today’s VOL. 38, NO. 5 • SEPTEMBER/OCTOBER 2026
A PUBLICATION OF THE FLORIDA DENTAL ASSOCIATION
Don’t Let Website Accessibility Catch You by Surprise page 33
TECHNOLOGY AI • CYBER The One Thing Artificial Intelligence Will Never Replace Page 36
Cybersecurity in 2026: What Every Dental Practice Should Be Doing Now Page 42
When the Abuse Isn’t Physical: Understanding Technology-facilitated Coercive Control in the Dental Setting Page 58
Vol. 38, NO. 5 SEPTEMBER/ OCTOBER 2026
fdaservices.com
THE FDAS TEAM IS FOCUSED on
YOU AND YOUR PRACTICE MIKE TROUT
CARRIE MILLAR
DAN ZOTTOLI
Arizona
Large Groups & DSO Specialist
Atlantic Coast
mike.trout@fdaservices.com
carrie.millar@fdaservices.com
dan.zottoli@fdaservices.com
904.254.8927
850.350.7155
561.791.7744
DENNIS HEAD
SCOTT RUTHSTROM
RICK D’ANGELO
JOE PERRETTI
Central Florida
Chief Operating Officer
West Florida
South Florida
dennis.head@fdaservices.com
scott.ruthstrom@fdaservices.com
rick.dangelo@fdaservices.com
joe.perretti@fdaservices.com
407.359.9700
850.350.7146
813.475.6948
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BROCK SHELTON North Florida brock.shelton@fdaservices.com 850.350.7140
MALPRACTICE • OFFICE INSURANCE • CYBER INSURANCE • WORKER’S COMP • DISABILITY
More Than Insurance — Your Policy Helps Fund Florida’s Dental Community.
contents SEPTEMBER/OCTOBER 2026 floridadental.org
7 TECHNOLOGY/AI/CYBER ISSUE 11
FDAPAC-supported Candidates
19 Leadership Development Expands with New LEAD Webinar Series 30 Florida Board of Dentistry Meets in Wesley Chapel 33 Don’t Let Website Accessibility Catch You by Surprise 36 The One Thing Artificial Intelligence Will Never Replace 40 5 Essential Insights From Our 2026 Cyber Claims Report 42 Cybersecurity in 2026: What Every Dental Practice Should Be Doing Now 45 10 Things You Can Do Today to Better Secure Your Practice
36
50 Cancer Patient Receives Donated Dental Care for Birthday 55 Restoring Smiles for Florida Veterans 58 When the Abuse Isn’t Physical: Understanding Technology-facilitated Coercive Control in the Dental Setting 67 In Loving Memory of Dr. Donald M. Cohen: Former “Diagnostic Discussion” Contributing Author
IN EVERY ISSUE 2
Staff Roster
4
President’s Message
7
Did You Know
9
Legislative Action
12 Preventive Action
45
17 Dental Benefits Spotlight 20 Practice Management 24 news@fda 26 Welcome New FDA Members 27 In Memoriam 63 Diagnostic Discussion 68 Career Center 70 Advertising Index
Check out Today’s FDA online
72 Off the Cusp
Today’s FDA | 1
545 John Knox Road, Ste. 200 Tallahassee, FL 32303 800.877.9922 or 850.681.3629
To contact an FDA board member, use the first letter of their first name, then their last name, followed by @bot.floridadental.org. For example, to email Dr. Hugh Wunderlich, his email would be hwunderlich@bot.floridadental.org.
EDITOR Dr. Hugh Wunderlich, CDE Palm Harbor
To call a specific staff member below, dial 850.350. followed by their extension.
BOARD OF TRUSTEES PRESIDENT Dr. Dan Gesek Jacksonville
PRESIDENT-ELECT Dr. Bertram Hughes Gainesville
EXECUTIVE OFFICE Drew Eason • chief executive officer/executive director
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17TH DISTRICT TRUSTEE Dr. Andy Brown Jacksonville
EXECUTIVE DIRECTOR Drew Eason, CAE Tallahassee
Dr. Bethany Douglas Jacksonville
Dr. MaKeba Earst Tallahassee
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Dr. Joe Richardson Eustis
2 | September/October 2026
ACCOUNTING
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FDA FOUNDATION
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GOVERNMENTAL AFFAIRS
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president’s president’smessage message
Membership and the Early Career Dentist By FDA President Dan Gesek, DMD
Dr. Dan Gesek and son Justin.
I remember graduating from dental school and beginning a lifelong career in dentistry. It was both exciting and very scary. I was newly married with our first child on the way. After spending years studying, taking exams, learning the art of dentistry and finally graduating, I now had significant responsibilities. There were more questions than answers. So where did I turn for help? Organized dentistry and specifically the Florida Dental Association (FDA) helped me. Why, you ask? Let me tell you. 4 | September/October 2026
I had so many questions: Where to practice? How do I find a practice? How do I find help reviewing contracts? These were the easy questions. The harder ones included financing, insurance and regulatory issues. As a member of the FDA, I received invaluable help from both the local and state dental associations and many of their members. When a dentist asks me why I am a member, it goes back to the beginning of my career. The decisions made early in a dental career often lay the foundation for long-term success. These decisions have to be researched, well-founded and forward-thinking. Membership
in the FDA provides the early career dentist with a reliable support system. The FDA has a comprehensive team of experienced professionals and trusted resources specifically designed to assist the Florida dentist. This support reduces uncertainty for the busy member dentist. As a member, you have access to all FDA members. The registry of all FDA members is found on the website in the members section under Find a Dentist. I used this list of members to help build my practice and develop a referral base as a specialist. The relationships you build will help guide you on your path for future success. The mentorship you can receive just by asking is invaluable. Dentists are more than willing to share their experiences. Dental schools provide outstanding clinical education, but real-world experiences often present challenges that require further guidance. Whether the issue is treatment planning, a difficult patient, what materials to use or even which lab to use, mentorship can be one of the most valuable benefits. Advocacy is another important member benefit. I never realized how important politicians were to practicing dentistry. Our legislators in Tallahassee pass laws that directly impact how we practice. These issues can include licensure, insurance-related statutes or regulatory changes. The FDA serves as that unified voice of organized dentistry in Florida. It advocates for dentists and patients to support the autonomous
practice of dentistry. I still remember my first visit to Tallahassee. A group of FDA member dentists visited our Representative to discuss a licensure issue and dental insurance concerns. Those discussions helped prevent changes to a bill that would have negatively impacted all our dental practices. And just like that, I was hooked! Continuing education has always been important in any lifelong career. Both the FDA and local dental societies provide high-quality and relevant education year-round. This comes in the form of in-person meetings and webinars. These in-person meetings also allow for effective networking, which further enhances the early career dentist’s experiences. The Florida Dental Convention is the annual summer meeting in Orlando that provides hands-on labs and a wide variety of clinical and practice management courses at little to no cost for both staff and dentists. These educational experiences provide the state-mandated courses, ensuring that each dentist has the opportunity to obtain the coursework necessary for relicensure each biennium easily. Another major benefit is support with third-party payers and dental insurance. The FDA helps members navigate difficult insurance issues. There are team members available daily to assist members in navigating the world of dental insurance. Recently, the FDA has established an insurance committee to improve access for our members in need of assistance with dental insurance carriers and reimbursement issues. This is a benefit to all members; all you have to do is call FDA headquarters! Practicing dentists need many types
The decisions made early in the career of dentistry often lay the foundation for long-term success.
of insurance to protect themselves, their families and their practices. FDA Services (FDAS) was started years ago by dentists for this very purpose. FDAS offers members a range of insurance, including malpractice, overhead, disability, cybersecurity and health. As a member of the FDA, you have access to the entire FDAS insurance portfolio of products at reduced rates. What a member benefit! Peer review is another important member benefit no dentist wants to use. If you have a disgruntled patient, the FDA can help diffuse the situation if the member dentist agrees. Allowing the FDA to work with the patient and the dentist can help prevent lawsuits or dental board actions. This unsung benefit may be the best not just for the early-career dentist but for all member dentists. The early-career dentist has free access to the FDA Career Center simply by being a member. This site allows recent graduates and all member dentists to find associates, explore ownership opportunities, and explore other career openings throughout Florida. Membership in the FDA provides access to the FDA website, which includes the Career Center, FDA publications and member services. The website, specifically the Member Center, has links to
the Member Assistance Programs, Peer Review, Publications, Third-Party Payer information, Legal Resources and so much more. The Crown Savings benefits provided by FDAS offer savings and fee reductions for many companies, including Bank of America, CareCredit, American Dental Association Credit Card, Best Card and Abyde. In conclusion, membership in the FDA provides many tangible benefits. Some are obvious, like advocacy, continuing education, peer review, mentorship and networking. Other programs become beneficial when used, such as FDAS, the Member Assistance Program, the Career Center, Crown Savings and Third-Party Payer/dental insurance consultations. The benefit of being an FDA member, and the perceived value, depends on how each member utilizes the resources made available. The FDA and its highly skilled team are always ready to serve you, the member dentist. If you aren’t an FDA member benefiting from these opportunities and many more, the question is: Why not? FDA President Dr. Gesek can be reached at dgesek@bot.floridadental.org.
Today’s FDA | 5
Your Team’s Next Career Move Starts Here. The Florida Dental Association’s Restorative Function for Dental Auxiliaries (RFDA) training and certification equips qualified dental assistants and hygienists to perform restorative procedures under a Florida dentist’s supervision — reducing chair time, increasing efficiency and elevating patient care. After a supervising dentist prepares the tooth, certified RFDAs may:
Place, pack and contour restorative materials
4-week Completion Hands-on Training Board-approved Labs
Size, fit and contour stainless steel crowns
Use slow-speed handpieces and hand instruments only
Train Your Team. Be an Instructor. Qualified dentists can serve as RFDA instructors, training the next generation of dental auxiliaries, whether for a single day or a full program. It’s a rewarding way to work hands-on with your team or support the profession, all while being compensated for your time.
Ready to take the next step? Scan the QR code to join the interest list. Be the first to know about upcoming programs for your team or learn how you can get involved as an instructor. C3FDA.COM
FREE ONLINE CE FOR FDA MEMBERS! Diagnostic Discussion Rooted in Dentistry BI-MONTHLY COLUMNS
WEBINAR SERIES
FDA members can earn up to 6 hours of general continuing education (CE) by reading the Diagnostic Discussion column included in the bi-monthly Today’s FDA and taking a quick online quiz.
This webinar series is your opportunity to stay informed, grow your skills and earn up to 6 CE hours at no cost.
Discussions and quizzes are available 24 hours a day at the convenience of your home or office.
Webinar topics include implant restoration, peri-implant disease, systemic oral health, diagnostic advancements and more!
Learn more at www.floridadental.org/online-ce
6 | September/October 2026
did you know ...
Your Dental Ads Must Include This Information By FDA Chief Legal Officer Casey Stoutamire
Did you know there is a rule that lists what all advertising by a dentist in any media must include? Rule 64B54.002 states: All advertising in any medium must identify the Florida-licensed dentist who assumes total responsibility for the advertisement. The term “identify” shall mean the use of the license number of the dentist as it appears on his license and renewal certificate or the use of the licensee’s commonly used name together with the current full name, address and telephone number the licensee has on file with the Department.
Yes, this means that any advertising you put out must include all this information or you are in violation of the Florida Board of Dentistry rules and could be subject to disciplinary action. However, there is no “police” actively investigating every piece of advertising put out by dentists. So how would the Board discover a violation? A fellow dentist, hygienist, assistant, patient, disgruntled patient or anyone with knowledge of this rule and its requirements would have to file a complaint with the Board, and an investigation would begin. FDA Chief Legal Officer Casey Stoutamire can be reached at cstoutamire@floridadental.org. Today’s FDA | 7
Dentists’
Day Hill on the
Save the Date TUESDAY, MARCH 23, 2027
REGISTRATION IS OPEN! Scan the QR code to reserve your room in the Four Points by Sheraton room block.
Scan the QR code to register, or visit floridadental.org/ddoh.
ARE YOU A MEMBER OF
FDAPAC CENTURY CLUB? A portion of your dues is transferred to the Florida Dental Association Political Action Committee (FDAPAC). FDAPAC provides campaign contributions to dental-friendly candidates.
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8 | September/October 2026
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FDAPAC Century Club members provide additional financial support of $150 or more for state campaigns. FDAPAC dues and contributions are not deductible for federal income tax purposes.
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legislative action
Help Wanted! By FDA Chief Legislative Officer Joe Anne Hart
LCDs are FDA members who actively build strong relationships with state legislators and other policymakers. LCDs help educate legislators about legislation as it moves through the process and how it will positively or negatively affect dentistry and patients’ access to dental care. The goal of the LCD program is to help deliver a unified message to legislators on dental issues being considered before the legislature. Constituent dentists play an important role in the FDA’s advocacy efforts because personal stories help illustrate how legislative and regulatory decisions may impact the practice of dentistry.
Become a Legislative Contact Dentist! This is an election year, and there will be many newly elected officials in Tallahassee after the November elections. As they begin pursuing legislative initiatives, stakeholder groups and industry representatives will vie for their attention, seeking
to secure support for their policy proposals. This is part of the process and is expected, especially when you have individuals serving who are not experts in your field or profession. The Florida Dental Association’s (FDA) Legislative Contact Dentist (LCD) program serves as the grassroots arm of organized dentistry.
As we get closer to November, we will need your help to ensure every legislator is assigned an LCD. You don’t have to be an expert on legislative issues to become an LCD — the FDA’s governmental affairs team will be your resource for information and guidance. If you are interested in participating in the LCD program, please contact the governmental affairs office at gao@floridadental.org or at 850.224.1089. FDA Chief Legislative Officer Joe Anne Hart can be reached at jahart@floridadental.org.
Today’s FDA | 9
UNITING
JUNE 24-26, 2027 GAYLORD PALMS RESORT AND CONVENTION CENTER | ORLANDO FLORIDADENTALCONVENTION.COM
10 | September/October 2026
FDAPAC candidates
FDAPAC-supported Candidates General Election: Tuesday, Nov. 3, 2026 (as of Aug. 31, 2026) Thanks to your Florida Dental Association Political Action Committee (FDAPAC) membership and support, FDAPAC has already contributed to many candidates’ campaigns for the 2026 General Election. Without the FDAPAC membership, FDAPAC Century Club members and FDAPAC Capital Hill Club members, organized dentistry would not be as effective during the Legislative Session. Below is a list of FDAPAC-supported House and Senate candidates for the 2026 General Election.
ATLANTIC COAST DISTRICT John Snyder, R-Palm City H-86 Jervonte Edmonds, D-West Palm Beach H-88 Debra Tendrich, D-Lake Clarke Shores H-89 Rob Long, D-Boynton Beach H-90 Kelly Skidmore, D-Boca Raton H-92 Hillary Cassel, R-Hollywood H-101 Mike Friend, D-Davie H-102 Robin Bartleman, D-Weston H-103 Mack Bernard, D-West Palm Beach S-24 Lauren Book, D-Hollywood S-30 Rosalind Osgood, D-Tamarac S-32
CENTRAL FLORIDA DISTRICT Chase Tramont, R-Port Orange H-30 Brian Hodgers, R-Viera H-32 Erika Booth, R-Orlando H-35 RaShon Young, D-Orlando H-40 Jose Alvarez, D-Kissimmee H-46 Jason Brodeur, R-Lake Mary S-10
NORTHEAST DISTRICT Audrey Gibson, D-Jacksonville H-13 Dean Black, R-Jacksonville H-15 Jessica Baker, R-Jacksonville H-17 Sam Greco, R-Palm Coast H-19 Judson Sapp, R-Palatka H-20 Jennifer Bradley, R-Fleming Island S-6
NORTHWEST DISTRICT Jon Fay, R-Gulf Breeze H-2 Patt Maney, R-Fort Walton Beach H-4 Shane Abbott, R-Marianna H-5
Tricia Berry, R-Panama City H-6 Allison Tant, D-Tallahassee H-9 Jay Trumbull, R-Panama City S-2
SOUTH FLORIDA DISTRICT Kevin Chambliss, D-Homestead H-117 Mike Redondo, R-Miami H-118 Juan Carlos Porras, R-Miami H-119 Ashely Gantt, D-Miami S-34 Alexis Calatayud, R-Miami S-38 Ana Maria Rodriguez, R-Doral S-40
WEST COAST DISTRICT Jennifer Canady, R-Lakeland H-50 Adam Anderson, R-Tarpon Springs H-57 Kim Berfield, R-Clearwater H-58 Karen Gonzalez Pittman, R-Tampa H-65 Traci Koster, R-Tampa H-66 Bill Conerly, R-Lakewood Ranch H-72 Fiona McFarland, R-Sarasota H-73 Kaylee Tuck, R-Sebring H-83 Colleen Burton, R-Winter Haven S-12 Josie Tomkow, R-Tampa S-14 Nick DeCeglie, R-St. Petersburg S-18 Jim Boyd, R-Bradenton S-20 James Buchanan, R-North Port S-22 Lauren Melo, R-Naples S-28 For additional information on FDAPAC-supported candidates, contact the FDA Governmental Affairs Office at 850.224.1089 or gao@floridadental.org.
Today’s FDA | 11
preventive action
Protecting Your Practice: 5 Cybersecurity Steps Every Dentist Should Take By FDA Services Chief Operating Officer Scott Ruthstrom
Dentistry has quietly become one of the more attractive targets in health care cybercrime. Becker’s Dental Review reports that in the first half of 2026, dental practices and dental benefit administrators across the country reported a striking run of breaches, from a ransomware attack on a Tulsa-area practice to a mid-year incident at DentaQuest,
12 | September/October 2026
the nation’s largest Medicaid and CHIP dental benefits administrator, that ultimately affected roughly 15 million people nationwide, as reported by DentaQuest and covered by Medix Dental. Multi-location practices and small single-doctor offices alike have shown up on breach lists this year.
Not all policies are created equal, so it’s worth reviewing coverage limits, understanding what triggers a claim, and confirming the policy addresses both first-party costs (your own losses) and third-party liability (claims from affected patients).
The reason is simple: dental offices sit on a goldmine of exactly what criminals want. Patient names, dates of birth, Social Security numbers, insurance information and health records are all stored in one place, often on systems with far less information technology (IT) support than a hospital has. That combination of high-value data and comparatively modest defenses makes practices of every size a viable target, not just the large groups that make headlines. The good news is that most successful attacks exploit a small number of predictable weaknesses. Here are five practical steps that meaningfully reduce your risk, none of which require a dedicated IT department to implement.
1. Train Your Team to Spot Phishing (and Keep Training Them) Most health care breaches trace back to an employee action, a clicked link, a fake invoice opened or a password entered on a convincing but fraudulent login page. Your front desk and clinical staff are your first line of defense, but only if they know what to look for. Effective training doesn’t mean a once-a-year lecture. Build in short refreshers, share real examples of scam emails as they show up in your inbox, and consider periodic simulated phishing tests so staff practice catching a fake message in
a low-stakes setting. The goal is a team that pauses and verifies before clicking, especially on anything involving payment changes, urgent account issues or attachments from unfamiliar senders.
2. Lock Down Passwords and Require Multifactor Authentication Weak or reused passwords remain one of the easiest ways into a practice’s systems. Require strong, unique passwords for your practice management software, email, and insurance portals, and turn on multifactor authentication (MFA) wherever it’s available. MFA, which requires a second confirmation, such as a text code or an authentication app, in addition to a password, blocks most account takeover attempts, even when a password has been stolen or guessed. A password manager makes this painless for staff since no one has to memorize a dozen complex login details. Pair this with a policy of immediately restricting access for any employee who leaves the practice; former-employee accounts left active are a common and avoidable gap.
3. Keep Software and Systems Updated Outdated software is a standing invitation. Vulnerabilities in operating systems, practice management platforms and imaging software are regularly discovered and just t
Today’s FDA | 13
Support Starts Here. FDA Member Assistance Program (MAP)
Built for You. Extended to Your Team. The FDA Member Assistance Program (MAP) provides trusted resources, expert guidance and confidential support at no cost to help you reduce stress, improve mental health and make life easier with resources now available for you and your entire team.
MAP Resources Balancing your practice and personal life can be challenging. With MAP, support is closer than you think. Resources include: • Mental Wellness Counseling
• 24/7 Mental Health Support
• Stress Management Assistance
• Life Coaching
• Child and Elder Care Resources
• Legal Referrals
• Grief and Loss Support
• Financial Consultation
Getting Connected is Easy No matter the concern, find the free confidential support you need with MAP.
You may be thinking... Between patients and staff, I am feeling stretched thin. How do I handle it all?
I need help with finding my work-life-balance.
I'm feeling overwhelmed with my student loans. Where do I begin?
• FDA members receive up to 4 counseling sessions, covering all household members. • Team members who work for an FDA member receive in-the-moment counseling.
Call: 800.451.1834 or visit AllOneHealth.com/portal to access your services. FDA Member Code: fdamap Team Member Code: fdastaff
Where do I even start on finding support for my aging parents?
For information on all wellness resources available for FDA members and their team, visit
floridadental.org/healthydentist.
preventive action
as regularly patched, but only if updates are installed. Set devices to update automatically where possible and make sure your IT vendor or in-house point person applies security patches promptly rather than letting them queue up. This applies to network hardware, too. An old router or firewall running outdated firmware is as much a liability as an unpatched computer.
4. Vet Your Vendors and Back Up Your Data Many recent dental data breaches didn’t start inside the practice at all; they started with a vendor. Clearinghouses, billing services, cloud-based practice management platforms, and insurance administrators all touch patient data, and a breach at any one of them can expose your patients even if your own network is never touched. Ask vendors directly about their security practices and make sure any business associate agreement spells out how they protect and report on data. Separately, maintain regular, tested backups of your practice data, stored somewhere disconnected from your main network (encrypted cloud storage or offline media). If ransomware ever locks your files, a clean backup is often the difference between a manageable disruption and a devastating one, and it removes the incentive to pay a ransom in the first place.
5. Carry Cyber Liability Insurance and Understand What it Covers Even a well-defended practice can be breached; the DentaQuest incident shows that a vendor’s exposure can become your practice’s problem regardless of how carefully you’ve locked down your own systems. Cyber liability insurance is designed for exactly this scenario. A good policy typically helps cover the cost of breach investigation, patient notification, credit monitoring, legal fees,
regulatory fines and business interruption — all expenses that can quickly reach well beyond what a small practice could absorb on its own. Not all policies are created equal, so it’s worth reviewing coverage limits, understanding what triggers a claim, and confirming the policy addresses both first-party costs (your own losses) and third-party liability (claims from affected patients). Cyber coverage is now treated as a standard part of a practice’s risk management plan.
The Bottom Line No single step makes a practice immune, but together these five measures — trained staff, strong authentication, current software, vetted vendors with solid backups and the right insurance — all address the vulnerabilities attackers exploit most often. In a year that has already seen dental practices of every size show up on breach notification lists, treating cybersecurity as a routine part of practice management rather than an afterthought is one of the most protective decisions a dentist can make. FDA Services (FDAS) is here to help, and we can review your current cyber plan to ensure it has the appropriate coverage. If you do not have a cyber plan, we can assist you with getting a policy through our preferred carrier, Coalition Insurance.
Sources Becker’s Dental Review, “9 Dental Data Breaches in 2026” and “3 Dental Data Breaches in 2026,” beckersdental.com Medix Dental, “DentaQuest Data Breach Hits 15 Million: What It Means for Dental Practices,” medixdental.com HIPAA Journal, “Healthcare Data Breach Statistics – Updated for 2026,” hipaajournal.com
FDAS Chief Operating Officer Scott Ruthstrom can be reached at scott.ruthstrom@fdaservices.com.
Contact FDAS For Your Insurance Needs! fdaservices.com | insurance@fdaservices.com | 850.681.2996
Today’s FDA | 15
OPIOIDS
HEALTH CARE PROVIDER CHECKLIST: INFORM Nonopioid alternatives are available for pain treatment, which may include nonopioid medicinal drugs or drug products. Nonopioid interventional procedures or treatments are available, which may include: acupuncture, chiropractic treatments, massage, physical or occupational therapy or other appropriate therapy.
DISCUSS Advantages and disadvantages of nonopioid alternatives. Patient’s risk or history of controlled substance abuse or misuse and patient’s personal preferences.
DOCUMENT IN PATIENT’S RECORD Nonopioid alternatives considered.
SUMMARY: All health care providers must include nonopioid alternatives for pain and pain management electronically or in printed form in their discussions with patients before providing anesthesia, or prescribing, ordering, dispensing or administering a schedule II controlled substance for the treatment of pain.
PROVIDE “Alternatives to Opioids,” an educational information pamphlet created by the Florida Department of Health is available in printed and electronic formats (required, available at bit.ly/2KXvZ2h). A checklist and poster are also available.
Exclusive Member Benefit!
FOR THE LATEST ON OPIOIDS, GO TO:
FLORIDADENTAL.ORG/NYK
NONOPIOID ALTERNATIVES LAW:
GO TO bit.ly/2KXvZ2h
dental benefits spotlight
He Who Documents the Most Wins!
By FDA President-elect Bertram J. Hughes, DMD
Insurance intrusion has become more of an issue for dental offices lately. Whether one is in-network or out-of-network, dental insurance companies have a policy for you. For some, it is Delta Dental’s latest scheme to charge dentists a $15 weekly fee to receive a reimbursement check. For others, it is Guardian saying they will only send reimbursement checks every other week, rather than weekly. If you are out-of-network, you are not immune to the insurance company trickery. Aetna, in one of its latest communications, stated that it would no longer issue paper checks
to out-of-network providers. Also, for out-of-network offices, Delta Dental has, in some cases, sent the check to the patient, disregarding the patient’s wish to assign benefits. As dentists fight back, often by dropping their direct contract with a plan, there have been reports of the insurance companies possibly interfering with the doctor-patient relationship. These reports include insurance companies sending letters to a dental practice’s patients, encouraging them to find another dentist and informing them that they can receive dental care at a lower cost by choosing an in-network dentist. What is more egregious is that some insurance companies are
blocking the umbrella association that an office may have. An umbrella association is when an office has a network leasing agreement with an umbrella plan, such as Connection Dental, Dentamax, etc., that covers the same plan the dentist is terminating the contract with. Umbrella plans typically pay higher fees than direct companies and also offer other administrative benefits for a dental practice. When dealing with a dental insurance carrier or dental plan, it is important to document, document and document. First, try to communicate in writing. This can be through email or traditional mail. If you are communicating by telephone, make sure you document the day, the time of day, the agent’s name and ID number or city. Keeping a composition folder near your phone is a great practice to gather this information consistently. While many of these insurance industry business tactics have not been tested in the courts or by regulators, having the data ready will be important when action is taken. If you feel that an insurance company has harmed your practice through some of the aforementioned business practices and you have documentation, feel free to email dentalbenefits@floridadental.org and the Florida Office of Insurance Regulation so our voices can be heard! FDA President-elect and Vice Chair of the ADA Council on Dental Benefit Programs, Dr. Hughes can be reached at BHughes@bot.floridadental.org. Today’s FDA | 17
SAVE THE DATE Friday, January 22, 2027 | Orlando, FL
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18 | September/October 2026
lead
Leadership Development Expands with New LEAD Webinar Series By FDA Leadership Affairs Manager Lianne Bell
What if leadership development didn’t have to wait until January? This fall, the Florida Dental Association (FDA) is expanding its annual leadership development programming with a new series of three free, interactive webinars led by Tiffany Olson, the featured speaker for the 2027 Leaders Emerging Among Dentistry (LEAD) program. The webinars are designed to give FDA and American Student Dental Association (ASDA) members practical leadership skills they can put to work immediately — whether they are leading a dental practice, working with a team, serving in a volunteer leadership role or considering a future leadership role within their dental association or dental school. Each one-hour session will offer an engaging, interactive learning experience focused on a different aspect of effective leadership:
a colleague, motivating others toward a common goal or finding the confidence to step into a volunteer leadership role. These webinars will explore skills that dentists can use every day, inside and outside the dental office. And this is just the beginning. The full-day LEAD 2027 program will return to Orlando in January with a full slate of leadership development and professional growth opportunities. Olson will lead a session on “Foundations of Public Speaking,” followed by programming focused on personal development, getting involved in organized dentistry and developing practical skills for participating in the FDA House of Delegates. The day will conclude with a leadership social event designed to encourage connections and networking among emerging leaders. The fall webinars are free and open to all FDA and ASDA members. Webinar attendance is not required to participate in LEAD, and registering for a webinar does not automatically register participants for the January LEAD program. The webinars are additional opportunities to learn, connect and get a taste of the leadership development experience LEAD has to offer.
• Difficult Conversations — Sept. 29 at 6:30 p.m. ET you are already serving in a leadership role or • Becoming a Respected Leader — Oct. 21 at noon ET Whether are curious about what your next opportunity might be, • The Art of Persuasion — Nov. 17 at 6:30 p.m. ET join us this fall and start building your leadership skills
The sessions are designed to be valuable on their own while also offering a preview of what participants can expect from Olson at LEAD 2027, taking place Jan. 22 in Orlando.
now.
Leadership looks different for everyone. It may mean managing a team, navigating a difficult conversation with
FDA Leadership Affairs Manager Ms. Lianne Bell can be reached at lbell@floridadental.org.
Registration information for each webinar and LEAD 2027 is available at floridadental.org/lead.
Today’s FDA | 19
practice management
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Build Different: The Competitive Advantage No One Can Copy The Breakfast That Changed My Perspective
By David Rice, DDS
I just keynoted a conference for more than 400 owner-dentists who all seemed to have one painful question … “Where do we find better associates?” It’s a fair question. Owners are frustrated. New grads often arrive less clinically experienced than previous generations, while simultaneously entering practice with unprecedented educational debt, different career expectations and a desire for mentorship. At the same time, experienced practice owners are balancing production goals, team challenges, leadership responsibilities and succession planning. It’s not a shocker that many feel trapped in the middle. But after hundreds of conversations with owners, associates and dental students during the past 12 years, I’ve become convinced we’re asking the wrong question. The question is less, “Where do we find better associates?’ and more, “How do we build better associates?” That mindset shift changes everything for dentistry.
20 | September/October 2026
Several months ago, I had breakfast with a highly respected dentist who had owned a successful practice for more than three decades. Their office was beautiful. Their reputation was stellar. Their team was loyal. Their patients loved and trusted them. Yet somewhere between coffee and eggs, that doc looked at me and quietly said, “David, I think I’m done hiring associates.” He wasn’t angry. He wasn’t cynical. He was disappointed. “They don’t diagnose, treatment plan, communicate, or think like an owner and they don’t stay.” Then he paused and said something that I still can’t shake. “Maybe this generation is just built differently.” Two weeks before that breakfast, I had spent an evening with a great group of graduating dental students. Their questions couldn’t have been more different. “How do I know if I’m missing something? How do I become more confident? I hope my first owner mentors me. I’m terrified of letting patients down.”
Because in the end, the greatest competitive advantage in dentistry won’t be the technology you own. It won’t be the procedures you perform. It won’t even be the patients you attract. It will be your ability to help another dentist become the professional they were always capable of becoming.
• They don’t rely on luck. • They don’t hope talented people figure it out. • They build systems. I realized something important that day. Neither genera• They establish expectations. tion is wrong. They see the world through a different lens. • They coach intentionally. • They provide feedback consistently. Friends, we have changed. Dentistry has changed. Today’s graduates enter a profession that looks very differ• They create cultures where people grow. Not one student referenced any of the many negative things I hear day in and out about students today; they all wanted to be better.
ent from the one many of us entered.
• Technology evolves rapidly. • Patient expectations continue to rise. • Practice models are changing. • Nationally and in Florida, ownership patterns and
practice models have shifted, with more early-career dentists choosing group practices or dental service organizations (DSO) before considering private ownership.
• At the same time, many experienced owners built their practices through repetition, independence and learning by doing.
Neither path is inherently better. They’re just different, and the challenge is that too many practices still expect yesterday’s development model to work in today’s environment. It doesn’t.
The Practices That Will Win the Next Decade The practices that thrive during the next decade won’t necessarily recruit better associates. They’ll develop them better. Think about the organizations inside and outside of dentistry that consistently produce exceptional leaders.
Why would we believe dentistry is any different? Every Great Practice Has Two Products When I speak with practice owners, I often ask a simple question, “What business are you really in?” Most answer, “We’re in the business of oral health and patient care.” Okay … sure. But every extraordinary practice has two products. One is exceptional patient care. The other is exceptional dentists. That second product doesn’t happen accidentally. It requires intentional leadership. It requires systems-driven mentorship. It requires a commitment to developing people.
Build Systems, Not Dependence One of the greatest mistakes owners make is assuming that experience automatically creates development. Please read that again because it does not. t Today’s FDA | 21
* The FDA may receive a portion of the fee from purchases made through this advertisement.
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Join us at facebook.com/groups/floridadentalchatter. 22 | September/October 2026
practice management Time alone doesn’t produce consistency; systems do. Great onboarding isn’t a checklist completed during the first week. It’s a development philosophy.
• Clinical calibration. • Communication. • Leadership. • Business understanding. • Decision-making. • Patient experience.
Those aren’t skills people magically acquire. They are competencies that should be intentionally taught, practiced and reinforced. When practices invest in those systems, something remarkable happens.
• Confidence grows. • Consistency improves. • Team trust strengthens. • Patients notice. • And associates begin thinking like future leaders instead of temporary employees.
Leadership Is Legacy At some point, every practice owner has to answer a deeply personal question. “What will my legacy be?” For some, it’s the patients they’ve served. For others, it’s the community they’ve impacted. I would argue there’s another measure: the dentists you’ve helped become extraordinary. Imagine looking back 20 years from now. Which accomplishment would make you prouder? Completing one more crown? Or knowing that the associate who once walked nervously into your practice now leads an incredible team, serves patients with confidence and is mentoring the next generation? That’s a legacy worth building.
Build Different Dentistry has always adapted. That’s one of its greatest strengths. The next evolution isn’t simply adopting new technology or learning the latest clinical technique. It’s becoming intentional about developing people. The future belongs to practices that don’t just hire associates.
• They build clinicians. • They build leaders. • They build future owners.
Most importantly, they build cultures where people can create careers and lives they’re proud of. Because in the end, the greatest competitive advantage in dentistry won’t be the technology you own. It won’t be the procedures you perform. It won’t even be the patients you attract. It will be your ability to help another dentist become the professional they were always capable of becoming. That’s what it means to Build Different. Stay tuned and ask about a Build Different Event near you. My commitment to all of you is to help you on this journey. FDA members get a 10% discount; learn more at floridadental.org/member-center/member-resources/ ignitedds. Dr. Rice can be reached at david.rice@ignitedds.com. Best-selling author, executive coach and founder of IgniteDDS, the nation’s largest community for new dentists and students, Dr. David Rice is a dynamic thought leader in the world of dentistry. With a passion for mentorship, leadership and business success, Dr. Rice travels the globe educating and connecting today’s top young dentists to their self-determined future. As Editor-in-Chief of DentistryIQ and Adjunct Faculty at The Pankey Institute, Dr. Rice is at the forefront of innovation in dentistry, guiding professionals in clinical excellence, business mastery and leadership development. *The FDA may receive a portion of the fee from purchases made through this advertisement.
Today’s FDA | 23
news@fda A WIN FOR FLORIDA DENTISTS: AETNA SAYS PAPER CHECKS WILL REMAIN AN OPTION After the Florida Dental Association (FDA) and the American Dental Association (ADA) challenged Aetna’s plan to discontinue paper checks for out-of-network dentists and urged the company to reconsider, Aetna has reversed course. Aetna now says the original communication announcing the change was sent “in error.” While that explanation raises some questions, the outcome is clear: Florida dentists can continue to receive paper checks and EOBs as before, with direct deposit also available. This is advocacy in action. The FDA stood up for Florida dentists, pushed back on a policy that could limit payment choice, and made sure your concerns were heard. Your voice is stronger with the FDA behind it. If you have questions, please contact FDA Chief Legal Officer Casey Stoutamire at cstoutamire@floridadental.org or 850.350.7202.
FINCEN PERMANENTLY ENDS BENEFICIAL OWNERSHIP REPORTING REQUIREMENTS FOR U.S. SMALL BUSINESSES Final rule makes March 2025 relief permanent following years of American Dental Association (ADA) advocacy The U.S. Department of the Treasury has finalized a rule making permanent in regulation the exemption from beneficial ownership information reporting requirements for U.S. companies, delivering the permanent relief the ADA had sought for dental practices. The Financial Crimes Enforcement Network, or FinCEN, announced Aug. 11 that U.S. companies will remain exempt from beneficial ownership information reporting under the Corporate Transparency Act. FinCEN also said it will remove previously submitted information about U.S. companies and U.S. persons that is no longer required. Businesses and individuals do not need to contact FinCEN to request deletion, and the agency will announce when the deletion process is complete. Please visit bit.ly/4xE9S65 to read the entire article.
REMINDER: NEW ANESTHESIA AND SEDATION PERMIT HOLDER REQUIREMENTS Several new Florida Board of Dentistry anesthesia rules took effect Aug. 19, 2026. Dentists who provide sedation are encouraged to review the following changes carefully to ensure their practices are prepared to comply with the new requirements regarding equipment, patient monitoring, anesthesia permits, inspections and authorized locations.
•
An electrocardiograph (EKG) is now required as standard equipment for moderate sedation permit holders.
•
The patient who is administered a drug(s) for moderate sedation must be continuously monitored intraoperatively by EKG, in addition to pulse oximetry and capnograph and the continuously monitored vital signs must be taken and recorded at a minimum of 5-minute intervals.
•
A pulse oximeter is required for all procedures performed in a dental office that involve the use of minimal sedation and its same day preop and postop readings must be documented in the dental records. Please visit bit.ly/4iXqcdA to read the entire article.
The FDA House of Delegates The FDA House of Delegates may consider proposed bylaws changes at its next meeting, scheduled for Saturday, Jan. 23, 2027, at the Marriott Orlando Airport Lakeside. Any proposed changes will follow recommendations from the Council on Ethics, Bylaws and Judicial Affairs after its fall 2026 meeting.
IN MEMORY OF DR. SANDRA LILO The FDA honors the life of Dr. Sandra Lilo, a dedicated leader, advocate and friend to organized dentistry. Throughout her years of service, Dr. Lilo was deeply committed to strengthening the dental profession and making a difference for those it serves. Her passion for advocacy helped ensure dentistry had a strong voice through her roles as an FDA Legislative Contact Dentist and an Action Team Leader at the ADA. Her service to the underserved in Florida as a member of the FDA Foundation Board of Directors reflected a lasting commitment to giving back and supporting the oral health of all Floridians.
Dr. Lilo works alongside other volunteers at the Florida Mission of Mercy event.
Dr. Lilo gave generously of her time, leadership and talents, leaving an impact that extends far beyond the positions she held. She will be remembered not only for her contributions to dentistry but also for the relationships she built and the lives she touched along the way.
The FDA Office Will Be Closed on the Following Dates • Dec. 25, 2026 • Nov. 26, 2026 • Nov. 27, 2026 • Dec. 31, 2026 • Dec. 24, 2026 • Jan. 1, 2027
news@FDA Learn more by visiting our virtual Member Center at floridadental.org
Welcome New FDA Members The following dentists recently joined the Florida Dental Association (FDA). Their memberships allow them to develop a strong network of fellow professionals who understand the day-to-day triumphs and tribulations of practicing dentistry.
Atlantic Coast District Dental Association Dr. Sebastien Bleau, Riviera Beach Dr. Ricardo J Amaya, West Palm Beach Dr. Radhika Kachhadiya, Davie Dr. Kevin Padron, Palm Springs Dr. Juliessa Criollo, Pompano Beach Dr. Bahia Mohd, Port St. Lucie Dr. Kyle Critelli, Coral Springs Dr. Phillip Evalen, Fort Lauderdale Dr. Michael Borshov, Boca Raton Dr. Peter M Novotny, Delray Beach Dr. Karla Sanchez, Tamarac Dr. Alesia Shaaban, West Palm Beach Dr. Maxwell Tune, Fort Lauderdale Dr. Monika Soliman, Fort Lauderdale Dr. Archak Chakraborty, Plantation Dr. Joanna C O’Hara, Deerfield Beach Dr. David S Dadoun, Boca Raton Dr. Hector Rojas, Plantation Dr. Lincoln McNish, Lauderhill Dr. Bosco Cheung, Coral Springs Dr. Holmes Galiano, Jupiter Dr. Dhiya Denny, Coral Springs Dr. Lidia Maricet Losada, Palm Beach Gardens Dr. Trinity Fry Boszko, Jupiter Dr. Tatyana Williams, Greenacres Dr. Orion W Valentin, Plantation Dr. Gema Torres Chacon, Pompano Beach Dr. Noel Yacoub, Pembroke Pines Dr. Jenifer Andrea Grisales Rivera, Margate Dr. Jad Hamade, Boca Raton Dr. Nina Houri, Palm City Dr. Daniela Gonzalez, North Lauderdale Dr. Alexandra Lueck, Plantation Dr. Julisa Jackson, Coral Springs Dr. Priscila Sevil, Fort Lauderdale Dr. Thu Pham, West Palm Beach Dr. Cassidy Robinson, Port St. Lucie Dr. Amir Kazzoun, Tampa Dr. Jared Kaler, Palm Beach Gardens Dr. Christian Rodriguez, Davie Dr. Gisselle M. McWhorter, Boca Raton Dr. Manal Choudhry, Delray Beach Dr. Julie Suarez, West Palm Beach Dr. Felipe Gomez Campos, Hallandale Beach Dr. Madeline P Stromak, Fort Pierce Dr. Paulo H Laino, Coral Springs
Central Florida District Dental Association
Dr. Sherry M Sharaby, Orlando Dr. Maria Virginia Munoz Estrella, Orlando
26 | September/October 2026
Dr. Apurva S Desai, Ocala Dr. Samuel Lynass, Oceanside Dr. Raul Jose Silvera Hernandez, Orange City Dr. Parth Patel, Ocoee Dr. Obai Takieddin, Winter Garden Dr. Mohamad Ismail, Rockledge Dr. Shrishti Monga, South Daytona Dr. Ali I ElTanbouly, Kissimmee Dr. Ana F Hernandez Perez, Gainesville Dr. Jessica Trieu, Orlando Dr. Kasandra M Shaw, Orlando Dr. Yih-Tsyr Sung, Minneola Dr. Vi Do, Winter Park Dr. Oanh Nguyen, Orlando Dr. Anthony A Aziz, Melbourne Dr. Marissa Andreou, Melbourne Dr. Esmirna Morillo Lajara, Clermont Dr. Noor Alain Ramzi Mutawe, Oviedo Dr. Henry J Brooks, Gainesville Dr. Dana Mutawe, Oviedo Dr. Mohamad Badran, Minneola Dr. Anand Patel, Gainesville Dr. Maria Rebeca Alvarado Mendoza, Orlando Dr. Saidel Hernandez Vazquez, Palm Bay Dr. Laura Alonso Hector, Gainesville Dr. Daniel M Autry, Merritt Island Dr. Raquel Alespeiti, Miami Dr. Tiffany Yoon, Daytona Beach Dr. Lilibeth Cruz Lozada, Orlando Dr. Marianella Natera-Fernandez, Ocala Dr. Yostina Nicola, Oviedo Dr. Michael Eid, Orlando Dr. Leylah K. Coimin, Daytona Beach Dr. Jannie Q Ho, Ocala Dr. Seemat Chowdhury, Lake Worth Dr. Ashley Dachel Fragoso, Orlando Dr. Maria Zakhary, Daytona Beach Dr. David Vargas, Orlando Dr. Hayden Welter, New Smyrna Beach Dr. Nora Terkawi, Orlando Dr. Brandon Wyn-Choi Them, Lake Mary Dr. Sergio L Maqueira, Ocala Dr. Andreina Lara Mendoza, Oviedo Dr. Sheya Patel, Melbourne Dr. Jinal Amin, Orlando Dr. Shiva Hejazi-Werner, Leesburg Dr. Andy Torres, Miami Dr. Kaylie Couch, Gainesville Dr. Zayd Ahmed, Palm Bay Dr. Yoniel Fermin Polanco, Orlando Dr. Nicholas Soto, Gainesville Dr. Carlos Eduardo Terres, Windermere Dr. Diana Torres, Newberry Dr. Kaely M Kantaris, Gainesville Dr. Hiba Syed, Orlando
Dr. Usama Al Saedi, Orlando Dr. Celine Hernandez, Ocala Dr. Rockwell Henry Farrell, Ocklawaha Dr. Omar Lababidi, Orlando Dr. Mazen Ayoub, Minneola Dr. Rehana G Koilpillai-Castro, Gainesville Dr. David Habib, Ocala Dr. Mandy M Sawires, Apopka Dr. Sophia Y Roth, Gainesville Dr. Darby E Graves, Winter Garden Dr. Thomas Koby-Hercsky, Titusville Dr. Marrisa Lee, Newberry Dr. Juliah Laemmer, Gainesville Dr. Austin Chan, Palm Bay Dr. Gabriela Bartelle, Winter Garden Dr. Samuel Jacob Funaro, Gainesville
Northeast District Dental Association
Dr. Florencia Bracigliano, St. Johns Dr. Sadie Alavi, Orange Park Dr. Joshua M. Graham, Ponte Vedra Beach Dr. Javier Alberto-Sowers Bonamego, Jacksonville Beach Dr. Patrick Canty, Middleburg Dr. Lenka Serdar, Ponte Vedra Dr. Gerald James Greenan, Jacksonville Dr. Meena Haitham Sholji, St. Johns Dr. Baher Khattar Almhithawi, Jacksonville Dr. Shreya S Iyengar, Jacksonville Dr. Chloe Joye Inez Ways, Ponte Vedra Dr. Ibram Samuel, Fleming Island Dr. Phyu S Aung, Jacksonville Dr. Meagan Bauer, St. Augustine Dr. Henna Patel, Jacksonville Dr. Hersh Shah, Jacksonville Dr. Nadia Smith, Jacksonville Dr. Vanessa Blanco, Jacksonville Dr. Samuel Shrewsbury, Jacksonville Dr. Manuel Miguel, St. Augustine Dr. Brooke E Meka, Knoxville Dr. Alexis H Piscitello, Gainesville Dr. Claudia Arias Garcia, Jacksonville Dr. Juhi Goyal, Jacksonville Dr. Logein Badi, St. Augustine
Northwest District Dental Association Dr. Kimberly Garcia, Destin Dr. Hans Lee, Freeport Dr. Cynthia Ton, Pensacola Dr. Peyton Burkett, Niceville
Dr. Kali Harris, Pensacola Dr. Baillie Jones, Crestview Dr. Mina R Zakhary, Santa Rosa Beach Dr. Brayden Oxborrow, Niceville Dr. Harrison Daniels, Tallahassee Dr. Nicole Youd, Panama City Dr. Erin Sinada, Destin Dr. Samantha Johnson, Mary Esther Dr. Jasmine Rojas, Marianna Dr. Daniel Overfelt, Tallahassee Dr. Katelynn N. Clark, Panama City Dr. Luke A Whitlow, Panama City Dr. Yul S Prince, Cantonment Dr. Jorge Lima, Santa Rosa Beach Dr. Morgan P. Pogalz, Santa Rosa Beach Dr. Joshua Boland, Panama City Beach Dr. Donald Jean Goudreau III, Gulf Breeze Dr. John Azzaro, Pensacola Dr. Shauni H Cooley, Bonifay
South Florida District Dental Association
Dr. Ashley Bryant, Marathon Dr. Luca Sfogliano, Miramar Dr. Diego Machado, Coral Gables Dr. Lexie Perez, Miami Dr. Abdullah Alomair, Miami Dr. Lisbet Vazquez, West Palm Beach Dr. Nayla Hernández Morales, Miami Dr. Marta E Brito Diaz, Miami Dr. Rafael Laborde Ramos, Cutler Bay Dr. Alberto Rivero del Toro, Miami Dr. Merve Izmirli Sieg, Weston Dr. Isis Valdés Acosta, Hialeah Dr. Noelbis Ramos, Miami Gardens Dr. Nicholas David Carrillo, Miami Dr. Daniel Osherov, Miami Dr. Paulina M Kalantarov, Pembroke Pines Dr. Ana Canizares, Miami Dr. Claudia Valladares, Miami Dr. Hansell Gomez, Cutler Bay Dr. Dayling Lopez, Hialeah Dr. Mirtha E. Bosch, Miami Dr. Juan E Montiel, Doral Dr. Marlene Barros, Pinecrest Dr. Jannet K Mathew, Dorchester Dr. Yatsunarys Pereda, Hialeah Dr. Rozhin Daneshgar, Weston Dr. Ignacio Lopez-Castro, Coral Gables Dr. Remi S Kadyimov, Hollywood Dr. Roger Nachar, Miami Beach Dr. Tamar Rogoszinski, Miami Dr. Rocio Acosta, Hialeah Dr. Luis Enrique Centeno III, Miramar Dr. Paola de Cardenas, Miami Dr. Mohammad Saqib Ihsan, Hollywood Dr. Beatriz Rodriguez Valentin, North Bay Village Dr. Alejandra M Flores, Key Largo Dr. Isabela Soto Lopez, Weston Dr. Christine N Tran, Miramar Dr. Jacqueline Marie Garcia, Davie Dr. Heather Dasher, Palmetto Bay Dr. Mirene Gonzalez, Miami Dr. Luis Salas Otamendi, Doral Dr. Eric Barreto, Miami Dr. Marina Figueredo, Miami Dr. Valeria Iza, Miami Dr. Mariela Mulet Garcia, Miami Dr. Maricely Monteagudo Pena, Miami Dr. Geraldine Palacios Carreno, Hialeah Dr. Amanda J. Katen, Miami Dr. Juan S Bojana, Hialeah
Dr. Raquel Villar Machado, Miami Dr. Kelly Barbara Perez, Clearwater Dr. Viviana Perello, Coral Gables Dr. Christina Marie Magluta, Miami Dr. Raul Perez Lopez, Miami Dr. Amanda Dahl, Coral Gables Dr. Liliana Hernandez Cleto, Miami Dr. Emanuel Dominguez-Henderson, Miami Dr. Wilner Triana, Davie Dr. Gretchen Perez Mayedo, Miami Dr. Diana Black, DeBary Dr. Thalia Gonzalez, Miami Lakes Dr. Jessica Vazquez, Cooper City Dr. Jessica Schlaen, Hollywood Dr. Carlos Pena, Cooper City Dr. Melissa Regla Valladares, Miami Dr. Dan Topiol, Miami Dr. Michelle Quesada Enriquez, Miramar Dr. Grant Rosenbaum, Hollywood Dr. Victoria Parente, Doral Dr. Ksenia Liss, Sunny Isles Beach Dr. Ivan Alejandro Majugariten, Miramar Dr. Laura Mendez, Hialeah Dr. Saola Lara, Miami Springs Dr. Jacqueline Le, Davie Dr. Christine Rodriguez, Miami Lakes Dr. Marie-Helene Julien, Davie Dr. Jorge Felix Velazquez, Miami Dr. Jennifer Nunez, Miami Dr. Paola Aleman, North Miami Dr. Andrea Estefania Marrero Pena, Doral Dr. Claudia Gomez Chavez, Miami Dr. Ottmar Raddatz, Miami
West Coast District Dental Association
Dr. Grace Rayner, Greenacres Dr. Nataly Clark, Holiday Dr. Jennifer Olivares, Sarasota Dr. Adam M Miller, St. Petersburg Dr. Ilianet Álvarez Ávila, Sarasota Dr. Gabriela Isabel Meinhardt Bello, Clearwater Dr. Christopher Michael Gordon, Longboat Key Dr. Adriana Rosendo Veliz, Fort Myers Dr. Suchita Bandarupalli, Thonotosassa Dr. Andre Pedroso, Sarasota Dr. Pal Patel, Winter Haven Dr. Santino Esposito, Largo Dr. Alexis Dulkoski, Lithia Dr. Yi Lin Li, Estero Dr. Brittany Leeper, Apollo Beach Dr. Hannah B Thompson, Bradenton Dr. Engy Eskandar, New Port Richey Dr. Lindsay Scott Hasson, Naples Dr. Thalia Rodriguez, St. Petersburg Dr. Issa Elabed, Philadelphia Dr. Gabriela Garzon, Cape Coral Dr. Cindy Di Nicola, Wesley Chapel Dr. Iriny G Tadros, Lutz Dr. Shaymaa Elshaer, Trinity Dr. Alexander Michael Powell, St. Petersburg Dr. Farah J. Basha, Tampa Dr. Jillian Carter, Bradenton Dr. Lauren Buschur, Tampa Dr. Carter Bedinghaus, Bradenton Dr. Nadia Hoxhalli, St. Petersburg Dr. Alec Dybiec, Tampa Dr. Danielle E Kleeman, Tampa Dr. Liam Ghazal, Lakewood Ranch Dr. Dongdan Winnie Guo, Sarasota Dr. Samantha Reilly Incognoli, Tampa Dr. Carl-El Jonathan Alain Semerzier, Sebring
in memoriam The FDA honors the memory and passing of the following member: Dr. Richard Chris Georgiades Sarasota Died: 8/19/2026 Age: 93
Dr. Ashley Megan Colby, Boca Raton Dr. Diana Hoang, Sarasota Dr. Ahmed Badawy, Trinity Dr. Charlie R Brimacombe, Naples Dr. Gabriela M. Torres Santana, Ruskin Dr. Valentina Barrucci Miani, North Port Dr. Nicole A Carlson, Clearwater Dr. Caitlin Villareal Blanchard, Sarasota Dr. Hamna Arshad Zaidi, Sanford Dr. Lauren Catherine Guillot, Englewood Dr. Carmen G Harkins, Tampa Dr. Timothy Joseph Dixon, St. Petersburg Dr. Jacklyn Molstad, Murrieta Dr. Gracie Groth, Bradenton Dr. Taylor Kluttz, Tampa Dr. Hardi Shukla, Lutz Dr. Yeny Monzon, Lutz Dr. Jyotika Jain, Tampa Dr. Adriana C Carrion Marquez, Clearwater Dr. Fadi El-Akawi, Clearwater Dr. Vanessa Ledesma Rojas, Sarasota Dr. Margaret Loze Khale, Tampa Dr. Cameron Fancher, Fort Myers Beach Dr. Ronza Saad, Seffner Dr. Luisana M Gonzalez Barberii, Wesley Chapel Dr. Mairin Valladares Caride, Largo Dr. Marnelli Deborah Geronimo Tan, Brandon Dr. Alexander V. Doan, Orlando Dr. Abdullah Naeem, Tampa Dr. Michelle Tran, Parrish Dr. Zaina Othman, Tampa Dr. Michelle Zharkov, Bradenton Dr. Shahriar Shahami, Fort Myers Dr. Matthew King, Port Charlotte Dr. Luis J. Gallardo-Vega, Lakeland Dr. Rosalba Rodriguez Garcia, Tampa Dr. Cade Awbrey, Lehigh Acres Dr. Juliette Defant, Dade City Dr. Shailja Desai, Davie Dr. Joseph Robert Colletti, Phoenix Dr. Connor Fitzgerald, Tampa Dr. Kujal Chauhan, Lakeland Dr. Shreeya Desai, Cape Coral Dr. Disha D Patel, Odessa Dr. Noah Nalewaja, Davie Dr. Maria Jessenia Walsh, Bradenton Dr. Safa Gurwala, Wesley Chapel Dr. Ashwin Meyyappan Sevugan, Sarasota Dr. Devesh Patel, Clearwater Dr. Barbahra Carolynie Amorim Reis, Fort Myers Dr. Spencer Morrison, Cape Coral Dr. Blake B. Hamel, Brandon Dr. Branda J Rayo, Fort Myers Dr. Omar Elrabi, Valrico Dr. David B. Mann, Bradenton Dr. Marian Teresa Salgado, Estero Dr. Gabriella H. Baydoun, St. Petersburg Dr. Themaar Abuhasna, Sarasota Dr. Emily M Tobkes, Brandon
Today’s FDA | 27
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board of dentistry
Florida Board of Dentistry Meets in Wesley Chapel By FDA Chief Legal Officer Casey Stoutamire
The next BOD meeting is scheduled for Friday, Nov. 6, at 7:30 a.m. ET in Ft. Lauderdale. The Florida Dental Association (FDA) was represented by Board of Dentistry (BOD) Liaison Dr. Steve Hochfelder and Chief Legal Officer Casey Stoutamire. Drs. Todd Britten and Brian Coleman were also in attendance. Hygiene students from St. Petersburg College, Hillsborough Community College, State College of Florida and Concorde Career Institute were also present. BOD members present included: Dr. Nick White, chair, Ms. Karyn Hill, vice chair, Drs. Marc Anderson, Brad Cherry, Andrew Forrest, Chadwick Marshall, Thomas McCawley, and Jessica Stilley-Mallah; hygiene member, Ms. Angela Johnson and 30 | September/October 2026
consumer member Ms. Kelly Mallette. Consumer member, Mr. Ben Mirza, was absent. The Board approved multiple Mobile Opportunity by Interstate Licensure Endorsement (MOBILE) applications. As a reminder, due to a change in legislation, the Board has discretion to grant a MOBILE license even if the application has information reported to the National Practitioner Database (NPDB). Thus, the Board questioned each applicant about the circumstances that led to the prior discipline or settlement reported to the NPDB. This agenda item will remain one of the larger items at each meeting due to the number of dentists and hygienists applying for licensure through this pathway.
The Board initiated rulemaking at the request of the Florida Department of Corrections. The language will allow assistants in correctional institutions to take radiographs under general supervision, but they will still be required to have formal training. The final rule language will be presented to the Board in November for approval. The Anesthesia Committee held a meeting the day before the Board meeting to discuss issues not finalized at the May meeting. While no new rules were proposed, there was much discussion on updating continuing training requirements for all permit holders. The Board approved a “fix” to the rule changes passed in November on remediable tasks delegable to dental assistants regarding implants. No significant substantive changes were made, but a section of the rule needed to be stricken, and other language needed to be moved to the correct section. Below is the rule language passed by the Board. Rule 64B5-16.005 Remediable Tasks Delegable to Dental Assistants
(1) The following remediable tasks may be performed by a dental assistant who has received formal training and who performs the tasks under direct supervision: (a) Placing or removing temporary restorations with non-mechanical hand instruments only; (b) Polishing dental restorations of the teeth when not for the purpose of changing the existing contour of the tooth and only with the following instruments used with appropriate polishing materials – burnishers, slowspeed handpieces, rubber cups, and bristle brushes; (c) Polishing clinical crowns when not for the purpose of changing the existing contour of the tooth and only with the following instruments used with appropriate polishing materials – slow-speed hand pieces, rubber cups, bristle brushes and porte polishers; (3) The following remediable tasks may be performed by a dental assistant who has received on-the-job training and who performs the tasks under direct supervision: (a) Applying topical anesthetics and anti-inflammatory agents which are not applied by aerosol or jet spray and; (b) Changing of bleach pellets in the internal bleaching process of non-vital, endodontically treated teeth after the placement of a
rubber dam. A dental assistant may not make initial access preparation. (c) Remove implant hybrid prosthetic dentures with a string attached to the removing tool at all times; (d) Remove healing abutments and place scan body on the implant in order to be able to perform intra oral digital scanning; and (e) Placing intermediate material that serves as a barrier between the implant screw and restoration of the access screw of the implant restoration
Remember, it is much better to be a spectator than a participant in BOD disciplinary cases.
(6) The remediable task of polishing crowns when not for the purpose of changing the existing contour of the tooth may be performed by a dental assistant who has received formal training and who performs the task under general supervision. This task must be executed only with slow-speed handpieces, rubber cups, or bristle brushed utilized with the appropriate polishing materials. Finally, the Board approved a change to rule 64B5-16.006 Remediable Tasks Delegate to a Dental Hygienist allowing properly trained hygienists to use certain lasers for certain tasks. The proposed rule language states: (2) The following remediable tasks may be performed by a dental hygienist who has received training in t Today’s FDA | 31
board of dentistry
these procedures in pre-licensure education or who has received formal training as defined by Rule 64B516.002, F.A.C., and who performs the tasks under Direct supervision: (j) Use a dental laser so long as the hygienist does not perform any procedure that is irreversible and the use of the dental laser shall be limited to the use of bacterial reduction/ disinfection of the gingival sulcus at settings that preclude hard and soft tissue removal except for incidental gingival curettage, if the following criteria are met: (1) Prior to utilizing a dental laser, the dental hygienist must successfully complete an in person interactive didactic and clinical training which includes laser safety, infection control, patient management and the operation of the specific laser(s) utilized in the dental practice. Training must be a minimum of 12 hours of instruction. Programs meeting the requirements of this subsection may be developed and offered to hygienists by any of the following agencies or organizations: a. The American Dental Association, the National Dental Associations, and state associations and societies affiliated with the American Dental Association or the National Dental Association.
32 | September/October 2026
b. National or state dental specialty programs c. Dental Colleges or hygiene schools accredited by the Commission on Dental Accreditation (CODA) or its successor entity (2) A dental hygienist utilizing a dental laser must maintain evidence of training as required which must be prominently displayed at the location where the dental hygienist is authorized to utilize lasers. (3) The use of Lasers by dental hygienists pursuant to this section is restricted to the following wavelength ranges: a. Diode Lasers: Wavelengths between 810 mm and 1064 mm for photothermal bacterial reduction b. Nd: YAG Lasers: Wavelength of 1064 mm for laser bacterial reduction. (4) When utilizing a dental laser pursuant to this section, a dental hygienist is prohibited from using lasers capable of removing hard tissue or those used for surgical cutting (such as CO2 at 10,600 mm) (5) The requirements contained herein do not apply to the use of non-adjustable laser units used for the purposes of diagnosis and curing.
(6) When utilizing a dental laser pursuant to this section, the dental hygienist must document the following information at a minimum, in the patient’s records: a. the type of utilized, to include the wavelength of the laser; b. the settings used, such as pulse or continuous wave, and the power setting; and, c. local anesthesia used, if any. As a reminder, these rules are not yet effective because they must go through the rulemaking process. Please contact the FDA with any questions on the effective date. There were three disciplinary cases and one recommended order with an informal hearing, involving a dentist with 12 pending cases. Topics included patient abandonment, performing endodontic treatment without the use of a rubber dam and performing a root canal below the standard of care. FDA Chief Legal Officer Casey Stoutamire can be reached at cstoutamire@ floridadental.org.
website compliance
Don’t Let Website Accessibility Catch You by Surprise
By Gary Altschuler, DMD
Did you know your practice website may need to comply with accessibility requirements under the Americans with Disabilities Act (ADA)? Until recently, I didn’t. The issue came to my attention during a conversation with a col-
league through the Florida Dental Association (FDA). They shared that they had temporarily taken down their practice website because they were concerned it might not be ADA compliant and could expose them to legal action.
over alleged website accessibility violations. Like many practice owners, I had no idea whether my own website met accessibility standards. Rather than take unnecessary risks, I temporarily shut down my website while I gathered more information.
That conversation prompted me to investigate further. I learned that dozens of small businesses in my county had reportedly been sued
Fortunately, organized dentistry proved invaluable. t Today’s FDA | 33
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www.accessibilitychecker.org
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34 | September/October 2026
website compliance
After speaking with another FDA colleague and doing additional research, I learned that website accessibility generally refers to ensuring that individuals with disabilities, including those who are blind or visually impaired, can effectively access and navigate a website using assistive technologies. It was a requirement I had never previously considered.
It is discouraging that conscientious small businesses and health care providers can face legal challenges for failing to meet technical requirements they may not even know exist. Dentists dedicate their careers to caring for patients of every background and ability. Our profession is built on providing compassionate and equitable care rather than a culture of exclusion.
Within a day, I worked with my website provider to add accessibility features, including an accessibility widget, to improve access for all users. Is it a guarantee of complete compliance? Probably not. Website accessibility is an evolving area, and no single solution can promise immunity from legal challenges. However, taking proactive steps to improve accessibility is the right thing to do for our patients and an important part of managing practice risk.
While many of us might wish there were an opportunity to correct accessibility issues before facing legal action, the reality is that practice owners must remain vigilant in an increasingly complex regulatory environment.
The experience also reminded me of another benefit of organized dentistry. Through FDA Services, members have access to cyber liability insurance and other resources that may help protect practices from certain technology-related claims and security incidents. Having trusted resources available when unexpected issues arise provides valuable peace of mind.
Having trusted resources available when unexpected issues arise provides valuable peace of mind.
My advice is simple: review your website, discuss accessibility with your website provider and understand what protections your practice has in place. Most importantly, stay connected with organized dentistry. Sometimes the most valuable member benefit isn’t a product or service, but rather the timely conversation with a colleague that helps you recognize a problem, find a solution and avoid becoming the next cautionary tale. Dr. Gary Altschuler is a periodontist in Gainesville and can be reached at gary@altschulercenter.com.
Today’s FDA | 35
The One Thing Artificial Intelligence Will Never Replace AI²: Authentic Intention in the Age of Artificial Intelligence By Dr. Mili Patel, Founder of Smile Design Dentistry
I still remember a patient looking across the operatory and asking me a question that had nothing to do with crowns, implants or treatment options. She simply asked, “Doctor, if I were your sister, what would you do?” That question stayed with me for more than 20 years because she was not asking for more information. She was asking if she could trust my intention. Looking back, I realize that moment 36 | September/October 2026
taught me one of the most important leadership lessons of my career. Today, dentistry stands at another defining moment. Artificial intelligence (AI) is transforming our profession in remarkable ways. AI can analyze information, summarize records, streamline operations,
improve communication and even help clinicians make better-informed decisions. Those advancements are exciting and necessary. Used thoughtfully, artificial intelligence gives us something increasingly valuable: more time to focus on people instead of paperwork.
artificial intelligence
But as AI becomes more powerful, I believe another form of AI must grow alongside it. I call it AI²: Authentic Intention. Authentic Intention is the conscious decision to ensure that every interaction begins with the right purpose. Before every recommendation, every difficult conversation and every leadership decision, we should pause and ask a simple question: Why am I doing this? Am I trying to protect my own comfort, or am I truly acting in the best interest of the person in front of me? Throughout my journey building Smile Design Dentistry from a single practice into a multi-location organization, I learned that systems create consistency, but intention creates culture. We invested heavily in technology, clinical excellence and operational processes. Those things mattered. But they were never what people remembered most. Patients remembered whether they felt heard. Team members remembered whether they felt respected. Trust was built one intentional conversation at a time. In health care, technology should never become a substitute for human judgment. AI can generate a beautifully written email, but it cannot decide whether the message reflects empathy. It can organize clinical data, but it cannot look a frightened patient in the eyes and offer reassurance. It can suggest
2.
I often tell my teams that patients do not say yes to treatment plans; they say yes to people they trust.
possibilities, but it cannot carry the ethical responsibility that belongs to a healthcare professional. That is why I believe the conversation surrounding AI has focused too heavily on what the technology can do and not enough on who we must become as we use it. The future of dentistry will not be defined simply by the practices with the newest software or the fastest workflows. It will be defined by leaders who understand that efficiency without intention can leave patients feeling processed instead of cared for. I often tell my teams that patients do not say yes to treatment plans; they say yes to people they trust. That belief has guided my career, and it will become even more important in the years ahead. As artificial intelligence becomes increasingly common, authentic relationships will become increasingly rare and therefore increasingly valuable. I hope that we embrace both forms of AI. Let AI handle repetitive tasks so that clinicians can devote more energy to listening, teaching and caring. Let Authentic Intention shape every decision that no algorithm can make:
how we lead, how we communicate, how we earn trust and how we serve. The greatest competitive advantage in the future of dentistry will not be technology alone. Technology will become accessible to everyone. Authentic Intention will not. It is a choice that every leader, every clinician and every team member makes every day. Technology may scale efficiency, but Authentic Intention will always scale trust. And in health care, trust has always been and will always remain the foundation of extraordinary care. Dr. Mili Patel is a dentist, entrepreneur, educator and leadership speaker. She founded Smile Design Dentistry and grew the Florida-based organization from a single practice to 60 locations, more than 600 team members and more than 80 doctors before its 2025 sale to Heartland Dental. She was honored as the 2026 Tampa Bay Businesswoman of the Year. Drawing on more than two decades of clinical and organizational leadership, Dr. Patel speaks on trust, culture, communication and authentic intention in the age of artificial intelligence. Dr. Patel can be reached at milidmd@gmail.com.
Today’s FDA | 37
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cyber
5 Essential Insights From Our 2026 Cyber Claims Report How Active Insurance is Helping Businesses Overcome the Cyber Protection Paradox By Robert Jones, Coalition
twice as likely to experience a cyber incident as they were five years ago. Attackers are working smarter, pivoting from simple encryption to complex data extortion and system-level financial fraud. To break this cycle, businesses need more than just shiny new tools; they need a clear-eyed understanding of how losses are actually occurring across the digital economy. Today, we’re releasing our 2026 Cyber Claims Report, derived from our analysis of Coalition’s more than 100,000 global policyholders and real-world claims. Below, we’ve identified five essential insights that illustrate how Coalition is helping businesses overcome the Cyber Protection Paradox and prioritize resilience with Active Insurance.
1.
64% of Closed Claims Resolved with No Out-of-Pocket Loss
Perhaps the most powerful proof of Active Insurance's benefits is how it protects policyholders’ bottom lines. In 2025, 64% of closed claims were resolved with zero out-of-pocket loss for the policyholder.*
In an era of record-breaking cybersecurity spending, the threat landscape continues to shift at an unprecedented pace. Businesses are investing more than ever in their digital defenses, yet many find themselves caught in the Cyber Protection Paradox: More security tools and increased spending aren’t making businesses any safer. In fact, businesses are now 40 | September/October 2026
Our goal isn’t simply to help cover losses after an incident, but to identify, intercept, and stop threats before they ever touch our policyholders’ capital. By intervening at the moment of impact and providing in-house expertise, we’re redefining what it means to be “covered.”
2.
Data Exfiltration is the New Ransomware Multiplier
Encryption alone is no longer the primary driver of ransomware severity. Attacks involving data exfiltra-
tion and encryption accounted for 70% of all ransomware claims in 2025.
institutions and law enforcement, we’ve clawed back over $158 million to date.*
When an attacker steals sensitive data, the claim typically doesn’t end with a system restore. It can ignite a long-tail cycle of forensic mining and legal liability. These dual-extortion incidents were twice as expensive as those involving encryption alone, with an average cost of $302,000.
From Passive Coverage to Active Insurance
3.
A Record 86% of Businesses Refused to Pay Ransoms
While initial ransom demands jumped 47% year over year to more than $1 million, businesses are finally reclaiming the leverage. In 2025, a record 86% of Coalition policyholders hit by ransomware attacks refused to pay the demand. This milestone signals a massive shift in defensive maturity. By utilizing robust recovery protocols and specialized negotiation teams, businesses are proving that they no longer have to be passive payers.
4.
New Pathways to Funds Transfer Fraud
Business inboxes remain the primary battlefield for financial loss, but our report reveals a technical evolution: 20% of all funds transfer fraud (FTF) events were driven by fraudulent instructions sent directly to banks, bypassing employee interaction entirely. Perhaps even more surprising: 39% of FTF events occurred without any confirmed email compromise. Rather than spending weeks manipulating an employee through social engineering, attackers are increasingly using compromised credentials to directly target financial systems, a shift toward faster, more silent fraud.
5.
$21.8M in Wire Fraud Clawed Back for Policyholders
When funds are stolen, the first 48 hours often determine whether that money is lost forever or successfully recovered in whole or in part. In 2025, Coalition successfully recovered $21.8 million in stolen funds on behalf of policyholders, averaging $202,000 per incident. Clawbacks are one of the more tangible examples of how Active Insurance can help policyholders recover from financial fraud. Through rapid coordination with financial
The findings in our 2026 Cyber Claims Report make one thing clear: The legacy playbook of traditional cyber insurance isn’t enough in a risk landscape where attackers move at machine speed and ransom demands are more aggressive than ever. The data proves that the Cyber Protection Paradox doesn’t have to be an inevitability for businesses that take an active approach to cyber risk. When businesses embrace Active Insurance by acting on real-time risk alerts and leveraging expert incident response, they don’t just survive attacks — they can stop them in their tracks. Go to coalitioninc.com/claims-report/2026 to view the 2026 Cyber Claims Report. *Every claim is unique. Claim scenarios and outcomes are for illustrative purposes only, and are intended to show how a claim may be (but not necessarily will be) evaluated and handled. These statements are not guarantees of future outcomes or coverage determinations. Whether a specific loss is covered by a policy depends on the unique facts of the event, the actual policy language as issued and applicable law. This article is designed to provide general information on the topic presented and is not intended to construe or render legal or other professional services of any kind. If legal or other professional services are required, the services of a professional should be sought. The views and opinions expressed as part of this blog post do not necessarily state or reflect those of Coalition. The reader is cautioned to consult independent professional advisors and formulate independent conclusions and opinions regarding the subject matter discussed herein. Coalition makes no representations as to the accuracy or completeness of this content. Any action taken based on this information is at the sole discretion and risk of the reader. Coalition and its affiliates expressly disclaim any liability for losses or damages resulting from the use of or reliance on this information, which is used strictly at the reader’s own risk. Copyright © 2026. All rights reserved. Coalition and the Coalition logo are trademarks of Coalition, Inc.
Today’s FDA | 41
Cybersecurity in 2026: What Every Dental Practice Should Be Doing Now By Gary Salman, CEO, Black Talon Security
A dental practice is more than a clinical environment. It is a digital business that depends on practice-management software, imaging systems, email, cloud applications, payment platforms and outside vendors. When those systems are unavailable, treatment may be delayed, schedules disrupted, records inaccessible and patient information exposed. Cybersecurity should therefore be treated as a patient-safety and business-continuity issue, not simply an information technology (IT) or HIPAA project. Ransomware remains one of health care’s most serious threats, but today’s attacks are not limited to
42 | September/October 2026
encrypting data. Criminals often steal patient, employee and financial information before locking systems, then threaten to publish it. Even when backups allow restoration, the practice may still face notification requirements, expenses, reputational damage and extortion. Backups are essential, but they are not a complete cybersecurity strategy. Attackers are also exploiting people and technology. Artificial intelligence can help criminals create convincing emails that impersonate doctors, administrators, vendors, banks or referring practices. A single click or
stolen password may expose email, payroll, banking and clinical systems. Attackers also scan firewalls, remote-access tools, computers, servers and software for vulnerabilities, sometimes exploiting newly disclosed weaknesses within hours or days. Because many attacks begin with human error or third-party access, employees need regular cybersecurity awareness training and vendor accounts should be limited, monitored, secured and removed promptly when no longer required.
cyber
This environment requires continuous risk reduction rather than annual compliance. Practices need a current inventory of devices and applications, advanced email and identity protection, multifactor authentication, endpoint detection and response, and 24/7 monitoring by qualified security personnel. Vulnerability scanning should identify weaknesses across computers, servers and internet-facing devices, with high-risk and known-exploited vulnerabilities prioritized for rapid remediation. Systems should then be rescanned to confirm that corrective action worked. Backups should be isolated from normal administrative accounts and tested by performing an actual restoration. Practices should also consider independent penetration testing at least annually to determine whether weaknesses can be combined to gain unauthorized access or move across the network.
Clear roles and collaboration are important. The IT provider should continue managing day-to-day technology, while a dedicated cybersecurity company supports specialized monitoring, vulnerability management, testing and reporting. This complementary approach adds objective oversight and useful checks and balances without replacing the IT provider or duplicating its services. Practice leaders should be able to see whether cyber risk is increasing or decreasing, which vulnerabilities require attention, whether security tools are operating correctly, and whether identified problems were resolved. Security should be supported by measurable evidence rather than general assurances. Every dental practice also needs a written incident-response plan. The plan should identify decision-makers, cybersecurity and legal contacts,
insurance resources, communication alternatives and procedures for continuing patient care when systems are unavailable. It should be tested through a tabletop exercise at least annually. No practice can eliminate every cyber risk. The goal is to prevent avoidable attacks, detect threats early, limit damage, protect patient information and recover safely. In 2026, cybersecurity must be continuously tested, measured and improved. Gary Salman is CEO and co-founder of Black Talon Security. A leader in the cybersecurity field, Mr. Salman has a 25-plus-year background in law enforcement and health care technology. His firm monitors and secures more than 2,000 dental practices and 65,000 computers and networks worldwide and has trained tens of thousands of health care professionals. Mr. Salman can be reached at gary@blacktalonsecurity.com.
Practice leaders should be able to see whether cyber risk is increasing or decreasing, which vulnerabilities require attention, whether security tools are operating correctly, and whether identified problems were resolved.
Today’s FDA | 43
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Learn more online at FloridaDental.org/PeerReview or by contacting FDA Peer Review Coordinator Lywanda Tucker at 850.350.7143 or ltucker@floridadental.org
44 | September/October 2026
technology
10 Things You Can Do Today to Better Secure Your Practice By Debi Carr, HCISPP, CAHIMS, DK Carr and Associates
For many practices, the Health Insurance Portability and Accountability Act (HIPAA) is a one-and-done process. Many practices believe they are compliant because they conduct a training once a year. Our technology has changed and today’s practices depend on that technology for almost everything — scheduling, imaging, charting, billing, etc. A single compromise can potentially disrupt the entire practice for days or even weeks. The good news is that protecting your practice and meeting compliance doesn’t necessarily require a huge cybersecurity budget or an information technology (IT) department down the hall; it starts with understanding your risk and putting reasonable safeguards in place to reduce them. This is also foundational for the HIPAA Security Rule. It’s a risk management process. So instead of asking, “Are we HIPAA compliant?” perhaps a better question is: “What are we doing today to reduce the risk to our practice and protect our patients?”
t
Today’s FDA | 45
technology Here are 10 practical places to start. You can’t protect what you
1 don’t know you have.
Create and maintain an inventory of all the technology used throughout the practice. This should include computers, servers, laptops, tablets, phones, printers, network equipment, software, cloud applications (including cloud practice management software) and medical or dental equipment that connects to the network. Don’t forget about older equipment. A device may still work perfectly well but contain an outdated operating system or software that is no longer receiving security updates. Also look for remote access programs that are no longer needed. Know Where Your Patient 2 Information Goes Follow patient information from the moment it enters your practice until it is left or is destroyed. Create a diagram of how a patient’s data flows through the practice. Where is it stored? Who can access it? Is it an employee or a vendor? Is it emailed? Does it go to your billing company? Your cloud software provider? A laboratory? An imaging provider? Your answering service? Your IT partner? Remote employee? This is commonly referred to as data mapping, and it can reveal risks you didn’t know existed.
46 | September/October 2026
Require Multi-Factor
stored, who has access to them and whether they are encrypted.
Passwords alone are no longer enough.
Most importantly, test your backups. Finding out that your backup doesn’t work when you really need it is too late.
3 Authentication
Multifactor Authentication (MFA) should be enabled wherever possible, particularly for email, remote access, cloud applications, administrative accounts and systems containing sensitive information. And while you’re reviewing passwords, eliminate shared accounts. Every employee should have a unique login for workstations and a separate password for the practice management applications and other technology. Protect Every Computer
4 and Device
Traditional antivirus no longer provides adequate protection against today’s threats. Talk with your managed service provider (MSP) about using endpoint detection and response (EDR) and whether it is a managed service that provides 24/7 monitoring and response. The important question isn’t simply, “Do we have antivirus?” Ask: Who’s watching our network at 2:00 a.m.? Test the
5 Backups Having a backup isn’t enough. Your practice should know what is being backed up, how frequently backups occur, where they are
Keep Systems
6 Updated
Cybercriminals track known issues in outdated software and operating systems and will take full advantage of published vulnerabilities when technology is outdated. Establish a process for installing security updates and patches on computers, servers, firewalls, routers, applications and other network-connected devices. Check licenses periodically to make sure they are current and up to date. Pay particular attention to end-of-life technology. If the manufacturer is no longer providing security updates, the practice needs a documented plan to replace, or otherwise address the risk. Secure Your
7 Network
There should be a perimeter firewall that is properly configured, maintained, updated and monitored. Default passwords should be changed, unnecessary services disabled and firmware kept current. There should be a current Intrusion Detection Subscription in place.
Separate business systems from guest Wi-Fi. Segment VOIP technology, including phones, on its own VLAN and behind the firewall. Any technology used in the practice should be kept behind the firewall. Control Who
8 Has Access
Team members should only have access to the information and systems necessary to perform their jobs. Have a documented process for granting access when someone is hired, changing access when responsibilities change, and immediately removing access when someone leaves the practice. Consider keeping a checklist of which systems and applications team members have access to, so that in the event they leave, you can quickly revoke their access. Periodically review user accounts. You may be surprised by how many former employees, vendors or old accounts still have access.
9
Don’t Forget Your Vendors
Vendors have been responsible for many of the cyberattacks we have seen in the past few years. Know who your third parties are and what information they can access. How do they access that information? Ask about their security practices, maintain appropriate Business Associate Agreements, and periodi-
cally review their access. And make sure their access is removed when you are no longer using the service. Remember: A signed BAA does not automatically mean a vendor is secure. Have a Plan for When
10 Something Goes Wrong Don’t wait for a ransomware attack, compromised email account, a hurricane or a fire to figure out what everyone is supposed to do. Create and document an incident response and contingency plan. Then test it.
Establish a process for installing security updates and patches on computers, servers, firewalls, routers, applications and other network-connected devices. Check licenses periodically to make sure they are current and up to date.
A written plan is important. A tested plan is much more valuable. One more thing! We all know if it is not in writing, then it didn’t happen! There is a common thread running through all 10 of these recommendations:
Documentation. Your practice should be able to demonstrate which risks have been identified, which safeguards or controls have been implemented to reduce those risks, what still needs to be addressed, who is responsible, and what progress has been made. That’s the purpose of a Risk Management Plan.
Cybersecurity and HIPAA compliance don’t happen all at once. Start by identifying your greatest risks, prioritize them, and begin working through them systematically. And train your team as you progress. Because HIPAA compliance isn’t something you complete once a year. It’s something you manage every day. Ms. Debi Carr is a cybersecurity consultant and can be reached at 844.DKCARR1 or debi@dkcarr.com.
A risk analysis identifies your vulnerabilities. Your Risk Management Plan outlines what you’re doing about them. Today’s FDA | 47
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dental lifeline
Cancer Patient Receives Donated Dental Care for Birthday By Dental Lifeline Network
“This would change my life.” At just 38 years old, Jameshia, a resident of Hillsborough County, has been battling breast cancer for years. Since 2023, she has gone through chemotherapy, radiation, mastectomy and lymph node removal, and is still undergoing treatment at the Moffitt Cancer Center. Sadly, her declining oral health became another challenge until Dental Lifeline Network • Florida’s Donated Dental Services (DDS) program came to help.
Jameshia’s Story Before being diagnosed with cancer, Jameshia worked as a security guard. After her diagnosis, she was unable to work and was not eligible to receive disability benefits. The cost of cancer treatment was so high that she had to live out of her car for a period of time to make ends meet. On top of this, Jameshia’s cancer treatments negatively impacted her oral health. She only had 18 teeth left in her mouth, which were infected, leaving her in severe pain and causing her difficulty eating. She would need a full-mouth extraction, but mounting medical bills made affording the necessary dental treatment seem impossible. Jameshia was at severe risk of sepsis and was left terrified and wondering if she would get the dental care she needed.
50 | September/October 2026
DDS Volunteers Step in to Help When all hope seemed lost, Jameshia was referred to the DDS program by the Moffitt Cancer Center, and a group of incredible DDS volunteers stepped in to help! Drs. Stephanie Mazariegos, Reza Iranmanesh and James Green worked with Jerry’s Dental Lab to treat Jameshia, who received the necessary extractions, a permanent upper denture and a lower partial denture. Thanks to this group of DDS volunteers, Jameshia received thousands of dollars in treatment that restored her smile and oral health, just in time for her birthday! “Thank you so much. I am so grateful for this program and now I’m able to smile again!” shared Jameshia.
The DDS Program and How You Can Make a Difference This group of DDS volunteers represents just a few of the 514 volunteer dentists and 212 volunteer labs in Florida who give their services through the DDS program. Through Florida’s DDS program, 2,322 people have received $12.5 million in donated treatment — but more volunteers are needed. Whether you are a dentist or a lab, you can make a life-changing difference through the DDS program.
Don’t wait! Sign up to be a volunteer by scanning the QR code below or visiting WhyIDental.org and you can transform the lives of individuals in need of life-saving dental care.
“Giving back isn’t an afterthought here; it’s a core value,” shared Dr. Mazariegos from Elevate Smiles. “That’s why my office is proud to work with the DDS program to treat patients who otherwise couldn’t access treatment.” Volunteering is easy: as a DDS volunteer, you can give someone like Jameshia a second chance at life, from your own office, on your own schedule.
Today’s FDA | 51
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Today’s FDA | 53
85% of Disabled Veterans enrolled in the VA do not qualify for VA Dental Care. The Wounded Veterans Relief Fund aims to change veterans’ access to critical dental services across Florida, and we need your help.
Help Us Save Lives, Become a Dental Partner Today
WVRF’s Critical Dental Assistance Program Pays Dental Partners Directly for treating veterans in our program.
inquireabout aboutbecoming becoming aa dental dental partner partner with ToToinquire withWVRF's WVRF'sCritical CriticalDental DentalAssistance AssistanceProgram, Program, contact ourMartin, Dental Outreach Coordinator, Tami Martin. contact Tami Director of Veterans Dental Program.
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veterans
Restoring Smiles for Florida Veterans By Nick Cannon, Wounded Veterans Relief Fund
low-income Florida veterans who do not have access to VA dental services and cannot afford treatment on their own. WVRF delivers this care through a statewide network of more than 200 dental locations and 350 partners, including general dentists, specialists, dental laboratories and implant providers. Participating dentists treat veterans through a discounted fee schedule, while many laboratory and implant partners donate materials or reduce their costs. This collaborative model allows WVRF to maximize charitable funding and help more veterans receive the treatment they need. Depending on each veteran’s clinical needs, care may include extractions, infection treatment, periodontal care, fillings, root canals, crowns, dentures, bridges and implants.
Untreated dental disease can affect far more than a veteran’s oral health. Persistent pain, infection and missing teeth can make it difficult to eat, speak, work and live with confidence. For the 85% of veterans who do not qualify for dental care through the U.S. Department of Veterans Affairs, the cost of treatment can create an additional and often overwhelming barrier. Wounded Veterans Relief Fund’s (WVRF) Critical Dental Assistance Program addresses this need by providing 100% free critical dental care to eligible
The demand for assistance continues to grow. In 2026, WVRF has completed treatment for 337 veterans, while more than 136 additional veterans are currently receiving care across Florida. Treatment averages approximately $2,800 per veteran, and the organization receives five to 10 new applications each day. So far in 2026, WVRF invested $1.1 million in critical dental care for Florida veterans, det Today’s FDA | 55
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veterans “For years, I struggled with dental pain that made it difficult to eat and deeply affected my confidence. Thanks to Wounded Veterans Relief Fund’s Critical Dental Assistance Program and the Florida Veterans Foundation, I am now pain-free and can finally smile with pride. I’m incredibly grateful for the difference they made in my life.” — Richard W., U.S. Navy Veteran, Vietnam War
livering more than $2 million in total dental services at standard, undiscounted rates. The Florida Veterans Foundation is an important supporting partner through the State of Florida’s Veterans Dental Grant Program. Reimbursed grant funding helps WVRF expand treatment for qualified veterans, while continued support from dental professionals, foundations, businesses, donors and community partners helps sustain the program. Behind each number is a veteran who once felt hopeless, with no affordable path to care, but whose health, confidence and dignity were restored through WVRF and its dental partners.
Dental Partners Needed WVRF is actively seeking general dentists and specialists in communities where access to care remains limited, particularly in the Big Bend, central Panhandle, north-central Florida, the Heartland, Polk County, the northern Space Coast and the Florida Keys. Dental professionals can make a direct impact by accepting veter-
ans through WVRF’s discounted fee schedule, providing specialty treatment, donating selected services or materials, or connecting the organization with additional dental resources. By joining the WVRF network, Florida’s dental professionals can help veterans receive critical care closer to home and move from pain
and hopelessness toward restored health, confidence and dignity. To become a dental partner or support the program, contact EFDA Director of Veterans Dental Program Wounded Veterans Relief Fund Tami Martin at dental@wvrf.org, call 561.855.4207 or visit their website at WVRF.org.
Today’s FDA | 57
When the Abuse Isn’t Physical: Understanding Technology-facilitated Coercive Control in the Dental Setting By Florida Partnership to End Domestic Violence Interim Chief Executive Officer Tanesha McDonald
When we think about intimate partner violence (IPV), physical injuries often come to mind. Yet for many survivors, abuse extends far beyond physical violence. Increasingly, technology has become another tool for coercive control — allowing abusive partners to monitor, intimidate, isolate and manipulate survivors in ways that may be invisible to others. Technology-facilitated abuse can include monitoring a survivor’s location through smartphones or wearable devices, accessing email or patient portals, controlling online banking, flooding a survivor with threatening messages or using artificial intelligence (AI) to create 58 | September/October 2026
fake communications or impersonate the survivor. While these tactics may not leave visible injuries, they can profoundly affect a person’s safety, health and ability to seek care. Dental professionals are uniquely positioned to recognize when something may not be right. A patient who repeatedly misses appointments, appears unusually anxious about checking their phone, declines follow-up care or is accompanied by a partner who insists on remaining present throughout the visit may be experiencing coercive
domestic violence control. While these behaviors alone do not confirm abuse, they may warrant a compassionate, trauma-informed approach. Small changes in practice can make a meaningful difference. Before sending appointment reminders or follow-up information, ask patients how they prefer to be contacted and whether that method is safe. Whenever possible, provide opportunities to speak privately with adult patients, recognizing that a controlling partner may monitor conversations, messages or online accounts. Avoid making assumptions, and instead create space for patients to make informed decisions about their care. Just as important as recognizing the signs is knowing where to turn for help. Every dental practice should establish a referral pathway to its local certified domestic violence center before a patient discloses abuse. Building relationships with local advocates allows practices to confidently connect patients with confidential safety planning, emergency shelter, counseling, legal advocacy and other survivor-centered services when appropriate. For practices serving patients across multiple communities, keeping information for the Florida Domestic Violence Hotline (1.800.500.1119) readily available can also provide a safe connection to trained advocates who can help survivors identify resources in their area.
As AI and digital technologies continue to evolve, so do the methods used to exert power and control. Health care providers are not expected to become technology experts, but understanding that abuse can occur through digital means is an important part of providing trauma-informed care. Every interaction in a dental office is an opportunity to foster trust and promote safety. By recognizing that technology can be another form of coercive control, and by developing partnerships with certified domestic violence centers, dental professionals can help ensure that patients experiencing abuse have a safe, supportive pathway to specialized services. Sometimes, knowing where to connect someone for help is just as important as recognizing they may need it. The Florida Partnership to End Domestic Violence’s (FPEDV) Interim Chief Executive Officer, Tanesha McDonald, can be reached at taneshamcdonald@fpedv.org. FPEDV is committed to supporting you through training, resources and collaborative opportunities that strengthen your response to intimate partner violence (IPV) in clinical settings. For more information, visit fpedv.org or contact us directly to learn how to better integrate IPV awareness into your practice.
Building relationships with local advocates allows practices to confidently connect patients with confidential safety planning, emergency shelter, counseling, legal advocacy and other survivorcentered services when appropriate.
Today’s FDA | 59
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diagnostic discussion
Diagnostic Quiz By Lauren Smolenski, DDS*, Sarah Fitzpatrick, DDS, Prokopios Argyris, DDS, Nadim M. Islam, DDS, and Indraneel Bhattacharyya, DDS
Case History:
Question:
A 55-year-old male presented to Dr. Kerwin Scott in Clermont for evaluation of a solitary, dark brown, flat, smooth-surfaced lesion with a diffuse, slightly ill-defined border. It measured approximately 6.5 x 6.0 mm and was found on the left mandibular gingiva facial of tooth #22. The lesion had been noted approximately one month before his visit, and the patient reported no symptoms. An excisional biopsy was performed and submitted to the University of Florida (UF) Oral and Maxillofacial Biopsy Service for microscopic evaluation. Histologic examination revealed a stratified squamous epithelium, with the basal cell layer demonstrating strong melanin pigmentation and the lamina propria showing slender, elongated melanocytes with dendritic extensions arranged in parallel to the epithelium, along with abundant melanin granules.
What is the most likely diagnosis based on the patient’s presentation, accompanying clinical image and the histologic features provided?
Fig. 1: Clinical image showing a 6.5 x 6.0 mm, dark brown lesion, showing a diffuse and slightly ill-defined border on the facial surface of tooth #22.
A. Oral Melanotic Macule B. Oral Melanoacanthoma C. Amalgam Tattoo D. Blue Nevus E. Oral Mucosal Melanoma
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Fig. 2: Histologic examination shows areas of stratified squamous epithelium with a basal cell layer demonstrating fine granular melanin pigmentation accompanied by bland plump spindle-shaped and dendritic melanocytes within the lamina propria arranged in parallel to the overlying epithelium along with an unremarkable connective tissue stroma. On higher power, the plump, spindle-shaped and dendritic melanocytes are found parallel to the epithelium and display melanin granules (H&E 10x, Inset: 40x). Today’s FDA | 63
diagnostic discussion
Free Online Continuing Education (CE) for FDA Members! FDA members can earn up to six hours of general CE by reading the Diagnostic Discussion column and taking the online quiz, available 24 hours a day, at www.floridadental.org/online-ce.
A. Oral Melanotic Macule Incorrect, but a strong contender in the differential! This is a mucosal discoloration that appears flat and brown and is due to a focal increase in melanin deposition; it has no association with sun exposure. Although this is a great differential for the case, clinically, an oral melanotic macule appears as a solitary, more well-defined rounded to oval-shaped lesion that is uniform in both color and shape. In contrast, this case shows a more diffuse, ill-defined discoloration pattern with variable amounts of pigmentation scattered throughout the lesion (see Fig. 1). Macules have a broad age range, with the average diagnosis made around 40 years of age, with a female predilection. The most commonly involved sites include the lower lip vermilion, the palate, gingiva and buccal mucosa. Histologically, there is an increase in melanin observed in the parabasal and basal cell layers of normal stratified squamous epithelium, along with areas of free melanin or melanin incontinence in the lamina propria. These lesions are typically surgically excised, with little to no chance of recurrence, and a very rare chance of malignant transformation.
B. Oral Melanoacanthoma Incorrect, but a good guess! This is a benign, acquired pigmentation of the oral mucosa characterized by dendritic melanocytes dispersed throughout the epithelium. It is thought to be more of a reactive process, with some cases attributed to local irritation or trauma. While this is a good differential for the case given the duration of onset being about one month, oral melanoacanthomas typically progress rapidly within weeks. At the same time, nevi tend to have a longer growth pattern of months to years. Looking at the site as well, melanoacanthomas tend to appear more on the buccal mucosa. However, 64 | September/October 2026
they can be found on the lips, palate, gingiva and alveolar mucosa, whereas intraoral nevi are more commonly found on the palate and gingiva. This lesion is commonly seen in the third and fourth decades of life with a female predilection. They are often solitary, but bilateral or multifocal involvement can be seen. Clinically, they appear smooth and can be slightly raised to flat, showing a brown to black color, which rapidly increases in size within a few weeks. Histologically, an abundance of dendritic melanocytes are found scattered throughout the lesional epithelium, along with epithelial spongiosis and mild acanthosis. Incisional biopsies are usually performed due to the rapid increase in growth in a short time period displayed by melanoacanthoma. Still, once a more serious melanocytic neoplasm is ruled out, no treatment is necessary. There is a rare chance of recurrence, and minimal to no risk of malignant transformation.
C. Amalgam Tattoo Incorrect, but this should definitely be in your differential! Amalgam can be implanted into the oral mucosa via contamination with amalgam particles and dust found within oral secretions, broken amalgam pieces which can be implanted into extraction sites, and even dental floss can transfer amalgam particles from fresh restorations. Clinically, they appear as colored macules, which are often blue, black or gray in color with variable borders and definition. The most common sites include the gingiva, buccal mucosa and alveolar mucosa. Radiographically, implanted amalgam may be visualized, with the fragments appearing densely radiopaque. Histologically, fine, black or brown granules stain the reticulin fibers of the collagen, surrounding nerves and vascular channels, along with smaller amalgam fragments, eliciting a bigger inflammatory response than the larger ones.
Radiographs are often taken to confirm that the mucosal discolorations are due to amalgam implantation. Still, if they are not able to be visualized radiographically, biopsies can be taken to rule out a more serious melanocytic neoplasm. Once identified and confirmed as amalgam, no further treatment is required, unless the pigmentation is found in a cosmetic or aesthetic area, in which case a conservative surgical treatment can be performed.
D. Blue Nevus Correct, great job! This is a benign proliferation of dermal melanocytes, located deeper within the connective tissue. These lesions can appear blue due to the Tyndall Effect, which occurs when deep melanocytes within the lamina propria of the connective tissue or the dermis are exposed. Since the melanin particles are deep to the surface, when the light is reflected, it has to pass through the overlying tissue. The colors with longer wavelengths, such as red and yellow, are absorbed more easily by the tissue. In comparison, the shorter wavelengths, such as blue, are reflected to the observer’s eyes, which allows us to visualize the blue color — hence the name blue nevus. The color variation seen is due to the amount of melanin present, the presence or absence of melanin in the cells overlying the epithelium/epidermis, and the depth of the melanocytic cells present. Interestingly, these lesions can also harbor either GNAQ or GNA11 somatic gene mutations. This lesion is usually seen between the third and fifth decades of life and is seen more frequently in females. Clinically, they appear as solitary or isolated lesions with a smooth surface, and can be flat or elevated, with a brown, blue or black color, usually measuring less than 10 mm in diameter. The lesions have a predilection for the hands, feet, face and the scalp, but intraorally, have a predilection for the palate, attached gingiva and buccal mucosa. Histologically, spindle-shaped, pigmented dendritic melanocytes with branching, slender dendritic processes are seen arranged parallel to the surface epithelium (see Fig. 2), along with few to numerous melanin granules surrounding them. The parabasal and basal cell layers of the epithelium often contain melanin pigmentation as well. These lesions do well with conservative surgical excision, with minimal recurrence and a rare chance of malignant transformation.
E. Oral Mucosal Melanoma Incorrect, but this entity should always be considered. Oral melanoma is a malignant neoplasm that is of melanocytic origin and has no causal association with UV radiation. This lesion should always be considered in the differential diagnosis of a rapidly growing pigmented lesion. As the lesion in the case presents with a one-month duration and somewhat ill-defined borders, oral mucosal melanoma should definitely be ruled out! However, when comparing the presented case to mucosal melanoma, some differences can be observed, most importantly the pigmentation and growth pattern. Oral melanoma interestingly may be seen in non-white populations such as patients of African or Asian descent. Oral melanoma will have rapid expansion and asymmetry, along with a vertical growth pattern. At the same time, the lesion presented shows a pretty symmetrical discoloration pattern along with slight irregularity in the borders and a diffuse growth pattern. The lesion presented here also does not show any thickened, ulcerated, or bumpy nature and remains less than 10 mm in diameter. Oral melanoma typically grows to larger sizes exceeding 10 mm. These lesions are usually seen in the fifth through seventh decades of life with a slight male predilection. Most cases are found on either the maxillary alveolus, hard palate or in the sinonasal region. Clinically, the lesions begin brown or black in color with irregular borders, which then develop asymmetry, color changes, ulcerations and more exophytic growth components. If there is any underlying or adjacent bone, destruction may be found. Histologically, at the epithelial and connective tissue junction, atypical melanocytes can be found. These melanocytes can proliferate along the basal cell layer and even downward into the connective tissue, often found in nests, or even show pagetoid spread, with infiltration of single tumor cells into the upper layers of the epithelium. For cutaneous and oral melanoma, especially those with a rapid onset, following the “ABCDE rule,” which includes evaluating the asymmetry, borders, color, diameter and evolution of a lesion, is always a helpful way to monitor these types of lesions. The treatment ultimately depends on the depth of invasion and the extent of the primary tumor. Mucosal melanomas often exhibit more aggressive behavior, and radical surgery is often performed along with adjunctive therapy, sometimes with systemic treatment as well.
t
Today’s FDA | 65
diagnostic discussion Clinicians are invited to submit cases from their practices. Cases may be used in the “Diagnostic Discussion,” with credit given to the submitter.
References: 1. Albagieh, Hamad et al. “Oral Blue Nevus of the Lingual Gingiva: A Case Report.” Cureus vol. 17,1 e77405. 13 Jan. 2025, doi:10.7759/cureus.77405 2. Natarajan, Easwar. “Black and Brown Oro-facial Mucocutaneous Neoplasms.” Head and neck pathology vol. 13,1 (2019): 56-70. doi:10.1007/ s12105-019-01008-2 3. Neville, Brad, W. et al. Oral and Maxillofacial Pathology. Available from: Elsevier eBooks+, (5th Edition). Elsevier - OHCE, 2023.
Dr. Islam
4. Ojha, Junu et al. “Intraoral cellular blue nevus: report of a unique histopathologic entity and review of the literature.” Cutis vol. 80,3 (2007): 189-92.
Diagnostic Discussion is contributed by University of Florida College of Dentistry professors, Drs. Nadim Islam, Indraneel Bhattacharyya, Sarah Fitzpatrick and Prokopios Argyris who provide insight and feedback on common, important new and challenging oral diseases. The dental professors operate a large, multistate biopsy service. The column’s case studies originate from the more than 16,000 specimens the service receives annually from all over the United States.
*Resident in Oral & Maxillofacial Pathology Drs. Islam, Bhattacharyya, Fitzpatrick and Argyris can be reached at oralpath@dental. Dr. Bhattacharyya
Dr. Fitzpatrick
Dr. Argyris
66 | September/October 2026
Conflict of Interest Disclosure: None reported for Drs. Islam, Bhattacharyya, Fitzpatrick and Argyris.
ufl.edu. The Florida Dental Association is an American Dental Association (ADA) CERP Recognized Provider. ADA CERP is a service of the ADA to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a continuing education provider may be directed to the provider or to ADA CERP at ada.org/goto/cerp.
diagnostic discussion
In Loving Memory of Dr. Donald M. Cohen: Former “Diagnostic Discussion” Contributing Author
Dr. Cohen
With heavy hearts, the University of Florida (UF) Oral and Maxillofacial Biopsy Service announces the passing of Dr. Donald M. Cohen (1947-2025) on Nov. 2, 2025. Dr. Cohen dedicated nearly 50 years of his life to oral pathology, not just as a career, but as a calling. To the dental students, his residents and colleagues at UF, where he taught from 2002 until his 2022 retirement, he was far more than a professor — he was a beloved guide and daily inspiration. Outside of his work, Donald found his greatest joy in life’s simple pleasures: traveling to new places, staying active, fishing and gathering with the friends and family he loved so dearly. He leaves behind a beautiful legacy in his devoted wife Carol, his three daughters and six grandchildren.
A Life of Purpose and Teaching
Dr. Cohen’s journey in oral pathology was built on a deep love for learning. He earned his dental degree from Washington University in 1973, later completing advanced degrees at Temple University and an MBA from the University of Nebraska-Lincoln. For more than 25 years, he shaped young minds at the University of Nebraska before bringing his warmth and wisdom to the UF College of Dentistry. There, he led the biopsy service, cared deeply for his patients and poured his energy into training the next generation of dentists and specialists. Dr. Cohen was a gifted teacher who truly cared about his students’ success, winning numerous awards, sharing his knowledge in more than 100 public lectures, and publishing 170-plus scientific papers. He also proudly served as president of the American Academy of Oral and Maxillofacial Pathology (AAOMP) from 2021-22.
Honoring His Legacy
Perhaps Donald’s greatest gift to the world was his heart for mentoring. He modeled genuine curiosity, kindness toward patients, and a selfless dedication to helping others grow. To keep his bright spirit alive, the Dr. Donald M. Cohen Memorial Award for Excellence in Clinical Oral Pathology has been created. If you would like to help honor his memory, please consider making a donation by visiting AAOMP.org and clicking the “Donate” tab. This award will support dedicated, midcareer pathologists who mirror the same passion, integrity and kindness that Dr. Cohen brought to his work every single day. The inaugural award will be presented at the AAOMP annual meeting in New Orleans in April 2027.
Today’s FDA | 67
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please call or text Dr. Robert S. Kilcourse, Jr., Broker, Exclusive Real
a dentist who is committed to providing exceptional comprehensive care while building lasting relationships with patients. Whether
Estate: 407.230.5255 or 407.767.9000. Visit careers.floridadental.org/ job/dental-office-for-sale-in-altamonte-altamonte-springs-
you are an experienced clinician or a recent graduate eager to learn
florida-0285.
and grow, we welcome the opportunity to meet you. What we offer: Established patient base of over 40+ years; Modern technology and equipment; Supportive, experienced clinical and administrative team; Positive, collaborative work environment; Competitive compensation; Full-time or part-time opportunities; Largely fee for service-based practice. Qualifications: DDS or DMD from an accredited dental school; Active Florida dental license (or ability to obtain one); Strong communication and interpersonal skills; Passion for comprehensive, patient-centered dentistry. If you’re looking for a long-term opportunity in a practice that values quality care, teamwork, and professional growth, we’d love to hear from you. Please send your CV and a brief introduction to bcraigdmd@gmail.com. or contact us at 850.510.2003 for a confidential conversation. We look forward to hearing from you. Visit careers.floridadental.org/job/associate-dentist-
Beautifully Equipped Dental Office for Rent in Quincy, FL. Fully equipped, 1705 Square foot operational dental office for rent. Turn key ready. Modern equipment. 3 Operatories. Dentrix Software. Dexis X-ray System. Intra-oral camera. Warm inviting building. Quaint small city location; great for a family practice. Are you a new dental grad looking to set up practice without going further into debt? Are you a seasoned northen dentist ready to get out of the rat race and relocate to a calmer, warmer State with great business opportunities? Then Quincy, Florida might be the perfect place for you. Visit careers.floridadental.org/job/beautifully-equippeddental-office-quincy-florida-0312.
tallahassee-florida-0316.
Jacksonville, FL Dental Practice for Sale. Located in Dental Office for Sale in Altamonte Springs, FL. PRICE JUST REDUCED!! PRIME MEDICAL/OFFICE REAL ESTATE OPPORTUNITY!! Exceptional opportunity to own a beautifully maintained 2,500 SF free-standing professional office building in a highly sought-after area of Altamonte Springs. Currently configured as a fully equipped dental office with 6 operatories plus plumbing for 2 additional operatories. Features include a newer tile roof, Dexis OP 3D CBCT, intraoral scanner, multiple digital X-ray sensors, 3 restrooms, and a fully digital infrastructure. Located on a busy roadway with 40– 50k+ vehicles a day, this property offers excellent signage and outstanding visibility. Perfect for a dentist looking to relocate or expand, while also offering excellent potential for medical, legal, insurance, real estate, or other professional office uses. Purchase includes the commercial building with an established dental office and equipment,
68 | September/October 2026
the greater Jacksonville area, this general dental practice offers a strong opportunity in Northeast Florida’s desirable First Coast region. With access to the Atlantic coast, a growing regional economy, and proximity to one of Florida’s largest metro areas, the practice is well positioned for long term stability and continued growth. The owner doctor has practiced in the community for more than a decade and has built a strong reputation with a large, active patient base. They are interested in exploring all transition options, creating flexibility for a buyer or group looking to step into an established, high volume practice. The practice is equipped with seven operatories and was recently remodeled, offering a modern and efficient clinical environment. The office supports multiple providers in addition to the owner doctor, providing built in production capacity and continuity of care. With effective advertising efforts, the practice serves 7,300 active
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Post an ad on the FDA Career Center and it will be published in our journal, Today’s FDA, at no additional cost. Today’s FDA is bimonthly; therefore, the basic text of all active ads will be extracted from the Career Center on roughly the first of every other month. (e.g., Jan. 1 for the Jan/Feb issue, March 1 for the March/April issue, etc.). We reserve the right to edit excessively long entries.
patients and attracts an average of 40 to 45 new patients per month.
patients and staff. With 1,135 active patients and an average of 10 new
With $2.6 million in collections and $250,000 in EBITDA, this is a prime
patients per month, the practice continues to show steady demand
opportunity to purchase a dental practice in the greater Jacksonville
while operating just four days per week. Collections total $635,000,
area. Practice highlights: 7 operatories; Collections of $2.6 million;
with true take-home earnings of $226,000, making this an excellent
Over $250,000 in EBITDA; 40-45 new patients/month; Multiple pro-
opportunity for a dentist seeking an established North Florida practice
viders. The greater Jacksonville area offers a strong mix of coastal
with real estate, stability, and room for future growth. Highlights: 5
access, outdoor recreation, and everyday convenience. With Amelia
operatories; Collections of $635,000; TTH of $226,000; Real estate
Island, Atlantic beaches, state parks, kayaking, fishing, and miles of
available. To learn more about this Tallahassee, FL dental practice for
trails nearby, the region appeals to those who want an active lifestyle
sale, contact Headwaters Transition: bailey@theptsgroup.com or call
without giving up access to a major metro. The area also offers historic
719.694.8320. Reference #FL61726H. Visit careers.floridadental.org/
communities, a growing economy, diverse dining, arts and culture,
job/tallahassee-fl-dental-practice-for- sale-tallahassee-florida-0315.
and convenient access to Northeast Florida and coastal Georgia. To learn more about this opportunity, contact Professional Transition Strategies: bailey@theptsgroup.com or call 719.694.8320. Reference #FL6326. Visit careers.floridadental.org/job/jacksonville-fldental-practice-for-jacksonville-florida-0313.
Tallahassee, FL Dental Practice for Sale. Goal: The owner doctor is seeking a transition for a long standing North Florida general dental practice. After practicing in the community for thirty years, the doctor is interested in selling the practice to another dentist and transitioning into retirement, offering a buyer the opportunity to step into an established practice with a loyal patient base, recently remodeled facility, and real estate available at the time of sale. Overview: Located in North Florida, about 60 miles east of Tallahassee, this general dental practice is positioned in a close-knit community along the I-10 corridor with access to the broader Tallahassee and South Georgia markets. The practice has served the community for three decades and has built a trusted reputation through consistent care, long standing patient relationships, and steady word-of-mouth referrals. The practice operates from a free standing building with
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ample parking, and the real estate is available at the time of the practice sale. The facility was recently remodeled and features five operatories, creating a comfortable and efficient setting for both
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Today’s FDA | 69
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2026 Statement of Ownership
Today’s FDA | 71
By FDA Editor Hugh Wunderlich, DDS, CDE
off the cusp On Sept. 10, 2001, I’d just completed the perfect molar crown preparation, and I was sad. I was three years into my midlife moment. Not a crisis, just a moment. It was the garden-variety course of mid-life reflections. My life was half over, and I hadn’t cured cancer or won the Nobel Prize. At some point every dentist also knows the lows. Difficult diagnoses, treatment complications, insurance frustrations, staffing shortages, regulatory burdens and the emotional weight of perfection can test even the most seasoned practitioner. There are the highs we tend to forget: relieving a patient’s pain, and restoring a confident smile. Where was the deep satisfaction in mastering both science and artistry while earning the trust of generations of families? Some days it feels as though every success is measured against an impossible standard while every setback lingers long after the office lights are turned off. My minimoment was sad because I didn’t have the right to feel depressed. My marriage, family and practice were all healthy. I’d been doing all the right things in life, yet I didn’t feel heroic. All that would change the next day.
On Sept. 11, 2001, the shrinking world got smaller. While millions watched, the actions of a few altered world markets forever and killed thousands of people. Most died because they worked in great symbols of American life. Many have called them heroes. I offer that they were heroes before Sept. 11. They all were living and working the American life. Each was a nurturer and provider to a family. A successful dental career is not defined by avoiding adversity but by continuing to serve despite it. Long after the crowns and fillings are forgotten, patients will remember how we cared, listened and helped them through vulnerable moments. As the 25th anniversary of Sept. 11, 2001, arrives, realize that the world that matters is smaller than you thought. And it’s not as divided as it seems. The peaks inspire us. The valleys strengthen us. Together, they shape not only better dentists but better human beings. It’s the small world you can touch. It’s interacting with the people you see every day. 25 years ago, those worlds were taken from 2,797 people.
Be a hero in your world. FDA Editor Dr. Hugh Wunderlich can be reached at hwunderlich@bot.floridadental.org.
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