Characteristics of Dental Malpractice Claims Page 44
Vol. 37, NO. 5 SEPTEMBER/ OCTOBER 2025
THIRD PARTY
30
40 Coverage Check-Up: How Rising Costs Leave Dental Practices
44 Characteristics of Dental Malpractice
48 Why It's Time to Update from Windows 10 — Before It's Too Late
50 FDC2026 Speaker: Hiring Best Practices and Leveraging AI for Employee Retention in Your Dental Practice
55 A Follow-up to the July/August Pterygoid Implant Article
EDITOR
Dr. Hugh Wunderlich, CDE Palm Harbor
BOARD OF TRUSTEES
PRESIDENT
Dr. John Paul Lakeland
SECRETARY
Dr. Bertram Hughes Gainesville
SPEAKER OF THE HOUSE
Dr. Don lIkka Leesburg
17TH DISTRICT TRUSTEE
Dr. Andy Brown Jacksonville
PRESIDENT-ELECT
Dr. Dan Gesek Jacksonville
IMMEDIATE PAST
PRESIDENT
Dr. Jeffrey Ottley Milton
TREASURER
Dr. Fred Grassin Springhill
EXECUTIVE DIRECTOR Drew Eason, CAE Tallahassee
To contact an FDA board member, use the first letter of their first name, then their last name, followed by @bot.floridadental.org. For example, to email Dr. Hugh Wunderlich, his email would be hwunderlich@bot.floridadental.org.
To call a specific staff member below, dial 850.350. followed by their extension.
EXECUTIVE OFFICE
Drew Eason • chief executive officer/executive director deason@floridadental.org Ext. 7109
Dan Zottoli, SBCS, DIF, LTCP director of sales • Atlantic Coast 561.791.7744 • cell: 561.601.5363 dan.zottoli@fdaservices.com
Joseph Perretti, SBCS director of sales • South Florida cell: 305.721.9196
joe.perretti@fdaservices.com
Dennis Head, CIC director of sales • Central Florida 877.843.0921 • cell: 407.927.5472 dennis.head@fdaservices.com
Rick D’Angelo, CIC director of sales • West Coast 813.475.6948 • cell: 813.267.2572 rick.dangelo@fdaservices.com
Brock Shelton director of sales • North Florida 850.350.7140
brock.shelton@fdaservices.com
Mike Trout director of sales cell: 904.254.8927
mike.trout@fdaservices.com
READY. SET. RENEW!
Keep Your Practice Moving — Renew Your License by February 28.
All Florida licensed dentists must renew their dental license for the 2024-2026 biennium by Feb. 28, 2026. You must complete 30 hours of CE credit to renew your dental license. Because you are an FDA member, we are here to help! The FDA o ers opportunities to earn 6 hours of free CE online at www.floridadental.org/online-ce.
NEW!
Fingerprinting & Background Screening Requirement
Requirements for First-Time Biennium Renewals
All Florida licensed dentists renewing their license by Feb. 28, 2026 must undergo a fingerprint-based Level 2 background check, including state and national criminal records checks, and are required to comply with the background screening requirements established in section 456.0135, F.S. Learn more at floridadental.org/fingerprinting.
If you are newly licensed (after Feb. 28, 2024) and renewing your license for the first time, you are only required to complete two courses for renewal. These courses are:
• 2 hours of CE on Prescribing Controlled Substances
• 2 hours of CE on HIV/AIDS
At the next renewal cycle, you must complete the full 30-hour requirement.
YOU MUST HAVE 30 HOURS OF CE CREDIT TO RENEW YOUR LICENSE
28 Hours of General Course Credit
Only 3 hours of the 28 hours can be practice management credit.
2 Hours of Domestic Violence Credits
This course is due every third biennium. Check your CE Broker account to confirm the last time you took this course.
2 Hours of Prescribing Controlled Substance Credit
This 2-hour course is included in the 28 hours of general course credit & must be taken each license renewal.
2 Hours of HIV/Aids Credits
This course is only required during your first license renewal cycle.
2 Hours of Medical Errors Credit
This course is required for all dentists and must be taken each license renewal.
You must have a current CPR certification to renew. The CPR certification course hours do not count toward the 30 hours required to renew.
QUESTIONS? Contact the FDA at ce@floridadental.org or 850.681.3629.
I Took a Deep Breath … and Said Yes
Leadership and social media in the dental profession
By FDA President John Paul, DMD
Those of you who know me from the post-millennium era might not recognize who I was back then. When I was in dental school, I never shied away from hard work or volunteering for projects. Still, I only joined what I had to (at my school, the American Student Dental Association and the Academy of General Dentistry were “had to”). I didn’t seek to be much of a leader in anything. I had been a leader in a very strong fraternity in college and imagined everything else would be a poor second act. I met up with a few of my classmates last week, and they were surprised that I had anything to do with tripartite leadership, much less being president of the Florida Dental Association (FDA). Knowing my usual desire to tell stories, Dr. Betty-Jo Simas asked me, “In one sentence, tell me why you are president of the FDA.”
I took a deep breath to shorten my answer and said, “I appreciate everyone who is a dentist and shares at least
some of the same weirdness as me. I want them all to do well, I think I can make a difference and they asked me to do it.” Hence, this bi-monthly message.
Some of you active on social media may have seen comments or posts referencing Florida, the 17th District delegation, or individual leaders within organized dentistry. While the ADA House of Delegates (HOD) has not yet set its agenda, conversations are already underway around potential topics — and yes, the Florida delegation has ideas and input, some aligned with others and some different.
We are choosing not to engage in social media back-andforth. Our focus is on listening to members and bringing well-reasoned ideas to the ADA HOD and working with those who have a vote to consider what’s best for the profession. That’s where our energy belongs.
Here is my advice: If you’re active on social media, focus on adding value. The most effective voices are the ones that help others, share helpful information and build up the profession. We have many members who do just that — Dr. Arnelle Wright is a great example. She understands platforms in ways I never will, and her posts are consistently uplifting and informative.
Your FDA is embarking on a new social media initiative with Dr. Alia Osserian, FDA Executive Director Drew Eason, FDA Communications and the team at Moore Communications. We’ll be highlighting member dentists on Florida Dental Chatter (join if you haven’t yet!) and developing templates and content ideas you can use on your own pages. Who knows — I might even post something myself.
FDA President Dr. Paul can be reached at jpaul@bot.floridadental.org
HEALTH CARE PROVIDER CHECKLIST:
Nonopioid alternatives are available for pain treatment, which may include nonopioid medicinal drugs or drug products.
Nonopioid interventional procedures or treatments are available, which may include: acupuncture, chiropractic treatments, massage, physical or occupational therapy or other appropriate therapy.
DISCUSS
t ien
t ien t ’s pers
DOCUMENT IN PATIENT’S RECORD
PROVIDE
“Alternatives to Opioids,” an educational information pamphlet created by the Florida Department of Health is available in printed and electronic formats (required, available at bit.ly/2KXvZ2h). A checklist and poster are also available.
SUMMARY:
All health care providers must include nonopioid alternatives for pain and pain management electronically or in printed form in their discussions with patients before providing anesthesia, or prescribing, ordering, dispensing or administering a schedule II controlled substance for the treatment of pain.
Protect Your Practice: FDA Offers Free Dental Provider Contract Review
By FDA Chief Legal Officer Casey Stoutamire
Did you know that the Florida Dental Association (FDA), through the American Dental Association (ADA), offers a free dental provider contract analysis service for members? This service provides you with information concerning a proposed contract so you can better understand and analyze its terms. Receiving a clear and concise explanation of the terms of a dental provider contract can help you decide if participating in such a plan is best for you and your patients, as well as help you avoid unpleasant surprises under the contract in the future.
How does it work? All you need to do is submit an unsigned copy of the third-party payer contract to Ms. Casey Stoutamire at cstoutamire@floridadental.org.
The ADA and FDA only offer contract analysis for dental provider contracts with third-party payers (dental insurance companies). The FDA and ADA do not provide analysis of employment or associate contracts, as many times, both parties to the contract are members of the association, and we do not want to put ourselves in the middle. We recommend each party hire its own independent legal counsel in that situation. If you need recommendations for an attorney, please contact Ms. Stoutamire.
FDA Chief Legal Officer Casey Stoutamire can be reached at cstoutamire@floridadental.org
Fact vs. Fiction:
Grassroots Advocacy Needed
By FDA Chief Legislative Officer Joe Anne Hart
The year is 2025 and all is not as it seems. More people than ever are turning to social media for their news, platforms that often lack credibility and accountability. Once someone clicks on a misleading or false post, algorithms feed them more of the same, creating an echo chamber of misinformation. This cycle has left many confused about what’s real and what’s made up by individuals with no qualifications, particularly those lacking medical or scientific training.
Misinformation isn’t new, but the speed at which it spreads today is unprecedented. Nowhere is this more evident than in health care. In dentistry, we’ve witnessed firsthand the consequences of misinformation, such as the controversy surrounding community water fluoridation. The latest target? Vaccines. Despite decades of research, science and proven public health success, vaccine credibility is under attack. Childhood vaccines have long been a cornerstone of preventive pediatric care, protecting children from dangerous infectious diseases. So why are so many people choosing fiction over science?
This is a wake-up call for grassroots advocacy. Florida legislators are responsible for shaping policies that protect public health, but they
Sen. Tracie Davis (D-Jacksonville) with her LCD, Dr. Andy Brown.
need accurate, science-based information to do so. While fringe groups will always attempt to influence policy with fear and falsehoods, we must ensure our elected officials have access to reliable, expert information early and often.
We need more dentists to step up as Legislative Contact Dentists (LCDs). As an LCD, you’ll receive the tools and support necessary to educate legislators about the Florida Dental Association’s (FDA) priorities. LCDs are a critical part of the FDA’s advocacy team, serving as the first line of defense by meeting with legislators in their home districts. Your participation helps counter misinformation and ensures dental policy is guided by science and experience, not speculation.
Fact:
Dentists are highly trained experts in oral health, and their education is rooted in science and research. Every dentist is a doctor. Your background, training and expertise make you uniquely qualified to inform and advise legislators on dental and public health issues.
Fiction:
Legislators are elected by the public, so they must be experts in all the issues they vote on.
FALSE! Legislators rely on professionals, like you, to help them understand complex issues, especially in health care. That’s why it’s essential for dentists to engage with legislators and offer guidance. As an LCD, you can become their trusted source for facts when it matters most.
To learn more about the LCD Program, contact the Governmental Affairs Office (GAO) at 850.224.1089 or gao@floridadental.org.
FDA Chief Legislative Officer Joe Anne Hart can be reached at jahart@floridadental.org
Your participation helps counter misinformation and ensures dental policy is guided by science and experience, not speculation.
Sen. Colleen Burton (R-Lakeland) with her LCD, FDA President Dr. John Paul.
Sen. Clay Yarborough (R-Jacksonville) with his LCD, Dr. Dan Gesek.
Eye-Opening Lessons from the Coalition Cyber Convention: Why Prevention Is the New Power Play
By FDAS Director of Insurance Operations Carrie Millar
In April, I had the opportunity to attend the Coalition Insurance Cyber Convention Active, and it was one of the most eye-opening cyber events I have attended. Coalition did something bold.
They started as a technology company focused on cybersecurity and then chose to sell insurance. Their model brings insurance into the cyber experience, embedding proactive protection directly into business operations.
One of Coalition’s most significant innovations is its proprietary scanning technology. Their system scans insureds’ networks and systems in near real-time to
detect existing vulnerabilities and potential threats. The platform alerts the business to any critical or severe technology exposures, offering a rare opportunity to address the issue before hackers gain access. Unlike traditional insurers who react after a breach, Coalition is actively working to prevent breaches before they happen.
Their commitment to cyber research is profound. Coalition operates honey pots to attract threat actors and continuously scans the dark web to identify what cyber-
preventive action
criminals are working on. Their insights give them and their policyholders a head start against emerging threats.
Emerging Threats: Business Email Compromise and Funds Transfer Fraud
One of the biggest concerns in cybersecurity today is Business Email Compromise (BEC). It is now the leading cause of cyber claims and often leads to funds transfer fraud. Some key statistics shared at the event:
• $35,000 is the average loss from a BEC event.
• $103,000 is the average loss from a funds transfer fraud event.
One compelling real-world example of Coalition’s system involves Change Healthcare. In 2023, Change Healthcare came to Coalition to request a cyber insurance bid. Coalition ran a scan and identified a Citrix system exposed to the internet without multi-factor authentication. Coalition offered a quote with a contingency that the vulnerability would be closed immediately. Change Healthcare declined both the insurance and the recommendation. In February 2024, Change Healthcare suffered one of the most significant cyberattacks in history, with damages exceeding $190 million.
It is a stark reminder that prevention is the real insurance.
In 2024 alone, Coalition stopped more than 614 threats before they could turn into claims.
New Tools for Prevention: Cyber Training for Employees
Recognizing that people are often the weakest link, Coalition now offers employee cyber training add-ons as part of their policies. For $300 per year for 10 employees, policyholders can access:
• Phishing simulations
• Targeted cybersecurity training
• Compliance assistance
It is a small investment that can prevent a massive loss.
What Every Dental Practice Should Be Doing
Cyberattacks do not just happen to large corporations. Dental practices are increasingly being targeted because they handle high-value patient data and often lack robust security measures.
Here are the steps we strongly recommend:
• Have a written incident response plan: Review it annually with your team.
• Print a copy of your cyber insurance policy: Keep it accessible in case your network is down.
• Train staff: Teach employees to report suspicious clicks immediately.
• Password management: Change passwords regularly and make them complex.
• Backups: Know how to access backups of daily schedules and critical files.
• Vendor communication plan: Pre-identify key contacts like your bank, insurance claims team and IT provider.
• Messaging control: Instruct employees not to speak to the media and have a clear script ready for informing patients if needed.
At FDA Services (FDAS), we believe cybersecurity success relies on three pillars:
• Strong IT support
• HIPAA compliance
• Comprehensive cyber insurance
How Much Cyber Insurance Do You Need?
Your cyber insurance limits should be at least double your monthly revenue. Ransomware attacks can cripple your cash flow for weeks or months, and the damages often exceed the loss of revenue alone.
When a breach happens, speed matters. Coalition’s average response time after an incident is just five minutes, a major advantage when the first 72 hours are critical for recovering stolen funds. In fact:
• Coalition successfully negotiates ransomware payments down 60 percent of the time.
• Coalition only pays the ransom 44% of the time, with most incidents resolved through negotiation or technical remediation.
• The average ransom demand for Coalition policyholders in 2024 was around $1.1 million, making professional negotiation essential.
Winning the Insurance Game
By FDA Secretary Bertram J. Hughes, DMD
As Insurance companies grow, they have become increasingly difficult to deal with in terms of reimbursement, administrative burdens and contracting. In addition, with the general public believing that they cannot see a dentist without insurance, this business model has become even more challenging to navigate. Organized dentistry is the key to helping the dental profession win the insurance game. There is the old saying, “If you see something, say something.” This pertains to your explanation of benefits (EOB), intrusive efforts by the plans and questionable contract language as it pertains to the dental office or the patient. Approaching insurance issues from the patient perspective, and in an organized way, is the key to meaningful change. Recently, efforts by the Florida Dental Association (FDA) and the American Dental Association (ADA) led to a nationwide policy change about recoupment by MetLife. This issue was initially brought to light by one of our members. If you feel that an EOB is questionable or an insurance
Approaching insurance issues from the patient perspective, and in an organized way, is the key to meaningful change.
policy is favoring profit over care, please reach out to the FDA or ADA for review. Solving these real-life issues will not only help your office personally, but also improve the quality of benefits for the public as a whole. You may contact the FDA directly at cstoutamire@floridadental. org or bhughes@bot.floridadental.org.
FDA Secretary and representative to the American Dental Association Council on Dental Benefits Program
Dr. Bert Hughes can be reached at berthughes@me.com.
Navigating Dental Insurance as a New Practice Owner: Simple Reflections
By ArNelle Wright, DMD, MS
Stepping into practice ownership brings many exciting firsts — new patients, new systems and new opportunities to shape the culture of your office. But one of the most complex areas I’ve had to navigate as a newer practice owner is dental insurance or third-party payers.
While dental school taught me how to care for patients, the realities of insurance participation and billing have been a steep learning curve. I want to share a few key lessons I’ve learned so far that I believe can help other dentists who are preparing for ownership or who are early in their journey.
One of the first and most important lessons I have to share is that if you’re going to be in-network with dental insurance companies, you have to start credentialing early. Credentialing takes time. It’s a long, laborious process, and one that must be started well in advance of opening your doors. Keep this in mind from a business success perspective: delays in credentialing ultimately delay your opportunities to see patients who are members in the plans you accept, which leads to delays in revenue. If you haven’t thought of
this yet, you must know that delays in revenue impact everything from payroll to team morale, and even continuation of patient care. Again, start earlier than you think you need to, and stay on top of the paperwork, like contracts, terms and fee schedules, to name a few.
Another eye-opening experience has been learning about network leasing. In many cases, insurance companies lease their networks to other payers, which means a patient’s benefits may be tied to an agreement you
didn’t directly sign. If you don’t understand this process, it can also affect reimbursements and negatively impact patient-provider relationships. Always ask questions about network leasing when reviewing your contracts. If you’re like me and you’ve acquired a practice, it’s also worth having a conversation with the selling provider about the plans they’ve accepted in the past and if there have been any network leases.
Let’s transition into the importance of provider contracts. The contracts we sign with insurance carriers are binding agreements that have real implications for our practices. I’ve learned that it’s critical to not only read these documents thoroughly but also to truly understand what you are agreeing to — whether it’s reimbursement rates, downgrades or timelines for payment. As the steward of the practice and leader of the team, it’s critical to understand how your contractual agreement impacts operational efficiencies and the patient experience. In addition to a thorough review of the contract, at some point in our busy schedules, we have to request and review the provider manual. The provider policy and procedure manual is likened to a governing document detailing the rules and regulations for you to abide by as an in-network provider.
Another point to remember is the importance of the Current Dental Terminology (CDT) code, produced and updated annually by the American Dental Association (ADA). Learning the codes (or at least ensuring your team is well-versed in the codes
new dentist
Ownership is a journey, and navigating insurance is part of the growth process. With the right mindset and resources, it can be a manageable — and even empowering — part of your story as both a dentist and an entrepreneur.
you use) not only aids in operational efficiency but also enhances accuracy in billing and documentation. Knowing what you can bill and how you should bill it matters — not only for accuracy and compliance but also for ensuring your practice is paid appropriately for the care you provide. This is an area where I’ve realized investing in team training pays dividends.
Beyond patient care, proper insurance billing is directly tied to the financial health of your practice. Monitoring billing isn’t just about cash flow — it also plays into yearend accounting and tax preparation. Staying on top of your chart of accounts throughout the year prevents surprises later and ensures your financial reports truly reflect your practice’s performance.
Resources for Growth
Thankfully, there are resources available to help. A few that have been particularly useful for me and my team include:
Vyne Dental and other clearinghouses that offer webinars and continuing education for team learning.
• The ADA CDT Dental Code Book, which is updated annually and should be on every new dentist’s shelf.
• Conferences, like FDC, where billing and practice management presentations are on the schedule to provide both education and networking with peers facing the same challenges.
• Insurance and third-party payer management can feel overwhelming at times, especially in the early days of practice ownership. But by starting the credentialing process early, understanding the nuances of network leasing, carefully reviewing contracts, mastering the dental codes and keeping a close watch on your billing, you can build a practice that is patient-centered while being financially sound.
Ownership is a journey, and navigating insurance is part of the growth process. With the right mindset and resources, it can be a manageable — and even empowering — part of your story as both a dentist and an entrepreneur.
Dr. ArNelle Wright is the FDA's 17th District Alternate Delegate to the ADA and serves as chair of the FDA New Dentist Task Force. She can be reached at arnellewrightdmd@gmail.com.
Helping Those in Need
The Florida Donated Dental Services (DDS) program provides lifechanging dental care to people like Leroy, 71, a Navy veteran who was struggling with severe dental issues and limited financial resources. With only 15 teeth, a ll of which were deteriorating, Leroy's health and quality of life were significantly impacted Through the DDS program, Dr Jeffrey Ottley, a dedicated DDS volunteer, along with a volunteer lab, provided Leroy with thousands of dollars in donated dental treatment, ultimately restoring his oral health and smile.
The DDS program allows me to help those in need with dentistry in my own office. Everyone should volunteer, it’s so gratifying and the patients truly appreciate you.
Dr Jeffrey Ottley
28 YEARS of life-saving volunteers
$12M
489
Volunteer Dentists in Florida in donated dental treatment
205
Volunteer Labs in Florida
2,275 PEOPLE SERVED in Florida since 1997
The 7 Must-Make Moves to Maximize Your Exit:
Do Not Sell Your Dental Practice Without Reading This
By David Rice, DDS
I need you to picture this day. You’ve spent a lifetime building your practice, only to sit down with a broker or buyer and hear, “Doctor, I’m sorry, your practice is worth less than you thought.”
According to the American Dental Association’s (ADA) Health Policy Institute, more than 80% of dentists ages 55 and older say they plan to retire by 2035. And despite what we tell each other at cocktail parties, most of us are relying on the sale of their practice to fund a significant portion of that retirement. But here’s the catch:
Nearly 60% of those practices are not financially or operationally prepared to sell. And friends — being totally honest, as I’ve always promised to be with you — the fallout is real.
Every year, the IgniteDDS team and I meet great clinicians — great people — who’ve dedicated their lives to their
patients, teams, and communities for all the right reasons. They have worked diligently in their practices and beyond. Then, with one of life’s biggest transitions on the line, these great clinicians, great people rush the sale, trust without verifying, and end up walking away with far less than their life’s work is worth.
If you’re even thinking about selling your practice in the next 2 to 5 years, this article is your wake-up call — and your roadmap.
Seven Must-Make Moves to Do Now If You Ever Want to Sell
1. Stop Thinking Like a Clinician and Start Thinking Like a Buyer
Buyers aren’t buying your clinical skills. They’re buying your reputation and brand, your team, your systems and your bottom-line profit. And it all has to function without you. If you’re like most dentists (PS, this was me many years ago), and your practice needs you to thrive, it’s time to rewire your operations … quickly.
Dr. David Rice
2. Get a Real Valuation — Not a Guess
Too many dentists base their expectations on hearsay or rough math. Instead, work with professionals who understand the nuances of dental valuation. These are individuals who can accurately audit your profit and loss statement, including your earnings before interest, taxes, depreciation, amortization and collections. Now, it’s true that at IgniteDDS, we’ve helped many clients increase their practice value by 30–50% in less than 18 months. And we can indeed do the same with you. So, if you have a runway to sell of two plus years, connect and we’ll help make your future broker meeting a meeting that makes you smile — big.
That said, if you are looking to sell within the next one year, then it’s going to be very helpful to have your practice assessed before we talk. We want you to know exactly where you stand today. That knowledge will help you choose the sell number a broker shares today, or choose to put in the work to exit exactly the way you want, with the number you want. If this is you, contact IgniteDDS at david.rice@ignitedds.com! We’ll connect you with the best in dentistry who will objectively share all your options, along with the risks and benefits of each.
3. Clean Up Your Financials — And Your Overhead
Buyers look for patterns and profitability over time (so you can’t just clean things up last minute — that’s a red flag). They look for bloated expenses, owner perks hidden in overhead, inconsistent reporting and friends, all of it spooks buyers. Your practice should demonstrate clean margins, steady revenue and expense discipline that a buyer can trust.
4. Make Yourself Less Necessary
If your name is on everything from treatment planning, patient relationships, leadership and more, your practice is harder to sell. Developing your team to run daily operations, creating clinical protocols that others can follow, and beginning to transition leadership moments to associate doctors or key team members is a shift my team brings to Florida Dental Association (FDA) practices every day. Buyers want confidence that revenue will continue even when you walk away.
5. Re-engage Your Team
Dentistry’s most significant challenge, team shortage! Knowing that, we must recognize that turnover kills deals. Before selling, stabilize your team, especially hygienists and front office leaders. Bonus: Buyers pay more for a well-trained, long-standing team they don’t have to rebuild or develop from the start.
Bonus: Just like buyers worry about a new team, they also worry about a 20 plus year tenured team. They’re worried they’ll leave when you leave. Balance is key.
6. Know Your Exit Type
There’s more than one way to sell a practice — so what do you want?
Want to walk away clean in six months or less? Want to partner and phase out over five years? Want to sell to an associate? Sell to a dental service organization (DSO), and if yes to this, which type of DSO — there are categories you need to know about!
Each path requires different prep and produces different outcomes. What you don’t want is to get boxed into a decision you can’t reverse because you ran out of time.
7. Bring in the Right Advisors — Early
As mentioned above, if you’re considering selling in two or more years and this article resonates with you, contact david.rice@ignitedds.com. We’ll set up a time to learn more about you and your goals. We don’t work with anyone we’re not confident we can’t systematize and grow.
If you’re thinking of selling in a year or less, the first step is to get the right broker and get your number. It’ll help you decide if you’re happy with the number they give you — OR — if you need to adjust your sell timeline.
Today’s biggest truth is that you need a strategic partner who understands the business of dentistry, has deep relationships with buyers (traditional or DSO) — including CPAs and legal advisors- and who has walked this path many times before.
Final Thought
This is your last bite of the apple. You’ve put in decades of hard work. You’ve taken risks and built a legacy-worthy practice. Make sure you don’t walk away disappointed.
Practice financing1
practice management
If you are two or more years out from a potential sale, your move is simple:
Schedule a free 60-minute Fit Call with the IgniteDDS Coaching Team
We’ll review where you are, where you want to be and exactly how to get there without guesswork.
If You’re Looking to Sell Within a Year
You’re still very welcome to set up a free 60-minute call. We’ll shift the call’s goal, to learn about how you’d like to sunset, to objectively share the risks and benefits, and connect you to the best brokers in dentistry that fit your
goals. Contact IgniteDDS at david.rice@ignitedds.com
Best-selling author, executive coach and founder of IgniteDDS, the nation’s largest community for new dentists and students, Dr. David Rice is a dynamic thought leader in the world of dentistry. With a passion for mentorship, leadership and business success, Dr. Rice travels the globe educating and connecting today’s top young dentists to their self-determined future.
As Editor-in-Chief of DentistryIQ and Adjunct Faculty at The Pankey Institute, Dr. Rice is at the forefront of innovation in dentistry, guiding professionals in clinical excellence, business mastery and leadership development. FDA members get a 10% discount; learn more at floridadental.org/ member-center/member-resources/ignitedds. Dr. Rice can be reached at david.rice@ignitedds.com.
Individual/Family Health Open Enrollment 2026!
Health care open enrollment is open starting Oct. 1, you must apply by Dec. 15, 2025 and pay your first premium, for a January start date. You can book an appointment with our health care advisor Jamie Idol calendly.com/Jamie-Idol. If you are interested in group health coverage or other employee benefits for your office, book an appointment with Jamie.
Fraud Alert: Protect Your License
We have seen a recent surge in fraudulent emails and phone calls targeting Florida health care practitioners by impersonating the Department of Health or the Division of Medical Quality Assurance (MQA). These scams leverage information about the licensure and enforcement processes to attempt to steal your personal or financial information.
If you have accidentally entered your credentials into any prompt or website that seems suspicious, or if you have been contacted by a suspicious caller or email, change your password immediately, gather the following information about the incident and report it by calling the MQA Customer Contact Call Center at 850.488.0595 or emailing MedicalQualityAssurance@flhealth.gov
• A description of the scam and how you were contacted.
• Screenshots of the phone call (with the timestamp and number).
• Photos of any documents or emails received (including the sender’s email or fax number).
• A copy of the envelope or bank charges, if applicable.
Thank you for helping us protect the integrity of Florida’s health care workforce.
AI is Changing How Dental Students Learn, and Florida is Leading the Way
At the University of Florida College of Dentistry (UFCD), artificial intelligence (AI) isn’t doing the thinking for students — it’s helping them think smarter.
Instructional Designer III Carrie Wells, Ed.D., through her role within the UFCD Office of Academic Affairs, is working with faculty to turn AI into a learning partner. To help students prepare for the rapidly shifting world of dentistry, she is asking: How do we harness artificial intelligence’s (AI) game-changing capabilities to elevate students’ practical skills without undermining critical thinking?
For a college that is training future health care providers, getting this right isn’t just academic; it’s about patient care.
To read the entire article, please visit bit.ly/47uTyKJ.
Utilize
the FDA’s Jumpstart Program in Solving Workforce Challenges
The FDA’s Jumpstart program is an initiative to connect member dentists with pre-dental students who are interested in volunteering or working with dental offices. It’s a
Ms. Jamie Idol
creative solution to assist in solving workforce challenges faced by Florida dentists. Jumpstart is a fast pass for students to gain real-world experience, connect with dentists and master skills that will help them stand out in the dental school application process and in the competitive field of dentistry. All of this while providing staffing for offices that may have difficulty hiring the right people. A true win-win!
As a result of the FDA’s efforts, members can access a student directory at floridadental.org/jumpstart. It notes students’ geographic location, interests and roles they could fill. If you have an interest in engaging any of these students, please contact them directly and make suitable arrangements. If you know pre-dental students who may be interested registering, encourage them to visit floridadental. org/jumpstart to sign up and learn more about transforming their enthusiasm into expertise.
ADA Find-a-Dentist: Help Patients Find You
ADA Find-a-Dentist has an enhanced search feature, making it easier for patients to discover you. Patients can search by address or zip code and filter by dental specialty, languages spoken, insurance accepted and distance. This powerful marketing tool is included in your member benefits. To increase your visibility and stand out by keeping your profile updated, log in to your ADA account portal.
Make sure to check the “Include in Find-a-Dentist” box to appear in search results. Learn more at findadentist.ada.
Florida Medicaid Health Care Alert
The Florida Dental Association (FDA) wants to ensure all members see the following information, which was shared in an email from the State of Florida Agency for Health Care Administration.
Florida Medicaid Health Care Alert
August 29, 2025
Provider Type(s): 01, 06, 35, 70
Statewide Medicaid Managed Care: Non-Emergency Dental Services in Ambulatory Surgical Center and Outpatient Hospital Settings Effective Oct. 1, 2025
MEDICAID ALERT!
On Feb. 1, 2025, the Agency for Health Care Administration (Agency) implemented new contracts with Medicaid health and dental plans to provide State Plan services to plan enrollees in the Statewide Medicaid Managed Care (SMMC) program. The new contracts required dental plans' reimbursement of non-emergency outpatient dental services performed in an Ambulatory Surgical Center (ASC) and outpatient hospital settings.
Effective Oct. 1, 2025, payment responsibility for non-emergency dental outpatient anesthesiology and sedation services (those performed in a hospital or ASC) will move from Florida Medicaid’s dental plans to Medicaid health plans. This change is part of the Agency’s ongoing efforts to reduce administrative complexity and simplify billing for providers.
The dental plans will continue to be responsible for the coverage of anesthesiology and sedation services (DDS, DMD, MD, DO, APRN and CRNA) when provided in conjunction with dental services in an office setting when medically necessary.
Health and dental plans are required to ensure continuity of care (COC) during the transition period for Medicaid recipients enrolled in the SMMC program. For at least sixty (60) days following the transition, medical managed care plans must honor any appointments and procedures scheduled prior to Oct.1, 2025, and reimburse non-participating providers at the rate they received prior to the transition date unless the provider agrees to an alternative rate.
For more information about the SMMC Program on the Agency’s website, visit bit.ly/4gg8xe6.
For questions email FLMedicaidManagedCare@ahca. myflorida.com
Welcome New FDA Members
Learn more by visiting our virtual Member Center at floridadental.org
The following dentists recently joined the Florida Dental Association (FDA). Their memberships allow them to develop a strong network of fellow professionals who understand the day-to-day triumphs and tribulations of practicing dentistry.
Atlantic District
Dental Association
Dr. Ola Abughoush, Fort Lauderdale
Dr. Paige Alshon, Boca Raton
Dr. John-Paul Arias, Port Saint Lucie
Dr. Galit Arreaza, Fort Lauderdale
Dr. Godlive Athis, Lake Worth
Dr. Melinda Babaian, Glendal
Dr. Cristina Cadet Prosper, North Bay Village
Dr. Kaitlyn Doolittle, Plantation
Dr. Charlotte Doyle, Fort Lauderdale
Dr. Victoria Fernandez, Miami
Dr. Argenis Ferrebus, Boca Raton
Dr. Edward Fox, Boca Raton
Dr. Drew Gearhart, West Palm Beach
Dr. Victoria Gorelik, West Palm Beach
Dr. Dominique Gross, West Palm Beach
Dr. Yanet Guzman Rodriguez, Jupiter
Dr. Isabel Hanson, Palm Beach Gardens
Dr. Liam Harb, West Palm Beach
Dr. Juan Hernandez Gonzalez, Oakland Park
Dr. Sufeeya Irani, Louisville
Dr. Olivia Iyar, Sunrise
Dr. Chaim Alen Jakob, Boca Raton
Dr. Diandra Jones, Lake Worth
Dr. Disha Kinra, Fort Lauderdale
Dr. Shivani Mann, Lake Worth
Dr. Juliana Marin, Coconut Creek
Dr. Layne Martin, Boynton Beach
Dr. Samuel Metzger, Boca Raton
Dr. Valentin Meyts, Fort Lauderdale
Dr. Barbaro Montiel Lugo, Fort Lauderdale
Dr. Stuart Newman, Palm Beach Gardens
Dr. Hunter Parker, Riviera Beach
Dr. Jon-Michael Parlato, Davie
Dr. Natalia Pylypenko, Parkland
Dr. Teresa Reis, Royal Palm Beach
Dr. Peyton Ross, Plantation
Dr. Eden Sabag, Gainesville
Dr. Soroush Samimi, Fort Lauderdale
Dr. Genesis Santiago-Alvarez, Ocala
Dr. Jim Skaff, Jupiter
Dr. Jenna Stephany, Gainesville
Dr. Yanisel Stuart-Salas, Plantation
Dr. Ervin Valcin, Port Saint Lucie
Dr. Llaimarys Verdecia Garcia, Sunrise
Dr. Nickoe Yadegari, Plantation
Dr. Maryam Zargar, Lake Worth
Dr. Clara Zhou, Delray Beach
Central Florida District Dental Association
Dr. Zahra Ahmad, Orlando
Dr. Mohammad Al-Ayna, Orlando
Dr. David Alpert, Gainesville
Dr. Laura Anderson, Ormond Beach
Dr. Aliuska Arner Medina, Orlando
Dr. Marisa Arriaga, Satellite Beach
Dr. Sandra Avila, Orlando
Dr. Muhammad Awan, Orlando
Dr. Shailja Bhatt, High Springs
Dr. Javier Broche, Apopka
Dr. Rafael Castro Mompie, Ocala
Dr. Shireen Chakkiwaka, Ocoee
Dr. Orlando Colon De Feria, Miami
Dr. Remi Conley, Satellite Beach
Dr. Clayton Cooper, Satellite Beach
Dr. Mark Dimitriu, Ocala
Dr. Clark Downey, Windermere
Dr. Morgan Evans, Gainesville
Dr. Xiaojing Fan, Daytona Beach
Dr. Shayegan Farokhrou, Kissimmee
Dr. Yarina Frias Guzman, Orlando
Dr. Valentina Garcia, Windermere
Dr. Erick Garcia, Gainesville
Dr. Daniel Ghabras, Port Orange
Dr. Daria Ghorbanpoor, Satellite Beach
Dr. Trenton Ginter, Summerfield
Dr. Parker Goldstein, Windermere
Dr. Ana Goldstein, Gainesville
Dr. Melany Gómez Carreras, Gainesville
Dr. Laura Gonzalez Sarmiento, Kissimmee
Dr. Adonis Gonzalez Yera, Orlando
Dr. Christopher Gough, Edgewater
Dr. Cassandra Gubala, Palm Coast
Dr. Farhana Gulamali, Orlando
Dr. Sarah Hameer, Gainesville
Dr. Kyle Harvey, Orlando
Dr. Beatriz Hernandez Cavanerio, Ocoee
Dr. Mary Herrera, Orlando
Dr. Daniel Hickman, Altamonte Springs
Dr. Jessica Jacobs, Gainesville
Dr. Illyssa Jaraplasan, Gainesville
Dr. Megan Kelly, Winter Garden
Dr. Imtiaz Khan, Orlando
Dr. Kendra Law, Rockledge
Dr. Ariana Madan, Orlando
Dr. Wendy Magda, Debary
Dr. Monica Makram, Gainesville
Dr. Valentina Malpica, Orlando
Dr. Trenton Mandato, Oviedo
Dr. Evelyn Marin, Gainesville
Dr. Nicholas Marshock, Winter Park
Dr. Maria Juliana Martinez Uzcategui, Orlando
Dr. Lane McCoy, Indialantic
Dr. Ian McLean, Clermont
Dr. Julian Mis, Gainesville
Dr. Sara Moore, Saint Cloud
Dr. Susan Nguyen, Orlando
Dr. Lidice Noguerol Govea, Altamonte Springs
Dr. Mary Norman, Ocala
Dr. Richard Ong, Mount Dora
Dr. Rosaleny Orie, Orlando
Dr. Chirag Panchal, Tampa
Dr. Aleecia Parchment, Clermont
Dr. Urvashi Patel, Plant City
Dr. Karishma Patel, Winter Springs
Dr. Dipali Patel, Titusville
Dr. Michelle Patel, Gainesville
Dr. Netra Patil, Clermont
Dr. Neifre Pereira Valdes, Orlando
Dr. Laura Perez Mendoza, Ocala
Dr. Jerzy PolmerskiII, Gainesville
Dr. Mahnoor Rehman, Wildwood
Dr. Clayton Riemenschneider, Fort Myers
Dr. Hadeel Salih, Orlando
Dr. Ragini Sharma, Gainesville
Dr. Sierra Smith, Gainesville
Dr. Alexa Stylianakis, Gainesville
Dr. Preeti Subramaniyan, Orlando
Dr. Khunsha Syed, Orlando
Dr. Maria Tempone, Winter Springs
Dr. Skyler Terrell, New Smyrna Beach
Dr. Sarah Thompson Maddox, Gainesville
Dr. Tek To, Winter Park
Dr. Mario Toma, Port Orange
Dr. Thinh Tran, Orlando
Dr. Timmy Tran, Lutz
Dr. Nicholas Tran, Ocala
Dr. Jessica Van Vliet, Gainesville
Dr. Joseph Wakim, Kissimmee
Dr. Timothy Ye, Winter Garden
Dr. Samah Yousef, Orlando
Dr. Julianne Zapanta, Apopka
Dr. Maryana Zaverukha, Orlando
Dr. Elizabeth Zorich, Orlando
Northeast District
Dental Association
Dr. Nashid Ahmed, Gainesville
Dr. Francis Alip, Jacksonville
Dr. Sydney Bates, Fleming Island
Dr. Chloe Boucher, Jacksonville
Dr. Ashley De La Vega, Middleburg
Dr. Sahar Hajibabaei, Saint Johns
Dr. Samir Hanania, Saint Johns
Dr. Mark Komforti, Saint Augustine
Dr. Alexander Lazzara, Gainesville
Dr. Haeeun Lee, Jacksonville
Dr. Dipal Mahajan, Saint Augustine
Dr. Logan Marks, Neptune Beach
Dr. David McCann, Jacksonville
Dr. Sarah Musso, Jacksonville
Dr. Kathryn Parker, Jacksonville Beach
Dr. Raena Patterson, Jacksonville
Dr. Adrieal Ragwah, Jacksonville
Dr. Farzan Roofeh, Jacksonville
Dr. Pooja Sam, Saint Augustine
Dr. Amer Sbeih, Jacksonville
Dr. Angeline Torres, Ponte Vedra Beach
Dr. Daniel Valiente, Jacksonville
Dr. Zhihang Xie, Jacksonville
Northwest District
Dental Association
Dr. Faris Al Nahhas, Pensacola
Dr. Sona Chacko, Tallahassee
Dr. Frances Duffek, Chipley
Dr. Angelika Dzieza, Tallahassee
Dr. Lana Eberly, Blountstown
Dr. Brayden Elsmore, Freeport
Dr. Kenol Felix, Tallahassee
Dr. Valentina Garcia Villada, Tallahassee
Dr. Albert Ghazal, Santa Rosa Beach
Dr. Katherine Lopez, Orlando
Dr. Shelby McCormick, Panama City
Dr. Ashton Murrah, Panama City Beach
Dr. Mary Nguyen, Panama City
Dr. Neel Patel, Destin
Dr. Walter Stallings, Pensacola
Dr. Alex Szymborski, Niceville
South Florida District
Dental Association
Dr. Sofia Abraham, Pembroke Pines
Dr. Andrea Adrianza, Miami
Dr. Loulia Alawa, Doral
Dr. Gretell Alonso Fiel, Miami
Dr. Roa Altell, Davie
Dr. Roxana Alvarez Acosta, Hialeah Gardens
Dr. Aaron Avila Lopez, Miami
Dr. Omaira Bolivar, Fort Lauderdale
Dr. Eugenia Briongos, Weston
Dr. Manuela Cardenas, Doral
Dr. Licet Cardenas Pena, San Juan
Dr. Jorge Luis Casanas Marrero, Coral Gables
Dr. Veronica Claro, Cutler Bay
Dr. Delia Coley, Weston
Dr. Katherine Colon Rodriguez, Miami
Dr. Aliett Contino, Miami
Dr. Sabrina Correa, Davie
Dr. Elona Covietz, Miami
Dr. Wilfredo Cruz Ibarra, West Park
Dr. Yanisbel del Rosario Estrada, Hialeah
Dr. Elizabeth Del Toro Gutierrez, Miami
Dr. Stefan De Solo, Miami
Dr. Colten Dougher, Davie
Dr. Lauren Dreese, Louisville
Dr. Daniela Duran, Fort Lauderdale
Dr. Francisco Espinosa, Palmetto Bay
Dr. Liris Estevez Pena, Miami
Dr. Adrian Estopinales Paredes, Miami
Dr. Maryangel Fernandez Roldan, Miami
Dr. Christina Franco, Miami Lakes
Dr. Yanelis Garcia, Davie
Dr. Luke Grillo, Hallandale Beach
Dr. Christopher Hall, Doral
Dr. Karl Hall, Miami
Dr. Julie Han, Ladera Ranch
Dr. Rouzbeh Heidari, Davie
Dr. Tashauna Holmes, North Miami Beach
Dr. Juliana Izquierdo, Miramar
Dr. Aislinn Jolicoeur, North Miami Beach
Dr. Anna Kelman, Miami
Dr. Daniela Lalinde, Palmetto Bay
Dr. Christofer Laskaratos, Hollywood
Dr. Emelie Lerebours, Pembroke Pines
Dr. Luther Light, Davie
Dr. Priyanka Manda, Davie
Dr. Armando Marrero, Miami
Dr. Mathias Martinez Coronel, Weston
Dr. Alvaro Martinez Galvis, Miramar
Dr. Daniel Mizrahi, Hollywood
Dr. Elysia Montgomery, Davie
Dr. Raquel Morel, Hialeah Gardens
Dr. Gilsa Morlote Henderson, Miami
Dr. Kely Noa, Miami
Dr. Alberto Ortega Valdes, Hialeah
Dr. Grettel Pantaleon, Miami
Dr. Nicole Peña, Doral
Dr. Randy Perez Padilla, Hialeah
Dr. Natalia Perna, Doral
Dr. Yanaig Polo, Miami
Dr. Emely Pozo, Cutler Bay
Dr. Michael Prado, Miami
Dr. Valentina Roa, Pembroke Pines
Dr. Alexandra Rodriguez, Biscayne Park
Dr. Sheyla Rodriguez Riera, Miami Lakes
Dr. German Rosales, Doral
Dr. Yesenia Rosell Padron, Miami
Dr. Olga Ruiz Veras, North Miami
Dr. Selena Sanchez, Davie
Dr. Lauren Saqui, Miami
Dr. Diana Seguro, Miami Beach
Dr. Fatma Serageldin, Miami
Dr. Chanoan Sumonthee, Miramar
Dr. Sheryl Traviesas Garcia, Hialeah
Dr. Nelson Triana, Miami
Dr. Alona Tsybulko, Sunny Isles Beach
Dr. Camila Tussie, Weston
Dr. Reinaldo Valdes, Homestead
Dr. Brandon Valerio, Fort Myers
Dr. Jennifer Vazquez, Davie
Dr. Adir Vegon, Sunny Isles Beach
Dr. Vianeth Velarde Gutierrez, Miami
Dr. Urjita Vinchurkar, Davie
Dr. Rebekah Webster, Miami
Dr. Isabella Woodson, Miami Lakes
Dr. Ashley Yeshoua, Aventura
Dr. Jessica Yuen Ye, Miami
WestCoast District
Dental Association
Dr. George Abadir, Clearwater
Dr. Zahraa Abdulabbas, Thonotosassa
Dr. Monica Abouelsaad, Tampa
Dr. Aref Al Naib, Clearwater
Dr. Grace Ansley, Naples
Dr. Laura Arias, Spring Hill
Dr. Nader Asfour, Oldsmar
Dr. Salma Atassi, Apollo Beach
Dr. Nasim Attaran, Montreal, Qc, Canada
Dr. Egan Baber, Tampa
Dr. Arun Babu, Riverview
Dr. Michael Bankes, Bonita Springs
Dr. Christopher Basily, Tampa
Dr. Pedro Belaunzaran, Tampa
Dr. Shay Berkovich, Davenport
Dr. Pedro Berrios, Tampa
Dr. Laura Betancur, Sunrise
Dr. Antony Boghdadi, Lutz
Dr. Brian Bradley, Cape Coral
Dr. Jeanne Bringas Delgado, Tampa
Dr. Kathryn Burchfield, Bradenton
Dr. Taryn Cade-Saez, Naples
Dr. David Campano, Pembroke Pines
Dr. Sarah Carter, Bonita Springs
Dr. Evelyn Casas Alvarez, Cape Coral
Dr. Jorge Ceballos, Bradenton
Dr. Kaitlyn Chomko, Cape Coral
Dr. Yulianys Coca, Clearwater
Dr. Destiny Corbett, Naples
Dr. Olivia Curcione, Fort Myers
Dr. Bich Dao, Sarasota
Dr. Brittany Desyr, Lauderhill
Dr. Austin Eisler, Naples
Dr. Luciel Eldeek, New Port Richey
Dr. Moustafa Elnaggar, Wesley Chapel
Dr. Arian Emam, Naples
Dr. Alexis Even, Bradenton
Dr. Mary Fahmi, Palm Harbor
Dr. Sarah Faituri, Seffner
Dr. Leslie Fickling, Riverview
Dr. Maria Victoria Flecha, Cape Coral
Dr. Christopher Garcia Diaz, Clearwater
Dr. Jaime Gazabon, Brooksville
Dr. Neda Ghias, Tampa]
Dr. Niki Ghomashchi, Largo
Dr. Bowen Gibney, Naples
Dr. Daniel Goncharuk, Naples
Dr. Jacqueline Gonzalez, Miami
Dr. Filip Grdic, South Pasadena
Dr. Sally Habhab, Tampa
Dr. David Haddad, Dunedin
Dr. Owayne Haughton, Largo
Dr. Violeta Hermoso, Clearwater
Dr. Nelda Iznaga, Sebring
Dr. Kira Jennings, Tampa
Dr. Ernest Jercinovic, Naples
Dr. Patrick Joseph, Fort Myers
Dr. Sravanthi Kanta, Tampa
Dr. Sandra Khabner, St. Petersburg
Dr. Mahdieh Kiany, Lakeland
Dr. Sahana Kodimoole, Tampa
Dr. Saskia Korda, Gainesville
Dr. Emily Krieg, Land O Lakes
Dr. Stacey Kutsch, Ave Maria
Dr. Marisela Lavermicocca, Naples
Dr. Brandon Lee, Largo
Dr. Unsa Malik, Lakeland
Dr. Brenda Manzanares, Lutz
Dr. Sama Maraqa, Riverview
Dr. Amberlin Medina Spacca, Fort Myers
Dr. Jeremy Meldrum, Valrico
Dr. Samantha Melnitsky, Fort Myers
Dr. Savannah Misiewicz, Tampa
Dr. Sally Moon, North Port
Dr. Patricia Morejon Aguilar, Naples
Dr. Hanya Muftah, Spring Hill
Dr. Adam Mustafa, Tampa
Dr. Flavia Myrtaj, Seminole
Dr. Nicole Nguyen, Nashville
Dr. Riley Nitsch, Fort Myers
Dr. Nasheen Nizamuddin, Land O Lakes
Dr. Alison Novakovic, Indian Shores
Dr. Nelson Paez Carrillo, Clearwater
Dr. Aatish Patel, Gainesville
Dr. Jignesh Patel, Palm Harbor
Dr. Shivangi Patel, Clearwater
Dr. Eduardo Perez Jr, Hawthorne
Dr. Isabel Perez Uzcategui, Port Charlotte
Dr. Alison Persaud, Palmetto
Dr. Akaash Pisipati, Naples
Dr. Jack Pohler, Treasure Island
Dr. Jaleh Pourhamidi, Sarasota
Dr. Barbara Quintero Chong, Clearwater
Dr. Rupam Rana, Fort Myers
Dr. Alesia Rockwell, Clearwater
Dr. Marielys Rodriguez, Lithia
Dr. Sandy Rofaiel, Clearwater
Dr. Carson Rushmore, Saint Petersburg
Dr. Bita Sadeghlo, Bradenton
Dr. Saed Sayegh, Oldsmar
Dr. Gabriella Schmitz, Bradenton
Dr. Jillian Sennello, Tampa
Dr. Jay Chetan Shah, Clearwater
Dr. Nancy Sheth, Odessa
Dr. Krisha Anil Shrimankar, Clearwater
Dr. Alec Simonson, Lake Wales
Dr. Jaclyn Soruco, Sarasota
Dr. Sarah Springer, Fort Myers
Dr. Kenneth Stephen, Tampa
Dr. Matthew Strickland, Osprey
Dr. Matthew Sullivan, Valrico
Dr. Kristina Taranov, North Port
Dr. Nivedita Thota, Odessa
Dr. Armin Vakili, Bradenton
Dr. Ritika Vellapally, Riverview
Dr. Ivan Vigoa, Lehigh Acres
Dr. Kendall Watson, Fort Myers
Dr. Andrea Zambrano, Clearwater
Dental Insurance Broker
in the Nation. Period.
employment agreements
Danger Zones in Employment Agreements
By Ms. Deborah Minnis, Labor and Employment Law, at Ausley McMullen Law Firm
Transactions were once confirmed by simple verbal or handshake agreements. However, society has become more paper driven in general and written agreements are now the norm.
Congratulations! You’ve graduated, passed all the examinations and met all the requirements to be licensed as a dentist. Even better, you have an offer of employment. However, before your first day at the practice, you’re presented with an employment agreement. What now? Here is a summary of important considerations with respect to employment agreements.
Term of Employment
In Florida, private employment relationships — as opposed to many government employment relationships — are generally at-will. In essence, the employment relationship can be ended at any time with or without cause, and with or without notice. This can only be changed by the execution of a written employment agreement with a defined term of employment. The term must be specifically stated. An agreement that merely sets out your annual salary is not enough. Be sure to review the agreement to determine: 1) if there is a definite term and, if so, 2) that the term stated matches any discussions/verbal agreements you had with the employer.
Termination Provisions
These provisions usually set out differences, if any, between termination (for cause or without cause) and voluntary resignations. For example, many employers will provide advance notice to an employee
when termination is without cause, but terminations for cause can be immediate. In addition, employers may require prior notice from an employee who voluntarily resigns. In some cases, if terminal leave pay-out is available, it may be tied to the employee providing the required notice.
Noncompete Provisions
Most employment agreements contain noncompete provisions. Individuals accepting these provisions can be prohibited from working for another employer engaged in the same business, being a partner in a business that competes with the employer or opening their own business that competes with the employer, after being terminated or even voluntarily leaving employment. Noncompete provisions have both time and geographical limitations. For example, they may prohibit competition for two years and within X miles from any office operated by the former employer. Many of them also limit or totally prohibit the employee from even referring patients to other practices. If the former employer is successful in enforcing a noncompete in court, damages and attorney’s fees can be awarded against the former employee.
Non-solicitation Provisions
Most employment agreements also include non-solicitation agreements. These provisions prohibit former employees from soliciting patients/ clients of the former employer’s practice when the employment relationship is terminated, whether voluntarily or involuntarily. Solicitation can be defined extremely broadly. For example, the provisions can prohibit the disclosure of names and
addresses, etc. of the former employer’s patients. Make sure you clearly understand how the practice defines patient/client. Many non-solicitation provisions also prohibit former employees from soliciting or recruiting their former co-workers. These provisions also include both time and geographical limitations. Damages and attorney’s fees can be awarded for violation of these provisions.
Malpractice Coverage Provisions
Such agreements usually contain provisions discussing how payment of malpractice insurance is made. They may also specify whether reimbursements are required from the employee if employment is terminated within a certain period of time and may include information regarding the need to pay for “tail coverage” upon employment termination.
Arbitration Provisions
Many employers are including arbitration agreements in their employment agreements. Under arbitration agreements, any challenge to matters concerning employment cannot be filed in court but must be submitted to arbitration. Arbitration is a process that involves either a single individual or a panel of three individuals accepting evidence and reaching a binding decision on employment-related challenges. There is no judge or jury in an arbitration proceeding. These provisions have also been determined to be apply to discrimination complaints.
Reimbursement Requirements
In many instances, employers will pay for employees to receive train-
ing, attend educational classes or even pay for licensing. However, many employers include provisions in employment agreements that allow them to recoup these costs under specific circumstances. For example, many agreements will have a minimum employment time period that has to be met to cancel the recoupment of costs.
Governing Law Provisions
All agreements, including employment agreements, specify the governing law and jurisdiction for suits filed to enforce their provisions. They will generally indicate which state’s laws are to be applied and where suits to enforce the agreement can be filed. For example, a nationwide company may require that such suits be filed in the state and county where its headquarters are located.
Transactions were once confirmed by simple verbal or handshake agreements. However, society has become more paper driven in general and written agreements are now the norm. The same is true for employment. The key is to be aware of what you are signing before you sign and to ask questions if you are unsure.
This article is for informational purposes only and is not intended to be a substitute for professional legal advice. If you have a specific concern or need legal advice regarding your dental practice, you should contact a qualified attorney.
Ms. Minnis practices labor and employment law at Ausley McMullen, and she also represents various local government bodies. She can be reached at dminnis@ausley.com
ADA Receives Clarification on No Surprises Act
By ADA News Jennifer Garvin
Dental providers and facilities are “generally required to provide uninsured patients with a good faith estimate of expected charges” unless the patient is enrolled in an excepted benefit plan or coverage such as a stand-alone dental plan, according to the Centers for Medicare & Medicaid Services (CMS).
This was one of the answers the American Dental Association (ADA) received from CMS when the Association shared common questions it has received from member dentists about the No Surprises Act, also known as surprise billing.
The No Surprises Act went into effect Jan. 1, 2022. The law gives consumers billing protections when getting emergency care, nonemergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers.
Many dentists have asked the ADA about good faith estimates and whether they need to provide them.
On Feb. 22, CMS sent an email to ADA confirming that dental providers are required to provide uninsured or self-pay individuals with a good faith estimate of expected charges under [federal regulation] 45 CFR 149.610. The agency did note that providers and facilities are “generally not required to provide a good faith estimate to an individual enrolled in
The No Surprises Act went into effect Jan. 1, 2022. The law gives consumers billing protections when getting emergency care, nonemergency care from out-ofnetwork providers at in-network facilities, and air ambulance services from out-ofnetwork providers.
an excepted benefit plan or coverage such as a limited-scope dental plan, even if the individual is not enrolled in other coverage.”
“This is because such an individual is considered to be enrolled in a group health plan or health insurance coverage under the Public Health Service Act, and therefore is generally not considered uninsured,” CMS said.
The CMS also said there were two exceptions to the good faith estimate rule:
“If the excepted benefit plan or coverage does not cover a scheduled or requested item or service (for example, because the excepted benefit plan is a limited-scope vision plan and the individual is scheduling dental services), and the individual has no other coverage for the item or service, that individual is considered uninsured with respect to that item or service, and the provider or facility must give them an uninsured
or self-pay good faith estimate,” the response said. “Similarly, if the individual does not seek to have a claim for the item or service submitted to their excepted benefit plan or coverage, and the individual has no other coverage for that item or service, that individual is considered self-pay with respect to that item or service, and the provider or facility must give them an uninsured (or self-pay) good faith estimate.
“In both of these cases, the individual with the uninsured or self-pay good faith estimate would be eligible to initiate the Patient-Provider Dispute Resolution process if the provider or facility’s bill is at least $400 more than the estimate in the good faith estimate.”
CMS also noted that in making the determination as to whether the individual is uninsured or self-pay, “there is no requirement in [the regulation] that providers or facilities verify coverage for each item or
service with the individual’s plan or issuer. Providers and facilities may make this determination based on its inquiries of the individual under [the regulation.]”
For information on all of the Centers for Medicare & Medicaid guidance on the No Surprises Act, visit CMS.gov/ NoSurprises.
The ADA continues to monitor this evolving issue and will share any updates the Association receives. This article is not, and should not, be considered legal advice.
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LEADERS EMERGING AMONG DENTISTRY
REGISTRATION
Friday, January 16, 2026 | Orlando, FL
Leaders Emerging Among Dentistry (LEAD) is the Florida Dental Association’s (FDA) signature leadership development program. LEAD equips participants with essential leadership and interpersonal skills through comprehensive training sessions while providing a backstage pass to your FDA and leadership opportunities within the organization.
FLORIDA DENTAL CHATTER
This Facebook group is designed for dentists to interact with other members, receive the latest updates and information, and engage with FDA leaders and sta across the country. This is the place to be in the know!
Centering Survivor Safety in Insurance and Benefits Administration:
What Third-Party Payers Need to Know About Intimate Partner Violence
By Florida Partnership to End Domestic Violence Chief Program Officer Tanesha McDonald
Intimate partner violence (IPV) affects millions of individuals each year, including many who access health insurance through employer-sponsored plans or state programs.
For survivors, navigating benefits systems can be a matter of safety, autonomy and access to critical care.
Insurance professionals — particularly third-party payers — play a vital role in ensuring systems respond in ways that protect, rather than endanger, those impacted by IPV.
Understanding the Intersection IPV is not only a public safety issue; it is also a health and economic crisis. Survivors face increased risk of injury,
chronic illness, mental health conditions and reproductive coercion. They may also experience financial abuse, where a partner controls, withholds or sabotages access to money and resources, including health insurance. Survivors may fear seeking medical care if their partner controls their insurance coverage, monitors their explanation of benefits (EOBs), or is listed as the policyholder.
Why Insurance Practices Matter
Routine processes, such as sending EOBs to the primary policyholder, requiring shared logins, or asking for spousal consent, can unintentionally compromise a survivor’s
third-party payers
For technical assistance or training on IPV-informed insurance practices, contact the Florida Partnership to End Domestic Violence (FPEDV) or your local domestic violence program at fpedv.org/get-help/.
safety. For example, a survivor receiving counseling or reproductive care may have their confidentiality breached if the EOB is sent to their abusive partner.
For third-party administrators and insurance professionals, it is critical to recognize how insurance design and claims processing may expose survivors to harm — and what can be done to mitigate it.
Best Practices for Survivor-Centered Insurance Administration
Confidential Communications Requests: Ensure that survivors can request alternative contact methods for sensitive communications, as protected under the federal Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule and the Affordable Care Act (§2719A of the Public Health Service Act). Survivors should be able to designate a safe mailing address, email or phone number.
Separate Policyholder Options: When feasible, allow survivors to enroll independently or remove a partner from a policy without requiring their consent if IPV is disclosed.
Training for Staff: Equip customer service and claims processing staff with trauma-informed training. Staff should be able to recognize red flags for IPV and respond with sensitivity, clarity and respect for confidentiality.
Partner with Advocates: Build relationships with domestic violence service providers who can assist survivors in navigating insurance concerns. Some survivors may need letters verifying abuse or assistance securing documents if their partner controls access.
Protect Data and Privacy: Ensure that online portals, printed mailings and automated systems do not disclose provider information or service types in a way that could put survivors at risk.
A Call to Action
As stewards of health access and benefit security, insurance professionals have a unique opportunity to reduce barriers and increase safety for IPV survivors. By making trauma-informed adjustments and supporting confidential access to care, you help ensure that survivors are not forced to choose between safety and health.
For technical assistance or training on IPV-informed insurance practices, contact the Florida Partnership to End Domestic Violence (FPEDV) or your local domestic violence program at fpedv.org/get-help/
FPEDV is Florida’s federally designated domestic violence coalition, dedicated to creating a future free from domestic violence through advocacy, education and support for service providers. As a statewide leader, FPEDV works to strengthen the capacity of domestic violence centers and community organizations by offering comprehensive technical assistance, training and resources. Visit www.fpedv.org for more information and resources.
The Florida Partnership to End Domestic Violence’s Chief Program Officer, Tanesha McDonald, can be reached at taneshamcdonald@fpedv.org
Protecting Practices, Preserving Professions:
The Insurance Solution That Keeps Dentists’ Dues Down
“Every policy you place with us supports organized dentistry. You’re not just buying insurance — you’re supporting your profession.”
By FDA Services Chief Operating Officer Scott Ruthstrom
For nearly 40 years, Florida Dental Association Services (FDAS) has been the trusted insurance partner of FDA members, providing tailored insurance solutions, advocating for the dental community and contributing millions to strengthened organized dentistry.
FDAS is wholly owned by the FDA, created in 1986 to solve a growing problem: malpractice insurance costs in Florida were spiraling out of control. Dentists needed a better option and banded together to create one.
FDAS partnered with a carrier willing to base premiums solely on dentist-specific claims data, not on broader medical malpractice trends. That carrier, now known as The Doctors Company (TDC), has been our trusted partner since the first policy.
Thanks to this collaboration, malpractice rates today are 20% lower than they were in 1986 and that’s not adjusted for inflation. This achievement reflects our long-standing commitment to developing dental-specific programs that deliver real, measurable value to the profession.
Today, FDAS has expanded into a national agency, assisting more than 12,000 dentists nationwide in almost every state.
More Than
Premiums, It’s About Value
At FDAS, cheaper is not always better. Our mission is to help dental professionals protect their practices with high-quality insurance products designed for the unique risks of dentistry. That’s why we partner exclusively with carriers who understand the profession and price policies based on dental-specific claims data, not broad assumptions.
One example is our professional liability program with TDC. Several years ago, Botox coverage cost dentists up to $2,000 annually as a separate rider. After we advocated for change and backed it with claims data, TDC eliminated the charge. Now, properly trained dentists are covered for Botox procedures at no extra cost.
Supporting Organized Dentistry
FDAS is not just an insurance agency; we are a critical source of non-dues revenue for organized dentistry. In the past decade, we’ve contributed more than $18 million to support advocacy, leadership development, continuing education and member resources.
When you choose FDAS, you’re protecting your practice and investing in the future of the profession.
Expanding to Serve Nationwide
While our roots are in Florida, our services now extend across the country. For the past eight years, FDAS has expanded to serve solo practitioners, group practices and Dental Service Organizations nationwide. This growth allows us to bring dental-specific expertise to practices often underserved by generalist brokers.
Emerging Threats: Cyber Risk
Is Real. So Is Our Protection
Cyber threats are no longer a hypothetical problem. Ransomware, phishing and data breaches are hitting dental practices of all sizes. That’s why we partnered with Coalition, a leader in cyber liability insurance. Their solution offers not only comprehensive coverage but also proactive monitoring tools to help prevent breaches before they happen. It’s precisely the kind of forward-thinking approach our clients expect.
Why Choose FDAS?
We know dentistry. We understand the risks, the insurance environment and the importance of long-term protection. And because we work together with the FDA, we are uniquely positioned to advocate for dentists.
When you work with us, you’re working with a team that:
• Specializes in dental risks
• Advocates directly with underwriters on your behalf
• Delivers true value
• Gives back to the profession
We Need Your Help: Let’s Keep Dues and Premiums Low — Nationwide
Here’s where you come in. The more practices we serve, the more we can give back to organized dentistry. Every policy placed with FDAS helps fund advocacy, education and resources to support dentists.
FDAS coverage is available to all Florida dentists. FDA members receive reduced member rates. Not a member yet? Join to access member pricing.
FDAS Chief Operating Officer Scott Ruthstrom can be reached at scott.ruthstrom@fdaservices.com.
Coverage Check-Up:
How Rising Costs Leave Dental Practices Underinsured
By FDA Services
Carrie Millar of FDA Services (FDAS) sat down with Andrew Medina of Blue Frog to gain an inside look at the true costs of building or renovating a dental practice in Florida. With construction prices continuing to rise and equipment lead times still delayed, it’s more important than ever for practice owners to understand the true value of their investment. Why? Because most practice
insurance policies are written on a replacement cost basis, and if you’re underinsured, you may not recover enough to rebuild after a loss. In this interview, Carrie and Andrew break down current cost trends and offer practical advice to help dentists protect what they’re building.
1. Andrew, for the past few years, what trends have you seen in the cost of building or renovating a dental practice in Florida?
For the last few years, we’ve definitely seen construction costs rise — especially in Florida. Labor, materials and specialty trades have all increased, and those increases continue to subtly climb — however at a slightly slower pace. The supply chain disruptions post-COVID pushed things upward, and while they’ve
stabilized a bit, we’re still seeing higher baseline costs than pre-2020. Permitting and inspections have also become more involved, which can impact timelines and overall costs.
2. What’s the average per-squarefoot cost for a ground-up build? Right now, in Florida, ground-up dental construction typically ranges from $475 to $575 per square foot, with MUCH of it depending on the site, scope and finishes. That figure doesn’t include the cost of dental equipment, which is a significant investment on its own. If you’re doing a fully customized, state-of-the-art practice, you can easily be on the higher end — or beyond and easily keep costs at bay for a project that favors a more conservative budget/ aesthetic.
Carrie Millar Andrew Medina
3. How about interior build-out? Does that include large dental equipment?
For interior build-outs, we usually see ranges between $200 and $275 per square foot, again depending on the level of finish, digital integration and custom cabinetry. That figure usually doesn’t include large dental equipment, such as chairs, cabinetry or imaging systems. Those are typically specified and purchased separately, though we coordinate closely with equipment reps to make sure everything fits and flows.
4. Are there any equipment items with longer lead times or supply issues?
Yes — items like panoramic X-ray machines, cone-beam computed tomography units and certain sterilization equipment are still experiencing longer lead times. Some cabinetry systems and specialty lighting can also be delayed, depending on the supplier. We always recommend locking in equipment orders early to avoid delays in the construction timeline.
5. Have dentists underestimated their budgets using outdated cost info?
Absolutely. We’ve worked with doctors who were planning based on pre-COVID estimates — say, $100–$150 per square foot for a build-out — and those numbers just aren’t realistic anymore. That can lead to gaps in financing, insurance and even delays in getting started. Costs have changed significantly in just a few years, and failing to update your expectations can lead to real headaches.
6. Are most dentists fully aware of the investment they’re making in their practice? Honestly, not always. When you add up construction, equipment, cabinetry, technology and all the finishes, it’s easy to be looking at $1-2 million or more for a large-scale practice or a smaller yet high-end practice. It’s a major investment, but because it happens in stages —design, then build, then equipment — it’s easy to lose track of the total value. That’s why working with a team like Blue Frog, that tracks, communicates, and delivers the full scope, is so important, so you always know where you stand.
7. What happens if dentists don’t update their insurance coverage after a renovation?
We’ve seen it happen — dentists complete a gorgeous renovation but keep their old insurance coverage, which was based on a smaller or lower-value space. If there’s a fire, storm or hurricane that shuts down operations, being underinsured could mean not recovering the full replacement cost. It can be devastating after putting so much into the practice.
8. Can dental owners assume their insurance from three to four years ago is still enough?
Not really. Given the uncertainty around tariffs and the rapid increase in costs — including construction, equipment and labor — it’s unlikely that a policy from three or four years ago still accurately reflects the current replacement value. An annual insurance review is a no-brainer, especially if you’ve renovated or expanded.
9. What’s your advice for aligning insurance with a new build or renovation?
My advice is to loop your insurance broker into the project early — just like you do with your contractor and equipment reps. Make sure they understand the full scope, especially the equipment and digital systems you’re investing in. And then revisit your coverage as the project nears completion. It’s one of the easiest ways to protect what you’re building.
10. Final piece of advice for dentists building or renovating in 2025?
Plan ahead and don’t underestimate what it will take to do it right — from costs to timelines to insurance. Make sure your budget reflects today’s numbers, not what you heard a colleague paid five years ago. The right design-build team, the proper financial planning and up-to-date insurance coverage can make all the difference in creating a clear vision for your future space that will continue to support your goals and lifestyle for the next 20 years.
Dental & Medical Sales, Blue Frog LLC
Andrew Medina can be reached at 706.247.2718 or amedina@bfrog.net
FDA Services Vice President of Business Development Carrie Millar can be reached at 850.681.2996 or cmillar@fdaservices. com.
FDAS is proud to be the wholly owned insurance agency of the Florida Dental Association and to support practice owners with smart, proactive insurance solutions tailored to the dental industry.
Starting Jan. 1, 2025, FDA members have free, confidential access to AllOne Health‘s counseling and work/life services.
The Florida Dental Association’s (FDA) Member Assistance Program (MAP) can help you reduce stress, improve mental health and make life easier by connecting you to the right information, resources and referrals.
All services are confidential and available to you and your household as an FDA member benefit. This includes access to short-term counseling and the wide range of services listed below:
Mental Health Sessions
Manage stress, anxiety and depression; resolve conflict, improve relationships and address personal issues. Choose from in-person sessions, video counseling or phone counseling.
Life Coaching
Reach personal and professional goals, manage life transitions, overcome obstacles, strengthen relationships and achieve greater balance.
Financial Consultation
Build financial wellness related to budgeting, buying a home, paying off debt, resolving general tax questions, preventing identity theft and saving for retirement or tuition.
Legal Referrals
Receive referrals for personal legal matters including estate planning, wills, real estate, bankruptcy, divorce, custody and more.
Work-Life Resources and Referrals
Obtain information and referrals when seeking childcare, adoption, special needs support, eldercare, housing, transportation, education and pet care.
Personal Assistant
Save time with referrals for travel and entertainment, professional services, cleaning services, home food delivery and managing everyday tasks.
Medical Advocacy
Get help navigating insurance, obtaining doctor referrals, securing medical equipment and planning for transitional care and discharge.
Member Portal
Access your benefits 24/7/365 through the member portal with online requests and chat options. Explore thousands of self-help tools and resources including articles, assessments, podcasts and resource locators.
FDA Career Center
dental malpractice Characteristics of Dental Malpractice Claims
accounting for 60% of cases. These errors often result in a significant financial impact, and nearly one-third led to indemnity payments averaging $86,000. In total, 35% of claims closed with a payment, with an average indemnity of $116,000 and a median of $50,000.
Procedures tied most closely to claims included prosthetic dental implants and tooth extractions, both of which carry elevated risks and high average payouts. Conversely, procedures like fitting dentures were less likely to result in payments.
By The Doctors Company Patient Safety and Risk Management; Jacqueline Ross, PhD, RN; Robin Wessels, MBA, RN, CPHRM and Nichole Pieters, MS, RN, CPHRM
Patient safety in dentistry, often practiced in decentralized and independent settings, presents unique challenges. This retrospective analysis of dental malpractice claims from 2010 to 2024 reveals how systemic vulnerabilities, rather than isolated oversights, can lead to adverse outcomes. By examining closed claims, we gain valuable insight into recurring issues and can identify targeted strategies for improving patient care.
Dental treatment performance or management errors are the most frequent allegations in dental claims, with improper performance of a treatment or procedure
While the majority of injuries were classified as low severity, 3% resulted in high-severity outcomes, including 20 patient deaths. These cases often involved failures in sedation management or diagnosis of serious conditions like malignancies. All high-severity claims resulted in indemnity payments exceeding $400,000 on average.
Injury types most often cited included teeth damage (21%), emotional trauma (15%), pain (11%) and nerve damage (9%). Notably, emotional trauma was an indicator of patient dissatisfaction with communication and care.
Some incidents, termed dental ‘never events’, should never occur. These included the extraction of the wrong tooth, use of contaminated instruments, aspiration or ingestion of tools and failure to recognize documented allergies. Forty claims involved wrong-tooth procedures, with nearly half linked to routine or surgical extractions and root canals.
Jacqueline Ross
Robin Wessels
Nichole Pieters
What Contributes to These Claims?
An analysis of the claims data revealed that technical performance issues — such as excessive force or improper technique — were the most common contributing factor, cited in 66% of claims. Patient-specific factors, such as medical comorbidities and communication breakdowns, also played a significant role.
Poor documentation, mismanagement of therapy and incomplete or inaccurate patient assessments were more prevalent in cases that resulted in indemnity payments. For example, diagnostic imaging, such as X-rays and computed tomography scans, was frequently delayed or not ordered at all.
Strengthening Patient Safety: Recommendations for Dentists
Improving patient outcomes begins with proactive strategies:
• Enhance Communication: Discuss treatment expectations in plain language. Use tools like “Ask Me Three” (bit.ly/4mjB1ok) at and teach-back (bit.ly/4grXn5T) to confirm understanding.
• Strengthen Informed Consent: Clearly explain risks, benefits and alternatives. Address cost concerns in advance to manage expectations.
• Ensure Safe Sedation Practices: Match sedation protocols to patient risk profiles. Use advanced monitoring tools and ensure staff are properly trained.
• Focus on Staff Competency: Conduct regular training and drills. Reinforce roles and emergency protocols.
• Build a Team Culture: Adopt Team Strategies and Tools to Enchance Performance and Patient Safety (bit.ly/48kiUv9)to foster communication, leadership and mutual support across your team.
• Conduct Thorough Assessments: Review the patient’s health history, current medications and any new or acute issues before treatment.
• Prevent Foreign Body Incidents: Use dental dams and tie floss to small tools. Discuss aspiration risks during consent.
Most incidents stem not from singular mistakes but from systemic gaps in communication, documentation, assessment and procedural judgment.
• Avoid Wrong-site Errors: Implement time-outs, double-check imaging and verify consent forms to prevent wrong-tooth extractions.
• Document Thoughtfully: Record clinical rationale, patient discussions and follow-up plans. Audits can identify documentation gaps.
• Understand Reporting Requirements: Adhere to state-specific laws regarding the reporting of adverse dental events.
• Support Patient Adherence: Communicate the importance of post-treatment instructions and identify potential barriers early.
Conclusion
Dental malpractice claims provide insight into the safety risks inherent in clinical practice. Most incidents stem not from singular mistakes but from systemic gaps in communication, documentation, assessment and procedural judgment. While many claims result in minor injuries, a small but significant portion involve life-altering harm or death. Dentists can mitigate these risks by implementing structured safety protocols, enhancing team coordination and fostering a culture of transparency and continuous improvement.
To read the full claim study visit The Doctors Company at bit.ly/4mtPzT1.
If you would like to be insured by The Doctors Company reach out to FDA Services online at fdaservices.com or call/text 850.681.2996.
Is your medical liability insurer invested in shareholder interests, or
INVESTED IN YOU?
Why choose a medical liability insurer that rewards investors versus rewarding you? At The Doctors Company we answer only to members like you. Not Wall Street. That’s why we’ve delivered $470 million in dividends to our members. And it’s why our unrivaled Tribute® Plan has awarded over $150 million to members who have spent their careers advancing the practice of good medicine.
Why settle for less than you deserve? Scan here for a rapid premium indication.
Why It’s Time to Upgrade from Windows 10 — Before It’s Too Late
By Sunset Technologies Director of Communications Michelle Hambidge
At Sunset Technologies, we design IT solutions for dental practices around three essential pillars: Uptime. Performance. Security. These aren’t just industry buzzwords — they’re what your practice relies on every day to care for patients and keep operations running smoothly.
That’s why the Windows 10 “End of Life,” which happens this month, is more than just another technology update. It’s a critical deadline that could impact your practice’s ability to stay secure, maintain compliance and recover from a cyber event.
What Does Windows 10 End of Life Mean?
When Microsoft retires an operating system, they stop providing security patches, software updates and
technical support. For Windows 10, that official cut-off date is Oct. 14 of this year. After that, any device still running Windows 10 will be exposed to new vulnerabilities that won’t be fixed, making it a prime target for cybercriminals.
This is exactly how ransomware breaches happen. Outdated software is involved in nearly every major cyber incident we’ve helped clients respond to. If your practice is still on Windows 10 next year, you’re leaving the front
Industry studies estimate the average cost of downtime at more than $5,600 per minute, and dental offices are especially vulnerable due to reliance on digital imaging, real-time scheduling and electronic health records.
door wide open — and you may not realize it until it’s too late.
The Real Cost of Downtime in Dentistry
For dental practices, downtime isn’t just a hassle; it’s a business risk. Industry studies estimate the average cost of downtime at more than $5,600 per minute, and dental offices are especially vulnerable due to reliance on digital imaging, real-time scheduling and electronic health records.
If a Windows 10 vulnerability leads to ransomware, you could face:
• A complete operational shutdown
• Loss of access to patient data and imaging systems
• Health Insurance Portability and Accountability Act violations and potential regulatory fines
• Reputation damage that lasts long after the breach is resolved
Even worse, your insurance carrier could deny a cyber claim if it finds you ignored a known risk by continuing to use unsupported software.
Performance Matters, Too
Upgrading isn’t just about security — it’s about keeping your practice running at peak performance. As Windows 10 reaches its end of life, you’ll likely experience:
• Slower performance and system lag
• Compatibility problems with the updated dental software
• Frequent crashes, login delays and backup failures
Your technology should help your team deliver better patient care, not hinder them.
Final Thoughts: Don’t Wait for a Breach
If you’re still running Windows 10, now is the time to act. Waiting until after October 2025 could put your practice’s operations, security and reputation at serious risk.
Stay protected. Stay compliant. Keep your team moving forward.
Sunset Technologies is the nation’s leading dental-focused IT security and managed services provider. For more than two decades, we’ve helped dentists across the country build secure, compliant and high-performing practices. From cyber protection to day-to-day IT support, our team ensures that you can focus on what matters most — your patients.
Contact Sunset Technologies at sunsetsecure.com or call 855.861.8833.
Hiring Best Practices and Leveraging AI for Employee Retention in Your Dental Practice
By Owner of The HR Lady LLC and Host of the “HR Empowerment” postcast Wendy Sellers, MHR, MHA, SPHR, SHRM-SCP
In today’s fastpaced dental industry, attracting and retaining talented employees is more critical — and challenging — than ever. With small dental practices often lacking dedicated human resources (HR) professionals, the hiring and retention process can become daunting. Fortunately, understanding effective
hiring strategies and implementing artificial intelligence (AI) technologies can dramatically streamline HR operations, improve candidate selection and enhance employee retention.
Effective Hiring Strategies
1. Planning Your Recruitment Process
An effective recruitment plan begins with clarity and preparation. The project plan should include clear
timelines, assigned responsibilities and backup contingencies. Remember, recruitment typically takes longer than expected and is therefore more expensive than anticipated. Being proactive ensures your practice remains efficient and effective even during the recruitment phase.
2. Crafting Compelling Job Ads
Creating an engaging and transparent job advertisement is vital. Dental professionals want clarity on job expectations, responsibilities and workplace culture. Clearly articulate essential and non-essential duties, the Americans with Disabilities Act compliance tasks and necessary skills, knowledge and certifications. Promoting transparency about your dental practice’s culture, values and benefits enhances your appeal to potential employees and encourages more aligned applicants. This also helps with employee retention. Additionally, AI technology can assist you in this process.
3. Thoughtful Interview Preparation
Your interview process should directly correspond with your job description. Generate structured interview questions aligned with essential tasks and responsibilities. Implementing pre-interview screening questions such as availability, salary expectations and certifications streamlines the selection process. Ensuring your interview team understands the legal aspects of
interviewing protects your practice from potential litigation and ensures fairness in candidate evaluation.
4. Utilize Scorecards
Adopting scorecards based on job descriptions and desired competencies can significantly reduce bias and enhance objectivity during the candidate assessment process. This structured approach ensures consistency across evaluations and provides valuable comparative data for decision-making. I also suggest using scorecards throughout the employee lifecycle. Why? It eliminates bias!
Enhancing Both Recruiting and Employee Retention with Generative AI
Generative AI technology can revolutionize your dental practice’s HR and operational efficiency. Here’s how:
AI-Powered Employee Engagement
Utilizing AI platforms like ChatGPT, Claude or Gemini can significantly simplify the creation of communication materials, including personalized employee feedback, basic policy updates (for formatting and language consistency) and frequently asked questions. This not only saves valuable time but also ensures consistency in messaging, crucial for maintaining high employee engagement.
Efficient
Goal Setting and Job Descriptions
Generative AI facilitates setting clear, achievable and measurable SMART goals (such as specific, measurable, achievable, relevant and timebound) and simplifies updating job descriptions and advertisements. It
can effortlessly ensure these documents stay current, compliant and attractive to potential hires, thus enhancing employee satisfaction and performance clarity.
Robust Feedback and Engagement Mechanisms
AI-driven feedback systems allow real-time insights into employee sentiments and concerns. This immediate feedback loop can significantly improve responsiveness to employee needs, increasing satisfaction and reducing turnover. AI-driven surveys and feedback systems provide insights that are critical for strategic decision-making, offering a pulse on employee morale and engagement.
Prompts and Safe AI Usage
Integrating AI safely requires careful attention to data security and privacy. Remember, never upload personal or sensitive data to AI platforms without guidance, and always verify AI-generated information. Factcheck, correct inaccuracies and complement AI with human judgment, leveraging empathy and experience to maintain balanced HR operations.
Implementing AI: Practical Steps for Dental Practices
• Start Small: Begin with low-risk, high-impact tasks like communications or engagement surveys.
• Educate Staff: Provide clear guidelines and training on AI use, setting clear expectations for its role and limitations.
• Continuous Evaluation: Regularly review AI outcomes to ensure accuracy, effectiveness and appropriateness.
Best Practices and Risk Management
• Always fact-check AI-generated outputs.
• Stay alert to biases inherent in AI systems.
• Maintain transparency about AI usage with your staff.
Implementing these strategies ensures that your dental practice not only attracts the right talent but also retains valuable team members through consistent, thoughtful engagement. By thoughtfully combining human judgment with advanced AI tools, dental practices can significantly improve hiring outcomes, employee satisfaction and operational efficiency.
Ms. Wendy Sellers, MHR, MHA, SPHR, SHRM-SCP is certified in Workplace Investigations and DiSC personality profiling. Ms. Sellers is the owner of The HR Lady LLC and host of the podcast “HR Empowerment.” Ms. Sellers can be reached at wendy@thehrlady.com, call/text 407.493.1582 or visit her website at www.thehrlady.com.
Ms. Sellers will present the courses “Artificial Intelligence for Employee Retention” and “Hiring Best Practices” during the 2026 Florida Dental Convention, June 25-27, at the Gaylord Palms in Orlando. Learn more at floridadentalconvention. com.
NEW BACKGROUND SCREENING REQUIREMENT FOR LICENSURE RENEWAL
All health care practitioners, including dentists and hygienists, will be required to have a background screening and fingerprinting in order to renew their licenses for February 28, 2026
Fingerprinting & Background Screening Requirement
Florida Dental License Renewal:
Per 2024 legislation, all Florida-licensed dentists and dental hygienists must complete a Level 2 background screening every five years. This includes electronic fingerprinting through a state-approved provider
Deadline:
Must be completed by February 28, 2026. Recommend completing at least 21 days in advance to avoid delays.
Who Must Comply:
All licensed health professionals in Florida, including dentists and hygienists. Dentists must complete this every other biennium.
Approved Vendors Only:
Fingerprinting must be done through a Florida Department of Law Enforcement (FDLE)-approved Livescan provider that is photo-capable and participates in the Care Provider Background Screening Clearinghouse.
Medicaid Providers:
May be required to complete fingerprinting; depends upon past screenings. Prior screenings must be within five
years and through an FDLE/Clearinghouse-compliant provider. You must have your Transaction Control Number (TCN) during licensure renewal. Only the fingerprint provider you used can issue that information.
Concealed Weapon Permits Do Not Qualify:
Fingerprints submitted for concealed weapon permits cannot be used for licensure screening.
Privacy Statement Required:
The privacy statement on your renewal application must be signed. Without it, results cannot be shared with the Florida Department of Health.
How to Complete Your Screening:
• Register in the CHAI system.
• Create or update your profile.
• Schedule an appointment with an FDLE- approved Livescan provider.
• Bring your ORI number (EDOH4560Z) to the appointment
• Keep your TCN which is required when renewing your license.
A Follow-up to the July/August Pterygoid Implant Article
By FDA Editorial Board
As a follow-up to the Pterygoid Implant article in the July/August 2025 issue of Today’s FDA, the editorial board felt that the article did not go deep enough into the complications of this procedure.
Pterygomaxillary implants, often placed in the posterior maxilla to provide anchorage when bone quality is poor, can offer stability but carry significant risks if not carefully planned and executed. Unlike conventional implants, these engage the dense cortical bone of the pterygoid region, which is anatomically complex and close to critical structures. The osteotomy associated with placing this type of implant carries associated vascular and neurological risks.
One of the major dangers is injury to the pterygoid venous plexus, maxillary artery branches or the greater palatine artery, potentially leading to severe bleeding or hematoma formation. Catastrophic hemorrhage has been reported with osteotomies in this area, and only the lucky are treated emergently by angiographic embolization, almost always in a hospital surgical/radiology arena. If bleeding does occur, it is often exceedingly brisk, cannot be visually localized or clamped, nor compressed, such as would be the case with an inferior alveolar artery violation in a closed canal.
Transit time to a hospital would almost certainly be insufficient and administration of lifesaving crystalloids, colloids or blood would be problematic.
The proximity to the pterygoid muscles and temporomandibular joint also raises the risk of postoperative pain, trismus or impaired jaw function. Misplacement may encroach on the infratemporal fossa or orbit, caus-
ing nerve damage, altered sensation or functional impairment.
Because of the anatomical variability in this region, inadequate imaging or surgical inexperience can lead to malpositioning, sinus perforation or implant failure. The surgical technique is technically demanding, often requiring CBCT-guided planning and advanced training. Infection and long-term peri-implantitis remain concerns, as cleaning access can be difficult in the posterior maxilla.
In short, while pterygomaxillary implants can provide a solution for atrophic maxilla cases, they should be approached with caution due to the high risk of vascular, neural, and functional complications. Even in a severely atrophic maxilla, many grafting options should be exhausted before contemplating a pterygoid implant.
Please find the following references:
1. Postoperative hemorrhage after Le Fort I osteotomy hemostasis with angiographic embolization: report of two cases — PMC. (descending palatine artery becomes greater and lesser palatine arteries once enters maxilla)
2. A new classification for pterygomaxillary implants and its related surgical implications: a retrospective cohort study — PMC.
diagnostic discussion
Diagnostic Quiz
By Jessica Li DDS*, Nadim M. Islam DDS, Indraneel Bhattacharyya DDS and Sumita Sam DDS
A 72-year-old female was referred to Dr. Timothy Jaeger’s clinic in Brandon, to evaluate a lesion on the lips. Upon evaluation, a pink-yellowish nodule near the left commissure was noted. The patient was asymptomatic and reported a history of cosmetic filler injection a month earlier. The lesion was excised and submitted to the Oral Pathology Biopsy Service at the University of Florida in Gainesville.
Question:
Based on the given history and clinical picture, what is the most likely diagnosis?
A. Lipoma
B. Traumatic neuroma
C. Foreign body granuloma
D. Fibroma
F. Mucocele
1: A pink-yellowish nodule is seen near the left oral commissure.
Fig. 2: The microscopic image shows surface epithelium overlying florid granulomatous inflammation in the stroma. (H&E, 5x magnification).
Fig. 3: The higher power image highlights granulomatous inflammation including multinucleated giant cells (blue arrow) surrounding foreign material (black arrow). (H&E, 20x magnification).
Fig.
diagnostic discussion
Free Online Continuing Education (CE) for FDA Members!
FDA members can earn up to six hours of general CE by reading the Diagnostic Discussion column and taking the online quiz, available 24 hours a day, at www.floridadental.org/online-ce.
A. Lipoma
Incorrect. Lipoma is a benign neoplasm composed of mature adipose tissue and is relatively uncommon in the oral cavity. Most cases are seen in adults 40 years or older. When present, it typically appears as a slow-growing, soft, yellowish and mobile submucosal mass. More than 50% of cases occur on the buccal mucosa and buccal vestibule. Less commonly sites include the lips, tongue and floor of the mouth. Although lipomas are painless and may resemble the current lesion in color, they are not reactive and are not expected to develop abruptly after a procedure like cosmetic filler injection. Histologically, lipomas exhibit lobules of mature adipocytes, usually surrounded by a fibrous capsule. The treatment of choice is conservative excision, and the prognosis is excellent.
B. Traumatic neuroma
Incorrect. Traumatic neuroma, or amputation neuroma, is a reactive lesion caused by disorganized nerve regeneration following trauma, often seen near surgical or local anesthesia sites, such as the mental foramen area, tongue or lips. Clinically, it presents as a firm, sometimes painful, nodular mass, particularly when palpated or compressed. The lesion can occur weeks after trauma, but is typically associated with distinct nerve injury. Histologically, traumatic neuroma shows haphazard nerve bundles embedded in fibrous stroma, sometimes with chronic inflammation. In the present case, the patient’s history of filler use suggests an alternate diagnosis. Excision, including a small portion of proximal nerve bundles, is recommended.
C. Foreign body granuloma
Correct! Foreign body granuloma is a chronic inflamma-
tory response to foreign materials, including exogenous materials such as cosmetic fillers, dental materials or surgical adjuncts. In addition, endogenous materials such as keratin from ruptured follicles or cysts can also elicit similar reactions. Foreign body reactions typically arise a month to years after injection. Clinically, it may present as a painless, pink to yellowish firm nodule, often in regions commonly targeted for fillers, like the lips, cheeks, and nasolabial folds (Fig. 1). Histologically, granulomas are characterized by multinucleated giant cells, macrophages and chronic inflammatory infiltrates surrounding the foreign material (Figs. 2 and 3). Polarized light microscopy may reveal birefringent particles. When combined with the clinical history and histopathological features, foreign body granuloma is the most reasonable diagnosis. The factors that influence the granuloma can depend on the injection volume, repetitiveness of the injections, and particle sizes, etc. For smaller lesions, conservative surgical excision is sufficient. For larger, deep-seated lesions, intralesional steroid injection may help resolve the inflammatory reaction. Furthermore, to prevent recurrence, injection into the subcutaneous fat layer is preferred over injection into the dermal layer, since the dermal layer is more likely to have an immunogenic response against the foreign material.
D. Fibroma
Incorrect. Fibroma is a localized reactive hyperplasia of fibrous connective tissue in response to chronic irritation or trauma. It is most often seen on the buccal mucosa, tongue, and labial mucosa, and there is a female predilection. Clinically, the buccal mucosa along the bite line is the most common site, as this area is frequently traumatized. It usually presents as an asymptomatic firm, smooth-surfaced, pink, dome-shaped nodule. While this
lesion is also painless and may be located near the commissure, fibromas do not typically appear with a yellow discoloration. Histologically, surface mucosa overlying a nodular mass with dense collagenous stroma is seen. If traumatized, chronic inflammation and ulcer formation may be appreciated. Conservative excision is recommended for treatment, and recurrence is usually not expected. However, submission for microscopic examination is still necessary, since other benign or even malignant lesions may have a similar clinical appearance.
E. Mucocele
Incorrect. Mucocele, or mucous extravasation phenomenon, is a common reactive lesion caused by rupture of a salivary gland duct and spillage of mucin into the surrounding tissue, often due to trauma like lip biting. The lower lip is by far the most common site, and most cases arise in children and young adults. Interestingly, in a clinicopathological review of more than a thousand cases, not a single mucocele was reported at the upper lip. Clinically, mucoceles present as dome-shaped, soft, bluish or translucent swelling, although deeper mucoceles may appear more pink and firm. Histologically, they lack an epithelial lining and instead show mucin surrounded by granulation tissue and macrophages. In this case, the patient’s age and history of filler injection make it a less plausible consideration. Mucoceles are treated by conservative surgical excision, and recurrence is unlikely.
Diagnostic Discussion is contributed by University of Florida College of Dentistry professors and Drs. Indraneel Bhattacharyya, Nadim Islam and Sumita Sam who provide insight and feedback on common, important new and challenging oral diseases.
The dental professors operate a large, multi-state biopsy service. The column’s case studies originate from the more than 16,000 specimens the service receives annually from all over the United States.
Clinicians are invited to submit cases from their practices. Cases may be used in the “Diagnostic Discussion,” with credit given to the submitter.
Conflict of Interest Disclosure: None reported for Drs. Islam, Bhattacharyya and Sam.
*Resident in Oral & Maxillofacial Pathology
Drs. Islam, Bhattacharyya and Sam can be reached at oralpath@dental.ufl.edu.
The Florida Dental Association is an American Dental Association (ADA) CERP Recognized Provider. ADA CERP is a service of the ADA to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a continuing education provider may be directed to the provider or to ADA CERP at ada.org/goto/cerp.
References:
Chi, A. C., Lambert, P. R. 3rd, Richardson, M. S., & Neville, B. W. (2011). Oral mucoceles: A clinicopathologic review of 1,824 cases, including unusual variants. Journal of Oral and Maxillofacial Surgery, 69(4), 1086–1093.
Lee JM, Kim YJ. Foreign body granulomas after the use of dermal fillers: pathophysiology, clinical appearance, histologic features, and treatment. Archives of Plastic Surgery. 2015 Mar;42(2):232–239.
Neville, B.W., Damm, D.D., Allen, C.M. and Chi, A.C. (2024) Oral & Maxillofacial Pathology, 5th Edition, WB Saunders, Elsevier, Missouri.
Osterne, R. L. V., LimaVerde, R. M. B., Turatti, E., Nonaka, C. F. W., & Cavalcante, R. B. (2019). Oral cavity lipoma: a study of 101 cases in a Brazilian population. Jornal Brasileiro de Patologia e Medicina Laboratorial, 55(2), 148–159.
Santos, T. de S., MartinsFilho, P. R. S., Piva, M. R., & Andrade, E. S. de S. (2014). Focal fibrous hyperplasia: A review of 193 cases. Journal of Oral and Maxillofacial Pathology, 18(Suppl 1), S86–S89.
Tamiolakis, P., Chrysomali, E., SklavounouAndrikopoulou, A., & Nikitakis, N. G. (2019). Oral neural tumors: Clinicopathologic analysis of 157 cases and review of the literature. Journal of Clinical and Experimental Dentistry, 11(8), e721–e731.
Tamiolakis, P., Piperi, E., Christopoulos, P., & SklavounouAndrikopoulou, A. (2018). Oral foreign body granuloma to soft tissue fillers: Report of two cases and review of the literature. Journal of Clinical and Experimental Dentistry, 10(2), e177–e184.
Dr. Bhattacharyya
Dr. Islam
Dr. Sam
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From the Shadows of Postle Hall at The Ohio State University
By FDA Editor Hugh Wunderlich, DDS, CDE
Everyone remembers their first time. My first was with Debbie Calabash. I can’t recall the exact date, but the Bee Gees were likely on the radio.
I do remember the location. It was the second floor of Postle Hall in Columbus, Ohio.
And I remember the tooth — yes, the tooth.
My first extraction was a maxillary right central incisor.
I am not sure why we were taking it out. It wasn’t Perio involved or broken to the gum — at least not till I broke it … to the gum.
I was only a freshman dental student and was assigned to only observe a senior dental student. In reality, it was a win-win situation. The senior got an extra pair of hands to get bloody and got his own personal go-fer.
I say “his” because at that time there were no female dental students, and I say “bloody hands” because back then we didn’t wear gloves. Although I am pretty sure Dr. Lister was on staff and made us wash our hands before dinner. t
To Dr. Russell, my first dental educator, thank you for teaching me when to walk away.
It was a ‘win’ for me as this duty was certainly better than waxing and processing custom trays in the “pits” with the other dental plebes.
It was especially fun when the senior student let me exact the forlorn No. 8.
I am pretty sure that this wasn’t SOP, but oh well ... what can you expect for $7? It was, after all, a teaching institution. So I got to learn how much pressure without expanding bone will snap a tooth.
I would learn to extract an entire tooth two years later from Dr. Orville Russell. Dr. Russell was really old. He was, like, 40.
He taught us that you could take out every tooth, under every circumstance, every time with a 301 elevator.
He was right. If you went to the forceps too soon, you put sunshine on the coronal portion, not the roots.
He was tough but fair. He had a sort of a brawny Yul Bryner build with Ross Perot droopy ears. This is why we called him “wingnut,” but never to his face. Oh wait … I forgot millennial docs might be reading this … think John Cena build with Yoda ears.
Personally, I was afraid of him, especially if you had to admit you missed a “block” and needed more than the single dispensed anesthetic cartridge.
On one occasion, I infiltrated the maxillary right yet intended to extract No. 14. Oops.
For some bizarre reason, the local did not cross the midline and two time zones to the opposite arch.
Thinking no one could “miss” an infiltration, Dr. “Bryner/ Perot-Cena/Yoda” snatched my elevator and flicked out No. 14 sans anesthetic. The patient kicked out a leg but did not cry out or yelp — he too was afraid.
Dr. Russell shared all he knew about surgery — from soup to nuts. We loved him. (Something I can’t say about the orthodontic department. But that is a different editorial).
What he really taught was confidence and the skill to treat almost all my patients and to recognize when to refer to my friends.
I love the relationship I have with all the oral surgeons in my area. I think they respect the fact that I don’t send them that sinus perforation at 4:30 p.m. (I schedule all my perforations much earlier in the day.)
However, I do send them the extractions that are beyond my ability and all those blood disorders with seven hyphens.
To Dr. Russell, my first dental educator, thank you for teaching me when to walk away.
And goodnight, Mrs. Calabash, wherever you are … sorry you had to be my first.
FDA Editor Dr. Hugh Wunderlich can be reached at hwunderlich@bot.floridadental.org.
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