ODA Journal: November/December 2019

November/December 2019 | Vol. 110, No. 6

Better Together

Message from the ODA President: Page 6

A LSO I N S I DE Annual Meeting Preview: Page 17 Opioid Prescribing Information: Page 36

www.okda.org

1

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Contents

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

Oklahoma Dental Association

November/December 2019 | Vol. 110, No. 6

Inside Front Cover Valliance Bank

ASSOCIATION

Inside Back Cover Mariner Wealth Advisors

0 5 Welcome New Members

Back Cover Delta Dental of Oklahoma

08 ODA Annual Awards - Nominations Open!

3000 Insurance Group Edmonds Dental Prosthetics,Inc. Endodontic Associates Lewis Health Profession Services OK Tobacco Settlement Endowment Trust Paragon Dental Practice Transitions TDSC

04 Calendar of Events 0 6 Message from the ODA President 09 Oklahoma Mission of Mercy 2020

36

Current Oklahoma Statutes on Opioid Prescribing:

A Review

10 ODA Rewards Partners Column 11 ODA Rewards Partners List 1 3 Champions of Health Awards 1 4 ODA Marketing Coach

09

1 5 ODA Membership By The Numbers 1 6 ODA Annual Meeting 2020 CE Preview 2 0 ODA Annual Meeting 2019 Social Events 2 2 OUCOD Student Activities 24 Newly Elected ADA Officers

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 © 2018 Oklahoma Dental Association.

25 Renew Your 2020 ODA/ADA Membership

25

25 In Memoriam 2 6 2019 Relief and Disaster Grant Program Donors

It's Time to Renew Your 2020 ODA/ADA Membership

27 Get Involved with the ODA: Nominations Open 2 8 2019 Smile Contributors 2 9 2019 Pride Contributors

LEGISLATIVE LOOP 30 ADA Advocacy News 31 2019 OK DENPAC Members

46

Differential Diagnosis of the Gingival Mass

Cover Photo: Message from the ODA President We Work Better Together Page 6

FEATURES 35 Do You Know About Vaping?

36 Current Oklahoma Statutes on Opioid Prescribing: A Review 38 Official Board of Dentistry Opioid Prescribing Notice 4 1 Request Form for E-Prescribing Waiver from the Oklahoma Board of Dentistry 4 2 Additional Opioid Best Practices Information 4 4 Collect What You Produce: The Psychology of Money 4 6 Differential Diagnosis of the Gingival Mass 4 8 Board of Dentistry Report 4 9 Hygiene Hotspot: Destruction of Evidence

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.

OKLAHOMA DENTAL FOUNDATION 52 Setting a National Standard for Infection Control 53 ODF 2019 Contributors

CLASSIFIEDS 54 ODA Classified Listings

www.okda.org

3

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

ADMINISTRATIVE STAFF EXECUTIVE DIRECTOR F. Lynn Means DIRECTOR OF GOVERNANCE & FINANCE Shelly Frantz DIRECTOR OF COMMUNICATIONS & EDUCATION Stacy Yates DIRECTOR OF MEMBERSHIP Kylie Ethridge PROGRAMS & OPERATIONS MANAGER Makenzie Dean SPECIAL PROJECTS MANAGER Abby Sholar

Stay connected with the ODA!

4

journal | Nov/Dec 2019

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

November 5 ODA Pizza & Politics 12:00 p.m. - 1:00 p.m.

OUCOD

November 15 OkMOM Steering 8:00 a.m.

ODA Building

November 19 New Dentist Trivia Night 6:00 p.m. - 8:00 p.m.

COOP Ale Works Brewery

November 8 ODA Annual Meeting Planning Committee 10:00 a.m.

ODA Building

Council on Governmental Affairs Meeting 9:00 p.m.

ODA Building

Rural Dentistry Luncheon 12:00 p.m. - 1:00 p.m.

OUCOD

RDGP Meeting 11:30 a.m.

ODA Building

Board of Trustees Meeting 1:30 p.m.

ODA Building

November 28-29 ODA Office Closed

November 14 ODA Faculty Appreciation Luncheon 12:00 p.m. - 2:00 p.m.

OUCOD

DENPAC Wine Tasting 6:30 p.m.

At the home of Dr. Krista Jones & Dr. Craig Stinson

December 6 Coding Workshop: Optimize Your Practice (page 7) 9:00 a.m. - 12:00 p.m.

OUCOD December 24-26 ODA Office Closed January 1 ODA Office Closed January 3 ODA Annual Meeting Planning Committee 10:00 a.m.

ODA Building January 10 ODA Council on Dental Education and Public Information 9:30 a.m.

ODA Building

DON'T FORGET All Dental Licenses and permits expire December 31, 2019.

Visit www.ok.gov/dentistry TODAY for instructions on how to renew online or by mail.

ODA Council On Nominations Meeting 11:00 a.m.

ODA Building January 24 Rewards Committee Meeting 9:00 a.m.

ODA Building January 30 Eastern District Meeting 6:00-9:00 p.m.

Pete's in Krebs

The ODA Journal Editorial Board is interested in your ideas and original articles. Do you have a unique case study you wish to share with your colleagues? Do you have a concern or particular interest in dentistry that you want to know more about?

Visit www.okda.org/members-only to complete a simple form and the Journal Editorial Board will take it from there.

ODA

ERS NEW m

Welcome, New Members

EW ODA NEW ODA

New Members Joined August 11 - October 11, 2019

Please join the ODA in welcoming our new members into Oklahoma’s community of organized dentistry

EMBERS MEMBERS

W ODA NEW ODA

EMBERS MEMBERS

Angela Coleman Kurt Ericksen Scott Laster Sarah Karnish Mark Curtis Bennett Parks

NEW ODA NEW ODA

MEMBERSMEMBERS

Central Northern Northern Oklahoma County Tulsa County Tulsa County

NEW ODA

MEMBERS

DIGITAL MEMBERSHIP CARDS We’ve gone digital! ADA membership cards can now be accessed online anytime, from anywhere.

You can park it in your smart phone’s virtual wallet or print it out. Follow these three easy steps to access your membership card today!

*Having trouble? Contact the American Dental Association at 312.440.2500 for assistance.

www.okda.org

5

MESSAGE FROM THE ODA PRESIDENT

We Work Better Together

By Dan Wilguess, DDS

As an ODA member, your livelihood is supported through the legislative and collective voice of 163,000 fellow doctors via the American Dental Association. As I serve our Oklahoma members at the national meeting, as well as in our various towns and cities, I am learning daily the priceless value of organized dentistry.

"As an ODA member, your livelihood is supported through the legislative and collective voice of 163,000 fellow doctors via the American Dental Association."

The Oklahoma Dental Association encourages your involvement with Association activities and works hard to develop social engagements, continuing education courses, and service opportunities that are enjoyable and valuable to you and your practice. The ADA considers socializing of such importance that it has provided additional funds for social events at the state level. Please make an effort to attend the next one and perhaps raise a glass with a colleague.

Being with friends and serving people around us are enormous parts of dentistry’s attraction, so please add OkMOM (scheduled for February 7-8, 2020 in 6

journal | Nov/Dec 2019

Stillwater) to your calendar. The planning team is energized about this event’s 11th year, and I’m personally thrilled that my hometown is the setting that will begin OkMOM’s second decade of service to our state. I guarantee that your involvement in these two days will impact your life forever!

OkMOM registration is now open and hotels in the area are available and ready to give you and your staff discounted rates.

Many of us learned how valuable our skills are to the service of others while we were in dental school. Here I must thank Dr. Raymond Cohlmia, Dean of OU’s College of Dentistry, and all of the College’s faculty for their dedication to the training of upcoming doctors in our profession. OUCOD provides the best dental education in the country, and creates exceptional professionals ready to contribute to dentistry as a whole. One of the more exciting outreach aspects of the ODA is its relationship-building activities with dental students and its commitment to helping new doctors transition into practice and specialty programs.

Our Association is strong and valuable.

As I’ve traveled with our ODA Executive Director Lynn Means to meetings in various states, I’ve observed how often her input and expertise is sought by other executive directors. Oklahoma dentists are well led and well represented. Ms. Means and her team are always available to explain the value of ODA membership, and to address any other questions that may arise.

Consider, for example, the many benefits of our ODA Rewards Partners program, ably led by Dr. Mary Martin and her committee.

You can save a significant amount of money in your practice and assist the ODA at the same time since a percentage of sales revenue is donated to the ODA. Back to your calendar: Dentist Day at the Capitol is Tuesday, February 18, 2020. Please

consider engaging with state legislators at this annual event. The new legislative session will be under way, and strong communication is necessary to build on the success of the previous session. Our Legislative Affairs Council, chaired by Dr. Lindsay Smith, has put in many exhaustive hours of work with our ODA Lobbyist Scott Adkins. Last year the Virtual Credit Card Bill was passed, which now gives your business the option to be paid how you choose, and to avoid additional credit card transaction costs. We also got a bill passed that requires insurance companies to honor claims as approved through predeterminations. For all of you who called and visited legislators, thank you for helping make our legistlative efforts so successful for all ODA members. Make sure the 2020 date is in your phone...Your efforts will be needed.

"Take a fresh look at your Association and know that we all work better together."

I am halfway through my year of service as your president; in conjunction with your ODA, I remain committed to assisting you.

If there is an issue you are not sure how to handle, or a concern you want addressed, please reach out. Take a fresh look at your Association and know that we all work better together.

Turn to page 15 to read ODA by the numbers.

Oklahoma Dental Association

O p t i m i z e Yo u r P r a c t i c e : U n d e r s ta n d i n g D e n ta l B e n e f i t s , t h e C D T C o d e - a n d M o r e

December 6, 2019 9:00 AM - 12:00 PM OU College of Dentistry // Room 108 3 CE hours

Speaker: James Welch Hollingsworth, DMD register at okda.org/educatioN COST:

ODA Members & Staff: $56 Non-ODA Members & Staff: $86

sponsored by

www.okda.org

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ODA Annual Awards Nominations Do you know of an ODA member colleague who should be recognized for his/her contributions to dentistry or someone who has gone above and beyond the call of duty with charitable and community work?

The ODA looks forward to recognizing members for outstanding achievement in the following areas:

Distinguished Dentist Service

Robert K. Wynne Public information

(Formerly known as Dentist of the Year)

A member dentist who has worked to advance the knowledge of dentistry and dental health through public education and public relations efforts.

Young Dentist of the Year

Dan E. Brannin Professionalism

A new member dentist who exhibits an active interest in organized dentistry and has enhanced the image of the dental profession. Eligible candidates for this nomination must have been in practice for 10 years or less.

The member dentist selected as having made significant contributions to the advancement of the principles and practice of ethics and professionalism in dentistry.

Thomas Jefferson Citizenship

Richard T. oliver legislative

A member dentist who has made significant contributions to community service and philanthropic works in the area of dentistry.

A member dentist who has given outstanding effort and leadership in the Oklahoma legislative process on behalf of the Oklahoma Dental Association.

The dentist selected as having made the greatest contribution to the advancement of dentistry in Oklahoma.

Nomination Form The nomination form can be found on the ODA website at www.okda.org/members-only/member-awards/, or on page 45 of the 2019-20 Membership Directory. Nominations must be made by an ODA Member Dentist.

The deadline to submit nominations is December 31, 2019.

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journal | Nov/Dec 2019

OKLAHOMA MISSION OF MERCY STILLWATER

YXa FEBRUARY 7 & 8

PAYNE COUNTY EXPO CENTER

VOLUNTEER REGISTRATION NOW OPEN AT OKMOM.ORG NEW FOR !

2020

OKMOM VOLUNTEER T-SHIRTS DESIGNED BY ESKIMO JOES!

Shirts are only guaranteed for pre-registered volunteers.

Online Registration closes January 28, 2020.

Sweatshirts available for purchase at okmom.org

DID YOU KNOW? As an ODA member your contribution to OkMOM 2020 can easily be included in your annual dues payment. Simply check the OkMOM box under Voluntary Donation when paying by mail or online.

Thank you for your support of OkMOM 2020!

www.okda.org

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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 two of our Partners. Learn about all of the Partners at www.okda.org/rewards-partners.

Insurance Verification Too Time Consuming?

Staff Spread Thin? We Can Help!

Insurance Answers Plus (IAPlus) is an innovative service that increases front office efficiency and helps manage your patient’s insurance. ⦁ ⦁ ⦁

120+ benefit answers on local or na�onal employer’s plans (regardless of carrier) Service includes automa�c daily plan updates - we even fight claims for you if paid differently.

Free ‘Real Time’ pa�ent eligibility - confirma�on of coverage in seconds, most major carriers.

OTHER OFFERS/SERVICES: Insurance/Coding Seminar: “Advanced Dental Billing with aTwist” is Friday, Nov 8th-San Antonio Riverwalk. Na�onal speaker Chris�neTaxin will go over the 63 changes in CDT 2020 (37 addi�ons, 5 revisions, 6 dele�ons & 15 editorial revisions). Cost: $315 (or group rates if 3+). A $139 room rate (on the Riverwalk) for overnight guests.

Expanded Remote Services: We can a�ach benefits, eligibility & history in your prac�ce management system. Op�ons for upda�ng your coverage books & elimina�ng duplicate employers.

E-Claims: ODA Members pay only 25 cents each, 1 st 60 days of claims are free. No set up/monthly fee.

Claims Follow - Up: Temporary or permanent help, remote access required, billed on a per hour basis.

Claims Follow - Up:Use promo code IAPlusZ1M to save $239 on se�ng up an NEA account.

NEA A�achments: NEA A�achments: .

Contact Us at: IAPlus.com or Call Us Toll Free: (800) 683-2501

Your State Logo Here BENEFITS WITH LANDS’ END®: Build your brand with 10% off all Lands’ End-label apparel, plus 10% off logos and promotional products.

You also get a FREE custom company storefront that lets your employees place their own orders.

WE SUPPLY CONFIDENCE™ - Legendary Lands’ End quality

- We fit every body, from size

XXS to 5XL

- Award-winning customer service

- No minimum orders, no inventory - Complete program management - Expert in-house embroidery

- Everything is Guaranteed. Period.®

SHOP ONLINE OR BY PHONE Shop the entire assortment at ada.landsend.com or call 800-990-5407

NEW! SCRUBS 10 journal | Nov/Dec 2019

Contact Account Manager Barb Ramsden for additional program information barbara.ramsden@landsend.com • 608-935-6452

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

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

Medical Evacuation Members receive reduced membership rates.

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

Luxury Vehicles Exciting member discounts on Mercedes-Benz vehicles.

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

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

Patient Payment Plans Help patients get what they need, without delay!

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

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

Website Design & Marketing Services Members can save on websites.

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

The Leader In Amalgam Separation Members can receive a free NXT Hg5 Collection Container with Recycle Kit with purchase of an NXT Hg5 Amalgam Separator.

Electronic Insurance Claims Receive e-claims for only .25 cents.

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.

Special Services & Shipping Discounts Members have access to new & improved flat discount pricing.

Electronic Credit Card, Check Management & Payroll Processing Services Receive special pricing, efficiently pay your staff & manage general HR needs.

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

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

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

Staff Logo Apparel Save up to 10% on products and logo embroidery.

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

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

FOR MORE INFORMATION:

VISIT OKDA.ORG/REWARDS-PROGRAM CALL 405.848.8873

www.okda.org

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we’re in this together.

AS AN ODA MEMBER, YOU CAN SAVE ON DENTAL SUPPLIES. ODA Supply Source offers:

• • • • •

Only products from direct manufacturers or authorized distributors.

More than 65,000 products from more than 500 brands (most available through dealers).

Product lines of more than 60 direct manufacturers that don’t sell through dealers.

No gray market, expired or counterfeit items.

FREE ground shipping on any order, regardless of size.

Endorsed by the Oklahoma Dental Association

877-659-7310 2019 12 journal | Nov/Dec

| support@ODASupplySource.com | Fax 877-659-5004

Customer support is available Mon-Fri, 8 am–7 pm.

CONGRATS to Dentists for the Disabled and Elderly in Need of Treatment (D-DENT)

2019

winner of the

dr. rodney l. huey memorial champion of oklahoma health award D-D ENT Awa r d ed Cha m pi o n s o f H ea lth To p H o n o r Rueben Reyes, Community Engagement Coordinator

Keynote speaker Sugar Ray Leonard [c] with D-DENT representatives [l-r] Dr. Rodney Shivers (Chair, Board of Directors), Shirley Harris (Executive Director), Barbara Lopez (Assistant Director), and Dr. Bernard Rhone (Board Member).

Each year Blue Cross Blue Shield recognizes individuals and organizations working to make a difference in the health of Oklahoma communities. Champions of Health award winners were honored during the Champions of Health Gala held September 26th at the Cox Convention Center in Tulsa, Oklahoma. Boxing legend Sugar Ray Leonard was the featured keynote speaker. This year D-DENT received the highest Champions of Health honor, the Dr. Rodney L. Huey Memorial Champion of Oklahoma Health award, as the overall winner.

D-DENT’s mission is to provide free comprehensive dental care to low-income, uninsured Oklahomans through a network of statewide volunteer dentists. D-DENT executive director Shirley Harris thanked all the dentists and dental professionals whose volunteer work has made D-DENT such a success. “Each one of you has had a positive impact on the oral health of the low-income, uninsured, elderly, developmentally disabled, and veterans of Oklahoma.”

D-DENT invites all dental professionals to help celebrate its accomplishments and the dental community that makes it possible at its annual Casino/Awards Night to be held December 6th at the prestigious Oklahoma History Center. Join the celebration that will include music, hors d’oeuvres, a cash bar, and free casino games!

For information on how you can make a difference volunteering through D-DENT call 405-424-8092.

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 treatment. This partnership with dentists throughout Oklahoma allows D-DENT to complete a patient’s full-mouth restoration, absolutely free.

In September, the ODA had the honor of attending the 16th Annual Champions of Health Gala benefiting the Oklahoma Caring Foundation. This event recognizes outstanding Oklahoma organizations and individuals who are making a positive impact on the health of our state through innovative programs. The ODA is proud to be a part of the coalition of partners who support this foundation and its mission of providing Oklahomans access to preventive health services. Congratulations to all of this year’s winners and finalists!

To learn more about the Champions of Health and its beneficiary, the Oklahoma Caring Foundation, visit championsofhealth.org.

(L-R) Dr. Daniel Wilguess, Lynn Means, Dr. Paul Mullasseril and Dr. Robert Herman at the Champions of Health Gala

Dr. Daniel Wilguess with Keynote speaker, Sugar Ray Leonard

www.okda.org

13

ODA MARKETING COACH

MANAGING MARKETING

What It Means and Why It Matters Marketing is more than just advertising and, whether you realize it or not, you’ve been marketing your practice since the first day you started treating patients.

Every interaction with every patient, vendor, supplier and neighbor is an opportunity to market the practice.

So is your presence in the community.

Marketing can be approached in many ways: it can be done on the fly, strategically, or somewhere in between the two. To be successful, it must be effective. To be effective, it must give you the platform to educate patients, both current and prospective ones, and engage with them. Engagement, or feeling involved with your practice, is especially important to patients who see themselves as health care consumers; these individuals expect to have equal responsibility and authority for managing their health care. Often, they actively research providers, treatment options and even pricing.

If patient engagement sounds like more than you’re ready for, make sure that your marketing keeps your practice visible, provides information, and highlights how your practice stands out from others in the community.

Effective marketing will help you gain the attention of the types of prospective patients that you want. It will also help you keep them in your practice for years to come.

While marketing budgets in most practices vary, mature practices or those nearing a transition in ownership typically invest more on marketing; new ones usually invest less since they’re also dealing with the costs of starting the business.

A good rule of thumb when budgeting for marketing expenses is to allow 3-6% of a new practice’s expenses; 2-3% for mature practices; and about 4% for practices that are in the middle.

Dentists in new practices should plan on spending about $40,000 on marketing during the first year and can include that amount in the overall financing of the practice. How you invest your marketing budget will depend on your goals, the market you’re in and the channels and tactics you use. When determining your total marketing budget, you should consider earmarking 5-10% of that amount to updating your website.

Don’t Forget! Check your state’s dental practice act to see what’s allowable and legal under local laws and regulations before you make any marketing plans.

Regulations vary so it’s important that you know your state’s restrictions, requirements, and even its stipulations about contests and “thank you” gifts for patient referrals.

It’s also a good idea to review the ADA Principles of Ethics and Code of Professional Conduct for guidance; pay special attention to sections 5.F., 5.H. and 5.I: these sections review advertising, announcing specialization and limitation of practice, and general practitioner announcement of services.

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/practicemanagement/marketing

14 journal | Nov/Dec 2019

ODA MEMBERSHIP BY THE NUMBERS Gender 78% 22%

*As of October 2019*

Member Locations

Male Female

Ages

11.15%

Central Oklahoma

6.9%

Eastern Oklahoma

15%

75+

20%

65 - 74

17%

55 - 64

16%

45 - 54

20%

35 - 44

12%

25 - 34

Membership 79%

Active

21%

Retired

6.02%

Northern Oklahoma

5.26%

Northwest Oklahoma

35.59%

Oklahoma County

10.96%

Southwest Oklahoma

24.13% Tulsa County

www.okda.org

15

go team, go!

Yo u r d en ta l t ea m c o u ld w i n

a free dinner

c o u rt esy o f t h e o da * to enter, Register four people as a team for the 2020 Annual Meeting. registration opens in february, 2020.

Once your team is registered, post a photo of your team or anything directly related to the annual meeting on social media and tag the oda for an extra contest entry! Use the hashtags #be interested & #ODAMeeting2020 Winners will be chosen at random. First place will receive a $250 gift card for a team dinner.

Second place will receive 4 free tickets to the 2020 president's party. * vist okda.org/team-contest for official rules & information

points

for

purchase Win free registration for the 2020 ODA Annual Meeting with odasupplysource Receive one point for every dollar you spend through ODASupplySource! The three ODA members with the most points will win FREE registration to the 2020 Annual Meeting in Oklahoma City. Simply shop, save and earn points!

Contest ends December 31st . If you have questions about the contest please contact the ODA at 800-876-8890

16 journal | Nov/Dec 2019

NEW FOR 2020 PRESENT

Annual Meeting & scientific day be interested Oklahoma City, OK April 16 - 18, 2020 The ODA is excited to have the OU College of Dentistry Scientific Day at the 2020 ODA Annual Meeting. Students and residents will display and present their research projects in the Exhibit Hall Friday morning. The ODA welcomes the opportunity to share this combined event with an additional 500 dental students, dental hygiene students, residents, faculty and graduates. This is an opportunity to meet and support the future professionals of dentistry! Meeting attendees will receive CE and have the opportunity to interact with the poster presenters while exploring the Exhibit Hall. www.okda.org 17 Meeting Registration Opens in February okda.org/annual-meeting

speakers For a full list of speaker, visit okda.org/annual-meeting/speakers

david maloley DDS

|

Host of “The Relentless dentist” Podcast

Lessons learned from the titans of dentistry Dr. David Maloley is the co-founder of DentalSuccessNetwork.com, author of “Titans of Dentistry: How the Top Performers Think and Act Differently, host of “The Relentless Dentist” podcast, and High Performance Coach. In this course, this jack-of-all-dental-trades will dive into the habits, thought processes and actions of the world’s most successful dentists. Everything Dr. Maloley teaches has been extensively tested and proven, and will provide a clear path to success without all the guesswork!

2 CE Hours

FriDay, April 17

Robert maguire ddS, MASCL The economics of great communication Communication is an area that is rarely spoken about in dental continuing education courses and yet from Dr. Maguire’s experience, great communication leads to more satisfied patients, increased happiness, greater job satisfaction, and improved profitability. In this course, Dr. Maguire will share practical knowledge regarding the importance and benefits of great communication within a dental practice. He’ll go through a process for developing a communication plan for your office. At the end of the course, you will come away with strategies you can apply and use on Monday morning.

6 ce hours

Friday, April 17

(Morning & Afternoon course)

earn ce hours at scientific day!

Friday, April 17

Earn Hours at the Student poster presentations & Ishmael Essays

18 journal | Nov/Dec 2019

the ODA Annual meeting is the premier educational and social event for dentists in Oklahoma

Lunch & Learns Theresa Gonzales DMD, MS, MSS

|

Professor, dept. of stomatology

medical university of South Carolina

Informing “Informed” Consent - An Ethical Imperative Informed consent is a process of communication that empowers a patient to make voluntary decisions about accepting or declining care. Informed consent has both ethical and legal implications in clinical practice. It is intended to shift the ethical paradigm for decision-making away from doctor-centered models to more patient-centered approaches. The ethics of informed consent center on patient autonomy and their right of self-determination. From this course, you will gain a greater understanding of how to practice in a way that is most ethically responsible for your patients.

1.5 CE Hours (Ethics)* Saturday, April 18

Ticketed Course

* AN ETHICS COURSE IS REQUIRED DURING EACH CE REPORTING PERIOD.

Mike Hunter Attorney General of Oklahoma Opioids As attorney general, Mike Hunter has made the safety and security of all Oklahomans one of his top priorities. Determined to end the state’s opioid overdose and addiction epidemic, his office has taken a multidisciplinary approach to solving the problem. Shortly after taking office, he formed the Oklahoma Commission on Opioid Abuse. The commission brought all stakeholders to the table and saw seven pieces of legislation become law in 2018. The laws give more tools to law enforcement personnel, prevent the diversion of opioid prescriptions from flooding the market and hold distributors, manufacturers and businesses accountable through proper oversight.

Hunter and the state of Oklahoma recently won a class action lawsuit against the nation’s leading opioid manufacturers for waging a more than decade-long fraudulent marketing campaign that has profited from the anguish of Oklahomans, who have become addicted or have died because of the crisis.

1.5 ce hours (Opioids)* Saturday, April 18

Ticketed Course

* DENTISTS ARE REQUIRED TO DO 1 HOUR OF OPIOID PRESCRIBING OR PAIN MANAGEMENT CONTINUING EDUCATION PER YEAR FOR A TOTAL OF 2 HOURS PER 2 YEAR REPORTING PERIOD. NEWLY LICENSED DENTISTS ARE REQUIRED TO DO 2 HOURS WITHIN THE FIRST YEAR OF RECEIVING THEIR INITIAL LICENSE.

To review the changes in Oklahoma law concerning prescription writing for Opioids and Benzodiazepines, see page 36.

www.okda.org

19

social events at the annual meeting

20 journal | Nov/Dec 2019

Stay Connected to ODA News

M N P

www.Facebook.com/Okdentalassoc @OklaDentalAssoc @OkDentAssoc

OKDA.org

www.okda.org

21

Fall Fun

The ODA hosts several events throughout the year for OU College of Dentistry students. This dedication to dental student programs helps to foster an awareness of the importance of organized dentistry early in their careers. With the help of the ODA Council on Membership and Membership Services, the ODA provides a variety of programs that benefit dental students not only educationally, but also personally.

ODA President, Dr. Dan Wilguess, and ASDA President, Edith Lu, with door prize winners at the ODA Fall Festival

OU College of Dentistry Students attend the 2019 ODA Fall Festival 2019 ODA Student Fall Festival

Dr. Melissa Jackson and third-year dental student, Chau Banh, at the ODA Mentor Meet & Greet

22 journal | Nov/Dec 2019

Dr. Brian Drew and second-year dental student, Thanh Truong, at the ODA Mentor Meet & Greet

Dr. Victoria Ball (Contemporary Endodontics of Oklahoma) and OUCOD Students at the ODA Progressive Office Tour Dr. Victoria Ball guides a student in using the Zeiss PROergo Microscope

Drs. Heath Whitfield and David Eckroat (Edmond Pediatric and Teen Dentistry) and Drs. John Archer, Gabe Luttrell, Geoff Sparks and Ryan Theobald (Orthodontic Associates) with OUCOD Students during the Progressive Office Tour

Emily Brooks (DS2), Dr. Lauren Klaus, Margaret Schick, Alex Sodderfelt (DS2), Dr. Rob Schick and Nancy Ha (DS3) attend the ODA Mentor Meet & Greet

Dr. Gregory Shanbour with OUCOD students during the ODA Progressive Office Tour

Dr. Mike Gliddon and third-year dental student, Edith Lu, at the ODA Mentor Meet & Greet

www.okda.org

23

Newly Elected ADA Officers Dr. Chad P. Gehani Installed as ADA President Dr. Gehani and the new and returning officers were installed in their offices before proceedings of the ADA House of Delegates at the ADA FDI World Dental Congress in San Francisco in September. The meeting was the 160th annual meeting of the ADA.

Dr. Chad P. Gehani, of Queens, New York, took office Sep. 9 as the 156th president of the American Dental Association.

During his address to the House of Delegates, Dr. Gehani told members it is his "responsibility to ensure that the ADA remains the guardian of your life commitment to the profession — and I am not just talking about your dues dollars. The ADA must be a responsible custodian of your time as volunteers and of your talents as clinicians, researchers and educators."

"The ADA must be relevant to all of us," he said.

President-elect Daniel J. Klemmedson, Second Vice President Vincent U. Rapini, Speaker W. Mark Donald and four new trustees assumed office: Dr. Richard J.

Rosato, 1st District; Dr. Terry Fiddler, 12th District; Dr. Brett Kessler, 14th District; and Dr. Craig Armstrong, 15th District.

Dr. Gehani, who served as a delegate from 2000-14, served as ADA 2nd District trustee from 2014-18. He previously served as president of the New York State Dental Association and the Queens County Dental Society. In addition to the ADA, Dr. Gehani is a member of the American Association of Endodontists and the Indian Dental Association.

Dr. Gehani received his dental degree from Columbia University College of Dental Medicine. He is the recipient of the Ellis Island Medal of Honor, which recognizes Americans who dedicate their lives to community and is bestowed by the Ellis Island Honor Society.

14th District Trustee, Dr. Daniel J. Klemmedson elected ADA President-elect Dr. Klemmedson, of Tucson, Arizona, is past 14th District trustee and has served as an ADA House delegate. He is a past president of the Arizona Dental Association, the Southern Arizona Dental Society, the Western Society of Oral and Maxillofacial Surgeons and the Arizona Society of Oral and Maxillofacial Surgeons.

Over the course of his career, Dr. Klemmedson has earned awards, including the Dentist of the Year award and the Hall of Fame Service award from the Arizona

Dental Association. In 2018, he received the Gerald E. Hanson Outstanding Service Award from the Oral and Maxillofacial Surgery Foundation.

He graduated from the University of Southern California and also earned his medical degree at the USC School of Medicine.

12th District Trustee, Dr. Terry Fiddler Dr. Fiddler is a dentist in Conway, Arkansas, and has served on the House of Delegates for more than two decades. He was chair of the ADA Council on Communications.

Dr. Fiddler has also served as the president of Arkansas State Dental Association and founded the

Arkansas Forensic Identification Team and the Arkansas State Dental Association Peer Review. He has received fellowships from the American College of Dentistry, the International College of Dentistry and the Pierre Fauchard Academy.

Visit ada.org/publications/ ada-news for a complete recap of the ADA meeting and information on all the new and returning officers.

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

24 journal | Nov/Dec 2019

It's Time to Renew Your ODA/ADA Membership The 2020 membership renewal period begins at the end of November. Make sure you renew by January 1, 2020 to maintain all of the great benefits membership provides. Our strength in Washington, D.C., at our State Capitol, and in your community is reliant on our united dental front, so renew for 2020 and help us continue the fight! We even offer convenient installment plans to fit your budget. Renew right away to keep your profession strong and help save the ODA money on renewal notice mailings.

Convenient Dues Installment Payment Plans You don’t have to pay your 2020 ODA/ADA/Component (Tripartite) dues all at once.

Your ODA understands that it may not be convenient to remit your membership dues in one payment. We are excited to provide you with the opportunity to pay your 2020 membership in 2-12 monthly installments! You have the option of renewing in a way that is convenient for you.*

To take advantage of an ODA dues installment plan, please contact Kylie Ethridge, ODA Director of Membership, at kethridge@okda.org or 405.848.8873. *There is a nominal $6.00 installment fee for each payment.

Auto Renew Plan This plan allows your dues to be renewed automatically and paid with your credit card or an ACH/ICA payment each year. The auto renew plan will give the option of a once-peryear payment or a 12-month payment plan that the ODA will process continuously from year to year until you ask the auto renew/payment to stop. You will be allowed to update/ change your credit card, recognizing it will expire at some point, or if you wish to change to a different card for future charges. However, to cancel any automated credit card charge, please contact the ODA. If the 12-month plan is selected, any monthly past-due payments will be automatically processed in order to catch up to the current month.

Related to voluntary contributions, the auto renew will continue to include the previous year’s amounts given (e.g., if you give $170 to DENPAC in one year, the auto renew option would continue to charge that same voluntary contribution in subsequent years). If you want to change a voluntary contribution for any subsequent membership year, simply contact the ODA to ask for the change in amount.

The process renew payments onon thethe 15th of each TheODA ODAwill will processauto auto renew payments 15th of month.

each month. https://www.modental.org/member-center/

join-renew :////

The ODA extends our deepest sympathy for our colleagues and friends who have passed.

James K. Callahan

Mack L. Rose

Arvil B. Holt

Randy J. Ryan

12/12/2018

Oklahoma County Dental Society

12/20/2018

Oklahoma County Dental Society

John J. McCrory 11/08/2018

Tulsa County Dental Society

06/19/2019

04/29/2019

Central District Dental Society Northern District Dental Society

Matthew C. Stephens

05/09/2019

Tulsa County Dental Society

Jerome B. Miller

Frank S. Wamsley

Richard K. Powell

Robert C. Wells

07/17/2019

05/13/2019

Darryl D. Reed 03/31/2019

Oklahoma County Dental Society Northern District Dental Society Northern District Dental Society

J. Dean Robertson 02/05/2019

Oklahoma County Dental Society

07/28/2019

06/29/2019

Southwest District Dental Society Central District Dental Society

Nelson L. Wolfe

11/13/2018

Tulsa County Dental Society www.okda.org

25

A Gift that Helps Your Colleagues Thank you to the following ODA Members who donated in 2018 to the Oklahoma Dental Relief and Disaster Grant Program The RDGP is a charitable entity that offers aid to dental professionals and their dependents who, because of misfortune, natural disaster, chemical dependence, physical disability, or other hindering conditions, are not wholly self-sustaining. This program exists to award financial aid to Oklahoma dental professionals, yet relies solely on contributions.

Dr. George Abdelnour Dr. Jeffrey Ahlert Dr. Addie Allen-Steed Dr. Errol Allison Dr. Jim Ambrose Dr. Clay Anderson Dr. Jamie Ariana Dr. Bonnie Arnould Dr. Forrest Arnould Dr. Douglas Auld Dr. Michael Auld Dr. Lauren Avery Dr. Jeannie Bath Dr. Bryce Baumann Dr. Robert Baumann Dr. Justin Beasley Dr. William Beasley Dr. Kari Bender Dr. Tamara Berg Dr. David Bird Dr. Bryan Blankenship Dr. Richard Bohlander Dr. Ryan Brackett Dr. George Bridges Dr. Matthew Bridges Dr. Nathan Brown Dr. Steven Brown Dr. Adam Bulleigh Dr. Bonnie Burton Dr. Patricia Cannon Dr. Wuse Cara Dr. John Carletti Dr. Bobby Carmen Dr. Mary Casey Kelly Dr. Conrad Casler Dr. Brian Chastain Dr. Adam Cohlmia Dr. Matthew Cohlmia Dr. Raymond Cohlmia Dr. Leon Conkling Dr. Debbie Corwin Dr. James Corwin Dr. Jeffrey Danner 26 journal | Nov/Dec 2019

Dr. Russell Danner Dr. Darrell Daugherty Dr. Susan Davis Dr. David Deason Dr. Steven Deaton Dr. William Deprater Dr. Bryce Dorrough Dr. Ana Dotson Dr. Brian Drew Dr. Kevin Duffy Dr. Patrick Dukes Dr. Heath Evans Dr. Barry Farmer Dr. Joseph Feng Dr. Chad Garrison Dr. Stephen Glenn Dr. Mark Goodman Dr. Sandra Grace Dr. Matthew Gray Dr. Evangeline Greer Dr. Steven Gregg Dr. Shannon Griffin Dr. Robert Gruenberg Dr. Jacob Hager Dr. Leslie Hardy Dr. Aaron Harman Dr. Edward Harroz, Jr. Dr. Edward Harroz, III Dr. James Herndon Dr. Marilyn Hiebert Dr. Myron Hilton Dr. Mathew Hookom Dr. James Hooper Dr. Brad Hoopes Dr. Mitchell Hoopes Dr. Jeffrey Housley Dr. Benjamin Humphrey Dr. Eugenia Johnson Dr. Katherine Johnson Dr. Mohammad Karami Dr. Larson Keso Dr. Michael Kirk Dr. Theodore Kondos

Dr. Robert Lamb Dr. Ashley Lanman Dr. Larry Lavelett Dr. Grady Lembke Dr. Christopher Leslie Dr. Marti Levinson Dr. Dustin Lively Dr. Robert Livingston Dr. Gary Lott Dr. Jeff Lunday Dr. Steve Lusk Dr. David Maddox Dr. David Marks Dr. Mark Massaro Dr. Stephen Mayer Dr. Jonas McCall Dr. Stephen McCullough Dr. Janna McIntosh Dr. Daniel McNair Dr. Glenn Mead Dr. Jamie Means Dr. Mark Mettry Dr. Lindsey Miller Dr. Robert Miracle Dr. Andrea Montgomery Dr. Patrick Montgomery Dr. Mohsen Moosavi Dr. Robert Morford Dr. James Murtaugh Dr. Jeff Parker Dr. Justin Power Dr. Karen Reed Dr. William Reeves Dr. Mark Revels Dr. Andrea Rios Dr. Erin Roberts-Svob Dr. Brant Rouse Dr. Miranda Ruleford Dr. Andrea Scoville Dr. Gregory Segraves Dr. Mickey Sehorn Dr. Meghan Sellmeyer Dr. Paul Shadid

Dr. Greg Shanbour Dr. David Simon Dr. Donald Smith Dr. Gregg Smith Dr. Lori Smith Dr. James Sparks Dr. Chad Spiva Dr. Braden Stoltenberg Dr. B. Dan Storm Dr. Patrick Stover Dr. James Strand Dr. Guy Strunk Dr. Carla Sullivan Dr. Joe Swink Dr. Jamie Talley Dr. Robert Talley Dr. Jim Taylor Dr. John Thomas Dr. Roy L. Thornbrough Dr. Kara Tims Dr. Corbyn Van Brunt Dr. Jonah Vandiver Dr. Randall Venk Dr. Nathan Villines Dr. Robert Webb Dr. Robert Wells Dr. Wavel Wells Dr. Amanda Wendelken Dr. Stephanie Wendt Dr. Steven White Dr. Theresa White Dr. W. Scott White Dr. Susan Whiteneck Dr. Kim Wilkinson Dr. M. Karen Willhoite Dr. Jack Willoughby Dr. Bernie Wynn Dr. William Wynn Dr. William Yadon Dr. Kendra Yandell

You can make a donation to RDGP at okda.org/programs.

Get Involved with the ODA Are you interested in becoming more active with the ODA through participation in a Council or Committee? What about a position of leadership within your local dental society? There are many ways to participate. The ODA Council on Nominations is accepting nominations for election at the April 2020 House of Delegates meeting. Contact the ODA at 800.876.8890 for more information about any of the volunteer opportunities. Nominations may be submitted to Dr. Paul Mullasseril, Council Chair, at presidentelect@okda.org, your component dental society’s president-elect, or the ODA office

by January 4, 2020.

Print Name: Component (District) Dental Society: Email Address: Phone Number:

Select the area(s) in which you are interested in serving: q Vice President

q Board of Trustees

q Speaker of the House of Delegates

q House of Delegates

q ADA Delegate

q DENPAC Board of Directors

q ADA Alternate Delegate

q

q Council on Budget and Finance

q Standing Committee on OHCA and DHS

q Council on Bylaws, Policy and Ethics

q Annual Meeting Planning Committee

q Council on Dental Care

q Oklahoma Mission of Mercy (OkMOM)

q Council on Dental Education and Public Information

Component (District) Office

Planning Committee

q Rewards Partners Committee

q Council on Governmental Affairs

q Investment Committee

q Council on Membership and Membership

q OK Dental Relief and Disaster Grant Program

Services

Board of Trustees

Nominations are Due by January 4, 2020 www.okda.org

27

Thank You to the 2019 Smile Contributors

Smile is a voluntary section of membership that helps the ODA shine a light on the importance of dentistry and all of the great things dentists are doing throughout Oklahoma. This voluntary contribution also helps support the ODA/ADA's ongoing Find-a-Dentist campaign. Your $25 Smile membership enables the ODA to promote a positive oral health message around the state through multiple public relations tools and also supports your ODA helping patients find a dental home.

Please consider supporting this important effort when renewing your 2020 membership!

Dr. Jeffrey Ahlert Dr. Errol Allison Dr. Jim Ambrose Dr. Jamie Ariana Dr. Marc Arledge Dr. Bonnie Arnould Dr. Forrest Arnould Dr. Douglas Auld Dr. Michael Auld Dr. Lauren Avery Dr. Jeannie Bath Dr. Robert Baumann Dr. Justin Beasley Dr. Kari Bender Dr. Bryan Blankenship Dr. Richard Bohlander Dr. Ryan Brackett Dr. Matthew Bridges Dr. Nathan Brown Dr. Steven Brown Dr. Adam Bulleigh Dr. Bonnie Burton Dr. Kristen Campbell Dr. Patricia Cannon Dr. Wuse Cara Dr. John Carletti Dr. Bobby Carmen Dr. Mary Casey Kelly Dr. Brian Chastain Dr. Adam Cohlmia Dr. Matthew Cohlmia Dr. Raymond Cohlmia Dr. Debbie Corwin Dr. James Corwin Dr. Lester Cowden

28 journal | Nov/Dec 2019

Dr. Jeffrey Danner Dr. Russell Danner Dr. Susan Davis Dr. David Deason Dr. Steven Deaton Dr. Michael Dial Dr. Bryce Dorrough Dr. Ana Dotson Dr. Brian Drew Dr. Kevin Duffy Dr. Heath Evans Dr. Barry Farmer Dr. Keifer Fisher Dr. Richard Freeman Dr. Emily Frye Dr. Chad Garrison Dr. Stephen Glenn Dr. Mark Goodman Dr. Sandra Grace Dr. Matthew Gray Dr. Steven Gregg Dr. Shannon Griffin Dr. Jacob Hager Dr. Harold Hall Dr. Michael Hansen Dr. Leslie Hardy Dr. Aaron Harman Dr. Edward Harroz, Jr. Dr. Edward Harroz, III Dr. James Herndon Dr. Marilyn Hiebert Dr. Myron Hilton Dr. James Hooper Dr. Jeffrey Housley Dr. Benjamin Humphrey

Dr. Donald Johnson Dr. Katherine Johnson Dr. Mohammad Karami Dr. Michael Kirk Dr. Jay Kruska Dr. Robert Lamb Dr. Larry Lavelett Dr. Grady Lembke Dr. Dennis Leseberg Dr. Marti Levinson Dr. Dustin Lively Dr. Robert Livingston Dr. Gary Lott Dr. Jeff Lunday Dr. Kevin Mailot Dr. David Marks Dr. Mark Massaro Dr. Stephen Mayer Dr. Stephen McCullough Dr. Janna McIntosh Dr. Glenn Mead Dr. Jamie Means Dr. Mark Mettry Dr. Lindsey Miller Dr. Robert Miracle Dr. Andrea Montgomery Dr. Patrick Montgomery Dr. Mohsen Moosavi Dr. Robert Morford Dr. James Murtaugh Dr. David Nittler Dr. Justin Power Dr. Karen Reed Dr. James Roane Dr. Erin Roberts-Svob

Dr. Miranda Ruleford Dr. Andrea Scoville Dr. Gregory Segraves Dr. Mickey Sehorn Dr. Meghan Sellmeyer Dr. Paul Shadid Dr. Kyle Shannon Dr. David Simon Dr. James Sparks Dr. Chad Spiva Dr. B. Dan Storm Dr. James Strand Dr. Carla Sullivan Dr. Joe Swink Dr. Robert Talley Dr. Jim Taylor Dr. John Thomas Dr. Roy L. Thornbrough Dr. Kara Tims Dr. Corbyn Van Brunt Dr. Jonah Vandiver Dr. Randall Venk Dr. Nathan Villines Dr. Robert Webb Dr. Robert Wells Dr. Stephanie Wendt Dr. Theresa White Dr. W. Scott White Dr. Susan Whiteneck Dr. Kim Wilkinson Dr. William Wynn Dr. William Yadon

Thank You to the 2019 Pride Contributors Pride is a voluntary section of membership that shows how much you care about the future of organized dentistry. Your Pride membership dues go directly to offset some of the costs of lobbying at the State Capitol. It is imperative that we continue to maintain a positive and powerful presence at the Capitol and your $25 ODA Pride membership continues to make that possible. Please consider making this small, additional contribution when renewing your 2020 membership.

Dr. Jeffrey Ahlert Dr. Addie Allen-Steed Dr. Errol Allison Dr. Jim Ambrose Dr. Jamie Ariana Dr. Marc Arledge Dr. Bonnie Arnould Dr. Forrest Arnould Dr. Douglas Auld Dr. Michael Auld Dr. Lauren Avery Dr. Jeannie Bath Dr. Robert Baumann Dr. Justin Beasley Dr. Kari Bender Dr. Bryan Blankenship Dr. Ryan Brackett Dr. Jamie Branham-Williams Dr. C .Todd Bridges Dr. Matthew Bridges Dr. Nathan Brown Dr. Steven Brown Dr. Adam Bulleigh Dr. Bonnie Burton Dr. Patricia Cannon Dr. Wuse Cara Dr. John Carletti Dr. Bobby Carmen Dr. Mary Casey Kelly Dr. Brian Chastain Dr. Nicole Chung Dr. Brian Coerver Dr. Adam Cohlmia Dr. Jeff Cohlmia Dr. Matthew Cohlmia Dr. Raymond Cohlmia Dr. Debbie Corwin Dr. James Corwin Dr. Lester Cowden Dr. Jeffrey Danner Dr. Russell Danner Dr. Darrell Daugherty Dr. Susan Davis Dr. David Deason

Dr. Steven Deaton Dr. Michael Dial Dr. Bryce Dorrough Dr. Ana Dotson Dr. Brian Drew Dr. Kevin Duffy Dr. Heath Evans Dr. Barry Farmer Dr. Bryan Fields Dr. Richard Freeman Dr. Emily Frye Dr. Chad Garrison Dr. Stephen Glenn Dr. Mark Goodman Dr. Sandra Grace Dr. Matthew Gray Dr. Jerry Greer Dr. Steven Gregg Dr. Shannon Griffin Dr. Robert Gruenberg Dr. Jacob Hager Dr. Bruce Hall Dr. Harold Hall Dr. Michael Hansen Dr. Greg Hardman Dr. Leslie Hardy Dr. Aaron Harman Dr. Edward Harroz, Jr. Dr. Edward Harroz, III Dr. James Herndon Dr. Marilyn Hiebert Dr. Mathew Hookom Dr. James Hooper Dr. Jeffrey Housley Dr. Donald Johnson Dr. Katherine Johnson Dr. Janet Julian Dr. Mohammad Karami Dr. Stephanie Kendrick Dr. Michael Kirk Dr. Michael Kubelka Dr. Robert Lamb Dr. Ashley Lanman Dr. Larry Lavelett

Dr. Grady Lembke Dr. Dennis Leseberg Dr. Christopher Leslie Dr. Marti Levinson Dr. Dustin Lively Dr. Robert Livingston Dr. Juan Lopez Dr. Gary Lott Dr. Jeff Lunday Dr. Steve Lusk Dr. David Maddox Dr. Kevin Mailot Dr. David Marks Dr. Mark Massaro Dr. Stephen Mayer Dr. Jonas McCall Dr. Stephen McCullough Dr. Janna McIntosh Dr. Zachary McNickle Dr. Glenn Mead Dr. Joseph Meador Dr. Mark Mettry Dr. Lindsey Miller Dr. Robert Miracle Dr. Andrea Montgomery Dr. Patrick Montgomery Dr. Mohsen Moosavi Dr. Robert Morford Dr. James Murtaugh Dr. David Nittler Dr. Justin Power Dr. Karen Reed Dr. Andrea Rios Dr. H. Grant Ritchey Dr. James Roane Dr. Erin Roberts-Svob Dr. Miranda Ruleford Dr. Andrea Scoville Dr. Gregory Segraves Dr. Meghan Sellmeyer Dr. Paul Shadid Dr. Greg Shanbour Dr. Kyle Shannon Dr. John Sheets

Dr. LaTonya Shelton-Miller Dr. Steffan Sigler Dr. David Simon Dr. Charles Sims Dr. Lori Smith Dr. Brooke Snowden Dr. James Sparks Dr. Chad Spiva Dr. B. Dan Storm Dr. James Strand Dr. Carla Sullivan Dr. Jackson Sullivan Dr. Joe Swink Dr. Robert Talley Dr. Jim Taylor Dr. John Thomas Dr. Roy L. Thornbrough Dr. Kara Tims Dr. JayCee Van Horn Dr. Jonah Vandiver Dr. Randall Venk Dr. Nathan Villines Dr. Robert Webb Dr. Robert Wells Dr. Stephanie Wendt Dr. Theresa White Dr. W. Scott White Dr. Quint Whitefield Dr. Susan Whiteneck Dr. Kim Wilkinson Dr. Jana Winfree Dr. David Womble Dr. William Wynn Dr. William Yadon

www.okda.org

29

LEGISLATIVE LOOP Legislative Overview & Political Update

ADA Advocacy News Anti-Vaping Efforts Recent vaping-related illnesses and deaths have brought attention to the use of e-cigarette products becoming an oral health epidemic for teens and young adults. Congress, in addition to the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), state and local health departments, and public health partners are responding to the multi-state outbreak of lung injury associated with e-cigarette product use, or vaping. On September 9, the ADA and 44 other health groups asked members of Congress to co-sponsor the Stopping Appealing Flavors in E-Cigarettes for Kids Act, or SAFE Kids Act. The bill would restrict the use of e-cigarette flavors and ban cigar flavors altogether. The coalition also sent letters of support to President Trump and the First Lady on their recently announced plan to curtail distribution of flavored e-cigarette products. The American Dental Association is also proud to be a supporting organization of the newly formed bipartisan Congressional Caucus to End the Youth Vaping Epidemic, which will review needed legislative solutions that will protect American youth from the dangers of vaping and nicotine addiction.

New Student Debt Bill Introduced in the House The ADA sent a letter to the House Committee on Education and Labor in support of H.R. 3418, the Protecting Our Students by Terminating Graduate Rates that Add to Debt Act (POST GRAD Act). This bill, sponsored by Rep. Judy Chu (D-CA), would reinstate eligibility for graduate and professional students with financial need to receive Direct Subsidized Stafford Loans, which are now only available to undergraduate students. In the letter, ADA President Chad P. Gehani and ADA Executive Director Kathleen T. O’Loughlin shared how dental student debt has risen to the point that today 85 percent of new dentists are starting their careers owing more than $287,000 in student loan debt. Over two-thirds (64.4 percent) of dental school seniors who graduated in 2017 reported that postgraduate debt moderately, very much or completely influenced their activity choice after graduation. The promise of a lower debt burden can help shape early career decisions about practicing in underserved areas, pursuing a career in academia or public service and filling other areas of national need. Enabling graduate and professional students to access Direct Subsidized Loans will not solve the student debt crisis.

But it will help offset the alarming levels of student debt that new dentists face at graduation and it is one of many bills in Congress that could positively affect new dentists.

SAVE THE DATE!

ADA Sets Record Straight on Status of Petition to FDA Regarding FDA SmileDirectClub.

The American Dental Association believes the public has a right to accurate information concerning the status of its pending citizen petition submitted to the U.S. Food and Drug Administration (FDA) about SmileDirectClub, LLC’s directto-consumer plastic teeth aligner business. SmileDirectClub’s (SDC’s) inaccurate public statements that the ADA’s petition has been “shut down” or “dismissed” may deter customers who have experienced clinical problems in connection with SDC’s aligner “treatment therapy” from reporting their negative experiences to the FDA. Read more at ada.org/publications/ada-news.

For more information on these and other ADA advocacy efforts, visit ada.org/advocacy 30 journal | Nov/Dec 2019

oda Dentist Day at the Capitol TUESDAY, FEBRUARY 18, 2020

ODA Building: 317 NE 13th St, OKC, OK 73104 4:00 P.M. ORIENTATION OF ODA'S LEGISLATIVE AGENDA 5:00 TO 6:30 P.M. DENTIST / LEGISLATOR RECEPTION

ALL ODA MEMBERS ARE STRONGLY ENCOURAGED TO ATTEND! REGISTER AT BIT.LY/DDAC2020

Thank you 2019 Oklahoma Dental Political Action Committee (DENPAC) Members!

Members who support DENPAC are very special people. They’ve taken the added step of making that extra, very important donation to Oklahoma dentistry – a small personal investment that pays huge dividends for dentistry in general, and to you as a practicing dentist, in particular! DENPAC contributors provide the funding that fuels the ODA’s legislative engine. Keep up the good work and please remember to support DENPAC when renewing your 2020 dues!

Dr. Jeffrey Ahlert Dr. Errol Allison Dr. Jim Ambrose Dr. Clay Anderson Dr. Jamie Ariana Dr. Tabitha Arias Dr. Glenn Ashmore Dr. Michael Auld *Dr. Douglas Auld Dr. Lauren Avery Dr. Robert Baumann Dr. William Beasley Dr. Kari Bender *Dr. Tamara Berg Dr. David Birdwell Dr. Bryan Blankenship Dr. Richard Bohlander Dr. Blaire Bowers Dr. Ryan Brackett Dr. Jamie Branham-Williams *Dr. C. Todd Bridges Dr. Matthew Bridges Dr. Nathan Brown Dr. Steven Brown Dr. Nathan Buckner Dr. Adam Bulleigh Dr. William Burchard Dr. Bonnie Burton Dr. Patricia Cannon Dr. Wuse Cara Dr. John Carletti Dr. Bobby Carmen Dr. William Carter Dr. Mary Casey Kelly Dr. Brian Chastain Dr. Brian Coerver Dr. Adam Cohlmia Dr. Raymond Cohlmia *Dr. Matthew Cohlmia Dr. Debbie Corwin Dr. James Corwin Dr. Lester Cowden Dr. Jeffrey Danner *Dr. Susan Davis Dr. David Deason Dr. William Deprater Dr. Myrna Domoney

Dr. Ana Dotson Dr. Brian Drew Dr. Kevin Duffy Dr. Katharine Dunnington Dr. Heath Evans Dr. Christopher Fagan *Dr. Timothy Fagan Dr. Barry Farmer Dr. Bryan Fields Dr. Emily Frye Dr. Chad Garrison Dr. Stephen Glenn Dr. Mark Goodman Dr. Matthew Gray Dr. Stephen Gray Dr. Evangeline Greer Dr. Jerry Greer *Dr. Shannon Griffin Dr. Clark Grilliot Dr. Robert Gruenberg Dr. Jacob Hager Dr. Harold Hall Dr. Kevin Haney Dr. Michael Hansen Dr. Mark Hanstein Dr. Leslie Hardy Dr. Aaron Harman Dr. Edward Harroz, III Dr. Richard Haught Dr. John Henry Dr. Richard Henry Dr. Robert Herman Dr. Jeffrey Hermen Dr. Randi Hobbs Dr. Mathew Hookom Dr. James Hooper Dr. Brad Hoopes Dr. Moiz Horani Dr. Roger Janitz Dr. Eugenia Johnson Dr. Donald Johnson Dr. Katherine Johnson *Dr. Krista Jones Dr. Mohammad Karami Dr. Michael Kirk Dr. Jandra Korb Dr. Mitchell Kramer

Dr. Jay Kruska Dr. Robert Lamb Dr. Ashley Lanman Dr. Larry Lavelett Dr. Grady Lembke Dr. Dennis Leseberg Dr. Christopher Leslie Dr. Marti Levinson Dr. Robert Livingston Dr. Juan Lopez Dr. Gary Lott Dr. James Lowe Dr. Jeff Lunday Dr. Steve Lusk Dr. David Maddox Dr. Kevin Mailot Dr. David Marks Dr. Molly Marshall Hays Dr. Mary Martin *Dr. Stephen Mayer Dr. Stephen McCullough Dr. Janna McIntosh *Dr. Glenn Mead Dr. Robert Miracle Dr. Mohsen Moosavi Dr. Robert Morford Dr. Anaita Mullasseril Dr. Paul Mullasseril Dr. James Murtaugh Dr. Lisa Nowlin Dr. Samuel Owens Dr. Garrett Phipps Dr. Jeffrey Pierce Dr. Justin Power Dr. Erin Roberts-Svob Dr. Thomas Rogers Dr. Brant Rouse Dr. Miranda Ruleford Dr. Robert Schick Dr. Andrea Scoville Dr. Gregory Segraves Dr. Meghan Sellmeyer Dr. Paul Shadid Dr. Gregory Shanbour Dr. John Sheets Dr. Steffan Sigler Dr. David Simon

Dr. Kent Smith *Dr. Lindsay Smith Dr. Brooke Snowden Dr. Geoffrey Sparks Dr. James Sparks Dr. Rachel Standlee Dr. Braden Stoltenberg Dr. B. Dan Storm Dr. James Strand Dr. Carla Sullivan Dr. Marc Susman Dr. Joe Swink Dr. Jim Taylor Dr. John Thomas Dr. Paul Thomas Dr. Kara Tims *Dr. James Torchia Dr. Steve Truong Dr. Travis Turney Dr. JayCee Van Horn Dr. Jonah Vandiver Dr. Nathan Villines Dr. Brett Warn Dr. W. Scott Waugh Dr. Robert Webb Dr. Mark Weems Dr. Robert Wells Dr. W. Scott White Dr. Quint Whitefield Dr. Susan Whiteneck *Dr. Daniel Wilguess Dr. Kim Wilkinson Dr. Vincent Willcox *Dr. C. Rieger Wood Dr. William Wynn Dr. William Yadon Dr. Kendra Yandell Dr. Stephen Young Dr. Justin Young Names in Purple are 2019 OKCapitol Club Members Names in Gold are 2019 DENPAC Grand Members *Current DENPAC Board Member

www.okda.org

31

Experience the Magic!

Disney Play & Learn Seminar November 21-26, 2019

Disney World’s Contemporary Resort in Orlando, Florida 12 Hours of CE • November 23-25 • 7:30-11:30 am

$369 per night*

*Double occupancy - add $25 per additional adult 18 and over

Registration Fees $550** ADA Member Dentist $750** Non-Member Dentist $275** Student ASDA Member

$275** Dental Office Staff $60** Non-Dentist Guest

**Up to 3 guests are included with your registration fee. For each additional guest, including children, there is an additional $60.00 registration fee per guest. If a dentist is not the primary registrant, then the primary office staff registrant must pay the dentist registration fee. All guests must be registered with the conference and with Disney Lodging Reservations in order to receive group discounts.

Visit disneyplayandlearn.org to download your registration form. Follow the link to reserve your room at the Contemporary Resort and to purchase park tickets.

Call 800.489.2532 or email disney@aldaonline.org for more information.

4-hour morning sessions so you can enjoy the parks afternoon and night! Group lodging discounts and multi-day discounts to all Disney Parks!

Open to all dentists, dental staff, families and friends.

Jennifer Hirsch Doobrow, DMD, FICD

Committing Your Practice To Ultimate Patient Care: An Interdisciplinary Team Approach to Periodontal, Regenerative and Implant Therapies Saturday, November 23, 2019 | 7:30 - 11:30 am This exciting and interactive course emphasizes the interdisciplinary team approach to ultimate patient care. Defining your practice and developing effective strategies for patient communication to enhance case presentation and case acceptance is the key to differentiating your practice in our challenging economic environment. Emphasis is placed on elevating the entire dental team as a key partner in care from early detection, assessment and treatment planning from tooth preservation to tooth replacement. A highlight of this program is creating an evidence based patient workflow plan for periodontal, regenerative and implant therapies. Collaboration among YOUR dental team is vital to creating a positive and lasting patient experience. Today is the day to go from good to great!

Edgar Luna, DMD

From Simple to Complex, Everyone Deserves a Diamond Smile!

Sunday, November 24, 2019 | 7:30 - 11:30 am It’s no surprise when I say that everyone wants to look and feel their very best. Our challenge, as dentists, is how do we take an average smile and turn it into an absolutely beautiful smile? In this course you will learn how to consistently obtain beautiful results no matter how challenging the case may be.

From the straight forward 10 unit veneer case, to the full mouth rehabilitation with lost vertical dimension case, we will show you stepby-step how to consistently obtain beautiful results. Some of the topics that will be discussed include: smile design, prep design, material, cements and the 2 major thoughts on occlusion.

Gerry George, CDT

Latest Trends in Restorative Implant Dentistry Monday, November 25, 2019 | 7:30 - 11:30 am Today’s fast paced world of dentistry can be hard to keep up with. Gerry George, CDT will help you with a current assessment of the world of Implant Dentistry. As he is a 35 year veteran of the dental technology industry he will provide a well rounded perspective of the current trends in implant dentistry. The focus of his discussion will center around restoring edentulous and partially edentulous patients. His approach will include discussing case planning, the value of study models, Diagnostics, restorative options and material choices. His knowledge and expertise will shed light on the many options and services available to specialists and general dentists as they tackle restoring complex implant cases for patients.

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DO YOU KNOW ABOUT VAPING? Your kids probably do.

E-cigarettes and vapor products are increasingly popular and accessible in Oklahoma – especially among youth – but do they know the dangers?

This is a JUUL️, the most popular brand of e-cigarette. Kids often refer to vaping as “JUUL️ing.”

WHAT IS VAPING?

WHY IS IT DANGEROUS?

“E-cigs” or “vapes” are battery-powered devices that heat nicotine juice to create an aerosol, which is inhaled by the user. The juice is often stored in replaceable pods. These devices have deceptively sleek designs that look like everyday items and can be easily hidden. E-cigarettes have become the most commonly used tobacco product among U.S. middle and high school students.

Vape juices often have dangerously high levels of nicotine.

In fact, just one JUUL️ pod contains as much nicotine as 20 cigarettes.

- Nicotine can impair youth brain development, which continues until at least age 25.

- Young people who use e-cigarettes are up to seven times as likely to use other forms of tobacco.

- Aerosols from vaping contain cancer-causing chemicals and heavy metals.

- Vaping can cause throat irritation and worsen respiratory conditions like asthma and bronchitis.

WHAT CAN YOU DO? - Ask kids about e-cigarettes and warn of their dangers.

- Learn about the shapes and types of e-cigarettes and how to spot them.

- Keep the conversation going; it’s important to talk often about the dangers of vaping.

Talk to your doctor today to learn more about protecting youth from a lifetime of addiction.

Need more resources to help protect our youth from e-cigarettes?

Discover signs of vape use, terms to know, tips for talking about vaping and more at

www.okda.org

35

ODA FEATURE

Current Oklahoma Statutes on Opioid Prescribing: A Review

By: M. Edmund Braly DDS FACS Associate Professor, Oral & Maxillofacial Facial Surgery ,University of Oklahoma College of Dentistry This article is intended to provide Oklahoma dentists with a review of the statutes that pertain to the prescribing of opioids and benzodiazepines to their patients. It will also cover what is currently being taught at the OU College of Dentistry on the subject.

Oklahoma has recently been at the center of national discussions of the opioid crisis because [1] so many of our citizens have fallen prey to opioid addiction and [2] Oklahoma’s Attorney General recently won a class action lawsuit against a major opioid producer. That lawsuit will be the first of hundreds to be filed nationally on behalf of other States, stakeholders, and patient groups.

Oklahoma dentists have been proactive in making sure that Dentistry is addressing the opioid crisis in a positive way. The Board of Dentistry and the ODA have worked to provide information that can help the practicing dentist understand the extent of the crisis and to be aware of guidelines that can significantly reduce unnecessary opioid prescribing. The ODA provided expert testimony to a task force of the State’s Attorney General, some of which was used in preparing the class action suit. We have seen dramatic changes in prescribing patterns as a result of nationwide awareness programs and CE presentations by the ADA, the AMA, the AAOMS, and many others.

The ODA’s Annual State Meeting has offered such presentations every year for the past several years, and the Oklahoma Board of Dentistry now requires CE specific to the subject. Many dental practices in the State are now marketing themselves as “opioidfree.”

Much of the material used for this article was provided by information from the Oklahoma State Medical Association (OSMA), the Oklahoma State Board of Pharmacy (OSBP), the Oklahoma Bureau of Narcotics and Dangerous Drugs (OBNDD), and professors at the OU College of Pharmacy. An initial notification to this Journal about statutory changes that were not widely known in the Dental community led to the decision to produce this review.

36 journal | Nov/Dec 2019

Seeking to turn the tide on the opioid crisis, the Oklahoma legislature has made several changes to how we will provide prescriptions to our patients. For instance, physicians and dentists will be required to submit narcotic prescriptions electronically by January 1, 2020. This will allow for a much closer monitoring of providers, patients, and dosages involved in prescription writing. Typically, the programs used to write and transmit prescriptions can be queried by BNDD computers several times per minute. The OBNDD is empowered to provide licensing boards with unsolicited referrals for prescribers if a patient receives one or more prescriptions in quantities or at a frequency inconsistent with accepted standards of safe practice. The most recent changes became effective May 1, 2019 and involve prescription writing of opioids and benzodiazepines. A summary of two new laws (Senate Bills 1446 and 848) was distributed to physicians and pharmacists for review. The document is available through the OSMA website. (See summary below.) Of course, the prescriber must also have checked the patient’s data in the Oklahoma Prescription Monitoring Program (PMP) website within 180 days of sending an opioid, benzodiazepine, or Soma (carisoprodol) prescription.

THE NEWEST REQUIREMENTS ARE AS FOLLOWS: 1. For acute pain, the prescriber shall not issue an initial prescription to exceed one week’s supply of the lowest effective dose of an immediate-release opioid drug. The words “acute pain” must appear on the face of the prescription. If the patient needs a second prescription, it cannot be written before the “do not fill date,” which would be one week after the initial prescription.

The second prescription, not to exceed seven days’ supply, should not be written

without a second consultation (by telephone or in person), which is then recorded in the patient’s chart. The chart entry should indicate that the prescription is necessary and appropriate, include the rationale for prescribing, and determine and document that the prescription does not present undue risk of abuse, addiction or diversion. “Acute pain” should also appear on the second prescription.

2. There are specific requirements for treating chronic pain with opioids, but they fall outside the normal parameters of dental health care. These patients are usually managed by physicians who are pain specialists.

3. The prescriber must thoroughly document the rationale for exceeding a 100mg MME (Morphine Milligram Equivalent). There is an app from the CDC called “CDC RX” which contains a handy MME calculator, CDC guidelines for prescribing opioids, an online training series for applying these guidelines, and a list of twelve recommendations related to opioid prescribing.

4. Prior to the initial prescription, the practitioner shall [1] take and document a thorough medical history, [2] conduct and document a physical exam, [3] develop a treatment plan, [4] access the PMP, [5] limit the supply to no more than seven days for acute pain, and [6] enter into a written Patient-Provider Agreement with the parent or legal guardian if the patient is under 18 years of age. Such an agreement is also required if there is a third opioid prescription given for the same “acute pain” regardless of the patient’s age. This is also true if any patient is given a prescription for an opioid and a benzodiazepine to be taken the same day.

5. Informed Consent and Risk Discussions: Prior to the initial prescription and again prior to the third prescription, the practitioner must discuss with the patient [1] the risks of addiction and overdose, and the dangers of taking opioids with alcohol, benzodiazepines and other CNS depressants, [2] the reason the prescription is necessary, [3] alternative treatments available, and [4] that risks may include fatal respiratory depression. The practitioner shall document these discussions in the patient’s chart.

6. A Patient-Provider Agreement (PPA) is required [1] at the time of a third prescription for an opioid drug, [2] if more than three months of opioid is required, [3] if the patient is to receive opioids and benzodiazepines together, [4] if the prescription exceeds 100mg MME, and/or [5] if the patient is pregnant. A PPA with the parent or legal guardian is required if the patient is under 18 years of age.

7. Exclusions: Senate Bills 1446 and 848 do not apply to patients receiving active treatment for cancer, hospice care, palliative care, drug abuse or opioid dependence, or to residents of a long-term care facility.

8. Any provider authorized to prescribe opioids must have a written policy that

includes execution of written contracts with patients [1] requiring opioid therapy for more than three months, [2] being prescribed opioids and benzodiazepines together, and [3] being prescribed dosages that exceed 100mg MME. ODA Members are encouraged to review the document entitled Compliance and Best Practice for an Act Regulating the Use of Opioid Drugs, Oklahoma Senate Bills 1446 and 848. The document includes additional information on managing chronic pain with opioids (not the usual purview of Dentistry).

At the OU College of Dentistry, students are being taught to manage postoperative pain with an alternating combination of ibuprofen and acetaminophen. In the Oral Surgery Clinics, we are having no difficulty managing postop pain from third molar extractions with this approach. When opioids are prescribed (which is rare) a typical prescription is for only 2-3 days.

Extreme care is taken to avoid introducing opioids to opioid-naive patients, especially adolescents.

Opioids, if deemed necessary, should be of the lowest effective dose of immediate release medication, for no more than three days. More information on managing pregnant and lactating patients is available from the following websites: www.opqic. org/omno, www.cdc.gov/treatingfortwo and toxnet.nim.nih.gov/newtoxnet/lactmed.htm.

The Oklahoma Dental Association, the Oklahoma Board of Dentistry, and the University of Oklahoma College of Dentistry are committed to providing appropriate guidance and continuing education so that dentists in our State continue to provide proactive and positive efforts at eliminating the opioid crisis.

Turn to page 38 for the official notice from the Oklahoma Board of Dentisty.

Turn to page 41 for the e-prescribing waiver request form.

If a patient is pregnant, it is important to consider that NSAIDs may be associated with increased risk of fetal harm if used during the first and third trimesters.

Required e-Prescribing in Oklahoma As of January 1, 2020 prescribers will be required to electronically prescribe Schedule II through V controlled substances in Oklahoma.

Waivers or extensions can be granted through the licensing board; if granted, prescribers will be required to use official prescription forms provided by the Oklahoma State Bureau of Narcotics and Dangerous Drugs Control.

Oklahoma Prescription Monitoring Program (PMP) Prescribers (or their designated staff) are required to check the Oklahoma PMP for new patients or if 180 days have elapsed since the last PMP check for the patient, prior to prescribing any of the following: opiates, synthetic opiates, semi-synthetic opiates, benzodiazepine, or carisoprodol (Soma).

National PMP Participation Oklahoma participates in the National Association of Boards of Pharmacy (NABP) PMP InterConnect, a network that facilitates the transfer and sharing of PMP data across state lines. Participating states linked through PMP InterConnect are thereby provided a more effective means of combating drug diversion and drug abuse.

Be on the lookout for more information about e-Prescribing in the 2020 January/February ODA Journal and in your ODA e-newsletters. www.okda.org

37

Susan Rogers, Esq.

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J. Kevin Stitt

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OKLAHOMA STATE BOARD OF DENTISTRY

ʹ͝ʹͲ Ǥ ‹Â?…‘ŽÂ? ÂŽÂ˜Â†Ç¤ÇĄ —‹–‡ Â?ŽƒŠ‘Â?ƒ ‹–›ǥ Â?ŽƒŠ‘Â?ƒ ͚;ͳͲ͡ Š‘Â?‡ ͜Ͳ͡Ȁ͡ʹʹnj͜ͺ͜͜ ƒš ͜Ͳ͡Ȁ͡ʹʹnj͜͸ͳ͜

Acute vs. Chronic Pain Opioid Prescribing, E-Prescribing and Continuing Education Changes and Requirements

This past legislative session there were several bills passed that were requested by the State Opioid Commission headed by the Attorney General’s office regarding prescribing and continuing education hours for all medical prescribers. A couple of the bills covered the same statutes but had contradictory language which has caused a great deal of confusion. This information will hopefully clear up the majority of the issues.

Senate Bill 848 and 1446 (2019) Both of these legislative bills went into effect on emergency May 21, 2019 Seven (7) day and Acute vs. Chronic – New requirements for ALL opioid prescriptions For any first time prescription of an opioid, you must write “ACUTE PAIN� on the prescription for the pharmacist to be able to fill it and the prescription is to be for the lowest effective dose of immediaterelease opioid drug. 63 O.S. § 2-309(I)(A). You may issue one subsequent 7-day prescription but you MUST DOCUMENT the rationale behind the need for the opioid and that it does not cause an undue risk of abuse, addiction or diversion. I have attached the legislation on page 4 of this document.

House Bill 2931 (2018) E-Prescribing This bill was enacted in 2018 but goes into effect January 1, 2020 This bill was also a request of the opioid commission. The specific statute is on page 6 of this document. *Pursuant to section 5(f). a practitioner may request a waiver from the Board. *Pursuant to section 9, any practitioner receiving a waiver may only write prescriptions from prescription pads issued from the Oklahoma Bureau of Narcotics.

38 journal | Nov/Dec 2019

There are still a couple of issues being worked out by multiple agencies based on this legislation however be advised of the following: 1. The primary software vendors used in dental offices are averaging about 4 weeks behind to get your office set up for e-prescribing. This will more likely become a longer time period instead of a shorter time period in the upcoming months.

2. Before you call them, please have a copy of your current dental license, OBN registration and DEA registration available.

3. The Board does not have a recommendation for a vendor, however make sure they have a DEA certified program.

4. OBN Will NOT process your prescription pad request until they have received a copy of the WAIVER FROM THE OKLAHOMA DENTAL BOARD. 5. No, there is no plan or ability to postpone the e-prescribing law as the legislative session does not even begin until February and it goes into effect January 1 st.

6. The Dental Board Members recognize that due to many circumstances beyond the control of practitioners many of you will need waivers. At the bottom of this information there is a form that you can fill out to request a waiver. ALL WAIVERS WILL EXPIRE DECEMBER 31ST OF 2020. As I said before, there are still many things being worked out and OBN does not have all the answers and we do not have all of the answers and probably won’t have until after this legislative session.

7. The Board is required to send a list of dentists with waivers to OBN before they will allow you to order prescription pads.

8. The address and name listed on your OBN registration is what will be printed on the prescription pads so make sure it is up to date and current.

If you are going to request a waiver for e- prescribing, PLEASE FILL OUT THE ATTACHED REQUEST FOR E-PRESCRIBING WAIVER FORM AND EMAIL IT TO: susan.rogers@dentistry.ok.gov. PLEASE DO NOT HAVE YOUR STAFF CALL THE BOARD OFFICE TO ASK QUESTIONS ABOUT EPRESCRIBING, THEY ARE OVERWHELMED WITH CONTINUING EDUCATION AND RENEWALS. Opioid prescribing is a serious issue and although I am happy to answer any question I can, I do not want any misinformation to be disseminated through your staff or ours. Please email me directly and leave me a cell phone number that I can call if the answer is too long to type. I will try to post a questions and answers information page as questions arise for everyone’s convenience.

We appreciate your patience, none of these items were requested by the Board or the Association or OBN and we are all trying to adapt and make a process for the changes as well.

2 www.okda.org

39

Dental Assistants Infection Control Continuing Education Requirement

Dental assistant infection control requirements will not officially be due until the 2021 reporting period beginning July 1, 2019 and ending June 30th, 2021. The infection control requirement is two-hours per reporting period. Please make sure the class includes and follows the CDC guidelines for infection control in a dental setting. We are working with OMES to add a continuing education section for dental assistants. This is currently anticipated for launch in January 2020. https://www.cdc.gov/oralhealth/infectioncontrol/guidelines/index.htm

Dentists Continuing Education and Required Opioid Hours

This session there were a couple of legislative bills that were enacted on top of each other. Senate Bill 848 was one of the primary opioid bills that went into effect on emergency May 21, 2019 and mandated continuing education for opioid prescribing or pain management hours. Two years ago, the Board requested that the legislature change our continuing education time period from three (3) years to two (2) years, the same as approximately 40 other State Dental Boards and based on CPR certifications two (2) year validity. When Senate Bill 848 was written by the legislative staff members, they used an old bill with our old outdated continuing education language of a three-year reporting period that was changed two years ago. This incorrect language went into effect May 21st, 2019. However Senate Bill 603 had the updated correct language previously passed two years ago and should revert the continuing education time period back to two years beginning November 1 st when it goes into effect.

Senate Bill 848 adds 1 hour of mandated opioid continuing education hours per year for each of the medical boards that have prescribing powers. Some of the other Boards report Continuing Education each year when they do their renewal and others have a two-year reporting cycle. Because the staff used the old incorrect statute, the Dental Board portion said three-years based on a three-year renewal.

The intent of the legislation is 1-hour per year and this section of the statutes is enforced by the Board pursuant to Senate Bill 848. DENTISTS ARE REQUIRED TO DO 1 HOUR OF OPIOID PRESCRIBING OR PAIN MANAGEMENT CONTINUING EDUCATION PER YEAR FOR A TOTAL OF 2 HOURS PER 2 YEAR REPORTING PERIOD. NEWLY LICENSED DENTISTS ARE REQUIRED TO DO 2 HOURS WITHIN THE FIRST YEAR OF RECEIVING THEIR INITIAL LICENSE. The Board Staff will provide a one-hour prescribing class and/or a 1-hour ethics class FOR FREE if requested. If you would like to have a class presented in your area, please email Deputy Chief of Investigations Jeff Puckett at: jeff.puckett@dentistry.ok.gov. We will try to post the upcoming classes on the website for anyone to attend.

Again, thank you for your patience during all of these changes.

Susan Rogers, Esq. Executive Director and General Counsel Oklahoma Board of Dentistry Susan.rogers@dentistry.ok.gov

40 journal | Nov/Dec 2019

3

Susan Rogers, Esq.

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J. Kevin Stitt

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OKLAHOMA STATE BOARD OF DENTISTRY ʹ͝ʹͲ Ǥ ‹Â?…‘ŽÂ? ÂŽÂ˜Â†Ç¤ÇĄ —‹–‡ Â?ŽƒŠ‘Â?ƒ ‹–›ǥ Â?ŽƒŠ‘Â?ƒ ͚;ͳͲ͡ Š‘Â?‡ ͜Ͳ͡Ȁ͡ʹʹnj͜ͺ͜͜ ƒš ͜Ͳ͡Ȁ͡ʹʹnj͜͸ͳ͜

REQUEST FORM FOR E-PRESCRIBING WAIVER FROM THE OKLAHOMA BOARD OF DENTISTRY This waiver will automatically expire on December 31st 2020

1. __________________________________________________________ Dentists Name as listed on license 2. __________________________________________________________ Dentist’s Address as listed on Dental license 3. __________________________________________________________ Dental License Number and Expiration Date 4. __________________________________________________________ Oklahoma Bureau of Narcotics Registration Number and Expiration Date

*Make sure your address is current and correct on your OBN registration this is the address that will be put on your prescription pads.

5. __________________________________________________________ United States Drug Enforcement Agency’s Number and Expiration Date __________________________________________________________ 6. I certify that I have read the attached statutes and information regarding e-prescribing and opioid required continuing education. Signature of Dentist 7. Please state your basis for the request of the waiver below:

PLEASE FILL OUT THE ATTACHED FORM AND EMAIL IT TO: susan.rogers@dentistry.ok.gov. As stated in the information below I am required to send a list of waiver dentists to OBN. If you have any additional questions, PLEASE leave me a cell phone number that I can call and talk to you directly with a good time to call up until 10 p.m. Thank you for your patience and cooperation as we all work through these changes. www.okda.org

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Additional Opioid Best Practice Information COMPLIANCE AND BEST PRACTICE FOR AN ACT REGULATING THE USE OF OPIOID DRUGS OKLAHOMA SENATE BILLS 1446 & 848

Continuing Medical Education: Prescribers are required to complete CME in pain management every year. MDs, DOs, PAs, Optometrists and Veterinarians, one (1) hour; Podiatrists and Advanced Practice Registered Nurses, two (2) hours; Dentists, three (3) hours.

OBNDD: May provide licensing boards with unsolicited referrals of prescribers if a patient receives one (1) or more prescriptions in quantities or frequency inconsistent with accepted standards of safe practice. 63 O.S. §2-309D(M) Prescription Monitoring Program – PMP: Failure to check PMP is grounds for disciplinary action by the respective licensing board of each Prescriber. PMP must be checked at the initial prescription and then at least every 180 days. 63 O.S. §2-309D(G) Acute Pain Prescription Limits: For acute pain, prescriber shall not issue an initial prescription for an opioid drug in a quantity exceeding seven (7) day supply. Prescription shall be for the lowest effective dose of immediate-release opioid drug and must state “acute pain” on the face of the prescription. 63 O.S. §2-309I(A). Following the initial seven (7) days, after consultation* (in person or by telephone), a subsequent 7-day prescription may be issued if prescriber determines the prescription is necessary and appropriate, documents the rationale for prescribing, and determines and documents the prescription does not present undue risk of abuse, addiction or diversion. A second 7-day prescription of an immediate-release opioid drug in a quantity not to exceed seven (7) days may be issued on the same day as the initial prescription if: (i) The subsequent prescription is due to a major surgical procedure and/or “confined to home” status as defined in 42 U.S.C. 1395n(a); (ii) The practitioner provides the subsequent prescription on the same day as the initial prescription; (iii) The practitioner provides written instruction on the subsequent prescription indicating the earliest date on which the prescription may be filled (i.e. “do not fill until” date); and (iv) The subsequent prescription is dispensed no more than five (5) days after the “do not fill until” date indicated on the prescription. 63 O.S. §2-309(I)(B)(5); *For best practice, the 7-day consultation should be performed by the physician; however, it does not appear to be required. If a medication needs to be changed due to allergy, ineffective dose or other medical condition, document thoroughly in the record the need and rationale for change.

Chronic Pain Prescriptions: If continuing treatment for three months or more, practitioner shall: (1) review every three (3) months the course of treatment, any new information regarding etiology of pain and progress toward treatment objectives; (2) assess patient prior to every renewal to determine if patient is experiencing dependency and document assessment; (3) periodically make reasonable efforts, unless clinically contraindicated to stop, decrease dosage, or try other treatment modalities; (4) review PMP; (5) monitor compliance with patient provider agreement, and state “chronic pain” on the face of the prescription. After one year of compliance with the patient provider agreement, physician may review treatment plan and assess patient at six-month intervals. 63 O.S. §2-309I(F). *Assessment may be performed by a mid-level PA/APRN. Face-to-face assessment is recommended but not required. For best practice, the PMP should be checked more frequently than 180 days, but it is not required by 63 O.S. §2-309(D).

Morphine Milligram Equivalent - MME: If you choose to prescribe greater than 100 MME, document the rationale thoroughly.

Prior to Initial Prescription for Pain a Prescription for any Opioid: Practitioner shall: (1) take and document a thorough medical history; (2) conduct and document a physical exam; (3) develop a treatment plan; (4) access the PMP; (5) limit supply to no more than seven (7) days for acute pain; (6) if the patient is under 18, enter into a Patient-Provider Agreement with the parent or legal guardian. 63 O.S. §2-309I(B) Informed Consent & Risk Discussions: Prior to initial prescription and again prior to third prescription, practitioner must discuss risks including: (1) risks of addiction and overdose, dangers of taking opioids with alcohol, benzodiazepines and other CNS depressants; (2) reason the prescription is necessary; (3) alternative treatment available; (4) risks can include fatal respiratory depression. Practitioner shall document the discussion in the medical record. 63 O.S. §2-309I(D) Patient-Provider Agreement: Practitioner shall enter into a Patient-Provider Agreement with a patient: (1) at the time of the third prescription for opioid drug; (2) If patient requires more than three months of pain management; (3) if patient is prescribed benzodiazepines and opioids together; (4) if patient requires more than 100 mg morphine milligram equivalents (MME); (5) If patient is pregnant; or (6) with the parent or legal guardian if the patient is a minor. 63 O.S. §2- 309I(J); 63 O.S. §2-309I(B)(6),(7); 63 O.S. §2-101(45); Excluded: The requirements of SB 1446 and SB 848 do not apply to patients receiving active treatment of cancer, hospice, palliative care, residents of a long-term care facility, or medications for treatment of substance abuse or opioid dependence. 63 O.S. §2-309I(H) Written Policy: Any provider authorized to prescribe opioids shall adopt and maintain a written policy including execution of written contract between practitioner and *qualifying opioid therapy patient. 63 O.S. §2-309I (I) * (1) Patient requiring opioid therapy for more than (3) months; (2) a patient who is prescribed benzodiazepines and opioids together; (3) a patient who is prescribed a dose that exceeds one hundred (100) MME. Disclaimer: This Best Practices document is subject to change without notice and is made available to facilitate understanding of SB1446 and SB848. This is not intended to be an official interpretation or commentary on the intent of the law. Revision 6/3/19

42 journal | Nov/Dec 2019

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43

Collect What You Produce: The Psychology of Money

By Cathy Jameson, PhD | Part 1 of a ten-part series Money. That word means many different things to different people. Money—or even the thought of money-- stimulates various emotions. Some positive. Some negative.

Take a moment right now and write down the word ‘MONEY’. Now, underneath, write out every word that comes to your mind when you think of ‘MONEY’, INCLUDING EMOTIONAL WORDS related to your thoughts regarding money.

Use this reflection to take a deep dive into a study of money—and the entire concept of Collecting What You Produce in this article series for the Oklahoma Dental Association Journal.

One of the many benefits that my husband, Dr. John H. Jameson, and I have found by being active members of the Oklahoma Dental Association is the constant access to instruction that has helped us along our path to a successful life in dentistry. I hope that the instruction in this series will be of benefit to you.

Money and Psychology. Do They Go Together?

Psychology is the science of human behavior.

A behavior is something you can see, hear, or feel touch you. In your practice, money is (1) seen physically—and it is experienced emotionally in the mind’s eye of both you and the patient. Money is talked about, so these discussions can be (2) heard, and the impact of money does (3) touch everyone involved—both the person paying and the person being paid.

So, it is felt, or experienced. Therefore, the psychology of money-- its impact on human behavior-- is seen, heard, and felt.

There aren’t many things that are as personal to a human being as “money”. In fact, some people are more protective about and take better care of their money than they do their teeth.

People work hard for their money. It is with money that they sustain life. They put food on the table, a roof over their heads, gas in the car. A person’s basic needs are met by things that are purchased with money. Money is the vehicle by which safety and security are obtained, in many ways. Without safety and security, a person is placed into a state of fright and “insecurity” which leads to a state of disequilibrium. No one can function at full capacity in that kind of state. Neither a team member nor a patient can function at full

44 journal | Nov/Dec 2019

stride nor can they make major decisions when money is a major issue of concern.

appropriate rewards for work well done can be distributed.

And so, it is to everyone’s benefit that we face this topic, issue, area of concern called “MONEY” and learn how to turn this area of concern into a comfortable pathway to health, happiness, and stress relief.

10. Money is a measure—a way to monitor many aspects of the health and well-being of your practice. When goals are accomplished, celebrations occur and appreciation can be expressed.

A HEALTHY WORK ENVIRONMENT

11. Some people think that their worth is in direct proportion to the amount of money they make. Other people think that they are not worthy of being paid for the services they provide—or don’t think they deserve to be paid well.

Practices that are financially healthy are— usually—happier. Practices that are constantly under financial constraints are—usually— stressed. This stress, when left unbridled, can harm the interpersonal relationships of people on the team. It can negatively affect feelings toward patients. It can affect treatment planning—and, thus, every system down the line. When one system begins to falter, there is a domino effect—all other systems begin to falter, as well.

Money is, in one way or another, related to most every area of the practice—and to the people within it.

Consider the following: 1. Money has paid for dental school, hygiene school, CDA and RDA courses, certifications, business courses, continuing education, licensures.

2. Money was involved with the purchase or the building of the practice and/or is paid monthly for the rent or lease of the facility 3. Money is paid for equipment and supplies without which you cannot function.

4. Money pays salaries, taxes, and benefits.

People cannot work without being paid—and that includes the dentists.

5. Patients pay for and you receive compensation for services provided.

6. Team members have feelings about money— feelings about the worth of the services being provided; feelings related to conversations about money with patients; feelings about how much they are paid, about asking for a raise, about their financial worth to the practice.

7. Money is the medium that people exchange for their dental care. They place a “value” on the care they are receiving.

8. Sometimes money isn’t collected expediently and collection efforts are put forth. This can, for some people, be difficult and/or avoided.

9. With a well-managed practice, financial goals can be set and accomplished and

12. Money is one part of security and freedom.

13. Money is an important part of providing for one’s family.

14. Money is a vehicle.

15. Money is not the reason you are a healthcare provider. However, without money and a financially sound business, you cannot provide the care and treatment you believe to be beneficial to your patients. If you are not financially sound, everyone loses—you, your team, your patients, your families, and your community.

16. Money isn’t bad. You can and deserve to Collect What You Produce.

Can you develop a healthy relationship to money? Yes. Might it take some work?

Perhaps. Remember that money is a vehicle.

It’s not money that you want or need. It’s what money will do for you. Therefore, take some time to consider what is important to your life and to your ultimate happiness.

For example. If you say, “We need to increase our production. We need to see more patients or do more treatment.”Peel the layer of that onion and look deeper. Why do you want to produce more? Is it the increased revenue, the actual money to be exchanged that will bring you pleasure? What will you gain from the increase?

Will you get to: *Do more of the procedures you love to do? *See more patients accept treatment and get healthier? * Pay the bills on time? *Have more take-home money for your family needs?

*Take more time off to spend with family or on personal interests?

Those motivators you just identified can be accessed. Financial stress is well under control.

*Buy a house?

And just the opposite happens when finances are NOT HEALTHY. Financial stress results.

Financial stress can be agonizing and depletes energy—energy that is better invested in caring for oneself, family, teammates—and patients!!

When stress becomes so overwhelming that is causes either psychological (emotional) or physiological difficulties, it is termed “distress”.

The definition of distress is “unpleasant feelings or emotions that impact your level of functioning—sadness, anxiety, distraction.

Distress, when left uncontrolled, can harm the interpersonal relationships of people on the team. It can negatively affect interactions with patients. It can impact treatment planning— and, thus, every system down the line. As I said earlier, when one system begins to falter, there is a domino effect—all other systems begin to falter, as well. (Jameson, 2016) This, of course, just adds insult to injury by causing even more distress.

*Pay off debt? *Fund your kid’s college? *Pay your team in a more equitable manner? *Fund a retirement program for you and your team? *Buy that boat that you have yearned for so that you can fish more often—or whatever?

In this list of possible reasons for wanting to increase production, it isn’t the money that is the “goal”. The money—the increased production-- is the means to the end: the vehicle. The ultimate goal could be health, family, quality time, stress relief. It could be any or all of these things or others. It isn’t the money that is the goal. It’s those things that enhance your life: health, physical well-being, family, communion with nature, peace, security, etc. These are examples of motivators that are substantial and relevant to life. Motivators are unique for each person. What are your motivators?

Money: Exchange of Value

Money is an exchange of value. Patients receive the value of health, well-being, improved appearance, keeping their teeth for a lifetime, comfort, function. Life-enhancing benefits.

You receive money as the patient’s part of the exchange. Money is a moveable entity. It flows from one person to another; or one business to another.

In his article entitled "Philosophy of Money," published in Philosophy of Economics magazine, Alla Sheptun says that “Money is a thing which, irrespective of its material or symbolic form, has its own mode of moving from one person to another and this particular mode of moving makes money into a means of social interaction, into a medium of communication. This is the source of the immense value of money for society.”

Money’s value to you and to your patients lies in the fact that it serves as an exchange of value for life enhancement. Both you and your patients benefit from an equitable exchange of value, which occurs when you feel good about the money you receive for services rendered and your patient feels good about the investment, they have made in you and in your care.

Create A Healthy Work Environment

You already know this—but when a person is stressed-out--or in a state of distress at work— they often take that home with them. Then, distress has a negative impact on the home environment and the people there—the family.

Not good. American Dental Association Surveys indicate the number one source of stress for dental families is financial stress.

No surprise.

Is there an answer? Yes. First, identify your own “stressors”. A stressor is something that causes stress. Once you have identified that stressor, begin to plan how you will deal with it, resolve it, overcome it, eliminate it. And, take action to do so.

Goal: to have a healthy, happy life—and to have a healthy, happy practice—one that is productive, profitable and one that has stress well under control!! There is resolve to any situation you have that is causing you stress.

Reach out to find the solutions. Successful people and successful practices are the ones that identify problems and commit to finding solutions. The solutions will lead you to health and happiness.

Cathy Jameson, PhD, is the founder of Jameson Management, Inc., an international management, hygiene, and marketing firm which offers proven management and marketing systems for helping organizations improve in a positive, forward-thinking culture.

Jameson holds a doctorate in management from Walden University where she focused her research on transformational leadership. Dr. Jameson has been inducted into the College of Education Hall of Fame and is a Distinguished Alumna of Oklahoma State University. She serves on the Board of Governors there.

Jameson has been named one of the top 25 Women in Dentistry and has received Lifetime Achievement Awards from the Excellence in Dentistry Organization and from the Academy of Dental Office Managers. She was a finalist for the Stevie Award for outstanding entrepreneurial women. She is a member of the American Association of Female Executives, National Speaker’s Association, Academy of Dental Management Consultants, National Society of Leaders and Success and Chi Omega Women’s Fraternity.

Jameson has lectured in all USA states and in 31 countries. She has had over 1,500 articles published throughout the US and the world.

She is the author of eight books, including the 3rd Edition of her bestseller, Collect What You Produce and Creating a Healthy Work Environment. These can be purchased from Amazon.

For more information on Dr. Jameson’s lecture or personal consulting services, contact her at cathy@jamesonmanagement. com. For more information on the consulting services of The Jameson Management Group, contact www.info@jamesonmanagement.com or www.jamesonmanagement.com

Create a Healthy Work Environment as a part of a healthy, happy life—whatever that means to you. The decision—the choice—is up to you.

Begin now. Take that first step.

Jameson, PhD, Cathy. (2016) Creating a Healthy Work Environment. Editide. Marshfield, VT.

Many components are imperative to truly CREATE A HEALTHY WORK ENVIRONMENT. One component is financial health. When the finances of a practice are healthy—bills can be paid, investments can be made in continuing education, equipment and facility can be upgraded, team members can be well compensated—and so can the doctor.

www.okda.org

45

Differential Diagnosis of the Gingival Mass

By Glen D. Houston, DDS, MSD (gdhdds@heartlandpath.com)

CASE HISTORY

A 45-year-old female presents with an asymptomatic, fluctuant soft tissue mass involving the anterior mandibular gingiva.

The patient notes that the "lump" has been present for several weeks and has slowly increased in size.

QUESTION #1 The clinical differential diagnosis should include (multiple answers): a. Pyogenic granuloma b. Pleomorphic adenoma c. Fibroma d. Peripheral giant cell granuloma e. Peripheral ossifying fibroma f. Squamous cell carcinoma ANSWER #1 Your differential diagnosis should include: a. Pyogenic granuloma c. Fibroma d. Peripheral giant cell granuloma e. Peripheral ossifying fibroma All four of the above entities can present intraorally as isolated, circumscribed masses involving the gingiva.

The pyogenic granuloma (a) is a common tumor-like growth of the oral cavity that is believed to be non-neoplastic in nature. It is also felt to represent an exuberant tissue response to local irritation or trauma. The pyogenic granuloma typically presents as a smooth-surfaced mass that may be ulcerated; the gingiva is, by far, the most common location. However, it may also be observed involving the lips, tongue and buccal mucosa.

The fibroma (c) is the most common tumor of the oral cavity. Although it can appear anywhere in the mouth, the buccal mucosa is the most common anatomic location.

The labial mucosa, tongue and gingiva are also common sites. It typically presents as a smooth-surfaced, firm nodule with a broad, sessile base. The fibroma is usually asymptomatic and not ulcerated.

The peripheral giant cell granuloma (d) is also a tumor-like growth of the oral cavity that occurs exclusively on the gingiva or the edentulous alveolar ridge, and presents as a nodular mass. This lesion may be red to reddish-blue in color, exhibit a sessile or 46 journal | Nov/Dec 2019

pedunculated base, and may or may not be ulcerated.

The peripheral ossifying fibroma (e) is another non-neoplastic lesion that also occurs exclusively on the gingiva. It typically presents as a nodular mass with a pedunculated or broad sessile base. It may be red to pink in color and usually exhibits surface ulceration. This lesion usually involves the anterior segments of the jaws.

Although the pleomorphic adenoma (b) may occur in the oral cavity and typically presents as a nodular mass, it would not be included in the differential diagnosis here because the attached mucosa is typically devoid of salivary gland tissue. Likewise, while squamous cell carcinoma (f) may also occur intraorally, this malignant neoplastic process typically presents as an area of erythroplakia, leukoplakia, or an ulcerated, fungating mass. Only about four to six percent of these cases occur on the gingiva or the alveolar mucosa.

QUESTION #2 Which procedures are indicated for this patient (multiple answers)? a. Intraoral radiographic survey b. Biopsy the lesion c. Advise the patient to watch the lesion 10-14 days, then re-evaluate area for any change d. Advise the patient that no further evaluation is needed

ANSWER #2 The following procedures are indicated in this case: a. Intraoral radiographic survey b. Biopsy the lesion The intraoral radiographic survey (a) will supplement your clinical observations and will also complete a comprehensive intraoral examination. Additionally an isolated, asymptomatic mass involving the alveolar ridge/mucosa is best managed by a biopsy, usually an excision (b).

There is little to be gained by advising the patient to watch the lesion for 10-14 days (c). To advise the patient that no further treatment is needed (d) is definitely not indicated in the treatment of this lesion.

QUESTION #3 Microscopic examination of the lesion reveals the following: a proliferation of loose fibrous connective tissue with foci of hemorrhage and numerous multinucleated giant cells. The overlying surface epithelium is unremarkable. Based upon these microscopic features, the correct diagnosis for the lesion is: a. Pyogenic granuloma b. Peripheral giant cell granuloma c. Epulis fissuratum d. Neurofibroma ANSWER #3 The correct diagnosis is peripheral giant cell granuloma (b). See "Discussion" section.

The other possibilities are not considered here. The pyogenic granuloma (a) is composed of a highly vascular proliferation of granulation tissue that exhibits numerous endothelial-lined vascular channels that are engorged with erythrocytes. Epulis fissuratum (c) is also known as inflammatory fibrous hyperplasia and is composed of hyperplastic dense fibrous connective tissue with a chronic inflammatory cell infiltrate. The neurofibroma (d) reveals a neoplastic process composed of interlacing bundles of spindle-shaped cells exhibiting "wavy" or "comma-shaped" nuclei in association with delicate collagen fiber bundles.

DISCUSSION The peripheral giant cell granuloma is a soft tissue lesion that has been reported for many years under a great variety of terms such as peripheral giant cell tumor, osteoclastoma, giant cell epulis, and peripheral giant cell reparative granuloma.

These various terms are indicative of the confusion over the true nature of this lesion.

Even today there is no universal agreement concerning the pathogenesis of this entity.

From a clinical standpoint, the peripheral giant cell granuloma usually presents as a solitary sessile or pedunculated mass that

occurs exclusively on the gingiva or alveolar mucosa. The lesion may be quite variable in size and is often red or hemorrhagic in appearance with surface ulceration present.

It usually occurs anterior to the molar teeth with a slight predilection for the mandible over the maxilla. In addition, it has been reported that females are affected twice as frequently as males. The lesion may be observed in children as well as adults.

Radiographically, there may or may not be evidence of involvement of the underlying osseous tissue. It has been observed that in the edentulous patient, however, superficial erosion of the underlying bone is quite characteristic and presents a pathognomonic feature known as peripheral "cupping" of the bone.

The microscopic appearance of the peripheral giant cell granuloma is quite unique. This lesion is composed of a non-encapsulated mass of loose fibrous connective tissue containing numerous multinucleated giant cells. Capillaries are usually quite numerous as are areas of hemosiderin deposition, foci of hemorrhage, and spicules of osteoid or bone. The overlying surface epithelium may be ulcerated.

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The treatment of the peripheral giant cell granuloma is surgical excision. If only superficial excision is carried out, recurrence may be observed (usually less than 10% of the cases). In the past, it was common practice to remove the adjacent teeth at the time of the excision to prevent recurrence but this practice has now been abandoned.

REFERENCES Lester SR, Cordell KG, Rosebush MS, et al. Peripheral giant cell granuloma: a series of 279 cases. Oral Surg Oral Med Oral Pathol Oral Radiol 118:475-482, 2014.

Katsikeris N, Kakarantza-Angelopoulou E, and Angelopoulos AP. Peripheral giant cell granuloma: clinicopathologic study of 224 new cases and review of 956 reported cases. Int J Oral Maxillofac Surg 17:9499, 1988.

Giansanti JS and Waldron CA. Peripheral giant cell granuloma: review of 720 cases. J Oral Surg 17:787791, 1969.

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47

BOARD OF DENTISTRY REPORT From Dr. Michel Howl, Oklahoma Board of Dentistry President The last reporting period for continuing education requirements ended this past June 30, 2019 with almost 700 letters having to be mailed out to licensees informing them that they were not in compliance with those requirements. The majority of these notices of non-compliance would have been prevented had the involved licensees just read the relevant information available on the Oklahoma Board of Dentistry’s website. One of the most frequent errors was not posting ethics course in the required ethics category.

Another common mistake was taking an online CPR course, which the website clearly states is not acceptable.

The new reporting period has now changed to two years ending June 30, 2021. Dentists will be required to have 40 hours, which must include a mandatory two hours on opioid prescribing.

Hygienists will now need 20 hours. The ethics and CPR requirements remain unchanged. Dental assistants will now be required to submit two hours of CE on infection control. At the moment, criteria for infection control courses have not been

finalized. At the Board’s upcoming November meeting we hope to establish guidelines for acceptable courses.

Failure to meet CE requirements will result in a fine of $1,000 for dentists and $500 for hygienists as set in the statutes. Dental assistants will be subject to revocation of their permits.

Everyone is strongly encouraged to read the CE information on the Board of Dentistry’s website before posting any CE courses. It is also advisable not to wait until the end of the reporting cycle to report CE hours. Many people found themselves unable to access their information when the state’s computer system crashed during the last few days of the reporting period.

If you have any questions about any of the information provided either here or on the Board of Dentistry’s website, please contact the Board Office during normal business hours (8:30am - 4:30pm) at 405-522-4844 or stephanie.miller@dentistry.ok.gov.

CE Category Information CATEGORY A: A. Formalized structured learning situations at colleges or universities at regular undergraduate or college course levels will be allowed one (1) hour credit for each hour of attendance. Regular university or college courses are evaluated at semester hours, i.e.: A dentally related three (3) hour college credit course will be allowed three (3) hours of continuing education credit.

B. Any university may co-sponsor a program within the State of Oklahoma. They must send a copy of the letter to the Board.

C. Programs sponsored by the Veterans Administration or Armed Forces, given at a government facility, will be granted hour-for-hour credit without university co-sponsorship.

CATEGORY B: A. Formalized Meetings: Meetings of the following recognized groups will be granted hour-for-hour credit for the scientific portions of their program: (i) National professional organizations and their components (ii) University-sponsored professional Alumni clinical meetings (iii) Organized Dental or Dental Hygiene Study Club Meetings (iv) Seminars sponsored by recognized Dental/Dental Hygiene constituent societies.

B. Advanced Study (Graduate study, internships, residencies),: Dentists or Dental Hygienists engaged in acceptable full-time programs will fulfill their continuing education requirements for each calendar year in which they are actively participating in such programs by nature of these activities, and will no longer have additional formal requirements for that year. However, persons so engaged must notify the Board.

CATEGORY C: A. Publishing Papers – Presenting clinics – Lecturing – Teaching: these activities will be granted six (6) hours credit for the original presentation, and hour for hour credit for additional presentation of the same material. Full or part-time teaching will receive credit for the semester credit hours. One (1) hour credit can be recorded for every 18 hours of clinical instruction.

B. Self-Instruction Programs – Study Tapes – Correspondence Programs: These programs will be granted hour-for-hour credit. Only 50% of the total requirement may be obtained through this category. The Dentist or Dental Hygienist must submit a certificate of registration from the sponsoring institution, organization or study club or have the participation in the course verified by the sponsoring agency in a manner specified by the Board Continuing Education Committee to be considered for approval.

C. Volunteer Service – Licensees who donate their expertise for the dental care and treatment of indigent and needy persons shall be granted hour for hour credit for up to ten (10) hours for a Dentist and five (5) hours for Dental Hygienist within a reporting cycle. Dentists and Dental Hygienists must submit proof of actual volunteer work from a recognized entity approved by the Board. Volunteer services submitted for credit shall not receive or have any expectation to receive any payment or compensation, either direct or indirect, for any dental care or treatment rendered.

CATEGORY D: Exceptions: Exceptions will be considered at the discretion of the Board.

A. No more than six (6) hours of the sixty (60) hour requirement for Dentists can be from practice management type courses.

B. No more than three (3) hours of the thirty (30) hour requirement for Dental Hygienists can be from practice management type courses CPR CATEGORY: A. For reporting required CPR course *NO ONLINE CPR COURSES WILL BE ACCEPTED!* ETHICS CATEGORY: A. For reporting required Ethics course journal | Nov/Dec 2019 48

HYGIENE HOTSPOT

DESTRUCTION OF EVIDENCE By: Donna Brogan RDH, BS ( Donna.brogan94@gmail.com) Have you ever spent time during a “bloody” prophy trying to educate the patient on the inflammation process, the causes of hemorrhaging tissue, the importance of interproximal cleaning, the advantages of power toothbrushes and the benefits of more frequent recalls only to have the dentist come in and say, “Looks great, see you next time.”? All that patient education goes down the drain and you know the next visit will be exactly the same.

As a rule, dental hygienists are meticulously clean people. We are also very compassionate and we want our patients to be as comfortable as possible at all times. This compulsion makes us constantly rinse the patient’s mouth so they don’t taste blood. It makes us continually clean up the mess, throwing away bloody 2x2’s and replacing stained patient napkins. Unfortunately, by doing so we are destroying the evidence of disease.

Before reclining the patient, involve them in the procedure by explaining what symptoms of disease you will be alerting them to during the appointment. Let them know that healthy tissue does not bleed. Just as they would be alarmed if their eye bled while placing a contact lens they should be equally alarmed when their gums bleed. When the patient is hemorrhaging (never say “bleeding a little bit”) take a picture with your intraoral camera to show both the patient and the dentist. Occasionally allow the patient to taste blood; it is important for them to know it is present.

Instead of throwing away those used 2x2’s, keep them on the instrument tray behind the patient so the dentist can see them during the exam. An important influencer in periodontal treatment acceptance is the dentist’s reinforcement of your recommendations. When the dentist sees the evidence of disease and hears the periodontal findings, he or she is in a better position to confirm your treatment plan and the patient is more likely to accept it and make appointments for the appropriate care. Don’t destroy the evidence -- let it help make your case.

Donna Brogan is a 1994 graduate and former faculty member of the University of Oklahoma Dental Hygiene Program. She was honored as the 2010 Alumna of the Year and received the Delta Dental Distinguished Service Award. She sits on numerous boards for local non-profits and was the first dental hygienist to serve as President of the College of Dentistry Alumni Association.

An educational consultant of over 20 years, Brogan enjoys writing for professional publications and facilitating courses around the world on dental-related topics including CAMBRA (Caries Management

by Risk Assessment), women’s wellness, nutrition, teeth whitening, alternative careers for dental professionals, and the oral/systemic link.

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49

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50 journal | Nov/Dec 2019

SHOP ONLINE A N D S TA R T S AV I N G TO DAY

Average No. Copies Each Issue During Proceeding 12 Months

STATEMENT OF OWNERSHIP, MANAGEMENT, AND CIRCULATION 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

Publication Title: Oklahoma Dental Association Journal Publication Number: 284-980 Filing Date: August 26,2019 Issue Frequency: Bimonthly Number of Issues Published Annually: 6 Annual Subscription Price: $56 Complete Mailing Address of Office of Publication: Oklahoma Dental Association, 317 NE 13th St, Oklahoma City, OK 73104 Contact Name: Stacy Yates, (405) 848.8873 Editor Name: Phoebe Vaughan, DDS Managing Editor: F. Lynn Means Complete Mailing Address of Headquarters or General Business: Oklahoma Dental Association, 317 NE 13th St, Oklahoma City, OK 73104 Full Names and Complete Mailing Addresses of Publisher, Editor and Managing Editor: Oklahoma Dental Association, 317 NE 13th St, Oklahoma City, OK 73104 Editor Name: Phoebe Vaughan, DDS, Managing Editor: F. Lynn Means Owner: Oklahoma Dental Association, 317 NE 13th St, Oklahoma City, OK 73104 Known Bondholders, Mortgagees, and Other Security Holders Owning or Holding I Percent or More of Total Amount of Bonds, Mortgages, or Other Securities: None Tax Status: Has Not Changed Publication Title: Oklahoma Dental Association Journal Issue Date for Circulation Data: September/October 2019

15. Extent and Nature of Circulation

a. Total Number of Copies (Net press run)

b. Paid Circulation

1. Mail Outside-County Paid Subscriptions

Stated on Form 3541

2. Mail In-County Paid Subscriptions Stated on Form 3541

3. Paid Distribution Outside the Mails Including Sales Through Dealers and Carriers, Street Vendors, Counter Sales, and Other Paid Distribution

4. Paid Distribution by Other Classes of Mail Through the USPS

c. Total Paid Distribution [Sum of 15b]

d. Free or Nominal Rate Distribution

1. Outside-County included on PS Form 3541

2. In-County included on PS Form 3541

3. Other Classes Through the USPS

4. Free Distribution Outside the Mail (Carriers or Other Means)

e. Total Free Distribution (Sum of 15d)

f. Total Distribution (Sum of 15c and 15e)

g. Copies Not Distributed

h. Total (Sum of 15f and g)

i. Percent Paid (15c divided by 15f times 100) 16. Electronic Copy Circulation 17. Publication of Statement of Ownership required.

Will be printed in the Nov/Dec 2019 issue of this publication 17. Signature and Title of Editor, Publisher, Business Manager, or Owner F. Lynn Means, Managing Editor, Sept 20, 2019

No. Copies of Single Issue Published to Filing Date

1710

1661

1689

1641

1689

1641

15 10 15 1704 6 1710 99.1%

10 1651 10 1661 99.3%

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51

OKLAHOMA DENTAL FOUNDATION

Setting a National Standard for Infection Control Practices Infection Control has been critical in dental practices for many years. In 2018, the Oklahoma Board of Dentistry added Infection Control (IC) to the requirements for Dental Assistant Expanded Duty Permits, and included the topic for CE courses for dentists and other related professionals.

Interestingly, IC issues are addressed in different ways, depending on the medical specialty involved and whether the focus is on patient safety, provider safety, or both. To address these various issues, the Oklahoma Dental Foundation has developed a course to provide comprehensive support to dental practices across the state; this course is currently under consideration by the Oklahoma Board of Dentistry as an approved IC class.

While there has been some uncertainty in the timing of the requirements for reporting IC training, the Board of Dentistry is creating the groundwork for such reporting and assuring consistency in IC knowledge – a significant step forward in better ensuring patient and provider safety.

One major hurdle in creating consistent IC controls in the dental practice is the variability in standards and procedures, depending on several factors. For instance, Centers for Disease Control (CDC) standards are focused on patient care and safety. A dental practice is in good standing if it follows CDC guidelines. On the other hand, the Occupational Safety and Health Administration (OSHA) has different standards and practices because its focus is on employee and provider safety. Again, a dental practice is on solid ground by following OSHA guidance.

However, a dental practice can best ensure it has the most consistent IC standards if it combines the requirements of both to the benefit of patients and providers alike. This is where the Oklahoma Dental Foundation’s (ODF) Infection Control course steps in.

52 journal | Nov/Dec 2019

Developed by Julie Nabors, Clinical Assistant Professor in Dental Hygiene at the OU College of Dentistry, this course is the only one in Oklahoma that follows the combined standards of CDC and OSHA. This course is available both in person and online. The ODF Comprehensive Infection Control course is based on the joint standards of the Organization for Safety, Asepsis and Prevention (OSAP).

What makes this course special? Nabors has completed the available steps to become Oklahoma’s first and only instructor who is certified in Dental Infection Prevention and Control (CDIPC).

Certification is a three-step process, with the third step to be available later this fall. She will complete it as soon as it is available.

This is a new certification created by OSAP and DANB and is the only dentistry-specific infection prevention certification available.

In addition, Nabors has over 100 hours of training with OSAP and APIC (Association for Professionals in Infection Control).

In the past year, Nabors has also worked extensively with Indian Health Service (IHS) Dental Practices. According to IHS, the ODF training has resulted in no injuries from dental sharps in the past 18 months, successful Joint Commission accreditation with zero negative sterilization findings, and sterilization logs deemed acceptable by the Joint Commission on Accreditation as a national best practice. (The surveyor took copies of the log to use as examples at other sites to be evaluated.)

The ODF is helping set a national standard for Infection Control practices. Has your dental practice prepared for better training?

Contact the ODF at 405.241.1299 or look at the material at www.okdf.org.

Thank You to the 2019 ODF Contributors Your ODF contribution goes directly to offset some of the costs associated with providing life-changing dental treatment and oral health education to Oklahomans in need. Please consider making this small, additional contribution when renewing your 2020 membership.

Dr. George Abdelnour Dr. Jeffrey Ahlert Dr. Errol Allison Dr. Jim Ambrose Dr. Jamie Ariana Dr. Bonnie Arnould Dr. Forrest Arnould Dr. Michael Auld Dr. Lauren Avery Dr. Jeannie Bath Dr. Bryce Baumann Dr. Justin Beasley Dr. William Beasley Dr. Kari Bender Dr. David Birdwell Dr. Bryan Blankenship Dr. Richard Bohlander Dr. Ryan Brackett Dr. Leon Bragg Dr. Jamie Branham-Williams Dr. Matthew Bridges Dr. Nathan Brown Dr. Steven Brown Dr. Adam Bulleigh Dr. Bonnie Burton Dr. Kristen Campbell Dr. Patricia Cannon Dr. Wuse Cara Dr. John Carletti Dr. Bobby Carmen Dr. William Carter Jr. Dr. Mary Casey Kelly Dr. Brian Chastain Dr. Brian Coerver Dr. Adam Cohlmia Dr. Matthew Cohlmia Dr. Raymond Cohlmia Dr. Debbie Corwin Dr. James Corwin Dr. Lester Cowden III Dr. Jeffrey Danner Dr. Russell Danner Dr. Darrell Daugherty Dr. Susan Davis Dr. David Deason Dr. Steven Deaton Dr. Michael Dial

Dr. Bryce Dorrough Dr. Ana Dotson Dr. Brian Drew Dr. Kevin Duffy Dr. Katharine Dunnington Dr. Heath Evans Dr. Barry Farmer Dr. Joseph Feng Dr. Bryan Fields Dr. Robert Flint Dr. John Folks Dr. Emily Frye Dr. Chad Garrison Dr. LaMont Gee Dr. Mark Goodman Dr. Sandra Grace Dr. Matthew Gray Dr. Steven Gregg Dr. Shannon Griffin Dr. Jacob Hager Dr. Michael Hampton Dr. Leslie Hardy Jr. Dr. Aaron Harman Dr. Edward Harroz III Dr. Edward Harroz Jr. Dr. Darrell Hazle Dr. James Herndon Dr. Marilyn Hiebert Dr. Myron Hilton Dr. James Hooper Dr. Mitchell Hoopes Dr. Jeffrey Housley Dr. Scott Hubbard Dr. Benjamin Humphrey Dr. Donald Johnson Dr. Eugenia Johnson Dr. Katherine Johnson Dr. Mohammad Karami Dr. Michael Kirk Dr. Theodore Kondos Dr. Mitchell Kramer Dr. Robert Lamb Dr. Leta Langford Dr. Larry Lavelett Dr. Grady Lembke Dr. Dennis Leseberg Dr. Christopher Leslie

Dr. Marti Levinson Dr. Shannon Lewis Dr. Dustin Lively Dr. Robert Livingston Dr. Gary Lott Dr. Karey Low Dr. Pamela Low Dr. James Lowe Dr. Jeff Lunday Dr. Steve Lusk Dr. David Maddox Dr. David Marks Dr. Mark Massaro Dr. Stephen McCullough Dr. Janna McIntosh Dr. Joseph Meador Dr. Jamie Means Dr. Mark Mettry Dr. Lindsey Miller Dr. Robert Miracle Dr. Donald Mitchell Dr. Andrea Montgomery Dr. Patrick Montgomery Dr. Mohsen Moosavi Dr. Robert Morford III Dr. James Murtaugh Dr. Jana Oister Dr. Larry (Lawrence) Olson Dr. Jeff Parker Dr. Garrett Phipps Dr. Steven Powell Dr. Justin Power Dr. Karen Reed Dr. William Reeves Dr. Chad Reid Dr. Scott Renfrow Dr. Darek Ridpath Dr. Erin Roberts-Svob Dr. Mack Rudd Dr. Miranda Ruleford Dr. Andrea Scoville Dr. Gregory Segraves Dr. Mickey Sehorn Dr. Meghan Sellmeyer Dr. Jeff Shadid Dr. Paul Shadid Dr. Greg Shanbour

Dr. Kyle Shannon Dr. LaTonya Shelton-Miller Dr. David Simon Dr. Gregg Smith Dr. James Sparks Dr. Chad Spiva Dr. Rachel Standlee Dr. Robert Steele Dr. Braden Stoltenberg Dr. B. Dan Storm Dr. James Strand Dr. Carla Sullivan Dr. Joe Swink Jr. Dr. Jamie Talley Dr. Jim Taylor Dr. John Thomas Dr. Roy L. Thornbrough Dr. Kara Tims Dr. Corbyn Van Brunt Dr. Paula Vanbuskirk Dr. Jonah Vandiver Dr. Randall Venk Dr. Nathan Villines Dr. Gregory Watkins Dr. Robert Webb III Dr. Robert Wells Jr. Dr. Wavel Wells Dr. Stephanie Wendt Dr. Steven White Dr. Theresa White Dr. W. Scott White Dr. Quint Whitefield Dr. Susan Whiteneck Dr. Daniel Wilguess Dr. Kim Wilkinson Dr. Vincent Willcox Dr. Jack Willoughby Dr. Ronald Winder Dr. William Wynn IV Dr. William Yadon Dr. Kendra Yandell

www.okda.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.

JOB OPENING NEW DENTIST WANTED: Searching for a dentist who is looking for employment and/or ownership opportunity in OKC area. Please call 405.365.3774 GENERAL DENTIST: US-OK-Oklahoma City | Job ID: 2019-13576 | Type: full-time | # of Openings: 1 | Category: Dentist | Oklahoma City, OK Overview: Let us allow you to do what you do best by doing the dentistry that you diagnose while exploring future partnership opportunities. We follow through on our promise to clinicians with our culture of patient centric care, our ability to deliver comprehensive integrated care, and our ability to support modern dentistry. PDS supported owner dentists know that being backed by the country's leading dental support organization allows them to focus on providing patient centric and clinically excellent care.

Benefits • Healthcare Benefits (Medical, Prescription Drugs, Dental and • Competitive Compensation and Benefit Package Vision) • Modern offices equipped with the latest dental technology • 401(k) Savings Plan • Malpractice Insurance The average full-time PDS-supported Dentist earns $160,000 - $390,000. Apply Today ! Testimonial:“Partnering with PDS has given me the opportunity to realize my dream of practice ownership. I am able to do the dentistry that I love.”- Dr. Callaway-Nelson Pacific Dental Services is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military status. Apply Here: http://www.Click2Apply.net/ryyx7ps3q7p5pxxh (PI114549432) HOPKINS DENTAL CLINIC SEEKING GENERAL DENTIST ASSOCIATE: Hopkins Dental Clinic in Shawnee is seeking a fulltime general dentistry associate. We are a high production, technology advanced, private practice in a prime location. We perform the full spectrum of procedures including advanced surgical and complete implants. We are care focused withouth the pressure of quotas, sales, or production demands.

Our reputation of high-quality dental care has resulted in a demand that exceeds what Dr. Hopkins can provide colo. Plus, the amicable exit of our previous associate who recently left to teach full time, means you could immediately step into a sizable existing patient base with steady growth. Please visit our website www.hopkinsdentalclinic.com, Dr. J. Eric Hopkins referenced within the ABOI & AAID sites, or call 405-275-1055 for more information. Interested parties can e-mail a resume to smile@hopkinsdentalclinic.com.

EQUIPMENT FOR SALE SIRONA 3D READY PANOREX FOR SALE: For sale 2012 Sirona 3D ready panorex. I bought the pano new from Patterson Dental OKC. They can help with the transfer and training of the unit.

Excellent condition. Every thing is ready for the cbct scanning upgrade. The pano is located in OKC. Asking $5,500.

Call 1-405-593-7517 for additional details.

PRACTICES FOR SALE PRACTICE FOR SALE • Motivated owner of established profitable dental practice in Tulsa OK area.

• Stand alone, self-owned building with dental practice on bottom floor next to periodontist.

• • • • •

Highly visible: located on busiest street in fastest growing town in the state.

Centrally located in high acclaimed Broken Arrow school district.

Plumbed four exam rooms, 3 fully equipped rooms.

Fully equipped lab, private office, 2 bathrooms Furnished waiting and break room

Call for more information 918-810-3011 INTRAORAL X-RAY SENSOR REPAIR/SALES: We repair broken sensors. Save thousands in replacement costs. Specializing in Kodak/ Carestream, major brands. We buy/sell sensors. American SensorTech 919-229-0483 www.repairsensor.com EQUIPMENT: MAKE OFFER- AT 2000 DEVELOPER | 2 REAR OAK AND LAMINATE CABINETS CALL 405-650-0945

SUBMIT A LISTING Submitting a classified ad is easy with our online form. Find the form and more information at okda.org/classifieds.

54 journal | Nov/Dec 2019

PRACTICE FOR SALE : Practice for sale in Northeastern Oklahoma in the growing town of Tahlequah. Northeastern State University is located here as well as the capital of the Cherokee Nation. New growth is expected as the Cherokee Nation has built a new state-of-of-the-art hospital and is partnering with Oklahoma State University Medical School to begin in the Fall of 2019. Lakes and rivers abound in this area providing water activities, fishing and hunting.

This four operatory office has two private offices, an upstairs for storage, covered parking times 5 spaces (that could convert to more operatories) and room for expansion. There is a large business area, central lab, dentist's bathroom, patient bathroom and staff bathroom. Lounge contains five lockers for staff. Digital x-ray, digital Panorex and 11 computer stations are available. Working a four day work week, Monday through Thursday, approximately 35-40 new patients per month this practice collects $1,000,000.00 plus per year. The office is 2500 square feet on a large corner lot with a busy street and great visibility. It has ample parking and three turn-ins. There is a good mix of endodontics, implants and oral surgery, crown and bridge, dentures, partials and cosmetic bonding. Wide range of patients from kids to seniors. Available for more information Monday through Thursday 8:00 to 5:00 at 918-456-4477 or 918-260-7200 after hours.

Dental professionals face unique financial challenges.

Are you prepared to navigate them?

At Mariner Wealth Advisors, we have experience helping dental professionals navigate the specific financial challenges faced at different stages throughout their careers. As your advocate, we work to ensure your personal and professional objectives are well cared for and integrated in order to help you arrive at your personal financial destination.

Our services include: •

Customized wealth planning

•

Business valuation and practice maximization

•

Tax planning

•

Retirement plan design, maintenance and consulting

For information about how Mariner Wealth Advisors can help support your personal and professional needs throughout the life of your dental practice, please contact us.

Joe Hendrix, CFP®, CPA Senior Wealth Advisor 405-353-1550 joe.hendrix@marinerwealthadvisors.com

Nicholas Harroz III, JD, CPA Senior Wealth Advisor 405-698-3715 nicholas.harroz@marinerwealthadvisors.com

Leigh Higgins, CPA Wealth Advisor 405-353-1557 leigh.higgins@marinerwealthadvisors.com

Previous results or outcomes experienced by clients are unique to that client situation. There is no guarantee of similar results or outcomes in the future. MWA does not provide all services listed in this piece. Some services are provided by affiliates and are subject to additional fees. *Barron’s awarded the 2019 #4 and 2018 #3 Top RIA Firms ranking to Mariner, LLC dba Mariner Wealth Advisors based on data compiled for Mariner Wealth Advisors and the 2017 #2 and 2016 #1 rankings to Mariner Holdings based upon data compiled for Mariner Holdings’ registered investment adviser subsidiaries.

Barron’s has transitioned the name of the 2016 inaugural award of Top Independent Advisory Firms to the Top RIA Firms. The number of firms included in the rankings were: 20 (2016), 30 (2017), 40 (2018) and 50(2019). Barron’s publishes these lists based upon a number of criteria and the firms’ filings with the SEC were used to cross-check the data provided to Barron’s. The listing includes the firms’ numbers of clients, employees, advisors, offices and state locations.

The award is not indicative of future performance and there is no guarantee of future investment success. For additional information visit www.barrons.com.

Mariner, LLC dba Mariner Wealth Advisors (“MWA”) is an SEC registered investment adviser with its principal place of business in the State of Kansas.

Registration of an investment adviser does not imply a certain level of skill or training. For additional information about MWA, including fees and services, www.okda.org 55 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.

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