mouth.

Dehydration. Systemic conditions such as fever, burns, diarrhoea, extreme blood loss, and situations such as sweating in cases of excessive physical workout lead to chronic bodily dehydration and cause dry mouth.

Working in stressful job situations or under high levels of anxiety can also be linked to transient phases of xerostomia.

Trauma and nerve damage. Injuries or surgery to the head and neck region resulting in any trauma to the salivary glands or in nerve damage can be potential causes of xerostomia.

Lifestyle. Continuous consumption of high-fructose-syrup/sugarcontaining drinks such as diet soda, as well as or along with smoking or chewing tobacco, can impact saliva production and worsen dry mouth. As well, mouth breathers, especially during sleep, can have higher complaints of dry mouth as compared to people who breathe through their noses. Regular use of methamphetamine is also associated with chronic xerostomia.

Signs and Symptoms The sensation of dry mouth is not always associated with clinically visible reduction of saliva either by quantity or quality, but can also be subjective – i.e., dependent upon the individual.

Hyposalivation, or reduced salivary flow, can have the following effects on Continued on next page 33

Clinical Feature Continued from previous page

the mouth, depending upon its severity and chronicity: • Difficulty in chewing, speaking, and swallowing (dysphagia) • Burning mouth (glossodynia) and inflammation of the tongue • Sores in the mouth • Swollen salivary glands • Angular cheilitis • Impaired sense of taste • Significant increase in tooth decay, plaque, gum disease, bad breath • Erythematous and atrophic mucosa • Oral candidiasis 29,30,31 Differential Diagnosis • Sjogren’s syndrome • Sarcoidosis • Lymphoma • Sicca syndrome • Parotid gland tumours 32,33 Treatment The treatment of xerostomia may differ from case to case. It can be divided into three major categories, called the three ‘S’ categories. They are: A. Supportive measures B. Salivary substitutes C. Salivary stimulants 26, 28, 36 Supportive Measures As mentioned above, there is enough evidence available suggesting a strong correlation present between medications such as anticholinergic anti-depression drugs and degree of oral dryness present. A detailed discussion with the primary physician and altering such agents often play an important role in the management of these patients. If dryness is from the intake of certain medications, it is always wise to request changing the medication to a different class if possible in an effort to reduce the dryness.

Salivary Substitutes A simpler solution for patients with dry mouth would be keeping the mouth moist with constant sipping of water or other non-sugary liquids in cases where the salivary glands fail to compensate for the loss of 34

saliva due to xerogenic medications, medical conditions, and so on. Salivary substitutes, or artificial saliva, are products that are used by people who have too little of their own naturally occurring saliva.

They are most often manufactured with a neutral pH, and contain a mixture of buffering agents, cellulose derivatives, and other flavoring agents. They are available in the form of sprays, gels, and lozenges, depending upon the severity of dry mouth and preference of an individual. These products mimic natural saliva in many factors; they do not, however, contain digestive and antibacterial enzymes or other proteins and minerals. Research is underway to develop artificial saliva with properties close to that of real saliva so as to provide maximum relief to the patients.

diseases, epilepsy, hyperthyroidism, and Parkinson's disease. Regular follow-up evaluations with the dentist are essential to assess the efficacy of these medications, and the dosage needs to be adjusted as necessary.34 According to the results of a pilot trial, acupuncture can improve the subjective symptoms of dry mouth in cases of severe radiationinduced xerostomic cases. Significant improvement in physical well-being and quality of life was observed in the head and neck cancer patients undergoing oncological treatment with regular acupuncture appointments. As this line of treatment is in its initial phases, more trials and studies need to be conducted. 35

It is not unusual for patients with xerostomia to have less than five percent of the normal quantity of saliva to protect the oral cavitiy.

Salivary Stimulants While salivary substitutes, oral moisturizers, and artificial saliva may provide some relief for the xerostomia, they generally are not very effective in patients with severe xerostomia.

In these patients, the use of salivary stimulants proves to be more helpful than salivary substitutes. Stimulation of taste receptors by chewing sugarfree chewing gum enhances salivary flow with no apparent side effects.

Recently the U.S. Food and Drug Administration (FDA) approved the use of two medications, pilocarpine HCl (Salagen) and cevimiline HCL (Evoxac), for the treatment of hyposalivation. Pilocarpine, being a cholinergic drug, needs to be supervised, and is contraindicated in patients with asthma, chronic obstructive airway disease, heart

Prevention and Maintenance It is not unusual for patients with xerostomia to have less than five percent of the normal quantity of saliva to protect the oral cavity. Frequent sips of water to increase their fluid intake throughout the day have been verified to be an effective measure to reduce the side effects of dry mouth.

Avoiding irritants such as smoking, alcohol, and intake of diuretics such as soda and caffeine may also prove to be helpful in the long run. Due to the nature of the disease, patients suffering from any form of clinical depression and medicational side effects should seek additional help so as to help them reduce the severity of depression.

Anxiety and chronic stress may require extra intervention by a specialist, counsellor, or even yoga sessions, so as to relax the patient and thus improve upon the overall physical and oral health.

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The risks for caries due to dry mouth, enamel erosion, or tooth fractures in patients with anxieties are extremely high. Meticulous oral hygiene with minimally abrasive toothpastes, toothbrushes, or irrigation devices is paramount. Protecting teeth against aggressive grinding, especially in depressed patients, can be provided with the use of customized mouthguards worn during stressful moments and during the night. A reduction in the incidence of root decay can potentially be avoided by using high concentration fluoride toothpaste and having regular dental check-ups. Mouth breathers should be encouraged to breathe through their noses, and special appliances can fabricated if required. 27, 36 n References 1. Ameida PD, Johann AC, Alanis LR et al.

Antidepressants: Side effects in the mouth.

Oral Health Care — Pediatric, Research, Epidemology and Clinical Practices 2012: 113-128.

2. Anttila SS, Knuuttila ML, Sakki TK. Depressive symptoms as an underlying factor of the sensation of dry mouth. Psychosom Med 1998; Mar-Apr;60(2):215-8.

3. World Health Organization, Mental Health.

Available at: http://www.who.int/mental_ health/management/depression/en/ Accessed April 11, 2015.

4. National Institute of Mental Health (2015a).

Older adults and mental health. Available at http://www.nimh.nih.gov/health/topics/olderadults-and-mental-health/index.shtml Accessed January 23, 2015.

5. Meiner SE. Gerontologic Nursing, Fifth Edition.

St. Louis: Elsevier; 2014.

6. National Institute of Mental Health (2015). The numbers count: Mental disorders in America.

Available at: http://www.nimh.nih.gov/health/ publications/the-numbers-count-mentaldisorders-in-america/index.shtml Accessed January 23, 2015.

7. Mental Health America (2015a). Depression in older adults. Available at http://www. mentalhealthamerica.net/search/node/ Depression Accessed from January 23, 2015.

8. Marcus M, Yasamy MT, Ommeren M et al.

Depression. A Global Public Health Concern.

WHO.2012. Available at: http://www.who.int/ mental_health/management/depression/who_ paper_depression_wfmh_2012.pdf Accessed March 22, 2015.

9. Hasin DS, Goodwin RD, Stinson FS et al.

Epidemiology of major depressive disorder results from the National Epidemiologic Survey on Alcoholism and Related Conditions. JAMA Psychiatry 2005;62:1,097-1,106.

10. WHO. Depression Fact Sheet no. 369. 2012.

Available at: http://www.who.int/mediacentre/ factsheets/fs369/en/ Accessed December 30, 2014.

22. Fox PC, Busch KA, Baum BJ. Subjective reports of xerostomia and objective measures of salivary gland performance. J Am Dent Assoc 1987;115;581-4.

23. Delli K, Spijkervet FK, Kroese FG et al.

Xerostomia. Monogr Oral Sci 2014;24:109-125.

24. Spolarich AE. Risk management strategies for reducing oral adverse drug events. J Evid Based Dent Pract 2014 Jun;14 Suppl:87-94.

25. Rhodus, N. Management of oral complications from radiation and chemotherapy. Northwest Dentistry 2010; 89(1):39-42.

26. Visvanathan, PV. Managing the patient presenting with xerostomia: A review. Int J Clin Pract 2010;64(3):404-407.

11. National institute of Mental Health. Depression.

Available at: http://www.nimh.nih.gov/health/ topics/depression/index.shtml Accessed March 22, 2015.

27. Dental health and dry mouth, oral care. Available at: http://www.webmd.com/oral-health/guide/ dental-health-dry-mouth Accessed June 20, 2012.

12. University of Michigan. Depression. Available at: http://www.med.umich.edu/1info/FHP/ practiceguides/depress/depress.pdf Accessed March 14, 2015.

28. Dry mouth. Available at: http://www. mayoclinic.org/diseases-conditions/dry-mouth/ basics/causes/con-20035499 Accessed May 10, 2014.

13. The Centers for Disease Control and Prevention. Work Place Health Promotion.

Available at: http://www.cdc.gov/ workplacehealthpromotion/implementation/ topics/depression.html Accessed March 14, 2015.

29. Ongole R, Praveen BN. Textbook of Oral Medicine, Oral Diagnosis and Oral Radiology, Second Edition. Elsevier; 2013.

14. Weissman MM, Bland RC, Greenwald S et al.

Cross-national epidemiology of major depression and bipolar disorder. JAMA 1996;276(4):293299.

15. Kassler RC, Bromet EJ. The epidemiology of depression across cultures. Annual Review of Public Health 2013;34:119-138.

16. Pratt LA, Brody DJ. Depression in the United States household population, 2005–2006. Centers for Disease Control and Prevention. NCHS Data Brief. September 2008. Available at: http:// www.cdc.gov/nchs/data/databriefs/db07.pdf Accessed April 20, 2015.

17. Valenstein M, Vijan S, Zeber JE et al. The costutility of screening for depression in primary care.

Ann Intern Med 2001;134:345-360.

18. Mental Health America (2015b). Depression: What you need to know. Available at: http:// www.mentalhealthamerica.net/search/node/ Depression Accessed January 23, 2015.

19. Mayo Clinic. Depression. Available at: http:// www.mayoclinic.org/diseases-conditions/ depression/basics/causes/con-20032977 Accessed January 24, 2015.

20. Mayo Clinic. Depression. Available at: http:// www.mayoclinic.org/diseases-conditions/ depression/basics/treatment/con-20032977 Accessed January 24, 2015.

21. Bartels, CL. Xerostomia: Helping patients with dry mouth.http://www.oralcancerfoundation. org/complications/xerostomia.php

30. The importance of saliva, symptoms of dryness.

Available at: http://info.sjogrens.org/symptomsof-dryness/bid/346893/Top-10-Tips-forBurning-Mouth-from-Oral-Candidiasis-Thrush Accessed March 13, 2014 31. Dry mouth and tooth decay, symptoms of dryness. Available at: http://info.sjogrens.org/ symptoms-of-dryness/bid/327968/Dry-Mouthand-Tooth-Decay Accessed Dec 10, 2013 32. Symptoms of sarcoidosis. Chronic Illness Recovery, Inc. Available at: https:// chronicillnessrecovery.org/index. php?option=com_content&view=article&id=190 Accessed April 16, 2014.

33. C Vitali, S Bombardieri, R Jonsson et al.

Classification criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group.

Ann Rheum Dis 2002;61:554–558.

34. Dry mouth? Don't delay treatment. FDA Consumer Health Information, U.S. Food and Drug Administration. Available at: http:// www.fda.gov/downloads/ForConsumers/ ConsumerUpdates/UCM254511.pdf Accessed May 9, 2011.

35. Nelson, R. Acupuncture relieves radiationinduced xerostomia in head and neck cancer.

Available at: http://www.medscape.com/ viewarticle/702232 Accessed May 01, 2009.

36. Little JW, Falace D, Miller C, Rhodus NL. Dental Management of the Medically Compromised Patient, Eighth Edition. Mosby; 2013: 609-610.

“Equipped with his five senses, man explores the universe around him and calls the adventure science.”

Edwin Hubble

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35

AUT HOR G UID EL IN E 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 36

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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E T H I C S

Committee Making the List Jack L. Churchill, D.D.S.*

Lists, lists, and more lists! Grocery list, honey-do list, wish list, bucket list, or when making an important, lifechanging decision — i.e., changing careers, buying a new home, or moving to another city — a pro/ con list? Listing the pros and cons of a decision side by side can help us commit to a decision. Though generally not the only tool we use, it can be a visual aid and can hedge us in one direction.

This brings us to another list — the “Top Dentist” list. Both Minneapolis St. Paul magazine and Minnesota Monthly have come out with their “Top Dentist” features recently.

Surveys are sent out beforehand to urge us to vote for a colleague we would trust to treat a member of our family.

Both general dentists and specialists are selected.

The highest vote-getters are then tagged as a “Top Dentist”. MSP magazine even has a “Top Dentist” Hall of Fame.

When receiving these surveys, each of us must decide whether or not to participate. Though obviously not lifechanging, this decision does impact our profession.

So, as an exercise, let’s use one list, the pro/con list, to help us decide whether or not to participate in another list, the “Top Dentist” list — be it completing the survey, being listed, advertising inclusion on the list, or buying the “Top Dentist” plaque for your office — being a “Top Dentist” customer, so to speak.

Let’s list the pros and cons of deciding whether or not to cooperate with these “Top Dentist” list-makers.

Pros to Participation 1. Participation has been deemed technically not unethical by the MDA. (It is not not okay to participate).

2. It means income for these magazines both from readership and from the advertising dollars from the dentists.

3. It is good PR for the dentist.

Patients see their dentist on the list, and obviously that makes him or her look good. As for attracting new patients, I cannot speak with authority, but I would suggest solely being on the list does not garner many fresh clients, but the spin-off advertising does.

4. It is good for bolstering our self-esteem. Who doesn’t like to see our names in print in a “Top Anything” list?

5. Certainly any accompanying article about dentistry is good for our profession in that it educates and may spur its readers to seek dental care.

These lists can create difficulties within group practices.

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Cons to Participation 1. These surveys are certainly unscientific. As dentists we do so many different things that it is hard to deem one dentist better than another. Someone who gets great crown impressions may have difficulty with posterior composites. Someone who has great chairside manner may have communication problems with his or her staff. A dentist’s full body of work is very hard, if not impossible, to understand and appreciate, let alone rate or quantify.

2. These lists are popularity contests only — filled with people who

are, yes, good and fine dentists, but also ones who are well known and popular, often outgoing and engaged in their profession. Other dentists who indeed are fine practitioners, who practice at a high level, who go to C.E., who love their patients and staff, yet are introverted and perhaps even reclusive, don’t have a chance to make these lists.

3 Those who subscribe to these lists may go against the ADA’s Principles of Ethics and Code of Professional Conduct. Section 5.F.2 asks us to avoid “statements that say that your services are superior in quality to those of dentists if that representation is not subject to reasonable substantiation”.

4. These lists can create difficulties within group practices.Years ago a doctor within a group came to me saying he felt very uncomfortable because all the doctors in his group had made the list … except him.

5. These lists cheapen our profession.

They take us from a “privilegeto-serve granted to us by our state and earned through hard work” to a world of 2-for-1’s and giant billboards, and grouped in with “Best Pizzas”, “Best Restaurants”, and “Best Craft Beers”.

6. They lessen the efforts of all those good and well-meaning practitioners who work just as hard and care just as much. These “other” dentists may only lack the panache, the savvy, the gallantry of Continued on next page *Dr. Churchill is a member of the Minnesota Dental Association Committee on Constitution, Bylaws and Ethics.

He is a general dentist in private practice in Minneapolis, Minnesota. Email is jackchurchill@msn.com 37

Ethics Committee Continued from previous page

those on the list, but do possess the quiet commitment to serve.

7. Journalism, as practiced by this particular group of journalists through these lists, thumbs its nose at our profession. They take advantage of our natural inclinations.Year after year they (the magazines) decline our calls for change and refuse to answer our questions.

8. These lists divide us. They do nothing to build up, only to tear down relationships.

They aggrandize one group of practitioners at the expense of others.

9. These lists are prideful.

10. There are five seemingly everpresent standard justifications or excuses offered by those listed: (a) “Everybody else is doing it!”

Response: “This isn’t high school.” (b) “People see through these lists. They know they’re not credible.”

Response: “Not true! People constantly refer to these lists. They put them up on their refrigerators. And they ask us why we’re not on them.” (c) “I didn’t know I was going to be on their list. I wasn’t informed.”

Response: “This does happen.

These magazines say they call for permission, but sometimes do not. If they do, they often speak only to the front desk. So be proactive. Call them.

The MDA has a form letter available on their website asking them not to list you. If you ask and they do anyway, go after them!” (d) “It’s not important.”

Response: “Integrity should be our biggest asset.” (e) “But we’re going the opposite way with these lists from our physician and attorney friends.”

Response: “So… that’s a bad thing?”

11. I have asked MSP magazine for the range of number of votes garnered

by those listed, and they refuse to answer. But we do know that the first time they published a list, they sent out 2,000 ballots and received 20% back (400), and from that, they formulated a 200 Top Dentists list.You do the math.

12. These lists are false and misleading, and as per Section 5.F.2 of our Code are a “misrepresentation of fact” and could “create an unjustified expectation about results the dentist can achieve…”

Author Stephen Covey describes the concept of “Everyday Greatness” as a type of greatness that is quiet by nature, which escapes the headlines, yet is deserving of respect and honor.

Our profession can exhibit “Everyday Greatness” and extract meaning only by existing “in harmony with timeless, universal principles” — those of vision, innovation, quality, empathy, unity, integrity, humility, and respect.

Sometimes it doesn’t come down to what to do, but what not to do. n

SUGGESTION BOX As part of its process in reviewing the content of Northwest Dentistry, the NWD Editorial Advisory Board of the Minnesota Dental Association invites readers to offer comments and suggestions on the material that appears in each of the journal’s departments: front of the book (editorial/opinion); covers and cover features; Clinical, Feature, and Practice Management departments; MDA committee and district reports, including Dentists Concerned for Dentists; and “Heading Home”. We want to know what you like, don’t like, would like to see or see more of. Ideas should be directed to Northwest Dentistry Managing Editor Sue Miller at nwdmiller@comcast.net n

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Readers

Well Remembered: Northwest Dentistry Is Looking

for Your Grandparent Stories

As Northwest Dentistry’s Managing Editor for a considerable number of years now, time has given me the luxury of letting ideas percolate until they are ready to step onto the stage. One such has felt like it has been sneaking up on me for years, when it had in fact it been walking beside me all the time.

Through countless interviews, feature articles, district reports, and all such communications in our pages came the thread of family for influence and inspiration – not the immediacy of our parents, but rather the informing presence that comes from grandparents.

This got me to thinking about my own — two I did know; two I never knew, but knew about.

Not all influences are to the good, nor does inspiration always come from happiness, but looking back does come hand in hand with looking inside. Northwest Dentistry is therefore extending the invitation to our readers to send us their Grandparent Stories for a feature article (and beyond).

Whether your story pops to mind immediately or this just gets you thinking; whether you’re from a family of dentists or no dentists at all; whether it happened by example, by

M ay- J une 20 16

NWD Managing Editor Sue Miller with her grandfather Frederick Miller Sr. at Miller Lake near Garrison.

words of wisdom, or by something that happened that opened your eyes and brought you forward, we would like to share that.

New dentists, we absolutely want to hear from you. Dentists who are grandparents, how does the topic feel to you? And finally, pictures please.

Don’t be afraid to surprise us — that’s the fun of a project like this. In support

of “who we are” comes “how we got here”, and the roads, we can only imagine, are many. With a nod and smile to Robert Frost, please let us know about the one “that made all the difference”.

For the Editors, Sue Miller, Managing Editor Please send stories and photos to Sue Miller at nwdmiller@comcast.net

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Annual Updates Annual Staff Training CDC Guidelines CPR Training Proper Record Keeping MN-MAY-2016.pdf 1 5/5/16 4:06 Written Manual

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Leanne M. Mathieu Kramer, LDA, CDA, CDPMA 763-878-2150 lmathieukramer@tds.net www.StatementsPlusComplianceSolutions.com

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Committee Recruitment and Retention Conference

Sparks Ideas for Innovation

Aruna Rao, D.D.S.*

Innovation is not just creativity.

Innovation is something different that has impact. Innovation is about the process of changing the way we do things. Not only can we get in the habit of experimenting with change in our organization, but we need to embrace the possibility of failing during the process.

The Annual Recruitment and Retention Conference once again did not fail to deliver in content and brought to light the very real membership struggles so many states and the ADA as a whole are facing.

I attended the conference along with New Dentist Committee cochairs Kirby Johnson and Alex Lund, as well as MDA Executive Director Carmelo Cinqueonce, Membership Director Dawn Jensen, and Mission of Mercy Chair Alejandro Aguirre.

The weekend was packed with information, intense discussion, and focused snapshots of state and local societies’ innovative membership events and programs.

We managed to brave the Chicago elements of snow, sleet, hail, rain, and wind all in one weekend!

We first heard from Dr. K. Drew Wilson, Chair of the ADA Council on Membership. The keynote speaker was Ron Porter, Executive Vice-President of Consulting & Innovation Practice of Linkage, Inc., based in New Jersey. Both men discussed various companies’ histories

Caption to come.

of “disruptive innovation” and how those outside of the industry have the greatest impact. I’m sure most of you have used Uber — the ridesharing service that has led to plummeting sales of taxi medallions in New York City. We aren’t sure what will happen to the “yellow cab” as time goes on, but the convenience of having a phone application to summon a car and avoid payment hassles seems to be a trend that will continue. Steve Jobs said, “They can’t see it until you show it to them.” Membership in organized dentistry is declining. Do other outlets sound better than the MDA or ADA? We need to find a balance in recruiting and retaining new members,

I am not going to discuss things like “Millenials” and “Baby Boomers” because, honestly, we’re all dentists here.

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while not forgetting about the dedicated lifelong members who have been with us for their entire careers.

How do we show our members, all members, why membership is essential to a successful career in dentistry?

I am not going to discuss things like “Millenials” and “Baby Boomers” because, honestly, we’re all dentists here. We just have different needs.

Whether you’re a woman, a new grad, a mid-career, a retiree, or an academician; whether you’re in a large group practice, solo, resident, or faculty, you are still important and deserve to have your voice heard. Moreover, you deserve to have your membership cater to you.

Continued on next page *Dr. Rao is a member of the New Dentist Committee of the Minnesota Dental Association. She is a pediatric dentist in private practice in St. Cloud, Minnesota.

Email is Arunarao611@umn.edu 41

New Dentist Committee Continued from previous page

I truly believe this conference opened new doors for us to explore.

There are successful events being done nationwide, and we have upand-coming, excited new dentists organizing similar membership events in their districts. Therein lies the tricky part — participation. A dichotomy lies in this as well.You have dentists who do not participate in events for various reasons, a group we desperately want

to engage. Then there is the group of (new) dentists who want to be involved, learn the ropes, and climb the leadership ladder.Yet this group often gets cast aside until it’s “their turn” — which in some cases takes several years. There is no guarantee if the participation “itch” will return at that point. The MDA, luckily, has bylaws in place to encourage participation beginning in dental school in hopes

those students turn into future MDA leaders.

We have been taught that a good challenge statement starts with “how might we…” If we were to challenge the status quo, how might we be disruptive up front, then sustain innovation to keep up with our changing membership? That’s the $64,000 question. n

“Our nation’s growing population of opioid-addicted patients is seeking alternative drug sources with prescription opioid medication abuse being limited by new legislation and regulations,” said. Dr. Eggleston. “Health care providers must be aware of increasing loperamide abuse and its under-recognized cardiac toxicity. This is another reminder that all drugs, including those sold without prescription, can be dangerous when not used as directed.”

Annals of Emergency Medicine is the peer-reviewed scientific journal of the American College of Emergency Physicians, the medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information, please visit www.acep.org

News Notes Continued from page 4

pertaining to loperamide discussed using the medication to self-treat opioid withdrawal (70%). Users also cited abusing the medication for its euphoric properties (25%).

The Upstate New York Poison Center experienced a sevenfold increase in calls related to loperamide abuse or misuse from 2011 through 2015, which is consistent with national poison data that reported a 71% increase in calls related to intentional loperamide exposure from 2011 to 2014.

Oral loperamide abuse postings to web-based forums increased ten-fold between 2010 and 2011.

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News

An Invitation to Come

to My House*

Howard W. Taylor, D.D.S.**

An Invitation You are cordially invited To join Dr. Howard Taylor At “his” House Friday, September 16, 2016 and Saturday, September 17, 2016 3800 American Boulevard East Bloomington, Minnesota 55425 To the members of the Minnesota Dental Association: I would very much like you to come to my House on September 16, 2016 and consider staying over for September 17.

It is a very fine House. It is an older House; I believe it was completed in 1928, making it about 88 years old.

My House has been remodeled many times – seems to never end. But I want the House to be “just right”, if you know what I mean.

This is a very large House. I’m rather proud of my House, as I’m sure you can tell already.

If you come to my House, I will make sure you have a tour. I think you will be impressed, as you will quickly see this is a working House. Let me give you a brief summary of what you would see if you accept my invitation.

The 2015 MDA House of Delegates hard at work.

• Develop ideas • Make working plans • Create and implement programs — all kinds of programs • Develop legislation • Evaluate products • Develop leaders (this is one of my favorites) We do a lot of things.

Although I refer to this as My House, it is really your House too. In actuality, I serve as the Head Butler at the House. My title is Speaker of the House, and my duties are to make sure everything is just right for you and all of the other people who also own this fine House.

The following, then, is the itinerary for this year’s tour.

I am rather proud of my House, as I’m sure you can tell already.

With a Purpose I view my House’s work as a Think Tank. With the help of many people, we: M ay- J une 20 16

9:00 a.m., Friday, September 16 We start our day officially at 9:00 a.m.

At that time I would introduce you

to all the people who serve at your pleasure; all the people who work all year to serve you.You would also meet the people who have volunteered for Friday and Saturday to make your stay productive. I think it is good to know who is minding the House when you are not home.

Our Think Tank collaborates with several other groups to provide a great product. Therefore, you would also meet the heads of these collaborating entities and hear their reports summarizing their activities of the past year, all in five minutes. I try to manage your time wisely, so they only get five minutes.

The piece d’ resistance of the morning is hearing the reports of two committees. They are preparing Continued on next page The 2016 Minnesota Dental Association House of Delegates. **Dr.Taylor is Speaker of the House of the Minnesota Dental Association. He is a general dentist in Saint Paul, Minnesota.

Email is taylor.hwt@gmail.com 43

Minnesota News Continued from previous page

ideas for your staff — yes, your House comes with staff — to implement.

House staff is made up of the staff of your Minnesota Dental Association, the MDA Board of Trustees, and our committees. The ideas in the reports have come from many people who are also owners of this House. In our Think Tank, we call these new ideas Resolutions. The resolutions come from the membership as suggestions about how to enhance service to the membership, also known as owners.

As Speaker, I also accept ideas (resolutions) that first morning.

Because these ideas have not been studied as carefully, I accept them only if the registered members (delegates) choose to consider the late arriving resolutions.

By this time, the morning is getting late, so lunch is in order. It is a working lunch, followed by open discussion of all of the resolutions. This can be really exciting.You do not want to miss this part of the tour of your House.

1:15 p.m., Open Hearings The open hearings are when the resolutions are discussed and people express support or disapproval for the ideas. No decisions are made at the hearing. The shared information creates an informed delegation and allows the committees to take that information and consider revisions to the resolutions in order to come up with a refined idea that would serve the membership.

4:00 p.m., Social Hour/Dinner Social hour for most people begins at about 4:00 p.m., but 4:00 is also when the assigned committees go to work to prepare the resolutions for the entire delegation.

That brings the tour of the House to a close for Friday the 16th.

I hope you will join me for completion of the tour, beginning at 9:30 on Saturday.

9:30 a.m., Saturday, September 17, 2016 Lots of things have happened since 4:00 p.m. on Friday. Some resolutions have likely been rewritten or modified.

The delegates had early breakfast meetings to study the revisions to the resolutions.

We start promptly at 9:30 a.m., so don’t be late.

The first item on the morning’s agenda is to go over each resolution one at a time. The delegates have been charged to look at the Big Picture, which means they must decide which resolutions really will offer a better service to you, the member/ owner, and not just to themselves. Delegates do have the option to offer changes to the resolution. However, changes must be accepted by a majority of the delegates. This part does get technical. As the Speaker of the House, it becomes my role to manage this process. We follow a parliamentary guide as our standard for fair discussion and decision making. Another part of my role is to assist participants in how to offer their changes so they are technically accurate. The process is really fascinating.

and delegates to the American Dental Association rounds out our morning.

Elections are critical for the process of serving the members. Everyone who is nominated comes from the membership, of course, but it is important to know that every member is eligible to be nominated. Many people have volunteered to have their names placed on the ballot with a willingness to serve terms that range from one to four years, depending upon the position. If you are still reading, give serious thought to what role you could take in keeping the Association relevant and vibrant.

The House adjourns around noon, but that is not the end. That is when things really get rolling for the MDA. The new Board of Trustees meets and finalizes strategy for the year, incorporating the newly adopted resolutions. Committees receive their assignments.

Our staff and board members receive their assignments and begin implementation steps.

Delegates do have the option to offer changes to the resolution.

Election and Installation After a decision to adopt or reject each resolution has been finalized, we move to the next item. That would be the elections.

Election of our officers, trustees,

Summary My House is also your House. The purpose of the House of Delegates is to identify the needs and wants of the membership and to then strategize their implementation. For the Minnesota Dental Association to fulfill its purpose, many people are needed in a wide range of capacities. An informed membership is potentially our best asset.

You own this House. Stop in often.

Become familiar with your House. It is a fine House that you own. n

“I hope that while so many people are out smelling the flowers, someone is taking the time to plant some.”

Herbert Rappaport

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Student District Jane Yang Associate Editor 515 Delaware St. S.E. Minneapolis, MN 55455 The End to a Great Year As the weather starts warming up, this also marks the beginning of many changes at the School of Dentistry.

The beginning of May marks the most exciting time for many students, graduation time! On May 13, we will see our class of 2016 walking for their graduation. The class of 2016 has spent the past four years together; working together, travelling together, studying together, and now, embarking on their final step of becoming dentists together. It is not an easy feat completing four years of dental school. Congratulations to each and every one of our graduating students this year! I can’t wait to see what the future holds for everyone.

ASDA Wraps Up Another Year Too The months of April and May also mark the winding down of the ASDA year. On March 21, the Scientific Sessions Committee chairs Kate Egan and Katee Rotty gave a very informative presentation on what the Scientific Sessions Committee does and how they contribute to the Star of the North Meeting. They also gave a brief introduction to the Star of the North event and what dental students can expect to gain from attending.

The event also helped to recruit the newest Scientific Sessions Committee chair member Jessica Skelton, who will be helping to organize and coordinate the meeting next year.

Next Stop: New Dentist On March 22, the School welcomed the MDA’s New Dentist Committee M ay- J une 20 16

MN ASDA at National Dental Student Lobby Day. From left to right are Aaron Henderson, Daniel Ditch, Hannah Rutten, Dan Allman, Lucy Corrin, Jane Yang, Quentin Knutson, Kim Rostvold, Janna Holmgren,Trent Neisen, Stephen Leeb, Ana Fusu, John Petersen, Arjan Majidian, Allison Forbes, Nick Schulte, Jerad Servais, Merideth Meador, and Amy Finn.

to give a very informative presentation about life after dental school.

Drs. Megan Pint, Alex Lund, Aruna Rao, and Jeff Remakel were our guests for a very informative Lunch and Learn about life after dental school, staying involved, and the biggest challenges each of them had faced when becoming new dentists. The Lunch and Learn was organized in a panel fashion, allowing each of the four speakers time to discuss their career choices, challenges they faced, their involvement in organized dentistry after graduation, as well as providing additional time for questions from the audience. We had a full house in attendance, and a great discussion from the audience ensued after the presentation. We have already received a great positive response about the presentation, and will definitely be adding more events like this in the future.

Sit Up Straight and Pay Attention At the beginning of April, the Clinical Explorations Committee chairs Jessica Skelton and Daniel Ditch welcomed Scott Belz from A-Doc, who presented on “Ergonomics in Dentistry”, a topic that plagues all, dentist and dental students, alike.

A-Doc brought with them their team of CEAS Certified ergonomics specialists to discuss proper sitting techniques and demonstrate to our students why it is important to develop proper sitting and working habits early in one’s career in dentistry.

You’re Going To Need a Bigger Lobby From April 10-12, 18 MN ASDA members — the biggest group we have ever brought to a national event — stormed the Capitol and Continued on next page 45

Student District Continued from previous page

Colin Peterson, Richard Nolan, Al Franken, and Amy Klobuchar.What an amazingly productive trip we had.

MN ASDA putting the “National” in National Dental Student Lobby Day. From left to right are Daniel Ditch, Jerard Servai, Allison Forbes, Nick Schulte, Merideth Meador, Kim Rostvold, Lucy Corrin, Dan Allman, Ana Fusu, Janna Holmgren,Trent Neisen, Jane Yang, John Petersen, Arjan Majidian, Quentin Knutson, Amy Finn, and Hannah Rutten.

lobbied on behalf of student debt and access to care. This year’s main resolutions were H.R. 649 Student Loan Refinancing Act and H.R. 4223 Post Grad Act, both targeted at giving post-graduate students access to better and more affordable financing options to support their post-graduate education. The third resolution was H.R. 539 Action for Dental Health Act, which mainly wanted to make dental donation events, such as Give Kids a Smile and Mission of Mercy, eligible for national funding.

The 18 members from Minnesota

were only a small part of the 500+ dental students who also flew out to Washington, D.C. for National Dental Student Lobby Day. The event began with introductions to how to lobby; how Congress, the Senate, and the House work; workshops on lobbying tips and how to talk to representatives from different parties; and much more. Even those who had never lobbied before definitely felt prepared afterward. Our members were able to meet with representatives or their staff liaison from the offices of Timothy Walz, John Kline, Erik Paulsen,

Stepping Away, and Forward Finally, it is with great excitement — and for some of us, sadness - that our district had our elections on April 20th. As I sadly pass on the role of Minnesota ASDA chapter president to Allison Forbes, I am eagerly waiting to see what great things she will be able to accomplish as our new president. The elections also welcomed our new Executive Committee and committee chairs: Vice-President Trent Niesen, Treasurer Josh Eggebraaten, Membership Chair Daniel Ditch, Communication Chair Quentin Knutson, President-Elect Robert Springer, and 30 new committee chairs. Congratulations to all, and to all who applied. This is already looking to be an exciting new year for our chapter!

Heartfelt With my final words, I would like to first say thank you. My first thank you goes to everyone at the MDA for your continual support of the Student District. Secondly, I would like to thank my previous ASDA chapter leaders and past presidents who made our chapter what it is today, and for giving me the guidance, confidence, and understanding of leadership to continue to lead this chapter. Finally, I would like to thank our new group of leaders for taking on these roles and continuing the great work. I see a lot of passionate new talent, and I cannot wait to see what you guys accomplish.

JY

“The cure for boredom is curiosity. There is no cure for curiosity.”

Dorothy Parker

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Saint Paul District Michael M. Pelke Associate Editor 3060 Woodbury Drive Woodbury, MN 55129 Time Dental school is four years long. Not four school years, four total years.

As my class was first to learn, that included no summer breaks. After my year one, the University of Minnesota converted to a trimester plan that eliminated summer breaks, and instead gave us a couple of three-week “reprieves” throughout the year. I believe that this is still how the School schedule is run. For the class of 2002, it was our unfortunate lot to be the first to try it out. Still, as we adjusted to this, one thing became clear: As a dental school class, we were all in this together. We were essentially a team that supported each other through class trials and tribulations. There were controversies, as I’m certain every dental school class has, and there were triumphs. We had classmates get married, and classmates have children. We were a tight knit group.

We had to be. Dental school is hard.

Dental school puts students under a tremendous amount of pressure to succeed, and to succeed on the first try. To most of us, that pressure is what drives us. After all, the very admissions regimen and process is enough to drive just about anyone bonkers. In fact, I recall thinking while driving to my admissions interview that if I have to, I will drop to my knees and beg to get into school. The number of hoops that one needed to go through was staggering, and seemed to continue after admission. That is where the friendships came in.

Throughout dental school, because of the encompassing amount M ay- J une 20 16

of time spent together, we all naturally became close friends. Obviously some were closer than others, and there were even a few short-lived romances, but on the whole we were friends.

We were friends who handed you a beer when you did well on a test, and handed you two beers, and a shoulder to cry on, when you didn’t do so well on a test. Maybe that’s too much information!

Dental school was difficult. I am sure most reading this would agree with that statement. The schedule and curriculum required that we attend class from 8:00 a.m. and leave around 5:00 p.m. Following a short break for exercise or dinner, most would reconvene for study time until late into the evening. Then repeat.

This was the schedule that most followed and allowed us to be successful in class.

And then there was Jack (not his real name). Jack didn’t seem to need to follow our rigorous study schedule. He did fine on his own. He was one of those people who understood the lecture the first time. He was also the one who finished the crown prep first in lab. He even carved his amalgam fillings with beautiful secondary grooves that precisely mimicked Mother Nature! I’m sure dental school was still difficult for him, but he definitely didn’t show it. He would consistently be one of the top scorers on every test, lab practical, and paper written. Most of the time he would study privately, but when we were able to lasso him for one of our group study sessions, it was always a treat. I know we got more out of it than he did. It often evolved into a tutoring session with Jack at the helm. He never seemed to mind. In fact, he may

have been responsible for boosting the GPA of more than a dozen dental students at once! Even through all this, he wasn’t the type of person who would throw his accolades in your face. If asked, he would relay his success and leave it at that.

Outside of class, dental school provided a group to commiserate with. Oftentimes, the time spent with classmates after the exams was just as instructional as the study time leading up to it. Jack was always there with a smile and a debriefing of whatever subject we had just finished. He was funny and supportive, always there with a pat on the back as if to say, “You’ll get ‘em next time”.

As the school years progressed, we started to become busier with patients and our own family lives. After dental school, Jack went on to become an oral surgeon. He finished his training on the East Coast before returning to the Twin Cities. He married another dentist, had three daughters, and seemed that he had it all. He was successful in practice and successful in life. We were happy that he was back in Minnesota. What general dentist doesn’t want to refer oral surgery to a close friend? It was ideal. However, something was not right. Unbeknownst to everyone around him, he was struggling inside.

Something was tearing him up. We didn’t know. No one knew. He never appeared depressed or alluded to the fact he was hurting. At social events or CE meetings he had the same jovial smile, and we sent jabs at each other over dental school exploits.

Everything seemed fine.

Then Jack died. A victim of a suicide that no one saw coming.

Continued on next page

Dental school puts students under a tremendous amount of pressure to succeed, and to succeed on the first try.

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Saint Paul District Continued from previous page

“What? Why? How?” was the reaction most gave; he was doing so well, he had everything to live for!

What happened? How could this happen to a classmate with whom we had made these incredible bonds? How could someone close to us do this? What did we miss? These are questions that will probably never be answered. We all have many questions, and nothing to say. The biggest question that looms in my mind and those of my tightly knit group of dental school friends is, why didn’t we reach out to him more?

Why didn’t we see this?

Jack’s passing shed a light on the darkness of mental illness. It is not like

a physical ailment that can be readily seen, but it can be just as damaging.

We see friends and colleagues who struggle with injury or the obvious signs of cancer/chemotherapy and approach them with a sincere “How are you doing?” Concern about their well-being is easy when they are going through a visibly difficult process.

How often do we ask our friends “How are you doing?” when they aren’t physically hurt? We often ask, “How is your office? How is your spouse?

How was your summer? How was your vacation?” Maybe we should be asking, “Are you doing okay, sincerely? How are you feeling?”

We are reminded that there

Concern about their well-being is easy when they are going through a visibly difficult process.

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are services through the MDA for counseling and mental illness. This is a wonderful member benefit, but it won’t help if we don’t reach out to our friends who are struggling and identify that, and offer our assistance.

Successful people have a hard time asking for help, as it is viewed as sign of weakness or vulnerability. I am not sure why Jack didn’t reach out; maybe he couldn’t. Perhaps situations like this show us that the message is for us to reach in. I encourage all of you to contact a friend you have lost touch with, or haven’t spoken with in a while. Ask them, “Are you doing all right?” Friendship is a drink on the beach during the good times and a shelter in the storm during the bad. We can often skip the drink on the beach, but when a storm is approaching, we need the shelter.

Rest in peace, old friend.

MMP

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West Central District Jeanni R. Foss Associate Editor 15167 Edgewood Drive, Suite 240 Baxter, MN 56425 foss2004@msn.com Editors’ Note: The West Central District report this issue is contributed

by WCDDS president Aruna Rao. The View from Here Volunteering can be one of the biggest time commitments outside of a full time job. It can be thankless, physically and mentally draining at times, but I would hope there is a fair amount of personal fulfillment one has during the countless hours of dedication to a role that most people have no idea requires so much work. I have to start this piece by thanking Jeanni Foss for her volunteer commitment to our district.

Her love for organized dentistry is certainly inspiring, and hasn’t slowed.

She has held several leadership roles in our district, most recently as our Associate Editor for Northwest Dentistry and District historian.

I hope that by giving her a break periodically with these articles, she will continue as an inspiration to new leaders in West Central Minnesota. Happily, we have many volunteers to thank. Our district officers continue to take time out of their busy schedules to plan and execute events for our members. Thank you to David Ude, Mike Hamann, Chris Dens, and Amber Cziok for their guidance and contributions.

The WCDDS was well represented at the recent MDA Leadership Conference. Left to right are WCDDS president Aruna Rao, Mike Hamann, Rachel Greiger, MDA president-elect Kevin Dens, and ADA 10th District Trustee Jim Zenk.

Leadership Is a Process We had a great turnout at the recent MDA Leadership Conference representing our district! West Central members Mike Hamann, Rachel Greiger, and Kevin Dens were all in attendance to show their support and commitment to continued leadership development. Each of them showed active participation by asking pointed questions and providing thoughtful insight into our current governance and political activism.

As membership numbers have rolled in over the last several months, I have to say I am extraordinarily proud of the West Central District.

We have one of if not the highest

At more than 98% membership, it is abundantly clear our dentists value their membership and connect the dots between the tangible and intangible benefits.

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Rich Moen accepting the MDA Humanitarian Service Award.

membership retention numbers out of all the districts! At more than 98% membership, it is abundantly clear our dentists value their membership and connect the dots between the tangible and intangible benefits.

What’s a Summer without Golf?

We love to enjoy golf in our district, and had the privilege of having two golf events in one year! Most recently, on May 21st, our first “Mulligan and Molar Mixer”, planned by new WCDDS member Kirby Johnson, was held at the Arrowwood Resort in Alexandria! This was an 18-hole golf networking event designed for members to come and have fun, golf, Continued on next page 49

West Central District Continued from previous page

eat great food, and learn about what organized dentistry has to offer! I hope this becomes an annual event as well, as our district is large, widespread, and certainly caters to members in all corners.

The annual Golf Scramble and CE Event will be held August 3, 2016 at Cragun’s Legacy Golf Course. Many thanks to David Ude for his hard work in planning this consistently successful event. This event is open to all MDA members, and helps raise money for the University of Minnesota School of Dentistry. Historically, the weather has been outstanding, and with last year’s tornado disaster in the rearview mirror for the Brainerd area, we are happy this resort is back and in full operation.

Reaching for Help It is one thing to discuss upcoming events, but it’s another to address the tragedies our dental community has faced in recent months. Recent passings of dear colleagues, friends, and family have deeply affected me personally and our dental community as a whole. There is no time like the

present and no time more important than now for us to rally together and lean on one another for support. If you are ever in need of services, the MDA has an extensive Wellness Program free of charge to dentists and their families.

We work so hard to deliver patient care, and we care so much about oral and systemic health, but mental health is so often overlooked in our daily lives. We tend to forget our minds, our spirits, need periodic priority.

Professional therapy and/or counseling are excellent, but if you need a stepping stone to sustained services, just picking up the phone and calling a friend or colleague can be incredibly therapeutic. I love meeting with my dental friends and classmates for brunch or happy hour, and am always in awe as to how much our lives are similar. We think the same things and feel the same way, even though our coping mechanisms can vary widely. Ultimately, if you feel something is not right with you,

chances are someone else has had the same experience, and there are people who can help should you need it.

WCDDS’ Rich Moen Receives MDA Humanitarian Award Finally, a big, hearty congratulations to Richard Moen of Morris on receiving the 2016 Humanitarian Service Award from the MDA. Currently serving as the Board president of the Caring Hands Dental Clinic in Alexandria, he has helped expand the clinic’s resources and was instrumental in expanding patients’ access to services through his legislative efforts. We are proud to have him in the West Central District!

There are people who can help should you need it.

Short and Sweet I wish you all a wonderful start to a beautiful Minnesota summer!

Respectfully submitted, Aruna Rao, President, West Central District Dental Society

“May I never grow too old to treasure ‘once upon a time’.”

Anonymous

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Southern District Jeffrey J. Taylor Associate Editor 313 Main Street N.E. P.O. Box 307 Mapleton, MN 56065-0307 kjet@hickorytech.net The Star of the North Meeting 2016 Many of you enjoyed (survived?) the recent MDA Star of the North Meeting. Hats off to the MDA members and staff who make ours an important, relevant, and well respected state meeting.

During the days there, I encountered one of my dental school classmates, and we determined that we had attended our first SON as first-year dental students, and haven’t missed one since. That first meeting was in 1976 — you do the math.

We also agreed that there were at least two “dental benefits” associated with aging. First, we agreed that the dentinoblasts in our maxillary incisors had performed admirably over the years, so we could now bite into ice cream without discomfort. Second, we were rapidly approaching Life Member status, with decreased membership dues. Whist visiting with SDDS officer Karl Haemig, he introduced me to a dentist from Cut Bank, Montana, (county seat of Glacier County) named Mark Haemig, or “Karl’s Dad”. As we were visiting, Dr. E.T. McNiece walked up to greet Mark.

Turns out that Mark and Ed were not only dental school classmates, but high school classmates. Must have been a distinguished neighborhood.

The Rice Crispy bars served on the Exhibitors Floor Saturday noon were a nice touch. I ate four.

The Big Party On Friday night, “Hairball” (you heard me correctly) performed for SON M ay- J une 20 16

The SON Exhibit Floor was the place to be for Mark Schlaefer, Maureen Sorensen, Grant Sorensen, and Garrett Starr.

Tradition was alive and well at this year’s Star of the North Meeting with father and son Mark and Karl Haemig.

If the performance by Hairball is a blur to you, then their work here is done!

attendees at Roy Wilkins Auditorium.

Did you check them out? Costumes, volume, pyrotechnics, and performance art — what more could you want?

The “Hairball” performance was impressive, but I would personally suggest that if such an event would Continued on next page 51

Southern District Continued from page 55

be planned for future Star of the North meetings, the sponsors might consider something of — I never thought I would ever write this — lesser volume and greater ability to simply visit. Maybe something with a string quartet, or a bluegrass band, or a jazz group — something with live music rather than computer-generated karaoke, lights, and explosives.

Legislative Affairs Bits and Pieces I recently received an informational email from our MDA lobbyist Dominic Sposeto. I learned that a bill had “surfaced” in the House Tax Committee that would authorize certain dentists who provide dental care to veterans of the U.S. Armed Services to take a state tax deduction for those services. This bill was requested by Concordia College political science students rightly seeking legislation to serve young veterans returning from active duty.

The Department of Veterans’ Affairs

would identify dental professionals willing to provide free or reducedfee dental services to veterans. The dental professional would be eligible for a tax deduction on his or her Minnesota state income tax. The deduction would be calculated on the applicable Medical Assistance reimbursement rate.

Our Legislative Affairs chair, Mike Flynn, responded in his standard, nononsense manner: “We’ve had similar bills in the past, but really, they have never made the cut. The math on this is $100 (Usual Fee) x 26.7% (MA reimbursement on Usual Fee) = $26.70. Tax deduction would be eight percent (likely Minnesota Individual Income Tax rate) x $26.70 = $2.13! But if you see 20 veterans at $500 each (Usual Fee; total Usual Fee of $10,000), that is $213.60 in tax savings! I do not know if services not covered by MA are eligible for a tax deduction.”

Mr. Sposeto spoke to the bill sponsor and the lead student at

Concordia College to suggest some concerns with the idea, especially using MA reimbursement for the tax deduction.

Perhaps we should again attempt to educate legislators and the public about the realities of the current MA reimbursement situation.

SDDS News Mikkel Haugen of St. Peter is our newest SDDS officer, Thank you, Mikkel! It will be an interesting and enjoyable ride.

Former SDDS members Paul Carlson and Linda Giang-Carlson have purchased Kevin Skjel’s practice in Appleton. Paul and Linda will be admirable West Central District members, and we wish them the very best.

Parting Quote “In America, any boy can become president, and I suppose it’s just one of the risks he takes.”

Adlai Stevenson

IND E X T O A D V E R T I S E R S

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Advanced Practice Management . . . . . . . . . . Cover II

Minnesota Dental Association . . . . . 10, 18, 30, 32, 48

AFTCO Transition Consultants . . . . . . . . . . . . . . . 24

Minnesota Transitions . . . . . . . . . . . . . . . . . . . . . . . 13

Argosy University . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Operation Grace MN . . . . . . . . . . . . . . . . . . . . . . . 20

Business Opportunities . . . . . . . . . . . . . . . . . . . 63-70

Pacific Dental Services . . . . . . . . . . . . . . . . . . . . . 5, 6

Dental Post . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Paragon Dental Practice Transitions . . . . . . . . . . . . . 40

Dyste Williams . . . . . . . . . . . . . . . . . . . . . . . . . . Insert

Plummer’s Arctic Lodges . . . . . . . . . . . . . . . . . . . . . 12

Foreman & Airhart . . . . . . . . . . . . . . . . . . . . . . . . . . 8

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

Fortress Insurance . . . . . . . . . . . . . . . . . . . . . . . . Insert

Southeastern District . . . . . . . . . . . . . . . . . . . . . . . . 24

Gateway Bank . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Statements Plus Compliance Solutions . . . . . . . . . . . 40

Joel Greenwald, M.D. . . . . . . . . . . . . . . . . . . . . . . . 30

Transition Resources . . . . . . . . . . . . . . . . . . . . . . . . 9

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

Universal Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . 20

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

J. White & Associates . . . . . . . . . . . . . . . . . . Cover III

Metro Dentalcare . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Winthrop Weinstine . . . . . . . . . . . . . . . . . . . . . . . . 19

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Northwestern District John E. Lueth Associate Editor P.O. Box 310 Bemidji, MN 56619 Summer Meeting is Sooner Than You Think!

Please join your colleagues and friends for the NWDDS Summer Meeting Friday, June 17, at the Jacob Brower Visitor Center in Itasca State Park in Park Rapids. Topics and speakers include • John Foss, D.D.S., M.D., on “Restoring Implants from Single Units to Multi-Unit Restorations” • Gary Hazelton, J.D., on “Current Law Topics Affecting Dentistry” • Karina Skatvold, RDH, M.H.R., on “Generations of Communication” John Foss, D.D.S., M.D., earned an undergraduate degree from the University of Minnesota at Morris.

He attended dental school at the University of Minnesota, earning his doctorate of dental surgery in 1998.

He then attended Case Western Reserve University in Cleveland, Ohio, earning his medical degree in 2001. He then completed his training in Oral and Maxillofacial Surgery at Metro Health Medical Center in 2004.

Immediately upon completion of his surgical training, John joined Oral and Maxillofacial Surgery Associates in the Brainerd Lakes area, serving the communities of Brainerd, Little Falls, Detroit Lakes, Bemidji, and beyond. Dr. Foss belongs to and remains active in a number of professional organizations.

He is board certified in oral and maxillofacial surgery. He is a member of the American Dental Association, Minnesota Dental Association, and Crow Wing County Dental Society.

He is currently the treasurer for the West Central District Dental Society.

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Gary M. Hazelton, J.D., is the founder and owner of Hazelton Law Group, located in Bemidji. He has been practicing since 1985; exclusively in the personal injury field since 1990.

Karina Skatvold, RDH, M.H.R., earned her Dental Doug and Kim Williams making a pretty happy moment.

Technician certificate from the Naval School of Assisting and Technology in San Diego, California. She worked as an assistant for the United States Navy until she was honorably discharged in 1995. Karina Dave Andersen, left, and MDA Executive Director Carmelo earned her Cinqueonce sharing the Joy of Fish.

Bachelor of will be a hands-on approach to Science degree in Dental Hygiene restoring implants from single units from Old Dominion University in Norfolk,Virginia. She then worked to multi-unit restorations. Zimmer as a civilian contractor for the United representative Chris Bjorkland will also States Navy’s Mid Atlantic Fleet be on hand to co present.

Periodontics department. She moved Gary Hazelton will be presenting to Iceland and served as sole base on current law topics affecting dental hygienist for the NATO and dentistry. Areas covered will include Naval Air Station located in Keflavik. malpractice and updates on employee Karina received her Master of Human law.

Relations degree with an emphasis in Karina Skatvold’s presentation adult counseling from The University will be titled “Generations of of Oklahoma. Karina Skatvold is Communication”. Are you frustrated currently employed as dental materials with staff bickering? Do you have an instructor and clinical faculty with the employee or employer who you just Minnesota State Dental Hygiene and don’t understand? Learning how to Assisting Department in Moorhead. communicate more effectively can John Foss will be presenting greatly improve working relationships. on implant dentistry. The focus Continued on next page 53

Northwestern District Continued from previous page

When you’re among friends, it’s all good. Left to right are Carmelo, Dan Rose, Zach Hazelton, Dave Andersen, and Mike Zakula.

It only looks like a version of Musical Chairs.

These guys actually do know what they’re doin’.

A hostile working environment can decrease productivity and increase stress levels. Discover your own personality type, perception, strengths, and weaknesses. With multiple generations in the office, communication styles and techniques vary.You will learn how to identify generational differences for enhanced communication with co-workers.

Better communication fosters increased harmony and a positive working environment.

This meeting’s C.E. offer two fundamental credits and four elective credits.

Boys and Girls Club Presentations by Area Dental Professionals 3-9-16 “Brownian Motion”: 1. The random movement of microscopic particles suspended in a liquid or gas, caused by collisions with molecules of the surrounding medium. en.wikipedia.org 2. The movement displayed by 1st through 5th graders at the end of a school day and after having been provided a snack containing sugar. anyparent.duh Peeling approximately 150 Bemidji Boys and Girls Club kids away from 54

When the sun is that warm, the day can take you anywhere up here! Carmelo and Dave Andersen with the day’s transport.

snacks and unstructured break time in order to (hopefully) absorb some oral health education and doing so before parents came by to pick them up certainly was a daunting challenge!

But dentists or staff from five Bemidji dental offices accepted the challenge, and they garnered kudos from Boys and Girls Club staff for doing it so well. The intrepid dental professionals — what might be considered “The New Dentist” representatives of the community (save one) — answered the call from the B&GC as a first opportunity to deliver such services at that facility. Boys and Girls Club leaders had expressed interest in the

past for dental health education for their kids, but until March 9th it had not been feasible.

Dividing into five different areas from classrooms to lounge, each office selected a topic from a list suggested

by B&GC. Props were used by some, and group participation by all. The kids were divided into groups and rotated among the presenters. If you have never tried to “break it down” and convey oral health concepts or practices to a crowd of kids, you may miss the appreciation for how to craft answers to questions from waaay out in left field.You may question your sanity at those moments when it seems Northw est Dentis try

Oral piercings and tobacco use were definitely “spellbinding” topics of interest for the tween-aged Boys and Girls Clubbers!

Dr. Jonetta Bakke got kids thinking about what she and dental auxiliaries do and about careers in dentistry!

Hands kept shooting up as Dr. Baret Williams-Furfaro of Great River Dentistry spoke about “Healthy Diets, Healthy Teeth”.

Scrubbing interesting food debris off the cast of teeth characters were Rose and Megan of Hazelton Family Dentistry as they covered “Daily Oral Care”.

that even you are unable to focus due to the constant movement of the bodies in your presence. Or you may not realize how cool it can be for a row of kids to don white t-shirts (to pretend that they are the teeth) and hold a skein of cloth to denote gingiva, all the while covered with food debris (most of it fake by all accounts!), then to have a five-foot green foam toothbrush demonstrate proper brushing techniques…getting into all the nooks and crannies after “flossing” with rope of a diameter suitable for mooring an oar boat!

Every office donated their time, talent, and dozens of toothbrushes to a thankful Boys and Girls Club. Kudos, dental volunteers!

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The Answers: West Indies, Third World, 20,000 Leagues Under the Sea

Happy at work with his group of kids at the Boys and Girls Club “dental day”, Dr. Blake Smith had them engaged with hands-on learning about athletic mouth guards.

Yes, We did Proofread This DDDDDWESTDDDDD World World ____ World < World World 20,000 = L. U. the S. If you know the answers to these and more word game challenges like them, you probably spent some time in an ice house on Lake of the Woods at the Northwestern District’s sixth biennial Winter Meeting - a tradition that has become hard to break due to its popularity. Great dental C.E., plenty of quality socializing, and a range of activities including fishing, wine tasting, and eating once again drew dental professionals to Sportsman’s Lodge on the Rainy River and 200 yards from the border with our neighbors to the north.

Consider these word puzzles a test of how thoroughly you can unwind and disconnect from your daily routine.

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Minneapolis District Cindy Trosen Sundet Associate Editor 7373 France Avenue South Suite 600 Edina, MN 55435 Spring Fling at the Warehouse Winery On Monday, April 11, more than 100 members and guests joined outgoing president Venetia Laganis at the Warehouse Winery in St. Louis Park for the District’s 2016 Spring Fling.

Located in the heart of a warehouse district, the winery is a hidden gem, boasting a one-of-a-kind atmosphere with artistic and eclectic décor. The Warehouse Winery was the perfect place for our celebration on this special evening.

Our newly installed officers are Leilani LaBelle, president; Cindy Sundet, president-elect; Kimberlee Murphy, vice-president; and Herbert W. Schulte, secretary/treasurer; along with Teresa L. Fong, MDA Trustee.

Following a wonderful social reception, the 2016 Guest of Honor Award was presented to Douglas Lambert. Doug’s long-time friend Stephen L’Abbe was the emcee of a very special presentation highlighting some wonderful events, Doug’s dental career, and his volunteerism within the dental association. Steve put together a wonderful tribute to Doug’s career which included some very enjoyable stories and remembrances from colleagues and family members.

An extra (special) added attraction was a poem written for Doug from his close friend William Hoffman.

Congratulations, Doug!

Election Results Congratulations to the following delegates and alternate delegates 56

Steve Gulbrandsen, left, and Kirby Johnson.

Welcome the District’s new dentists, here at the Spring Fling.

MDDS past-president Mark Omlie, left, with a fine selection of District newbies.

Guest of Honor Doug Lambert and incoming MDDS president Leilani LaBelle.

Our annual array of the officers and their welldeserved thank-you gifts.

Joey and Mark Omlie with daughter Jessica.

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Guest of Honor Doug Lambertâ&#x20AC;&#x2122;s office crew, complete with the dentist contingent of Paul Belvedere and Sandra Houck with Doug in the foreground.

Venetia Laganis, and Leilani LaBelle.

Many of the Districtâ&#x20AC;&#x2122;s past-presidents took time to surround Executive Director Michelle Quade to help her celebrate 20 years on the job.

New president Leilani LaBelle and our Doug, Beth, Anna Mae, and Greg Lambert. Good company is always the hallmark of these evenings. roster of officers, left to right, are Leilani, Trustee Teresa Fong, Executive Director Michelle Quade, Vice-President Kim Murphy, and Secretary/ Treasurer Herb Schulte. Absent is President-Elect Left to right are Doug Lambert, Bob Sampson, Cindy Sundet.

Jesse Veil, and Rob Derr.

More new dentists enjoying the Spring Fling. Looks to be a keeper.

elected by the membership of the MDDS. They will represent the Minneapolis District Dental Society in the MDA House of Delegates September 16 and 17 in Bloomington.

All MDDS members are welcome to attend the Tuesday, August 23, 2016 caucus meeting scheduled to begin at 6:00 p.m. at the Minneapolis Marriott Northwest Hotel in Brooklyn Park.

The 2016 resolutions will be discussed along with other business. Please contact the District Office if you plan to attend.

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Delegates Leilani L. LaBelle, Chair, President Cindy T. Sundet, President-Elect Kimberlee M. Murphy, Vice-President Herbert W. Schulte, Secretary/ Treasurer Teresa L. Fong, MDA Trustee David L. Basi Monique D. Baune Susan E.M. Block Benjamin R. Bowling Andrew M. Doroschak Russell A. Dylla Donna M. Hecker Sandra J. Houck

Kenton M. Johnson Woojin Kwon Kristin J. Langguth Michael J. Leonard Michal J. Madden Sarah J. Magnuson Jennifer Marker Johnson Ian A. Park Jeffrey R. Remakel Clayton R. Shepard Tasha T. Strait Cale A. Strait Jonathan O. Twomey Ryan F. Wolff Melissa S. Zettler Continued on next page 57

Minneapolis District Continued from previous page

The following poem was written for MDDS 2016 Guest of Honor Douglas Lambert by his friend William Hoffman, and presented at the District’s Spring Fling April 11, 2016.

Ode to Longfellow There once was a dentist named Douglas.

His skill and technique, they were flawless.

He created great smiles.

Patients journeyed for miles.

All his colleagues found his work priceless!

He has served with the District and state, With wisdom and advice that’s first rate.

With meetings galore, He’s the last out the door.

Always willing to work and create!

So we Honor him here with this night, Singing praises and cheers that are bright.

You’ve done us all proud!

So we cheer you out loud!

Congratulations to Doug, our bright light!

Alternate Delegates Michael P. Capp Lilah S. Ekim David S. Gesko Jerod T. Klava Archana Mani John C. Marker Catalina S. Morarasu Charles W. Puffer Kacie Bowles Sharpe Mathew K. Woodward

Adele Della Torre Tom M. Hanson Karlene A. Johnson David E. Kilber Lisa K. Kruchoski Todd W. Lund Mitchell B. Olson Lisa M. Spier John C. Stangl David C. Streif

Congratulations to Members Who Have Reached Membership Milestones The Minneapolis District Dental Society congratulates the following members who have reached membership milestones within our organization. We all extend our sincere gratitude for their contribution to the dental profession through their years of membership. Please congratulate these longtime MDDS members as they reach these milestones.

50 Years of Consecutive Membership George H. Winn Thomas W. Anderson P. Louis Michelich Lee A. Armstrong Jerome A. Erickson Michael J. Harrison Thomas E. Kraft Rodney A. Lenz Stephen H. Christensen John H. DeMarais Gary M. Rohrer William F. Liljemark

25 Years of Consecutive Membership Keith E. Abrahamson Christine D. Baylon Stephen A. Bejarano Robert Boyat

Save the Date for a Traditional Summer Sporting Event The MDDS’ annual Trapshoot Tournament is scheduled for Wednesday, August 17. We will be

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returning to the Metro Gun Club in Blaine. The day will culminate with our now legendary gourmet wild game dinner and prizes. For those of you who have not participated for a while or who have never joined us, this is an event not to be missed. Everyone is welcome to come out and enjoy the wonderful wild game dinner even if you are not in the tournament.

The registration form will be mailed out as the date gets closer and will be placed on the District website.

For more information, please contact the District Office at (651) 631-9845.

Welcome, New Members Congratulations to the following new members of the District.

Casey A. Chantelois, D.D.S. Kyle J. Nordeen, D.D.S. Upcoming Programs and Events Friday, July 15 and Saturday, July 16, 2016 MN Mission of Mercy Moorhead, Minnesota Many Volunteers Need Wednesday, August 17, 2016 Trapshoot Event Metro Gun Club Blaine, Minnesota Tuesday, August 23, 2016 MDDS Caucus Meeting All Members Welcome Minneapolis Marriott Northwest Hotel Brooklyn Park, Minnesota Friday, September 15, and Saturday, September 16, 2016 MDA House of Delegates Bloomington, Minnesota Thursday, September 29, 2016 Student Networking Event McNamara Alumni Center Minneapolis, Minnesota Friday, January 27, 2017 91st Annual Midwinter Dental Meeting Minneapolis Marriott Southwest Hotel Minnetonka, Minnesota Northw est Dentis try

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Southeastern District Christopher E. Carroll Associate Editor 150 East 4th Street Winona, MN 55987 pedsdent@hbci.com Stars of the North Thought I’d take this month’s report to highlight the contribution a few of the District’s members make to our MDA Star of the North Meeting. There was a lot going on at a big meeting, and I’m sure I am leaving some people out, so please accept my apologies as well as my thanks for your part in putting on a great show.

First of all I wish to thank Alicia Bullard of Winona. She is on the Scientific Sessions Committee, and those in the know consider it to be the hardest working committee of the MDA. There is a lot of travel involved in attending all of the big meetings across the country, and there are many, many speakers to sample and review. In addition, there are many jam-packed meetings to attend to hammer out the myriad of details necessary for conducting so large a meeting as the Star of the North.

As if that didn’t keep her busy enough, for this year’s meeting Alicia beat the bushes to flush out three volunteers (her husband, Brad Bullard; Paul Morgan; and me, all from Winona) to serve as speaker hosts and more. Unfortunately, a family emergency precluded Alicia from attending this year’s meeting, but her great contribution had already been made before the doors ever opened.

Just a word on being speaker host: It really is an easy task, and even more rewarding than I had anticipated. I met my speaker for breakfast at the St. Paul Hotel. From there we went to the MDA information booth and got M ay- J une 20 16

The intrepid Dr. Brad Bullard (next to last on the left) also hosted the tour of Surley Brewery. Seems like the Star of the North has a job for everybody.

Paul Morgan served as host to speaker Leslie Canham.

Paul, a veterinarian’s husband, seemed well chosen for this duty since it included hosting trusty service dog Mocca.

My good friends Dr. Mike Flynn, his wife, Dr. Priscilla Flynn and me at the MDA President’s Reception.

Michael received the much deserved MDA Outstanding Service Award.

a small packet of everything needed for the job. Then it was off to the presentation hall to check out the room and AV set-up. (We did need a little technical help, but there was plenty available.)

Greeting the attendees was fun as well. I got to chat with a lot of new acquaintances and shake hands with or hug some familiar ones. After my speaker and I were treated to lunch at the elegant “317 on Rice Park”, we canvassed the convention floor. Then it was back to the presentation hall for the afternoon session.

My speaker and I became great friends in a short amount of time, and were talking of a reunion as I was seeing him off to the airport. All in all, this was a great experience that far exceeded my expectations. I’m certainly going to be a speaker host again, and I would recommend your giving it a try as well.

One of Our Own Is Recognized SEDDS’ Mike Flynn received the Outstanding Service Award at this year’s MDA President’s Reception.

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A recounting of his long history of MDA service and accomplishments has already been reported many times, so I won’t repeat it here. I would simply wish to add that of all the wonderful men and women I have known who have served our profession, I personally know of no one who had put more time, effort, thought, heart, and soul into it as has Michael. Congratulations, Michael, on an honor well deserved.

A Reminder of Our Upcoming Meeting The District’s annual Summer Meeting will be held in Austin August 19th at the fabulously restored 1871 mansion, the Hormel House. Please plan on joining your colleagues there. We have a great program planned, and the invitation is open for you to check out the sites around Austin. This will be a great opportunity to visit the brand new “Spam Museum”, an obligatory pilgrimage for any self-respecting Minnesotan.

Our speakers will be: Neal Jeffrey, former All-American quarterback at Baylor University and quarterback for the San Diego Chargers, learned early in life how to overcome adversity. Neal has been a stutterer since childhood, so, in order to fulfill his dreams, he had to find a way to “get through what he couldn’t get over”. Today he is a powerful and passionate communicator, speaking to corporate conferences, national conventions, sales organizations, sports teams (the New York Yankees twice), school districts, student groups, and churches from coast to coast. He inspires his audiences to go “higher,

The beautifully restored 1871 Hormel House in Austin, where the Southeastern District will hold its annual meeting the morning of August 19th.

swifter, stronger” in the critical areas of their lives.

Dr. Mark T. Murphy is the Principal of Funktional Tracker and lead faculty for clinical education at Microdental.

He also serves on the adjunct faculty SEDDS Annual Meeting speaker SEDDS Annual Meeting speaker at the University Dr. Mark T. Murphy.

Neal Jeffrey. of Detroit Mercy Hospital, and the is an informative and entertaining Pankey Institute, where he has served speaker, blending a stand-up style of on the board of directors. He practices humor and anecdotes with current general dentistry in Rochester, evidence-based research that you can Michigan, and lectures internationally take home and use in your practice on leadership, practice management, right away. communication, case acceptance, CEC planning, occlusion, and TMD. He

Now We Know Who Said It “It’s a naive wine without any breeding, but I think you’ll be amused by it’s presumption.”

James Thurber

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Dentists

The Promises Are Real…

When I finally admitted that I was powerless over alcohol, something strange happened: my life started getting better.

Instead of trying to remain in control of everything (work, family, marriage relationship, children) while also trying very hard to remain in denial about my “problem”, I finally decided that I didn’t want to fight anymore, and simply let go and started relying on a higher power. This took a continuous act of surrender and a large amount of humility.

In my professional life, it was becoming exceedingly difficult to hide the fact that I was alcoholic, and as a result, my clients suffered because I knew they weren’t getting the best possible care that I could provide, while my peers did their best to look the other way. In my personal life, those who loved me most chose to treat me with caution and never fully relied on me in a way they needed. Looking back now, albeit very difficult, I realized that I was falling apart in almost every way and leaving a wake of broken relationships and less-than-my-best work lying on the table.

My life started getting better when I realized that I had a problem with alcohol. I began surrounding myself with peers who were also struggling. I reached out and started attending meetings and found a sponsor, something I had never done in my past attempts at sobriety. I began to fully submit to every aspect of recovery that was available to me because the alternative was becoming a very dark and insidious road.

I had heard of “The Promises” of Alcoholics Anonymous in meetings, but never really gave it much thought, until some of those Promises started to actually manifest in my personal and professional life.

For those of you not familiar with the A.A. Promises:

Stay warm!

In the early days and months of my recovery, these words didn’t seem to resonate that much for me.

However, I continued on my path and went to meetings each week, sometimes a few times a week, and was diligent about getting together with my sponsor. The opportunity to talk with someone who had been through the process and shared my struggles was invaluable, and now my sponsor is one of my closest and most trusted friends.

Self-seeking did slip away from my life. I have come to recognize my selfishness more quickly and make steps to change in the moment rather than sit with my unresolved expectations of others to fester, understanding how this can cause problems. The feeling of being useless and feeling sorry for myself has also subsided.

It is true that my whole attitude and outlook on life have changed in some incredibly profound ways, and I do know a new freedom and new happiness. Before, in my addiction, I believed that using was the path to freedom and happiness. Now I see very clearly that it was a terrible lie. In truth, I was a slave to my addiction, and eventually it caught up to me. It always does.

My life has a sense of profound peace now, and while it is not always perfect — I make mistakes and get angry or impatient, or even get down or overwhelmed with life sometimes — I have found that dealing with challenging situations is much easier in sobriety. My loved ones have noticed the change too, and my relationships — both personally and professionally — have never been better. There is a simple-hearted contentment that exits in my sobriety that I have begun to realize I want to share with others who may also struggle or feel lost in their addiction.

The promises are real because they are being fulfilled among us, if we work for them.

Grateful DCD member

The Promises of A. A. If we are painstaking about this phase of our development, we will be amazed before we are halfway through. We are going to know a new freedom and a new happiness. We will not regret the past nor wish to shut the door on it. We will comprehend the word serenity, and we will know peace. No matter how far down the scale we have gone, we will see how our experience can benefit others. The feeling of uselessness and self-pity will disappear. We will lose interest in selfish things and gain interest in our fellows. Self-seeking will slip away. Our whole attitude and outlook upon life will change. Fear of people and of economic insecurity will leave us. We will intuitively know how to handle situations which used to baffle us. We will suddenly realize that God is doing for us what we could not do for ourselves.

Are these extravagant promises? We think not. They are being fulfilled among us — sometimes quickly, sometimes slowly. They will always materialize if we work for them.

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Dentists Concerned for Dentists Continued from previous page

Those who loved me most never fully relied on me in a way they needed.

I realized that I was falling apart in almost every way.

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 mood-altering 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 1 (800) 632-7643. You can also visit our website at www.dcdmn.com

“Poetry is what in a poem makes you laugh, cry, prickle, be silent, makes your toenails twinkle, makes you want to do this or that or nothing, makes you know that you are alone in the unknown world, that your bliss and suffering is forever shared and forever all your own.”

Dylan Thomas

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Opportunities Careers FT Licensed Dental Assistant Linden Hills Dentistry is searching for a Full Time Licensed Dental Assistant who is reliable, professional, personable, team-oriented and whom can keep up with a very fast paced; multi-doctor environment. Applicants must have a current CPR and License certifications. Prior experience is a plus.

Come work with an exceptional team!

Please reply with a cover letter and attached resume to katy@lhdmpls.com.

For more information on our office please visit www.lindenhillsdentistry. com Dental Therapist, Grand Rapids MN We are looking for Dental Therapist to join our team at Miskovich Dental, in Grand Rapids MN. If you have interest in: A high technology practice that includes a 3D x-ray (Galileos), Cerec as well as other modern instrumentation and modalities, mentoring from a dentist with a passion for high quality dentistry and continuing education, a warm, inviting and financially thriving community with beautiful scenery.

If you have interest, please visit our website at www.miskovichdental.com as well as contact Jessica Nelson at by phone at (218) 326-3437 or email jessica@miskovichdental.com. We are looking forward on expanding our team.

Dentist Does your owner Doctor keep pushing off your buy-in? If that's your story, you may have found the right place.Our well-established group practice is looking for a full-time dentist who can provide all aspects of dentistry.

We're located in the western suburbs, within a wonderful community.

Excellent earning potential with very competitive salary and benefits. A few years of experience is preferred, but not necessary. A great opportunity awaits. Please reply with Cover letter and Resume to clinicmgr2014@ gmail.com. Inquiries will be kept in confidence.

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Locum tenens. Very skilled and experienced DDS looking for opportunities to help a practice with a provider gone Locum Tenens. I had founded and ran a large practice and staff in Plymouth, MN. Also I am very skilled in all phases of dentistry and and terrific with people. I am seeking work in metro area and surrounding areas.

Contact drsteve@bogerdental.com or 612-817-1755 Minneapolis GPR Resident Looking for Private Practice Associateship I am a high energy general dentist completing a GPR advanced training program in Minneapolis that is looking for a full time employment opportunity as an Associate Dentist in the Minneapolis/St. Paul area. I am a Minnesota licensed dentist that graduated from the University of Minnesota School of Dentistry in May 2015 prior to completing a GPR at the University of Minnesota Medical Center. I have gained additional educational and clinical experience in dental implants, molar endodontics, complex treatment planning, dental trauma, hospital dentistry, conscious sedation, fixed prosthodontics, removable prosthodontics, and oral surgery. I am interested in treating adults and children alike in all facets of general dentistry. Contact bussa.nick@ gmail.com DENTIST - OUTSTANDING OPORTUNITY AVAILABLE Available immediately for part-time dentist (2-3d/week) leading to full time. This opportunity could lead to partnership for the right individual. We are a fee for service private practice, with the latest techniques in dentistry along with excellent customer service.

We have a state of the art facility and great staff. The Ideal Candidate: DDS/ DMD from an accredited University and active Minnesota State Dental Board licensure. Has a strong sense of ethics and willingness to be mentored, coached and trained. Experience preferred, but great attitude is most appreciated. Please, send resume gdental3@gmail.com

Lab Technician Associate Dentist/ Future Owner needed to join growing practice in Northeast Wisconsin Earn more in a four day work week than you would in a big box clinic working five days a week. Receive a $15,000 sign on bonus, 6 weeks of vacation and mentoring by senior Doctor as needed. We are a full service dental practice focusing on comprehensive care including restorative, cosmetic, implant and sedation dentistry. Located in Sister Bay, WI, this opportunity lies in the heart of Door County, which boasts spectacular outdoor recreation, great schools and friendly people. If you want to change peopleâ&#x20AC;&#x2122;s lives through dentistry, while living in a great community email resumes to drpaul@doorcountydentistry.com.

Visit www.doorcountydentistry.com for practice details.

Flexible Locum Tenens Opportunity Midwest Dental is seeking experienced dentists to fill daily/ weekly/monthly locum tenens needs to cover leaves and extended vacations.

Perfect for dentists wanting to pick up extra hours. We offer competitive pay and give you complete freedom to work as many locum sessions as you'd like! May involve travel with overnight stays. Typically includes 32-36 hours/ week when needed. Opportunities are available at practices across the country.

Contact Carly Rufledt at 715-2259126 or crufledt@midwest-dental.com Part-Time Oral Surgeon Opportunity OMS needed 2-3 days per month in Woodbury. Excellent income potential including a daily guarantee.

Contact Ed at 949-842-7936 or send CV to looname@pacden.com General Dentist Wanted in Montevideo, MN. A rural general practice in SW MN. Fast paced, progressive office looking for a motivated, friendly Dentist. Join our fun and loving team. Email melissa@ mainstreetdental.org Continued on next page 63

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Full Time Associate General Dentist needed in Golden Valley, MN Valley Dental Group is seeking a full time associate General Dentist.

We are a multi-specialty dental group practice, accredited by the AAAHC that has provided lifetime quality dental care for 42 years in Golden Valley, MN. To be considered, you must have excellent patient management/ dental skills and have a minimum of 3 years of experience. Please send resume and letter to Barbara@valleydental.com Full/Part Time Dentist Needed for Associate Position with Buyin Potential Well established practice with three dentists. Saint Peter Family Dental Center has been serving St. Peter MN and the surrounding communities for 35 years with team members who have been with us for 15, 20 and 25 years. Modern, efficient office with all digital x-rays. Great area to raise a family, a terrific school system and many area lakes for outdoor recreation. Only 45 minutes from the Twin Cities metro area and home of Gustavus Adolphus College. For more information, please email our office at Diana@stpfd.com.

Dental Associate South of the River Dalseth Family and Cosmetic Dentistry is currently seeking an associate to work 4 days per week.

We are a well established practice in Apple Valley, MN. We take great pride in our patients, facility, and high level of dentistry. We have state-ofthe art equipment including CBCT. We are a top-notch team and deliver a comprehensive level of care. An associate must be able to perform endodontics, exodontia, along with other general dentistry. We are a busy, growing practice with a committed staff. Please send CV to Pascal Dalseth DDS (www.dalsethdental.com) at pascaldds@gmail.com

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Dentist opportunity with Healthcare System in Southwest Minnesota Avera Tyler is seeking a full time Dentist to join a thriving dental practice in Southwest Minnesota. This is a solo practice opportunity working for a major healthcare system. This is an established dental office fully staffed with competent employees and includes modern equipment.

This opportunity has a competitive guaranteed salary, production bonus, PTO and wonderful benefits. Avera Tyler is part of the Avera system of care. Avera encompasses over 300 locations in over 100 communities in a five-state region. The Avera brand represents system strength and local presence, compassionate care and a Christian mission, clinical excellence, technological sophistication, an array of specialty care and industry leadership.

This is a great opportunity for an entry or experienced dentist looking to not have management headaches and settle in a wonderful community. Contact dave.dertien@avera.org Associate Dentist Dental Associates of Minnesota, a group practice located in the Twin Cities, provides quality, affordable care for our patients. We are looking to hire a full-time general dentist. Each office features paperless charting, an experienced staff and a busy schedule. We offer sedation, implants and pediatric dentists within our growing group. We also work closely with multiple faculty members from the University of Minnesota Dental School. If you would like to learn more please email us at: makid@ dentalassociatesmn.com General Dentist Office Located in Central Minnesota Full Time position available for a caring general dentist with excellent clinical skills. This opportunity can lead to a partnership.

The office has been updated with Eaglesoft and Schlick Digital xrays.

Contact Tammy@fallscourtdentists. com if interested.

Associate Dentist Grand Rapids, MN We are looking for an Associate Dentist to join our team at Miskovich Dental, in Grand Rapids MN. If you have interest in: A high technology practice that includes a 3D x-ray (Galileos), Cerec as well as other modern instrumentation and modalities. Mentoring from a dentist with a passion for high quality dentistry and continuing education. A warm, inviting and financially thriving community with beautiful scenery.

If you have interest, please visit our website at www.miskovichdental.com as well as contact Jessica Nelson at by phone at (218) 326-3437 or email jessica@miskovichdental.com. We are looking forward on expanding our team.

Full-Time Associate Dentist Wanted Established 2 Dentist office seeking a full-time, confident and personable Associate Dentist with potential for partnership. Our office is amalgam free and provides a wide variety of dental technologies and services including Cad Cam technology (Professional training provided) Cone Beam CT, Laser technology, Implant Technology including guided surgery, cosmetic dentistry, monitored IV sedation, orthodontics, endodontics, prosthodontics, local hospital privileges, sinus surgery, periodontal services, and 3rd molar extractions. This position is part of a team approach working to deliver the best treatment that Dentistry can provide. If interested, please call Tricia @ 320-864-3215 Associate Dentist- Prior Lake Beautiful, state of the art, family orientated dental office is looking for a part-time associate to join our team in Prior Lake. Associate position would be 2-3 days a week (Wednesday &amp;/ or Thursday afternoon/evening and Fridays) with excellent compensation.

Ideal candidates should have 2+ years of experience with excellent clinical and communication skills. Please email your resume to tombmorgan@yahoo. com or fax to 952-447-4660 Northw est Dentis try

General Dentist St. Cloud MN Area We are seeking a full-time associate, with a path towards partnership, for a busy and growing practice. Extensive growth opportunities available, especially for a doctor with interests in endo or oral surgery. We are an established and modern general dental practice with a top-notch and experienced team dedicated to providing comprehensive care to our patients. We offer a wide range of services for our patients from family dentistry to full mouth reconstruction and cosmetic dentistry. Please contact Dr. Kathleen Moen at kmoen86@ gmail.com. Confidentiality is assured.

Associate Dentist in West Metro Group Practice Unique full time opportunity in a progressive, vibrant, team oriented multispecialty group practice with an established history in the community. We are looking for a dentist to work with our dedicated and experienced support staff to deliver personalized patient care utilizing technology such as digital radiography and cerec technology. This is an associate position to develop to partnership.

Comprehensive care, high skill level and experience required. Resumes to: sbruning@bassettcreekdental.com General Dentist - Fergus Falls Minnesota Apple Tree Dental, a nationally recognized, innovative, independent non-profit group practice; provides comprehensive care to patients of all ages and abilities in our Centers for Dental Health, and on-site at long term care facilities, and other community-based settings. Apple Tree is currently seeking a dentist who is passionate about making a difference in the lives of our patients in Fergus Falls, Minnesota. We offer comprehensive pay and a full benefits package, including medical, dental, vision, disability, 401K w/match, paid time off, and more! Please e-mail your cover letter and CV/resume to hr@appletreedental.org. For more information: www.appletreedental.org Equal Opportunity Employer M ay- J une 20 16

Full Time General Dentist Full Time General Dentist position available in Michigan's beautiful Upper Peninsula.

Located in a vibrant college town on the shore of Lake Superior. We are a well-established, busy, multi doctor practice providing quality dentistry for the entire family. We operate 5 days a week with no evening or weekend hours. We have an excellent work environment including a friendly, caring, dedicated staff; state of the art equipment; and a great income earning potential for the right person.

Please send resume to nhebner@ superiorsmilesdental.com Great Dentist Wanted – Chatfield MN – $$$$ signing bonus Midwest Dental is seeking a great dentist to lead our Midwest Dental practice in Chatfield Minnesota. This position offers excellent compensation and benefits, a great work-life balance, and unlimited opportunity for professional development. Our support team handles the administrative details, allowing you to lead your team while focusing on dentistry. If you possess a passion for providing quality care and are looking for a rewarding career opportunity, please contact Derek Lindholm at 715577-4551 or dlindholm@midwestdental.com Seeking Associate Dentist with opportunity to Buy In Dr. Greg Kaake and his staff invite you to Miller Hill Dental where you’ll find an attractive top notch facility, very up-to-date technology and a great team. We are looking for a Doctor who wants to gain experience and who enjoys what Duluth has to offer, wants to deliver a wide range of services and values continuing education. The right candidate will have an opportunity to buy-in. Please contact us and/ or email your resume to admin@ millerhilldental.com if interested. Dr. Greg Kaake at 1832 Maple Grove Road in Duluth MN 55811 Phone: (218) 722-1070 Fax: (218) 733-0959 www.MillerHillDental.com

Dentists Opportunities in Beautiful Northern Minnesota!

Scenic Rivers Health Services Federally Qualified Healthcare Center (www.scenicrivershealthservices. org) Scenic Rivers Health Services is seeking providers for one or more of our locations in Cook, Tower, and Floodwood, MN. We now operate six medical and three dental clinics in beautiful northern Minnesota!

Create a Practice of Your Own & Enjoy a Positive Work Life Balance.

Highly Competitive Sign-On Bonuses & Salaries, Flexible Work Weeks: 8-12 patients per day, No Production Contracts, Comprehensive Malpractice Coverage, Moving Expense Reimbursement, National Health Services Core Loan Repayment Options & Organizational HPSA Score of 22! Full benefit package, 3,000 annual continuing education benefit, 10 annual CME days, 20 vacation days, 6 holidays, 3 personal days.

Our facilities are newly remodeled and well equipped with digital x-ray and panorex, electronic dental records (Dentrix), intraoral cameras, and diode lasers. Work with excellent clinical and support staff including full time hygienists. Our appreciative patients come from all over the Iron Range and northern Minnesota. For Employment Inquiries Please Contact: Travis Luedke, Clinic Manager 20 Fifth St, SE, Cook, MN 55723, tluedke@ scenicrivershealth.org; 218-361-3190.

Scenic Rivers Health Services is an Equal Opportunity Employer Dentist Full time 4-5 days a week.

Main Street Dental is seeking a Dentist to join the practice. The clinic is computerized and has an amazing TEAM with Longevity. Applicants will need to provide comprehensive general dentistry with compassion. Please call Tammy 320 632 6621 x 4 or email Tammy@fallscourtdentits.com Continued on next page

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Great Dentist Wanted – Central MN – $$$$ signing bonus Midwest Dental is seeking great dentists to lead our Midwest Dental practice in Central Minnesota. This position offers excellent compensation and benefits, a great work-life balance, and unlimited opportunity for professional development. Our support team handles the administrative details, allowing you to lead your team while focusing on dentistry. If you possess a passion for providing quality care and are looking for a rewarding career opportunity, please contact Derek Lindholm at 715577-4551 or dlindholm@midwestdental.com Great Dentist Wanted – Superior WI – $$$$ signing bonus Great Dentist Wanted - Superior WI $$$$ signing bonus: Midwest Dental is seeking great dentists to lead our Midwest Dental practice in Superior Wisconsin This position offers excellent compensation and benefits, a great work-life balance, and unlimited opportunity for professional development. Our support team handles the administrative details, allowing you to lead your team while focusing on dentistry. If you possess a passion for providing quality care and are looking for a rewarding career opportunity, please contact Derek Lindholm at 715-577-4551 or dlindholm@midwest-dental.com Great Dentist Wanted – Rochester MN – $$$$ signing bonus Midwest Dental is seeking great dentists to lead our Midwest Dental practice in Rochester Minnesota. This position offers excellent compensation and benefits, a great work-life balance, and unlimited opportunity for professional development. Our support team handles the administrative details, allowing you to lead your team while focusing on dentistry. If you possess a passion for providing quality care and are looking for a rewarding career opportunity, please contact Derek Lindholm at 715577-4551 or dlindholm@midwestdental.com 66

Dental Associate - Walker, MN Pederson-Bilben Family Dental is seeking a full time dental associate for a thriving established private practice.

We have a doctor looking to retire so a new associate would be busy from the start. Interest/Experience in molar endo and oral surgery would be helpful but not required.

We provide comprehensive general dentistry in a comfortable setting that thrives on strong patient relationships.

Our dental staff has many years of experience and works efficiently in a team like environment. We have seven computerized treatment rooms and are completely digital. Our dental practice has been serving the patients of the Walker Area Community for more than forty years! The community of Walker, Minnesota is located in the heart of lake country on famous Leech Lake. A motivated individual can make a great career and living where most people vacation. If interested in biking, hiking, golfing, fishing, boating, hunting, camping or winter sports- this community has it all! Confidentiality assured. You'll be on track for eventual ownership if desired. Generous guaranteed base level of pay. Contact Dr. Mike Pederson at pedmike3@gmail.com Website: PedersonFamilyDental.com Associate Dentist Needed Our Fargo Practice seeks a great addition to our highly productive and growing office. We believe in seeing our patients one at a time and delivering a superior experience. The latest in technology and a cohesive team is looking forward to meeting you. 2 Years General Practice experience preferred. Applicant must possess excellent clinical and communication skills. Full-time, 4 days/week.

Compensation based on Qualifications.

Contact brad.andersondds@gmail.com

Full-time Associate DDS - Now offering signing bonus!!!!!!! Do you want to run your own clinic without the headaches of running the business office? Family &amp; Cosmetic Gentle Dentistry is a thriving group Practice with 14 offices in Minnesota. Due to recent growth and expansion, we are seeking full-time Associate DDS for our Cottage Grove, Eagan, Coon Rapids, Hutchinson and Alexandria offices. Our clinics offer digital x-ray, paperless charting, and a full-staff of experienced dental professional to help manage the clinic. We pride ourselves on giving our DDS the autonomy to run their practice the way they chose without the interference of a board of directors. We offer a flexible schedule with no weekends, competitive compensation, 401K with an employer match and medical, dental, disability and life insurance. If you would like to learn more about these exciting opportunities, please send your resume and cover letter to scarlson@smilemn. com West Central MN Dentist 45 minutes from Minnetonka Hutchinson Family Dentistry is seeking an Associate Dentist w/ buy in options.

A brand new office in a remodeled downtown building from two offices that have been around for over 80 yrs.

New facility, state of the art equipment, Huge pt base and top notch staff ready to help you grow professionally.

We would prefer 2-3 yrs experience however not a major requirement if the right person fits our model.

Sound too good to be true? Check us out, hutchfamilydentistry.com and send your resume to MNagel@ hutchfamilydentistry.com Part Time Oral Surgeon Needed OMS needed 3-5 days per month in our Richfield, Woodbury and Blaine offices. Excellent income potential and state-of-the-art facilities. Contact looname@pacden.com

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Northern MN Dental Practice looking for Associate Dentist!

Northern Minnesota Dental Practice is looking for a full-time Associate to join our busy, fast-paced, state-ofthe-art Dental Practice with the most up to date technology advancements.

We are looking for a self-motivated individual who wants to be part of a professional team where patient care is our first priority. Competitive wage and medical benefits are included. rachmiskovich@gmail.com METRO DENTALCARE OPPORTUNITES We have opportunities at Metro Dentalcare we would like to explore with you.

Founded in 1968, Metro Dentalcare offers a complete range of routine, cosmetic and specialized dental health services practice is fully digital with electronic dental record, digital radiography and digital impressions.

Metro Dentalcare is a growing group practice in the Twin Cities area and offers a comprehensive benefit package and compensation. For more information on our company, visit our website at www.metro-dentalcare.com or contact Julie Dunn at 612.861.9122, jdunn@metro-dentalcare.com Duluth/Superior-Dentist Community Health Lake Superior Community Health Center (LSCHC), with sites in both Duluth, MN and Superior, WI, has an immediate opening for a staff dentist. LSCHC is a federally-qualified health center, dedicated to serving the needs of low income and underserved communities.

The ideal candidate is a progressive professional, with strong interpersonal skills, the ability to foster a positive team environment, and has a DDS/ DMD degree. We offer a competitive salary and excellent benefits. Please go to www.lschc.org and fill out an application. Submit your application and resume to lschhumanresources@ lschc.org or mail to LSCHC, 4325 Grand Ave, Duluth, MN 55807.

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General Dentist The Dental Clinic of Marshfield currently has an opportunity for a general dentist to join our staff.

This is an excellent opportunity to build your practice within a long-established group practice. We are looking for an individual who is interested in a long-term opportunity to join a quality practice. We offer associates, after 3 years of employment, the potential for a buy-in as an equal partner to the corporation. We offer an associate a guaranteed starting salary along with a very comprehensive benefit package. For further information or to apply, contact Dental Clinic of Marshfield, 306 W. McMillan Rd., PO Box 929, Marshfield, WI 54449, Attn: Mr. Neil Armitage or call (715) 387-1702 or email neil.armitage@ dentalclinicofmarshfield.com General Dentist Associate (Opportunity for partnership/ ownership)-Fergus Falls, MN Established practice looking to replace a retiring dentist. Looking for an Associate DDS-immediate or future buy-in possible. Associate would have an immediate patient base. Prairie's Edge Dental is a modern office featuring 3D Cone Beam technology, computer records &amp; digital radiography.

This position offers a flexible schedule that will work with applicant's needs.

We have a dedicated staff the strives to provide the best care possible to our patients. Contact greendent@live.com Dentist needed for busy Community Dental Clinic Community Dental Clinic in Park Rapids, MN is seeking a full or parttime dentist. We are a public health care clinic that focuses on MN Public Program patients. Compensation package includes: health, life, eye, disability insurances, 401(k), PTO & competitive salary. Please apply online at www.sjahs.org Human Resources CHI St. Joseph's Health Park Rapids, Mn 56470. Email sheanathompson@ catholichealth.net or call 218-616-3064

Dentist--Edina Centennial Lakes Dental Group seeks a full-time dentist to join our Edina practice in late Spring 2016. We are a successful group of six dentists with locations in Edina and Golden Valley. The Edina location is a beautiful, four-doctor practice supported by an outstanding staff and state-of-the-art equipment. A full-time practice and potential buy-in await the right person. We are looking for an experienced dentist who appreciates the advantages of a group setting. Visit our website at: www.CentLakeDent. com and if interested, contact us at judy@centlakedent.com Dentist- Winona, MN We are seeking a dentist to join our amazing team. This position will lead to a partnership in our modern and busy practice, as we are replacing a retiring doctor. Beautiful Winona, Minnesota is a great place to raise a family and offers a variety of outdoor activities.

Contact david.gilmer@yahoo.com if interested. Visit our website (www. waterfrontfamilydentistry.com) for more information.

Central MN Lakes Area - Buy In/ Buy Out Available Well established, busy, three doctor group practice in central Minnesota, with two doctors ready to retire, needs a dentist, maybe two, to transition into the practice. Buy in/buy out options available, We have up to date facilities, including twelve computerized treatment rooms, digital x-rays/pano, over 7000 active patients and a long term, dedicated support staff.

We are conveniently located between St. Cloud, Brainerd and Alexandria, with easy access to those towns and the Twin Cities, Excellent schools and churches, a great place to raise your family. Please contact Marilyn @ 320732-6141, or lpdental@embarqmail. com

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VIBRANT GROUP PRACTICE - Full Time Dentist LifeSmiles Dental in beautiful Fergus Falls, Minnesota is growing and has an excellent opportunity for a full-time associate dentist to join our team of busy doctors. Our state-of-the-art practice thrives on strong patient relationships and the teamwork of our dedicated long-term staff. Digital radiography/ scanning, paperless charting, intra-oral cameras, and soft tissue laser enable our doctor-driven model. If you are goaloriented, enthusiastic, and have a desire to share your skills, we are committed to your success with superior compensation, 401k match, mentoring, flexible schedule, and a progressive clinical environment including future partnership opportunity. Whether experienced or soon graduating, we would love the chance to meet with you and discuss the benefits of our work/life balance. Come see for yourself why Fergus Falls was recently awarded in 10 Best Places to Live and Boat in the USA and &amp; Most Beautiful Towns in MN! Visit us on Facebook at Facebook.com/ LifeSmilesDental or contact us today for more information at 218-7392481 or email Dr. Todd McGovern at tjmcgovern@lifesmilesdental.com Thank you!

Practice for sale, Great opportunity, Bloomington/Edina, Minnesota Area Well established 2 doctor practice in the Bloomington/ Edina area has an opportunity for an experienced dentist to buy in/buy out ownership and assume leadership as the senior doctor hands off responsibilities.

The doctors have an outstanding reputation and have been voted top dentists. They continue to invest in the future with new dental technologies and procedures which has allowed for continual growth. The staff includes some 20+ anniversaries as well as new young talent. Great opportunity for the right candidate. Call 866-519-1195 for more.

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General Dentist with Park Dental - Twin Cities and Western Wisconsin Park Dental welcomes applicants of all experience levels who are committed to professionalism and patient care. Founded in 1972, we are an independent group practice, owned and managed by doctors, with locations in the Twin Cities and western Wisconsin. We offer excellent benefits and compensation. For confidential consideration, please contact: Dr. John Gulon at 651-633-0500, or jgulon@ parkdental.com. Visit our website at www.parkdental.com.

Associate Dentist We are looking to hire a dedicated general dentist.

We are a group practice located in the Twin Cities Metro Area. We are committed to providing quality comprehensive care in a comfortable setting. The ideal candidate will have experience in all aspects of general dentistry and is confident working as part of a team. The office is digital and well-staffed. A self-motivated individual can experience great success along with long-term growth potential.

This position has the flexibility for either part-time or full-time. Contact makid@dentalassociatesmn.com General Dentists HealthPartners Dental Clinics approach to care is built on evidenced-based care with a focus on disease management, risk assessment and risk reduction. If you want to make a difference in the way dental care is delivered, we want you to be part of our team. For more than 30 years weâ&#x20AC;&#x2122;ve been recognized as a leader in innovative dentistry. Weâ&#x20AC;&#x2122;re committed to finding the most effective ways to improve dental health. We offer an excellent compensation and benefits package. To explore joining our team, please call 952-883-5151, email angie.m.blackowiak@healthpartners. com or visit www.healthpartners.com/ careers

Growing Practice Seeking Associate Watertown Dental Care, Watertown, SD, is seeking an energetic, motivated dentist to join our team! In our state of the art, fully computerized office, we average over 50 new patients per month. A new dentist would enjoy the benefits of a large patient base, a well trained dental support team, and a mentor dentist with extensive post-graduate training in many areas of general dentistry. If you are interested in this outstanding opportunity, please contact us at Lindsey@watertowndentalcare.com.

Associate Dentist (Woodbury, MN) General dental practice seeks a part-time associate dentist, starting at one day a week, with excellent clinical skills, especially in the areas of enododontics, extractions and implants.

We are an upscale established practice in Woodbury. A strong sense of ethics and integrity is a must. This is an excellent opportunity with an attractive earning potential. Please contact us @ 651-341-0027

Dental Practices for Sale APPLE VALLEY *NEW LISTING* This is a small 30 year old general practice in existence since 1985. 1,000 square feet, 3 ops, fully digital (Dexis), paperless, very affordable lease and averaging $252,000 a year for the last three years. 90% of all endo and 100% of all oral surgery is referred out. 622 very good, loyal patients still with work to be done.

Asking price is $150,000 including A/R. A full prospectus is available by contacting Dr. Mike Prazich of Transition Resources at drprazich@ transitionresources.net Practice for Sale - Collecting $400K on a 3-day work week!

EXCEPTIONAL PRACTICE in Grant County, WI. Small town charm, 1100+ active patients, averaging collections of $400K+ on a 3-day work week. Fantastic investment opportunity! Visit www.EdgeAdvise. com for more information. P537 Northw est Dentis try

General dentist looking to buyout a dental practice I am a U of M graduate looking to buyout a dental practice in the west metro, northeast metro, or east metro. lund1320@ gmail.com Partnership with Intention to Sell Active and extremely successful busy dental office needs another dentist to help with the patient load.

The dental office is up to date with modern equipment including a 3D panorex. Dr. Jess offers all phases of dentistry: Orthodontics, Periodontics, Endodontics, Prosthetics, Implants, Surgery, Sleep Medicine and Hospital Dentistry. The office takes pride in treating patients with T L Care and is located on the busy main street.

Patients come from over 100 miles away. Contact leejess@mchsi.com SW Metro practice buy-out SW Metro, practice in rapidly growing Scott County, just SW of Bloomington.

Beautiful new building built in 2011, Digital xray including Pano, all new equipment, wonderful staff and patients. 3 ops with 2 additional plumbed treatment rooms ready to go. $439,000 collections ON A 3 DAY/WEEK WORK SCHEDULE. 1800 active patients. Tremendous growth potential for someone who wants to add an associate or increase hours to take the practice soaring. No PPOs except Delta Premier. Highly successful and lucrative practice, current owner doctor willing to stay for transition if so desired. Contact doctor@jordandentalcare.com Dental Practice Partnership/ Ownership Opportunity Minnesota: Partnership/ownership opportunity in fee-for-service, 2 location, $3 million practice. Estimated take home income +/- $400,000/yr, income opportunity in top 1% of private practices in the nation, seeking additional owner in main practices or founding partner of 3rd location, dental school debt? No problem! please email inquiries to: toothdoc1980@gmail.com M ay- J une 20 16

Endodontist Practice for Sale - Northwest, WI This turnkey specialty practice is located in a Wisconsin community that is continually recognized as one of the best places to live, work, and raise a family. Well-established, up-to-date equipment, and a welcoming office makes this practice a must-see! Contact us today www.EdgeAdvise.com (P526) Northwest Suburban Dental Practice for Sale Successful long term practice. Collections averaging over $475,000 on three days a week.

Great growth potential in a growing suburb. 800 active patients. Office shows like new with 3 operatories and low overhead. Most specialties referred. tom@denticaremn.com Minneapolis Dental Practice for Sale This practice is in the heart of Minneapolis and is in like new condition with 3 operatories. Last yearâ&#x20AC;&#x2122;s production was $755,000 on 2100 active patients. The office is open 4 days a week and has the potential to expand. Great opportunity at $495,000.

Contact Tom at (612) 247-6316.

Dental Office for Sale Downtown Minneapolis Metro Area Excellent office with focus for 35 years on esthetics, occlusion and fixed prosthodontics available for a talented dentist. Over 1600 active patients of record, excellent fiscal health, 5 operatories with state of the art computers, digital radiography, pt. education system, intra- oral camera.

Outstanding future potential, excellent cash flow, social media connected.

Favorable financing from bank and owner to make this a win-win sale.

Contact dentalfuture15@gmail.com Bemidji, MN Retiring dentist of 42 years is seeking full-time associate with Buy-in/Buy-out options. Bemidji, an economic regional hub, in NW MN is surrounded by lakes, connecting airport, and a University. Excellent location.

Contact LeeScotland1@gmail.com or jonettascotland@hotmail.com or call 218-751-8325.

A must see State-Of-The-Art practice! 5 equipped treatment rooms - advanced technology including digital and a cone-beam CT unit.

Great location off main road, limited competition and averaging over $700k in collections. Don't delay, contact us today! Visit www.EdgeAdvise.com.

P567 F/T ASSOCIATE - BUYER SOON ELY, MINNESOTA: A full time associate position is available immediately in this modern and very busy practice. Youâ&#x20AC;&#x2122;ll receive an excellent compensation package and work with an excellent staff. Please send your resume, including references to drprazich@transitionresources.net.

SW MINNES0TA: Full time associate position available immediately; guaranteed salary of $175,000 for 3 years and an excellent benefit package is offered. Loan forgiveness a possibility.

Very well equipped modern office with over 1,650 active patients with only 3%-5% medical assistance. Please send your resume, including references to drprazich@transitionresources.net.

BIWABIK, MN This is a metropolitan practice located in out-state MN. Averaging over $665,000 in collections/$350,000 income with over 2,515 active patients and an outstanding staff. Digital x-ray, digital pan, paperless, CEREC, laser technology and rotary endo. You can work as an associate for 6 months and then buy the practice or buy outright. The selling dentist owns the building and will sell it for the tax appraised value. Asking price is $375,000 INCLUDING the Accounts Receivable but not including building.

Contact drprazich@transitionresources. net Dental Practice Wanted for Purchase Individual dentist looking to purchase a practice in Saint Paul proper but will consider east metro.

Information will be kept confidential.

Contact gregcruz@msn.com for more information.

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NW Outer Ring of Minneapolis Beautiful, well established and highly respected, 4 operatory general practice averaging over $750,000 in collections over the past 3 years on 4 days per week. 1,300 active patients, CAD-CAM, laser, rotary endo and complete digital radiography make this a great opportunity. Price: $495,000 including A/R. Building for sale or lease. Complete prospectus is available. Contact Dr. Mike Prazich at drprazich@transitionresources.net 45 Minutes Southwest of MetroPRACTICE FOR SALE 1,400 Active Patients, $350,000 2014 Collections, Low Overhead/High Profit, Opportunity for Immediate Growth, Located at High Visibility Intersection, Attractive Brick Building also For Sale, Large Operatories, Room for Expansion. Contact Joe Fricton at jfricton@mntransitions.com or 651357-7918 or Dave Linde at dlinde@ mntransitions.com or 612-269-4895 SE North Dakota Dental Practice for Sale Retiring dentist is looking for an ethical, caring dentist that wants to live in SE North Dakota. This is a beautiful dental practice in a town of 8000. We are forty-five minutes from Fargo and the lakes, and three hours from Minneapolis. This is a very well established family dental practice, fully computerized, 4 ops, 2 more plumbed, collect over $450,000, with lots of potential for growth. Contact: jpope@ wah.midco.net N O R T H W E S T E R N MINNESOTA Well established, modern practice. The practice; has over 5,200 active patients, has 5 operatories, keeps its overhead below 60% and has averaged approximately $690,000 a year for the last 4 years on a 4 day week. A full prospectus is being completed. Contact Dr Mike Prazich at drprazich@transitionresources.net or 612-598-2058. Transition Resources http://www.transitionresources.net

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Services Part time Associate We are a wellestablished, premier dental office located in the northern suburbs with an outstanding reputation, 39 years in the community, and over 100 new patients per month. We have an immediate opening for a part time (potentially leading to full time) associate dentist.

What we offer: A friendly and caring work atmosphere, three-day work week (Tuesday, Wednesday, and Thursday), Competitive pay and benefits, a team that is very experienced and highly trained, Location that is right off of HWY 36, providing easy access to our office for our loyal (and expanding) patient base. We are an EOE. Ideal Candidate: Ability to project a positive, caring, and professional image while exceeding our patientâ&#x20AC;&#x2122;s expectations in service, comfort, and quality to provide the perfect patient experience; an experienced doctor with strong production skills and a drive to succeed; must be able to work independently and deliver a high quality of care, but also have the ability to work within a team setting with humor, enthusiasm, and professionalism.

Required experience must be at least 3 - 5 years and must be a licensed DDS or DMD in the state of Minnesota.

To apply, you will need to send the following two items via email: 1) your resume with contact information; and 2) your written answers to at least two of the following questions: 1. Tell us a little about yourself. 2. What is your best quality or attribute? 3. How would your previous coworkers describe you and your work? 4. What about this job is attractive to you? Contact walter.l.hunt@comcast.net Handpiece Repair Northstar Handpiece Express repairs all makes and models of high speed, slow speed, and electric handpieces. 15 years in business, free estimates, 1-day service on most handpieces, longest warranties in the industry. northstarhandpiece. com Contact joe@northstarhandpiece. com

Dentists Concerned for Dentists (DCD) offers careful, considerate and confidential help for people concerned with alcohol/ other drug problems, family/marital struggles and emotional/ mental health issues. Services include information, referrals, consultations, and interventions. Monthly support group meeting. Contact advertising@ mndental.org for more information.

OSHA is your office in compliance? Written manuals, MN Pollution Control Requirements, annual updates, office evaluation, CDC Guidelines, Annual Staff Training.

Contact lmathieukramer@tds.net

Equipment Sirona XG3D Cone Beam Scanner/ Panoramic X-ray for sale Used XG3D for sale. Excellent condition. Professionally re-crated and ready to ship. Great for first scanner or second location. Great opportunity.

Amazing images. Incredibly diagnostic.

Contact pikelakedental@prodigy.net

Space for Rent or Lease Shopping Center End Cap Available 3,500 S.F. new construction space available in a successful retail center in White Bear Township. can be divided. Located 3 blocks from Highway 96 and 35E. Jim Faulkner 651-470-9048. Email for pictures and information. jfaulkner@fci-mn.com Dental Office space for Rent 1645 Sq. ft., Plumbed and partitioned for dental practice. In a professional building. Ample free parking attached.

Near downtown St. Cloud, MN Available after June 1,2016. Call 320252-0783 Stillwater (Former Metro Dental Space) 3,325 SF with signage on Highway 36, pylon and monument sign panels. Space built out by Metro Dental 10 years ago. Space needs cosmetic work, but mechanical infrastructure in place. This is the first stop into MN on the West side of the new bridge. eric@ midwestretailventures.com - 952-6973650 or jim.larson@cushwakenm.com 952-831-1000 Northw est Dentis try

Minnesota Dental Association Directory OFFICERS, TRUSTEES, AND COMMITTEE CHAIRS 2014-2015

Officers

Trustees

Committee Chairs

President

Minneapolis District

Affinity Products

Peter N. Cannon 400 Robert Street North Suite 270 Saint Paul, MN 55101-2015 (651) 224-2787 (office) (651) 223-5557 (fax) pcannon@skypoint.com

President-Elect

Kevin Dens 6980 Fairview Road Baxter, MN 56425-7836 (218) 454-7000 (office) (218) 829-3347 (fax) kcdens@msn.com

First Vice-President

R. David Resch 1371 Seventh Street West Saint Paul, MN 55102-4205 (651) 222-0351 (office) (651) 222-1556 (fax) dr.dresch@comcast.net

Second Vice-President

David E. Andersen 19033 U.S. 71 Park Rapids, MN 56470-3202 (218) 732-3291 (office) (218) 237-2532 (fax) superdav@unitelc.com

Treasurer

Travis Schmitt 204 4th Street Southwest Suite 144 Austin, MN 55912-4427 (507) 437-2023 (office) (507) 437-7387 (fax) **call before faxing tschmitt00@gmail.com

Speaker of the House

Howard Taylor 3909 Silver Lake Road Northeast Saint Anthony, MN 55421-4352 (612) 789-4200 (office) (612) 789-9669 (fax) taylor.hwt@gmail.com

Teresa L. Fong 500 Osborne Road Northeast Suite 345 Fridley, MN 55432-2769 (763) 786-4260 (office) (763) 786-2302 (fax) tfong@mpda-mn.com

Saint Paul District

Stephen R. McDonnell 1371 7th Street West Saint Paul, MN 55102-4205 (651)222-0351 (office) (651)222-1556 (fax) mcdonnellsn@comcast.net

Northwestern District

John E. Lueth 1311 Bemidji Avenue North Bemidji, MN 56601-3811 (218) 751-1111 (office) (218) 444-6318 (fax) luethdds@gmail.com

Northeastern District

Michael N. Miskovich 1121 Southeast 4th Avenue Grand Rapids, MN 55744-3956 (218) 326-3437 (office) (218) 327-1211 (fax) mike@miskovichdental.com

Southern District

Maureen Sorensen 1029 3rd Avenue Worthington, MN 56187-2398 (507) 376-9797 (office) gmcdm@iw.net

Southeastern District

Matthew Vaillant 421 West 4th Street Red Wing, MN 55066-2555 (651) 388-6709 (office) (651) 388-3187 (fax) matthewvaillant@me.com

West Central District

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

Student District

Christine Lucachick University of Minnesota School of Dentistry 515 Delaware Street Southeast Minneapolis, MN 55455-0357 (218) 244-5183 (cell) cmlucachick@gmail.com

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Evidence Based Dentistry

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

Gary C. Anderson 515 Delaware Street Southeast 6-296 Malcolm Moos Tower Minneapolis, MN 55455-0357 (612) 624-3908 (office) (612) 624-0777 (fax) ander018@umn.edu

Barriers to Care

Legislative Affairs

James Nickman 500 Osborne Road Northeast Suite 345 Fridley, MN 55432-2769 (763) 786-4260 (office) (763) 786-2302 (fax) james.nickman@att.net

Board of Dentistry

R. David Resch 1371 Seventh Street West 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

Dental Marketplace

Cindy Sundet 3925 West 50th Street Suite 203 Edina, MN 55424-1247 (952) 920-0707 (office) (952) 920-3631 (fax) cindysundet@gmail.com

Environment and Safety (Co-Chairs) Frederick (Rick) Nolting P.O. Box 367 Byron, MN 55920-0367 (507) 775-6649 (office) (507) 775-2169 (fax) nolting@aol.com

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

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

MnMOM

Alejandro M. Aguirre Plymouth City Center II 15600 36th Avenue North Suite 260 Plymouth, MN 55446-3261 (763) 694-9588 (office) (763) 694-9794 (fax) aaguirreg@comcast.net

Membership

Jeff Remakel 5000 W 36th Street Suite 250 Saint Louis Park, MN 55416-2776 (952) 920-3700 (office) jeffremakel@hotmail.com

New Dentist (Co-Chairs) Kirby M. Johnson 301 Highway 23 Suite 2 Spicer, MN 56288-8002 (320) 796-2158 (office) (320) 409-1180 (fax) kirbymjohnson@gmail.com

AMERICAN DENTAL ASSOCIATION James K. Zenk 1317 Grove Avenue Montevideo, MN 56265-1708 (320) 269-6416 (office) (320) 269-8136 (fax) jzenk@montedentistry.com

Affiliated Organizations Minnesota Dental Foundation Stephen F. Litton 1850 Kelly Drive Golden Valley, MN 55427-4120 (612) 868-9580 sflitton@aol.com

MINDENPAC

James Nickman 500 Osborne Road Northeast Suite 345 Fridley, MN 55432-2769 (763) 786-4260 (office) (763) 786-2302 (fax) james.nickman@att.net

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

Alex R. Lund 1835 County Road C West Suite 220 Roseville, MN 55113-1835 (651) 636-2123 (office) (651) 636-2614 (fax) lund1320@gmail.com

Peer Review

Byron G. Rowell 510 Northwest 2nd Avenue Grand Rapids, MN 55744-2627 (218) 326-1266 (office) (218) 326-9502 (fax) rowelldent@qwestoffice.net

Scientific Session

Erik Skatvold 841 Belsy Boulevard Moorhead, MN 56560 (218) 236-5466 (office) (218) 236-4948 (fax) drerik@skatvolddental.com

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H E A D I N G

Home

“Success is a little like wrestling a gorilla.

You don’t quit when you’re tired.

You quit when the gorilla is tired.”

Robert Strauss

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Shelly Ryan CRDA

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Journal of the Minnesota Dental Association Volume 95, Number 3 May-June 2016

NOW COMPLETE! Tooth by the Lake

Volume 95, Number 3 Northwest Dentistry May-June 2016

Doctor: Kari Seaverson, DDS Location: Hopkins, MN Project Type: Clinic Remodel / Expansion Area: 4,300sf Architect: The Foundation Architects Dental Equipment Supplier: Patterson Dental Time Frame: 3 months Heritage Construction Project Managers: Tim Keppel L. Richard Etshokin

WE ARE READY TO SERVE YOUR DENTAL NEEDS. 763.633.4080 www.HeritageConstructionMN.com

“Keeping Out of Harm’s Way”: Pearls, Pitfalls, and Lurking Perils of a Life in Dentistry