TDA Today - July 2014

JULY 2014

CONTENTS

VOLUME 15, ISSUE 7

AVAILABLE ON TDA.ORG

TSBDE Rule Update

This recurring section is designed to help TDA members keep up with important Texas State Board of Dental Examiners (TSBDE) rules, other regulations, and state law affecting their practices.

• President’s Post

• Member Spotlight

- Jerry J. Hopson, DDS, Bonham

• DENPAC • TDA Perks • Alliance of the TDA • TDA Smiles Foundation • Meet Your Staff

- Donna Cortez, Program Manager

July Texas Dental Journal Differences between reported and actual restored caries lesion depths: Results from The Dental PBRN Immediate dentures in an HIV positive patient

Around the State

August 1-2 Dentists Who Care Conference South Padre Island August 1-2 Texas Mission of Mercy Williamson County August 8 Texas State Board of Dental Examiners Austin

TSBDE Adopts New Rules The Texas State Board of Dental Examiners (TSBDE) recently published 2 new rules and 2 rule changes, all with an effective date of June 11, 2014.

Dental Treatment of Sleep Disorders The new rule authorizes dentists to screen dental patients for identification of benign snoring and obstructive sleep apnea (OSA) and to identify contraindications of dental treatment of benign snoring and obstructive sleep apnea. Screening tools include validated objective measures and subjective measures such as home sleep tests. However, if the dentist orders a sleep study (eg, polysomnography), the results must be interpreted by a Texas licensed physician. If the patient’s screening results indicate OSA, the dentist must refer the patient to a Texaslicensed physician to confirm or rule out OSA. The rule prohibits dentists from diagnosing or ruling out OSA. Dentists may not treat or monitor OSA without collaborating with a Texas-licensed physician. This means that dentists may only fabricate an oral appliance to treat OSA under the prescription of a physician and that the physician must perform all clinical follow-up and further treatment decisions for patients with OSA. This protocol does not prevent dentists from independently diagnosing, treating, and monitoring any dental comorbidity related to OSA. Dental comorbidities include periodontal disease, bruxism, and temporomandibular joint disorders.

The rule does allow dentists to independently treat and monitor benign snoring with an oral appliance as long as no apneic episodes are discovered and the dentist considered referral to

a Texas-licensed physician in accordance with the standard of care. Oral appliances must be fabricated by a Texas-licensed dentist or under the prescription of the dentist. Yearly, treating dentists must adequately monitor the orthotics, stability and health of occlusion and orofacial musculoskeletal system.

Dentists wishing to treat or monitor benign snoring or OSA must complete 12 hours of minimum basic education, a combination of didactic and clinical, in sleep-disordered breathing for the first year, with 3 hours of continuing education in sleep-disordered breathing for each subsequent year that the dentist treats or monitors benign snoring or OSA. Treating dentists must comply with the Dental Practice Act and board rules including provisions relating to records, standard of care, and business promotion.

Pediatric and Special Needs Case Management and Protective Stabilization The new rule defines the scope of practice by a dentist in the treatment of pediatric and special needs patients. The new rule is based upon the “Guideline on Protective Stabilization for Pediatric Dental Patients” published by the American Academy of Pediatric Dentistry.

The goals of patient management are, in part, to establish communication, alleviate fear and anxiety, and deliver quality dental care. Depending upon the situation, patient management may need to include protective stabilization.

Protective stabilization is an advanced behavior guidance technique in dentistry using any manual method, physical

TDA Holds Leadership Conference More than 70 representatives attended the TDA Leadership Conference on Friday, June 13, 2014, in Austin. TDA President Dr David H. McCarley facilitated the 1-day conference, hosted

by TDA Financial Services, Inc. (TDA Perks).

August 9 TDA Board of Directors meeting Austin August 22 South Central States Meeting Dallas

The conference combined meetings of the TDA New Board Members Orientation, TDA Component Executive Directors, TDA Component Presidents Committee, and TDA Council/ Committee Training.

August 23-24 ADA 15th Trustee District Delegation Dallas

Using your smart phone, scan this QR code to access the TDA Today on TDA.org.

Continued on page 4

Component society executives met with Jeanine Pekkarinen, manager of ADA Membership Recruitment, Retention and Outreach, at the TDA Component Executive Directors meeting at the TDA Leadership Conference in June 2014 in Austin. Pictured are (L-R) Pekkarinen, 10th District ED Nancy Nisbett of Austin, 20th District ED Linda Shafer of San Antonio, 3rd District ED Tiffany Groothuis of Tyler, and 5th District ED Jane Evans of Dallas.

presentation, conference attendees donated approximately $5,000 to DENPAC.

Attendees heard presentations from TDA Perks, the TDA Smiles Foundation, and TDA legal counsel, and they received a legislative update from Dr Richard Black, chair of the TDA Council on Legislative and Regulatory Affairs. Dr Lisa A. Heinrich-Null of Victoria, chair of DENPAC, reported on the current activities of DENPAC and the necessity for donations. Following her

In the afternoon, Dr McCarley held a break-out session for new council and committee chairs and members and discussed their roles and duties. TDA President-elect Dr Craig Armstrong conducted a roundtable discussion with the TDA Component Society Presidents Committee.

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Summer Postcards from the Alliance

Smart Training Offers All OSHA, Compliance Training for $63

April Cobb, ATDA Publicity Secretary

Summertime is in full swing for dental families across Texas. TDA members and their Alliance of the TDA (ATDA) spouses are enjoying glorious vacations and participating in charitable events.

Dentistry allows us these great opportunities and we hope Texas dentists, dental spouses, and families grab every opportunity to “fill their buckets” with priceless summer memories.

TDA Perks partner Smart Training’s new subscription program offers unlimited access to every dental-specific OSHA and compliance training module in its library. The subscription includes an American Red Cross-certified Bloodborne Pathogens course.

For more information regarding this and other TDA Perks Program, visit tdaperks.com or call 512-443-3675.

ATDA members directly support the dentists but are also an organized force of dental spouses who impact legislation important to dentistry, dental health education, and the overall well-being of the dental family. If you would like to learn more about the Alliance, please contact ATDA Publicity Secretary April Cobb at aprilcobb@hotmail.com.

happy healthy smiles... that’s our mission!

ATDA Members and Their Families Enjoy Summer Vacations

Fort Stockton Texas Mission of Mercy On September 20, 2014, Ft. Stockton will host its very first Texas Mission of Mercy (TMOM), and we are very excited to bring this life-saving dental care to the citizens of west Texas. The care provided to the most needy Texans in these regions will help relieve pain, as well as improve oral and overall health in these communities.

TDASF is in great need of dental volunteers in order to make this event happen.

Please consider volunteering for this much-needed TMOM! TMOM events depend on the generous involvement of Texas dentists. To sign up to volunteer for this event, or to make a monetary contribution, please visit tdasmiles.org.

Dr David and Karen Cox of San Antonio watch Raphael Nadal play tennis at the French Open in Paris, France.

Dr Russell and Paula Owens of Burleson participate in the Mineral Wells Texas Mission of Mercy with their granddaughters, Leah and Sara Jahn.

TDA Member Leads Beaumont to Improve Overall Community Health TDA member Dr Alan B. Coleman, mayor pro tem of Beaumont, was named an individual champion at the It’s Time Texas Summit in Austin in June 2014.

Coleman

Dr Coleman was recognized for demonstrating extraordinary achievements in leadership, management, and commitment to improving overall community health. It’s Time Texas is a non-profit organization that is dedicated to making Texas the healthiest state in the nation.

Dr Coleman has led Beaumont to the #1 ranking in the National League of Cities Let’s Move! initiative started by First Lady Michelle Obama to fight the childhood obesity epidemic in the U.S. There are 446 cities committed to Let’s Move!, and Beaumont was the first city in the U.S. to receive all 5 gold medals.

Dr Stephen and Conni Durbin of Ennis visit the Grand Canal in Venice, Italy.

He created a Southeast Texas Regional Health Coalition. This group’s first task will be to address the childhood obesity issue and provide access for citizens to improve their personal health and make good lifestyle choices.

NOTICE: The selection of the Nominee for Trustee to the American Dental Association will be made on Sunday, August 24, 2014, during the Second Caucus meeting of the Fifteenth District Delegation scheduled in Grapevine, Texas.

Pennies for Politics DENPAC spent the last year inviting all TDA members to use their small change to promote big change for dentistry in Texas. You may have seen your DENPAC representative more than once shaking the change jug at your local dental society meeting. Component societies were encouraged to compete to see which could collect the most change for “change.”

Congratulations to our hardworking and distinguished winners!

Dr David and Marcella Lovett of Lubbock tour castles, distilleries, golf courses, and sites around Scotland.

JULY 2014 • TDA Today • 2

Greater Houston Dental Society Change Champ Dr Tommy Harrison

$1,604.28

Nueces Valley Dental Society Change Champ Dr Fred Philips

$733.01

Fort Worth District Dental Society Change Champ Dr Gary Greer

$396.13

El Paso Dental Society Change Champ Dr Michael Najera

$312.51

Total Change for Change

$4,030.58

* denpac.org

President’s Post David McCarley, DDS, TDA President TDA leadership attended the ADA Washington Leadership Conference in Washington, DC, in late May 2014 to advocate for our patients and profession. It is quite the eye opener to experience national politics, in which partisan politics are the norm. The process is very slow compared to Texas and involves several more steps of approval and conformation before action.

TDA MEMBER

SPOTLIGHT Jerry J. Hopson, DDS, Bonham

The TDA was well represented and fielded the usual questions about how Texas enacts legislation in just 120 days every 2 years. It makes me proud of our process in Texas and stands as a testament to our founding fathers. Several topics were discussed regarding upcoming legislation on Capitol Hill in Washington, DC, including:

He rides a Fat Boy. He wears leathers.

He’s a Weekend Warrior.

Action for Dental Health Act 2014 (HR 4395) This bill funds 2 federal grant programs. The first would provide $10 million annually to qualified state and local organizations offering free dental services for underserved populations. The second program would provide $10 million annually to organizations implementing Action for Dental Health initiatives that reduce the barriers to care.

Jerry J. Hopson, DDS, of Bonham is a dentist by day, biker by night … or at least on the weekends. He rides a 1993 Harley Davidson Fat Boy when he’s not driving his 1976 GMC truck, and he says being king of the road is exhilarating.

Medicaid RAC Audits Centers for Medicare and Medicaid Services (CMS) were asked to examine the Medicaid RAC (Recovery Audit Contractor) programs that have been implemented across the states and assess the impact such audits have had on providers enrolled in the program and subsequent patient access to services.

Student Loan Interest Deduction Act of 2013 (HR 1527) This bill will assist in easing the burden of student loan debt by significantly increasing the deduction allowed for student loan interest and making the deduction available to all regardless of income. It was assigned in April 2013 to a congressional committee for consideration before sending it to the House or Senate.

Additionally, the Federal Student Loan Refinancing Act was also assigned in May 2013 to a congressional committee for consideration before sending it to the House or Senate. President Obama also signed an executive order in June 2014 calling for expansion of a program to lower monthly federal student loan payments.

All of this legislation is very promising and could help the access to care and student debt problems. We can only hope that our legislators in the 113th US Congress who are currently in session can be as responsive and effective as their Texas counterparts.

MEETYOURSTAFF Donna Cortez is the TDA’s Donna program manager. She Co TDA P manages the peer review rogram rtez Mana program, the ethics ger and judicial program, and the third-party resolution program. She staffs the Council on Peer Review, which reviews and resolves problems or misunderstandings regarding dental treatment. Peer review exists for the benefit of the patient and the dentist as an alternative to civil litigation and serves as a confidential means of resolving complaints. Donna also staffs the Council on Dental Economics, which lately has been very busy serving as a resource in community oral health issues, which include oral health planning, preventive dentistry, nutrition, and fluoridation.

Where did you grow up? I grew up in Corpus Christi, which will always be home.

Between Austin and Corpus, I am really not sure where I spend the most of my time. When people ask me where I live, I usually say somewhere on I-35/I-37 southbound!

What is one thing about you that might surprise people? People are always surprised at the fact that I have an almost 30-year-old son. I actually have 3 wonderful sons, Andrew, Jacob, and Nathan, all of whom I am extremely proud.

They help keep the miles on my car high and the balance in my bank account low!

What is your favorite thing about the job? Definitely the customer service, both internally and externally. I enjoy working with the TDA leadership, my council chairs, the public, and of course our wonderful staff. I hear many people say, “I could never listen to complaints all day!” But, it doesn’t really bother me. Many people just want someone to listen. If my listening can make a difference, then I’m happy to do so.

Where did you work before TDA? Customer service roles have always seem to end up being part of my job descriptions. Before coming to TDA in 2001, I worked with TDA Director of Membership Lee Ann Johnson at the Texas State Teachers Association. And, I was also previously employed by Texas A&M University at the Art Museum of South Texas. My work in associations and non-profit positions have definitely been my most meaningful learning experiences.

Why did you decide to come to the Texas Dental Association? Both times, coming to TDA was a great opportunity for me. This second time was a more difficult choice because it meant leaving my home and family and moving back to Austin, but it was an opportunity I couldn’t pass up. Thankfully, being a previous TDA employee left me with lasting relationships that made the transition easier.

TDA Vice President Jerry J. Hopson, DDS, rode his Harley Davidson from Bonham to Colorado to visit the Garden of the Gods, the Royal Gorge, and the Great Sand Dunes.

“I always wanted to ride,” Dr Hopson says. “My parents, of course, didn’t want me to.” So, after taking a motorcycle safety riding class in 2000 with his wife and some local friends, he bought himself a beautiful blue Harley with lots of chrome and just the right amount of power and prestige. As an initial member, he belongs to the “Booger Holler Scooters and Street Cars Riding Club.”

Dr Hopson graduated from Texas A&M University Baylor College of Dentistry in 1978 and started his general dentistry practice in Bonham. He is a vice president on the TDA Board of Directors. With his wife, Deborah, they have one daughter, Morgan, who is an accomplished violinist and a graduate of Texas Christian University.

Deborah also has her motorcycle license and prefers to ride her own bike, but occasionally will accompany Dr Hopson. They have ridden the hill country ride together in Austin. He says the best thing about motorcycling is the ride itself: “The scenery, the outdoors, wind in your face, and a clear mind.”

He’s attended the Republic of Texas (ROT) Biker Rally in Austin 4 times. It’s the largest “turnstile” motorcycle rally in the country, and tens of thousands of motorcyclists descend on the city. The most recent ROT Rally wrapped up in June, but Dr Hopson couldn’t attend as it coincided with a TDA Board meeting. “It’s loud, it’s rowdy, there’s lots of chrome,” he says, laughing. “You can’t help but think about how much all of those bikes cost.”

Dr Hopson is not the only TDA dentistDr Hopson tends to his bike during a ride turned-biker. In fact, a hill country ride is to Colorado a couple of years ago. being coordinated to occur at the American Dental Association (ADA) annual session in San Antonio in October with TDA President Dr David McCarley of McKinney, former ADA and TDA President Dr John Findley of Plano, former TDA Board member Dr Larry Herwig of Dallas, and TDA Delegate Dr Art Nelson of McKinney.

“There are a lot of logistics to getting the bikes down there,” he says. “I enjoy riding in a group rather than by myself. People see and hear you coming. Also, it’s safer.”

He puts the brakes on motorcyclist stereotypes, as he doesn’t fit the mold of a tough biker.

“You never know who that person is on the motorcycle,” he says, recalling an encounter at a dental meeting in Scottsdale, Arizona.

“These 3 guys looked rough — they’d ridden all day wearing their boots, leathers, and dorags as they entered our hotel. We were concerned about getting in their way. When they came down later to dinner, cleaned up and dressed in their civilian clothes, turns out one was a banker, one a pharmacist, and one a surgeon.”

It shows that motorcycling appeals to all walks of life — whether it’s the machine’s guttural and distinctive growl, its strength and power, or the connection between the rider and the environment. As the biker’s mantra goes, “Four wheels move the body. Two wheels move the soul.”

This recurring section highlights the lives of TDA members outside of the office. If you have an interesting story about yourself, if you are working on a project that your peers might find interesting, or if you have a hobby that keeps you busy, please contact TDA Managing Editor Nicole Scott, nicole@tda.org, 512-443-3675.

JULY 2014 • TDA Today • 3

TSBDE Rule Update, continued from page 1

or mechanical device, or equipment that immobilizes or reduces the ability of the patient to freely move their arms, legs, body, or head. There are 2 types of protective stabilization —active stabilization and passive immobilization. Active stabilization involves restraint by a person such as the dentist, parent, or allied dental personnel. Active stabilization occurs when the patient is restrained to be point of being immobilized. Holding a patient’s hand to comfort them during dental treatment does not constitute active stabilization. Conversely, passive immobilization is achieved through the use of a restraining device such as papoose board. Restraining devices must be specifically designed for protective stabilization, appropriately sized for the patient, and constructed of material that minimizes potential injury to the patient.

Only the dentist may perform protective stabilization, but dental staff may assist the dentist as necessary. Based upon the results of prestabilization considerations detailed in the rule, including whether to defer or discontinue treatment, a dentist may decide to use protective stabilization if a patient requires immediate diagnosis, emergent care, or treatment and cannot cooperate due to medical and physical conditions or lack of emotional or cognitive development. In these cases, protective stabilization prevents the patient from uncontrolled movements that could endanger the patient, staff, or dentist. Protective stabilization is contraindicated for cooperative patients and patients who cannot be safely immobilized due to medical, psychological, or physical conditions.

Protective stabilization requires separate informed consent from the dental procedures being performed. The consent includes an explanation of the benefits and risks of protective stabilization, as well as alternative behavior guidance techniques, and a clear explanation of the anticipated restraining devices. In addition to informed consent, dentists should consider allowing parental or guardian presence in the operatory or direct visual observation of the patient. If the treating dentist determines that allowing the presence of parents or guardians would risk the health and safety of the patient, parent, guardian, or dental staff, the dentist must inform the parent or guardian of the reason for the denial and document the explanation in the patient’s chart.

Dentists utilizing protective stabilization must complete advanced training through either an accredited post-doctoral program or pediatric dentistry residency program providing clinical and didactic education in advanced behavior management techniques, or, completing an extensive continuing education course of at least 8 hours of clinical and didactic coursework in advanced behavior management.

Amendments to Rules The TSBDE made technical amendments clarifying the board’s requirements and procedures when reviewing a dental licensure by credentials application, and clarifying record retention requirements for dentists. Details on the amendments may be found on the “TSBDE” webpage under the “Advocacy” header on tda.org.

The new rules and amended rules may be found at 22 Texas Administrative Code (TAC) §§101.12, 108.14, 101.3, 108.8.

For more information, please contact TDA Policy Manager Diane Rhodes at 512-443-3675, diane@tda.org.

EDITORIAL STAFF Daniel L. Jones, DDS, PhD, Editor Nicole Scott, Managing Editor • Billy Callis, Publications Coordinator Barb Donovan, Art Director • Paul H. Schlesinger, Consultant BOARD OF DIRECTORS PRESIDENT — David H. McCarley, DDS 972-562-0767, drdavid@mccarleydental.com PRESIDENT-ELECT — Craig S. Armstrong, DDS 832-251-1234, drarmstrong01@gmail.com IMMEDIATE PAST PRESIDENT — David A. Duncan, DDS 806-355-7401, davidduncandds@gmail.com VICE PRESIDENT, NORTHEAST — Jerry J. Hopson, DDS 903-583-5715, dochop@verizon.net VICE PRESIDENT, SOUTHEAST — William S. Nantz, DDS 409-866-7498, wn3798@sbcglobal.net VICE PRESIDENT, SOUTHWEST — Joshua A. Austin, DDS 210-408-7999, jaustindds@me.com VICE PRESIDENT, NORTHWEST — Steven J. Hill, DDS 806-783-8837, sjhilldds@aol.com SENIOR DIRECTOR, NORTHEAST — William H. Gerlach, DDS 972-964-1855, drbill@gerlachdental.com SENIOR DIRECTOR, SOUTHEAST — Karen A. Walters, DDS 713-790-1111, kwalters@sms-houston.com SENIOR DIRECTOR, SOUTHWEST — John B. Mason, DDS 361-854-3159, jbmasondds@aol.com SENIOR DIRECTOR, NORTHWEST — Charles W. Miller, DDS 817-572-4497, cwdam@sbcglobal.net DIRECTOR, NORTHEAST — Dennis E. Stansbury, DDS 903-561-1122, drstansbury@gmail.com DIRECTOR, SOUTHEAST — Duc “Duke” M. Ho, 281-395-2112, ducmho@sbcglobal.net DIRECTOR, SOUTHWEST — James R. Foster, DDS 956-969-2727, fosterdds@gmail.com DIRECTOR, NORTHWEST — W. Kurt Loveless, DDS 806-797-0341, wklovedds@gmail.com SECRETARY-TREASURER* — Ron Collins, DDS 281-983-5677, roncollinsdds@yahoo.com SPEAKER OF THE HOUSE* — John W. Baucum III, DDS 361-855-3900, jbaucum3@gmail.com PARLIAMENTARIAN** — Arthur C. Morchat, DDS 903-983-1919, amorchat@suddenlink.net EDITOR** — Daniel L. Jones, DDS, PhD 214-828-8350, djones@bcd.tamhsc.edu *Non-voting member • **Non-member attendee TDA Today (USPS 022-007) is published monthly except for December by the Texas Dental Association, 1946 S IH-35 Ste 400, Austin, Texas 78704-3698, 512-443-3675. Periodicals Postage Paid at Austin, Texas and at additional mailing offices. POSTMASTER: Send address changes to TDA TODAY, 1946 S IH-35 Ste 400, Austin, TX 78704-3698. Copyright 2014 Texas Dental Association.

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Single issue price: TDA members $1. In-state ADA affiliated, $3 + tax. Out-of-state ADA affiliated, $3. In-state non-ADA affiliated, $6 + tax. Out-of-state non-ADA affiliated, $6.

Contributions: Manuscripts and news items of interest to the membership of the Association are solicited. Manuscripts should be typewritten, double spaced, and the original copy should be submitted. Please refer to Instructions for Contributors in the annual September Directory of the Texas Dental Journal for more information. The Information for Contributors is available at tda.org. All statements of opinion and of supposed facts are published on authority of the writer under whose name they appear and are not to be regarded as the views of the Texas Dental Association, unless such statements have been adopted by the Association. Articles are accepted with the understanding that they have not been published previously. Authors must disclose any financial or other interests they may have in products or services described in their articles.

Advertisements: Publication of advertisements in this publication does not constitute a guarantee or endorsement by the Association of the quality of value of such product or of the claims made of it by its manufacturer.

Perks’ Dental Supplies Partner Now Has JULY 2014

VOLUME 15, ISSUE 7

AVAILABLE ON TDA.ORG

TDA Perks Supplies recently changed its key dealer to one that carries a larger inventory—and is able to ship products much more quickly. The average delivery time fell from 7.2 days to 4 days in the last month!

Download a price-comparison form at tdaperks.com Programs by Company, TDA Perks Supplies

Support@TDAPerksSupplies.com | F: 888-740-4154

512-270-6999 Support: M-F, 8 AM to 7 PM