July 2011 TDA TODAY

JULY 2011 JUNE, 2008

VOLUME ISSUE67 VOLUME 12, 9, ISSUE

AVAILABLE ONLINE AT TDA.ORG AVAILABLE ONLINE AT TDA.ORG

Wolinsky Named New Dean of Baylor Every Member Matters Rise’ Lyman, DDS, TDA Focus Committee College ofFuture Dentistry

Inside Inside Texas Medicaid Medicaid in My Office? Electronic

Health Membership growth is vital to any thriving organization. The Texas Dental Association (TDA) Board is strongly Yes, I Think So!Record Incentive Concluding a yearlong nationwide search, the Texasgoal A&M University System Board of Regents earlier addresses this committed to the Membership within the “TDA 2009” strategic plan, which continued growth.

Program Richard M. Smith, DDS month approved Dr.I am Lawrence as as theevidence new dean Texas A&Mand Health Science proud E. to Wolinsky report that, of for thatthe commitment for the secondCenter year in a row, the TDA received (TAMHSC) Baylor the College of Dentistry in Dallas. following ADA awards in 2008: Future Changes to Texas TDA Smiles Foundation Dr. Wolinsky currently serves as the associate dean for academic programs and had personnel in the Schoolinofthe year 2007.

• Greatest Percentage Membership Net Gain: Texas a net gain of UCLA 198 members Medicaid Dental Program Dentistry. He begins his new•duties 1. Dental Society with Greatest Percentage of Non-Members to Membership: TMOM gains ardent advocate TopSeptember Constituent As the TAMHSC-Baylor College of Dentistry dean, Wolinsky’s responsibilities include promoting excellence Represents a conversion of 4.7 percent of non-members into membership at end in of year 2007.

TDA Smiles Foundation dentistry education, graduate•education, and research through recruitment of high quality faculty; ensuring andRepresents a 97 Ask the President Top Constituent Dental Society to Improve Retention Rate Percentage space in 2007: Record Breaking Smiles Wolinsky resources for all programs; and overseeing curriculum,retention student affairs, and educational Incoming President’s message percent Association rate, which is an increasepolicies. of 7 percent from the previous year. on Wheels “We are delighted to welcome Dr. Lawrence Wolinsky to Dentist our leadership team,” said Dr. Nancy Dickey, • Greatest Percentage of New Members: Represents a gain W. of 111 new dentist members (those Hilton Israelson, DDS president of the Texas A&M Health Science viceout chancellor for health affairs for the A&M System. “Dr. Wolinsky brings years of experience Welcome, New Board dentists whoCenter are 1-9and years of school). across a variety of roles — roles that ultimately led him to seek the role of dean. He is committed to excellence in research and innovation in education; Members Let’s Talk of the to the growth of goals.” our Association is the TDA Externship Program, which builds student awareness bothAnother goals areexample consistent withcommitment the TAMHSC’s overarching Outgoing President’s message of organized dentistry.

Thistoinnovative program, created in 2007, offers students the opportunity to gain insight into the different components Wolinsky is honored be selected.

TDA Leadership Conference of organized dentistry including legislative and regulatory affairs, membership, governance, continuing education, and charitable dentistry and “I am looking forward to moving to Dallas and continuing the tradition of excellence that the Baylor College of Dentistry and the Texas A&M A. David May, Jr., DDS to gain aScience better understanding Health Center share,” of he their said. role as future leaders of the dental team. The program is open to dental students from each of the three Alliance of the TDA dental schools in Texas.

This year the externship program will takeinplace June 20of – June in Austin at Division the TDAofcentral office. & Medicine at the In addition to being associate dean, Wolinsky is a professor the Section Oral 27 Biology in the Oral Biology 2008-2009 TDA Board of Directors As School an ongoing effort to enhance valuetheand benefits of the Association, theHis TDA Council academic on Membership developed a surveycreating that was asent UCLA of Dentistry, having the joined dental school faculty in 1980. numerous achievements included mentorship to all members in 2006.

The to results that members havedevelopment a high satisfaction rating with such asthrough the TEXAS Meeting, re-accreditation.

TDA program for junior faculty assistclearly themshowed in mapping their career and guiding the benefits dental school a successful Meet Your TDA Staff publications, and research the abilityprojects to participate philanthropically in treatment the TDA Smiles Foundation.

A great disease numberand of the discounted programs Wolinsky’s focus on identifying new methods for periodontal management of caries. offered He wastoamong the TDA’s new Finance Director members through TDA Perks Program alsoofreceived high satisfaction rating.

In accordance in with the strategic the Council Membership, first to explore thetheplaque-inhibiting effects naturala plant compounds and instrumental developing an plan, antimicrobial gel on (Atridox®) for managing Dee Dee Delagarza will survey members again in 2009. periodontal disease. He also aided in creating a remineralizing toothpaste (Enamelon®) to help reverse early tooth decay. from all a collaborative effort between ADA, TDA, and localSan component societies are the keys tomedicine from Tufts Dental Ethics Participation Wolinsky obtained hismembers Ph.D. inand synthetic organic chemistry at thethe University of California, Diego, his doctorate in dental Congratulations to TDA successful membership recruitment and retention.

We encourage every member to get involved whether it is by attending local meetings, University School of Dental Medicine and a certificate in periodontology from UCLA. His wife, Dr. Amerian D. Sones, is a prosthodontist, and they Strength of Our Profession Component Societies taking part grown in Givechildren Kids a Smile!

Day activities, have three — Julia, Zachary, andvolunteering Andrew. at a Texas Mission of Mercy, or participating in TDA Legislative Day activities in Austin. Each member matters and is essential to the continued growth of our Association and of organized dentistry.

This is the seventh and final in a series of articles focused on the TDA’s accomplishments guided by the strategic plan. To view the entire plan, Streamline Your Insurance Claims log in at www.tda.org and click on “TDA 2009” under “Current Issues” on the member homepage. For more information, please contact Lyda Creus Speeding up confirmation of benefits Molanphy, staff liaison to the Future Focus Committee, at the TDA central office, (512) 443-3675. and eligibility

August Journal News

Around the State

Grassroots Advocacy Helps TDA Achieve Legislative Goals

August 5 Texas State Board of Examiners (TSBDE) was reduced 10 percent,TSBDE Rule Update Dental Examiners To be The Voice of DenTisTry in Texas less than originally proposed and feared.

Requirements Austin for dental office radiograph machines Insurance August 5&6 Public Organizational In addition to theMembership daily work performed Development In the News Image Excellence Dentists Who Care Conference

by TDA legislative staff and consultants, the TDA members in theIsland news South Padre grassroots activities of member dentists played

On June 29, 2011, the 82nd legislative Mlawmakers ission: session officially ended with Texas meeting for a total of 170 days — 140 days in regular session and 30 in special session.

During that time, legislatorsAdvocacy were faced with Manpower balancing a budget with an unprecedented shortfall, redistricting, state agency reviews, andMembership a host of other divisive issues including a crucial role in passing SB 554, historic Dentists will valuerestructuring membership of and in the TDA. August 5 & 6 immigration reform, theparticipation Texas legislation which prevents state regulated Windstorm TDA Smiles Foundation ObjectivesInsurance Association, and health insurance companies from capping fees on care1.reform.

Improve perceived value and benefits of membership in TDA. dental services they refuse to cover.

Smiles on Wheels Tooth Whitening: A Clinical Review

Thisa.volatile legislative landscape made about it Increase members’ knowledge the impact and benefits of TDA membership.

Despite the insurance industry’s ceaseless Texarkana very difficult for stakeholders to successfully b. Ensure that components are an integral aspect of the membership process. attempts to kill or stall the legislation, the TDA Historical Perspectives achieve their special interests c. goals.

CreateMost greater awareness of focused the availability of the Peer Review, Ethics & Judicial, and Risk Management benefits.

TDA prevailed due to the incredible response Dentists,August dental12 hygienists, and the energy and retaining what they d. attention Activelyon promote adherence to the Code of Ethics. and work performed by member dentists who TDA Board of Directors dental team have. However, hard work

by TDA’s legislative staff andand consultants, along e. Enhance communication with members non-members. contacted their legislator(s). The legislation takes effect September 1, 2011.

Austin with calls, personal visits from member to legislators, f. e-mails, Build and student awareness of and interestdentists in organized dentistry andContracts membership in TDA. signed or renewed before that date will be subject to prior law.

The 2007 C.T. Rowland Award helped organized dentistry achieve many of students its goals this session. dental school. g. Ensure ongoing contact with throughout It is important to note that this law only affects insurance plans August 13 Orthodontic case report h. Work closely with dental school faculty. regulated by the State of Texas. Dentists will need to determine if a Strategic Planning i. Evaluate number of nonmember dentists who attend and participate in TDA activitiespolicy (TEXAS Meeting,by TDA Budget particular insurance is regulated the Smiles State of Texas or the Austin Foundation programs, The El Paso Dental Conference

Per the Texas Constitution, the etc.). biennial state budget is the only piece federal government (Employee Retirement Income Security Act of 1974 Metrics of legislation that must pass every session and it must be balanced. Without or ERISA). The TDA’s Third Party Payor Web Tool (www.tda.org) August 27 1. Seventy percent licenseditdentists in TX be members of TDA byas2009 (baseline of 68.5% in January 2007); increase it, Texas government and of allactive the programs funds cease to will function. serves a resource to members.

According to the Web Tool, “HMOs ADA 15th District Trustee membership ratetask to 97 Apriland 2007 (baseline 96%(and in 2006).

Lawmakers facedretention a daunting thispercent session.bySales franchise PPOs) regulated by the Texas Department of Insurance must Delegation Golf Tournament a-d. were Increase theand number dentists serving component peer reviewinclude and ethics judicial affairs committees a tax revenues down there of was no appetite forontax increases or stateand “DOI” or “TDI” on the face to of attain the identification cards August 14: Dallas participation of Fund 2-5 percent to the total members August depletion of the Rainyrate Day to closerelative the estimated $20number billion of component they society issue. If you see by “DOI” or 2009.

“TDI” on the card, you know that the 2.

Ninety percent of TX dental school graduates actively licensed in TX will be members of TDA five years after graduation (89% budget gap. The legislature balanced the 2012-2013 budget by cutting plan is regulated by the Texas Department of Insurance.” Please use TDA Board Meeting August 28 dental student conversion from the graduating class of 2005 in Texas).the tool as a resource. Staff members at the TDA central office are also Austin, Texas spending.

3.

Increase the number of member dentists actively participating in TDA by 1 percent a year (as measured by a variety of means ADA 15th District Trustee

Although a majority of items funded by state government received available to assist you.

– participation TXsession, Meeting, TXDDS, FSI participations, TDA may legislative annualDental Association’s some level of reduction at this theTMOM, TDA is very pleased toprograms, report DENPAC

Additionally, dentists utilizeday) the with American Delegation October 15-19: Second Caucus to TDAadvocacy Board byefforts the Council that the report Association’s resultedon inMembership. preserving funding for (ADA) Contract Review Service to analyze unsigned insurance contracts.

Dallas ADA Annual Session baseline nonmember at TDA activities TDA Smiles Foundation, Membership) the4.two Establish largest oral health of programs in theparticipation state: Medicaid dental and (CAS, This service offers analysis of third-party contracts (i.e., from 5. Established baseline of members’ understanding the benefits of their TDA membership throughabout Member Children’s Health Insurance Program (CHIP) dental. of and satisfaction with managed care companies) and informs members the provisions ofSan Antonio, Texas Benefits and Services Survey (completed Nov 2006), re-evaluate % increase at that time for 2009.

Throughout the session, TDA’s legislative staff and consultants the contracts so they can make informed decisions about the implications 6. Sixty-five percent of all full-time faculty will be TDA baseline In = 63%). worked closely with key legislators to defend funding levels formembers both by 2009 of (2006 participation. order for a TDA member to use this service, the dental programs. Neither program received additional funding cuts in process must be initiated by the TDA. Please contact the TDA Member the 82nd session and were funded at the same level as 2011 — more Services & Administration Department for more information.

The TDA will update it’s strategic plan with another statewide retreat in August of 2008.

Update Profile than $300 million dollars in funding protected. Adequate funding will tda.org Join – Membership Info promote continued dentist participation and access to oral health services us on Facebook Protecting Dentistry for the state’s most vulnerable children.

Along with advancing the dental profession, the TDA is equally www.groups.to/texasdental Ask a Colleague

It is important to note that although funding for these programs committed to protecting the practice of dentistry. During the legislative tda.org Follow – Features was not cut, participating dentists will likely see a reduction in session, the TDA tracked more than 200 bills relating to dentistry. us on Twitter reimbursement rates because of the transition to the commercial Many of them violated Association policy and were killed or amended to twitter.com/theTDA TEXAS Meeting Photos administration of Medicaid. Managed Care Organizations (MCOs) are protect dentists and the profession. scheduled to begin administering the Medicaid program in March 2012.

For example, the TDA amended legislation exempting dental care texasmeeting.com/estore Get LinkedIn

Funding for the State Oral Health Program at the Department of benefits from an exclusive provider benefit plan as well as amending Linkedin.com, search “Texas State Health Services was not cut but the method of finance changed from legislation to exempt dental practices from registering diagnostic imagingVolunteer for ‘08 ADA Dental Association” state funds to federal funds. Funding for the Texas State Board of Dental tda.org/volunteerada08 Continued on page 2 In 2003, Texas Dental Association members from across the state develop TDA’s first strategic plan, TDA 2009.

July Journal News

Around the State

Click & Connect Click & Connect

Grassroots Advocacy, continued from page 1 equipment. The TDA also fought legislation that would have taxed cosmetic dental procedures, made dental assistants independent contractors, allowed dental patients the ability to consent to a prophylaxis without undergoing an X-ray if ordered by the treating dentist, and mandated dentists and other health care professionals to post their pricing information on the internet.

Scope of Practice

The TDA prevented dental hygienists from once again trying to increase the number of facilities where they may perform designated services for up to 12 months before the dentist examines the patient. Legislation which would permit dental hygienists to administer local anesthetic was also halted.

Privacy of Electronic Health Information

The legislature debated privacy of electronic health information during the session and the TDA helped shape the final legislation in a manner favorable to dentistry.

HB 300 requires entities covered by the Health Insurance Portability and Accountability Act (HIPAA), including dentists, to comply with the amended Texas Medical Privacy Act (TMPA). Effective September 1, 2011, covered dentists must train new employees within 60 days of hire per federal (HIPAA) and state (TMPA) privacy requirements. Also, if a covered dentist uses an electronic health records system for patient records, he or she will have 15 business days from the date of the patient’s request to give the patient an electronic copy of their dental record.

Health Care

The legislature focused much of its time and energy this session on balancing the budget. Roughly 35 percent of the state budget funds health and human services agencies and programs. Several bills, including SB 7, were designed to create further efficiencies in state government health care programs.

SB 7 also amends the Insurance Code to authorize the creation of “Certified Healthcare Collaboratives” that may include dentists. The legislation also expands Medicaid managed care into the Rio Grande Valley and allows Texas to partner with other states — Interstate Health Care Compact — to direct its own health and human services programs and take innovative health care approaches not currently available under federal Medicare and Medicaid regulations.

Looking to the Future

The TDA’s legislative success is a true testament to the dedication and passion of TDA members, and the Association’s future success relies heavily on the continued involvement of each and every TDA dentist.

There are numerous legislative initiatives that the TDA will need to address during the 2013 legislative session — hopefully a time in which the landscape will be more favorable for pursing specific priorities for dentistry. Such initiatives include helping prevent the illegal practice of dentistry, shielding dentistry from potentially unfair tax regulations, strengthening the State’s oral health infrastructure, and improving the dental public health safety net.

The TDA continuously needs to strengthen its grassroots efforts and contact dentist database. If you have a personal relationship with a legislator and want to serve as a TDA Contact Dentist, please contact the TDA Department of Legislative and Regulatory Affairs.

Texas Medicaid Electronic Health Record (EHR) Incentive Program

This is the eighth in a series of articles to keep you informed of the Texas Medicaid Electronic Health Record (EHR) Incentive Program and continuing efforts to implement health information exchange initiatives across Texas. The incentive program provides incentive payments to Medicaid providers for the adoption and meaningful use of certified EHR technology. Future articles will focus on helpful reference websites, health information exchange, meaningful use for dentists, certified EHR technology for dental practices, and other relevant topics of interest to dentists.

Last month’s update detailed the requirement for EHR program participants to use certified EHR technology. As it stands now, there is not a certification available for dental practice management software. However, both Patterson Technology and Henry Schein Practice Solutions are trying to certify Eaglesoft and Dentrix software. You may contact the vendors for additional information.

In addition to using certified EHR technology, program participants must also prove “meaningful use” (MU) of the certified EHR technology. “Meaningful use” means that participants demonstrate that the EHR technology is being implemented in measurable ways.

The Centers for Medicare and Medicaid Services (CMS) defines three main components for meaningful use: • • •

The use of a certified EHR technology in a meaningful manner, such as e-prescribing; The use of certified EHR technology for electronic exchange of health information to improve quality of healthcare; and The use of certified EHR technology to submit clinical quality and other measures.

Currently, many of the core meaningful use objectives don’t apply to dentists and this makes it very difficult for the average dentist to participate in the Medicaid EHR program.

The Texas Dental Association’s Committee on Access, Medicaid & CHIP is currently working with the Health and Human Services Commission (HHSC) to help establish MU criteria for dentists in Texas. Once completed, HHSC will be able to transmit the information back to the federal government which ultimately determines the MU criteria for participating in the EHR program.

CMS has detailed information for the Medicaid EHR program at www.cms.gov/EHRIncentivePrograms. For help in the Texas enrollment process, e-mail HealthIT@tmhp.com or call (800) 925-9126, Option 4.

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.

This TSBDE Update will address Texas State Board of Dental Examiners (TSBDE) Chapter 110 — 22 TAC §110.3 — Nitrous Oxide/Oxygen Inhalation Sedation permit. It is important to note that licensed dentists lacking sedation permits may continue to utilize local anesthetic and prescribe minor tranquilizers for anxiolysis. A dentist holding an active Nitrous Oxide/Oxygen Inhalation Sedation permit before June 1, 2011, will automatically have his/her permit reclassified as a new Nitrous Oxide/Oxygen Inhalation Sedation permit in accordance with §110.3.

As a reminder, although Chapter 110 became effective June

1st, the TSBDE will not start enforcing requirements until January 1, 2012. This delay is intended to allow ample time for dentists to get any additional anesthesia/sedation certifications they need.

The TSBDE defines Nitrous Oxide/Oxygen Inhalation Sedation as a minimally depressed level of consciousness, produced by the administration of nitrous oxide alone, in which the patient retains the ability to independently and continuously maintain an airway and responds normally to tactile stimulation and verbal command (1).

The summary below is taken directly from Chapter 110 — 22 TAC §110.3 — Nitrous Oxide/Oxygen Inhalation Sedation.

A dentist applying for a Nitrous Oxide/Oxygen Inhalation Sedation permit must meet one of the following educational/ professional criteria:

§110.3 (a) (1): satisfactory completion of a comprehensive training program consistent with that described for nitrous oxide/oxygen inhalation sedation administration in the American Dental Association (ADA) Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students. This includes a minimum of fourteen (14) hours of training, including a clinical component, during which competency in inhalation sedation technique is achieved. Acceptable courses include those obtained from academic programs of instruction recognized by the ADA Commission on Dental Accreditation (CODA); or courses approved and recognized by the ADA Continuing Education Recognition Program (CERP); or courses approved Continued on page 4

Evidence-Based Practice Tip of the Month Stephen R. Matteson, D.D.S., Editor

This article appeared in the journal Lung recently; it reported that poor dental hygiene in nursing homes, including cleaning of dentures, increased the incidence of pneumonia. Enter Pubmed number 21533635 on the PubMed website: pubmed.gov.

Reference El-Solh AA. Association Between Pneumonia and Oral Care in Nursing Home Residents. Lung 2011 Apr 30. [Epub ahead of print].

Welcome, New TDASF Board and Committee Members

Happy, Healthy Smiles …

That’s Our Mission!

A Record-Breaking Smiles on Wheels On June 11, 2011, TDA Smiles Foundation (TDASF) broke its own record for value of care provided at a Smiles on Wheels event. Mineral Wells was the site of the 16th Smiles on Wheels.

The local committee, spearheaded by Dr. Saskia Vaughan and Mrs. Ginny Arrott, helped make it an amazing success. Volunteer dental professionals came from all over Texas, joining local community volunteers, to set up operations in the Mineral Wells Senior Center and the First Baptist Church. Five of the dentists were first-time volunteers. Showing exemplary teamwork and efficiency, the team provided charitable dental care to 159 Texans. The value of care was $130,811, beating the previous record for value of care delivered at a Smiles on Wheels event by more than $14,000.

Dr. Steven Banks of Amarillo treats a patient at Smiles on Wheels in Mineral Wells.

Dr. Russell Owens of Ft. Worth and Dr. Kavin Kelp of Austin with a satisfied patient at Smiles on Wheels in Mineral Wells.

Dr. Tom Novak of Weatherford treats a patient at Smiles on Wheels in Mineral Wells.

July 2011 / TDA Today / 2

Dr. Saskia Vaughan (left) of Mineral Wells, the dental chair of Smiles on Wheels in Mineral Wells, poses with a local volunteer.

Dr. Robert St. John of Bowie with a patient at Smiles on Wheels in Mineral Wells.

TDASF is excited to welcome Dr. Ben Taylor of San Antonio, Dr. Doug Bogan of Houston, and Dr. James Douthitt of Amarillo to the TDASF Board of Directors. We are also pleased to welcome Dr. Colin Lathrop of The Woodlands, Dr. Jeff Harden of Houston, and Mr. Wade Barker of Dallas, to the TDASF Access Committee. All have been amazing assets to TDASF through their dedication and hard work. We look forward to having their incredible skills and knowledge at our fingertips.

A New Style of Mission On August 5 and 6, 2011, TDASF will debut a new program model and needs your help.

Texarkana will be the launch site for the first half-sized Mission of Mercy event, tentatively nicknamed “Mini-MOM” or “Half TMOM.” Dentists, hygienists, nurses, dental assistants, office staff, and community volunteers are encouraged to sign up at the website, tdasf.org. With this mission, TDASF hopes to treat 500 patients over 2 days using 20 dental chairs. By comparison, a typical TMOM event uses 40 chairs over 2 days to treat 1,000 patients, and a typical Smiles on Wheels event uses 15 chairs for 1 day to treat 150 patients.

TDA Leadership Conference

Preston’s Press

On Saturday, June 25, 2011, TDA president Dr. J. Preston Coleman hosted the TDA Leadership Conference at the Austin Marriott South. The 1-day conference hosted by TDA Perks Program combined meetings of the TDA Presidents-Presidents-elect Conference, the TDA Council, Committee and Affiliate Training, and the TDA Component Society Presidents Committee. A total of 71 component society officers, various council and committee (L-R): Members from around the state are pictured at the TDA Leadership Conference last members, Texas dental school students, and TDA staff month in Austin: TDA DENPAC chair Dr. Philip Nauert of Bellaire, TDA Council on attended the conference.

Membership member Dr. Lynne Gerlach of Plano, Dallas County Dental Society president

The morning session included presentations by TDA Financial Services, Inc. board member Dr. Michael Dr. Bill Gerlach of Plano, TDA parliamentarian Dr. David McCarley of McKinney, and North Texas Dental Society president Dr. David Wilhite of Plano.

D. Vaclav, who discussed the TDA Perks Program and its benefits to TDA members; TDA Smiles Foundation chair Dr. W. Kurt Loveless, who reported on the Foundation’s recent activity and encouraged participation in the Texas Missions of Mercy, Donated Dental Services program, and Smiles on Wheels events; and TDA Council on Legislative & Regulatory Affairs chair Dr. Richard C. Black, who moderated a panel discussion on recent legislative activity along with TDA director of public affairs Mr. Jess Calvert and TDA policy manager Ms. Diane Rhodes. Each council and committee chair also gave presentations detailing current and future projects. Presidents from each society gave an overview of society activities.

Dr. Coleman and TDA Committee of the New Dentist chair Dr. Andrea Janik Keith installed students from each of the three Texas dental schools as officers of the TDA Student Organization (TDASO): University of Texas Health Science Center at San Antonio Dental School (UTHSCSA) D3 student Ms. Sarah Shin, the University of Texas Health Science Center at Houston School of Dentistry TDA installed officers of the new TDASO at the TDA Leadership (UTHealth) D3 student Mr. Coleman Meadows, and Texas A&M Health Science Center (TAMHSC) — Baylor College of Dentistry D3 Conference in Austin last month: (L-R): UTHSCSA D3 student Ms. Sarah Shin, UTHealth D3 student Mr. Coleman Meadows, and student Mr. Ryne Wilson.

TAMHSC-Baylor D3 student Mr. Ryne Wilson.

Members of the TDA Board of Directors, the TDA Smiles Foundation Board of Directors, the TDA Financial Services, Inc. Board of Directors, council and committee members, and TDA staff attended the afternoon sessions.

Dr. Coleman, TDA speaker of the house Dr. Glen D. Hall, and TDA executive director Ms. Mary Kay Linn addressed the group on Association rules and policies, confidentiality, roles, interaction as representatives of TDA, conflicts of interest, and writing resolutions. TDA Future Focus Committee chair Dr. Lisa B. Masters offered a presentation on strategic planning, including plans for facilitating action plan updates, an invitation for feedback and communication with the committee, and advised of the committee’s continued support of the “TDA 2014” strategic plan for interim updates.

At the Component Society Presidents Committee meeting, TDA president-elect Dr. Michael L. Stuart conducted a round table discussion about challenges and successes within component societies.

Twenty seven officers representing 17 component societies attended, along with Greater Houston Dental Society executive director Ms. Susan McKee and several TDA staff members. TDA director of member services and administration Ms. Lee Ann Johnson addressed the committee and answered TDA president Dr. J. Preston questions regarding membership and component society Directors and Officers insurance policies. Mr. Coleman addresses the group at the TDA Leadership Conference in David Baker, TDA Perks general manager, and Mr. Josh Epstein, Marketing Specialist, spoke to the Austin last month. group regarding the TDA Perks Advocate Program.

(L-R): Amber Todora, graduating senior dental student from the University of Texas Health Science Center at San Antonio Dental School (UTHSCSA), receives a $1,000 scholarship presented by Dr. Lisa Masters, president of San Antonio District Dental Society (SADDS), for her active participation in the American Student Dental Association and volunteerism at TDA and SADDS events. In order to qualify, Todora had to submit a short essay and the winner was chosen by the SADDS Board of Directors. The scholarship is meant to bridge the gap between family and financial aid until Todora starts to practice dentistry.

Future Changes to Texas Medicaid Dental Program

As previously reported, the Health and Human Services Commission (HHSC) is seeking the services of two or more dental contractors (managed care organizations) to commercially administer the statewide Medicaid/Children’s Health Insurance Program (CHIP) dental programs — the Texas Dental Program — beginning in March 2012.

Although previously HHSC publicized that Texas would make the tentative contract award announcement on July 1, 2011, the official procurement schedule now shows that the award announcement will be made August 15, 2011. However, it is still very likely that HHSC will announce the selected dental contractors (managed care organizations) by late July 2011.

With an anticipated contract start date of September 1, 2011, it is imperative that dentists interested in participating in the Medicaid part of the new Texas Dental Program be prepared, once the contracts are awarded, to immediately select the managed care organization (MCO) plan(s) in which they intend to participate.

Additionally, as stated in the Request for Proposal (RFP), the awarded contractors (MCOs) must assist Medicaid members in self-selecting a “Main Dental Home” (MDH) within 30 days of enrollment in the MCO’s dental plan. Otherwise, the MCO will assign the member to a MDH.

The TDA intends to work closely with both HHSC and the selected MCOs on developing MDH enrollment information that participating dentists may send to their current Medicaid patients as soon as possible. This will help ensure that Medicaid participating dentists are able to retain their existing patient base under commercial administration.

For questions or comments, contact TDA’s policy manager Ms. Diane Rhodes at (512) 4433675 or diane@tda.org.

J. Preston Coleman, D.D.S., TDA President 2011-12

In the past month, I have had the privilege of visiting several component societies. Each one has been a unique and friendly experience that has shown how diverse, yet how similar, we are as dentists caring for the public in our own communities. These experiences have demonstrated to me how very important the Texas Dental Association is to all of us in the dental profession.

Earlier this month, I received an invitation to a party sponsored by the Great Expectations program at the University of Texas Health Science Center at San Antonio Dental School (UTHSCSA). In San Antonio, Dr. Risé Martin has been the driving force for the program. I was familiar with Great Expectations, which originated at Texas A&M Health Science Center – Baylor College of Dentistry in Dallas by Dr. Moody Alexander several years ago. All three dental schools have since embraced the program, and this was my first opportunity to see it up front.

When I arrived at the home of Dr. Pam Ray, about 90 dental students in small groups were discussing with a member of the San Antonio District Dental Society (SADDS) various aspects of the world of dentistry and dental education. Each group is assigned several mentors, one SADDS member, one instructor from UTHSCSA, and one student mentor. As I traveled from group to group, the dental students asked me many questions about the dental profession and the TDA. They even asked some questions about Texas politics and the recently completed legislative session.

Their enthusiasm and curiosity about our profession was both amazing and refreshing considering that they are still students.

As the evening continued and the students began to leave, I spoke with some of the SADDS mentors whom I had known for many years. I sensed their enthusiasm and saw how they placed great value on working with the dental students. And, I had one other revelation about our profession’s bright future.

When talking to two students, I unwittingly asked, “How long have you been in dental school?” Was I ever amazed when one of them replied, “We all started 2 days ago.”

Alliance of the TDA The Alliance of the TDA (ATDA) hosted its 6th Annual Cooking Class at the organization’s 81st Annual State Convention in San Antonio in May. State Convention Chairman Ms. Janell Dunsworth (Dallas 5/NE) along with the Marriott Rivercenter Executive Chef Donald Hoffman put together an unforgettable “Chili Cook-off” for more than 50 ATDA members and guests.

Chef Hoffman and his staff prepared a smorgasbord of ingredients and attendees divided into four teams. Members of Chef Hoffman’s staff assisted in the preparation; however, ATDA members came up with the recipes and did most of the cooking. Chef Hoffman donated cloth aprons which were embroidered by ATDA president-elect Ms. Sharon Bryant (Dallas 5/NE).

Chili entries ranged from a traditional spicy chili to beer chili to vegetarian chili.

Two members of Chef Hoffman’s team served as judges. The winning team’s “Sweet & Spicy” entry combined pineapples and cherries and had a little kick that caught the judges’ attention.

The annual event has grown in popularity each year and is a way to introduce dental spouses to the ATDA. For more information about the ATDA, please contact TDA Alliance liaison Ms. Donna Musselman, (512) 443-3675, donna@tda.org.

Marriott Rivercenter Executive Chef Donald Hoffman is pictured with members of the Alliance of the Texas Dental Association (ATDA) at the organization’s 6th Annual Cooking Class during its annual convention in San Antonio in May.

July 2011 / TDA Today / 3

TSBDE Update, continued from page 2 and recognized by the Academy of General Dentistry (AGD) Program Approval for Continuing Education (PACE); or

§110.3 (a) (2): satisfactory completion of an ADA/CODA approved or recognized pre-doctoral dental or postdoctoral dental training program which affords comprehensive training necessary to administer and manage nitrous oxide/oxygen inhalation sedation.

Additionally, a dentist performing nitrous oxide/oxygen inhalation sedation must adhere to standard of care requirements (§110.3 (b) (1-4)) and clinical requirements (§110.3 (c) (1-8) (d)) including maintaining under continuous direct supervision auxiliary personnel capable of reasonably assisting in procedures, problems, and emergencies incident to the use of the sedation as well as maintaining current certification in Basic Life Support (BLS) for Healthcare Providers for the assistant staff by having them pass a course that includes a written examination and hands-on demonstration of skills.

The dentist is responsible for the sedative management, adequacy of the facility and staff, diagnosis and treatment of emergencies related to administration of nitrous oxide, and providing the equipment and protocols for patient rescue.

The dentist must induce the nitrous oxide/oxygen inhalation sedation and must remain in the room with the patient during the maintenance of sedation until pharmacologic and physiologic vital sign stability is established.

In nonemergency situations, at least one member of the assistant staff should be present with the dentist during the administration nitrous oxide/oxygen inhalation sedation.

After pharmacologic and physiologic vital sign stability is established, the dentist may delegate the monitoring of nitrous oxide/oxygen inhalation sedation to a dental auxiliary certified by the TSBDE to monitor the administration of nitrous oxide/ oxygen inhalation sedation (§115.2 and §114.4).

Permitted dentists under this section shall not supervise Certified Registered Nurse Anesthetist (CRNA) performing nitrous oxide/oxygen inhalation sedation unless the dentist holds a Nitrous Oxide/Oxygen Inhalation Sedation permit issued by the TSBDE.

Patients considered for nitrous oxide/oxygen inhalation sedation must be suitably evaluated prior to the start of any sedative procedure. In medically stable individuals (ASA I, II), this may include a review of their current medical history and medication use. However, patients with significant medical considerations (ASA III, IV) may require consultation with the patient’s primary care physician or consulting medical specialist.

The patient, parent, guardian, or care-giver must be advised of the risks associated with the delivery of nitrous oxide/oxygen inhalation sedation and must provide written, informed consent for the sedation.

The patient’s baseline vitals must be obtained in accordance with §§108.7 (Minimum Standard of Care, General) and 108.8 (Records of the Dentist).

Required documentation per the permit includes: a patient’s pre-operative baseline vitals, the individuals present during the sedation administration, the maximum concentration administered, and the start and finish times of the inhalation agent.

The dentist has the responsibility to evaluate all equipment for proper operation and delivery of inhalation agents prior to use on each patient. The inhalation equipment must have a fail-safe system that is appropriately checked and calibrated. The equipment must have either a functioning device that prohibits the delivery of less than 30 percent oxygen, or, an appropriately calibrated and functioning in-line oxygen analyzer with audible alarm. An in-line oxygen analyzer must be used with nitrous oxide and oxygen delivery equipment capable of delivering less than 30 percent oxygen. The permitted dentist/facility must be able to deliver positive pressure oxygen at all times and the equipment must have an appropriate nitrous oxide/oxygen scavenging system.

Recovery from nitrous oxide/oxygen inhalation sedation, when used alone, should be relatively quick, requiring only that the patient remain in the operatory chair as needed. Patients having unusual reactions to the sedation should be assisted and monitored in either an operatory chair or recovery room until stable for discharge. Only the dentist may determine that the patient is appropriately responsive prior to discharge. The dentist is prohibited from leaving the facility until the patient meets the discharge criteria and is discharged from the facility.

A dentist holding a Nitrous Oxide/Oxygen Inhalation Sedation permit shall not intentionally administer minimal sedation, moderate sedation, deep sedation, or general anesthesia.

Because sedation is a continuum, it is not always possible to predict how an individual will respond. If a patient enters a deeper level of sedation than the dentist is qualified to provide, the dentist must stop the dental procedure until the patient returns to the intended level of sedation. A dentist must be able to rescue patients who enter a deeper state of sedation than intended. The dentist, personnel, and facility must be prepared to treat emergencies that may arise from the administration of nitrous oxide/oxygen inhalation sedation.

For children twelve (12) years of age or under, the dentist should observe the American Academy of Pediatrics/American Academy of Pediatric Dentists Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures.

For more information, please contact TDA policy manager Ms. Diane Rhodes at (512) 443-3675, diane@tda.org.

Reference 1.

TSBDE Chart: Anesthesia Rules – Summary of Requirements: http://www.tsbde.state.tx.us.

EDITORIAL STAFF Stephen R. Matteson, D.D.S., Editor Nicole Scott, Managing Editor Barbara Donovan, Art Director Lauren Oakley, Publications Coordinator Paul H. Schlesinger, Consultant BOARD OF DIRECTORS J. Preston Coleman, D.D.S., President Michael L. Stuart, D.D.S., President-elect Ronald L. Rhea, D.D.S., Immediate Past President Vice Presidents Lisa B. Masters, D.D.S., Southwest Robert E. Wiggins, D.D.S., Northwest Larry D. Herwig, D.D.S., Northeast Karen E. Frazer, D.D.S., Southeast Senior Directors T. Beth Vance, D.D.S., Southwest Michael J. Goulding, D.D.S., Northwest Arthur C. Morchat, D.D.S., Northeast Rita M. Cammarata, D.D.S., Southeast Directors Yvonne E. Maldonado, D.D.S., Southwest David C. Woodburn, D.D.S., Northwest Jean E. Bainbridge, D.D.S., Northeast Gregory K. Oelfke, D.D.S., Southeast Ron Collins, D.D.S., Secretary-Treasurer Glen D. Hall, D.D.S., Speaker of the House David H. McCarley, D.D.S., Parliamentarian Stephen R. Matteson, D.D.S., Editor Mary Kay Linn, Executive Director William H. Bingham, Legal Counsel 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.

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JULY 2011

VOLUME 12, ISSUE 7 AVAILABLE ONLINE AT TDA.ORG

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