2015 - July/Aug TFDA

Scope of Practice FDA Says Thank You Claim Management Going Paperless One Swab at a Time

Expanding Your Scope of Practice VOL. 27, NO. 5 • JULY/AUGUST 2015

TRY MY AGENT When we contacted Rick [D’Angelo], we advised him that time was an issue since our renewal date with previous insurance was within 30 days. He was quick to get back with responses/quotes/suggestions. He answered all of our questions. He was extremely professional and everything was completed in a matter of less than a week. Very pleased!

“

“

- Karen Hoeft, Office Manager Premier Dentistry of Sarasota, plc

800.877.7597 ∞ insurance@fdaservices.com ∞ www.fdaservices.com

Pictured: Dr. Jason Swartz (Left) and Karen Hoeft (Right) Photo courtesy of Premier Dentistry of Sarasota

contents

40

Expanding Your Scope of Practice

news

literary

20 Board of Dentistry

62

Letter to the Editor

22

House of Delegates

68

Book Reviews

43

Bitewing Images

73

Books on the Shelf

52

Florida’s Action for Dental Health

f e at u r e s

columns 3

Staff Roster

19

The FDA Says Thank You

5

President’s Message

24

Buying Commercial Real Estate for Your Practice?

6

Legal Notes

28

Claim Management

11

Information Bytes

30

Best Scanning Options for Dental Offices to Go Paperless

47

Diagnostic Discussion

76

Off the Cusp

34

Saving Lives One Swab at a Time

44 Preventing Wrong Tooth Extraction 51

The Wolves Within

56

FDC2015

61

Seeking Opportunities to Expand Focus

classifieds 64 Listings

Read this issue on our website at:

www.floridadental.org.

www.floridadental.org

Today’s FDA is a member publication of the American Association of Dental Editors and the Florida Magazine Association.

July/August 2015

Today's FDA

1

FLORIDA DENTAL ASSOCIATION

L A C LO Y L E V & LI GATHER FOR FUN & CONTINUING EDUCATION IN YOUR DISTRICT. WCDDA 2015 SUMMER MEETING FRIDAY-SUNDAY, AUG. 7-9, 2015 The Ritz-Carlton, Naples

Speakers: Dr. Gerard Kuge & Dr. William Robinson www.wcdental.org • 813.654.2500 • wc.dental@gte.net

NEDDA PRESENTS TRIAGING THE OROFACIAL PAIN PATIENT FRIDAY, OCT. 30, 2015 Sheraton Jacksonville Hotel

Speaker: Dr. Henry Gemillion www.nedda.org • 904.737.7545 • ddeville@nedda.org

NWDDA 2016 ANNUAL MEETING

FRIDAY & SATURDAY, JAN. 29-30, 2016 The Grand Sandestin

www.nwdda.org • 850.391.9310 • nwdda@nwdda.org

WCDDA ANNUAL MEETING 2016

FRIDAY, FEB. 19, 2016 USF Center for Advanced Medical Learning & Simulation in Downtown Tampa Speakers: Drs. Jeff Brucia and Rhonda R. Savage www.wcdental.org • 813.654.2500 • wc.dental@gte.net

CFDDA ANNUAL MEETING

FRIDAY & SATURDAY, APRIL 15-16, 2016 Marriott Orlando World Center

www.cfdda.org • 407.898.3481 centraldistrictdental@yahoo.com

For a complete listing, go to www.trumba.com/calendars/fda-member.

2

Today's FDA

July/August 2015

JULY/AUGUST 2015 VOL. 27, NO. 5

EDITOR Dr. John Paul, Lakeland, editor

STAFF Jill Runyan, director of communications Jessica Lauria, communications and media coordinator Lynne Knight, marketing coordinator

BOARD OF TRUSTEES Dr. Ralph Attanasi, Delray Beach, president Dr. William D’Aiuto, Longwood, president-elect Dr. Michael D. Eggnatz, Weston, first vice president Dr. Jolene Paramore, Panama City, second vice president Dr. Rudy Liddell, Brandon, secretary Dr. Richard Stevenson, Jacksonville, immediate past president Drew Eason, Tallahassee, executive director Dr. James Antoon, Rockledge • Dr. Andrew Brown, Orange Park Dr. Jorge Centurion, Miami • Dr. Robert Churney, Clearwater Dr. Richard Huot, Vero Beach • Dr. George Kolos, Fort Lauderdale Dr. Jeffrey Ottley, Milton • Dr. Howard Pranikoff, Ormond Beach Dr. Barry Setzer, Jacksonville • Dr. Beatriz Terry, Miami Dr. Stephen Zuknick, Brandon Dr. Ethan Pansick, Delray Beach, speaker of the house Dr. Tim Marshall, Weekiwachee, treasurer • Dr. John Paul, Lakeland, editor

PUBLISHING INFORMATION Today’s FDA (ISSN 1048-5317/USPS 004-666) is published bimonthly, plus one special issue, by the Florida Dental Association, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914.

FDA membership dues include a $10 subscription to Today’s FDA. Non-member subscriptions are $150 per year; foreign, $188.

Periodical postage paid at Tallahassee, Fla. and additional entry offices. Copyright 2015 Florida Dental Association.

All rights reserved. Today’s FDA is a refereed publication.

POSTMASTER: Please send form 3579 for returns and changes of address to Today’s FDA, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914.

EDITORIAL AND ADVERTISING POLICIES Editorial and advertising copy are carefully reviewed, but publication in this journal does not necessarily imply that the Florida Dental Association endorses any products or services that are advertised, unless the advertisement specifically says so. Similarly, views and conclusions expressed in editorials, commentaries and/or news columns or articles that are published in the journal are those of the authors and not necessarily those of the editors, staff, officials, Board of Trustees or members of the Florida Dental Association.

EDITORIAL CONTACT INFORMATION All Today’s FDA editorial correspondence should be sent to Dr. John Paul, Today’s FDA Editor, Florida Dental Association, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914.

FDA office numbers: 800.877.9922, 850. 681.3629; fax 850.681.0116; email address, fda@floridadental.org; website address, www.floridadental.org.

ADVERTISING INFORMATION For display advertising information, contact: Jill Runyan at jrunyan@floridadental.org or 800.877.9922, Ext. 7113.

Advertising must be paid in advance.

For classified advertising information, contact: Jessica Lauria at jlauria@floridadental.org or 800.977.9922, Ext. 7115.

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CONTACT THE FDA OFFICE 800.877.9922 or 850.681.3629 1111 E. Tennessee St. • Tallahassee, FL 32308 The last four digits of the telephone number are the extension for that staff member.

FLORIDA DENTAL ASSOCIATION FOUNDATION

EXECUTIVE OFFICE Drew Eason, Executive Director deason@floridadental.org 850.350.7109 Greg Gruber, Chief Financial Officer ggruber@floridadental.org 850.350.7111 Graham Nicol, Chief Legal Officer gnicol@floridadental.org 850.350.7118 Judy Stone, Leadership Affairs Manager jstone@floridadental.org 850.350.7123 Blair Fowler, Leadership Concierge bfowler@floridadental.org 850.350.7114

ACCOUNTING Jack Moore, Director of Accounting jmoore@floridadental.org 850.350.7137 Leona Boutwell, Finance Services Coordinator Accounts Receivable & Foundation lboutwell@floridadental.org 850.350.7138 Joyce Defibaugh, FDA Membership Dues Assistant jdefibaugh@floridadental.org 850.350.7116 Deanne Foy, Finance Services Coordinator Dues, PAC & Special Projects dfoy@floridadental.org 850.350.7165 Tammy McGhin, Payroll & Property Coordinator tmcghin@floridadental.org 850.350.7139

MEMBER RELATIONS

(FDAF)

Kerry Gómez-Ríos, Director of Member Relations kgomez-rios@floridadental.org 850.350.7121

Ashley Merrill, Member Relations Coordinator amerrill@floridadental.org 850.350.7110

Health Gioia, Director of Foundation Affairs hgioia@floridadental.org 850.350.7117

Kaitlin Alford, Member Access Coordinator kalford@floridadental.org 850.350.7100

Christine Mortham, Membership Concierge cmortham@floridadental.org 850.350.7136

Meghan Murphy, Program Coordinator mmurphy@floridadental.org 850.350.7161

FLORIDA DENTAL CONVENTION (FDC) Crissy Tallman, Director of Conventions and Continuing Education ctallman@floridadental.org 850.350.7105 Elizabeth Bassett, FDC Exhibits Planner ebassett@floridadental.org 850.350.7108 Brooke Mills, FDC Meeting Coordinator bmills@floridadental.org 850.350.7103

GOVERNMENTAL AFFAIRS Joe Anne Hart, Director of Governmental Affairs jahart@floridadental.org 850.350.7205 Alexandra Abboud, Governmental Affairs Coordinator aabboud@floridadental.org 850.350.7204

FDA SERVICES 800.877.7597 or 850.681.2996 1113 E. Tennessee St., Ste. 200 Tallahassee, FL 32308 Group & Individual Health • Medicare Supplement • Life Insurance Disability Income • Long-term Care • Annuities • Professional Liability Office Package • Workers’ Compensation • Auto • Boat Scott Ruthstrom, Chief Operating Officer scott.ruthstrom@fdaservices.com 850.350.7146 Carrie Millar, Agency Manager carrie.millar@fdaservices.com 850.350.7155

Debbie Lane, Assistant Membership Services Manager debbie.lane@fdaservices.com 850.350.7157 Allen Johnson, Support Services Supervisor allen.johnson@fdaservices.com 850.350.7140 Alex del Rey, FDAS Marketing Coordinator arey@fdaservices.com 850.350.7166

Mable Patterson, Accounts Payable Coordinator mpatterson@floridadental.org 850.350.7104

Angela Robinson, Customer Service Representative angela.robinson@fdaservices.com 850.350.7156

INFORMATION SYSTEMS

Jamie Idol, Commissions Coordinator jamie.idol@fdaservices.com 850.350.7142

Stephanie Taylor, Membership Dues Coordinator staylor@floridadental.org 850.350.7119

Larry Darnell, Director of Information Systems ldarnell@floridadental.org 850.350.7102

COMMUNICATIONS AND MARKETING Jill Runyan, Director of Communications jrunyan@floridadental.org 850.350.7113 Lynne Knight, Marketing Coordinator lknight@floridadental.org 850.350.7112 Jessica Lauria, Communications and Media Coordinator jlauria@floridadental.org 850.350.7115

Will Lewis, Information Systems Helpdesk Technician/ Database Administrator wlewis@floridadental.org 850.350.7153

Pamela Monahan, Commissions Coordinator pamela.monahan@fdaservices.com 850.350.7141

Carol Gaskins, Assistant Membership Manager carol.gaskins@fdaservices.com 850.350.7159

Casey Stoutamire, Lobbyist cstoutamire@floridadental.org 850.350.7202

Maria Brooks, Membership Services Representative maria.brooks@fdaservices.com 850.350.7144 Melissa Staggers, West Coast District Membership Services Representative melissa.staggers@fdaservices.com 850.350.7154

Porschie Biggins, North Florida Membership Services Representative pbiggins@fdaservices.com 850-350-7149

RISK EXPERTS Dan Zottoli Director of Sales Atlantic Coast 561.791.7744 Cell: 561.601.5363 dan.zottoli@fdaservices.com

Dennis Head Director of Sales Central Florida 877.843.0921 (toll free) Cell: 407.927.5472 dennis.head@fdaservices.com

Marcia Dutton, Administrative Assistant marcia.dutton@fdaservices.com 850.350.7145 Sarah Beall, Membership Services Representative sarah.beall@fdaservices.com 850.350.7171

Nicole White, Membership Services Representative nicole.white@fdaservices.com 850.350.7151

Mike Trout Director of Sales North Florida 904.249.6985 Cell: 904.254.8927 mike.trout@fdaservices.com

Joseph Perretti Director of Sales South Florida 305.665.0455 Cell: 305.721.9196 joe.perretti@fdaservices.com

Rick D’Angelo Director of Sales West Coast 813.475.6948 Cell: 813.267.2572 rick.dangelo@fdaservices.com

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, Dr. John Paul: jpaul@bot.floridadental.org. www.floridadental.org

July/August 2015

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3

CARE NOW!

Florida Mission of Mercy Jacksonville April 20-23, 2016 Your donations support dental health programs that impact Floridians in the most need!

Mission of Mercy Project: Dentists Care Give Kids A Smile Educational Materials Scholarships Disaster Aid

For more information, or to volunteer: www.floridadental.org/foundation 800.877.9922 foundation@floridadental.org

@Ralph RALPH ATTANASI JR., DDS, MS

#sitback#relax#enjoytheride Living in a modern world can be exhila-

have hired a professional public relations

rating! Brand new ideas and technology

firm in order to be certain that our respons-

enhance our daily lives and provide us with

es to the media and the public are on point,

a great deal of knowledge. We’re on the cusp

cogent and timely. It’s imperative that we

of new beginnings, and it’s going to be a

are able to move at the lightning speed and

world filled with change and challenges. I

quick response time that we all have grown

can’t wait! Let’s go check it out …

accustomed to in our personal and business interactions.

The Florida Dental Association (FDA) has embraced many recent trends, regarding

In addition, we need to look outside our

membership, technology, governance and

borders and be able to be global advocates

social media. These topics have been ad-

for oral health care as well. Do you remem-

dressed in the last few years, but it’s time to

ber how the Ebola scare in Dallas this past

redirect and refocus our viewpoint now that

October changed the face of global health

we can evaluate what has been successful

crises and how vulnerable it made us all

and what needs to be redefined.

feel? Rapid communication enabled health care authorities to track the source of the

We need to adapt to our changing environ-

virus, locate potentially exposed citizens

ment. In just a few short years, we’ve moved

and disseminate information rapidly as

from snail mail to email to texting. We have

events began to unfold. This type of rapid,

evolved from handwritten charts to voice

coordinated and focused approach allowed

command dictation to electronic medical

us to avoid a health care crisis. It also dem-

records — and this is just the beginning!

onstrated that we no longer will have the luxury of waiting until things “blow over”

The FDA is now the third largest state

“

What a great time for dentistry!

What a great time for us!

”

techniques to 3-D printed restorations — is here and will become even more refined in the next few years. What a great time for dentistry! What a great time for us!

Now more than ever, the FDA needs your input and your guidance. You have great ideas and you have the power to drive our organization forward. Send us your thoughts!

Now come on … let’s enjoy the ride!

before mounting a response.

dental association in the United States.

As such, we need to be at the forefront of

We need to look forward in our own

technological integration. We are improv-

practices as well. The digital age of dentistry

ing communication with each other and the

has arrived! We’re now realizing that digital

ADA through the Aptify database, which

workflow — from radiographic diagnosis

provides a wealth of information to us. We

to guided surgery to digital impression

www.floridadental.org

Dr. Attanasi is the FDA President. He can be reached at rttanasi@bot.floridadental.org.

Please follow us on Facebook (Florida Dental Assocation) and Twitter (@FDADental).

July/August 2015

Today's FDA

5

Legal Notes

King v. Burwell: My Predictions and Some Observations on William Howard Taft Graham Nicol, Esq., HEALTH CARE RISK MANAGER, BOARD CERTIFIED SPECIALIST (HEALTH LAW)

For better or worse, by the time you read this article the U.S. Supreme Court will have decided whether to eliminate tax credits for health insurance coverage purchased through federally run marketplaces. To quote your favorite stockbroker: “Past performance does not predict future results.” But, allow me to make some predictions based on how the lower federal circuit courts have ruled, as to how I think the High Court will rule.

Thirty-four states, including Florida, have not established their own health insurance marketplaces. This means that the federal exchange operates by default in the majority of states. Under the Affordable Care Act (ACA), the federal government — via our taxes — pays for health insurance purchased by and for the benefit of certain families. Only taxpayers between 100 and 400 percent of the federal poverty line get subsidies. They receive tax credits that pay for all or some of the cost of their health insurance coverage. The rest of us have to pay full price. Without the tax credits, we have a large population of uninsured; with the tax credits, we don’t. Either way, the result is a huge impact on society.

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Today's FDA

July/August 2015

This brings me to my first prediction: The Court will decide the case without regard to societal impact; how many individuals get tax credits; how much the tax credits are worth; and, what the economic or political impact will be. Hundreds of studies have been done, thousands of pages have been written and millions of hours of punditry have speculated on how many people’s finances will be up-ended, whether the health insurance industry will collapse and who will become the next president based on the outcome of King v. Burwell. All the media predictions are based on what the Court wants to achieve. But that’s not how U.S. Supreme Court justices are trained to think.

It seems almost impossible that the Court would be able to ignore the economic and political impact its ruling will have. But that’s exactly what they do every time they decide a case. Sound legal judgment is not based on who wins or loses from an individual perspective, but rather on what the law says applied to the facts at hand. Picking winners and losers based on who we like is how we pick a middle-school baseball team.

It’s not how the High Court decides cases.

King v. Burwell’s impact on American life will echo for centuries, and it’s hard for rational human beings to ignore that burden when making such a momentous decision. But again, my first prediction is that’s precisely what the Court will do. Not that the justices are irrational or non-human — they’re just special lawyers!

I’m confident my prediction will come true. The Court deals with momentous decisions every day. They aren’t concerned with societal impact. Their rulings always

make history — every decision they make changes America, if not the world. The Court’s very function is to resolve great moral issues based on razor-thin reasoning, recognizing that outcomes could easily be decided either way. Someone always wins and someone else always loses. The stakes are always enormous and both sides always have merit. Yet, the Court still must act. It is idealistic, but it’s not naïve, to think the Court will decide King v. Burwell based on jurisprudence, not economic fallout. This is what they are sworn to do and they do it every time they issue a ruling.

President Bill Clinton, a lawyer’s lawyer if there ever was one, was laughed at by many when he said, in a far different context than health insurance subsidies and tax credits, that the answer “Depends on what the definition of ‘is’ is.” But, from a lawyer’s point of view, he was right! Lawyers all had differing opinions about the morality of what he did, but we all understood the validity of his argument. And, from a jurisprudential perspective, his argument is correct. You can’t fairly apply a law to the facts unless you first know what the law says and means. Wise legal analysis (also known as “jurisprudence”) does not allow you to fudge based on who you want to see win or lose, it requires you to understand what the law means and apply it fairly to the facts established regardless of who’s ox gets gored.

My second prediction is that the analysis will depend on whether the phrase “established by the state” is ambiguous and, assuming that it is found to be so, what the definition of “establish” is. One of the tenets of jurisprudence says if the plain language of the statute (i.e., “the law”) is clear and www.floridadental.org

Legal Notes unambiguous, then judges should not look at the legislative intent behind the statute or what the law was intended to accomplish.

So, the first issue for the Court to decide is whether the phrase “established by the state” is ambiguous. If it is, we all know the intent behind the law was to make health insurance available to as many Americans as possible by using taxes to subsidize the poorer among us. Further, we all know that to achieve that outcome, it doesn’t matter whether the insurance was bought on the federal or a state exchange. Therefore, we can all predict the outcome if we look to intent.

If the words “established by the state” are ambiguous, then we look at the intent behind the law, and presto! — the tax credits for insurance purchased on the federal exchange are lawful. On the other hand, if the words “established by the state” are plain and obvious, and there is no room for confusion, then we decide based on only that language, not what the language was intended to accomplish, and voilà! — the tax credits for insurance purchased on the federal exchange are not lawful.

My third prediction is that the Court will indeed rule that the statutory phrase “established by the state” is ambiguous.

I don’t have as much confidence in this prediction as the other two, but I still think it’s an odds-on bet based on what the lower federal courts did when faced with the same language. Based on the same facts and the same law, two different courts reached contradictory conclusions. Only one was correct and my legal opinion is it was the one that looked to intent after finding the language ambiguous.

In May 2012, the Internal Revenue Service (IRS) issued a final rule that made subsidies available to individual purchasers on both state-run and federally run marketplaces.

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Immediately, lawsuits were filed arguing that this rule contradicts the plain language of the ACA and that tax credits are allowed only when insurance is purchased on an exchange “established by the state.”

Two years later, but ironically on the same day (July 22, 2014), the appellate decisions came down. First, the D.C. Circuit Court of Appeals ruled in Halbig v. Burwell that subsidies are available only through state-based marketplaces, which was a blow to the ACA because it meant the subsidies were not available in 34 of the 50 states. But later that afternoon, the 4th Circuit Court of Appeals ruled in King v. Burwell that subsidies also are available through the federally run marketplace, meaning the ACA subsidies remain intact in all states.

The plaintiffs in Halbig argued that the ACA’s plain language means tax credits are available only through state-run marketplaces. Their theory was the subsidies were set up this way to provide only states with financial incentives so that states will run their own marketplaces rather than placing the administrative burden on the federal government. The D.C. Circuit Court of Appeals agreed, holding in the Halbig case that the federal exchange is not an “exchange established by the state,” and therefore, “Section 36B (of the ACA) does not authorize the IRS to provide tax credits for insurance purchased on the federal exchange.”

In contrast, the 4th Circuit Court of Appeals in King v. Burwell reached the opposite conclusion by finding Section 36B of ACA to be ambiguous. “(B)ased solely on the language and context of the most relevant statutory provisions, the court cannot say that Congress’s intent is so clear and unambiguous that it forecloses any other interpretation.”

Because the 4th Circuit Court found the language ambiguous, it upheld the defendant’s position that the IRS interpretation

of the statute to allow credits for insurance bought on federal or state-run exchanges is permissible.

I also think the phrase “established by the state” is ambiguous. For example, does it require an affirmative act of creation of an exchange by the state Legislature, or can creation of an exchange occur by legislative inaction? That was certainly the case in Florida. If a state Legislature takes no action to establish a state exchange, I personally think they still established a state exchange because they knew that non-action would have the state default to the federally run exchange. The cliché, “No decision is a decision,” seems to apply because ever since the ACA took effect, we all knew we were going to have insurance marketplaces in every state covering all Americans. We just didn’t know how many state exchanges would be state-run versus federally run, but we knew each state would have an exchange “established” one way or another.

But that’s easy for me to say because the fate of millions of people doesn’t depend on my decision. Honestly, I’m glad I’m general counsel for the Florida Dental Association, because I don’t think I have what it takes to be a Supreme Court justice! Good lawyers are able to argue for one side; better lawyers can see the argument from both sides; and the best lawyers go on to become judges — capable of deciding based on the law and the facts without regard to who wins or loses while, importantly, still being able to sleep at night (sometimes even on the bench).

It takes a special kind of person to sit on the U.S. Supreme Court or to be president.

There’s another cliché that says, “Anyone who wants to run for president should automatically be disqualified.” If you are prideful enough to think you can do the job, you’re Please see LEGAL, 9

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LEGAL from 7

not the kind of thinking man or woman we want making these decisions. For most of us, the responsibility is too great and we know it. This brings me to my observations on William Howard Taft.

In 1910, then U.S. President William Howard Taft signed the commission for Chief Justice Edward Douglas White. At the time he remarked, “There is nothing I would have loved more than being Chief Justice of the United States.” Remarkably, the POTUS also wanted to be chief justice of the SCOTUS! Later, his wish came true. To this day, William Howard Taft is the only American who has served both as president and chief justice.

I wonder how he slept at night?

POSTSCRIPT: For better or worse, my predictions were right. Ambiguity in one clause of the legislation was construed to uphold the ACA. Chief Justice Roberts was roundly called a sell out by those who believe he put politics

and economics ahead of jurisprudence. But in my opinion, the language was ambiguous and legislative intent was therefore properly used to interpret it. If it was based solely on partisan politics, the vote would have been 5-4; instead it was 6-3.

Although many of us (including me) don’t like the outcome, the problem was not with the Court’s legal reasoning. It is, and always has been, with the legislation itself.

For many years now, the federal government has regulated public health, safety and welfare to the detriment of state’s rights and in violation of Constitutional guidance on federalism and limited government.

What’s my next prediction? Nationalization of dental licensure by continued antitrust enforcement against regulatory boards; allowing health insurance to be sold across state lines; a single-payor system; and expansion of ancillary staff functions are all too easy (and depressing).

So, instead, let me predict future legal challenges to the principles represented by the

ACA at the state level via fights over Medicaid expansion, access to equal care and the definition of essential health benefits (which is tied to what the most commonly available health insurance policy covers in each state). Also, expect more legal challenges at the federal level over the president unilaterally rolling back the deadline for employers to provide insurance or face tax penalties, which chamber must introduce tax bills first and whether insurance must cover contraception. So, while the president and the Supreme Court may now sleep better at night, the rest of us will continue to worry about the future of health care delivery and financing.

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.

Graham Nicol is the FDA’s Chief Legal Counsel.

Patient Abandonment At some time in their practice, all dentists will need to terminate a doctor/patient relationship. This Legal CE explains how to do so without violating Florida’s patient abandonment law. It covers the following topics: potential civil and disciplinary liability resulting

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Take this course online to earn free CE credit. For link, go to floridadental.org/members. FDA Members Only!

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6/10/2015 3:47:16 PM

Information Bytes

Spam, Phishing and Spoofing, Part 3: I’ve Been Spoofed Again!

By Larry Darnell DIRECTOR OF INFORMATION SYSTEMS

Have you wondered how it’s possible that you’ve received a lot of emails — from yourself — that you don’t even remember sending? It may very well be that those emails have been spoofed. Spoofing used to mean a lighthearted parody or joke about a way of life or a character trait, but this spoof is all too real and dangerous.

There are many mail systems that send email to your inbox. The protocols (which are the manner in which mail is sent to and received by you) sound like an acronym disaster movie: POP, SMTP or IMAP; not to mention the different ports on a computer that can receive communications, such as 25, 110, 587 or 993; or secure methods like SSL, TLS and SPA. Because there are so many different methods for mail to be sent and received, and so many email client software programs, few means of authentication have developed to verify that email is actually from who it says it’s from.

Think about it in reference to snail mail.

Usually, the return address is written on the outside of an envelope. When you receive that old-school USPS mail, how do you

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“

To really know where an email comes from, it’s useful to look at the message source.

”

know it’s really from that individual? Surely you don’t rely solely on the return address on the outside for that, right? It’s exactly that way of thinking that gets us in trouble with email. We are socially engineered to open everything to verify it’s from who we think it is. When you see an email — even if it is from yourself — you instinctively open it. The problem is, it’s incredibly easy for scammers and spammers to inject an email address into their message that can make it appear to be from anyone, you included.

It’s a proven fact that most people will open an email if it’s from someone they know by name, even themselves. This is simply referred to as spoofing an email address … and it’s not that hard to do.

To really know where an email comes from, it’s useful to look at the message source, which you can do in just about any email client by looking at the message headers.

However, almost all of that information can be (and often is) hidden, modified or falsified. There are a few email authentication methods deployed, but it’s having a hard time catching up with the technology.

Oftentimes, those authentication methods may prevent legitimate mail from getting through to you. Junk mail filtering, spam filtering, anti-virus scanning, content filtering and encryption-level verification slow down email communication methods.

Imagine having to call everybody you email just to make sure they got your email. That is horribly inefficient.

So, what are you to do? It comes back to a theme I have been preaching throughout this series: Think twice about opening that email or clicking that link, even if it appears to be someone you know (or even yourself).

Use the tools available to you to check your messages. If it takes a few more minutes to keep you from identity theft or your computer system from being compromised, it is well worth the extra time to consider the consequences. If you think you have been spoofed or someone calls to report that they have been receiving a ton of emails from you that you did not send, immediately change all of your email passwords for all accounts because you may have been more than just spoofed — you may have been hacked.

Wondering what’s next? I’ll tackle what you need to know when buying a computer for your home or office. You don’t have to rely on the Geek Squad to know what you need.

Find out in the next edition of “Information Bytes.”

Mr. Darnell can be reached at ldarnell@ floridadental.org or 850.350.7102.

July/August 2015

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*Please note that FDA members have their names listed in bold.

New Date for 2016 Dentists’ Day on the Hill The Florida Dental Association’s (FDA) 2016 Dentists’ Day on the Hill (DDOH) is now scheduled for Tuesday, Feb. 2, 2016, instead of Wednesday, Feb. 3, 2016. Due to an unnegotiable two-night minimum requirement for hotels located in downtown Tallahassee, the date was moved to avoid additional costs for hotel accommodations.

A legislative briefing will be held the night before on Monday, Feb. 1, at 6:30 p.m. at the Aloft Hotel in Tactic 3 Meeting Room.

Hotel reservations for Monday night can be made at the Aloft Hotel by calling 850.513.0313. The room rate is $189 and there is free parking.

To register for DDOH, go to http://www. floridadental.org/ddoh2016/.

Florida Dental Association Elevator Speech As we continue to raise awareness and name recognition of the FDA through social media, media relations and other communications efforts, you may be asked by your patients, colleagues or even media reporters about what the FDA is and why you’re a member. To help you with these opportunities to promote your association, the following is the FDA’s elevator speech, which provides a concise, clear description of our organization. We welcome you to use this messaging in media interviews, public speaking engagements and opportunities to speak with patients and colleagues

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about the FDA. We also encourage you to personalize this message by adding your own personal reasons for being a part of the FDA.

FDA Elevator Speech As the state’s premier professional organization representing Floridalicensed dentists, the Florida Dental Association ensures patients receive the highest quality of care from its member dental professionals. The Florida Dental Association is a constituent society of the American Dental Association and the leading expert on issues affecting Florida dentists and the oral health of Floridians. As Florida’s advocate for oral health, the Florida Dental Association serves as the voice of Florida dentists and advocates for issues affecting its members and the dental health of Floridians.

Experts, Learners and Authors: Beyond the Bite Blog The FDA encourages our leaders, members and staff to share their insights, expertise and personal stories as we continue to build and promote Beyond the Bite. While our monthly e-newsletter, News Bites, will continue to share important news and updates related to the FDA and member issues, Beyond the Bite is an opportunity to provide more in-depth resources, tips and best practices to help support members’ professional growth and success. If you have an idea for a post you would like to submit or topic you would like to see covered, please send a brief overview to Jill Runyan at jrunyan@floridadental.org.

Delegation of Duties Chart Now on FDA’s Website The FDA has created a delegation of duties chart for its members. It can be found on the FDA’s website at http://www.floridadental.org/members/governmental-affairs/ delegation-of-duties. This “cheat sheet” lists duties, with their corresponding supervision level, that a dentist can delegate to dental assistants and hygienists per Florida statute and rule. It also separates the duties by the form of training the dental assistant or hygienist must obtain — pre-licensure education, formal training or on-the-job training.

If you have any questions, please contact Casey Stoutamire in the FDA’s Governmental Affairs Office at 850.224.1089 or cstoutamire@floridadental.org.

Who are the Members of the AFDA? They are your spouses and significant others! The Alliance of the FDA’s (AFDA) programs support the work of the FDA. Currently, their two projects are DDOH and the Florida Mission of Mercy (FLAMOM). At the FDA House of Delegates meeting during the Florida Dental Convention (FDC), the Alliance presented Drs. Rick Stevenson and Andy Brown, chairs for the 2016 FLA-MOM, with a check for $4,000! The Alliance’s members support the FLA-MOM project and encourage available Alliance members to sign up to volunteer. q The Alliance exists for YOU — we support our member dentists and the FDA! q The Alliance is a worthwhile investment

www.floridadental.org

of $80 annually on the FDA dues statement. q There is one annual meeting, which is held during FDC — easy and fun! q Ask your spouse or significant other to join us!

Plan now for DDOH! Fact: Most dental households have at least two votes — the dentist and spouse. That’s why the Alliance requests that your spouse or significant other join us at DDOH! Carol Nissen, DDOH chair for the Alliance, has reserved a room block at the Aloft Hotel in Tallahassee for the legislative briefing/reception on Monday, Feb. 1, 2016. Legislative visits will be Tuesday, Feb. 2 and include a tasty boxed lunch from Andrew’s Second Act restaurant. Double the impact and fun of DDOH by bringing your spouse or significant other.

We want to have enough food for all, so be sure to register!

National Board Dental Exam, is in development and will replace Part I and II. It will integrate basic sciences, clinical sciences and behavioral sciences into one exam.

Dr. Robinson is one of 15 commissioners, which also includes examiners (AADB), practitioners (ADA), faculty (American Dental Education Association) and one hygienist, as well as one public member.

Broward County Dental Association Held Give Kids A Smile Event

www.floridadental.org

The Dental Society of Greater Orlando’s journal, which is published quarterly, was the recipient of the Silver Scroll Award from the International College of Dentists for most improved journal! The hard work of the journal’s editor, Dr. Ed Kennedy, and his assistant, Dr. Jim Flatley, has paid off. Dr. Flatley will be attending the award ceremony at the ADA Meeting in Washington, D.C. this fall to accept the award.

Congratulations!

On Feb. 7, the Broward County Dental As-

Medicaid Field Offices Closed As of June 30, 2015, the following Medicaid field offices will be closed:

FDA Member Appointed to the Joint Commission on National Dental Examinations Dr. William F. Robinson of Tampa recently was appointed to the Joint Commission on National Dental Examinations by American Dental Association (ADA) President Dr. Maxine Feinberg as a representative of the American Association of Dental Boards (AADB). The Joint Commission develops and conducts highly reliable state-ofthe-art cognitive examinations that assist regulatory and other agencies in licensure and other matters pertaining to dentists and dental hygienists. The Commission is responsible for Part I and Part II National Dental Boards, the Dental Hygiene National Boards and administers the Dental Admission Test. A new exam, the Integrated

Affiliate Journal Receives Silver Scroll Award

sociation (BCDA) held a Give Kids A Smile event at Broward College. Special thanks to Roxanne Cuthbertson and Curtis Briggs at Henry Schein. Dr. Amada Buschemi coordinated the event along with Maricel Castillo, the BCDA’s executive director. BCDA dentists were able to provide free dentistry to 81 children in need and almost $20,000 in free dental services! For information about the event, please contact Dr. Buschemi 954.551.2810 and Maricel Castillo at 954.296.0878.

q Field Office 2 – Panama City (covering Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Washington and Wakulla counties) q Field Office 3 – Alachua (covering Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee and Union counties) q Field Office 9 – West Palm (covering Broward, Indian River, Martin, Okeechobee, Palm Beach and St. Lucie counties) For assistance regarding Medicaid services, policies or fee-for-service billing, providers should contact the Medicaid helpline at 877.254.1055 to speak with a Medicaid representative.

Please see NEWS, 16

July/August 2015

Today's FDA

13

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NEWS from 13

CDC Awards Manatee County for Excellence in Community Water Fluoridation Manatee County has been awarded for its excellence in community water fluoridation. The U.S. Centers for Disease Control and Prevention (CDC) gave the county a Water Fluoridation Quality Award for 2013. Community water fluoridation is the “precise adjustment of fluoride in drinking water to a level that is effective in preventing cavities,” according to a letter sent from Oral Health Florida to the county commission on June 26.

Manatee County was one of 2,184 public water systems nationwide that received the award for maintaining a consistent level of fluoridated water throughout 2013, according to the letter. Thirty-five of the systems are located in Florida.

While fluoridation began nationally more than 70 years ago, the Florida State Board of Health officially endorsed fluoridation in 1949. About 13 million people in Florida have fluoridated water delivered to their homes daily, according to the letter.

ADA Offers Online Education for Dentists who Treat Nursing Home Residents The ADA is offering online training for dentists interested in providing care for nursing home residents.

Nearly 1.4 million nursing home residents face the greatest challenges to accessing dental care of any group in the nation. At the same time, the elderly population of America continues to grow, and the number of people ages 65 and older is expected to nearly double by 2050.

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Through the ADA’s online continuing education course, “Dentistry in Longterm Care: Creating Pathways to Success,” dentists are able to expand their practices to nursing homes, assisted living facilities and senior centers. The course provides strategies to work with challenging medical and cognitive conditions, getting access to patients, useful equipment and supplies, and information about caring for elderly people.

For a limited time, the 10-hour course is being offered to ADA members for $250.

Non-members can register for $650. Dentists who register for the program can register up to three of their non-dentist team members at the reduced tuition of $150 per person. Team members must register at the same time as the dentist to take advantage of the reduced tuition.

Registration is available online: http://www. ada.org/en/education-careers/continuingeducation/long-term-care-course.

Welcome New FDA Members These dentists recently joined the FDA. Their membership allows them to develop a strong network of fellow professionals who understand the day-to-day triumphs and tribulations of practicing dentistry.

Atlantic Coast District Dental Association Sandra Angel, Coral Springs Prince Arrington III, Deerfield Beach Michael Cohen, Boca Raton Zaileen Juma, Boca Raton Marianna Kaufman, Wellington Heather Kohn, Sunrise Renee Litvak, Fort Lauderdale Victor Lopez Perez, Fort Lauderdale Numa Munoz, Aventura Marilyn Riley, Oakland Park

David Salar, Boca Raton Richard Singer, Fort Lauderdale Luis Torres, Davie

Central Florida District Dental Association Juan Amaya, Orlando Ali Behzadi, Casselberry Ruben Borrero-Serrano, Orlando Barry Cates, South Daytona Lina Cortes, Orlando Michael Freeman, Sanford Michel Furtado Araujo, Melbourne Darline Harper, Kissimmee Andrea Irarrazabal, Orlando Lydia Legg, Gainesville Carlos Medina Cardona, Deland Chitra Nagaraj, Ocala Gabriel Nossa, Gainesville Chris Rae, Deland Ross Smith, Melbourne Damion Williams, Sanford

Northeast District Dental Association Joseph Abid, Jacksonville Derek Hoffman, Orange Park Deshaydia Mackey, Jacksonville Aylin Mazzuoccolo, Saint Johns Nisarg Parikh, Orange Park Roshan Patel, Jacksonville Joshua Perry, Ponte Vedra Beach Salvatore Pezzella, Jacksonville Shanta Singh, Jacksonville Steven Smith, Jacksonville Matthew Walker, Cross City Dennis Weber, Jacksonville

Northwest District Dental Association Gary Moeller, Shalimar Justin Palmer, Hurlburt Field Charles Schildroth, Pensacola Caitlin Tysinger, Pensacola

www.floridadental.org

South Florida District Dental Association Angel Agreda, Miami Monica Agudelo, Miramar Marisel Almeida, Miami Jose Diaz, Miami Jean–Jacques Edderai, North Miami Beach Celia Espinosa, Hialeah Aliuska Garcia Fernandez, Miami Jacqueline Garcia, Castellanos, Miami Christina Hernandez Bonnet, Fort Lauderdale Patricia Hong, Miami Jaydee Marrero, Coral Gables Karen Martinez, Miami Juan Packer, Hollywood Ernesto Perez, Miami Karim Revoredo, Miami Hilma Rodriguez, Hialeah Julie Sugar, Miami

West Coast District Dental Association Margaret Bressler, Seminole Aaron Broderick, Fort Myers Troy Brown, Myakka City Mendee Bull–Ligon, Saint Petersburg Jessica Capellan, Belleair Bluffs Adam Cheslock, Clearwater Lori Conrad, Bradenton Nicole Decambra, Tampa Christopher Fitzgerald, Tampa Genevieve Garris, Bonita Springs Thomas Gilton, Tampa Victor Grasso, Ave Maria Danielle Grimes, Tampa Ulises Guzman, Tampa Terry Hamblen, Palm Harbor Lawrence Harkins, Palm Harbor Lakshmi Immadi, Valrico Rajiv Kalra, Tampa Amrita Marajh Selz, Belleair Bluffs Loryn Merrill, Brooksville Harvey Mossak, Brandon Sonja Munoz Latorre, Bradenton Thuy Nguyen, Clearwater

www.floridadental.org

Rushi Patel, Crystal River Sherlin Paul, Tampa Tierney Pettinato, Tampa Rachael Phillips, Tampa Brittany Pierpont, Lakeland Robert Powless, Tampa Era Pyakurel, Tampa Kurush Savabi, Riverview Marina Shurova, Saint Petersburg Douglas Stilian, Tampa Katie Tulipano, St. Petersburg Frank Vascimini, Homosassa

In Memoriam The FDA honors the memory and passing of the following members: John P. Egitto Palm Beach Died: 3/19/15 Age: 67 Earl R. Thomas Boynton Beach Died: 4/5/15 Age: 90 James E. Dillard Brooksville Died: 4/17/15 Age: 72 James L. Griffin Jacksonville Died: 4/17/15 Age: 85 Benjamin J. Brown Defuniak Springs Died: 4/19/15 Age: 90

Karmal N. Zakhari South Pasadena Died: 4/21/15 Age: 81 Donald M. Keene Port Orange Died: 4/22/15 Age: 75 Daniel G. Thomas Fernandina Beach Died: 5/2/15 Age: 72 Jerry M. Denson Orlando Died: 5/22/15 Age: 79 Maurice M. Weaver Lake Wales Died: 6/21/15 Age: 72

A contribution has been made to The Florida Dental Association Foundation’s 2016 Mission of Mercy Program In Memory of W.L. Mullens By his son, Richard C. Mullens, DDS

Richard K. Suttell Seminole Died: 4/19/15 Age: 67

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COMPREHENSIVE ORTHODONTICS This course is designed for doctors interested in adding Ortho to their practice, as well as more experienced doctors looking to achieve better diagnostic capabilities to achieve a more effective finish to their cases.

WITH SO MANY TO CHOOSE FROM

WHY TAKE THIS ONE?

Dr. ALAN MACDONALD

Dr. ROBERT BOND

OVER 60 YEARS

OF COMBINED

EXPERIENCE

Instructors Dr. Bond and Macdonald are senior international association of orthodontics instructors and have over 60 years of experience doing and teaching orthodontics. This is an ADA certified course with up to 200 hours of CE credit available.

Doing orthodontics begins with proper diagnosis. You will learn how to diagnosis your orthodontic cases so you can choose the best possible treatment options for your patients.

You are responsible for your patient’s treatment and are the one they will be coming back to.

All of the orthodontic options available will be taught so you will be able to provide your patients with a number of treatment options. Invisalign, short term treatment (anterior teeth only), early treatment, interceptive orthodontics and full comprehensive will all be taught.

You will learn orthodontic diagnosis so you won’t have to leave it in the hands of someone else who may or may not know what they are doing. Remember you are ultimately responsible for your patients. You will learn why orthodontic cases relapse and how to prevent it from happening or how best to retreat the problem.

1 2 3 4

If you’re thinking of signing up for an ortho course or adding ortho to you practice, you need to visit the following link and listen now! Dr. Bond reveals the 5 critical things that you need to know *before* joining an Ortho course. WWW.CSWFOP.COM/5THINGS.HTML Questions? Call...

1-877-206-7846

Course Begins: Nov. 14th 2015 Miami Beach, Florida 33139

Register NOW! WWW.CSWFOP.COM

Volunteers

The FDA Says Thank You! Outgoing 2014-2015 Council/Committee Volunteers ...

The Florida Dental Association (FDA) would like to thank each of our council and committee members who have completed their terms on the groups listed below. Many of them are returning to continue their service on other FDA leadership groups.

FDAPAC

The FDA appreciates your time and dedication for serving in this capacity.

FDA Services Board

Council on Financial Affairs: m Dr. Rudy Liddell – WCDDA m Dr. Steven Bryan – NWDDA m Dr. Andre Grenier – ACDDA m Dr. Ralph Attanasi, BOT Liaison – ACDDA m Dr. Paul Miller, Consultant – WCDDA

Audit Committee m Dr. Paul Miller, Consultant – WCDDA

Council on Dental Education and Licensure m Dr. Mike Grandy – NWDDA

Governmental Action Committee

m Dr. David Hanle – NWDDA

Council on Dental Health m Dr. Mike Hartley – NWDDA

m Dr. Steven Bryan, President – NWDDA m Dr. Dave Boden, Trustee – CFDDA

Committee on Conventions and CE m Dr. John Krueger – WCDDA

Council on Dental Benefits m Dr. Walt Colon, Chair – NWDDA

Council on Dental Health

m Dr. Brett Zak, Chair – CFDDA m Dr. Erin Shiveler – NWDDA m Dr. Esteban Leon – SFDDA m Dr. Marcus Higgins – NEDDA

m Dr. Phillipe Bilger – ACDDA m Dr. Jeff Smith – CFDDA m Dr. Suzanne Ebert – NEDDA m Dr. Joseph Gay – SFDDA m Dr. Andy Brown, BOT Liaison – NEDDA m Dr. Cesar Sabates, ADA Council – SFDDA m Dr. Ed Zapert, Public Health – NWDDA

Council on Membership

Council on Communications

m Dr. Valerie Marino – ACDDA

m Dr. Thomas Reinhart, Chair – WCDDA m Dr. Roger Robinson, Vice chair – NEDDA m Dr. Bill Marchi – NWDDA m Dr. Curtis Hill – CFDDA m Dr. Michael Costabile, BOT Liasion – ACDDA m Dr. Simon Ghattas – ACDDA m Dr. Mark Limosani – SFDDA

Council on the New Dentist

FDA Foundation Board of Directors m Dr. Harry Futrell – NWDDA m Dr. Carol Stewart, UF Rep m Dr. Audrey Galka, NOVA Rep.

m Dr. Dave Boden, Consultant – ACDDA m Dr. Terry Buckenheimer, FDA Immediate Past President – WCDDA m Dr. Zack Kalarickal – WCDDA

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Board of Dentistry

Board of Dentistry Meets in Gainesville

By Casey Stoutamire FDA LOBBYIST

“

The BOD approved the Council’s recommendation to lower dental hygiene licensure and renewal fees as recommended by the BOD Budget Task Force.

”

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The Florida Board of Dentistry (BOD) met in Gainesville on Friday, May 29. The FDA was represented by FDA BOD Liaison Dr. Don Ilkka and FDA Lobbyist Casey Stoutamire. Other FDA members in attendance included FDA President, Dr. Rick Stevenson; Drs. Bert Hughes, Andy Brown, and Mark Romer. Dr. Isabel Garcia, Dean of the University of Florida College of Dentistry (UFCD), attended the meeting along with many UFCD students. Also in attendance were numerous dental assisting and dental hygiene students from Santa Fe Community College.

Nine out of 11 BOD members were present, which included: Dr. Bill Kochenour, chair; Dr. Leonard Britten, vice chair; Drs. Dan Gesek, Robert Perdomo, T.J. Tejera; and Joe Thomas; hygienists, Ms. Catherine Cabazon and Ms. Angie Sissine; and consumer member, Mr. Tim Pyle. Dr. Wade Winker and Mr. Anthony Martini were absent.

Dr. Kochenour gave a report on the American Association of Dental Boards (AADB). At its recent meeting in Chicago, this group discussed impaired practitioners and how different state dental boards handle this issue. Dr. Winker attended this meeting and spoke about Florida’s Professional Resource Network (PRN program) and the success the state has with this program. Dr. Winker also was nominated to the AADB’s Board of Directors. Furthermore, FDA member Dr. Eva Ackley was named president-elect of AADB. Congratulations to Dr. Winker and Dr. Ackley!

Ms. Cabazon, chair of the BOD Council of Dental Hygiene, gave an update on the actions taken by the Council at its May 18 conference call. The BOD approved the Council’s recommendation to lower dental hygiene licensure and renewal fees as recommended by the BOD Budget Task Force (Rules 64B5-15.006, 15.008, 15.009, 15.012. 15.0121). Ms. Cabazon also reported that the Florida Dental Hygiene Association (FDHA) has created a task force to look at Rule 64B5-2.0144, Licensure Requirements for Dental Hygiene Applicants from Unaccredited Dental Schools or Colleges, and make recommendations to update, streamline and condense the remedial course requirements. Currently, only one program in Florida offers the remedial course, Palm Beach State College, and it frequently cancels the course due to a low number of participants. This has led to hygiene applicants requesting waivers

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Board of Dentistry from the BOD to allow them to take the exam without completing the remedial course since the course is not available. The FDHA anticipates having its proposed rule recommendation to the BOD before its August meeting.

Mr. David Flynn, BOD attorney, gave an update on Rule 64B5-17.002, Written Dental Records: Minimum Content, Retention, which now is effective. He worked with the Joint Administrative Procedures Committee (JAPC) on their approval of the rule; specifically section (9) pro bono dental events. Mr. Flynn recommended seeking legislation that would put this subsection’s language into statute. After much discussion by BOD members, this issue was sent to the BOD Rules Committee for further discussion.

There were six disciplinary cases and four voluntary relinquishments at this meeting.

One voluntary relinquishment was that of Dr. Howard Schneider, a pediatric dentist from Jacksonville. Dr. Schneider was not at the meeting, but several members of the media were in attendance. If you have not yet attended a BOD meeting, it is suggested that you take the opportunity to attend and see the work of the BOD. It is much better to be a spectator than a participant in BOD disciplinary cases.

The next BOD meeting is scheduled for Friday, Aug. 21, 2015 at 7:30 a.m. EDT in Safety Harbor at the Safety Harbor Resort and Spa. The remaining BOD proposed meeting date for 2015 after the Aug. 21 meeting is Nov. 20. The location for the Nov. 20 meeting has not yet been noticed.

Upcoming BOD Meetings The next BOD meeting is scheduled for Friday, Aug. 21, at 7:30 a.m. EDT in Safety Harbor Resort and Spa. The remaining proposed meeting date for 2015 is Nov. 20.

Ms. Stoutamire can be reached at 850.350.7202 or cstoutamire@floridadental.org.

benefit

NUMBER

15

Helping Members Succeed It is really rare to see customer service anymore, so you are very much appreciated. Thank you for all that you do!

— Dr. Rebecca Benedict

Get to Know Your Membership Concierge Ms. Mortham advised me to be part of the Association so, together with other members, we can voice what is needed for all dentists and make Florida Dental Association become a stronger organization. Christine even wrote a personal note to thank me for working with her. Furthermore, Christine took an extra step by making the membership payment easier for my accounts payable supervisor in the office. That is top-notch customer service! — Dr. James T. Yang

CHRISTINE MORTHAM

Are you taking advantage of all the benefits the FDA and ADA offer? As your Membership Concierge, Christine gives her undivided attention to FDA members and future members alike. She has a wealth of information and can help direct you to the path of success. Call her with your questions!

800.877.9922 or 850.350.7136  cmortham@floridadental.org

House of Delegates

House of Delegates June 12-13, 2015

By FDA Staff

On June 12-13, the Florida Dental Association (FDA) House of Delegates (HOD) met in Orlando at the Gaylord Palms Resort and Convention Center. The HOD discussed many issues, including the following business.

Election of Officers The following officers were elected and installed during the June HOD meeting.

President: Dr. Ralph Attanasi

President-elect: Dr. Bill D’Aiuto

First Vice President: Dr. Mike Eggnatz

Second Vice President:

Dr. Rick Stevenson, 2014-2015 FDA president, brought Dr. Bert Hughes to the stage to recognize that the Florida Dental Convention (FDC) has grown by 10 percent compared to last year; 36.5 percent over the last five years; and that the convention had more than 7,000 attendees. Dr. Stevenson mentioned the FDA rebranding, the strategic plan and the work being done by the Bylaws Task Force, the Building Task Force and the Workforce Innovation Task Force, as well as the upcoming Florida Mission of Mercy (FLA-MOM) event that will be held in April 2016 in Jacksonville. Dr. Stevenson also asked Mr. Drew Eason, FDA executive director, to join him on stage to give a membership report. The HOD responded with a round of applause for the FDA winning six out of seven possible membership awards and for being the only state in our size category to show growth of 1%. Dr. Stevenson also thanked Mr. Scott Ruthstrom, FDA Services chief operating officer, for selling more than 9,000 policies for the ninth year in a row. In addition, Dr. Ralph Attanasi gave his address as the FDA’s incoming president.

Dr. Jolene Paramore

Secretary: Dr. Rudy Liddell

Speaker of the House: Dr. Ethan Pansick

Treasurer: Dr. Bryan “Tim” Marshall

Editor: Dr. John Paul

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17th District Trustee Report Dr. Terry Buckenheimer congratulated the FDA staff for its achievement at not only reversing the downward trend, but also actually increasing the FDA’s membership. He noted that Florida was the only state in the nation to have membership growth and now other states are seeking Florida out to see what we did right. Dr. Buckenheimer stressed that this is a period of unprecedented rapid change for organized dentistry due to issues such as Medicaid, licensure, the Affordable Care Act and community water fluoridation.

Report of the Board of Dentistry Chair Dr. Bill Kochenour thanked the FDA and its volunteers for regular attendance at the Board of Dentistry meetings. He stated the Board’s vision was to be the healthiest state in the nation. He also stated that the new records rule is now in effect.

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House of Delegates

Strategic Planning Task Group Recommendations for Councils and Committees The HOD changed the structure and mission of several councils and committees.

The Council on Dental Benefits and Care was sunsetted and a task force will be created when needed. The Council on Communications also was sunsetted and a task force will be created when needed.

Adoption of New Bylaws and Workgroups Manual The resolution said: RESOLVED, that the FDA adopt the proposed Bylaws and Workgroups Manual attached in the HOD

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agenda; provided, however, that amendments to the Workgroups Manual require a two-thirds vote of the BOT; and provided further, that the HOD can rescind the BOT changes to the Workgroups Manual by a simple majority vote of the HOD.

Date of Next House of Delegates Meeting The next HOD meeting will be Jan. 22-23, 2016 at the Tampa Airport Marriott.

HOD Direction The HOD also adopted a policy on campaign funding for ADA campaigns. It says: RESOLVED, that starting Fiscal Year 20152016, the FDA create an ADA Campaign Fund (a board-designated net assets fund) to provide financial assistance to FDA members running for ADA elective office and who are approved as candidates by

both the 17th District Delegation and the FDA HOD, and that $8,500 each fiscal year be budgeted for the ADA Campaign Fund, until such time as funding totals the sum of $34,000.

July/August 2015

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Commercial Real Estate

Alain Sabbah PARTNER AT CIRRUS CONSULTING GROUP DENTAL OFFICE LEASE NEGOTIATORS

Just as the dental office lease agreement is critical to your practice as a tenant, it is also equally important to your business when you own the building (or real estate) that you practice in.

A properly structured lease agreement between the practice and building is critical to maximizing the value of your practice

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and property, and will offer the protection necessary to support the future growth of both of your businesses.

Why Does the Lease Matter if I Own the Building?

Acquiring a commercial property is expensive and comes with certain liabilities.

As such, it is smart to acquire the property through a different company (legal entity) than your dental practice so that it’s not “the dental practice” that is buying the real estate. Therefore, there should be two separate companies: “Company A” (the building/landlord) and “Company B” (the practice/tenant).

Your dental office lease agreement will help separate the responsibilities and obligations between these two parties, and establish important details, such as how much rent you should pay each month and who will be responsible for paying for building repairs (operating costs) when they arise. Ensuring this ‘separation’ of the two assets maximizes the value of both businesses.

The Office Lease: Facilitating Your Practice Sale As a building owner and dentist, the appraised value of your practice will be determined by three main components: n the equipment n the goodwill (patients) n the dental office lease agreement

www.floridadental.org

Commercial Real Estate

Without a properly structured lease in place, you will face multiple challenges when the time comes to sell your practice.

It’s important that future buyers feel confident that the practice has a long-term lease already in place with fair and affordable terms that will support their success and provide them with the flexibility to run the practice and grow.

Leasing Items to Consider for Your Practice Sale n Term and Options: The lease should provide sufficient term and “options to renew” that are available to both you and future buyers. Often, language in the lease is written to prevent future tenants from exercising their options

www.floridadental.org

after the lease is transferred from one tenant to another. n Practice Assignment: The assignment language should support a smooth practice transition while providing protection to future buyers for their practice assignment. n “Use” Provisions: Customize the “use” and “associate” language to provide the flexibility for tenants to bring in associate dentists and practice alternative forms of dentistry in the space, enabling them to maximize their business and compete in the marketplace.

Creating a Lease to Drive Success By securing a lease that outlines these and other pertinent details, you will help secure both the future success of your property and your dental practice.

Alain Sabbah is a principal at Cirrus Consulting Group, a firm devoted to superior office lease negotiation and review services for dentists. Alain can be reached at 1.800.459.3413 or asabbah@cirrusconsultinggroup.com.

For more information about Cirrus, visit them online: www.cirrusconsultinggroup. com/lease.

July/August 2015

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benefit

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PROFESSIONAL STAFF I HELP MEMBERS SUCCEED by keeping them informed about industry news, as well as FDA happenings, through social media, e-newsletters, and editing content for Today’s FDA. I also help members navigate our classified advertising website and place display ads in Today’s FDA. — Jessica Lauria Communications & Media Coordinator

QUESTIONS ABOUT ADVERTISING IN TODAY’S FDA? 800.877.9922 or 850.350.7115 jlauria@floridadental.org

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MAKING CHANGES?

YOUR FDA STAFF IS “HELPING MEMBERS SUCCEED” EVERYDAY!

LET US KNOW! Call or email us to update your information.

Then, contact the Board of Dentistry! Florida statutes require practitioners to update profile information within 15 days after a change occurs.

Call 850.488.0595 or go to floridasdentistry.gov.

RETIRING? Retired members receive all the benefits at little or no cost! We want to make sure you receive the forms for retired membership. Call us for more details.

CALL OR EMAIL THE FDA MEMBER RELATIONS DEPARTMENT TO UPDATE YOUR MEMBER STATUS OR CONTACT INFORMATION. 800.877.9922 • fda@floridadental.org

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7/8/2015 1:54:25 PM

Claim Management 28

Today's FDA

By Lynne Leggett VICTORY DENTAL MANAGEMENT

One of the biggest complaints I hear from my clients is the amount of time it takes for insurance companies to pay claims. For the average practice, insurance payments represent approximately 50 percent of their generated income. Therefore, the length of time it takes to get paid for claims has a significant impact on your cash flow. The more time spent processing claims, the longer the negative impact to your cash flow.

Before I started my own consulting business, I worked as a practice administrator and have used several different companies to process claims. If your practice files claims on your patients’ behalf, make it a goal to get paid as soon as possible. This can be accomplished by using a vendor that specializes in claims management, which will enable you to manage the claims process faster and more accurately, and thereby improves your cash flow. Look for a vendor that provides the following capabilities: electronic eligibility, electronic claims, claim status, claim tracking, detailed reports, electronic remittance advice (ERA), Watchdog and patient statements.

There are several things you can do to reduce the time between submitting the claim and receiving payment. I suggest a daily review of the upcoming schedule and running an electronic eligibility report on every patient who has insurance. This is a simple report that ClaimX™ can run for you. It works by sending an electronic eligibility on every patient that has insurance from your appointment book in your practice management software. The report is run several days in advance of the appointment date. This way, your staff is armed with the knowledge of what insurance will pay and what the patient will owe for their visit.

This information will help your staff have intelligent conversations about treatment plans and increase case acceptance.

When the patient checks out, their claim should be sent electronically. If you are using a claims vendor that has real-time capability, please use this function so that you can collect what the patient owes to the penny at the time of service. By doing this, you’ll avoid spending any additional time or money sending a statement. ClaimX™ has two levels of claim validation checking that occur before the insurance company even receives the claim. This allows for the majority of claim errors to be corrected before submission.

Therefore, sending your claims correctly on the day of service — with no errors — will ensure you’ll receive payment from the insurance company in a timely fashion. By shortening this length of time, you are improving your cash flow.

July/August 2015

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Claim Management

After sending a claim, there may be times when you need to know its status with the insurance company. Your office policy may be to wait until the insurance pays the claim before sending a statement to the patient. By using a system like ClaimX™, which has real-time claim status checking capability, you will be able to use this function electronically and get the information needed within a few minutes of submitting the request.

From a cash flow perspective, it’s a great benefit to see when you can expect payment from an insurance company. Your practice also has the ability to have claims that are past their normal payment date highlighted so that your staff can spend their time on those claims instead of calling on all outstanding claims. The ability to spend less time on outstanding claims will save time and money for your office. This function is called claim tracking or Watchdog, depending on the claims vendor.

Using an ERA enables your practice to know which claims have been paid, as well as the amount. If you are sending secondary claims, having this information from the primary insurance will help you send your secondary claims faster, thereby getting paid from both insurance companies promptly.

I am a big proponent of making technology work for you and as a result, making your life easier. Once the insurance company pays their portion, the next step is creating a patient statement. By sending electronic statements, you are able to just click a button instead of wasting time stuffing envelopes. Don’t be concerned if you like to write notes on your statements. You will have this opportunity at the bottom of your statement to customize if needed. This ability also enables your office to send statements every day if patient owes a remaining balance. It’s a good business practice to post checks and send statements every day so that you shorten the payment time, thus improving your cash flow.

Managing your claims process effectively is one of the keys to improving your cash flow.

Knowing you have options with a company that focuses on this segment of your business is beneficial to a practice owner. Take the time to find the right vendor for you and your business goals.

ClaimX™ is an FDA Services Crown Savings Merchant. FDA Services has researched and vetted business solutions so FDA members can take advantage of exclusive deals and discounts offered through the Crown Savings program. Members who participate will save time, money and hassle, putting the focus back on patient care. ClaimX™ can be reached at 866.886.5113, Option 1.

www.floridadental.org

“

For the average practice, insurance payments represent approximately 50 percent of their generated income.

The more time spent processing claims, the longer the negative impact to your cash flow.

”

July/August 2015

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Going Paperless

Best Scanning Options for Dental Offices to Go Paperless

By Robert Fuchs MARKETING MANAGER PLUSTEK TECHNOLOGY

Going paperless makes it easier for your practice to become regulation compliant and your data becomes more manageable and accessible — boosting overall efficiency.

Here are some tips on how to pick the right scanner for your needs and scan your way to a digitized practice.

How Do You Get Started?

First, you need to either upgrade or choose a new electronic charting system. Do you want to continue the same trend of

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consuming your filing cabinets with paper folders? Today’s charting software saves you from creating more handwritten records.

The first step is to find the newest version of your existing practice management software, what it has to offer if you upgrade, and how to encourage staff and doctors to use the system.

Choosing the Required Hardware To go paperless, you have to scan your existing paper records and digitize incoming documents. The basic scanner you’ll need is a document scanner with an automatic

document feeder (ADF). Here are some terms you need to know when choosing an ADF scanner: m Simplex versus duplex: Simplex scans one side of a page while duplex scans both sides. m Dots per inch (DPI) or resolution: The higher the resolution, the more detail in the scanned image. However, you will never need to scan a document with resolution exceeding 300 DPI. m Color mode: This includes black and white, grayscale and color modes. In most cases, black and white, which produces a smaller file size, works best for most documents. www.floridadental.org

Going Paperless m Page per minute (PPM): PPM is used to measure scanning speed. If scanning both sides (duplex mode), then this is called images per minute (IPM). There are two images in a page in duplex mode. When shopping for a scanner, speed is the main factor on pricing — the higher the scanning speed, the higher the price. Scanning your back files will require a higher speed scanner. m Ultrasonic sensor: Many document scanners are equipped with an ultrasonic sensor to detect multi-feed by measuring the thickness of the fed paper.

If the thickness increases, it means the scanner pulled multiple pages at once or an object is pasted on the scanned paper. Some production scanners may have up to three sets of ultrasonic sensors, which allow users to exclude certain areas (such as where a photo was pasted on). Multi-feed detection is an important feature in a production scanning setting for a service bureau.

Back File Chart Scanning For back-file scanning, you may want to consider hiring a service bureau to scan your existing files, which costs around $0.06 per page (http://www.file2disc.com/ scanning-prices.html) depending on your requirements and volume. Most services require a minimal of 25,000 pages (about five boxes on average, holding approximately 5,000 pages per box). If you need fewer indexes and have more volume, you may negotiate a better price. You easily can spend thousands of dollars for scanning services. However, if you want to save some money, your best option is to do it yourself (DIY). Scanning is not complicated if you properly sort and prepare the documents before scanning.

If you decide to go for DIY, the best strategy is to have your employees process records ahead of each patient’s visit. Executing this www.floridadental.org

tactic, you will need a document scanner capable of scanning at least 80 PPM (Plustek PS456 for $849 or Fujitsu FI-7180 for $1,485 on Amazon). If your staff marks up file folders with notes, you may want to scan the whole folder by using a large format tabloid size document scanner ($1,699 Plustek SC8016 to $3,024 Kodak i3200 on Amazon). The alternative for scanning the notes on the folder is to buy a lower cost A3 flatbed scanner, such as Mustek A3 1200S for $169 or Plustek OpticSlim 1180 for $199.

Radiology Negative Scanning Here are some options for radiology negative scanning. If all your dental negatives are size 1, which is smaller than 1.18" (3 cm) x 1.57" (4 cm), and you do not need high quality images (e.g., for insurance companies), then you can purchase a “slide converter” for $49 (“Ultimate” side converter). Please note these inexpensive slide converters are designed for “slides” and can work for black and white negatives, too. If you have size 2 (1 ¼" x 1 5/8") and size 3(1 1/16" x 2 1/8") media, consider the Plustek F50 ($129). If you’re looking for luxury, the Plustek’s flagship Optic Film 120 ($2,000) is nice to have. However, if you personally own some aged films and you want them to be digitized, then Plustek’s Optic Film 120 is the best choice.

manually input the patient information, you will need capture software (like idCliQ from OCR Solution) to automate the data extraction process. Capture software can populate data to an electronic patient registration form and send the patient’s profile to a subscribed based “eligibilities service.”

Many people will just use a small footprint ID card scanner for new patient registration (such as Plustek D430 for $199 or Fujitsu ScanSnap S1300i for $252). However, you may consider a stand-alone scanner with a large touch screen that is capable of scanning cards and everyday paper documents (such as Plustek eScan A150 for $599 or Fujitsu ScanSnap N1800 for $1,399).

In addition, with proper integration, a large screen stand-alone scanner also can be used by new patients to fill out a registration form, or as a patient eligibility verification station (idCliQ from OCR Solution, subscription needed).

The Final Word Once your paperless system is established, you’ll never want to go back to traditional paper charting. Digitalizing makes your operation — including reimbursements — smooth. What else could be preventing you from going paperless today?

Happy scanning!

Daily Paperwork and ID Scanning Going paperless still means you will need to scan. Paperless really means “less paper.”

Since your patients, vendors and local authorities still use paper documents daily, scanning will be ongoing.

Most dental systems still generate paperwork during new patient registration and don’t have the capability to capture insurance/ID card text data. If you don’t want to

Robert Fuchs is the Marketing Manager of Plustek Technology. Respected as one of the world’s leading image solution providers, Plustek manufactures high-quality scanners and security surveillance products to buyers worldwide. In business since 1986, Plustek began as an original equipment manufacturer (OEM) for many large companies, creating an innovative array of products including: scanners, IP cameras, servers and imagingrelated devices. For more information, visit www.plustek.com/usa.

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Bank of America is a registered trademark of Bank of America Corporation. Bank of America Practice Solutions is a division of Bank of America, N.A. ©2015 Bank of America Corporation ARFDGLFJ | Flyer-0914-Dent | Rev. 02/15

Saving

Lives One at a

Swab Time 34

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Blood Cancer

By Jessica Lauria FDA COMMUNICATIONS AND MEDIA COORDINATOR

Imagine you could help cure millions of people suffering from blood cancer and other blood diseases with just one swipe of your hand.

It really is that simple.

Blood cancer is the third leading cause of cancer deaths in the U.S. and kills more children than any other disease.1 Approximately every three minutes, one person in the U.S. is diagnosed with a blood cancer,2 and more than 150,000 Americans are diagnosed with a blood cancer each year.3 Many patients fighting blood cancer and other blood diseases, like sickle cell anemia, can be saved with a bone marrow or stem cell transplant. Since only 30 percent of all patients are able to find a compatible bone marrow donor in their family, 70 percent must search for a match.4 Every year, nearly 13,000 patients need transplants using cells donated from an unrelated donor, and half will not find a match.4 These statistics are heartbreaking, but knowing there is a way to help brings some hope. Delete Blood Cancer DKMS is an organization seeking to do just that: they are dedicated to the mission of building a critical mass of bone marrow and blood stem cell donors for patients in need. Delete Blood Cancer DKMS was founded in 2004 and is the U.S. arm of DKMS, the German bone marrow donor center.

Many think the only way to donate includes a painful pelvic bone procedure, and it’s enough to turn them off to the idea of donating. However, it can be as simple as just donating blood. The cancer patient’s doctor selects the method that is best for that patient, and while the pelvic bone procedure may be necessary for certain patients, 75 percent of the time donating is performed by drawing blood stem cells.4 Registered donors are then added to the Be the Match® Registry, the United States’ official registry operated by the National Bone Marrow Donor Program®. Be the Match® uses cheek swab results to compile a registry of potential donors, which currently includes more than 11 million donors.

To be eligible to register, a person must be: q between 18 and 55 years old q in general good health q willing to donate to ANY patient q not already registered q living permanently in the U.S. q at least 4’10” and 110 lbs.

As a dentist, how does this involve you? Expanding the number of venues available to perform these swab tests has fallen in the dental profession’s lap. In addition to their medical knowledge, dentists are among the most trusted professionals, making them a “perfect match” to educate patients about becoming potential donors.

Dental practices are a great location for bone marrow registration due to the ideal bone marrow candidate demographic — healthy people between the ages 18 and 55, and from various races. The best donor-patient matches happen between those who share the same ancestry; having more ethnic diversity on the registry increases the chance of finding matches for all patients.

Delete Blood Cancer DKMS, with its partners the Michigan, Georgia and New York State Dental associations, recognized this and conducted pilot programs to register potential bone marrow donors in dental practices in their respective states. Participating dental practices have solicited their patients to join the bone marrow donor registry during routine dental hygiene appointments.

Becoming a donor registration site actually is quite simple and requires minimal training. Involve the entire dental staff to seamlessly incorporate donor registration, with little to no disruption to current practice procedure. Provide literature in the reception area. Have the front office inform patients as they check in that the practice is participating in a nationwide effort to increase the bone marrow donor registry, with the ultimate goal of providing lifesaving matches for blood cancer patients in need. The hygienist can ask if the patient would like to register and answer any questions about Please see SWAB, 37

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benefit

Helping Members Succeed

NUMBER

14

How are you managing your managed-care contracts?

Banish the confusion with this definitive reference for Florida dentists.

A FREE BENEFIT AVAILABLE ONLY TO FDA MEMBERS A thoroughly researched and referenced handbook written clearly in an easy-to-follow format.

Written by Graham Nicol, Esq., Health Care Risk Manager, Board Certified Specialist (Health Law) and the FDA’s Chief Legal Counsel

to e M t n a W u ? t Yo a h Sign W ok andbocts H ’s t s i a t Contr da Den A Florianaged-care on M aw) ealth L ol, Esq., ialist (H am Nic ec h p S ra G ed By ertifi Board C anager, W Risk M re LTH LA a C h N HEA Healt ION O T A IC L B IAL PU OFFIC ION’S OCIAT S S A L DENTA ORIDA THE FL

INSIDE: Chapter 1: The Basics: Types of Health Care Delivery Systems

Go to floridadental.org/signwhat

Questions? Call 800.877.9922

Chapter 2: The Basics: Types of MCO Models Chapter 3: The Basics: Types of Reimbursement Methods Chapter 4: MCOs & Other Types of Risk Chapter 5: How to Negotiate with MCOs Step by Step Chapter 6: Your Rights under Florida DMPO Contracts Chapter 7: Your Rights under Florida Health Insurance & PPO Contracts Chapter 8: Your Rights under Florida HMO Contracts Chapter 9: Your Rights under PLHSO Contracts Chapter 10: Fighting Back

Blood Cancer

“

In addition to their medical knowledge, dentists are among the most trusted professionals, making them a ‘perfect match’ to educate patients about becoming potential donors.

”

SWAB from 35

donating, with the dentist following up and answering any additional questions during the exam. The registration process takes just five minutes and includes an eligibility/ health screening, a registration form and cheek swab samples to collect cells for use in matching the donor with a patient.

Getting Started If you are interested in participating, contact Delete Blood Cancer DKMS at dental@ deletebloodcancer.org. A staff coordinator will reach out to you to discuss the process, provide training and materials, as well as promotional tools to help make your program a success.

How Much Does it Cost?

All materials required for the program, including registration kits, patient literature and promotional material are free of charge.

In addition, prepaid envelopes are supplied to mail in completed registration kits to Delete Blood Cancer DKMS.

www.floridadental.org

Alternative Ways to Help: q Donate money to support the initiative. q Host a drive for a day, a week, a month — it’s up to you. q Arrange a community-based drive. q Hold fundraisers to increase awareness. q Become a donor yourself and encourage staff to do the same.

By integrating the program into your dental practice, the opportunity to register donors is significant. The more donors the Be the Match® Registry receives, the better chance there is for patients to find a match.

One simple action gives hope for a cure, and when it gains momentum and in turn creates more action — you will be providing many blood cancer patients a second chance at life.

References: 1. http://www.pediatriccancergenomeproject.org/site/facts-childhood-cancer 2. Leukemia & Lymphoma Society 3. http://www.phrma.org/sites/default/files/ pdf/LeukemiaLymphomaOverview2013.pdf 4. http://www.deletebloodcancer.org.

Ms. Lauria is the FDA Communications and Media Coordinator and can be reached at jlauria@floridadental.org or 850.350.7115.

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benefit

NUMBER

Helping Members Succeed It’s the best reason to join the FDA! PR is a very friendly, low-key, nonadversarial process that looks out for the best interests of the dentist and the patient.

— Dr. Edward Daniel

The Peer Review Mediation Program settles disagreements between patients and dentists more economically and efficiently than the legal system and is available only to FDA members.

This program is free of charge.

FOR MORE INFORMATION 800.877.9922 • fda@floridadental.org www.floridadental.org/peer-review

benefit

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Helping Members Succeed

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ON L I N E

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24 HOURS a day • Free clinical & practice management CE Go to www.floridadental.org. Click Convention & CE. Questions? Call 800.877.9922 * These courses expire on 1/30/2016.

Compleat Dentistry

Expanding Your Scope of Practice Compleat dentistry is a slower-paced, deliberate style of dentistry, espoused by Pankey, Dawson and so many others, in which the dentist knows the patient well, knows the work, knows their own abilities and limitations, and uses this knowledge to take care of the patients who trust them with their care. The world will change, but the principles of compleat dentistry will remain the foundation of an exceptional practice. The spelling is an homage to Isaak Walton,

“

whose book, “The Compleat Angler,” was about so much more than fishing.

By Dr. Edward Hopwood

Are you stressed out because your waiting room barista just quit

The best way for a dentist to increase the scope of practice is to begin doing comp exams.

”

and you need to find a replacement ASAP? Did your second chairside pedicurist leave for sabbatical this month? Are you considering leaving your family next weekend to take a course in phrenology? Then we need to talk.

Many practices are finding open time on their schedule, resulting in a keen interest in increasing their scope of practice so that the dentist can not only stay busy, but also obtain some revenue from the increased busyness. This often translates into far-reaching disciplines such as Botox®, tattoo removal and all kinds of uses for a laser. I think it is unnecessary to step so far away from our field, as there are many ways to increase the scope of our practice within the realm of comprehensive dentistry.

A true complete exam, which takes about an hour of doctor time, is the hallmark of a comprehensive practice. I often suggest doing comp exams to dentists who find their practices are not busy enough. Their response is ironic: they explain that they don’t have time to do the exam. I suspect their real concern is that they are not able to charge enough for an exam in order to make it worthwhile. The best way for a dentist to increase the scope of practice is to begin doing comp exams. The exam provides the time to get to know the patient and

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Compleat Dentistry

identify any problems — and when the dentist gets good at it — identify why the problems

It’s interesting to talk to dentists who find

are occurring. Money lost in the time for the exam will be made up many times over with

their practices are “sooo slow” but have no

the treatment that will follow.

time to complete a comp exam or a diagnostic wax-up. These same dentists often

The magic occurs when we are able to identify why a problem has occurred. Again, a great

are searching far away from our profession

way to increase the scope of practice is to begin to ask, “Why?” Unfortunately, this too often

to find some niche in order to be busy and

is overlooked in modern dental practices. This tooth split and needs extraction; you can

make more money. The ironic part is that

replace it with an implant, bridge or partial. The missing link is why the tooth broke. A di-

they are not even maximizing their poten-

agnosis is not simply describing what happened, a diagnosis is explaining why it happened.

tial as dentists. In the past month, if you

Only after a proper diagnosis can proper treatment be recommended. If you think all split

find that you have made more apnea ap-

teeth are from old amalgams, you have a tremendous opportunity to increase the scope of

pliances than facebow transfers, then there

your practice.

is a tremendous opportunity to increase the scope of your practice — all within the

When you begin to ask why, you will naturally progress to a thirst for an improved under-

confines of regular dentistry.

standing of occlusion. This is not simply the “tap tap, mark it in red” occlusion of dental school, but the important occlusion in centric relation. This opens up many opportunities

My pursuit of a comprehensive practice

to increase the scope of practice. Proper centric relation occlusion often is readily obtained

began with a hope to do the “big cases.” I

in a properly fabricated and carefully adjusted night guard (I still make mine by myself in

soon came to realize that it’s impossible to

the lab). I can honestly say that fabricating night guards has been the best way for me to

do the big cases predictably and successfully

improve my understanding of occlusion.

without a comprehensive practice. What shocked me is how important comprehen-

But it gets better from there — some patients are so excited about having the proper occlu-

sive dentistry has been in my day-to-day

sion in their guard, they will beg you to make their teeth hit that way during the day. You

life. Big cases only come along once in a

will then need to be able to perform equilibrations, but you will be more confident in your

while, but this stuff can be applied to every

abilities because you have practiced on night guards. The current state of the art for equili-

patient. When every patient is evaluated

bration no longer relies entirely on grinding away tooth structure. There often is a need to

comprehensively and given an appropriate

add tooth structure. Fortunately, with the tools available to us, this does not mean full-

diagnosis, there is little need to go too far

mouth restoration. Often, addition to tooth structure can be conservatively accomplished

afield with the scope of practice in order to

with bonded resin. Of course, you’ll know how much to add by completing a diagnostic

stay busy and earn a healthy salary.

wax-up. Equilibration, functional bonding and diagnostic wax-ups are all ways of expanding the scope of practice for the average dentist.

Dr. Hopwood is a restorative dentist in Clearwater and can be reached at edward-

The above examples only pertain to occlusion. A complete exam also involves periodontal

hopwood@gmail.com.

evaluation. Statistics indicate there is a large portion of the population with untreated periodontal disease. A careful periodontal exam with a proper diagnosis will open up various avenues to help our patients. Almost always, periodontal disease and occlusal disease are synergistic, with disastrous consequences for the teeth and the smile aesthetics.

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CDT Code and Technology

Bitewing Images – Addressing the CDT Code and Technology Conundrum Today, extraoral imaging devices are capable of acquiring similar diagnostic information to those seen on multiple bitewings.

This image also may capture additional information — all by a single exposure taken on one extraoral receptor. How does a dentist document this procedure — is it a bitewing or bitewings, an extraoral image or what? Before answering the question, let’s look at the definition found in the American Dental Association’s (ADA) online Glossary of Dental Clinical and Administrative Terms: Bitewing radiograph: Interproximal radiographic view of the coronal portion of the tooth/teeth. A form of dental radiograph that may be taken with the long axis of the image oriented either horizontally or vertically, that reveals approximately the coronal halves of the maxillary and mandibular teeth and portions of the interdental alveolar septa on the same image.

With all this in mind, there is more than one Current Dental Terminology (CDT) code to consider: s D0270 bitewing – single radiographic image s D0250 extraoral – first radiographic image

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Both are consistent with the glossary definition, but is one more appropriate than the other? It depends. A bitewing (e.g., D0270), with the film or receptor placed in the oral cavity, is the well-known method for imaging posterior teeth. But what about patients who are not able to accept placement of an intraoral film or receptor? D0250 is more appropriate since the imaging media would be extraoral, as specified in this code’s nomenclature.

Some may disagree, saying the bitewing nomenclature does not limit it to intraoral imaging. No matter what CDT code is selected by the dentist, the choice must be supported by information and images placed in the patient’s records. There is a more elegant and specific solution on the horizon — a new code in CDT 2016 that dentists may use on patient records and claims — but we will have to wait until Jan. 1, 2016 before using it.

D0251 Extraoral Posterior Dental Radiographic Image Image limited to exposure of complete posterior teeth in both dental arches. This is a unique image that is not derived from another image.

The addition of D0251 is one of three interrelated changes to the extraoral imaging codes in CDT 2016. As illustrated below: D0250 is revised to clarify the procedure’s scope and methodology, so there is no overlap with D0251 and it is no longer a “…first...” image procedure; D0260 is deleted as it becomes redundant by the D0250 revision. Multiple D0250 images are documented on a claim using the “Qty” (quantity) field on the service line.

D0250 Extraoral – 2-D Projection Radiographic Image Created Using a Stationary Radiation Source, and Detector These images include, but are not limited to: lateral skull; posterior-anterior skull; submentovertex; waters; reverse tomes; oblique mandibular body; and lateral ramus.

CDT code maintenance requests from ADA members prompted these coming changes, and exemplify the importance of member participation in the CDT code maintenance process. For information about this and other CDT Codes, and how the CDT code set is maintained, go online (http://www. ada.org/en/publications/cdt/), email (dentalcode@ada.org), or call the ADA Practice Institute staff at 800.621.8099.

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Tooth Extraction

“

Use your written and radiographic records to verify (twice) the correct tooth or teeth to be extracted before picking up your forceps.

6.

7.

Tooth Extraction

Preventing Wrong Tooth Extraction

By Barbara Worsley, DMA, VICE PRESIDENT, PATIENT SAFETY, AND

Pamela Willis, BSN, JD, PATIENT SAFETY RISK MANAGER II

Extraction of the wrong tooth occurs with surprisingly high frequency and is, in most cases, preventable.

Always Document Why the Extraction is Warranted n Include subjective patient complaints and your own objective clinical findings (e.g., results of periodontal probing and radiographic findings). n Place any fax transmissions of updated treatment requests, updated emails or non-electronic records in the medical record. n Document a description of the tooth or teeth to be extracted (e.g., “upper right first premolar”) to circumvent possible errors in tooth numbering by referring providers.

Double-check the Tooth Number n Check the referral form letter and the copy of the X-ray films in the presence of the patient; confirm the correct tooth with your patient. n Physically confirm the tooth to be extracted. Touch the tooth in the patient’s mouth and ask for confirmation that it is the one the patient believes should be extracted. n Examine any appliance sent with the patient to be sure it matches up with the tooth to be removed. n Develop a standardized referral form to improve communication between the referring dentist and the surgeon. www.floridadental.org

n Insist that all referrals appear on the same form for consistency. Insist that both the name and number of the tooth or teeth be noted on a referral. n Remember that missing teeth may cause other teeth to shift and be misnumbered. n Don’t assume — contact the referring dentist if you have any questions about the extraction request and document the discussion.

Remain Cautious

Promote Safety Systems

n Identify any wrong-site tooth extraction as soon as possible to improve the patient’s clinical outcome and reduce your legal liability. n Disclose the event to the patient. The ideal disclosure also should include a simultaneous offer of a well-reasoned solution (e.g., implant, orthodontic movement or bridge) and a discussion regarding cost deferral. n Don’t leave it up to the patient to try to find a solution. n Contact your patient safety risk manager for assistance with our disclosure guidelines.

n Develop and use an extraction checkoff list incorporating The Joint Commission’s Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery™. n Use The Joint Commission’s Speak Up™ program to enhance your safety systems. (Its brochure, “Help Avoid Mistakes in Your Surgery,” is available at www.jointcommission.org/topics/ speakup_brochures.aspx). n Obtain a signed informed consent from the patient in advance of his or her appointment if possible. n Confirm that you have the patient’s informed consent to remove the specific tooth or teeth. n Ensure the consent is specific and does not simply state that “extractions will be performed.” n Extract only the specific tooth or teeth for which you have received consent. n Provide the patient with a mirror so you can both see what the planned procedure will entail.

n Use your written and radiographic records to verify (twice) the correct tooth or teeth to be extracted before picking up your forceps. n Encourage your staff to speak up if they notice any confusion or potential problems with tooth selection.

Be Proactive if Something Goes Wrong

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each health care provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

Reprinted with permission. ©2015 The Doctors Company (www.thedoctors.com).

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Diagnostic

Diagnostic Discussion

By Drs. Indraneel Bhattacharyya and Nadim M. Islam

A 63-year-old Caucasian female was referred to Dr. Michael Hashemian, an oral and maxillofacial surgeon in Spring Hill, Fla. for evaluation of an asymptomatic, swelling on the left lateral border of her tongue that was present for two years. She complained of an increase in size when the swelling touched her teeth. She also noted a recent increase in size of the lesion.

Intraoral examination revealed a fairly welldefined, firm, slightly mobile lesion measuring 1.5 x 1.5 cm (Fig. 1). Upon incision, a yellowish, well-circumscribed, nodular, firm mass (Fig. 2 and 3) extruded from the site, which was completely removed and submitted to the University of Florida Health Oral Pathology Biopsy Service for microscopic diagnosis. The lesions revealed a well-circumscribed encapsulated mass of cellular connective tissue with spindle cells arranged in a palisaded pattern (Fig. 4).

The patient’s medical history was significant for asthma and was being treated with a bronchodilator. Other medications included alprazolam, gabapentin, multivitamins, fish oil, ginger root and probiotics. She had no known drug allergies.

Fig. 1

Fig. 2

Fig. 3

What is the most likely diagnosis?

A. Lipoma B. Granular Cell Tumor C. Fibrous Hyperplasia/Scar E. Traumatic Neuroma F. Schwannoma Please see DIAGNOSTIC, 48

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Fig. 4

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Diagnostic DIAGNOSTIC from 47

Diagnostic Discussion A. Lipoma Incorrect. Excellent choice! Based on the yellowish color, well-circumscribed nature of the lesion and age of the patient, this entity is on the top of the differential diagnoses list. Lipomas are common benign tumors of adipose tissue, but are distinctly uncommon in the oral cavity. However, based on the texture and location, lipoma is an unlikely diagnosis in this case. Typically, lipomas occur on the trunk and proximal portion of the extremities. Since most lesions occur in adults 40 years or older, this patient’s age is appropriate. Oral lipomas account for 1-4 percent of all lipomas.

Intraorally, lesions are smooth, yellowish and soft, seen most frequently on the buccal mucosa or buccal vestibule. Tongue, lips and floor of the mouth are less common sites. Multiple head and neck lipomas are seen in neurofibromatosis and Gardner’s syndrome. Obese people are more prone to lipomas; however, if calorie intake is decreased, the lesion does not decrease in size. Conservative surgical removal is the treatment of choice, and these lesions rarely recur.

B. Granular Cell Tumor Incorrect. Another excellent choice! Based on the age of the patient and location of the lesion, this was our first choice as well.

However, given the clinical appearance and the extremely well-circumscribed nature of the lesion, granular cell tumor was not foremost on the differential list. Granular cell tumor is an uncommon, benign soft tissue tumor of uncertain derivation. It is thought to arise from either Schwann cells or neuroendocrine cells. They occur during 40-60

48

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years of age and with more than 50 percent of all granular cell tumors occurring in the tongue. Tongue lesions most often occur on the dorsal surface. They also are reported to occur in other sites, such as buccal mucosa, labial mucosa or oropharyngeal tissue.

Clinically, it appears as a solitary, pink to yellow painless, sessile, long-standing nodule that is less than 2 cm in diameter. These lesions tend to be less well-circumscribed and insinuate between skeletal muscle and other tissues of the tongue. Microscopically, granular cell tumors consist of large polygonal cells containing a distinctly granular and somewhat basophilic cytoplasm with small, rounded nuclei. They are arranged in a syncytium with indistinct cell outlines.

Lesions typically are treated by conservative surgical excision. Recurrence is seen in less than 7 percent of cases.

C. Fibrous Hyperplasia/Scar Incorrect. Good choice! Fibrous hyperplasia may be considered given the age of the patient and the history of the lesion touching the patient’s teeth. Fibrous hyperplasia, fibroma or a hyperplastic fibrous scar are, however, generally well-circumscribed nodular growths with a positive history of trauma to the area. Fibroma or fibrous hyperplasia occurs as a result of fibrous connective tissue hyperplasia in response to local irritation or trauma, which was not obtained in this case. It is the most common soft tissue “tumor” of the oral cavity. These are not considered to be true neoplasms but represent a reactive lesion as mentioned before. Buccal mucosa along the bite line is the most common site followed by labial mucosa, tongue and lips. The lesion typically appears as a smooth-surfaced, sessile, asymptomatic, firm, mucosa-colored nodule seen typically during 40-60 years of age. Females are twice as likely to develop this reactive lesion. Pain may occur due to secondary trauma and

ulceration. Most fibromas are 1.5 cm or less in diameter. Microscopically, they consist of a nodular aggregate of dense, relatively acellular collagen fibers interspersed by occasional blood vessels. Treatment consists of conservative surgical excision. Recurrence is extremely rare.

D. Traumatic Neuroma: Incorrect. Based on the location, this is a fairly good choice. However, many traumatic neuromas are associated with an altered nerve sensation ranging from pain to anesthesia. This patient was asymptomatic. Traumatic neuromas arise after transection or damage of a nerve bundle. After the nerve bundle is damaged, regeneration is attempted by the proximal portion in an attempt to re-establish innervation with the distal end by axons through a tube of proliferating Schwann cells. During this regeneration, if scar tissue is encountered, a nodular lesional mass develops at the site of injury. Lesions are typically smooth-surfaced and non-ulcerated with a predilection for the mental foramen area, tongue and lower lip. They most often are seen in middle-aged patients. Microscopically, traumatic neuromas demonstrate a proliferation of nerve bundles interspersed with dense fibrous connective tissue with variable inflammation and vasculature.

Intraosseous traumatic neuromas present as radiolucent defects. Treatment consists of surgical excision. Lesions usually do not recur.

E. Schwannoma Correct! A great choice based on the location (tongue), asymptomatic and well-circumscribed nature of the lesion.

However, these lesions are seen most commonly in young- and middle-aged patients.

Schwannoma, also called neurilemoma, is an uncommon benign neoplasm of Schwann cell origin that arises in associa-

www.floridadental.org

4

4.

Diagnostic tion with a nerve trunk. Up to 45 percent of schwannomas are present in the head and neck. Lesions are slow-growing, asymptomatic and lesions ranging in size from a few millimeters to several centimeters. There is no gender predilection. Pain may arise in some instances. Though they may occur anywhere intraorally, the tongue is the preferred site. Intraosseous lesions present as unilocular or multilocular radiolucent expansile lesions most common in the posterior mandible. Multiple painful lesions are seen in schwannomatosis as a result of mutation of the SMARCB1 gene on chromosome 22. Bilateral schwannomas of the auditory nerve are a characteristic feature of neurofibromatosis type II, an autosomal dominant condition caused by mutation of a tumor suppressor gene on chromosome 22. Microscopically, the majority of schwannomas are encapsulated. Lesions are composed of alternating regions consisting of compact spindle cells called Antoni A areas, and loose, hypocellular zones called Antoni B areas. This lesion demonstrated the classic Antoni A areas with aggregates of spindle cells (Verocay bodies) arranged in a palisaded manner with cleared amorphous zones in the center of the aggregates (Fig. 4). The capsule is clearly visible on the left image and Verocay bodies are seen on higher magnification on the left side. The

benefit

NUMBER

16

ONLINE CE: THE EASY WAY

proportions of these components, Antoni A and Antoni B, in a given tumor vary.

Surgical excision is the treatment of choice.

Recurrence does not occur. Malignant transformation is extremely rare.

important, new and challenging oral diseases.

References: 1. Wright BA, Jackson D. Neural tumors of the oral cavity. Oral Surg Oral Med Ora Pathol 40:509-522, 1980.

2. Colreavy MP, Lacy PD, Hughes J et al.

Head and neck schwannomas- a 10year review. J Laryangol Otol 114:119-124, 2000.

3. Merker VL, Espaeza S, Smith MJ, et al.

Clinical features of schwannomatosis: a retrospective analysis of 87 patients.

Oncologist 17:1317-1322, 2012.

4. Hoa MSlattery WH 3rd. Neurofibromatosis 2. Otolaryngol Clin North Am 45:315-332, 2012 5. Ellis GL, Abrams AM, Melrose RJ. Intraosseous benign neural sheath neoplasms of the jaws: report of seven new cases and review of the literature. Oral Surg Oral Med Oral Pathol 44:731-743, 1977.

Diagnostic Discussion is contributed by UFCD professors, Drs. Indraneel Bhattacharyya, Nadim Islam and Don Cohen, and provides insight and feedback on common,

Dr. Bhattacharyya

Dr. Islam

The dental professors operate a large, multi-state biopsy service. The column’s case studies originate from the more than 10,000 specimens the service receives every year from all over the United States.

Clinicians are invited to submit cases from their own practices. Cases may be used in the “Diagnostic Discussion,” with credit given to the submitter.

Drs. Bhattacharyya, Islam and Cohen Dr. Cohen can be reached at ibhattacharyya@dental.ufl.edu, MIslam@ dental.ufl.edu and dcohen@dental.ufl.edu, respectively.

EARN FREE CE CREDIT

“DIAGNOSTIC DISCUSSION.” Visit the FDA website and click the “Online CE” button for this free, members-only benefit.

Be sure you are logged in to the members-only side of www.floridadental.org.

You will be given the opportunity to review this column and its accompanying photos, and will be asked to answer five additional questions.

Questions? Contact FDC Meeting Coordinator, Brooke Mills at bmills@floridadental.org or 800.877.9922.

* These courses expire on 7/31/2016.

TFDA_0815_DiagnosticDiscussionCE.indd 1 www.floridadental.org

July/August 2015

Today's FDA6/10/2015 49

3:54:04 PM

FDA Services welcomes ...

Mike Trout as our new North Florida Director of Sales.

North Florida members can contact Mike for any of their insurance needs.

Contact Info: Phone: 904.254.8927 Fax: 850.681.7737 Mike.Trout@fdaservices.com

Leadership

The Wolves Within

By Deanna M. Goodrich, RDH EXECUTIVE COACH, FORTUNE MANAGEMENT

Leadership is a big word with a broad, deep and pervasive meaning. You know it when you see it, and you know when it is missing.

To help understand the powers of leadership, let’s look at a Native American tale about a Cherokee man who was teaching his grandson about life. He said, “A fight of leadership is going on inside of me. It is a terrible fight between two wolves. One wolf represents pessimism: fear, anger, envy, sorrow, regret and superiority. The other wolf stands for optimism: joy, peace, love, hope, generosity, truth and compassion.”

As the little boy listened to his grandfather speak about this terrible conflict, he asked, “Which wolf will win?” The grandfather simply replied, “The one that I feed.”

Feeding the optimistic wolf begins with YOU! Choose to enlarge your vision. Where are you now and where would you like to be?

We all can relate to leaders such as Mahatma Gandhi, Nelson Mandela, Mother Teresa and Martin Luther King Jr. The common thread here is they had strong principles and solid beliefs. They had an ability to influence others through hope and optimism by creating a cause that others could relate to.

Attract the good around you. Hire a world-class team. Your team is your best asset. Leadership is less about doing and more about being for others. John Quincy

www.floridadental.org

“ ”

Feeding the optimistic wolf begins with YOU!

Adams, the sixth President of the United States, stated: “If your actions inspire others to dream more, learn more, do more and become more — you are a leader.”

Step forward every day. Create daily goals for the mind/body/spirit. The power in setting goals shows in happiness and in achieving financial rewards. Did you know that by writing and sharing goals with a trusted person multiplies your chances of success by three times?

Prepare for success. Attend continuing education opportunities, get involved with a mastermind group, and surround your self with ideas and innovative minds. We know what we know, but opportunities lie in what we don’t know.

Believe in yourself. What if you had no limiting beliefs or there was no meaning attached to the word fear? How would this change your life, your practice and your relationships? Man is what he believes — believe in yourself.

Plan before you do. There are five steps to create massive results: w Define the gaps. w Determine what the end project looks like. w Create a plan and act. w Measure the results. w Refine the plan (sometimes a tweak is all that is required to fulfill the goal).

Ask questions and question everything. The most basic of all human needs is the need to understand and be understood.

Move outside your comfort zone. Get comfortable with being uncomfortable. “If we keep doing what we’ve always done, we will keep getting what we already have.”

Begin with the end in mind: imagine if you and your team were stranded on an island and the only way to safety was to build a ship. Would it be wise to assign tasks of how to collect the wood, plan the design and build the ship? Or would it be wise to inspire your team to long for freedom, safety and courage?

This is leadership, and the end begins with YOU. For a complimentary leadership analysis, please contact Executive Coach for Florida, Michelle Amiel at michelleamiel@fortunemgmt.com or 561.702.5459.

Deanna M Goodrich, RDH, is an Executive Coach for Colorado, and can be reached at Deannagoodrich@fortunemgmt.com.

July/August 2015

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FADH

Florida’s Action for Dental Health Continues to Improve the Oral Health of Floridians

“

As the FDA moves forward in our efforts to support FADH, we encourage members to share their ideas and input on these issues and additional opportunities to achieve our goals.

”

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From left to right: Dr. Andy Brown, 2016 FLA-MOM Co-chair, Mrs. Jerilyn Bird, FDA Alliance President and Dr. Richard Stevenson, 2016 FLA-MOM Co-chair.

Mrs. Bird presented a $4,000 check from the Alliance of the FDA to the 2016 FLA-MOM event at the 2015 Florida Dental Convention.

www.floridadental.org

FADH

By Joe Anne Hart FDA DIRECTOR OF GOVERNMENTAL AFFAIRS

In February 2015, the Florida Dental Association (FDA) launched Florida’s Action for Dental Health (FADH) to help improve access to oral health for all Floridians. This comprehensive initiative is focused on three primary objectives: 1. Promote attainable dental care for the uninsured and under served in Florida.

2. Collaborate to maximize use and capacity of the current dental workforce to optimally serve Floridians with preventive and therapeutic dental care.

3. Expand opportunities for public health dentistry to serve Floridians.

The FDA is collaborating with many stakeholders and working daily to address and solve our state’s oral health access problems. As we near our six month milestone from the launch of FADH, the following are some key successes achieved to date in support of these objectives.

Collaboration with Stakeholders to Support and Expand Volunteer Safety Net Programs in Florida During the June 2015 House of Delegates meeting at the Florida Dental Convention, Mrs. Jerilyn Bird, President of the Alliance of the FDA, presented a $4,000 check to the FDA Foundation in support of the 2016 Florida Mission of Mercy (FLA-MOM) event scheduled for April 22-23 in Jacksonville. As we seek to promote attainable dental care for the underserved, a key strategy is to support and expand volunteer safety net programs. The FDA appreciates the Alliance’s support and the participation of their members in volunteering at the 2016 FLA-MOM.

Community Dental Health Coordinator Curriculum Established at Mattia College As the FDA seeks to maximize use and capacity of the dental workforce to serve Floridians, another key strategy of FADH is to establish ADA-designed Community Dental Health Coordinator (CDHC) education programs at dental, dental assisting and dental hygiene schools in Florida. By completing this curriculum, dental team members can be certified as CDHCs and help bring more Floridians into the oral health system. On Aug. 29, Miami’s Mattia College will become the first dental education program in Florida to integrate the CDHC curriculum through collaboration with the FDA and ADA. The FDA recognizes Mattia College for their commitment to improving the oral health of Floridians.

Please see FADH, 55

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FADH

FADH from 53

Medicaid Dental Care Reinstated for Foster Children in Eight Counties Through the promotion of FADH, the FDA was the featured guest on “Perspectives,” an hour-long talk and call-in program on WFSU-FM (Tallahassee’s NPR station). During this interview, we received a call from a concerned parent who was unable to secure dental care for his foster children. The FDA took this concern to the Florida Department of Health (DOH), resulting in a contract agreement with Dental Health & Wellness to provide dental care to foster children in Jefferson, Leon, Madison, Marion, Suwannee, Taylor, Volusia and Wakulla counties. We applaud the DOH and Dental Health & Wellness for their continued partnership to improve access to dental care.

These are just a few of the great initiatives being implemented through the efforts of FADH. As the FDA moves forward in our efforts to support FADH, we encourage members to share their ideas and input on these issues and additional opportunities to achieve our goals. We would like to hear from you about the issues facing your communities and any examples of how these issues have been addressed.

Interested in learning more about opportunities to support FADH? Contact a Workforce Innovation member from your component to share your feedback and join us in improving the oral health of all Floridians.

Workforce Innovation Task Group l Dr. Jolene Paramore, Chair – NWDDA jparamore@bot.floridadental.org l Dr. Terry Buckenheimer – WCDDA tbuckenheimer@bot.floridadental.org l Dr. Bill D’Aiuto – CFDDA bdaiuto@bot.floridadental.org l Dr. Kim Jernigan – NWDDA kjernigan@bot.floridadental.org l Dr. George Kolos – ACDDA gkolos@bot.floridadental.org l Dr. Rodrigo Romano – SFDDA rromano@bot.floridadental.org l Dr. Barry Setzer – NEDDA bsetzer@bot.floridadental.org

www.floridadental.org

l Dr. Jim Antoon, Consultant – CFDDA jantoon@bot.floridadental.org

l Dr. Don Ilkka – CFDDA dilkka@bot.floridadental.org

l Dr. Ralph Attanasi, Consultant – ACDDA rattanasi@bot.floridadental.org l Dr. Mike Eggnatz, Consultant – SFDDA meggnatz@bot.floridadental.org

l Dr. Cesar Sabates – SFDDA fdacesar@gmail.com

l Dr. Rick Huot, Consultant – ACDDA rhuot@bot.floridadental.org

l Dr. Rick Stevenson – NEDDA rstevenson@bot.floridadental.org

l Mr. Bob Macdonald l Dr. Rick Stevenson, Consultant – NEDDA executive.director@flpdmpfoundation.com rstevenson@bot.floridadental.org

Sub-workgroup on Elder Care

Ms. Hart can be reached at 850.350.7205 or jahart@floridadental.org.

l Dr. Nolan Allen, Chair – WCDDA nallen2@tampabay.rr.com l Dr. Terry Buckenheimer – WCDDA tbuckenheimer@bot.floridadental.org

July/August 2015

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FDC2015

FDC 2015 Go to https://flic.kr/s/aHskdntx2Z to view all FDC2015 photos.

All photos taken by: Dr. Tony Wong, Larry Darnell and Jill Runyan.

C

FDC2015

FDC2015

FDC2015

Dental Staff

Seeking Opportunities to Expand Focus

By Paige Anderson, RDH

For example, the conversation could start

Sometimes, casual conversation with pa-

during a review of a patient’s medical his-

tients will reveal opportunities to educate.

The importance

tory. Upon seeing that a patient is diabetic,

Patients love to tell stories about their ba-

of the connection

a dentist or hygienist could explain how

bies or young children. I always try to work

between oral and

elevated blood sugar levels can, in turn,

oral care for children into that conversation,

systemic health

elevate the sugar content in their saliva and

and make the parents aware that their little

is well estab-

make them more prone to decay. Likewise,

one should see a dentist shortly after their

lished. However,

a discussion on the impact of periodontal

first tooth erupts, and then regularly as

despite mounting

pathogens on the pancreas could be appro-

prescribed by the dentist from then on. This

evidence on the

priate. If a patient is pregnant, or trying to

also is a great opportunity to motivate my

correlation be-

become pregnant, a clinician should start a

patient to floss. After all, your little one is

tween periodontal health and overall well-

discussion of pregnancy-induced gingivitis

more likely to take care of their teeth if they

being, the general public still does not seem

and its causes, or the risk of preterm labor

have a good example to follow. In addition,

to grasp these connections. After all, we

for pregnant women with periodontal

I let them know that oral bacteria are trans-

would expect to see much more compliance

disease.

missible to their children, so the cleaner

with flossing if they did. The volumes of

their teeth are, the healthier their children’s

research demonstrating a clear link between

A clinical exam also can provide many

oral health and heart disease only now is

opportunities to discuss these topics. Does

becoming mainstream knowledge. How can

your patient present with thick or bub-

However you choose to incorporate

we help improve general awareness of the

bly saliva? Encourage them to stay better

expanded focus into your daily practice,

multitude of other links between oral and

hydrated and explain how insufficient

the most important factor is keeping your

systemic health?

hydration adversely affects saliva quality

eyes open for opportunities to educate and

teeth are likely to be.

and, in turn, increases risk for caries. Here

inform. In this way, dental professionals can

By incorporating deeper patient education

in sunny Florida, proper sun protection is

elevate the dental IQ of an entire popula-

into our daily practice, we can help push

sadly neglected by many residents. If you

tion, and thereby add value to our chair

new research into the mainstream, thereby

notice sun damage to your patient’s lips or

time — and hopefully compliance in our

helping the general public become more

ears, feel free to encourage them to wear

patients.

aware of the importance of their oral health.

sunscreen with a high SPF and discuss the

There are many opportunities for introduc-

risks of melanoma on labial tissue.

ing these ideas into our appointments.

www.floridadental.org

Ms. Anderson is a dental hygienst and can be reached at rdhwriterpaige@gmail.com.

July/August 2015

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61

Letter to the Editor

Is Dentistry Already Succumbing to the “New Normal”?

By Dr. Carlos A. Sanchez

5. Since when did it become the primary

and is unable to stop this downward spiral

mission of a dental program to train

afflicting our profession. The Federal Trade

At the House of Delegates (HOD) meeting

students to become employees of Med-

Commission (FTC) has made it clear they

held during the Florida Dental Convention,

icaid or corporate masters?

will go after us if we press the issue, but Big

we heard reports from the deans of Florida’s

Insurance has the protection of McCarran-

three dental schools, beginning with the

While it was good to know LECOM grads

Ferguson and can collude, profile, exclude,

dean of LECOM. There wasn’t time set

had an excellent pass rate on the board

price fix, etc. to their heart’s content. At

aside to ask any questions; however, here

exam, there’s a lot more to successfully

every HOD we hear how the American

are the ones I would have loved to have

practicing dentistry than passing an exam.

Dental Political Action Committee has

asked LECOM’s dean, Dr. Anton Gotlieb.

I’ve taken issue in the past with schools for

been trying to repeal it for many years. So

cutting corners with clinical faculty that

far, all we’ve received from Washington,

haven’t even passed the National Boards

D.C. is a combination of lip service and

instructors to teach subjects like endo,

Part 1. What we heard from LECOM isn’t

Lucy pulling the football away from Charlie

perio, oral and maxillofacial surgery,

merely cutting corners — it’s knocking

Brown. Big Government is hell-bent on do-

pediatric and implant dentistry?

down foundations! I truly feel for the un-

ing to dentistry what they’ve already done

suspecting graduates who don’t know what

to medicine, optometry and pharmacology.

they don’t know, especially the fact the mar-

We also heard from the ADA’s first vice

ketplace will sort them out without mercy

president, Dr. Jonathan Shenkin, who told

or compassion. One of my colleagues spoke

us the news on membership numbers is

to a LECOM student who told her — in no

not good across the entire nation. Must we

uncertain terms — she had no aspirations

ask ourselves why? The American Medical

of ever having her own practice, was fine

Association has a well-deserved 20 percent

being an employee and readily accepted

market share … how much longer before

dental therapists as part of the dental team.

we end up there? The ADA has taken on

While it’s the right of any dentist to decide

insurance carriers in court, maybe we need

where they work and what kind of profes-

to take on the FTC. Now, that would really

sional life they will pursue, the schools

skyrocket our membership numbers!

1. Where are the indispensable specialist

2. Why was so much invested in a “state of the art facility” that still necessitates farming out your students to numerous places, including Erie, Pa.?

3. What type of real-world experience do students get when they depend on a mannequin (however “bionic” it may be) for the lion’s share of clinical procedures?

4. How is a period of “intensive training” for D-1s to make dentures for patients any better than denturism, something Florida roundly rejected in the 1990s and sent packing, never to return until LECOM rebranded and repackaged it?

should aim high, not for the lowest common denominator.

Dr. Sanchez has a practice in Coral Gables and can be reached at sancheztooth@bell-

Meanwhile, the American Dental Associa-

south.net.

tion (ADA) has only two seats on the Commission on Dental Accreditation (CODA)

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July/August 2015

www.floridadental.org

C lassified A dvertising

Opportunities

64

The FDA’s online classified system allows you to place, modify and pay for your ads online, 24-hours a day. Our intent is to provide our advertisers with increased flexibility and enhanced options to personalize and draw attention to your online classified ads!

The FDA online classified ad model is for “paid online advertising.” Effectively, the advertising rate you pay will entitle you to online classified ads with increased exposure. As an added benefit, we will publish the “basic text” format of paid, online classified ads in our bimonthly printed journal, Today’s FDA, at no additional cost to you. All ads posted to the online classified system will be published during the contracted time frame for which you have posted your online classified advertisement.

Our magazine is published bimonthly, and therefore, all ads currently online will be extracted from the system on roughly the following dates of each year: Jan. 15, March 15, May 1, July 15, Sept. 15, Nov. 15. The ads extracted at this time will then be published in the following month’s issue of Today’s FDA. Please view the classified advertising portion of our website at http://www.floridadental.biz/.

Today's FDA

July/August 2015

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Established in 1975 in Aventura, Coral Springs, Delray Beach, Boynton Beach, Stuart, Ft. Pierce and Melbourne. Call: Kelly Oliver 954.461.0172. Fax resume to: 954.678.9539. Email: careers@dentaland.net.

POSITION DESIRED: ORTHODONTIST – Seeking FT/PT locum tenens position (temporary professional) Member of ADA, AAO, Certified, licensed specialist.

Experienced, personable, good sense of humor, managerial, and organizational skills, can consult, treat your patients in your office. Successful in drawing patients; experienced in young patients starting at 7 yrs. Willing to travel. Per diem open. Please contact: johnmaria7@yahoo.com, or call 305.932.3584.

Dentist associate/partner wanted. Beautiful, modern, buildout. Part time initially. Fast growing Port St. Lucie area, Treasure Coast. Associate leading to quick partnership. No investment needed. Compensation is 45 percent collections & partnership. Excellent opportunity for aspiring dentist who’d rather be an owner. 561.632.6332.

POSITION DESIRED: Associate. I am a general dentist looking for associate position in Naples/fort Myers area. 30 years’ experience in all phases of general dentistry with focus on full mouth. Reconstruction and veneers. vdolce25@aol.com.

Kool Smiles. Associate Dentist Positions – FT/ PT opportunities in AR, AZ, CT, DC, GA, IN, KY, LA, MA, MD, MS, NM, OK, SC, TX, VA!!! UP TO $70,000.00 SIGN-ON BONUS + RELOCATION!!!

EARN UP TO $650 DAILY GUARANTEE OR % OF COLLECTIONS!!! We are the nation’s leader in general dental care to underserved kids, teens, and adults. For more info contact our recruiters today at http://www. koolsmilesjobs.com/connect!

Looking For Associate Destin, FL. By way of introduction, my name is Dr. Olivier Broutin and I practice in the Destin area. We’re looking for a doctor to work in our practice. We have a thriving practice and we need help! We are creating a great opportunity for someone who wants to treat people. We’ll handle the marketing, new pt generating and management hassle. We offer great income potential, excellent working conditions and training. We have all the latest high tech equipment, including CEREC and CBCT. We think we have it all! If you would be interested please email us your resume to OBDMD1@gmail.com.

www.floridadental.org

Oral surgeon wanted. Longstanding oral surgery practice with excellent reputation seeks associate leading to partnership in Southwest Florida coastal community on the Gulf of Mexico. Great school systems in family oriented community with a large network of referral dentists. All phases of oral surgery available to BCBE surgeon. Contact gatormom143@ me.com.

GENERAL DENTIST- TAMPA/ CLEARWATER. Looking to hire enthusiastic dentist FT/PT. Flexible hours w/well-trained staff. State-of-the-art facility, fully computerized. High income potential doing what you enjoy. Fax resume 813.886.5559.

Endodontic Position available. Established Endodontic office in need of FT/PT Associate with Buy-in opportunity. Tampa area. Please send CV to chris@ cpendo.com or fax to 813.374.9048.

General Dentist and Specialist Openings for Multiple Offices. General Dentists and Specialists. Grow with us: Large intimate group practice seeks experienced, highly-productive General Dentists and Specialists for busy growing general and multi-specialty practices.

Gentle Dental Group operates 29 large, well-established practices in Broward, Palm Beach, Dade, and the Treasure Coast with new practices on the horizon in the Orlando Market. Our beautiful and modern facilities are in premium locations and state-of-the-art equipment and digital X-rays with a supportive staff and professional management team. Cash, private, and insurance. Highest compensation in industry. Full schedules, excellent benefits, malpractice insurance reimbursement, and CE. www.GentleDentalGroup.com.

Call Bradford Cabibi, Doctor Recruiter: 561.999.9650, ext. 6146. Fax or email CV to: 561.526.2576 or bcabibi@ gentledentalgroup.com.

Dynamic Dental Health Associates of FL and Dynamic Dental Partners Group (DDPG), a new private fee-for service group, is growing and expanding rapidly. Top Compensation, daily guarantee, health insurance, modern facilities with latest technology, great patient flow, no administrative headaches and professional mgmt. We also buy dental practices and create exit/ transition strategies for solo and group practices. If interested in selling your practice, please email Marvin Terrell (President/COO) at MTerrell@ddpgroups.com.

If interested in a General Dentist position, please email your CV to Jeff Hokamp at jhokamp@ddpgroups.com or call 941.312.7838. Current openings in Gainesville, Jacksonville and St. Petersburg. We are offering a $5,000 signing bonus ($2,500 at start and $2,500 after 6 months) for the full time positions. Please don’t hesitate to send your CV if interested in other areas in FL. General Dentist Associate Position Available In Orlando – Lake Nona Area! Seeking an experienced highly motivated associate with exceptional clinical and communication skills. Must be a goal oriented self-managed leader who loves to learn. We are looking for a long term candidate to work with our exceptional dental team. Practice is completely computerized and paperless with equipment such as Cerec and Galileos CT Scan, laser, digital X-rays and intraoral cameras. identistry@gmail.com.

Endodontic Associate Christie Dental is a multispecialty dental group with approximately 55 dentists and specialty doctors in nearly 20 practice locations in the Brevard and Ocala Florida area. Christie Dental offers individuals and families a full range of dental care, including general dentistry, hygiene and specialty care, such as pedodontics, oral surgery, endodontics, orthodontics and periodontics. We currently have a part time opportunity for an Endodontist to join our team in the Ocala, FL one day per week. This is a great opportunity to supplement your schedule and we expect this to grow! Contact Kate Anderson by email: kateanderson@amdpi.com or 781.213.3312.

FLORIDA – Orlando/Daytona Beach/Jacksonville/ Tampa/Sarasota regions: Join our 60 office group practice. Flexible schedule. Top salaries. Training and mentoring for new/recent graduates. Both General Dentists & all Specialists needed. Fully digital offices. Call Dr. Andrew Greenberg 407.772.5120 (confidential), fax CV to 407.786.8763, visit www. greenbergdental.com or e-mail to drgreenberg@ greenbergdental.com.

General Dentist – Associate wanted for upscale practice in Southwest Florida. Must be proficient in ALL aspects of general dentistry and have at least three years’ experience. We offer a flexible schedule with no weekends required. Ideal candidate must possess superior skills and truly care about the quality of dentistry that is provided. Will consider buy-in or purchase proposals. Only candidates who provide a detailed resume and/or CV will be considered. beautifulsmiles1000@gmail.com.

Associate General Dentist needed for a part time position at a Private General Dentistry Office. Our practice is located in Ocala Florida and the position is for 2 days per week, Mondays and Wednesdays. We are a full service dental practice with a great deal of removable services and an on-site acrylic lab. Please send resume. carolinadentures@yahoo.com.

Periodontist needed. A periodontist that is excited about implants, extractions and dentistry. alexwangdmd@gmail.com.

Full Time Oral Surgeon. Coast Dental is a network of dental practices throughout California, Florida, Georgia, Nevada, and Texas providing high quality comprehensive dental care. Oral Surgeons get the benefit of working in a practice with a network of internal referrals and patients at their fingertips. Plus, we offer a tremendous compensation structure, on average our full time Surgeons earn $450k. jennifer. vandenberge@coastdental.com.

Endodontist. Coast Dental is a network of dental practices throughout California, Florida, Georgia, Nevada, and Texas providing high quality comprehensive dental care. Endodontists get the benefit of working in a practice with a network of internal referrals and patients at their fingertips. Plus, we offer a tremendous compensation structure. jennifer. vandenberge@coastdental.com.

ENDODONTIST-TAMPA BAY AREA. Quality associate needed for busy, modern endodontic office.

New graduates encouraged to apply. Send CV to julieh@aeoftb.com.

You must look into this Opportunity! It’s one of a kind!!

By way of introduction, my name is Dr. Anish Patel, and I practice in Panama City, FL. I am creating a great opportunity for someone who wants to treat people.

I will handle the marketing, new patient generating and management hassle. We offer great income potential and great working conditions. I think we have it all, please email us at 10Xdoctor@gmail.com for more information. P.S. If you are the first to refer someone who I hire, I will gladly pay you a $1000.00 finder’s fee, please email 10Xdoctor@gmail.com or fax 850.763.0087; your name, your email address, prospective Doctor Name and Prospective Doctor Phone number.

PT/FT OPPORTUNITY IN WEST PALM BEACH. Associate Dentist (FT/PT) needed for busy Dental office in West Palm Beach who is comfortable treating Children (3-5 days/week). Medicaid provider is a plus, We are a private practice with experienced staff and friendly office environment. We offer excellent commission, daily guarantee. Please send resume to drleminh1@firstcaredental.net.

General Dentist wanted for family private practice.

Looking for a personable dentist, minimum 2 years’ experience. Must have Florida Dental License. High end family practice, High tech, digital, paperless, CT scan in house. Senior dentist willing to train the right doctor how to perform molar root canals and surgery.

Please email resume and salary expectations. Part-time or Full time. ohcorlando@gmail.com.

Pediatric Dentist. Excellent opportunity for a compassionate, ethical, pediatric dentist looking for an associate position leading to partnership. This wellrespected private Pediatric dental practice has been established for 23 years. Office is located in a beautiful state-of-the-art building with experienced, caring staff devoted to providing high quality preventive care.

The practice is high energy with a great reputation for providing excellent care and patient service. Associate must have excellent interpersonal and social skills and be highly motivated. We have an onsite pediatric anesthesiologist for I.V. sedations. The practice has a desired suburban location in a very close proximity to the Orlando and Tampa. You may visit our website at www.dentistry-pediatric.com to learn about our practice. If you are interested in being part of our outstanding team providing quality care you may email your resume to dry@dryasrebi.com or call 813.600.8032.

Tampa Dentist Associate. Associate Dentist Wanted – Large privately owned practice in South Tampa. Long established practice with large patient base. Candidate should be comfortable doing RCT, extractions, perio, implant restorations. Excellent opportunity to grow into a solid long term position. Full time M-F, 9-5.

Four to five days /week. Stress free professional practice with emphasis on solid doctor/patient relationship. mikula28@aol.com.

Please see CLASSIFIEDS, 66 www.floridadental.org

July/August 2015

Today's FDA

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Your Classified Ad Reaches 7,000 Readers!

CLASSIFIEDS from 65 Pediatric Dentist. Pediatric Dental Group is growing and we are looking to add a full-time Pediatric Dentist to our team. We are a private group owned and operated by 2 Board Certified Pediatric Dentists, and have 3 locations in the Orlando area. All of our locations are modern with digital records and X-rays. Services include in-office sedation and general anesthesia at several local hospitals. We offer a competitive compensation package, and environment tailored to foster professional growth. New grads welcome, hospital based residency graduates preferred.

Our pediatric dentists are happy to help ease your transition from residency into practice. Come live in Orlando, one of the best cities to live in Florida! Please visit www.pediatricdentalgroupflorida.com to learn more about our practice. Interested candidates please contact Jocelyn at 321.720.2402 or Jocelyn.espejo@ pdgorlando.com to learn more about the opportunity.

Multiple Openings Across Florida. Bright Now! Dental has General Dentist openings and an Oral Surgeon opening across the state! The Oral Surgeon will be traveling to our offices in the Tampa Bay area. The General Dentist openings are Tampa and Orlando areas. All of our offices are digital and very modern, staffed with experience front and back office experts.

Email matt.odonnell@smilebrands.com if interested!

Simply Smiles Miami, located in Pinecrest, FL is growing. Our office is looking for a part time (once a week) General Dentist and Endodontist. Our office participates in HMOs and PPOs. Must have at least 1 year of experience. kmiro67@aol.com.

Oral Surgeon (part-time) Great Expressions Dental Centers has a current opening for a part-time Oral Surgeon (alternating Fridays) in our busy Lakewood Ranch, FL office in East Bradenton, FL. Strong referral network of 8 offices in surrounding area. Oral Surgeon can expect unlimited production based earnings, malpractice coverage assistance, a stable patient base with the ability to handle all OS needs for market and a fully staffed OS team. Apply via this ad for consideration! Molly Johnston | Clinical Recruiter | Great Expressions Dental Centers PSC-North | 300 East Long Lake Rd Suite 311| Bloomfield Hills, MI 48304 USA. phone 248.430.5555 |Ext. 72467| fax 248.686.0170 | web www.greatexpressions.com. “Look for the Smile Above Our Name!”

General Dentist Opportunity in Tampa, FL. Coast Dental has an opportunity for a General Dentist in our Tampa, Florida practice. We take care of the administrative burden so you can focus on the dentistry. Sound familiar? Yes, we do that (and do it well), but so does every other group practice. So what else? Here are just few things that separate us from the competition: real clinical autonomy (from implants to invisible braces), private practice environment (most practices have one general dentist, meaning ‘your’ patients, ‘your’ diagnosing, and ‘your’ treatment), favorable schedules (8-12 patients/day) giving you time to build a connection with your patients, agreements that are easy to understand and fair, extremely desirable locations, and a path to equity ownership, to name a few. nina.voelker@coastdental.com.

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General Dentist Opportunity in Orlando, FL. Coast Dental has an opportunity for a General Dentist in our Orlando, Florida practice. We take care of the administrative burden so you can focus on the dentistry. Sound familiar? Yes, we do that (and do it well), but so does every other group practice. So what else? Here are just few things that separate us from the competition: real clinical autonomy (from implants to invisible braces), private practice environment (most practices have one general dentist, meaning ‘your’ patients, ‘your’ diagnosing, and ‘your’ treatment), favorable schedules (8-12 patients/day) giving you time to build a connection with your patients, agreements that are easy to understand and fair, extremely desirable locations, and a path to equity ownership, to name a few. nina.voelker@coastdental.com.

Busy general practice in Venice needs a full time associate. Prefer implant placement trained and IV sedation. High tech office with great patients and staff.

Position has grossed in high 200K. tom@venicedentist. com.

Great Expressions Dental Centers has a current opening for a full-time (5 days/week) General Dentist to join one of our Jacksonville, FL practices. Our dentists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. When considering a career with GEDC, Dentists can expect unlimited production based earnings, full benefits, malpractice coverage. We do it all for you. You became a dentist to help people. It’s your profession and your passion. Relocation or sign-on bonus possible as well!

Molly Johnston | Clinical Recruiter | Great Expressions Dental Centers PSC-North | 300 East Long Lake Rd Suite 311| Bloomfield Hills, MI 48304 USA. phone 248.430.5555 |Ext. 72467| fax 248.686.0170 | web www. greatexpressions.com. “Look for the Smile Above Our Name!”

Come join our team! Great Expressions Dental Centers has a current opening for a part-time Pediatric Dentist to join our Miami, FL practice. Our Specialists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. Specialists can expect unlimited production based earnings vs. a base, benefits, continuing education reimbursement, paid time off, malpractice coverage assistance, a stable patient base with full office staff. **Please watch more about our Doctor Career Path (http://www.screencast.com/t/ M3xWM5CYN) and apply via this ad to join our team!

For More Information Contact: Ross Shoemaker, MBA| Lead Clinical Recruiter | Great Expressions Dental Centers Practice Support Center - South | 1560 Oakbrook Drive, Norcross, GA 30093 USA. phone 678.836.2226 | ext 72226 | fax 770.242.3251 |web www. greatexpressions.com.

Fort Myers, FL – Dentist Needed. Come join our team! Great Expressions Dental Centers has a current opening for a full time General Dentist in our lucrative Fort Myers, FL practice. Our dentists have the clinical freedom and autonomy enjoyed in a traditional private practice without the additional financial or administrative burdens associated with practice management. We do it all for you. You became a dentist to help people. It’s your profession and your passion.

But the demands of owning and managing an office are not only financially taxing but time consuming.

Which is why Great Expressions Dental Centers is built on a provider-first philosophy. Ross Shoemaker, MBA | Lead Clinical Recruiter | Great Expressions Dental Centers Practice Support Center - South | 1560 Oakbrook Drive, Norcross, GA 30093 USA. phone 678.836.2226 | ext 72226 | fax 770.242.3251 |web www.greatexpressions.com. Apply Here: http://www.

Click2Apply.net/25x22vj.

Benevis – Associate Dentist Opportunities Nationwide.

Benevis is seeking Associate Dentists for our client practices throughout the US! Benevis provides nonclinical practice services including dentist recruitment for private practices, as well as some of the nation’s largest dental organizations. Our clients offer generous compensation, sign-on bonus up to $70,000, paid relocation, sponsorships, CE reimbursement, 401K and other benefits. Contact us today about openings NATIONWIDE – jobs@benevis.com.

ASSOCIATE GENERAL DENTIST-JACKSONVILLE, FLORIDA. Associate general dentist needed to work for a quality family dental office in Jacksonville, Florida. All phases of dentistry including implant surgery, oral and periodontal surgery, endodontics, orthodontics, restorative, prosthetics, and sedation is practiced. Practice is predominantly fee for service, and PPO. Looking for a motivated and quality minded dentist. Equity position available. zfrank@bellsouth.net.

General Dentist Needed in GA w/ $20K Signing Bonus.

Multi-Location Private Dental Group around Atlanta seeks General/Pediatric Dentists for our pediatric/ teen practices in Lilburn/Dacula/Gainesville, GA. PT and FT opportunities available immediately! $20,000 Sign-On Bonus with Standard Contract, Compensation Package and more. If interested, please send your cover letter, CV, and references to HR@TeboDental.com.

Florida Community Health Centers with multiple sites surrounding the Lake Okeechobee has an excellent opportunity for a GENERAL DENTIST to join our team in Fort Pierce & Okeechobee, FL locations. Both practices are 60-80% Pediatrics, the candidate must be experienced and comfortable working with children and adults. Current licensure in the State of Florida required. Competitive salary & excellent benefits.

Possible NHSC loan repayment opportunity. Fax CV to Human Resources at 561.844.1013 or e-mail jobs@ fchcinc.org. EOE/DFWP.

www.floridadental.org

For Sale/Lease KODAK & CARESTREAM INTRAORAL X-RAY SENSOR REPAIR. We specialize in repairing Kodak and Carestream RVG 5100 and 6100 dental X-Ray sensors. Repair and save thousands over replacement cost. www.KodakDentalSensorRepair. com/919.924.8559.

Dental office for sale, lease, or lease/purchase. Excellent opportunity at minimal expense. Centrally located in an attractive 10 unit condominium complex with two general dentistry practices, a chiropractic office, and other professional businesses. Fully furnished/ equipped for the practice of dentistry. 3 operatories wired/plumbed for water, suction, compressed air & nitrous oxide/oxygen Suitable for general dentistry, periodontics, endodontics, prosthodontics or oral surgery. A) Purchase includes all equipment/ furnishings. B) 3 Year Lease includes use of all equipment/furnishings. C) Lease/purchase: to be consummated anytime during 3 year period for appraised value at that time. Photos, inventory of equipment/furnishings and floor plan available. contact Dr. Roger Lee 941.349.1352, royroddyboy@gmail.com.

PEDO/ORTHO OFFICE SPACE FOR SALE IN LEESBURG, FL. 3,800 SQ FT, 9 CHAIRS FULLY EQUIPPED, JUST ADD PATIENTS. CONTACT SUZY BUNN, REALTOR, COLDWELL BANKER, TYRE & TAYLOR REALTY. 352.360.8720, OFFICE 352.357.4100.

Dental Space Available in Destin, FL. Great opportunity to open a dental practice in a beautiful shopping center in Destin, FL anchored by Fresh Market, Marshalls and Homegoods. Space has never been occupied and Landlord willing to help with build-out and/or an improvement allowance. The above pricing is PSF of leased space but does not include extra charges. Please call to discuss. 443.921.4347.

East Fort Lauderdale. Stand Alone Building!! Class “A” Dental Office for sale or lease. Move your practice to the best location in Fort Lauderdale...a couple of blocks off the beach. Includes all equipment. 4ops, dental lab, sterile room, recovery room, doctor’s office. Does NOT include practice. Current occupant relocating to larger space. wbalanoff@me.com.

Brandon, Fl. FOR LEASE Beautiful 2000 sf lakefront office space available for custom build out. Adjacent to Endodontist. Ideal for Oral Surgeon or Periodontist.

Contact Julie at 813.654.3636 or julieh@aeoftb.com.

Bradenton/Anna Maria Island Beaches; General and Cosmetic Practice. 1600 Sqft bldg in park like setting with great traffic view. Five digital ops; paperless; Dentrix, DexIs and Panorex. New compressor and vacuum purchased in 2015. Strictly fee for service; 500,000.00 plus in production with 96% collection.

32 hr work week w/ 6 weeks vacation/yr. Building FOR SALE with new roof and 2 new AC units in 2013. Interior/Exterior Painted in 2014. 250,000.00.

For detailed practice info VISIT and REGISTER: dentaldirectsales.com. Owner is retiring and moving.

www.floridadental.org

Tampa – #FL161. Tampa – General 4 Op, 1,200 Sq Ft Office, GR $488,000, great location, high visibilityMotivated Seller!! Tampa is a vibrant city. Residents can experience a large range of great amenities, year round!

Please contact: Henry Schein Professional Practice Transitions’ Consultant: Heather Brown-Licensed Sales Associate, Cell: 727.844.8588, Email: Heather.Brown2@ henryschein.com.

Largo – #FL108. 3 Ops-1,200 Square Foot OfficeExpandable Office Space Available!! Largo, FL is centrally located less than 15 minutes from Clearwater Beach and a ½ hour from Tampa. The local beaches provide activities such as fishing, boating, swimming, kayaking, beaching, and much more. Tampa Bay offers amenities such as the Hard Rock Cafe and Casino, the Amphitheater, Ybor City, the Straz Center, and unlimited restaurants and night life venues. Please contact: Henry Schein Professional Practice Transitions, Heather Brown-Licensed Sales Associate. Cell: 727.844.8588. Email: Heather.Brown2@henryschein. com.

Orlando – #FL112. 5 Ops-Well-Established Practice-Dr. willing to stay on as associate! Orlando has unlimited recreation, a variety of restaurants, golf courses, professional sporting events, festivals, and spas. We are also less than 2 hours from either coast offering swimming, fishing, boating, and more. Please contact: Henry Schein Professional Practice Transitions, Heather Brown-Licensed Sales Associate Cell: 727.844.8588. Email: Heather.Brown2@henryschein. com. #FL112.

Oldsmar/Palm Harbor – #FL110. 7 Ops--3,800 Sq. Ft. Office Space in Beautiful, Fast-growing Area!! Updated Equipment and All New Computers--Digital Office with Lab!! **Real Estate Included!!!!** This gorgeous well-established practice is located centrally between Tampa and Clearwater in a continually growing, high traffic area. The white sandy beaches of Clearwater offer recreation such as swimming, fishing, scuba diving, snorkeling, and jet skiing. Tampa offers world-class museums, outstanding theater and concert venues, theme parks, and championship golf courses. Please contact: Heather Brown-Licensed Sales Associate, Henry Schein Professional Practice Transitions, 727.844.8588/Heather.Brown2@henryschein.com.

Tampa, FL – #FL163. Tampa, FL – the city offers unique and exciting recreation for all ages and interests and an exciting nightlife. A diverse selection of great restaurants and some of the state’s best attractions. We are also within 30 minutes of the Gulf! Please contact: Henry Schein Professional Practice Transitions, Heather Brown-Licensed Sales Associate, Cell: 727.844.8588, Email: Heather.Brown2@henryschein. com. #FL163.

Clay County, FL – 6 Ops – 3,200 sq/ft Office -- All Updated Equipment!!! #FL164. 4 Ops-1,200 Square Foot Office-Great Location with High Visibility!! 40 Year Established Practice - ~2,000 Active Patients-$600K Gross on 2 ½ days per week and No Marketing! **HIGHLY MOTIVATED SELLER!!!** Tampa is a vibrant city that takes pride in its rich, cultural heritage. Residents can experience delicious culinary cuisine, exceptional shopping, and year-round fantastic weather! Local attractions include Busch Gardens, The Florida Aquarium, Lowry Park Zoo, Clearwater Marine Aquarium, the Straz Center, MOSI and much more.

Professional sporting events abound with teams such as the Tampa Bay Buccaneers, Tampa Bay Lightning, and the Tampa Bay Rays. The nearby gulf offers white sandy beaches with unlimited water sports activities! Beautiful place to work, live and play!! Please contact: Henry Schein Professional Practice Transitions, Heather Brown-Licensed Sales Associate, Cell: 727.844.8588, Email: Heather.Brown2@henryschein.com.

Fully equipped Dental Office in Carrollwood. Fantastic location in Carrollwood, Tampa. 4 fully functional operatories. 5th room plumbed. Move in ready. Ideal for relocating, new graduate or satellite office. hzlart@ gmail.com.

Sarasota Dream Practice. AmycusKragge@gmail.com.

BUSINESS OPPORTUNITY: Equity partner needed.

Equity position available. Practicing dentist needed with 2 years minimum private practice experience.

Great opportunity for partner full or part time. Low overhead - excellent profit margins with little to no management responsibilities. Management and administrative support provided. Email resume to willgschwab@gmail.com.

7 Ops 2,000 sq ft Office VERY MOTIVATED SELLER!! #FL111. We are located in Ocala, FL. Our city is an equestrian lover’s dream! The area boasts 70,000 acres of thoroughbred breeding and training farms; whether you love the thrill of competition or just enjoy riding horseback, this is the place for you! Our city also offers unique attractions, outdoor adventure, championship golf, and rich arts & culture. Please contact: Henry Schein Professional Practice Transitions, Heather Brown-Licensed Sales Associate Cell: 727.844.8588.

Email: Heather.Brown2@henryschein.com.

July/August 2015

Today's FDA

67

Book Reviews

Book Reviews into five main sections: 1) Single-tooth Restorations; 2) Fixed Partial Dentures; 3) Implants; 4) Full Mouth Reconstruction; and, 5) Computer Aided Design/Computer Aided Manufacturing (CAD/ CAM).

Atlas of Dental Rehabilitation Techniques

By Drs. Romeo Pascetta and Davide Dainese Published by Quintessence

Reviewed by Dr. Howard Abrahams

Initially, I was interested in reviewing this book because the title led me to believe the content would be more clinical in nature. I quickly found out this book was written by two talented Italian dental technicians. Their focus was on the techniques they employ to create the most functional and aesthetically pleasing restorations.

The book itself is physically beautiful. There are 416 pages, most with wonderful full-color images of these technicians’ masterful creations. One of the authors’ first points is the importance of magnification, both on the clinical side and the laboratory side. The reality is that most practitioners do not practice with a high-powered microscope. This is undoubtedly due to their lack of experience with microscopes in a clinical setting, as well as the high cost of these powerful instruments. The authors encourage more practitioners to use a high-powered microscope in their practices to inspect tooth preparations and impressions before sending to the dental laboratory. The importance of an accurate impression and representation of the clinical situation cannot be over-emphasized.

The authors review, step by step, their recommendations and techniques for successful restorations. These techniques are not unique to these technicians, but they are effective in their hands and are presented throughout the book in a logical format with exquisite pictures to help illustrate their presentation. The book is divided

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In Section 1, Single-tooth Restorations, I was surprised that the authors primarily discussed metal-ceramic crowns despite the emergence of all porcelain/zirconia restorations. Section 2, Fixed Partial Dentures, features the authors’ beautiful work, with the majority using Captek™. In the implant section, it was interesting to see the technicians advocating hand-waxed metal bars and frameworks for implant prostheses. It has been my experience that CAD/CAM milled bars are easier to fabricate, more precise and considerably more economical considering the cost of today’s precious metal alloys. The last section deals with CAD/CAM, and I was extremely happy to see a section on this because, until this point, I was getting the feeling that the authors were not too keen on emerging techniques and technology.

In summary, I would say this book has inspiring photos of impressive laboratory work. There are a few good tips for practitioners, but it focuses on many things that a typical practitioner may not appreciate unless they possess a strong background in dental laboratory technology. Most of the book focuses on classic dental technology, i.e., metal-ceramic crown and bridge. I was surprised to see the amount of Captek™ the authors used. I’m certain Captek™ works well in the hands of many practitioners; I guess I was surprised only because I don’t use Captek™ at all. My reasons have nothing to do with whether Captek™ is good or bad, it’s just a function of how I was trained and what is available out there today.

I read this book in two to three days. It’s an easy read as most of it is pictures. This book would be most appreciated by restorative doctors with laboratory background. When you think about it, any restorative doctor does have some background in dental technology. The scope of this book would not really be appropriate for dental auxiliary staff, with regard to what they know or need to know to be effective.

The reviewer claims no financial interest with the publication.

Dr. Abrahams is a maxillofacial prosthodontist in Miami Beach and can be reached at dr.abrahams@gmail.com.

www.floridadental.org

Book Reviews

My overall impression of the book is that, in a very concise and efficient fashion, treatment protocols are presented to guide the operator to clinically and subjectively acceptable treatment outcomes in implant dentistry. The book allows the reader to understand and consider those details about peri-implant tissues that are vital to the final restoration and allows the reader to forgo learning these lessons through trial and error. I would recommend this book to my colleagues, and especially to those new to the profession.

The reviewer claims no financial interest with the publication.

Dr. Laing is a general dentist in Tallahassee and can be reached at chrislaingdds@outlook.com.

Peri-Implant Tissue Remodeling: Scientific Background and Clinical Implications

By Luigi Canullo, DDS, PhD; Roberto Cocchetto, DDS, MD; and Ignazio Loi, DDS, MD Published by Quintessence

Reviewed by Dr. Chris Laing

The book’s authors did well in delivering an evidence-based guide to protocols involved in restoring dental implants and managing the peri-implant tissues. The book is purposed to outline “prosthetically guided implant treatment” and some of the physiology involved to help minimize “restorative complications” is made clear. Also to be appreciated: its layout allows the reader to follow along with clear, high definition photographs and visual aids. The book also is an easy read.

The information presented is consistent with widely held clinical conclusions based on available research. Being a new dentist, I found this book to be appropriately organized and made understanding “prosthetically” driven implant restorative concepts fluid, building upon the previously presented information. Moreover, I believe that this book’s target audience is the clinician and would not be a recommended read for other members of the dental team.

Contrarily, I believe that clinical experience is required to fully appreciate references made to specific procedures, namely those involved in connective tissue grafting and flap design. www.floridadental.org

Cone Beam Volumetric Imaging in Dental, Oral and Maxillofacial Medicine

By Jörg Neugebauer and Joachim E. Zöller Published by Quintessence Reviewed by Dr. Joseph Barnett

Cone beam volumetric imaging has about as much radiation as a dental panorex — equivalent to being outside for about seven days — and has 50-100 times less radiation than a medical computed tomography (CT) scan. This large textbook is well-written and pe rfect for anyone wanting to learn about cone beam technology and how it’s used.

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Book Reviews

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Cone beam generates thin slices of imaging, which eliminates the overlap of body structures — making teeth and bone easy to study.

Non-radiating magnetic resonance imaging (MRI), however, is best for evaluating soft tissue.

The last 69 pages covered implant dentistry in an easy to follow format. The authors were careful to explain that cone beam does not prevent placing implants into nerves. All procedures must be done properly and verified by clinical findings. Cone beam allowed less invasive procedures; however, I didn’t notice any flapless implant placement cases!

All conventional dental views, such as panoramic tomography, can be generated clearly by cone beam. A disadvantage is that metallic and zirconium objects can cause white rays of radiation scatter. This throws a shadow, making adjacent bone sometimes appear missing, such as next to an implant.

I highly recommend this textbook for anyone interested in cone beam technology, which may become state of the art. Enclosed is a DVD to help readers practice cone beam case planning.

The book is well-illustrated and shows the dental anatomy and the cone beam’s potential; however, more labels on the images would have been useful. The authors mentioned possible “life-threatening bleeding” from the lingual foramen when placing implants, but the foramen were not labeled. There were a few typos and the nomenclature was slightly different, such as: “dentition difficilis” for teething trouble; “severe retraction” for ridge resorption; “osteosynthesis screw” and “paramolar”; “laterognathia or “facial skew” meant over development of one side of the mandible; and “63” meant the upper-left deciduous canine.

Dr. Barnett is a periodontist in Tallahassee and can be reached at jdbarnettgums@hotmail.com.

The reviewer claims no financial interest with the publication.

The authors admit cone beam may not add enough information to be worth the 2.5-5 times more radiation. Caries could easily be detected, but was not a benefit over conventional radiographs.

Wisdom teeth and nerve canals could be detected; however, studies have not shown a reduction of risk with cone beam. They mentioned great promise for periodontics and cone beam has been “extremely useful” for endodontics. Case reports were fascinating, such as the severely fractured tooth root that regained vitality and was saved just by splinting.

Pages 41-194 seemed more like a great pathology book, covering about every anomaly, boney lesion, dental specialty and defects.

It was interesting to see these in 3-D views. I liked how the book discussed lesions and the high risk nearby structures. I learned that radiation necrosis was most often on the mandible, but bisphosphonate necrosis was equally found on mandible and maxilla. The sinus chapter showed cysts, displaced teeth, and implants and sinusitis conditions, which have a dental etiology in 10-12 percent of cases.

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Challenging Nature: Wax-up Techniques in Aesthetics and Functional Occlusion

By Dr. Paul Kano Published by Quintessence Reviewed by Dr. Steve Taborda

“Challenging Nature: Wax-up Techniques in Aesthetics and Functional Occlusion” by Dr. Paulo Kano, a talented dentist and one of the foremost dental technicians, creates a benchmark in

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Book Reviews

dentistry and simplifies the way students, dental technicians and dentists approach and integrate the concept of wax-up techniques in aesthetic and functional occlusion.

I highly recommend this book for every dental student, dental technician and restorative dentist in search of excellence and the integration of form and function.

This oversized hardcover book has 628 pages and eight chapters. Chapters 1 to 6 are “atlas-like” in structure and describe dental nomenclature, morphologic characteristics, and waxup techniques and exercises with outstanding photography.

Chapter 7 has an incredible collection of well-documented clinical cases. Chapter 8 is on cementation and is a mustread for anyone involved in adhesive dentistry, as it presents straightforward information on this topic. As mentioned by the author: “In restorative dentistry, the adhesive process is more important than the mechanical and biological fulfillments because it strengthens the restoration and dental structure as a whole.”

The reviewer claims no financial interest with the publication.

The methodology is instructional, simple and easy. The amazing integration of high quality photography guides readers step by step through the author’s revolutionary wax-up technique that recreates the complex morphology of premolar and molar teeth. C lear and precise commentaries provide concise explanations of the techniques that c a n b e u n d e r s t o o d b y students as well experts in the area. Paulo Kano consistently demonstrates clear integration and balance between dental form and function in addition to each detail that composes dental anatomy. The author states, “I tried to make this book simple, using the photographic sequences to work in tandem. Thus, I suggest that readers examine the figures one by one and then read the respective legends. In addition, the exercises included here must be completed by some practical courses. In this way, the wax-up of posterior teeth can be refined by all professionals.”

Dr. Taborda is a restorative dentist in Daytona Beach.

Fundamentals of Implant Dentistry, Vol. 1: Prosthodontic Principles

By Josh Beumer III, DDS, MS; Robert F. Faulkner, DDS, MS; Kumar C. Shah, BDS, MS; and Peter K. Moy, DMD Published by Quintessence Reviewed by Drs. Barry Shipman and Rodrigo Souza

In today’s world of smile design, digital and CAD-CAM dentistry, this book becomes a perfect re source to have handy when considering the fact that fabrication of posterior prosthetic teeth is an art that requires technicians and clinicians to reproduce the minute details of occlusal form and function. Considering the wax-up t e c h n i q u e s shown in this book makes the amazing world of digital dentistry more enjoyable. Clinicians who use CAD-CAM systems and work closely with their technicians c a n e a s i l y i nt e g r at e t h e i n f o r m at i o n i n t h i s t e x t into their practices.

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Dr. John Beumer III collaborated with more than 28 authors — clinicians, scientists and educators — to write his textbook, “Fundamentals of Implant Dentistry, Vol. 1: Prosthodontic Principles,” for the dental community. The primary text editors are Drs. John Beumer III, Robert Faulkner, Kumar Shah and Peter Moy; all of whom are associated with the UCLA School of Dentistry. The text contains up-to-date biological, clinical and treatment procedures that can be understood easily and applied to the restoration of the Please see REVIEWS, 72

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edentulous and partially edentulous patients. The text offers implant rehabilitation outcomes that improve oral function to include mastication, speech, deglutition and the patient’s aesthetic needs and desires. The book has more than 430 pages, with many excellent diagrams, charts and clinical pictures, each titled and referenced appropriately. All chapters end with elaborate reference sections and offer the readers literature that supports the clinical information found in the text. The chapters are succinct and informative, and cover all aspects of implant dentistry from implant outcome data (IOD) to patient selection to prosthodontic procedures to placement of the final restoration. Many of the color pictures serve to add critical clinical information to the text.

The textbook is divided into three sections. Section I, Chapters 1 and 2, covers biology, osseointegration and maintenance of dental implants. This section clearly introduces osseointegration to the reader and begins the restoration process with good basic science of the osseointegration of implants in bone. Section II, Chapter 3, discusses the edentulous patient and bone resorption patterns. Chapter 4 reviews the restoration of the edentulous mandible with overdentures. The author favors splinting two implants in the mandible for better prosthesis support. Chapter 5 covers the restoration of the edentulous mandible with fixed prosthesis. Several prosthodontic alternatives are described including the CAD/CAM process.

Chapter 6 discusses the treatment and restoration of the edentulous maxillae with overdentures. Here, the author suggests that surgical augmentation of resorbed maxillae is difficult to treat and when implants are recommended, overdentures may be more preferable.

Section II concludes with Chapter 7, the restoration of the edentulous maxillae with fixed prosthetic support — a technique patients desire that can present restorations with possible speech problems.

Section III begins the restoration of the patient who is partially edentulous. It covers restorations by quadrants and divides Chapters 8 and 9 into patient selection, examination and treatment planning, and the appropriate prosthodontic procedures. Basic prosthodontic principles are supported, which impact clinical decision making. The second part of Section III, Chapters 10 and 11, discusses the treatment of the multiple-tooth defects and the

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restoration of the single tooth defect in the aesthetic zone. The last, Section IV, is referred to as “Special Topics” and offers specific insight into other special areas of implant rehabilitation. Chapter 12 discusses implants and partially edentulous patients, primarily Kennedy Class I and II patients. It identifies this option for patients with limited bone, yet a desire to support and maintain residual bone supporting areas, specifically the retro-molar pad and buccal shelf with the use of conventional removable partial dentures supported with implants. Chapter 13 discusses the use of implants in growing children and Chapter 14 identifies problems associated with head and neck cancer patients, specifically those treated with curative doses of radiation therapy. Lastly, Chapter 15 recognizes the expansion of implant use in orthodontics — they’re not only used for implant rehabilitation, but also for orthodontic temporary anchorage and for temporary use in pre-implant orthodontics.

Last of all, this text has a word index as well as a pictorial glossary, which I haven’t seen before. It is innovative and one of the text’s highlights. In an era of digital e-books, fast information and visual searches, this added feature provides the reader with the opportunity to visualize and view clinical definitions, as well as to read about them and easily locate them in the index. The text material is not intended to be an in-depth treatment of any specific area of implant dentistry, but it definitely presents the fundamental principals in implant prosthodontics and supports the use of basic prosthodontic principals as the basis for all implant restorative procedures. I would recommend the book to all students, restorative dentists, periodontists, oral and maxillofacial surgeons, and any member of the implant rehabilitation team. This resource would be a great addition for practitioners with some beginning to moderate exposure to modern implant dentistry.

The reviewer claims no financial interest with the publication.

Dr. Shipman is a clinical professor in the AEGD Program at the University of Florida School of Dentistry Hialeah Dental Center, and can be reached at bshipmandmd@earthlink.net. Dr. Souza is an assistant professor and AEGD Program Director at the University of Florida School of Dentistry Hialeah Dental Center, and can be reached at rsouza@dental.ufl.edu.

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Books On The Shelf

Books on the Shelf Books Available for Review If you are interested in reviewing one of the books listed here, please contact Director of Communications Jill Runyan by email at jrunyan@floridadental.org or by mail at 1111 E. Tennessee St., Tallahassee, FL 32308.

Authors should review their books within four to six weeks and are given the books they review.

Books on the Shelf: 2014 QDT, Quintessence of Dental Technology, Vol. 37 Edited by: Sillas Duarte Jr., DDS, MS, PhD 212 pages Published 2014 by Quintessence Publishing Price: $128 2015 QDT, Quintessence of Dental Technology, Vol. 38 Edited by: Sillas Duarte Jr., DDS, MS, PhD 220 pages Published 2015 by Quintessence Publishing Price: $132 At the Forefront: Illustrated Topics in Dental Research and Clinical Practice By: Hiromasa Yoshie, DDS, PhD 108 pages Published 2012 by Quintessence Publishing Price: $98

Best Practices in Endodontics: A Desk Reference By: Richard Schwartz, DDS and Venkat Canakapalli, BDS, MDS 368 pages Published 2015 by Quintessence Publishing Price: $134

Foundations of Dental Technology: Anatomy and Physiology By: Arnold Hohmann and Werner Hielscher 300 pages Published 2014 by Quintessence Publishing Price: $98

Color Atlas of Fixed Prosthodontics: Vol. 1 By: Yoshiyuki Hagiwara 196 pages Published 2013 by Quintessence Publishing Price: $120

Inspiration: People, Teeth and Restorations By: Luis Narciso Baratieri, DDS, PhD, MS 482 pages Published 2012 by Quintessence Publishing Price: $228

Controversial Issues in Implant Dentistry Edited by: Prof. Hernandez Alfaro, MD, DDS, PhD, FEBOMS 264 pages Published 2013 by Quintessence Publishing Price: $168 Dancing Hands By: Herluf Skovsgaard, DDS 296 pages Published 2013 by Quintessence Publishing Price: $198 Evidence-based Dentistry for the Dental Hygienist By: Julie Frantsve-Hawley, RDH, PhD 376 pages Published 2014 by Quintessence Publishing Price: $56

Lingual Orthodontics By: Giuseppe Scuzzo and Kyoto Takemoto 885 pages Published 2010 by Quintessence Publishing Price: $230 Oral Implantology Surgical Procedures Checklist By: Louie Al-Faraje, DDS 92 pages Published 2013 by Quintessence Publishing Price: $68 Oral Implants: Bioactivating Concepts Edited by: Drs. Rolf Ewers and Thomas Lambrecht 536 pages Published 2013 by Quintessence Publishing Price: $328

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Orofacial Pain and Headache, Second Edition By: Yair Sharav, DMD, MS and Rafael Benoliel, BDS 664 pages Published 2015 by Quintessence Publishing Price: $168 Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management By: Reny de Leeuw, DDS, PhD, MPH and Gary D. Klasser, DMD 312 pages Published 2013 by Quintessence Publishing Price: $48 Periodontal Diagnosis and Therapy By: Giano Ricci 752 pages Published 2014 by Quintessence Publishing Price: $340 Periodontal Review: A Study Guide By: Deborah A. Termeie, DDS 296 pages Published 2013 by Quintessence Publishing Price: $68 Promoting the Oral Health of Children: Theory and Practice, Second Edition By: Aubrey Sheiham, Samuel Jorge Moyses, Richard G. Watt, Marcelo Bonecker 450 pages Published 2014 by Quintessence Publishing Price: $110

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Reintervention in Endodontics By: Mario Luis Zuolo, Daniel Kherlakian, Jose Eduardo de Mello Jr., Maria Cristina Coelho de Carvalho and Maria Ines Ranazzi Cabral Fagundes 332 pages Published 2014 by Quintessence Publishing Price: $180 Sinus Floor Elevation: Avoiding Pitfalls Using Cone-Beam CT By: Dr. Yasuhiro Nosaka 120 pages Published 2014 by Quintessence Publishing Price: $120 Smile! Your Guide to Esthetic Dental Treatment By: Douglas A. Terry, DDS 54 pages Published 2014 by Quintessence Publishing Price: $29.50 Soft Tissue Management: The Restorative Perspective — Putting Concepts into Practice By: Ariel J. Raigrodski, DMD, MS 209 pages Published 2015 by Quintessence Publishing Price: $132

Summitt’s Fundamentals of Operative Dentistry: A Contemporary Approach, Fourth Edition By: Thomas J. Hilton, DMD, MS; Jack L. Ferracane, PhD; and James C. Broome, DDS, MS 612 pages Published 2013 by Quintessence Publishing Price: $128 The Art of Detailing: The Philosophy Behind Excellence Edited by: Rafi Romano, DMD, MSc 360 pages Published 2013 by Quintessence Publishing Price: $240 The Biomechanical Foundation of Clinical Orthodontics By: Charles J. Burstone, DDS, MS and Kwangchul Choy, DDS, MS, PhD 608 pages Published 2015 by Quintessence Publishing $180 The Long Climb: From Barber-Surgeons to Doctors of Dental Surgery By: Philias Roy Garant, DMD 496 pages Published 2013 by Quintessence Publishing Price: $38

Success Strategies for the Aesthetic Dental Practice By: Linda Greenwall, BDS, MGDS RCS, MSc, MRD RCS, FFGDP and Cathy Jameson, PhD, MA, BS 176 pages Published 2012 by Quintessence Publishing Price: $98

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Books On The Shelf

The Magical Toothfairies: The Secret of the Magic Dust By: Henry Olberg 38 pages Published 2012 by Quintessence Publishing Price: $18.99

Treatment Planning for Traumatized Teeth, Second Edition By: Mitsuhiro Tukiboshi, DDS, PhD 240 pages Published 2012 by Quintessence Publishing Price: $82

What’s in Your Mouth? Your Guide to a Lifelong Smile By: Douglas A. Terry, DDS 48 pages Published 2014 by Quintessence Publishing Price: $29.50

The Oral-Systemic Health Connection: A Guide to Patient Care By: Michael Glick, DMD 312 pages Published 2014 by Quintessence Publishing Price: $118

What’s in Your Mouth?

What’s in Your Child’s Mouth?

By: Douglas A. Terry, DDS 66 pages Published 2013 by Quintessence Publishing Price: $29.50

Zygomatic Implants: The Anatomy-Guided Approach By: Carlos Aparicio, MD, DDS, MSc, DLT 254 Pages Published 2012 by Quintessence Publishing Price: $168

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OFF THE CUSP

JOHN PAUL, DMD, EDITOR

Whistlin’ in the Dark I was listening to a buddy’s podcast the other day and he was asked, “Knowing what you know, would you donate your body to a medical school?”

I’m not sure what was said next because the voice in my head kept saying, “Oh, hell no.”

I remember gross anatomy. In Charleston, you take “gross” in the summer — 100 degrees, 100 percent humidity — before dental classes begin. Two people walked into our dissection room and quit the first day.

Every time you got on an elevator someone said, “I smell freshmen.”

The gross lab was open 24 hours a day. For the gunners in my class that meant extra study time, but for most of us it meant we could go to the beach after class and come back to study after dark. That can make for an interesting night of being alone in a room with 75 cadavers in various stages of entropy. Mortuary science would come through and remove the portions of bodies no longer being studied and not being kept in adequate formalin, so some tables just contained parts. Without being disrespectful, you had to find some way to laugh to keep from crying.

The discussion came up on the podcast because they felt as time passes, soon there will be no more actual human dissection

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“

A room full of cadavers helped you learn what to expect and how to deal with something that isn’t what you expect.

”

but we will use sim labs and mannequins.

No more icky smells, no risk of prion-based diseases, no concern about disrespect for the person who thought enough of you to donate their body, and no need for closure for families and students at a memorial service when your study is complete.

If this comes to pass, I feel sorry for future students and even sorrier for their patients.

One of the most important things I learned in anatomy was that “normal” means about 50 percent of the people look the same. If you’re any good at math, you realize that means about 50 percent look different — they just don’t all look the same different. A room full of cadavers helped you learn what

to expect and how to deal with something that isn’t what you expect. With the dead, when you make a mistake, it affects your grade — but it doesn’t affect their life.

There is some talk that all testing should be done on mannequins. I realize that mannequins tend to show up for their appointments and so far no one has found a way to bring a lawsuit on a mannequin’s behalf, but at some point you have to start helping real people with all their attendant idiosyncrasies and concerns. That’s the job you signed on for.

Although, I was watching a lecture with Dr. Paul Palo once and he said to me, “I think I’d like to be an expert dentist.” While that was a fine aspiration, I asked what brought out his comment. He said, “Well, I’ve looked at this fellow’s slides all day and I haven’t seen one drop of blood or pool of saliva.

So it appears expert dentists only work on cadavers, and I figure that might be easier than what I do all day.”

Dr. Paul is the editor of Today's FDA. He can be reached at jpaul@bot.floridadental.org.

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