Feb 2014 Texas Dental Journal

A PERKS PROGRAM FOR TDA MEMBERS

e spore Judy, did we run th

test this week?

Texas law requires that “sterilization equipment and its adequacy shall be tested and verified in accord with American Dental Association (ADA) recommendations”.

The CDC and ADA recommend weekly sterilizer monitoring with biological indicators.

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February 2014

Journal TEXAS DENTAL Every Member‌One Association

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102102TexasTexas DentalDental Journal Journal l www.tda.org l www.tda.org l February l February 20142014

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TEXAS DEnTAl JournAl Established February 1883

Vol 131, No 2

n

120

128

n

February 2014

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ABOUT THE COVER

For its biannual special membership issue, the TDA Council on Membership presents “Every Member ... One Association.” The TDA membership represents all fields and aspects of dentistry, from private practice to public health to rural dentistry. Each member is as similar as is different. Whether practicing as a military dentist or a correctional facility dentist, the common bond each has is TDA membership.

120 122 124 128 131 132 136 140 142 144

is THE fAsT lAnE THE TORTOisE OR THE HARE? David L. Doerre, DDS, Burkburnett

Dr Doerre explains the benefits of small town solo dentistry.

PREPAREd fOR THE CHAllEngE Philip N. R. Estes, DDS, Frisco

As a solo-practice owner dentist, Dr Estes describes how his service in the U.S. Army Reserves parallels his TDA membership.

my lifE As A CORRECTiOnAl dEnTisT

William M. Walton, DDS, Clyde What started as a means to provide for the future of his family turns into a passion. Read Dr Walton’s experience as a correctional facility dentist.

sHARing A ROOf

Lisa S. Jacob, DDS, Austin Dr Jacob shares her experience as a pediatric hospital dentist and the opportunity to work in multidisciplinary teams.

A PRACTiCE wiTH OnE Big VOiCE

Georganne P. McCandless, DDS, Tomball Dr McCandless explains how advice and years of honing her skills helped her in private practice.

THE AdVAnTAgEs Of A miliTARy PRACTiCE

Phillip J. Harvey, DDS, Burkburnett As a dentist in the U.S. Air Force, Dr Harvey explains the opportunities and fulfillment of military practice.

BEing A RURAl dEnTisT

Carole Lynne Bates, DDS, Farmersville Dr Bates’ life as a rural dentist is much different than her previous occupation that allowed her to travel the world, but she would not change a thing.

PEdiATRiC PUBliC HEAlTH

Yvonne E. Maldonado, DDS, El Paso Mentorship has proved invaluable as Dr Maldonado describes in her experience as a public health dentist.

my POsiTiVE ExPERiEnCE

Andrea Janik, DDS, San Antonio Dr Janik tells her positive experience in a large group practice model.

TRAnsiTiOning fOR THE fUTURE

Stephen R. Wright, DDS The first years out of dental school were tough, and Dr Wright explains how serving as an associate dentist to purchase an established practice was right for him.

MONTHLYFEATURES 108 112 116 118 152

154 160

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President’s Message TDA Governance: Call for Nominations Oral and Maxillofacial Pathology Case of the Month Critically Appraised Topic of the Month 2013 TDA Annual Session TEXAS Meeting Photo Contest Winner Dental Artifacts TEXAS Meeting Preview

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Oral and Maxillofacial Pathology Case of the Month Diagnosis and Management Calendar of Events Value for Your Profession In Memoriam Memorial and Honorarium Donors Advertising Briefs Index to Advertisers

TDA members, use your smartphone to scan this QR Code and access the online Texas Dental Journal.

Editorial Staff

Editorial Advisory Board

BOARD OF DIRECTORS TEXAS DENTAL ASSOCIATION

Daniel L. Jones, DDS, PhD, Associate Editor Harvey P. Kessler, DDS, MS, Associate Editor Nicole Scott, Managing Editor Barbara Donovan, Art Director Paul H. Schlesinger, Consultant

Ronald C. Auvenshine, DDS, PhD Barry K. Bartee, DDS, MD Patricia L. Blanton, DDS, PhD William C. Bone, DDS Phillip M. Campbell, DDS, MSD Michaell A. Huber, DDS Arthur H. Jeske, DMD, PhD Larry D. Jones, DDS Paul A. Kennedy Jr, DDS, MS Scott R. Makins, DDS Daniel Perez, DDS William F. Wathen, DMD Robert C. White, DDS Leighton A. Wier, DDS Douglas B. Willingham, DDS

The Texas Dental Journal is a peer-reviewed publication.

Texas Dental Association 1946 S IH-35 Ste 400, Austin, TX 78704-3698 Phone: 512-443-3675 • FAX: 512-443-3031 E-mail: tda@tda.org • Website: tda.org Texas Dental Journal (ISSN 0040-4284) is published monthly, one issue will be a directory issue, by the Texas Dental Association, 1946 S IH-35, Austin, TX, 78704-3698, 512-443-3675. Periodicals Postage Paid at Austin, Texas and at additional mailing offices. POSTMASTER: Send address changes to TEXAS DENTAL JOURNAL, 1946 S IH 35, Austin, TX 78704. Copyright 2014 Texas Dental Asociation. All rights reserved.

Annual subscriptions: Texas Dental Association members $17. In-state ADA Affiliated $49.50 + tax, Out-ofstate ADA Affiliated $49.50. In-state Non-ADA Affiliated $82.50 + tax, Out-of-state Non-ADA Affiliated $82.50.

Single issue price: $6 ADA Affiliated, $17 Non-ADA Affiliated, September issue $17 ADA Affiliated, $65 NonADA Affiliated. For in-state orders, add 8.25% sales tax.

Contributions: Manuscripts and news items of interest to the membership of the society are solicited. Electronic submissions are required. Manuscripts should be typewritten, double spaced, and the original copy should be submitted. For more information, please refer to the Instructions for Contributors statement printed in the September Annual Membership Directory or on the TDA website: 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 journal 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 Texas Dental Journal is a member of the its manufacturer.

American Association of Dental Editors.

Member Publication

PRESIDENT David A. Duncan, DDS 806-355-7401, davidduncandds@gmail.com PRESIDENT-ELECT David H. McCarley, DDS 972-562-0767, drdavid@mccarleydental.com IMMEDIATE PAST PRESIDENT Michael L. Stuart, DDS 972-226-6655, mstuartdds@sbcglobal.net VICE PRESIDENT, NORTHWEST David C. Woodburn, DDS 806-358-7471, olddave1@gmail.com VICE PRESIDENT, NORTHEAST Jean E. Bainbridge, DDS 214-388-4453, jbainbridgedds@sbcglobal.net VICE PRESIDENT, SOUTHEAST Gregory K. Oelfke, DDS 713-988-0492, greg@oelfke.com VICE PRESIDENT, SOUTHWEST Yvonne E. Maldonado, DDS 915-855-2337, yvonnedent2000@yahoo.com SENIOR DIRECTOR, NORTHWEST Steven J. Hill, DDS 806-783-8837, sjhilldds@aol.com SENIOR DIRECTOR, NORTHEAST Jerry J. Hopson, DDS 903-583-5715, dochop@verizon.net SENIOR DIRECTOR, SOUTHEAST William S. Nantz, DDS 409-866-7498, wn3798@sbcglobal.net SENIOR DIRECTOR, SOUTHWEST Joshua A. Austin, DDS 210-408-7999, jaustindds@me.com DIRECTOR, NORTHWEST Charles W. Miller, DDS 817-572-4497, cwdam@sbcglobal.net DIRECTOR, NORTHEAST William H. Gerlach, DDS 972-964-1855, drbill@gerlachdental.com DIRECTOR, SOUTHEAST Karen A. Walters, DDS 713-790-1111, kwalters@sms-houston.com DIRECTOR, SOUTHWEST John B. Mason, DDS 361-854-3159, jbmasondds@aol.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@msn.com PARLIAMENTARIAN Michael D. Vaclav, DDS 806-355-7463, drvaclav@suddenlinkmail.com INTERIM EXECUTIVE DIRECTOR Michael L. Stuart, DDS 512-443-3675, mstuartdds@sbcglobal.net LEGAL COUNSEL Mr William H. Bingham 512-495-6000, bbingham@mcginnislaw.com

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Auto insurance that works for you.

Did you know that Liberty Mutual Insurance offers TDA members, quality auto insurance? You could save hundreds of dollars with our valuable discounts, including our Multi-Policy Discount when you also insure your home with us. Plus, you’ll receive coverage you can trust, including features OFFER AVAILABLE FOR and options such as Accident Forgiveness2, New Car Replacement3, and Lifetime Repair Guarantee.4

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President’s Message David Duncan, DDS, TDA President

The young dentists coming out of school, the dentists looking to bring in an associate, or the dentists looking to slow down have so many more options and opportunities that navigating the waters can be very difficult. I feel it is TDA’s role to help advise and inform them on all the different practice models.

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I remember that famous line by Groucho Marx, “I don’t want to belong to any club that will have the likes of me as a member.” Folklore has it that he was being invited to join a club. Actually, he was resigning from a club.

Either way, he wasn’t going to be a member.

In today’s changing work place environment an association such as ours has to find a way to “reinvent” itself and find an umbrella large enough to include everyone. The young dentists coming out of school, the dentists looking to bring in an associate, or the dentists looking to slow down have so many more options and opportunities that navigating the waters can be very difficult. I feel it is TDA’s role to help advise and inform them on all the different practice models. So, in this issue of the Journal you will see articles from military, public health, faculty, solo/associateship and managed care organizations.

Just one night last week I was in a local restaurant when a young man asked “Aren’t you David Duncan?” I said, “Yes” and he replied that he was a dentist here in Amarillo and recognized me from my picture on the Journal. He told me he had been here 4 years and just talked to one of our members about joining the society. That’s great, right? Yes in the fact that he is joining, but no in regards that he had been here 4 years and yet to be invited, one-on-one, to any of our dental functions. Our market share is declining and I think it is because members like this young man are not being approached. We have to do better at telling and showing nonmembers what we are about. All of health care is changing and the laws governing providers like us are changing. Representing a large market share of our members is a must to have our voices heard in Austin and Washington DC. Don’t be embarrassed like I was when a dentist in your community tells you he hasn’t been invited. Find those dentists and bring them. It’s about all of us!

Texas Dental Journal l www.tda.org l February 2014

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CAT OF THE MONTH Critically Appraised Topics

In the Primary Care Setting, the Value of Adjunctive Aids for Oral Cancer Examinations Remains Unanswered (UT CAT #265) Clinical Question: Should clinicians use oral cancer adjunctive aids for earlier detection of oral cancer?

Clinical Bottom Line: Systematic reviews revealed that there is no evidence to support the use of adjunctive aids for the screening of premalignant or malignant oral lesions in a general practice setting. Tissue biopsy remains the gold standard for diagnosis.

Best Evidence: Patton LL, Epstein JB, Kerr AR. Adjunctive ! techniques for oral cancer examination and lesion diagnosis: a systematic review. J Am. Dent. Assoc.

Jul.139(7):896-905, 2008, PMID 18594075.

Brocklehurst P, Kujan O, Glenny AM, Oliver R, Sloan P, Ogden G, Shepherd S. Screening programmes for the early detection and prevention of oral cancer. Cochrane Database Syst Strength of Evidence Rev. Nov. 2010. PMID 21069680.

Key Results: In a general practice setting, there is no robust evidence to either support or not support the use of adjunctive diagnostic aids to screen for oral cancer. Further research is needed to determine the costeffectiveness of visually based adjunctive aids.

Comments on Evidence: Both systematic reviews describe a detailed search of relevant articles, and both expressed concern about the lack of high quality definitive research. After Brockelhurst’s analysis of 1,719 studies, only one met the inclusion criteria. The one nine-year RCT reviewed consisted of 191,873 patients and has a high risk of bias.

__ Systematic Review & Meta Analysis ___ Randomized Trials ___ Cohort Study ___ Case Series

___ Case Reports

Faces you Know, Names you Trust.

___ Editorials & Opinions ___Animal Research

___ In-Vitro Research Applicability or Significance:Kathleen At the present time, disciplined visual Hamilton, DDS, MBA, CMEA examination remains the standard Joel for screening for premalignant or malignant C. Small, DDS, MBA, FICD oral lesions in the primary care setting.

Lynne Gerlach, DDS, FICD, FACD

Authors:

As dentists, we understand all of the personal and professional milestones Dr.experience Michaell A. to Huber is Dr.in Cook Deana you’ve achieved your life.

Weisbring that knowledge and Meredith Key is Oral Medicine Subject currently Hamilton, Small & practice transitions.

Our currently a Junior Associates a Resident where in we focus on dentalan Expert and an Associate firm offers a variety of comprehensive resources to general/restorative dentistry the Dept. of Dental Student at

Professor in and the Dept. practices, including sales, purchases, associateships, partnerships, both of Periodontics at UTHSCSA.

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CATs Student Technical Editor: Judy Philip. For more information on the CATs program, contact Mabel Hernandez at PRACTICE 210-567-3516 SALES • APPRAISALS • BUYER REPRESENTATION ASSOCIATESHIPS PARTNERSHIPS • CONSULTING or visit http://cats.uthscsa.edu.

The CATs•program is supported•by NIH R25DE018663.

1102 Journal l www.tda.org l October 110 TexasTexas DentalDental Journal l www.tda.org l February 20142011

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Member of The Institue of Business Appraisers, Inc. CALL 1-800-583-7765 OR DFW AREA 214-503-9696 Texas Dental Journal l www.tda.org l June 2011 2011 509 Texas TexasDental DentalJournal Journall lwww.tda.org www.tda.orgl lOctober February 20141103 111

Official call fOr NOmiNatiONs

Official Call for Nominations: Statewide Election of TDA President-elect

Official Call for Speaker of the House Nominations

CHAPTER VI, Section 30 of the TDA Bylaws state that the president-elect shall be nominated in turn clockwise from and by the members of each of the 4 divisions — Southeast, Southwest, Northwest, and Northeast. Every third year the president-elect shall be nominated on a statewide basis. The divisional rotation of the president-elect will continue in the intervening years.

Nominations for the elective office of TDA Speaker of the House may be submitted to TDA Secretary-Treasurer Dr Ron Collins.

Only an active, life, or retired member in good standing of this Association shall be eligible. A curriculum vitae (CV) must accompany a letter of intent and the nominee will also have to sign a conflict of interest statement. If a CV is not submitted, the nominee must present their qualifications verbally before the House of Delegates. Nominations are in order at any time until the close of nominations at the beginning of the next to the last meeting of the House of Delegates; however, we request that nominations be made as early as possible so that membership eligibility can be verified.

Nominations statewide for the elective office of Texas Dental Association (TDA) president-elect may be submitted to TDA Secretary-Treasurer Dr Ron Collins.

Only an active, life, or retired member in good standing of this Association shall be eligible. A curriculum vitae (CV) must accompany a letter of intent, and the nominee will also have to sign a conflict of interest statement. If a CV is not submitted, the nominee must present his or her qualifications verbally before the House of Delegates. Nominations are in order at any time until the close of nominations at the beginning of the next to the last meeting of the House of Delegates; however, we request that nominations be made as early as possible so that membership eligibility can be verified.

Duties of the president-elect are found in the Bylaws and include the following: a. b. c. d. e. f. g.

To preside in the absence of the president.

To assist the president as requested.

To serve as an ex-officio member of the Board of Directors and the House of Delegates.

To perform such other duties as may be provided in these Bylaws.

To succeed to the office of president at the next annual session of the House of Delegates following his/her election as president-elect.

To serve on the Council of Legislative and Regulatory Affairs.

To serve as chair of the Committee of Component Society Presidents.

Duties of the subsequent position of TDA president are also enumerated in the Bylaws and include the following: a. To serve as official representative of this Association in its contacts with governmental, civic, business, and professional organizations for the purpose of advancing the objects and policies of this Association. b. To serve as an ex-officio member of the Board of Directors of the Association. c. To be presiding officer of the Board of Directors of this Association. d. To be the supervising authority of the executive director on behalf of the Board of Directors. e. To annually appoint the parliamentarian for the Association who shall serve as the speaker pro-tem of the House of Delegates, should it become necessary for the speaker to be absent. f. To call special sessions of the House of Delegates and Board of Directors as provided in Chapters IV and V of these Bylaws. g. To appoint, with approval of the Board of Directors, the members of all committees and such others as may be necessary to the work of the Association except as otherwise provided in these Bylaws. h. To submit an annual report to the House of Delegates at the first session concerning his/her activities during the year and presenting such matters as should be brought to their attention, or may require their action. i. To conduct annually a presidents-presidents-elect conference for component presidents and presidents-elect. j. To perform such other duties as may be provided in the TDA Bylaws.

Duties of the speaker of the house are found in the Bylaws and include the following: a. b. c. d.

e. f.

g.

h.

Nominations are to be mailed to TDA Secretary-Treasurer Dr Ron Collins, Texas Dental Association, 1946 S IH-35 Ste 400, Austin, TX 78704; or e-mailed to TDA Interim Executive Director Dr Michael L. Stuart, mstuartdds@sbcglobal.net.

(Ref. TDA Bylaws, Chapter VI – Sections 30 and 90A,B)

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i.

To serve as an ex-officio member of the Board of Directors without vote.

To serve as an ex-officio member of the Executive Committee without vote.

To preside at all meetings of the House of Delegates.

To determine the order of business for all meetings, subject to the approval of the House of Delegates, in accordance with Section 140B of this Chapter.

To appoint tellers to assist him/her in determining the result of any action taken by vote.

To appoint members of reference committees in consultation with the president, president-elect and the immediate past-president by the first Board of Directors meeting of the calendar year.

To notify the divisional officers and the Committee on Credentials, Rules and Order, prior to the annual session, the number of delegates and alternates necessary to constitute a quorum.

To meet with the divisional officers prior to the meeting of the divisional caucuses at the annual session to review the Rules For Caucus Procedures, Nominations, and Elections.

To appoint a parliamentarian pro tem,

should it become necessary for the parliamentarian to be absent during a session of the House of Delegates. j. When the need shall arise, appoint special committees to perform duties not otherwise assigned by these Bylaws, to serve until adjournment sine die of the session at which they were appointed. k. In the event that the divisional nominee for a particular office be declared ineligible, that the Speaker of the House of Delegates shall direct the divisional caucus to reconvene to select a new nominee. l. The installation of officers shall be held during the closing meeting of the House of Delegates at such time as determined by the Speaker and conducted by the retiring president or past-president. The term of new officers begins at the adjournment of the House of Delegates. m. The secretary of this Association shall serve as the secretary of the House of Delegates. In absence of the secretary, the speaker shall appoint a secretary of the House of Delegates pro-tem.

Nominations are to be mailed to TDA Secretary-Treasurer Dr Ron Collins, Texas Dental Association, 1946 S IH-35 Ste 400, Austin, Texas 78704; or e-mailed to TDA Interim Executive Director Dr Michael L. Stuart, mstuartdds@sbcglobal.net.

(Ref. TDA Bylaws, Chapter IV – Sections 100, 110A, 150C, 150D, Chapter V – Sections 10, 70Aa, and the TDA House Manual).

Official Call for Editor Nominations Nominations for the elective office of TDA editor may be submitted to Dr. Ron Collins, TDA secretary-treasurer. Only an active, life, or retired member in good standing of this Association shall be eligible. A curriculum vitae (CV) must accompany a letter of intent and the nominee will also have to sign a conflict of interest statement. If a CV is not submitted, the nominee must present their qualifications verbally before the House of Delegates. Nominations are in order at any time until the close of nominations at the beginning of the next to the last meeting of the House of Delegates; however, we request that nominations be made as early as possible so that membership eligibility can be verified.

Duties of the editor are found in the Bylaws and include the following: a.

Official Call for Secretary-Treasurer Nominations Nominations for the elective office of TDA secretary-treasurer may be submitted to Dr Ron Collins, TDA secretary-treasurer. Only an active, life, or retired member in good standing of this Association shall be eligible. A curriculum vitae (CV) must accompany a letter of intent and the nominee will also have to sign a conflict of interest statement. If a CV is not submitted, the nominee must present their qualifications verbally before the House of Delegates. Nominations are in order at any time until the close of nominations at the beginning of the next to the last meeting of the House of Delegates; however, we request that nominations be made as early as possible so that membership eligibility can be verified.

b.

Duties of the secretary-treasurer are found in the Bylaws and include the following: a. b. c. d. e. f. g. h. i.

Examine the income and expenses of this Association and report at each meeting of the Board of Directors.

Serve as recording officer and custodian of the records of the House of Delegates and the Board of Directors.

Ensure that the minutes of the House of Delegates and the Board of Directors be maintained.

Serve as secretary to the Executive Committee, without the right to vote.

Serve as secretary to the House of Delegates.

Serve as chair of the Budget Committee.

Serve as chair of the Assets Oversight Committee.

Serve as the secretary of the American Dental Association Fifteenth Trustee District Delegation.

Perform such other duties as shall be specified by the Board of Directors and these Bylaws.

Nominations are to be mailed to TDA Secretary-Treasurer Dr Ron Collins, Texas Dental Association, 1946 S IH-35 Ste 400, Austin, Texas 78704; or e-mailed to TDA Interim Executive Director Dr Michael L. Stuart, mstuartdds@sbcglobal.net.

(Ref. TDA Bylaws, Chapter IV – Sections 70A-B, 110B; Chapter V – Sections 10, 70Aa, 80B; Chapter VI – Section 90G; Chapter VIII – Section 80)

c.

d.

To be editor-in-chief of all journals and publications of the Association and exercise full editorial control over such publications, subject only to policies established by the House of Delegates, Board of Directors and these Bylaws and provided such content is not in conflict with or contrary to the TDA’s established policies, legislative agenda, or advocacy efforts.

To control the selection of scientific material published in the Journal. The editor may appoint associate editors, with the concurrence of the Board of Directors, to gather and/or review material for publication. Such associate editors shall serve as long as the editor deems necessary; but never longer than the term of the Editor.

To attend all open meetings of the Board of Directors and the House of Delegates of this Association, and the annual session of the American Dental Association.

To hold no other elective office in this Association or the American Dental Association while serving as editor, except the editor may be elected as delegate or alternate delegate to the ADA House of Delegates from his/her respective division.

Nominations are to be mailed to TDA SecretaryTreasurer Dr Ron Collins, Texas Dental Association, 1946 S IH-35 Ste 400, Austin, Texas 78704; or e-mailed to TDA Interim Executive Director Dr Michael L. Stuart, mstuartdds@ sbcglobal.net.

(Ref. TDA Bylaws, Chapter VI – Section 90I)

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Here are the distinct advantages of the webcast (contact us at 214-679-9680 to see which courses are available for webcast): 1. You can receive continuing education credit for simultaneous live lecture CE hours.

2. There is no need to travel to the program location. You can stay at home or in your office to view and listen to the course.

3. There is not a post-test after the webcast course concludes, so you will receive immediate CE credit for attendance 4. You can enjoy real-time interaction with the course instructor, utilizing a question and answer format

Nitrous Oxide/Oxygen Conscious Sedation Course for Dentists:

McKinney, Texas: Credit: Time: McKinney, Texas: McKinney, Texas: Rockport, Texas: Tyler, Texas: Credit: Time:

Each course date is by appointment with Dr. Canfield, please call for details 14 hours (clinicians must complete the online portion, first) 7:00 am – Registration; 7:30 am – 5:00 pm – Clinical Presentation

**Level 1 and Level 2 Enteral Sedation Renewal Courses (only 1 day needed to renew): Friday, March 28, 2014; or Saturday, March 29, 2014 Saturday, May 3, 2014; Friday, June 6, 2014; or Saturday, June 7, 2014 Saturday, July 5, 2014 Friday, July 18, 2014 8 hours lecture 7:00 am – Registration; 7:30 am – 5:00 pm – Presentation

**Level 1 Initial Minimal Sedation Permit Courses:

McKinney, Texas: McKinney, Texas: Credit: Time:

Friday & Saturday, March 28-29, 2014 Friday & Saturday, June 6-7, 2014 18 hours lecture with 20 clinical experiences 7:00 am – Registration; 7:30 am – 5:00 pm – Presentation

McKinney, Texas: McKinney, Texas: Credit: Time:

March 28-29, 2014 & April 12, 2014 Thursday – Saturday, June 5-7, 2014 24 hours lecture/participation with clinical experiences and 3 live sedations 7:00 am – Registration; 7:30 am – 5:00 pm – Presentation

Level 2 Initial Moderate Sedation by Oral Administration Permit Course:

Level 1 to Level 2 Transitional Moderate Sedation Permit Course (must have a Level 1 permit):

San Antonio, Texas: McKinney, Texas: Credit: Time:

Friday, March 7, 2014 Sunday, April 12, 2014; or Saturday, June 7, 2014; or Saturday, July 19, 2014 8 lecture/participation hours with clinical experiences and 3 live sedations 7:00 am – Registration; 7:30 am – 4:30 pm – Presentation

ACLS (Advanced Cardiac Life Support) & PALS (Pediatric Advanced Life Support) Program):

Houston, Texas: McKinney, Texas: Credit: Time:

Friday, June 13, 2014 Friday, August 1, 2014 8 hours lecture/Participation 7:30 am – Registration; 8:00 am – Presentation start time

Houston, Texas: McKinney, Texas: Credit: Time:

Friday and/or Saturday, June 13-14, 2014 Friday and/or Saturday, August 1-2, 2014 16 hours lecture for 2-day program; or 8 anesthesia hours for 1 day program 7:30 am – Registration; 8:00 am – 5:00 pm – Presentation

Level 3 & Level 4 Parenteral Sedation Permit Renewal & ACLS Course:

AGD Codes for Level 1 & 2 programs: 132 Anesthesia & Pain Control; 163 Conscious Sedation; 164 Oral Sedation AGD Codes for Level 3 & 4 programs: 132 Anesthesia & Pain Control; 163 Conscious Sedation The above continuing education programs fulfill the TSBDE Rule 110 practitioner requirement in the process to obtain selected Sedation permits.

This is only a partial listing of sedation courses. Please consult our website for updates and new programs.

Find us on the web at www.sedationce.com Call us at 214-384-0796 to register for any program

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A 2-day hands-on surgical cadaver course is included.

The representative faculty will be composed of all the clinical specialties (Radiology, Prosthodontics, Periodontics, Oral Maxillofacial Surgery and Endodontics) of Implant Dentistry and foundational basic sciences.

Upon completion of this program, registrants will be eligible for Fellowship Status in the International Congress of Oral Implantologists. For an additional $1,000, you may enroll in on-line education and receive the additional 150 CEU hours needed to be eligible for the Associate Fellow exam in the American Academy of Implant Dentistry (AAID).

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Surgical Cadaver Bone Grafting Course (M. Sharawy, DDS, PhD)

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Continuing Education dates are subject to change. Please confirm dates and time when registering.

Mention code TJ-01 when registering and get 5% off registration if enrolled before 1/31/14.

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Oral and Maxillofacial Pathology Case of the Month Case History A 5.5-year-old boy presented to the hospital emergency room with a chief complaint of a nontender gingival growth that was first noticed earlier in the day. While brushing his teeth in the evening the parents became alarmed by the fact that the child was spitting blood into the sink and decided to have this problem evaluated immediately. Except for a history of chronic otitis media that was successfully treated with the placement of myringotomy tubes, the child was healthy. He was not taking any medications and had no known allergies.

Because the oral bleeding had subsided and the child was not in acute distress, a referral was made to the university pediatric dentistry clinic for diagnosis and management of the oral condition for the following day.

The clinical examination revealed a tapered finger-like, soft tissue projection, measuring 5 mm X 3 mm, involving the alveolar mucosa, distal to the primary maxillary right second molar (Figures 1A and B). The apex of the enlargement was covered by a creamed-colored pseudomembrane, while the base of lesion was reddish-pink, smooth, and glistening. The lesional margins were clearly defined and there was an abrupt transition from normal alveolar mucosa and the fingerlike projection. The gingival enlargement was nontender to palpation, but bled freely with gentle manipulation. The surrounding alveolar mucosa was smooth and pink except for the blanched areas overlying the mesial cusp tips of the erupting first permanent molar. A bite-wing radiograph of the area revealed a normally developed crown of the erupting permanent maxillary first molar (Figure 2). No other similar lesions in the mouth were observed.

Because the lesion bled with minimal manipulation, the lesion was excised, following the topical application of a compounded anesthetic, consisting of 10 mg lidocaine, 10 mg prilocaine, and 4 mg tetracaine and was submitted for routine histopathologic examination. The microscopic findings included a thin sheet of fibromyxomatous tissue that was subacutely inflamed with superficial bacterial

Matthew K. Geneser, DDS, clinical assistant professor, Department of Pediatric Dentistry, The University of Iowa College of Dentistry, Iowa.

John W. Hellstein, DDS, clinical professor, Department of Oral Pathology, Radiology and Medicine, The University of Iowa College of Dentistry, Iowa.

Geneser

Hellstein

Catherine M. Flaitz, DDS, MS, distinguished teaching professor, Department of Diagnostic and Biomedical Sciences, The Flaitz University of Texas School of Dentistry at Houston, Texas.

Figures 1A and B. Erythematous and ulcerated soft tissue enlargement of the right posterior alveolar mucosa, overlying an unerupted permanent first molar, indirect mirror view.

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colonization (Figures 3A-C). In a focal area the inner margin was partially lined by flattened reduced enamel epithelium (Figure 3C, arrow).

The child returned for post-surgical evaluation 2 weeks following the biopsy and the gingival site had healed uneventfully. The underlying molar was partially erupted and the surrounding tissues were healthy (Figure 4).

What is the final diagnosis?

See page 164 for discussion and answer.

Figure 2. Bite-wing radiograph illustrating that the maxillary first permanent molar is close to eruption.

Figure 3A. This photomicrograph shows fibromyxomatous connective tissue with an area of necrosis and residual granulation tissue. (Hematoxylineosin, original magnification 20x.)

Figure 3B. This photomicrograph shows acute and chronic inflammatory cells within the connective tissue and superficial bacterial colonization.

(Hematoxylin-eosin, original magnification 40x.)

Figure 4. The partial eruption of the maxillary first permanent molar about 10 days following the surgical removal of the soft tissue enlargement.

Figure 3C. This photomicrograph shows a minute area of flattened epithelial cells, consistent with reduced enamel epithelium (arrow).

Subjacent to the lining epithelium is microcystic area in the underlying connective tissue. Numerous inflammatory cells are also noted. (Hematoxylin-eosin, original magnification 40x.)

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Private Practice

In conjunction with the February observance of National Children’s Dental Health Month, Burkburnett dentist Dr David “Butch” Doerre and his staff visited area school campuses, church preschools, and daycare facilities to give educational presentations stressing the importance of good dental care and nutrition. Dr Doerre is in his 25th year of leading the informative forums which culminate with all the youngsters receiving a free goody bag containing all the essentials for good oral hygiene. Dr Doerre kicked off this year’s visits with presentations at I.C. Evans Elementary. Students are (from left) Angelina Wilson, Katey Neff, Devin Bishop, Kasandra Neal, Landen Pitman, Dalton Taylor, and T’Rea Mullins. (Photo by Jeff Bromley).

Is the Fast Lane the Tortoise or the Hare?

David L. Doerre, DDS, Burkburnett

Small town solo practice may seem like the turtle pace to those living in the major metro areas. You may feel you will miss out on all the opportunities available.

What I found was I have all the same opportunities whenever I want.

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ne reason for my choosing to return to our small community of Burkburnett, where I graduated high school, was the chance to live a slower-paced life style than that experienced while at dental school in Houston. So I thought!

Upon my return to town, I associated with a local dentist thinking this was the slow way of getting into the practice of dentistry without too much overload on my expenses. What I found was that I was not cut out for working under someone else’s opinions of the ideal practice. I wanted to offer and treat each patient with the type of dentistry I thought was best for their concerns.

So now I have been in solo practice for the past 33 years and still going, going, going. Where’s the slow pace?

I love treating my patients, my friends, my neighbors, my church, and yes, my relatives as if all of them are my family. I interact with my “family” in all settings around town. This includes teaching the kids at the schools every February, church functions, Friday night football games, all aisles of the grocery store, etc. Being part of this community is my ideal setting.

Small town solo practice may seem like the turtle pace to those living in the major metro areas. You may feel you will miss out on all the opportunities available. What I found was I have all the same opportunities whenever I want. I once met my brother and his family at a Texas Rangers game in Arlington. He lived in McKinney at the time. I arrived at the field in a 2-hour time frame. It took

him 1 hour and 45 minutes. Everything my family and I need is still within easy reach whenever we want to go, without the daily commute back and forth to work. It takes me 5 minutes to get to work, 6 if the school bus stops in front of me.

There are multiple small communities and rural situations that might be perfect for a recent graduate from dental school or a change of pace from an existing practice model. It provides a low overhead to help you reduce your educational loans and expenses.

It helps the underserved areas of the state and provides many grateful patients who will stay loyal to you and allow you to do the same for them.

The most beneficial thing I received upon graduation was when several of the local dentists already in practice introduced me to the Texas Dental Association and the local component

society. Those dentists knew the power of being a part of organized dentistry, and I will be forever grateful to them for helping me. Over the years the Texas Dental Association has provided me with everything from friends and mentors to practice aids and TDA Perks. It has provided a small town dentist the opportunity to represent you at the state level with appointments to various committees and councils. I am humbled to serve as your chair to the Council on Membership and hope this issue will give you an insight to the many practice models available to fit your needs.

How you approach your practice of dentistry and life in general will keep you on the right path for your desires.

You can have it both ways by living the hare’s pace in the tortoise setting and providing needed care in underserved areas.

Everything my family and I need is still within easy reach whenever we want to go, without the daily commute back and forth to work. It takes me 5 minutes to get to work, 6 if the school bus stops in front of me.

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Army Reserves

Prepared for the Challenge Philip N. R. Estes, DDS, Frisco Major, United States Army Reserves, with 13 years of service, including a deployment to Iraq; earned the Bronze Star Medal for service in Iraq from November 2004 to November 2005; solo-practice owner in Frisco, Texas, since 2009.

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s a young man I decided that I wanted to become a family dentist serving my community in private practice. The rewards of my career for me personally are endless: freedom, education, self-determination through

financial independence, and a sense of being a tremendously positive influence on my community promoting health for the families I serve.

I also wanted to serve my country and to be prepared for the challenges that our nation faces. The events of 9/11 changed a lot for me, as it did for all of us. I see it as the duty of all medical professionals to be prepared to respond when natural disasters, acts of terrorism, or

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Major Estes in Iraq

Dr and Mrs Estes

With daughter Maddy

mass injuries from industrial accidents occur within our neighborhoods. Our health care system is not designed to meet the overwhelming requirements that such events produce. We all know examples of this from West, Texas, to Hurricane Katrina to the Boston Marathon bombing. Serving in the U.S. Army Reserves places me in a position to do my part to help out in a similar scenario.

Additionally, the U.S. Army Reserves gives me a chance to get out of the office and meet new people who also serve. Building a professional network of colleagues who share my values is a huge bonus. I am constantly mentored and have a chance to be a mentor to junior officers. Plus the friendships you forge while serving are some of the deepest ones to be had.

Homecoming

If I had to give advice a senior dental student, I would suggest he or she starts with the end in mind, then plan backwards to determine what he or she needs to be doing to reach life’s ambitions. Figure out what you want your lifestyle to be like, where you want to live, when and if you want to get married and start a family. Then, orient what you do each day to build on the next step towards your goals.

Big pitfalls are: making snap decisions, getting into bad relationships, building up excessive debt, and not exploring all of your options. If you are looking for a way to pay down your debt, serve your country, have some adventure, and meet interesting people, then look into the U.S. Army Reserves. See if it fits. I have served the Army, but it has served me right back.

Additionally, being a TDA member has helped me in my practice setting.

For me, it is simple math. There is great strength in numbers. Alone we are powerless to affect the system and that is how I felt before I joined the TDA. Yet together we can protect our profession and sharpen each other. There is no one who knows it all and lots out there who run into the same problems that I run into who have offered me solutions that work. Our profession is too tough to figure everything out for yourself, not to mention the business side of it. The TDA helps me network with other professionals who care about patients, the future of dentistry, and are committed to the very best product our profession can provide the public we serve.

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Correctional Facility Dentist

My Life as a Correctio William M. Walton, DDS, Clyde

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onal Facility Dentist When I started working 1 day a week as an independent contractor at a Texas Department of Criminal Justice (TDCJ) facility 17 years ago, I had no idea I would eventually become a correctional facility dentist with the Texas Tech University Health Sciences Center (TTUHSC).

In the beginning, I gave up my golf day to earn extra income to pay for the college education of my 3 children. But even when the college expenses were behind me, I continued to enjoy my work at the prison and even added more time.

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Dr Walton and his staff I operated a solo private dental practice for 35 years, but the challenges of operating in a small town and how to transition toward retirement lead me to consider a fulltime position at the prison. This type of practice is not for everyone, but it has been great for me.

TDCJ dental clinics provide diagnostic, preventive, surgical, basic restorative and periodontal services to patients in the system. The goals are elimination of pain and preservation of function.

Difficult surgery and large composite or amalgam restorations are the norm.

Owning my own dental practice was my dream in becoming a dentist.

As times have changed, a large number of dentists are employees in one situation or another. Being a correctional dentist is very fulfilling for me.

Dental assistants and clerks are employees either of the university or a local hospital. Equal access to care is a benchmark and clinic procedures are audited to be sure that patients are treated in a timely manner consistent with the priority of their needs. Referrals are allowed on cases

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In the beginning, I gave up my golf day to earn extra income to pay for the college education of my 3 children. But even when the college expenses were behind me, I continued to enjoy my work at the prison and even added more time.

that require additional expertise.

Dentists make all treatment decisions.

Patient education is often more effective because the dental team can be blunt about the patient’s responsibilities in attaining oral health. At times you even hope oral hygiene education might impact the patient in other areas of personal responsibility.

Work conditions are good. Hours are normal and employees receive paid holidays and vacation. Security is the highest priority. For the most part, I am comfortable that I am safe; but employees are always cautioned to not become complacent.

Employees go through a metal detector and are pat searched upon entering the facility. No cell phones or cameras are allowed.

Certain email communication is possible while on the unit.

Membership in the TDA has been very important to me.

Many mentors were helpful in molding my appreciation of the profession. Volunteering in organized dentistry has been a way to honor the support they gave me as a young dentist. Early on I was encouraged to attend reference committee meetings at the annual session to participate in the formulation of the policies of the TDA. I have been privileged to be one small part of the chorus that is the voice of dentistry in Texas, the TDA. Others may wish to fragment responsibilities for the delivery of dental treatment, but I believe the TDA will remain steadfast in its support of the dentist as the head of the dental team.

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Pediatric Hospital Dentist

Sharing A Roof Lisa S. Jacob, DDS, Austin

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work at Dell Children’s Medical Center Pediatric Dentistry Clinic in Austin, Texas, a facility that caters to medically complex patients, their families, and its care teams. As its chief of pediatric dental medicine, I have the opportunity to work in multidisciplinary teams. Systemic conditions and their corresponding treatments often have significant impact on a patient’s oral health. My program uses the multi-specialty collaborations available at Dell Children’s to gain a detailed understanding of my patient’s medical treatment in order to provide the best dental care possible for my patients. With easy access and communication with our plastic surgeons, orthodontist, social workers, physician assistants, nurses and speech therapists, the best oral health care for my patients can be delivered. Since many of these patients are severely compromised, dental treatment often needs to be performed under general anesthesia. In the hospital setting, this can be coordinated when the patient is having another procedure performed under general anesthesia, thus increasing efficiency and reducing risks for the patient.

I find it rewarding to work on medically complex patients.

For example, a child born with cleft lip and palate will undergo many surgical procedures in his or her lifetime.

When I meet a newborn with cleft lip and palate, I tell the parents that the child may have some issues with their teeth. But, the one thing they can do is prevent dental decay in their child by monitoring their diet and hygiene.

Many parents of medically compromised children feel overwhelmed and helpless with the surgeries’ rehabilitation regimen. Educating the parents to help the child brush his or her teeth may be one of the few areas that a parent can control over their child’s overall health condition.

Dell Children’s Medical Center is home to various medical specialties. Sharing a roof has allowed for increased awareness of the importance of oral health to overall medical health to members of our medical community.

I present many oral health cases to various specialists at Dell Children’s Medical Center and to our community pediatricians on a yearly basis. Most recently, I reviewed the management of dental trauma for our Dell Children’s Trauma care team in order to help triage the patients with dental problems in our emergency department.

Dell Children’s Medical Center is home to various medical specialties. Sharing a roof has allowed for increased awareness of the importance of oral health to overall medical health to members of our medical community. I present many oral health cases to various specialists at Dell Children’s Medical Center and to our community pediatricians on a yearly basis.

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In my hospital, I have the opportunity to practice clinical dentistry, teach, and perform research. For the past 3 years, I have been training the pediatric medical residents affiliated with the Austin branch of The University of Texas Southwestern Medical School. All the first year pediatric medical residents do a rotation in the dental clinic and observe my team at work. The residents are taught about the importance of oral health care, primary dentition, growth and development, and dental trauma. I also coordinate a craniofacial elective in which a third-year pediatric medical resident learns more about craniofacial care. This allows our future medical professionals know the importance of oral health care and help us in our quest to prevent dental decay.

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If I had to give advice to senior dental students about practicing in a hospital-based practice, I would tell a student that if they like working in teams, then hospital dentistry is a good option. While there is less autonomy than working in a private dental practice, working in a hospital setting challenges ones knowledge daily. No 2 days are alike, and a multidisciplinary practice allows for

f I had to give advice to senior dental students about practicing in a hospital-based practice, I would tell a student that if they like working in teams, then hospital dentistry is a good option.

Another passion of mine is to perform dental research. One of my research projects revealed that 10% of the patients admitted as an inpatient from Dell Children’s Medical Center’s Emergency Room had facial cellulitis due to dental decay. The costs associated with a hospital stay for a patient with facial cellulitis is far greater than an outpatient visit for an extraction of a symptomatic tooth in a dental office. Sharing the results of the study showed how much more cost effective it is to provide outpatient dental services and preventive care.

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One of my proudest accomplishments in this position has been being able to educate interested parties on how to treat medically complex patients. I have created and chaired the Central Texas Dental Symposium for the past 3 years. This continuing education seminar is aimed at training oral health professionals on how to manage medically complex pediatric patients.

daily interactions with a number of different health care providers.

My daily workweek includes clinical duties 2 days a week and providing dental treatment in the operating room 2-3 days a week. I also care for patients who come to our emergency room and those who are inpatients as well. In a hospital-based practice I am continuously challenged and learn something new every day. I treat each child based on his or her individual needs both in prevent dental problems and treating dental conditions.

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I have been a TDA member for 12 years, and believe that TDA is the voice for all dentists in Texas. It represents our needs and helps make legislative changes. As the vice president of the Texas Academy of Pediatric Dentistry (TAPD), I have had the opportunity to participate in a number of events in coordination with the TDA. In 2009, I was the TAPD liaison for the First Dental Home initiative, which was created by the committee on access of the Texas Dental Association. The goal of this committee was to ensure that children in underserved communities Texas have a dentist who could provide them with dental care. I have been amazed at the reduction of dental decay in children under 3 years of age who have Medicaid and participate in the First Dental Home program.

As a member of the Council on Legislative and Regulatory Affairs for TAPD, I have been able to represent organized dentistry along with TDA members for House Bill 1480, which involved regulations of dental service organizations. I also was able to comment on House Bill 2483, which pertained to health programs in schools. As a participant in legislative committees, I feel it is important that we, as dentists, take an active role in upcoming legislation.

Private Practice Dentist

their children’s treatment needs, fine tuned my behavior management techniques, and learned about overall business operations. In 2004 I decided to “hang my shingle” and open a pediatric dental office in a small town community just north of Houston– Tomball, Texas. My official practice model is a clinical practice setting that is partly private pay with a few PPO insurance plans. This practice model is one in which I feel in control of all the business aspects and one in which the insurance companies work with me as a specialist.

A Practice With One Big Voice

Georganne P. McCandless, DDS, Tomball

I have been practicing pediatric dentistry for 16 years. I often wonder sometimes where the time has gone. There are many days that I still feel like I am “practicing” my technique.

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ike many of my colleagues, right out of dental school, I went to work for a great pediatric dentist that I consider a mentor, Dr Judith A. Ragsdale of The Woodlands. My many years there were invaluable for a variety of reasons. I learned how to manage a busy schedule, how to talk to parents about

I can honestly say that not a day goes by that I regret opening my own private practice. If I had to give any advice to senior dental students or residents getting ready to graduate, it would be to find a great place to work your first several years out. Pay attention to honing your dental skills and observe the business operations of a private dental practice. There is a big learning curve to having your own practice, any and all advice from colleagues that have successfully managed a practice are good resources. I am uniquely lucky in that my husband works for Patterson Dental Supply Company as an equipment specialist so his advice was and still is invaluable as he has been involved in dentistry for more than 20 years. We all have bad days at the office, but it’s been the single best business decision I have made to date.

Another good “business” decision I made was to join organized dentistry.

I was very involved as a student and continue active membership to this day. I am painfully reminded at times just how our state governance dictates to us what we can and can’t do under our licenses. Thankfully, my membership in the TDA gives me one big voice in terms of guiding legislation as it relates to dentistry. I am forever grateful to our member leaders who serve in this capacity and give voice to our everyday practice issues.

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Air Force

The Advantages of a Military Practice Phillip J. Harvey, DDS, Burkburnett There are several advantages that I see in military practice — camaraderie, educational opportunities, team dentistry, personal fulfillment, and financial benefits are the first that come to mind.

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here comes the time, in the life of every dentist, when a decision about the environment in which they will practice, must be made. Traditionally that choice is made in the third or fourth year of dental school, when the stark realization that real life will be happening quite quickly. For me, that choice came earlier than for the majority of my classmates.

First a few words on what influenced me to join the Air Force. The decision

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to apply for and ultimately accept an Air Force Health Profession Scholarship was multifactorial. From my youngest days I was instilled with a desire to serve my country through a career in the military. I grew up as an Air Force kid in a second-generation Air Force family. The decision was also a financially calculated one. My first of 5 children was born in my initial year of dental school. With close to $100,000 of school debt looming and the burden of providing for my growing family, the Air Force seemed

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and has proven to be a smart financial decision. The events of September 11, 2001, unfolded during my first year of dental school and after discussion with my wife, cemented the decision in my mind.

As is usually the case the needs of the Air Force determine the number and duration of the scholarships offered.

At the time, the longest scholarship offered was a 3-year deal that required a 3-year commitment of service. The scholarship was awarded based on

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dental and undergraduate GPA and an interview process with the local health care recruiter. As I imagine, in most dental schools, the recruiters for each of the services had a constant presence. Informational pizza lunches with the traditional handing out of memorabilia and branded trinkets made information on the process easy to come by. I contacted my local recruiter and began the course that ultimately landed me the 3-year health profession scholarship from the Air Force.

endorsement from the Department of Defense or the United States Air Force.

This scholarship did more than just pay my tuition. It also paid for my books and clinical supplies, as well as a monthly stipend that allowed my wife to cut back to part time as an RN and stay home more with our son. By graduation time we were a family of 4 with my daughter’s arrival late in my third year. From a financial aspect it was one of the best decisions I have ever made. I watched as my classmates, frantically in some cases and calmly in others, searched for apprenticeships or took out huge loans in order to hang their shingles in their home towns. I am sure that if you asked them today, it was worth the stress and they are happy with where they are, but, as my dental school career wound to a close I was relieved to have only the stress of completing my requirements and of challenging the dental boards to worry about. For that, I am very grateful.

My first assignment demonstrated the camaraderie that is possible when you get to work every day with colleagues and friends in a competition free environment. Upon arriving at my first duty station at Lackland AFB Texas, as a commissioned officer in the Dental Corps, I was given my own fully stocked treatment room and, an experienced and dedicated assistant. My patients were scheduled for me by the clinic staff. This left me very little to concern myself with except actually treating my patients.

I was assigned a mentor, a colonel with a career’s worth of experience, who made himself available for any questions I had and for guidance as I embarked on my own career. I often wonder at the overwhelming task of developing the same skills in a setting that is competitive and financially motivated. This initial experience in the Air Force was very satisfying, I was 1 of 3 “new accessions” and we had a great time stretching our dental wings and building lifelong friendships. It reminded me a lot of the friendships and fun that I had in dental school.

But this article is to be about practice models. As I sit here, 6 years beyond my initial payback of 3 years, I have no experience with civilian single private practice, public health, group private practice, or prison service based models. I can however speak with some authority on my own experiences with the military model of practice. I should at some point, and this seems as good as any, state that the views I express as I write, are my own and I do not intend to reflect any

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I sincerely believe that dentistry in the Air Force, for the most part, is about as an ideal of a setting that can be had. Experiences are varied and I can only relay what mine have been.

There are several advantages that I see in military practice — camaraderie, educational opportunities, team dentistry, personal fulfillment, and financial benefits are the first that come to mind.

This blissful period in my career lasted only 9 months, however. The Air Force, and military in general, is big on continuing dental education.

The second phase of my career began when I was selected for a slot in the Oral and Maxillofacial Surgery Residency and had to transition back

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into school mode. The 4 years I spent in residency were grueling difficult ones, the time of my life. I had the opportunity to rotate through various prominent civilian residencies for about 12 of my 48 months, providing me the unique opportunity to compare the 2 models. The training I received in the Air Force was of the highest caliber, the variety of cases and quality of patients, without equal.

There are educational opportunities for everyone in the Dental Corps. All the dental specialty residencies are available on an annual application cycle, including Advanced Education in General Dentistry and General Practice Residency programs. The different short courses to be taken are too numerous to count. I cannot imagine a practice setting outside of the military that can offer this kind of opportunity to continue your dental education.

The third phase of my career followed my residency, that of mature Air Force dental provider. My current assignment is in a clinic with all of the dental specialties represented, team dentistry at its finest. Have a question about a periodontal issue?

Right down the hall. Orthodontics?

Right next door. Coordination between prosthodontics and surgery for implant placement? Easy. No long waits for referrals to be mailed, no phone tag. Simple face-to-face discussion of what is best for the patients needing our comprehensive care. This is especially beneficial for our junior general dental staff, they get as much experience as they desire in any of the dental specialties as well as guidance on the residency application process and the benefits of additional training.

Often financial potential is thought of as a reason to avoid military service.

While it is true that private practice is often a more lucrative career financially, military pay has allowed my family to live very comfortably, secure in the knowledge that I have a steady income, good quality health care, and a sense of fulfillment I cannot imagine having elsewhere.

Sometimes I almost feel guilty in the personal fulfillment I get from my practice. Going to work should not be this fun. It is often said, and here it is true, I get to work on the best patients in the world, young men and women who dedicate their lives, in every sense, to the preservation and protection of our great nation. Young people who get the treatment they need, not the treatment they can afford. It is our mission in the Dental

Corps to make sure these airmen are mission ready, ready to fly, fight, and win. I get to put on a uniform every morning that signifies that I am part of something bigger than myself. It makes me proud.

I would advise every dental student to seriously consider all the practice opportunities available. The military model is certainly not for everyone but does deserve careful consideration.

Regardless of your practice model, membership in our professional societies is critical. For those of us who practice in Texas, the TDA is our collective voice and advocate.

Membership in professional societies is one of the aspects that make dentistry the wonderful career we know it to be.

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Rural Practice

Being a Rural Dentist Carole Lynne Bates, DDS, Farmersville After residing in Farmersville for a couple of years, I had the greatest opportunity to purchase the local existing practice. I continuously say that this was the best decision I have ever made!

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cannot tell you how much I love being a rural dentist. My story is an interesting one, and could also be considered an unbelievable one. What brought me to a small rural town of more than 3,000 people about 40 miles from the great metropolis of Dallas is quite entertaining. I am the owner/dentist of Farmersville Dental, a thriving private practice in the small rural town of Farmersville.

Farmersville is also the place where my family and I have come to call our home. I bought the existing practice in September 2010 and have been very busy practicing dentistry ever since.

I cannot say that I grew up in a small Texan town, hence the reason for purchasing in this location, because I am not even a native Texan. I am actually Canadian, but I have been in this great state of Texas for about 15 years now. My first career included traveling the nation and the world on

tour with Disney On Ice. I was a figure skater for the ice shows and had a wonderful opportunity to perform, travel, and meet people from all over the world. Of course the most special person I met on the road was my husband Scott. He traveled and toured with us as a backstage crewmember, specifically, the “props guy.� We married while still on the show but soon decided to start our family and settle in Texas, and I wanted to pursue something other than ice skating.

Dentistry, however, was not something I pursued right away.

While refusing to completely hang up my skates, I coached skating at the Dallas Galleria for almost 5 years before getting into dental school and starting my second career. I attended dental school in Houston and have since moved back to the Dallas area.

Pursuing our dreams, my husband and I have always wanted to own acreage,

My first career included traveling the nation and the world on tour with Disney On Ice. I was a figure skater for the ice shows and had a wonderful opportunity to perform, travel, and meet people from all over the world.

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What makes my office appealing to many patients is the warm, laid-back country atmosphere.

In my small-town office, with its homey feel, patients can come in and chat with the familiar hygienists and assistants and feel comfortable.

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and we came upon this beautiful piece of land in the hilly countryside of Farmersville.

After residing in Farmersville for a couple of years, I had the greatest opportunity to purchase the local existing practice. I continuously say that this was the best decision I have ever made! I can truly say that I am as busy as any urban dentist. My staff is a great, tough, hard-working group of women, and I appreciate them immensely. Most people that live rurally do not want to trek out to the city for a job and prefer local employment. All of my employees have grown up in or near Farmersville and East Collin and Hunt Counties.

Rural people do not want to deal with city traffic by driving long distances to be away from family. The staff positions that I offer are locally in demand due to stability, regular consistent hours, and a great work environment.

What makes my office appealing to many patients is the warm, laid-back country atmosphere. In my smalltown office, with its homey feel, patients can come in and chat with the familiar hygienists and assistants and feel comfortable. Since we are all local residents, we see our patients when out at football games, at the grocery store, and even dropping our kids off at school. While patients always express dental anxiety, they usually leave our office comforted and reassured.

My structural, stand-alone office building is simply an old remodeled house with low ceilings, a small break room, and 6 operatories (2 hygiene and 4 doctor) arranged peculiarly as

a maze. However, the office functions perfectly fine and successful as a dental office. Most significantly, I completely own the building and the land on which it is situated. I do not have to cater to any landlord or worry about lease contracts as many urban and suburban dentists do.

Another benefit of my location is that I don’t have to invest in major marketing schemes. Most of my marketing is done by sponsoring the local activities, such as supporting the 5K run at the Farmersville “Old Time Saturday” flee market, or having game booths at the “Scare On The Square” Halloween event, or when “Fancy the Tooth Fairy” visits the elementary school to explain oral health and hand out toothbrushes to the kids. There is also an annual bike ride through the Farmersville country roads in which I donate and place business postcards for the athletes. My business is currently a member of the local Chamber of Commerce, which has a welcome packet for any new family or individual that moves into town.

My 2 school-age boys, as well as several of my employees, have kids in the local schools who are involved in several sports, and I always donate to fundraisers.

I have been an American Dental Association tripartite member ever since I purchased my own practice, and I really appreciate the benefits it offers me. I rely on the info they provide as well as trust the products and services they promote to dentists. There are so many choices out there and to have the TDA do the research and confirm the validity of the company is extremely valuable. Possibly, one of the most

helpful matters that the TDA offers its members are the frequent emails sent out in regards to any new information on the Affordable Care Act. We all know it is complicated, and no one really knows the outcome or consequences in store for dentists.

I also recently attended the North Texas Dental Society meeting. I truly enjoyed and appreciated the information, camaraderie, and CE credits made available. Yearly, I take my entire family to San Antonio and make it a family vacation while I attend the TDA annual session.

While many dentists and graduating dental students may only consider practicing dentistry in largely populated urban and suburban areas, I want to make it known that a successful, prosperous, and thriving dental practice can most certainly be attained in the country. I am continuously occupied working from one operatory to the next (rarely am I sitting in front of the computer in my personal office). I have a consistent, steady flow of new patients each month. My outstanding staff is friendly, the patients are friendly, everyone is cooperative, and overall, the setting is professionally casual.

My cherished dental office in the little town of Farmersville is an extremely valuable and prized business opportunity for me, and it really is my ideal setting.

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Public Health Dentist

Pediatric Public Health Yvonne E. Maldonado, DDS, El Paso

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y first job after graduating from dental school was working for La Clinica de Familia, Inc., a community health center. I would have never found this opportunity had it not been for the National Health Service Corps. During my senior year in dental school, a representative from the National Health Service Corps came to talk to my class about a career option in the National Health Service Corps. She also took us to lunch.

I was intrigued by the opportunity to be able to work in a federally underserved area, receive a salary, and have my dental school loans paid off.

I kept her phone number, and once I graduated from dental school, I contacted her and started the application process. She informed me that a new state-of-the-art medical and dental facility was being constructed close to my hometown.

She gave me the name of the dental director of La Clinica de Familia, and I began the process of applying for the open position in Sunland Park, New Mexico, with La Clinica de Familia and also applying for the Loan Repayment Program through the National Health Service Corps.

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This was a wonderful experience for me for a number of reasons. Not only did I get all my loans paid off in 3 years but I had a wonderful mentor, Dr David A. Cenk of El Paso. He was always there by phone if I needed advice on a case and he would spend Fridays at my location mentoring me.

I was concerned about the speed of my procedures and the best advice he gave me was, “Don’t worry about your speed, that will come. Just continue to do quality dentistry. That is what matters most.” The speed did come, it took years, but most importantly, quality dentistry was being provided to every patient. I highly and enthusiastically recommend the National Health Service Corps to all dental school graduates. Working at La Clinica de Familia was a wonderful and rewarding experience. I recently visited a business in that community and they recognized me and asked how I was doing. One day when I retire, I would really enjoy working again for La Clinica de Familia and the community of Sunland Park, New Mexico. If I was a senior dental student, I would definitely look into applying with the National Health Service Corps. Not only do you provide a necessary service to a community with great need, your loans can be paid off and you earn a generous salary with benefits at the same time. When you add up the amount you make from the salary you earn plus the money you receive from the National Health Service Corps to pay your loans, the yearly amount is a very generous one. I hope students consider this option.

The next adventure in my career was working for the City of El Paso Health and Environmental District. I always enjoyed working with pediatric patients, and this was an opportunity to work and expand my knowledge treating pediatric patients in a public health setting. I gained experience working with pediatric patients and

was with the City of El Paso Health and Environmental District for approximately 3 years. This was also a good financial opportunity for me since my annual salary increased by about 35%.

My next move was as an associate in a pediatric dental office. I had a wonderful mentor, Dr L. Hampton Briggs of El Paso. He was my hands-on instructor for all pediatric procedures.

Like Dr Cenk, he always stressed quality over speed. He also stressed ethical values and one thing that always impressed me with him is that the focus should always be on the patient and on quality of care. He said too many people were too focused on money. “The focus should never be money. If you have quality dentistry, the speed and the monetary benefit will come.” He taught me moderate oral sedation and hospital dentistry.

He was a great mentor, teacher, and clinician. I was an associate in his office for 5 years, and as I worked part-time, I was able to raise a family.

reference for me. When I graduated from dental school, joining my component dental society, the El Paso District Dental Society, was an automatic decision. It was reassuring to have camaraderie within the dental community. I felt welcomed and embraced by the dentists in El Paso.

It is because of the El Paso District Dental Society (EPDDS) that I have been able to serve on the Board of Directors for the Texas Dental Association. This is my last year on the TDA Board of Directors, and it has been a privilege to serve Texas dentists and meet and make friends with dentists across the state. I look forward to my 50year anniversary as a dentist and plan to be a lifelong member of the EPDDS, TDA, and ADA. I hope I can give back as much as I have received from organized dentistry.

My mentors were all members of organized dentistry. If I had not been a member of the EPDDS, I would have never seen the job listing Dr Briggs had posted in the newsletter for the EPDDS. All these events helped shape my career, and I am eternally grateful for all these opportunities and experiences, without which I would not be the dentist I am today.

Finally, in 2008 I opened a pediatric dental office with pediatric dentist Dr Nanni T. Baker of El Paso. We have a large pediatric dental office in El Paso, Texas. The reason we opened an office is stated in our mission statement. We wanted “To provide pediatric dental care and superior service with honor, integrity and compassion to every child, parent and staff member in whose lives we are blessed to make a difference.” All that I have learned in all the years prior to the opening of The Dental Ark, I learned from my mentors. Dr Baker is my business partner but also my mentor. I am so blessed to have her in my life.

Beginning in dental school and throughout my career, organized dentistry has been at my side. I was a member of the American Dental Association (ADA) and the TDA as a student. The ADA was a great

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Dental Service Organization

Dr Janik pictured above with her two Great Danes, Luke and Abby.

My Positive Experience Andrea Janik, DDS, San Antonio I am privileged to be both a member of the TDA and a Pacific Dental Services (PDS) supported dentist. In my opinion, both organizations share some common values. Admittedly, at first blush, this may not be obvious.

Historically, the large group practice model has not generated the best reputation within dentistry — many traditionally associate such retail branded, multi-unit practices with inferior “drill and fill mill” dentistry.

But my recent personal experiences in a large group practice have been exceptional and have exceeded my expectations. The positive experiences I have had with PDS parallel the experience I have had with the TDA.

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came to a PDS-supported office after a variety of other experiences in dentistry. Recently, I relocated to San Antonio after practicing in the Dallas/Forth Worth Metroplex for 5 years in both a traditional private practice setting (solo doctor/solo location practice) and a non-profit/public health setting. During those 5 years I also became involved on all 3 levels of the organized dentistry tripartite. On the local level, I served as an alternate delegate and as membership chair for the Dallas County Dental Society. On the state level, I chaired the TDA

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Dr Janik with her dental team.

Committee on the New Dentist for the past 3 years. And, on the national level, I am currently in the 2nd year of a 4-year appointment to ADA New Dentist Committee. My career has truly been enhanced by my involvement with the TDA, and I am having the same positive experiences as a PDS supported dentist.

TDA resolution 56-2011-RCBS-H states: “The policy of the Texas Dental Association (TDA) is that the dentist is the ‘Head of the Dental Team.’” One of the prominent misconceptions I hear about large group practice is that a nameless, faceless corporate titan in some far-away city controls the actions of the dentists in the practice in order to maximize profit. This is simply not true in my view. From my perspective, I have always had control over the treatment plans of my patients. Additionally, I have control over my schedule, my patient load, my materials, the labs I use, etc. Indeed, there is nothing that comes between me and providing the best possible dental care to my patients. In all of my practice settings, I am empowered to truly be the “Head of the Dental Team.”

The TDA and PDS share the common strength of placing emphasis on the importance of continuing dental education. The TDA Annual Session held each May provides hundreds

of hours of high-quality continuing dental education. This meeting has a national reputation of being one of the best, and each year the council on Annual Session works hard to continually improve the meeting.

I was able to see this first hand serving as the new dentist liaison to this council for 2 years. PDS and the owner-dentists they support have also placed an emphasis on continuing education. During my first year of practice as a PDS-supported dentist, I have had 75 hours of free continuing education available to me. Indeed, many (if not all) of the PDS-supported owner-dentists require their associate dentists to complete these continuing education hours, demonstrating that these owner-dentists understand that it makes financial sense for their dentists to spend time away from the office learning the state-of-the-art in dentistry.

Giving back to the community has always been important to Texas dentists. Another similarity between being a TDA member and a PDS supported dentist is the significance of donated dental care. I am glad that these organizations understand the value of giving back to the community. The TDA strategic plan promotes “access to dental care for underserved Texans.” The TDA Smiles Foundation, the charitable arm of the

TDA, extends dentistry to many Texans in need with their Texas Mission of Mercy (TMOM) Events. The TMOM events are held in a single community in Texas for a weekend and provide care to those in the community that are in need of dentistry but can otherwise not afford it. Pacific Dental Services hosts a similar event called “We Serve Day.” On We Serve Day all of the participating PDSsupported offices in not only Texas, but the entire U.S., open their doors to those in their community that are in need of dentistry. In 2012, the total for donated dental care on We Serve Day in Texas was $268,550.

I am happy to report that in 2013 that number grew to $331,857. I was honored to contribute to that figure by providing dental care to women that are currently being served by San Antonio’s Arms of Hope as well as a few of my own patients in the practice that needed a little help along the way.

Dentistry is rapidly changing. The number of dentists joining a large group practice is at an all time high, making large group practice the fastest growing sector in dentistry.

Where I stand today, I am lucky to be associated with 2 such high caliber organizations, the Texas Dental Association and Pacific Dental Services.

The TDA serves all dentists and supports our success.

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Associate Practice

The Wright family: wife, Allyson; son, Noah (8); Dr Wright; daughter, Addie (12); and son, Zane (10)

Transitioning for the Future Stephen R. Wright, DDS In 2003, as a senior dental student at the University of Texas Health Science Center at San Antonio Dental School, I was consumed with weighing options regarding job opportunities after graduation. During a practice management class, I clearly remember a guest dentist stating that I should choose a practice location based on opportunities for professional success rather than personal desires. The point was valid. A graduate’s practice location should be determined by where there is the greatest need for their services, not geographical wants and desires.

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understood that, but I was a married 32-year-old with a growing family. I wanted to base my future practice location around family, but also in a location where my services were needed. In addition, we learned about different avenues of entering the dental field. The traditional practice model–graduating from dental school and opening a solo practice–presents many challenges for the graduates of the past 10 years.

Today, corporate dental clinics are enticing many debt laden graduates to sign contracts with guaranteed salaries and bonuses. Other graduates choose to give back, as well as pay off debt by serving in public health or military clinics. Finally, a significant number of graduates will work as an associate with an established dentist. The best such relationship provides the opportunity for the associate to ultimately purchase the practice. This affords the graduate the opportunity to practice dentistry, get their name out in the community, and have a predictable salary, but without the tremendous risk of debt and potential failure. As I discovered, there is risk in any avenue you choose.

After graduation, I made my decision about practice location based on where my family wanted to live.

Additionally, I decided to associate in order to have a guaranteed salary to provide for my growing family. Taking the advice also given in my practice management class, I sent letters to every dentist in the area and talked with a couple of dentists that I already knew. I did not get overwhelming responses. From the 50 letters I mailed, I received 3 responses. One dentist was honest and stated he did not have a position, but was willing to talk to me. Another dentist wanted to talk about a business venture he was pursuing — opening a semi-corporate dental office in the town where we wanted to live. The third dentist was

In order to live and practice in my desired location, I would be driving a total of 160 miles each week. I had not envisioned being the ‘traveling dentist’, but I was willing to do whatever was required to become an excellent dentist and provide for my family.

Pictured are Dr Wright and his wife Allyson with Dr Bill Birdwell and his wife Susan. Dr Wright purchased his practice from Dr Birdwell.

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“…the unthinkable happened. The dentist I was working for in my hometown informed me that his practice could not support 2 dentists…While not completely surprised, I was devastated.” looking for an associate, but could not support a dentist full time. This dentist had a main office, as well as a satellite office, in his small hometown 20 miles away. I made the decision to associate with this dentist because his practice consultant connected me with another dentist in a neighboring town 60 miles away who was also looking for an associate for 1 1/2 days a week. In order to live and practice in my desired location, I would be driving a total of 160 miles each week. I had not envisioned being the “traveling dentist,” but I was willing to do whatever was required to become an excellent dentist and provide for my family.

The first 3 years were tough, professionally. In the hometown practice, I struggled with impatience.

I wanted to be busy and practice the skills I had been taught. I spent many days looking at charts and reading dental journals. There were days when I was busy and saw a lot of patients, but those were few and far between. I understood that I was “new in town,” but as the days and months went by, I began to realize that my practice and income were not

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growing or improving. At the office 60 miles away, things were different.

I had patients on the schedule every day. Some days were quieter than others, but as I met patients through hygiene and with the staff’s confidence in my abilities, I began to have more productive days. The relationship in the neighboring town was growing so much that the owner dentist considered asking me to work in his practice full time. Though I was productive, felt encouraged and excited to be in that practice, I personally felt that staying in our hometown was the right decision.

This meant I would continue to fight the feelings of inadequacy that were creeping in while working. Again, I based my decision on personal and family desires rather than where there was greater need for my services. I began to research what opening a solo practice entailed. I spoke with leasing agents, dental supply companies, and bankers. Through my research, it became apparent that it would be difficult to secure funding for a loan that would meet my practice and family’s needs.

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During this time, the unthinkable happened. The dentist I was working for in my hometown informed me that his practice could not support 2 dentists. Thus, he dissolved our associateship. While not completely surprised, I was devastated. I had always exceeded expectations in prior jobs, including working in a doctor’s office and teaching high school science. However, even as I write this, I am reminded that it was the best thing that could have occurred. At that moment though, my confidence and self-worth dropped to an all-time low. With a family to provide for, I had to act quickly and figure something out.

While researching information on the internet, my wife came across the website Transdent, a subsidiary of Mercer Advisors. The purpose of the company is to connect recent graduates with established dentists who are hoping to transition from full-time practice into retirement.

Out of curiosity, she searched our town and was surprised to discover one office looking for an associate.

She recognized the pictures of the office because she and her family had been patients there. Ironically, this practice was located across the street from where I was presently working and owned by a dentist that I knew, respected, and had previously spoken with while I was still in dental school!

I set up an appointment to visit him at his office. When I told him about my associateship dissolving, he was surprised. He explained his Mercer transition plan and gave me a complete information packet, specifically about his practice, developed by Mercer. Essentially, the structure of a Mercer transition is for a “younger” dentist to work in a practice for a 1-year trial period.

During this year, the associate (younger dentist) and the owner dentist have the opportunity to

time to adjust to the new doctor and build trust and confidence in their abilities and services. Moreover, because the senior dentist now “works for” the new owner, he earns more credibility with the patients.

Dr Wright with a patient. decide whether they work well together and the relationship is the right fit with the patients and staff.

Our transition was divided into 3 phases. Phase 1, as I described previously, is the Trial period. During this year, the owner dentist and associate decide if they are a “good match.” In addition, the owner dentist and spouse, along with the associate dentist and spouse, attend a weekend workshop at Mercer headquarters in Scottsdale, Arizona. Phase 2, the “Equity Period,” begins when the 2 parties agree they want to move forward. At this point, either party can back out with no strings attached. The Equity Period does not commence until a contract, with a defining timeline and financial structure, is mutually agreed upon. Though the contract is heavy laden with owner considerations, the transition is only successful if the associate succeeds. As a result, the contract outlines ways the owner dentist must work to assist the associate (future owner) with opportunities for success At the end of the equity period, the final phase began. As opposed to 6 years prior, I was able to negotiate financing with several institutions eager to provide assistance because of my 5-year production history in the practice.

Though the financing was a big part of the transition, the most important aspect in the transition was the agreed upon length of time the senior dentist would remain in the practice. In my agreement, the senior dentist transitioned to working 2 days a week for the next 3 years. The patients have had ample

It has been 18 months since I purchased the practice. It has been, without a doubt, the best professional decision I could have made. Because I began my dental career at a later age and with a family to provide for, it would have been extremely challenging for me to open a solo practice. Associating was the best option for me. Furthermore, because my transition was multi-year, I benefitted it 2 main ways. First, I was able to complete continuing education in implant dentistry. I most probably would have not have been able to afford this training without the allowance the owner dentist had to provide. Secondly, I received “handson” mentorship both clinically and administratively. During these 6 years, I developed a foundation that helped me define my practice leadership model. You don’t learn everything you NEED to know in dental school.

Some things can’t be taught! It might have been an easier road if I had been more business minded in my selection of a practice location, but as I mentioned, there are many factors that weigh into a making a long term decision.

For me, I would not change the last 10 years. I was able to learn and grow from three excellent dentists and my family has been blessed by living close to our extended family. And in the end, I was able to purchase an established practice with healthy accounts receivables, a healthy hygiene recare system, and a very experienced senior associate! Every path will have challenges — we can be sure of that! However, it is how we face our challenges that will determine our success!

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Gordon C. Damon, Jr., D.D.S. has acquired the practice of Jay W. Baxley, D.D.S. & Chad C. Perry, D.D.S. -

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LAST CHANCE: ANNuAL OSHA TrAiNiNg COurSE This video streamed course will fulfill your annual OSHA requirement on Bloodborne Pathogens Training. It’s economical, easy and fun!

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Texas Dental Association 143rd Annual Session 2013 TEXAS Meeting Photo Contest Photographer: Jeffery L. Corbet, DDS, Bedford Title: “Spire in the Sky” Category: Built Environment Award: Second Place

Information on the 2014 TEXAS Meeting Photo Contest is available on texasmeeting.com.

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Dental Artifacts Enlightened Diagnosis by Transillumination Kim Freeman, MA, DMD, MS

A

few years ago I stumbled upon a dental text authored by W.J. Cameron. It was called “Diagnosis

by Transillumination.� The publication date was 1924. The copy of the book I acquired (Figure 1) was from the estate of Dr Olson who was the previous dean at the University of Texas School of Dentistry at Houston (UTSD).

In modern terms transillumination is thought to be used primarily in the determination of fractures and their extent in teeth. Sometimes the outline of canals can also be visualized by the use of a transilluminatior. The book by Cameron outlines techniques for determining tooth and adjacent peridontium health, and sinus infection including the frontal sinuses.

The author uses a light of his own design, which he patented for this process (Figures 2, 3, 4). His assertion is that with this light shadows are created reflecting the health of the tissue both pulpally and in surrounding areas.

Shadowing from the light shows either restricted or non existent blood flow.

Within the sinus it reflects in infection or obstruction. The lack of circulation, either by collection of fibrous tissue or stasis, changes the way light passes through the area. In the area adjacent to an abscessed tooth, shadowing is evident indicating the offending tooth.

Two other types of lamps of his design are for use in the antrum and other maxillary sinuses. One can be inserted into a fresh extraction site, and another against the palate (Figures 5, 6, 7). Is this a valid

Figure 2.

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Figure 1.

way to diagnose pathology? Have we forgotten a previous technique that may have some real benefit?

How many times would we like to differentiate a maxillary infection or sinusitis from pulpal eitiology?

Pulp testing currently with the EPT is suspect, with only a collection of testing including thermal, percussion, and palpation testing along with radiographic findings rendering a diagnosis. Any other test to add to the determination of pulp or sinus status is not only needed, but imperative. Doppler testing of blood flow although promising is in its infancy.

Figure 3.

With luck, someone that reads this article will delve further into examination of a technique almost 100 years old.

Figure 4.

Figure 5.

Figure 7.

Figure 6.

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PLACE YOUR NEXT DISPLAY AD HERE! Display advertising in the Texas Dental Journal is one of the best ways to reach the majority of Texas dentists. The Texas Dental Journal is the official publication of the Association. Established in 1883, it is the longest, continuously published dental journal in the Americas and second in the world to the British Dental Journal. Published monthly, the Journal’s circulation exceeds 9,000, its readership exceeds 50,000, and it’s the only statewide publication of its kind to reach the majority of Texas dentists. TDA Perks Partners, allied groups, and non profits receive discounts!

For more information, please visit our website at tda.org or contact TDA Managing Editor Nicole Scott nicole@tda.org 512-443-3675 ext 124

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TX-NOV-2013.pdf

1

12/20/13

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LAW OFFICES OF HANNA & ANDERTON EXPERIENCED LAWYERS REPRESENTING TEXAS DENTISTS MARK J. HANNA, JD Former General Counsel, Texas Dental Association

* Representation Before the Texas State Board of Dental

Examiners

* Medicaid Audits and Administrative Hearings * Employment Issues - Texas Workforce Commission

Hearings

FRANK B. WALKER, JD Former General Counsel, Texas State Board of Dental Examiners

* Standard of Care Reviews and Expert Opinions * Employment/Associateship Contract Reviews * Practice Acquisition and Sales * Business Organizations, PAs, PCs, and LLCs

ROBERT M. ANDERTON, DDS, JD, LLM Past President, Texas Dental Association and American Dental Association

* Risk Management Consultation and Compliance

Reviews

* Civil Litigation

900 Congress Avenue, Suite 250 Austin, Texas 78701 Phone: 512.477.6200 Fax: 512.477.1188 Not Board Certified by the Texas Board of Legal Specialization

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To The Texas Mission of Mercy and TO OURKids TMOM/ VOLUNTEERS: Give aGKAS sMile volunTeers: It was an amazing two days! We are so grateful to all the dentists, dental staff, GHDS staff, UTSD faculty, staff and students, pre-dental students, friends, family, TDA Smiles Foundation staff and board, and many others who participated in the Texas Mission of Mercy (TMOM) and Give Kids A Smile (GKAS) events in Houston on February 7-8, 2014.

It was truly an honor for the Greater Houston Dental Society and The University of Texas School of Dentistry at Houston to host the events.

Nearly 1,400 patients experienced a warm and caring environment, and we know they went home in better oral health than when they arrived.

Without all of you and your dedication, it would not have been a success.

THANK YOU!

Randal M. Glenn, DDS President Greater Houston Dental Society

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John A.Valenza, DDS Dean UT School of Dentistry at Houston

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PREVIEW Implant Solutions for the Implant Patient: Diagnosis and Treatment Planning for Predictable Results David Little, DDS

Introduction

W

hile implant treatment planning for the edentulous patient must be comprehensive, it need not be overly complex. Clinicians must understand and utilize various impression techniques, proper abutment and attachment selection,

and effective scans and guides to best prepare for surgery. Success with implants is dependent upon an efficient visualization of treatment outcomes, proper diagnosis and treatment planning, and incorporation of advanced technologies—such as cone beam computed tomography (CBCT) or planning software—into the process.

Diagnosis Diagnosis is one of the most crucial steps in the treatment planning process, and all efforts to ensure its accuracy must be undertaken. This usually means integrating various forms of technology, such as digital radiographs or photographs, CBCTs, and digital impressions into the

Dr David Little’s Class Schedule at the Texas Meeting: Implant Solutions for the Edentulous Patient Workshop Thursday, May 1 • 1:30 pm – 4:30 pm Implant Dentistry: Enhancing Diagnosis, Case Acceptance, and Restorative Outcomes Using the Latest Technology Friday, May 2 • 8:30 am – 11:30 am Implant Diagnosis and Treatment Planning Workshop Friday, May 2 • 1:30 pm – 4:30 pm Dr Little is adjunct professor at University of Texas Health Science Center at San Antonio, an international speaker, and implant researcher in private practice in San Antonio, Texas.

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Figure 1.

A. Digital 2D panoramic radiograph.

B. CBCT scan with radiographic template.

C. CBCT scan with cross sections.

D. 3D rendering upper jaw.

A

C

workflow. It is important to note that these means of image capturing, such as digital impressions, may be affected by other workflow steps or materials (eg, copings), so careful consideration is warranted (1, 2).

Use of technologies such as these assist clinicians in ensuring proper placement of the implant in the optimal location where sufficient, stable bone exists (3, 4) (Figure 1).

A

C

B

D

Treatment Planning

When developing a treatment plan for implant patients, practitioners must be as thorough as possible. Implant treatment should be restoratively driven, and this is best accomplished through a collaborative approach that involves all members of the team. Treatment planning software permits a predictable, esthetic

outcome. The use of 3D implant planning software such as SimplantŽ (Materialise Dental, Glen Burnie, MD) allows clinicians to create a virtual treatment plan. When the program is used, the patient’s diagnostic information is easily captured by the software. Any treatment planning software is generally helpful to the overall process of designing the ideal implant and restoration for a

B

D

Figure 2. A) Simplant planning screen shot; B) 3D planning implants and abutments; C) 3D planning angled implants; and D) Sterolithic model and milled abutment.

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161

patient. It can then be reviewed by the clinician or any member of the treatment team, in 3D to better observe any anatomical factors that could influence proposed treatment.

This process can also be outsourced to imaging centers, such as iMagDent (iMagDent San Antonio, Texas), or dental laboratories (Figure 2).

A

B

C

D

Implant Surgery

With advancements in technology come simplified workflows and helpful information to assist clinicians in everyday procedures. This is especially true with the development of surgical guides to aid in the placement of implants. These guides are used by practitioners and their teams to ensure that implants are placed in the optimal position while simultaneously minimizing risk. Using a surgical guide means that clinicians will be aided in their attempts by planning software that will allow them to see the implant in 3D and have detailed information about the conditions of the patient’s mouth and the surrounding dentition.

Surgical guides can facilitate the process by allowing team members to work together in such a fashion that collaboration is possible from the very beginning. They can start at the end of the process by visualizing the implant and restoration in place and then work backward to indentify the perfect implant placement position based on the patient’s anatomy (5) (Figure 3).

Prosthetic Restoration Design

The development of advanced materials and systems has provided clinicians with a greater abundance of options from which to provide their patients with the ideal implant and

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Figure 3. A) Tooth borne surgical guide on stereolithic model; B) Tooth borne guide with angled implants; C) Soft tissue surgical guide; and D) Bone borne surgical guide.

A

C

B

D

Figure 4. A) Prefabricated abutment; B) Titanium milled abutment; C) Gold hue milled abutment; and D) Zirconia milled abutment.

prosthetic restoration. The advent of CAD/CAM systems has ushered in a new era of restorative materials, with zirconia and all-ceramic materials playing major roles (6). These materials can be used in both the anterior and posterior regions of the mouth, simplifying the decisionmaking process while sacrificing neither esthetics nor strength (7).

They can also be used for custom all-

Texas Dental Journal l www.tda.org l February 2014

ceramic abutments and frameworks for metal and all-ceramic abutments (6, 8, 9) (Figure 4).

With the use of CAD/CAM systems, time spent designing and fabricating implant abutments and restorations is greatly reduced, but esthetics are not in any way compromised. In fact, restoration esthetics are often tremendously improved, as CAD/

A

B

3.

C

D 4.

5.

Figure 5. A) Titaniun milled bar with processed denture teeth facial view; B) Occlusal view; C) Full Zirconia milled restoration; and D) Upper and lower Full contour Zirconia restorations fabricated with titanium sleeves on abutments.

CAM software and systems allow clinicians to design the abutment and the restoration. The optical qualities of CAD/CAM processed materials permit restorations to blend in well with the patient’s surrounding natural dentition. Finally, CAD/CAM systems allow for greater ease of fabrication while simultaneously providing a high level of biocompatibility, durability, accuracy, and longevity when designing and milling implant abutments and restorations (Figure 5).

the proper tools, diagnosis, and treatment plan can reduce the confusion that may surround this restorative procedure. A collaborative team approach benefits clinicians as they avail themselves of the latest advances in technology to achieve the best possible treatment outcomes for their patients. Those who do choose to avail themselves of these technological benefits will find themselves greatly aided in this pursuit (Figure 6).

Conclusion

References

While placing implants has been viewed as a complex procedure, A

1.

2.

Chee W, Jivraj S. Impression techniques for implant dentistry. Br Dent J. 2006 Oct 7; 201(7):429-32.

Yamamoto E, Marotti J, deCampos

6.

7.

8.

9.

TT, Neto PT. Accuracy of four transfer impression techniques for dental implants: a scanning electron microscopic analysis. Int J Oral Maxillofac Implants.

2010 Nov-Dec; 25(6):115-24.

Goenka P, Marwah N, Dutta S. A multidisciplinary approach to the management of a subgingivallyfracturedtooth: a clinical report. J Prosthodont. 2011 Apr; 20(3):218-23. doi: 10.1111/j.1532849X.2010.00682.x. Epub 2011 Feb 1.

Mendoza A, Solano E, Segura-Egea JJ. Treatment and orthodontic movement of a root-fractured maxillary central incisor with an immature apex: 10-year followup. IntEndod J. 2010 Dec; 43(12):1162-70. doi: 10.1111/j.1365-2591.2010.01790.x.

Epub 2010 Sep 6.

Orentlicher G, Horowitz A, Abboud M. Guided implant surgery: indications and guidelines for use. Compend Cont Educ Dent. Retrieved from http:// cced.cdeworld.com/courses/4632Computer-Guided_Implant_ Surgery:Indications_and_Guidelines_for_ Use#sthash.9UYZSGVe.dpuf Dentsply International Inc. Cerconht Full Contour Zirconia. York, Pennsylvania: Dentsply International Inc; 2011:1-2.

Little A. David, Crocker J. Justin. Clinical Use of a New Metal Free Restorative Technology. Case Reports. Dentsply Asia Update. 2003; 1-3.

Christensen RP, Ploeger BJ. A clinical comparison of zirconia, metal and alumina fixed-prosthesis frameworks veneered with layered or pressed ceramic: a threeyear report. J Am DentAssoc. 2010 Nov; 141(11):1317-29.

Sailer I, Gottnerb J, Kanelb S, et al.

Randomized controlled clinical trial of zirconia-ceramic and metal-ceramic posterior fixed dental prostheses: a 3-year follow-up. Int J Prosthodont. 2009 NovDec; 22(6):553-60.

B

Figure 6. A) Custom patient specific zirconia abutments; and B) Final restorations teeth number 7 and 10.

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Oral and Maxillofacial Pathology Diagnosis and Management

Herniated Dental Follicle Oral and Maxillofacial Pathology Case of the Month (from page 116)

Diagnosis Although this soft tissue lesion appears to be intimately associated with the tooth eruption process, the herniated dental follicle had not been previously described in the literature as such. The entity has been seen in both the primary and permanent (Figures 1A and B) dentitions, and is associated with the normal emergence of a tooth. The soft tissue papule or nodule represents a portion of the dental follicle – a component of the tooth that is critical for promoting normal eruption (1). Furthermore, oscillation of the primary teeth has been documented clinically during the eruption process, resulting in the superficial presence of the crown of a tooth and then the subsequent intrusion of the tooth, leaving minute areas of perforated alveolar mucosa (2). This oscillating pattern of tooth eruption has been defined as a transitional phase of eruption and appears to be common (2). In a few cases, the opening is large enough for parts of the residual dental follicle to be extruded through the alveolar mucosa. External mechanical pressures such as teething rings, massaging of the gum pads, and eating could potentially cause this perforation of the alveolar mucosa to occur. This may be especially important when the teeth are close to breaking through into the oral environment, as noted in the present example. Typically, these lesions are an incidental finding except when there is bleeding or if a child

164

appears to be experiencing teething symptoms.

This extruded dental follicle is of a small size appropriate for the associated erupting tooth with a papular, polypoid or fingerlike appearance. It has a smooth glistening surface and varies in color from translucent amber to brightly erythematous to creamcolored with an area of ulceration.

Although it is uncertain how long these lesions are present, it appears that they resolve or atrophy with the eruption of the tooth. This is contrast to the hyperplastic dental follicle that actually interferes with tooth eruption, possibly due to the downregulation of matrix metalloproteinases (3).

Radiographically, the primary finding is a crown of an erupting tooth within soft tissue in which tooth eruption is eminent.

Unless the lesion is symptomatic, such as periodic bleeding from the site or if a secondary infection is suspected, then no treatment is necessary. It is expected that the residual dental follicle will atrophy and slough off as the tooth erupts. Recognition of this gingival entity is important because it most likely represents a variation of normal in the early emergence of the tooth.

The microscopic findings reveal a soft tissue papule that consists primarily of thin strands of edematous fibromyxomatous connective tissue

Texas Dental Journal l www.tda.org l February 2014

with scattered small capillaries and a variably dense acute and chronic inflammatory infiltrates. Isolated rests of odontogenic epithelium may be present within the stroma.

A discontinuous surface of reduced enamel epithelium is observed lining the inner surface, while the outer surface may be partially lined by an atrophic and spongiotic layer of nonkeratinized stratified squamous epithelium. Overall, the histopathologic findings are consistent with an inflamed dental follicle (4).

The differential diagnosis of this entity includes an eruption cyst, eruption sequestrum, parulis, and pyogenic granuloma. The eruption cyst is an odontogenic lesion that represents the soft tissue counterpart of the dentigerous cyst. The cyst develops as a consequence of the dental follicle separating from the crown of an erupting tooth and expanding within the overlying alveolar mucosa.

This cystic lesion typically occurs under the age 10 and in some cases the lesions are congenital (5, 6).

Although these cysts may develop at any site where a tooth is erupting, including natal or supernumerary teeth, the most common location is with the primary mandibular incisors, followed by the permanent maxillary first molars and the primary maxillary incisors (5). Clinically, this entity produces a soft, compressible swelling of the alveolar mucosa that varies in color from translucent to red or purplish-blue. Many of these pigmented lesions simply represent

a hematoma due to some bleeding into the surrounding tissues as the tooth erupts. Although these cysts are typically asymptomatic some can be large and dark in color, which is often disconcerting to the parent. Most eruption cysts are solitary lesions, but multiple lesions have been described.

Radiographically, the crown of an erupting tooth is observed within soft tissue. Although many eruption cysts spontaneously resolve within 5 weeks of appearance (7), uncovering the mucosal site or marsupialization may be indicated to allow for timely tooth eruption (5).

The eruption sequestrum is an uncommon disturbance of tooth eruption that is associated with a calcified spicule entrapped within the overlying alveolar mucosa. These small calcified fragments are typically seen in the central occlusal fossa of a molar (8). The origin of this calcified tissue has been debated and either represents over-retained necrotic alveolar bone or residual mineralized tissue from the dental follicle (8,9).

Any molar can be affected, but the most common tooth to be involved is the permanent, mandibular, first molar and bilateral examples have been reported (10). Many of these lesions are asymptomatic but pain and swelling may be noted. Gingival inflammation and pericoronitis have been associated with some cases due to secondary bacterial infection.

The tissue fragment is mobile but that characteristic may be difficult to determine in the early stages.

In fact, some examples may mimic a hypoplastic defect of the tooth.

Occasionally, the child may complain of the side of the tongue being tender because of the rubbing of the surface against the rough and exposed mineralized tissue. Radiographically, a small irregular radiopacity is detected superior to the occlusal surface of the molar. Although some cases spontaneously resolve due to the

exfoliation of the sequestrum, local debridement with removal of the mobile hard tissue is recommended to prevent secondary infection of the soft tissues and demineralization of the tooth (8).

The parulis or gum boil is a soft tissue abscess of the gingiva or alveolar mucosa. It is usually the result of an odontogenic infection but periodontal infection or entrapped foreign bodies may be other causes (11). It typically presents as a localized, soft and fluctuant nodule on the labial/ buccal gingiva or vestibular mucosa.

The surface is smooth with a red to yellowish-red color. Manipulating the nodule may cause tenderness and often results in a release of a purulent exudate with some bleeding and flattening of the enlargement.

Radiographically, signs of a nonvital tooth and alveolar bone loss are usually observed. Treatment involves identifying the source of the infection, local debridement of the soft tissue and management of the odontogenic infection, if present (11).

The pyogenic granuloma is a vascular reactive lesion triggered by local irritation (12). The soft tissue nodule can occur anywhere in and around the mouth, but the gingiva is by far the most common site of involvement, especially the anterior region (13). Local irritants such as plaque, calculus, hypoplastic dental defect, dental caries, irregular restorations, orthodontic appliances, food impaction and trauma are triggering factors. These reactive lesions can occur at any age, but favor children and young adults. There is a female predilection which supports a hormonal influence in some cases.

These soft tissue nodules may have a smooth to papillary to bosselated erythematous surface that is frequently ulcerated and friable. The lesions tend to increase in size rapidly over a period of weeks or several months and then remain fairly static.

Bleeding with minor manipulation is a common feature of this entity because it is primarily composed of granulation tissue with abundant tiny capillaries interspersed. Treatment involves excisional biopsy and removal of the contributing factors in order to prevent recurrences. Although the exact recurrence rate is unknown, a recent retrospective study reported a rate of approximately 8% (13).

References 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

Craddock HL, Youngson CC. Eruptive tooth movement – the current state of knowledge. Br Dent J 2004; 197:385-91.

Hulland SA, Lucas JO, Wake MA, Hesketh KD. Eruption of the primary dentition in human infants: a prospective descriptive study. Pediatr Dent 2000; 22(5):415-21.

Kim S-G, Kim M-H, Chae C-H, Jung Y-K, Choi J-Y. Downregulation of matrix metalloproteinases in hyperplastic dental follicle results in abnormal tooth eruption.

BMB reports 2008; 41(4):322-27.

Tegginamani AS, Prasad R. Histopathologic evaluation of follicular tissues associated with impacted lower third molars. J Oral Maxillofac Pathol 2013; 17:41-44.

Bodner L, Goldstein J, Sarnat H. Eruption cysts: a clinical report of 24 new cases. J Clin Pediatr Dent 2004; 28(2):183-86.

Aleman Nava RM, Martinez Mendoza MG, Leonardo MR, Silva RA, Herrara HW, Herrera HP. Congenital eruption cyst: a case report. Braz Dent J 2010; 21(3):25962.

Aquilo L, Cibrian R, Bagan JV, Gandia JL. Eruption cysts: retrospective clinical study of 36 cases. J Dent Child 1998; 65:102-6.

De Queirez AM, Rocha CT, da Silva LAB, Brentegani LG, da Silva RAB, de Rossi A, Nelson-Filho P. Eruption sequestrum – case report and histopathological findings.

Braz Dent J 2012; 23(6):764-67.

Maki K, Ansai T, Nishida I, Zhang M, Kojima Y, Takehara T, Kimura M. Eruption sequestrum: x-ray microanalysis. J Clin Pediatr Dent 2005; 29(3):245-47.

Schuler JL, Camm JH, Houston G. Bilateral eruption sequestra: report of case. ASDC J Dent Child 1992; 59(1):70-72.

Neville B, Damm D, Allen C, Bouquot J. Oral & Maxillofacial Pathology. 3rd Edition, St. Louis: Saunders - Elsevier Inc. 2009, 136-38.

Buchner A, Shnaiderman-Shapiro A, Vered M. Pediatric localized reactive gingival lesions: a retrospective study from Israel.

Pediatr Dent 2010; 32:486-92.

Gordon-Nunez MA, de Vasconcelos Carvalho M, Benevenuto TG, Lopes MF, Silva LM, Galvao HC. Oral pyogenic granuloma: a retrospective analysis of 293 cases in a Brazilian population. J Oral Maxillofac Surg 2010; 68(9):2185-88.

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CALENDAR OF EVENTS MARCH2014 27-29

The Greater Houston Dental Society will host its annual Star of the South dental meeting in Houston. For more information, please contact Ms Charlotte Bolls, meeting planner, GHDS, One Greenway Plz Ste 110, Houston, TX, 77046. Phone: 713-961-4337; FAX: 713-961-3617; Email: cbolls@ ghds.org; Website: starofthesouth. org.

APRIL2014 3-5

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The Louisiana Dental Association will host its annual session and New Orleans Dental Conference at

Texas Dental Journal l www.tda.org l February 2014

New Orleans Morial Convention Center in New Orleans, LA. For more information please contact Ms Normalee Ward, LDA, 2121 N Causeway Blvd Ste 153, Metairie, LA 70001; Phone: 504-834-6449; FAX: 504-838-6909; Email: norma@nodc. org; Website: nodc.org.

11-12

The Arkansas State Dental Association will host its scientific annual session at Statehouse Convention Center in Little Rock, AR. For more information, please contact Ms Angela Rogers, ASDA, 7480 Hwy 107, Sherwood, AR 72120; Phone: 501-834-7650; FAX: 501-834-7657; Email: angela@angelarogersgroup. com; Website: arkansasdentistry.org.

26-28

The Oklahoma Dental Association will host its annual meeting at the Cox Convention Center in Oklahoma City, OK. For more information, please contact Ms Lynn Means, ODA, 317 NE 13th St, Oklahoma City, OK 73104; Phone: 405-848-8873; FAX: 405-848-8875; Email: lmeans@okda. org; Website: okda.org.

JUNE2014 6-7

The Texas Academy of General Dentistry will host its annual New Dentist Conference at the Omni Southpark Hotel in Austin, Texas. For more information, please contact Lindsey Robbins, education director, TAGD, 409 W Main St, Round Rock, TX, 78664; Phone: 512-244-0577; FAX: 512-244-0476; Email: lindsey@ tagd.org; Website: tagd.org.

14

The TDA Smiles Foundation will hold a 14-chair Texas Mission of Mercy in Mineral Wells. For more information, please contact Foundation Director Judith Gonzalez at TDASF, 1946 S IH35 Ste 300, Austin, TX 78704; Phone: 512-448-2441; Email: judith@tda. org; Website: tdasmiles.org.

MAY2014 1-4

19-21

The Texas Dental Association will host its annual Texas Meeting at the Henry B. Gonzalez Convention Center in San Antonio, Texas. For more information, please contact Sandy Blum, annual session director, TDA, 1946 S IH 35 Ste 400, Austin, TX 78704; Phone: 512-443-3675; FAX: 512-443-3031; Email: sblum@ tda.org; Website: texasmeeting.com.

The American Dental Association will host its annual Washington Leadership Conference in Washington, DC. For more information, please contact Brian Sodergren, ADA, 1111 14th St, NW Ste 1100, Washington, DC 20005; Phone: 202-789-5168; FAX: 202-7892258; Email: sodergrenb@ada.org; Website: ada.org.

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.

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Provided by TDA Perks Program

value for your

profession

9 Tips for Making Your Slow Season More Profitable Brooke Franks, ProSites, Inc.

W

hether you’re the owner of a high-profile dental practice or managing a small specialty practice, everyone experiences a slow season. With empty appointment books and fewer new patients, a slow period can seem damaging,

but actually holds immense potential. How can you use your slow season to bring in more new patients? Here are some tips: 1. Start Online Many practice owners think having a website is enough of an online presence. Your website should be the cornerstone of your web presence, but during a slow season, a website alone may not provide the exposure you need to keep your appointment books full.

Time and again marketing professionals stress the importance of managing your online social networks.

Social media is critical; each platform gives your practice added exposure.

And managing social profiles is an inexpensive and easy way to spread news about your practice.

To benefit from your social media presence, it’s important to provide regular posts and updates about your practice. Patients want to know

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Since Google announced its “freshness” update, periodically updating your site can positively impact search engine optimization (SEO) and help you stand out on search engine results. what’s going on with your practice, and when you post valuable information, they become more likely to share this information with their individual networks.

If you’re experiencing an especially slow season, use extra time to stockpile social media posts. Creating a supply will help you maintain a steady posting schedule during a busy season; you can simply copy, paste, and publish a ready-togo post onto your social media profiles.

Blogs are also a proven source of beneficial web traffic. A blog allows you to write regular articles or blurbs about events your practice sponsors, or cutting-edge technology your practice acquires. Current and prospective patients have a way to gain insight into your education, experience, and specialties. Blog posts can also be written ahead of time and saved to be published at a later time.

2. Provide Online-Only Specials During a slow season, the most cost-effective and broadreaching method of advertising is online, and many people have a difficult time passing up on a good deal.

Consider running specials on services that patients and prospects need, compared to elective services. Extending a discount on a necessary service such as an exam and cleaning will make patients more inclined to schedule an appointment. Also, promoting your special on Facebook or Twitter will capture the attention of current and prospective patients.

3. Refresh Your Website If you haven’t refreshed the design or content on your website in a while, a slower season is the perfect time to revamp. Since Google announced its “freshness” update, periodically updating your site can positively impact search engine optimization (SEO) and help you stand out on search engine results.

4. Create a Cure You can increase patient loyalty and gain the interest of potential new patients any time of the year by offering a cure to a problem. If your services can cure a common dental problem that often comes up during your slow season, let your market know. For example, Halloween candy may cause children to acquire cavities.

You could create a social media post that reads: “Did you overindulge on holiday sweets? Prevent new cavities from forming with a post-holiday checkup! Contact us to schedule your appointment today.”

5. Reach Out to Existing Customers When marketing your practice, don’t forget to reach out to your current patients. Many practices unintentionally drop marketing efforts directed at prospects as soon as prospects become patients. Remember that marketing to current patients has more earning potential (than marketing to prospective patients)—especially during a slow season.

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value for your

profession

If you want to get the attention of current patients, direct mail is one of your best bets. You may be thinking, “No one looks at junk mail.” If so, you’d be completely wrong. Studies indicate: • 89% of people with families open all the mail they receive.

• 76% of people make a purchase based on the mail they see.

• These numbers increase when the mail is directly addressed to the recipient.

Knowing these statistics, you could capitalize on sending direct mail to your patients containing coupons or information on a promotion that’s valid during your slow season.

In addition, not everyone is plugged in to Twitter or wants to search the Internet to find your practice.

Completely ignoring these consumers allows your competitors to capitalize on your missed opportunities. Sending informational mailers marketing your practice reaches these individuals.

6. Speak Their Language As means of communication increase and improve, some people are becoming less inclined to communicate by phone. Text messaging and emailing have become ways of the world. If you don’t adapt, you may be faced with frustrated patients.

Studies show 80% of patients prefer alternate means of communication, such as email or text messaging.

Offering the ability to make

170

In addition, not everyone is plugged in to Twitter or wants to search the Internet to find your practice. Completely ignoring these consumers allows your competitors to capitalize on your missed opportunities. electronic appointment requests and communicate via email allows your patients to receive alerts and reminders on-the-go, and enables them to respond in their time, not yours. This is a convenience that many practices are not offering. During your slow season, your patients may be busier than usual, and little details like these could win them (as well as new patients) over.

7. Be Accommodating Working the standard 8 to 5 used to be par for the course, but as schedules change and the economy shifts, you have to adapt to your market’s demand. If you find patients increasingly scheduling early morning appointments, shift your schedule to accommodate these early risers.

Similarly, if you’re losing patients because they work the same hours you do, any practice staying open later to gratify them is likely stealing your business.

Compete by shifting to later open and close times. Putting your patients’ needs first will make your patients more likely to stay with your practice and allow you to accommodate new patients who may prefer your schedule over their previous providers’.

Texas Dental Journal l www.tda.org l February 2014

8. Create a Seasonal Promotion Careful consumers are savvy and always looking to score a great deal.

If you’re experiencing a slow season, make the most of this.

9. Ask for Testimonials Happy patients will likely refer their friends and family, and are more inclined to give you positive feedback.

This creates the perfect opportunity for them to post details online about their experiences with your practice, so prospects can see how pleased others are with your services.

Put these proven marketing tactics to use, and you’ll likely start increasing your practice foot traffic—even during the toughest of times.

TDA Perks Program partner ProSites is a leading website design and Internet marketing company specializing in dental-practice marketing. ProSites offers easy and affordable website solutions to help dentists successfully market their practice online. For more information, please call 888-541-6452 or visit www.prosites.com/TDA. For more information regarding TDA Perks Program, please visit tdaperks.com, or call 512-443-3675.

Memorial and Honorarium Donors

In Memoriam

to the Texas Dental Association Smiles Foundation

Those in the dental community who have recently passed

In Memory of:

Andrepont, John Willie

Ellen Macaulay

Port Neches, Texas

Jay Macaulay

October 7, 1920 — December 22, 2013

Dr Billy Bridgeford

Life Member: 1991

17th District Dental Society

50 Year: 2011

Dr Billy Bridgeford

Drechsel, Charles W., III

Dr Michael Wedin

Walnut Springs, Texas

Dr Stephen Matteson Dr William Gerlach

David C Hildebrand Dr L K Croft

Nick Bartkowiak Dr Steven Spivack

Elna O’Neal Dr Don Lutes

In Honor of: Lee Mahlmann, DDS, MS Dr Wayne Ley

Your memorial contribution supports: • •

educating the public and profession about oral health; and improving access to dental care for the people of Texas.

Please make your check payable to: TDA Smiles Foundation 1946 S IH 35, Austin, TX 78704

Good Fellow: 1987

October 19, 1927 — December 20, 2013 Good Fellow: 1977 Life Member: 1992 50 Year: 2002 Richards, Ronald Clyde Pearland, Texas July 8, 1941 — November 23, 2013 Life Member: 2006 Starkey, Claude Maurice Yantis, Texs January 7, 1929 — November 27, 2013 Good Fellow: 1983 Life Member: 1994 50 Year: 2007 Troutt, Jack Edwin Paris, Texas February 28, 1924 — November 5, 2013 Good Fellow: 1984 Life Member: 1989 50 Year: 2003

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ADVERTISING BRIEFS Practice OpportunitieS ABBEVILLE DENTISTRY: We are seeking an honest, hard-working, patient focused dentist who want to contribute to a culture of caring, nurturing and skilled professionals. If you have the desire to be a part of a team where you can focus on patients and not worry about the headaches that come with the business side of dentistry, please call us. If you are seeking an environment that provides stability, growth and continuing education, we’d like to share with you how you can fit into that plan. Twenty years ago, I started my practice simply dedicated to serving my patients and community. Now, I’m privileged to guide over 10 practices and 80 wonderful staff. I’ve turned the administrative, operations and marketing efforts over to people who enjoy doing those sorts of things so our doctors and staff can focus on their patients.

I’ve also been able to provide young doctors with an environment where they can grow and practice what they love doing without the worry of costly overhead or administrative headaches. At the same time, offering the potential for significant income and a great life balance. You’ll enjoy a great environment with no egos and no political barriers. We’re growing and need a

ADVERTISING BRIEF INFORMATION SUBMISSION AND CANCELLATION DEADLINE: 20th, 2 months prior to publication (eg, November 20th for January issue)

few quality individuals to join us in creating something truly special. We’re forming a new, interactive, fun environment that kids and their parents will find refreshing and exciting. If you’d like to talk about this opportunity, please give me a call. I’d be happy to share the vision, the success and the expectations we have while answering your questions candidly and openly. I hope you’ll consider this position and give me a call.

Call Britt Bostick, DDS, 806-438-5745 or email bbost35821@aol.com.

ADS WATSON, BROWN & ASSOCIATES: Excellent practice acquisition and merger opportunities available.

DALLAS AREA: 5 general dentistry practices available (East Dallas, Richardson, Southeast of Dallas, and North of McKinney). FORT WORTH AREA: 2 general dentistry practices (West Fort Worth and Arlington).

NORTH TEXAS: 2 pediatric practices. HOUSTON AREA: 1 orthodontic practice. EAST TEXAS AREA: 1 general dentistry practice. WEST TEXAS AREA: 1 general dentistry practice. AUSTIN AREA: 1 general dentistry practice available northwest of Austin. BRYAN/COLLEGE STATION AREA: 1 general dentistry practice available.

SAN ANTONIO AREA: 1 general dentistry practice available. OKLAHOMA AREA: 1 general dentistry practice available. For more information and current listings, please visit our website at www.adstexas.com or call ADS Watson, Brown & Associates at 469-2223200.

MONTHLY RATES: First 30 words = $40; each additional word = 10¢ Ads must be submitted via e-mail, fax, or web through tda.org and are not accepted by phone. Journal editors reserve 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. Advertisements must be not quote revenues or gross or net incomes; only generic language referencing income will be accepted.

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AMARILLO: General dentist for a locally owned practice looking to provide care for our patients as well as build their own patient base. Ownership opportunity available. Please contact Dr Britt Bostick, DDS, bbost35821@aol.com or call 806-438-5745.

AMARILLO: Pediatric dentist for a locally owned

will support and enhance your growth and earning

practice looking to provide care for our patients as well

potential while helping create a smooth transition.

as build their own patient base. Ownership opportunity

Interested candidates should call 903-509-0505 and/or

available. Please contact Dr Britt Bostick, DDS,

send an email to steve.lebo@sbcglobal.net.

bbost35821@aol.com or call 806-438-5745.

Associate needed for dental office in small, quaint AMAZING PRACTICE SELL: Sherri L. Henderson &

town. Potential for practice purchase. 361-645-8148.

Associates, LLC, Northeastern Oklahoma green country. This great general practice draws from 5 large

ATTRACTIVE EAST TEXAS DENTAL PRACTICE: SLH

surrounding counties and is 35 minutes from Tulsa.

Dental Sales is looking for a qualified buyer that would

Busy traffic location; 1,550 sq ft, 2 ops, 1 hygiene op,

like the opportunity to immediately transition into a

and 1 additional shared hygiene op. The doctor is

general dentist office. This well-established practice

retiring after 45 years in practice. Great production

has been in its current location since 1993 and is in

potential and chance to own or lease half of the

a beautiful home surrounded by many professional

beautiful free standing building (3,100 sq ft). Pictures

buildings and a stable community. The current dentist

available. Listing #3001. Call Sherri at 972-562-1072.

is transitioning, and both the practice and building

Visit www.slhdentalsales.com.

are for sale. This predominantly fee-for-service practice contains 2 dentist operatories and 2 hygienist

ARLINGTON / FORT WORTH: Associate position

operatories, along with a welcoming reception area,

available. Full time dentist and specialist needed to join

business and private offices, lab, etc., with room for

our successful dental group in Arlington & Fort Worth.

expansion. Video available. Listing #3005. For more

Interested candidates should email CV to txdentaljobs@

information, please contact our office at 972-562-1072,

gmail.com.

email sherri@slhdentalsales.com, or visit our website at www.slhdentalsales.com.

ASSOCIATE FOR TYLER GENERAL DENTISTRY PRACTICE: Well-established general dentist in Tyler with over

AUSTIN: Progressive, patient centric office is seeking

34 years experience seeks a caring and motivated

an experienced dentist; must be friendly, caring and

associate for his busy practice. This practice provides

professional. Opportunity is available (if desire) for

exceptional dental care for the entire family. Our office

practice ownership. Serious inquiries email: fahoosha@

is located in beautiful East Texas and provides all phases

gmail.com, mike@miloinc.com.

of quality dentistry in a friendly and compassionate atmosphere. The practice offers a tremendous

AUSTIN PEDIATRIC PRACTICE SEEKING FULL-TIME

opportunity to grow. The practice offers excellent

ASSOCIATE: Great benefits! Progressive, fast-paced

production and earning potential with a possible future

practice. Capable caring staff. We are looking for

equity position available. Our knowledgeable staff

a bright career-oriented pediatric dentist to join an Texas Dental Journal l www.tda.org l February 2014

173

ADVERTISING BRIEFS organization committed to providing high quality

location in a low competition area provide an excellent

dental care to children and adolescents. Our dental

opportunity for a doctor looking for a stand-alone

team strives to offer exceptional care with integrity.

or satellite office. Excellent collections in 2012 with

For consideration, send your confidential resume to

overhead running at 50%. The real estate is owned by

dentalresume27@yahoo.com.

the seller and is available for purchase for fair market value. NEW BRAUNFELS (ID #T226): This established,

Austin private practice seeks Associates (GPs,

fee-for-service general family practice is located in

Prosthodontists) due to growth and increased capacity.

the rapidly growing area of New Braunfels along the

Excellent compensation / benefits. Email resume to

IH-35 corridor between Austin and San Antonio. The

operations@omnidentalgroup.com or call 512-773-

practice boasts a 100% fee-for-service patient base

9239.

and is located in a free-standing building with 3 fully equipped operatories. The practice is not in network

AUSTIN, SAN ANTONIO & DALLAS AREA PRACTICE

with any PPOs, and relies solely on word-of-mouth

OPPORTUNITIES — MCLERRAN & ASSOCIATES:

referrals for new patients, and refers out a substantial

CORPUS CHRISTI AREA (ID #T231): This is an

amount of specialty work, providing the new owner

opportunity to purchase an established, general

with solid upside potential. The annual revenue of the

dentistry practice located on the South Coast of Texas in

practice is consistently high. Excellent opportunity to

an area that is experiencing rapid growth as a result of

purchase an established practice for much less than the

oil drilling in the nearby Eagle Ford Shale. The practice

cost of a start up! RIO GRANDE VALLEY (ID #T224): This

has a large, fee-for-service/PPO patient base, strong

is an established general/cosmetic family practice with

new patient flow, consistent annual revenue, and solid

a large, predominantly fee-for-service patient base and

cash flow. The office occupies a free-standing building

excellent location on a high traffic thoroughfare near

with 2 fully equipped operatories (digital X-ray units

major retailers. The practice has an excellent annual

and computers) and ample room to add 2-3 additional

revenue and solid net cash flow despite the office being

operatories. The real estate is owned by the seller

open only 3 days per week, not being in network with

and being offered for sale at fair market value. Given

any PPO plans, and doing very little external marketing.

its close proximity to the Gulf of Mexico, this turnkey

The office boasts 5 fully equipped operatories, digital

practice is an ideal opportunity for an avid fisherman/

X-ray units, Pano, and computers in each operatory. SAN

outdoorsman or beach lover. EAST OF SAN ANTONIO

ANTONIO (ID #T218): This general family practice on the

(ID #T227): This established general family practice is

northwest side of San Antonio, just outside of loop 410,

located in a community east of San Antonio in a free-

is located in a high traffic retail location and presents

standing building with good visibility and easy access.

a unique opportunity to attract and retain patients.

The office has 3 fully equipped operatories with a

The practice is located in a turn-key, 7-operatory (6

fourth plumbed room. The practice’s low overhead/high

equipped) office, boasts a large active patient base, and

profitability, fee-for-service/insurance patient base, and

sees many new patients per month. This is an excellent

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ADVERTISING BRIEFS opportunity with tremendous upside potential. SAN

operatories with 6 operatories currently equipped.

ANTONIO (ID #T209): This established pediatric practice

Excellent revenue with only one doctor producing.

is located in East Central San Antonio in a medical/

Serious inquiries only as this is a unique opportunity

dental building. The practice has seen high, consistent

not suited for most solo practitioners looking to acquire

annual revenue over the last 3 years with a strong net

a practice. CENTRAL AUSTIN (ID #T225): Located in

income. The office has 3 fully equipped operatories,

a very desirable area of north central Austin, this

strong upside potential, and would be an attractive

established fee-for-service general family practice offers

stand-alone practice or ideal satellite location. SAN

a lot for an incoming dentist. The practice is located

ANTONIO (ID #T206): This established, general family

in a 1,500 square foot, 4 operatory facility within a

practice provides an opportunity to purchase 2 office

small, two-story professional condominium building.

locations for less than it would cost to do a start-up. The

The practice boasts a committed and well-trained staff,

practice collected high revenues in 2012 between the

strong hygiene program, solid active patient base and

2 locations and realized a very strong cash flow. This

excellent gross annual revenues. While the practice is

is an excellent starter practice with tremendous upside

a strong opportunity “as-is,” an incoming owner doctor

potential. SAN ANTONIO (ID #T181): This general, family

would have ample opportunity to grow the practice

practice is located in West/Central San Antonio and

given that the current owner is not accepting any PPO’s,

boasts a large, PPO/Medicaid patient base with many

relies only on word of mouth referral to generate new

new patients being seen per month. This turnkey office

patient flow, and is referring a significant amount of

is paperless and computerized, has 4 fully equipped

specialty work out of the office. AUSTIN (ID #T228):

operatories with recently updated equipment, and

This is an opportunity to purchase a busy practice in

provides room for expansion. The practice has seen

an attractive strip center with a major retail anchor.

consistently high annual revenues over the past several

The office boasts a high traffic/visibility location with

years with strong net cash flow. This is an ideal solo

a modern build-out, 4 fully equipped operatories with

practice or satellite office with tremendous upside

digital X-rays and computers, intraoral camera, and

potential. SAN ANTONIO (ID #T159): This oral surgery

digital Pano. The practice also has a fee-for-service/

practice has a solid referral base, great location,

PPO patient base, solid new patient flow, and excellent

attractive build-out, excellent equipment, and stable

annual revenue. This is an ideal stand alone or satellite

revenue/cash flow. The practice owner is available

office with solid upside potential! SOUTH OF AUSTIN

for a transition. AUSTIN (ID # T222): This is a unique

(ID #T229): This is an opportunity to purchase an

opportunity to purchase a practice located in a busy

established, general dentistry practice with a large

retail center in Austin. The practice is ideal for a doctor

fee-for-service/PPO patient base in a rapidly growing

or company looking for a large facility to establish

town located just 20 minutes south of Austin. The

a multiple doctor and hygienist office for less than

practice has excellent, consistent annual revenue,

the cost of building out a shell space and equipping

solid cash flow, and 3 fully equipped operatories with

a startup. The practice has a total of 18 plumbed

computers and digital X-ray sensors. The practice refers Texas Dental Journal l www.tda.org l February 2014

175

ADVERTISING BRIEFS out a substantial amount of specialty work and does

is excited and ready for a new member and future

very little internal or external marketing, providing

owner that will allow their current dentist to pursue

a buyer with strong opportunity for growth. WACO

other opportunities. The office space is 1,500 square

AREA (ID #T189): This small, established family practice

feet with 4 treatment rooms equipped, 2 private

is an excellent opportunity for someone looking to

offices, and 6 highly experienced employees. The new

practice in a growing rural community with very little

practitioner will lease space from the group dental

competition. This office has solid upside potential

practice. The group practice occupies a portion of the

considering that the owner doctor is only working part-

building complex and is looking to transfer ownership

time. High revenues for the past several years. Contact

of the patient base and/or equipment within 6 months.

McLerran & Associates. Practice sales, appraisals, buyer

Pictures can be made available. Listing #3050 CB. For

representation, and lease negotiations. To request more

more information contact our office at 972-562-1072 or

information on our listings, register at www.dental-

email sherri@slhdentalsales.com or visit our website at

sales.com. David McLerran or Brannon Moncrief in

www.slhdentalsales.com.

Austin at 512-900-7989; San Antonio 210-737-0100.

BROWNSVILLE SEEKING ASSOCIATE: Established AUSTIN: A well-established pediatric practice is seeking

general dental office in Brownsville (30 minutes away

an energetic dedicated full-time pediatric dentist. We

from South Padre Island) is seeking a caring, energetic

have an extensive client base with continued growth.

associate. We are a busy office providing dental care for

Our office is a leader in all aspects of pediatric dentistry

mostly children. Our knowledgeable staff will support

including sedation and anesthesia dentistry. We have

and enhance growth and earning potential allowing the

3 offices with state-of-the art technology and a highly

associate to focus on patient dental care. Interested

trained support staff. We are looking for the right fit

candidates should call 956-546-8397.

for our practice. Ideally, someone who is looking for a long-term opportunity. New grads are welcome to apply.

DALLAS / FORT WORTH: Area clinics seeking associates.

Please email resume to tal@austinchildrensdentistry.com.

Earn significantly above industry average income with paid health and malpractice insurance while working

AWESOME PRACTICE IN EAST TEXAS FOR SALE: SLH is

in a great environment. Fax 312-944-9499 or email

looking for a qualified associate or new graduate, with

cjpatterson@kosservices.com.

an option to buy, that would like the opportunity to immediately transition into a general dentistry practice

DALLAS AREA: New and beautiful general dentistry

in this growing town of East Texas. The owner is willing

practice on I-30 near Rockwall. Over 5 years of clinical

to stay for a negotiated amount of time if necessary

experience required. Perfect for dentists who refer

to ensure a smooth transition. The location of the

endo! Pay based on collections. PPO and Medicaid

practice is near the hospital in a beautiful scenic area

accepted. M-F 2:00 PM-8:00 PM and Saturdays

surrounded by many professional buildings. The staff

available. Visit www.mockingbirddentalgroup.com.

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ADVERTISING BRIEFS DDR DENTAL — Houston (Chimney Rock):

DENTALONE PARTNERS is opening new offices in Austin

General practice. Terrific growth opportunity with

and the surrounding areas. Each practice is unique

newly renovated facilities. Fronts high traffic Chimney

in that it has an individual name like Preston Hollow

Rock Road. Four operatories in use and plumbed for 4

Dental Care or Waterside Dental Care. Our patient base

more. Free standing building with 7,000 total sq ft also

consists of approximately 70% PPO and 30% fee-for-

available for sale. Contact Chrissy Dunn at 800-930-

service. All our offices have top of the line Pelton and

8017 or www.DDRDental.com.

Crane equipment, digital X-rays, and intra-oral cameras.

We offer competitive compensation packages with

DDR DENTAL — Houston (West Side): General

benefits. To learn more about working with one of

practice. Excellent gross with very high net income.

DentalOne Partner practices, please contact Andrew

Fronts Westheimer near Beltway 8 in established

Risolvato at 972-755-0838 or andrew.risolvato@

strip center. Dentist earns high income on 4 day work

dentalonepartners.com.

week. Three fully equipped operatories, 2 dentists and 1 hygiene. Established patient-base with growth

DENTALONE PARTNERS is opening new offices in Dallas

opportunity. Contact Chrissy Dunn at 800-930-8017 or

and the surrounding areas. Each practice is unique

www.DDRDental.com (Dental Trust™ Member).

in that it has an individual name like Preston Hollow Dental Care or Waterside Dental Care. Our patient base

DDR DENTAL — Houston (THE Woodlands /

consists of approximately 70% PPO and 30% fee-for-

Conroe): Periodontal practice — Two offices in

service. All our offices have top of the line Pelton and

growing Woodlands and Conroe. Exceptional combined

Crane equipment, digital X-rays and intra-oral cameras.

gross with very, very high net income. Established

We offer competitive compensation packages with

patient-base with growth opportunity. Well cared for

benefits. To learn more about working with one of

facilities with 4 operatories in Woodlands office and 4

DentalOne Partner practices, please contact Andrew

operatories in Conroe office. Contact Chrissy Dunn at

Risolvato at 972-755-0838 or andrew.risolvato@

800-930-8017 or www.DDRDental.com (Dental Trust™

dentalonepartners.com.

Member).

DENTALONE PARTNERS is opening new offices in San DDR DENTAL — Panhandle Texas: Oral surgery

Antonio and the surrounding areas. Each practice is

practice — extremely high gross with exceptionally

unique in that it has an individual name like Preston

high net income. Four fully-equipped operatories

Hollow Dental Care or Waterside Dental Care. Our

with surgical suite. Option to purchase building also

patient base consists of approximately 70% PPO and

available. Well-established referral and patient base.

30% fee-for-service. All our offices have top of the line

Contact Chrissy Dunn at 800-930-8017 or www.

Pelton and Crane equipment, digital X-rays, and intra-

DDRDental.com.

oral cameras. We offer competitive compensation packages with benefits. To learn more about working Texas Dental Journal l www.tda.org l February 2014

177

ADVERTISING BRIEFS with one of DentalOne Partner practices, please

DFW AREA: Seeking general dentists and specialists.

contact Andrew Risolvato at 972-755-0838 or andrew.

Our offices are located in the Dallas / Fort Worth area.

risolvato@dentalonepartners.com.

We are looking for caring, energetic associates. New graduate and experienced dentists welcome. We

DENTALONE PARTNERS is opening new offices in the

offer benefits, a helpful working environment and an

upscale suburbs of Houston. Each practice is unique in

opportunity to grow. We accept most insurance and

that it has an individual name like Gulf Breeze Dental

Medicaid. Please submit your resume via email to

Care or Waterside Dental Care. All of our offices have

jennifer@smileworkshop.com or call our office at 214-

top-of- the-line Pelton and Crane equipment, digital

757-4500.

X-rays, and intra-oral cameras. Our patient base consists of approximately 70% PPO and 30% fee-for-service. We

EAST TEXAS: Well-established dental practice seeks

offer competitive compensation packages with benefits.

caring, proficient, and motivated dentist for associate

To learn more about working with DentalOne Partner

employment. Our office is located in a mid-sized town

practices, please contact Andrew Risolvato at 972-755-

with abundant outdoor activities including hunting and

0838 or andrew.risolvato@dentalonepartners.com.

fishing and a “small town” atmosphere. We offer all phases of dentistry. Interested candidates should email

DENTISTS ARE NEEDED full and part-time to provide

correspondence and resume to mloon242@aol.com.

care in various Texas Tech University Health Science Center’s (TTUHSC) Correctional Health Clinics.

EDINBURG: Falcon Dentistry PA dba Falcon Dental

The positions are on the TTUHSC staff and with

Center seeks dentist in Edinburg. Doctor of Dental

all applicable benefits: malpractice insurance, life

Surgery degree required. Texas dental license required.

insurance, retirement plan, vacation, holiday time, and

Qualified applications may submit resume directly to

a competitive salary. Contact 806-381-7081, ext. 8324.

Atlantis Gloria Moya, office manager, via fax at 956-2874926 or via email at falcondentistry@gmail.com.

DENTISTS: A practice of 1 year looking for a BC/BE pediatric dentist to come on board as employee with

EL PASO PRACTICE FOR SALE: Large West side El

possible buy-in. This is an all pediatric dentists’ office.

Paso practice in a professional building with strong

You would be working next to a BC pediatric dentist.

collections. Each treatment room has large windows

Good terms with great pay and work hours. Must be

with fantastic views. The practice is computerized and

able to get Board Certified within 1 year. OR cases done

has digital X-rays. Majority full fee with some PPO

at El Paso’s Children’s Hospital. Excellent opportunity.

plans. Visit tx-pt.com or call at 214-460-4468; rich@

Contact 719-671-5617 or tparco@dentalquestions.com.

tx-pt.com.

EL PASO: Full-time position for a general dentist. Do not waste your best years at dead end jobs. Great earning

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ADVERTISING BRIEFS potential and future partnership option. Affordable El

our practices. Carus Dental has been accredited by the

Paso Dental is looking for a Texas-licensed dentist to

Accreditation Association of Ambulatory Health Care

work full- time in our office in El Paso. Applicant must

since 2000. We offer a competitive salary and excellent

be licensed in the state of Texas and have 1 year of

benefit package including a 401k, health insurance and

experience. If interested please submit a resume with

a professional work environment. To learn more about

an accurate contact number and email address to the

American Dental Partners and Carus Dental please

following: drdarj@gmail.com.

visit us at www.amdpi.com and www.carusdental. com. If interested, please send CV and cover letter to

EL PASO: We are hiring a skilled and compassionate

kateanderson@amdpi.com.

dentist to join our stable and successful practice. We are seeking a highly professional dentist with a knack

GALVESTON: Well-established, successful practice

for general dentistry. Prospective candidates must

of 35 years needs FT associate dentist for FFS/PPO

be dynamic, fun loving, and looking for a long term

practice. Experienced staff, new equipment, Galveston.

commitment. Our practice is highly productive affording

Senior owner loves to teach sedation, implants, and

our providers an opportunity to attain competitive

other surgical procedures. No Medicaid, No DHMO

compensation. If interested, please forward your CV to

practice in 6 ops, 2 surgical suites, all operatories

annette@vistahillsfamilydental.com.

computerized with digital X-ray and intra-oral cameras; digital panoramic X-ray; paperless charts for easy

EL PASO: Well-established general practice of over

documentation. Visit www.todaysdentistrytexas.

30 years seeking full-time general dentist associate.

com. The Galveston area is just south of Clear Lake

Associate would be sole dentist at one of 2 office

25 minutes which has planned communities with

locations with full staff including hygienist. Income

superior schools, multiple educational, recreational and

opportunity well above average. Professional

cultural venues as well as access to all of the Houston

opportunity even greater. Send resume to

cultural and sport venues, shopping and restaurants.

drartbejarano@gmail.com.

We are minutes away from all types of water sports including several large marinas. Possibility of buy-in and

ENDODONTIST — FULL TIME, Killeen: Carus

partnership possible after an interim term. Interview

Dental, established in 1983 in Austin, has always been

today! Email CV to kkcarroll10yahoo.com or call 832-

committed to the traditional doctor-patient relationship

385-8875.

and to the highest quality in dental care and service.

We currently have approximately 48 doctors on staff

GARY CLINTON ORTHODONTIC WEST CENTRAL

across our 21 practices in Austin, Houston and Central

PRACTICE FOR SALE: Gorgeous practice in a booming

Texas. We offer dental services in general dentistry, oral

city. Outright sale with minimal transition or longer

surgery, orthodontics, pediatric dentistry, endodontics,

transition as desired by purchaser. Beautiful building to

periododontics and prosthodontics in some or all of

lease/purchase. High traffic area. The Texas economy Texas Dental Journal l www.tda.org l February 2014

179

ADVERTISING BRIEFS is breaking records in this city. Call Gary Clinton,

National Association of Certified Valuators and

specialized orthodontic practice appraiser/broker.

Analysts (NACVA). I follow the business valuation

Member of the Institute of Business Appraisers,

standards of the North American Business Valuation

Inc. Call 1-800-583-7765.

Standards Counsel (NABVSC). Experience is critical in this most complex of business transitions. “For 40

GARY CLINTON DALLAS OUTLYING COMMUNITY

years you’ve seen the name...a name you can trust.” I

PRACTICE FOR SALE: Four minutes from the downtown

personally handle every sale/transition and complete

area of this growing, beautiful, nice sized community.

professional certified appraisals for which Congress

Nearby lake; wonderful schools. Four operatories;

has set guidelines under the North American Business

Average gross. A free appraisal can be very costly to

Valuation Standards Council. If buyer purchases your

one party or both. Gary Clinton is a senior dental

building with the practice, there is no additional charge.

appraiser, a 27-year member of the Institute of Business

Every call is very confidential. General and specialty

Appraisers, Inc., now the National Association of

appraisals and practice sales. 100% funding available.

Certified Valuators and Analysts (NACVA). I follow the

DFW 214-503-9696. WATS 800-583-7765.

business valuation standards of the North American Business Valuation Standards Counsel (NABVSC).

GARY CLINTON DENTON AREA GENERAL PRACTICE

Experience is critical in this most complex of business

FOR SALE: D-1 DENTON PRACTICE: Five operatories,

transitions. “For 40 years you’ve seen the name...a

nice equipment; 30-plus year dentist retiring. Flexible

name you can trust.” I personally handle every sale/

transition; no low fee plans. Contact Gary Clinton 214-

transition and complete professional certified appraisals

503-9696.

for which Congress has set guidelines under the North American Business Valuation Standards Council. If

Gary CLINTON FORT WORTH AREA 2 EXCELLENT

buyer purchases your building with the practice, there

PRACTICES FOR SALE: Well established adult

is no additional charge. Every call is very confidential.

restorative practices; doctors are both retiring; one

General and specialty appraisals and practice sales.

in great Southwest area of Fort Worth; one in nearby

100% funding available. DFW 214-503-9696. WATS

Fort Worth suburb. A free appraisal can be very costly

800-583-7765.

to one party or both. Gary Clinton is a senior dental appraiser, a 27-year member of the Institute of Business

GARY CLINTON DALLAS PRACTICE NEAR TRINITY

Appraisers, Inc., now the National Association of

RIVER GREENBELT FOR SALE: Doctor retiring for

Certified Valuators and Analysts (NACVA). I follow the

health reasons; well-established 30+ year old practice.

business valuation standards of the North American

High demand lower income area. A free appraisal

Business Valuation Standards Counsel (NABVSC).

can be very costly to one party or both. Gary Clinton

Experience is critical in this most complex of business

is a senior dental appraiser, a 27-year member of

transitions. “For 40 years you’ve seen the name...a

the Institute of Business Appraisers, Inc., now the

name you can trust.” I personally handle every sale/

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Texas Dental Journal l www.tda.org l February 2014

ADVERTISING BRIEFS transition and complete professional certified appraisals

GARY CLINTON PANHANDLE & WEST TEXAS PRACTICES

for which Congress has set guidelines under the North

FOR SALE: W-1 Exceptional collections; high net

American Business Valuation Standards Council. If

on 4 days a week. Only dentist in small community.

buyer purchases your building with the practice, there

Progressive family dentist retiring to travel. Upgraded

is no additional charge. Every call is very confidential.

equipment. Nice office. Doctor will sell or lease

General and specialty appraisals and practice sales.

building. P-1 Amarillo/Panhandle Area. Well

100% funding available. DFW 214-503-9696. WATS

established practice; excellent operating profits. A

800-583-7765.

free appraisal can be very costly to one party or both.

Gary Clinton is a senior dental appraiser, a 27-year

GARY CLINTON HOUSTON PRACTICES FOR SALE: H-1

member of the Institute of Business Appraisers, Inc.,

NORTH OF HOUSTON AREA. Premier practice; excellent

now the National Association of Certified Valuators

gross with 5 operatories; exceptional recall. Over 30

and Analysts (NACVA). I follow the business valuation

years; well-established. Digital equipment. Hygiene

standards of the North American Business Valuation

profits will cover debt service. H-2 Northwest

Standards Counsel (NABVSC). Experience is critical

Houston in Lake Houston Area. Well established

in this most complex of business transitions. “For 40

practice. High estimated gross on 3 days. Excellent

years you’ve seen the name...a name you can trust.” I

recall. A free appraisal can be very costly to one party

personally handle every sale/transition and complete

or both. Gary Clinton is a senior dental appraiser, a 27-

professional certified appraisals for which Congress

year member of the Institute of Business Appraisers,

has set guidelines under the North American Business

Inc., now the National Association of Certified Valuators

Valuation Standards Council. If buyer purchases your

and Analysts (NACVA). I follow the business valuation

building with the practice, there is no additional charge.

standards of the North American Business Valuation

Every call is very confidential. General and specialty

Standards Counsel (NABVSC). Experience is critical

appraisals and practice sales. 100% funding available.

in this most complex of business transitions. “For 40

DFW 214-503-9696. WATS 800-583-7765.

years you’ve seen the name...a name you can trust.” I personally handle every sale/transition and complete

GARY CLINTON SOUTHWEST FORT WORTH DENTAL

professional certified appraisals for which Congress

OFFICE SPACE FOR LEASE OR PURCHASE: Lease with

has set guidelines under the North American Business

3 months free rent. Dental office has been in same

Valuation Standards Council. If buyer purchases your

location since 1979. No patients. Great low cost start-

building with the practice, there is no additional charge.

up space. Call Gary Clinton at 214-503-9696.

Every call is very confidential. General and specialty appraisals and practice sales. 100% funding available.

GARY CLINTON, BROKER/SENIOR APPRAISER OF

DFW 214-503-9696. WATS 800-583-7765.

GENERAL & SPECIALTY PRACTICES WITH 40 YEARS IN DENTISTRY: We need sellers...general and specialty practices! We have pre-qualified buyers. When we Texas Dental Journal l www.tda.org l February 2014

181

ADVERTISING BRIEFS sell your practice, if you own your office, there is no

HOUSTON/CLEAR LAKE — DENTAL OFFICE: In high

real estate commission. Gary Clinton, PMA. I need

visibility smaller professional building at highest traffic

practices in or near Austin, San Antonio, DFW, and

corner location in adjacent family oriented, high income

Houston area and other metro Texas locations which

master planned community. Adjacent CVS, nearby

are in high demand. Call me confidentially. 1-880-583-

schools, retail and office centers, NASA and other long

7765 or Dallas area 214-503-9696 Dallas area.

term tenants (UTMB orthopedic and urgent childcare center, podiatrist and chiropractor) drive patient traffic.

GOLIAD: Associate/buy-in partnership opportunity

Nice finishes and all plumbing and electrical in place

available in high producing and high collection practice.

for 6 or more operatories, offices and consult rooms.

100% fee-for-service practice. If you have excellent

Lease incentives, negotiable terms. Dwight Donaldson,

communication skills, a light touch and above average

Monument Real Estate, 281-240-0077, ddonaldson@

skills, we should meet. Our practice uses Cerec

terramarktx.com.

technology, places and restores implants, is 100% digital and has a high emphasis on cosmetic dentistry. Great

LAREDO / MCALLEN: If you are looking for a great

emphasis on patient comfort with oral sedation used

opportunity to join an amazing team with ownership

extensively. Our town has an excellent school district

potential and minimal administrative responsibility, this

and our patients have a great appreciation for quality

is it! We are looking for a motivated and personable

dentistry. Visit our website at www.goliaddentalcare.

individual with a positive attitude who is passionate

com. Call Dr Dan Garza at 361-645-2381 or email

about working with children. Our 3 locations offer

dmolar@sbcglobal.net.

a modern environment with all digital records and X-rays. We offer in-office oral conscious sedation and

HOUSTON AND SAN ANTONIO: Care For Kids, a

general anesthesia at local hospitals. Our emphasis

pediatric focused practice, is opening new practices

is on exceptional patient service, team member

in the San Antonio and Houston area. We are looking

development and having a lot of fun. Our compensation

for energetic full-time general dentists and pediatric

package includes a percentage of collections with a

dentists to join our team. We offer a comprehensive

daily guarantee, plus 401k, medical, vacation, and

compensation and benefits package including medical,

holidays. Our mission is to positively impact the lives

life, long- and short-term disability insurance, flexible

of our patients, their families and our team members. If

spending, and 401(K) with employer contribution. New

you would like to be a part of this amazing team please

graduates and dentists with experience are welcome.

call Dr Guzman at 956-607-0732 or email drguzman@

Be a part of our outstanding team, providing care for

littleheroesdentistry.com.

kids of Texas. Please contact Anna Robinson at 913322-1447; email arobinson@amdpi.com; FAX: 913-3221459.

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ADVERTISING BRIEFS LAREDO: We are looking for a pediatric dentist for

Excellent net on 3.5 days per week. Loyal, long-term

a rapidly growing practice. Strong referral sources.

staff. Beautiful, free-standing, custom designed and

Hospital cases performed twice a week at local hospital.

built office also for sale or lease. Four operatories, lab,

State-of-the-art practice with digital X-rays and charts.

sterilization area, private office, consultation room, staff

If part-time, then dentist can fly in to see patients and

lounge, business office, reception area and covered

still maintain living at their current city. Partnership in

parking. Located on major artery near downtown.

future is an option if candidate interested. Please email

Doctor desires career transition. Call 432-638-2583.

t2tpdlaredo@gmail.com.

MIDLAND: One of the fastest growing cities in Texas LONGVIEW PEDIATRIC PRACTICE SEEKING FULL-TIME

needs a dynamic, caring, patient-focused dentist

ASSOCIATE: Sherri L. Henderson & Associates, LLC is

to join our growing practice. Associate and buy-in

looking for a qualified associate to transition into an

opportunities are available. Please contact Britt

active pediatric dental practice. The associate will be

Bostick, DDS, at bbost35821@aol.com or call 806-438-

working with a knowledgeable staff and a great new

5745.

patient flow. This practice is dedicated to performing high quality dental care to the children and adolescents

NORTH TEXAS: Pediatric dentist needed for busy north

of the surrounding communities. The dentist/owner

Texas practice.Enjoy life in Sherman, Texas, a family-

established the practice 14 years ago, and offers a

oriented city with the convenience just 1 hour north

future opportunity to buy-in. This beautiful pediatric

of Dallas, but without the hustle and bustle of the big

practice is 5,000 sq ft, with 4 doctor chairs and 4

city! Excellent practice opportunity for motivated and

hygiene chairs, plus a quiet room and a new patient

nurturing pediatric dentist seeking full-time associate

room. A full-time schedule of 4.5 days per week is

with potential for partnership. Practice has a great

offered, with salary based on 40% of production.

reputation and is committed to providing quality

Health insurance and benefit plans are negotiable.

comprehensive care for our patients and families in a

Listing #3435. Photos available. For more information,

fun and relaxed atmosphere. State-of-the-art facility

please contact our office at 972-562-1072, email

with highly trained and dedicated staff. Competitive

sherri@slhdentalsales.com, or visit our website at

compensation and benefits. Fee-for-service, limited

www.slhdentalsales.com.

Medicaid. Must possess high personal standards, strong work ethic, excellent technical and communication

MIDLAND FANTASTIC OPPORTUNITY: General dental

skills, and be willing to treat the full range of pediatric

practice for sale. Nation’s #1 per capita income,

dental patients. Opportunities for in office conscious

booming economy, consistently low unemployment

sedation, IV sedation and hospital dentistry. Please

rate. Well-established practice (over 30 years) with

email resume/CV to bth1@cableone.net.

Dexis, digital pano, 4 total operatories, fee for service, no PPO’s or capitation plans, little external marketing.

Texas Dental Journal l www.tda.org l February 2014

183

ADVERTISING BRIEFS Opportunity to transition into a busy oral

since 2000. We offer a competitive salary and excellent

surgery practice within a multi-disciplined practice.

benefit package including a 401k, health insurance and

Present oral surgeon is retiring. Practice is private fee

a professional work environment. To learn more about

for service. New i-CAT (3D) in office. For information

American Dental Partners and Carus Dental please

contact Paul Kennedy, DDS at pkennedy@gte.net or

visit us at www.amdpi.com and www.carusdental.

361-960-6484

com. If interested, please send CV and cover letter to kateanderson@amdpi.com.

Oral surgeon needed. Oral surgeon will be busy for a full day or 2 with implant and bone grafts.

PEDIATRIC PRACTICE FOR SALE: Very large private

Competitive pay. Flexible in scheduling. Please call 361-

pediatric practice in large metropolitan area in Texas,

387-3442.

mix of PPO and Medicaid in a beautiful, free-standing 5,000 sq ft building with 10 chairs. Highly profitable

Oral SURGERY PRACTICES: D-1 DALLAS SUBURBAN

private practice established 30 years. Texas Practice

MID-SIZED CITY. Very nice office. Bread-and-butter

Transitions, Inc. Rich Nicely has been serving Texas

practice. Three-day-a-week practice; excellent referral

dentists since 1990. Visit www.tx-pt.com or call at 214-

base. SA-1 San Antonio. Fast growing outlying

460-4468; Rich@tx-pt.com.

community — lakes, Hill Country beauty; highly rated schools. Flexible transition. Will phase out PRN. High

Practice for sale Southwest of Fort Worth

net on 4 days a week. Mid-sized community. W-1

in fast growing area. Average gross; 6 operatories;

West Texas Central Area — Oral surgeon retiring;

Excellent lease. Seller is relocating. Need to move

Flexible transition. Seller phase out. High net. Mid-

quickly on this one. DFW 214-503-9696. WATS 800-

sized community. All are confidential. Gary Clinton,

583-7765.

oral surgery appraiser. Call 800-583-7765.

READY TO SELL — CORPUS CHRISTI AREA: Sherri PEDIATRIC DENTIST, Part time: Carus Dental,

L. Henderson & Associates. The DDS is relocating to

established in 1983 in Austin, has always been

another city. This cosmetic and general dentistry

committed to the traditional doctor-patient relationship

practice was established in 1982 in a professional office

and to the highest quality in dental care and service.

complex with 1,400 sq ft and 3 existing treatment

We currently have approximately 48 doctors on staff

rooms. This location would make a great place for a

across our 21 practices in Austin, Houston and Central

start-up or satellite practice and it has plenty of space

Texas. We offer dental services in general dentistry, oral

next door for expansion. The location is on one of

surgery, orthodontics, pediatric dentistry, endodontics,

the busiest streets with access to Padre Island Drive.

periododontics and prosthodontics in some or all of

This is a cash basis practice with a dedicated loyal staff

our practices. Carus Dental has been accredited by the

and great revenue potential. The current owner has

Accreditation Association of Ambulatory Health Care

extensive experience with TMJ and sleep apnea and

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ADVERTISING BRIEFS would be willing to return to the practice periodically if

graduates as well as very experienced dentists looking

the new owner was interested. Listing #3070. Pictures

for the opportunity to transition into your already

available. Contact 972-562-1072 or email sherri@

established practice. These dentists have great people

slhdentalsales.com. Visit www.slhdentalsales.com.

skills, case presentation experience and can be a very valuable and reliable addition to your bottom line.

SAN ANTONIO NORTH WEST: Associate needed.

CONTACT US. If you are unsure about the right timing or

Established general dental practice seeking quality

simply would like to talk about the opportunities, call us

oriented associate. New graduate and experienced

today for a complimentary consultation in person or by

dentists welcome. GPR, AEGD preferred. Please contact

telephone. All contact with you is strictly confidential.

Dr Henry Chu at 210-684-8033 or versed0101@yahoo.

Call on our experience to assist you in making that

com.

transition dream become a reality. Call 972-5621072 or email sherri@slhdentalsales.com, website

SAN ANTONIO: Pediatric dentist. Well-established

slhdentalsales.com.

and growing pediatric practice is seeking a caring and energetic associate for a full-time and part-time

SUGAR LAND, CYPRESS, PEARLAND AND THE

position. We offer excellent production with incredible

WOODLANDS: Full- and part-time positions available.

earning potential, vacation and other benefits. New

Well established and rapidly growing practices that

graduates are welcome. Please submit your resume to

offer great financial opportunity. High income potential

velezluke@yahoo.com.

and future equity position. Email CV to Dr Mike Kesner, drkesner@madeyasmile.com.

SLH DENTAL SALES (Sherri L. Henderson & Associates): Consulting and staging for your

TEXAS PRACTICE TRANSITIONS: ORTHODONTIC

transition! Let us help you make a transition plan. We

PRACTICES — Five chair orthodontic practice in

can analyze the market, review your current patient

McKinney. Eight-chair orthodontic office in Arlington.

base, secure the staff, spruce up the office space,

PEDIATRIC — Very large private pediatric practice

and much more. We specialize in practice transition

in large metropolitan area in Texas, mix of PPO and

consulting and can assist you in a plan to help you

Medicaid in a beautiful, free-standing 5,000 sq ft

create all the right conditions to begin that step from

building with 10 chairs. Highly profitable private

retiring to starting up a new practice. Our team has

practice established 30 years. MCKINNEY — mid-

decades of hands-on experience in the dental market

sized collections in 5 treatment rooms in a beautifully

place as practice owners, employees, and management

finished facility, paperless, 100% digital practice with

advisors. Associates, partners and buyers available. Are

a digital pano. NORTH TEXAS — Large prosthodontic

you seeking an associate, partner, or buyer? SLH has

practice 30 minutes from Dallas, premier free-standing

qualified candidates ready in all parts of Texas looking

building with 7 ops, 100% digital, 100% full fee. RURAL

for your specific practice profile. There are many

30 MINUTES FROM DALLAS — Smaller practice in a Texas Dental Journal l www.tda.org l February 2014

185

ADVERTISING BRIEFS nice free-standing building, digital X-rays, 100% full

environment! WEST HOUSTON GENERAL DENTAL

fee. DALLAS SUBURB — Large practice, 6 ops, 100%

PRACTICE FOR SALE: Small general dental practice

digital, 1,900 full fee patients, 8 days of hygiene. WEST

with high percentage restorative revenues. Several

TEXAS — Small practice in Panhandle area. ONE HOUR

new patients per month; 2 fully equipped operatories

NORTH OF HOUSTON — Medium-sized full-fee practice,

with 1 additional hygiene room and another room

free-standing building, digital X-rays. EAST TEXAS —

plumbed for expansion. Digital Pano. Same location

Very low overhead, medium sized full fee practice in

for 13 years. Cash and Insurance revenues. Motivated

free-standing building. Rich Nicely has been serving

seller! Excellent opportunity for start up at low cost.

Texas dentists since 1990. Visit www.tx-pt.com or call

SOUTH OF HOUSTON, TEXAS COASTAL PLAINS GENERAL

at 214-460-4468; rich@tx-pt.com.

DENTAL PRACTICE FOR SALE: Well-established for 28 years and in same location for last 17. Strong revenues

THE HINDLEY GROUP, LLC – DENTAL PRACTICE SALES:

and healthy profit margin on 4 days per week! 2,500

NEW LISTING! NORTH HOUSTON, ENDO PRACTICE:

sq ft building with 4 fully equipped operatories also for

Highly regarded endodontist selling well established

sale. Experienced, dependable staff. Great opportunity!

practice due to family relocation. Fantastic revenues

WEST CENTRAL TEXAS GENERAL DENTAL PRACTICE:

on 3 days per week with very strong profit margin.

25-year-old well-established family dental practice

Friendly, knowledgeable staff. NEW LISTING! THE

for sale. Open 4.5 days per week; 2,400 sq ft building

WOODLANDS, TEXAS, GENERAL PRACTICE: This

with 4 fully equipped operatories, 3 direct digital X-ray

44-year-old practice has been located in a wonderful

units in operatories, plus numerous other upgrades

Woodlands location for the past 9 years! This general

to equipment and building, which is also for sale.

dental practice is open 4.5 days per week, operating

Steady new patient growth and outstanding staff.

from 2,395 sq ft with 3 fully equipped fully digitized

NORTHWEST HOUSTON GENERAL DENTAL PRACTICE:

operatories. Upper-Middle class patient demographic,

Well established, very traditional practice with

FFS with mostly insurance and some cash revenues.

moderate fee-for-service revenues and healthy profit

Lower revenues due to lack of marketing and declining

margin. Open 4 days a week; 1,200 sq ft facility with

health of owner. Substantial upside opportunity!

3 fully equipped operatories. Doctor retiring. NORTH

Must Sell! NEW LISTING! SOUTH HOUSTON, ORTHO

OF HOUSTON GENERAL DENTAL PRACTICE: Very well

PRACTICE: Retiring orthodontist desires to sell

established practice in the same location for 31 years.

remaining patients, equipment and centrally located

Moderate cash revenues with some PPO insurance.

office condominium of 1,160 sq ft. Optimum purchaser

Practice open 4 days per week; 2,200 sq ft with 2 fully

candidates would include: an orthodontist wanting

equipped operatories and 3 additional plumbed. Loyal,

a larger location, an orthodontist desiring a satellite

experienced staff. Doctor is retiring. Call 800-856-1955

location, or an orthodontist wanting to grow a practice

or email kate@thehindleygroup.com.

in this affluent Houston area. Perfect for a new resident graduate wanting to be in the strong Houston economic

186

Texas Dental Journal l www.tda.org l February 2014

ADVERTISING BRIEFS WACO: Great associate opportunity. Waco practice looking for motivated associate with a desire to join a PPO/fee-for-service practice. Great pay, great work environment with 2 other dentists and top notch staff.

Please contact Dr Johnson at 435-237-2339 or email at johnson.2978@gmail.com.

WESLACO: Private practice is looking for a licensed fulltime general dentist. Hours are Monday through Friday, 8:00 AM to 5:00 PM. Call 956-655-8295.

Office Space BEAUMONT: New beautiful orthodontic office for lease, completely furnished and equipped on the best location in Beaumont — 6-chair bay, 2 business offices; 2,300 sq ft with lots of supplies. For more information, please call 409-861-2851 or email drtsyler@gmail.com.

DALLAS AND ROCKWALL: Orthodontic or other specialty office for lease to share with owner. Furnished and equipped. Dallas office is 4,000 sq ft in Lake Highlands area with 2,500 sq ft leasable residence

DDR Dental Trust

Serving Texas Dentists for more than 40 Years

• Practice Appraisals • Practice Sales • Associate Agreements

800-930-8017

James L. Dunn, Trustee Texas Dental Journal l www.tda.org l February 2014

187

ADVERTISING BRIEFS above. Rockwall office is 1,800 sq ft in antique building

school districts, stunning yet affordable waterfront

and furnishings. Email rcppc@sbcglobal.net.

neighborhood developments, NASA, BOEING, UTMB. Contact Vijay Bhagia 832-618-0652 or eduvillageland@

EAST TEXAS DENTAL PRACTICE: Malakoff dental

gmail.com.

practice for sale. Malakoff is near Athens. Dentist retiring due to health. General practice established in

NORTH TEXAS DENTAL PRACTICE OPPORTUNITIES:

this location in 1974. Location will make a great place

Lewis Health Profession Services has multiple career

for a start-up or satellite practice due to numerous

opportunities available in the greater Dallas/Fort

surrounding small towns. The practice, equipment

Worth area. Practices for sale, associate opportunities,

and real estate are available for purchase. Lot on main

finished out dental offices, and specialty practice

highway is also available for future office site. There is

opportunities. Lewis Health Profession Services has

a great potential for growth. Current practice is only 3

30 years experience in dental practice transitions,

days a week. For more information contact either of

with over 1,000 successful transitions completed.

the following: Stanley Fulgham, 817-657-7239, 9:00

Dentistry is our only business. We confidentially deal

AM to 8:00 PM Monday through Saturday or email

with all clients. Lewis Health Profession offers seller

to stanleyf@sbcglobal.net. Donna Fulgham, 214-642-

representation, buyer representation, opportunity

2038 9:00 AM to 8:00 PM or email to rodneyshouse@

assessments, associate placement and strategic

comcast.net.

planning services. Please check out our web site at www.lewishealth.com for current opportunities. For

EL PASO: Lease space previously occupied for 23

additional information, contact Dan Lewis at Lewis

years by oral surgeon. Plumbed for gases and suction;

Health Profession Services 972-437-1180 or dan@

2 operatories, 2 consult rooms; large storage area;

lewishealth.com.

finance room; private office; kitchen/lounge. Just off the busiest street on the Westside. Located in between

SAN ANTONIO FOUR-OPERATORY PRACTICE FOR SALE:

2 general dentists and orthodontist next door. Well kept

We have outgrown the space, looking to relocate. Space

building. Very reasonable rent. Contact Rick Ponsford at

is perfect for a specialist. Transition available. The space

915-581-4440 or 915-526-0109.

is located right off the Dominion Country Club golf course in San Antonio. Very modern, tranquil, pleasant

HOUSTON / LEAGUE CITY: Medical/office space

location, granite countertops, plumbed for nitrous,

available for lease in a stellar location, right outside the

second floor with balcony. Please contact Dr Stratton at

largest school in Texas with 4,200 students on campus.

210-687-1150 or email tiffini@dominiondentalspa.com.

In a fast growing area with a lot of young families, located close to the waterfront, boardwalk, Gulf Coast

SEGUIN: Orthodontic office space for lease in. Office

beaches, Houston downtown, NASA and Hobby Airport.

was phased down when orthodontist retired. Office

Home to one of the state’s top rated Independent

is equipped and functional. Great for a start up or a

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Texas Dental Journal l www.tda.org l February 2014

ADVERTISING BRIEFS miscellaneous

satellite location. Email inquiries to lmassadds@gmail. com.

LOOKING TO HIRE A TRAINED DENTAL ASSISTANT?

position wanted

We have dental assistants graduating every 3 months in Dallas and Houston. To hire or to host

Soumava Sen, DDS PC seeks Dentists for offices

a 32-hour externship, please call the National

in Fort Worth and other locations throughout TX. Must

School of Dental Assisting at 800-383-3408; Web:

have DDS & valid TX dental license. Email resumes

schoolofdentalassisting-northdallas.com.

lcuica@hotmail.com

for sale EQUIPMENT FOR SALE: New handheld portable X-ray unit. New intraoral wall X-ray unit, new mobile X-ray on wheels. New chairs/units operatory packages, new implant motors. Everything is brand new, with warranty.

Contact nycfreed@aol.com.

Interim Services HAVE MIRROR AND EXPLORER, WILL TRAVEL: Sick leave, maternity leave, deployment, vacation or death, I will cover your office. Call Robert Zoch, DDS, MAGD at 512-263-0510 or drzoch@yahoo.com.

Locum Tenens Board Certified Pediatric Dentist Available. Need help with your hospital cases or need temporary coverage in your office?

Excellent references available. Email for more info:

PLACE A CLASSIFIED AD IN THE

TEXAS DENTAL JOURNAL It’s a member benefit! Reach more than 9,000 of your dental colleagues.

COST PRINT: $40 for the first 30 words, 10 cents per word after that.

ONLINE: $10 a month (no word limit),: $60 one-time additional fee to post online immediately.

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OFFICE COVERAGE for vacations, maternity leave, illness. Protect your practice and income. Forest Irons and Associates, “Dentists Helping Dentists Since 1983.”

CONTACT For more information, please visit tda.org or contact Managing Editor Nicole Scott at 512-443-3675 ext 124 or by e-mail nicole@tda.org.

Call 800-433-2603 (EST). Visit www.forestirons.com.

Classified_qtr page for TDJ.indd 1

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12/16/2013 5:55:46 PM

Texas Dental Journal l www.tda.org l February 2014

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Inside Back Cover Program ..........................................654/Back TDA Member Spotlight ..........................................702 Texas Dental Journal Classifieds..........................189 TDA Perks Program Texas Dental Journal...............................................663 Display Ads.................115/156 Texas Dental Journal Classifieds.........................729 Texas Dental Journal ..................158 Texas Dental Journal Display Ads .......................705 Texas Health Steps.................................................103 TEXAS Meeting ......................................................659 University of Nevada, Las......................................665 Vegas..........................115 UTHSCSA Dental School UTHSCSA Dental / OSHA..........................151 / SouthSchool Texas Pathology Lab .............661 Veatch Consulting .................................................669 UTHSCSA / South Texas Pathology Lab..............149 Waller, Joe ..............................................................681 Waller, Joe...............................................................119

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Now Now youyou cancan choose choose thethe time time andand place place WeWe offer offer more more than than 40No 40 CENo CE courses courses Dentists Dentists and and dental dental hygienists hygienists gray gray market, market, expired expired or counterfeit or counterfeit items. items.

Get Get a price a price estimate estimate by by sending sending a list a list of of by 9byaccrediting to take to take the the courses courses you you need need and and want. want. approved approved 9 accrediting bodies. bodies. cancan earn earn Dental Dental CECE credit credit forfor These These include include dental dental content: content: these these courses: courses: items items using using SKU SKU or distributor or distributor item item • Available and FREE to any dentist or • Available and FREE to any dentist or TDATDA Perks Perks Supplies Supplies vendors vendors must must sellsell products products vv • Breastfeeding • First Dental Home - 1.25 hours • First Dental Home - 1.25 hours dental hygienist dental hygienist numbers numbers viavia email, email, phone phone or fax. or fax. • Breastfeeding pursuant pursuant to manufacturer to manufacturer guidelines. guidelines.

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