ODA Journal: May/June 2019

May/June 2019 | Vol. 110, No. 3

Be Interested, Not Interesting.

Dr. Dan Wilguess 2019-2020 President www.okda.org

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Contents

ADVERTISERS Thank you to these businesses who advertise in the ODA Journal

May/June 2019 | Vol. 110, No.3

Inside Front Cover Valliance Bank Back Cover Delta Dental of Oklahoma 3000 Insurance Group Endodontic Associates Lewis Health Profession Services OK Tobacco Settlement Endowment Trust Edmonds Dental Prosthetics,Inc. Paragon Dental Practice Transitions Patterson Dental DemandForce UPAL MedPro Group Corporate Realty Advisors Dallas Dental Symposium Commerce Bank

ASSOCIATION 04 Calendar of Events 0 5 Welcome New ODA Members 0 6 Letter from ODA President, Dr. Dan Wilguess 07 2019-2020 ODA Executive Committee and

Board of Trustees 08 ODA Rewards Partners

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Annual Meeting Highlights

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ODA Supply Source Challenge

THE OKLAHOMA DENTAL ASSOCIATION JOURNAL (ISSN 0164-9442) is the official publication of the Oklahoma Dental Association and is published bimonthly by the Oklahoma Dental Association, 317 NE 13th Street, Oklahoma City, OK 73104, Phone: (405) 848-8873; (800) 876-8890.

Fax: (405) 848-8875. Email: information@ okda.org. Annual subscription rate of $39 for ODA members is included in their annual membership dues.

POSTMASTER: Send address changes to OKLAHOMA DENTAL ASSOCIATION JOURNAL, 317 NE 13th Street, Oklahoma City, OK 73104.

Periodical postage paid at Oklahoma City, OK and additional mailing offices.

Subscriptions: Rates for non-members are $56. Single copy rate is $18, payable in advance.

Reprints: of the Journal are available by contacting the ODA at (405) 848-8873, (800) 876-8890, editor@okda.org.

Opinions and statements expressed in the OKLAHOMA DENTAL ASSOCIATION JOURNAL are those of the author and are not necessarily those of the Oklahoma Dental Association. Neither the Editors nor the Oklahoma Dental Association are in any way responsible for the articles or views published in the OKLAHOMA DENTAL ASSOCIATION JOURNAL. Copyright Š 2018 Oklahoma Dental Association.

Oklahoma Dental Association

10 Message from ODA Rewards Committee Chair, Dr. Mary Martin 1 4 ODA Marketing Coach 1 5 Anesthesiology Recognized as a Dental Specialty 1 8 Congratulations 2019 OUCOD Graduates 2 0 Opioid Mitigation in the Management of Acute Dental Pain 50 Finally, Five (not so) FAQs

LEGISLATIVE LOOP 2 2 ODA Legislative Update 2 2 Students and Dentists Advocate Together in Washington DC 2 3 2019 OKCapitol Club & DENPAC Grand Level Members 24 ADA Legislative News

SPOTLIGHT 2 9 Sam Owens, DDS

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FEATURES

Palatal Mass Cover Photo: ODA President , Dr. Dan Willguess with his family after being sworn in as President

2 6 Tax Season is Over...But Questions Remain 2 8 Water Fluoridation (in the news again) 30 55 Dentists Across Oklahoma Honored for 25 Years of Service (D-Dent) 32 Palatal Mass 34 Hygiene HotSpot 34 New Dentist Corner 38 The Difference Between Being Busy or Profitable 4 2 2019 Annual Meeting Highlights

CLASSIFIEDS 4 8 ODA Classified Listings

Is Your Information Correct?

Help the ODA keep you informed about legislative actions, CE opportunities, events and other important member-only news.

Contact Kylie Ethridge, ODA Membership Director, at kethridge@okda.org or 800.876.8890 to provide the ODA with all of your current contact information.

www.okda.org

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ODA JOURNAL STAFF EDITOR Phoebe Vaughan,DDS ASSOCIATE EDITOR Frank J. Miranda, DDS EDITORIAL BOARD MEMBERS M. Edmund Braly, DDS Mary Hamburg, DDS, MS Somer Heim, DDS Daryn Lu, DDS EXECUTIVE DIRECTOR F. Lynn Means DIRECTOR OF COMMUNICATIONS & EDUCATION Stacy Yates OFFICERS 2019-2020 PRESIDENT Daniel Wilguess, DDS president@okda.org PRESIDENT-ELECT Paul Mullasseril, DDS presidentelect@okda.org VICE PRESIDENT Chris Fagan, DDS vicepresident@okda.org SECRETARY/TREASURER Robert Herman, DDS treasurer@okda.org SPEAKER OF THE HOUSE Doug Auld, DDS speaker@okda.org IMMEDIATE PAST PRESIDENT Shannon Griffin, DMD pastpresident@okda.org

CALENDAR OF EVENTS Visit the ODA’s online calendar at OKDA.ORG for all upcoming meetings and events.

May 27 ODA Closed Memorial Day June 7 Tulsa County Dental Society Charity Golf Tournament Forest Ridge Golf Club, Broken Arrow 11:00 a.m.

Council on Dental Education and Public Information meeting ODA Building 9:30 a.m.

RDGP meeting ODA Building 11:00 a.m.

June 14 ODA Rewards Committee Meeting ODA Building 9:00 a.m.

OkMOM Steering Committee Meeting ODA Building 11:00 a.m

ODA Board of Trustees Meeting ODA Building 1:30 p.m.

June 20 Tulsa Happy Hour R Bar and Grill 5:30-7:30 p.m.

August 2 Annual Meeting Planning Committee ODA Building 10:00 a.m.

July 4-5 ODA Building Closed July 12 Council on Membership A Membership Services Meeting ODA Building 10:00 a.m.

July 19 ODA Council on Governmental Affairs Meeting ODA Building 9:00 a.m.

August 23 South Central States Leadership Conference Grapevine, TX 1:00 p.m.

August 25-26 ADA District 12 Pre-Caucus Grapevine, TX August 27 ODA Student Fall Festival 5:00-7:00 p.m.

ADMINISTRATIVE STAFF EXECUTIVE DIRECTOR F. Lynn Means DIRECTOR OF GOVERNANCE & FINANCE Shelly Frantz DIRECTOR OF COMMUNICATIONS & EDUCATION Stacy Yates DIRECTOR OF MEMBERSHIP Kylie Ethridge

YOU DESERVE A DRINK

MEMBER COMMUNICATIONS MANAGER Madison Douglas SPECIAL PROJECTS MANAGER Abby Sholar

ODA MEMBER HAPPY HOUR

THURSDAY, JUNE 20 | 5:30 - 7:30 Stay connected with the ODA!

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journal | May/June 2019

R BAR AND GRILL 3421 S PEORIA AVE, TULSA RSVP TO ODA MEMBERSHIP MANAGER, MADISON AT MDOUGLAS@OKDA.ORG

ERS NEW m

EW ODA NEW ODA

Welcome, New Members

New Members Joined February 13, 2019 - May 3, 2019 Please join the ODA in welcoming our new members into Oklahoma’s community of organized dentistry

EMBERS MEMBERS

EW ODA NEW ODA

EMBERS MEMBERS

Steven Miller Bradley Acker Nathan Bulleigh Janet Barresi Traci Blessing Priyanka Kulkarni Matthew Hall Falon Waisath

NEW ODA NEW ODA

MEMBERS MEMBERS

Central Northern Northern Oklahoma County Oklahoma County Oklahoma County Tulsa County Tulsa County

NEW ODA

MEMBERS

STAY CONNECTED TO THE ODA!

M N P

@OkDentalAssoc @OklaDentalAssoc @OkDentAssoc

www.okda.org

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FROM THE ODA PRESIDENT DR.DANIEL WILGUESS

WHAT DOES THE ODA MEAN TO YOU? As we begin a new year for our outstanding Oklahoma Dental Association, I encourage you to reflect on what your membership means, and how the ODA protects and promotes dentistry. The various ODA councils and committees (see sidebar listing) strive to represent your interests while you focus on patient care. We are very fortunate to have Lynn Means, a member of the American College of Dentists, as our executive director. Please take the time to review the many benefits of your ODA membership (such as the Rewards Program), and you will find a terrific team of professionals working for you and your practice.

Your ODA is entering the second year of its strategic plan; you can follow its progress via the ODA website. The goals of the plan are to educate the public on critical oral health issues, advocate within state government, enrich and increase membership in the association, and always strive toward maximum organizational efficiency.

Following in the footsteps of the ODA presidents who preceded me, I will represent you both on the state and national levels. To be effective I need to know what you want the ODA to do to positively impact your practice and your future. We will be working daily to stay in front of many legislative issues that will face us, but we also want to know of any other needs that are important to you.

Thank you to all who served this past February at our 10th Oklahoma Mission of Mercy. The goodness of the dental profession always shines through at this event. The next OkMOM will be in Stillwater, and I will be thrilled to take this outreach to the hometown that gave me so much. Dr. Chris Leslie has agreed to be the Chair for OkMOM Stillwater and is already making arrangements with local businesses and services to make it an enormous success!

Please plan to participate by marking February 7th and 8th, 2020 on your calendars now.

Due to evolving technology, advances in materials, and support for all parts of the dental practice through professional organizations, we are currently delivering dental care in better ways than ever before.

This year I hope you will not only capitalize on your existing relationships, but also foster some new ones. Join a study club or become a mentor to a young dentist. You may even consider starting a dental lunch group.

These relationships will be a blessing beyond measure, both personally and professionally.

Thank you for allowing me the honor of serving as your ODA president for 20192020. I hope you will join me in promoting what our Oklahoma Dental Association is achieving for us all.

ODA C OUNC ILS AND C OMMI TTEE S Executive Committee Board of Trustees House of Delegates Council on Budget and Finance Council on Bylaws, Policy, & Ethics Council on Dental Care Council on Dental Education & Public Information Council on Governmental Affairs Council on Membership & Membership Services Council on Nominations Annual Meeting Planning Rewards Partners Investments Editorial

2018-2019 ODA President Dr. Shannon Griffin passing on the ODA president's pin to Dr. Dan Wilguess during the House of Delegates Meeting in Tulsa, OK 6

journal | May/June 2019

Dr. Raymond Cohlmia Swearing in Dr. Dan Wilguess for his 2019-2020 presidential term.

Oklahoma Mission of Mercy

2019-2020 ODA EXECUTIVE COMMITTEE

President Dr. Daniel Wilguess

President-elect Dr. Paul Mullasseril

Vice President Dr. Chris Fagan

Secretary/Treasurer Dr. Robert Herman

Immediate Past President Dr. Shannon Griffin

Speaker of the House Dr. Douglas Auld

2019-2020 ODA BOARD OF TRUSTEES Dr. Daniel Wilguess, President and ADA Delegate

Dr. M. Edmund Braly, Central Component Trustee

Dr. Paul Mullasseril, President-elect

Dr. Sid Nicholson, Eastern Component Trustee

Dr. Chris Fagan, Vice President

Dr. Jandra Korb, Northern Component Trustee

Dr. Robert Herman, Secretary/Treasurer

Dr. Susan Davis, Northwest Component Trustee

Dr. Douglas Auld, Speaker of the House and ADA Delegate

Dr. Edward Harroz III, OK County Component Trustee

Dr. Shannon Griffin, Immediate Past President

Dr. Paul Wood, Southwest Component Trustee

Dr. Rieger Wood, ADA Delegate

Dr. Lindsay Smith, Tulsa County Component Trustee

Dr. Krista Jones, ADA Delegate Dr. Stephen Young, ADA Delegate

For the full list of ODA Council and Committee members, visit www.okda.org/about-the-oda/leadership. www.okda.org

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Discounted annual rates (800) 527-7478 www.medjetassist.com

Savings on vehicles for purchase or lease (866) 628-7232 www.ada.org/mercedes

Discount of 15% off all purchases in-store and online.

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25% discount on a new website (888) 433-1747 www.prosites.com/oda

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FINANCIAL SERVICES Sign up for a convenient patient financing solution for only $25.00 (800) 300-3046 www.carecredit.com/dental

Discounts on digital video services & on-hold messaging (800) 460-4653 www.works24.com

INSURANCE

Reduced premiums on a variety of insurance plans (800) 375-8356 www.3000ig.com

Point earning credit card for all your personal & business needs (888) 327-2265 www.adavisa.com

FOR MORE INFORMATION VISIT:

OKDA.ORG/REWARDS-PROGRAM 8

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ODA PARTNERS COLUMN

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By adding our payroll and HR services you’ll have everything you need to efficiently pay your staff along with resources to help ensure regulatory compliance and effectively manage general HR needs.

To learn more, contact: Michael Burdge, Relationship Manager 405.590.3096 or michael.burdge@heartland.us

heartland.us

ODA members save up to 30% off the everyday public web price of Lenovo products for the home and office, including laptops, tablets, desktops, accessories and more!

Take advantage of great deals on top products, such as the award-winning ThinkPad laptops and innovative multimode YOGA tablets. Check the site often for special offers and sales.

www3.lenovo.com/us/en/ada 1-800-426-7235, ext. 4886

Oklahoma Dental Association www.okda.org

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ODA MEMBERS CAN NOW GET SIGNIFICANT SAVINGS ON DENTAL SUPPLIES

I hope that headline got your attention, because the Oklahoma Dental Association is rolling out an exciting new program!

ODASupplySource.com includes catalogs from more than 60 direct manufacturers and more than 200 well-known brands from only authorized dealers. In addition, everything includes full manufacturer warranties and no gray market or expired products. All orders are shipped directly from the manufacturers to eliminate the middle man and to maximize savings.

After almost a year of research and negotiation, I along with our Rewards Committee, and Board of Trustees, am pleased to announce a new reward benefit that will save members thousands of dollars per year on dental supplies.

ODA Supply Source will leverage the buying power of our more than 1,600 members to give all dental offices access to special pricing previously available only to large practices.

Regardless of size, all dental offices will save money!

Effective May 15, 2019, we are launching ODA Supply Source to provide members with significant discounts on more than 60,000 products used in dental practices.

ODA is the seventh state dental association to partner with SourceOne Dental. Dentists in other participating states report saving significant money. For example, a dental practice spending $100,000 per year on supplies could easily see savings of $15,000 to $25,000. This more than covers the annual cost of Tripartite dues for a full-time, active dentist. So, you will actually make money being an ODA member!

By: Dr. Mary Martin, ODA Rewards Committee Chair

Powered by SourceOne Dental, this new member benefit offers convenient, low-cost, one-stop, online shopping with free shipping on everything. The average customer will see savings of 15-25 percent.

To demonstrate the savings, dentists are encouraged to send us a copy of your current dental supply invoice and we will do a price comparison to give you an estimate of projected cost saving. Simply call 877-6597310, email support@odasupplysource.com, or fax: 877-659-5004 four months of invoices and you will be sent a cost comparison. You will also be entered into the ODA Supply Source Challenge (more information below)!

Please visit www.ODASupplySource.com to learn more and place your first order.

I welcome the opportunity to speak with you about this new member benefit and encourage you to email me at doctormartin@ sbcglobal.net with any questions.

“Powered by SourceOne Dental, this new member benefit offers convenient, low-cost, one-stop, online shopping with free shipping on everything. The average customer will see savings of 15-25 percent.�

ODA SUPPLY SOURCE CHALLENGE TAKE THE

FOR A CHANCE TO WIN A $100 SOUTHWEST AIRLINES GIFT CARD!

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by emailing, faxing, or calling in your invoices Simply submit four months of recent supply invoices for a free custom side-by-side price comparison showing you the savings on the same products!

Phone: 877-659-7310 | support@odasupplysource.com | Fax: 877-659-5004 * Submit invoices NOW- August 31st for the chance to win a $100 Southwest airlines gift card! *

10 journal | May/June 2019

Phone: 877-659-7310 | suppor t@odasupplysource.com | Fax: 877-659-5004

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With FREE support available by phone, online, email and text, the Oklahoma Tobacco Helpline can help your patients quit tobacco and improve their overall health. FREE patches, gum and lozenges are available to your patients through the Helpline.

Order FREE brochures, holders and more from the Oklahoma Tobacco Helpline at OKhelpline.com.

Give them more than a healthy smile. www.okda.org

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PLANS FOR ODA MEMBERS: • • • •

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ODA MARKETING COACH Managing Marketing | Defining and Managing Your Brand

Your Logo and Tagline Ideally, the logo for your practice will serve as both a visual representation that reinforces the positive aspects of your brand and a reminder of what sets it apart from other practices in the community. Some dentists hire a graphic design or marketing professional to help create their logos; others go it alone or opt not to use visual images but instead rely on text alone.

• Keep the logo and any text simple, easy to read and legible.

While the choice is yours, keep in mind that even if you decide not to use any graphics, the size and style of the font used on stationery and in your ads can leave a lasting impression and should always be consistent.

• Trademark your logo. You can get started on that by reviewing the United States Patent and Trademark Office’s (USPTO) information on Trademark basics: What Every Small Business Should Know Now, Not Later.

Remember that the purpose of all of your marketing efforts, including the design of your logo, is to encourage the patient to begin or continue his/her relationship with you and your practice.

• Experiment with type fonts, but avoid any that are too elaborate since they can be difficult to read.

Take a look at the logos used by others dentists in your area or your specialty.

What makes them stand out? How could they be improved or more evocative, more effective? Keep those thoughts in mind when developing your own logo.

The following Dos and Don’ts for Dental Logos offers tips on what to do – and what to avoid – when creating or approving your logo:

• Make sure the logo is memorable and easy on the eyes.

• Document the first use of your logo.

• Be consistent and use the same colors and “look” in your signage, website, flyers, postcards and other marketing materials.

• Don’t use clichés.

• Don’t use images of teeth, toothbrushes and/or dental instruments.

• Don’t use elaborate shapes.

• Don’t be too wordy.

• Don't use more than two fonts or more than three colors.

Practices with effective brands and strong names typically don’t need a tagline or some type of catchy statement that finishes telling the story you want to share. When used correctly, taglines stress why patients should be seen in your practice instead of the one down the street. Oftentimes, dentists assume that everyone, both active and prospective patients, knows what services they offer. A good tagline can provide that information.

So what makes a tagline good? Keep it simple, benefit-driven and separate from your logo. Keep in mind that your tagline will help create and reinforce patient expectations so be sure it communicates something you know you can deliver, such as “Compassionate Care.”

Copyright © 2019 American Dental Association.

All rights reserved. Reprinted by permission.

For additional resources on how to grow your practice, visit the ADA’s Center for Professional Success at ada.org/success.

Future issues of the ODA Journal will include individual articles from this module, but you can see the module in its entirety at http://success.ada.org/en/ practice-management/marketing

14 journal | May/June 2019

Anesthesiology Recognized As A Dental Specialty Dental anesthesiology becomes the 10th dental specialty recognized by the National Commission on Recognition of Dental Specialties and Certifying Boards.

The recognition comes after the National Commission on March 11 adopted a resolution based on an application from the American Society of Dentist Anesthesiologists to recognize dental anesthesiology as a dental specialty.

“This historic vote by the National Commission certainly reflects the ADA’s ongoing efforts towards improved patient care and safety in the areas of dental sedation, dental anesthesiology and access for those with special health care needs,” said Dr. James Tom, president of the American Society of Dentist Anesthesiologists.

The ADA House of Delegates in 2017 established the National Commission to oversee the decision-making process for recognizing dental specialties. The "Requirements for Recognition of Dental Specialties" is still managed by the ADA's Council on Education and Licensure and the ADA House of Delegates.

Dental anesthesiology now joins the following dental specialties: dental public health; endodontics; oral and maxillofacial pathology; oral and maxillofacial radiology; oral and maxillofacial surgery; orthodontics and dentofacial orthopedics; pediatric dentistry; periodontics; and prosthodontics.

Dental specialties are recognized "to protect the public, nurture the art and science of dentistry and improve the quality of care," according to the National Commission website.

A sponsoring organization seeking specialty recognition for discipline of dentistry must document that the discipline satisfies six requirements, as outlined in the "Requirements for Recognition of Dental Specialties." The sponsoring organization of the proposed specialty must provide documentation to show that it is a distinct and well-defined field that requires unique knowledge and skills

beyond those commonly possessed by dental school graduates; that it requires advanced knowledge and skills; and that it scientifically contributes new knowledge, education and research in both the field, and the profession.

The American Society of Dentist Anesthesiologists submitted its application to the National Commission in September 2018.

Following a review by the National Commission's Review Committee on Specialty Recognition in November 2018, the National Commission invited public comment for a 60-day period.

At its February 2019 meeting, the review committee considered all the comments received that directly related to whether the application met all the requirements for specialty recognition and made a recommendation to the National Commission to grant specialty status. At its March 11 meeting, the National Commission determined that the application did indeed meet the "Requirements for Recognition of Dental Specialties" and adopted a resolution recognizing dental anesthesiology as a dental specialty. A resolution needs a twothirds majority vote to be approved.

Following approval by the National Commission, the sponsoring organization must establish a national board for certifying diplomats in accordance with the "Requirements for Recognition of Dental Certifying Boards."

The National Commission on Recognition of Dental Specialties and Certifying Boards is comprised of nine general dentists, appointed by the ADA Board of Trustees; one specialist from each of the nine recognized specialties, appointed by the sponsoring organization; and a public/ consumer member appointed by the National Commission.

“Being the 10th ADA-recognized specialty in 20 years validates to the public and the profession that organized dentistry is willing to challenge the status quo and explore new collaborative efforts with our counterparts in medicine and nursing,” said Dr. Tom. “We look forward to widely promulgating sedation and anesthesia awareness and education in all facets of oral health care, and as dentist anesthesiologists working alongside all other dental professionals, we hope to drive the profession forward cooperatively.”

The recognition comes nearly 175 years after a Hartford, Connecticut, dentist extracted one of his third molars to test the analgesic properties of nitrous oxide. It was Dr. Horace Well's introduction of nitrous oxide, and the demonstration of anesthetic properties of ether by Dr. William Morton, a student of Dr. Wells', that gave the gift of anesthesia to medicine and dentistry.

Copyright © 2019 American Dental Association.

All rights reserved. Reprinted by permission.

www.okda.org

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CONGRATULATIONS, 2019 OUCOD GRADUATES! The ODA hosted its annual Senior Signing Day on May 2nd. Most of the new OUCOD graduates attended!

They enjoyed food, fun, and most importantly, completed an ADA/ODA Membership Application with zero dues.

Welcome to the ODA!

THANK YOU TO OUR SPONSORS!

Drs. William Yeary and Troy Schmitz present the Randy White Memorial Scholarship to Will Seibold, Class of 2019. journal | May/June 2019 18

OUC OD CLASS OF 2019 Javeria Ahmad Jeremy Archer Micah Asadi Savneet Basati Jamie Bell Anthony Boon Karlee Brownlee Graham Busby Sam Campbell Brandon Cohlmia Cama Cord Joshua Crossley Kanyon Cunningham Londan Davis Tara Denton Sheila Emamian Brock Frazee

Srujan Gadusu Uzma Hajiyani Carlee Holland Ryan Howard Krysten Jackson Mohammad Kandar Kenzie Karnish Douglas Kooken Bryce Lamer Ryan Montgomery Greg Moses Charles Mosley Narayan Naik Austin Neil Garrett Nelson Tri Nguyen Philip Osborn

Tarandeep Pannu Eric Parsons Cooper Pasque Olivia Pogodzinski Schuyler Pracht Eman Qureshi Weslee Reese Karla Rios Rami Roz Will Seibold Zachary Siegler Arpit Singh Shelby Steffenhagen Jonathan Suttle Tuan Tran Lynna Van Merkey Terrick Washington

www.okda.org

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OPIOID MITIGATION IN THE MANAGEMENT OF ACUTE DENTAL PAIN

By Dr. Ray A. Beddoe, DMD, PharmD, MS A synopsisis of Dr. Beddoe's session at the 2019 ODA Annual Meeting

The purpose of this article is threefold: [1] to set the perspective; [2] to outline the current paradigm shift; and [3] to suggest further strategies.

THE PERSPECTIVE In 2017, over 70,000 people died of opioid overdose. This number exceeds the number of people who died at the height of the AIDS epidemic of the 1990’s. We are this country’s second worst prescribing offender (family doctors prescribe 15 percent of opioids followed by dentists at 12 percent). We are, however, the number one prescriber of opioids to people between the ages of 10-19. We do this because we are implicitly taught that pain is the fifth vital sign (along with pulse, blood pressure, temperature and respiration) and it has to be managed accordingly. Pharmaceutical companies have successfully convinced our mentors (from whom we learn our prescribing habits) that we need to eliminate pain and that opioids are a safe and effective way to do this. We have learned well…all too well.

THE CURRENT PARADIGM SHIFT The paradigm has finally shifted. Many carefully controlled clinical trials in respected peer-reviewed journals have repeatedly demonstrated that the management of acute dental pain can be mitigated by the use of NSAIDs alone or

in combination with acetaminophen. This premise is based on the 1986 proposal by the World Health Organization (WHO) of an analgesic ladder that advocates the stepwise introduction of adjuvants like steroids and NSAIDs for pain management prior to prescribing opioids.

FURTHER STRATEGIES Because of the far-sighted latitude of the WHO analgesic ladder to allow steroids, I currently use them as an injectable (dexamethasone) during surgery and orally (methylprednisolone) after surgery to further reduce post-procedural discomfort some of which has already been achieved with NSAIDs and acetaminophen. This regimen further decreases the perceived need for opioids. If opioids are deemed necessary, I suggest an average of a threeday supply of a relatively weak opioid with a daily 20-50 mme (milligram morphine equivalent), as opposed to the current ADA guidelines that recommend a seven-day supply of an opioid with a daily 50-90 mme.

Like so many anecdotal reports, I have seen a dramatic decrease in my own opioid prescribing habits since adapting

these guidelines. Collectively, we have written almost half a million fewer opioid prescriptions over a five-year period; from 18.5 million in 2012 to 18.1 million in 2017.

I hope that we can continue to implement these changes to improve clinical outcomes and decrease opioid addiction.

DID YOU KNOW? In 2016, 1 in 5 deaths among young adults were opioid related.

As the death rate of major killers like cancer and heart disease decline, opioid death rates continue to climb.

The prescribing rates for controlled substances among adolescents and young adults nearly doubled from 1994 to 2017.

Dr. Ray A. Beddoe is a Board-certified periodontist currently practicing in Broken Arrow. He has been in private practice for 28 years and currently serves part-time on the faculty at the OU College of Dentistry as a Clinical Assistant Professor of Periodontology. His past service to the ODA includes Annual Session Chairman (2006) and Co-Chairman of the Technology Committee (2005—2007). In 2008 the ODA recognized his contributions with the President’s Leadership Award. In addition to his Doctor of Dental Medicine degree Beddoe also holds a Doctor of Pharmacy degree (both from the Medical University of South Carolina). A statewide lecturer on many topics, he has been a featured speaker at ODA Annual Sessions on Drug Therapy in Dentistry.

20 journal | May/June 2019

ADA Statement on Recently Published Research Related to Opioid Prescriptions The American Dental Association (ADA) is aware of recently published research related to opioid prescriptions for dental procedures.

A growing body of research supports ADA policy that dentists should prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) alone or in combination with acetaminophen over opioids as first-line therapy. The ADA continues to be dedicated to raising awareness and taking action on the opioid public health crisis.

In order to combat opioid abuse among adolescents and across all ages, the ADA has urged all 163,000 member dentists to double down on their efforts to prevent opioids from harming patients and their families.

Dentists have written nearly half a million fewer opioid prescriptions over a five-year period, from 18.5 million in 2012 to 18.1 million in 2017. This is progress, and we know there is still more we can do.

In March 2018, the ADA adopted policy related to opioid prescribing by dentists for acute pain that supports:

Mandatory continuing education regarding prescription of opioids and other controlled substances.

Statutory limits on opioid dosage and duration of no more than seven days for the treatment of acute pain, consistent with the Centers for Disease Control and Prevention evidence-based guidelines.

Dentists registering with and utilizing Prescription Drug Monitoring Programs (PDMPs) to promote the appropriate use of opioids and deter misuse and abuse In April, researchers from the ADA Science Institute, Case Western University and the University of Pittsburgh published a scientific review of studies in the Journal of the American Dental Association which concluded that NSAIDs alone or in combination with acetaminophen are generally more effective and are associated with fewer side effects compared to opioids.

The findings support the ADA’s 2016 policy statement that dentists should “consider NSAIDs as the first-line therapy for acute pain management.”

Working together with physicians, pharmacies, policymakers and the public, the ADA believes it is possible to end this tragic and preventable public health crisis that has been devastating our families and communities.

Copyright © 2019 American Dental Association. All rights reserved. Reprinted by permission.

The ODA and the ADA are committed to ending the scourge of opioid abuse that has been devastating our families and communities. For more resources and information an how the ADA is working to combat opioid abuse, visit www.ADA.org/opioids.

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21

LEGISLATIVE LOOP Legislative Overview & Political Update

ODA LEGISLATIVE UPDATE (as of May 7, 2019) We were recently successful in passing HB 1157, the Virtual Credit card bill, by both the House and Senate and are now waiting on the Governor’s signature. In recent years, insurance companies have started paying providers using electronic payments, EFTs and virtual credit cards – which is costing dental offices anywhere from 2.5-6% of every reimbursement. This bill simply ensures that insurance companies cannot require providers to accept one form of payment – and also requires insurance companies to inform providers that they have the ability to choose physical checks instead of electronic payments. Thank you to Representative

Rande Worthen and Senator John Michael Montgomery for authoring our bill.

SB 948, the Prior Authorization Bill, has been passed by the Senate and the House with the title off, which means the bill requires more work. It has been assigned to a Conference Committee and the ODA continues to work closely with the bill’s authors, Senator Dave Rader and Representative Ryan Martinez, to negotiate with the insurance industry and get the bill to the Governor’s desk.

This bill will require insurance companies to stand by their prior authorizations.

Students and Dentists Advocate Together in Washington DC On April 14-16, 2019, the American Dental Association with the American Student Dental Association hosted Dentist and Student Lobby Day on Capitol Hill. More than 1,000 dentists and dental students from all 50 states, Washington, D.C., and Puerto Rico, came together to advocate on behalf of patients and for the profession of dentistry.

Attendees came to Washington to urge lawmakers to pass bills that will counter the antitrust exemption for health insurance companies amending the McCarran-Ferguson Act. Dentists and dental student advocates also are working to fight for private insurance coverage for medically necessary surgeries or procedures, including dental work and reconstructive surgery to repair congenital or developmental mouth abnormalities that insurance companies deem “cosmetic” with the Ensuring Lasting Smiles Act (ELSA). Advocates also highlighted the need for Higher Education Act reauthorization, with a focus on legislative initiatives that could help alleviate exorbitant amounts of student loan debt. Advocates asked Congress to remove the barriers for individuals to take advantage of the Public Service Loan Forgiveness program, which forgives any remaining student debt after ten years of payment and qualifying public service.

Rear Admiral Timothy L. Ricks was a distinguished guest speaker at the event. Rear Admiral Ricks presented an overview of oral health over the past 20 years and updated attendees on the new Surgeon General’s Report on Oral Health and how it will help shape the next 20 years in oral health developments.

Attendees from the ODA and OUCOD included Drs. Matt and Raymond Cohlmia and Shannon Griffin; OUCOD students Amber Bewley, Gabriel Duffy, Ashley Long, Samirah Mohamad, Kaylee Speer and Mary Temple-Goins; and Lynn Means, ODA Executive Director.

22 journal | May/June 2019

K

WE DON’T FUNDRAISE. WE FRIENDRAISE!

CAPITOL CLUB Jeffrey Ahlert Errol Allison Jim Ambrose Glenn Ashmore Michael Auld Douglas Auld Tamara Berg Ryan Brackett C Todd Bridges Matthew Bridges Steven Brown Adam Bulleigh Patricia Cannon Wuse Cara John Carletti Bobby Carmen

THANK YOU TO THESE 2019 DENPAC CAPITOL CLUB MEMBERS!

Adam Cohlmia Raymond Cohlmia Matthew Cohlmia Susan Davis Ana Dotson Brian Drew Heath Evans Christopher Fagan Timothy Fagan Barry Farmer Chad Garrison Shannon Griffin Clark Grilliot Mark Hanstein Leslie Hardy Aaron Harman

Edward Harroz Richard Haught Robert Herman Jeffrey Hermen Randi Hobbs James Hooper Brad Hoopes Moiz Horani Donald Johnson Katherine Johnson Krista Jones Michael Kirk Mitchell Kramer Larry Lavelett Robert Livingston Juan Lopez

Paul Shadid Gregory Shanbour David Simon Lindsay Smith James Strand Jim Taylor James Torchia Jonah Vandiver Nathan Villines Robert Webb Daniel Wilguess C Rieger Wood William Yadon

Gary Lott Kevin Mailot David Marks Stephen Mayer Janna McIntosh Robert Miracle Robert Morford Paul Mullasseril Lisa Nowlin Samuel Owens Justin Power Erin Roberts-Svob Brant Rouse Miranda Ruleford Andrea Scoville Gregory Segraves

OKCapitol Club is for that “ABC” group of DENPAC members; or those who want to be “ABOVE AND BEYOND CONTRIBUTORS.” OKCapitol Club members truly understand the importance of the ODA’s participation in the political process and want to support candidates who are committed to the state’s oral health and the issues that affect your practice. OKCapitol Club members support those efforts even more by contributing an additional $300 to DENPAC ($470 total) per year. For more information about Capitol Club, contact Lynn Means at 800-876-8890 or lmeans@okda.org.

DENPAC Grand Level DENPAC funds our voice. Without our input, legislators are merely making decisions based on what sounds good, what makes the fewest people angry, or what is easiest for them.

Whether you like it or not, the campaign contributions we make to dentistry-friendly candidates are what open those lines of communication. It’s what reminds legislators once they’re in office to go directly to the ODA for information, and not somewhere else.

For more information about DENPAC, contact Lynn Means at 800-876-8890 or lmeans@okda.org.

THANK YOU TO THESE 2019 DENPAC GRAND ($1,000) LEVEL MEMBERS! Douglas Auld

Mark Hanstein

Mitchell Kramer

James Torchia

Matthew Cohlmia

Richard Haught

Juan Lopez

Daniel Wilguess

Susan Davis

Robert Herman

Paul Mullasseril

C Rieger Wood

Shannon Griffin

Krista Jones

Lindsay Smith

www.okda.org

23

ADA Legislative News RAISE Act 2019 The ADA and members of the organized dental coalition led by the American Association of Orthodontists, sent a letter of support to Congressional leadership on the Responsible Additions and Increases to Sustain Employee (RAISE) Health Benefits Act of 2019 (S. 503, H.R. 1366). The bill would allow for consumers to set aside pretax dollars in flexible spending accounts (FSAs) to pay for healthcare services and items not covered by insurance, such as vision and dental services, doctor copayments, prescription drugs and medical supplies. The RAISE Act would significantly expand the current flexible spending account annual contribution cap to $5,000. This bill would also allow families with more than two dependents to save an additional $500 a year for each additional dependent. The coalition also urged legislators in the Senate Committee on Finance and House Committee on Ways and Means to overturn a “use-it-or-lose-it” rule that restricts families from carrying over the full balance in these savings accounts from one year to the next.

S. 350 / H.R. 1418 – McCarran-Ferguson Repeal for Health Insurance would amend the McCarran-Ferguson Act and empower the Federal Trade Commission and U.S. Department of Justice to enforce the full range of federal antitrust laws against health insurance companies engaged in anticompetitive conduct. S. 350, introduced

by Sens. Daines (R-MT) and Leahy (DVT) and H.R. 1418, introduced by Reps.

DeFazio (D-OR) and Gosar (R-AZ), will not interfere with the states’ abilities to maintain and enforce their own insurance regulations, antitrust statutes and consumer protection laws. Because states may vary in their enforcement efforts, the impact of repeal on health insurance companies would differ from state to state. The bill is narrowly drawn to apply only to the business of health insurance, including dental insurance, and would not affect the business of life insurance, property or casualty insurance, or any other similar insurance areas. Repeal of the limited antitrust exemption for health insurance companies would help inject more competition into the insurance marketplace by authorizing greater federal antitrust enforcement in instances where state regulators fail to or cannot act. Promoting lower prices, greater consumer choice, and increased innovation through robust 24 journal | May/June 2019

competition is the role of the antitrust laws.

The Higher Education Act (HEA), which provides the statutory authority for most federal student loan programs to operate, is several years overdue for reauthorization. This Act would alleviate the exorbitant amounts of dental student debt by adhering to the following principles: 1. Protect the Direct Unsubsidized Stafford Loan (Direct Loan) and Grad PLUS loan programs for graduate and professional degree students.

2. Reinstate eligibility for graduate and professional degree students to use federal Direct Subsidized Stafford Loans, which is currently available to undergraduates only.

3. Lower the interest rate caps and the total amount of interest that can accrue and compound on Direct and Grad PLUS loans.

4. Extend the deferment period and halt the accrual of interest while a dentist is completing a medical/dental internship or residency, as provided in H.R. 1554, the Resident Education Deferred Interest Act (or REDI Act).

5. Permit federal graduate student loans to be refinanced whenever interest rates are lower and economic conditions are more favorable.

6. Lower the administrative fees and simplify (and add more transparency to) the federal graduate student loan application process.

7. Remove the barriers for individuals to take advantage of the Public Service Loan Forgiveness program, which forgives any remaining student debt after ten years of payments and qualifying public service.

8. Permit those with private graduate student loans to take advantage of federal student loan forgiveness programs.

9. Encourage institutions of higher education and lenders to offer training to help students make informed decisions about how to finance their graduate education.

10. Encourage collaborative approaches to handling borrowers who fail (or are at risk of failing) to fully repay their federal student loan(s) in the required time period.

Most dental students rely on federal student loans to finance their dental education.

In 2017, over two-thirds (66.9 percent) of graduating dental school seniors reported using Direct Loans to pay for dental school

and, to a lesser extent, Grad PLUS Loans (65.1 percent).1 The default rate on dental student loans is extremely low, making them good investments for the federal government. In fact, most dentists pay back their loans much faster than other federal loan recipients. In 2017, 84.5 percent of dental school seniors graduated with an average educational debt of $287,331. It is an uphill battle for a highly indebted young dentist to establish a career in an economy where over 50 percent of practicing dentists own or are partnered in a small business. Lenders view early career individuals who are almost $288,000 in debt as a higher credit risk, which makes it more difficult to invest in a group practice.

The same is true for any highly indebted person trying to obtain a car or home loan, or even a credit card. As a matter of public policy, reducing a new dentist’s early career debt, even marginally, is a sound economic investment. For an early career dentist, a lower debt burden will make banks more open to lending funds to invest in a group practice and make other high value purchases. Moreover, a lower debt burden will remove barriers for those wanting to pursue careers in public service, teaching, research and administration early in their careers.

S. 560 / H.R. 1379 - Ensuring Lasting Smiles Act (ELSA) would require all private group and individual health plans to cover medically necessary services resulting from a congenital anomaly or birth defect. This would include inpatient and outpatient care and reconstructive services and procedures, as well as adjunctive dental, orthodontic, or prosthodontic support. The bill specifically exempts cosmetic surgery. S. 560 is sponsored by Sens.

Tammy Baldwin (D-WI), Joni Ernst (R-IA), Sherrod Brown (D-OH), and Lisa Murkowski (R-AK), and H.R.1379 is sponsored by Reps. Collin Peterson (D-MN) and Denver Riggleman (R-VA).

READ MORE ABOUT THESE AND OTHER ADA LEGISLATIVE INITIATIVES AT ADA. ORG/ADVOCACY.

With storm season approaching, Oklahomans face the risk of devastating disasters.

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Relationships.

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Make a tax-deductible contribution to the RDGP

The Oklahoma Dental Relief and Disaster Grant Program (RDGP) is a charitable trust established to provide aid to dental professionals affected by natural disasters, physical disability, chemical dependence, or other hindering conditions.

The RDGP is reliant solely on contributions from individuals like you. Help Prepare & Provide for those in need. You never know when it could be you.

866.898.1867 info@paragon.us.com paragon.us.com

Approved PACE Program Provider FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement 4/1/2016 to 3/31/2020 Provider ID# 302387.

Contact the ODA at 800.876.8890

OKLAHOMA – AUGUST 2016 – 1/4 Page 4/C – 3.875”(W) x 5.25”(H)

Registration is Now Open for ADA FDI 2019 September 4th-9th

It’s been more than 20 years since FDI World Dental Federation has met in conjunction with the ADA Annual Meeting. That all changes this year. Make plans now to attend the ADA FDI World Dental Congress 2019 at the Moscone Center in San Francisco, California. Registration is now open! We look forward to seeing you there! Visit ada.org/meeting for the latest information. www.okda.org

25

Tax Season Is Over…

But Questions Remain

(Common questions about wrapping up this year’s taxes and preparing for next year)

By Joe Hendrix, Senior Wealth Advisor for Mariner Wealth Advisors We can all breathe a sigh of relief that we’ve made it through yet another tax season.

And while it may be the last thing you want to consider, now is the time you should consider making any necessary adjustments to your tax strategy. The following are some common questions resulting from this year’s filings that may help you prepare for next year.

until your tax return is filed. Instead, those funds could be used for investments, to pay off debt, or to increase your savings.

While it’s too late to make adjustments to your 2018 withholdings, you may consider using this year’s filing to adjust your 2019 withholdings, with a goal of increasing the amount of money available to save or invest throughout the year.

My tax refund seems larger this year.

That’s a good thing, right?

How can I ensure I’m putting my tax refund to good use?

Many discount and online tax preparers tout larger refunds as a benefit of using their services. While the idea of receiving a large lump sum can sound appealing, it may not always be a positive.

In 2017, the average tax refund amounted to roughly $3,000 per return filed. Each year, for the millions of Americans who receive refunds, the question becomes, “What should I do with the money?”

The Tax Cuts & Jobs Act of 2017 provided for an increased standard deduction of $12,000 for individuals and $24,000 for married couples. This increase, coupled with the fact that many individuals have not adjusted their withholding amounts since the passage of the act, means that many taxpayers are receiving a larger-thannormal return. While receiving a refund is generally preferred over owing the IRS a large sum of money, too large of a refund can be detrimental to a taxpayer’s financial situation.

According to a recent poll, 27 percent of respondents said they were using their refund to pay off debt, which is generally advantageous, especially if that debt is in the form of high-interest credit cards or personal loans.

If you are receiving a large refund every year, the amount withheld throughout the year may be too much. Paying more than necessary over the course of a year essentially equates to giving the federal government an interest-free loan

26 journal | May/June 2019

For those who don’t carry a balance on their credit card month-to-month, there are many efficient ways to use a tax refund.

If you are adequately prepared for and just entering or nearing retirement, a tax refund can be a great way to fund a vacation, make home repairs or improvements, or fund a large purchase. Because a tax refund is simply a return of excess tax payments, using it to fund an upcoming purchase can be more efficient than liquidating taxable assets, thereby potentially generating a tax on any existing capital gains. Similarly, drawing on a qualified retirement account like an IRA would trigger ordinary income

to the recipient, whereas tax refunds have already been taxed and can therefore be spent without any adverse tax ramifications.

While using funds in this manner should be considered in the context of your overall financial plan, sometimes it’s important to enjoy the fruits of your labor, especially when you can avoid additional taxes.

Should I consider converting my IRA to a Roth IRA or using a Roth 401(k)?

If you are nearing retirement with a large portion of your net worth held in a traditional IRA, you may consider converting a portion to a Roth IRA. Because traditional IRA distributions are taxed as income, some individuals find themselves in a higher tax bracket in retirement because they’re drawing solely from their traditional IRA for living expenses.

To potentially mitigate some of the tax consequences, a portion of your traditional IRA can be converted to a Roth IRA, which permits tax-free distributions.

At the time of conversion, the amount converted is considered taxable income, which is why it makes sense to do the conversion in a year when your income is lower, typically the year following retirement.

As this transaction has the potential to create a large amount of taxable income, it’s critical that you make sure your tax advisor receives the 1099 from the IRA custodian to ensure the income is included on your tax return.

Without the 1099, your tax preparer won’t be aware of the conversion and may accidentally omit the income, which is not viewed favorably by the IRS. Depending on your practice’s retirement plan, it is possible you may be able to contribute to a Roth 401(k). With tax rates at near-historical lows, paying the tax on these contributions now may be a good idea as it provides tax-free growth and can serve as an effective retirement planning hedge should tax rates be higher while in retirement.

What are some ways to avoid capital gains taxes?

Recent tax law changes have many investors wondering if it’s still possible to avoid capital gains taxes. The good news is that most strategies to beat capital gains still work but may require a few modifications. The following are several actions you can take that may help avoid long-term capital gains taxes.

• Harvest losses – It is still possible to offset long-term capital gains by harvesting losses within your portfolio. For losses that are greater than your gains, you can deduct up to $3,000 per year against your ordinary income and carry over any excess to future years. This is always an effective income tax planning measure at year-end to help offset capital gains that were previously recognized during the year. Some mutual fund investments also distribute capital gains recognized by the fund throughout the year, so it is key to pay attention to your account activity in December to monitor and plan accordingly.

• Make charitable donations – Even if you no longer itemize deductions, it’s still possible to make a charitable donation of appreciated stock to avoid capital gains tax.

One option is through funding a donoradvised fund. This type of fund provides an income tax deduction for the fair market value of any stock donated, with the added bonus of no capital gains tax. Your advisor can provide additional information on this type of fund.

• Consider a 1031 exchange – A 1031 exchange (also called a like-kind exchange) allows property owners to roll capital gains from the sale of a property into the purchase of a new property, which then takes on the first property’s lower cost basis. This arrangement allows you to keep money working on your behalf that otherwise would have been paid out in taxes.

• Buy and hold – If you leave appreciated stock to your heirs at the time of your death, they will receive an automatic step-up in basis to the current market value at the date of your death; therefore, you avoid capital gains tax.

• Utilize Roth contributions – Because contributions to a Roth IRA or 401(k) are made with after-tax money, they are not taxed at distribution.

• Make gifts to family members – An annual gift exclusion still exists – up to $15,000 per individual each year. Highly appreciated stock that is given to a child or parent continues at its lower cost basis until it is sold. If that child or parent is in a lower tax bracket at the time of the sale, the capital gains rate is zero. However, when making a gift to a child under age 24, be aware of updates to the “kiddie tax.”

• Consider opportunity zones – Opportunity zone funds invest in economically distressed communities and may be eligible for preferential tax treatment.

This preferential treatment may include a temporary deferral of accumulated capital gains, a potential 15 percent cost basis step-up on capital gains invested, and a 0 percent capital gains rate on new gains for investments held 10 years. This is a complicated addition to the tax code and we recommend consulting with your tax advisor prior to making an opportunity zone investments.

qualifying capital assets to be exempt from capital gains tax. Examples are selling stock of an Oklahoma based company (even your practice), selling real estate located in Oklahoma, etc. Please note there are specific requirements such as ownership and holding periods to qualify, but this can be a great way to save a 5% tax on your overall capital gains.

As with all financial decisions, planning for the upcoming tax year can be a challenge.

Equipment and supply purchases, payroll adjustments for employees and maximizing retirement plan benefits are all effective ways to manage your tax burden. Note that income tax planning isn’t something that should be completed after the year is over. We recommend having a 4th quarter sit down with your CPA and wealth advisor to evaluate your current year, discuss what’s on the horizon and determine what steps need to be taken to minimize your income tax liability for the year. Communication with your trusted advisors is key to avoid surprises and better manage your tax situation. For assistance with tax planning strategies specific to your financial situation, contact your wealth advisor or CPA.

• Manage your tax bracket – Work with your advisor to sell stock during years in which your income is lower, and keep an eye on paying zero capital gains taxes whenever possible.

Joe joined Mariner Wealth Advisors in 2015. Previously, he spent over five years with Grant Thornton, LLP as a tax manager and also spent two years with Chesapeake Energy Corporation as a tax analyst. Joe has knowledge of individual, partnership and corporate income taxation and has served as a consultant for many large, publicly traded corporations and partnerships, primarily focusing on the energy industry.

• Invest in your home – Under the new tax laws, individuals can exclude up to $250,000 of capital gains in their primary residence ($500,000 for married couples filing jointly).

Be sure to keep any receipts for home improvement projects that may add to your home’s cost basis.

Joe has both a bachelor’s degree and master’s degree in accounting from Oklahoma State University. He is a CERTIFIED FINANCIAL PLANNER™ professional, a Certified Public Accountant and a board member of the Citizens Caring for Children and the Oklahoma Venture Forum organizations.

• Save for college using a 529 – Contributions to 529 savings plans grow tax-free. When used for education expenses, withdrawals are also tax-free.

• Remember your HSA – A health savings account allows you to contribute using pretax dollars, and that money grows and is distributed tax-free. Another bonus of HSA accounts is that they allow investors to save for future healthcare expenses in retirement.

• Oklahoma Capital Gain Deduction – The state of Oklahoma allows for certain

Mariner, LLC dba Mariner Wealth Advisors (“MWA”), is an SEC registered investment adviser.

Registration of an investment adviser does not imply a certain level of skill or training. MWA is in compliance with the current notice filing requirements imposed upon registered investment advisers by those states in which MWA maintains clients. For additional information about MWA, including fees and services, please contact MWA or refer to the Investment Adviser Public Disclosure website (www.adviserinfo.sec.gov). Please read the disclosure statement carefully before you invest or send money.

www.okda.org

27

Water Fluoridation (in the news again)

In 2015 the Department of Health and Human Services announced the final recommendations for the optimal level of fluoride in the community water system.

The ODA first printed this statement along with an article from Dr. Jana Winfree in our May/June 2015 Journal.

In light of the recent CNN story "FDA Proposes New Fluoride Standard For Bottled Water, But Some Say It's Still Too High" published April 2, 2019 the Journal’s editorial board felt the need to republish the statement to ensure that our readership can respond to any patient questions. (The entire CNN article can be found at: https:// www.cnn.com/2019/04/02/health/fdafluoride-bottled-water-bn/index.html) WASHINGTON, D.C. — The American Dental Association (ADA) today commended the Department of Health and Human Services (HHS) for announcing the final recommendation for the optimal level of fluoride in community water systems.

The recommended ratio of fluoride to water, newly calibrated at 0.7 parts per million, results from years of scientifically rigorous analysis of the amount of fluoride people receive from all sources.

The ADA supports the recommendation, which was released for comment four years ago. The new recommendation will help ensure an effective level of fluoride to reduce the incidence of tooth decay, while minimizing the risk of cosmetic fluorosis in the general population.

“Water fluoridation is effective and safe,” said ADA President Dr. Maxine Feinberg.

“It has now been 70 years since Grand Rapids, Mich., became the first U.S. city to begin adding fluoride to its water system.

Since then, decades of studies and the experience of tens of millions of people have affirmed that water fluoridation helps prevent cavities in both children and adults. Today’s announcement is based on solid science.”

Extending the availability of optimally fluoridated water is one of eight initiatives of Action for Dental Health, launched by the ADA in 2013 with the goal of making 28 journal | May/June 2019

good oral health available to all Americans, especially those who lack adequate access to preventive and restorative care. Through both education and advocacy, the ADA and state dental societies have set a goal to bring fluoridated water to 80 percent of the population on public water systems by 2020, using a baseline level of 74 percent in 2010.

The Association strongly urges communities that already are doing so to continue fluoridating water at the levels the government recommends. People who live in the dwindling number of non-fluoridated communities should help educate their state and local officials about the need to fluoridate. They also should talk to their dentists about other ways to ensure that they are receiving the right amount of fluoride, through such means as supplements or topical applications.

“Dentistry is proud of its record in preventing disease,” said Dr. Feinberg. “The ADA and other health organizations in the U.S. and around the world understand that community water fluoridation is one of the safest, most effective and least costly ways to do so."

“The recommended level is now officially set at 0.7 parts per million, but the health benefits have not changed, and neither has the ADA’s commitment to bringing optimally fluoridated water to the greatest possible number of people.”

A DDI TI ONA L RE SOURC E S There are numerous free water fluoridation resources for you to utilize in your office.

The ADA offers videos and articles at both www.mouthhealthy.org and www.ada.org/ en/public-programs/advocating-for-thepublic/fluoride-and-fluoridation.

The poster [pictured] is available to download and print in English and Spanish at www. ilikemyteeth.org/ fluoridation/ how-fluorideworks/.

ODA MEMBER SPOTLIGHT

Sam Owens, DDS Broken Arrow, OK

By Abby Sholar, ODA Special Projects Manager

When Dr. Sam Owens chose to become a dentist, he wanted each day to be a new challenge. Since graduating from the OU College of Dentistry (Class of 2010), Owens still feels lucky to experience challenges and triumphs every day in his career. This year, he led the ODA Annual Meeting Planning Committee with the goal of providing Oklahoma dental teams the best possible experience at this yearly conference. His committee worked diligently to provide new, creative CE opportunities and more social events to give dental teams the opportunity to learn, network and have fun!

Outside of his work life, Owens enjoys spending as much time as possible with “my amazing wife Daisi and our two children, Harris [4] and Lee [2]. Daisi and I agree that our lives have improved since becoming parents in greater ways than we could have ever imagined.” When not working (Daisi is a CPA), the Owens family loves to travel and is planning a camping trip in the near future to unplug and explore nature.

and our amazing ODA staff makes it super easy and fun to get involved,” he said. “Through the ODA, I have formed a number of new relationships in a very short time, ones that I will cherish for the rest of my life. I look forward to meeting new friends and colleagues in the future.”

When Owens isn’t practicing, planning the ODA Annual Meeting, or spending time with his family, you’ll most likely find him on the golf course. If he weren’t a dentist, he would switch the white coat for a green blazer and take on the top golfers in the best courses around the world!

Owens considers himself lucky to have a career that he loves and a family that makes life fun. He will continue to spend his time cultivating genuine relationships and taking advantage of all the fun life has to offer!

“Since having children, Daisi and I have been involved in a number of charities that benefit underprivileged children in the Tulsa area,” Owens said. “While not dental related, it has easily been the most eye-opening activity we’ve been a part of together.

Every child deserves a fair shot at being successful and happy.”

For Owens, family bonding doesn’t stop at home! He practices in Broken Arrow with his father, Dr. James Owens. The duo stepped out of their comfort zone to open a practice together, but that risk made them closer as a family and stronger as professionals. Owens has always looked up to his parents as role models in the dental profession. He could see the passion they had for the craft in the relationships they formed with their patients. They inspired him to make his own memories with patients and strive to improve the health of every person who sits in his dental chair.

Owens has one piece of advice for the newest graduating class of dental students: get involved with the Oklahoma Dental Association! When he graduated from OUCOD and joined the ODA, Owens did so because he thought it was something he was “supposed to do,” but now he realizes what an impact the ODA has had on each aspect of his practice. “The possibilities are endless,

FAST FAC TS: Book I am currently reading: Spearhead by Adam Makos. We could learn a lot from soldiers that fight for our freedom.

If I Could Have Dinner with Anyone from History: Jesus. I have a lot of questions...

My Ideal Vacation: Either on a beach or on a mountain with my family. It doesn’t get any better than that!

Favorite Quote: Don’t complain. It doesn’t do anybody any good and no one wants to hear it! www.okda.org

29

55 Dentists Across Oklahoma Honored for 25 Years of Service

By Ruben Reyes Community Engagement Coordinator D-DENT (Dentists for the Disabled and Elderly in Need of Treatment) hosted its first Annual J. Don Harris Service award ceremony to honor 55 distinguished volunteer dentists. The award is named after Dr. J. Don Harris who, in 1986, was one of the original founders of D-DENT. The event was held at the elegant setting of the Oklahoma History Center in Oklahoma City. The ceremony was attended by dental professionals and supporters from across the state.

This special evening celebrated 55 dentist volunteers, who each have dedicated over

25 years of charitable dentistry to their local communities through D-DENT. Throughout D-DENT’s 32 years of service, volunteer dentists have provided over $22,668,333 in charitable dental care from the comfort of their private dental clinics. D-DENT screens each patient for eligibility and pays for any lab bill the dentist may incur.

During the ceremony, Dr. J. Don Harris was presented with the “Legacy Award” for exceptional achievement and continuous, passionate contributions to dentistry.

D-DENT is a non-profit organization that provides free comprehensive dental care through a network of volunteer dental professionals, for individuals with I/DD, the elderly, and veterans residing in Oklahoma.

D-DENT volunteer dentists work from the comfort of their private dental clinics.

D-DENT pays any dental laboratory fees the dentist may incur during the patient’s dental restoration.

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30 journal | May/June 2019

THE 201 8 J. DON HARRI S SERVIC E AWARD F OR DISTINGUI SHED VOLUNTEER S WERE PRE SE NTED TO THE F OLLOWING DE NTISTS: Dr. Michael Adams

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Dr. Islo D. Ashmore

Dr. Vic Trammell

Dr. Larry Prince

Dr. Greg Hardman

Dr. Bryce Dorrough

Dr. Edmund M. Braly

Dr. Michael Weaver

Dr. James B. Lowe

Dr. C. Brian Hooper

Dr. Steven Durr

Dr. Mary Casey-Kelly

Dr. James Sparks

Dr. Glenn Mead

Dr. David W. Keck

Dr. Ronald L. Graves

Dr. John Ainsworth

Dr. Gary M. Suttle

Dr. Ray Plant

Dr. Dennis Leseberg

Dr. Gerald Cross

Dr. James A. Baker

Dr. Ernest Turner

Dr. Jack Sheets

Dr. J. Don Harris

Dr. Michael Duffy

Dr. Hugh Burch

Dr. Susan Whiteneck

Dr. Stephen Mayer

Dr. Michael Jackson

Dr. Eric Eakers

Dr. Kent Cohenour

Dr. Jim Spurgeon

Dr. Dennis Morehart

Dr. Larry Lander

Dr. Jerry Greer

Dr. Mark Allen

Dr. Don Swearingen

Dr. Brian Prince

Dr. Eric Loper

Dr. Dunn Cumby

Dr. Lillian Barnes

Dr. William Uraneck

Dr. Terry Smith

Dr. Edwin Henslee, III

Dr. Michael Dugan

Dr. William Carter, Jr.

Dr. W. Trent Yadon

Dr. Arnie McGee

Dr. Krista M. Jones

Dr. Mark Goodman

www.okda.org

31

ODA FEATURE

PALATAL MASS By: Glen D. Houston, DDS, MSD Diplomate, American Board of Oral and Maxillofacial Pathology CASE HISTORY: A 63-year-old male was referred for consultation by his physician for a soft tissue swelling involving the palate (Fig. 1). The lesion has been present for "almost a year" and has recently exhibited a large area of ulceration. The patient reported that the lesion was initially painless but is now quite painful. The patient also notes a long history of alcohol and tobacco use.

QUESTION #1: Your clinical differential diagnosis for a mass involving the palate might include (multiple answers): a. Salivary gland neoplasm b. Neurofibroma c. Antral carcinoma d. Palatal abscess e. Fibroma ANSWER #1 : Your clinical differential diagnosis should include all of the conditions noted above because they may all present as a "palatal mass.� The palatal mucosa contains numerous lobules of minor salivary gland tissue.

Salivary gland neoplasm (a), whether benign or malignant, must be considered in the differential diagnosis for this case. Benign neoplasms such as pleomorphic adenoma (benign mixed tumor) and canalicular adenoma should be included. Specific examples of adenocarcinomas arising from minor salivary gland tissue include mucoepidermoid carcinoma and adenoid cystic carcinoma that can also present as palatal masses.

Neurofibroma (b) is the most common type of peripheral nerve sheath neoplasm. It arises from a proliferation of Schwann cells and perineural fibroblasts. This neoplasm is common in young adults and presents as a slow-growing, soft, painless mass. Although the skin is the most common location for the neurofibroma, it has also been observed with some frequency in the oral cavity.

Antral carcinoma (c) is typically a disease of the elderly patient. There is a male 32 journal | May/June 2019

predilection for this malignant neoplastic process and the patient generally complains of a chronic, unilateral, nasal stuffiness or notices an ulceration or mass of the hard palate or the alveolar bone. Intense pain or paresthesia of the mid face or maxilla may also be observed.

Palatal abscess (d) may also present as an ulcerated palatal mass. The usual source of the abscess is typically a nonvital tooth in the area or a localized periodontal defect.

Traumatic or irritation fibroma (e) is the most common "tumor" of the oral cavity. The lesion typically presents as a pink, firm mass or nodule with a broad, sessile base that may exhibit surface ulceration.

QUESTION #2: Which of the following procedure(s) should be performed to yield a definitive diagnosis? a. Biopsy of the lesion b. Radiographic survey c. Periodontal evaluation d. Observe the patient closely for 10-14 days to evaluate any changes in the lesion

Observation of the patient for 10-14 days to evaluate any changes in the lesion (d) is of little or no benefit in the management of this ulcerated palatal mass.

QUESTION #3: A radiographic survey revealed an ill-defined, radiolucent area in the underlying osseous tissue adjacent to the palatal mass. A fine needle aspiration was inconclusive. Biopsy of the lesion yielded the following microscopic features: lack of encapsulation with invasion of the adjacent soft tissue; composed of small, deeply-staining, cuboidal cells arranged in islands exhibiting a "Swiss-cheese" pattern; and tumor cells observed in the perineural lymphatic spaces, as well as involving adjacent peripheral nerve fibers. The correct diagnosis for this lesion is: a. Antral carcinoma b. Pleomorphic adenoma c. Adenoid cystic carcinoma d. Basal cell carcinoma e. Neurofibroma

e. Vitality tests of the teeth in the area

ANSWER #3: The correct diagnosis is (c) adenoid cystic carcinoma. (See the "Discussion" section.)

ANSWER #2: The procedures to yield a definitive diagnosis should include:

The other possibilities are not considered here because:

a. Biopsy of the lesion b. Radiographic survey c. Periodontal evaluation e. Vitality tests of the teeth in the area Vitality tests of the teeth in the area (e) and a radiographic survey (b) in conjunction with a periodontal evaluation (c) and clinical examination are indicated in order to complete a comprehensive oral examination.

An incisional biopsy (a) is indicated in order to establish a definitive microscopic diagnosis and treatment plan.

Antral carcinoma (a) is usually a moderatelyto-poorly differentiated squamous cell

carcinoma, but occasionally may be an adenocarcinoma. The various histologic features characteristic of this neoplasm are not observed in the present case.

Pleomorphic adenoma (b), a benign mixed tumor, is an encapsulated salivary gland neoplasm composed of islands of cuboidal cells arranged in duct-like structures. Loose myxomatous stroma, hyalinized connective tissue, cartilage, and even bone may be observed.

Basal cell carcinoma (d) is a malignant neoplasm composed of islands of hyperchromatic, basaloid epithelial cells that demonstrate palisaded peripheral nuclei.

These islands arise from the basal cell layer of sun-damaged skin.

Neurofibroma (e) is a benign neural neoplasm composed of a proliferation of Schwann cells and perineural fibroblasts. This tumor exhibits interlacing bundles of spindle-shaped cells that exhibit wavy nuclei and are associated with delicate collagen bundles and variable amounts of myxoid matrix. This pattern is not observed in the present case.

DISCUSSION: Adenoid cystic carcinoma was first reported in the German literature

by Theodore Bilroth in 1859. It is the most common intraoral malignant salivary gland neoplasm and is most commonly observed involving the palate. It represents 15% to 25% of all minor salivary gland tumors and onefourth of all palatal salivary gland neoplasms.

In addition to being observed arising in the major and minor salivary glands, it has also been reported arising in the glandular tissue of the pharynx, larynx, trachea, bronchus, nose, antrum, lacrimal glands, breast, ceruminous glands of the ear, and Bartholin's glands of the vulva.

basophilic cells arranged in islands producing a "Swiss cheese" pattern. These tumor cells characteristically invade the perineural lymphatics and extend great distances along peripheral nerve sheaths.

Adenoid cystic carcinoma is generally treated by radical surgical removal. In the palate, wide excision with partial maxillectomy is necessary. Neck dissection is indicated when lymph nodes are palpable. Postsurgical adjunctive radiation therapy may provide suppression of tumor growth, but is contraindicated as a primary mode of treatment. This neoplasm pursues a slow rate of growth and many years may pass before recurrence and distant metastasis become detectable. Metastasis is usually to the cervical lymph nodes followed by distant spread of the tumor to the lungs and brain. The five-year survival rate for palatal lesions is 70%; the 20year survival rate is below 15%.

Glen D. Houston, DDS, MSD Diplomate, American Board of Oral and Maxillofacial Pathology Dr. Houston works at Heartland Pathology Consultants, PC in Edmond, OK. He can be contacted with questions at gdhdds@ heartlandpath.com REFERENCES Bhayani MK, Yener M, El-Naggar A, et al. Prognosis and risk factors for early-stage adenoid cystic carcinoma of the major salivary glands. Cancer 118:2872-2878, 2012.

Bradley PJ. Adenoid cystic carcinoma of the head and neck: a review. Curr Opin Otolaryngol Head Neck Surg 12:127-132, 2004.

Ellington CL, Goodman M, Kono SA, et al. Adenoid cystic carcinoma of the head and neck: incidence and survival trends based on the 1973-2007 Surveillance, Epidemiology, and End Results data. Cancer 118:44444451, 2012.

ODA SPEAKER’S BUREAU

Are you an expert in a topic related to dentistry?

Would you like to share that knowledge with Oklahoma dentists or other dental professionals?

The adenoid cystic carcinoma is characteristically seen during the fifth and sixth decades of life. There is no sex predilection. This neoplasm typically presents as a swelling of the palate lateral to the midline and frequently demonstrates surface ulceration. Pain is not uncommon and despite its malignant behavior, it may demonstrate a lengthy growth progression. Because of this clinical presentation, it may mimic other malignant or benign salivary gland tumors, neural lesions, mesenchymal tumors, antral carcinomas with palatal extension, and even a palatal abscess.

The ODA is building a Speakers Bureau of member dentists who are qualified and who desire to speak at various events.

The microscopic features of adenoid cystic carcinoma reveal a glandular tumor that lacks encapsulation and is composed of small,

Learn more at okda.org/members-only www.okda.org

33

HYGIENE HOTSPOT Mary Hamburg, DDS, MS

My vision for the Hygiene Hotspot is to discuss topics that impact dental and dental hygiene professionals; to answer those questions discussed during lunch, in staff meetings, or during office training/calibrating sessions. If you would like to have a topic discussed please email it to marioperio@gmail.com. I will not use your name/location/office. If I do not know the answer, I will find someone who does! Until I hear from the dental community at large, I will answer some of the most common questions I have been asked.

How do you complete a full mouth cleaning when the patient only needs 2-3 quadrants of scaling and root planing?

Periodontitis is a diagnosis for the full mouth; however, the treatment for the disease (scaling and root planning [S/ RP], gingival flap, osseous surgery) does not always encompass the full mouth. The dilemma for this situation is the patient could have gingivitis for many areas and not need S/RP: only a prophylaxis. But you cannot use a D1110 code on periodontitis patients and you cannot use a D4910 code on the same day as a D4341/4342.

In my practice, the goal is to get the patient’s bacterial load as low as possible in order to stimulate healing and break the inflammatory cycle. Thus, I clean the other areas of the mouth during the S/RP but since I cannot code a D1110 at the same time as the D4341/4342, the procedure is not

coded or billed for the day. For those who say I performed a procedure that should be coded and billed, I agree. To code and bill appropriately, it is ideal to perform the S/ RP for the specified areas and then have the patient return in 2-4 weeks for the first periodontal maintenance (D4910) procedure to address the other areas of the mouth.

When is the best time to refer a patient for treatment of soft tissue recession?

Most periodontists would prefer to see the patient as soon as the recession starts. When a recommendation for soft tissue grafting is made, most patients nod their heads with, “Sure, I’ll think about it.” Years later the defect is finally to the point where the patient either notices it or it has now become sensitive. There are three factors that should be weighed when debating treatment. The first one what impact, if any, is the recession

having on sensitivity or esthetics. The second factor is the amount of recession: 2-3mm is the ideal level for when to treat (depending on the other factors). Tissue type around the recession is the last factor. The American Academy of Periodontology recommends 2mm of keratinized tissue for a defect to remain stable. Lack of keratinized tissue or tissue that is rolled and erythematous (determined by bleeding on probing, or BOP) is more likely to result in continued progression. Keep in mind that soft tissue grafting is very predictable under the right circumstances. Recession is caused by loss of bone. The more bone lost around a tooth, the harder it is to grow tissue and correct the defect.

New Dentist Corner Marni Russell, DDS (OUCOD '17)

Sometime in February 2018, while I was still in the AEGD residency at the OU College of Dentistry, I started writing down my goals. The first item on the list? Find a job. After breaking this goal into small, achievable tasks, I narrowed down my options. Luckily, Dr. Shannon Griffin was my attending faculty that day, and she guided me into my current situation by asking me questions about what I wanted. I told her I wanted to avoid corporate dentistry at all costs, I wanted to practice with another dentist for at least a few years while I got my bearings, I wanted the potential of practice ownership, and I wanted to love going to work. Soon enough, I was meeting with a lawyer to draw up contracts to buy in with Dr. Jim Farley, who has a wonderful 40-year-old general practice in Edmond.

Figuring out how best to manage a practice transition is still a challenge for Jim and me, but we are always united in two aspects: we want to run an ethical practice that takes good care of our patients, and we want good people on our team. The two of us are also fortunate to have known each other my entire life; I grew up with his kids at church in Edmond, and his oldest daughter, Emily, and I married a pair of brothers. Jim is very knowledgeable about running a business, and I brought in the knowledge of procedures, like implant dentistry, to help keep more of our patients “in-house.” Our contract has the buy-out occurring over five years, by which time I hope to have established the patients’ trust. I am so grateful to have an experienced mentor who not only leads by example (you should see him treat pediatric patients; it’s magical!), but also treats me as an equal business partner.

I split my time between the practice and teaching Operative Dentistry at OUCOD. Teaching has turned out to be the balance my life was lacking. I actually feel giddy when I enter the dental school building to help out in clinic or in the simulation lab! (I would never have imagined that feeling as a student!)

Though I am certainly not qualified to give advice at this stage of my career, I do have some thoughts about practice transitions. For new grads and retiring dentists alike, find a partner that you enjoy and trust. Support each other and give each other grace. Though young people have a very different financial position coming out of school these days, they can energize a practice with new ideas. Older dentists have the tools to run a successful business, and they are the best cheerleaders to help long-time patients trust “the new guy.” I don’t know what tomorrow may bring, but I know I’m on the right track with the right people. I truly love going to work.

34 journal | May/June 2019

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The Difference Between Being Busy or Profitable By: Craig Dreiling, Founder & CEO, Solutions-101

Network Access, Third Part Administrators (TPA’s), Active Payor List, Leased Network These are all words that have been inundating the Dental Insurance world, and if you aren’t on the front line, you are facing a dilemma.

If you have ever been in the situation where you are trying to estimate a patient portion, only to find out you have estimated completely wrong, you have probably experienced one of the aforementioned arrangements. Contract alliances have the dynamic ability to be both beneficial and devastating, and because of that, network expansion and constant absorption of existing patient bases are creating situations of stagnant income.

“I have seen more patients this year than I did last, but produced the same amount of income.” That is a regular statement I hear, followed by, “I thought we dropped that network but I am still being paid in-network fees.”

So, what are they and how do they work?

They come in many forms and many names but all function in a similar way. Contract alliances can create expansion or implosion of a patient base, generation or loss of revenue and sometimes, total chaos. It is vital as a practitioner and business owner

to become proactive in understanding how these networks will affect your overall practice, as these arrangements become most critical when they start dictating your income.

There is an abundance of articles written on the minutia of Leased Networks available with a quick search on the internet, however this article is not to define the contracts or legal aspects of how they work.

This is to outline their ability to alter production and income.

SCENARIO: -2 Years ago, your practice decided to take a contract with Company A. You were able to negotiate a strong reimbursement schedule at 80% of your regular office fees.

-Last month you received a notice from Company A about “Network Expansion with Company B.” A quick mailing and a couple pictures of what the member cards look like.

This is where you now have to realize the implications you are being confronted with: -Are these all new patients to the practice or do I have existing patients that have been absorbed by that expansion?

-Can I do anything to include or exclude my participation?

Looking at both situations, let’s say you have no patients in your current practice that are under Company B. You now have the opportunity to grow a NEW patient base within your practice. This is the part where generation of income can be created.

However, let’s look at the more common occurrence where you DO have existing patients under Company B. After researching your patient charts, you find out that you in fact have 100 patients that are currently in your practice with Company B. This now means you will see the SAME patient base you have already acquired, but under a newly reduced fee schedule.

Assuming Company B was previously reimbursing your practice at your regular office fee, we know that Company A reimburses at 80%. You are now required to see Company B patients at 80% since Company A expanded their network. What does this mean? In simple math you will be seeing the same 100 patients you already have in your practice, but be getting paid for 80 of them (since you have a 20% write off with the contract via Company A).

So maybe Company A taking Company B under that reduced schedule doesn’t have significant impact on the practice but the exposure is now open. Typically, Company B will lease or rent with more than just one company, so here is where the situation becomes sticky.

As in many offices, there are typically more than just one In-Network contract.

For example purposes, we will assume the aforementioned office has another contract with Company D at a 35% reduction/ writeoff.

38 journal | May/June 2019

If company D expands their network and rents to Company B, Company B will have the right to pay you under Company D’s 35% reduced fee schedule. Assuming you retained all 100 of Company B’s original patient base, you are now continuing to see that same 100 patients but being paid for 65 of them. This can be a never-ending cycle and creates what many call the “web” of companies and alliances.

So how does an office combat this struggle?

Most commonly it’s trying to increase new patients to the practice. This is always a good thing, but sometimes feels like a moot point. If you were able to get 35 new patients to your practice from Company B your production will reflect the new patient base, however, your income will be the same as it was before any network expansion. By taking a 35% write-off via Company D, 35 new patients in Company B will actually be the same income you realized before the network was leased to Company D. You are back to “even” by seeing new patients.

This leads back to the original statement: The Difference Between Being Busy or Profitable. The goal is to position those agreements in the most positive way for both the practice and patient base. Being vigilant with your reimbursement and network arrangements are your best bet for staying ahead of the curve. Strong negotiating skills are always good, but not understanding those agreements will sometimes vacate any increases or hours spent negotiating. Ask questions, request disclosure of networks and monitor your data.

When Craig was completing courses and chairside hours in anticipation for attending dental school, he discovered the effects insurance can have on a practice. With that discovery, he also realized a need for something that can help practices stay ahead of the data and continue to focus on the more important aspect of dentistry, patient care. Passionate about helping, Craig and his team have been able to assist offices in recapturing revenue that was either unknown or thought to be lost. In his free time, Craig loves to spend time with his 3 kids and wife. Anything outdoors, or at the lake, is where you will find him relaxing and laughing with friends and family. Grateful for an amazing group of doctors to work with, Craig and Solutions-101 makes sure that they provide a service that is beneficial for each case that they take on.

Solutions-101 has helped practices across the United States realize profitability in an ever changing market environment. Their proven method has allowed them to expand to meet clients needs, resulting in a dedicated team to ensure success. They have been referred to offices from multiple sources, allowing them to create networks that can continue to help offices once their services have completed.

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#WhyODAWednesday social media contest

Dr. Allen-Steed’s contest entry

This spring, the ODA held a social media contest where ODA Members used the hashtag #WhyODAWednesday and told their followers why they love being a member of the ODA! Dr. Addie Allen-Steed participated and was the lucky winner of one free member-basic registration to the 2019 ODA Annual Meeting in Tulsa. Thanks to all who participated!

Dr. Allen-Steed and her staff at the 2019 ODA Annual Meeting

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41

2019 Annual Meeting THANK YOU TO OUR 2019 SPONSORS! PLATINUM 3000 Insurance Group Delta Dental of Oklahoma Patterson Dental GOLD Henry Schein

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Thank you to the Oklahoma Dental Assistants Association and the Oklahoma Dental Hygienists’ Association members who joined us this year!

42 journal | May/June 2019

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43

Continuing Education SCIENTIFIC SESSIONS

OKLAHOMA STAMPEDE

New!

THE OKLAHOMA STAMPEDE PRESENTERS Dental / Medical Emergencies Dr. Robert Livingston, Green Country Study Club

Prevention and Management of Work-Related Pain Among Dentists Drs. Larson Wayman & Christopher Caldwell, OUCOD AGD Candidates

Comprised Anterior Esthetic Cases: A Team Approach Dr. Mary Hamburg, iClub Study Club

Review of Implant-Supported Fixed Complete Denture Materials Drs. Kami Chervilov & Kevin Ripp, OUCOD AGD Candidates

Interdisciplinary Management of Implants in the Esthetic Zone

Noise Exposure Evaluation of a Dentist During Typical Work Week Dr. Greg Stewart, OUCOD AGD Candidate

David Wong, Catalina | May/June 2019Wine Mixer: A Spear Study Club 44 Dr.journal

HOUSE OF DELEGATES

Dr. David Bird accepted the Whiteneck tray on behalf of the Oklahoma County Dental Society. This is awarded to the Component with the highest attendance at the House of Delegates Meeting.

Dr. Shannon Griffin, 2018 / 2019 ODA President, addressing the house.

ODA Past President and Past DENPAC Chair, Dr. Juan Lopez, with Dr. Moiz Horani and Dr. Mathew Hookom. Drs. Horani and Hookom accepted the Kouri Cup on behalf of the Eastern District Dental Society, the Component with the highest percentage of DENPAC members.

Dr. Stephen Glenn presents a plaque to Dr. Raymond Cohlmia in recognition of 4 years of service as the ADA 12th District Trustee.

Dr. Daulton Roberts accepted the Cohlmia Cup, presented by Dr. Nicole Nellis, on behalf of the Northwest District Dental Society. This is awarded to the Component with the highest percentage of new members.

Dr. Shannon Griffin presents ADA President, Dr. Jeffrey Cole, with a plaque in recognition of his presidency and leadership.

LEADERSHIP ACADEMY CONGRATULATIONS TO THE 2019 ODA LEADERSHIP ACADEMY CLASS! Dr. Jeffrey Cole, ADA President, at the Leadership Academy Breakfast, presenting to the 2019 Class and members of the ODA Board of Trustees.

From left to right: Dr. Shannon Griffin, Dr. Tabitha Arias, Dr. Daulton Roberts, Dr. Lauren Nichols, Dr. Nicole Chung, Dr. Leaha Nels, Dr. Gregory Shanbour, Dr. Mohsen Moosavi, Dr. Steffan Sigler, Dr. Moiz Horani, Ms. Lynn Means

ODA MEMBERS RECOGNIZED FOR 50 YEARS OF MEMBERSHIP

50 YEARS OF MEMBERSHIP Dr. William Anderson Dr. William Glasgow

Dr. William Gray Dr. Richard Haught

Dr. Robert Hughes Dr. Richard Powell

thank you for your membership!

Dr. Daniel Slanker Dr. William Wynn www.okda.org

45

AWARD WINNERS CONGRATULATIONS TO THE 2019 ODA AWARD WINNERS!

Dr. Phoebe Vaughan

Dr. James Sparks

Dr. Robert Livingston

ROBERT K. WYNN FOR DENTAL EDUCATION & PUBLIC INFORMATION

DAN E. BRANNIN FOR ETHICS & PROFESSIONALISM

THOMAS JEFFERSON FOR CITIZENSHIP

Dr. Stephen Glenn JAMES A. SADDORIS LIFETIME OF LEADERSHIP

Dr. Chris Fagan

Dr. Mathew Hookom

Dr. Tamara Berg

PRESIDENT’S LEADERSHIP

YOUNG DENTIST OF THE YEAR

DISTINGUISHED DENTAL SERVICE

Nominations for the 2020 ODA Awards will open in September. We look forward to honoring members who are committed to their service to the ODA, their profession and their community. Visit the ODA Members-only website for a full list of previous winners and to nominate your colleagues.

2019 / 2020 EXECUTIVE COMMITTEE Dr. Shannon Griffin pins Dr. Daniel Wilguess with the traditional ODA president’s pin.

President: Dr. Daniel Wilguess Vice President: Dr. Chris Fagan President-elect: Dr. Paul Mullasseril Speaker of the House: Dr. Douglas Auld 46 journal | May/June 2019 Secretary/Treasurer: Dr. Robert Herman

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www.okda.org

47

CLASSIFIEDS Looking to fill an open position in your office, need to sell dental equipment or a practice? Check out the latest listings below and visit okda.org/classifieds for additional listings.

JOB OPENING Dentist Great Opportunity for full time Dentist in Oklahoma and NW Arkansas.

Spring Dental is seeking a caring, and dynamic Dentist to join our growing organization. Must be motivated, have outstanding clinical and communication skills, and be a team player. We offer career growth, modern office and equipment, huge patient base, and a positive culture trained team.

Our office is very active and offers an excellent opportunity for a production-oriented individual who is dedicated to providing superior patient care.

Whether you are fresh out of school or a seasoned veteran looking for a change, we match you with practice opportunities that meet your long-term goals while providing you with support along the way. We offer relocation assistance, CE reimbursement, malpractice insurance, guaranteed salary, health insurance and a team of doctors and staff to help you reach your goals. Please feel free to contact me with any questions: Creed Cardon | Email: ccardon@thespringdental.com | Phone: 716-796-8660 Pediartic Dentist Pediatric Dentist Opportunity in the Oklahoma City and Tulsa area. Great career opportunity for a compassionate and energetic Pediatric Dentist who is interested in joining a dynamic team. Work with modern equipment, a huge patient base, and a friendly trained staff. Our office is very active and offers an excellent opportunity for a production oriented individual who is dedicated to providing superior patient care. Benefits include: sign on bonus, relocation assistance, CE reimbursement, malpractice insurance, guaranteed daily minimum or production based compensation which is higher, health insurance, and a team of doctors and staff to help you reach your goals. Please feel free to contact me with any questions: Dr. Tyler Owens | Email: towens@thespringdental.com | Phone:(480) 287-0908 | Job Type: Full-time Part Time Hygienist wanted just south of Norman.

Dental hygienist please come join our happy family at Herndon Family Dentistry! Competive wages and a great work environment await you at our busy and well established dental practice.

Please call 405-527-7070 or email HerndonFamilyDentistry@yahoo.com and/or JimHerndonDDS@gmail.com.

Associate Full-time or Part-time DDS needed in the Grand Lake Oklahoma Area. If interested please call 918-791-1848 or send resume to lakehavendentalpc@gmail. com.

PRACTICES FOR SALE Building for Sale-Stillwater For sale or lease: Stillwater, OK. Fully plumbed dental office with seven operatories and potential for up to ten. Heavy traffic area. Approximately 3800 sq ft.

Inquiries call (405) 624-3880.

PRACTICE FOR SALE SOUTH OKLAHOMA CITY. General Dentistry. "COLLECTED" revenues of $608,700 in 2018. FOUR nicely equipped operatories with foru more rooms plumbed for future expansion. ALL digital X-rays with NEW digital panoramic. Also new compressor and Autoclave. Aeraging 58 new patients/month. Highly trained staff staying after the sale There are numerous opportunities for increasing revenues and income just waiting for someone to take the helm. This is a terrific opportunity.

Call Dr. Max Wilson, Professional Practice Associates, 406-359-8784 or mw or www.ppa-brokers.com PRACTICE FOR SALE EASTERN OKLAHOMA. "COLLECTED" $981,000 in a 32-hour work week Six chairs and digital X-rays throughout, including the digital panoramic. Eleven computer terminals throughout the office This practice is ready to go for the new owner. It is located in the most beautiful area of Oklahoma and the local amenities for life style are abundant. Plus, if you enjoy outdoor activities of all kinds, then tis area is second only to "paradise".

Call Dr. Max Wilson Professional Practice Associates 405-359-8784 or weww.ppa0brokers.com

48 journal | May/June 2019

Place a Classified Ad Placing an ad with the ODA allows you to target your ad to a specific audience. Unlike other classified ad sources (local newspaper, other online classified sites, etc.), a listing with the ODA gives you exposure to the people who would be most interested in your ad. The online version of the ODA Journal contains active hyperlinks within the advertisement, ensuring you get maximum exposure for your ad.

SUBMIT A LISTING Submitting a classified ad is easy with our online form.

Find the form and more information at www.okda.org/classifieds.

PRICING

ODA Members Online - Free ODA Journal - $40 for first 50 words (additional words $0.15 each)

Non-ODA Members Online or ODA Journal - $83 (>50 words) (additional words $0.32 each)

QUESTIONS? Visit: www.okda.org/classifieds

Bundle (online & Journal) $149 (>50 words) (additional words $0.32 each)

Email: advertising@okda.org

Call: 800.876.8890

www.okda.org

49

Finally, Five (not so) FAQs! Clay Anderson, DDS Frederick, OK

1. Bedroom, desk, or car- which do you clean first?

Bedroom 2. In three words, what do you think of garden gnomes?

Not my garden 3. When ___ comes on my car radio, I have to crank it up and sing along!

Space Cowboy 4. Do you believe there is life on other planets?

Yes 5. Honesty is the best policy or it's okay to lie sometimes?

"Everything said should be true, but not everything true should be said." - Craig Groeschel Sm File mcdc full page ad2.pdf 1 4/10/2019 2:28:51 PM

S T. C H A R L E S C O N V E N T I O N C E N T E R

November 14-15 { g r e a t e r s t l o u i s d e n t a l s o c i e t y. o r g }

Enhancing Your Dental Practice Through

CBCT Technology Friday, June 7th, 9:00-3:00 Indigo Hotel 121 S Elgin Ave Tulsa OK 74120 Cost: $99 Proceeds benefit Oklahoma Dental Foundation

G R E AT E R

S T.

LO U I S

D E N TA L

S O C I E T Y ’ S

7 8 T H

A N N U A L

• Today’s Initial Exam and giving patient’s the “wow” and ultimately treatment plan acceptance • When to refer out your images to be read by maxillofacial radiologists • The numbers…the ROI… • How to select what’s best for your office and why you may really be surprised • The steps to integrating you and your team • How digital scanning and CBCT imaging work together in so many ways!

• Clinical Casework on what you are missing in 2D and finding in 3D and how this ultimately makes your decision making far superior • Clinical casework on resorption, implants, and far more

Dr. Lou Graham

F E AT U R I N G Karen Baker, BS, MS | Beth Burns, DDS, RYT 200, CLC | Stephen J. Chu, DMD, MSD, CDT | Nancy Dewhirst, RDH, BS Brett E. Gilbert, DDS | Cathy Stewart, RDH, MS | Kevin Henry | Baron Grutter, DDS | Uche Odiatu, DMD | Wayne Kerr, DDS Hygiene CE Express | Parag R. Kachalia, DDS | Stanley F. Malamed, DDS | Judy Kay Mausolf Carrie Webber | Howard S. Glazer, DDS | Alex Touchstone, DDS & Crystal May Corky Willhite, DDS | Richard Williamson, BS, ACE, CPT | Shannon Brinker, CDA | Connie Fisher, LCSW Preventative Maintenance Workshop | Judy Bendit, RDH | David Meinz, MS, RDN

2019 OPENS THIS SUMMER 50 journal | May/June REGISTRATION

REGISTRATION IS FREE FOR GSLDS MEMBERS & AFFILIATES (ADA dentists outside our boundaries)

Dr. Graham is an internationally recognized lecturer extensively involved in continuing education for dental professionals, focusing on incorporating current clinical advancements through “conservative dentistry.” He emphasizes in his teachings the same concepts he practices: dental health diagnosis, treatment plans for medically compromised patients, conservative treatment, cosmetic dentistry, and customized approaches to periodontal care, implants and laser dentistry. Dr. Graham is a published author in many leading national and international dental journals. He is a member of the ADA, AACD, AGD, Chicago Dental Society and Illinois Dental Association. Dr. Graham is a graduate of Emory Dental School. He is the former Dental Director of the University of Chicago’s Department of Dentistry. Dr. Graham is the founder of Catapult Education, LLC and he enjoys providing dental care at his private practice, University Dental Professionals, in Chicago, IL There will be a hands-on experience in mapping the mental nerve, implant planning (even if you aren’t placing) and how to navigate the software for everyday use.

Please bring your computer (no Macs).

Please RSVP by May 31st to Brandon Sass 918.202.3129 or email bsaas@burkhartdental.com Lunch will be provided and 5 CE included

Serving you so you can serve your dental patients.

You work hard. With Commerce in your corner, you can focus on why you chose to become a dentist in the first place. Leave the rest to us sounds like just what the doctor ordered.

866.365.9346 commercebank.com Š 2019 Commerce Bancshares, Inc.

www.okda.org

51

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405-607-2137 (OKC Metro), 800-522-0188, Ext. 137 (Toll Free) or PR@DeltaDentalOK.org 52 journal | May/June 2019