SFDDA Spring Issue 2019

sfdda Volume 60, No.4 www.sfdda.org Spring 2019

spring edition

Inside this issue: President’s Message - Dr. Enrique Muller, Pg 3 “More on Complying with HB21” - Dr. Richard Mufson, Pg 4 Legislative Priorities - Joe Anne Hart, Pg 12 Mandatory CE - “Human Trafficking,” Pg 16

SFDDA Annual Business Meeting, Pg 18 Hurricane Season, Pg 21 Classifieds, Pg 23 South Florida Baptist Mobile Dental Unit, Pg 23

President’s Message ‐Enrique Muller, DMD, MSC

I am humbled and honored to have served as your SFDDA president for the 2018-2019 year and truly hope I have lived up to your expectations, as well as having had a positive effect on our association.

I hope you enjoyed the amazing presentations that were put together for all of you throughout the year by the affiliate boards, who worked arduously to bring you not only incredible speakers but also the opportunity for social networking and camaraderie between all the affiliates of the SFDDA. Your executive boards have demonstrated an unwavering determination to live up to the goals of organized dentistry. We thank you for your service.

goes out to the SFDDA board of officers and executive council for their help and leadership throughout my term.

I would like to extend a special thank you to our executive director, Yolanda Marrero, and to Jackie Quintero, without whom I would never have been able to fulfil my term, nor accomplish anything. They make it possible for our association to function as perfectly as it does.

I would be remiss if I did not express my gratitude to Dr. Michael Eggnatz, Dr. Cesar Sabates, Dr. Alan Friedel, Dr. Irene Marron, Dr. Jeanette Peña-Hall, Dr. Beatriz Terry, Dr. Carlos Sanchez and Dr. Richard Mufson for their guidance, counsel, mentorship and

“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.”

We continue to strengthen our relationship and focus on the affiliates, which have been incredibly well received, and it shows in the staggering membership retention and growth.

We reached and surpassed by a substantial margin our sponsorship goals. We would like to thank all of our sponsors for making this possible and encourage them to continue to work with us for the coming year.

We were also able to provide the state-mandated Controlled Substance Prescribing course before the deadline despite the difficulty it entailed.

I would like to thank our immediate past president, Dr. Joseph Pechter for all of his hard work, as well as our president-elect, Dr. Oscar Peguero, to whom I also wish the best of luck for his upcoming tenure. My gratitude

friendship during my tenure.

It is no secret that I have been adamant about recruiting new young members, who are the future of our organization and profession, while transitioning our existing long-time members into a mentorship role for the new generation. We need to understand how they relate and rely on each other so we can continue to grow our association and its affiliates.

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. 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.

Enrique Muller, DMD, MSD 3

In My Opinion Complying with the Law - HB 21 – When Prescribing Opioids and Other Controlled Subtances: Sharing an Easier and More Streamlined Method ‐ Richard A. Mufson, DDS, Editor Many of us are apparently not following the new law and don’t even know it. Or…some may know, but have chosen not to care, or not to prescribe?

not to increase their awareness, or perhaps are too fearful of taking on the task of understanding how to incorporate the tools for following the law into their practices and medical records?

Our Florida Dental Association (FDA) has without question taken the lead on disseminating to members all available information pertaining to HB 21, as it has developed, and I would encourage all of you to visit the FDA “landing page” on the new law at: http://www.floridadental.org/membercenter/member-resources/hb21-opioid-law.

Next Question: How or When Could This New Law Affect Me Anyway?

The Florida Board of Dentistry (BOD), as of December 4, 2018, finalized and approved Rule 64B5-17.0045, Standards for the Prescribing of Controlled Substances for the Treatment of Acute Pain. The Rule, in addition to defining the term, acute pain, and conditions not to be included within that definition, adds a long list of specific and detailed requirements we must follow if/when prescribing. The requirements largely involve items of documentation within our medical records (see Figure 1).

The requirements within the new BOD Rule were not created from scratch, but rather were already spelled out within statute, signed into law by Governor Rick Scott on March 18, 2018, and having taken effect on July 1, 2018. HB 21 also called for, as a mandate, the professional licensing boards falling under Department of Health to adopt rules establishing standards of practice as enumerated within the law.

However, many of us apparently have had no problem with the “head in the sand” approach to this. A large percentage of dentists I have spoken with seem unaware of the multifaceted requirements. Or, if the list of new requirements has seemed all too challenging or work-intensive (which on first glance, I felt the same) – some of us have simply chosen not to prescribe. And who knows? In some small way, perhaps that could be a good thing.

On the other hand, we must ask ourselves this question: Shall a given percentage of our patients who may truly need or benefit from prescription pain medications be denied simply because their treating dentists have either chosen

The answer to this question, if one were prescribing but not following the law to the letter - as can often be said of many of the legal aspects of what we do in practice - is not “black and white.”

On one hand, we can rest assured that Lieutenant Frank Drebin and the Opioid Police Squad will not be marching into our offices anytime soon and demanding to see our medical records. The more likely scenario would arise if either: (1) the amount, frequency and pattern of prescribing were to suggest a given practitioner as being an obvious “outlier,” and thereby raising red flags and potentially inviting investigation, or (2) in the event one were to become the subject of a Department of Health/BOD investigation of say, an alleged matter involving one of our patient’s treatment. As a secondary and unrelated aspect of such an investigation, review of our record may indicate a lack of compliance as related to prescribing. This could then result in additional hefty fines, continuing education sanctions, or in more egregious cases, a significant threat to our license to practice.

However, that aside, most of us must be thinking – “But there must be an easier way.”

OK, yes, perhaps there is an easier way.

Following the Law in Daily Practice (refer to Table 1) (1) The prescribing part: The initial requirements seem easy to follow. Learning how to calculate the maximum number of pills in a 3-day supply should be simple math – i.e., q 4h = 6 pills max per 24 hours x 3 days = 18. OK, no problem.

If additional medication is needed for a given patient, one continued on page 7

4

Figure 1

New Opioid Rule Approved by BOD* (*Courtesy of Florida Dental Association) As required by HB 21, the Board of Dentistry (BOD) recently finalized and approved Rule 64B517.0045, Standards for the Prescribing of Controlled Substances for the Treatment of Acute Pain.

It became effective on December 4, 2018, and if you do not comply, you will be subject to discipline by the BOD. Adopts the following standards for the prescribing of controlled substances for acute pain. Please note, these are the new standards for prescribing opioids and are in addition to the 3-day limit required by HB 21.

1. Evaluation of the Patient. A medical history and physical examination appropriate for the patient’s clinical condition must be conducted and documented in the medical record. The medical record also shall document the presence of one or more recognized medical indications for the use of a controlled substance.

2. Treatment Plan. The written treatment plan shall indicate if any further diagnostic evaluations or other treatments are planned, including non-opioid medications and therapies if indicated. After treatment begins, the dentist shall adjust medication therapy, if necessary, to the individual medical needs of each patient.

3. Informed Consent and Agreement for Treatment. The dentist shall discuss the risks and benefits of the use of controlled substances, including the risk of abuse and addiction as well as physical dependence with the patient, persons designated by the patient, or with the patient’s surrogate or guardian if the patient is incompetent. The discussion also shall include expected pain intensity, duration, options, use of pain medications, non-medication therapies and common side effects. Special attention must be given to those pain patients who are at risk of misuse or diversion of their medications. The Florida Dental Association has provided a the form used by OMSNIC on their website at floridadental.org/opioidlaw.

4. Periodic Review. Based on the circumstances presented, the dentist shall review the course of treatment and any new information about the etiology of the pain.

Continuation or modification of therapy shall depend on the dentist’s evaluation of the patient’s progress. If treatment goals are not achieved, despite medication adjustments, the dentist shall re-evaluate the patient and determine the appropriateness of continued treatment. The dentist shall monitor patient compliance of medication usage and related treatment plans.

5. Consultation. The dentist shall refer the patient as necessary for additional evaluation and treatment in order to achieve treatment objectives. The management of pain in patients with a history of substance abuse or with a comorbid psychiatric disorder requires extra care, monitoring and documentation, and may require consultation with or referral to an expert in the management of such patients.

6. Medical Records. The dentist is required to keep accurate and complete records to include, but not be limited to: a. the medical history and a physical examination, including history of drug abuse or dependence, if indicated --- b. diagnostic, therapeutic and laboratory results --- c. evaluations and consultations --- d. treatment objectives -- -e. discussion of risks and benefits --- f. treatments --- g. medications (including date, type, dosage and quantity prescribed) --- h. instructions and agreements --- i. drug testing results, if indicated -- -j. justification for deviation from the three-day prescription supply limit for a Schedule II opioid controlled substance for acute pain --- k. outline of problems encountered when attempting to consult the Prescription Drug Monitoring Database (PDMP), E-FORCSE, --l. periodic reviews. Records must remain current, maintained in an accessible manner, readily available for review, and must be in full compliance with Rule 64B5-17.002, F.A.C, Section 456.057, F.S., Section 466.018, F.S., and Section 466.028(1)(m), F.S.

Table 1

Table 12 - Summary of Lega al Requirements – Complying C with HB B 21 Requires a prescriber or dispenser of any “controlled substance” (not just opioids) to: (1) consult the E-FORCSE database to review a patient’s controlled substance e dispensing history – prior to prescribing or dispensing a controlled substance for a patient who is 16 years or older, and (2) document the fact that the database was consu s lted (the specific information viewed is not required) within the medical record.

Prescriptions for a Schedule II opioid for the treatment of acute pain** * (1) may not exceed a “3-day supply,” except…

(2) 7-da d y supplly is allowed “if” the following conditions are met: (a) more than a 3-day supply is needed based on the professional judgment of the provider, (b) the prescriber indicates “ACUTE PAIN EXCEPTION” on the presc s ription, (c) the prescriber documents in the medical/dental record the acute medical condition, lack of alternative options, s and rationale which justifies prescribing medication above and beyyond the 3-day limit.

(3) If a prescriber writes a prescr s iption for a Schedule II opioid for the treatm ment of chronic non-malignant pain (i.e., for conditions such as jaw fracture, burn injury, y etc.), the prescriber must indicate “NON-ACUTE PAIN” on the prescription.

Requires each person registered with the DEA and authorized to presc s ribe controlled substances to take a 2-hour BOD-approved continuing education course each and every biennium on prescribing co ontrolled substances

*Excludess “non-opioid” controlledd substances listed in Schedule S V **Excludeed from definition of acuute pain: cancer, terminaal conditions, palliative care c for incurrable, rable progressive illnesss or injury, injury traumatic injjury with Injury Severity Score (ISS) off 9 or greater; n ISS of 9 or greater, th he If prescrib bing a Schedule II “conttrolled substance” for an prescriberr must concurrently presscribe an emergency op pioid antagonist (requiires nguage clarification – ass opioid antagonists, such as naloxone, only act on further lan opioids, and not all “controlled su ubstances”).

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In My Opinion, continued from page 4

may exercise the “7 day supply” option – by checking the “Acute Pain Exception” box on the prescription, and by entering into your medical record other required documentation (as in Table 1 – blue section, #2a, b, and c).

(2) The E-FORCSE part: Once registered with the PDMP database, also known as E-FORCSE (Electronic-Florida Online Reporting of Controlled Substances Evaluation Program) – you (or your designee) need only devote a few seconds, for patients of age 16 years and older, by typing in a name, date of birth and (optional) patient’s zip code to consult and view patient information. You then need only document in your record that you have consulted the database. If a technical glitch occurs with the website or database access, you need only document what occurred in your record.

(3) Incorporating the List of Additional Requirements Within HB 21/BOD Rule: After the initial requirements in HB 21 were rolled out, all seemed relatively straightforward.

However, I recall when first glancing at the long list of additional documentation requirements included within the new BOD Rule (as in Figure 1), I first thought, “Oh no. How in the world will that even be possible?”

An idea then came to mind. What if the long list of required items were converted into a simple handy-dandy checklist (see Figure 2, which demonstrates an executed version)? If worded correctly and appropriately, with a convenient “yes” or “no” option for us to simply place a checkmark next to each required item on the list – my belief has been that it would serve as a legitimate and legally sufficient means of documenting compliance with each required item, while taking only seconds to complete.

Please note that the third item on the checklist (and item #3 in Fig 1) is an informed consent required when prescribing controlled substances. It must be signed by the patient as a separate document, apart from the consent they may also be signing for a given procedure to be performed. A sample consent form appears in Figure 3, and was provided to the Florida Dental Association courtesy of OMS National Insurance Company.

However, there are several caveats. Just as with any checklist or template, such a method presupposes we have actually done the things on the list we are attesting to have done.

We also obviously need to ensure the information applies to each individual patient, and is not simply a same/similar cookie-cutter version of events for all patients and all records.

Please be aware the checklist leaves out one important required item listed within HB 21/BOD Rule – “Medical Records” (#6 within Figure 1).

The reason for this relates to the presumption that each of us would (or should) inherently include within our medical

records - as a separate matter, and not suitable for inclusion within a checklist format - the general items of what the law asks for (i.e., medical history, evaluation, diagnoses, results of radiographs or other tests, discussion of risks and benefits, treatments, medications, etc.), and which would become apparent if/when our records may be subjected to review.

I also wanted to share a separate, smaller checklist, to again help streamline the process of documenting the required items if/when the “7-day” prescribing option is needed (see Figure 4, which also demonstrates an executed version).

The Summary of the “How To” When Prescribing: This is the general order and routine of “how I do it” when prescribing: (1) Do the math and calculate the appropriate amount of medication for a 3-day supply (certainly much can be said for writing for less and/or encouraging alternatives such as NSAIDs or other choices in lieu of, or in combination with, controlled substances), (2) Consult the E-FORCSE database, and document in your record that you have done so, (3) Obtain the separate informed consent when prescribing controlled substances, (4) Use the Standards for Complying checklist, as in Figure 2, (5) If a 7-day option is subsequently needed, use the checklist, as in Figure 4.

Disclaimer I hope you will find this article useful to you and your practice in terms of making the process easier, more streamlined and more efficient when prescribing. It must be emphasized that the information shared, including the idea for the checklists – represents a method I alone have developed and chosen for “how I do it.” As stated earlier, I believe it serves as a legitimate and legally sufficient means of complying with, and for documenting, the standards enumerated within HB 21 and BOD Rule. I am not an attorney, and the information herein has not been officially vetted nor approved by legal counsel, nor by any individuals within the Florida BOD or Department of Health.

I would also invite any feedback, concerns or questions regarding any of the information or techniques presented. ________________________________________________ Richard A. Mufson, DDS is the editor of the SFDDA Newsletter and many be contacted at (305) 935‐7501 or MufsonOralSurg@aol.com

Figure 2

Richard A. Mufson, DDS

Pa atient Name: __________ __ __ __ __ __ __ __ __ __ __ ___ _____________ __ __ __ __ __ __ __ __ __ __ __ __ _

Include within Medical Record - Sttandards for Complying witth HB 21 and Rule 65B5-17.0045 17 7.0045 Yes No

a

( ) ( ) Patient evaluation: Medical Hx and patient evaluation conducted and documented in the medical record; medical indications for controlled substance also documented?

( ) ( ) a

( ) ( ) a

a

( ) ( )

( ) acute pain following surgery ( ) acute pain prior to surgery ( ) other ______________ _____ a Treatment Plan: performed indicating any further diagno ostic evaluations, treatment planned; nded Alternatives to non-opioid medications (Tylenol, NSAIDs, etc.) have been recommended prior to, in lieu of, and/or only if needed, in combination with opioid/controlled medication on.

Any necessary adjustments to therapy and patient’s medical needs will also be performed.

Informed Consent: obtained – discussed risks and benefits of use of controlled substances, including risk of abuse and addiction, physical dependence, persons designated by patient, or with patient’s surrogate or guardian? Discussion included expected pain, intensity, duration, options, proper use of pain medication, non-medication therapies?

Is patient at higher risk of misuse or diversions of their medications? – If yes, special attention was given as part of the consent process?

R e v ie w : a (aPe) rIsiordeviciew required during g course of treatment for any new information about etiology of

( ) ( )

pain, requiring possible continuation or modification of therapy – depending on further evaluation and patient progress ??

a ( ) a ( ) (c) Has re-evaluation been required and/or performed to determine appropriateness of continued treatment?

( ) ( ) (b) Have treatment goals no ot been achieved despite anyy medication adjustments?

a Consultation:

( ) ( )

(a) Is referral needed for additional evaluation/treatment in order to achieve treatment objectives? (b) Does patient have any history of substance abuse orr comorbid psychiatric disorder requiring additional care, monitoring and/or referral to a pain and/or psychiatric expert forr management?

_______ ________________ __ _______ (signed – practitioner / date)

8

Figure 3

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Acute Pain Exception / 7-Day Option Requirements Yes

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More than a 3-day supply is needed based on the judgment of the provider?

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“Acute pain exception� box checked/indicated on the prescription form?

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Continued acute pain following recent__ extraction (a) the acute medical condition _________ __ __ __ __ __ __ __ __ __ ________________________ __ _____ __ __ (b) the lack of alternative options __________________ _______________ _____are not helping Patient reports other__ options (NSAIDs, __ other)

Surgical treatment was (c) rationale justifying medication in excess of the 3-day supply: ______________ of greater complexity in this patient: and tolerance to pain/medication is also a factor __________________________________________________ ___________ ___ __ __________________ (signature)

10

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Legislature Approves FDA Priorities

By Joe Anne Hart, FDA Chief Legislative Officer

The Florida Legislature approved the Florida Dental Association’s (FDA) priority legislation to reinstate the Dental Student Loan Repayment Program and expand the Donated Dental Services (DDS) program, as well as continuing education (CE) legislation for the prescribing of controlled substances.

Legislation passed in CS/HB 843 that will encourage dentists to work in rural and underserved areas as fulltime Medicaid providers in settings such as county health departments and community health centers. In return, dentists will be eligible to receive $50,000 a year to repay student loan debt for a maximum of five years.

Additionally, the legislation would codify the DDS program in statute and allow for the program to be expanded to provide more access to dental care for individuals who are elderly, disabled or medically compromised, and unable to afford dental care. CS/HB 843 now heads to the governor for consideration. Should the bill be signed into law, it would be effective July 1, 2019.

Despite passing the substantive legislation to reinstate the Dental Student Loan Repayment Program and expand the DDS program, the final budget did not allocate funding to implement these provisions. Should CS/HB 843 become law, the statutory authority would be on the books to support these programs and the focus for

SFDDA 2018-2019 Officers and Executive Council

Young Member Melissa Sedeño (305) 822-7684

President Enrique Muller, D.M.D. (305) 707-2266

Trustees & FDA Line Officer

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

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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 (Interim Alt. Trustee) Gina Marcus, D.M.D (305) 446-6655

the 2020 legislative session would be to secure funding to implement these programs.

FDA-supported legislation passed in HB 549 that would require dentists to take a two-hour CE course on the safe and effective prescribing of controlled substances during licensure renewal. Last year, legislation passed that required all health care practitioners to take CE for the prescribing of controlled substances from a statewide association of physicians, unless the health care provider practitioners’ practice act included the CE requirement. With the passage of HB 549, dentists will no longer be mandated to only receive CE for the prescribing of controlled substances from a statewide association of physicians. Dentists will be able to receive CE for controlled substances from dentists and dentalaffiliated groups. Should this bill be signed into law, it would be effective July 1, 2019.

For additional information on the 2019 Legislative Session, please be sure to click on the link below for the complete Sine Die Capital Report. https://www.floridadental.org/docs/librariesprovider57/private-library-florida/public/capital-report-2019/capital_report_05-16-19-_sine_die.pdf?sfvrsn=2

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) 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: southfloridadistrict@gmail.com 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, product or service.

Thank you for attending this year’s affiliate dinner meetings.

We look forward to welcoming you back when the meetings commence again in September .

The SFDDA events are Graciously Sponsored by:

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MANDATORY CONTINUING EDUCATION ON HUMAN TRAFFICKING

After recent incidents of undercover human trafficking rings in Florida, the Legislature prioritized strengthening Florida’s laws on human trafficking.

CS/CS/CS/HB 851 by Rep. Heather Fitzenhagen (R-Fort Myers) outlines several changes to human trafficking laws. It creates a new section of law that requires persons who are licensed or certified under the following to take a one-hour CE course on human trafficking by Jan. 1, 2021: f ch. 457, acupuncture f ch. 458, medical practice f ch. 459, osteopathic medicine f ch. 460, chiropractic medicine f ch. 461, podiatric medicine f ch. 463, optometry f ch. 465, pharmacy f ch. 466, dentistry f ch. 468, part II, nursing homes f ch. 468, part III, occupational therapy f ch. 468, part V, respiratory therapy f ch. 468, part X, dietetics and nutrition practice f ch. 480, massage practice f ch. 486, physical therapy practice The course must address both sex and labor trafficking, how to identify individuals who may be victims of human trafficking, how to report cases on human trafficking and resources available to victims. Additionally,

by Jan. 1, 2021, a sign must be posted in a place accessible to employees that is at least 11 inches by 15

inches in size, printed in 32-point sized font (in English and Spanish) that reads: “If you or someone you know is being forced to engage in an activity and cannot leave, whether it is prostitution, housework, farm work, factory work, retail work, restaurant work or any other activity, call the National Human Trafficking Resource Center at 888.373.7888 or text INFO or HELP to 233-733 to access help and services.

Victims of slavery and human trafficking are protected under United States and Florida law.”

Each licensing board that requires a licensee or certificate holder to complete a one-hour CE course on human trafficking must include the hour required for completion in the total number of hours for CE required by law for that profession. At this time, it is unclear if the one-hour CE requirement on human trafficking is onetime only, or if it will be a part of ongoing CE for each licensure renewal cycle. The BOD is authorized to promulgate rules to implement the CE requirement and will be able to provide further clarification.

If the governor signs CS/CS/CS/HB 851 into law, it goes into effect on July 1, 2019, except as otherwise expressly provided in the bill. ___________________________________________ Please know that your dental association is preparing to offer the required course for our members and you will be informed when it becomes available should the bill be signed into law.

The article above is a reprint from the FDA’s Capitol Report. Use the link below to acces this and much more information regarding the 2019 Florida Legislative Session. https://www.floridadental.org/advocacy/legislative-action-center/capital-report 16

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South Florida District Dental Association 2019 Annual Business Meeting The SFDDA held their Annual Business Meeting on April 17 at the Doubletree by Hilton Grand Hotel Biscayne Bay. President, Dr. Enrique Muller, welcomed Dr. Jolene Paramore, FDA President, who attended the event along with Mr. Drew Eason, Executive Director of the FDA. During the meeting, Dr. Michael Eggnatz awarded Life Member Certificates to Drs. Andrew Hirschl and Ira Lelchuk.

The South Broward Dental Society also awarded service plaques to their 201819 officers, Drs. Sawan Malik, outgoing President, Fredericka Salbo, PresidentElect and John Aylmer, Secretary.

Pictured Above: Drs. Oscar Peguero and Enrique Muller Pictured Below: Drs. Andrew Hirschl, Michael Eggnatz and Ira Lelchuck

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The election of officers took place and the following were installed for the 201920 year: SFDDA Line Officers - Drs.

Oscar Peguero, President, Mariana Velazquez, President-Elect, Ernesto Perez, Secretary, Melissa Sedeño, Young Member Representative, Orlando Dominguez, Treasurer and Enrique Muller, Immediate Past President.

Trustees - Drs. Beatriz Terry, Trustee, Gina Marcus, Alternate Trustee, Mark Limosani, Alternate Trustee.

Affiliate Presidents - Drs. Laura Herschdorfer, MDDS, Frederica Salbo, SBDS and Tim Franklin, NDDS. Dr. Michael Eggnatz was presented with an award for completing his term as FDA line officer and for his service and dedication to organized dentistry.

Pictured Below: Drs. Sawan Malik, Fredericka Salbo and John Aylmer

Pictured left: Dr. Jolene Paramore addresses the group

Pictured right: Dr. Ernesto R. Perez, with his parents, Marta and Dr. Ernesto J. Perez.

Pictured Above: Drs. Michael Eggnatz and Enrique Muller Pictured Below l-r: Drs. Laura Herschdorfer, Ernesto Perez, Melissa SedeĂąo, Mariana Velazquez, Beatriz Terry, Gina Marcus, Fredericka Salbo, Oscar Peguero and Tim Franklin

Dental Practice Financing Together To gether, we’ll find the right financing g solutions to help you reach ach your business ness goals As your pract practice financing experts, we’ll work with you to identify ntifyy your unique q business needs and find the right g financing g* ssolutions to help you reach your goals — like purchasing new equipment, expanding your operation and more efficiently managing your cash flow w.. ●

New Office Start-Ups

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Practice Sales and Purchases

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Business Debt Consolidation†

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Office Improvement and Expansion

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Owner-Occupied Commercial Real Estate**

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Equipment Financing

Tow wnie Choice award winner for Best Practice and Equipment Financing

Your locaal dental al financing g experts expe

Jonathan Burns 614.309.7611 jonathan.burns@bankofamerica.com

Bank of America can also help youu with Cash Management, Employer Solutions and Individu idual needs.

For more information mation or to get g started today t y,, p y please contact us. We look forward to spea speak king with you soon. * All progrraams subject su to credit approval and loan amounts are subject ct to creditworthiness. Somee restrictions may applyy.. The term, amount, interest rraate and repayment re schedule for your loan, and any product ffeeature tures, including interest rraate lockks, may vary depending on your creditworthiness and on the type, amount and collaterraal ffoor your loan. **Ow Owner-Occupied Commercial Real Estate, 51% owner occupancy occ required. † Bank of America Prraactice Solutions may prohibit use of an account to pay offff or pay down anoother Bank of America account.

Bank of America is a registered trraademark of Bank Ban of America Corporraation. Bank of America Prraacctice Solutions is a division of Bank of America, N.A. ©2015 Bank of America Corporraation | flyyer-0715-den-rep2 er| ARVYXDWV | Revv.. 07/15

Jason Nunez 614.804.0627 jason.nunez@bankofamerica.com

Hurricane Season is Upon Us Are You Ready?

Dear South Florida District Members!

Although we were fortunate that in 2018 our district had a relatively quiet season, the predictions for 2019 include nine to fifteen named storms, including four to eight hurricanes.

The hurricane season starts June 1st and runs through November 30th, it may seem that there is time to prepare. But why put off for tomorrow? It’s better to prepare now and have you plan of action ready for both home and office.

The Florida Dental Association, Miami-Dade County and Broward County have put together very good preparedness guides to help you. Please use the links below to download the information.

Remember, a storm can form at any moment and come from any direction.

Plan Early and Stay safe!

ARE YOU READY? Hurricane Season | June 1 – November 30

BEFORE

DURING

AFTER

2019 OFFICIAL HURRICANE READINESS GUIDE Su Guía de Preparación contra Huracanes Gid Preparasyon pou Siklòn PROUDLY SPONSORED BY

https://www.floridadental.org/ member-center

http://www.broward.org/Hurricane

https://www8.miamidade.gov/global/em ergency/hurricane/home.page

21

Classifieds OPPORTUNITIES AVAILABLE FLORIDA (SOUTHEAST AND ORLANDO–Over 60 practices): Sage Dental is seeking experienced General Dentists and Specialists to come grow with us! We offer excellent earning potential and the opportunity to focus on patient care in our digital facilities. We take care of the administration tasks (insurance claims, payroll/staffing, marketing, etc.) for you so that you can enjoy a work-life balance again! Take the next step in your career and apply online at https://www.mysagedental .com/career-opportunities/ or email your CV to bcabibi@mysagedental.com today!

Call us at 561-999-9650 ext. 6146 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 ).

OPPORTUNITIES WANTED

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

PERIODONTICS AND IMPLANTS: Experienced, bilingual Periodontist available to provide services in a quality oriented dental practice in Miami-Dade or Broward County one day a week. If interested please call (305)302-4008.

DENTAL PRACTICE FOR SALE TIRED OF SOUTH FLORIDA PATIENTS?: This practice is for you. Great opportunity for: 1) a Doc looking to keep 12 days in another office, 2) A relocation, 3) A Doc ready to downsize/work only 3 days a week, 4) A Doc like the idea of working Tues.-Th. for 237K/yr. Practice in a semirural setting while being 45min. from Weston, Wellington and other suburbs. If you are accustomed to 'coastal' patients this practice will be a breath of fresh air. "Country" patients and staff will change the way you feel about the profession. Low cost buy the building= no rent. There are many unseen advantages compared to an office in Miami, WPB, or Ft. Lauderdale areas.

Email me for NDA, practice details, and a pro forma for your lender. med2miami@g mail.com

OFFICE SPACE-SALE OR RENT HOT! HOT! HOT! JUST BECAME AVAILABLE: Rare opportunity. Prime location in Boynton Beach. Plumbed dental space. 1350 sqft. 4 ops. With cabinets and lots of room to expand. No other dentists or dental space in the plaza! Competitive rent. Motivated landlord. This is your rare chance to get out of over crowed MiamiDade with minimal investment and build a practice of your dreams. Call Today! Hector Yusti (786) 328-2925 or hyusti@hotmail.com OFFICE SPACE FOR LEASE: in Coral Gables. Wholefoods building directly across from Sunset Place. Three fully equipped operatories, digital pan/ceph machine, private consult room, lab, break room, sterilization area, private restrooms, large waiting room, Class “A” building with plenty of free parking for specialty practice.

For further information contact Jilien 305984-3240

PERIODONTICS IMPLANTS: Highly trained and skilled. Trilingual Periodontist more than 25 years of experience. Using cutting edge techniques in Periodontal esthetics bone grafting and implants. Looking for part time associate ship in Broward and Dade. Please call (561)573-8741

Volunteers are needed for the Annual South Florida Baptist Mobil Dental Unit.

Please call Jackie Quintero at (305) 667-3647 for more information or to register for a morning or afternoon shift.

First Week: September 30 - October 4 New Dawn Church 17200 NW 87th Avenue Miami, FL 33015

Second Week: October 7- October 11 Miami Rescue Mission 2031 NW 1st Street Miami, FL 33127 23

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