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April 2011

Journal TEXAS DENTAL

Chlorhexidine as the Only Irrigating Solution in Endodontic Treatments? Fritz Heitmann: Hunter, Dentist, Hardware Baron, Houston Leader

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Texas Dental Association 140th Annual Session 2010 TEXAS Meeting Photo Contest Award: Best of Show Photographer: Dr. Roy Tiemeyer Title: “Skimmers” For information on entering your photo in the 2011 TEXAS Meeting Photo Contest, please visit texasmeeting.com.

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Contents

TEXAS DENTAL JOURNAL n Established February 1883 n Vol. 128, Number 4, April 2011

ON THE COVER Big Bend National Park

Striking deep red rock formations in the Big Bend National Park are formed by layered sandstone that’s eroded into spires and ridges. Big Bend is located in Brewster County, Texas. The park received its name from the large curve formed by the Rio Grande River, the international boundary between Texas and Mexico.

TDA GOVERNANCE 349

Official Call to Delegates

CLINICAL REVIEW 357

Can I Use Chlorhexidine as the Only Irrigating Solution in my Endodontic Treatments?

Markus Haapasalo, D.D.S.

A reprint from the Canadian Dental Association, the author compares irrigants to use continuously during instrumentation followed by a rinse.

HISTORICAL 363

Fritz Heitmann: Hunter, Dentist, Hardware Baron, Houston Leader

Bill R. Baker, D.D.S., M.S.D., M.P.H. H. Frederick Brown, Jr., J.D., M.Div.

The authors highlight the successes of a dentist, Houston businessman, and civic leader in the late 19th and early 20th centuries.

NOTE

The “Oral and Pathology Maxillofacial Case of the Month” in the March 2011 Texas Dental Journal was republished with permission from the San Antonio District Dental Society.

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MONTHLY FEATURES

348 350 352 370 376 378

President’s Message

Honorarium Donors

382

384 388 390 406

BOARD OF DIRECTORS TEXAS DENTAL ASSOCIATION

TDA 140th Annual Session 2010 TEXAS Meeting Photo Contest The View From Austin Dental Artifacts Oral and Maxillofacial Pathology Case of the Month In Memoriam / TDA Smiles Foundation Memorial and Oral and Maxillofacial Pathology Case of the Month Diagnosis and Management Value for Your Profession Calendar of Events Advertising Briefs Index to Advertisers

EDITORIAL STAFF

Texas Dental Journal (ISSN 0040-4284) is published monthly, one issue will be a directory issue, by the Stephen R. Matteson, D.D.S., Editor Texas Dental Association, 1946 S. IH-35, Austin, Texas, 78704-3698, (512) 443-3675. Periodicals Nicole Scott, Managing Editor Postage Paid at Austin, Texas and at additional mailBarbara S. Donovan, Art Director ing offices. POSTMASTER: Send address changes Paul H. Schlesinger, Consultant to TEXAS DENTAL JOURNAL, 1946 S. Interregional Highway, Austin, TX 78704. EDITORIAL Annual subscriptions: Texas Dental Association members $17. In-state ADA Affiliated $49.50 + tax, ADVISORY BOARD Out-of-state ADA Affiliated $49.50. In-state NonRonald C. Auvenshine, D.D.S., Ph.D. ADA Affiliated $82.50 + tax, Out-of-state Non-ADA Affiliated $82.50. Single issue price: $6 ADA AffiliBarry K. Bartee, D.D.S., M.D. ated, $17 Non-ADA Affiliated, September issue $17 Patricia L. Blanton, D.D.S., Ph.D. ADA Affiliated, $65 Non-ADA Affiliated. For in-state William C. Bone, D.D.S. orders, add 8.25% sales tax. Phillip M. Campbell, D.D.S., M.S.D. Contributions: Manuscripts and news items of interest to the membership of the society are solicited. The Tommy W. Gage, D.D.S., Ph.D. Editor prefers electronic submissions although paper Arthur H. Jeske, D.M.D., Ph.D. manuscripts are acceptable. Manuscripts should be Larry D. Jones, D.D.S. typewritten, double spaced, and the original copy Paul A. Kennedy, Jr., D.D.S., M.S. should be submitted. For more information, please refer to the Instructions for Contributors statement Scott R. Makins, D.D.S. printed in the September Annual Membership DirecRobert V. Walker, D.D.S. tory or on the TDA website: www.tda.org. All statements of opinion and of supposed facts are published William F. Wathen, D.M.D. on authority of the writer under whose name they Robert C. White, D.D.S. appear and are not to be regarded as the views of the Leighton A. Wier, D.D.S. Texas Dental Association, unless such statements Douglas B. Willingham, D.D.S. have been adopted by the Association. Articles are accepted with the understanding that they have not The Texas Dental Journal is a been published previously. Authors must disclose any financial or other interests they may have in products peer-reviewed publication. or services described in their articles. Advertisements: Publication of advertisements Texas Dental Association in this journal does not constitute a guarantee or 1946 South IH-35, Suite 400 endorsement by the Association of the quality of Austin, TX 78704-3698 value of such product or of the claims made of it by Phone: (512) 443-3675 its manufacturer. FAX: (512) 443-3031 E-Mail: tda@tda.org Texas Dental Journal is a member of the Website: www.tda.org American Association of Dental Editors. Member Publication

PRESIDENT Ronald L. Rhea, D.D.S. (713) 467-3458, rrhea@tda.org PRESIDENT-ELECT J. Preston Coleman, D.D.S. (210) 656-3301, drjpc@sbcglobal.net IMMEDIATE PAST PRESIDENT Matthew B. Roberts, D.D.S. (936) 544-3790, crockettdental@gmail.com VICE PRESIDENT, SOUTHEAST R. Lee Clitheroe, D.D.S. (281) 265-9393, rlcdds@windstream.net VICE PRESIDENT, SOUTHWEST John W. Baucum III, D.D.S. (361) 855-3900, jbaucum3@msn.com VICE PRESIDENT, NORTHWEST Kathleen M. Nichols, D.D.S. (806) 698-6684, toothmom@kathleennicholsdds.com VICE PRESIDENT, NORTHEAST Donna G. Miller, D.D.S. (254) 772-3632, dmiller.2thdoc@grandecom.net SENIOR DIRECTOR, SOUTHEAST Karen E. Frazer, D.D.S. (512) 442-2295, drkefrazer@att.net SENIOR DIRECTOR, SOUTHWEST Lisa B. Masters, D.D.S. (210) 349-4424, mastersdds@mdgteam.com SENIOR DIRECTOR, NORTHWEST Robert E. Wiggins, D.D.S. (325) 677-1041, robwigg@suddenlink.net SENIOR DIRECTOR, NORTHEAST Larry D. Herwig, D.D.S. (214) 361-1845, ldherwig@sbcglobal.net DIRECTOR, SOUTHEAST Rita M. Cammarata, D.D.S. (713) 666-7884, rmcdds@sbcglobal.net DIRECTOR, SOUTHWEST T. Beth Vance, D.D.S. (956) 968-9762, tbeth55@yahoo.com DIRECTOR, NORTHWEST Michael J. Goulding, D.D.S. (817) 737-3536, mjgdds@sbcglobal.net DIRECTOR, NORTHEAST Arthur C. Morchat, D.D.S. (903) 983-1919, amorchat@suddenlink.net SECRETARY-TREASURER Ron Collins, D.D.S. (281) 983-5677, roncollinsdds@hotmail.com SPEAKER OF THE HOUSE Glen D. Hall, D.D.S. (325) 698-7560, abdent78@sbcglobal.net PARLIAMENTARIAN Michael L. Stuart, D.D.S. (972) 226-6655, mstuartdds@sbcglobal.net EDITOR Stephen R. Matteson, D.D.S. (210) 215-1515, texdented@gmail.com EXECUTIVE DIRECTOR Ms. Mary Kay Linn (512) 443-3675, marykay@tda.org LEGAL COUNSEL Mr. William H. Bingham (512) 495-6000, bbingham@mcginnislaw.com

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President’s Message Ronald L. Rhea, D.D.S., TDA President

The Official Call to Delegates of the TDA in this issue signifies the prelude to the 2011 annual session of the TDA. It seems as if yesterday, with the closing of the 140th Annual Session, I was installed as president of the Texas Dental Association. Soon, a full year will have passed, and Dr. Preston Coleman will be installed as TDA president. However, prior to his installment, the 141st Session of the TDA House of Delegates (HOD) will convene and decide the fate of many issues that come to bear on the practice of dentistry in Texas. This TDA HOD will meet during the final days of the biennial session of the Texas State Legislature. Here too, many issues will be decided that will affect the practice of dentistry in our state. Besides the issues brought by the TDA, the huge issues of managing an $18 billion to $30 billion shortfall in the state budget and the mandatory redrawing of the legislative district lines will keep anxiety high in Austin. The TDA has an excellent staff and legislative consultants who work for you every day. Nevertheless, we will all be affected by the tremendous forces at play. Dentists can expect to be involved in balancing the state’s budgetary shortfall. We have been assured that there will be “no new taxes” but can expect some “tweaking” to occur. That’s politician-speak for “it is going to cost us money.” This can come from the restructuring of the business franchise tax that we saw implemented in past sessions, increase in our license fees, or as the least popular, a direct tax on dental services. All Texas citizens will pay more for less government services until the economy rebounds. Our

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job is to see that the budget is not unduly balanced on the backs of dentists and dental patients. If you are asked to write or call your legislator, please respond immediately! If we choose to be passive in the political process, then we will be very active in paying for it! Because of the increase in the state’s population, four new US Congressmen or Congresswomen will be elected from the Lone Star State. Drawing these new congressional districts will add to the mix in Austin. Between now and the elections in 2012, we can expect considerable scrambling to determine who will run for election to these offices. There are, of course, no incumbents. Is there a Texas dentist who would consider becoming a member of the US House of Representatives? We will be asking. I would like to take this opportunity to thank all the volunteers who have worked this year to unselfishly promote the interest of dentistry and dental care in Texas. Whether it is the leadership of the local district dental societies, members of the councils and committees of the TDA and ADA, officers and directors of the TDA, this work would not occur without you. Likewise I continue to be in awe of our professional staff in Austin. Their talents and devoted efforts are without equal. Their labors benefit greatly all Texas dentists and Texas dental patients. The symbiotic relationship between our unselfish volunteers and our devoted, talented professional staff is what makes Texas the finest place in the world to practice dentistry. Again, thank you all.


Official Call to the 2011 Texas Dental Association House of Delegates HOUSE OF DELEGATES: In accordance with Chapter IV, Section 70, paragraph A of the Texas Dental Association (TDA) Bylaws, this is the official call for the 141st meeting of the Texas Dental Association House of Delegates. The opening session of the House will convene at 8:00 a.m. on Thursday, May 5, 2011, in Ballroom B on the street level of the San Antonio Convention Center in San Antonio, Texas. The second meeting of the House will be at 8:30 a.m. on Saturday, May 7, 2011, in Ballroom B. The Sunday, May 8, 2011, meeting will be in the Marriott Rivercenter Hotel, starting at 8:30 a.m. REFERENCE COMMITTEE HEARINGS: Reference Committees will meet on Thursday, May 5, 2011, in the Convention Center (please see the on-site program for specific room assignments). Reference Committee A will start at 11:00 a.m. or 15 minutes after the adjournment of the House of Delegates, whichever is later. Reference Committee E will start at 12:00 noon. Reference Committee B will start at 1:00 p.m. Reference Committee C will start at 1:30 p.m. Reference Committee D will start at 2:00 p.m. The agendas for these meetings will be sent to the Delegates and Alternate Delegates prior to the meetings. REFERENCE COMMITTEE REPORTS: Reference Committee Reports will be e-mailed in PDF format to all participants and these reports may be downloaded from any location with Internet access. Printed reports will be available on Friday, May 6, 2011 at 9:00 a.m. outside Rooms 1066 and 1067, the TDA Convention Offices in Exhibit Hall C, and may be downloaded at this location. CANDIDATES FORUM: As a reminder, the TDA / ADA Candidates Forum will be held on Friday, May 6, 2011, from 2:00 p.m. to 4:00 p.m. in the Convention Center (please see the on-site program for specific room assignment). DIVISIONAL CAUCUSES: Divisional Caucuses (Northwest, Northeast, Southwest, Southeast) will be held at 5:15 p.m. on Friday, May 6, 2011 (please see the on-site program for specific room assignments). DELEGATE BOOK: In accordance with TDA Bylaws, the Delegate Book will be sent 30 days prior to the Annual Session. The supplement to the Delegate Handbook, containing the agenda and subsequent reports, will be sent after the spring TDA Board of Directors meeting, April 1-2, 2011. Delegates and alternates will receive their House book in a searchable PDF format.

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Texas Dental Association 140th Annual Session 2010 TEXAS Meeting Photo Contest Category: Natural Wonders Award: 2nd Place Photographer: Dr. Steven M. Aycock of San Marcos, Texas Title: “Cactus Bloom” For information on entering your photo in the 2011 TEXAS Meeting Photo Contest, please visit texasmeeting.com.

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The View From Austin Stephen R. Matteson, D.D.S., FICD, Editor

Pool Safety for Texas Kids Readers of February 2011 TDA Today newsletter may have noticed the “Evidencebased Practice Tip of the Month” on Pool Safety. In response, Dr. Randy Parham of Fort Worth sent the Editor the following message describing an extremely unfortunate incident that occurred in his family (reprinted with Dr. Parham’s kind permission): Dear Dr. Matteson, Thank you for your article on child drownings in the TDA Today. My grandson Grayson Satarino drowned 6 months ago today. He was a 16-month-old apple of his grandfather’s eye. Grayson drowned at his other grandparents’ house while they were taking care of him while his parents were at work. Details are still vague as to how it happened but they had a door that led directly outside to the pool area. This has been the hardest thing to deal with. We not only grieve for our Grayson but also for my daughter and son in law. In trying to come to some kind of terms with this death, I researched pool safety requirements in the U.S. Several states have pool safety laws but nothing is on the books in Texas. I approached my State Senator Wendy Davis of Ft. Worth about sponsoring legislation that would hopefully help prevent others from having to go through what we have as a family. Senator Davis has introduced SB 771 for pool safety. New pool owners will be required to install pool alarms and alarms on doors that lead directly to the pool area from the house. Pool builders will also be required to offer pool alarms to customers. Contractors inquire about tile color and textures etc., but seldom address safety issues. This bill will be named in honor of Grayson. We hope that by having this bill that we can afford protection to those that can’t protect themselves. Thanks again for bringing this issue up and we will add to our patient

questionnaire as to whether or not a pool is present in the household. Sincerely, Randy A. Parham, D.D.S. UTHSCSA Class of 1981 Surprisingly, more than 50 pool drownings occurred in Texas during the first 6 months of 2010. A Cochrane Review on this subject provides valuable background information on this topic. Pool drownings of children can be reduced 75 percent by the installation of fencing that not only surrounds the pool, but that also prevents access to the pool from the house. This Cochrane review can be viewed by entering CD001047 into a Google search. The Centers for Disease Control and Prevention Childhood Injury Report states that the highest risk age group for drowning is 1-4 years old and that males are at about three times the risk of drowning than females. Drowning is the second leading cause of unintentional injury death for children and adolescents. (http://www.maafirm. com/library/CDC_childhoodinjury.pdf). It is estimated that for each drowning death, there are one to four nonfatal submersions serious enough to result in hospitalization. Children who still require cardiopulmonary resuscitation (CPR) at the time they arrive at the emergency department have a poor prognosis, with at least half of survivors suffering significant neurologic impairment (American Academy of Pediatrics). So the question is, “Is it in the domain of dentists to advise parents on this safety practice?” Pediatricians counsel families on this topic. Texas dentists could join the effort. We could include a question in our health/social history questionnaire about the presence of a pool on patients’ property and if so, bring the specifics of this information to parents’ attention. Why not? The Editor sends his best wishes to the Parham family. Preparing for an emergency is necessary at home and at the office. The July 2011 issue of the Texas Dental Journal will focus on medical emergency preparedness and the steps you can take to ensure you and your staff and family are ready should such a situation occur.

Additional information of swimming pool safety can be found at: • http://www.poolsafely.gov/ • http://www.safekids.org/safety-basics/ safety-resources-by-risk-area/drowning/: Safe Kids USA, a nonprofit for helping to save child lives • http://www.drowningpreventionfoundation.org/: Drowning Prevention Foundation, a nonprofit for helping to prevent drowning. • http://www.cdc.gov/healthyswimming/ design_and_operation.htmdrowning APPENDIX Here is information from the American Academy of Pediatrics on swimming pool safety: POOL SAFETY • Install a fence at least 4-feet high around all four sides of the pool. The fence should not have openings or protrusions that a young child could use to get over, under, or through. • Make sure pool gates open out from the pool, and self-close and self-latch at a height children can’t reach. • If the house serves as the fourth side of a fence surrounding a pool, install an alarm on the exit door to the yard and the pool. • Never leave children alone in or near the pool or spa, even for a moment. • Keep rescue equipment (a shepherd’s hook, a long pole with a hook on the end, and life preserver) and a portable telephone near the pool. Choose a shepherd’s hook and other rescue equipment made of fiberglass or other materials that do not conduct electricity. • Avoid inflatable swimming aids such as “floaties.” They are not a substitute for approved life vests and can give children a false sense of security. • Children age 4 and older should be taught to swim. Parents may choose to start swimming lessons before age 4 if their children are developmentally ready, but swim programs should never be seen as “drown proofing” a child of any age. • Whenever infants or toddlers are in or around water, an adult should be within arm’s length, providing “touch supervision.” • Avoid entrapment: Suction from pool and spa drains can trap an adult underwater. Do not use a pool or spa if there are broken or missing drain covers. Ask your pool operator if your pool or spa’s drains are compliant with the Virginia Graeme Baker Pool and Spa Safety Act. • Large inflatable above-ground pools have become increasingly popular for backyard use. Children may fall in if they lean against the soft side of an inflatable pool. Although such pools are often exempt from local pool fencing requirements, it is essential that they be surrounded by an appropriate fence just as a permanent pool would be so that children cannot gain unsupervised access. Source: http://www.aap.org/family/tipppool.htm.

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Peer Review: Process Snapshot Peer review is organized dentistry’s dispute resolution process that generally handles complaints from patients against dentists regarding the quality or appropriateness of clinical dental treatment received.

Need a peer review sign for your office? You may print a copy of the peer review sign from the Resources section of the members homepage on the TDA Website (tda.org).

For more information about peer review please contact the Council on Peer Review via Cassidy Neal at 512-443-3675 ext. 152.


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July 26 to 28, 2011: AGD House of Delegates July 28 to 31, 2011: AGD Annual Meeting & Exhibits

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Speakers • Gordon J. Christensen, DDS, MSD, PhD (“The Christensen Bottom Line”) • David S. Hornbrook, DDS, FAACD (“Hot Topics in Restorative and Esthetic Dentistry”) • Terry T. Tanaka, DDS, MAGD (“Treatment Planning Guidelines for Fixed and Removable Prosthodontics”) • Pascal Magne, PhD, Dr.Med.Dent. (“Biomimetic Restorative Dentistry”) • Howard S. Glazer, DDS, FAGD (“What’s Hot and What’s Getting Hotter”) • Harold L. Crossley, DDS, PhD (“What’s the Real Deal About Street and Prescription Drug Abuse” and “The 30 Most Physician-Prescribed Medications”) • Karl R. Koerner, DDS, MS (“Surgical Extractions Using New High-tech Devices”) • Louis Malcmacher, DDS, MAGD (“Total Facial Esthetics for Every Dental Practice”) • Joseph J. Massad, DDS (“Dentures and Implant Overdentures: How They Have Improved the Quality of Life”) • Russell A. Baer, DDS (“Basic Implant Surgery for the General Dentist”)

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CLINICAL REVIEW

Can I Use Chlorhexidine as the Only Irrigating Solution in my Endodontic Treatments? Reprinted with permission from the Canadian Dental Association: J Can Dent Assoc 2011;77:b16.

Markus Haapasalo, D.D.S.

Background Pulpitis and apical periodontitis are caused by invasion of bacteria deep into dentin or the root canal space. For apical periodontitis, the shortand long-term success of endodontic treatment depends on elimination of microbes from the root canal system and prevention of reinfection via coronal leakage. In the treatment of teeth with pulpitis, where the root canal is bacteria free, the goal is to clean and fill the root canal while preventing access of microbes to the canal space during and after treatment (1). The first steps in every endodontic treatment are diagnosis, decision on treatment, and information to the patient. Following these, treatment consists of preparation of access cavity, location of the root canals, instrumentation, irrigation and disinfection, root filling, and coronal restoration of the tooth. In endodontic discussions, much of the focus is on instrumentation; however, in addition to removing some of the root canal contents, the main goals of instrumentation are to allow effective disinfection and to make root filling technically possible. Although instrumentation, irrigation, local medicaments (used in some cases), and root filling all contribute to the elimination of root canal microbiota, there is consensus that irrigation plays a central role in eradication of the infection (2,3). Irrigation has a number of important functions: mechanical washing effect, reduction of friction between instrument and canal wall dentin, temperature control, dissolution of organic and inorganic tissue and antimicrobial effect. No single irrigating solution is sufficient to carry out all these functions. The process must entail the combined use of two or more solutions, in a specific sequence, to achieve the goal of safe and effective irrigation (2,3).

Dr. Markus Haapasalo is head of the Department of Oral Biological and Medical Sciences and chair of the Division of Endodontics at the University of British Columbia faculty of dentistry, Vancouver, British Columbia. Correspondence to: Dr. Markus Haapasalo, Department of Oral Biological and Medical Sciences, Faculty of dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC V6T 1Z3. E-mail: markush@interchange.ubc.ca Acknowledgements: Special thanks to Dr. Ya Shen and Wei Qian for their help with scanning electron micrograph images. This article has been peer reviewed. The author has no declared financial interests in any company manufacturing the types of products mentioned in this article. Haapasalo

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Chlorhexidine

Comparison of Irrigants All irrigating solutions are reasonably effective in washing, reducing friction (i.e., lubricating instruments) and balancing against a rise in temperature. The important differences between products are related to their ability to dissolve tissue and kill microbes, two key areas (2). Traditionally, sodium hypochlorite (NaOCl) and ethylene diamine tetraacetic acid (EDTA) have been the most commonly used root canal irrigants. NaOCl dissolves organic tissue effectively (less so vital pulp tissue) and kills bacteria and yeasts. EDTA dissolves inorganic tissue by chelation, but it has no antibacterial activity in the root canal. Because of the differences between these irrigants, the classical recommendation of using NaOCl (2 percent – 6 percent) during instrumentation and EDTA (17 percent) after treatment is still valid and highly recommended (Figures 1–4). These two solutions cannot be used simultaneously as NaOCl loses its antimicrobial efficacy in the presence of EDTA.

A new and noteworthy twist in this area has come from recent studies that indicate that longterm exposure (1 hour) to NaOCl can weaken the structural integrity of dentin.

A new and noteworthy twist in this area has come from recent studies that indicate that longterm exposure (1 hour) to NaOCl can weaken the structural integrity of dentin. It has also been shown that, after the final EDTA (or citric acid) rinse, even a short NaOCl

Figure 1. Smear layer after instrumentation. Chlorhexidine (CHX) has no effect on the smear layer and sodium hypochlorite (NaOCl) affects only the organic part of the smear layer, which is not sufficient to remove it.

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Figure 2. Smear layer removed by NaOCl followed by ethylene diamine tetraacetic acid (EDTA).

Figure 3. Irrigation by EDTA alone results in incomplete removal of the smear layer, because the organic matter of the layer has not been dissolved.


rinse (1 minute) causes quite prominent erosion of root canal surface dentin (4,5). Therefore, until further information is available, final rinse with NaOCl after EDTA should be limited to a few seconds. Another option, with several benefits, would be to use chlorhexidine (CHX) as the final rinse. CHX does not dissolve tissue (no erosion) but it kills microbes (Figure 5). It also improves the quality (i.e., strength) of long-term resin bonding to dentin by inhibiting dentin enzymes (e.g., matrix metalloproteinases), which otherwise degrade the bond over time (6). Recent studies have shown that CHX mixed with a surface active agent (CHXPlus, Vista Dental Products, Racine, WI) has superior antibacterial effects compared with CHX alone (7). However, as CHX has no tissue-dissolving effect, its use as the main or only root canal irrigant cannot be recommended. Even if (in theory) all bacteria were killed by CHX, the canal walls would be covered by a smear layer and organic debris including biofilms, which would not allow an adequate seal between the sealer–root filling and the canal wall dentin.

Conclusion The irrigant of choice is NaOCl used continuously during instrumentation followed by a 2-minute rinse with EDTA to remove the smear layer. When maximal antimicrobial effect is desirable, CHX is a good choice (rather than NaOCl) as a final rinse after EDTA to further facilitate disinfection and to improve dentin bonding (where relevant).

Figure 4. Uninstrumented area of a root canal wall after irrigation with NaOCl and EDTA. The special structure, “calcospherites,” are clearly seen, indicating complete removal of any organic debris covering them.

References 1. Haapasalo M, Endal U, Zandi H, Coil JM. Eradication of endodontic infection by instrumentation and irrigation solutions. Endod Topics. 2005;10(1):77-102. 2. Haapasalo M, Shen Y, Qian W, Gao Y. Irrigation in endodontics.Dent Clin North Am. 2010;54(2):291-312. Review. 3. Zehnder M. Root canal irrigants. J Endod. 2006;32(5):389-98.Review. 4. Tatsuta CT, Morgan LA, Baumgartner JC, Adey JD. Effect of calcium hydroxide and four irrigation regimens on instrumented and uninstrumented canal wall topography. J Endod. 1999;25(2):93-8. 5. Marending M, Paqué F, Fischer J, Zehnder M. Impact of irrigant sequence on mechanical properties of human root dentin. J Endod. 2007;33(11):1325-8. 6. Carrilho MR, Geraldeli S, Tay F, de Goes MF, Carvalho RM,Tjäderhane L, et al. In vivo preservation of the hybrid layer by chlorhexidine. J Dent Res. 2007;86(6):529-33. 7. Shen Y, Stojicic S, Qian W, Olsen I, Haapasalo M. The synergistic antimicrobial effect by mechanical agitation and two chlorhexidine preparations on biofilm bacteria. J Endod. 2010;36(1):100-4.

Figure 5. Uninstrumented part of a root canal wall after irrigation with CHX alone or EDTA alone. These solutions do not dissolve organic tissue, which, therefore, remains if NaOCl is not used during instrumentation.

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HISTORICAL

Fritz Heitmann: Hunter, Dentist, Hardware Baron, and Houston Leader Bill R. Baker, D.D.S., M.S.D., M.P.H. H. Frederick Brown, Jr., J.D., M.Div.

Introduction In 1991, Dr. E. W. “Danny” D’Anton gave us an excellent history of the University of Texas Dental Branch at Houston (UTDB) (1). He stated that Texas Dental College, which was to become the UTDB, had its beginning in 1905 and followed its course until the time of his writing. He mentioned the third site of the college, from 1915 into the 1920’s, as occupied the second floor of the Heitmann Hardware building at the corner of Fannin Street and Franklin Avenue in downtown Houston (2). That was the first time I heard the name Heitmann. Almost 20 years later, I heard it again.

Baker

Brown

Dr. Baker is a retired colonel, USAF Dental Corps; professor, University of Texas Health Science Center at San Antonio Dental School. He currently resides in Boerne, Texas. 
Rev. Brown served in the US Navy as an Underwater Demolition Team platoon commander and practiced law in Houston for 25 years. He became an ordained Episcopal priest in 1996 and currently serves churches in the Texas Hill Country. Address: Bill R. Baker, D.D.S., 314 Schweppe St., Boerne, TX 78006-2726; Phone: (830) 249-7530; E-mail: bakerbr@gvtc.com. The authors have no declared potential conflicts of financial interest, relationships and/or affiliations relevant to the subject matter or materials discussed in the manuscript.

Abstract Frederick (Fritz) A. Heitmann was a Houston business and civic leader in the late 1800’s and early 1900’s. He succeeded his father in the family hardware business, was hugely successful, and was known for helping establish the Houston Ship Channel among other large projects. His

great success obscured his earlier contribution to the frontier as a dentist in the gold fields of Colorado. His father insisted he learn a skill independent of fluctuations in the business world. He apprenticed himself to a dentist and used those abilities, along with others, to gain a large stake to build the business. Also, he had strong opinions, and liked to talk. He told his story to his grandson, and his grandson’s buddy, the co-author of this article.

Key woRDS: History, frontier dentistry, Port of Houston Dental Branch, UTDB Tex Dent J 2011;128(4): 363-367.


Fritz Heitmann A couple of other retired or semi-retired men and I get together for lunch at a truckstop café in Boerne, Texas, about once per month. The other two are retired lawyers and I am a retired dentist. One of the lawyers, after retirement from a successful practice in Houston, pursued a long deferred ambition to become an Episcopal priest. We three formed our friendship at a church he served. At one of our lunches, Father Fred (H. Frederick Brown, Jr.) told us of a most remarkable person, Frederick A. (Fritz) Heitmann. The fact Mr. Heitmann was a dentist caught my attention, and the story was so interesting we decided to tell Texas dentists about him. First, an introduction by Father Fred: I first met Fritz Heitmann in 1946. I was 8 years old and he was 88. His grandson, Freddy, was our neighbor, and he was my age. Earlier that year, Mr. Heitmann had fallen off his horse and sustained serious injuries. With his activities curtailed, he wanted some company. Freddy’s mother asked my parents if I could accompany him to the Heitmann home where we could swim and play tennis. There was a clear caveat, however. Before we could play tennis or swim, we had to meet with Mr. Heitmann for a chat, and after we finished our tennis and swimming, we were to have lunch with Mr. Heitmann. The next morning, a chauffeur driven limousine stopped in front of our house. The driver was holding the back door of the limo open while Freddy was at our front door ringing the doorbell. I emerged from the door carrying my father’s old tennis racquet with broken strings. “Leave that here,” said Freddy. “Granddad bought new racquets for us to use.” The Heitmann mansion was located in an exclusive subdivision across South Main from Hermann Park. The limo pulled into the garage (Mr. Heitmann called it the Carriage House), which was larger than our home. As we walked toward the Heitmann mansion, I saw a servant placing a pitcher of lemonade on a table next to the tennis court. Another servant was cleaning the swimming pool. In the living room, two servants were helping Mr. Heitmann out of his wheelchair. He wanted to shake hands with us standing up. I had never seen a man that tall and that old. He was at least 6.5 feet tall. My grandparents had been born in the 1890’s. This man had been born in the 1850’s, before the Civil War. The servants sat Mr. Heitmann into a large armchair and our “chat” began. Freddy and I were to have many such “chats” with his grandfather over the next few years. These chats were actually history lessons with Mr. Heitmann doing most of the talking. We were eventually allowed to ride our bicycles (Mr. Heitmann called them “wheels”) to the Heitmann mansion, but the routine remained the same. First the history lesson, then tennis and swimming, followed by lunch with Mr. Heitmann, and occasionally, Mrs. Heitmann joined us for lunch. On those occasions, Mrs. Heitmann would allow Freddy and me to ride in the elevator.

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Frederick Augustus Heitmann, 1858-1955, was born in Frostown, Texas, a town 11 years older but later engulfed by upstart Houston. His father was a businessman and immigrant from Potsdam, Prussia. Frederick W. Heitmann, the father, primarily dealt in hardware and cotton until the American Civil War placed Houston in a very bad place. “War is bad for business,” Fritz told his grandson Fred Strange and his grandson’s buddy, Fred Brown, in 1946. He was remembering his father’s struggles as a hardware merchant with no hardware and as a cotton exporter whose largest cargo, representing all the money he could scrape together, was intercepted by Northern blockaders. With a bit of acrimony, he added, “…unless, you are a Dallas merchant who can trade with both sides.” His resentment extended to the Port of Galveston and those who controlled it. Fritz felt business reverses permanently broke his father’s spirit during the Civil War. As Fritz grew up during the Civil War and Reconstruction Era, he, and his buddy George Hermann hunted game and fished together to help feed their families. They gave part to people who were in need, and sold the rest to Union troops during Reconstruction. He remembered starvation in Houston. “The only thing worse than war is reconstruction,” he said.

Frederick A. Heitmann at age 80 (courtesy Houston Metropolitan Research Center, Houston Public Library, Houston, Texas, Litterst-Dixon Collection, MSS 1248-3714).

Fritz attended private schools in Houston. His father, a practical Prussian, insisted he learn a trade, since business was a

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Fritz Heitmann

Fritz suggested, “Send me out to Dr. Fielding.” Dr. Fielding was a successful and skilled dentist who had a 10-acre orchard and garden near the Southern Pacific depot. A manuscript (author unknown) in the “Heitmann Collection” of the Houston Research Library says, “…in his youth he was apprenticed to a dentist, under whose preceptorship he mastered the details of that profession as far as it had progressed at the time. For a time he followed dentistry in the mining camps of Colorado, particularly in Leadville, but in 1881 returned to Houston and joined his father in the hardware business.” Fritz, himself, gave the best description of this time to his grandson and his buddy. “When times are tough, you must be alert for opportunities to make a successful life. Gold had been dis“I had a dentistry book and I studied it well. I bought covered in Colorado, but the gold a dentist’s chair and dental supplies. I mounted the fields were in remote and rugged mountains. The miners had no dentist’s chair on a buckboard, loaded the supplies, doctors or dentists to attend to including my six-shooter and repeating rifle and plenty their medical needs. I had saved some money from selling the wild of ammunition, hitched-up my horse and set out for the game that I trapped and shot, and from doing hard labor. I had Colorado gold fields.” a dentistry book and I studied it well. I bought a dentist’s chair and dental supplies. I mounted the dentist’s chair on a buckboard, loaded the supplies, including my six-shooter and repeating rifle and plenty of ammunition, hitched-up my horse and set out for the Colorado gold fields. Business was very good there. Payment for my dental services was only in gold and I had accurate scales to measure it out. I spent very little. I shot deer, elk, and bear and sold the meat and the hides. I never wasted my time prospecting for gold or gambling.” Fritz’s story was that his father wanted Fritz to buy out his interest in the company, but Fritz had no money of his own. To earn that money, he went to Colorado to trade his dental skills for gold. By age 18, when he went to Colorado as a dentist, Fritz had a full beard, was around 6.5 feet tall, weighed as least 250 lbs., and was a formidable man. Merchants in Leadville and other mining camps vied to have him park his dental wagon (in Korea, I called mine a dental van) in front of their places of business. Being a crack shot, hunter, and trapper since childhood, he took 1 day per week to hunt, the next day to dress and prepare the meat for sale and hung it outside his wagon where he slept and practiced dentistry and sold meat for the next 5 days. Periodically, he would move, starting the same schedule at another gold camp.

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After a few years of this, his father, back in Houston, became homesick for his only son. Once, he accosted a neighboring businessman, Fred Ziegler, and asked, “Don’t you think I had better call for Fritz, as I am getting old and I need him?” Ziegler replied, “By all means, do.” So Fritz returned to Houston in 1881 and became a part of the firm. In 1889 Frederick William Heitmann died, and Fritz became president of the business. He kept the business name of Frederick W. Heitmann. Also, when his own son was born in 1918, he gave him the name Frederick William Heitmann, II. It is an understatement to say the business thrived under Fritz’s leadership. When Spindle Top came in at Beaumont, he “had the foresight to buy all of the pipe for oil that was available, and all the banks would pay for, and he considerably increased the family fortune,” Fred Ziegler recalled. He kept that jump ahead in supplying steel to the oil fields. Also, he purchased a strip of land near Spindle Top from lumberman James L. Kirby of Silsbee. For a number of years he was busy purchasing steel in Philadelphia and arranging for its transportation to Houston, at first via Galveston. He was a member of the original Deep Water Committee to promote the Houston Ship Channel and furnished great tonnage for the Southern Steamship Company to bring directly to Houston, bypassing his old nemesis, Galveston. Also, he was one of the prime promoters and member of the committee of the Intra-Coastal Canal. He presided over several national hardware organizations, was on the board of several banks, administered the estate of his old chum George Hermann, helped develop River Oaks, prized good horses, and was a man of many talents. He maintained those interests to the end of his life. He died in Houston in 1955 at age 96. The Frederick A. Heitmann Collection of the Houston Metropolitan Research Center sheds no light on the arrangements between the Texas Dental College and the use of the F. W. Heitmann building. One wonders if Fritz’s hand was not in the decision to locate a dental school in It is an understatement to say the business thrived Houston. After being shunned by under Fritz’s leadership. When Spindle Top came in at Dallas dentists, the founders of the school were welcomed in Houston. Beaumont, he “had the foresight to buy all of the pipe Fritz was long past his practicing days by 1905, but he was a for oil that was available, and all the banks would Houston civic leader of note. The pay for, and he considerably increased the family Fondren Library at Rice has a collection of F. W. Heitmann business fortune.” ledgers. Perhaps they may be able to illumine this question. In 1946, Fritz told the boys, “I devoted all my efforts to business, but I finally did find time, in my midfifties, to get married.” We are happy he did. It was through his grandson that we get to know this remarkable hunter, dentist, hardware tycoon, and Houston leader.

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While you’re at tda.org, be sure to check out the following:

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Dental Artifacts

Old McConnell Had a Chair Kim Freeman, M.A., D.M.D., M.S. The McConnell folding dental chair was manufactured by the Southern Novelty Company in Demorest, Georgia. All indications are that these portable chairs were in use from between 1910 to 1920. There were two styles of these, a standard and pedo version (Figures 1, 2). When not in use, they could be folded up to a very thin profile for storage or transport (Figure 3).

Figure 1.

Figure 3.

The weight of the adult version was 35 pounds. Despite the small amount of weight, the footrest, headrest, and vertical heights were easily adjustable. An advertisement in a 1915 national equipment catalogue (Figures 4a, 4b) shows a price of $16.50. Interestingly, in the testimonial portion of the advertisement is an endorsement by the Texas State Board of Dental Examiners. It was their favorite. Whether the same can be said of the examinees is strictly subject to speculation! Figure 4a.

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Figure 4b.

Figure 2.


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Oral and Maxillofacial Pathology Case of the Month Case History A 41-year-old male presented to the Oral and Maxillofacial Surgery Clinic with a chief complaint of pain and swelling of the left posterior maxilla which he first noticed 2 months previously. He attributed the symptoms to a possible carious tooth in the area. He was taking Ibuprofen occasionally for the pain. He reported no other significant medical history. His family history was significant for oropharyngeal cancer on his father’s side. A panoramic radiograph showed multiple carious teeth. Clinical examination revealed a hemorrhagic lesion of the left maxillary gingiva and hard palate causing buccal and palatal enlargement (Figure 1). Erythematous patches were noted in the posterior soft palate and oropharynx. A palpable lymph node was detected on the anterior border of the left sternocleidomastoid muscle. Subsequently, the patient underwent an incisional biopsy which was sent for histopathologic examination, with a provisional diagnosis of squamous cell carcinoma.

Aparna Naidu, D.D.S., M.S., assistant professor, Department of Diagnostic Sciences, Texas A&M Health Science Center, Baylor College of Dentistry, Dallas, Texas Drew B. Havard, D.M.D., resident, Department of Oral and Maxillofacial Surgery, Texas A&M Health Science Center, Baylor College of Dentistry, Dallas, Texas

Naidu

Havard

Ray

Wright

J. Michael Ray, D.D.S., assistant professor, Department of Oral and Maxillofacial Surgery, Texas A&M Health Science Center, Baylor College of Dentistry, Dallas, Texas John M. Wright, D.D.S., M.S., regent’s professor and chair, Department of Diagnostic Sciences, Texas A&M Health Science Center, Baylor College of Dentistry, Dallas, Texas

What is your differential diagnosis?

Microscopic Findings Histologic sections showed a soft tissue specimen composed of a proliferation of plump spindle cells forming small slit-like vascular spaces (Figure 2). Some of the vascular spaces were ill-defined and irregularly shaped (Figure 3) Numerous extravasated red blood cells were seen. The overlying epithelium was within normal limits.

What is the final diagnosis? See page 382 for the answer and diagnosis.

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Figure 1. Left maxillary mass involving the buccal and palatal gingiva. Erythematous patches can be seen in the posterior soft palate.


Figure 3. A low power (10X) photomicrograph shows several vascular spaces which vary in shape and size.

Figure 2. A medium power (20X) photomicrograph shows a proliferation of small vessels and numerous red blood cells in a cellular background stroma.

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In Memoriam

Those in the dental community who have recently passed Henry, Walter Loyd Gladewater, Texas Dec. 3, 1918 – Jan. 28, 2011 Good Fellow, 1977 • Life, 1983 Fifty Year, 2002 Hooper, Hilton Arthur Tyler, Texas Jan. 13, 1921 – June 29, 2006 Good Fellow, 1971 • Life, 1986 Fifty Year, 1994 Jones, Ray Erwin Austin, Texas March 8, 1924 – May 27, 2006 Good Fellow, 1978 • Life, 1989 Fifty Year, 2002 Little, Jim D. Lexington, Kentucky April 24, 1943 – Feb. 2, 2011 Good Fellow, 1997 • Life, 2009

Maher, Lawrence Warren, Jr. La Porte, Texas July 16, 1941 – Feb. 7, 2011 Good Fellow, 1991 • Life, 2007

to the Texas Dental Association Smiles Foundation

In Honor of: Dr. Arlet Dunsworth By Nancy Nicosia

In Memory of:

Noble, F. Pierce Texarkana, Texas June 21, 1918 – Nov. 9, 2010 Good Fellow, 1973 • Life, 1983 Fifty Year, 1993

Mary Mason By Corpus Christi Dental Study Club

Santos Ramirez By Charles Robertson

Palmer, Hubert Bernard San Antonio, Texas Sept. 6, 1912 – Nov. 17, 2010 Life, 1992

Mrs. Genevieve Hart By Don Lutes

Joe Plummer By Charles Robertson

Sidney Thomas Bogan By Ronald L. Rhea

Frank Melisse By Charles Robertson

Sue Green By Cody Robert

Joveta Stone By Charles Robertson

Schubert, Joseph Andrew, Jr. Alice, Texas Nov. 26, 1934 – April 29, 2010 Life, 2000 • Fifty Year, 2010

Your memorial contribution supports: • educating the public and profession about oral health; and • improving access to dental care for the people of Texas.

Sweeney, Edward A. Rochester, New Hampshire April 22, 1931 – Aug. 28, 2006 Life, 1997

Lorenzen, Kenneth E. Lubbock, Texas Williams, Lionel L. April 16, 1923 – June 29, 2006 Houston, Texas Good Fellow, 1980 • Life, 1988 Jan. 22, 1947 – Feb. 1, 2011 Fifty Year, 2002 TX-FEB-2011.pdf 1 2/2/11 5:28 PM

C

M

Y

CM

MY

CY

CMY

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Memorial and Honorarium Donors

Texas Dental Journal l www.tda.org l April 2011

Please make your check payable to:

TDA Smiles Foundation, 1946 S IH 35, Austin, TX 78704


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Oral and Maxillofacial Pathology Diagnosis and Management

Kaposi’s Sarcoma Oral and Maxillofacial Pathology Case of the Month (from page 376)

Discussion Kaposi’s sarcoma is a rare neoplasm which arises from endothelial cells lining blood and lymphatic vessels (1). There is significant evidence supporting the causative role of human herpesvirus 8 (HHV-8) in Kaposi’s sarcoma (2). This neoplasm was first described by Hungarian dermatologist Moritz Kaposi in 1872 (3). The majority of cases were first described in older males of Italian, Jewish, or Slavic ancestral origin. This “classic” type of Kaposi’s sarcoma usually affects the skin of the lower extremities and oral mucosal involvement is rare. This form grows slowly over years, gradually developing into painless tumor nodules. The African or “endemic” type of Kaposi’s sarcoma may occur in a slow growing nodular form, or more aggressive and infiltrative forms which can rapidly disseminate to lymph nodes and visceral organs. An iatrogenic immunosuppression associated type of Kaposi’s sarcoma can be seen in the recipients of organ transplants (4,5). Since the beginning of the AIDS epidemic in the 1980’s, most cases of Kaposi’s sarcoma have been associated with HIV infection. The HIV related form most commonly affects the trunk, arms, head and neck (5). About 70 percent of individuals who

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have skin or organ involvement have oral mucosal lesions (6,7). In 22 percent of cases, the oral cavity is the first site of involvement. Common intraoral sites of involvement are the gingiva, hard palate, and tongue. A committee of experts on the oral manifestations of HIV, in collaboration with the World Health Organization, classified Kaposi’s sarcoma as one of the oral diseases most strongly associated with HIV infection (8). These diseases include candidiasis, hairy leukoplakia, and non-Hodgkin’s lymphoma. Clinically, intraoral Kaposi’s sarcoma initially presents as a reddish purple to brown colored flat macular lesion which forms a thickened plaque and eventually a raised nodule. If the mass becomes large enough, it may produce pain, bleeding, and necrosis. The differential diagnosis for this clinical presentation includes lymphoma, angiosarcoma, giant cell granuloma, and when pink to red in color, squamous cell carcinoma. A provisional diagnosis can be made clinically when a history of HIV is known. Biopsy is recommended to make a definitive diagnosis or if the HIV status is unknown. Histologically, Kaposi’s sarcoma is characterized by a proliferation of blood vessels surrounded by a cellular stroma consisting of oval to spindle shaped endothelial cells. Large areas of

erythrocyte extravasation are usually present. In the case we are reporting, the individual was unaware that he was HIV-positive. While the histology supported a diagnosis of Kaposi’s sarcoma, additional studies for the presence of HHV-8 in the nuclei of the tumor cells were ordered to validate the diagnosis before informing the patient (Figure 4). The patient then underwent serum testing, which confirmed he was positive for HIV. The prognosis of Kaposi’s sarcoma depends somewhat on the type of the disease. The majority of patients who develop the classic form of the disease never develop widely disseminated lesions. Some of the more aggressive endemic forms have a much poorer prognosis. The iatrogenic type that occurs in transplant recipients has an aggressive course, but if the immunosuppressive medication is discontinued, the tumors may regress (4). HIV associated Kaposi’s sarcoma has the potential to progress to a widespread malignancy which can metastasize to lymph nodes and multiple organs (4). The incidence and clinical course has improved dramatically since the introduction of highly active anti-retroviral therapy (HAART). Utilizing specific drug combinations, this type of therapy


has been highly effective in prolonging survival and maintaining immune competence. Some authors theorize that Kaposi’s sarcoma may actually represent an excessive reactive proliferation induced by chronic inflammation, because of the regression seen in clinical lesions seen after HAART (9, 10). When protease inhibitors are included in the regimen, they have been shown to inhibit tumor growth and angiogenesis, which has led to a 30 percent to 50 percent reduction in the incidence of Kaposi’s sarcoma along with significant regression of lesions already present (11,12). Intraoral lesions may produce discomfort or impaired function, which may necessitate surgical excision. Local intralesional injection of chemotherapeutic agents may be considered if the lesions do not regress after HAART is administered. References 1. Flotte TJ, Hatcher VA, Friedman-Kien AE. Factor VII-related antigen in Kaposi’s sarcoma of young homosexual men. Arch Dermatol 1984 (120):180-182. 2. Flaitz CM, Jin Y-T, Hicks MJ et al. Kaposi’s Sarcoma-associated herpesvirus-like DNA sequences (KSHV/HHV-8) in oral AIDSKaposi’s sarcoma: a PCR and clinicopathologic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997 (83):259264. 3. Kaposi M. Idiopathic multiple pigmented sarcoma of the skin (Idiopathices multiples pigment sarcom der haut) Dermatol Syph 1872 (4): 265-272. 4. Friedman-Kien AE, Saltzman BR. Clinical manifestations of classical, endemic African, and epidemic AIDS-associated Kaposi’s sarcoma. J Am Acad

Figure 4. A medium power (20X) photomicrograph of an immunohistochemical stain demonstrating the presence of HHV-8 in the nuclei of the neoplastic endothelial cells.

Dermatol 1990 (22):1237-1250. 5. Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and Maxillofacial Pathology. Third Edition. St. Louis: Saunders Elsevier 2008; 270-271, 557559. 6. Lager I, Altini M, Coleman H. Oral Kaposi’s sarcoma: a clinicopathologic study from South Africa. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003 (96): 701-710. 7. Ficarra G, Berson AM,Silverman S, et al. Kaposi’s sarcoma of the oral cavity: A study of 134 patients with a review of the pathogenesis, epidemiology, clinical aspects, and treatment. Oral Surg Oral Med Oral Pathol 1988 (66):543-550. 8. EC-Clearinghouse on Oral Problems Related to HIV infection and WHO Collaborating Centre on Oral Manifestations of the Immunodeficiency Virus. Clas-

sification and diagnostic criteria for oral lesions in HIV infection. J Oral Pathol Med 1993;22:289291. 9. Martellotta F, Berretta M, Vaccher E, et al. AIDS-related Kaposi’s sarcoma: state of the art and therapeutic strategies. Curr HIV Res. 2009 (7):634-8. 10. Brooks JJ. Kaposi’s sarcoma: a reversible hyperplasia. Lancet 1986 (6);2:1309-11. 11. Monini P, Sgadari C, Toschi E, Barillari G, et al. Antitumour effects of antiretroviral therapy. Nature Reviews Cancer 2004 (4): 861-875. 12. Tirelli U, Bernardi D. Impact of HAART on the clinical management of AIDS-related cancers. Eur J Cancer. 2001 (37):1320-4.

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Provided by TDA Perks Program

value for your

profession Sound Advice:

Tips for Choosing the Right Telephone System for your Business Ron Schott and Eoghan McCloskey, aceOnHold.com Since the article, “Sound Advice: How to Leverage Your Telephone’s On-Hold Feature to Build Loyalty and Enhance Patient Experience,” was published in the August 2010 issue of Texas Dental Journal Journal, we’ve received a few questions regarding considerations to make when choosing a new, upgraded phone system for your practice. Over the past 10 years, we’ve had four different phone systems — all of them different. Along the way, we’ve learned some things that we’ll share with you and hope you find helpful.

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Simply put, choosing the right phone system for your practice can mean the difference between presenting your business as unprofessional and small-time versus professional and on the leading edge of technology, i.e., the right phone system can vastly improve patient and customer interaction. It’s estimated that 82 percent of small businesses, (those with 24 employees or fewer), do not have a business-grade phone system, so it’s a vast understatement to say that choosing a “real” phone system that suits your business needs can distinguish your practice from others and give you a considerable competitive advantage. And don’t underestimate the benefits of a well-designed and streamlined phone system in attracting new customers and keeping existing ones. Even the simplest choices, such as whether to use silence, music alone, or music with on-hold advertising can have a dramatic effect on whether or not your customer stays on the line or hangs up, whether or not he or she calls back, and his or her willingness to purchase goods and services from your practice. There are many phone systems to choose from; and telephoneservice technology changes constantly. The selection process can seem intimidating and complicated. A good place to start is with an evaluation of your current and future telecommunication needs. We’ve organized the key components for choosing a telephone system into the acrostic (the first letter of each component forms the word “phones”) to the right:

P H O N E S

Prioritize Features. Caller ID, conferencing, auto-attendant, messages-on-hold, voicemail, voicemail to e-mail, find-mefollow-me. Determine which ones you’ll use immediately, and which ones you’re likely to implement in the future. Distinguish between need-to-haves and nice-to-haves. Homework. Spend some time studying available phonesystem options. Consider it a fact-finding mission. Your goal should be to understand more about the current technology and the range of prices in the market. Expect 5-7 hours of research, just to get your bearings. Over Budget. Don’t under invest! Too often, the old cliché, “penny-wise and pound-foolish” is true: we try to save a few bucks, and end up owning equipment that will not grow with us. The actual cost of IP or PBX phones (newer technology) is similar to analog multi-line phones (old technology); so be sure to consider the benefits of investing in a system that will meet your needs now and for several years to come. New or Used. One way to leverage your up-front investment is to purchase a used/refurbished phone system. It’s not unusual to find a used PBX for 10 or 20 cents on the dollar. Though used systems may save money, many people still decide to purchase a new one, because newer technology is always emerging, and because of the risk of purchasing a “lemon.” Equipment Assets. If you already own phones, keep in mind that many PBX units have some compatibility to connect with regular analog telephones. You may not reap all of the benefits a PBX has to offer, but using existing phones could be an interim solution to keep costs low. You can buy the PBX, use your current phones, and switch to IP phones as funds allow. Seek Advice. Ask at least 10 other small businesses (yes, 10!) about their telecommunications solutions. If you’re lucky, you may find a few that have “been there, and done that,” and can prove to be an invaluable resource, saving you research time and the headache of sifting through vendors. Locating your telephone vendor by referral is always preferable.

Phone System Types As noted, telephone technology is rapidly changing and growing increasingly complex. At the same time, there’s a growing trend towards greater user-friendliness, easy setup, and integration with existing technologies. Knowing the differences between each platform and understanding the benefits and drawbacks as they relate to your business forms the basis for choosing the right telephone solution for your practice. Texas Dental Journal l www.tda.org l April 2011

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Plain Old Telephone Service (POTS) is the type most familiar to many people. Calls are made and received over copper telephone wiring — the same kind you’d use to hook up a home telephone. Many small businesses simply visit the local office-supply store, pick up a two- or four-line business phone, and plug it in. While integrated features like conference calling, voice mail, and the ability to transfer calls between stations (phones) make the POTS approach acceptable for some small-office and home-office situations, it’s not the favored business option. If your phones are an integral part of customer contact, we suggest you lean toward newer, more scalable approaches geared particularly toward business needs. Private Branch Exchange (PBX) refers to a system with a central unit or “brain” that manages your lines, phones, and calls. PBX solutions can be hosted by a third-party provider or managed on-site. These two approaches are referred to as Hosted PBX (see VoIP below) and Premise-Based PBX, respectively. The primary advantage of a Hosted PBX system is lower up-front cost, because there’s little or no equipment expense. A premise-based PBX requires a greater initial investment, but can save money in the long run because you can add extensions (phones) without necessarily adding to your monthly service expense, (which is likely when you use a hosted solution). VoIP (Voice over Internet Protocol) is projected to be the future of telecommunication. Rather than copper wire, a high-speed internet connection is used to make and receive calls. Hosted PBX services have an abundance of VoIP providers that offer a way to

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lower the up-front costs (of having a hosted service) over purchasing a Premise-based PBX. Keep in mind, the lower the initial hardware cost, the more likely your VoIP provider will require a long-term commitment of 3 to 5 years or more. VoIP service can also be used with many premise-based PBX systems.

Hybrid PBX Solutions Newer PBX systems geared particularly toward small businesses, (such as TalkSwitch), are gaining popularity among small-business owners because of their ability to work with either analog (copper wire) or VoIP (voice over internet), or both. These Hybrid PBX systems deliver many, if not all, of the same features as a larger, more expensive PBX system; but at a much lower cost. TalkSwitch, for example, is perfect for a business with only three or four employees; but it has the capability to accommodate up to 64 employees, with a separate phone line for each employee. Other examples of systems are: Altigen, Allworx and SwitchVox. There’s also an open-source code project for PBX called Asterisk. The software code is free and customizable but will require technical expertise and build-it-yourself hardware.

Deciding What’s Right for Your Business When you’re armed with a stronger understanding of how each telephone system differs, it’s easier to make a better decision on which type is ideal for your practice. A small start-up that needs to control costs may look to VoIP, because it requires a minimal hardware investment, and it offers features like: voice mail, conference calling, and call forwarding. Other small businesses may prefer the long-term savings of a premise-based PBX system. In either case, it’s always a good practice to figure the cost of ownership over a 3-, 5- and 7-year period, so you have a better understanding of your expenses over the long-term. Remember to factor in the cost of: monthly service, calling plans, long distance, toll-free number usage, upgrades, expansion, maintenance and technical support. When comparing services, you’ll discover a confusing world of plans, options and add-on charges. There are two fundamental schools of thought in pricing for monthly service. One is to charge by the line; the other is to charge by the phone, or “per seat.” There’s no hard and fast recommendation when it comes to choosing between these pricing models. If you’re charged per line, you’re charged by the number of simultaneous calls you need to be able to take. This is the most familiar approach, because it’s the traditional method used by POTS and PBX systems. The provider doesn’t care how many phones you have connected; it’s charging by the number of lines you have (i.e. the concurrent-calls capacity). Most Hosted PBX VoIP solutions charge per user (seat, phone, etc.). Therefore each phone represents a line that can make and receive calls. Usually, a line to phone ratio of 1:1 is overkill, so be cautious entering into this type of arrangement with more than five or six phones, unless you’re absolutely certain you need the capability of handling simultaneous calls for each and every phone.


As you determine which pricing method is advantageous in your situation, be certain your vendor is fully disclosing ALL OF YOUR MONTHLY CHARGES, and provides a sample monthly bill. Don’t rule out plans that charge by the minute. You may find that a good per-minute price saves tremendously more than some so-called “unlimited” calling plans. Certainly, there are situations where an unlimited calling plan is best, but don’t assume it’s going to be cheaper. Remember: it’s the right combination of hardware and service that will ultimately create the value you receive for the dollars you spend.

Contract Fine Print Before signing any agreement, pay close attention to contract termination fees. Say your business grows more rapidly than expected, and you move from a VoIP to a PBX system to accommodate the growth. The cost of terminating a long-term contract with a VoIP provider may bear heavily on the overall cost-effectiveness of such a transition. Also be sure to inquire about the customer-support options of each provider. The peace of mind of having technical support available for questions and technical issues may be well worth the extra financial investment. Make sure you have a clear understanding of any limits contained in “unlimited” calling plans. It bears repeating: Carefully review every contract associated with the phone service you choose before committing to a binding agreement. Selecting a telephone solution that meets your business’ current and future needs is a powerful tool for setting yourself apart from your competition. Creating a less frustrating and more enjoyable phone

experience for your patients builds loyalty and gives your practice a professional edge. Remember that the key to picking the right system is finding the optimum combination of telephone hardware and service plan that is dynamic enough for your business now, and for where it will be in 5 years. Take time to understand the technology; make careful, informed decisions; don’t lock yourself into a long-term service plan without fully understanding the commitment; and when in doubt, ask questions. Your telephone system is an integral part of your business, and it’s well worth your while to choose one that will benefit your practice now and in the long run.

Glossary of Terms POTS: Plain Old Telephone Service. The oldest type of telephone service. If you have ever used a home telephone with a standard telephone jack, you have used a POTS system. PSTN: Public Switched Telephone Network. A collective term for the network of analog and digital telephone systems used by the entire world to make and receive phone calls. VoIP: Voice Over Internet Protocol. Also called IP telephony, broadband phone, internet phone, or voice over internet. VoIP uses a high-speed Internet connection, rather than a traditional phone line connection, to make and receive phone calls. PBX: Private Branch Exchange. A system used to interconnect multiple phones (and other devices that use phone lines) to each other, and to connect them to outside telephone lines on the Public Switched Telephone Network. Although not exactly the same, the term Key System Unit (KSU) is sometimes used interchangeably. Hosted PBX: A software PBX hosted and maintained by a phone or Internet provider, rather than purchased by the business and installed inhouse. Typically managed by the end-user through an online portal. Premise PBX: The opposite of hosted PBX systems, PBX equipment is purchased or leased by the business and maintained in-house by the business itself. Hybrid PBX: Hybrid PBX can have several different meanings. In today’s world of telephone technology, it’s mostly used to describe a premisebased PBX that has the capability of integrating POTS and VoIP service, as well as analog and digital (IP) phones. Multi-Line Business Phone: Two and four-line business phones available at office-supply or electronics retailers. Distinguished by the user’s need to select a line on which to place a call (e.g, “Line 1,” “Line 2”), as opposed to PBX and VoIP phone systems that automatically choose an available line to place a call. aceOnHold is a TDA Perks Program partner that delivers personalized and professional on-hold messaging with no contracts or monthly fees. aceOnHold offers a 100 percent-satisfaction guarantee. For more information, contact aceOnHold at: (800) 892-9179, or visit: https://www.aceonhold. com/home/tda/. For more information regarding other TDA Perks Programs, visit tdaperks.com, or call (512) 443-3675. Texas Dental Journal l www.tda.org l April 2011

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Calendar of Events 388

May 2011 5–8 The Texas Dental Association will hold its 141st annual session, The TEXAS Meeting, at the Henry B. Gonzalez Convention Center in San Antonio, Texas. For more information, please contact TDA, 1946 S. IH 35, Ste. 400, Austin, TX 78704. Phone: (512) 443-3675; FAX: (512) 443-3031; Web: texasmeeting.com. 6 The TDA Smiles Foundation (TDASF) will hold its Healthy Smiles Golf Classic in San Antonio, TX. For more information, please contact TDASF, 1946 S. IH 35, Ste. 300, Austin, TX 78704; Phone: (512) 443-2441; Web: tdasf.org. 9 – 11 The ADA will hold its Washington Leadership Conference in Washington, D.C. For more information, please contact Mr. Brian Sodergren, ADA, 1111 14th St., NW, Ste. 1100, Washington, DC 20005. Phone: (202) 789-5168; FAX: (202) 789-2258; E-mail: sodergrenb@ada.org; Web: ada.org. 17 – 21 The American Academy of Cosmetic Dentistry will hold its annual scientific session at the Hynes Convention Center in Boston, MA. For more information, please contact Ms. Kelly Radcliff, AACD, 5401 World Dairy Dr., Madison, WI 53718. Phone: (800) 543-9220; FAX: (608) 222-9540; E-mail: kelly@aacd.com; Web: aacd.com. 26 – 29 The American Academy of Pediatric Dentistry will hold its 64th annual session at the Marriott Marquis New York in New York, NY. For more information, please contact Dr. John S. Rutkauskas, CAE, AAPD, 211 E. Chicago Ave., Ste. 1700, Chicago, IL 60611-2663. Phone: (312) 337-2169; FAX: (312) 337-6329; E-mail: jrutkauskas@aapd.org; Web: aapd.org. June 2011 10-11 The Southwest Prosthodontic Society will hold its annual meeting at Moody Gardens in Galveston, TX. For more information visit swprosthodonticsociety.com or contact Dr. G. Romero at (713) 664-1661, gromero1@sbcglobal.net; or Dr. Mark Connelly at (281) 481-8530, m.e.connelly1@comcast.net. 11 The TDA Smiles Foundation (TDASF) will hold a Smiles on Wheels mission in Mineral Wells, TX. For more information, please contact TDASF, 1946 S. IH 35, Ste. 300, Austin, TX 78704; Phone: (512) 448-2441; Web: tdasf.org. 15 – 18 The ADA will hold its 25th New Dentist Conference in Chicago, IL. For more information, please contact Mr. Ron Polaniecki, ADA, 211 E. Chicago Ave., Chicago, IL 60611. Phone: (312) 440-2599; FAX: (312) 440-2883; E-mail: polanieckir@ada.org; Web: ada.org. 17 – 18 The Southwestern Society of Oral Medicine will hold its 62nd annual meeting, “Diabetes, Inflammatory Periodontal Disease and the Relationship to Systemic Health,” at the Marriott Plaza San Antonio Hotel in San Antonio, TX. For more information, please contact Dr. Ron Trowbridge, 2943 Thousand Oaks, Ste. 4, San Antonio, TX 78247. Phone (210) 653-7174; FAX (210) 653-8204. 23 – 25 The ADA Council on Access, Prevention and Interprofessional Relations (CAPIR) will meet in Chicago, IL. For more information, please contact Ms. Carrie Campbell, ADA, 211 E. Chicago Ave., Chicago, IL 60611. Phone: (312) 440-2500; FAX: (312) 440-7494; E-mail: campbellc@ada.org; Web: ada.org. July 2011 15-17 ADPAC, the American Dental Political Action Committee, will meet. For more information, please contact Ms. Cynthia Taylor, ADA, 1111 14th St., N.W., Ste. 1200, Washington, D.C. Phone: (202) 789-5172; FAX: (202) 898-2437; E-mail: taylorc@ada.org. 28 – 31 The Academy of General Dentistry will have its annual meeting and exhibition at the Ernest Morial Convention Center in New Orleans, LA. For more information, please contact Ms. Rebecca Murray, AGD, 211 E. Chicago Ave., Ste. 900, Chicago, IL 60611. Phone: (312) 440-3368; FAX: (312) 440-0559; E-mail: agd@agd.org; Web: agd.org.

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August 2011 5&6 The TDA Smiles Foundation (TDASF) will hold a Texas Mission of Mercy event in Texarkana, TX. For more information, please contact TDASF, 1946 S. IH 35, Ste. 300, Austin, TX 78704; Phone: (512) 448-2441; Web: tdasf.org. 18 & 19 National Conference on Dentist Health and Wellness will be in Chicago, IL. For more information, please contact Ms. Mary Gilliam, ADA, 211 E. Chicago Ave., Chicago, IL 60611-2678. Phone: (312) 440-2500. FAX: (312) 440-7494; E-mail: online@ada.org; Web: ada.org. September 2011 12 – 17 The American Association of Oral and Maxillofacial Surgeons will meet at the Pennsylvania Convention Center in Philadelphia, PA. For more information, please contact Dr. Robert C. Rinaldi, AAOMS, 9700 W. Bryn Mawr, Rosemont, IL 60018. Phone: (847) 678-6200; FAX: (847) 678-6286; Web: aaoms.org. 14 – 17 The FDI Annual World Dental Congress will meet at the Banamex Convention & Exhibition Centre in Mexico City, Mexico. For more information, please contact Mr. John Hern, FDI/USA Section, ADA, 211 E. Chicago Ave., Chicago, IL 60611; Phone: (800) 621-8099 ext. 2727; FAX: (312) 440-2707; E-mail: hernj@ada.org. 22 – 27 The ADA Kellogg Executive Management Program will be in Chicago, IL. For more information, please contact Mr. Ron Polaniecki, ADA, 211 E. Chicago Ave., Chicago, IL 60611; Phone: (312) 440-2599; FAX: (312) 440-2883; E-mail: polanieckir@ada.org; Web: ada.org. October 2011 9 – 12 The Alliance of the American Dental Association will hold its convention in Las Vegas, NV. For more information, please contact Ms. Patricia Rubik-Rothstein, AADA, 211 E. Chicago Ave., Ste. 730, Chicago, IL 60611-2678. Phone: (312) 440-2865; FAX: (312) 440-2587; E-mail: manager@allianceada.org; Web: ada.org. 10 – 13 The American Dental Association will hold its 152nd annual session in Las Vegas, NV. For more information, please contact the ADA, 211 E. Chicago, Ave., Chicago, IL 60611-2678. Phone: (312) 440-2500; Web: ada.org. 13 – 16 The Southwestern Society of Orthodontists will hold its annual session at the Westin Galleria in Houston, Texas. For more information, please contact Ms. Judy Salisbury, Southwestern Society of Orthodontists, 10032 Wind Hill Dr., Greenville, IN 47124. Phone: (812) 923-2100; FAX: (812) 923-2900; E-mail: jsalisbury00@gmail.com; Web: flyingdentists.org. 19 – 22 The 35th Annual American Society for Dental Aesthetics International Conference will be held in Amelia Island, FL. For more information, please contact Dr. Dan Ward, ASDA, 635 Madison Ave., New York, NY 10022; Phone: (800) 454-2732; E-mail: dward@columbus.rr.com; Web: asdatoday.com.

The Texas Dental Journal’s Calendar will include only meetings, symposia, etc., of statewide, national, and international interest to Texas dentists. Because of space limitations, individual continuing education courses will not be listed. Readers are directed to the monthly advertisements of courses that appear elsewhere in the Journal.

Calendar of Events

28 – 30 The International Association of Comprehensive Aesthetics will meet at the Manchester Grand Hyatt in San Diego, CA. For more information, please contact Ms. Mary Williams, IACA, 1401 Hillshire Dr., Ste. 200, Las Vegas, NV 89134. Phone: (888) NOW-IACA; FAX: (702) 341-8510; E-mail: info@theiaca.com; Web: theiaca.com.

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g n i rtis

e v Ad

Briefs

IMPORTANT: Ad briefs must be in the TDA office by the 20th of two months prior to the issue for processing. For example, for an ad brief to be included in the January issue, it must be received no later than November 20th. Remittance must accompany classified ads. Ads cannot be accepted by phone or fax. *

Practice Opportunities

AUSTIN: Associate to purchase. High grossing, family practice located in retail center with seven operatories was recently remodeled. Near major freeway. High growth area. Practice boasts solid, well-established patient base. ID #108.

RIO GRANDE VALLEY: Excellent four operatory, 20-year-old general practice. Modern, new finish out in retail location with digital radiography. Fee-for-service patient base and very good new patient count. Great numbers. Super upside potential. ID #093.

Advertising brief rates are as follows: 30 words or less — per insertion…$40. Additional words 10¢ each.

AUSTIN: North, high grossing, five operatory practice in free-standing building. Plenty of room to expand. Fee-for-service patient base, good equipment. Owner wishes to sell and continue part-time as an associate. ID #115.

SAN ANTONIO: Prosthodontic practice with almost new equipment and build out. Doctor wants to sell and continue to work as associate. Beautiful office! Perfect for stand alone or satellite office. ID #060.

NEW! AUSTIN: Unique, quality fee-forservice practice in five operatory freestanding building. Grossed near seven figures, boasts quality staff and wellestablished patient base. ID #123.

SAN ANTONIO, NORTH CENTRAL — Two-op practice just off major freeway; perfect starter office. Terrific pricing. ID #009.

The JOURNAL reserves the right to edit copy of classified advertisements. Any dentist advertising in the Texas Dental Journal must be a member of the American Dental Association. All checks submitted by non-ADA members will be returned less a $20 handling fee. * Advertisements must not quote revenues, gross or net incomes. Only generic language referencing income will be accepted. Ads must be typed.

MCLERRAN AND ASSOCIATES:

NEW! AUSTIN: Newly built out, seven operatory (four equipped) practice in high growth, affluent area in northwest. Practice grossed mid-six figures on limited schedule in second year, is equipped and priced like a startup. Excellent opportunity with tremendous upside. ID #124. NEW! AUSTIN: Two operatory practice in free-standing building grossing low six figures on a part-time schedule. Practice and real estate available in transition. ID #125. CORPUS CHRISTI: Doctor retiring, six op office with excellent visibility and access. Good numbers, excellent patient base, good upside potential. Excellent practice for starting doctor. Priced to sell. ID #023. CORPUS CHRISTI: Three operatory, feefor-service/crown and bridge oriented family practice in great location. High

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grossing practice on 3-day week! Doctor ready to retire. Make an offer. ID #098.

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SAN ANTONIO: Four operatory general family practice located in professional office building off of busy thoroughfare in affluent north central side of town. Very nice equipment and decor. Excellent opportunity. ID #003. SAN ANTONIO: Well-established, endodontic specialty practice with solid referral base. Located in growing, upper middle income area. Contact for more information. ID #074. SAN ANTONIO: Oral surgery specialty practice. Very good referral base. Almost new build out, great location, and excellent equipment. Good gross and net. Transition available. ID #113. SAN ANTONIO, NORTH CENTRAL: Six operatory general practice located in high growth area. All operatories have large windows with great views. Very nice equipment, solid patient base, great hygiene program. Priced to sell. ID #112.


SAN ANTONIO, NORTH CENTRAL: Three operatory office in retail/office center with great visibility and access. New equipment and nice build out. Good solid numbers, very low overhead. ID #111. SAN ANTONIO: Six operatory practice with three chair ortho bay located in 3,400 sq. ft. building. Modern office with newer equipment. Free-standing building on busy thoroughfare. Practice has grossed in seven figures for last 3 years. Great location with super upside potential. ID #055. SAN ANTONIO, NORTH CENTRAL: Five operatory, state-of-the-art facility with new equipment. Located in a medical professional building in high growth, affluent area. Grossing seven figures with high net income. ID #106. SAN ANTONIO NORTH WEST: Excellent, four-chair general family practice in high traffic retail center across from busy mall location. Solid gross income on 30 hours/ week. Ideal opportunity for doctor wanting a quick start in low overhead operation. ID #086. SAN ANTONIO, SOUTHEAST: Three operatory, 30-year-old practice in high traffic retail center, good equipment, solid patient base, low overhead. Perfect location for a satellite office or high gross Medicaid office. ID #121. NEW! WEST OF SAN ANTONIO: Doctor retiring. Four operatories in modern, open, free-standing building. Excellent fee-for-service patient base. Newer equipment. Very nice decor. Very nice numbers with low overhead. Low competition in mid-sized city. ID #122. NEW! NORTHWEST SAN ANTONIO: Five operatory, 28-year-old practice in high visibility retail center. Excellent location, very good equipment. Solid patient base and hygiene program. ID #127.

NEW! NORTH CENTRAL SAN ANTONIO: Five operatory, 11-year-old practice in beautiful free-standing building. Great location! Excellent equipment and decor. Fee-for-service practice. ID #126. SOUTH TEXAS BORDER: General practitioner with 100 percent ortho practice. Very high numbers, incredible net. ID #021. WACO AREA: Modern and high-tech, three op general family practice grossing in mid-six figures with high net income. Large, loyal patient base. Office is well equipped for doctor seeking a modern office. ID #107. Contact McLerran Practice Transitions, Inc.: statewide, Paul McLerran, DDS, (210) 737-0100 or (888) 656-0290; in Austin, David McLerran, (512) 7506778; in Houston, Tom Guglielmo and Patrick Johnston, (281) 362-1707. Practice sales, appraisals, buyer representation, and lease negotiations. See www.dental-sales.com for pictures and more complete information. HOUSTON AREA PRACTICE OPPORTUNITIES! MCLERRAN & ASSOCIATES: General PPO/Medicaid practice located on the west side of Houston, five operatories, retail location, high traffic, great visibility. Seller only working part time, practice poised for growth. #H125. HOUSTON: Well-established general and cosmetic practice located in highly visible, upscale location. Beautiful office with five+ operatories, production over seven figures, seller willing to transition. #H127. HOUSTON: General, fee-for-service practice, established in the beautiful Memorial area of Houston for over 30 Texas Dental Journal l www.tda.org l April 2011

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years. Low fixed overhead costs, with significant outbound referrals, practice has great upside potential for buyer looking to increase revenue to the mid six-figure range and still generate a desirable net income. New patients are generated from loyal patient following that is not insurance based, staff is very stable and effective. Seller available for a short transition period. #H128. HOUSTON: 40-year-old practice in just completed new office. Memorial City area. All new equipment, digital X-ray and computerized. Revenues near six figures. Demographics lean towards an adult, middle income earning clientele. Two full-time hygienists. #H129. SOUTHWEST OF HOUSTON: This beautiful, five operatory general practice was established 14 years ago and moved to its current location approximately 8 years ago. With the seller working only 2 days per week, production has remained steady over the last few years in the mid six-figure range. With a strong hygiene program (4 days per week) and good visibility, the practice is poised for growth with a full-time dentist seeking patients. #H120. Contact McLerran & Associates in Houston: Tom Guglielmo and Patrick Johnson, (800) 474-3049 or (281) 3621707. Practice sales, appraisals, buyer representation, and partnership consulting. See www.dental-sales.com for more complete information. GARY CLINTON / PMA WEST OF FORT WORTH PRACTICE FOR SALE: A little more than an hour west of Fort Worth, this is an excellent high six-figure grossing practice with high operating profits. Excellent recall; six operatories; fee-for-serivce; no DMO or low fee PPO. We have the best source for 100 percent buyer funding. Gary Clinton is a senior member of the Institute of Business Appraisers, Inc. “For over 37 years, you’ve seen the name ... a name you can trust.” I personally handle every appraisal/ transition/sale. No real estate commission. Every call is very confidential.

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General and specialty practice certified appraisals. DFW: (214) 503-9696; WATS: (800) 583-7765. GARY CLINTON / PMA NORTHWEST OF DALLAS CARROLLTON AREA PRACTICE FOR SALE: Well-established practice/exceptional recall; full general service practice with lots of crown and bridge. Retiring dentist. Will continue to work as needed 1 day per week. We have the best source for 100 percent buyer funding. Gary Clinton is a senior member of the Institute of Business Appraisers, Inc. “For over 37 years, you’ve seen the name ... a name you can trust.” I personally handle every appraisal/transition/sale. No real estate commission. Every call is very confidential. General and specialty practice certified appraisals. DFW: (214) 503-9696; WATS: (800) 583-7765. WE NEED SELLERS! Some areas reduced fees. No real estate commission. Gary Clinton / PMA. Serving the dental profession since 1973: I have buyers! Sell your practice and travel while you have your health. In many cases, you can stay on to work 1-2 days per week if you wish. I need practices to sell/transition as follows: any practice in or near Austin, San Antonio, DFW and Houston areas, and other Texas locations. We have buyers for orthodontic, oral surgery, periodontic, pedodontic, and general dentistry practices. Values for practices have never been higher. Tax advantages high for present time. One hundred percent funding available, even those valued at more than seven figures. Call me confidentially with any questions. We have the best source for 100 percent buyer funding. Gary Clinton is a senior member of the Institute of Business Appraisers, Inc. “For over 37 years, you’ve seen the name ... a name you can trust.” I personally handle every appraisal/transition/sale. No real estate commission. Every call is very confidential. General and specialty practice certified appraisals. DFW: (214) 503-9696; WATS: (800) 583-7765.


ORTHODONTIC PRACTICES FOR SALE / TRANSITION —GARY CLINTON / PMA TEXAS: O-1 West Central Texas mid-sized to larger community — Ideal transition; professional referral based; traditional fee-for-service, referral, highly productive. Gorgeous building with room for two in this planned 50/50 partnership; within 5 years complete buy-out with owner working 1-2 days as needed. O-2 South Texas — Retiring orthodontist. Initial associateship with high salary, transitional sale, or immediate buy-out; seller will stay 1-2 days per week as needed. Seven figure practice collections; 60 percent profits; lovely building. He is ready to spend time with his grandchildren. Easy drive to San Antonio. We have the best source for 100 percent buyer funding. Gary Clinton is a senior member of the Institute of Business Appraisers, Inc. “For over 37 years, you’ve seen the name ... a name you can trust.” I personally handle every appraisal/transition/sale. No real estate commission. Every call is very confidential. General and specialty practice certified appraisals. DFW: (214) 503-9696; WATS: (800) 583-7765. GARY CLINTON / PMA ARLINGTON PRACTICE FOR SALE: The place to be for young families. Texas Rangers baseball. Cowboys football, and Six Flags for entertainment. Well-established practice. Excellent recare program. Near seven figure gross, over 50 percent net. Garden style offices and operatories. We have the best source for 100 percent buyer funding. Gary Clinton is a senior member of the Institute of Business Appraisers, Inc. “For over 37 years, you’ve seen the name ... a name you can trust.” I personally handle every appraisal/ transition/sale. No real estate commission. Every call is very confidential. General and specialty practice certified appraisals. DFW: (214) 503-9696; WATS: (800) 583-7765. GARY CLINTON / PMA FORT WORTH AREA GENERAL PRACTICES FOR SALE: Fl — Excellent patient base;

well-established recall. Bread and butter practice. Very fast growing area near Texas Motor Speedway. Average gross with excellent net. F-2 —Primarily fee-for-service 30+-year-old practice in southwest Fort Worth/White Settlement/Lake Worth area. Associate buy-out or outright sale. Solid recall program. Above average gross. F-3 — Near Burleson. Excellent practice for sale. We have the best source for 100 percent buyer funding. Gary Clinton is a senior member of the Institute of Business Appraisers, Inc. “For over 37 years, you’ve seen the name ... a name you can trust.” I personally handle every appraisal/ transition/sale. No real estate commission. Every call is very confidential. General and specialty practice certified appraisals. DFW: (214) 503-9696; WATS: (800) 583-7765. ORAL SURGERY PRACTICES FOR SALE. GARY CLINTON / PMA: OS-1 West Houston / Sugar Land area — High growth area. State-of-the-art practice. Many referring doctors for cosmetic and implant, and reconstructive surgery. Outright sale. Seven-figure gross. Seller and family are relocating out of state; will transition on a limited basis. OS-2 Southwest Houston — Retiring surgeon. Bread and butter practice. Seven-figure gross on 4 days; will transition. We have the best source for 100 percent buyer funding. Gary Clinton is a senior member of the Institute of Business Appraisers, Inc. “For over 37 years, you’ve seen the name ... a name you can trust.” I personally handle every appraisal/transition/sale. No real estate commission. Every call is very confidential. General and specialty practice certified appraisals. DFW: (214) 503-9696; WATS: (800) 583-7765. GARY CLINTON / PMA PLANO / FRISCO AREA: Future rapid growth area where people will want to live. Practice in the middle of the high growth area. Projected seven-figure gross. Newly equipped, gorgeous office. We have the best source for 100 percent buyer fundTexas Dental Journal l www.tda.org l April 2011

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ing. Gary Clinton is a senior member of the Institute of Business Appraisers, Inc. “For over 37 years, you’ve seen the name ... a name you can trust.” I personally handle every appraisal/transition/sale. No real estate commission. Every call is very confidential. General and specialty practice certified appraisals. DFW: (214) 503-9696; WATS: (800) 583-7765. GARY CLINTON / PMA HOUSTON PRACTICES FOR SALE: H-l North Houston. Fast growing, most requested area; seven-figure gross, high net. Nine operatories, full recall. Very attractive large building. H-2 Well-established practice, retiring dentist. Excellent recall in southwest Houston area. H-3 Clear Lake area practice. Well-established. Average gross. We have the best source for 100 percent buyer funding. Gary Clinton is a senior member of the Institute of Business Appraisers, Inc. “For over 37 years, you’ve seen the name ... a name you can trust.” I personally handle every appraisal/transition/sale. No real estate commission. Every call is very confidential. General and specialty practice certified appraisals. DFW: (214) 503-9696; WATS: (800) 583-7765. GARY CLINTON / PMA BRYAN / COLLEGE STATION PRACTICE FOR SALE: Retiring dentist; excellent visible location ready to hand over the ball to a young motivated dentist. Will transition PRN. We have the best source for 100 percent buyer funding. Gary Clinton is a senior member of the Institute of Business Appraisers, Inc. “For over 37 years, you’ve seen the name ... a name you can trust.” I personally handle every appraisal/ transition/sale. No real estate commission. Every call is very confidential. General and specialty practice certified appraisals. DFW: (214) 503-9696; WATS: (800) 583-7765. GARY CLINTON / PMA WEST TEXAS AREA WELL-ESTABLISHED PRACTICES FOR SALE: W-l North of Lubbock — Highly productive practice; large growing patient base. Doctor will work for

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purchaser as needed. Purchase building outright or lease/purchase. W-2 Abilene — Retiring dentist outright sale/PRN transition; great location south side of Abilene. W-3 San Angelo — Excellent well-established restorative practice. Very nice newer equipment. Dentist relocation. Purchase building or lease/ purchase. Transitional or outright sale. We have the best source for 100 percent buyer funding. Gary Clinton is a senior member of the Institute of Business Appraisers, Inc. “For over 37 years, you’ve seen the name ... a name you can trust.” I personally handle every appraisal/ transition/sale. No real estate commission. Every call is very confidential. General and specialty practice certified appraisals. DFW: (214) 503-9696; WATS: (800) 583-7765. GARY CLINTON / PMA AUSTIN PRACTICE FOR SALE: Excellent practice with gross over high six figures. Building may be purchased with practice or leased with later purchase options. We have the best source for 100 percent buyer funding. Gary Clinton is a senior member of the Institute of Business Appraisers, Inc. “For over 37 years, you’ve seen the name ... a name you can trust.” I personally handle every appraisal/transition/sale. No real estate commission. Every call is very confidential. General and specialty practice certified appraisals. DFW: (214) 503-9696; WATS: (800) 583-7765. GARY CLINTON / PMA GARLAND PRACTICE FOR SALE: North Garland area. Doctor retiring for health reasons; 20+ year practice. Average gross. We have the best source for 100 percent buyer funding. Gary Clinton is a senior member of the Institute of Business Appraisers, Inc. “For over 37 years, you’ve seen the name ... a name you can trust.” I personally handle every appraisal/ transition/sale. No real estate commission. Every call is very confidential. General and specialty practice certified appraisals. DFW: (214) 503-9696; WATS: (800) 583-7765.


GOLDEN TRIANGLE GENERAL DENTAL PRACTICE — SALE: Outstanding practice for sale developed by published mentor. Supported by outstanding staff and latest in dental equipment. Strong revenues and profit margin. Excellent new patient flow. Given high level of FFS revenues, doctor to transition to comfort level of purchaser. Come build your retirement in low competition community. Contact The Hindley Group at (800) 8561955. Visit us at www.thehindleygroup. com. NORTH TEXAS GENERAL DENTAL PRACTICE — SALE: Small, well-established practice in mid-sized community in north Texas. Three fully-equipped operatories. Experienced staff with excellent skills. Doctor will assist with transition. Contact The Hindley Group, LLC, at (800) 856-1955. Visit us at www. thehindleygroup.com. CORPUS CHRISTI GENERAL DENTAL — SALE: Moderate revenues with a very healthy profit margin. Experienced and loyal staff. Totally digital and highly efficient facility layout. If you need to practice to refund your retirement, but don’t want to fight the competitiveness of the city, come see this practice. Contact The Hindley Group at (800) 856-1955. Visit us at www.thehindleygroup.com. DFW METROPLEX ORAL SURGERY PRACTICE — SALE: Well-established practice enjoying 2009 revenues exceeding seven figures from two locations. Extensive referral base, experienced staff, and highly qualified mentor to assist in transition. Don’t miss this opportunity. Contact The Hindley Group at (800) 8561955. Visit us at www.thehindleygroup. com. SOUTH OF HOUSTON GENERAL DENTAL PRACTICE — SALE: Established practice in mid-size town generating revenues approaching very high six figures the last 3 years. Associate in place providing orthodontic treatment. Building is also for sale. Contact The Hindley

Group at (800) 856-1955. Visit us at www.thehindleygroup.com. DALLAS / FORT WORTH: Area clinics seeking associates. Earn significantly above industry average income with paid health and malpractice insurance while working in a great environment. Fax (312) 944-9499 or e-mail cjpatterson@ kosservices.com. WACO PEDIATRIC DENTAL PRACTICE — SALE: Well-established practice with moderate revenues and high profit margin on 4 days per week. Limited competition and a large facility. Ample room to grow in this community that is home to Baylor University. This is a wonderful central Texas community in which to raise your family. All ortho cases are being completed, unless purchaser would like to expand new cases. No Medicaid being seen, but good opportunity with facility capacity. Experienced staff and steady new patient flow. Wonderful mentor. Building also available. Contact The Hindley Group at (800) 856-1955. Visit us at www.thehindleygroup.com. BRYAN/COLLEGE STATION GENERAL DENTAL PRACTICE — SALE: Well-established practice in mid-size town. Four operatories. Healthy revenues, excellent profit margin, and strong new patient flow. Doctor must transition due to health reasons. Building also for sale. Contact The Hindley Group, LLC, at (800) 8561955. Visit us at www.thehindleygroup. com. EAST TEXAS GENERAL DENTAL PRACTICE — SALE: Well-established practice in small town in hills in East Texas. Moderate revenues on 4 days per week; three operatories; excellent staff. Room to expand in adjacent space. Contact The Hindley Group, LLC, at (800) 856-1955. Visit us at www.thehindleygroup.com. FORT WORTH ORTHODONTIC PRACTICE — SALE: Excellent opportunity for satellite office; general dentist wanting to add orthodontics to services offered; Texas Dental Journal l www.tda.org l April 2011

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female dentist desiring part-time position while children in school; or older dentist wanting to utilize orthodontics as less physically taxing exit strategy. Doctor will mentor or assist with transition. Contact The Hindley Group, LLC, at (800) 856-1955. Visit us at www. thehindleygroup.com. WEST TEXAS GENERAL DENTAL PRACTICE — SALE: Spacious office with five fully-equipped operatories; two additional spaces plumbed for future use. Strong revenues and profit margin. Excellent new patient flow. Eight hygiene days per week. Contact The Hindley Group. LLC, at (800) 856-1955. Visit us at www.thehindleygroup.com. ARLINGTON ORAL SURGERY PRACTICE — SALE: Highly successful practice with strong revenue history of more than seven figures. Selling doctor cut production in half due to back injury but will assist purchaser in rebuilding practice. Extensive referral pattern. Building also for sale. Contact The Hindley Group, LLC, at (800) 856-1955. Visit us at www.thehindleygroup.com. SOUTHEAST OF HOUSTON GENERAL DENTAL PRACTICE — SALE: Wonderful location on well-traveled street. Practice is 30+ years old. Excellent revenues and profit margin. Four fully-equipped operatories. Perfect opportunity for new or recent graduate. Contact The Hindley Group at (800) 856-1955. Visit us at www.thehindleygroup.com. NORTH CENTRAL TEXAS GENERAL DENTAL PRACTICE — SALE: Wonderful opportunity in small town that is 1 hour north of DFW Metroplex. Four operatories. Good new patient flow. Excellent staff. Building also for sale. The Hindley Group, LLC, (800) 856-1955. Visit us at www.thehindleygroup.com. ASSOCIATESHIPS: EAST TEXAS GENERAL DENTAL PRACTICE — Small but busy practice generating mid-range revenues on 4 days per week. Located in

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quaint small town with excellent access to forests and lakes for hunting, fishing, and boating. Excellent opportunity for dentists looking ahead to separation from the military. Pre-determined buy-in terms. SOUTH CENTRAL TEXAS PERIODONTAL —Wonderful practice completing periodontal treatment seeks long-term associate who desires to be a partner within 1-2 years. Great location with strong new patient flow. Predetermined purchase and partnership terms. Wonderful mentor looking for an “equally-yoked” individual. Excellent staff. SAN ANTONIO PERIODONTAL AND ENDODONTAL ASSOCIATESHIPS — Periodontal associateship with predetermined buy-in for very active, multioffice periodontal practice. Endodontist associate also needed in this practice. Outstanding mentor and cohesive staff. If you are “equally yoked” and the right person, this is an outstanding opportunity. WEST TEXAS GENERAL DENTAL PRACTICE — Associateship with pre-determined buy-in and partnership terms. Nine operatories. Strong mentor and experienced staff. Excellent revenues and profit margin. Medicaid component. EAST TEXAS GENERAL DENTAL PRACTICE — Associateship for busy practice in large facility. Strong mentor. Excellent revenues and profit margin. Predetermined buy-in and partnership terms. EAST OF HOUSTON GENERAL DENTAL PRACTICE —Well-established practice in small town seeks associate desiring practice buy-in with pre-determined terms. Steady new patient flow and strong revenues. Contact The Hindley Group, LLC, at (800) 856-1955. Visit us at www.thehindleygroup.com. HOUSTON AREA PRACTICE FOR SALE: Profitable practice for sale. Wellestablished. Call Jim Robertson at (713) 688-1749. ADS WATSON, BROWN & ASSOCIATES: Excellent practice acquisition and merger opportunities available. DALLAS AREA — Six general dentistry practices available (Dallas, North Dallas,


Highland Park, and Plano); five specialty practices available (two ortho, one perio, two pedo). FORT WORTH AREA — Two general dentistry practices (north Fort Worth and west of Fort Worth). CORPUS CHRISTI AREA — One general dentistry practice. CENTRAL TEXAS — Two general dentistry practices (north of Austin and Bryan/College Station). NORTH TEXAS —One orthodontic practice. HOUSTON AREA — Three general dentistry practices. EAST TEXAS AREA — Two general dentistry practices and one pedo practice. WEST TEXAS — Three general dentistry practices (El Paso and West Texas). NEW MEXICO —Two general dentistry practices (Sante Fe, Albuquerque). For more information and current listings, please visit our website at www.adstexas.com or call ADS Watson, Brown & Associates at (469) 222-3200. FULLY EQUIPPED MODERN DENTAL OFFICE SPACE AVAILABLE FOR LEASE. Have four ops. Current doctor is only using 2 days a week. Great opportunity to start up new practice (i.e., endo, perio, oral surgery). Available days are Monday, Tuesday, Thursday per week. If you are wanting an associate, please inquire. Call (214) 315-4584 or e-mail ycsongdds@yahoo.com. TEXAS PANHANDLE: Well-established 100 percent fee-for-service dental practice for immediate transition or complete sale at below market price by retiring dentist. Relaxed work schedule with community centrally located within 1 hour of three major cities. The office building can be leased or purchased separately and is spaciously designed with four operatories, doctors’ private office and separate office rental space. This is an excellent and profitable opportunity for a new dentist, a dentist desiring to own a practice, or a satellite practice expansion. Contact C. Vandiver at (713) 205-2005 or clv@tauruscapitalcorp.com. SUGAR CREEK / SUGAR LAND: General dentist looking for periodontist, endo, ortho specialist to lease or sell. Suite is

1,500 sq. ft. with four fully-equipped treatment rooms, lab, business office, telephone system, computers, reception and playroom; 5 days per week. If seriously interested, please call (281) 342-6565. AUSTIN: Unique opportunity. Associateship and front-office position available for husband/wife team. Southwest Austin, Monday through Thursday. Option to purchase practice in the future. Send resume and questions to newsmile@onr. com. GALVESTON ISLAND: Unique opportunity to live and practice on the Texas Gulf coast. Well-established fee-forservice, 100 percent quality-oriented practice looking for a quality oriented associate. Ideal for a new graduate or for an experienced dentist wanting to relocate and become part of an established practice with a reputation for providing comprehensive, quality dental care with a personable approach. Practice references available from local specialists. Contact Dr. Richard Krumholz, (409) 762-4522. ASSOCIATE FOR TYLER GENERAL DENTISTRY PRACTICE: Well-established general dentist in Tyler with 30+ years experience seeks a caring and motivated associate for his busy practice. This practice provides exceptional dental care for the entire family. The professional staff allows a doctor to focus on the needs of their patients. Our office is located in beautiful East Texas and provides all phases of quality dentistry in a friendly and compassionate atmosphere. The practice offers a tremendous opportunity to grow a solid foundation with the doctor. The practice offers excellent production and earning potential with a possible future equity position available. Our knowledgeable staff will support and enhance your growth and earning potential while helping create a smooth transition. Interested candidates should call (903) 509-0505 and/or send an email to steve.lebo@sbcglobal.net. Texas Dental Journal l www.tda.org l April 2011

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ASSOCIATE NEEDED FOR NURSING HOME DENTAL PRACTICE. This is a non-traditional practice dedicated to delivering care onsite to residents of long term care facilities. This practice is centered in Austin but visits homes in the central Texas area. Portable and mobile equipment and facilities are used, as well as some fixed office visits. Patient population presents unique technical medical, and behavioral challenges, seasoned dentist preferred. Buy-in potential high for the right individual. Please toward CV to e-mail renee@austindentalcares.com; FAX (512) 238-9250; or call (512) 2389250 for additional information. GREAT OPPORTUNITY FOR A PEDIATRIC DENTIST OR GP to join our expanding practice. We are opening a new practice in the country (Paris, Texas), just 1 hour past the Dallas suburbs and our original location. The need for a pediatric dentist out there is tremendous, and we are the only pediatric office for 70 miles in any direction. We are looking for someone that is personable, caring, energetic, and loves a fast-paced working environment in a busy pediatric practice. We are willing to train the right individual if working with children is your ambition. This position is part-time initially, and after a short training period will lead to full-time. If you join our team, you will be mentored by a Board certified pediatric dentist and will develop experience in all facets of pediatric dentistry including behavior management using oral conscious sedation as well as IV sedation. For more information, please visit our websites at www.wyliechildrensdentistry.com and www.parischildrensdentistry.com. Please e-mail CV to allenpl2345@yahoo.com. SOUTHWEST FT. WORTH — GENERAL DENTAL PRACTICE WITH BUILDING FOR SALE OR LEASE: This very successful, well-established practice has an excellent patient base with referrals from near and far. The seller is retiring immediately or will negotiate a comfortable transition. With a low overhead

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and excellent profit margin, this practice makes a great investment for just the right person. Five treatment rooms, 3,200 sq. ft. plus 800 sq. ft. for additional expansion or rental space. The practice is located in a high visibility and stable economic community. With this practice comes an experienced staff, computers in all treatment rooms, nice equipment, imaging software, and much more. Get out of that associate position and be an owner! Appraisal performed by a CPA/CFP/CVA. Call (972) 562-1072 or (214) 697-6152 or e-mail sherri@slhdentalsales.com. ASSOCIATE SUGAR LAND AND CYPRESS: Large well-established practice with very strong revenues is seeking an associate. Must have at least 2 years experience and be motivated to learn and succeed. FFS and PPO practice that ranks as one of the top practices in the nation. Great mentoring opportunity. Possible equity position in the future. Base salary guarantee with high income potential. Two days initially going to 4 days in the near future. E-mail CV to Dr. Mike Kesner, drkesner@madeyasmile. com. SEEKING ASSOCIATE DENTISTS. Dental Republic is a well-established general dental practice with various successful locations throughout the Dallas Metroplex. A brand new state-of-the-art facility in a bustling location will be opening soon. Join our outstanding and professional team in creating beautiful healthy smiles for all. Let us give you the opportunity to enhance your professional career with excellent hours, competitive salary/benefits, and by forming longlasting friendships with our patients and staff members.-Please contact Phong at (214) 960-3535 or e-mail CV to phong@ dentalrepublic.com. CARE FOR KIDS, A PEDIATRIC FOCUSED PRACTICE, is opening new practices in the San Antonio and Houston area. We are looking for energetic full-time general dentists and pediat-


ric dentists to join our team. We offer a comprehensive compensation and benefits package including medical, life, long- and short-term disability insurance, flexible spending, and 401(K) with employer contribution. New graduates and dentists with experience are welcome. Be a part of our outstanding team, providing care for Texas’ kids. Please contact Anna Robinson at (913) 322-1447; e-mail: arobinson@amdpi. com; FAX: (913) 322-1459. DDR PRACTICE SALES — DUNN/ISENHART: SERVING TEXAS DENTISTS FOR OVER 40 YEARS. National direct (and fax): (800) 930-8017. CORPUS CHRISTI: Laid back lifestyle with the benefits of the Gulf Coast. Lucrative revenues on 4 days per week. Denture focus could be expanded to a broader scope of restorative general treatment. In-house lab with experienced technician. Great location, great staff, and a great lifestyle. Motivated seller. High six-figure gross provides owner six-figure income. Dentists will work as associate if desired. Call DDR Practice Sales at (800) 930-8017. BRYAN/COLLEGE STATION AREA: Well-established practice serving rural community of 5,000 just 20 minutes from College Station. Providing sevenfigure gross collections with substantial 40 percent net. High quality implant practice. Four fully equipped operatories, private office, two full-time hygienists and a great staff. Ownership of free-standing 1,900 sq. ft. building is optional. Over 4,000 patient base with average age of 45. Call DDR Practice Sales at (800) 930-8017. GALVESTON: Must sell for relocation. Thriving practice in Galveston providing the best of both worlds ... the great outdoors and a laid back lifestyle, yet quick access to metropolitan Houston. This 15-year practice has three fully equipped operatories, private office, full-time hygienist, and a great staff. Half interest in

free-standing building included in price. Generating mid six-figure gross collections on only 3 days per week. Owner currently splits time with out-of-town practice. Call DDR Practice Sales at (800) 930-8017. AUSTIN: Five operatory, two hygienists, one associate dentist, gross of seven figures in 2010. Mature practice; doctor wants to sell practice but is also willing to work contact for buying dentist; great location in beautiful Austin. Practice in the heart of most desired city in Texas. Substantial net income with four fully equipped operatories and two full-time hygienists. Current associate will remain at buyer’s discretion. Call DDR Practice Sales at (800) 930-8017. DALLAS: Practice in high-traffic professional building, run very lean. Mid sixfigure net. Need to add patient charts to your practice? Call DDR Practice Sales at (800) 930-8017. CORPUS CHRISTI: General dentistry practice —location, location, location; 25-year-old practice grossed more than seven figures last year with a single dentist and one hygienist. Updated office, very profitable practice, excellent staff. Call DDR Practice Sales at (800) 9308017. HOUSTON: Motivated buyer seeking Galleria area practice. Willing to acquire office, staff, or charts only. Looking to expand his practice. Call DDR Practice Sales at (800) 930-8017. SAN ANTONIO: Beautiful fast-growing area, exceptional practice with five operatories. Ten-year-old practice, doctor motivated to sell. Earns a seven-figure gross on 4-day week. Excellent opportunity for younger dentist to make his or her mark. Call DDR Practice Sales at (800) 930-8017. SAN ANGELO, ABILENE: Associates — outstanding earnings. Historically proven at over twice the national averTexas Dental Journal l www.tda.org l April 2011

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age for general dentists; future potential even greater. Thriving, established practice in great location. Bright and spacious facility. Experienced, efficient, loyal staff. Best of all worlds; big city, earnings, small-town easy lifestyle, outstanding outdoor recreation. Contact Dr. John Goodman at john@goodman.net or (325) 277-7774. ASSOCIATE DENTIST NEEDED IN EULESS: Well-established general practice seeking full-time associate/future partner. Cosmetic and full family practice. Please send resume to wendy.tcd@ sbcglobal.net. ESTABLISHED, SUCCESSFUL GENERAL PRACTICE AVAILABLE FOR OWNERSHIP with no personal financial investment. Niche market limited to removable prosthetics and related services. Guaranteed minimum salary plus unlimited potential from net profits. Full benefits package. Onsite lab. Monday through Friday, 8 a.m. to 5 p.m. Professional gratification, personal rewards. Email michele.cooke@affordablecare.com. KATY: Dr. Bui X. Dinh, D.D.S., M.S. is looking for a dentist right now with minimum 2 years experience. Please contact office manager Michelle, (832) 620-6982 or fax resume to (281) 579-6045. FOR SALE SALE — — GREAT GREAT41-YEAR 41-YEARSUCSUCCESSFUL CESSFUL PRACTICE PRACTICEIN INSOUTH SOUTHCENCENTRAL TRAL TEXAS. TEXAS. Owner Ownerretiring retiringbut butwill willstay stay through through transition transition period. period. Five operatories Five in beautiful building, Pan-O, digitalPanX-ray. operatories in beautiful building, Experienced long-term dependable staff. O, digital X-ray. Experienced long-term Room for multiple dentists. mail dependable staff. Room forPlease multiple denletter of interest Box 1, 1946 IH tists. Please mailtoletter ofTDA, interest toS. Box 35, Ste. 400, TX Ste. 78704. 1, TDA, 1946Austin, S. IH 35, 400, Austin, TX 78704. SEEKING ASSOCIATE: Established general dental office in Brownsville SEEKING ASSOCIATE: Established(30 minutes away from Padre Island) general dental officeSouth in Brownsville (30 is seekingaway a caring, energetic associate. minutes from South Padre Island) We are a busy officeenergetic providingassociate. dental is seeking a caring, care foramostly children. Our knowlWe are busy office providing dental edgeable staff will support and enhance care for mostly children. Our knowlgrowth and earning potential edgeable staff will support andallowing enhance

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the associate to focus on patient dental growth and earning potential allowing care. Interested should call the associate to candidates focus on patient dental (956) 546-8397. candidates should call care. Interested (956) 546-8397. NEW, TYLER: Excellent opportunity, location, and lifestyle. Join an estabNEW, TYLER: Excellent opportunity, lished doctor share a 2-year-old, location, and and lifestyle. Join an estabfree-standing, award-winning building lished doctor and share a 2-year-old, on busy south award-winning Tyler Street. Five of 10 free-standing, building ops and private officeStreet. available. on busy south Tyler Five Share of 10 reception, lab, and sterilization. Equity ops and private office available. Share position inlab, property available or Equity lease. Ereception, and sterilization. mail dburrow@suddenlinkmail.com. position in property available or lease. Email dburrow@suddenlinkmail.com. TEMPLE DENTAL CENTER IN TEMPLE IS FOR SALE: Doctor changing profesTEMPLE DENTAL CENTER IN TEMPLE sions. Four operatories, tons of IS FORFiresale! SALE: Doctor changing profesequipment and Four instruments, three wallof sions. Firesale! operatories, tons X-rays (filmand justinstruments, needs sensors to conequipment three wall vert), (also easily converted) VeX-raysPanorex (film just needs sensors to conlopex processor. Calleasily (254)converted) 791-0977 Veand vert), Panorex (also leave doctorbrown80@ lopex message. processor.E-mail Call (254) 791-0977 and hotmail.com. leave message. E-mail doctorbrown80@ hotmail.com. SAN ANTONIO NORTH WEST: Associate Established general Associdental SANneeded. ANTONIO NORTH WEST: practice seeking quality oriented asate needed. Established general dental sociate. graduate and experienced practice New seeking quality oriented asdentists welcome. GPR,and AEGD preferred. sociate. New graduate experienced Please contact Dr. GPR, HenryAEGD Chu at (210) dentists welcome. preferred. 684-8033 or versed010l@yahoo.com. Please contact Dr. Henry Chu at (210) 684-8033 or versed010l@yahoo.com. GREAT PRACTICE IN BEAUTIFUL EAST TEXAS. This fee-for-service GREAT PRACTICE IN BEAUTIFUL practice was established by a prominent EAST TEXAS. This fee-for-service community-involved dentist an practice was established by awith prominent excellent reputation for quality care. community-involved dentist with an The office hasreputation 1,300 sq. ft. fourcare. availexcellent forwith quality The able largeavailprivate officetreatment has 1,300rooms sq. ft.and withafour office. Don’t miss the opportunity to beable treatment rooms and a large private come of miss this stable economic to town office.part Don’t the opportunity bewith experienced staffeconomic and a growing comean part of this stable town patient Interested? 562with an base. experienced staff Call and (972) a growing 1072 or base. e-mailInterested? sherri@slhdentalsales.com. patient Call (972) 5621072 or e-mail sherri@slhdentalsales. EXPERIENCED DENTISTS ARE com. NEEDED FOR TWO PRIVATE GROUP EXPERIENCED DENTISTS ARE AND PRACTICES LOCATED IN KATY NEEDED General FOR TWO PRIVATE GROUP SPRING. dentistry practice with PRACTICES IN atmosphere KATY AND a comfortableLOCATED and friendly SPRING.administrative General dentistry practice with without responsibilities. a comfortable andposition friendly with atmosphere Fullor part-time competiwithout administrative responsibilities. tive compensation, benefits, and flex-


ible schedule. Fullor part-time Great position opportunity with competifor a tive compensation, quality oriented person. benefits, Please and call flexDr. ible schedule. Akerman at (832) Great 934-2044 opportunity or e-mail for a quality oriented person. Please call Dr. yourhappydentist@aol.com. Akerman at (832) 934-2044 or e-mail yourhappydentist@aol.com. TEXAS — PEDIATRIC DENTAL ASSOCIATE NEEDED. Fast-growing pediatric TEXASpractice dental — PEDIATRIC is looking DENTAL for a pediatric ASSOCIATE NEEDED. dentist to join ourFast-growing team. We arepediatric located dentalof practice is looking pediatric north San Antonio just for 10 aminutes dentist from New to Braunfels join our team. and We 45 minutes are , located northAustin. from of San Antonio We offer just a generous 10 minutes comfrom New Braunfels pensation package including and 45 minutes paid time from Austin. We offer a generous comoff and holidays. Experience is a plus, pensation package including paidPlease time but new graduates are welcome. off and holidays. a plus, respond via e-mailExperience to Sherri atisvelezluke@ but new graduates yahoo.com or by faxare (210) welcome. 659-9436. Please respond via e-mail to Sherri at velezluke@ yahoo.com or by NEEDED fax (210) 659-9436. ENDODONTIST TO JOIN WITH HOUSTON PERIODONTIST. FullENDODONTIST NEEDED TO JOIN or part-time. Brand new state-of-theWITH HOUSTON PERIODONTIST. Fullart office. Associateship with possible or part-time. Ideal Brand state-of-thepartnership. fornew primary or second art office. Associateship with by possible office. Please initiate contact fax to partnership. (713) 795-5514. Ideal for primary or second office. Please initiate contact by fax to (713) 795-5514. AMARILLO: SEEKING FULL-TIME DENTIST TO WORK IN STATE CORRECAMARILLO: SEEKING FULL-TIME TIONAL SETTING. We offer a flexible DENTIST TO WORK IN STATE CORwork schedule, excellent state benefits, RECTIONAL SETTING. We offer a salary retirement, and a very competitive flexible work schedule, excellentfaced state without the financial challenges benefits, and a very competiin privateretirement, practice. Contact the dental tive salary the financial chaldirector at without (806) 381-7080 x 8301, e-mail lenges faced in private practice. at mack.hughes@ttuhsc.edu, or Contact visit the job the site dental at http://jobs.texastech.edu. director at (806) 381-7080 x 8301, e-mail at mack.hughes@ttuhsc. EAST edu, orTEXAS visit the GENERAL job site atPRACTICE http://jobs. texastech.edu. NEEDS ASSOCIATE TO TRANSITION TO OWNER/PARTNER, buyout to fit EAST TEXAS GENERAL PRACTICE situation. Thirty-five-year-old practice NEEDS ASSOCIATE TRANSITION in dynamic northeast TO Texas hub city, centrally TO OWNER/PARTNER, located and easily buyout accessible to fit situation. Thirty-five-year-old practice Dallas, Shreveport, and Arkansas. Great for in dynamic fishing, hunting, northeastand Texas all outdoor hub city, accentrallyPractice locatedisand tivities. in aeasily 2,300accessible sq. ft. office Dallas, Shreveport, and Arkansas. Great (owned) in a professional building across from for fishing, the regional hunting, hospital. and allFour outdoor ops, two hygienists provide days/ activities. Practice is in6ahygiene 2,300 sq. ft. week. Softdentinand Kodak digital X-rays office (owned) a professional building including across from Pano. the Good regional patient hospital. base Four and excellent staff to stay. Doctor ops, two hygienists provide 6 moving hygiene closer to grandkids. 572-4141. days/week. SoftdentCall and(903) Kodak digital

X-rays including Pano.CARE Good is patient LONESTAR ON-SITE seeking a base and excellent staff stay. practice. Doctor caring dentist to join ourtogroup moving closerhave to grandkids. We currently a PT (2-3 Call days)(903) oppor572-4141. tunity available in the Houston, Texas, area. We offer a competitive salary. Paid LONESTAR insurance, ON-SITE CARE is seeking malpractice a flexible sched-a caring to join our grouppatient practice. ule (nodentist weekends), established We currently havesupplies, a PT (2-3and days) opporbase, equipment, complete tunitysupport available in the Houston, Texas, office provided. If interested in area.opportunity, We offer a competitive Paid this please call salary. Maria toll malpractice a flexible schedfree at (877) insurance, 724-4410 or e-mail caring@ ule (no weekends), established patient healthdrive.com. base, equipment, supplies, and complete office support provided. If interested in EXCITING OPPORTUNITY FOR TEXAS this opportunity, please callgeneral Maria toll DENTISTS. We are seeking denfree at 724-4410 or e-mail caring@ tists for(877) our future locations in Lubbock, healthdrive.com. Abilene, Midland, and Odessa. Full- or part-time available. Exceptional salary EXCITING FOR TEXAS plus bonus.OPPORTUNITY Health insurance available. DENTISTS. We are seeking general This is an immediate opportunity to dentists for our future locations inaLubbock, perform quality dentistry with helpful Abilene, Midland, Odessa. Fullor and energetic staff.and Please e-mail your part-time available. Exceptional salary CV resume to erik.pierson@mydcdental. plus and bonus. insurance com joinHealth our team today. available. This is an immediate opportunity to perform qualityMOUNTAIN dentistry with a helpful NEW MEXICO RESORT and energetic staff. Please e-mail OPPORTUNITY. Tired of the fast your pace? CV resume erik.pierson@mydcdental. Join me andtowork 2-3 days/week. Great com andbase joinwith our team today. patient good attitudes because they love living in this beautiful place. NEW MEXICO MOUNTAINX-ray RESORT Modern equipment/digital and OPPORTUNITY. Tiredmild of the fast pace? Pano. Cool summers, winters, six Joincourses, me and work 2-3 hiking, days/week. Great golf hunting, skiing, patientracing, base with because horse arts,good and attitudes culture theater. they loveorliving in thisMust beautiful place. General specialist. be dedicated Modern equipment/digital X-ray and to good patient care and have outgoing Pano. Cool summers, mildto winters, six personality. Send resume Dr. John golf courses, hunting, hiking, skiing, Bennett at 200 Sudderth Dr. #C, Ruidohorse and culture theater. so, NMracing, 88345;arts, FAX: (575) 257-5170; or Generaljnbennett@windstream.net. or specialist. Must be dedicated e-mail: to good patient care and have outgoing personality. Send resume to Dr. John AUSTIN AREA: Well-established, busy Bennettdental at 200practice Sudderth Dr. #C, general located 45Ruidomiles so, NM 88345; FAX: seeks (575) part-time 257-5170;genor southeast of Austin e-mail: jnbennett@windstream.net. eral or pediatric dentist. Fax resume to (830) 875-2212. AUSTIN AREA: Well-established, busy general dental practice located 45 miles DALLAS / FORT WORTH: Dental One southeast Austin seeks part-time is opening of new offices in the upscalegeneral or pediatric dentist. FaxWorth. resume to suburbs of Dallas and Fort Den(830) 875-2212. tal One is unique in that each office of our 60 offices has its own, individual name such as Riverchase Dental Care Texas Dental Journal l www.tda.org l April 2011

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and Preston Hollow Dental Care. All our PEDIATRIC DENTAL ASSOCIATE offices haveExcellent top-of-the-line Pelton for anda NEEDED. opportunity Crane equipment, X-rays, and inpediatric dentist todigital join our well-estabtra-oral cameras.practice We are 70 percent PPO, lished pediatric in San Marcos. 30 percent fullyour fee. We take no Please e-mail resume to managed care or Medicaid. We offer competitive jsalinas74@grandecom.net. salaries and benefits. To learn more about working for Dental One, please HOUSTON: Pediatric dental office seekcontact Rich pediatric Nicely at (972) 755-0836. ing full-time dentist. Associate with buy-in/partner opportunity. FastHOUSTON DENTAL ONE is opening growing office looking to expand. Please new offices incvanalfen@yahoo.com. the upscale suburbs of e-mail CV to Houston. Dental One is unique in that each office of DENTIST our 50+ offices has its ASSOCIATE NEEDED INown individual name. Well-established All our offices have topSOUTH TEXAS. general of-the-line Peltonfull-time and Crane equipment, practice seeking associate to digital X-rays, and of intra-oral cameras. meet the demands a growing practice. We are 100 percentand FFS with some PPO Excellent benefits location. Great plans. offer competitive benearningWe potential. Interestedsalaries, candidates efits, and opportunities. To should callequity (956) buy-in 655-8295 and/or e-mail learn more aboutto working for Dental One, or send resumes vickypad@yahoo.com. please call Andy Davis at (713) 343-0888. OFFICE SPACE PEDIATRIC DENTAL ASSOCIATE NEEDED. Excellent opportunity for a SPACE AVAILABLE FOR SPECIALIST. pediatric dentist to join our well-estabNew professional building located southlished practice in San between Marcos. west ofpediatric Fort Worth in Granbury Please e-mail your resume elementary and junior high to schools off of jsalinas74@grandecom.net. a state highway with high visibility and traffic. Call (817) 326-4098. HOUSTON: Pediatric dental office seeking full-time pediatric dentist. Associate ORTHODONTIST NEEDED NEXT TO with buy-in/partner opportunity. FastDENTIST IN HIGH GROWTH, HIGH growing office looking to expand. Please TRAFFIC AREA IN ROUND ROCK, e-mailof CV to cvanalfen@yahoo.com. north Austin in one of the fastestgrowing counties. Available at $155/sq. ASSOCIATE DENTIST NEEDED IN ft. For more information, e-mail john@ SOUTH TEXAS. Well-established general herronpartners.com or call (512) 457practice 8206. seeking full-time associate to meet the demands of a growing practice. Excellent benefits andSQ. location. Great SHERMAN — 1,750 FT. DENTAL earning candidates OFFICE.potential. BuildingInterested has established genshould call (956) 655-8295 and/or e-mail eral dentist and perio/implant dentist. or send resumes to vickypad@yahoo.com. Plumbed and ready to go. High traffic and visibility with lots of parking. OFFICE ShermanSPACE is beautiful and growing town 50 miles north of Dallas and near Lake SPACE FOR SPECIALIST. Texoma,AVAILABLE the second largest lake in TexNew building located arts southas. Itprofessional has great schools, a vibrant west of Fort Worth Granbury between community, and is in home to many, many elementary junior high schools off of Fortune 500and companies such as Texas a state highway high visibility Instruments andwith Tyson Foods. Call and (760) traffic. Call (817) 326-4098. 436-0446.

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ALLEN: Prior dental, high end practice ORTHODONTIST NEEDED NEXT TO that relocated. Five GROWTH, plumbed and ready DENTIST IN HIGH HIGH ops, reception, conference, two TRAFFIC AREAoffice, IN ROUND ROCK, north bath, some cabinets, no equipof Austin in built-in one of the fastest-growing ment. High traffic visibility withft. lots counties. Available at $155/sq. For of parking. Affluente-mail residential, across more information, john@herronthe street from grocer. Offering partners.com orlarge call (512) 457-8206. 5-7 years lease plus extensions. Levin Realty, (323) SHERMAN —954-1934, 1,750 SQ.levinrealty@ FT. DENTAL sbcglobal.net. OFFICE. Building has established general dentist and perio/implant dentist. INGLESIDE FORand Plumbed andDENTAL ready to BUILDING go. High traffic SALE! 1,700 two chairs plumbed. visibility with sq. lotsft., of parking. Sherman Rental side,and neargrowing Corpustown Christ!. Busy is beautiful 50 miles main street location. Vacant, equipnorth of Dallas and near Lake no Texoma, ment. Landscaping, parking, owner/ the second largest lake in Texas. It has dentist, $115,900. Greatarts opportunity! great schools, a vibrant community, Photographs available. E-mail mbtex@ and is home to many, many Fortune 500 aol.com or call 480-2236. companies such(702) as Texas Instruments and Tyson Foods. Call (760) 436-0446. ARLINGTON DENTAL OFFICE FOR LEASE: Prior Current doctor is only using 1 ALLEN: dental, high end practice day arelocated. week. Has four up-to-date that Five plumbed andoperaready toriesreception, with HD TVs in conference, each op, assistant ops, office, two computer, computer, edubath, somedoctor built-in cabinets,Casey no equipcational system, X-rays, ment. High trafficdigital visibility withdigital lots panoramic electric handpiece, of parking. machine, Affluent residential, across sterilization room, laboratory, and Cerec the street from large grocer. Offering CAD/CAM technology. Perfect forLevin new 5-7 years lease plus extensions. practice(323) start954-1934, up. Visit our website to Realty, levinrealty@ view our office. Contact (817) 274-8667, sbcglobal.net. info@docdds.com, www.docdds.com. INGLESIDE DENTAL BUILDING FOR THE BEST FACILITY INchairs TOWNplumbed. CAN BE SALE! 1,700 sq. ft., two YOURS. We near buildCorpus free-standing Rental side, Christi.dental Busy officesstreet throughout theVacant, state ofno Texas. main location. equipOne-hundred percent financing is availment. Landscaping, parking, owner/ able. Each facility is custom designed to dentist, $115,900. Great opportunity! your specifications by nationally acPhotographs available. E-mail mbtex@ claimed or Fazio aol.com callArchitects. (702) 480-2236. THROUGHOUT TEXAS: Why lease ARLINGTON DENTAL OFFICE FOR when owning a building provides so 1 LEASE: Current doctor is only using many incredible Past day a week. Has advantages? four up-to-date operaclientswith tell us a custom faciltories HDbuilding TVs in each op, assistant ity for theirdoctor practice was easily the edubest computer, computer, Casey decision system, of their career. I’d be happy cational digital X-rays, digitalto put you in touch withelectric them to hear of panoramic machine, handpiece, their experiences We’ve helped sterilization room,directly. laboratory, and Cerec more than 800 of your fellow CAD/CAM technology. Perfectdentists for new achieve their during the pastto20 practice start dream up. Visit our website years... look forward to using that view ourAnd office. Contact (817) 274-8667, experience to assistwww.docdds.com. you. Check us out info@docdds.com,


at fazioarchitects.com. Then, giveCAN me aBE THE BEST FACILITY IN TOWN call at (512) 494-0643. Or e-maildental jim@ YOURS. We build free-standing fazioarchitects.com. offices throughout the state of Texas. One-hundred percent financing is availROUND ROCK: Property sitedesigned availableto able. Each facility is custom for dental/medical on Gattis your specifications facility by nationally acSchool Road the area’s new high claimed Fazionear Architects. school. Excellent frontage with more than 25,000 carsTEXAS: passingWhy by daily. THROUGHOUT lease Demographics this area are through when owning afor building provides so the roof. Call Jimadvantages? at (512) 494-0643 many incredible Past or e-mail jim@fazioarchitects.com. clients tell us building a custom facility for their practice was easily the best ROUND ROCK OLD SETTLERS decision of their— career. I’d be happy to DENTAL pad sites availput you inPARK: touch Three with them to hear of able. experiences Thriving two-doctor practheir directly. general We’ve helped tice already onsite. Good frontage and more than 800 of your fellow dentists traffic on four-lane High achieve their dreamroad. during thegrowth past 20 area hasAnd shortage of specialty dentists. years... look forward to using that Call Jim at to (512) 494-0643 or e-mail experience assist you. Check us out jim@fazioarchitects.com. at fazioarchitects.com. Then, give me a call at (512) 494-0643. Or e-mail jim@ AUSTIN — MCNEIL DRIVE DENTAL fazioarchitects.com. PARK: Successful general dentist with established practice has two sites ROUND ROCK: Property site pad available available. Beautifulfacility woodedonarea with for dental/medical Gattis great traffic School Roadvolumes. near the Once area’syou newtour highthis office, you will want to build next door. school. Excellent frontage with more Call Jim at (512) e-mail than 25,000 cars 494-0643 passing byordaily. jim@fazioarchitects.com. Demographics for this area are through the roof. Call Jim at (512) 494-0643 or WHITNEY: Free-standing vacant e-mail jim@fazioarchitects.com. building for sale. Perfect location, 6 miles from the lake for SETTLERS any specialty ROUND ROCK — OLD start-up. PARK: Location nearpad hospital comDENTAL Three sites availplex, Thriving 2,600 sq.two-doctor ft., no equipment, four able. general pracbathrooms, privateGood office,frontage built 1978. tice already onsite. and Pictures available. For more infortraffic onare four-lane road. High growth mation (972) 562-1072 ordentists. e-mail area hascall shortage of specialty sherri@slhdentalsales.com Call Jim at (512) 494-0643 or e-mail jim@fazioarchitects.com. PLAINVIEW, TEXAS, COULD USE TWO NEW For sale — fully AUSTIN — DENTISTS. MCNEIL DRIVE DENTAL equipped free-standing, high visibilPARK: Successful general dentist with ity dental office. Excellent opportunity established practice has two pad sites for right person. Contact Dr.area J. Irvin available. Beautiful wooded with Gaynor, jigaynor@suddenlink.net or this great traffic volumes. Once you tour (806) 292-3156. office, you will want to build next door. Call Jim at (512) 494-0643 or e-mail HIT THE GROUND RUNNING IN jim@fazioarchitects.com. THRIVING CITY OF FLOWER MOUND. Beautiful adorned dental office, five operatories. Plumbed chairs, state-of-

the-art equipment. Rent below market. WHITNEY: Free-standing vacant A really great opportunity for a beginbuilding for sale. Perfect location, 6 ner or from a seasoned practitioner. Landlord miles the lake for any specialty supportedLocation and onsite. This is a oncestart-up. near hospital comin-a-lifetime opportunity where youfour plex, 2,600 sq. ft., no equipment, can move in private immediately a beautiful bathrooms, office,inbuilt 1978. and well-appointed office the Pictures are available. Forsitting more on inforcreek with abundance. Please mation callwindows (972) 562-1072 or e-mail contact Nick at (972) 899-9992 or (972) sherri@slhdentalsales.com 899-6412. PLAINVIEW, TEXAS, COULD USE FOR SALE TWO NEW DENTISTS. For sale — fully equipped free-standing, high visibility denLARGE OF QUALITY tal office.INVENTORY Excellent opportunity for right REFURBISHED AIR DENTAL person. Contact Dr. J. DRIVEN Irvin Gaynor, jiHANDPIECES. All haveorbeen gaynor@suddenlink.net (806)repaired 292-3156. and tested by a qualified technician. All haveTHE new GROUND ceramic bearing turbines and HIT RUNNING IN THRIVall are fiberoptic. For sale — Star Beauti430 ING CITY OF FLOWER MOUND. SWL, $269; dental Kavo 640B, ful adorned office,$279; five operatories. Kavo 642B, $299; Kavo 647B, $299; Plumbed chairs, state-of-the-art equipMidwest Tradition push button or great lever, ment. Rent below market. A really $239; new Kavo coupler fiveopportunity for amulti-flex beginner or a seasoned hole, $249; new Kavo coupler six-hole, practitioner. Landlord supported and $149; new five-hole, $145. onsite. ThisStar is a coupler once-in-a-lifetime opSlow speed and implant portunity where you can handpieces move in immeavailable, Qualityand discounts are posdiately in atoo. beautiful well-appointed sible. sitting I have been TDA member for 25 office on thea creek with windows years. If what you are looking foratis(972) not abundance. Please contact Nick on this list, stock a wide variety at 899-9992 orwe (972) 899-6412. wonderful prices, just inquire. Call (877) 863-4848 FOR SALEor visit our website www. truespindental.com. LARGE INVENTORY OF QUALITY INTERIM SERVICES REFURBISHED AIR DRIVEN DENTAL HANDPIECES. All have been repaired TEMPORARY COVERand tested by aPROFESSIONAL qualified technician. All AGE (Locum Tenens): Let turbines one of our have new ceramic bearing and distinguished docs keep overhead all are fiberoptic. For saleyour — Star 430 covered, your revenue-flow open wide, SWL, $269; Kavo 640B, $279; your staff busy, your patients Kavo 642B, $299; Kavo 647B, treated $299; and booked for recall, allbutton for a flat Midwest Tradition push or daily lever, rate not a percent of production. Na$239; new Kavo multi-flex coupler fivetion’s $249; largest, most distinguished team. hole, new Kavo coupler six-hole, Short-notice coverage, $149; new Star couplerpersonal, five-hole,mater$145. nity, and disability leaveshandpieces our specialty. Slow speed and implant Free, no obligation quotes. Absolute available, too. Quality discounts are conposfidentiality. integrity sincefor 1996. sible. I haveTrusted been a TDA member 25 Some of regularfor partyears. If our whatteam you seek are looking is not time, permanent, or buy-in on this list, we stock a wide opportunivariety at ties. Always seeking new dentists join wonderful prices, just inquire. Callto(877) the team. Bread procedures. 863-4848 or visitand ourbutter website www. No cost, strings, or obligations — ever! truespindental.com. Texas Dental Journal l www.tda.org l April 2011

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Work only SERVICES when you wish. Name your INTERIM fee. Join online at www.doctorsperdiem. TEMPORARY PROFESSIONAL COVERcom. Phone: (800) 600-0963; e-mail: AGE (Locum Tenens): Let one of our docs@doctorsperdiem.com. distinguished docs keep your overhead covered, revenue-flow open wide, OFFICE your COVERAGE for vacations, your staff busy, patients maternity leave, your illness. Protecttreated your and booked recall,Forest all for Irons a flat and daily practice andfor income. rate not a percent of production. NaAssociates, (800) 433-2603 (EST). Web: tion’s largest, most distinguished team. www.forestirons.com. “Dentists Helping Short-notice coverage, Dentists Since 1983.” personal, maternity, and disability leaves our specialty. Free, no obligation quotes. Absolute conMISCELLANEOUS fidentiality. Trusted integrity since 1996. Some of our seek regular partLOOKING TOteam HIRE A TRAINED DENtime, permanent, or buy-in opportuniTAL ASSISTANT? We have dental assisties. seeking new dentistsintoDallas join tantsAlways graduating every 3 months the Bread procedures. and team. Houston. To and hire butter or to host a 32No cost, strings, please or obligations ever! hour externship, call the — National Work when Assisting you wish.atName Schoolonly of Dental (800)your 383fee. Join online at www.doctorsperdiem. com. Phone: (800) 600-0963; e-mail: docs@doctorsperdiem.com.

3408; Web: www.schoolofdentalassistingOFFICE COVERAGE for vacations, northdallas.com. maternity leave, illness. Protect your practice and income. Forest Irons and DENTAL OFFICE needed to(EST). lease 12 Associates, (800) 433-2603 Web: hours per week for Dental Assisting www.forestirons.com. “Dentists Helping School. are during ofDentistsClass Sincehours 1983.” fice downtime one weekend day and one weekday evening. Lease payment MISCELLANEOUS to office is $500 to $1,500 per month, LOOKING HIRE A TRAINED DENdepending TO on enrollment. Seeking locaTAL WeAntonio, have dental tionsASSISTANT? in Dallas, San and assisHoustants graduating every 3 months in Dallas ton. Please call the National School of and Houston. To hire or to509-2864. host a 32Dental Assisting at (800) hour externship, please call the National School of Dental Assisting (800) 383THE NATIONAL SCHOOLatOF DENTAL 3408; Web: www.schoolofdentalassistingASSISTING — NORTH DALLAS offers northdallas.com. the Texas RDA course and exam. Call (800) 383-3408 for available dates. DENTAL OFFICE needed to lease 12 hours per week for Dental Assisting School. Class hours are during office downtime one weekend day and one weekday evening. Lease payment

DOCTORS PER DIEM INC

TEMPORARY Doctors PerCOVERAGE Diem pu Feb p 244 join the team or post a job online, no charge see profiles of our providers or heck....just pick up the phone

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to office is $500 to $1,500 per month, DOCTORSCHOICEGOLDEXCHANGE. depending on enrollment. locaCOM: Try our high prices Seeking for dental tions Dallas, San24 Antonio, and Housscrap.inCheck sent hours after you ton. Please the National of approve ourcall quote. See why School we have Dental Assisting at (800) 509-2864. so many repeat customers. Visit www. DoctorsChoiceGoldExchange.com. THE NATIONAL SCHOOL OF DENTAL ASSISTING — HANDPIECE NORTH DALLAS offers THE DENTAL REPAIR the Texas course and exam.you Call GUY, LLC.RDA I’m pleased to inform (800) 383-3408 available dates. that we are now for operating a full-service handpiece repair shop in Friendswood, DOCTORSCHOICEGOLDEXCHANGE. Texas, where my father Dr. Ronald COM: prices for Groba Try has our beenhigh practicing for dental over 35 scrap. sent doing 24 hours after you years. ICheck have been his handpieces approve ouryears quote. See why we for over 20 and decided to have proso many repeat customers. Visit www. vide this service to other dentists. First DoctorsChoiceGoldExchange.com. and foremost, we provide expert service for your precision instruments and are THE DENTAL HANDPIECE REPAIR qualified to service nearly every make GUY, LLC. I’m pleased to inform you that we are now operating a full-service handpiece repair shop in Friendswood,

Thomas John Kennedy pu March p 337

Texas, where my father Dr. Ronald and model of high-speed, low-speed, Groba has been practicing 35 and electric handpieces on for theover market. years. have been doing hisless handpieces We useI quality parts, take time, for years decided to pro-free andover our 20 costs areand lower. We provide vide thisand service to other dentists.and First pickup delivery, warranties, and foremost, weon provide expert service next-day service most high-speed for your precision are units and a 1-weekinstruments turnaroundand for slow qualified to service sealers, nearly every make speeds, ultrasonic and electrics. and model of high-speed, low-speed, The Dental Handpiece Repair Guy wants and handpieces on the facility market.of to beelectric your handpiece servicing We use We quality parts, take less time, to choice. would appreciate a chance and costs are lower. provide free earnour your business! Call We (800) 569-5245 pickup and website, delivery,www.thedentalwarranties, and or visit our next-day service on most high-speed handpiecerepairguy.com. units and a 1-week turnaround for slow speeds, ultrasonic sealers, and electrics. The Dental Handpiece Repair Guy wants to be your handpiece servicing facility of choice. We would appreciate a chance to earn your business! Call (800) 569-5245 or visit our website, www.thedentalhandpiecerepairguy.com.

AJ Riggins pu March p 337

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Advertisers Academy of General Dentistry .............................355 ADS Watson, Brown & Associates ......................349 AFTCO ....................................................................372

Your Patients Trust You. Who can YOU Trust?

A.J. Riggins Co ......................................................405 Anesthesia Education and Safety

Foundation ..........................................................368

DDR Dental Trust ...................................................374 Dental Systems......................................................369 Doctors Per Diem ..................................................404

The Professional Recovery Network (PRN) addresses personal needs involving counseling services for dentists, hygienists, dental students and hygiene students with alcohol or chemical dependency, or any other mental or emotional difficulties. We provide impaired dental profesprofes sionals with the support and means to confidenconfiden tial recovery. If you or another dental professional are concon cerned about a possible impairment, call the Professional Recovery Network and start the recovery process today. If you call to get help for someone in need, your name and location will not be divulged. The Professional Recovery Network staff will ask for your name and phone numbers so we may obtain more information and let you know that something is being done.

Fortress Insurance ................................................377

Gary Clinton, PMA .................................................362 Hanna, Mark — Attn. at Law .................................375 Henderson, Sherri L. & Associates......................353 Hindley Group........................................................374 JKJ Pathology........................................................371 Kennedy, Thomas John, D.D.S., P.L.L.C..............405 Knight Dental Group .............................................381 MK Michaelangelo Studio .....................................361 Ocean Dental..........................................................380

OSHA Review............................... Inside Back Cover Paragon ..................................................................378

Patterson Dental ..........................Inside Front Cover Portable Anesthesia Services ..............................379 Professional Solutions..........................................354 Professional Recovery Network...........................360 Robertson, James M .............................................369 Shepherd, Boyd W.................................................371

Statewide Toll-free Helpline 800-727-5152 Emergency 24-hour Cell: 512-496-7247

Southern Dental Associates.................................351

SPDDS ....................................................................375

Stern Empire ......................................................Insert TDA Express ..........................................................373 TDA Financial Services Insurance

Program..........................................346/Back Cover

Professional Recovery Network 12007 Research Blvd. Suite 201 Austin, TX 78759 www.rxpert.org

TDA Perks Program...............................................347 Texas Health Steps................................................343

Texas Medical Insurance Company .....................356 TEXAS Meeting ......................................................346

USA Civilian Dental Corps....................................379 UTHSCSA ...............................................................372 UTHSCSA Oral & Maxillofacial Lab......................369

Waller, Joe..............................................................373

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Join us on Facebook, Twitter and LinkedIn! The Texas Dental Association has created groups on Facebook, Twitter and LinkedIn. The goal of these groups is to provide updates on events and current issues. If you do not have a Facebook or LinkedIn account, you can set one up in minutes! Questions? Contact Stefanie Clegg, TDA web & new media manager at (512) 443-3675 or stefanie@tda.org

Join us on facebook.com/texasdental or groups.to/texasdental Follow us on twitter.com/theTDA Get LinkedIN at linkedin.com, search “Texas Dental Association�


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