sfdda Volume 60, No.1 www.sfdda.org Summer 2018

In this Issue: HB 21 - Florida's New Law on Prescribing Controlled Substances:

-Opinion-Editorial: The Good, the Bad and the Ugly - page 4 -Navigating Through and Complying With the New Law - page 7

President’s Message, pg.3 FDA Awards, pg.12

Meet your Affiliate Presidents, pg. 16

Affiliate Meetings in September, pg. 19

Florida Board of Dentistry Report, pg. 22 Make a Difference, pg. 25 Classified’s, pg.26

New Members, pg. 27

Register Today "Opioids and Controlled Substances"

To ensure your license stays active, all Florida licensed dentists registered with the U.S. Drug Enforcement Administration to prescribe controlled substances must take a two-hour continuing education course on opioid training by January 31, 2019. This deadline does not follow the license renewal biennium schedule. The course must be completed by January 31, 2019.

The SFDDA has partnered with the Florida Osteopathic Medical Association to offer our members this course which fulfills the new Opioid C.E. requirement.

Register on-line at www.sfdda.org or call (305) 667-3647 This CE course includes dinner

Opioid use, misuse, and abuse has risen to epidemic proportions. Scores of legislative and regulatory efforts have been undertaken to attempt to address this issue. Recently, Florida overwhelmingly passed HB 21, signed into law by Governor Scott. Encompassed within this law are changes to how opioids are prescribed and monitored, along with mandatory continuing education.

Speaker: Dr. Joshua Lenchus President of the Florida Osteopathic Medical Association

Note from the Editor:

October 24, 2018 6:30 p.m. Tropical Acres Restaurant 2500 Griffin Road Davie, FL

At the conclusion of this presentation, the participant will:

1. Differentiate types of pain as defined, along with prescribing stipulations;

2. Recognize prescribing limitations as delineated; 3. Integrate the requirements of the new opioid law, HB 21, into one's clinical practice

This session, supported by the Florida Osteopathic Medical Association, satisfies this State-mandated 2 hour requirement.

Many questions and concerns have been expressed regarding HB 21, the new law on prescribing controlled substances, since it took effect only weeks ago. Many dentists confess they are not aware of, and frankly are not yet following, certain aspects of the law. Two articles regarding HB 21 are included within this newsletter. The first is an “opinion” piece, and the second is a “how to” article on navigating through and best complying with the law. I sincerely hope you will find the information useful for you and your practice.

President’s Message Enrique Muller, DMD, MSC

Dear friends, colleagues and fellow South Florida District Dental Association members,

I am humbled and honored to serve as your SFDDA president for the 2018-2019 year. After serving as past president of the North Dade – Miami Beach Dental Society, as well as different line officer positions in the SFDDA, I hope to have a positive effect as president.

I am excited to welcome you back to a wonderful new season of great lectures and fantastic speakers at our three affiliate dental societies that are striving to bring you the new hot topics of the moment. The SFDDA has also planned many special events this year to integrate with our affiliates and offer you great content.

I hope you enjoy the amazing presentations that have been put together for all of you throughout this year. I hope you will grace us with your presence. Please help us spread the word and recruit new members to keep growing our association and organized dentistry.

In this modern age of social media and immediate access to information, we need to remember that social interaction is just as important and often neglected, while at the same time embracing change. We have to continue to evolve and move into the future by streamlining access to our content, yet always remembering that we represent organized dentistry and the personal connections it stands for.

I believe we need to focus on recruiting new young member. They are the future of our organization and profession. We also need to transition our existing long-time members into a mentorship role for the new generation. It is essential to the proper functioning and growth of our association and its affiliates that we understand all the different types of members and their roles, but more importantly, how they relate and rely on each other.

Remember that the SFDDA and all of the affiliate boards have worked arduously so that your dues are included with your ADA/FDA membership, and you get five dinner meetings of your choosing at any affiliate. This is a great savings to you, as well as an amazing opportunity to increase networking and camaraderie between all the affiliates of the SFDDA.

I would like to thank our immediate past president, Dr. Joseph Pechter for all of his hard work last year, as well as our executive board for their help and leadership throughout the years.

Please don’t forget to “like” us on our Facebook page: https://www.facebook.com/south.dentalassociation/ - and be on the lookout for the electronic communications.

I look forward to seeing you all at our affiliate meetings and SFDDA events.

Enrique Muller, DMD, MSC President

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In My Opinion

New Law on Prescribing Controlled Substances and Prescription Drug Monitoring Program (PDMP) Database, E-FORCSE: The Good, the Bad and the Ugly

- Richard A. Mufson, DDS, Editor

Most of us can recall childhood memories of our parents forcing us to take medication when we were sick, which we did not like, because it tasted awful, and it often may have resulted in resistance, some crying, and even stomping our feet in some cases, but which we ultimately knew was “good for us.” This metaphorically best describes how I personally have felt about this new law being forced upon us. This opinion piece in large part more reflects the child-like complaining. However, if you get through that part, a more positive and uplifting one follows. First, the Bad and the Ugly I must admit – I felt offended and resentful upon the passing of the new “opioid law.” I envisioned it would result in more potential harm than good. I also offer my apology to anyone who may have initially thought, when this was debated in Tallahassee, it would be a great idea.

Much of my indignation, I feel, is a throwback to my high school and college days, or the “hippie days” of the 60’s and 70’s, in which Woodstock, demonstrating against the Viet Nam War, enduring the Watergate scandal, and the general concept of “questioning authority” seemed to be the rage, and in the DNA of many of us growing up in that era. Don’t get me wrong. I was generally a well-behaved kid, and respectful of my parents and others in positions of authority.

And, now as a “grown up,” I have come to appreciate that I share at least one similarity in common with many of my “right-of-center” friends and colleagues. And that is, we have a serious disdain for “Big Government” or “Big Brother” telling us what to do, or how to run our lives. To be fair, I am sure there are worthy exceptions.

Fast forward to House Bill 21: Controlled Substances. We strongly lobbied against passage of this then-bill, now law, before the Legislature at our annual FSOMS Day on the Hill this past January 24. And, during FDA’s Dentists’ Day on the Hill, our colleagues voiced many concerns with mandates included within the bill.

The general feeling was that the proposed law seeking to limit prescribing Schedule II opioid pain medications to an arbitrary time frame of “3 days,” in addition to other perceived 4

onerous mandates, would not be a good idea. Again, to be fair, there would also be a 7-day option – but clearly as an “exception” to the rule, and with certain conditions and specific documentation requirements on the part of the prescribing doctor (further details of which appear within the related article in this newsletter). When also considering the 7-day limit recommended and/or statutorily imposed by other states, agencies and even our own American Dental Association - the required Florida 3-day limit, as the primary required option under the law, appeared far more restrictive, and would not appear to take into account a wide and variable range of individual patient needs, tolerance, nor the type or extent of the surgical procedure performed.

Very bothersome to me personally would be the fact that the law takes away, or at the very least calls into question, something that we as physicians, dentists and other prescribing health care professionals inherently possess and hold very dear – by virtue of our extensive education, training and experience - and that would be our judgment.

Although some could make the case that the 7-day “exception” leaves our judgment alone and unaffected, I respectfully do not agree.

There have been many instances in my daily practice over the years, in which I have reserved the right (as we all have) to use discretion in writing for a relatively wide and variable range, relative to amount, or number of days, of medication – while taking into account a wide variety of factors – whether it be a higher/deeper level of surgery performed, or the size/weight of a given patient, or those perceived to have a lower or higher tolerance to medication than others (i.e., as observed during IV sedation, or from prior experience with the same patient).

HB 21 in effect has now over-regulated what we do, and has legally narrowed our options. The 7-day “exception,” on its face, is intended to be just that – an “exception” to the rule and (although we admittedly need to take a deep breath and see how the law plays out in the future) it very much leaves open the possibility, should this option be utilized with some-

what higher frequency by some than others, for regulatory agencies to over-analyze and/or scrutinize our behavior and patterns of prescribing.

Once again, it represents another added layer of bureaucracy, while leaving us potentially more exposed to legal harm.

And back to the concept of “Big Government,” the very thought of John Q. Legislator telling us, in effect, that we are not capable of doing this on our own – i.e., exercising our own judgment - at least a manner which we have been accustomed to exercising for many years, and that we therefore need someone else to do this for us – is in my view reprehensible.

The law’s potential impact also seems quite striking when considering that we, as dental professionals, are in the unique position of being called upon to see patients on a daily basis, many of whom share a common theme – pain whether related to a dental abscess, or post-operative pain following endodontic, surgical or other procedures. As oral surgeons, the frequency, complexity and depth of surgical procedures performed, and hence the resulting amount and duration of pain, would seemingly result in even greater challenges for our patients and us as prescribing practitioners.

Without getting too carried away, I also find it disturbing that Governor Scott and the Florida Legislature have also decided that all of us need a special course each biennium teaching us how to prescribe controlled substances, including opioid medications, and moreover, that the courses may only be taught to us by one of four “medical” associations in our state, the Florida Medical Association, Florida Osteopathic Medical Association, Florida Academy of Family Physicians, or Florida College of Emergency Physicians. I very much believe that we, as dental professionals, by virtue of what we do every day, possess a much higher level of training, knowledge and experience relative to the pharmacological effects, proper dosing, and potential adverse effects when prescribing pain medications as compared to many or most of our physician colleagues. We, after all, should be the ones teaching this course!

Dentists as the “Cause of the Problem” At the risk of continuing what would appear to be frustrated child-like rant - I have also had a “problem” with the world assuming that “we dentists” are somehow “the cause of the problem.” Depending on the news outlet or source involved, or varying surveys or studies cited – there is no doubt significant controversy over whether the target at which all of this has been aimed belongs on our back, as opposed to elsewhere.

Hundreds of thousands of narcotic pills, largely oxycodone, have been dispensed from “pill mills” throughout Florida (although many have thankfully been shut down). Many drug traffickers have come from other states, most notably Virginia and Kentucky, traveling down I-75, on what has been referred to as the “Oxy Express,” to bring back large amounts of pills, addiction, and in many cases, overdoses and death, back to their home states.

Also not exactly a big news flash – the importation of fentanyl and other potent drugs from manufacturing labs in China and elsewhere have resulted in addiction and death in many unsuspecting communities throughout the US.

On the other hand, contrast that with the eighteen Vicodin or Percocet I prescribe after removing four impacted wisdom teeth. I also counsel patients and parents on taking NSAID’s prior to, in lieu of, or combined with the narcotic medicine, and only taking it, as the bottle reads, “…as needed” or “if needed” for pain.

Again, I also must contrast this with eighty pills of Vicodin prescribed by my orthopedist after hip surgery several years ago. I admit that I used a reasonably sizeable portion of them – and the medication did help (for both post-surgery and subsequent physical therapy). I was also prescribed a much lesser amount of Vicodin after removal of my wisdom teeth at UF College of Dentistry Oral Surgery Department at age 26 – which also helped. I also can say there was no sense of drug-seeking behavior initiated by those prescriptions, and I am not addicted to anything.

But, we dentists are the problem? Some studies rightfully suggest that even a limited amount of narcotic medication prescribed during the teenage years (i.e., when wisdom teeth are frequently removed), notably at a very susceptible timeframe in the lives of our children, when brain function and decision-making processes have not fully matured – is a problem. Other studies completely discount this, and point to other factors entirely as underlying reasons for drug-seeking and addiction among our youth – such as poverty, emotional or physical trauma, mental illness such as anxiety, depression, among others.

Finally, the “Good” A minor digression: I came up with a great idea some thirty years ago, when I first started practice and became involved in our then “East Coast District Dental Society.” Feeling frustrated by the occasional drug seeking patient, I formed a small ad hoc committee, along with Drs. John Taback and Fred Knoll, to study the possibility of a data base which would track all such patients and their prescriptions. The result: I was told it could not be done. From a legal point of view, it would be too great an invasion of patient privacy. Fast forward to 2018. This is now being done in Florida (since 2009) and elsewhere, in the form of the web-based system used to collect and store controlled substance dispensing information – the Prescription Drug Monitoring Program (PDMP), also know as E-FORCSE - Electronic-Florida Online Reporting of Controlled Substances Evaluation Program. The law also mandates that we register with, log-in and view the database for a each and every patient before prescribing any controlled substance.

I did not mean to imply that there is only a negative side to this new law. There is a positive side. And “yes, we have a problem,” and further, anything we can do to help raise our collective awareness, and then take steps to mitigate the potential risks and negative effects that opioids and other concont. on pg 6

“In My Opinion” cont. from pg 5

trolled substances pose for our communities and our children – is a far more helpful concept than remaining inactive, with no attempt to reach solutions to help fight what has become known as the “opioid crisis.”

Similar to other awareness-raising moments in history – whether it be realizations such as the evils of tobacco and smoking, or the need to carefully check what people bring onto airline flights (since 2001) – simply raising our awareness on this issue will, or should, have the effect of (1) our watching more carefully the amount of medication we prescribe, (2) more strongly looking for and considering other non-narcotic alternatives for pain control.

Finally, taking the “bottle half full” approach rather than half empty, and recalling the memories of when mom or dad would force medication down my throat – because they knew it was needed and good for me – perhaps I can put aside my childlike complaining, make the best of this “new medicine,” and while focusing on the fact that HB 21 may likely be far more helpful than harmful to our patients and our communities. _______________________________________________ Richard A. Mufson, DDS is the editor of the SFDDA Newsletter and many be contacted at (305) 935-7501 or MufsonOralSurg@aol.com

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Volunteer to help underserved patients get the dental care they need. Join us on the Baptist Mobile Dental Unit

Oct 22-26, 2018 & Oct 29-Nov 2, 2018 Doral Vineyard Church 8041 NW 14th Street Doral, Florida 33126

Morning Shift - 8:30 am to 12 pm Afternoon Shift - 1 pm to 5 pm Volunteer for one or more days, morings, afternoons or both.

Call (305) 667-3647 ext 13 or email: jackie.sfdda@gmail.com

Navigating Through, and Complying With HB 21- Florida’s New Law On Prescribing Controlled Substances HB 21 was signed into law by Governor Rick Scott on March 18, 2018, and went into effect on July 1, 2018. The new law imposes a number of legal requirements and obligations upon all health care practitioners who prescribe such medications – which include, but are not limited to opioids. There are also penalties if we do not comply with the multiple facets of the new law.

In many respects, such laws are not new, and a number have been considered or have passed in other states and jurisdictions in response to our nationwide drug epidemic. The webbased electronic “Prescription Drug Monitoring Program” (PDMP) is certainly not new in Florida, having been put into place by the Legislature in 2009. Prior to HB 21, the law required both pharmacists and practitioners who dispense controlled substances to consult and report to the database. Since 2011, in response to the “pill mill” epidemic, Florida laws have been put in place regulating controlled substance prescriptions for chronic non-malignant pain, requiring such prescribing practitioners to designate themselves as such on

- Richard A. Mufson, DDS, Editor

To ensure compliance with the new law, the Florida Department of Health (FDOH) and Board of Dentistry (BOD) recommends making a notation within our dental/medical record – that we have consulted the database prior to writing each and every prescription for a controlled substance.

Printing out the report and/or including it within the patient’s record – is not required and is not recommended. The reason relates to the risk of inadvertently including such information as part of a future would-be request for records (whether by a patient, attorney, whomever), which if not redacted/omitted – would constitute a felony violation of Federal and Florida laws (due to a “super-confidentiality” status shared by alcohol/drug records, psychiatric and HIV/AIDS testing records or results).

The “Prescribing” Part of the Law The law retains previous regulations for prescribing medications for “chronic non-malignant pain,” and essentially has added new requirements for what we, as dentists, are frequently called upon to do – treat and prescribe for “acute pain.”

“…the law does require that we document within our dental/medical record that we have consulted database for each and every prescription for a controlled substance.

their practitioner profiles, and comply with standards of practice within the law. So-called “pain clinics” were also required to register with Department of Health, and to statutorily comply with new regulations.

The New Law – HB 21 Any and all health care practitioners who prescribe any controlled substance in Schedules II–V (only non-opioid controlled substances from Schedule V are exempted) are now required to (1) register with the PDMP database, also known as E-FORCSE (Electronic-Florida Online Reporting of Controlled Substances Evaluation Program), (2) the practitioner (or their designee) must log-in to the database and view a patient’s history of controlled substance prescriptions prior to prescribing, and (3) consult the database each and every time such a medication is prescribed – for any patient who is 16 years or older. Although we are required to view the information, under the presumption it may factor into our judgment when prescribing for a given patient, we are not required to document the information viewed. However, the law does require that we document within our dental/medical record that we have consulted the database prior to each and every prescription for a controlled substance.

Acute pain has been defined as, “a normal, predicted, physiological and time-limited response to an adverse chemical, thermal or mechanical stimulus associated with surgery, trauma, or acute illness.” However, the Florida Legislature exempted from this definition the following conditions: (1) cancer, (2) terminal conditions (i.e., considered by a treating physician as non-reversible, and anticipated to result in death within one year), (3) palliative care for an incurable, progressive illness or injury, or (4) a traumatic injury with an injury severity score (ISS) of “9 or greater.”

Despite intense lobbying efforts on the part of medical groups such as FMA and our own FDA - the Legislature chose to enact language consisting of a 3-day limit when prescribing Schedule II opioids for treatment of acute pain.

However, a “7-day option” is allowed within the law in the event that the following conditions and documentation requirements are met: (1) if more than a 3-day supply is needed based on the judgment of the provider, (2) the prescriber checks the “ACUTE PAIN EXCEPTION” box on the prescription form, and (3) documentation is entered into the medical record indicating the acute medical condition, lack of alternative options and the rationale justifying medication in excess of the 3-day supply limit.

cont. on pg. 8

“Navigating”cont. from pg. 7

Additional latitude is permitted when practitioners are prescribing for “non-acute pain” - which should be also indicated as such on the prescription form, and rationale documented within the medical record – for conditions known to coincide with a prolonged period of pain beyond 7 days, such as in burn patients, or jaw fractures. What Constitutes a “3-day” Supply? – And Other FAQ’s Many questions have been raised relative to the implementation of the statute, including our precise responsibilities involved in order to best follow the law and avoid penalties and other associated potential legal harm.

Examples: “Do I need to check the data base every time I prescribe for the same patient, and even if providing say, a second prescription following a 3-day supply?” Answer for now: “yes”. “Do I need to consult the database for the same patient undergoing a separate condition or treatment arising after a previous recent condition or treatment?” Answer again, for now: “yes”.

“Do I need to document information viewed when consulting the data base?” Answer: No. We need only document that the online site was consulted. However, as a separate point, practitioners are inherently expected to rely on their own individual professional judgment, and perhaps have thoughtful conversations with patients regarding past history – much as we would be expected to do for any other aspect of a patient’s medical history – when deciding how such information may play a role in prescribing medication. In the event of obvious over-prescribing and/or failure to take into account a patient’s drug history, one may presume that “red flags” may prompt investigation and potential legal problems for such prescription outliers. Another big question: “What constitutes a ‘3-day’ supply?”

Further Board Clarification Anticipated To answer these questions and others, it is anticipated that further guidance and clarification will be forthcoming from the individual boards within the Department of Health (Boards of Medicine, Dentistry, etc.), a process expected to at least begin within the next several months (the next BOD meeting is scheduled for August 24).

Until then, however, most agree that for now we are left to rely on the current language available within the text of the current statute, such as: “…prescriber or dispenser must consult the system to review a patient’s controlled substance dispensing history before prescribing or dispensing a controlled substance for a patient age 16 or older.” As a result, assume we must check the database each and every time we prescribe, irrespective of whether the patient is an existing patient, or not, and when involving multiple successive treatments.

More on the “3-day” Supply Question Again, this is a question likely requiring further clarification. At face value, it would appear the interpretation of this requirement would rest upon “doing the math.” If a prescription is written with a frequency of “q 4h,” for example, one can divide the number of hours in a day by this number (i.e., 24 hours ÷ 4 = 6), and then multiply that number by three (6 x 3 = 18) to calculate a 3-day supply.

If a prescription were written with a frequency of “q 6h” – a 3-day supply would then amount to a number of 4 pills per 24 hour period x 3 days = 12 total. This method of course does not take into account the amount of medication within a given pill (i.e., 5 mg versus 7.5 mg or 10 mg), and therefore, 3-day prescriptions may result in varying total amounts of a given medication prescribed. Morphine Milligram Equivalent (MME) A different method of calculating daily or multiple-day supplies – based on dosage - is also a topic of frequent discussion or questions – the “Morphine Milligram Equivalent” (MME). The concept of utilizing MME has made its way into pain studies, research papers, journal articles, language or policy utilized by outpatient and hospital pharmacies, regulatory bodies and agencies, and appears in several state laws.

One of a number of recommendations by the Centers for Disease Control and Prevention includes prescribing, “…the lowest effective dosage when starting opioid therapy, and when planning to increase the dosage to > 50 MME/day, assess the patient’s benefits versus the harms of being on the new dose. Avoid increasing dosage to > 90 MME/day or appropriately justify a decision to do so.” However, dosage limitations based on MME are not included within of the language of the new controlled substance prescription law in Florida.

Although not included within the statute, certain pharmacies chains – most notably Walmart and Sam’s Club – have developed their own internal policy of limiting the amount of daily medication they will allow to be prescribed and filled – to no greater than 50 MME per day. Other pharmacies either have or may be anticipated to follow this same pathway.

A phone call was recently placed to my office from a pharmacist who was refusing to fill a patient’s prescription written for “Hydrocodone 7.5 mg q 3-4 h prn pain.” The reason given related to the fact that the range of 3-4 h prn pain (which incidentally is how I have prescribed this and other codeinebased medications for many years) leaves open the possibility of a patient taking the medication as many as 8 times in a 24 hour period (if the patient chose to take one every 3 hours).

When multiplying 7.5 x 8 potential doses per day, and given that hyrdocodone shares the same milligram equivalence with morphine (1 = 1), this equates with 7.5 mg x 8 = 60 MME per day, and exceeding their internal policy limit. However, the pharmacist agreed to fill the prescription if I authorized a change from “q 3-4 h” to “q 4h prn pain” – which would result in a calculation of 7.5 mg x 6 times per day = 40 MME per day.

If a prescription is written, as another example, “take 1-2 q 3-4 h,” pharmacists will typically calculate based on the maximum number and frequency a patient could take. Based on this example, a patient could take a maximum of 2 pills every 3 hours. To avoid confusion, or controversial calls from pharmacists, many have chosen to avoid a “range” of pills or frequency. cont. on pg 10

“Navigate” cont. from pg .8

It may be better to write, for example, “take one q 4h prn pain,” and then verbally explain any variations to the patient they may utilize, if needed.

Calculation of MME dosing is relatively uncomplicated when one checks an equivalence table (see Table 1), a number of which are readily available on Google and other search engines. It should also be pointed out that, whether one uses MME or the mathematical method mentioned earlier in calculating daily dosing or the amount of medication in a 3-day versus 7-day supply – neither method takes into account a patient’s individual pain or medication tolerance, type of surgery performed, nor a practitioner’s judgment for each individual situation or case.

One unfortunate aspect of the new law, which has come under criticism, but hopefully will change for the better with time, is that it has had the unintended effect of placing prescribing practitioners and pharmacy personnel in an adversarial or antagonistic position with one another.

Many dentists have also expressed concerns regarding numerous calls involving pushback, in one form another, from pharmacists since the law took effect, for silly issues, such as the “acute pain exception box was not checked” (some pharmacists have not yet caught on that this is not required for an initial 3 day prescription for acute pain). However, most ascribe such encounters to a lack of understanding of certain aspects of the law - by both dentists and pharmacists, perhaps - rather than lack of clarity of existing language within the law.

The FDA has also been proactive and on top of this issue, and after alerting the BOD, a notice was sent out to pharmacists, which also included information sent out by the Board of Pharmacy.

As a third (and final) prong or facet of the new law: Each and every person registered with the DEA and authorized to prescribe controlled substance must take a board-approved twohour continuing education course on prescribing controlled substances. The course must be taken from a “statewide professional association of physicians in this state that is accredTM activities designated for the AMA ited to provide educational PRA Category 1 credit or the American Osteopathic Category 1-A continuing medical education credit as part of biennial license renewal.” Such medical associations include (1) Florida Medical Association, (2) Florida Osteopathic Medical Association, (3) Florida Academy of Family Physicians, or (4) Florida College of Emergency Physicians. Each practitioner required to take the course must do so by January 31, 2019, and then prior to each subsequent licensure renewal.

Summary As mentioned, the individual boards within Department of Health, including the Board of Dentistry, are expected to promulgate further clarification of HB 21, likely in the form of Rules and other communications. Your Florida Dental Association has also been very helpful in passing this information along, and will continue to do so as more information becomes available. For more information on creating an account for access to E-FORCSE and the Florida Prescription Drug Monitoring Program, please visit the following web sites: https://flpdmph.hidinc.com and https://florida.pmpaware.net

Please also visit the FDA website and “landing page” for HB 21: http://www.floridadental.org/member-center/member-resources/hb21-opioid-law ________________________________________________ Richard A. Mufson, DDS is the editor of the SFDDA Newsletter and many be contacted at (305) 935-7501 or MufsonOralSurg@aol.com

Special thanks to FDA’s Joe Anne Hart and Casey Stoutamire for their assistance and guidance in editing portions of this article.

The Nominating Committee of the South Florida District Dental Association is accepting applications for the following positions: - SFDDA Secretary - FDA Trustee (Incumbant, Dr. Beatriz Terry) - FDA Alternate Trustee* (Vacated seat of Dr. Irene Marron) - FDA Althernate Trustee** (Vacated seat of Dr. Rodrigo Romano)

Applications are due no later than November 1, 2018 and may be found at the SFDDA Website www.sfdda.org by logging in to the members only section.

*Dr. Marron has been elected as FDA Incoming Line Officer, Secretary, term commences June 2019 ** Dr. Romano has been elected as FDA Treasurer, term commences June 2019

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Florida Dental Association 2018 Awards

Both Drs. Irene Marron-Tarrazzi and Michael Eggnatz were honored at the FDA 2018 Awards Luncheon which took place, Friday, June 22, at the Gaylord Palms Resort during the Florida Dental Convention.

Dr. Michael Eggnatz received the President’s Award for his service to the FDA, and organized dentistry.

Dr. Eggntaz has held leadership positions at every level of the tripartite. He has served on the ADA 17th District Delegation and has been an FDA trustee, GAC member, legislative contact dentist, Donated Dental Services board member, and FDA Board of Trustees liaison to the Committee on Conventions and Continuing Education. Dr. Eggnatz is a past president of the South Broward Dental society and the South Florida District Dental Association and served as general program chair for the Miami Winter Meeting for nine years. He also served as president of the Greater Miami Chapter of Alpha Omega and as deputy and state regent. Dr. Eggnatz has been on the FDA HOD since 1997, and is a fellow of both the American and International College of Dentists and the Pierre Fauchard Academy.

Dr. Marron-Tarrazzi received the Dentist of the Year award for her contributions to organized dentistry in this past year.

Having held membership for over 14 years, Dr. Marron Tarrazzi has served in many leadership positions including ADA Second Vice President, president of the SFDDA and treasurer of the FDA PAC. She is also a past member of the ADA New Dentist committee, alumna of the ADA Institute for Diversity in Leadership and a speaker for the ADA Success Program. In 2017, Dr. MarronTarrazzi won the Women to Watch Award from the Lucy Hobbs Project.

FDC Fun at 80’s Flasshb 12

Florida Dental Association 2018 House of Delegates Dr. Cesar Sabates received the President’s Choice Award for his selfless dedication to the dental profession during Dr. Eggnatz’ FDA presidential year.

Dr. Cesar Sabates currently serves as the ADA 17th District Trustee, and is a past president of the Florida Dental and South Florida District Dental Associations. He is also a past president of the West Dade Dental Society, Latin American Academy of Osseointegrated Dental Implants, and the American Brotherhood of Latin American Dentists. He has served as a Delegate to the American Dental and Florida Dental Associations. Dr. Sabates is a past treasurer of the SFDDA. He is a fellow of the American and International College of Dentists, Pierre Fauchard Academy and was SFDDA 2003 Dentist of the Year

Dr. Rodrigo Romano was elected as the new Florida Dental Association Treasurer-elect.

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Dr. Romano is the immediate past Chairman of the Florida Dental Association Council of Financial Affairs and is a past treasurer of the South Florida District Dental Association and the Miami Dade Dental Society, where he was also president. He has served as delegate to the American and Florida Dental Associations and is a FDA alternate trustee. Dr. Romano is immediate past chair on the ADA Council on Membership. He is fellow of the Pierre Fauchard Academy and a board member of the Florida Association of Periodontists.

Wearing “SFDDA Vice” T-shirts, some of the SFDDA Delegation take a fun break at the FDC’s 80’s Flashback party.

Pictured l-r: top Row, Drs. Eddy Sedeño, Melissa Sedeño, Oscar Peguero, and Elaine deRoode. Pictured bottom row l-r: Drs. Mark Limosani, Rodrigo Romano, Beatriz Terry, Jeannette Peña Hall, Orlando Dominguez, Michael Eggnatz, Irene Marron, Executive Director, Yolanda Marrero and Dr. Enrique Muller.

SFDDA 2018-2019 Officers and Executive Council President Enrique Muller, D.M.D. (305) 707-2266 President Elect Oscar Peguero, D.M.D. (786) 519-3636

Secretary Mariana Velazquez, D.D.S. (305) 595-4122

Treasurer Orlando Dominguez, D.D.S. (305) 386-2766 Immediate Past President Joseph Pechter, D.M.D. (954) 981-0012 Young Member Melissa Sedeño (305) 822-7684

Trustees & FDA Line Officer

Michael D. Eggnatz, D.D.S., FDA Imm. Past President (954) 217-8888 Jeannette Peña Hall, D.M.D., Trustee 305-667-8766 Beatriz Terry, D.D.S., Trustee (305) 275-1212 Alternate Trustees

Irene Marron, D.M.D. M.S. (305) 646-1524

Rodrigo Romano, D.D.S., M.S. (305) 403-3682

Delegates to the Executive Council from the Affiliates Societies Carlos Sanchez D.M.D. (MDDS) Laura Herschdorfer, D.D.S.(MDDS) Richard Mufson D.D.S (ND/MBDS) Tim Franklin, D.M.D. (ND/MBDS) John Aylmer, D.D.S (SBDS) Fredericka Salbo, D.D.S. (SBDS)

MA ARCH 11--12, 2019 A 9 TALLA A AHASSE EE flo oridadental.org/ddoh al.org/ddoh oh This past legislative session, many dentists, dental students and spouses traveled to Tallahassee to advocate on behalf of organized dentistry. Our numbers impressed the legislators who were debating crucial policy issues for the dental profession during that time. Help us increase that number for 2019 and sign up for DDOH today!

The saying, “There is strength in numbers,” directly applies to your participation in DDOH. When members take time away from their practices and daily lives to travel to the Capitol to participate in advocacy efforts, elected officials sit up and take notice. Participating in these meetings shows legislators you care about legislation impacting your patients as well as your profession. The FDA has a room block at the Doubletree by Hilton Tallahassee for a rate of $219 with a $15 self-parking fee or $18 valet fee. To book your room, please call 850.224.5000 or follow this link http://www.floridadental.org/advocacy/dentists-day-on-the-hill to book your reservation today. Rooms for this event fill up quickly — so reserve your room today!

Affiliate Society Presidents

Carlos M Gonzalez D.M.D. (MDDS) Rita Steiner, D.M.D. (ND/MBDS) Sawan Malik, D.M.D. (SBDS)

Richard A. Mufson, D.D.S., Editor Yolanda Marrero, Managing Editor Jackie Quintero, Advertising Manager SFDDA NEWSLETTER Copyright: © SFDDA 2018 Published by the South Florida District Dental Association 420 S. Dixie Highway, Suite 2E Coral Gables, FL 33146 Send announcements and correspondence to the Editor: 420 S. Dixie Hwy, 2-E Coral Gables, FL, 33146-2271 Phone: (305) 667-3647 FAX: (305) 665-7059 or email to: sfdda@sfdda.org

Disclaimer: Opinions stated in the SFDDA Newsletter are not necessarily endorsed by the South Florida District Dental Association, its Executive Council or Committees. Advertisements printed should not be construed as an endorsement by the Association of the company, 8 product or service.

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North Dade Miami Beach Dental Society Rita Steiner, D.M.D. Dear Friend and colleagues

It is my pleasure to greet you, and to serve you as president of the North Dade-Miami Beach Dental Society at the beginning of a new year.

The preceding year was a wonderful success due to the hard work of our past president, Dr. Evan Rubensteen, and our wonderful executive board, to whom I say, “thank you.” I am excited, humbled and full of enthusiasm to make the upcoming year both meaningful and fun.

I have been a practicing endodontist in Aventura for the past fourteen years. I love my job and I’m extremely grateful to be serving our community.

I was born in New York, but raised in Europe. I came to South Florida as a foreign-trained general dentist in 1997. This country and community have welcomed my family and me with open arms, and for that I also say, “thank you.”

My goal for the upcoming year is to bring an atmosphere of meaningful relationships to our local affiliate society.

A kind word, personal invitation, or follow-up call, can be an essential aspect in cultivating such an environment. Your partnership and participation are fundamental to ensuring that our profession stays deeply rooted in our values, and forward-focused in seizing the opportunities of tomorrow.

Perhaps you could ask a colleague you know, but are not that close with, to join us for a meeting and informative lecture. As we seek to enjoy the next chapter in the history of the North Dade-Miami Beach Dental Society, I am grateful to you all for joining us in fulfilling our grand purpose.

Sincerely,

Rita Steiner

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South Broward Dental Society Sawan Malik, D.M.D. Dear Friends and Colleagues,

I want to thank you for giving me the opportunity to serve as your president of the South Broward Dental Society for the 2018-2019 year! A little background on myself: I grew up a few hours north of here in Orlando and trained at Nova Southeastern University for both dental school and my periodontics residency. As a third generation dentist, you could say I come from a “dental family� with my father, who was an orthodontist, and my mother, who is a general dentist. Admittedly, I am a huge dental nerd, but I also enjoy running, hiking and getting out to the beach! If I have not met you yet, I would love to, and I look forward to getting to know all of you better throughout this coming year!

We have a great team serving as your board (per usual!), which will be preparing exciting lectures for you throughout the coming year. The year will kick off with a lecture from Diana Meyer, Esq., who will give a presentation on dental practice acquisition, partnerships and contract structures. Also, we will dive into digital dentistry and incorporate all fields of dentistry to keep the year going! I would like to thank our immediate past president, Dr. Alfredo Tendler, for his hard work and dedication last year. He put on some great lectures and served us well! I would also like to thank our executive board for all their hard work.

One major goal I have for this year is to increase new member recruitment. We have had the largest growth of any district in the state of late, and I want this trend to continue. While the experience, advice and knowledge from our current members is invaluable, new members ensure the society will continue to grow and thrive. I want everyone to make it a point to bring a friend or colleague to a meeting, while allowing them to see if it is something they would be interested in becoming a part of! As always, anyone interested in joining the board should come speak to Yolanda or myself.

Thank you and I look forward to a great year!!

In your service,

Sawan Malik

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Miami Dade Dental Society Carlos M. Gonzalez, D.D.S. Dear Friends and Colleagues,

I am Dr. Carlos Gonzalez, and I have always had a deep interest in dentistry. My mother, Dr. Lilian Gonzalez, has been a practicing dentist in South Florida for over 25 years, and so it would seem that I have found myself “working� in the dental field for as long as I can remember. From cutting up dental bibs as a boy, to becoming an administrative assistant of the six dental offices that are the family business, I pursued my dream to become a dentist. I graduated from UNIBE, Dominican Republic in 2012. After that, I attended the Florida Institute for Advanced Dental Education, where I completed a two-year AEGD residency.

I have had a passion for organized dentistry since I graduated dental school. Before becoming president of the Miami Dade Dental Society, I served on the board as Secretary and Vice President. Prior to that, I served on the board of the Latin American Academy for Osseointegrated Dental Implants (LAODI) for over 4 years. I am also an active member of the American Academy of Cosmetic Dentistry. I am excited to have new board members joining us this year, including Dr. Laura Herschdorfer who is serving as Vice President and Dr. Ernesto Perez Jr, who is our new Secretary/Treasurer for the society.

We have interesting lectures planned for this year that encompass many different topics our attendees will be able to put to their practices right away. We look forward to seeing you at our first meeting on September 6, 2018 at Casa Juancho Restaurant in Miami.

On a personal note, it is my hope that, along with my fiancĂŠ, Dr. Laura Montalvo, I may continue to master my chosen profession, bring dental communities together, one day open an office of our own, and to continue to practice and serve the South Florida community. And, in the process, we would also hope to have time to enjoy our favorite hobbies - cars, sports, and spending time with our two children.

Sincerely,

Carlos M. Gonzalez

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Affiliates Continuing Education Dinner Meetings...

The affiliate societies kick off the year in September with these excellent lectures. To register visit www.sfdda.org North Dade - Miami Beach Dental Society September 4, 2018

Miami Dade Dental Society September 6, 2018

Elizabeth Feldman, DMD, MS Taeheon Kang, DDS, MS "Dental Oncology & Maxillofacial "Extremely Easy Sinus Surgery" Prosthetics - The Team Approach" Casa Juancho Restaurant Novecento Restaurant 2436 SW 8th St, Miami, 18831 Biscayne Blvd, Aventura, FL 33135Time: FL 33180 6:30 p.m. - 9:00 p.m.

Affiliates Corner...

South Broward Dental Society September 12, 2018

Diana Meyer, Esq. "Transitions and Acquisition" Tropical Acres Restaurant 2500 Griffin Road, Davie, FL 33312 6:30 p.m. - 9:00 p.m.

A GREAT MEMBER BENEFIT that provides you with continuing education and a nice dinner in the company of your friends and colleagues is offered by the SFDDA’s three affiliate societies. Check on sfdda.org for upcoming events.

Miami Dade Dental Society

Usually meets in the Coral Gables area on the 2nd Tuesday of select months between September and April President: Dr. Carlos Gonzalez

North Dade - Miami Beach Dental Society

Usually meets in the Aventura area on the 1st Tuesday of select months between September and April President: Dr. Rita Steiner

South Broward Dental Society

Usually meets in the Davie area on the second select of Wednesday months between September and April President: Dr. Sawan Malik

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Florida Board of Dentistry Report Dr. Don Ilka, BOD Liaison

Reprinted with Permission of the Central District Dental Association

The Florida Board of Dentistry (BOD) met in Tallahassee on Friday, May 18, 2018.

The FDA was represented by FDA BOD Liaison, Dr. Don Ilkka, and Director of Third Party Payer of Professional Affairs, Casey Stoutamire. Other FDA members in attendance included Drs. Andy Brown, Walter Colon, Mike Eggnatz, Dan Gesek, Rick Huot, Bernie Kahn, George Kolos, Eddie Martin, Jeff Ottley, Howard Pranikoff, and Mike Regan. FDA professional staff in attendance included Drew Eason, Joe Anne Hart, and Alexandra Abboud.

All the BOD members were present which included Dr. TJ Tejera, Chair; Dr. Joe Calderone; Dr. Naved Fatmi, Vice-Chair; Dr. Matt Freedman; Dr. Nick Kavouklis; Dr. Claudio Miro; and Dr. Nick White; Ms. Cathy Cabanzon, and Ms. Angie Sissine, hygiene members; and consumer member, Mr. Fabio Andrade. There is one dental and one consumer position open on the board that the governor has not yet filled. This was the first meeting for Drs. Freedman and White. The BOD took the following actions on May 18th:

Petition for Variance or Waiver The FDA’s petition for variance for its online radiography course. The petition was postponed until the August meeting so that the FDA can provide more information on the clinical guidelines for the dentist who will be doing the hands-on training. Presentation on Dental Therapy

The BOD heard a presentation on dental therapy from Dr. Frank Catalanotto. He did not go through his presentation (slides) and just stated he was there for information and to answer any questions. There were no questions from the BOD and they did not give him a platform to engage the members in a debate on the issue. Presentation on Florida’s Action for Dental Health

Dr. Mike Eggnatz, FDA President, made a presentation on Florida’s Action for Dental Health. It was well-received, and he did a great job fielding some very pointed questions from Dr. Kavouklis and Mr. Andrade. Ultimately, it was Dr. Miro who helped our position the most. He stated that access to care is a societal issue and it doesn’t matter how much money you throw at it or if you create new providers, the only way to fix the issue is to educate patients on the importance of oral health. He stated that there is access, but patients choose not to use it. This led to a great discussion on

Community Dental Health Coordinators.

Board Counsel Report

Mr. David Flynn, BOD Counsel, informed the BOD that there are several rules open for development due to HB 21 on opioids. He also updated the BOD on an FTC case from Louisiana and stated Florida may be looking to “tighten up” its active supervision of boards made up of market participants (which includes the BOD). Under this opinion, Florida would need to have a mechanism in place to not only review board actions, but also have the ability to revise them or veto them.

Rules Committee Report

Ms. Sissine updated the BOD on the status of the digital scanning and restorative function dental auxiliary (RFDA) proposals. The digital scanning proposal will be reviewed by the Hygiene Council on its June 18th call and then move to the full Board for action at the August meeting. The RFDA proposal will be discussed during a face-to-face meeting the day before the August meeting and then move to Hygiene Council for its review so that it can be voted on at the November meeting. HB 21 and Opioids

The BOD discussed HB 21 (opioid legislation) and its implications for dentistry and the BOD moving forward. The Florida Medical Association, the Florida Academy of Family Physicians, the Florida College of Emergency Physicians, and the Florida Osteopathic Medical Association were approved as providers of the mandatory CE course. This means the FDA’s joint course with the FMA at FDC was approved. The BOD approved rule language requiring all licensees registered with the DEA to prescribe opioids to take a twohour CE course on opioids by January 31, 2019 and at each subsequent biennium as required by HB 21. The 2 hours will be included in the 30 hours (and not in addition too). In addition, teaching permit holders will have to take the 2-hour CE on opioids as well.

The BOD will be doing a complete rewrite of Rule 64B5-17.0045, Standards for the Use of Controlled Substances for Treatment of Pain. There will be another multi-board meeting on June 21 and Mr. Flynn expects draft language to come out of that meeting and ready for the BOD to review at its August meeting. The Department of Health would like as much consistency in the guidelines across the various provider groups as possible. Mr. Flynn asked the BOD to start thinking about the disciplinary guidelines and the

various implications of HB 21 and the BOD will make decisions on the guidelines in August.

The BOD discussed its Citation Authority for failing to check and report data into the Prescription Drug Monitoring Database (PDMP). The BOD approved a $250.00 ďŹ ne for failing to report controlled substance information to the PDMP and a $100.00 ďŹ ne for failure to consult the PDMP prior to dispensing a controlled substance. There was much discussion on how the department would monitor these violations. It was stated that they will not be auditing the PDMP and that violations would most likely be discovered as part of a larger investigation on another issue. The BOD approved a motion to revise the various dental licensing applications to add a question asking if the applicant is registered with the DEA. Licensure Applications

The Board reviewed the application of Dr. Albert Hazzouri, who is a friend of President Trump. Ultimately, he withdrew his application when it became certain that the BOD was going to deny his application as he had not taken the ADEX exam. He wanted the BOD to give him a license as a favor to the President and the BOD did not back down.

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Disciplinary Cases

There were three disciplinary cases, one determination of waiver, and two voluntary relinquishments that dealt with fraudulently accessing opioid medications, failing to meet the minimum standard of care and Medicaid fraud.

If you have not yet attended a BOD meeting, it is suggested that you take the opportunity to attend and observe the work of the BOD. It is much better to be a spectator than a participant in BOD disciplinary cases.

The next BOD meeting is scheduled for Friday, August 24, 2018, at 7:30 a.m. at Crown Plaza Tampa Westshore, 5303 West Kennedy Boulevard, Tampa, Florida 33609.

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MAKE A DIFFERENCE TO BETTER ORAL HEALTH IN SOUTH FLORIDA Dear SFDDA member,

Beatriz E. Terry, D.D.S., M.S.

I am writing today to invite you to join me in an en- With your generosity, we may even be able to bring the deavor to improve access to oral health care for people MOM event to South Florida. Our target year is 2021!! But the process to put on one of these events is arduous. in our South Florida community. It requires numerous volunteers dedicating time and talThrough the South Florida Dental Foundation (SFDF), ent to locate venues, donors and sponsors. And it costs you can make a difference. The SFDF supports many lots of money. local oral healthcare programs like the SFDDA’s collaboration with Miami Dade County Public Schools to The SFDF Board asks your help in supporting all of bring awareness of good dental hygiene habits to ele- these worthwhile causes. PLEASE consider making a mentary-age children in the county. The SFDF also pro- monetary donation, no matter how small or large. You vides support to local dental clinics that provide care to have a unique opportunity to improve access to care underserved communities such as the May Van Sickle right here at home. Donate by clicking on the “Foundation” link at www.sfdda.org. Children Dental Clinic. Another important program for which our foundation has provided funding is the FDA’s Mission of Mercy (MOM), which took place this past March in Fort Myers. Our last SFDDA newsletter highlighted this event along with the volunteers from our district. I am proud to say that I have volunteered in all four MOM events to date – in Tampa, Jacksonville, Pensacola, and Fort Myers.

We will keep you updated on the progress of all of the programs we support, and we welcome your help in volunteering at FDA MOM. Please just let us know your interests. For more information on the MOM, visit flamom.org. With sincere gratitude,

The next MOM event is being held in Orlando on March 22-23, 2019, and I plan on volunteering there as Beatriz E. Terry, D.D.S., M.S. well. Please join me!! It is one of the most rewarding Diplomate, American Board of Periodontology things you can do for others and for YOU. Just ask any President, South Florida Dental Foundation of our local members who have participated.

Make Your Donation to the South Florida Dental Foundation at www.sfdda.org 25

Classifieds OPPORTUNITIES AVAILABLE

PACIFIC DENTAL SERVICES SUPPORTED OFFICES: are currently looking for a full-time Associate Dentist to add to our successful and growing practice in Winter Springs, Florida. This office is fully digitized and equipped with SiroLaser, CEREC® CAD/CAM, intraoral cameras, VELscope®, and digital X-rays. Pacific Dental Services Supported Offices offer: Competitive earning potential, with no earning cap. Benefits, including: Medial, Dental, Vision, 401K All Lab & Supply fees, malpractice insurance, and any CE credits taken through the PDS institute® Mentorship and training Great working environment, with a fun, friendly, and supportive team. If interested in the position, please apply here: https://pacden.csod.com/ats/careersite/JobDetails.aspx?site=1&id=11504 &source=JobTarget Apply Here: http://www.Click2Apply.net/hhwwhq5xgqp d6nmq PI103646057

PACIFIC DENTAL SERVICES SUPPORTED OFFICE: is currently looking for a full-time Associate Dentist to add to their successful and growing practice in Gainesville, Florida. This office is fully digitized and equipped with SiroLaser, CEREC® CAD/CAM, intraoral cameras, VELscope®, and digital X-rays. This office offers: Competitive earning potential, with no earning cap. Benefits, including: Medial, Dental, Vision, 401K The office pays all lab & Supply fees, malpractice insurance, and any CE credits taken through the PDS institute® Mentorship and training Great working environment, with a fun, friendly, and supportive team. If interested in the position, please apply here: https://pacden.csod.com/ats/careersite/JobDetails.aspx?site=1&id=11221&source=Jo bTarget Our state of the art practice in Gainesville, FL has an exciting oppty for a talented Dentist. Fully digital office w/ SiroLaser, CEREC® CAD/CAM, intraoral cameras, VELscope®, and more! Competitive production-based comp plan with bonuses/benefits including: Med/Dent/Vision, 401K w/match, malpractice, AGD CE, and fully paid lab fees. Great working environment, with a fun, friendly, and well-trained support team. Clinical autonomy with a focus on excellence and creating patients for life. 26

To run classified or display advertising in the SFDDA  Newsletter, please contact: Jackie Quintero at (305) 667-3647 ext 13 or email jackie.sfdda@gmail.com

To be considered immediately, please apply here:https://pacden.csod.com/ats/careersite/JobDetails.aspx?site=1&id=11221&so urce=JobTarget Apply Here: http://www.Click2Apply.net/7kvqc849kt4v 5m23 PI103645830

PACIFIC DENTAL SERVICES SUPPORTED OFFICE: is currently looking for a full-time Associate Dentist to add to their successful and growing practice in Port Orange, Florida. This office is fully digitized and equipped with SiroLaser, CEREC® CAD/CAM, intraoral cameras, VELscope®, and digital X-rays. This office offers: Competitive earning potential, with no earning cap. Benefits, including: Medial, Dental, Vision, 401K The office pays all lab & Supply fees, malpractice insurance, and any CE credits taken through the PDS institute® Mentorship and training. Great working environment, with a fun, friendly, and supportive team.If interested in the position, please apply here: https://pacden.csod.com/ats/careersite/JobDetails.aspx?site=1&id=11503&source=Jo bTarget PI103645995 PART TIME: High quality prosthodontist and periodontist needed for selective cases at my office.Please call or e-mail. David Vine, D.D.S. 305.538.1115 (dvine@davidvinedentist.com ).

DENTIST WANTED TO SHARE SPACE: Lovely modern office. A dentist with a practice preferred. But will help a new dentist get started. Contact Dr. Faine 305-661-9556.

BEAUTIFUL DOWNTOWN/BRICKELL DENTAL OFFICE: Looking for a full time Hygienist, Front Desk and two Dental Assistants. Send resume recruitingdentistry@gmail.com

SEEKING P/T ENDODONTIST: Large Multi Specialty practice in Miami-Dade seeking Endodontist to grow with us. Applicant must possess clinical and patient skills. Please email or call Kristina at kristinaperez@altimadentalgroup.com or 786804-4662

ENDODONTIST OPPORTUNITY!: 25+ year, multi-doctor, privately owned family practice seeking a highly motivated and high character Endodontist to help treat our great patients and work with a wonderful

and experienced team. With nearly 2,000 5-Star reviews, join a successful practice and jump right in to a strong schedule with over 100 new patients a month waiting for quality, comprehensive care. Enjoy a high percentage based compensation and an already established patient base. Please forward CV to Holly Strempel at hollymdmg@gmail.com

DENTAL PRACTICE FOR SALE

OCALA FLORIDA PRIVATE GENERAL DENTISTRY PRACTICE FOR SALE!: 4 fully equipped State of the Art Operatories in busy street front location. This practice is located in the heart of Sunny Ocala Florida and has a consistent growth with incredible opportunity to earn. The practice is currently open 4 days per week with a loyal and impressive retiree patient base, and could easily support additional days. Fully paperless currently using Dentrix software with a fully functional on site acrylic lab. It is truly a MUST SEE and I do not expect it to last long. Price: 595,000 Contact:Jude Mastapasco Judem824@yahoo.com (352)427-2070 Photos available to upload

DENTAL PRACTICE FOR SALE: Modern 4 operatory fully digital, established for 10 years. Fee for service. Not HMO or Medicaid. Long term lease. Staff willing to stay.305-244-2771

OFFICE SPACE – SALE OR RENT

SPECTACULAR DENTAL OFFICE: Space for rent with two equipped operatories. Brickell area. Call us @ 305-510-4446 Gabriella

GREAT OPPORTUNITY: to open your own business and sublease our beautiful new office at an easily affordable price in the South Miami Area. Please call Veronica at 305-798-2961 for more information.

MISCELLANEOUS

FOR SALE: 2-Jed Med Microscopes, 2Bellmont X-Ray Machines, 1 Bellmont Dental Chair, ADEC Cart & other miscellaneous equipment for sale. Call 305-4511251

Our Newest Members and Reinstated Members Dr. Ricardo Carrillo

Dr. Jose Abrahantes

Dr. Marlene Moreira

Dr. Dhunia Dopazo Alonso

Dr. Reshma Baddaloo

Dr. Mario Onate Hernandez

Dr. Patricia Fornes

Dr. Angelica Cruanas Morales

Dr. Ronald Jarquin

Dr. Alina Diaz

Dr. Katherine De Armas Dr. Martin Drubi

Dr. Bianca Gonzalez

Dr. Philippe Jean

Dr. Lisandra Amador

Dr. Alberto Blackwood Dr. Ana De Feria

Dr. Ivonne Duarte

Dr. Michelle Nguyen Dr. Maria Petroche Dr. Loines Pina

Dr. Jose Ramirez

Dr. Alexander Rodriguez Castillo

Dr. Vanessa Lebron

Dr. Eliseo Fiffe

Dr. Katrina Sanchelima

Dr. Claudio Miro

Dr. Jovani Gonzalez

Dr. Ellie Suzuki

Dr. Javier Martinez Dr. Omar Morell

Dr. Sandra Oilar

Dr. Jose Vazquez Llana

Dr. Clara Llodra

Dr. Silvia Dumois-Gonzalez Dr. Adriana Rodriguez

Dr. Sanaz Ghiassi

Dr. Jordan Siegel

Dr. Ela Gozlan

Dr. Mauricio Tijerino

Dr. Jonathan Journo

Dr. Angela Urruchi

Dr. Quan Huynh

Dr. Sara Karim

Dr. Catherine Lopez

Dr. Brian Tran

Dr. Jonathan Wechter

Dr. Leilani Lorenzo

SFDDA Members,

Visit our website at sfdda.org to create your own login and update your referral details or to access members only information. If you are looking for something on our website and do not find it, please let us know, and we will try to find it for you, and we will also make

that it’s on the site in the future. (305) 667-3647

We communicate via email, social media and text message. Please be sure that your contact information is updated and ready to receive our communciations. You never know when you will be called to action, or invited to attend a lecture or event. To confirm or update your informatio, please call the SFDDA at(305) 667-3647, or email us at southfloridadistrict@gmail.com, or click on “Stay Connected” on our website, www.sfdda.org. 27

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