ODA Journal: May/June 2022

May/June 2022 | Vol. 113, No. 3

Dr. Robert Herman 2022-2023 ODA President www.okda.org

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Contents

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

May/June 2022 | Vol. 113, No.3

Inside Front Cover 3000 IG Inside Back Cover ODASupplySource Back Cover Delta Dental of Oklahoma Authentic Dental Laboratory, Inc. Edmonds Endodontic Associates Endodontic Practice Associates Lewis Health Profession Services MedPro Patterson Dental Southwest Dental Conference Valliance Bank

EDITORIAL

0 6 Guest Editorial: OUCOD Celebrates 50 years of Serving

ASSOCIATION 04 Calendar of Events 07 Welcome ODA New Members 10 Letter from ODA President, Dr. Robert Herman

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Letter from ODA President

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If you or a company you know is interested in advertising in the Journal, please contact Stacy Yates at advertising@okda.org

Annual Meeting Highlights

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 © 2021 Oklahoma Dental Association.

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2022-2023 ODA Executive Committee and Board of Trustees

1 2 House of Delegates Recap 1 3 SAVE THE DATE: OkMOM 2023 1 4 ODA Rewards Partners 1 6 2022 ODA Annual Meeting Highlights 1 8 ODA Award Winners 2 2 RDGP Information

LEGISLATIVE LOOP 2 6 An Update on HB3023- The ODA's Insurance Bill

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.

Oklahoma Dental Association

2 6 ODA Legislator of The Year Award 27 SB 1337: Another Attempt at Managed Care Medicaid 2 8 ADA Advocacy News 30 2022 OKCapitol Club & DENPAC Grand Level Members

FEATURES

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Keep It Local Treating a Patient with Worn Dentition

32 Differential Diagnosis: Palatal "Swelling" 34 Practice Managment: Preparing for a Transistion 36 Keep It Local: Treating a Patient with Worn Dentition 38 Hygiene Hot Spot: The 3-Letter Word in Dentistry

Cover Photo: ODA President Dr. Robert Herman with his family.

39 New Dentist Corner: SmileCon

CLASSIFIEDS 4 0 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 Faherty ODA Membership Director, at kfaherty@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 Mary Hamburg, DDS, MS ASSOCIATE EDITOR Roberta A. Wright, DMD, MDSc, FACP

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

EDITORIAL BOARD MEMBERS M. Edmund Braly, DDS, FACS, FAACS Daryn Lu, DDS Phoebe Vaughan, DDS Elizabeth Silver, DDS

May 5 Sr. Signing day ODA Building 5:00 p.m.

EXECUTIVE DIRECTOR F. Lynn Means

May 14 OU College of Dentistry Graduation

DIRECTOR OF COMMUNICATIONS & EDUCATION Stacy Yates OFFICERS 2022-2023 PRESIDENT Robert Herman, DDS, MS president@okda.org PRESIDENT-ELECT Paul Wood, DDS presidentelect@okda.org VICE PRESIDENT Daryn Lu, DDS vicepresident@okda.org SECRETARY/TREASURER Nicole Nellis, DDS treasurer@okda.org SPEAKER OF THE HOUSE Mtich Kramer, DDS speaker@okda.org IMMEDIATE PAST PRESIDENT Chris Fagan, DDS pastpresident@okda.org ADMINISTRATIVE STAFF EXECUTIVE DIRECTOR F. Lynn Means

June 3-5 ODA CE Getaway Grand Lake June 10 OkMOM Steering Committee ODA Building 8:00 a.m.

May 20 Bikes &Brews Tour OKC 6:00 p.m.

DE/PI Council ODA Building 10:00 a.m.

May 24 Council on Budget and Finance ODA Building 5:30 p.m.

Rewards Committee ODA Building 11:00 a.m.

Council on Bylaws, Policy and Ethics ODA Building 12:30 p.m.

May 30 ODA Closed May 31 Memorial Day ODA Closed

June 24 ODA Insurance Webinar Zoom 9:00 a.m July4-5 ODA Closed July 15 Governmental Affairs ODA Building 9:00 a.m.

Membership & Membership Services Council ODA Building 11:00 a.m.

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

June 17 RDGP ODA Building 11:00 a.m

A new day for dentistry starts

DIRECTOR OF GOVERNANCE & FINANCE Shelly Frantz DIRECTOR OF COMMUNICATIONS & EDUCATION Stacy Yates

One that reflects our community.

One that embraces everyone’s unique talents and contributions.

DIRECTOR OF MEMBERSHIP Kylie Faherty

One that encourages diversity of thought and lifts all voices.

PROGRAMS & OPERATIONS MANAGER Makenzie Dean

One that continues to drive dentistry forward.

SPECIAL PROJECTS & COMMUNICATIONS MANAGER Mackenzi Graham

It’s time to build our future together — a new day for dentistry starts now and there’s a place for you in it.

MEMBERSHIP SERVICES MANAGER Madison Bolton

Let’s build our new day Stay connected with the ODA! ADA.org/ReNEW

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Dr. Josephine Chang Pallotto Member Since 2012

journal | May/June 2022

Dental Benefits IT'S NOT INSURANCE A TWO-PART WEBINAR SERIES

After this webinar, ODA Members will have a better understanding of the In vs Out of Network Contracting, Direct vs Leased Network Contracting, why dental benefits can create busyness and not profitability, and a true understanding of how setting UCRs impact your market.

EVENT INFORMATION June 24th, 2022 Via Zoom

The second webinar will be August 5th. A separate registration link will be sent at the conclusion of the first webinar.

9:00 a.m. - 12:00 p.m.

FREE for ODA Members

OBJECTIVES Networking: Leased vs. Direct How Dental Benefits Actually Work Zip Code vs Percentile UCR Lists

Intro and Chat with the ODA Recap of the State Bill Contracting

Register TODAY www.s101medical.com/society-101/oda www.okda.org

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ODA EDITORIAL

OUCOD Celebrates 50 Years of Serving Many years ago, I made the decision to immigrate to the United States with nothing but $250, one suitcase and a deep admiration for the work and education taking place at the University of Oklahoma College of Dentistry, where I was coming to complete a graduate prosthodontics program.

Having served in many roles at the college since then, I am grateful for the chance to continue the legacy of excellence established by previous leadership and look forward to a future of ongoing innovation and progress at the OU College of Dentistry.

Paul Mullasseril, DDS, MS DEAN, OU COLLEGE OF DENTISTRY

One thing I admire about the college is the focus not only on providing excellent education and resources to students and patients, but also on how to best care for the oral health needs of the community.

With that in mind, there is so much to look forward to at the OU College of Dentistry. In 2021, the college announced the expansion of its predoctoral program to the OU-Tulsa campus and the construction of a brand new, state-ofthe-art dental clinic located in the OU Health Physicians Schusterman Center Clinic building on the OU-Tulsa campus. Construction of the 5,000 square-foot clinic is already underway, and it is expectedto open in June 2022. This new student clinic will provide routine dental cleanings and fillings and advanced procedures such as restorations and emergency extractions.

This is a big step in addressing the growing need for accessible and affordable dental care across the state of Oklahoma.

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journal | May/June 2022

In addition, plans are underway for a brand new, state-of-the-art OU Health Dentistry Faculty Practice Clinic and Clinical Research Facility, which will be located on the OU Health Sciences Center campus. This new clinic will provide more opportunities to treat patients while expanding more opportunities to clinical research at the college.

In addition, September 2022 marks 50 years since the college accepted its first class of dental students. This landmark event will be celebrated with alumni and friends September 21-24, 2022. Please mark your calendars to join in on this momentous occasion. More details will be provided as they are confirmed.

While the OU College of Dentistry has certainly come a long way in our 50-year history, the college is exceptionally excited about the next 50 years!

As I look to the future and my goals for the college, I have laid out several key areas to focus on. Some include becoming the leader in dental health care in the state, use of advanced technology in dental clinics, providing quality customer care to patients, becoming the regional leader in continuing dental education, recruiting the most capable students across the country, promote diversity, equity and inclusion and accelerate clinical research.

In the years to come, the OU College of Dentistry looks forward to educating students and treating patients in Oklahoma as advancements in dentistry continue to progress.

FOLLOW

U US Facebook @okdentassoc

Twitter @okladentassoc Instagram @okdentassoc YouTube @TheOKDentAssoc

www.okda.org

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FROM THE ODA PRESIDENT DR. ROBERT HERMAN Wow! We have just completed our ODA Annual Meeting and what a great meeting it was. I was so proud to be part of the great success that Drs. Chris Fagan and Blair Bowers put together for our first in-person meeting in three years. It was terrific to see so many friends in-person once again.

The CE lineup was spectacular, as were the social events and the superb exhibit hall. I especially appreciated so many exhibitors coming to our meeting, and it really was great to see the many young faces from the College of Dentistry in attendance.

Our House of Delegates was well-attended and productive. Dr. Doug Auld was topnotch once again as our Speaker and has completed his tenure of service. I want to convey my appreciate and gratitude to Drs. Chris Fagan and Doug Auld for their service to organized dentistry in Oklahoma over this last year and throughout their careers..

I am extremely energized after our meeting!

We heard an incredible report of the strategic vision for the American Dental Association, as presented by Oklahoma’s own Dr. Raymond Cohlmia. Dr. Cohlmia is no stranger to anyone reading this letter, and his passion for our profession is stronger than ever. His energy is contagious.

The changes that will be proposed to the trustees of the ADA are far-reaching and will benefit our local organization in many ways. I am very eager to have the opportunity to partner with the ADA in a new chapter in our shared history. With so many exciting and new initiatives on the horizon, it is a great time to be part of

Dr. Herman being sworn into the presidency by Dr. Terry Fiddler, American Dental Association Twelfth District Trustee.

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organized dentistry. I believe our ODA Journal will be filled with many sensational updates over the coming months. I am also very excited to have the opportunity to work with the dedicated professionals on our executive committee. Dr. Paul Wood will do a terrific job as our President-elect, and I am also very excited to welcome Drs. Daryn Lu, Nicole Nellis, and Mitch Kramer to their respective new roles. Most importantly, I am thrilled to continue to have the expert guidance and support from our Executive Director, Mrs. Lynn Means on the executive committee.

2021-2022 ODA PRESIDENT, DR. CHRIS FAGAN, PASSING ON THE ODA PRESIDENT'S PIN TO DR. ROBIE HERMAN DURING THE ODA'S HOUSE OF DELEGATES MEETING.

Dentistry within Oklahoma is in an incredibly strong position. The public trusts and values our contributions to their overall health. Recently, there was contentious legislation that raised questions from some of our members about how dentists are perceived by our patient population. I wish to assure all of you that I understand our role as a dental association to ensure the continued trust and high esteem of the public towards our profession. I will strive to ensure that level of trust is not compromised by those outside of the doctor/patient relationship. Dentists have always placed the needs of patients at the forefront of our conscious. Byfar, most of us consistently demonstrate high levels of ethics and service on a daily basis. Our membership represents roughly 85% of all licensed practicing dentists in Oklahoma. I am proud to speak on behalf of our membership and continue to promote the importance of the dentist/ patient relationship in all our initiatives and communications.

We have some amazing plans for the coming year! The ODA leadership team is excited to visit Shawnee for the long awaited OkMOM in February 2023. Drs. Rich Brown and Nicole Nellis have already been hard at work in securing a terrific CE line up for the 2023 Annual Meeting in Tulsa. Furthermore, I am happy to share that Dr. Nellis has agreed to chair the Annual Meeting. She is full of new ideas and already has some great plans in store. I am also pleased to share that my lovely bride, Krista, will be hosting an event for spouses attending the meeting. Keep your eyes peeled for details about the return of the spouse event!

Our many councils will continue their excellent work on behalf of our membership, and I also look forward to hosting several other events that will appeal to non-members who might be practicing in a corporate or DSO model. I wish to spread the good news about the value of organized dentistry with our peers across the state, regardless of practice model. Our tent is big enough for all dentists!

In closing, I am honored to have the opportunity to continue my role within organized dentistry and look forward to hearing any suggestions or comments that you might have for the ODA leadership. I expect our year will be busy but full of fun times. Cheers!

2022-2023 ODA EXECUTIVE COMMITTEE

President Dr. Robert "Robie" Herman

President-elect Dr. Paul Wood

Vice President Dr. Daryn Lu

Secretary/Treasurer Dr. Nicole Nellis

Immediate Past President Dr. Chris Fagan

Speaker of the House Dr. Mitch Kramer

2022-2023 ODA BOARD OF TRUSTEES Dr. Robert "Robie" Herman, President and ADA Delegate

Dr. Mary Temple-Goins, New Dentist Trustee

Dr. Paul Wood President-elect

Dr. M. Edmund Braly, Central Component Trustee

Dr. Daryn Lu, Vice President

Dr. Douglas Auld, Eastern Component Trustee

Dr. Nicole Nellis, Secretary/Treasurer

Dr. Jandra Korb, Northern Component Trustee

Dr. Mitch Kramer, Speaker of the House

Dr. Colin Eliot, Northwest Component Trustee

Dr. Chris Fagan, Immediate Past President

Dr. Edward Harroz III, OK County Component Trustee

Dr. Tamara Berg, ADA Delegate

Dr. Matthew Bridges, Southwest Component Trustee

Dr. Matthew Cohlmia, ADA Delegate

Dr. Lindsay Smith, Tulsa County Component Trustee

Dr. Tim Fagan, ADA Delegate Dr. C. Rieger Wood, 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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HOUSE OF DELEGATES RECAP The House of Delegates establishes all ODA policies not otherwise provided for in the Bylaws, elects the Speaker of the House and council members, confirms the appointments of the Secretary/ Treasurer and the council chairs, adopts an annual budget and sets the membership dues. The House of Delegates meets annually and is comprised of the Board of Trustees, four officers from each Component, one delegate per fifteen members from each Component and four OUCOD dental students.

The House of Delegates met on March 31, 2022 at the ODA Annual Meeting in Oklahoma City. The House ratified a $1,161,597 budget, which did NOT include a dues increase for the eleventh consecutive year. They adopted a strategic plan which will be the guideline for budgeting and programming for the next three years. The House amended the Bylaws to allow a member of the Board of Trustees to substitute a member of the Component to serve for that meeting only, with all the rights and privileges of other Trustees. Formerly, only an officer or past officer of the Component could substitute.

The House was presented with recommendations from a task force created to review and modernize the ODA awards. Most awards named after dental professionals were recommended back to the task force. The Thomas Jefferson Citizenship Award was renamed the ODA Public Service Award. The Benjamin Franklin Scroll was renamed the ODA Journal Award. The Distinguished Dentist Service Award was renamed the Richard Haught Dentist of the Year Award.

The Board of Trustees, instead of the Council on Membership, was given the responsibility of selecting award recipients, unless otherwise specifically dictated in ODA policy. The number of years an ODA member is nominated consecutively for the same award, but not selected, was limited to two years.

The ODA Leadership Academy is a statewide program to develop future leaders in organized dentistry and educate them on the foundational keys to its success. The Class of 2022 was comprised of eight dentists; each sponsored by their component dental societies.

Congratulations to the following members who graduated from the ODA Leadership Academy during the House of Delegates meeting: Dr. Seth Brooks, Central Dr. Twana Duncan, Eastern Dr. Cheryl Fleming, Tulsa County Dr. Mary Temple-Goins, Southwest Dr. Jenny Harreld, Oklahoma County Dr. Sydney Rogers, Northwest Dr. Troy Schmitz, Oklahoma County Dr. Ryan Theobald, Oklahoma County If you are interested in serving on the ODA House of Delegates, contact your component president or the ODA office at 405-848-8873

The next meeting of the ODA House of Delegates is scheduled forApril 27, 2023 at 1:00 p.m. in Tulsa.

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The Chairside Instructor: A Visual Guide to Case Presentations, 12th Edition

The House elected the following members into leadership:

The Chairside Instructor is an invaluable tool in educating patients and staff alike. With more than 220 images across 50 topic areas, this resource can be used to explain conditions to patients or illustrate a treatment plan.

ADA Dental Drug Handbook: A Quick Reference, Second Edition The second edition of the ADA Dental Drug Handbook has been revised to include the latest, most up-to-date information to assist in treating patients. This ADA quick reference, created by a team of dentists, pharmacists, scientists, and experts in pharmacology, serves as a clinical educational resource to deliver concise and accurate information about prescribed medications used in dentistry.

The ADA Complete HIPAA Compliance Kit

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The House elected the following members into State Life Membership: Dr. William Beeson, Dr. James Brown, Dr. Byan Chrz, Dr. Terry Cotterell, Dr. Benjamin Edwards, Dr. Michael Jackson, Dr. Joe Maltsberger, Dr. Patrick Montgomery, Dr. Michael Nelson, Dr. Philip Ring, Dr. Robert Shirley, and Dr. Jack Willoughby.

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ADAcatalog.org Updated: September 20, 2021

SAVE THE DATE

FEBRUARY 3 & 4, 2023

HEART OF OKLAHOMA EXPO CENTER

VOLUNTEER REGISTRATION OPENS OCTOBER 17 AT OKMOM.ORG

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OKLAHOMA DENTAL ASSOCIATION REWARDS PARTNERS Insurance Products For You & Your Practice The insurance coverage you need for your business, personal life & employee benefits.

Answers On Employer Dental Plans The solution for dental practices & you receive a $300 discount.

Tours & Cruises Access to guided ocean, river and land-based tours designed to immerse travelers in the history and culture of people and places.

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Debt Collection Services Members receive 10% off Tier 1 pricing.

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Interpretation Services Save nearly 70% off of interpretation services compared to those who aren’t ODA members.

In-House Dental Membership Plan Provide better care for your uninsured patients, without insurance getting in the way.

Scrap Metal Recovery Receive 85-97% of the current market price.

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Computers & Technology Members are eligible to save up to 30% off the everyday public web price of Lenovo’s entire product line.

Bio-Hazard Waste Removal & Treatment Receive special pricing for waste pickup.

Medical Evacuation Members receive reduced membership rates.

Luxury Vehicles Exciting member discounts on Mercedes-Benz vehicles.

Dental & Office Supplies Save on more than 65,000 products.

Secure Communications Solutions Receive preferred pricing & waived set-up fees.

Website Design & Marketing Services Members can save on websites.

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Appliances Access to member-only savings of up to 25% off MSRP on select GE appliances.

Scrubs, Lab Coats & More Members receive a 15% discount of all purchases in-store and online.

Emergency Medical Kits Save 10% on emergency medical kits & AEDs.

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Student Loan Refinancing You can save on your student loan debt!

Members are eligible to receive a special offer from Laurel Road.

Point-Earning Credit Card The only credit card endorsed for ADA members.

On-Hold Messaging, Digital Video & Overhead Music Connect with your patients while they wait.

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ODA PARTNERS COLUMN

These are endorsed companies of the ODA that save ODA members money while keeping dues lower by providing royalties to the ODA.

The ODA endorses companies that have been researched and proven to offer products and services that provide real savings. By being an ODA member, you’re automatically eligible for these savings.

Below is information about one of our NEWEST Partners. Learn about all of the Partners at okda.org.

ODA SOURCE ODA SUPPLY SUPPLY SOURCE TOP SPENDERS The two ODA members who spend the most between now and next year's Annual Meeting will each receive a $500 prize!

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This year's ODASupplySource top spenders were Dr. Stephanie Kendrick and Dr. Kevin Howarth!

THIS YEAR'S TOP SPENDERS!

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2022Annual Meeting THANK YOU TO OUR 2022 SPONSORS!

PLATINUM 3000 Insurance Group Delta Dental of Oklahoma Patterson Dental

SILVER Endodontic Associates First Liberty NBC Bank Kuraray Noritake Dental

GOLD Simmons Bank Brasseler

BRONZE Orthodontic Arts Valliance Bank

! s k n tha 3000 Insurance Group Align Technology Invisalign iTero Exocad Allied Powers, LLC Ashton Gray, LLC Bank of America Practice Solutions BioHorizons Bio-One OKC BQ Ergonomics Brasseler USA Burkhart Dental Supply BURST Carestream Dental, LLC CARR Catalyst Dental Allies Chickasaw Nation Department of Health

OTHER SUPPORT

Bedford Camera Supply ODASupplySource

EXHIBITORS

Commerce Bank Delta Dental of Oklahoma DentalHQ * Designs For Vision, Inc. Essentials Dental Supply Evans + Davis Express Dental Lab First Citizens Bank First Liberty Bank First United Bank Fotona Garfield Refining GlaxoSmithKline Consumer Healthcare Henry Schein Dental Hopkin & Associates Huntington National Bank Insurance Answers Plus *

Ivoclar Kaylor Dental Lab, Inc. Kuraray LumaDent, Inc. Medi Lazer MediLoupes MidFirst Bank Midwest Dental Equipment & Supply National Dentex NBC Oklahoma ODASupplySource * Oklahoma Tobacco Settlement Endowment Trust Orascoptic Patterson Dental ProSites * Protomad

Scars & Stripes Screenblue Technical Services Securian Advisors Shofu Dental Corporation Solutions 101 Solutions Dental Lab Suction Solutions, LLC SurgiTel Ultradent Products Inc. UnitedHealthcare US Army Medical Recruiting US Health Group Valliance Bank Wells Fargo Practice Finance Woody & Associates, CPA’s, PLLC Works24 *

* ODA Rewards Partners

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

16 journal | May/June 2022

Social Events WELCOME RECEPTION

MORNING MIXER

SPONSOR

SPONSOR

ODA HAPPY HOUR

SPONSORS

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Continuing Education FRIDAY

SATURDAY

18 journal | May/June 2022

HOUSE OF DELEGATES

ODA past president, Dr. Paul Mullaseril, pinning Dr. Chris Fagan with the past president’s pin.

The 2022 ODA Annual Meeting chair, Dr. Blaire Bowers, providing a pre-Annual Meeting report to the House of Delegates.

Dr. Auld, Speaker of the House 2016 - 2022, sharing his final thoughts as he welcomes the new Speaker, Dr. Mitch Kramer.

Past president, Dr. Paul Mullaseril, and ODA Membership Director, Kylie Faherty, drawing for the DENPAC raffle prizes.

Dr. Chris Fagan pinning Dr. Robert Herman with the President’s pin as Dr. Herman becomes the ODA President for the 2022 - 2023 term.

Dr. Bryan Sorgen accepted the Cohlmia Cup, presented by Dr. Nicole Nellis, on behalf of the Oklahoma County Dental Society. This is awarded to the Component with the highest percentage of new members.

50 YEARS OF MEMBERSHIP

ODA MEMBERS RECOGNIZED FOR 50 CONTINOUS YEARS OF MEMBERSHIP Dr. C. B. Worthington Dr. Chester Wilks Dr. Don Morton Dr. James Murtaugh

Dr. Joseph Fallin Dr. Michael Forth Dr. Thomas Coury Dr. William Blubaugh

Dr. Walter Davis Dr. Gary Lott Dr. Kevin Avery

thank you for your membership!

Drs. Joseph Fallin and James Murtaugh were recognized for their 50 plus continous years of membership by Dr. Chris Fagan.

LEADERSHIP ACADEMY CONGRATULATIONS TO THE 2022 ODA LEADERSHIP ACADEMY CLASS!

From L to R: Drs. Chris Fagan, Ryan Theobald, Troy Schmitz, Sydney Rogers, Jenny Harreld, Mary Temple-Goins, Cheryl Fleming, Twana Duncan, Seth Brooks

www.okda.org

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AWARD WINNERS CONGRATULATIONS TO THE 2022 ODA AWARD WINNERS!

Dr. Paul Mullaseril

Dr. Steve Lusk

Dr. Michael Howl

ROBERT K. WYNN FOR DENTAL EDUCATION & PUBLIC INFORMATION

DAN E. BRANNIN FOR ETHICS & PROFESSIONALISM

THOMAS JEFFERSON FOR CITIZENSHIP

Dr. Edmund Braly DISTINGUISHED DENTAL SERVICE

Dr. Blaire Bowers

Dr. Lauren Nichols

PRESIDENT’S LEADERSHIP

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Dr. Lindsay Smith

RICHARD T. OLIVER FOR LEGISLATIVE LEADERSHIP

2022 / 2023 EXECUTIVE COMMITTEE (Left to Right)

President: Dr. Robert Herman President-elect: Dr. Paul Wood Vice President: Dr. Daryn Lu Secretary/Treasurer: Dr. Nicole Nellis Speaker of the House: Dr. Mitch Kramer

20 journal | May/June 2022

President’s Party A CELEBRATION IN HONOR OF 2021 / 2022 ODA PRESIDENT, DR. CHRIS FAGAN

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21

ARE YOU READY FOR STORM SEASON? Oklahomans know all too well that you can never be too prepared for severe weather, but where do you turn when you need immediate relief in the aftermath of a devastating storm?

Help is available! 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. Over the last three years, the RDGP awarded $28,000 in disaster assistance to individuals and dental organizations affected by severe weather. Aid is provided confidentially and without remuneration. Whether you are affected at home or office, contact the RDGP to apply for immediate assistance 800-876-8890.

The RDGP accepts tax-deductible donations from individuals and dental organizations from around the country to provide aid after devastating destruction caused by tornadoes and other natural disasters across the state. Funds are awarded to dental professionals who are victimized by the storms.

Additionally, the funds are used for programs like the Oklahoma Dental Foundation MobileSmiles Program to aid in relief efforts in several Oklahoma communities.

The RDGP relies solely on contributions from individuals and dental foundations. The donations received help prepare & provide for those Oklahoma dentists and dental foundations in need of resources after destructive storms.

22 journal | May/June 2022

DO YOU OR SOMEONE YOU KNOW S T R U G G L E W I T H S U B S TA N C E A B U S E ?

The RDGP also contributes to the Oklahoma Health Professionals Program which is an outreach program designed to support and monitor medical and allied health professionals throughout Oklahoma who are experiencing difficulty with substance abuse. The services provided by the OHPP are confidential and at no cost. Services include expert consultation and intervention designed to encourage healthcare professionals to seek help for substance abuse and behavioral concerns. If you or someone you know needs help, please call the 24-hour confidential direct line (405-601-2536). The RDGP voluntary section on the ODA dues statement funds the ODA’s contribution to the Health Professionals Program.

Whether you need help or want to provide help, don’t wait!

Contact the RDGP manager today at sfrantz@okda.org or call 800-876-8890 Tax-deductible donations to the program can be mailed to: OK Dental Relief and Disaster Grant Program 317 NE 13th Street Oklahoma City, OK 73104 For grant application and program guidelines, visit okda.org/programs/member-support/

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www.okda.org

25

LEGISLATIVE LOOP Legislative Overview & Political Update

AN UPDATE ON HB 3023 - THE ODA’S INSURANCE BILL This following letter was sent to all members via email on March 24, 2022.

As you may recall, HB 3023 passed the House Insurance Committee with very little debate. The ODA was asked by Committee members to negotiate with the insurance industry on aspects of the bill before the bill could advance to the full House for consideration. During a good faith meeting with one insurance company, moderated by Representatives Rande Worthen and Marcus McEntire, it was quickly evident that the insurance company was entirely unwilling to negotiate.

After that, ODA members engaged, sending HUNDREDS of emails and making HUNDREDS of calls to our State Representatives, educating them on the unfair practices of bundling, downcoding and non-covered services, and elevating the discussion in a big way!

Simultaneously, the insurance industry began dumping thousands of dollars into a statewide ad campaign, employing fear and bully tactics, about the possible rise in insurance costs should our bill pass. The insurance industry also activated their large group plans by asking those companies to engage in the fight. The insurance industry also convinced the State Chamber to come out against our bill, convincing them that HB 3023 would negatively impact Oklahoma companies’ ability to provide dental benefits to their employees. These tactics were enough to give House leadership pause on allowing this bill to advance to the House floor. Late yesterday, House leadership made the decision that HB 3023 would not be placed on the agenda for a House vote.

Although this is a disappointing outcome, WE ARE MORE RESOLUTE THAN EVER to advocate on these issues and continue to educate the Legislature and the public on these and other intrusive insurance policies designed only to strengthen big insurance’s bottom line but do nothing to improve patient care. Additionally, we were able to let the insurance industry know we are no longer going to stand by while they wedge themselves between us and our patients by dictating what care our patients receive based solely on price and not the optimum standard of care.

WE WANT TO THANK EACH OF YOU FOR THE TREMENDOUS EFFORT YOU INVESTED IN FIGHTING FOR THIS BILL. MAKING YOUR VOICE HEARD AT THE STATE CAPITOL IS WHAT WILL CONTINUE TO PROTECT OUR PROFESSION AND MOVE IT FORWARD IN OKLAHOMA. PLEASE STAY ENGAGED! The ODA remains committed to defend our patients, our businesses, and our profession.

Sincerely, Chris Fagan, DDS, ODA President Lindsay Smith, DDS, ODA Council on Governmental Affairs Chair

REP. Rande Worthen honored with ODA Legislator of the Year award The ODA Legislator of the Year is an elected or appointed offical who has exhibited exceptional support for the art and science of dentistry in Oklahoma. Rep. Worthen was recognized during the ODA House of Delegates Meeting on March 31, 2022.

26 journal | May/June 2022

SSB 1337: Another Attempt at Managed Care Medicaid On March 23, the Senate passed SB 1337, a bill that will convert the state’s Medicaid system to insurance managed care. SB 1337, by Senator Greg McCortney and Representative Marcus McEntire, is an Oklahoma Health Care Authority bill that was drafted and passed with no input from Medicaid providers – only from the insurance companies. The bill passed with the title off, which means that the authors agree that work still needs to be done on the bill before it passes.

The following letter was sent to each House member from the Oklahomans Caring for Oklahomans Coalition, a group of healthcare organizations who are united in our fight against managed care Medicaid. Follow the work of the Coalition and sign up for Coalition news and legislative alerts at oklacares.org.

March 25, 2022 The Honorable XXXX 2300 N Lincoln Blvd., Rm XXX Oklahoma City, OK 73105 Dear Representative XXXX: Insurance managed care is again on the table before the Oklahoma Legislature, following the recent passage of SB 1337.

Oklahoma Chapter

SB 1337 was brought for consideration at the request of the Oklahoma Health Care Authority without any real input from the organizations represented by Oklahomans Caring for Oklahomans – an advocacy group dedicated to preserving the relationship between patients and their health care providers.

To be clear, emailing a handful of doctors a copy of SB 1337 a few hours before the bill was presented for a vote does not constitute seeking and implementing input from Oklahoma’s health care community, which serves rural and urban Oklahomans.

Importantly, a recent poll from Cole Hargrave Snodgrass and Associates found 84% of all Oklahomans agreed with a simple statement: “I do not want any government laws getting between me and my doctor.” The same poll found that Oklahomans have a general distrust of health insurance systems, whose favorability comes in at only 32%.

ADVANCING THE PRACTICE SINCE 1946

OHCA continues to aggressively promote insurance managed care, giving the national insurance companies opportunities for input into this process that have so far been denied to local health care providers.

When we don’t work together, insurance managed care could negatively impact physical and behavioral health care, causing Oklahomans to lose their providers, including doctors, nurses, dentists, dental hygienists and hospitals, while insurance companies profit from rationed care.

Oklahoma health care providers have been promised a seat at the table – and we’re still waiting for the invitation. In the interim, we remain united and opposed to insurance managed care.

For more information, visit: www.OklaCares.com | Contact: info@oklacares.org

www.okda.org

27

ADA Advocacy News THE ADA Supports Efforts to Regulate Synthetic Nicotine

Teenage vaping remains a serious problem as e-cigarette companies continue to circumvent federal oversight of tobacco plant-derived nicotine by using an unregulated synthetic version. Lawmakers on Tuesday proposed language for inclusion in the federal omnibus budget bill that would give the FDA authority to regulate synthetic nicotine. The ADA has advocated for the regulation of synthetic nicotine, and the Association joined 61 other organizations in sending a letter to leaders of the House and Senate in March urging the lawmakers to give the FDA authority to regulate synthetic nicotine products, calling it a "serious public health situation."

REDI Act Introduced in the Senate

Legislation under consideration in Congress would allow dental and medical students to defer interest accrual on federal education loans while they participate in internships or residency programs. The Resident Education Deferred Interest (REDI) Act has passed in the House and was introduced last year by Representative Brian Babin, R-Texas, who is a dentist. A Senate companion measure was introduced February 16 by Senators Jacky Rosen, D-Nevada, and John Boozman, R-Arkansas.

ADA Thanks Congress for Cures 2.0 Act

In a March 17 letter, ADA President Cesar R. Sabates, DDS, and Executive Director Raymond A. Cohlmia, DDS, thanked the lawmakers for introducing HR 6000, the Cures 2.0 Act. The bill contains several issues the ADA supports. The ADA is urging lawmakers to include dentistry when developing a strategy to prepare for the next pandemic. “It is critical that dentistry be recognized as a viable resource in expanding the nation’s medical surge capacity,” Drs. Sabates and Cohlmia wrote. “For example, early in the COVID-19 pandemic, federal officials granted pharmacists the ability to order and administer tests. Dentists were never granted that authority by the federal government, even though 24 states and the District of Columbia did so. In order to avoid these types of problems in the future, dentists need to be included in the Cures 2.0 Act as an essential part of the response strategy for future pandemics.” Drs. Sabates and Cohlmia also said that dentists are among those providers who can administer vaccines and urged the lawmakers to recognize that in the bill, noting that both the Pandemic and All-Hazards Preparedness Act and the Federal Emergency Management Agency’s National Response Framework both identify dentistry by name as a “vital” medical countermeasure. “Having dentistry at the planning table early on — and being there in a codified way in the Cures 2.0 Act — will help ensure that this vital national resource is not overlooked.”

ADA Joins Forces to Ask for Increased Access to ORs

Improving access to dental surgical services for children and adults with special needs and disabilities can help increase oral health equity and eliminate disparities in oral health treatment. The ADA, The American Academy of Pediatric Dentistry and The American Association of Oral and Maxillofacial Surgeons told lawmakers in comments sent to the House Ways and Means Subcommittee on Health regarding the Bridging Health Equity Gaps for People with Disabilities and Chronic Conditions during the hearing. Operating room access is a key challenge. "Our organizations have collectively witnessed a major decrease in operating room access for dental procedures over the last decade," according to the comments. The groups said the problem stems from a lack of sustainable billing mechanism for dental surgical services in Medicare and Medicaid.

Dentist and Student Lobby Day

The ADA recently held its annual Dentist and Student Lobby Day in Washington, DC. Dentists and dental students from across the country lobbied the following bills to their members of Congress: S. 1793/H.R. 3461 – the Dental and Optometric Care Access Act of 2021 (DOC Access Act) would prohibit dental and vision plans from setting the fees network doctors may charge for services not covered by the insurers. Even though 41 states including Oklahoma have passed non-covered services laws for dental, and three additional states have passed similar laws for optometric, many dental and vision plans are federally regulated, so insurers claim they are exempt from having to follow state laws. This bill would close this loophole and is narrowly drawn to apply only to dental and vision plans regulated by the federal government. This legislation would not interfere with the states’ abilities to maintain and enforce their own insurance regulations and laws; instead, it complements the work already done by most state legislatures across the country.

S. 3166/H.R. 4439 – the Medicaid Dental Benefit Act of 2021 (MDBA) would make comprehensive dental care a mandatory component of Medicaid coverage for adults in every state. This would open the door to regular care in more appropriate and cost-effective settings, resulting in fewer people turning to emergency departments to relieve dental pain. This change would save our health system an estimated $2.7 billion annually.

S. 754/H.R. 1916 – the 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.

This bill passed the House on April 4 after an ADA-initiated grassroots email campaign that generated thousands of emails from dentists to Congress. The bill next moves to the Senate and the ADA will continue its advocacy to make sure the bill passes the Senate and becomes law.

28 journal | May/June 2022

Dentists and students also lobbied two bills that address student debt: H.R. 2160 – the Student Loan Refinancing Act • Provides multiple opportunities for borrowers to refinance their federal Direct Loans, Direct PLUS Loans and Direct Consolidation Loans when interest rates are lower.

• Ensures the refinanced rates are fixed to protect borrowers from interest rate hikes when economic conditions are less favorable.

H.R. 4122/S. 3658 – the Resident Education Deferred Interest Act (REDI Act) • Allows medical and dental residents to automatically defer payments on their federal student loans until after their medical or dental residency is completed.

• Suspends the accrual of interest on federal student loans during the residency period.

Both bills will provide fair and reasonable ways to help offset the unprecedented levels of educational debt that new dentists face at graduation. Combined with enhanced public service loan forgiveness programs, they may also lead more highly indebted young dentists to practice in underserved areas.

Read about these and many other ADA advocacy efforts at ada.org/advocacy.

ARE YOU GETTING OUR LEGISLATIVE ALERTS? We send out important alerts via email and text throughout the legislative session. Contact our membership services team at information@okda.org to update your contact information.

WHY JOIN DENPAC

DENPAC is the political action committee of your Oklahoma Dental Association. DENPAC works hard to make political contributions to dentistry-friendly, state-level legislators. $50 of your DENPAC dues also goes towards ADPAC to support national campaigns. Currently, 20% of the ODA membership funds 99% of the ODA’s legislative and advocacy efforts.

HOW TO JOIN DENPAC

Contact Lynn Means at 800-876-8890 or lmeans@okda.org to join the DENPAC team TODAY!

www.okda.org

29

K

CAPITOL CLUB Dr. Jeffrey Ahlert Dr. Clay Anderson Dr. Michael Auld Dr. Douglas Auld Dr. William Beasley Dr. Tamara Berg Dr. Bryan Blankenship Dr. Elizabeth Bohanon Dr. Edmund Braly Dr. Michael Breland Dr. C Todd Bridges Dr. Trace Bridges Dr. Matthew Bridges Dr. Nathan Brown Dr. Steven Brown Dr. Ronald Bulard Dr. Adam Bulleigh Dr. Jamie Cameron Dr. Tricia Cannon

WE DON’T FUNDRAISE. WE FRIENDRAISE! THANK YOU TO THESE 2022 DENPAC CAPITOL CLUB MEMBERS! Dr. Wuse Cara Dr. John Carletti Dr. Bobby Carmen Dr. Jennifer Chambers Dr. Raymond Cohlmia Dr. Matthew Cohlmia Dr. Russell Danner Dr. Susan Davis Dr. David Deason Dr. Stacia Dowell Dr. Brian Drew Dr. Twana Duncan Dr. Heath Evans Dr. Christopher Fagan Dr. Timothy Fagan Dr. Barry Farmer Dr. Sandra Grace Dr. Shannon Griffin Dr. Kevin Haney

Dr. Mark Hanstein Dr. Aaron Harman Dr. Edward Harroz Dr. Richard Haught Dr. Robert Herman Dr. Jeffrey Hermen Dr. Mathew Hookom Dr. Brad Hoopes Dr. Jennifer Jenkins Dr. Donald Johnson Dr. Eugenia Johnson Dr. Krista Jones Dr. Jandra Korb Dr. Mitchell Kramer Dr. April Lai Dr. Robert Lamb Dr. Marti Levinson Dr. Juan Lopez Dr. Daryn Lu

Dr. David Marks Dr. Stephen Martin Dr. Alan Mauldin Dr. Stephen Mayer Dr. Janna McIntosh Dr. Glenn Mead Dr. Kenner Misner Dr. Mohsen Moosavi Dr. Paul Mullasseril Dr. Aaron Neale Dr. Nicole Nellis Dr. Robert Nowlin Dr. Karen Reed Dr. Roger Richter Dr. Ryan Roberts Dr. Erin Roberts-Svob Dr. Brant Rouse Dr. Mack Rudd Dr. Troy Schmitz

Dr. Scott Searcey Dr. Paul Shadid Dr. Steffan Sigler Dr. Floyd Simon Dr. Lindsay Smith Dr. James Sparks Dr. Sara Spurlock Dr. James Strand Dr. Steven Strange Dr. Carla Sullivan Dr. Jim Taylor Dr. Stephen Taylor Dr. Kara Tims Dr. Jonah Vandiver Dr. Nathan Villines Dr. Robert Webb Dr. Daniel Wilguess Dr. Paul Wood Dr. Rieger Wood

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 opens 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.

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30 journal | May/June 2022

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31

ODA FEATURE

DIFFERENTIAL DIAGNOSIS: Palatal “Swelling”

By: Glen D. Houston, DDS, MSD (gdhdds@heartlandpath.com) HISTORY This 38 year old female was referred by her primary care provider for evaluation.

The patient's chief complaint is a "swelling" involving the “roof of the mouth”. The physician's provisional diagnosis is rule out dental infection. The area has been present for "several days" according to the patient and is asymptomatic.

QUESTION #1 Your working differential diagnosis for a mass involving the palatal mucosa would include: a. Neurofibroma b. Malignant lymphoma c. Salivary gland neoplasm d. Palatal abscess e. Antral carcinoma ANSWER #1 Your differential diagnosis should include all of the lesions listed above, because they can all present as a palatal mass. The neurofibroma (a) is a peripheral nerve neoplasm that is composed of a mixture of Schwann cells and perineural fibroblasts.

This neoplasm is typically observed in the young adult and presents as a slow growing, soft, asymptomatic mass that presents as a circumscribed nodule. The skin is the most common location for the neurofibroma, but lesions of the oral cavity are not uncommon.

Malignant lymphoma (b) is a malignant neoplasm of lymphoreticular histogenesis.

This lesion may develop in the oral soft tissue or centrally within the jaws. The soft tissue lesion appears as a nontender, diffuse swelling that most commonly affects the palatal mucosa, gingiva, and buccal vestibule. Because of the numerous lobules of minor salivary gland tissue involving the palatal mucosa, both benign and malignant salivary gland neoplasms (c) can also be observed arising from the palatal mucosa. Benign salivary gland neoplasms such as pleomorphic adenoma and basal cell adenoma would be included in the differential diagnosis. Malignant salivary 32 journal | May/June 2022

gland neoplasms such as mucoepidermoid carcinoma and adenoid cystic carcinoma must also be considered. The palatal abscess (d) may also present as a mass. The source of the abscess is typically a nonvital tooth in the area or a periodontal defect. The antral (maxillary sinus) carcinoma (e) is typically a disease of the elderly individual with a slight predilection for males. Affected patients typically notice an ulceration or mass involving the hard palate or the alveolar bone.

QUESTION #2 Which of the following adjunctive techniques may be useful in obtaining a definitive diagnosis? a. Biopsy b. Radiographic survey c. Fine needle aspiration of the lesion d. Vitality testing of the teeth in the region e. Bone marrow aspiration ANSWER #2 The appropriate adjunctive techniques useful in obtaining a definitive diagnosis include the following: a. Biopsy b. Radiographic survey c. Fine needle aspiration d. Vitality testing of teeth in the region The vitality testing of the teeth in the region (d) and a radiographic survey (b) in conjunction with the clinical examination are indicated in order to complete a comprehensive oral examination. A fine needle aspiration (c) or incisional biopsy (a) is indicated in order to

render a definitive diagnosis concerning the observed palatal mass. The bone marrow aspiration (e) is not indicated this early in the patient evaluation.

QUESTION #3 Imaging studies of the area reveal a wellcircumscribed radiolucent lesion involving the maxilla adjacent to the mass. A fine needle aspiration revealed inconclusive results. An incisional biopsy was performed and the pathology report describes sheets of cuboidal cells forming ductlike structures, loose myxoid material, and cartilaginous tissue. The correct diagnosis is: a. Antral carcinoma b. Pleomorphic adenoma c. Ameloblastoma d. Adenoid cystic carcinoma ANSWER #3 The correct diagnosis is pleomorphic adenoma (b) - see "Discussion" section.

The other possibilities are not considered here because antral carcinoma (a) is typically a squamous cell carcinoma but occasionally may be an adenocarcinoma involving the maxillary sinus. The various cytologic and morphologic features of a malignant neoplasm observed with this condition are not present in the present case. The ameloblastoma (c) is composed of numerous islands, cords, and sheets of odontogenic epithelium dispersed throughout a mature fibrous connective tissue stroma. The epithelial proliferation consists of a core of loosely arranged cells resembling stellate reticulum of the enamel organ. This central core is surrounded by a single layer of tall columnar ameloblastlike cells. The adenoid cystic carcinoma (d) is composed of a mixture of ductal cells and myoepithelial cells that can have a varied arrangement consisting of three major patterns which are cribiform, tubular, and solid variants. These patterns are not observed in the present case.

DISCUSSION This particular neoplasm of salivary gland origin has masqueraded under a variety of names throughout the years, but the term "pleomorphic adenoma" most accurately characterizes the unique microscopic pattern of this lesion.

The pleomorphic adenoma is the most common of all salivary gland neoplasms. It represents over 50% of all cases of salivary gland neoplasms of both major and minor salivary gland origin and 90% of all the benign salivary gland neoplasms. Of the major salivary glands, the parotid gland is the most common site for the pleomorphic adenoma. It may occur, however, in any of the major glands or in any of the widely distributed intraoral accessory (minor) salivary glands. This lesion presents somewhat more frequently in women than in men and is usually observed in patients in the fourth to sixth decades of life.

The typical history described by the patient is usually that of a small, painless nodule which slowly increases in size. Pain is not a common symptom of this lesion. It usually does not demonstrate fixation either to the underlying structures or overlying mucosa and is seldom ulcerated.

The diverse microscopic pattern of this lesion is one of its most characteristic features. A common finding is islands of cuboidal cells arranged in ductlike structures.

Loose myxoid stroma, hyalinized connective tissue, cartilage, and even osseous tissue are observed. This neoplasm is typically

encapsulated, although neoplastic islands may be found within the fibrous capsule.

The treatment of choice for this tumor is excision. In this particular case, surgical excision with removal of a margin of normal tissue and the overlying mucosa would be sufficient to prevent recurrence or persistence of the lesion.

The use of radiation therapy or multiagent chemotherapy is of little benefit and is therefore contraindicated in the treatment of the pleomorphic adenoma.

About the Author: Dr. Houston works at Heartland Pathology Consultants, PC in Edmond, OK. He can be contacted with questions at gdhdds@ heartlandpath.com REFERENCES 1. Friedrich RE, Li L, Knop J, et al. Pleomorphic adenoma of the salivary glands: analysis of 94 patients.

Anticancer Res. 2005;25:1703-1705.

2. Stennert E, Wittekindt C, Klussman JP, et al.

Recurrent pleomorphic adenoma of the parotid gland: a prospective histopathological and immunohistochemical study. Laryngoscope.

2004;114:158-163.

3. Stennert E, Guntinas-Lichius O, Klussman JP, et al. Histopathology of pleomorphic adenoma in the parotid gland: a prospective unselected series of 100 cases. Laryngoscope. 2001;111:2195-2200.

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33

PRACTICE MANAGEMNT Preparing for a Transition By: Suzanne Ebert, DMD Whether you’re considering buying, selling, hiring an associate, or finding a new job, you’re probably wondering: how long is it going to take?

At ADA Practice TransitionsTM (ADAPT), we work with dentists in all 50 states — including Oklahoma — to help them find the right practice or person to reach their goals. Through our work, we can confirm that there’s no “standard” timeline for practice transitions.

In nearly every case, the longest phase of the process is finding the dentist or practice that fits your goals. This part can range from a few weeks to more than a year.

However, there are several things you can do to streamline the process.

With a bit of preparation, you’ll be ready to act when you find that right person or practice.

1. Assess your situation Your search period will largely depend on your situation, so it’s wise to start by setting realistic expectations. For example, if you are trying to sell a fully updated practice in a highly desirable area with strong financials (and you have all the documentation in order), you may be able to sell in just a few months. A less desirable area or a practice that is not at all updated usually takes longer.

For a job search, a tight restrictive covenant/non-compete clause may extend your search, unless you are willing to consider practices in an entirely different area. In general, the more narrow your search, the longer it will take.

Once you have found the right person or practice, the rest of the process can move quickly — if you are prepared. An associate hire can be executed within a few weeks if both sides know what they want. A sale naturally takes longer, but if the buyer and seller both have their paperwork in order (financing lined up, practice valuation complete, etc.), it can close faster.

2. Understand what you want – and what you don’t want I often see candidates drag their feet because they aren’t quite sure what they want. By the time you start talking to prospective matches, you should have a pretty good idea of your goals. (ADAPT members have access to a trove of “Get Ready” resources to help think this through, plus an Advisor who can act as a sounding board.)

Start by making a list of your must-haves and must-NOT-haves. This exercise will help you make quicker, more informed decisions when presented with a potential candidate.

Involve your spouse or partner to make sure you are on the same page.

They can provide valuable feedback and brainstorm what is best for the whole family.

can learn a lot with a 15-minute chat, and you may discover that this opportunity is actually quite good. The would-be associate may have skills you hadn’t considered, or the practice may have “good bones” that you can transform into your dental dream home.

Be especially open about location. So often, I see candidates immediately rule out a practice just because it isn’t where they think they want to live. But these practices can offer the best opportunities, particularly rural practices where the cost of living is lower, practices cost less, and you may be able to enjoy a great work-life balance by working part time.

4. Build your team Identify your lawyer and accountant before you need them. It is much easier to take the time to find the right professionals – who have navigated the intricacies of dental practice transitions – now, before crunch time.

Start talking to your state or local society to find vetted professionals well versed in your state’s regulations. You can also ask colleagues for their recommendations.

5. Line up your financing If you are buying a practice, your lender can make or break your transition. Begin by interviewing at least three lenders. Ask about the terms they offer, their process, and what they require. Find out how you can strengthen your application, such as improving your credit.

Still have student loans? Don’t let that stop you from pursuing your dream of practice ownership. Since banks see dental practices as relatively safe investments, they will lend to people with student debt, provided their credit is in good shape and their personal spending is in check. Start the conversation with a lender to learn how you can make it happen.

6. Get your paperwork in order If you are selling, your buyer (and their lender and accountant) will need a lot of information about the practice’s finances. The entire transaction will go much more smoothly if you have it all rounded up, ready to go. Work with your accountant to prepare the reports and data the buyer’s lender will require.

If you are buying, ask your lender and accountant what they will need from you – tax returns, bank statements, etc. – and begin assembling your file.

7. Write your job description and have a plan If you are hiring, think about how the new associate will fit into the practice. Ask yourself:

3. Keep an open mind

• What hours will they work?

Don’t overly narrow your focus. The perfect opportunity may not look like you expect it to. If a candidate or practice checks most, but not all, of your boxes, I recommend having an initial conversation. You

• Will you need to hire additional staff?

34 journal | May/June 2022

• How will you divide current and new patients?

If you are looking for an associateship, think about your ideal schedule, preferred treatments, skills you want to learn, and how you want to work with staff.

Discuss your preferences during the interview process to ensure both sides are on the same page and you can work together successfully.

8. Get started Now is a great time to embark on a practice transition. The pandemic gave a lot of us time to think about the big picture and recalibrate our goals. At ADAPT, we’re seeing many long-time owners preparing to sell, while smart, entrepreneurial buyers are ready to take charge of their futures.

Finding the perfect opportunity can take time, but remember that it’s worth the wait to get it right!

Start by creating your free profile at adapracticetransitions.com, where you’ll be matched with dentists who share your goals, timelines, and approach to dentistry. You can also access the ADAPT blog for resources to help prepare for the next phase of your career.

ABOUT THE AUTHOR Dr. Suzanne Ebert graduated from University Of Louisville College Of Dentistry in 1998. After completing a residency, she started a solo private practice and enjoyed being a private practitioner for 11 years.

Upon the sale of her practice, she elected to continue her career by providing dental care to indigent populations as the Dental Director at a local Federally Qualified Health Center. Under her tenure the clinics expanded and addressed real needs in the community including eldercare, special needs care and ER diversion. As Adjunct Faculty for the University of Florida, she had the privilege of working directly with senior dental students as they rotated through the clinics. Dr. Ebert is unwavering in her desire to protect private practice dentistry. She is a vocal advocate of having a strong association to lead the dental profession through the issues facing it today.

Simplify Your Practice Transition Powered by the ADA, ADA Practice Transitions™ supports independent dentistry by helping you buy or sell a practice, hire an associate, or find a job.

Create your free profile to connect with dentists who share your approach to dentistry, access customized career resources, and receive guidance from a dedicated ADA Advisor.

DENTIST

FOR SALE

BUY OR SELL A PRACTICE

Dr. Suzane Ebert spoke at this year's ODA Annual Meeting covering this topic. Visit adapracticetransitions.com for more information.

HIRE AN ASSOCIATE FIND A JOB

ADAPracticeTransitions.com

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35

KEEP IT LOCAL

Treating a Patient with Worn Dentition By: Krysten Jackson, DDS One of the most difficult challenges that the restorative dentist will face is the patient with severe wear. This patient presented to me with a chief complaint of her back teeth breaking, as well as a cosmetic complaint of her teeth looking short. On initial exam, severe generalized wear was seen on anterior and posterior teeth. Using the “Global Diagnosis” treatment planning and protocol (by Dr. Robbins and Dr. Rouse), I was able to reach a diagnosis of dentoalveolar extrusion. Knowing that this was the diagnosis, I knew that a collaborative, multi-disciplinary approach would be needed to restore her dentition.

Figure 1. Patient presented with generalized severe wear, and with little remaining coronal tooth structure. As a result, she had several fractured non-restorable posterior teeth and loss of OVD.

phonetics. Once the patient felt comfortable with the provisionals, I moved on to final impressions.

The temporary crowns were removed and all preps were refined. Final scans were taken. The provisionals were able to be used as the guide for the final crowns. At final crown delivery, the patient’s tissue was healthy and the crowns functioned well for the patient.

Figure 2. Patient at post-op for functional crown lengthening.

Treatment and management of severe tooth wear can be extremely difficult. It is of upmost importance to identify the etiology of the wear, so that pathologic factors can be identified, eliminated, and prevented. This case called for a comprehensive approach, and by doing so, we were able to restore her OVD, as well aschieve the patient’s goal.

This case was treatment planned and completed by Krysten Jackson, DDS and Adam Cohlmia, DDS. Crown lengthening and implant placement by Jacob Hager, DDS.

Figure 3. Patient after initial prep and temporization.

The original treatment plan was for orthodontic intrusion and full mouth zirconia restorations. However, this plan was unable to be carried out because the patient did not have enough tooth structure remaining to bond brackets to. Knowing this, the patient was sent to the periodontist for functional crown lengthening. Fractured teeth were removed, implants placed into edentulous sites, and functional crown lengthening performed.

ABOUT THE AUTHOR Dr. Krysten Jackson is from Lawton, Oklahoma.

She attended Cameron University, and earned a BS in Cell and Molecular Biology with a minor in chemistry in 2014. She attended the University of Oklahoma College of Dentistry, and received her Doctorate of Dental Surgery in 2019. After graduating the University of Oklahoma College of Dentistry, she continued on to complete a residency in Advanced Education in General Dentistry (AEGD). She practices at her private office in El Reno, Oklahoma.

After the patient healed from functional crown lengthening, the patient was brought in for a records appointment. Gingival contours were evaluated, and scans were taken for a wax-up. Next the patient returned from tooth preperation and long-term provisional crowns were placed. These were used to evaluate esthetics, function, and 36 journal | May/June 2022

Figure 4. Patient in final crowns with healed gingival tissue.

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37

HYGIENE HOTSPOT

The 3-Letter Word in Dentistry: SRP Taking Patients from Compromised to Compliant By: Mary Hamburg, DDS., MS During my dental training, I was taught that there are certain words one must not say in front of the patient. Whether it was to prevent an outburst of fear from the patient or to quell my discomfort about discussing blood and pus, I was not sure. No doubt it takes skill and a certain degree of dental acumen to discuss a troubled disease status. But do we dentists take it too far? Suppuration instead of pus.

RBCs instead of blood. Hiding calculus that is removed from teeth.

Does hiding the negative aspects of the patient’s disease effect their acceptance of treatment? Are we making treatment into a 3-letter word, hindering patient’s care?

I had the privilege to work with a wise, experienced dental hygienist during my first years of practice as a periodontist. We often had loud debates about almost every subject in dentistry, not because we disagreed, but simply because we enjoyed the subject matter.

One of our discussions centered around a teaching technique she developed after years of cleaning compromised patients’ teeth. She placed all the calculus she removed on a 2X2 clipped to the patient’s napkin, and showed it to them after the cleaning. As someone who can drain an abscess with a straight face without gagging, this revelation was astonishing and disgusting! How dare we show the patient what we are doing in their mouth and prove why the treatment is necessary?! The audacity!

This revelation changed the way I discussed periodontal disease with patients. If patients could see the problem, would they move forward with treatment? Could discussing the issues like pus and bleeding with the patient instigate a discussion? Would symptoms be harder to ignore just because it doesn’t hurt?

After years of perfecting my consult routine, I have developed a list of three very important things I make sure patients hear while they are in my care. First, I explain what the periodontal probing measurements mean, “1, 2, 3 are normal and 4, 5, 6 are problem areas.” Simple, uncomplicated and without judgement. The next thing I discuss is the bleeding points or BOP. I mention that these areas with bleeding mean active bone loss is occurring and have the potential with worsen without intervention. If suppuration or pus is noted, then I mention an active infection is present in that area and show them intraorally. Last, I show the patient their radiographs. I demonstrate the normal bone levels at the CEJ and point out areas where the bone does not meet that mark. It can easily be done on a full mouth radiographic assessment. With these steps, patients are engaged by the time we get to the treatment plan. They want to know how we are going to stop the disease progression.

Patients and clinicians have many hurdles to care. Insurance, finances, and time are just a few. Patients will make the financial and time investments if they understand what they are working toward, and they cannot do that if they do not understand the full picture.

If we hide the signs of disease because we are worried about hurting

38 journal | May/June 2022

the patient’s feelings, then we are ultimately hurting their overall health. We can no longer afford to think of periodontal disease as a process that does not have systemic implications, such as diabetes or heart disease. We need to give our patients the full picture so they can make the best decision for their health by discussing all aspects of their disease.

ABOUT THE AUTHOR: Dr. Mary A. Hamburg is a 2008 graduate of the OU College of Dentistry, where she also received her periodontal and implant specialty training. She has served the Oklahoma City metro area as a boardcertified periodontist for the last nine years. She is a member of the Oklahoma Dental Association Board of Trustees, currently serving as Editor of the ODA Journal. She has also served as an executive board member of the Oklahoma Association of Women Dentists for the last nine years. Hamburg currently practices in Midwest City Dental Implants and Endodontics of Oklahoma, and in Yukon at Rosewood Dental of Yukon. She is also a Clinical Assistant Professor in OUCOD’s Advanced Education in General Dentistry (AEGD) program. Hamburg and her husband Dustin live in Norman with their two boys, Daxton [8] and Caden [5].

NEW DENTIST CORNER

SMILECON: THE REIMAGINED AMERICAN DENTAL ASSOCIATION ANNUAL MEETING GIVES DENTISTS A LOT TO SMILE ABOUT By: Sydney Rogers, DDS It was the American Dental Association’s first-ever “SmileCon”- the ADA’s annual session attended by dentists from across the United States reinvented in a creative, engaging platform. It was also my first-ever national conference to attend, and I couldn’t have been more excited to head to Las Vegas in October 2021.

SmileCon kicked off with Oklahoma Dental Association leader, Dr. Daryn Lu, hosting the energetic Opening Session. Dr. Lu introduced the keynote speaker, Michelle Poler, who shared her thoughts on reframing our fears. Instead of asking, “What’s the worst that could happen?”. she instead asked, “What’s the BEST that could happen?” This session set the tone for the conference and got attendees excited for the next few days. That evening featured the New Dentist Reception which gave recent graduates a chance to connect in a less formal environment. I enjoyed speaking with a dentist out of Washington, D.C., about our mutual experience of working at a VA dental clinic. It was a fun opportunity to network with other new dentists from across the country.

There was a range of continuing education opportunities from which to choose at SmileCon, and on the second day of the conference, I attended several informative sessions. I appreciated the diversity in presenters and presentation topics—ranging from technical, hands-on endodontic courses to lectures on improving quality of oral healthcare for patients with disabilities. It was simple to select courses to attend using the ADA smartphone app which was user-friendly and had the full CE course list for easy browsing.

Colorful signage and event volunteers made finding classrooms straightforward. Even for a neophyte such as myself, it was a manageable task to attend the conference—and to get a lot out of it.

I was proud to be an Oklahoman attending the first annual SmileCon, and I appreciated how well-represented Oklahoma is at a national level. As Dr. Raymond Cohlmia was introduced as the new Executive Director, I realized how fortunate we are to be practicing dentistry in a state with a legacy of strong leadership within organized dentistry. Thank you to the Oklahoma Dental Association for the opportunity to attend the conference as your New Dentist representative! SmileCon was a worthwhile conference that was organized, approachable, and fun for dentists at every stage of their careers. Next year’s SmileCon will be held in Houston, Texas—an easy drive or flight for us Okies. I hope to see y’all there!

ABOUT THE AUTHOR: Dr. Sydney Rogers graduated from the University of Oklahoma with a B.A. in Letters before attending the OU College of Dentistry, graduating in 2017.

She completed a General Practice Residency at the Oklahoma City VA HealthCare System, and after working an additional year at the VA, she moved back to her hometown of Enid with her family in 2019. She practices at Enid Family Dental. When not working, Dr. Rogers spends time with her husband and two children and enjoys playing the violin in her church orchestra and with the Enid Symphony.

Learn more smilecon.org

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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.

PRACTICE FOR SALE Dental Office For Sale – Muldrow, OK: Selling price of $395K is the value of real estate only. Attractive free-standing 2600 square foot office has 4 equipped treatment rooms and is conveniently located on the main 5 lane highway that runs through town. The practice opened in 1973 (by current doctor and owner) and has been the only dental practice in Muldrow serving the community and surrounding communities.

Dentist is retiring this year. Muldrow is a nice community with an excellent school system and is 10 minutes from Fort Smith, AR. For more information call Don @479-629-4479; e-mail: savingpaws@aol. com or text: 479-651-2852.

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

QUESTIONS? Email: advertising@okda.org

Call: 800.876.8890

Visit: okda.org/classifieds 40 journal | May/June 2022

O KLAHOMA H EALTH P ROFESSIONALS P ROGRAM

Sharing Smiles, The ADA Seal of Acceptance is honoring its 90th anniversary and ready for the celebrations – and innovations – to come!

Over the years, we’ve seen a lot of dental product trends come and go. And today, your patients have more choices than ever when it comes to taking care of their oral health at home.

Good thing there are more than 400 products with the ADA Seal of Acceptance.

When you see the Seal, you can trust that product has been independently evaluated by experts and found to be safe and effective.

As dental product innovations continue, the Seal has science-backed resources to help you facilitate conversations with your patients and recommend personalized products: • An interactive online database to search products by category, brand name and attributes • A downloadable chairside guide to quickly locate approved products when there isn’t a screen nearby • An interactive, 360-degree video to teach patients how ADA Seal products can support good oral health all day long

Scan this QR code or go to ADA.org/SealToolkit to access these resources and more!

Since 1983, the Oklahoma Health Professionals Program (OHPP) has provided services to over 1,000 physicians and health care providers with alcohol and chemical dependence. OHPP is an outreach program designed to support and monitor medical and allied health professionals throughout Oklahoma who are experiencing difficulty with substance abuse.

The OHPP continues to be a leader nationally in identifying problems, assisting in treatment, and returning to practice health care professionals who have suffered from substance abuse or dependency.

OHPP services are confidential and include expert consultation and intervention designed to encourage health care professionals to seek help for substance abuse and behavioral concerns.

Advance Your Clinical Decision Making

When an individual contacts the OHPP about a health care professional or about himself or herself, the director or designated associate director assesses the situation and assists in guiding the health care professional.

ADA clinical resources make the lives of ADA members easier, giving them more time to focus on what’s most important: patient care. Find the answers you need to make every visit a seamless experience for you and your patient.

Participation with OHPP is voluntary and confidential.

OHPP will strongly urge a professional who is ill to get help, and although OHPP does not provide direct treatment, we will suggest specific treatment options.

We respond to the concerns of families, colleagues, and hospitals by providing coordinated interventions and referrals to treatment.

MEMBERS GET ACCESS TO RESOURCES FROM LEADERS IN SCIENCE AND RESEARCH

Cutting-Edge Research

Current Dental Standards

The ADA Science and Research Institute, LLC

ANSI/ADA standards and ADA technical reports

PracticeUpdate Clinical Dentistry

conducts some of the leading laboratory

for dental products and informatics ensure

Sign up for free access to peer-reviewed research

research in dentistry and provides access to

patient safety and professional standards.

on oral and overall health, expert commentary

the latest scientific information, including

Download the most recent reports.

and continuing education opportunities curated

clinical practice guidelines.

ADA.org/SRI

by an editorial board of leading experts.

ADA.org/standards

ADA.org/PracticeUpdate

PATIENT + PRACTICE DATA OVERVIEW

YOUR DERE DASHBOARD

LEVERAGE DATA TO IMPROVE YOUR PRACTICE

QUALITY MEASURE REPORTING TO IMPROVE PATIENT OUTCOMES

The Journal of the American Dental Association

JADA Foundational Science Coming soon: JADA Foundational Science,

ADA Dental Experience and Data Exchange™

From cutting edge research to online CE,

ADA’s new cross-disciplinary, open access

Better data drives better patient outcomes.

ADA members get full access to dentistry’s

journal, bridges basic and clinical sciences in

Join the first dental data registry open to all

most-read scientific journal.

oral-health research.

practices to advance the profession’s clinical knowledge and improve population health.

ADA.org/JADA 3

AMERICAN DENTAL ASSOCIATION

ADA.org/JADAFS

ADA.org/DERE

In addition, OHPP hosts a number of support group meetings open to all health care professionals, students, residents in recovery as well as those seeking peer support.

OHPP recognizes the difficulty of reporting a colleague who may be impaired. Because of the potential risk to patient care, OHPP encourages medical professionals to make referrals if a problem exists, no matter how long there has been a problem.

Direct Line: (405) 601-2536 Confidential Fax: (405) 605-0394 Robert Westcott, MD - Director

Updated: September 20, 2021

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41

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Be Mouth Healthy for Life with the ADA’s MouthHealthy.org This award-winning website has information patients need to take better care of their oral health.

• Oral health concerns by life stage • A-Z topics with videos • ADA® Dental Symptom Checker™ • ADA Seal of Acceptance products • Tips and activities to make oral health care fun for kids • ADA® Find-a-Dentist™ to help locate an ADA member dentist

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EMPOWERING DENTISTRY AS ESSENTIAL HEALTH CARE

Hilton Anatole Dallas • August 26-27, 2022 42 journal | May/June 2022

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Patient Returns

Check out

Health through Oral Wellness® (HOW®) is a preventive benefits program designed to boost our

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subscribers’ current Delta Dental plan.

With HOW, our members at a higher risk for developing caries and/or periodontal disease could qualify to receive enhanced preventive benefits, based on the results of the HOW approved

Register your practice location* today at DeltaDentalOK.org/HOWReg 44 journal | May/June 2022

assessment performed in a dental office.

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